Permit (77) CITY OF TIGARD MASTER PERMIT
la
COMMUNITY DEVELOPMENT Permit#: MST2016-00154
T(GA.R,D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/11/2016
Parcel: 1 S 134AC00600
Jurisdiction: Tigard
Site address: 11396 SW IRONWOOD LP
Subdivision: ENGLEWOOD Lot: 34
Project: MacDonald
Project Description: Master bedroom/bathroom addition. Trade work under separate permit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 1 First: 280 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 280 sf Value: $34,000.00 Rear: 15
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ADD SF VB R-3 280
Owner: Contractor:
MACDONALD,JONI C INTERIOR REVISIONS CUSTOM REMODELft Required Items and Reports(Conditions)
11396 SW IRONWOOD LOOP 17270 SW 131 AVE
TIGARD,OR 97223 TIGARD,OR 97224
PHONE: 503-260-6039 PHONE: 503-473-5231
FAX: 503-684-5856
Total Fees: $1,435.04
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility •-" ation Center. Those rules - -t forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtai , •py of the ru.s or direct questions to OUN' .y calling 50 . 3 • .;.0" -44.
'----(--------"
Issued By: �y�-'/�,. Permittee Signa •:'4ae�
�`% ;03.639.4175 by 7:00 a.m.for the next avail ,i'le inspection da e.
This permit card shall be kept in a conspicuous place on the jo•site until completion of the •roject.
Approved plans are required on the job site at the t• e of each inspection.
Building Permit Application Ls _2C-1
Residential 4'.1 ,-, ` FOR OFFICE USE ONLY
City of Tiliggard Received V / / �y /��/ J z
c Date/By: 7 49 l/ Permit No.: !s cF
13125 SW Hall Blvd.,Tigard,OR/ 'P 3 >a p 1 Plan Review r
>: Phone: 503.718.2439 Fax: 503 598.1960 Date/By: i il--D) 3(_ 3 Other Pennit:
Ti GARD Inspection Line: 503.639 4175 1 4 , Date Ready/By: �, 4 , Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: f Z/f p .�� Supplemental Information
d s 1 i �4 '�';:,I.,. 1, ).Y�
_ ikk €P g,,x 1 t' �4- i A �3'_ -H nr t;,,i� Ta �.l r ii ,,; �?P ,t,4�F;V: ili -r----
44-
e r ` ae- �° + Cin" t_,g = � `�` A:ry1." 1;!' F4J4II a
.� � ilErh .,rte:°
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
[11.4ddttion/alteratton/replacement 0 Other equipment,materials,labor,overhead,and the profit for the
gg 4 1$ `a a i e ;:r,WiTIS work indicated on this application.
dwelling Valuation: $ (3p
'1-and 2-family dg 0 Commercial/industrial ) Jb�-
Number of bedrooms:
❑Accessory building 0 Multi-family '
0 Master builder 0 Other: Number of bathrooms:
` ' " m'cr+ 7 � Total number of floors:ryet ! A ®., w + Io ! ®
Job site address: i t:" .:1(0 SiI.,.1 i i?... -e.1 v.dcsc�c-.) Lcizcp New dwelling area: 'Z£y.3 square feet
City/State/ZIP: +G.A217 l a. 91 Z23 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: it- N e,K 6 0 J Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
"- li s -ILD�� IP N o KI * n lg' work indicated on this application.
AsTtz. I�j�17 tz f M ? 1�2F->}i r2c t::.. \ Valuation: $
�1 M�I�iTlclr.t
( 1-4-"V3 [f Loe - 6Fpg2.�r� 2MrT> Existing building area: square feet
/ New building area: square feet
a vi ii , , =`'11 9 Ar'..:_ `i' h.-V ,` 0, rNA ,q 0, Number of stories:
Name:_Jo r4 1 KA AcIxv-4 Al... Type of construction:
Address: 1 i to 5'usJ l iZ r.w.,„Iti6D Lc.2. -p Occupancy groups:
City/State/ZIP: %It A ep I C\e Cl 7Z2..3 Existing:
Phone:(5 s3) ZL. — (A39 Fax:( ) New:
_ r t , r e+ +S (I
, . nr s P � _� a�u �`, 1,te, �;r�i?#,%�i,' e�l ;1 Vi , . t
Business name: (t r rt..Q-1u e_ "Q,eN iSte►3S Cc , ;>;r..1 xsvEl.i aG, 1 L
I Structural plan review fee(or deposit):
Contact name: ..._3‹,,,,,/ 15.6r :.1=9._
FLS plan review fee(if applicable):
Address: r7 al SW i.. 1 AVG.
Total fees due upon application:
City/State/ZIP: --'���q,Zi t O 2_ et-�•L24
S(, Amount received fp3�q 5 3
Phone:(9 ) 1413-S"L31 Fax: :(5(.3) 4 gg- =�R _ o
+T9V is
E-mail:�oU1 1 tvTr_17-4( .2ZN i S to p4S_C3s 11:,11,14:-, ,K.C�tt .- t t A
s '_' d� u 9 Co ercial and residential prescriptive installation of
ct ,r ' �(1� s< �r ® � . a K;14: roof-to
. ��.� ��_ � fi � _,� � „� p unted Photovoltaic Solar Panel Sys m.
Business name: c . 1��..V t` Submit two( ets of roof plan with conn on details
and fire departmentcess,along wi a 2010 Oregon
Address: Solar Installation Specia od ecklist.
City/State/ZIP:
Permit Fee includes • 'ew $180.00
and ad
Phone:( ) Fax: istrative fees): i
( ) State surchar '' 12%of permit fee): ---'-',...(21.60
CCB lic.: "7S1 aEs 6,('t1 /1 stal fee-due upon application: $201.60
Authorized signature: `p'F _-!), This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: Jr-.( 5G • v 2_ Date: 4/Z ViL,
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application..(Illy LS 2S—
Residential1 . ...4 FOR OFFICE USE ONLY
City of Tigard Received 7 Hy /6
al 13125 S W Hall Blvd.,Tigard,OR/ 't3 2 99
Date/By: 7 e���G Permit No.:
!' 2�i 6 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I GA R U Inspection Line: 503.639.417 '` `Ni t1g Date Read B Anis:
Internet: www.tigard-or.gov '' s ,i t I1 t Ready/By: See Pe2 for
Notified/Method: Supplemental Information
)3I 11 );N � � -
� . tea ,, ,,7,:ti.« ,�^' ,
0 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
ddition/alteration/replacement 0 Other:
equipment,materials,labor,overhead,and the profit for the
ar � � iv vO � . w, t , 4
work indicated on this application.A. cr t 4o *m ,a� .
U�1-and 2-family dwelling 0 Commercial/industrial Valuation: $•
3 tcz.ogs.65
❑Accessory building 0 Multi-family Number of bedrooms: I
❑Master builder 0 Other: Number of bathrooms:
- . ;,z .. ?, 1 • O t; 9!, , i� � Q , ,A. ' ti f r W s,.. Total number of floors:
Job site address: i i-Z54(4, S1ki 1 17.s_114\l-Ie sz AD Loa New dwelling area: Z$C] square feet
City/State/ZIP: f c.At217 ic.. Q 9-7Z.Z3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
; � # �t equipment,materials,labor,overhead,and the profit for the
. . ,hm _,. ; k s IPTION Off`WOR ,It work indicated on this application.
AS-Tt'3Z 13�17P� M 4 i3ATH►zcswi apt-na,� Valuation: $
( -VgS 0 og, . 6gP�� /4,w-fir)
building area: square feet
New building area: square feet
'.c.,10-4*- Number of stories:E ' , • ,,, rs ,...,,,,,.- -4,4,•44,?,,,,,," , . , _,
Name: e Ai K.A Ac 1 x L At.3 Type of construction:
Address: l i-70•1(4051hf 11Zt. \AJ cj t Lc i -p Occupancy groups:
City/State/ZIP: —FIteA ell I e. 1 722,3 Existing:
Phone:(503) Z.. (1431 Fax ( )
New
" m3 Z-----
titio s � ''''9'-'-'"----"- a YBUILDING] x t �m
. -- p-- 1-;s! _ 7r":" P ., i ' - - . ,, ..
(Pleasej"oeeac e 3 ,:Business name:'N'TcQ.m �_ytSa3S �b1
A4.71,4 c Structural plan review fee(or deposit):
Contact name: .___Sdz7,/ `5,�x=e_
FLS plan review fee(if applicable):
Address: 1-7z-p S t31 AVE.
City/State/ZIP: Total fees due upon application:
y "-T►r�-a t D+z 91 ZZ-
Phone:(< 3) ( Fax::(r�3) 6 P,8 Amount received 36752 -
q73-s3 gq_
E-mail:—3<S,1>1 L (ATEp_ ,PHOTOVOLTAICSOLAR :0## FEES*+ t
Co ercial and residential prescriptive installation of
roof-top unted Photovoltaic Solar Panel Sys m.
Business name: 5Aµ , 41�v� Submit two( is of roof plan with conn on details
and fire department ess,along wi a 2010 Oregon
Address: Solar Installation Specia od ecklist.
City/State/ZIP: Permit Fee(includes . • : :ew $180.00
Phone:( ) Fax:( )
and ad . strative fees):
p�, State surchar: 12%of permit fee): $21.60
CCB lic.: "'759 2SE,
etal fee due upon application: $201.60
Authorized signatuY rre: � e This permit application expires if a permit is not obtained
�— f�(� within 180 days after it has been accepted as complete.
Print name: JOb`(�. j Q_ Date: 4/Z Z/ *Fee methodology set by Tri-County Building Industry
J Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
7f4CO■
MMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: Hip l(0-00 /5-47/
Site Address: /l 396 S-.)/o 4-bine.)00j Lor
Project Name: ALcrizyka% 15' Lot #:
vv�
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review 471Proposal: Aied (a430%�
11 Verify site address/suite# exists and active ' permit system.
Giver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
v
ree(3) copies of site plan tiristing structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
awn to scale(standard architect or engineer scale) floor elevations
o h arrowv,tlin locations (required for new,may apply for additions)
e address,project or subdivision name and lot number �,f anon of wells/septic systems
.plicant information(name and phone number) PIO.sion control (including drainage-way protection,silt fence
fr .t dimensions and building setback dimensions sign,location of catch basin,etc.)
ii' !:i area,building coverage area,percentage of coverage and Street names
pervious area(applicable if R-7,R-12,R-25&R-40) ( beet tree size,type and location
r Property corner elevations (2 foot contour lines if more than ( fisting trees to be retained with drip line,and tree
4 foot differential) u 'protection measures
❑ Clean Wate,r�,Srvices—Service Provider Letter (lot platted prior to 9/10/1995): ��
i.
Required: LV Yes,applicant was notified ❑ No Received: ❑ Yes 1: No
04'ublic Facilities Improvement (PFI) Permit
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
land Use Case#:
ping: /2-2-/
LId Setbacks: Front c,,X) Rear /5-- Side J Street Side NM-Garage ,-20
J]lfandscape Requirement: 0/0
ICA kot Coverage Maximum: 0/0
I/ Building Height: Maximum Height :370 Actual Height //
gt Visual Clearance
P1Pfasements
PIAnsitive Lands: ❑ Yeso Type
rban Forestry Plan
konditions "Met"prior to issuance of building permit
otes:
Approved By Planning: - = Date:
i
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fonns\BldgPennitRvw_RES_012116.docx
Building Permit Submittal
Original Submittal Date: 4/7057//40
Site Plans: # 3
Building Plans: # -j
Building Permit#: 12"-Enter building permit#above.
Workflow Routing: av Planning C 1 ngineering Permit Coordinator 3uilding
Workflow Sign-off: E rSign-off for Planning(include notes from planning review)
Route Application Documents: Er Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: ((j c Date: 'i/�-0
Engineering Review
Slope at building pad:
Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
(s
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: , 2 ep Date: .41::".481,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
EWIC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes i N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
OK to Issue Permit ) 6Approved by Permit Coordinator: Dater ���/ '
1:\Building\Fonns\BldgPennitRvw_RES_012116.docx
�5 nc9-0/6—DO /5
Clean Water Services File Number
C1eanWaterr Services 16-001520
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: Tigard
,a' �`"z
2. Property Information (example 1S234AB01400) 3. Owner Information r7.
Tax lot ID(s): 1S134AC00600
Name: Joni MacDonald � `' 19 � �#
Company: f, ��7 ��Jli
Address: 11396 SW Ironwood loop
Site Address: 11396 SW Ironwood loop '=l s, "/e
City, State,Zip: Tigard,Oregon,97223 ; >
City, State,Zip: Tigard,Oregon,97223rd
Phone/Fax: 503-260-6039
Nearest Cross Street: SW Springwood dr E-Mail:
4. Development Activity (check all that apply) 5. Applicant Information
IA Addition to Single Family Residence(rooms,deck,garage) Name: Jody Becker
❑ Lot Line Adjustment ❑ Minor Land Partition Company: Interior Revisions Custom Remodeling,Inc.
❑ Residential Condominium ❑ Commercial Condominium
CI Residential Subdivision Address: 17270 SW 131 ave.
❑ Commercial Subdivision
❑ Single Lot Commercial ❑ Multi Lot Commercial City, State,Zip: Tigard,Oregon,97224
Other Phone/Fax: 503-473-5231
E-Mail: jody@interiorrevisions.com
6. Will the project involve any off-site work? ❑Yes XI No ❑Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
Adding a room addition of 280 sq.ft.Rain drain will be extended and new addition will be connected to it.
This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ
1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army
COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law.
By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority
to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify
that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate.
Print/Type Name Jody Becker
Print/Type Title President
ONLINE SUBMITTAL Date 4/25/2016
FOR DISTRICT USE ONLY
❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A
SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report
may also be required.
❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This
Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently
discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and
approvals must be obtained and completed under applicable local,State,and federal law.
Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially
sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water
quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order
07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law.
❑ This Service Provider Letter is not valid unless CWS approved site plan(s)are attached.
❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed by - Date 4/25/16
2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • Phone:(503)681-5100 • Fax: (503)681-4439 • www.cleanwaterservices.org
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11396 SW IRONWOOD LOOP, TIGARD, OR, April 27, 2017 at 9:17:41 AM
97223
Record Type: Record ID:
Residential - Master Permit MST2016-00154
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11396 SW IRONWOOD LOOP, TIGARD, OR, April 27, 2017 at 9:17:41 AM
97223
Record Type: Record ID:
Residential - Master Permit MST2016-00154
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor