Permit CITY OF TIGARD MASTER PERMIT
2 COMMUNITY DEVELOPMENT Permit#: MST2016 00323
T'[G.ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2016
Parcel: 2S114BC00300
Jurisdiction: Tigard
Site address: 10085 SW RIVERWOOD LN
Subdivision: PICK'S LANDING NO.1 Lot: 58
Project: Blachly
Project Description: Replacing existing front deck.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf
Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0
Dwelling Units: 0 Smoke
Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $6,600.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 LaundryTrays: 0
Y 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
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0
Catch Basins: 0
Drywell-Trench Drain: 0 Other Fixtures: 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 G
ALT P yrou Group: Square Feet:
SF VB
R-3 0
Owner: Contractor:
BLACHLY,VICTORIA D&STEVE H RICK'S CUSTOM FENCING&DECKING INC Required Items and Reports(Conditions)
10085 SW RIVERWOOD LN 4543 SW TV HWY#A
TIGARD,OR 97224 HILLSBORO,OR 97183
PHONE: PHONE: 503-640-5434
FAX:
Total Fees: $411.40
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 Notification Center. Those r les are set forth in OAR
952-001 10 throug AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 8 or 1.800.3 23
Issu By: A_____, OC
/ Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti n ate.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application Ls a is-h ...
Residential
ISECiEN Et) 1 (1R 01 1 11 1 I *,1 (1\1 1
City of Tigard
_ - I
Rectived G J,
13125 SW Hal Blvd,Tigard,OR 97223 ,,r " /(0 671 pennit'4°.",cr&oit.)--T 63,43
(...0 Iv Plan Review
Phonc 503.639A171 Fax: 503.598.1960 NU k.1 1 Datear g_) c- ) c----r other. %mit:raiz/ea),13
Inspection Line: 503.639.4175
r*1'610)t=4/BY. 4 ) Id Sarnia
Werner www.tigard-ar.gov 01)( ‘..1 NISI() ahot lefLatorr— - .-c- .., &winnow information -
TYPE OF WtelaIN
/ REQUIRED DATA:I-AND 2-FAMILY DWELLING
i
0 New construction 0Danolition , .....4: Permit fees*me based on the value of the work performed.
11LIC '' ' . Indicate the value(rounded to the nearest dollar)of all
tilAdditionfaltaationftephscemact _ 0 Other:
c-rt/621 lAp equipment,materials,lalaor,overhead,and the Iwo&for the
CATEGORY OF CONSTRUCTION i I,.
i t.--N -tvork indicated on tins applicrgion.
FC v i' 40a 53
jg-1-and 2-family dtvelit* Co
0 nnnercialfindustrial / i Valuation: s
Number of bedrooms:
0 Ammo),building 0 muiti-famay
1 amnia builder I 0 Other . litrata diazilmens-. --- t
Kat STIR INVINIMATMN AND LOCATION TeAal inthtter of flows:
Job site acidivs 00 es-- s tv R e.‘--v4/OA 1.v• New dwelling arta: square feet
City/State/EP: T,,; (.4.4,0( 0,,.. /74,2 kk Gmagelosport area: square feet
SuiteibldgJapt.no.: (Project name: e f i kr Covered peach area: square feet
Cross street/directions to job site:
Deck area: ...----- square feet /54.
6 1A1 6-Ne eit.rn. fel4A-1 OY Other IMI=arm square feet
REQUIRED DATA:CObINIERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:
equipment,materials,labor,overhead,and the profit for the
-
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Re_pkx).- E-Pos41-A-7 F-v-c3vvi- CLeck
FAsting building area: square feet
New building area: square feet
Cl PROPERTY OWNER 0 TENANT Number of stories:
Name: ii---i -i (S/&(j 1. Type of construction:
Address:
Ocrawancy groups:
City/StateafP:
Existthw
Phone:( ) Fax:( )
New:
Mammon' 0 CONTACT?MON
NOTICE
_
Business name: R4-ti<5 (..L.s-folv, F.e.pv c N-fr All contractors and subcontractors are required to be
' licensed with the Oregon Construction Contractors Board
Contact i CA IA-erfip_ maks-ORS 701 and may be required to be licensed in the
Address: 4/,SN 4 3 z e T; li. /L.,/ _ jurisdiction in which work is being performed.If the
applicant is menu*from licensing,ihe&Bowing reasons
9 9- 1 A.3 aPPIY:
)
E-mall:r5f tAte.. L4-1.ei,,,,_
CONTRACTOR
ne .
13usiss none: -d9- BUILDING PERMIT FEES*
(Pram rafta•refer
Address: -------
Shuchnal plan review fee(or deposit):
City/State/DP:
FLS plan review fee(if applicable):
Phone:( ) t---- Far( )
Total fees due upon applicrtion: /17. 1/CCB lic.: 500 e 8
Armand received:
Authorized sign:gine: / j
lA . L %..- This permit mikados expires ifs permit is not obtained
1 within 180 days after it has been accepted as complete.
Print name: £i...e..u.c._ L4.124.e_ Dom 7—d 6/— /4. I * Fee methodology set by Tri-County Building Industry
City of Tigard
11,1 N COMMUNITY DEVELOPMENT DEPARTMENT
T I c R o Building Permit Review — Residential
Building Permit #: /75-W)Il,-60 3
Site Address: /Odes- se-c) ,v_e,-,„ ,, /,,? L
o2,w,
Project Name: ,J,,-,,A/ Zee
Lot #:
(New dwelling=suer, ion name;Addition or Alteration=last name of owner)
Planning Review
Proi osal: / ..,
At
.1 erify site address/suite# exists and active/i'n permit system.
ver Terrace Neighborhood: V No 0 Yes,See River Terrace Review Addendum Attached
Siy Plan Elements:
ree(3)copies of site plan 4'
sting structures on site
�1'te plan must be on 8-1/2”x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
awn to scale(standard architect or engineer scale) i oor elevations
orth arrow P•-- 11.ty locations(required for new,mayapply for additions)
li
eaddress,project or subdivision name and lot number • i , ation of wells/septic systems
PP y
plicant information(name and phone number) P
��� ..ting trees to be retained with drip line,and tree
F4 t dimensions and building setback dimensions protection measures
II It area,building coverage area,percentage of coverage and 0 3 et tree size,type and locatio
d buildiR-40)corner elevations(2 foot contour lines if more than
4 foot differential)
❑ Clean Water S ces—Service Provider Letter(lot platted prior to 9/10/1995):
1,0 1Required: V Yes,applicant was notified ❑ No Received: ❑ Yes LIQ'No V�
iblic Facilities Improvement(PFI) Permit
quired: CIYes,applicant was notified 1Q No Applied For: ❑ Yes
❑ No,stop intake
Iand Use Case#: 42)772 O/( •4.//:
oning: ,��'- ",. (P h
Setbacks: Front ___LT.
__L Rear a/ Side 5 Street Side & 1, Garage c-�C
�
fg/ ndscape Requirement: °A)
Ji° 'iiot Coverage Maximum:
r4 Building Height: Maximum ��Height $
g Actual Height �i� y/62 '
prrisual Clearance
fijeasements
Witnsitive Lands: ❑ Yes Zo Type
ban Forestry Plan
fi3onditions "Met"prior to issuance of building permit
Notes:
e
Approved By Planning: �.--_. $,®
Date:
Revisions (after Building Submittal only) Reviewer
Revision 1: 0 Approved CI Not Approved Date
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPermitRvw RES 060116.docx
Building Permit Submittal
Original Submittal Date: S/is %f-
Site Plans: # 3
Building Plans: #
Building Permit#: nter building ppermmiit#above.
Workflow Routing: anning L Englneeringt Coordinatorud g
Workflow Sign off: �gn-off for Planning(include notes from planning review)
Route Application Documents: [engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
citig: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician:
Date: r7,7�
� ��
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
Assess Water Quantity Fee in-lieu: El Yes ❑ No
LIDA Facility on lot: 0 Yes El No
❑ NOT Approved by Engineering:
Date:
Notes:
Approved by Engineering:
Date: g__/5_Revisions (after Building Submittal only)
Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved El 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:
SDC Fees Entered: Wash Co Trans Dev Tax: El Yes T/A
Tigard Trans SDC: El Yes N/A
Parks SDC: El Yes N/A
P'CIK to Issue Permit S/
/� Date: /
Approved by Permit Coordinator:
I:\13uilding\Forms\B1dgPermitRvw_RES_060116.docx