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Permit (40) CITY OF TIGARD MASTER PERMIT , !PI 11.. '' COMMUNITY DEVELOPMENT Permit#: MST2017-00199 Tr GAty D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/21/2017 Parcel: 251106604300 Jurisdiction: Tigard Site address: 12300 SW AMES LN Subdivision: ARLINGTON RIDGE Lot: 20 Project: Roth Project Description: Construct 455 sf cover over existing patio slab. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: Total: 0 sf Value: $10,500.00 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]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: ALT SF VB R-3 0 Owner: Contractor: ROTH,THERESA D&MICHAEL D RIVER CITY CONTRACTING Required Items and Reports(Conditions) 12300 SW AMES LN 20360 SW CARLIN BLVD TIGARD,OR 97224 BEAVERTON,OR 97078 r PHONE: PHONE: 503-828-6600 `�t' 1 FAX: 1 Total Fees: $527.09 f This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty des `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 iss nc or if work is suspended for more the 180 days. AT • • •regon law requires you to follow the rules adopted by the Oregon Utility Notification; C nter.// Those rules are set forth in OAR 952-00 .010 through 0'R•. -.01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 32 987r 1.800.332.2344. , Issue. By: ,0 '\ Permittee Signature: y \i Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 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 Residential A EC I D Received I. ' City of Tigard Date/By: Le... S / 7 Permit No.: 5 7----„,,e,7 Gr 197 13125 SW Hall Blvd.,Tigard,OR 97223 ''If ry Plan Review Com/ Phone: 503.718.2439 Fax: 503.598.19�b'N z 017 Date/By: �j 7... )'III Other Permit: �-i It D Inspection Line: 503.639.4175 (� TIG Date Ready/By: Jam- H See Page 2 for Internet: www.tigazd-or.gov CITY OF TIGARD N ified/Method: a//i, Supplemental Information BUILDING DIVISIO I47 u, i TYPE OF WORK REQ D DATA:1-AND 2-FAMILY DWELLING 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 ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ /c2. � 0 El1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building ElMulti-familyNumber of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /d3 OL ' 5 cc) 4/1,14‘..5 4,--, New dwelling area: square feet City/State/ZIP: j j.9/4/tai '(-)/f- 77.g25 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: d'(.24/ Covered porch area: /,.9"--,5.--- square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I 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 DESCRIPTION OF WORK work indicated on this application. - --_ Rat.� (� _ „,j Valuation: $ SACaExisting building area: square feet L-.,-0-1 t (-J.LJ z • New building area: square feet a PROPERTY OWNER 0 TENANT Number of stories: Name: i4/1+ k 1„ ,o7"*t Type of construction: Address: /33 do 5 vc> AIM e6 L,1 Occupancy groups: City/State/ZIP: !t jald OK. 17;13 Y Existing: Phone:( ) Fax:( ) New: Q APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Business name: t.i 1c' e-',i/ Cc / (Please"fee le fee scheduschedule)s, �4�r-,�� Structural plan review fee(or deposit): Contact name: "D c", 4 D le y ^� / / FLS plan review fee(if applicable): r7` Address: £.�c 0 3 c'u C>4/r/;4 ../d/+ City/State/ZIP: 12 c'�0e,^...,1p:4 ©a24'J Total fees due upon application: Phone:(9e/5 ) 0,)6--6 6 oz, I Fax::( ) Amount received: l , It* E-mail: `J(e y, f fie, el S Pk e..01V\ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* � CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Ph k toVoltaic Solar Panel System. Business name: _ Submit two(2)sets o sof plan with connectio I ails Address: f and fire department acce- along wit 1 • 110 Oregon 4,45 4 �j,)L't Solar Installation Special4 re checklist. _ City/State/ZIP: 54y Permit Fc udes plan 'ew $180.00 and administrative fees . Phone:( ) I Fx:( ) CCB lic.: j p 5' State surcharge(12%of permit fee): $21.60 Total fee due upon application: 1.60 Authorized signature: i This permit application expires if a permit is not obtained `� within 180 days after it has been accepted as complete. Print name: ��`�,y Date: rv�5"�j *Fee methodology set by Tri-County Building Industry 'J��1 5 Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) A Building Permit Application Checklist One— and Two—Family Dwelling I OR OFFICI. USE Oy1.v City of Tigard Date/BReceived Permit No.: 11 13125 SW Hall Blvd.,Ti ard,OR 97223 y S Associated permits: >a Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical I I G A K D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW lcs 10 1'Lk 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. II • U 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 0 0 0 4 Fire district approval required. Name of district: • 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0 6 Sewer permit. 0 0 0 7 Water district approval. ❑ ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 A 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0 furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0 floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0 Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0 prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0 systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 H 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0 architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review. 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 24 Two(2)sets each are required for Items 16,19,20 and 22 above. 0 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0 and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0 including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) f v COMMUNITYCity DEVELOPMENT DEPARTMENT 11114 ■ ermit 1 ilding G A R D Building Permit Review - Residential Bu Site Address: 12300 9N ArYleS Lant. Project Name: ( DP_C.EC ( y Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: Covex an eXlSfi g" Verify site address/suite# exists and active in permit system. .1K) River Terrace Neighborhood: K. No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: N: hree(3) copies of site plan Existing structures on site ' Site plan must be on 8-1/2"x 11"or 11 x 17"paper ,*Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations North arrow NttJtility locations&easements(required for new and additions) Site address,project or subdivision name and lot number j Sidewalk/driveway approach Applicant information(name and phone number) McLocation of wells/septic systems SLot dimensions and building setback dimensions At'fisting trees to be retained with drip line,and tree P IA-Square footage of buildings to be demolished protection measures ,Lot area,building coverage area,percentage of coverage and f f 8rreet tree size,type and location impervious area(applicable if R-7,R-12,R-25&R-40) KStreet names iFroperty corner elevations(2 foot contour lines if more than LAtorm water quality facility required if>1,000 sf of CO 4 foot differential) impervious area is created or replaced. watt*semeis -Service Prider.. �� > . � �latt�d riot��9/10/4995);. r Y�, OrViti:. � tom. 4 o_ f ❑ es ,``` .: a ' .4ibud '6�Public Facilities Improvement(PFI) Permit: —tet tzt d,�.rJi„ Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake � ! Land Use Case#: to A- 54-Zoning: R 3.5 Required Setbacks: Front 2.0 Rear 15 Side Gj Street Side n1Jet— Garage N 14 Landscape Requirement: N/4 9' Lot Coverage Maximum: � {� 0/0 'Nig/Building Hei ht: g Maximum Height 50 Actual Height ±10 g„Visual Clearance N/A- Sensitive Lands: ❑ Yes No No Type Urban Forestry Plan tJ het- Conditions "Met"prior to issuance of building permit NJk Notes: Approved By Planning: Afilkia dA,t l t- Date: (0'5117 Revisions (after Building SubmittL only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: El Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvw RES 051617.docx Building Permit Submittal rr Original Submittal Date: l.2 (S I 1 7 Site Plans: # o3 Building Plans: # i Building Permit#: ❑' Enter building permit#above. Workflow Routing: E1 Planning ❑ Engineering Id" Permit Coordinator Building Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: D Engineering: (1) copy of permit application, (1) site plan, (1) building plan and ,,priginal 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: , i' 0......A.–.:–.0..-- Date: (p/s--// 7 Engineering Review ��yr ['lope at building pad: 3 (O [ (;onditions "Met"prior to issuance of building permit lasements (encroachments) per engineering conditions of approval and plat Ga' Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 2-No Assess Water Quantity Fee in-lieu: ❑ Yes Ie lvo LIDA Facility on lot: ❑ Yes 'No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: '(t.,-_'--\, _) ---, Date: C.—1 -- l? Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review 0 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: DC Fees Entered: Wash Co Trans Dev Tax: ❑ YesN/A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes go' N/A LIDA ❑ Yes N/A /r OK to Issue Permit /0Date: (c/i 1--- Approved by Permit Coordinator: I:\Building\Forms\BldgPermitRvw_RES_051617.docx Clean Water Services File Number C1eanWateer Services 117-001981 I Sensitive Area Pre-Screening Site Assessment 1. Jurisdiction: Tigard 2. Property Information(example 1S234AB01400) 3. Owner Information Tax lot ID(s): 2S110BB04300 Name: Mike Roth Company: Address: 12300 SW Ames Lane Site Address: 12300 SW Ames Lane City, State,Zip: Tigard,Oregon,97224 City,State,Zip: Tigard,Oregon,97224 Phone/Fax: Nearest Cross Street: E-Mail: 4. Development Activity(check all that apply) 5. Applicant Information 12 Addition to Single Family Residence(rooms,deck,garage) Name: Doug Drey ❑ Lot Line Adjustment Li Minor Land Partition Company: River City Contracting ❑ Residential Condominium ❑ Commercial Condominium ❑ Residential Subdivision Address: 20360 SW Carlin Blvd ❑ Commercial Subdivision U Single Lot Commercial ❑ Multi Lot Commercial City,State,Zip: Beaverton,Oregon,97078 Other Phone/Fax: 5038286600 Covered patio E-Mail: dreys@msn.com 6. Will the project involve any off-site work? ❑Yes al No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project 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 Doug Drey Print/Type Title Owner ONLINE SUBMITTAL Date 6/12/2017 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. XBasedSensitive 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 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 REOUIRED. Reviewed by L`' `��"e --- Date 6/13/17 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: 12300 SW AMES LN, TIGARD, OR, 97224 June 26, 2017 at 10:06:39 AM Record Type: Record ID: Residential - Master Permit MST2017-00199 Inspection Type: Inspector: 299 Final inspection Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor