Permit (145) CITY OF TIGARD MASTER PERMIT
a Fli a.. COMMUNITY DEVELOPMENT Permit#: MST2017-00426
T(£ ARO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/16/2017
Parcel: 2S114AB01202
Jurisdiction: Tigard
Site address: 16305 SW 92ND AVE
Subdivision: None Lot: None
Project: STEWART
Project Description: 480 sq. ft. carport.
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: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
No
Total: 0 sf Value: $10,824.00 Rear: 5
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
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Bckflw Prevntr: 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]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:
ACS SF VB R-3 0
Owner: Contractor:
STEWART,HAROLD&BETHANY NW CUSTOM STRUCTURES LLC Required Items and Reports(Conditions)
16305 SW 92ND AVE 4590 SW WATSON AVE
TIGARD,OR 97224 BEAVERTON,OR 97005
PHONE: PHONE: 888-536-1585
FAX:
Total Fees: $455.88
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 t - r_ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain- opy of th-rules or direct questions to OUNC by calling 50 1 3`2.19987 or 1.800.332 44.
Issued By:6 Permittee Signature: i'. '-ar!%��i' iL�j,L =
a 1503.639.4175 by 7:00 a.m.for the next available inspec".n date.
This permit card shall be kept in a conspicuous place on the job site unti ompletion of the roj t.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential l,
.:, 1 Ul2 01 Flt tsl, 0N1.1
City of Tigard ,4E1k.,VA Received �,�
11
DateB : ArAr Permit No.:.1 '7
IN " 13125 SW Hall Blvd.,Tigard,OR 97223 /
Plan Review I
Phone: 503.718.2439 Fax: 503.598.1960 0(l� 2 /0 ,' Date/By: J! )3–1)7 7 other Permit:
1 It r) Inspection Line: 503.639.4175 Date Ready y: , .rays: ta See Page 2 for
Internet: www.tigard-or.gov .otified/Method: / /) ,'(a Supplemental Information
ltrg,00
; .eY 4' :iib '''::;LinVi '` ''. . A '^AND -
❑New construction 0 Demolition Permit fees*are based on the value of the work performed. y
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ®Other:carport equipment,materials,labor,overhead,and the profit for the
JOIE e ti o
work indicated on this application.
❑ 1-and 2-familydwelling Valuation: $
0 Commercial/industrial r
®Accessory building 0 Multi-family Number of bedrooms: Q J Oa t T. '
❑Master builder 0 Other: Number of bathrooms:
JOB INF+I)fRl A� i Total number of floors:
Job site address:16305 SW 92°a Ave New dwelling area: square feet
City/State/ZIP:Tigard/OR/97224 Garage/carport area: t-i.90 square feet
Suite/bldg./apt.no.: Project name:Carport/Canopy Covered porch area: square feet
Cross street/directions to job site:Flaglot Deck area: square feet
Directly across from the Tigard HiSchool Football stadium Other structure area: square feet
SrrvG-c r /wIeh l
/ ," /' - 4eIye- TA
311
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S114A1301202 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
^ � �, work indicated on this application.
Metal Carport from http://nwcustomstructures.com Valuation: $
480 sqft carport installed on site yard,more than 5ft from all property lines. Existing building area: square feet
Will be installed by NW Custom Structures New building area: square feet
' :.. „ ROPER ..,�. ,. , . 0,,TENAN _ Number of stories:
Name:Harold Stewart Type of construction:
Address:16305 SW 92"Ave Occupancy groups:
City/State/ZIP:Tigard/OR/97224 Existing:
Phone:(971)285-7135 Fax:( )
New:
Business name: ! s , :r :f+ . r . . ,
Contact name:Harold Stewart
Structural plan review fee(or deposit):
Address:16305 SW 92"Ave FLS plan review fee(if applicable):
City/State/ZIP:Tigard/OR/ 07224 Total fees due upon application: 11�] y
Phone:(971)285-7135 Fax::( ) Amount received: 11
E-mail Harold@Terahex.com PHOTOVOLTAIC SOtiitt usyste
Commercial and residential prescriptive installation of
„" .; ,. ''° � R o roof-top mounted Photo Voltaic Solar Panel System.
Business name:NW Custom Structures Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4590 SW Watson St. Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton/OR/97005 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(888)/5361585, J� Fax:( ) State surcharge(12%of permit fee): $21.60
CCBlic.: 9.6-11 'l1►rg I i `1
� Total fee due upon application: $201.60
Authorized signature: �� 7"------„. _r.`` -,> This permit application expires if a permit is not obtained
L'Y. G'"�' c5!_.f-`--`L4, — --' '""� within 180 days after it has been accepted as complete.
Print name:Harold tewart Date:11/1/2017 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
Il COMMUNITY DEVELOPMENT DEPARTMENT
i 2
T I G A R D Building Permit Review — Residential
Building Permit #: .77-)57--,70i 7-cc ia
Site Address: /( & cYl&) 1( 417/ /9,-,
Project Name: 72--e2ty 'li-- C2arp or-1- Lot #:
(New dwelling=subdivision name;Acitlition or Alteration=last name of owner)
Planning Review /�J // J
Proposal: AJ-P Cle 7G'f�,P 0( �' 0(`I -- 27 PO c
VJ Verify site address/suite# exists and activ to ermit s stem.
p y
❑ River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Si Plan Elements:
ree(3) copies of site plan sting structures on site
rte plan must be on 8-1/2"x 11"or 11 x 17"paperfti
Footprint of new structure(including decks)with finished
1 rawn to scale(standard architect or engineer scale) floor elevations
ii.corth arrow !S1,i;. 'ty locations&easements (required for new and additions)
to address,project or subdivision name and lot number MS. ewalk/driveway approach
.plicant information(name and phone number) ocation of wells/septic systems
pe.t dimensions and building setback dimensions Existing trees to be retained with drip line,and tree
i 11`., are footage of buildings to be demolished srotection measures
al�i 3
area,building coverage area,percentage of coverage and J "reet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40)
Street names
Property corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑Yes
t
4 foot differential) If yes,is a storm water quality facility shown? ' Yeso
❑ Clean Water ervices—Service Provider Letter(lot platted prior to 9/10/1995):
Required: Yes,applicant was notified ❑ No Received: Yes ,ZNo
V4Kublic Facilities Improvement(PFI) Permit: ,7
p i/®itiii �:.
Required: ❑ Yes,applicant was notified i No Applied For: ❑ Yes ❑ No,stop intake
01 and Use Case#:
s, '
oning: E— Li
0 Required Setbacks: Front Nip, Rear C- Side 5 Street Side Garage
..ndscape Requirement: 0/0
� ��
of Coverage Maximum:
/ /
YI Building Height: Maximum Height /s Actual Height 1J`7 1 1
lid isual Clearance
E1 ensitive Lands: ❑ Yes TNo Type
*Urban Forestry Plan
conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs 061417.docx
Building Permit Submittal
Original Submittal Date: ///01/1 7
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: lanning engineering EriCrmit Coordinator H wilding
Workflow Sign-off: E gn-off for Planning(include notes from planning review)
Route Application Documents: Ei--E gineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
0-1wilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: LZ Date: 4/62 /j 7
Engineering Review
[YSlope at building pad: /i;
[ 'Conditions "Met"prior to issuance of building permit
E Easements (encroachments) per engineering conditions of approval and plat
2-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes
Assess Water Quantity Fee in-lieu: ❑ Yes o
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 1,44 A 4 v._ Date: I / --'7—I Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ 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:
?c4SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: El Yes N/A
LIDA ❑ Yes N/A
J2'OK to Issue Permit
rApproved by Permit Coordinator: Date: //API--
I:
/ /I--I:\Building\Forms\BldgPennitRvw_RES 061417.docx
Clean Water Services File Number
C1eanWateer\ Services 17-003669
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: Tigard
2. Property Information(example 1S234AB01400) 3. Owner Information am
Tax lot ID(s): Name: Harold Stewart !!t-1,4 m" �
2S114AB01202 Company:
Address: 16305 SW 92nd Ave a`u U yr I 2017
Site Address: 16305 SW 92nd Ave City,State,Zip: Tigard,Oregon,97 ?zi ,h {
City,State,Zip: Tigard,Oregon,97224 Phone/Fax: 971-285-7135 t (k
r
E-Mail:
Nearest Cross Street: Flag Lot Harold@Terahex.com
4. Development Activity(check all that apply) 5. Applicant Information
❑ Addition to Single Family Residence(rooms,deck,garage) Name: Harold Stewart
❑ Lot Line Adjustment ❑ Minor Land Partition Company:
❑ Residential Condominium ❑ Commercial Condominium
Residential Subdivision Address: 16305 SW 92nd Ave
❑ ❑ Commercial Subdivision
❑ Single Lot Commercial ❑ Multi Lot Commercial City,State,Zip: Tigard,Oregon,97224
Other Phone/Fax: 971-285-7135
Carport E-Mail: Harold@Terahex.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
City of Tigard Case No MST207-00426
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 Harold Stewart Print/Type Title
ONLINE SUBMITTAL Date 11/9/2017
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.
❑ 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 17-05, 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 G '/---r/ Date 11/13/17
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:
16305 SW 92ND AVE, TIGARD, OR, 97224 March 8, 2018 at 10:45:53 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00426
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
No one home for inspection, 10:41 am.
No plans found on site for inspection, provide approved plans on site for
inspection. R109
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16305 SW 92ND AVE, TIGARD, OR, 97224 March 9, 2018 at 11 :25:57 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00426
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide missing rod anchors at post with no anchors per approved plans, 2 on
each side.
Provide missing gable brace per approved plans.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16305 SW 92ND AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Master Permit MST2017-00426
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Corrections complete from previous inspection.
Violation Summary:
Inspector Contractor