Permit (178) CITY OF TIGARD MASTER PERMIT
311:' COMMUNITY DEVELOPMENT Permit#: MST2018-00221
T t GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/13/2018
Parcel: 2S103DB06800
Jurisdiction: Tigard
Site address: 11180 SW EDEN CT
Subdivision: GENESIS NO.3 Lot: 53
Project: BUSHNELL
Project Description: Replacing 620 sf deck with 370 sf 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 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $22,000.00 Rear: 0
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
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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:
BUSHNELL,CHARLOTTE C THREE RIVERS CUSTOM DECKS INC Required Items and Reports(Conditions)
11180 SW EDEN CT 23885 S MOUNTAIN TERRACE
TIGARD,OR 97223 BEAVERCREEK,OR 97004
PHONE: 503-407-1906 PHONE: 503-632-8777
FAX: 503-632-8770
Total Fees: $757.23
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.11198877 or 1.800.3) ..G44.
Issued By: l/'�_-.Awe,: - Per- -- Signature: r
Call '% .- .4175 by 7:00 a.m.for the next available inspection date. ��
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR OFFICE USE ONLY
City of Tigard AUG 8 2018 Received
Date/B : _, EMT ifiNgfallmi
. Et , ,.,,, Iii• .41W , A ,t ..."
II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review - -111 ;11 1 I Phone: 503.718.2439 Fax: 503.598.1960 --,--.',. - - ''-',.-""" D t/B • .
S .tf Other Permit:
TIGARD Inspection Line: 503.639.4175 -., ,.,, , , - :,-,-.i -.,.•,--.‘!Date Ready/By: Juris: 10 See Page 2 for
Internet: www.tigard-or.gov '' '''''''''''''"-""' ''' ' - 'Notified/Method: Supplemental Information
::'7:•:.: '::"''',, '''''''73gt:'':404-12,-45iiiiViiiii OF wó at•:fitr4. fx.e•A)t-le;/,, ,,:i.,, ,----, ' 7":"-IlTri ;nri7,5:24(ft::tif4tit:ilit*-111. ii4ceiF.,P
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EI New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement l Other: equipment,materials,labor,overhead,and the profit for the
.' ' ,;';,: , ,Z4-121:g,,,$V:T;.: • , ,;''''',- work indicated on this application.
CATfc01(217 OF, COWF#PCTIIm • ;•• : •
Valuation: $ . ,/ 060•oo
El 1-and 2-family dwelling 1=1 Commercial/industrial
El Accessory building 111 Multi-family Number of bedrooms:
D Master builder OrOther.
• • 41:2 .-- Number of bathrooms:
);stti ii;i:.4.!t•;:,4Ar4ii.VnokrTIMI,..w,=;,.;,4 Total number of floors:
",-.',.---'"':,..--'-',.-.7.--..,-,t'7.- ' ''' '72.mu.,...,.-. ''':"PN '',
Job site address: t\ k(ge, 5 4...t) Cie_ f1/4..) c_...7-, New dwelling area: square feet
City/State/ZIP: '1-1 1 Ara. I (..) - '--2-t.71--..7 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 5 .„,....c( Covered porch area: square feet
Cross street/directions to job site: Deck area: l7.„C)square feet
Other structure area: square feet
" "OjiiN4FliegaCitlii -', iii4
f,....:-..,,..-.- - '4,7ir. .."'Q••.•`',,ff' ','
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
, AA-AN.5 ,-04''..z.:76"iiiao,'• 1,1,- ,-• . ,,,, '‘NON4'''''ft,',,,,',,,'''':',:''''''
t9M4tIONNMONMPY '' :40 A?ik,'CitircION 0, ,1i.:?) • ;'.wggtt4V,clgcggoftzin---, , work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
''''''''''' -- , •' ''''-'4,ii6iiiii.,i0,;.'",,,,• •••'4'
0WNER-401.kk...,:r/, h,o,:: ••••:ArA,..`w—'1.4:-..,r'.',5".:', .,,-,' .,.,,,,• ••,,,,-
"
,,.."--: ' "--7rj'-frEMIZSIt ' , ,,,,.'•..-*ti• Number of stories:
Name: C kel--e0 14---#1-e 13eisiviA-c( Type of construction:
Address: 7 ( jg CS S...e,i ..e:..e.,A..) C----7'-- Occupancy groups:
City/State/ZIP: 1.--tviv.„( i ,-li --2-2...„-a_..) Existing:
'
Phone:(423 e_ed? '56(0 Fax:( ) New:
OttACAPIT ",,. '1';',-;:: , -4 • 0 c0AtiuitsyRstip' ' ''Tori4-,,- --Il)ItmozatE.4.19.:Ar:,..,,, *,.-
' ' '''' ' . '• ' ' ' ' ' ' ' ,.' ' ''.„,''''''''''''''''' ''''''' ' • .'',:?:104iiiii:',ISMiViiiiiiiii4e44-4.:42,'3:Alf*.tat;-:•' 'ti!:',1*
Business name: --1-14.Ad-e_.- oe..-2‘..-c....-i (-.Cr 1 tvt-f-t 41-ic_c_t-3 Structural plan review fee(or deposit):
Contact name: /4444,..c-T- 6Ljice.,-.
FLS plan review fee(if applicable):
Address: .1-3 S e c
Total fees due upon application:
City/State/ZIP: acz4.40.-- 1,...7 C)it q/2,0 V
Amount received:
Phone:(163) 76(0 _s-(-7‘7,,/ Fax::( )
''illiii6:031,:ilieTOjiii*::'•'. •:.A...1.t.,',:::12Fr';;:'::,it,i,..:!K
E-mail:
tA4 a c.'ri e--a--e 4et-i-e--) .-/ .."{7 vc-ia •ce,,„.& o . --, . installation
.:,,,,,,,'.gog,...•
7- t7v! yav,5,,r ,1 ,,,, , „,•„,,„ ,..,, .., ,,§;,..... ., .-, ••NtWito Commercial and residential prescriptive iiof
,,, , ,'.:5.': •.',4K?,'FI,,F.:,',40,0444, Ff.94t07RA.t4p ,:LEop -- ; ".'",',.',",;-i. .',"'": ' ' "".. ''",',"""'AMIlk roof-top mounted PhotoVoltaic Solar Panel System.
Business name: //N
Submit two(2)sets of roof plan with connection details
....5(: .
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review
$180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 157 sr....,/
Total fee due upon application: $201.60
Authorized signat • 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: Date: Service Board.
I:\Building\Pe BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Albert Shields
From: Jonny Gish
Sent: Thursday, September 6, 2018 7:01 AM
To: Albert Shields
Cc: Khoi Le;Theresa Reynolds; Rob Block
Subject: MST2018-00221
Albert,
I have approved this for release and included notes. We have an 8" SS line running perpendicular to the property lines
from SW 110th. I talked with the homeowner(11180 SW Eden Ct)yesterday,and will visit with her onsite today, and she
has agreed to grant the easement. Public Works will be paying for the surveying and we will take care of the
recording. We would like to have this recorded prior to final inspection.
Jonny
Jonny Gish
City of Tigard: Engineering
Senior Technician
503-718-2467
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
1
Albert Shields
From: Albert Shields
Sent: Tuesday, August 21, 2018 12:13 PM
To: 'MBUTLER@decksby3rivers.com'
Cc: Allyson Armstrong
Subject: MST2018-00221, Bushnell Deck
Attachments: Albert Shields.vcf
Matt, on reviewing the application and plans for MST2018-00221 Engineering has noted that, before they can approve
the application,they must receive documentation of the sanitary sewer easement through the rear of the subject
property. Please submit such documentation. Until it is received I am coding this application as "Approved (for Plan
Review) but Not Released." Plan Review will proceed but the permit will be on Hold until the documentation is
received. Please let me know if you have any questions.
Albert Shields
City of Tigard
Permit Coordinator
(5031 718-2426 Work
,Ibrerkt tiga€d-or.gov
13125 SW Hail Blvd,
Tigard,Oregon 97217
www.tigard-or.gov
1
et
AUG 8 2018
Clean Water Services File Number
CleanWater Services 18-002365
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: Tigard
2. Property Information(example 1S234AB01400) 3. Owner Information
Tax lot ID(s): Name: Charolette Busness
251030E306800 Company:
Address: 11180 SW Edent Ct
Site Address: 11180 SW Eden Ct. City, State,Zip: Tigard,OR,97223
City, State,Zip: Tigard,OR,97223 Phone/Fax: 503.407.1908
Nearest Cross Street: Genesis Loop E-Mail: charbusnell@gmail.com
4. Development Activity(check all that apply) 5. Applicant Information
EA Addition to Single Family Residence(rooms,deck,garage) Name: Matt Butler
U Lot Line Adjustment ❑ Minor Land Partition Company: Three Rivers Custom Decks,INC
❑ Residential Condominium ❑ Commercial Condominium
Address: 23885 S Mountain Terrace
❑ Residential Subdivision ❑ Commercial Subdivision
❑ Single Lot Commercial ❑ Multi Lot Commercial City, State,Zip: Beavercreek,OR,97004
Other Phone/Fax: 503.706.5174
Replace existing deck with small deck E-Mail: mbutler@decksby3rivers.com
6. Will the project involve any off-site work? ❑Yes No ❑Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
All work to be done with hand tools. No equipment to be used.
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 Matt Butler Print/Type Title General Manager
ONLINE SUBMITTAL Date 7/31/2018
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 Date 7/31/18
2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • Phone: (503)681-5100 • Fax: (503)681-4439 • www.cleanwaterservices.org
A
City of Tigard
1111 u COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R o Building Permit Review — Residential
Building Permit #: As 7-1,0/T-002,2--/
Site Address: //J ,') L() iE /1 011,--71--
Project Name: _66' Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review Q
Proposal: /77 Y� 0)c=.20 94 c ei_ ..V/t.1 r"-PrdiC2 !0T/A.— W
efed-
hLl Verify site address/suite# exists and activ in permit system.
t4iver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Si- ,Plan Elements:
ViThree(3)copies of site plan a E . ting structures on site
L✓I 'te plan must be on 8-1/2"x 11"or 11 x 17"paper kr.11, otprint of new structure(including decks)with finished
yawn to scale(standard architect or engineer scale) oo elevations
rth arrow la . ty locations&easements (required for new and additions)
fr to address,project or subdivision name and lot number IJ'f alk/driveway approach
p licant information(name and phone number) ion of wells/septic systems
of dimensions and building setback dimensions ��.sting trees to be retained with drip line,and tree
Square footage of buildings to be demolished •ro -ction measures
t area,building coverage area,percentage of coverage and tD ° et tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) i'i Street names
VJPro.erty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replace.? ❑Yes o
4 oot differential) If es,is a storm water .uality facili shown? ,' EYes No
WA Clean Water .rvices—Service Provider Letter(lot platted prior to 9/10/1995):
' -quired: 1'f, Yes,applicant was notified ❑ Received: II Yes ❑ No
M ublic Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified V No Applied For: ❑ Yes E No,stop intake
IV and Use Case#:
Ironing: le— C-
)ICJ Required Setbacks: Front Rear / Side Street Side 0 i Garage OP(
Landscape Requirement:
i11'I of Coverage Maximum:
Building Height: Maximum Height ) Actual Height E Vist 1'1'1 D ii-e
i-isual Clearance
M. Sensitive Lands: �4 Yes ❑ No Type kW-/m p l ._7 __,��
____,
'��7rban Forestry Plan /!! COfr7ci(Or
, onditions "Met"prior to issuance of building permit
Notes:
❑ Approved By Planning: — 1411111111111WrcoF,Date: �' g
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\BldgPennitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: Br/(fl/d-
Site Plans: # 3
Building Plans: # 3
Building Permit#: Lt Enter building permit#above.
Workflow Routing: Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
Workflow Sign-off: Sign-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.
ciP Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
/A/4_ c
By Permit Technician: i4 Date: 5
En/gineering Review .
G
ViSlope at building pad: G.,2 5/
E Conditions "Met"prior to issuance of building permit
❑ Fasements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility: ./V/11-
Assess
/V/AAssess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
F Plat Recorded:
2 NOT Approved by Engineering: Date: g/,2 r/
Notes: PIZO()i 06 DOCu/'1 •v 74-77C- ) OF SSE 1-)6K. 54,v 1Mi q 645.-J't6 'T 7JeeujN
1644r of PRo PeRF/
❑ Approved by Engineering: Date:
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 /
?i<lpproved,NOT Released: /34.4_, oma. ac :C ��; �� lute: r/2 I) i45
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:
S DC Fees Entered: Wash Co Trans Dev Tax: CIYes /A
/ Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes >N/A
LIDA ❑ Yes N/A
OK to Issue Permit 22i'n
�
Approved1/
by Permit Coordinator: / llate: 6/1 8
I:\Building\Forms\BldgPermitRvw_RES_010118.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11180 SW EDEN CT, TIGARD, OR, 97223 October 12, 2018 at
9:19:01 AM
Record Type: Record ID:
Residential - Master Permit MST2018-00221
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor