Permit CITY OF TIGARD BUILDING PERMIT
IN°'r .,
COMMUNITY DEVELOPMENT Permit#: BUP2020-00160
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/28/2020
Tf GARD Parcel: 2S104DA01300
Jurisdiction: Tigard
Site address: 12680 SW WALNUT ST
Project: Walnut Street Partition Subdivision: None Lot: None
Project Description: Demolition of a 2,000 sq.ft.barn. Demo credits do not apply.
Contractor: NORTHWEST RECLAIMED WOOD LLC Owner: MOORE, CAROLYN REVOCABLE LIVING
23535 SANTIAM WAY SE BY HAUCK,TERRY C
LYONS, OR 97358 1211 SW 5TH AVE#1700
PORTLAND, OR 97204
PHONE: 503-779-8941 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 07/23/2020 $149.75
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 07/23/2020 $0.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 07/23/2020 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $5,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total S230.95
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 503.232.1987 or 1.800.332.2344.
Issued By: O �� Permittee Signature:�^ Cat .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" G e. t 7 „4/ •
Residential FOR OFFICE USE ONLY
City of Tigard ��y y� Received 7 /2b 4 Pit No.: Afr�� /60
\Pfj 1L•. DateBy: �J �7
= a 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.598.1 6 Date/By: Other Permit:
f I G AR D Inspection Line: 503.639.4175 2020 Date Ready/By. runs: ® See Page 2 for
Internet: www.tigard-or.gov JUL 2 Notified/Method: ],,�^--C., Supplemental Information
TYPE OF WO 1 , f. 1"-A:st.r`§=" -4 REQUIRED DATA:1-AND 2-FAMILY DWELLING
r. 52; r i qti« t ....X :.
❑New construction gDemolition 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.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuator: $ AP*
ElAccessory building El Multi-familyNumber of bedrooms: N A
❑Master builder ,Other:feat,/5K6-1, 'p Me, Number of bathrooms: 1V 4-
JOB SITE INFORMATION AND LOCATION Total number of floors: N4
Job site address: 121r 40 51,.., WR'L . Lir S'112E>;T New dwelling area: /t//1 square feet
City/State/ZIP: 'Ti 6f1 api a 2 a7 2.1-3 Garage/carport area: AA square feet
Suite/bldg./apt.no.: TA.Q.A! Project name: pi IN 02 /'D 24(1.1-4,, Covered porch area: PA- square feet
Cross street/directions to job site: Deck area: A- square feet
V1lLIJ IC Lo.ATV.11 'I t"ow /R 650 r ft-^6 L or Other structure area: INA square feet
Val✓.G*-*A`•1 Jrr if SiA-, l`^ALiv' SrQre1 • REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: .^ Lot no.: --- Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 7,5109 DA al 3 dp 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.
Valuation: $ S Voo `✓
MOLI'rt rt,J QF t •4N 1 SHG D IN - /PP"e-T I
tF eT(,Aty N F 01 Inr 0/1- j.ArMp Wo-Ta T,I/v, Existing building area: ?1 UUG square feet
New building area: /u or square feet
Dir PROPERTY OWNER ❑�T^ENANT Number of stories: 1
Name: (j,p L y Pi / "de 44 76 V OLa:�it.5i. I rd S r/ 1-C 4 A r )I V Type of construction: � V/ a-/3 'aeM U
Address: J 2 I I 5W S- P .• / 5rt I1'o Occupancy groups: /lv/�V p
City/State/ZIP: Io2Ti,RNo r de 41701 Existing: Pqu,n/�l`fhLb
Phone:(9( 3) 310 - 3/t S Fax:( ) New: J1+O
❑ APPLICANT Of CONTACT PERSON BUILDING PERMIT FEES*
� e ^ (Please refer la fee sd le redu
Business name: O amen ����yS LLG
Structural plan review fee(or deposit): —
Contact name: s'co-r-I 6"1510
p FLS plan review fee(if applicable):
Address:
I So 5w (o Apt. Stier?, flop
Total fees due upon application: * _30 .S
City/State/ZIP: 114,-I1„..0).M ( D , 0?'129N 2 !—
�+ Amount received: 10 Phone:4111 )311 . frii S Fax: :( )
E-mail: 51..64 �'/ ( �L(� Gu ry,M U/l 1 7/I tt co PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR J Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: PO2TH WST FE GL/U/1'rCrd WOOD t(.(� Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 2-353 S 540,0 T I A M Akt Li SE Solar Installation Specialty Code checklist.
City/State/ZIP: Lt/Un,s et ef� st• Permit Fee(includes plan review $180.00
/r and administrative fees):
Phone:(5o3) ��11- O AN / Fax( ) State surcharge(12%of permit fee): $21.60
CCB lic.: Soo I 40
1 Total fee due upon application: $201.60
Authorized signature: 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: GUrS - rF am'�� Date: 6� /�Z I /70 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-613T(11//02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
11111
c Building Permit Review — Residential
TIGARD
Building Permit #: , /lhdp- C,)i(AO
Site Address: 12680 SW Walnut Street
Project Name: Walnut Street Partition - demo only Lot #:
Planning Review
Proposal: Demo existing 2,000-square-foot barn
❑o Verify address/suite #active in Accela. reIn River Terrace: ❑r No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: erosion Control
0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures
O Drawn to scale(standard architect or engineer scale) eootprint of new structure(including decks)and FFE
O orth arrow _.Jtility locations&easements(required for new and additions)
Mite address,project or subdivision name and lot number FAidewalk/driveway approach
0 pplicant information(name and phone number) / ocation of wells/septic systems
O .t dimensions and building setback dimensions �Lrltreet tree size,type and location
D:quare footage of buildings to be demolished treet names
0 xisting structures on site NLkorner elevations (2'contours if more than 4'differential
Mist area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es o
r
�,�impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 'es r o
F' kClean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ElYes,applicant was notified ❑No Received: ❑Yes ❑r No
����}},
i Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified Q No Received: ❑Yes Q No
,OSDC Exemption for ADU applied for: ❑Yes ❑No Received: El Yes 0No
iPublic Facilities Improvement (PFI)Permit:
Required: ❑Yes,applicant was notified ❑r No Applied For: ❑Yes ❑No,stop intake
❑° Land Use Case #: MLP2020-00004 ❑s Zoning: R-4.5
N/A. - - - ed Setbacks: Front: Rear: Side: Street Side: Garage:
❑ Building - .;,• : Max. Height: Actual Height:
U Landscape Area: % ❑ Lot Coverage Max: °
Entrance _ Set back no more t' .. :'from street-facing wall ❑ Paralle - eet or offset 45 degrees or less
Windows — Minimum 12%of area of. . - -facing facades
Garage _ Gara e door is behind widest street- ac 1._ .all I Yes ❑No,one of the following is met:
Door extends no more than 5'from a . •-re is a covered porch extending beyond garage.
Door extends no more th.• . •om wall and there is . • ft.window above garage on 2"a floor.
tiara• following:e door width is 2'or less ❑ 50%or less of facade ► 0%or less and includes 7 of
❑ _
Cove -• •arch Recessed entrance ❑Wall offset 1'Ro. -. e ❑ Roof offset
h
re shingles Lap Siding ❑Roof itch ❑ Gable, or gambre ; Dormer
Accent siding��, Window trim Window recess Window projection • Balcony
risual Clearance OUrban Forestry Plan
❑r Sensitive Lands: ❑ Yes ILI No Type:
❑r Conditions met prior to issuance of building permit
Notes:For demo only - OK to issue _
❑ Approved By Planning: `X--L. Date: 7/27/20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:1 Building 1 Forms\B IdgPermitRvw_RE S_122419.docx
Building Permit Submittal
Original Submittal Date: 7/1l�j
Site Plans:
Building Plans: #
Building Permit#: n r building ermit# above. � r�
Workflow Routing: la g II Engineering ermit Coordinator
Workflow Sign-off: ff for Planning(include notes from planning review)
Route Application Documents: ngineering: (1) copy of permit application,(1) site plan, (1) building plan and
origal plan review routing form.
uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: dehO ',,t'1
By Permit Technician: -70 fC) Date: 7A23a
Engineering Review
❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval an. . •t
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 0 1 o
Assess Water Quantity Fee in-lieu: ❑ Yes 111 No
LIDA Facility on lot: ❑ Ye ❑ No
❑ Final Plat Recorded:
❑ NOT Approved by Engineerin:• Date:
Notes:
❑ Approved by E : neering: Date:
Revisions (a , `uilding Submittal only) Reviewer Date
Revi • 1: ❑ Approved ❑ Not Approved
'evision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
laConditions "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:
. 1-SDC Exemption: ❑ Received Does not a..ly
•
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes �611 7,,N/A
Tigard Trans SDC: El Yes ,tR N/A
Parks SDC: ❑ Yes r.
til /A
LIDA 0 Yes 5 N/A
,15 OK to Issue Permit
Approved by Permit Coordinator: s f -- Date: -
I:\Building 1 Forms 1Bl dgPermitRvw_RE S_1224 19.docx
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approved by Planning
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PARTITION SITE PLAN DAN
25-1-4AD TL 4900 and 2S-1-40A TL 1300 mini NY � '�I WESTLAKE
SW Walnut Street Tigard, OR o CON6U TAZ TB"`
cpm NY
Carolyn Moore Trust ° O • SURVEYING • PUNNING
OM NO. s.rmra iao a au-aeae