Permit CITY OF TIGARD SINGLE FAMILY
ipqMANUFACTURED PERMIT
2 COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: SFM2020-00002
TIGARD Date Issued: 9/1/2020
Parcel: 2S102AA03902
Site address: 8915 SW COMMERCIAL ST 4 Jurisdiction: Tigard
Subdivision: TIGARD HIGHWAY TRACTS Lot: 27
Project: Rodriguez
Project Description: New residential manufactured dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: Bedrooms: First: sf Basement: sf Left: Parking Spaces:
Height: Bathrooms: Second: sf Garage: sf Front: Smoke
Dwelling Units: Third: sf Right: Detectors:
Total: sf Value: $0.00 Rear:
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Catch Basins:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Other Fixtures:
Tubs/Showers: Garbage Disp: Water Heaters: Water Lines: Drains:
Bckflw Prevntr:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Fum<100K: Vents: Woodstoves: Gas Outlets:
Furn>=10OK:
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0-200 amp: 0-200 amp: W/Svc or Fdr:
Ea addl 500 sf: 20 1-400 amp: 201-400 amp: W/O Svc/Fdr:
Mfd Home/Feeder/Svc: 401-600 amp: 401-600 amp:
601-1000 amp: 601+amp-1000v:
1000+amp/volt:
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Ecompasing: N
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SFM VB R-3
TOTAL FEES: $495.56
REQUIRED ITEMS AND REPORTS
Owner: Contractor:
CASCADE MOBILE VILLA LLC Tf /1O Lt.oc "co 27?/K/ES77
B915 SW COMMERCIAL ST f , ,gQX /2,7
TIGARD,OR 97223 t(LE60A/ C/Ty Biz_. 9 7aY5
PHONE: 503-980-5884 PHONE: 503-655-5626
FAX:
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 throu AR 952 1-0090. 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: aT' Permittee Signature: dif rlti/4Li G9-T70A,
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.
Manufactured Dwelling ��y�?`' ��
Placement Permit ApplicatioIRECEI\J V ED FOR OFFICE USE ON1.1
Received G Pennil No.' �/;
City of Tigard AUG 0 4 2020 Dateive i'J/ �. S'FM Zo o-D•
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598'196b lY OF TIGARD Date/By: 31/p 7.6) A/14- Other Permit:
Inspection Line: 503.639.4175 t 111 r11 AI 111 V I C Q�� Date Ready/By: lung. 163 See Plan Submittal
l I C i S IC t� Internet: www.tigard-or.gov Notified/Method l/�I D Requirements
Site Address: MI 5
15stidCcowee 'IC u ( 54 , () rt.y Name: 0/dika j�),/J0xiii/'
Suck Name: C-gCo Q. nA t ± I U 1I4k #� Address: ��I�S*I(/C l � �61r
Subdivision&Lot#: '' UaU N
Directions to inspection site: City: 9,P.� I State: 49 I ZIP:9,ZgJ3
Phone:5-43-33 RD 6 I Fax: 31734039-9.��
Is property inside city limits? , )Yes 0 No E-mail:
LOCAL GOVERNMENT APPROVALS
Zoning Sanitation
Signature: Signature:
Jurisdiction: Jurisdiction:
Date: Date:
MANUFACTURED UN%'ELI.I\(. PLACEMENT PERMIT FEES
Cost(each) No.of Sum
(1) Installation/re-inspection Items
(a) Placement(includes placement,electrical feeder,30'of water/sewer connection). $ 275.50 $
(b) State surcharge at 12%(of placement fee only). $ 33.06 $
(b) Re-inspection(includes inspection and 12%state surcharge). $ 100.80 $
Placement permit to be obtained only by homeowner,or Oregon-licensed manufactured dwelling installer.
(2) Electrical
(a) Service and/or feeder(new service installation or alteration/relocation of existing service). $ See Electrical Permit Application
Electrical service permit to be obtained only by-homeowner performing work or signing supervisor of Oregon-licensed electrical contractor
performing work.
(3) Plumbing
(a) New water service(for services over 30 lineal feet). $ See Plumbing Permit Application
(b) New sanitation/storm sewer or rain drain(for services over 30 lineal feet). $ See Plumbing Permit Application
Plumbing permit to be obtained only by homeowner performing work or Oregon-licensed plumbing contractor performing work.
(4) Miscellaneous fees
(a) Administrative fee(State of Oregon). $ 30.00 $
(b) System development fees(sewer connection,storm water,parks development&traffic impact). $ See Permit&System Development Fees
SUB-TOTAL $
y
Name: ���"-' ��/yr v �t��� Name: � A/,U)'l1� l ��l�'�
Address:Po )20 x 1 2'dr 7 Address::�$Uc'rl J Sc.,) Cpl rt;l'A� S+ ,1--,
City:gri6t, I State: &), I ZIP: �70 U� City:�� �_�J I State: o — I ZIP: a f 3
Phone 7934/��5/_2 / Fax:x F% Phone:/ �►O o_CQ pu I Fax:
CCB No.: 5 7 r' !lGfD/ DI No.: E-Mail:l �J�✓✓y� -y 5 VU ! 1 I •CoW\
Name: J /(1'
J �y� / yj I hereby'eet rhfy I that the information above is true and correct.
/�(.Z/�/// !9 �/7!/ All work to be performed shall be in accordance with all
Address: governing laws and rules. /
City: 7 A✓1l1 t� Stat�ry/Y arZIP:�7z�� 4 /3, -/
Phone: l/ COl Fax:Fa Authorized S gnature Date
CCB No.: MDI/LSI No.: Print Name: A if G 1/'e-
\ S I:Building\Permits\ FM-Penn itApp.doc 10/16/2014 a ��CIWwV" f
III ' Building Permit Application
Plan Submittal Requirements
TIGARD Manufactured Dwelling
1. SITE PLAN-Three (3) copies, fully dimensional and drawn to scale,labeled with:
A. ❑ map&tax lot# ❑ subdivision name ❑ subdivision lot# ❑ site address
❑ zoning ❑ applicant name ❑ phone number
Size requirement: 8-1/2"x 11",to a maximum 11"x 17".
All details listed below shall be incorporated into the site plan:
B. North arrow.
C. "Drawn to scale"indicates standard architect or engineer scale.
D. Footprint of structure,including accessory structures,garage,carport and decks shall reflect actual building
dimensions,including retaining walls.
E. Finished floor elevations,all levels.
F. Garage finished floor elevation.
G. Corner lot elevations. If more than 4 feet elevation differential,plan must show contour lines at 2-foot intervals.
H. Location of all cuts and fills on the lot.
I. Driveway corner elevations.
J. Zoning setbacks (front,side and rear).
K. The location of all public and private easements.
L. The location,termination,and all invert elevations of all drainage piping(sanitary and storm) showing all
elevations necessary to show positive gravity flow to the approved drainage device(i.e.peepholes,storm lateral,
sanitary lateral).
M. Residential driveways, sidewalks will be shown on site plans and will be in accordance with the City of Tigard
standards. Driveway cuts shall not be permitted within 30 feet of intersecting right-of-way lines,nor within 6 feet
of property lines. Weep holes/drain pipes will be installed 6 feet from adjoining property lines. Multiple
driveways on individual parcels of land must have 30 feet of separation;joint-use driveways require a formal
agreement.
N. Show all erosion control devices proposed for site. Contact Clean Water Services (CWS) at 503-681-5113 for
assistance.
O. Show location of existing facilities and new or relocated structures (utilities,well/septic systems,mailboxes,
power poles,water meter,light pole, stop sign,etc.).
P. Indicate property slope directions.
Q. Existing and finished contours when slope in any direction exceeds 20% (additional requirements may apply- see
grading policy).
R. Site plan to include tree size,type and location per approved project street tree plan (if applicable),and City of
Tigard Street Tree List.
S. Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,
driplines,and protection measures must be drawn to scale and must include the project arborist's signature of
approval.
2. BUILDING PLANS-Three (3) full sets for illustrating the manufactured dwelling foundation or basement
construction (no redlines or tape-ons accepted).
Size requirement: up to 24"x 36"maximum,folded into eighths (9"x 12")with the plans inside. No rolled,
reversed or mirrored plans will be accepted.
All details listed below shall be incorporated into the building plans:
A. Scale (architectural or engineering only).
B. Cross sections of the manufactured dwelling foundation or basement(every set of plans shall contain a
minimum of two cross sections at mid-point of each direction).
C. Exterior elevation (all views shall be shown).
D. Basement wall,foundation and retaining wall sections.
E. Documentation by manufacturer indicating that manufactured dwelling roof can support over-framing of
garage roof.
F. Driveway construction.
1:\Building\Permits\SFM-PermitApp.doc 10/16/2014
City of Tigard
1111 4 COMMUNITY DEVELOPMENT DEPARTMENT
I Building Permit Review — Residential
TIGARD
Building Permit #: 5 F 1 '1 Zp 7-0 --0000 o2_,
Site Address: 8915 SW Commercial Street
Project Name: Rodriguez Lot #: 4
Planning Review
Proposal: New manufactured dwelling
QVerify address/suite #active in Accela. ❑r In River Terrace: ❑r No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: rosion Control
0: copies of site plan on 8-1/2"x 11"or 11 x 17"paper r\ etained trees with drip line and tree protection measures
Dprawn to scale(standard architect or engineer scale) C .„Footprint of new structure(including decks)and FFE
0 'orth arrow �hility locations&easements (required for new and additions)
D.ite address,project or subdivision name and lot number . sidewalk/driveway approach
0 pplicant information(name and phone number) vocation of wells/septic systems
0 .t dimensions and building setback dimensions `.C'treet tree size,type and location
v, Iliquare footage of buildings to be demolished J street names
II 'fisting structures on site .. omer elevations(2'contours if more than 4'differential
II .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? j es ° o
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es ° 'o
❑o Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑✓ Yes,applicant was notified ❑ No Received: ❑Yes ❑r No
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified ° No Received: ❑Yes ❑° No
SDC Exemption for ADU applied for: Yes 11 No Received: ❑ Yes 11 No
Public Facilities Improvement(PFI) Permit:
Required: El Yes,applicant was notified ❑ No Applied For: ❑Yes ❑ No,stop intake
Land Use Case #: ❑ Zoning: MU CBD
Required Setbacks: Front: Rear: Side: Street Side: Garage:
Building Height: Max. Height: Actual Height:
Landsca.e Area: % Lot Coverage Max:
ntrance - k no more than 8'from street-facing wall Parallel to st -- or offset 45 degrees or less
Windows I Minimum 1 ' , : .rea of all street-facing facades ul
Garage I Gage door is behind wi.- eet-facing wall 1'` i es ❑ No,one of the following is met:
Door extends no more than 5' r. - . .ll an. . -re is a covered porch extending beyond garage.
— Door extends no more than 5'fro o aI an. . ; - is a 12 sq ft.window above garage on 2nd floor.
❑ Gara l e door width is I12' • ess ❑ 50%or less of fac..- I 60%or less and includes 7 of following:
I Covered porch ! Recessed entrance ❑ Wall offset I 1 ' -ave Roof offset
• Fire s '-.. es I Lap Siding ❑ Roof itch 0 Gable,hi ,or gambre .• Dormer
■
P :ccent siding I Window trim U Window recess U Window projection io. e.lcony
Visual Clearance ri Urban Forestry Plan
Sensitive Lands: 0 Yes El No Type:
Conditions met prior to issuance of building permit
otes:Pre-existing use in Downtown. Setbacks will be as required by Building.
CI Approved By Planning: Date: 8/6/20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
I:\Building\Forms\Bld gPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 1/z
Site Plans: #
Building Plans: #�7�_3�
Building Permit#: Cf> nter buildin permit# above. A n
Workflow Routing: 8-Planning ngineering R-i''imit 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
on final plan review routing form.
uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: '''.-)n ai --• Date: /, 2-, ,.. -e)
Engineering Review
Slope at building pad: f�`
Conditions "Met"prior to issuance of building permit "lam'
ements (encroachments) per engineering conditions of approval and plat NA-
-Water Quality/Quantity Facility: /
Assess Water Quality Fee in-lieu: ❑ Yes u No
Assess Water Quantity Fee in-lieu: ❑ Yeso
LIDA Facility on lot:
❑ Yes 1.3 No
la-Final Plat Recorded: 1t(4-
0 NOT Approved by Engineering: Date:
Notes:
I pproved by Engineering: 7 WL,6n Date: Be/zi MPw
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Permit Coordinator Review
yElConditions "Met" prior to issuance of building permit
� Q Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
`'\ SDC Exemption: ❑ Received VU Does not a..
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes y/A
Tigard Trans SDC: ❑ Yes /A
Parks SDC: ❑ Yes /A
LIDA ❑ Yes N/A
K to Issue Permit O t _
Approved by Permit Coordinator: —=z ' ' Date: g/"VZZ
I:16u i Id ing\Forms\BIdgPermitRvwRE S_122419.docx
00O0,—
CleanWater� Services
SENSITIVE AREA PRE-SCREENING SITE ASSESSMENT
Clean Water Services File Number
1. Jurisdiction:Washington County
2. Property Information(example: 15234AB01400) 3. Owner Information
Tax lot ID(s): Name: William Gregg Davidson
Company:
Address: 8915 SW Commercial St unit 4
OR Site Address: 8915 SW Commercial St unit 4 City, State,Zip: Tigard, Oregon, 97223
City, State,Zip: Tigard, Oregon , 97223 Phone/fax:
Nearest cross street: Commercial St Email:
4. Development Activity(check all that apply) 4. Applicant Information
❑ Addition to single family residence(rooms, deck,garage) Name: Mayra Rodriguez
❑ Lot line adjustment 0 Minor land partition
Company:
❑ Residential condominium 0 Commercial condominium Address: 8915 SW Commercial St unit 4
El Residential subdivision 0 Commercial subdivision City,State,Zip: Tigard, Oregon, 97223
❑ Single lot commercial 0 Multi lot commercial Phone/fax: 5039805884
Other Manufacture dwelling Email: Rm7758@gmail.com
6. Will the project involve any off-site work? ❑Yes 0 No 0 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 Mayra Rodriguez Print/type title
Signature ONLINE SUBMITTAL Date 8/7/2020
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 19-5,Section
3.02.1,as amended by Resolution and Order 19-22.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 19-5,Section 3.02.1,as amended by Resolution and Order 19-22.All required permits and
approvals must be obtained and completed under applicable local,state and federal law,
O THIS SERVICE PROVIDER LETTER IS NOT VALID UNLESS CWS APPROVED SITE PLAN(S)ARE ATTACHED.
El 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 LDR Date 8/26/2020
Once complete,email to:SPLReview@cleanwaterservices.org • Fax: (503)681-4439
OR mail to: SPL Review, Clean Water Services,2550 SW Hillsboro Highway, Hillsboro,Oregon 97123
3evse0 2/2020
Main Office • 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • p: 503.681.3600 f:503.681.3603 • cleanwaterservices.org
= _
,f. May-a- Pc6(ti VqZ, aekl
0 ,...,-- 0 t• Q0S'ASPIXCS
"., 30'St.. ki-Nit rm., •b..brat.tr
get IS Su) &Arnett l'cl -.3-I- •1/40 -. La&c
ov- (-1-1u3 -- . e ;I b, Electric
(48) a&-StiZSLI •
t5z) 332- 14°14 (c.„t-i.e ,
- ,
1
Es
i 0 x
.. . ..
i
1 I ) 0 o D
.... ,..,, ,.. , . .
-- ' .10
,
. . ,
,.
4, 1
• , I
F
e
, ' 1
1 1
.....0.**".•"*.H\-:C... ..,.., ...?)
,.,
* i
'..-..,1 1 ...-.
‘1,(\
1
i
1
, I
. ri\014t
, . 1
i) c•‘\, wc..±:1
t
Dianna Ornelas
From: Mayra Rodriguez (MRodriguez7) <rm7758@gmail.com>
Sent: Wednesday, August 26, 2020 3:40 PM
To: #Building Permit Technicians
Subject: Fwd: 8915 SW Commercial
Attachments: Manufactured Home Mayra Rodriguez.pdf
Caution! This message was sent from outside your organization.
Hello,
This is what I received from clean water services regarding the application I had submitted.
g g pp
Please let me know if there is anything else I need to do for the manufacture home.
Thank you,
Mayra Rodriguez
Begin forwarded message:
From:Veronica Mirola <MirolaV@CleanWaterServices.org>
Date: August 26, 2020 at 3:17:54 PM PDT
To: "rm7758@gmail.com" <rm7758@gmail.com>
Subject:8915 SW Commercial
HI Mayra,
Attached is what the city needs to continue their review. The swap of the manufactured home is not
considered development. Please forward the information to the city of Tigard.
Thank you,
Veronica Mirola I Permit Technician II
Clean Water Services I Planning & Development Services
2550 SW Hillsboro Hwy I Hillsboro OR 97123
0 503.681.3655 I f 503.681.4439
engage permits I news I facebook I twitter
Clean Water Services accepts Visa,MasterCard and Discover with a 3%fee.To make payment by phone please call 503-681-5100.
1