Permit 71 _ CITY OF TIGARD MASTER PERMIT
NF ' COMMUNITY DEVELOPMENT Permit. MST2020-00276
1-I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/07/2020
Parcel: 2S108DB02700
Jurisdiction: Tigard
Site address: 15312 SW SEINE DR
Subdivision: POLYGON AT BULL MOUNTAIN Lot: 25
Project: Rommel
Project Description: Replace existing deck with larger 476 sf deck
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: Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $10,733.80 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
Fum<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:
ROMMEL,SCOTT R&(LIANA STANLEY DEWAYNE MOORE Required Items and Reports(Conditions)
15312 SW SEINE DR 6107 SW MURRAY BLVD#263
TIGARD,OR 97224 BEAVERTON,OR 97008
PHONE: PHONE: 503-522-0047
FAX:
Total Fees: $572.63
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 1.8' _2.
00332.2334`4.
Issued By: \\Ut ni Wt,e- n -Permittee Signature: C apptt Ste'
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 to i/2D - $
Residential RECEIVE;! FOR OFFICE i. til. O\l.\
Received ,/ /ss e1'J�I-ity57'�6,
- City W Tigard Da"y `Q aT '2o �� PermitNo.: !1!!V GVL{
• 13125 SW Hall Blvd.,Tigard,OR 97223 0 C T O l 2020 plan Review b I A ^
Phone: 503.718.2439 Fax: 503.598.1960 Date/By; 74„w s Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: 1 lurix. ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: /) Cl/'W, 40() 61 Supplemental Information
ET'19/L f }/V/
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
[l Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the rofit for the
CATEGORY OF CONSTRUCTION work indicated on this application. I ill
F gal-and 2-family dwelling 0 Commercial/industrial Valuation: $ LO-P, a p
Number of bedrooms:
ElAccessory building ❑Multi-family
❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 5 3 (Z SJ ,S,Q,l n2i New dwelling area: square feet
City/State/ZIP: - t y,,r,hl (R 4")1'L+j Garage/carport area: square feet
Suite/bldg./apt.no.: a Project name: g u m rn e..4 cle4X- ,Q,.knt,rn Covered porch area: square feet
Cross street/directions to job site: I cop!,- Deck area: in 7(° square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.
r r Valuation: $
R / ,^�� �>t< 6 u3 i Existing building area: square feet
1 rr 61 New building area: square feet
l PROPERTY OWNER 0 TENANT Number of stories:
5
Name: 1-:1- t rvmt'1q Type of construction:
Address: 14j 2 12 5,1,3 S.LI-IJt. pr. Occupancy groups:
City/State/ZIP: I t G `0 2- q-,22,') Existing:
Phone:(51,-3 ) 3 g -2*:i' `y Fax:( --)-- New:
0 APPLICANT V CONTACT PERSON BUILDING PERMIT FEES*
Business name: yyl e t) i- CJ.7�kklti I70 7 (Please refer to fee schedule)
�)�F Structural plan review fee(or deposit): /9( r2o
Sr
Contact name: , Alp u,a..
FLS plan review fee(if applicable):
Address: (el n•7 Sy y ry)UY 7�ci- S,
City/State/ZIP: Ti.4av-t,()-vh Oet— 9';0) Total fees due upon application:
Phone:O.3 ) 52 .-Oo� Fax::( i Amount received:
E-mail: 5J rrl �a Iry opu Ci l C)CS,c per. PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: tl � } (�,S.}�L.c}1 Or") and
two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: I. I01 St) PVWfv-c-) gistI 2L3 Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
e and administrative fees):
Phone:(503 ) 522- CO y Fax:( )
7 State surcharge(12%of permit fee): $21.60
CCB lic.: I05S 2g Total fee due upon application: $201.60
Authorized signature: This permit application expires If a permit is not obtained
,,/A. within 180 days after it has been accepted as complete.
Print name: Si h ry l by f(� Date: 9-�ff p *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) S 3 3 . a 7
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
TIGARD
24-Hour Inspection Line: 503.639.4175 El Electrical 0 Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 ❑ _
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 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 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 0 0
9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 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 ❑ ❑ ❑
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 ❑ ❑
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 ID ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 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
architect licensed in Ore•on and shall be shown to be a..licable to the •ro'ect under review.
JURISDICTIONAL, SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 ❑ 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, El El ❑
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
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.
L:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
City of Tigard
IIC COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: PI ST2 32O-d027
Site Address: i5 312 SW Sell- Dr.
Project Name: Rom mci Lot #:
Planning Review
Proposal: de(._
l Verify address/suite#active in Accela. a In River Terrace: ❑ No Nr Yes, r River Terrace Review Addenrju
net- ilM'e4 —ere' "i
Site Plan Elements: Yosion Control n
copies of site plan on 8-1/2"x 11"or 11 x 17"paper 3r etained trees with drip line and tree protection measures
rawn to scale(standard architect or engineer scale) ootprint of new structure(including decks) and FFE
orth arrow
tility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number,&.
(1ridewalk/driveway approach
Applicant information (name and phone number) ocation of wells/septic systems
'A Lot dimensions and building setback dimensions treet tree size,type and location
Z'.•uare footage of buildings to be demolished gStreet names
Existing structures on site omer elevations(2'contours if more than 4'ti‘iXot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes X.No
'impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? 1141".No
VClean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ No
Sc Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ No
,.*" SDC Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No
la-Public Facilities Improvement (PH) Permit:
Required: ❑ Yes,applicant was notified XI No Applied For:n❑ Yes ❑ No,stop intake
and Use Case#: Zoning: 1� �•�
Required Setbacks: Front: N`A. Rear: IS Side: Street Side: NSA— Garage: NbA
Building Height: Max. Height: 30 Actual Height: -t kg
1cLandscape Area: % ' Lot Coverage Max:
Entrance 10 Set .ack o more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less '
Windows 11 lin u 12% . area of all street-facing facades
Garage 11 0,ar ge oor i b,hind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
M oor e en.s no more than 5'from wall and there is a covered porch extending beyond garage.
t oor e' end .a more than 5'from wall and there is a 12 sq ft.window above garage on 2°d floor.
❑ Garag door '.a ❑ 12'or less ❑ 50%or less of facade LI 60%or less and includes 7 of following.
❑ overe pore ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ ire s ',gles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
Visual Clearance lik Urban Forestry Plan
X Sensitive Lands: ❑ Yes No Type:
'Conditions met prior to issuance of building permit
Notes: pp � //��
Z Approved By Planning: i l�SYWJc1C 11.-� Date: (0 2V
Revisions (after Building Submittal— only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: /VA//.2OZo
Site Plans: # 3
Building Plans: # 3
Building Permit#: []- Enter building permit#above.
Workflow Routing: L Planning EEngineering cD-Permit Coordinator L9'Building
Workflow Sign-off: [irSign-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.
ig-"Building: original permit application, site plans,building plans,engineer and
beam calculations and, details,if applicable,etc.
Notes:
By Permit Technician: %J/417 Date: �O 07
Engineering Review
❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes ❑ No ��
Assess Water Quantity Fee in-lieu: 0 Yes ❑ No
LIDA Facility on lot: 0 Yes 0 No `,
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
1114roved by Engineering: Date: /d 4/ .24:::7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 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:
SDC Exemption: ❑ Received Does not apply
'SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes 0 N/A
Tigard Trans SDC: ❑ Yes 'eq N/A
Parks SDC: ❑ Yes 1l N/A
LIDA 0 Yes 2 N/A
OK to Issue Permit
Approved by Permit Coordinator: Qe4-- Date: t° 1151 2-0
1:\Building\Forms\BldgPermitRvw_RES_122419.docx