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Permit
CITY OF TIGARD MASTER PERMIT 2. COMMUNITY DEVELOPMENT Permit#: MST2020-00341 Date Issued: 02/11/2021 1 GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103BC01700 Jurisdiction: Tigard Site address: 12905 SW 121ST AVE Subdivision: CANOGA PARK Lot: 1 Project: Armas Project Description: Replace roof trusses and wall studs due to fire damage. BUILDING Floor Areas Required Setbacks Reauired Stories: 0 Bedrooms: 0 First: 0 at Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Ri ht: 0 Detectors: Dwelling Units: 0 Third: 0 sf 9 Total: 0 sf Value: $5,500.00 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 0 Storm Sewer: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Tubs/Showers: 0 Garbage Disp: 0 Bckfiw 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 SrvclFeeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea addi 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 Ecompasing: N Other: N Other Description: BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: ARMAS,JANET OWNER Required Items and Reports(Conditions) 22383 SW LEE DR SHERWOOD,OR 97140 PHONE: PHONE: FAX: Total Fees: $295.48 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: .---- --------- Permittee Signature: . 39.4175 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 Applicatio S- 12 17 20 Firpg-P-rote4tieff-System -Ai-.iNED FOR OFFICE USE ONLY Received permit No.: T City of Tigard DEC 1 2020 \2123 2cr[o �J Ms 2o'zo-oo34\ 14 Da[eBy: • 13125 SW Hall Blvd.,Tigard,OR 97 6 It�-V A_ Date By:iew n,� Other Permit: Phone: 503.718.2439 Fax: 503.598 60 t ��F T�GY t i I It) Inspection Line: 503.639.4175 BUII DING DIVISION DateReady/By: / Ea See Page 2for T I(i n IL U Internet: www.tigard-or.gov Notified/Method: 1 ?.t 1161 Supplemental Information TYPE OF WORK ltr/j/ 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 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. �j co CAI�,1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 5��J Numberofbedrooms: ❑Accessory building 0 Multi-family ❑Master builder 0 Other: Number of bathrooms: /� JOB SITE INFORMATION AND LOCATION Total number of floors: 1 ` Job site address: ' 2„-! 0 S C la (a ` ' -Y A/h V e- New dwelling area: square feet City/State/ZIP: 4, t 0,Ck Cry a _ Garage/carport area: square feet Suite/bldg./apt.no.: •-} Project name: \ _ Co CAA �. A/ ,5 Covered porch area: square feet Cross street/directions to job site: S t.J F \eC}q .c --' Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST V. Subdivision: I Lot no.: 1 0 0 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 DESCRIPTION OF WORK work indicated on this application. s+aKe 0(kk A Yee-etc c e N(2ooc= ws5e 0In Valuat ;p 1 er o $ V t S eck n OP O u5t'; (t D C�GZ f t�1, ,P�TY 5. s. Existing 'Aiding area: p C� U square feet ` YY\a`t 'P if...e-vc.t�i,,sf.Ge, Sd 'e- 10kAs ve(1/ tottli s (Titc. f New building are square feet 1�1-PROPERTY OWNER 0 TENANT Number of stories: Name: Hi a G,r w\c,5' yt va rc[6 t-, �1 Type of construe' n: \ Address: 1 a-( ©5 s 1 2.. I ci- Ave. Occupancy ups: City/State/ZIP: ; 0. ,, Q 7 �] 7 Existi : (97 Phone: 1) Cl'i ej -7 l C 05 Fax:( ) New: i' 0 APPLICANT 0 CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: apply: 114 Phone:( ) FFaax::( ) E-mail: t-r tAari('\r-on c(-1d 4J all • Can - CONTRACTOR BUILDING PERMIT FEES* / (Please refer to fee schedule) Business name: 1 1 rA f. a c_ 1,,,\G S 0 el INkC�4r I /1 cR Permit fee: Address: -P,e 5 ice' b ov- State surcharge(12%of permit fee): City/State/ZIP: FLS plan review(40%of permit fee): Phone:( ) Fax:( ) (Due upon application submittal.) CCB lie.: Total permit fees: Ad rAmount received: Authorized signature: - This permit application expires if a permit is not obtained / within 180 days after it has been accepted as complete. Print name: ka t O G (.' ,�-pugs S Date: l 2 i 2 /g0 * Fee methodology set by Tri-County Building Industry Service Board. I:33uildinB�Permits1FPS.PermitApp 031016.doc 4404613T(11/02/COM/WEB) I City of Tigard: Fire Protection Permit Checklist Page 2% Supplemental Information D. cribe work to be done: 1.) ,.e of Work: • 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm device ❑ Ne ystem Number of sprinkler heads: Number of alarm devices: ❑ Additio .r LI 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit requir- : and Alteration (3) copies of sketch showing area (3) copies of sketch sho -g area to existing of work within building structure of work within building s. cture system ❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan re ,ew required and (3) sets of plans. (3) sets of plans. Additional description of work: Type of System (Complete A, : C or D as applicable): A.) Commercial Sprinkler Sprin S er Type ❑ Wet • Dry Additional Standpi.-s Information: Sprinkler .ply Line ❑ Y•s ❑ No Hazard Gro . Density Design Area K. Factor S r•'nkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Cale ations E Yes include: Individual omponent ❑ Yes Cut Sh- is Fire Alarm Proje.t Valuation: $ D.) Residential Sprinkler(Stan. Alone System) Square Footage: Permit Fee: 0 to 2,000 $198.75 2,001 to 3,600 $246.45 3,601 to 7,200 $310.05 7,201 and greater $404.39 Sprinkler Project Square Footage: sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A,B &C above): $ Permit fee based on project valuation (see fee schedule): $ Permit fee based on square footage (see D above): $ State Surcharge (12% of permit fee): $ FLS Plan Review(40% of permit fee): $ TOTAL: $ 1:\Building\Permits\FPS_PernvtApp_031016.doc 2 1 A I211- /20 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT • T 1 G A R D Building Permit Review — Residential Building Permit #: ► csvioZ.-Oa 341 Site Address: 12905 SW 121st Ave Project Name: Armes Lot #: Planning Review Proposal: Replace roof and wall sections due to fire! /719 721) illy?* Or- . c ZI Verify address/suite#active in Accela. A In River Terrace: ® No ❑ es, River Terrace Review Addendum • n Elements: Erosion Control ❑3 copies of si E p on 8-1/2"x 11" or 11 x 17"paper ❑Retained trees with drip line a e protection measures ❑Drawn to scale (standard arc or engineer scale) Footprint of new e(including decks)and FFE ❑North arrow ❑Utili ' ons&easements(required for new and additions) ❑Site address,project or subdivision name and lot number idewalk/driveway approach ❑Applicant information(name and phone numbe ❑Loc • f wells/septic systems ❑Lot dimensions and building setbac nsions ID Street tree.size,typ ocation ESquare footage of build e demolished ❑Street names ❑Existing s son site ❑Corner elevations (2'contours if more than 4 tial) ❑ tea,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑ 7No impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? DYes ENo ® Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: ❑ Yes,applicant was notified IX No Received: ❑ Yes El No ® Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs Required: ❑ Yes,applicant was notified l] No Received: ❑ Yes ❑ No ® SDC Exemption for ADU applied for: ❑ Yes X No Received: ❑ Yes ❑ No ® Public Facilities Improvement (PF'I) Permit Required: ❑ Yes,applicant was notified x] No Applied For: ❑ Yes ❑ No,stop intake FS7 Land Use Case#: N/A ® Zoning: R-4.5 ✓ 'Required Setbacks: Front: 20 Rear: 15 Side: 5 Street Side: 15 Garage: n/a V Building Height Max.Height: 30 Actual Height: ® Landscape Area: % ❑ Lot Coverage Max: El Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 de a--- Windows r - . 12%of area of all street-facing facades Garage ❑ Garage doo - • •dest street-facing wall ❑ Ye •.,one of the following is met: ❑ Door extends no mo•- ' om wall and t•- - . ered porch extending beyond garage. ❑ Door extends no more than 5'f •• .ere is a 12 sq ft.window above garage on 2°d floor. ❑ Garage door width is ■ • ess ❑ 50%or less . - ❑ 60%or less and includes 7 of following: ❑ C• _. ❑ Recessed entrance ❑ Wall offset IN - -•ve ❑ Roof offset ire shingles ❑ Lap Siding ❑ Roof pitch El Gable,hip,or gam. - El Dormer ❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection • Q Visual Clearance n/® Urban Forestry Plan ® Sensitive Lands: ❑ Yes TE No Type: nal Conditions met prior to issuance of building permit Not : Approved By Planning: Date: .2 9" �-) Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved I:1Bui(ding\Forms\BldgPermitRvw_RES_122419.docx Building Permit Submittal Original Submittal Date: \2\ 11 \2OL 0 Site Plans: # -Z Building Plans: # 3 Building Permit #: [ ' Enter building permit#above. Workflow Routing: fa Planning Nr Engineering [ ' Permit.Coordinator a Building Workflow Sign-off: la' Sign-off for Planning(include notes from planning review) Route Application Documents: 7 Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. I' Building. original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: \--\-ct UCt r\Oel}3tV- Date: VA ZSI 7,6Z6 Engineering Review ® Slope at building pad: ;T onditions "Met"prior to issuance of building permit�asements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: E Yes D'No Assess Water Quantity Fee in-lieu: ❑ Yes ,�No LIDA Facility on lot: ❑ Yes Ld'No f a Final Plat Recorded: ❑ NOT Approved by Engineering: Date: Notes: 2 Approved by Engineering: 12k,v (5..i4.4,z Date: _/Z•ZA Zozo Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Permit Coordinator Review 'SConditions "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: 91 SDC Exemption: ❑ Received ,EL Does not apply KSDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 4 N/A Tigard Trans SDC: ❑ Yes , N/A l Parks SDC: ❑ Yes Ps�l N/A LIDA ❑ Yes Al.-N/A ig- OK to Issue Permit Approved by Permit Coordinator: Arri-n Date: 1 Z 129 12,020 I:\Building\Forms\BldgPermitRvw_RES_122419.docx Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. 0hi /el YYlC f' #71 Print Name of Permit Applicant \ �� 1 772 Signature of Permit Applicant Date Permit#: MST .ozo-0o3y1 s s`A \2 A•1 Address: \Z-q0 \ ►' S r M1i �a oQ a'1 ZS3 Issued by: r. -" Date: 411 /? _ ti=1V This Copy for Permit Offices Lina Smith From: Agnes Lindor Sent: Thursday, December 17, 2020 11:48 AM To: madorinronald Cc: Lina Smith Subject: RE: 12905 SW 121st Ave Great,thanks! Agnes Lindor I Associate Planner City of Tigard ( Community Development 13125 SW Hall Boulevard Tigard, Oregon 97223 Phone: 503.718.2429 Email: Agnest@tigard-or.gov From: madorinronald <madorinronald@gmail.com> Sent:Thursday, December 17, 2020 11:46 AM To: Agnes Lindor<agnesl@tigard-or.gov> Subject: Re: 12905 SW 121st Ave Caution!This message was sent from outside your organization. Allow sender I Block sender Yes the height will stay the same and we are just replacing some wall studs not walls so everything will look the same as it does on the print Sent from my T-Mobile 4G LTE Device Original message From: Agnes Lindor<agnesl@tigard-or.gov> Date: 12/17/20 10:11 AM (GMT-08:00) To: madorinronald@gmail.com Cc: Lina Smith <LinaCS@tigard-or.gov>, #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: 12905 SW 121st Ave Hi Ronald- I am look at your permit that you submitted and I have a couple of questions. Is the height of the roof going to be the same as it currently is?What is the height? Also, I see you are replacing some walls, looks like they are going in the same footprint (no expansion), correct?Are you modifying windows? Or it is going to exactly the way it is now,just replacing the walls? 1 Thanks, AgneoLimclmr | Associate Planner City ofTigard Community Development 1]12SSVV Hall Boulevard Tigard, Oregon 97ZZ3 Phnne: 50].718.Z429 Emai|: 4gncsL(a)hgard'or.gov DISCLAIIMER� E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-rnail may be disclosed to another party un|ess exeript from disclosure under Oregon Public Records Law. E-mails are retained by the City cf Tigard in compliance with the Oregon Administrative Rules "City General Records Retenfion Schedule."