Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2021-00055
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/8/2021
Parcel: 2S108AB01400
Jurisdiction: Tigard
Site address: 15345 SW BULL MOUNTAIN RD
Project: Bull Mountain Summit Subdivision: None Lot: None
Project Description: Demo 3,370 sf dwelling on septic system. DEMO CREDITS FOR TRANSPORTATION AND PARKS APPLY
TOWARDS NEW CONSTRUCTION.
Contractor: BRIAN CLOPTON EXCAVATION INC Owner: HILLIARD, TERESA B
P 0 BOX 509 145 KINGSTON DR
WILSONVILLE, OR 97070 GEORGETOWN, KY 40324
PHONE: 503-682-0420 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM T Permit Fee-Additions,Alterations, 03/08/2021 $256.22
ype of Const:
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 03/08/2021 $0.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 03/08/2021 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $12,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $337.42
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: ® Permittee Signature:
03.639.4175 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 Applicatio> E z;A,
Residential CEIVEI rtltl t)I 1 Ill i ,t (1.1 ti
City of Tigard FEB 1 Received `�
6 2021Date/By: Z/Zy/?i'/ 0 Permit Noi3u p/1 n lii UUUcs"
III 13125 SW Hall Blvd.,Tigard,OR 9722, Plan Review 41C
_ Phone: 503.718.2439 Fax: 503.598.1 )/OF TIGARD Date/By: Other Permit:
C I GA RD Inspection Line: 503.639.4175 DUILDING DIVISION Date Ready/By: tuns: See Page 2 for
Internet; www.tigard-or.gov
Notified/Method:-3/Zl'Z/ 4 '�el 1 Supplemental information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction KDemolition 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-anddwellingValuation: $ / 2., 4/V
2-family ❑Commercial/industrial G+e curt)
o Accessory building 0 Multi-family Number of bedrooms: 4.
❑Master builder 0 Other: Number of bathrooms: ./
JOB SITE INFORMATION AND LOCATION Total number of floors: /
Job site address: /5 3 4,46- _5'k) 3 u /1j v 77-J,c, 6,44 New dwelling area: 3.5 7 . square feet
City/State/ZIP: Pe5i 72-All -1) , C R 9 77 ./ Garage/carport area: 3'6 5/ square feet
Suite/bldg./apt,no.: Ai/J$ Project name:JJ i% _1,,'JC,C„tJ�G1-/,L, 61.,:,1.6`f i'1 Covered porch area: N14. square feet
Cross street/directions to job site: Gf) J 3$. Gv c , ,/ square feet
<_:. Deck area: r
Other structure area: /4.,'/A square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: /V //,. Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: / >� C•f� . Indicate the value(rounded to the nearest dollar)of all
c s Jo c'-,0 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
/..) `cs le f=1f t5 i,1-Jt�- 1.--4 2/Y'1=. /-:;ie Valuation: $
(6 t%ti c.) t 5 ro/t,t 0/1/ S 3"7 7C. , �- u.6 r Existing building area: square feet
)G?i i r5 -x. 774 y-CIS e,49—„,[x �Avy �y.L New building area: square feet
,krPROPERTY OWNER ❑ TENANT 4t. ��� ltunber of stories:
Name: kc';fV//fit A hoe-,.._, r J-t-- - /47 1 construction:
Address: <jO30 ,a) ,F; ,tJ e Occupancy groups:
City/State/ZIP: Po f 71-4/u/..) . Cj a c f/7 i C�
� Existing:
Phone:(Se ) /7 / '_3344 Fax:( ) /Jr- _ New:
1 A APPLICANT Ar CONTACT PERSON BUILDING PERMIT FEES*
Business name: /e /�i136 t__ (Please reperto fee schedule)
Contact name: Structural plan review fee(or deposit):
" i FLS plan review fee(if applicable):
Address:
2):3O S �c S7 Atli. —
City/State/ZIP: r'n ;7,, , ` 9 7 /9 Total fees due upon application:
Phone:(^ ) 7 / Fax::( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: 9 c 0 p u� L '9, /`?it- .,71•
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaie Solar Panel System.
Business name: 6�i'`_ _) /v f t . ��v4.,f(�� Submit two(2)sets of roof plan with connection details
K�'� 6 and fire department access,along with the 2010 Oregon
Address:
CI. ajjC -Ski) Solar Installation Specialty Code checklist.
City/State/ZIP: /q�f Jd �t Q Permit Fee(includes plan review
6 t ` �17i and administrative fees): $180.00
Phone:O ) to p- ��1 Fax:
/ ( ) State surcharge(12%of permit fee): $21.60
CC$lie.: 56 337 �j,'/r' Total fee due upon application: $201.60
Authorized signatur� `'" This permit application expires if a permit is not obtained
ii f.9.7 within 180 days after it has been accepted as complete.
Print name: *Fee methodology set by Tri-County Building Industry
y`c}lJ�� F„�ti Date: f l/�� gi Service Board.
I:1Building'Petmits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) 33
City of Tigard
114 r COMMUNITY DEVELOPMENT DEPARTMENT
a
TIGARD Building Permit Review — Residential
Building Permit #: x.-3u '2-0 g,/ -0005".5
Site Address: / 5-- c2 &// ikwg,402_ tck_
Project Name: I��� �,fyl� 1 yy�,+-_ Lot #:
Plan ng Review
Pr osal: l 'm v . -eit73 _ s.-e_
Verify address/suite#active in Accela. n River Terr e: L/I No ❑ Yes, River Terrace Review Addendum
Sit Plan Elements: LT Er.sion Control
copies of site plan on 8-1/2"x 11"or 11 x 17"paper 1V etained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) 1 ootprint of new structure(including decks)and FFE
IV orth arrow I tility locations&easements(required for new and additions)
0 ' e address,project or subdivision name and lot number ❑Sidewalk/driveway approach
�gA,ilicant information(name and phone number) ‘1,, WlLocation of wells/septic systems
1.14.t dimensions and building setback dimensions Q treet tree size,type and location
'I uare footage of buildings to be demolished �JStre names
6CJE ting structures on site rner elevations(2'contours if more than 4'differential)
of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EYes 1L1i No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
.jVI
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes ❑ No
giSDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes Cl No
Public Facilifyis Improvement(PFI) Permit:
R ed: ,� Yes,applicant was notified CINoplied For: ,p Yes ❑ No,stop intake
Land Use Case#: 'Gl2�:2�D 0UL�._ E Zoning: /C---9—'
hi 'equired Setbacks: Front: Rear: Side: Street Side: Gara.e•
❑ Buil.il : eight: Max. Height: Actual Height:
❑ Landscape Ar-. % ❑ Lot Coverage Max:
Entrance ❑ Set back no -•.re than 8'from street-facing wall ❑ Parallel to -et or offset 45 degrees or less
Windows ❑ Minimum 12%of a • of all street-facing facades
io
Garage ❑ Garage door is behind wide . eet-facing wall 2 Yes ❑ No,one of the following is met:
❑ Door extends no more than • wall an. •re is a covered porch extending beyond garage.
❑ Door extends no more than 5'from .0 • d there is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'o • s ❑ 50%or - of facade Cl 60%or less and includes 7 of following:
❑ Covered porch • 'ecessed entrance ❑ Wall o z ❑ 1'Roof eave ❑ Roof offset
❑ Fire shin•1- ❑ Lap Siding ❑ Roof pitch ❑ Ga. , .'.,or gambrel roof ❑ Dormer
❑ Ac • siding ❑ Window trim ❑ Window recess ❑ 'c•' ..w projection ❑ Balcony
❑ Visual Clea - e ❑ Urban Forestry Plan
❑ Se •: e Lands: ❑ Yes ❑ No Type:
Conditions t prior to is anc�/ f bull permit
;Xi' /��',r /b✓ ';/� g ) Dy7Approved B Planning: Date: e2
PP Y g f%��
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved Cl Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPenmitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 4//6/L/
Site Plans: # 2-
Building Plans: #
Building Permit#: "Enter building permit#above.
Workflow Routing: _Planning Engineering —ermit Coordinator 8-'$uilding
Workflow Sign-off: cam- 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.
'Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: 40a;S.n",e..�C.et--+- Date: 2/z_,5/-/
Engineering Review
Er—Slope at building pad: 2%
Er-Conditions"Met"prior to issuance of building permit Gr/'-
2/Easements Easements (encroachments) per engineering conditions of approval and plat H/4'
2"-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Ct'No
Assess Water Quantity Fee in-lieu: ❑ Yes lI 'No
LIDA Facility on lot: ❑ Yes CNo
Er Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: rew,ftr ,e,, Date: ;31r/ZUZ'
Revisions (after Building Submittal only) / Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El 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 YtDoes not apply
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: El Yes N/A
LIDA ❑ Yes K. N/A
,g: OK to Issue Permit
Permit Coordinator: Date: 3 Z �Z
Approved by � (
I:\Building\Forms\BldgPennitRvw_RES_122419.docx