Permit CITY OF TIGARD MASTER PERMIT
IIa. ' COMMUNITY DEVELOPMENT Permit#: MST2021-00200
TT G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/26/2021
Parcel: 1 S 125DA11900
Jurisdiction: Tigard
Site address: 6570 SW ALFRED ST
Subdivision: 1997-078 PARTITION PLAT Lot: 3
Project: Black
Project Description: Repair of house, roof, walls,floor and sheathing cause by fallen tree.
BUILDING •
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $170,000.00 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 Storm Sewer: 0
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel TVDBS 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
Furna=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 add'I 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 VS R-3 0
Owner: Contractor:
BLACK,JESSE W&KAREN K BRIGHT CONSTRUCTION LLC Required Items and Reports(Conditions)
6570 SW ALFRED ST 1248 SPRUCE ST
TIGARD,OR 97223 LAKE OSWEGO,OR 97034
PHONE: PHONE: 971-678-6618
FAX:
Total Fees: $2,836.89
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 it 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: ftolIN Vain/De,We4ye Permittee Signature: O n'Appli.c 7.t-O vt
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 =-S/IS 2,1
Residential RECEIVE ' rOR OFFICE USE ONLY
City of Tigard RECEIVE .' Received Dr-/ - / ;4r, Permit No.:MS12021^002O0
• 13125 SW Hall Blvd.,Tigard,OR 97223 ll' Plan Review 5 r111
11111 C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �( AA Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / a��s. H See Page 2 for
I I C'A R U Internet: www.ti and-or. ov r, otiSed/Method: �d er Supplemental Information
g g nl ii! niNIr_, f�lt/I:,It?N%�G J of
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
Permit fees*are based on the value of the work performed.
❑New construction ❑Demolition
Indicate the value(rounded to the nearest dollar)of all
IN Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ I710,COO
(g) 1-and 2-family dwelling ❑Commercial/industrial
Number of bedrooms:
0 Accessory building ❑Multi-family
/ ❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
lc/ Job site address: l j 1 r-; Skis) Bl-Fi7 - Sr New dwelling area: 0 square feet
City/State/ZIP: -r „q- c , O1Z.. 0 -c3 3 _ Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: Pee Oft,Ae I Pt1Le.S Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: 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.
Valuation: S
lr- NI)V X, r-CAI-t C/0e:n(5 3 --1x-`�C .-C1
shcati t tin CDIr, Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name: 5e,SSe 13tbCIL Type of construction:
Address: (4)G5e p SVJJ F -vCA 54 Occupancy groups:
City/State/ZIP:--'go colt be. alb 22.3 Existing:
Phone:(CA1.1 ) LOA.-Gj — 03°) Fax:( ) New:
® APPLICANT ffiI CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: M11er-- Cpy--) kilh lin 50C)111etsrS
Structural plan review fee(or deposit):
Contact name: G1D1p 1 tt.„.V\\O
FLS plan review fee(if applicable):
Address: O Q) SW Oar.. Sk , SO\'Ite. i OI3
Total fees due upon application:
City/State/ZIP:T(ov-4 iaY)d O' 01121-3
/ Z Amount received:
Phone:(e303 24- - t 2, Q Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: &AO')Cr,Wlti\e,'r —Se- •C.C>!Y1
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: �6csic t Um,C t-13 C.h 01 r1 Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 113 Cam. )S? . Solar Installation Specialty Code checklist.
City/State/ZIP: p(Z ?G) Permit Fee(includes plan review $180.00
I,f�[� GP�J�IE r and administrative fees):
Phone:(o .1) LQ-4.5- tok 1 a Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: a'3'1 O1 1% Total fee due upon application: $201.60
Authorized signature:C1 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
` Date: s, / *Fee methodology set by Tri-County Building Industry
Print name:
Gait L7t W,ll] �[I2. 2.. Service Board.
1:ABuilding\PermitsVBUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
. Date/By: No.:
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
TIGARD 24-Flour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes 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
3 Verification of approved plat/lot. ❑ ❑
4 Fire district approval required. Name of district: • ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . 0 ❑ gl
6 Sewer permit. ❑ ❑
7 Water district approval. ❑ El 1E
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0
9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 i 7
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® CI
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.
II Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if m ❑ 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 ® 0 0
and location. ,
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 1,3 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- .J ❑ 0
floor,wall construction,roof construction. More than one cross section maybe required to clearly portray
construction. Show details of all wall and roof sheathing,roofmg,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. 14 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- Di 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 21 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 4 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 ®. ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. El ❑ 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ 0 a
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 14 ❑ ❑
architect licensed in Ore•on and shall be shown to be applicable to the .ro ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 1 I above. Site plans must be 8-1/2"x 11"or 11"x 17". ® ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® ID ❑
25 Building plans shall not contain red lines or tape-ors. "Mirrored"building plans will not be accepted. 1 ❑ ❑
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. atl ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 E
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 K
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, ❑ 0 121
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.
I:1Building\Permits\BUP-RESPetmitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
III11 COMMUNITY DEVELOPMENT DEPARTMENT
e Building Permit Review — Residential
TIGARD .,
. Building Permit#: VST202I- 00200.
Site Address: 6570 SW Alfred St
Project Name:
Black Lot #:
Pl nning Review
P oposal: Repair house from fallen tree damage; no change to ootprint or setbacks; repair like-for-like
Verify address/suite#active in Accela. iN° n River Terrace: No ❑ Yes, River Terrace Review Addendum
Si Plan Elements: ,erosion Control
opies of site plan on 8-1/2"x 11"or 11 x 17"paper _etained trees with drip line and tree protection measures
awn to scale(standard architect or engineer scale) and FFE
rth arrow tility locations&easements(required for new and additions)ocation of wells/septic systems
�txeet tree size,type and location
t address,project or subdivision name and lot number sidewalk/driveway approach
pplicant information(name and phone number)
dimensions and building setback'dimensions
uare footage of buildings to be demolished street names
ootprint of new structure(including decks)
xi g structures on site Thmer elevations (2'contours if more than 4'differenti
t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 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
II Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Requited: 0 Yes,applicant was notified ❑No
Received: ❑Yes ❑No
II Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
•Required: ❑Yes,applicant was notified 0 No
Received: ❑Yes 0 No
i r ❑Yes ❑l;lo Received: ❑Yes ❑ No
�1II SDC Exemption for ADU applied for:
II Public Facilities Improvement(PFI)Permit: Applied For: ❑ Yes ❑ No,stop intake
Required: 0 Yes,applicant was notified 0 No
II and Use Case#: 0 Zoning:
No change Rear: No change.. Side: No change Street Side: N/A Garage: No change
equired Setbacks: Front: g NO change
Building Height: Max. Height: 30 dual Hei ht:
11 .. dscape Area:
❑ Lot Coverage ,x:
Entrance Set back no more than 8'from street-facing wall
. allel to street or offset 45 degrees or less
Windows M 12%of area of all street-facing facades ,• 0 Yes ❑ No,one of the following is met:
Garage Gara e door • hind widest street-facing wall
gDoor extends no -.re than 5' from At and there is a covered porch extending beyond garage.
❑u Door extends no more 'ti ' .om wall and there is a 12 sq ft.window above garage on 2°d floor-
❑ Gara e door width is p or less ' 50%or less of facade 60%or less and includes 7 of following:
Covered port II Recessed entrance
A
1 Wall offset I]
1'Roof cave Roof offset
_ Fire s •• es I Lap Siding ❑Roof itc Gable,hi ,or gambrel roof Dormer
111 Window trim Window rece Window projection ❑Balcony
cent siding �'
❑ Visual Cl rice ❑ Urban Forestry Plan
❑ Se.: . Lands: 0 Yes ❑ No `l'ype:
C Co itions met prior to issuance of building permit
No s• Z
Approved By Planning:
Date:
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ____--
0Not Approved
I:\Building\Forms\BldgPermitRvw_RES_l224I9.docx
Building Permit Submittal
Original Submittal Date: 0� C2/
Site Plans: # /�
Building Plans: #
Building Permit#: Lt -Enter buildingermit#above.
Workflow Routing: Planning Engineering Permit Coordinator Et—ding
ErSign-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.
Liz Building: original permit application, site plans,building plans,engineer and
beam calculations and tru details,if applicable,etc.
Notes:
By Permit Technician: d� /6 �Z
Date:
Engineering Review
[1iope at building pad: 4,
aonditions "Met"prior to issuance of building permit Hilt_
R�yEasements (encroachments)per engineering conditions of approval and plat VS(a.
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes [� No
Er
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: 0 Yes a-No
�alinal Plat Recorded: /1/44-
❑ NOT Approved by Engineering: Date:
Notes:
[Approved by Engineering: r„`,
ehZkatJ Date: s-pikazi
Revisions (after Building Submittal only) Reviewer
Revision 1: ❑ Approved ❑ Not Approved Date
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
44-Conditions "Met"prior to issuance of building permit _
0 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 a ly
SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes N/A
Er OK to Issue Permit
Approved by Permit Coordinator:
Date: S`(,gCerli
I.1Bu i Id ingTorms1Bl dgPermitRvw_RE S_I224I9.docx