Permit 1111 CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2021-00189
T 1 G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/06/2021
Parcel: 2S111DC05700
Jurisdiction: Tigard
Site address: 9425 SW BRENTWOOD PL
Subdivision: SUMMERFIELD NO.9 Lot: 537
Project: Ribacchi
Project Description: Adding a 36 sq ft addition to dinning room.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 36 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 23 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 - Third: 0 sf Right: 0 Detectors:
Total: 36 sf Value: $4,408.56 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
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 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
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=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:
ADD SF VB R-3 36
Owner: Contractor:
RIBACCHI FAMILY TRUST TL REMODEL AND CONSTRUCTION INC Required Items and Reports(Conditions)
BY RIBACCHI,RICHARD A& PO BOX 1996
RIBACCHI,MARY B TRS LAKE OSWEGO,OR 97035
36335 S BOULDER ORES
TUCSON,AZ 85739
PHONE: PHONE: 503-984-2783
FAX:
Total Fees: $448.76
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 y u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 1-009 You obtain a co of the rules or direct questions to OUNC by calling 503.23
1987 or 1.800.332.2344. •
Permittee Signature: Y .//d/ GC
Issued By: 9 �/
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.
r
Building Permit Applicat ,ECEIVED 6-544212t
Residential MAY 1 2 2021 FOR OFFICE USE ONLY
City of Tigard Received ��!3 /�a2 J ms rio21 ./ IS,
TY OF TIGARD Date/By: !/� /� Permit Nc. L1l U
Ili ') 13125 SW Hall Blvd.,Tigard,OR 97_ Review
a : Phone: 503.718.2439 Fax: 503. DING DIVISION P
Dlanate/By: QIZ(i_ A 4 Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: /� f hirls Et See Page 2for
Internet: www.tigard-or.gov .ied/Method: �IG i1 Supplemental Information
i
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
51 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: (� /� 7 63 r
❑ Accessory building El Multi-familyNumber of bedrooms:
0 Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7(/Zr B•r e,„ I r-.J' p lq..C.152- New dwelling area: 'atsquare feet
City/State/ZIP: ra1 rY�- �"7QS-ZL Garage/carport area: square feet
Suite/b1dg./apt.no.: Project name: 7::,rr,,,,,iL.,3, 4 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERC L-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.
Aof dr"n 5 (,- 3 b SY1*-{ e e ) Y't Ki Valuation: $
D��
�0 Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: �.(el.tmvet (2..( ,t:-c-�; Type of construction:
Address: ' Y2 '- ,tre r tliwo to.ce Occupancy groups:
City/State/ZIP: J� c t' 'Q_O 4i"�ZZti Existing:
Phone:(f63 )%$°(1rZJ O#') Fax:( )
New:
0 APPLICANT cy CONTACT PERSON BUILDING PERMIT FEES*
Business name: 7-R... Q tt �r�t2l 1 !xc.4 (Please refer to fee schedule)
d- C_(9t ts'}r I't Structural plan review fee(or deposit):
Contact name: CAA.le-i1 1._2
FLS plan review fee(if applicable):
Address: 2S Y3o ,11.0 kr IWad 4tie Sig qv l I4
J/JD»(!t�1 tJ Total fees due upon application:
City/State/ZIP:
p Q70 Amount received:
Phone:(SIDS )70$- 7fp( i Fax: :( )
(,r7f/r.!"��7��L�12z0�'p] co PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name: t(r Ql o t r Go 1-y 4)'dam
D \ and fire department access,along with the 2010 Oregon
Address: 25•"p� SC.r_J y�sy,�t0<t/,7 ty, O,Q ,j /4ll Solar Installation Specialty Code checklist.
City/State/ZIP: / f��,� 9 701, Permit Fee(includes plan review $180.00
LLJ r/�G'Lr (lI /'c' and administrative fees):
Phone:(SW ) q) 4 2/793 /' ,Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: /9'! Z/L/ E t 3 /2-2- Total fee due upon application: $201.60
Authorized signature:,J °'GGG���f� ' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: -re ' Date: *Fee methodology set by Tri-County Building Industry
/,!12SU2`„l y L-B�Yl rilfl.,a' //Zl P-02-1 Service Board.
1:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
City of Tigard
IN • COMMUNITY DEVELOPMENT DEPARTMENT
C
T 1 G A R D Building Permit Review — Residential
Building Permit #: Ik,4S 1202I - OCO I Jq
Site Address: 9425 SW (3rerr vooej Place_
Project Name: elbc>vCG6 Lot #:
Planning Review
Pry4
osal: dcl//An rb do -E'62r/ d -
'L_d Verify address/suite# active in Accela. , p(In River Terrace: No ❑ Yes,River Terrace Review Addendum
Sitt Plan Elements: ❑Erosion Control
UJcopies of site plan on 8-1/2"x 11"or 11 x 17"paper ❑Retained trees with drip line and tree protection measures
'yawn to scale(standard architect or engineer scale) ❑Footprint of new structure(including decks)and FFE
orth arrow �yv�]Utility locations&easements (required for new and additions)
tito address,project or subdivision name and lot number ❑Sidewalk/driveway approach
pplicant information(name and phone number) ❑Location of wells/septic systems
Lo .imensions and building setback dimensions ❑ xeet tree size,type and location
012: are footage of buildings to be demolished I1d5tre t names
Y4 Exis g structures on site �er elevations(2'contours if more than 4'differential)
area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replace ? Yes MP .
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? Yes IT_ o
Clean Water Services-Service Provider Letter (lot platted prior to 9/10/1995):
Required: El Yes,applicant was notified ❑ No Received: ❑ Yes ❑ 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 ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
and Use Case#: ❑ Zoning:
gutted Setbacks: Front: 13/ Rear: / Side: (? Street Side:,0/ Garage: '
' Building Height: Max. Height: 3S Actual Height: �.5
O. andscape Area: % ❑ Lot Coverage Max: % .
Entranc- • Set back no more than 8'from street-facing wall ; R arallel to street or offset 45 degrees or less
Windows ❑ 6 I urn 12%of area of all street-facing facades to
Garage ❑ Garage do• behind widest street-facing w. ❑ Yes ❑ No,one of the following is met:
❑ Door extends : . ore than 5' fr. all and there is a covered porch extending beyond garage.
❑ Door extends no more . from wall and there is a 12 sq ft.window above garage on 2"d floor.
El Garage door width is • 'or less ■ 50°%0 or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered po ❑ Recessed entrance ■ Wall offset El 1'Roof eave ❑ Roof offset
❑ Fire s•:• gles ❑ Lap Siding ❑ Roof pitc ❑ Gable,hip,or gambrel roof ❑ Dormer
■ ccent siding ❑ Window trim ❑ Window rec- . ❑ Window projection ❑ Balcony
❑ Visual C • ance ❑ Urban Forestry Plan
❑ S-• true Lands: ❑ Yes ❑ No Type:
rii Conditions met prior to issuance of building permit
No s:
Approved By Planning: �� � Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.doex
Building Permit Submittal
Original Submittal Date: $ `t
Site Plans: # 2
Building Plans: # 3
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit 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
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: C/ Date:
Engineering Review
[ 'Slope at building pad: 2%
R.-Conditions "Met"prior to issuance of building permit h I a
L�Easements (encroachments)per engineering conditions of approval and plat h
C\Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Er.-No
Assess Water Quantity Fee in-lieu: ❑ Yes 13'No
LIDA Facility on lot: ❑ Yes 21-No
Q'Final Plat Recorded: PI/0.-
0 NOT Approved by Engineering: Date:
Notes:
[ 'Approved by Engineering: ini Date: 4/2`//2eZ t
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Permit Coordinator Review
`�(
�fi_7 Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Datc:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant: 'Does
SDC Exemption: ❑ Received not ap ly
N ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: !2�It -- Date: 6'4y/2
I:\Building\Forms\BldgPennitRvw_RES_122419.docx