Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2021-00185
Date Issued: 8/10/2021
T 1GAg D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112CA03700
Jurisdiction: Tigard
Site address: 15540 SW 79TH AVE
Project: Brookside Subdivision: Lot:
Project Description: Demolition of a 1,300 sq.ft.house on sewer for Brookside subdivision. UPON FINAL INSPECTION, DEMO
CREDITS FOR SEWER, PARKS,AND TRANSPORTATION FEES WILL APPLY.
Contractor: KRAGER PHENIX EXCAVATING Owner: LAYTON, RONALD J
10573 NE CEDAR FALLS LP 15630 SW 79TH AVE
HILLSBORO, OR 97006 TIGARD, OR 97224
PHONE: 503-858-3464 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 07/29/2021 $210.59
Occupancy Grp: Occupancy Load: Demolition
Erosion Control w/Development 07/29/2021 $80.70
Dwelling Units: 0
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 07/29/2021 $0.50
11x17)
Bedrooms: 0 Bathrooms: 0
Value: $8,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $291.79
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:
0
.7,711."--e"""i""111'
al 3.639.4175 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 /di ii-a--
Residential
RECEIVED FOIz OFFICE USE ONLY
Received
City of Tigard Date/By: 7J )l 47l Permit No.: /q�/..::y2/-„)I S['�-
11111 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /l V v w ('�lJ LZ
i Phone: 503.718.2439 Fax: 503.598.1960 JUI.2 8 2021 Date/By: Nftt Other Permit:
T I C A R D Inspection Line: 503.639.4175 Date Ready/By: p Juris: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: F/AU/2/ /j�� Supplemental Information
BUILDING DIVISION �f//�
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
❑Addition/alteration/replacement ❑ Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
KI-and 2-family dwelling ❑Commercial/industrial Valuation: �5OO
CIAccessory building El Multi-family Number of bedrooms: 2
El Master builder ❑Other: Number of bathrooms: Z
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: j 5 J 1(0 5 jt) 7 hi j� New dwelling area: /30Q l square feet
City/State/ZIP: ! ' (9 itr.C) , 0(2_ -2 22 f Garage/carport area: 4/00 square feet
Suite/bldg./apt.no.: Project name: l Covered porch area: 0 square feet
Cross street/directions to jobsite: _2 #l'JlC �5'T- Deck area: square feet
l 3 C/ns�" 7 ) 13-14-/ } /J ,7(4/L,A1M44 Other structure area: 0 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 13/20OKSIO 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.
POW) C 5117-l4) 157/�36 t c—1 tyr)iLi Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER El TENANT Number of stories:
Name: /1��/2c)d AZ4) LA-11) Type of construction:
Address: ( 5"Nic.> 5(,.i 7q 4 AA.",A" Occupancy groups:
City/State/ZIP: !` 6 .4z v7 ! 64 5 2 2,2 Y Existing:
Phone:( ) Fax:( ) New:
l)f APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule
Structural plan review fee(or deposit): 1
Contact name: (ok ) LA''PA)
Address: 1 j3(i. 5(" 7)i FLS plan review fee(if applicable):"lye O r
ji/1D` �/ O 2- ' 7 Z z y Total fees due upon application: z a s
City/State/ZIP: 7`
l
Phone:(fC ) � $f5� 4 Fax::( ) Amount received: 2./J•SS
L C-E/+r PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
L pffii i/l3( t 5"4f
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: 14.A.0=2- Roet-W
p/� and fire department access,along with the 2010 Oregon
Address: i p Ai 6i'e ? q� S L p Solar Installation Specialty Code checklist.
City/State/ZIP: Ha,L) 1 71)6 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( � ii,„,-,6 �o Fax:( )(f� - State surcharge(12%of permit fee): $21.60
CCB lie.: /
3 aU/�} Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: AAOW 4 Date: SiSi *Fee methodology set by Tri-County Building Industry
"O/`�` Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T1cARD Building Permit Review — Residential
Building Permit #: ,0*/)/26aV--00/g"�
Site Address: 15540 SW 79th Ave
Project Name: Layton Demo Lot #:
Planning Review
Proposal: demo house
li ® Verify address/suite#active in Accela. g7 In River Terrace: ® No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: ®Erosion Control
Pg3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ❑Retained trees with drip line and tree protection measures
®Drawn to scale(standard architect or engineer scale) footprint of new structure(including decks)and FFE
ILINorth arrow ®Utility locations&easements(required for new and additions)
®Site address,project or subdivision name and lot number fidewalk/driveway approach
XlApplicant information(name and phone number) ®Location of wells/septic systems
.ot dimensions and building setback dimensions f1aStreet tree size,type and location
KISquare footage of buildings to be demolished ®Street names
®Existing structures on site fl Corner elevations(2'contours if more than 4'differential)
.ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? LJ Yes ❑No
® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified Cji 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 K No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: SUB2018-00006 K] Zoning: R-7
• ed Setbacks: Front: Rear: Side: Street Side: Gara e:
❑ Building Max.Height: Actual Height:
❑ Landscape Area: % ❑ Lot Coverage Max:
Entrance ❑ Set back no more m street-facing wall ❑ P reet or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all DOES NOT APPLY
Garage ❑ Garage door is behind wides ❑ No,one of the following is met:
❑ Door extends no more rch extending beyond garage.
❑ Door extends n an 5'from wall and there is a dow above garage on 2nd floor.
❑ Garage do is ❑ 12'or less ❑ 50%or less of facade ss and includes 7 of following:
vexed porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eav ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof met
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ B
Visual Clearance lia Urban Forestry Plan
i Sensitive Lands: ® Yes ❑ No Type: Low value habitat
• Conditions met prior to issuance of building permit
Notes: ((��.•,,,,
Approved By Planning: 11\ -Z fA✓ti0ZU'U Date: 7/29/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1 dgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 7 420/
Site Plans: # _
Building Plans: #
Building Permit#: nter building permit#ab ve.
Workflow Routing: arming ngineering ermit Coordinator ❑ Building
Workflow Sign-off: off for Planning(include notes from planning review)
Route Application Documents: [neering: (1) copy of permit application, (1) site plan, (1)building plan and
on . plan review routing form.
utlding: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: .ek,,lie ("7+,
By Permit Technician: ---e--"'" Date: 7/11
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: ❑ Yes ❑ No
Assess Water Quantity Fee in lieu: ❑ Yes CI No
LIDA Facility on lot: ❑ Yes ❑ No
o-1 \ ❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
ZNotes:
('Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer ate
Revision 1: ❑ Approved CI Not Approved
Revision 2: El Approved ❑ Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
Approved,NOT Released: NCths Aree_pl Ctlovl (,meter. Date: 511 f 2D21
Notes:
S. Revisions (after Building Submittal only)
4Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
FfSDC Exemption: ❑ Received / Does not aptly
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
'��YY" Tigard Trans SDC: CI Yes Le N/A
Parks SDC: ❑ Yes / N/A
LIDA CIYes 7 N/A
/OK to Issue Permit
Approved by Permit Coordinator: Date: %1,5 fr12/1
i:\Building\Forams\Bl dgPermitRvw_RES_122419.docx
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RECEIVED
JUL 2 8 2021
CITY OF TIGARC
BUILDING DIVISION
4
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SAS
?i 7"
CITY OF TIGARD
Approved by Planning
Date: if air _ 1 .____r__
.(9Y\ Lam,i)Y1 - . s .46 3 55 .------