Permit — .- _ ..
CITY OF TIGARD BUILDING PERMIT
IIIII s COMMUNITY DEVELOPMENT Permit#: BUP2021-00235
Date Issued: 10/6/2021
TIGARD 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S135DC10100
Jurisdiction: Tigard
Site address: 11900 SW 95TH AVE
Project: Weston Oaks Subdivision: 2020-016 PARTITION PLAT Lot: 2
Project Description: Demolition of a 950 sq.ft.dwelling on sewer and a 350 sq.ft.accessory structure. UPON FINAL INSPECTION,
DEMO CREDITS FOR PARKS,TRANSPORTATION,AND SEWER SDC FEES WILL APPLY.
Contractor: D &T EXCAVATION INC Owner: BOZMA LLC
PO BOX 3767 14787 SW MILLIKAN WAY
WILSONVILLE, OR 97070 BEAVERTON, OR 97003
PHONE: 503-263-2607 PHONE:
FAX: 503-263-2648
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 10/06/2021 $225.80
Demolition
Occupancy Grp: Occupancy Load: Erosion Control w/Development 10/06/2021 $80.70
Dwelling Units: 0
Info Process/Archiving-Sm$0.50(up to 10/06/2021 $1.00
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0 Misc Administration Fee 10/06/2021 $4.00
Value: $10,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $311.50
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
wit be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR•-/001-0090.Y vy o.a - .•. of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ` ittee Signature: SC.c ^c
Call 503.63 75 by 7:00 a.m.for the next a .fable inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application '' MA E
Residential FOR OFFICE USEONLY
CityofT> and RECEIVED eBY y,/ab aI ,,, , 4I,6�aJ_ M5
g Permit No.:
• ]3125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
s Phone: 503.718.2439 Fax:
503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 SEP 2$ qQqy
TIGAtr
Date Ready/By: hats: See Page 2 for
Internet: www.eigard-or.gov Notified/Method: %31(ir I led Supplemental Information
CITY OF TIGARC.
TYPE,Q RK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ltVISIOI� 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-and 2-family dwelling 0 Commercial/industrial Valuation: $ 10 r OQ� Qc.
❑Accessory building 0 Multi-family Ntunberofbedrooms: 2 bedrooms
❑Master builder ❑Other: Number of bathrooms: 1 bathroom floor SITE INFORMATION AND LOCATION Total number of floors: 1 wl bsmnt.
Joh site address: 11900 SW 95th Avenue New dwelling area: square feet -
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Weston Oaks Covered porch area: square feet
Cross street/directions to job site: 95th and Greenburq Road Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1 S 1 3 5 DC 1 01 OO 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.
Demo of existing home and barn Valuation: $
C17'1 Q�_-e— - V. — ffe 1 'Ogg?* I T. Existing building area: square feet
New building area: square feet
51 PROPERTY OWNER ❑ TENANT Number of stories:
Name: Bozma, LLC Type of construction:
Address: 14787 SW Millikan Way Oceupancygroups:
City/State/ZIP: Beaverton. OR 97003 Existing:
Phone:( ) Fax:( ) New:
Ul APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: Bozma, LLC
Matt We I n e r — Structural plan review fee(or deposit):
Contact name:Address: 14787 SW Millikan Way FLSplanreviewfee(ifapplic¢ble):
City/State/ZIP. Beaverton, OR 97003 Total fees due upon application:
Phone:(5031 970-5699 Fax::( ) Amount received:
E-mail: matt(a�crandallgroup.com PHO'1'OVOL'TAICSOLAR PANEL SYSTEM FEES.
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: D&T Excavation (Murray D iq na m) submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address; P.O. Box 3767 Solar Installation Specially Code checklist.
City/State/ZIP: Wilsonville, OR 97070 Permit Fee(includes plan review $180.00
Phone:(503 612-9284 Fax:(503)612-9287 age(12%of fees):
State surcharge(12% permit fee): $21.60
CCB lie.: 151668 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:. 4 ,Z.,e r Date: 9127/21 "Pee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPermi4App.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G R D Building Permit Review — Residential
Building Permit #: 51,,f0` I— S—
i
Site Address: 11900 SW 95th Ave
Project Name: Weston Oaks Lot #:
Planning Review
Proposal: demo house and accessory structures
KI Verify address/suite#active in Accela. ® In River Terrace: E No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: ®Erosion Control
n3 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) ❑ rint of new structure(including decks)and FFE
®North arrow ❑Utility to • ns&easements(required for ne additions)
K]Site address,project or subdivision name and lot number ❑Sidewalk/dri oes not apply.
®Applicant information(name and phone number) ❑Location of vj -
inLot dimensions and building setback dimensions ❑Street tree size,type and o
®Square footage of buildings to be demolished ❑Street names
OExisting structures on site ❑Corner ele ' ns(2'contours if more than ' erential)
laisLot area,building coverage area,percentage of coverage and >1,00 of impervious area created or replaced? ❑ e No
impervious area(applicable if R-7,R-12,R-25&R-40) es,is a storm water quality facility shown? ❑Yes ❑
I1 Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified CAS No Received: ❑ Yes ❑ No
® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes ❑ No
e SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
J Public Facilities Improvement (PFI) Permit
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
® Land Use Case#: PDR2020-00001 ® Zoning: R-7
ed Setbacks: Front: Rear: Side: Street Side: Garage:
❑ Building ' t: Max.Height: Actual Height:
❑ Landscape Area: % ❑ Lot Coverage Max: °
Entrance ❑ Set back no more t 'from street-facing wall ❑ Paralle reet or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all s cing facades
Garage ❑ Garage door is behind widest street-fat Does not apply. t Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'fry overed porch extending beyond garage.
❑ Door extends no more t from wall and there is a t.window above garage on 2nd floor.
❑ Garage door width i 12'or less ❑ 50%or less of facade ° or less and includes 7 of following:
❑ Coy orch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roo e ❑ Roof offset
ire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roo Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection n
isual Clearance ER Urban Forestry Plan
E Sensitive Lands: ❑ Yes iEl No Type:
0 Conditions met prior to issuance of building permit
Notes: Meet conditions prior to issuance. L,
'0 Approved By Planning: A�I�1.M C ti Date: 9/30/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved Cl Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Fonns\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 4Tj gi
Site Plans: #
Building Plans: #
( Building Permit#: ❑ Ent ilding permit#a ve.
j Workflow Routing: lanning ngineering rmit Coordinator ❑ Building
Workflow Sign-off: Ki.°S'ign-off for Planning(include notes from planning review)
'..A., Route Application Documents: ngineering: (1) copy of permit application, (1) site plan, (1)building plan and
N. opal plan review routing form.
Ti'T:uilding: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: iefv ) on
By Permit Technician: Date: f/W4,31
Cr
Engineering Review
1Z 0--S-lope at building pad: 2%'
Rt.-Conditions "Met"prior to issuance of building permit
O'Easements (encroachments)per engineering conditions of approval and plat
E''Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes [No
" ['No
Assess Water Quantity Fee in-lieu: ❑ Yes
IDA Facility on lot: ❑ Yes i•-"No
Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
v p
Approved by Engineering: x , rl +1-keit, Date: /0--4-2e921(.
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
OConditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: -Ica2 pet,,.., to(gI2i2A -Psi- Date:
Notes: 1l �Y 2Ut.�-co� h 5 I?,b?/�
Revisions (after Building Submittal only)
® Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received ,,Zr. Does not apply
zErSDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes X N/A
Tigard Trans SDC: ❑ Yes /1 N/A
Parks SDC: ❑ Yes /el. N/A
LIDA ❑ Yes /N/A
OK to Issue Permit
Approved by Permit Coordinator: Aar-. \-
Date: PI S I ill
I;;
I:\Building\Forms\BldgPen iitRvw_RES_122419.docx
Agnes Lindor
From: Agnes Lindor
Sent: Monday, October 4, 2021 9:22 AM
To: matt@crandallgroup.com
Cc: Monica Bilodeau; #Building Permit Technicians
Subject: 11900 SW 95th Ave Demo
Hi Matt-
Planning needs a report from the arborist stating that the tree protection fencing is installed as per approved Land Use
plans. Please send over this letter so we can release the permit.Thanks,
Agnes Lindor l Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email:AgnesL@tgard-or.gov
1