Permit IIIIIIII q CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2021-00262
Date Issued: 11/3/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AC01700
Jurisdiction: Tigard
Site address: 10970 SW 95TH AVE
Project: Ashbrook Villas Subdivision: ASHBROOK FARM Lot: PTS 22-
Project Description: Demolition of a 1,400 sq.ft. house on sewer,288 sq.ft.detached garage,and a 200 sq.ft.shed. UPON FINAL
INSPECTION, DEMO CREDITS FOR PARKS,TRANSPORATION,AND SEWER WILL APPLY.
Contractor: K&G CONSTRUCTION CO Owner: ABVOZBP21 LLC
26090 NW TIMBER CO 1815 NW 169TH PL STE 1040
FOREST GROVE, OR 97116 BEAVERTON,OR 97006
PHONE: 503-681-2370 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 11/03/2021 $744.51
Demolition
Occupancy Grp: Occupancy Load: Erosion Control w/Development 11/03/2021 $161.40
Dwelling Units: 0
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 11/03/2021 $2.00
11x17)
Bedrooms: 0 Bathrooms: 0
Value: $52,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $907.91
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: Flo- j VaA4,De,Weg - Permittee Signature: 00,Ato-p-Liza4i.avt,
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 E. - ID/i I21
Residential DECEIVE
City
of Tigard dI d Received / mil"
Date/Bv: lf)��'"�I -- Permit No.: lye DI�/ /'1/1�l A
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie V •�'l�✓v 1 �(/(/H/
Phone: 503.718.2439 Fax: 503.598.196011114
OCT 1 9 2021 Date/By: A// Other Permit:
I I GA R h Inspection Line: 503.639.4175 Date Ready/By: Ed See Page 2 for
Internet: www.tigard-or.gov NotiticdMethod: f/ / ) tie? Supplemental Information
CITY OF TIGARD ,
TYPE OF W o ; �q ILDING DIVISION 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.
❑ I-and 2-family dwelling ❑Commercial/industrial Valuation: SZ f oon
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: l Q 170 9,5+ 'AU-. New dwelling area: square feet
City/Stare/ZIP: "-K-sc.„.r+L. 1 f3 Ne- i 7 2Z 7 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: � ,:„,+00K kj t1v Covered porch area: square feet
Cross street/directions to job site: 56.3 95-)\-• Au6, Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: -GJV)'j('0O 0 \0\,5 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. 't♦A� 1 S� 3,A _C ��X LT \7 0 0 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
2ry o D r- e..-1\1s,;� 1rNo m-e,- k\- /'1 5PA
existing building area: square feet
vo,e c . fain P-�A-1 i tDi l,r� ,c,_,P��..,}(J6 5,,y�w building area: square feet
„IR'PROPERTY OWNER 0 TENANT Number of stories:
Name: /cs O 2,.(2 c 2)/ "L., Type of construction:
Address: l4 1 11�� 11000,A1 Q\wv
f i [ ` t b� Occupancy groups:
City/State/ZIP la,,,),,�Y A I Q� 9'7006 Existing:
Phone:(S-0 ) 476 y— 825' Fax:( ) New:
;APPLICANT S.CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
t�V N�� ��-� �� ---- .. — Structural plan review fee(or deposit).
Contact name: Cam.,, .e...„ c.9 IrrN�`/
t FLS plan review fee(if applicable):
Address: k g 15 N 16,1 + P\cCZ 5U>ve.„*- to q o Total tees due upon application: /
City/State/ZIP: i5 0.e.No� 1�e_ 700 k, r ,'d� �'
Amount received:
Phone:(5-0 j) �9'6 ct s>2.ci k Fax::( )
E-mail: CeLkc C;CO k`JU x\- 001 e� I-6(_ . CO ivA, PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: (b yS� C�(<'! Submit two(2)sets of roof plan with connection details
` and fire department access,along with the 2010 Oregon
Address: �O ! 0 tIL) `r ry\be R 1 Solar Installation Specially Code checklist.
City/State/ZIP: r.-0 c' CJ-c- 6-1 rJ U{.-./ 0It ??/I b Permit Fee(includes administrativeplan i S180 00
ll `"' and fees):
Phone:(J0?,) (p 8r - ?37 0 Fax:( ) State surcharge(12%of permit fee): S21.60
CCB lie.:
j Z8 1Total fee due upon application: S201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days alter it has been accepted as complete.
Print name: / Date: r f / *Fee methodology set by Tri-County Building Industry
G,4 G G E�/ /�/��%�y Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(I I/02/COM/WEB)
City of Tigard
11111 COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Residential
Building Permit #: g(s, ja/_.. 6t4
Site Address: 10970 SW 95th Ave
Project Name: Ashbrook Villas Demo Lot #:
Planning Review
Proposal: Demo all existing structures on site
E Verify address/suite#active in Accela. ® In River Terrace: ® No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: ®Erosion Control
Xl3 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) ootprint of new structure(including decks)and FNh
XlNorth arrow ❑Utili ations&easements(required for new an tions)
r - e address,project or subdivision name and lot number ❑Sidewalk/dri approach
❑Applica •-- •rmation(name and phone numb- • ❑Location of wells/se • stems
❑Lot dimensions an. • •• - ••• • --• 'ens ❑Street tree size, Does not apply.
❑Square footage of b Does not apply. ❑Street names
❑Existing struc -. •n site ❑Corner elev • s(2'contours if more than • erential)
❑Lot . -.., •uilding coverage area,percentage of covera• -.a >1,000 impervious area created or replaced? ❑ No
•
impervious area(applicable if R-7,R-12,R-25&R-40) I es,is a storm water quality facility shown? ❑Yes ❑
1 ® Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: CI Yes,applicant was notified EX No Received: CI Yes ❑ No
® Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
t Required: ❑ Yes,applicant was notified ® No Received: ❑ Yes ❑ No
IIII SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes El No
I Public Facilities Improvement (PFI) Permit: PFI2021-00173
Required: IX Yes,applicant was notified El No Applied For: ® Yes ❑ No,stop intake
® Land Use Case#: PDR2020-00002 X7 Zoning: R-12
• - ed Setbacks: Front: Rear: Side: Street Side: Garage:
❑ Building ` -- - Max.Height: Actual Height:
❑ Landscape Area: % ❑ Lot Coverage Max: °/
Entrance ❑ Set back no more than . a street-facing wall ❑ Paralle eet or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all stree- •.• facades
Garage ❑ Garage door is behind widest street-facin Does not apply. es ❑ No,one of the following is met:
❑ Door extends no more than 5'fro .- .. . . - .• ed porch extending beyond garage.
❑ Door extends no more t• rom wall and there is a 12 sq . :•dow above garage on 2nd floor.
❑ Garage door width i i 12'or less ❑ 50%or less of facade ❑ 60°0 a and includes 7 of following:
❑ Coy- -. .orch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
re ire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof • :- .1 er
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
-Visual Clearance Ei Urban Forestry Plan
® Sensitive Lands: E Yes ❑ No Type: Sig. Wetland, CWS Veg. Corridor,
® Conditions met prior to issuance of building permit Sig. tree groves, & Mod./low habitat
Notes: 1,
® Approved By Planning: G7Ntellb Date: 10/25/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: '!
Site Plans: #
Building Plans: #
Building Permit#: 9erbuilding ppermi above.
Workflow Routing: re"Planning L^�F;ngineering ermit Coordinator 0 Building
Workflow Sign-off: -off for Planning(include notes from planning review)
Route Application Documents: 14J..Engtneering: (1) copy of permit application, (1) site plan, (1)building plan and
griginal plan review routing form.
INEr Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: ' _ Date: f j//Ai
Engineering Review
Slope at building pad: 212
E( onditions"Met"prior to issuance of building permit 4 4
❑ F asements (encroachments)per engineering conditions of approval and plat ti/..
[WWater Quality/Quantity Facility
Assess Water Quality Fee in-lieu: 0 Yes 2*.No
Assess Water Quantity Fee in-lieu: 0 Yes 2/No
LIDA Facility on lot 0 Yes ErNo
[2/Final Plat Recorded: w/e•.
❑ NOT Approved by Engineering: Date:
Notes:
L'J A roved byEngineering: Date: �b
PP g g r / 12,
Revisions (after Building Submittal only) I Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 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:
f2nDC Exemption: 0 Received Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes gN/A
Tigard Trans SDC: 0 Yes 71 N/A
Parks SDC: 0 Yes /N/A
LIDA 0 Yes N/A
VOK to Issue Permit
Approved by Permit Coordinator: Date: f( ( ( (2o14
I:\Building\Forms\B1dgPerm itRvw_RES_122419.docx