Permit 11111 CITY OF TIGARD BUILDING PERMIT
a COMMUNITY DEVELOPMENT Permit#: BUP2021-00273
Date Issued: 12/7/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S106DC16100
Jurisdiction: Tigard
Site address: 13921 SW ROY ROGERS RD
Project: Riverside at Scholls Meadow Subdivision: None Lot: None
Project Description: Demolition of a 2,170 sq.ft. house on septic,2,160 sq.ft. pole barn, 576 sq.ft. barn, and a 30 sq.ft. pump house.
SEPTIC TANK TO BE PUMPED AND FILLED. UPON FINAL INSPECTION, DEMO CREDITS FOR PARKS AND
TRANSPORTATION FEES WILL APPLY.
Contractor: SUBCOM EXCAVATION & UTILITIES LLC Owner: RIVERSIDE HOMES LLC
PO BOX 4055 15350 SW SEQUOIA PKWY STE 320
HILLSBORO, OR 2022 PORTLAND, OR 97224
PHONE: 503-648-9310 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 12/06/2021 $619.25
Occupancy Grp: Occupancy Load: Demolition
Erosion Control w/Development 12/06/2021 $107.60
Dwelling Units: 0
Info Process/Archiving-Sm$0.50(up to 12/06/2021 $2.50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $40,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $729.35
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: F-1a-LL Va.., Pe, Wege, Permittee Signature: Qvt,A
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-'R 12-121
Residential FOR OFFICE I SF ONLY
City of Tigard RECEIVE • Received 1// —� , /j}t•� Permit No. �jJ r_Al)l
1.3
;, • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �,/ it WOE
Phone: 503.718.2439 Fax: 503.598.1960 cC 9 q qq Date/By: Aifr4 Other Permit.
t I G A R t> Inspection Line: 503.639.4175 aIEP gm Date Read B 47714
���` PI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: /,2/& /al 47 I f supplemental Information
CITY OF TIGARL 60! „o,l I-z-f,y,le;
TYPE OF WONILDING DIVISION, REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction I 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 E 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: $40,000(remove buildings)
❑Accessory building 0 Multi-family
Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13921 Roy Rogers Road New dwelling area: square feet
City/State/ZIP: Tigard, OR 97140 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Riverside at Scholls Meadow Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
West side of Roy Rogers Road near Jean Louise Road. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:(future)Riverside at Scholls Meadow PDR 2021-001 Lot no.: Permit tees*are based on the value of the work performed_
Tax map/parcel no.:2S106DC16100 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.
Removal of single family house,two barns, pump house. valuation: $
Septic system to be decommissioned. Well to be decommissioned. Existing building area: square feet
Not on City services. New building area: square feet
ill PROPERTY OWNER 0 TENANT Number of stories:
Name: Riverside Homes LLC Type of construction:
Address: 15350 SW Sequoia Parkway, Suite 320 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing:
Phone:(503 )645-0986 ext 104 Fax ( ) New:
i82 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name Riverside Homes LLC (Please refer to fee schedule
Structural plan review fee(or deposit):
Contact name: Niki Munson
Address: FLS plan review fee(if applicable):
Same as above 1
Total fees due upon application: ,A '7,4.
City/State/ZIP: TT
Amount received:
Phone:( ) Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail, nmunson@riversidehome.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Subcom Excavation and Utilities Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1049 SW Baseline St. Suite D430 Solar Installation Specialty Code checklist.
City/State/ZIP: Hillsboro, OR 97123 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503 )314-4856 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lie.: 195965 PP Total fee due upona lication: $201.60
/ �Authorized signature: / / '� i l �j -• This permit application expires if a permit is not obtained
LLL within 180 days after it has been accepted as complete.
Print name: Niki Munson Land Acquisition Manager Date: 09/27/2021 *Fee methodology set by Tri-County Building Industry
Service Board.
l:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
e veived
City of Tigard Rec RecDate Permit No.
III13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
TIGARD 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. ® ❑ ❑
3 Verification of approved plat/lot. ® ❑
IXI
4 Fire district approval required. Name of district: ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity, . ❑ ❑ IX
6 Sewer permit. ❑ ❑ CK
7 Water district approval. ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ ❑
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.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ 71
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 ❑ ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑
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- 0 ❑ 11
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,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. 0 E]
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- ❑ ❑ [A
prescaiptivepath 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 0 ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ DKI
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 0 ❑ I]
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ ❑
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 ❑ ❑ NJ
architect licensed in Oregon and shall be shown to be.••licable to the iro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 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. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
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. ❑ ❑ ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ Cl
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
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, ❑ ❑ ❑
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:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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City of Tigard
Ili
COMMUNITY DEVELOPMENT DEPARTMENT
II
TIGARL7 Building Permit Review — Residential
Building Permit #: d
1 Site Address: l 3ci 21 S L AJ t' 2CVER-WS
Project Name: plreaS10 ftr SCfk U 3 pie1t7uk.1 Lot #:
Planning Review
Proppsal: v
j 94erify address/suite# active in Accela. iver Terrace: ❑ No des,River Terrace Review Addendum
�'In R ��
Site an Elements: IGErosion Control
, copies of site plan on 8-1/2"x 11"or 11 x 17"paper detained trees with drip line and tree protection measures
D D awn to scale(standard architect or engineer scale)
th arrow
Footprint of new structure(including decks)and EVE,
Uplity locations&easements(required for new and additions)
} Site address,project or subdivision name and lot number Swalk/driveway approach
4pplicant information(name and phone number) J�5L �ation of wells/septic systems
if
[1 dim Li1Sensions and building setback dimensions et tree size,type and location
SS care footage of buildings to be demolished Ad Street names
TIExisting structures on site IT Corner elevations(2'contours if more than 4'differential)
Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes No�
im 'ous area(applicable if R-7,R-12,R-25&R-40)
( pp If yes,is a storm water quality facility shown? ❑Yes No
Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
quired: ❑ Yes,applicant was notified ❑ No Received: [rT Yes ❑ No
.Yr Water Meter Fixture Unit Worksheet—Addiitio ;Remodels and ADUs
aired: ❑ Yes,applicant was notified L� No Received: ❑ Yes ❑ No
C Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI)Permit
quired: ❑ Yes,applicant was notified L�J No Applied For: ❑ Yes ❑ No,stop intake
IJ Land Use Case#: Q2�21 I ❑ Zoning:
�_ 'equired Setbacks: Front: Rear: Side: Street Side: Garage:
❑ Buil.rr• - -it ht: Max. Height: Actual Height:
❑ Landscape Area: % ❑ Lot Coverage Max:
Entrance ❑ Set back no more t . " om street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all`s--.: '.`facades
Garage ❑ Garage door is behind widest street-facing w.. _,_ ❑ Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and the - covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 1 ,s. window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ .' .r less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof ea•. ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel ro. ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection :alcony
❑ Visual Clearance ❑ Urban Forestry Plan
❑ Sensitive Lands: ❑ Yes ❑ No Type:
❑ Conditions met prior to issuance of building permit
Ns:
VJoApproved By Planning: �'.. " --- Date: /1 Al2/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BIdgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 03111
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: arming gineering tt Coordinator ❑ Building
Workflow Sign-off: 1."<n-off for Planning(include notes from planning review)
Route Application Documents: gineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
ing: original permit application, site plans,building plans,engineer and
c4bbeam calculations and trust details,if applicable,etc.
Notes: A", LA16
_0 r
By Permit Technician: Art' _ Date: /0)7,1r
Engineering Review
1
C"Slope at building pad: r/:
n 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
44 Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
tom' A roved by Engineering: Date: 0...<74P2(
PP
"t. Revisions (after Building Submittal only) Reviewer Date
IRevision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Permit Coordinator Review
4Conditions "Met"prior to issuance of building permit
,f.
0 Approved,NOT Released: fi(e� pr (*iN, `IA 1. _ Date: I( 1 i %I 14 24
Notes: -Tree pvicawn not Ise-e4td On ocrk Cudt v-r- tat-
, Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
a OSDC Exemption: ❑ Received ❑ Does not apply
, SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes '�N/A
Parks SDC: E Yes 'ET—N/A
LIDA ❑ Yes Er-N/A
/OK to Issue Permit
Approved by Permit Coordinator: _ Date: 12 Z tia
I:\Building\Forms\BldgPennitRvw_RES_122419.docx
CleanWater Services
RECEIVED
SEP 2 9 2021
CITY OF TIGARL
March 20,2019 BUILDING DIVISION
Pacific Community Design
12564 SW Main St
Tigard OR 97223
RE: CWS file 19-000771 West River'Terrace Phase 2 located at 13921 SW Roy Rogers
on TLID 2S106DC16100
Clean Water Services has received your Sensitive Area Certification for the above
referenced site. District staff has reviewed the submitted materials including site
conditions and the description of your project. Staff concurs that the above referenced
project will not significantly impact the existing Sensitive Areas found near the site. In
light of this result,this document will serve as your Service Provider letter as required by
Resolution and Order 17-5, Section 3.02.1. All required permits and approvals must be
obtained and completed under applicable local, state,and federal law.
This letter does NOT eliminate the need to protect Sensitive Areas if they are
subsequently identified on your site.
If you have any questions,please feel free to call me at(503)681-3605.
Sincerely,
Chuck Buckallew
Clean Water Services
2550 SW Hillsboro Highway
Hillsboro,OR 97123
Phone: 503.681.3605
Fax: 503.681.4439
buckallewePcleanwaterservices.org
2550 SW Hillsboro Highway • Hillsboro,Oregon 97123
Phone: (503)681-3600 • Fax: (503)681-3603 • cleanwaterservices.org