Permit CITY OF TIGARD MASTER PERMIT
it. DEVELOPMENT'• Permit#: MST2022 00014
Date Issued: 02/02/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103CB13000
Jurisdiction: Tigard
Site address: 12194 SW JAMES ST
Subdivision: 2012-001 PARTITION PLAT Lot: 2
Project: Fulkerson
Project Description: Relocate kitchen, removing walls, install beam to open main level and relocate fireplace. Vault
nook. Trade permits to be pulled separately.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front 0 Smoke
Yes
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $87,930 00 Rear: 0
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 Drains: 0 Storm Sewer: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw 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
Furn>=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 N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
FULKERSON,SARA J&JONN E MOUNTAINWOOD HOMES INC Required Items and Reports(Conditions)
12194 SW JAMES ST PO BOX 2257
TIGARD,OR 97223 BEAVERTON,OR 97075-2257
PHONE: PHONE: 503-746-7338
FAX:
Total Fees: $1,830.59
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
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Issued By: Edgewater a Ma(dov aoCo- Permittee Signature: a �pi°`'
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 lob site at the time of each inspection.
Building Permit Application / _,‘
Residential i 1'Y.,IV D FOR OFFICE USE ONLY
CI of Tigard Received
Ty b Z Received"),/,..,
2� �/� Permit No.("'(S`r2o2z-Cc0 I
11 Date/By: 1 1
,1111
y 13125 SW Hall Blvd.,Tigard,OR 97223 JAN � 22 Plan Review
': = Phone: 503.718.2439 Fax: 503.598.1960/���r Date/By: � I-0/1?/ J Other Permit:
r 16 A R 1) Inspection Line: 503.639.4175 CL C CT 1 DGARD Date eady/By. / / lurk: ® See Page 2 for
Internet: www.tigard-or.gov BUILD; NG.O VIS!a.�tk! fled/Method: // Yl./i Supplemental Information
TYPE OF WORK GGG REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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.
® 1-and 2-family dwelling ElCommercial/industrial Valuation: $$7,930.80
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder ElOther: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:12194 SW James St. New dwelling area: square feet
VA City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Fulkerson Whole House Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
Relocate kitchen and open up main level by removing several walls. Valuation: $
Install beam and wrap columns. Relocate fireplace and create bouns Existing building area: square feet
room. — r yy�.•lr1 C.11� /�
y �Jr J r New building area: square feet
/'�.rC�
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Sara and Jonn Fulkerson Type of construction:
Address:12194 SW James St. Occupancy groups:
City/State/ZIP:Tigard Existing:
Phone:(971)777-0521 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mountainwood Homes (Please refer ta fee schedule)
Structural plan review fee(or deposit): ((0 i3
Contact name:Kim Hancock
Address:8324 SW Nimbus Ave FLS plan review fee(if applicable):
City/State/ZIP:Beaverton OR 97008 Total fees due upon application:
Phone:(971 )269-5253 Fax: :( ) Amount received:
E-mail: khancock@mountainwoodhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Mountainwood Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:8324 SW Nimbus Ave Solar Installation Specialty Code checklist.
City/State/ZIP:Beaverton OR 97008 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 503)746-7338 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:184317 Total fee due upon application: $201.60
Authorized signature: 44.,k,_,/--1_____A____, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:KimberlyHancock Date:1/11/22 *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
Cityof Tl and Received
III
g Date/By: Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
2 Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing ❑ Mechanical
TICARD
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes \o N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ El
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑
3 Verification of approved plat/lot. ❑ ❑
4 Fire district approval required. Name of district: ❑ ❑ IN
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ 0 Ed
6 Sewer permit. ❑ ❑ El
7 Water district approval. ❑ ❑ Igl
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ Igi
9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ El
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 ® ❑ ❑
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 ® 0 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® 0 ❑
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
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. ® ❑ ❑
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- ® 0 ❑
prescriptive path 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 ® ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑
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 g] 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 ❑ 21
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 ® 0 0
architect licensed in Ore.on and shall be shown to be applicable to the .ro'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". I ❑ ❑
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 ❑ ❑ IRI
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑
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)