Permit �� CITY OF TIGARD MASTER PERMIT
IIIt COMMUNITY DEVELOPMENT Permit#: MST2022-00069
Date Issued: 04/06/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112CC18400
Jurisdiction:
Site address: 15875 SW AVON PL
Subdivision: DURHAM OAKS Lot: 20
Project: Brink
Project Description: Repair one damaged top chord of a MPC truss that was fracture during a tree impact event. Replace
small portion of roof where the puncture damage sheathing.
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 st Garage: 0 sf Front. 0 S':cke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors'.
Total: 0 sf Value: $12,000.00 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
Fum<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 addl 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 V B R-3 0
Owner: Contractor:
BRINK,ALEXANDER&JOANI PORTLAND CONSTRUCTION SOLUTIONS Required Items and Reports(Conditions)
15975 SW AVON PL 14915 SW 72ND AVE
PORTLAND,OR 97224 TIGARD,OR 97224
PHONE: PHONE: 503-908-9822
FAx: 503-336-6557
Total Fees: $474.01
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 A
a59-nn1-nn1n thrn„nh n a99_nMAn9nr Vnii an/nht n a rnrnr nf+ha n,laa nr Hi rapt ni ipetinne M nl INC'.Hy ra Ili nn Fn3 9. 10A7 nr+ an 91ae
Issued By: i 01-1-4-1 �/t/t7�/fA/` Permittee Signature: - __,-e
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 ApplicatiollpECElVED M- 51611ZZ.
Residential FOR OFFICE USE ONLY
Cityof Tigard MAR 0 9 2022 Received q /fJ� Q. /,.may
'� g Date/By: O�/,S LG - Permit No.:4SI T2Vu.00Qly /
w i3125 SW Hall Blvd.,Tigard,OR 9722 .1 y OF TIGARD PIanReview
Phone: 503.718.2439 Fax: 503.598. Date/B '�j//C2f D L'T/ Other Permit
Inspection Line: 503.639.4175 LDING DIVISION ate Read i�` / /r JWHn� ® See Page x for
TIGARD y y 1
Internet: www.tigard-or.gov otified/Method: ! ' .. 1 Supplemental Information
TYPE OF WORK REQUIRED DATA:D I-AND 2-FAMILY DWELLING
❑New construction 0 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: Repair/Tree Strike equipment,materials,labor,overhead,and the profit for the
/� CATEGORY OF CONSTRUCTION work indicated on this application.
J� • I-and 2-family dwelling 0 Commercial/industrial Valuation: $ 12,000.00
1� ❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: Repair/Tree Strike New dwelling area: square feet
City/State/ZIP: 15073 SW Avon Place Garage/carport area: square feet
Vot i s
Suite/bldg./apt.no.: Project name: Brink Residence 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: CPO 4M METZGER I lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: R2124961 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.
Valuation: $
Repair nne rlamaJarl top chnrd of a MPC truss that was
fractured during a tree impact event. Replace small portion of Existing building area: square feet
roof where puncture damaged sheathing. New building area: square feet
• PROPERTY OWNER 0 TENANT Number of stories:
Name: Alex Brink Type of construction:
Address: 15975 SW Avon Place Occupancy groups:
City/State/ZIP: Tigard, OR 97224 Existing:
Phone:( 503)432-1446 Fax:( ) New:
• APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: Degenkolb Engineers '�
Structural plan review fee(or deposit): S
Contact name: Cecelia Guess
FLS plan review fee(if applicable):
Address: PO Box 17175
Total fees due upon application:
City/State/ZIP: Portland, OR 97217
Amount received:
Phone:( 503)826-6719 Fax: :( )
E-mail: cguess@degenkolb.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photovoltaic Solar Panel System.
Business name: Portland Construction Solutions Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 1495 SW 72nd AVE Solar Installation Specially Code checklist.
City/State/ZIP: Portland, OR 97224 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 803) 880_7917 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 174542 Total fee due upon application: $201.60
•
•
Authorized signature: C This permit application expires if a permit is not obtained
within ISO days after it has been accepted as complete.
Print name: Cecelia Guess Date: 2-30-2022 *Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of TigardIII Date/By:
Received
Permit No.:
• 13125 SW Hall Blvd.,Ti d,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 ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW )es No N/.
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 ❑ 0
3 Verification of approved plat/lot. 0 0 ❑
4 Fire district approval required. Name of district: ❑ ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 ❑
6 Sewer permit. 0 0 ❑
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 ❑ ❑
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 ❑ ❑ 0
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, 0 0 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 ❑ 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. 0 0 0
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 0 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 0 0 0 •
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
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 ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ 0
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.
.IURISDICTIONAL 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". 0 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 ❑ 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 ❑
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
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, 0 0 0
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\Permits1BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Residential
TIGARD
0 mismusurnimaisrmairmisamt. � .-
Building Permit #: l45TZO22-00o
Site Address: /ScrIs S w d lic- -1 FLAG it
Project Name: �Q_1 N� Lot#:
Planning Review
Prop sah RCPA I l2 1Zx F
IR Verify address/suite #active in Accela. r In River Terrace: 2 No 0 Yes,River Terrace ReviewAddendrrm
-Sitejlan Elements: ❑Erosion Control
03 copies o sr x 11" or 11 x 17"paper ❑Retained trees with drip line and tree protection measures
❑Drawn to scale(standard ar h ect ror eer scale) ❑Footprint of new structure(mcluding decks) and FFE
❑North arrow --___^-� ❑Utility locations&easements(required fot new and additions)
❑Site address,project or subdivision name and lot number�R.S{dewalk/driveway approach
❑Applicant information(name and phone number) ❑Locationb> i s/septic systems
❑Lot dimensions and building setback dimensions ❑Street tree size,type cation
❑Square footage of buildings to be demolished ❑Street names
❑Existing structures on site ❑Corner elevations(2'contours if more than ' . ferential)
❑Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? s ENo
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EYes ❑No
Clean Water Services -Service Provider Letter of platted prior to 9/10/1995):
_Reqwired: ❑ Yes,applicant was notified 19 No Received: ❑ Yes ❑ No
Water Meter Fixture Unit Worksheet-Additions,_tion Remodels and ADUs
R 'red: ❑ Yes,applicant was notified CI No Received: ❑ Yes ❑ No
iv-pc Exemption for ADU applied for: ❑ Yes Et o Received: ❑ Yes 0 No
Public Facilities Improvement (PFI)Permit:
Requited: 0 Yes,applicant was notified - No Applied For: ❑ Yes ❑ No,stop intake
❑ Land Use Case#: Zoning 12-" 19-
1:1 Required Setbacks: Front Rear: /S Side: 5- Street Side: /f Garage: 7t
❑ Building Height: Max. Height: ' S'.-- Actual Height:
❑ Landscape Area: `24.) % ❑ Lot Coverage Max: SO %
E ce ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows • ' UM 112%of area of all street-facing facades
Garage ❑ Garage door•s b ' d widest street-facing wall ❑ Yes ❑ No,one of the following is met:
❑ Door extends no mo 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'fro nd there is a 12 sq ft.window above garage on 2.d floor.
0 Garage door width is ❑ 12'or less ❑ 50%or e acade ❑ 60%or less and includes 7 of following.
0 Covered porch ❑ Recessed entrance ❑ Wall offset 'Roof eave 0 Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or rel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projec' ❑ Balcony
❑ Visual Clearance ❑ Urban Forestry Plan
❑ Sensitive Lands: ❑ Yes ❑ No Type:
❑ Conditions met prior to issuance of building pet 't
Notes:
❑ Approved By Planning: f Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPemvtRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: Get f2DI2-
Site Plans: #
Building Plans: # .3
Building Permit#: lErEnter building permit#above.
Workflow Routing: O'Planning Engineering [Permit Coordinator [WBuilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: [i Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 0//5/7.022_
Engineering Review
R.-Slope at building pad: �° o
C'�Conditions "Met"prior to issuance of building permit n/e.
VEasements (encroachments)per engineering conditions of approval and plat I
SY/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes 121 ,To
Assess Water Quantity Fee in-lieu: 0 Yes Si No
LIDA Facility on lot: 0 Yes [B'No Add Fee: ❑ Yes ❑ No
[l Final Plat Recorded: N A-
❑ NOT Approved by Engineering: Date:
Notes:
Er-Approved by Engineering: j ,67yo24,4_7 Date: 3/20z.
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
Permit Coordinator Review
OWConditions "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:
7SDC Exemption: ❑ Received Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes , /N/A
Parks SDC: ❑ Yes X1J N/A
LIDA ❑ Yes Ali N/A
/OK to Issue Permit
Approved by Permit Coordinator: Date: 1./2'
I:\Building\Forms\BldgPernutRvw_RES_1208021.docx