Permit Support Document Building Permit Aaalica 4n ' y 13 Z,Z * '(2y 1Zp --
Residential I III(HI III I l .l ttrt r
City of Tigard RECEIVE ' 4 /d /3 2020 OSrZ620-
13125 SW Hall Blvd.,Tigard, rim �°'°""O" �Z7
= OR 97223
e , Phone: 503.718.2439 Fax 503.598.1960 S E P 2 4 2020 navrntµ Other Petnal
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Inspection Line: 503.639.4175 t�,"��fy"1#f� DateKc�edyAtx � t
I c1Tet ww,v.tigsrd-ar.gov CITY OF"TIGARD NAariea/M�e wit Posterat
Supplemental tsrm,„Qa,uae
BUILDING DIVISION
TYPE OF WORK ,»._.
RE;QUiR1 n DATA:1 AN`n 2-FA.MILY DWELLING
❑New construction
�.�,! ❑Demolition Permit fcx,"tare .��:. on thewart fa,ra�cc1
6:►,+ddition/alterationlreplacanent 0 Other:
Indicate the value(founded to the nest dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF C'ONSTRIATION work indicated on thisr r (rcatpcm. W
❑ 1-and 2-family dwellingValuation: $
0
Commercial/industrial
70 [PO
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master braider
❑Other:iyi0 Yd. my 6485�- Number of bathrooms: —
JOB Snit INFORMATION AND LOCATION Total number of floorrs:
Job sit°address: 1 154 U SW ENS eb New dwelling area: squerc feet
City/State/ZIP: 77 6fn(Zip. Ole 22,'3 Oarageicatport area: square feet
Sttitr/bldglatpc.no.: Prof6 1'Tc.K name:97 ��^^ /�lq R6-E �""Covered porch
.
D p area: square feet
Crass street/directions to job site: Deckarea: 0.
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHIMILIST
Subdivision: I Lot no.: "Permit fees'the 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,ovahead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
I-'en P 1 tnirwj f 2 zx ni, +m�,/ 9 grace, Valuation: $
7 /
Q Isvmr . 5}v G 011 `j"o,p. Existing building area square fact
New building area: square fed
r ROPER?Y ow1NER p TENANT Number of stories:
Name: Ji'1!1" ?t�t"�'Yt�r Type of construction:
Address: •//5A 5ui ('re n_b v Ad �gam:
City/State/ZIP: 7/ a>-(4 0 r- q7 2.-z
Phone:(50 5) cis 70 tl 2 Fax:( )
New:
9'RlsPh1C.eNT 0 CONTACT PERSON De .DING PERMIT Fes'"
ti
Businoss name: ( r +Sty Alp fort I
Structural plan review fee(or deposit): //7://
=flnm' - n l ce 4Cr(A0 o*: FLS plan review fee{if applicable}:
City/State/ZIPTotal foes duce upon
Phone;(ems;) t�C�' 7 7 e if Fax::( )749
Amount received
E-mail: (dun I ce . qa/ectir, ``r Q"ia 1-ay in
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEZ '
V CONTRACTOR (/ C�ial and residential roe i tall.atioo of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: 1 Submit two(2)sets of roof plan with connection details
Address: ` OWAN and Tut d ment aeoat.,along with the 2010 Oregon
Solar installation Specialty Code checklist
City/State/ZIP: Permit lee(includes plan rakiev.
Phone ( ) Fax:( ) and admfnistracivc fees l: $180.00
CCB lie.: State surcharge(1210 of rc emit fee): $21.60
f 'total fit due upon application: S201.60
Authorized signature: , f.` ApT . .._
1 bh permit sptiiirr Ova expttxS Us permit ix obtained -
Print prune: ,C/r a within 180 do}a after it has been accepted as complete.
Un ce. AA� ,Y1a,, Date: p Fee meth+xlology set by Tri-County Building In
t "2!'�"��_. Services Board. dustrY
113udtlntg1Permits1BUP-RFSPexmitApp.doc 02/2412011 440-4613T(11/02/COM/WED)
RECE1VPD
Property Owner Statement SEP 2 4 2020
Regarding Construction Responsibilities CiT OF lGARD
Oregon Law requires residential construction permit applicants who are not licensed VMPriiiiPG DIVISION
Construction Contractors Board to sign the following statement before a building permit can be
issued (ORS 701.325 (2))
This statement is required for residential building,electrical, mechanical,and plumbing permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this statement.This statement will be filed with the permit.
Please check the appropriate box'
I own, reside in, or will reside in the completed structure and my general contractor is'
Name CCEW Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
V" I I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
L)1 /("C' .Jer /ea1
Print Name of Permit Applicant,
/a 7 24%20
Signa ure of Pe 1-App11 ant Date
Permit#: .Y
Address: //56/(2 5L6/ (jr eri1 bc!rcq / • •,. .
`3« rd of 1722 3 111r.
Issued by: Date: +i t r
This Copy for Permit Offices
City of Tigard
.1114
a COMMUNITY DEVELOPMENT DEPARTMENT
T 1 r RD Building Permit Review — Residential
' A
Building Permit #: M cS T 20 20-00 27 g
Site Address: 11540 SW Greenburg Rd
Project Name: Galeana Garage Addition Lot #:
Planning Review
Proposal: Adding onto existing detached garage
0 Verify address/suite#active in Accela. 0 In River Terrace: 0 No ❑ Yes, River Terrace Review Addendum
Site Plan Elements: erosion Control
12; copies of site plan on 8-1/2"x 11"or 11 x 17"paper etained trees with drip line and tree protection measures
1
011rawn to scale(standard architect or engineer scale) Footprint of new structure(including decks)and FFE
IN orth arrow „Jtility locations&easements(required for new and additions)
111.ite address,project or subdivision name and lot number �°''idewalk/driveway approach
1111- pplicant information(name and phone number) \p/„_.ocation of wells/septic systems
IN • •' ensions and building setback dimensions \ street tree size,type and location
02.,uare footage of buildings to be demolished ,street names
IS�, xisting structures on site °Comer elevations(2'contours if more than 4'differential
1\ O:, area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? es ° o
impervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? es o
❑ Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: 0 Yes,applicant was notified ❑ No Received: CI Yes 0 Nos!
Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑Yes,applicant was notified 0 No Received: ❑Yes 0 No
SDC Exemption for ADU applied for: ❑Yes 0 No Received: ❑Yes 0 No
,4Public Facilities Improvement(PFI) Permit:
Required: ❑Yes,applicant was notified 0 No Applied For: ❑ Yes ❑No,stop intake
Land Use Case #: El Zoning: R-4.5
0 Required Setbacks: Front: N/A Rear: 5 Side: 5 Street Side: N/A Garage: 20
O Building Height: Max.Height: 15 Actual Height: 15
1 dscape Area: % 0 Lot Coverage Max: 0/0
Entrance Set back no more than 8'from street-facing wall ❑ Parallel to street or off - degrees or less
Windows ti :...um 12%of area of all street-facing facades
Garage Gara e do. ' behind widest street-facing wall ❑Yes is No,one of the following is met:
Door exten. ,. more than 5' from wall and there is . -. ered porch extending beyond garage.
t
Door extends no mo : an 5' from wall an. . -re is a 12 sq ft.window above garage on 2nd floor.
❑ Gara e door width is 12'or . / 0%or less of facade — 60%or less and includes 7 of following:
Covered porch Re a entr.. _.❑ Wall offset 1'Roof eave Roof offset
Fire shingles Lap Siding Ro. .itch ❑ Gable,hi ,or gambrel roof Dormer
Accen .. g Window trim :.w recess U Window projection ❑ Balcony I
❑ Visual Cleara , 0 Urban Fores Plan e
❑ Sens• ' - ands: 0 Yes U No Type:
onditions met prior to issuance of building permit
Notes:
0 Approved By Planning: S-hu� Date: 9/30/20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
2
Building Permit Submittal
Original Submittal Date: ag'2 ZQZ_
Site Plans: #
Building Plans: #
Building Permit#: [nter building}permit# above.Workflow Routing: T �yanning lkEngineering [ Permit Coordinator Ef"Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1)building plan and
n'original plan review routing form.
I'Building: original permit application, site plans,building plans,engineer and
beam calculations and .t details,if applicable,etc.
Notes:
By Permit Technician: '��4M17/// Date: je/)/2020
Engineering Review
2"-slope at building pad: Zzn
Et-conditions "Met"prior to issuance of building permit f/Gt_
O'Easements (encroachments) per engineering conditions of approval and plat N/A_
El—Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes IErNo
Assess Water Quantity Fee in-lieu: ❑ Yes na-No
LIDA Facility on lot ❑ Yes Q'No
LiFinal Plat Recorded: H l�
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: /Yen f gyp Date: /o/i r/zu2.o
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ 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:
aSDC Exemption: ❑ Received Does not a ly
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes IS N/A
Parks SDC: ❑ Yes g N/A
LIDA ❑ Yes &'N/A
aOK to Issue Permit
Approved byPermit Coordinator: Date:
PP \40
I:\Building\Forms\BldgPermitRvw_RES_122419.docx
r
14
a
t p
TIGARD
City of Tigard
September 24, 2020
Eunice Galeana,
11540 SW Greenburg Rd
Tigard, OR 97223
RE: Garage Permit
Hello Ms. Galeana,
Please find enclosed your check#795 dated September 24, 2020 in the amount of$180.00.
I understand that
you
have applied forapermit to expandyour garage. A t this time, we do not
Ppp g g
accept checks to be submitted with the application.
Once planning has approved your permit application it will be routed to the building division.
Due to the current remote working conditions, we are experiencing significant delays in
processing applications. Please allow 1-3 weeks and the permit technician will contact you to
pay the plan review submittal fee online.
Once the plan review submittal fee has been paid, the plans will be routed off site for plan
review. Please allow an additional 3-5 weeks for the permit to be ready to issue.
If you have any questions,please contact the permit technicians at
TigardBuildingPermitsnaa,tigard-or.gov or 503-718-2439.
Thank you for your patience during this time.
2a/11_,2LVJ--2
Dianna rnelas
Building Division Services Supervisor
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov