Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2022-00172
Date Issued: 08/09/2022
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110BB02500
Jurisdiction: Tigard
Site address: 12228 SW CHANDLER DR
Subdivision: ARLINGTON RIDGE Lot: 2
Project: Peterson
Project Description: Removing old deck and replacing with 360sf deck w/stairs.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $8,694.00 Rear: 15
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 Bckflw Prevntr: 0 Catch Basins: 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'I 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:
PETERSON,LYNN&PAULETTE Required Items and Reports(Conditions)
12228 SW CHANDLER DR
TIGARD,OR 97224
PHONE: PHONE:
FAX:
Total Fees: $498.63
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
Q59-nn1-nnln thr-inh n0 QS9-M1-noon VV,-, jhl,,,/, of thu nI..nr Hir t--ti—to 01 IN('.by Tallinn�n 9 1QA7 nr 1 Ann 339 93dd
Issued By: Permittee Signature: 1
Call 503.6 9.4175 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
Residentialnote
City of Tigard JUN Q22 Reee;ved
Date/By: Z
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF T IGA ate/e : 7 (0 22 Other Permit
Inspection Line: 503.639.4175 Juris: Q See Page 2 for
Internet: www.tigard-or.gov tl(JILDING �VI igfieeMethd:
Supplemental Information
TYPE OF WORK 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 El Other: equipment,materials,labor,overhead,a he profit for tete
CATEGORY OF CONSTRUCTION work indicated on this application. Uf
�1-and 2-family dwelling ❑Commercial/industrial Valuation: $
❑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: 1221 s Li Can- —(v-(— D(— New dwelling area: square feet
City/State/ZIP: ' I `' 4,jl� 2 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: �ZOL Covered porch area: square feet
Cross street/directions to job site: ; Deck area: 3 square feet
S4� C kn I e- {- ,S l,J 2, i S 4vP— Other structure area:_,---' square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 Lot no.: Z7 Q Permit fees*are based on the value of the work performed.
Tax map/parcel no.: S (�(� Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK y work indicated on this application.
e,+10 (A C k f e- I/n�r 6(c i.tf Valuation: $
S+ h f J �, �� N_`,- ,— �,'�t� Existing building area: square feet
I t^l.� r� New building area: square feet
ROPERTY OWNSIjTF
TENANT Number of stories:
Name: h (,tv e . t�C 1!,(4h Type of construction:
Address: i Z2�9 •(.j C kct-L le 0' Occupancy groups:
City/State/ZIP: ot- A Q c(72-2-1 Existing:
Phone:W3 142 3 q Fax:( ) New:
❑ APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
Business name: tease mer to fee schedule
Structural plan review fee(or deposit):
Contact name: a �.
FLS plan review fee(if applicable):
Address: and CU
City/State/ZIP: Total fees due upon application:
Phone:( � � ' Amount received:
3 Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photovoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.. Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained-
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print nam Date: Service Board.
I:\Building\Permits\BUP-RESPermitApp.doe 02/24/2011 4404613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling
City of Tigard Received Permit No.:
� 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:Associated permits:
i Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITENISARE REQUIRED FOR PLAN REVIEW N CS No V
I Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ I ❑
3 Verification of approvedplat/lot. ❑ ❑ I ❑
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic sstem permit or authorization for remodel. Existing system capacity ❑ ❑ 1 ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑plan ❑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 he completed if
copyright violations exist.
1 I 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 ❑ ❑ ❑
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- ❑ ❑ ❑
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- ❑ ❑ ❑
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 ❑ ❑ ❑
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 ❑ ❑ ❑
,h;,ll he zhown to he anplicable to the project under review.
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 r
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development rues uucuuteut. LI i Li i u
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ ;FEJ1
❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard El E] El
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\PcnnitsBUP-RESPerniitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
i
= Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.ti.ard-or.gov
TO: Ally(bvl\ Ar -�rbii-q DATE R% +I ED:
DEPT: BUILDING DIVISION
FROM: JUL 5 2022
CITY GF TGA I
COMPANY: 9ULDING D
PHONE: �S i� 74 3 By:
EMAIL: M-f b ocE 0 (
RE: 12Z2W S L,J Cka.01d(.ea— MET)-022- _ CO 1
(Site Address) II q (Permit Number)
Ari,,5-ivn (}Z�°stye �64KSI
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies:71 Description: Copies: Description:
✓�. Additional set(s)of plans. Revisions:
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technic D Z Initials:
Fees Due: ❑Yes No ,fee Descn tion: Amount hue.
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes 00 1 19N4--' ❑ Done
Applicant Notified: Date: Initials: Vlff
Building Permit Submittal
Original Submittal Date: Z
Site Plans: #
Building Plans: #
Building Permit#: ,�� ter building permit#above.
Workflow Routing: -E '-Tlanning .0'fngineering �rmit Coordinator ,-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
original plan review routing form.
Iff Building: original permit application,site plans, building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: 114 X"001
By Permit Technician: Date: 4r z
Engineering Review
C7�Slope at building pad: 0%
ewC"19"Conditions "Met" prior to issuance of building permit fill-
2"
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes R�No
Assess Water Quantity Fee in-lieu: ❑ Yes No"No
LIDA Facility on lot: ❑ Yes R No Add Fee: ❑ Yes ❑ No
Final Plat Recorded: A(w
❑ NOT Approved by Engineering: Date:
Notes:
C'Approved by Engineering: 7eAw,-/ dnLAeu, Date: �l/3/Z2Z
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ 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:
SDC Exemption: ❑ Received ❑ Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /`J N/A
Tigard Trans SDC: ❑ Yes VN/A
Parks SDC: ❑ Yes f�N/A
LIDA El Yes � N/A
,2� OK to Issue Permit
Approved by Permit Coordinator: A—;-)m ,,/J,, Date: 14 1A}
I:\Building\Fonns\B1dgPennitRvw RES_1208021.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review Residential
9.:
Building Permit #: ZZ- 2
11
Site Address: le Y
Project Name: �e kr Lot #:
Planning Review
Proposal: & P( C CV t&q+-' eC fes.
Verify address/suite #active in Accela. ❑ In River Terrace: No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: CEze�trel
P3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ( stained tr *?'a �+nP end+*_w
prawn to scale(standard architect or engineer scale) Footprint of new structure(including decks) and FFE
Zorth arrow
ite address,project or subdivision name and lot number ❑Side i e�eap xpPraatlr
(&Applicant information(name and phone number) ms
Mot dimensions and building setback dimensions $treet'tre2'sizee and]rararinu
[94q;,a £001�� of bbuildings to g�1,�„+��1-3.hw �tfeet--names�--
[Existing structures on site u ore tharr4�diff�P�i3Tia1)
�B'I75Y aha;Tiiiid3�rTg"Ccsverxge azea;percentagtr6f'w7erage and >�A9A_sf cafa e�aie rca�rearted-tsr reps o
type u< s area{app abrlellTt 7,7�� T1�2�&� "— If-yes;-is a storm water quality faciiir5 shown? --~❑Yes C3Pvo
Clean Water Services -Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified '�2)No Received: ❑ Yes ❑ No
Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ,'a No Received: ❑ Yes ❑ No
�.>SDC Exemption for ADU applied for: ❑ Yes No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified f�? No Applied For: ❑ Yes ❑ No,stop intake
e 2PZoning:
Required Setbacks: Front: -2-411 Rear: 151 Side:_5Streets Side: -2-0t Garage:
PBBuilding Height:
Y�r Max. Height: l Actual Height:I k C 4C1(��k�'
fi"{c scape Area. % ale °
�Izst C-� �r �V1ax. /o
F _P____ -��-udcA�lc,�Irol�;�a fry, ctYPPt-fa�1„o wall ❑ Parallel to street or offset 45 degree,.urless
Gatage•--Q. 11�ar4ge door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
❑ Door exti nds np more than 5' from wall and there is a covered porch ext ,dingo n garage.
El Door extends no more iltaa�,from wall and there is a 12,-,q_ft-urii�above garage on 2nd floor.
❑ Garage door width is El 12'or less�_C`� (l°lvoTie`ss of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch _❑�-•es e-d entrance -NVa offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire sh es''w ❑ Lap Siding ❑ Roof pitch�`Gab`l�e�,hip,or gambrel roof ❑ Dormer
ding ❑ Window trim ❑ Window recess L]-wi ow projection ❑ Balcony
' -- nce r a orestry an �- C I,,
25 Sensitive Lands: �� Yes El No Type: t-t S 5k_ 11o,?g e S
❑ Conditions met prior to issuance of buildin permit
Notes: vV t C' S
FU Approved By Planning: Date: ,aa
(Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\Building\Forms\B1dgPemiitRvw_RES_122419.docx
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
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 CCB# 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
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.
Print Name of Permit Applicant
12—
Signature
of Permit Applicant Date
Permit#: 1!►ST �G72- W I / L F
_ Q 1 0
Address: 122_2 S L) C"A,�f
Issued by: Date: .__ _
This Copy for Permit Offices
F Information Notice to Owners About
Construction Responsibilities
(ORS 701.325 (3))
Homeowners acting as their own general contractors to construct a new home
or make a substantial improvement to an existing structure, can prevent many problems
by being aware of the following responsibilities:
• Homeowners who use labor provided by workers not licensed by the Construction Contractors
Board, may be considered an employer, and the workers who provide the labor may be considered
employees. As an employer, you must comply with the following:
• Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages
at the time employees are paid. You will be liable for the tax payments even if you don't actually
withhold the tax from your employees. For more information, call the Department of Revenue at
503-378-4988.
• Unemployment Insurance Tax: Employers are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment
Department at 503-947-1488.
• Oregon's Business Identification Number(BIN): is a combined number for both Oregon
Withholding and Unemployment Insurance Tax. To file for a BIN, go online to the Oregon Business
Registry. For questions, call 503-945-8091.
• Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation
Law, and must obtain Workers Compensation Insurance for their employees. If you fail to obtain
Workers Compensation Insurance, you could be subject to penalties and be liable for all claim costs
if one of your workers is injured on the job. For more information, call the Workers Compensation
Division at the Department of Consumer and Business Services at 800-452-0288.
• Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from
employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax.
For a Federal EIN number, go online to www.irs.gov.
Other Responsibilities of Homeowners:
• Code Compliance: As the permit holder for a construction project, the homeowner is responsible
c-- __a:a.:__ L...ar:__ _sc:_:_i_ _i 4L._ ___-___:_a_ a:.Y-.. .._ aL__a aL_ -__..:-_J :_____a:___ ___ L_