Permit (3) ENGINEERS
1819 SW 5TH AVE#266
PORTLAND, OR 97201
'AI,c two'consulting TEL: 503-739-2401
pic.n resoew consutant ,sels;rnc brace. stucturel design.structural evaluation WWW.kbtengineers.coln
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STRUCTURAL CALCULATION
Project: Attached Addition
Re: New Beam at Existing Opening
Client:
16236 SW 103rd Ave
Tigar ,
Job No.: 21-1021-1
Date: Aug 22nd, 2023
Since the new addition framing runs parallel to the exiting house opening and no additional loading from
the addition on the existing header, the called out beam 3 ''V2"x 1 l 7/8"24F-V4 GLB is not required
unless the existing opening enlarged. This is based on the loads and assumptions stated within the
structural calculations set. If these loads and assumptions are not correct,this set should be revised. The
adequacy of the existing structure is the responsibility of others.
P� R OFFS
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EXPIRES: 12/31/23
Structural Construction Management Seismic Bracing
CITY OF TIGARD MASTER PERMIT
IIIII . COMMUNITY DEVELOPMENT Permit#: MST2022-00201
T i G A R..T.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/16/2022
Parcel: 2S114BB16300
Jurisdiction: Tigard
Site address: 16236 SW 103RD AVE
Subdivision: RIVERVIEW ESTATES Lot: 9
Project: Heye
Project Description: Addition and attic conversion to a bedroom. TRADE PERMITS TO BE PULLED SEPARATELY.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 1 First: 168 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 424 sf Garage: 0 sf Front: 20 Smoke
Yes
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 592 sf Value: $72,496.32 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 Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Bckflw Prevntr: 0
Drywell-Trench Drain: 0 Other Fixtures: 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 add9 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-3 592
Owner: Contractor:
HEYE,ASER B OWNER Required Items and Reports(Conditions)
TIEL-HEYE,KIMBERLY E
16236 SW 103RD AVE
TIGARD,OR 97224
PHONE: PHONE:
FAX:
Total Fees: $3,288.52
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 t
the 180 days. ATTENTION: Oregon law re ires you to !low the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
QF9-r1nl-n(Nn thrn,,nh(lAR 9 n1-n n,Vn maw nhfain nnn, f tha nilac nr rlirant nnactinne to fll INC h,Tallinn Fn 9 10R7 nr 1 Ron 1'19 9'14,d
Issued By: Permittee Signature: � r71 /71�/1 1;7
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
Residential RECEIVE! FOR OFFICE ESE ONLY
City of Tigard Received / Cs
JUN 2 9 2022 Date/By: /� , I, 8'fp49,2,v0(2 20/
ui 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 CITY/� t` Date/By: 2� Other Permit:
T]G 4 K p Inspection Line: 503.639.4175 CI l 1 V F T ft AH Li Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard-or.gov P Notified/Method: I �J'r Supplemental Information
BUILDING DIVISIG+�a / 77//JS
r
TYPE OF WORK REQUIRED DATA:I-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
�ition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on t s application. `�Z
Valuation. $
and 2-family dwelling ❑Commercial/industrial 4��1
ElAccessory building 0 Multi-family Number of bedrooms: ONE I
El builder ❑Other: Number of bathrooms: y .
JOB SITE INFORMATION AND LOCATION Total number of floors: WO eta
Job site address: IL �3 go /0 New dwelling area: 5�� square feet 1lZ(j �,,
City/State/ZIP: T7!�✓►�i� L -„ZC f Garage/carport area: square feet J ( 1) /S
Suite/bldg./apt.no.: Project name: i (14.5 gefyidli Covered porch area: 0 square feet
Cross/ street/directions to job site: Deck area: square feet
!0 Def,41019 Other structure area: 0 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
r-WV - ( V / .- A- f5 1f0! Valuation: $
PIUS: 1 �" n ,/sk ii3 s^T76i e-n �6 M Existing building area: square feet
s-• CA 01>ek • 1-rfn_a-t- re-rrakt -V-C— New buildingarea: square feet
1ROPERTY OWNER 0 TE ANT Number of stories:
Name: t L7 / /g Type of construction:
Address:/6 2,3 4, cto l 6b Occupancy groups:
City/State/ZIP: --7-7i,%0 OCL 9 a-1244 Existing:
Phone:(i 7 I ) -- 12 tie` Fax:( ) New:
APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
fContact name: ,4 i3 1 6- Structural plan review fee(or deposit):
1 1 FLS plan review fee(if applicable):
Address: (6Z310 S(,,,) /0 3 vm/ �j
Total fees due upon application: xY 3,a }:City/State/ZIP: -n6 ,0 0'1/_ 9 c,� 'T-z 2, d./
Phone:(Q 7 I) G, (,o $i7Lt j Fax: :( )
Amount received:
i
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:abli?ti e e. Q®I ., c4,on
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: D z`. Submit two(2)sets of roof plan with connection details
c,04and 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 lie.:
Total fee due upon application: $201.60
Authorized signature: 4...
This permit application expires if a permit is not obtained
y� ( within 180 days after it has been accepted as complete.
Print name: ,4 el ,I t e!i Date: 6``� 7i2 *Fee methodology set by Tri-County Building Industry
v�� / Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T( 1/02/COM/WEB)
1
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Date/By:
Received Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 a
g Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T 1GARD 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. ❑ ❑ 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: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑
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 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 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 0 ❑ ❑
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,roofmg,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 0 ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 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 ❑ ❑ ❑
architect licensed in Ore_on and shall be shown to be as•licable to the uro'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 ❑ ❑ ❑
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\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
80%
NI
City of Tigard
41
COMMUNITY DEVELOPMENT DEPARTMENT
l.. c� Building Permit Review — Residential
Building Permit #: At s7--). 2-2 „ )C> 0I
Site Address: /('2`3(e' S66 Ib3Rd) Av
Project Name: *Ye-- Lot #:
Planning Review
Pro VT sal: &tJ
Verify address/suite #active in Accela. In River Terrace: No ❑ Yes,River Terrace Review Addendum
Site n Elements: O C Erosio Control
Ispies of site plan on 8-1/2"x 11"or 11 x 17"paper ❑R e ees with drip line and tree protection measures
i
D awn to scale(standard architect or engineer scale) new structure(including decks) and FFE
M o th arrow ' locations&easements(required for new and additions)
.p. , ,•dress,project or subdivision name and lot number , tdewalk/driveway approach
J!p cant information(name and phone number) O Location of wells/septic systems
.L tt dimensions and building setback dimensions .JStre-t tree size,type and location
1 VS. re footage of buildings to be demolished P treet names
P :sting structures on site � `1 orner elevations (2'contours if more than 4'differential)
0 1 .t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? EYes No '
1,d Clean Water Services—Service Provider Lette of platted prior to 9/10/1995):
R uired: ❑ Yes,applicant was notified No Received: E Yes E No
PW-Water Meter FlOqre Unit Worksheet—Additions,Remodels and ADUs
/Required: Yes,applicant was notified ❑ No / Received: ❑ Yes ❑ No
f SE Exemption for ADU applied for: ❑ Yes [a'No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified rr'No Applied For: ❑ Yes E No,stop intake
.2r1::,and Use Case#: -2 Coning: 2--7'
Re uired Setbacks: Front: %2 Rear: / Side: ' Street Side: /-5— Garage: ?-
Building Height: Max. Height: 1 3 Actual Hei ht:
‘,12'Landscape ea: 'f� % Lot Coverage Max: V %
Entrance et back no more than 8'from street-facing wall LI Parallel to street or offset 45 degrees or less
Windows inimum 12%of area of all street-facing facades
a e Garage door is behind widest street-facing wall E Yes E No,one of the following is met:
ends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no n 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or less %or less of facade E 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ffset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding E Roof pitch ❑ a , ' or gambrel roof E Dormer
E Accent siding ❑ Window trim ❑ Window recess ❑ Win o .ection ❑ Balcony
ual Clearance ❑ Urban Forestry Plan
Sensitive Lands: ❑ Yes LNo Type:
9-4—Conditions met prior to issuance of building permit
Note
Approved By Planning: Date: 294
Revisions (after Building Submittal only Reviewer
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: C/(z / ,2_
Site Plans: #
Building Plans: #
Building Permit#: Tnter building permit#above.
Workflow Routing: Planning engineering ICJ Permit Coordinator ....JD-Building
Workflow Sign-off: .-Pr-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.
Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: Al 1
By Permit Technician: I ' Date: ,
En ineering Review
Slope at building pad: /S A
2VConditions "Met"prior to issuance of building permit h/-
Easements (encroachments)per engineering conditions of approval and plat M 1°"
2/Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes CYNo
Assess Water Quantity Fee in-lieu: 0 Yes l"No
LIDA Facility on lot: 0 Yes C "No Add Fee: 0 Yes Q'No
E'Final Plat Recorded: it i�
❑ NOT Approved by Engineering: Date:
Notes:
["Approved by Engineering: 9-" g ,1 Date: '7/I /Z 2-
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 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:
Z SDC Exemption: 0 Received Does not apply
.? SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes N/A .
Tigard Trans SDC: 0 Yes N/A
Parks SDC: 0 Yes Je N/A
LIDA 0 Yes tiel N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 1I(2I24V.
I:\Building\Forms\BldgPennitRvw RES_1208021.docx
Property Owner Statement RECEIVE f
Regarding Construction Responsibilities JUN 29 2022
Oregon Law requires residential construction permit applicants who are not licensed with1UC JF TIGARL)
Construction Contractors Board to sign the following statement before a building pern�q( IPS DIVISION
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.
Af5131?--
Print ame of Permit Applicant
Z
Sign ture of Permit Applica t Date
Permit#: d'p,.ai .lam
Address: /0-3 (0 SLJ /03 Ayr.
/ fro, og --7P41
�Date: / t S//)_Issued by: �-1
This Copy for Permit Offices
Information Notice to Owners About
` ` { 16` 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
for notifying building officials at the appropriate times, so that the required inspections can be
performed. Homeowners are also responsible for resolving any failure to meet code requirements
that may be found through inspections.
• Property Damage and Liability Insurance: Homeowners acting as their own contractors should
contact their insurance agent to ensure adequate insurance coverage for accidents and omissions,
such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not
otherwise covered as employees by Workers Compensation Insurance.
• Expertise: Homeowners should make sure they have the skills to act as their own general
contractor, and the expertise required to coordinate the work of both rough-in and finish trades.
CONSTRUCTION CONTRACTORS BOARD
PO Box 14140, Salem, OR 97309-5052
Telephone: 503-378-4621 —Fax:503-373-2007
Website Address:www.oregon.gov/ccb
f/property_owner adopted 9-2016 This Copy for Permit