Permit CITY OF TIGARD BUILDING PERMIT
Il,•n Permit#: BUP2022-00290
COMMUNITY DEVELOPMENT
Date Issued: 12/8/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135DA00200
Jurisdiction: Tigard
Site address: 11120 SW HALL BLVD
Project: Lynch Subdivision: METZGER ACRE TRACTS Lot: PTS 9&
Project Description: Demolition of(1)220 sq.ft.shed and(1)1,320 sq.ft.residential dwelling on sewer. UPON FINAL INSPECTION,
DEMO CREDITS WILL APPLY FOR PARKS,TRANSPORTATION AND SEWER.
Contractor: HARRIS EXCAVATION INC Owner: LYNCH, JAMES
21303 SW HELLS CANYON RD XU, HAN
SHERWOOD, OR 97140 8390 SW 80TH AVE
PORTLAND, OR 97223
PHONE: 503-431-0919 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Info Process/Archiving-Sm$0.50(up to 12/06/2022 $1.00
Occupancy Grp: Occupancy Load: Erosion Control w/Development 12/06/2022 $80.70
Dwelling Units: 0
Stories: 0 Height: 0 ft Permit Fee-Additions,Alterations, 12/06/2022 $301.85
Demolition
Bedrooms: 0 Bathrooms: 0
Value: $15,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $383.55
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 er. Those rules are s h in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a c rules or direct questions to OUNC by calling 503.2 .1987 or 1.800.332.2344.
Issued By: /J ee Signature: y_f
-
03.639.4175 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
,q42 fl&A tei I ""C 'I f FOR OFFICE USE ONLY
City of Tigard RDate,BY` it/,2/ Permit No: 1�1 n 'j1�criQ lc,
1,1 13125 SW Hall Blvd.,Tigard,OR 97223 N Q 1' , Plan Review ` 1T^�"G�` `-oc
Phone: 503-718-2439 Fax 503-598 1960 pategy /�/�y Related Permit_
Inspection line: 503-639-4175 (�At - ' `r
1 I�,.1 N U P� i.� � �✓r 13(�llt�-% Date ReadylBy- � � q�� � have a See Page 2for
Internet www.tigard-or.gov �i - ., '+ ,'t ,'! Noti£ied,'Method_ r 1 j, �7 Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction igi Demolition Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Additien/alteration/replacement 0 Other: equipment materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
06 1-and 2-family dwelling El Commercial industrial Valuation: $ I i 000
Number of bedrooms:
ElAccessory building ElMulti-family
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: i 112 0 Ct �C {-6 ik GI New dwelling area square feet
City/State/ZIP: '��/ly�uv �J�Irl.�� C %',[,r�?32-2 79 Garage'carpart area: square feet
Suite/bldg./apt.it: Project name: tie/l ,/ Covered porch area: square feet
Cross street directions to job site: f���'_' Deck area: square feet
Other structure area square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#t: Permit fees`are based on the value of the work performed.
Tax map/parcel tk: 1 c 13 DR—U OZ. 0 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead and the profit for the
DESCRIPTION OF WORK p �y work indicated on this application.
�'s nA.& // 620
stk. !.A(�\ ‹�1 i" Valuation: $
(_k-A- l -i-. 3")) ?iv Existing building area: square feet
() fC.._Y/7►ja -c , /j/1 4. / New building area: square feet
3 0 PROPERTY O ❑ TENANT Number of stories:
Name: (111v'.e � 'rt.) Type of construction:
yl„ Address: 0 Sl '1 .) �7 Occupancy groups:
City/State ZIP: 3
f v �v q� 3 �' 11 l 2. Existing:
M Phone.�o3} 9 .�z^s�v I ' Fax:( ) New:
\---J,, gt APPLICANT
/�+ ❑r CONTACT PERSON BUILDING PERMIT FEES'
(PleBusiness name: ti7i
_p (/ JLt C t ,(� C(� k �cviewaere( rer deposit): _
J �'� J `- Structoral plan review See(or deposit):Contact name:
Address: O�i s s\ L t , �.n FLS plan review fee(if applicable):
` ` '�w) k ) - 9 1-1�� Tonal few due upon application:
City(State/ZIP: V` O�
��L{ 3 1 ^� I ( Amount received:
Phone: t Fax: :( )
E-mail: Z t LQ,Ca hair 15 e KCc._vck_h dr\ . PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES"
CONTRACTOR Commercial and residential prescriptive installation of
roof-tap mounted PhotoVoltaie Solar Panel System.
Business name: Par
' I- Ei ')(',- , J I. f\ c . Submit two(2)sets of roof plan with connection details
1 �i�"* t v�� ` ` and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $t80.00
and administrative fees):
Phone:( ) Fax:( )
r ^ State surcharge(22"o of permit fee): $21.60
CCB Lie.: I SLTotal fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
,,, �-1 within 180 days after It has been accepted as complete.
Print name:(77 �eiY._, (( (At.i Date: /6II ?/2.2 * Fee methodology set by Tri-County Building Industry
f-l3 Service Board.
City of Tigard
N .
" COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: G c cl 0
Site Address: k(IZO AASlu t V\O lerified in Accela
Project Name: UrdV\ S PeAdlo Lot/Unit #:
Proposal (include housing type): ` eVY)O lS Obkh1ckn1 Zone:
Required Site Plan Elements: < 'f1/t r) pv,'6 Pi+w
copies of site plan on max 11x17"
��--12-Brown to standard scale -B'R'e arter trees, drip line/ tree protection
ID-No tlrarrow .Strdaet:-and site trees shown / labeled
ite address, project name, lot # -B-Tabletalculating tree canopy at maturity
AI Street names (N/A for SFR)
Applicant name and phone # bird rectangle dimensioned (if applicable)
e-tot-aritrsetback dimensions ❑ Vision clearance triangle
'xisting structures & square footage - dttttty locations &easements
e-Feotprint of new structure and FFE -Rr-operty corner elevations
-0-Sid ik/driveway dimensioned ❑-61DA (>1,000 sf disturbance)
tul aIce and lot coverage percentage osion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Garage doors dimensioned
❑ Dra standard scale Summa table with calculations for:
❑ Building heig •mensioned al facade area
❑ Facade dimensione ❑ Total window and door area
❑ Windows and doors dimensio ❑ Total garage area
Required Floor Plan El nts: ary table that includes
❑ Each story cr nsioned ❑ Total floo area
❑ Each s floor area calculated ❑ Floor area per story
Planning Review
The following standards have been met:
Setbacks ❑ Front: Rear: Side: Min/Max Street Side: / Garage:
Height ❑ - Height: Proposed Height:
❑ Yes ❑ N/A Landsc-.-
❑ Yes ❑ N/A Screening (••:• only)
❑ Yes ❑ N/A % Window Covera•
❑ Yes ❑ N/A Garage (SFR Only)
Parking (Other Res)
❑ Yes ❑ N/A Entrance (SFR, Rowhou -, Quad o
❑ Yes ❑ N/A Other building desig andards (Rowho - only)
❑ Yes ❑ N/A Accessory Struct - Standards
❑ Yes ❑ No Qualifying pre isting unit exempt from standards - .ttage unit only)
Additional standards for 'ourtyard Units, Cottage Clusters, Row • es, and Quads:
❑ Yes ❑ N/A Unit Co
❑ Yes ❑ N/A Lot W".th and Size
❑ Yes ❑ N/A Pathway
Additional standards for Courtyard Units and Cottage Clusters only:
❑ Yes 0 N/A Unit Area:
❑ Yes ❑ N/A Floor Area (per story)
❑ Yes ❑ N/A Courtyard
❑ Yes 0 N/A Fence
❑ Yes ❑ No Jlal/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes ❑ No WI/A Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes ❑ No
Applied For: ❑ Yes ❑ No, stop intake
4:Sensitive Lands: ❑ Yes 9l0No
%%Land Use Case #: ❑ Conditions met prior permit issuance
Approved By Planning: Date: h l/mot 2A
Notes t,1 lid VA.
AN-.
Revision 1: p
Approved ❑ Not Approved e— Date: /2-/i 2/ZZ
Revision 2: 0 Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: If/m/a,D
Site Plans #:
Building Plans #: l/Q
Building Permit #: ®-Building permit # entered on page 1
Workflow Routing: El-Planning ❑ Enginnring ID-Permit Coordinator ❑ ilding
Workflow Sign-off: 8-Sign-off for Planning (include notes from planning review)
Route Documents: ❑ E neering: (1) copy of permit application, (1) site plan, (1) building plan
an original plan review routing form.
❑ Binding: original permit application, site plans, building plans, engineer and
beam calcula ions and trust details, if applicable, etc.
Permit Technician: ' L/\ Date:
Notes:
Engineering Review
❑ Slope at building pad:
❑ Conditions met prior to issu ce of permit
❑ Easements (encroachments) p engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee -lieu:,. s ❑ No
Assess Water Quantity Fee '-lieu: ❑ Yes ❑ No
LIDA Facility on lot: 0 Yes ❑ No Add Fee: ❑ Yes ❑ No
❑ Final Plat Recorded
❑ NOT Approved: Date:
Notes:
Approved By Engineering: Date:
Revision 1: 0 Approved ❑ Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
Permit Coordinator Review Conditions met prior to permit issuance J6 ZO n-0 OOO 1 -e_„crAreeL'. \l Q)1\ r �W iU Lcprdian
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required: Date notified applicant:
u DC Exemption: ❑ Applied for ❑ Received 1261Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A ❑ Deferred
Parks SDC: ❑ Yes N/A ❑ Deferred
LIDA ❑ Yes N/A
K to Issue/Approved by Permit Coordinator: Vv.) \\ Y C. Date: Z- ' `Z2
Revision 1: 2'Approved ❑ Not Approved Date: J L�1-2,17 yL'L
Revision 2: 0 Approved 0 Not Approved Date: