Permit , a CITY OF TIGARD MASTER PERMIT
0 COMMUNITY DEVELOPMENT Permit #: MST2009 -00230
,4-,i GAR d 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/11/2009
Parcel: 2S 111 DCO5900
Jurisdiction: Tigard
Site address: 9445 SW BRENTWOOD PL
Subdivision: SUMMERFIELD NO.9 Lot: 535
Project: Eischen
Project Description: Enlarge patio door and add window in living room.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes
Total: sf Value: $3,700.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
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
Fum > =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 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add9 Br Cir:
601 -1000 amp: 0 601 +amp- 1000v: 0
1000 +amp /volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
EISCHEN, STAN 8 BETTY NOVA VENTURES INC 1 MST Requires electrical signature.
9445 BRENTWOOD PL 11115 SW INDUSTRIAL WAY
TIGARD, OR 97224 Tualatin, OR 97062
PHONE: 503 -440 -2095 PHONE: 503 -691 -6542
FAX: 503 -691 -6542
Total Fees: $325.98
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 ac • := th 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. AT TION: Oregon law re ' es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 through OAR 952401 1000 Y ay obtain a copy of the rules or direct questions to OUNC by calling 503.246.6 99 or 1.800.332.2 4.
Issue. By: ► \ /f Permittee Signature:
Building Permit Application ,_ , l le , : . `n
a1 tifix' ,� ? e 5�'l i ` tt+ le rl�if, 'Y . ... r tti{ r qd. t
Residential f a v
D`C U9 2d ()I 4 t ; t (>I I ICI Util ()i�l1�F3 T > ��Y«
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CITY OFTIG �a of p
ty g ' B Permit No.:, 5 � 9 00.2 30
° 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 BUILDING DIV I % 18 view - I s ® i
. Other Permit:
T I - T �Z l Inspection Line: 503.639.4175 Date Rea... luriss ® See Page 2 for
us Internet: www.tigard- or.gov Notified/Method: /,, G 09 —7 4 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1:1 I- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 3 UU
❑ 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: 4 1 4 s1..0 e €I,11..yoot ?L. New dwelling area: square feet
City /State /ZIP: 1, `4 (1Q7 0 2 °1.111.`( Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: EtsotEK1 Z(vMpO * 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: Lot no.: Permit fees* are 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, overhead, and the profit for the
'DESCRIPTION OF WORK work indicated on this application.
1z. E A■OV E. E.X+1-5Ttts1 7 (1,11.0 g(9 Q A El.) Ltict'(TE Valuation: $
p,O D App C 0101 J (o S X111 Qt - j v V L / LN & EP Existing building area: square feet
New building area: square feet
• ❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: bl- Lu A (5e. 1.4t; I A r E 4 .3 Type of construction:
M Address: Gklti t{S S kJ 6 (LetSk,00 9 ' L' Occupancy groups:
M City /State /ZIP: tto kZa 0 Z 61 1 1t2_ 4 Existing:
I\ Phone: ( 93) y, yp_ tc y % Fax: ( ) New:
❑. APPLICANT �$ CONTACT PERSON NOTICE
Business name: J +� Q � All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
n Address: jurisdiction in which work'is being performed. If the
City /State /ZIP: 2 " V733 applicant is exempt from licensing, the following reasons
NI) apply:
Q Phone: W J Z 1 J Fax::( )
E -mail:
CONTRACTOR .
Business name: NO V v EN X11 i2S5 Z 0 L BUILDING PERMIT FEES*
Address: (,, t kS SW .4 lJ Q) 51 L(N- t4 try
(Please refer to fee schedule)
Structural plan review fee (or deposit):
Tv ►t.0tLT�N OE ° 17 Of°Z
� � City /State /ZIP: ( ) ` tpg4Z 503) ( `( 4 Z FLS plan review fee (if applicable):
Phone: Fax:
C// / ( Total fees due upon application: A g �/
CCB lie.: + ( 7'
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: S� iO Z f f Date: 1 L_.O� _ * Fee methodology set by Tri- County Building Industry
Service Board.
: \Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11 /02 /COM/WEB)
Building' Permit Application Checklist
One- and Two - Family Dwelling nt>4F�koN.1�1
City of Tigard Received Permit No.:
+ n 13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
_ Phone: 503.639.4171 Fax:. 503.598.1960. Associated permits:
0 `
` 24- Hour Inspection Line: 503.639.4175 El Electrical ❑ Plumbing ❑ Mechanical
( I t. ARD
Internet: www.tigard - or.gov ❑ Other:
� k i 1 'Q�' �) � � % 1 1
ti ,ya FOR IyLANsRrV1r4 _�u. w>.r ._,., •
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
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 ❑ 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 ❑ ❑ ❑
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 Toad.
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 ❑ ❑ ❑
architect licensed in Ore • on and shall be shown to be a . licable to the •ro•ect under review.
kis'i3tC 1IONr\I SNP C�� ICS �! .,r.: °
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, ❑ ` ❑ ❑
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.
1 : \ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(1 I /02/COM/WEB)
le 1 Permit f' EKED 1 4 W. 1 11 ! It 1 1 , 0,1 1
r
City Df Tigard D a t' �/ �� . i aor+nt?4 /�?7 � ' - Gb
13125 SW' 1-1a11 Blvd., Tigard, OR 1 Q 2009 �, , Review Other Permit: Phone: 505.639,417 Fax 503.5 0 031611y: .010 10Apedion Uric: 507.639 4175 RL Pais p.a dyyfay: �► g tsrevml laPom�namtmn
lntcrtt4t www.ttgatd -er,gm IrrY 8 , ethod
^l �F Tt _ 1 i
NMiiSacifM •
.ch :i i a pl . ,, rte .a" 1
New construction ❑ Addition/alteration/replacement
Plato cheek all that apply (.choir 3 ran of plane wntarpe checked below):
0 Seculac ar seder 400 moms o Mac ❑ Banding aver thrall etorlee.
0 Demolition Q Otter: where the aveifablc fault comma ❑ MIAMI rand ba lymrdr.
r mm6 10,900 traps at 190 .mite or Q Floating bnlldlogt.
lees to ground, fa exasada 14,000 d Centmtreiai•LM nricufmrrl
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building armpi Air iii: ruler inetenenene. bvimimgn
❑ Mu1ti -famil [] Master builder ❑ Other: ❑ fire pmrp. ❑ tnctaltntion er 75 KVA Of
.•.- .�. 0 !memory +yotam. tango' x:9"raaty dcrtvcd eynem.
:l5 ❑ addition of new motor toad of 0 "A" " P" "1- T ''l• ? - ,
no.: Job site address: tr 1ooi� ram. oaceoa�ey,
Job
' '_,,,4 .e • . 4 ,. ❑ Six or more raatdentint roots, 10 Roaoalional vehicle pain.
City /St iejzw: • • ❑ Paeard Gtattirie . CI Supply voltage air m ore then
` "1 {D a' . .--- —
0 }� 0I4s. doua locatiorm. 600 wilts mem,inal,
r i � N ir1 a 3Cr71 or fewrl son anpf in ones.
;quite/bldg./apt. no.: i Project name ' LSL.M ��., __ k ..
Cross Erect/directions to job sire: _ t"+ "lei niM
New reaidentlul tingle. or multi - limply dwelling nail.
Includes attached - • e.
Subdivision: Lot no. 1,000 so. R. or Icae (63.34 4
E. add'1 • .. It 01 ptytticm 33.92 1
Tax map/parcel nn.. NEFRlli
77'77 , . .. 67.84 2 •
r ,� 11 Limited energy, multi•femily 67.84 2
Q rL._• P�G�A W a�� r �lr lto V It W �kNtr Services or hedcrA b t1adon tlltcrNtlnn,end /orrelocation
260 amps or lore 100.70 2
e • , . . ti '1E't' • 201 amps to 400 !traps _._ 133.56 2 1
Name; , u - 401 to 600 t 100.30 2
L
U C 601 amps to 1,000 imps .301,04 2
Address:
t�3i..k, 5 vj KrAir weep i? L. Over 1,000 !imps or volts _1 552.26 MN 2
Temporary services or (cotters Installation, attention, andfur
City StatealP: 7l , dr1Z =21 relocation
Phone: (y i ) ! „ /a S Fax: 1 ) 200 am s r en lass T - 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made an property the! 1 own which is not
intended for sale. !star. rent, or exenangc, according to ORS 447, 449. 670. and 701. 401 amps to 599 amps ■ 168.54 2
B rrine h eiroutts Ste, alttrmti . o r 6EtrM1b t anti
Owner signature Date: A. pee for branch circaitc wolh �T--
above service or tt:cdcr fee. 7.42 2
each brands circuit
Business name: _ a or Conch c;rcuitA
w_ — - _ J wrrkout Wilk C OT feeder foe, { 56,18 15-,. �d 2
Contact name. brands circuit t
Address; Each add'1 branch circuit J. j 7.42 . . 2
1i s c1uneons (service or ket not !Eluded) C icy /State /71P: PIA n red or modular 6134 2
-- - - dwelling, 16rvia andf9rfeeder i
Phone: ( ) rex:: ( }
_ Mumma only 67.84 2
E -melt; - Pump or itti8ati0n circle 67,8 2 -
et
9 ' . • _ 7 Elm n outline 11109 i . 57.84 2
Business name: L �,C_.� �,� L - ce . _ r Signal aircett(s) lirmtod-
-_ energy panel. alterarlon_ or
Addree $e/Q5 �1 L, �GOOU , t 7 (;tension. Describe: Page 2 2
I
City.' 7.TP lo1ct __L i.. c.Z Z l- Ettth edditionel Ins pethioo raver oltowable In an or the stove
Per inspection 66.23
Phone: (gD) .. _ Fax: (S4 e� fZ - a2°t0
P e r ____, Mvestigatioa bairn hr min) ' 6625 _
CCB Lic.: [ I ( lrleatrcal l,ic.: 2.4, . I it,. c_i Su
pprv. Lic.: •11-0 , 1nduatrial plant pa hour 7e,1 m
rv, Electrician Al at p >1t r
Su t.
p gr p1C. required /� �'r� Sulmrtal' _
Print name' `"" - 1 Date: Plan r e v i e w ( 2 1 % alma r.$)_ L
-- --.. —. 1 . j State serchartje (12% of permit fee); li ,r(,
Author{,cd signature:
_ L TOTAL PBRMIT PF.E: Met'
Priest name: TMx permit appllelNsa egwrae If a permit he rant Mwmae4 witbir ISO
drys nine it IM been aeectee/ ae compute
Number of irnpam;onr dlowed Per pann't,
• iw.uMinxVer,nicaLc- verm:rveeose loco) ao AA151 1;t6COMMEB
a ) 9 tA c e c t - ((i ) aha (` t w/ 0-e tier- -
!G race.) Co ►- -Wac-