Permit *, ( a CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00311
COMMUNITY DEVELOPMENT DATE ISSUED: 9/9/2008
.Tic'A_tiP, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S105DB - 06100
SITE ADDRESS: 13230 SW 154TH AVE ZONING: R - 25
SUBDIVISION: MENLOR RESERVOIR LOT: 001 JURISDICTION: TIG
PROJECT: CITY OF TIGARD
Project Description: Demolition of 1750 sq ft house, 160 sq ft accessory structure. Septic tank is to be pumped and either
filled or removed. SDC credits available for future construction.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Owner: Contractor:
CITY OF TIGARD OWNER
13125 SW HALL BLVD
TIGARD, OR 97223
Contact #:
Phone: 503 - 639 - 4171
Reg #:
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/9/2008 $62.50 Ersn Cntrl 681 -4444
[TAX] 12% State Surcha 9/9/2008 $7.50
[ERPRMT] Erosion Cont 9/9/2008 $26.00
[ERPLN] Erosn Pln Rv C 9/9/2008 $8.45
(additional fees not listed here)
Total $112.90
This permit is issued subject to the regulations contained in the Tigard Muniapal 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 than 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 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503.246.6699 or 1.800.332.2344.
Issued B Permittee Signatu 2 f rv—(.—___
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 5 4 ' ,� r xx ... - � 1 f. - tfu.,,, ;�_,
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City of Tigard DateBva / 9 9 Q �� is I Permit No: , u g .00 5//
±� ' 7!.,
1 1 r a 13125 SW Hall Blvd., T OR 97223 Plan Review
- g - C • - Phone. 503.639.4171 Fax: 503.598.1960 Date/By: Permit:
•A R D Inspection Line: 503 639.4175 Date Ready /By: luris See Page 2 for
Internet: www.tigard or.gov Notified/Method: / 1 [i Supplemental Information
. TYPE OF .WORK , - - REQUIRED DATA: 1 -AND 2- FAMILY DWELLING
❑ New construction Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration/replacement 0 equipment, materials, labor, overhead. and the profit for the
a CATEGORY OF CONSTRUCTION . work indicated on this application.
:N. RI 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
- .Accessory building ❑ Multi - family Number of bedrooms:
?`' ❑ Master builder ❑ Other: Number of bathrooms:
1(1 JOB SITE INFORMATION AND LOCATION ' • Total number of floors:
s't Job site address: 1 3x30 SLO i 5 Ill Ave New dwelling area: square feet
• City /State /ZIP: I�ti16rTOo� e,0 anti "n . OR q7„2.)4 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: CA 0 h'_ / M_&i L OR, Covered porch area: square feet
,, Cross street/directions to job site: V Z 6 - 5 ` 1 4 d / b �dE,• , dr. Deck area: square feet
' + T (=lea 7 � Other structure area: square feet
.T) REQUIRED DATA: COMMERCIAL -USE CHECKLIST.
Subdivision: I 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.: Z S (� j g(, I �� equipment, materials, labor, overhead, and the profit for the
• `' DESCRIPTION .OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
.. . _ .t_ -s . •►0.. ' ..4 III
0 I New building area: square feet
•ROPERTY OWNER 0. TENANT Number of stories:
Name: C 111 f Type of construction:
t ddress: 1 3 i j- 5 S 4A.) 1.4rA 4 5 ad Occupancy groups:
4
City /State /ZIP: l 69R t�� "3 Existing:
Phone: (SO3) C, 1 3 4 3 6--41 7 4a / 7 I Fax: (S ) � PXI/ ' �O New:
a . ❑ APPLICANT . ` . ❑ CONTACT PER SON `. • NOTICE
�, Business name: 011.71 o F - T a d All contractors and subcontractors are required to be
3 Contact name: /V) t /, L(/ee, fL licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: �7 Si J i �(/�/f /�fyVl s - jurisdiction in which work is being performed. if the
a. ) applicant is exempt from licensing, the following reasons
Cit y /Sta te /ZI 776 0t? 7 ;) y Vi h CUPO (� 4r l n (/1s apply:
4: i Phone: ( 5 ) it Y Z 5.1 3 Fax:: ( 563) 6 p, - rf i 4 <v
4 E -mail: lam, /re 0 '�� —u r 5 oV
V CONTRACTOR •
IFIAusiness name: - h yam r l at er„seu .e 4-/ 4.) • -.BUILDING PERMIT FEES* -
(Please iefer to fee schedule)
Address: I a t.I 0 0 SW owl l U
.(� I Structural plan review fee (or deposit):
City /State /ZIP: ii C 0 z q 7 I µ0 =
Phone: ( 03) ( _ g5 ( ) FLS plan review fee (if applicable):
Fax:
CCB lic.: Total fees due upon application:
C 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: G-. 114 La 4.4_ 1 Lou-IL- Date: q/ q 10 li.' * Fee methodology set by Tri- County Building Industry
Service Board. ,y Q
I: \Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4 613T(I1/02/COM /WEB) ( -p //a • /
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Building Permit Application Checklist
; � COI
One- and Two - Family Dwelling OFFIC E U SE ONLY •, ,� £ ` ' F 4
11111 City of Tigard Received Permit No.:
D /By:
V 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
C Phone: 503.639.4171 Fax: 503.598.1960
.:TIGARD
24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑ Mechanical
- , . Internet: www.tigard- or.gov ❑ Other:
j�j *THE FOLLOWING ITENIS;ARE
E;RQUIRD
EFOR PLAN _REVIEW > :4 v
p es'.: f No , N/A
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 permi . ❑ ❑ ❑
7 Water distric : pproval. ❑ ❑ ❑
8 Soils report. • t carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control a plan ❑ permit required. Include drainage -way protection, silt fence . sign and location of catch- ❑ ❑ ❑
basin protection, etc.
10 3 Complete sets of gible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into th• plans or on a separate full -size
sheet attached to the plan with cross references between plan location and detail . Plan review cannot be completed if
copyright violations exist.
11 Site /plot plan drawn to scat: The plan must show lot and building setbac dimensions: property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. elevat . n differential. plan must show contour li s at 2 -ft. intervals): location of easements
and driveway: footprint of struct e (including decks): location of wells /.eptic systems: utility locations: direction
indicator: lot area; building coverage area: percentage of coverage: i •ervious area: existing structures on site: and
surface drainage.
12 Foundation plan. Show dimensions, . chor bolts, any hold -dow s and reinforcing pads, connection details, vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room • entification, wind w size, location of smoke detectors, water heater, ❑ ❑ ❑
furnace, ventilation fans, plumbing fixtures, ,alconies and . cks 30 inches above grade, etc.
14 Cross section(s) and details. Show all frami •- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑
floor, wall construction, roof construction. Mors than o - e cross section may be required to clearly portray
construction. Show details of all wall and roof sh • , th' g, roofing, roof slope, ceiling height, siding material, footings
and foundation. stairs, fireplace construction, therm. insulation. etc.
15 Elevation views. Provide elevations for new cons• c '.n: minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade ' the ch. ge in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation • levations ith cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lat ral analysis p : ns. Must indicate details and locations: for non- ❑ ❑ ❑
prescriptive path analysis provide specificat'.ns and calculatio to engineering standards.
17 Floor/roof framing. Provide plans for all oors /roof assemblies indicating member sizing, spacing, and hearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provio a cross sections and details owing placement of rebar. For engineered ❑ ❑ ❑
systems. see item 22, "Engineer's cal. lations."
19 Beam calculations. Provide two se . of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and /or any beam/. ist carrying a non - uniform load.
20 Manufactured floor /roof truss • sign details. ❑ ❑ ❑
21 Energy Code compliance. Ide ify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑
for four or more appliances:
22 Engineer's calculations. Wh:, required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Oregon a d shall be shown to be applicable to the .roject under review.
.JURI SDICTIONAL Si E 4
23 Three (3) site plans are required for Item 1 I above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ a
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(11 /02 /COM/WEB)
•
City of Tigard
pzoo8 -op 3L
TIGARD Tidemark Journal Entry Request
This form is used to request a journal entry for Tidemark case fees to: 1) correct revenue accounts
of paid case fees, or 2) transfer fees between revenue accounts to pay case fees. Receipts and
documentation must be attached when applicable. All Tidemark journal entry requests must be
routed to the Tidemark System Administrator for processing. The Tidemark System
Administrator will route the request to Accounts Payable and a copy of the journal entry will be
returned to the Tidemark System Administrator to adjust or pay case fees.
DATE: September 17, 2008
REQUESTED BY: Dianna Howse
CASE NO.: BUP2008 -00311
RECEIPTNO.: N/A DATE: N/A
EXPLANATION: City of Tigard project to demolish residential structure at 13230 SW 154th Ave.
"Posted" Account Description Posted "Post To" Account Description Post To
(Account where fees currently reside.) $ Amount (Account fees are to be transferred to.) $ Amount
Example: 245 - 0000 - 433000 Example: 245- 0000 - 432000
[BUPPLN] Pln Rv [BUILD] Permit Fee
225- 6400 - 757014 $112.90 245 - 0000 - 432000 $62.50
Clute Property House Demo [BUILD] Permit Fee
100 - 0000 - 207020 7.50
[TAXI 12% State Surcharge
100 - 0000 - 207307 26.00
[ERPRMT] Erosion Control
100 - 0000 - 207308 8.45
[ERPLN] Erosn Pln Rv CWS
245- 0000 - 433010 8.45
[EROSN] Erosn Pln Rv COT
TOTAL: $112.90 TOTAL: $112.90
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Fees Adusted: E #: Date: /p , B : �•
1:\ Building\ Refunds \loumallintrvReyucst.doc 09/15/06
General Ledger
Journal Entry Proof List
User: Phyllis
Printed: 09/22/2008 - 2:18 PM
Account Number Account Description Debit Amount Credit Amount Line Description System Reference Project Management
Journal Entry: 000328 03 2009 Journal Entry Date: 09/22/2008 System: General Ledger
100- 0000 - 101000 Cash & investments 41.95 0.00 Bup2008 -0031 I /Demolition
Permit/Klute Property
100- 0000 - 207020 State Bldg Permit Surcharge 0.00 7.50 Bup2008- 00311/Demolition
Permit/Klute Property
100- 0000 - 207308 Erosion Plan Check Fee - USA 0.00 8.45 Bup2008 -00311 /Demolition
Permit/Klute Property
100- 0000 - 207307 Erosion Permit Fee - USA 0.00 26.00 Bup2008 -00311 /Demolition
Permit/Klute Property
225- 0000 - 101000 Cash & Investments 0.00 112.90 Bup2008- 00311/Demolition
Permit/Klute Property
225- 6400 - 757014 Clute Property House Demo 112.90 0.00 Bup2008- 00311/Demolition
Permit/Klute Property
245- 0000 - 101000 Cash & Investments 70.95 0.00 Bup2008- 00311/Demolition
Permit/Klute Property
245- 0000 - 432000 Building Permits 0.00 62.50 Bup2008 -00311 /Demolition
Permit/Klute Property
245- 0000 - 433010 Erosion Control Plan Check Fee 0.00 8.45 Bup2008- 00311/Demolition
Permit/Klute Property
Journal Entry Totals 225.80 225.80
Journal Entry Balance 0.00
01., - Journal Entry Proof List (Printed: 09/22/2008 - 2:18 PM) Page 1
10/7/2048
4:40PM '
Payment History For
CCEL Case #: BUP2008 -00311
Recorded
Type Fee ID # Description Fees Paid Date Paid Check # Receipt # By Due History
PRMT 200810071637139120 [BUILD] Permit Fee 62.50 62.50 10/7/2008 JE #328 DLH 0.00
SUR1 200810071637202720 [TAX] 12% State 7.50 7.50 10/7/2008 JE #328 DLH 0.00
Surcharge
EROS 200810071637288970 [ERPRMT] Erosion 26.00 26.00 10/7/2008 JE #328 DLH 0.00
Control
ERPC 200810071637361310 [ERPLN] Erosn Pln Rv 8.45 8.45 10/7/2008 JE #328 DLH 0.00
CWS
ERP2 200810071637410380 [EROSN] Erosn Pln Rv 8.45 8.45 10/7/2008 JE #328 DLH 0.00
COT
Total Fees: $112.90 Paid: $112.90 TOTAL REMAINING DUE: $0.00
Page 1 of 1 CasePaymentHistory..rpt