Permit lii I BUILDING PERMIT
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PERMIT #: BUP2008- 00198
COMMUNITY DEVELOPMENT DATE ISSUED 6/25/2008
Tt , ,,. ,„ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 103 B D -02900
SITE ADDRESS: 12020 SW CARMEN ST ZONING: R-4.5
SUBDIVISION: CARMEN PARK LOT: 002 JURISDICTION: TIG
PROJECT: HORAK
Project Description: Construct 528 sq ft accessory structure. No electrical work at this time.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ACS FIRST: sf N: S: E W:
TYPE OF USE: SF SECOND: sf PROJECT `OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: • 1 HT: 12 ft GARAGE: 528 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: 50 psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: 20 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 19,715.52
Owner: Contractor:
TRAVIS HORAK OWNER
12020 SW CARMEN ST
TIGARD, OR 97223
Phone: 503 - 231 -8161 Contact #:
Reg #:
FEES
REQUIRED ITEMS AND REPORTS
Description Date Amount
[BUPPLN] Pln Rv 6/6/2008 $167.34
[BUILD] Permit Fee 6/25/2008 $257.44
[TAX] 12% State Surch 6/25/2008 $30.89
[CDCPLN] CDC Pln Re 6/25/2008 $46.00
(additional fees not listed here)
Total $550.57
•
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 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 _ `, % ■ 'ermi -e Signature: ” _- 4
- —
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.
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71 City W Tigard 0 6 2008
13125 SW Hall Blvd., Tigard, OR 97223 U,N Plan Review
a Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit
y /�IAJ �, 7 -
Tic; A R 0 Inspection Line: 503. 639.4175 `•> p FTIGARD Date Read ?v ® See Pagel for
Internet: www.tigard-or.gov BU DIVISION D s t! o rMetnod: (v ~� S laformadoo
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TYPE OF WORK S(, 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- and 2- family dwelling ❑ Comercialfindustrial Valuation: $ . /�•
m
® 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: 12020 SW Carmen St. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job.site: Deck area: square feet
Other structure area: Sag square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Carmen Park Lot no.: 2900 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 251036D02900 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.
Build a 22' X24' accessory structure with a concrete floor. Valu tion: $
See drawings for more information. Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Travis J Horak Type of construction:
Address :. 12020 SW Carment St. Occupancy groups:
City /State/ZIP: Tigard, OR 97223 Existing:
Phone: (541)231 -8161 Fax: ( ) New :.
® APPLICANT ❑ CONTACT PERSON NOTICE
Business, name: Same as Property Owner Al] 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
Address: jurisdiction in which work is being performed. If the .
City /State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax: ( )
E -mail:
CONTRACTOR
Business name: ' - })J a /C�
�`„' BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City /State/ZIP: Structural plan review fee (or deposit): /67 37
Phone: ( ) Fax:( )
FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received:
Authorized signature: /7............ �; ---- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Travis Norsk Date: 6/6/08 * Fee methodology set by Tri-County Building Industry
CITY OF TIGARD
°BWU ING DIVISION PERMIT #: DUP 2 110 00108
13125 SW Hall Blvd., Tigard, OR.97223 D ATE ISSUED: 6125/20013
Phone: (503) 639-4171 - b
Inspection Requests (24 Hrs.): (503) 639 -4175 .. '. 11
INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 10
SITE ADDRESS: 12020 SOF CARMEN ST CLASS OF WORK:
SUBDIVISION: CARMEN PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HORAK
DESCRIPTION: Construct 528 sq ft accessory structure. No electrical work at this time.
OWNER: HORAK, TRAVIS PHONE #: 603. 231 -8161
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/17/2008 Pour Time: 11:00
Code # Inspection Description Confirm # Contact # Message
220 Slab 072816 -01 541- 231 -8161 N
Corrections /Comments/ Instructions:
l ` PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
_ FAIL CALL FOR INSPECTION II] ADDITIONAL FEES ASSESSED
Inspector: Date: 7 -/ 7 --D. Phone #: (503) 7,18- ._ ms's .
CITY OF TIGARD
BuI IN DIVISION PERMIT #: BUP2b08.00 9E3
13125 S.J Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/25/2008
Phone: (503) 639 -4171 , r• ,1 E1f11
Inspection Requests (24 Hrs.): (503) 639 -4175 A 11
INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7:OOAM PAGE: 19
SITE ADDRESS: 12020 SW CARMEN ST CLASS OF WORK:
SUBDIVISION: CARMEN PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HORAK
DESCRIPTION: Construct 5213 s ft accessory structure. No electrical work at this time.
OWNER: HORAK, TRAVIS PHONE #: 603 - •231.8161
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/16/2008 Pour Time: 2:00
Code # Inspection Description Confirm # Contact # Message
220 Slab 07.2724 02 541-231-8161 V
Corrections /Comments /Instructions: (0:
- D ''R o ,/, /J,_ I A-P /1-r✓ •., s;,
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1
Inspector: Date: - 7-2 3 - 6 - 6 - 8 _ - J
#: (503) 718 - __-_]d
CITY ��mm m ��m� mmm�o���m��
BUUULDUNd DIVISION
PERMIT #: 13UP20M-00198
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Q25/20013
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ^111.
INSPECTION WORKSHEET FOR DATE: 9V12Y2008 TIME: 7:OOAkA PAGE: 18
SITE ADDRESS: 12020 SW CARMEN ST CLASS OF WORK:
SUBDIVISION: CARMEN PARK LOT #: UOZ TYPE OF USE:
PROJECT NAME: MgRAK
DESCRIPTION: Construct 528 sq ft mxxeouwly structure. No electrical work et this time.
OWNER: M0RAK.TRAV1S PHONE #: 503
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
250 Roof nailing 075419-01 907-7413-3789 M
Corrections/Comments/Instructions:
/
71 PASS ri PARTIAL APPROVAL CANCEL | | NO ACCESS
FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: /2 -- °M Phone #: (503) 718-
'' ''
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: BUP200B -00198
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/25/2008
Phone: (503) 639 -4171 .
Inspection Requests (24 Hrs.): (503) 639 -4175 ` `` �i
■ INSPECTION WORKSHEET FOR DATE: 9/12/2008 TIME: 7:00AM PAGE: 34
SITE ADDRESS: 12020 SW CARMEN ST CLASS OF WORK:
SUBDIVISION: CARMEN PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HORAK
DESCRIPTION: Construct 528 sq ft acc :essory structure. No electrical work at this time.
OWNER: HORAK, TRAVIS PHONE #: 503 -231 -€3161
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9012/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 075339-01 907-148-3769 N
Corrections/Comments/Instructions:
mil/ _% _. ... .o iei %.' - Ar:d_.
PASS ❑ P ARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: —1 L —lam 0 Phone #: (503) 718-
CITY OF TIGARD
BUIL DINb DIVISION PERMIT #: Bt1P200B -00198
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6//25/2008
Phone: (503) 639 -4171
A l
Inspection Requests (24 Hrs.): (503) 639 -4175 1I..
I
INSPECTION WORKSHEET FOR DATE: 9/12/2008 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 12020 SW CARMEN ST CLASS OF WORK:
SUBDIVISION: CARMEN PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HORAK
DESCRIPTION: Construct 528 sq tt accessory structure. No electrical work at this time.
OWNER: HORAK, TRAVIS PHONE #: 503 231 -B10 i
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9112/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
236 Shear walls/anchors 075417 -01 907-748-3769 N
Corrections /Comments /Instructions:
ie A.0,- ,eg-pi9L.4.
•
;' 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / , Date: l 5 —�-7 Phone #: (503) 718-
CITY OF TIGARD
BUDDING DIVISION PERMIT #: BUP2008 00198
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/25/2000
Phone: (503) 639 -4171 `.. ' �i�' (
Inspection Requests (24 Hrs.): (503) 639 -4175 ...:.:'!+� 1I..
INSPECTION WORKSHEET FOR DATE: 9/12/2008 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 12020 SW CARMEN S1 CLASS OF WORK:
SUBDIVISION: CARMEN PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HORAK
DESCRIPTION: Construct 528 sq ft accessory structure. No electrical work at this time.
OWNER: HORAK, TRAVIS PHONE #: 503 - 231 - 816
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/17J2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 075417 -02 907 -748 -3769 N
Corrections /Comments /Instructions:
1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL e, CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
A Inspector: O Date:- / 2,- ,63 Phone #: (503) 718-
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RECENED
� FEB 17 2009
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CITY OFTIGARD
BUILDING DIVISION
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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.
tq ,, ' ER BUILDING +1IVISION
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`� "° ° i TRANSMITTAL LETTER T[ G�A� R D�''"
TO: Ls . DATE RECEIVED:
DEPT: BUILDING DIVISION
FROM: CYWr\SLf
COMPANY:
PHONE: By :
RE: (Site Address) 310 C'✓✓Y SA . , 200 .001 4a
( ) ( rrm Case Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor oof raming. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):
REMARKS: ZS) Lit `*5-1z.(A J4( A S S
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\ Building\ Forms \TransmittalLetter - Revisions.doc 4/4/07