Permit 'CITY OF TIGARD BUILDING PERMIT
PE RMIT #: BUP2004 -00313
DEVELOPMENT SERVICES DATE ISSUED: 7/23/2004
`6.
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S108AD 11100
SITE ADDRESS: 14480 SW CHARDONNAY AVE
SUBDIVISION: YOUNG PARTITION /MLP2002 -00010 ZONING: R -7
BLOCK: LOT: 002 JURISDICTION: URB
REISSUE: CUSTOM FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD 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: 10 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: 40 psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET:
DWELLING UNITS: 1 FRNT: 15 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,500.00
Remarks: Construction of 40 sq ft addition for storage.
Owner: Contractor:
JONES, DELMA OWNER
14480 SW CHARDONNEY
TIGARD, OR 97224
Phone: 503 - 579 -4668
Phone: 503 - 579 -4668
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[UBUILD] Permit Fee 7/23/2004 $72.10 Final Inspection
[UTAX] 8% State Surcht 7/23/2004 $5.77
[UBUPLN] Pln Rv 7/23/2004 $46.87
[UCDC] Urb CD Review 7/23/2004 $42.00
Total $166.74
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 By:
Permittee
Signature: r ;
Call 639 -41 by 7 p.m. for an inspection the next business day
7- 7 ill v^(
.
Building Permit Application, ED FOR OFFICE USE ONLY
City Of Tigard ��� v Date/B y: / �/ jI Permit No,: r ' �a
13125 SW Hall Blvd., Tigard, OR 97 3 Plan Review \ —
�� r �oo /�� ara:AA ,I'l Date/B : Other Permit:
Phone: 503.639.4171 Fax: - �,. �
Inspection Line: 503.639.4175 �� Date Ready/By: D See Attached Checklist for
Internet: www.ci.tigard.or.us r , Aatt Notified/Method: Supplemental lnformation Qh
G.
_ :` "` ' s T� p� C • _. r ; REQUIRED 'DAT ` 1.-AND 2 F
❑ 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 r
'CAT OF C
work indicated on this application.
Valuation: $ .34-00 i
❑ 1- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: CP
JOB :SITE INFORMATION AND LOCATION- Total number of floors:
Job site address: / 1 . - / 4 d Q S W 1 ' / A W L ) 0 A/ /v,9 y f9 i New dwelling area: square feet
City/State/ZIP: — �i a 412 6 t D A f7-2 1 11 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: — 07,4'e5 ST 4 4, /POn Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet 'lO
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= W
. ORK ., work indicated on this application.
. /x G t „T _ . a J - _ , Valuation: $
/J � /GO' Existing building area: square feet
New building area: square feet
.5 t , ® PROPERTY'- OWNEIts ❑ TENANT °: .. . Number of stories:
Name: �78-L / VA L 704/66 Type of construction:
Address: 0 4'd 54) C1/(4-46 a/V Ab951 4 / Occupancy groups:
City/State /ZIP` 7 ,q Q oZ Existing:
Phone: (.5-03) gyo',,z 8.z A Fax: ( ) New:
.
':' t ❑ APPLIC - ®; :CONT PERSON
_ -�' .A .. w . - :.. - ;, . •-•,_ - n ' NOTI
Business name: 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
Address: jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State /ZIP:
apply:
Phone: ( ) Fax::( )
E -mail:
.... _ ' CONTRACTOR .,. . s .z
Business name: l r+ e 9 l l M 7 ^ ` /J
`"t • °= t9f )f /L "; BUILDING PERMIT FEES*
Address: .
Please refer to fee schedule.
City/State/ZIP:
4, 79 oz Fax: ( ) Fees due upon application
Phone:
Amount received
CCB lic.:
Date 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./ )e 1; / -- Date: * Fee methodology set by Tri-County Building Industry
C% Service Board.
i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(1 l /02/CON/WEB)
One- and Two - Family Dwelling
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Building Permit Application Checklist 1 R %US oivL p, e �'
.,
City of Tigard Received
Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
Phone: 503.639.4171 Fax: 503.598.1960 d�cr,Xi llI +,
❑ Electrical ❑ Plumbing ❑ Mechanical
24- Hour Inspection Line: 503.639.4175 B
Internet: www.ci.tigard.or.us ` "°- ❑ Other:
" ,; " M " , ,; AWirifFif . inECOINOiITEMS, ` rA igjii- QUIRED F ikt:takREVIEW t 1" i s TNo r,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. ❑ Ell . ❑
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 detail. 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 carryinga non - uniform load.
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 applicable to the .ro'ect under review. •
Aim }'L il' 'FRr�1> tif'"• ...I
�J�IJRISDICTIONAL
23 Five (5) 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 tree protection measures as required by conditions 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.
i:\Building\Permits \One- Two - FamilyChecklist.doc 12/03 • -
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CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: aufa — D(93l3
PLANNING DIVISION:
Required Setbacks: Approved ❑ Not Approved
Side s St eet Side: O
,:,.0,t; ,lam Garage: �D Rear: /S
`kua` ( ''earanee: ,Z) .Approved ❑ Not Approved
!::'m; rt) B„i Height• feet
- S Scrvicee •ovider Letter Required: ❑ Yes ,►: No 40 ,i/EA /
I {� ❑ Receiv.-d g4.3E2TSffie��S
+ . s , � _ ■ ■ Date: 7/ cv y fl-s A.6.LV r 44//944//95 iv.✓ �
N 'I EE ZING DEPARTMENT: ` CoNs7 - a om)
Actual lope:$% El Approved ❑ Not Approved /9"./ cxiS%7�/G - .S . - 49 - 8 ,
Site PI t: (04 ___ ®- Approved ❑ N�o proved �/�
By: Date: 7 I I5 �Cp2
Notes:
7/6
/
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
/ G UP 4 0q -6 63 (3
Received D. e Requested 7 �1 AM PM BUP
•
Location • £IJ ,% .,.&J, Suite MEC
/
Contact Person Ph ( ) PLM
Contractor Ph ( ) / / SWR
BUILDING Tenant! m r C�c— `t
5 7�1 - 6,6 p ELC v /
t . " -19 2 —
Footing ELC N a P•a. Li
Foundation
ACC2SS: * 0 Ftg Drain 4 32 4 cy2 ELR
Crawl Drain
Slab Inspection Notes: , . . SIT
Post & Beam - /M • `
Shear Anchors
Ext Sheath/Shear 7
Int Sheath/Shear
Framing
Insulation
Drywall Nailing /�
Firewall '� A L_ � 1' O 9 V
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: L\
PART FAIL
I BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In .
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for rei spection RE: n U , ., ble to inspect - no access
Fire Supply Line ly
ADA f 40� I.1 — ∎4 ∎∎
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
•
CITY OF TIGAF D 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 gi g% MST
Sup c71040 T -vim ,3/ 3
Received Date Requested 7 - °Z / AM P^ - > BUP
Location A 4.i� i�• ���_ Suite ) MEC
Contact Person _ Ph ( ) 7 9 ZJ 74 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation ACCess:
Ftg Drain , ELR
Crawl Drain __ _ �_ __ - - --
Slab Inspection Notes _ L SIT
Post & Beam
Shear Anchors .
Ext Sheath /Shear
Int Sheath/Shear
min #i E ,„ --� — rL&JO t vlc YctlTS.
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceilin.
Roof
Other:
Final
aZIP PART FAIL
• MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Anal E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: n Unable to inspect — no access
Fire Supply Line
ADA Ext
Inspe for
Approach /Sidewalk
Date
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL