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Permit CIY OF TIGARD »� MASTER PERMIT COMMUNITY DEVELOPMENT DATE ISSUED: 10/ T2007 TIGARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 135DB -06000 SITE ADDRESS: 11540 SW GREENBURG RD ZONING: R -4.5 SUBDIVISION: MILLER LOT: 006 JURISDICTION: TIG PROJECT: GALEANA Project Description: Convert garage to habitable space. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 5,000.00 REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 0 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st WIO SVCIFDR: 1 SIGN /OUT UN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 SIGNAUPANEL: IN PLANT: MANU HMISVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC/FDR>=225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable EUNICE GALEANA OWNER laws. All work will be done in accordance with approved plans. This 11540 SW GREENBURG RD permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97223 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.' Those rules are set forth in OAR 952- 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503- 957 -7042 Contact #: • questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 222.11 REQUIRED ITEMS AND REPORTS • Issued By: jze4ztL elkf 4) Permiftee Signature : -1 // 9 0 6/,--0 /',o,,3 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. q ' Building Permit.Ap cio IV ED Residential ' , FFI C E 3 USY . , S'� t�, 1 *, ;; . F ORO �V C E , NLchill,.:; f i 4- 0 3, c City of Tigard S EP 1 Permit No.: �y —�($v >rz� ° 13125 SW Hall Blvd.. Tigar., 0 ° 97?31161):14D • C Phone: 503.639.4171 Fax ' 1 }9 fsQ ' IVIS`ON a , , . ; _ Other Permit: i Inspection Line: 503.639.6' -1; � ''` '' Date • Re. /By: 1011 ® See Page 2 for T G A R ll Internet: www.tigard-or.gov �;= ethod: �� . a /� • Supplemental Information TYPE OF WORK / ` u f d'QUIRED 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. Valuation: $ 3 CX)O ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building El Multi-family Number of bedrooms: ID Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: t‘ 54 0 SW 612. FA)1 e 6 1S,D _ New dwelling area: square feet City /State /ZIP: T .1 CS) r, q 2- Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: , /t Lt 9 1 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: 1 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 WORK work indicated on this application. l km 0 TH'e 6102 A 6l� i A) To /_I 1f11U6 Room Valuation: $ Existing building area: square feet New building area: square feet / ❑' PROPERTY OWNER ❑: TENANT Number of stories: Name: Type of construction: Address: 5 ArA Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ ' APPLICANT ❑ _ CONTACT - PERSON .; NOTICE Business name: Ann ___ 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: U • Q q Phone: ( ) Fax:: ( ) / _ 1 '� 1 1 E -mail: lU - ( ` 0 I / CONTRACTOR Business name: �. � p� BUILDING PERMIT FEES* • - ✓ V1( C� �a Address: (Fl refer to fee schedule) , / Structural plan review fee (or deposit): � � 1. ` City /State /ZIP: t / ;, to J �� o� y V � V `4_ � FLS plan review fee (if applicable): Phone: (50:1) C7 57 7 01 2 Fax: ( ) 4 ,' CCB lic.: [ Total fees due upon application: Amount received: `'f' ( . Authorized signature: T his permit application expires if a permit is not obtained f �� within 180 days after it has been accepted as complete. Print name: - & --- (,)/U I • 1 0 0 /'</ 4 Date: q - G — 07 * Fee methodology set by Tri- County Building Industry Service Board. 1: \Building \Permits \BUP -RES PermitApp.doc 02/23/07 440- 4613T(11/02/COM /WEB) P Building Permit Application Checklist One - and Two-Family Dwelling �'': iii.g �a �FOR4. SE �; r< � r '..:'.7.,'"'•.--'^ Received C ity o f Tigard D as Permit No.: III 13125 SW Hall Blvd., Tigard, OK : 97223 - ; ' ' ' Y Phone: 503.639.4171 Fax: 503 598.1960 r Associated perm its: ' , ;; 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical T I G A R v _._. Internet: www.tigard- or.gov ❑ Other. • 1 THE NG L bw ITEMwfxti RE PLAN REVIEW $ : r v %a w Y No Xar si N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ ❑ 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. 1 I 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 atid.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. 1, 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 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 Oregon and shall be shown to be applicable to the •roject under review. +F t ' - `� .e AeiP. R ;9 s ' S v c 7 i k F ,4 ' "4 / , J y Y/ 13" '' fo ,.z - 3. IURIS DI C�TIONAL SPCCII�ICSt , � . .: '.4 7L �.� w.�:- s .� �, . � < " ,, ., �_ :ii la ` . . _,. r a ��i.,. -:,.' . 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\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(11/02 /COM/WEB) . 66^� Construction Contractors Board Perm": e°181° 700 Summer St NE Suite 300 Address: 11 W a -e4)b mi PO Bog 14140 /� Salem OR 97309 -5052 1 1 Issued by: / Date: 1/ --/ / b 7 Phone: 503- 378 -4621 �� Web Address: www.ccb.state.or.us Statement: Information Notice to Property owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: we 1. I own, reside in, or will reside in the completed structure. [a- 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ❑ 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. • OR ra; 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ai„lCC.46 rizc-d /6/Z /07 (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06 -01 -04 • .Acting "as Your -( General Contractor ?. : - • INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES - - NOTE: This information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an ekisting structure, you can prevent many problems by being aware of the.following.responsibilities and concerns. Employer Responsibilities You will; in most instances, be ruled to be an "employer" and the contractors --you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the. construction or improvement of a residential structures‘ As the employer, you Must comply with the following: Oregon's Withholding Tax Law: As an employer;you must withhold income taxes from employee wages at the time employees are paid. You will be liable far the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503 - 378 -4988: - Unemployment Insurance Tax: As an employer, you are required to -pay a tax for unemployment insurance purposes: on the wages of all employees. For more information, call the Oregon Employment Department at 503 -947 -1488. • The Oregon Business Identification Number (BIN) is a combined number for both .Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503- 945 -8091 or www.dor.state.onus/formsna, .htnill for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for*all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503 - 947 -7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from wages:; • You will he Liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1- 800 - 829 -4933 or -visit their web site at www. irs.gov. -ether Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. • Liability and Property Damage Insurance: Contact your - insurance agent to see if you have adequate insurance' coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, t © `coordinate the work of rough -in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503- 378 -4621) or write the agency at PO Box 14140, Salem, OR 97309 -5052. Property_owner.doc 06 -01 -04 CITY OF TIGARD ` BUILDING DIVISION PERMIT #: I1/MS1 2007- 00180 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/212007 Phone: (503) 639 -4171 eV • Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1f912O08 TIME: 7:01AM PAGE: 14 SITE ADDRESS: 11.540 SW GREENBURG RD CLASS OF WORK: SUBDIVISION: MILLER LOT #: OOG TYPE OF USE: PROJECT NAME: (3ALEANA DESCRIPTION: Convert garage to habitable space. OWNER: (3AI.E:ANA, EUNICE PHONE #: 503957 - 7042 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 1/9/200a Pour Time: Code # Inspection Description /G1:31firtak# Contact # Message 139 Electrical final 062651 -01\ 503 957- 7042 N Corrections /Comments /Instructions: c(z Von L3 5Os- 235 - 3e0 2 $Obi Ns16e 6) be NIEv-6 Tickzstt c6NN azIs ,6N1S eLld . n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS )FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - NO) Date: I 9. 6 Phone #: (503) 718- Zl -1'0 CITY OF TIGARD BUILDING DIVISION #: MST2007- 001130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2/20g7 Phone: (503) 639 -4171 ' y 41j. Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: /2/412007 TIME: 7 :01A1v1 PAGE: 18 SITE ADDRESS: 11640 SW GREENBURG RD CLASS OF WORK: SUBDIVISION: MILLER LOT #: 006 TYPE OF USE: PROJECT NAME: GALEANA DESCRIPTION: Convert garage to habitable space. OWNER: GALEANA, EUNICE PHONE #: 503957 -7042 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 060751 -01 603- 957 -7042 N C rr ctions /Co m ents /Instructions: ( _11 _ 1 e 1 L.) . l I / . � 0 ,��� - r f L, L i, ., ■ OW: A 4 .1 e I r j . L , lo ,.._-_, , , 4 ii; i'i .(74 .1 i 1 A / — C w l I Ai 144);1141 JAA A,0 4,1 1/1111-41 9 ( WA/1Z ) CIAAA ,4,4 64 ,, i ih'i i kj G2 i , f -z re-6P-- 1& Aove /44 �' 1. - L 1 A/1_,,,,, ,11s P /742 -dt Y (J - W f , , es_ _ _ l ., & ' 14/ 1' / �_ r d (' ' PI ) -,WlA'f1 I IT�/ lt.l ! / J il l �// ! ' i i ■ c), G7 it.�f' .1.. //I ''./ ► ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS V FAIL C . L FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: �'/ l' Date: Phone #: (503) 71 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2007- 00180 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2/2007 Phone: (503) 639-4171 , r . Inspection Requests (24 Hrs.): (503) 639 -4175 67I IL INSPECTION WORKSHEET FOR DATE: 12/3/2007 TIME: 7:00AM PAGE: 46 SITE ADDRESS: 11640 SW GREENBURG RD CLASS OF WORK: SUBDIVISION: MILLER LOT #: 006 TYPE OF USE: PROJECT NAME: GAL._E.ANA DESCRIPTION: Convert garage to habitable space: OWNER: GALEANA, EUNICE PHONE #: 503-957 -7042 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 12/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 060624 -01 503 - 639.1704 Y Corrections/Comments/Instructions: o y� oo-f- «a -+P,1 a/a e<<. it CAL - / llt .S'vi4Tl()A./ / nt4P4C 7Mti S c...-1,1-e-.7-15 ..�` i2c5 ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /.. —3 -7 Phone #: (503) 718 - 2.446—