Permit I; CITY OF TIGARD MASTER PERMIT
I II a COMMUNITY DEVELOPMENT Permit#: MST2010 -00169
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/12/2010
Parcel: 1S125DD09100
Jurisdiction: Tigard
Site address: 9674 SW VENTURA CT
Subdivision: WASHINGTON SQUARE ESTATES NO. 3 Lot: 99
Project: Glanz
Project Description: Phase II - 100 square foot addition to existing garage.
10/27/2010: Reprinted to add (1) branch circuit per Building Official; payment transferred from
:_2010 -001
BUILDING
Floor Areas Required Setbacks Reaulred
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 100 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes
Total: sf Value: $3,747.00 Rear: 0
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Catch Basins:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Other Fixtures:
Tubs/Showers: Garbage Disp: Water Heaters: Water Lines: Drains:
Bckflw Prevntr:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Fum<1 00K: Vents: Woodstoves: Gas Outlets:
Fum > =100K:
ELECTRICAL
Residential Unit Service Feeder Temo SrvclFeeders Branch Circuits
1000 sf or less: 0 -200 amp: 0 -200 amp: W/ Svc or Fdr: 1
Ea add! 500 sf: 20 1-400 amp: 201 -400 amp: 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 401 -600 amp: Ea add'I Br Cir:
601 -1000 amp: 601 +amp- 1000v:
1000 +amp /volt:
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet:
Owner. Contractor: Required Items and Reports (Conditions)
GLANZ FAMILY TRUST SAMUEL PHILIP DIGREGORIO
BY KENNETH RICHARD GLANZ &, 1839 SE PARKVIEW CIRCLE
BESSIE JEAN GLANZ, TRUSTEE, Milwaukie, OR 97267
9674 SW VENTURA CT
PHONE: PHONE: 503 - 310 -5692
FAX:
Total Fees: $246.44
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 1 Permittee Signature: OAS �� /$L /e77 " /
a CITY OF TIGARD MASTER PERMIT
III s . COMMUNITY DEVELOPMENT Permit #: MST2010 -00169
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/12/2010
Parcel: 1S125DD09100
Jurisdiction: Tigard
Site address: 9674 SW VENTURA CT
Subdivision: WASHINGTON SQUARE ESTATES NO. 3 Lot: 99
Project: Glanz
Project Description: Phase II - 100 square foot addition to existing garage.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 100 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes
Total: sf Value: $3,747.00 Rear: 0
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Catch Basins:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Other Fixtures:
Tubs /Showers: Garbage Disp: Water Heaters: Water Lines: Drains:
Bckflw Prevntr:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Fum <100K: Vents: Woodstoves: Gas Outlets:
Fum > =100K:
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 0 -200 amp: 0 -200 amp: W/ Svc or Fdr:
Ea addi 500 sf: 20 1-400 amp: 201 -400 amp: 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 401 -600 amp: Ea add! Br Cir:
601 -1000 amp: 601 +amp- 1000v:
1000 +amp /volt:
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & 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)
GLANZ FAMILY TRUST SAMUEL PHILIP DIGREGORIO
BY KENNETH RICHARD GLANZ &, 1839 SE PARKVIEW CIRCLE
BESSIE JEAN GLANZ, TRUSTEE, Milwaukie, OR 97267
9674 SW VENTURA CT
PHONE: PHONE: 503- 310 -5692
FAX:
Total Fees: $238.13
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 the 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 t�'AR 952- 001 -0100. You ma • - -. -. �. • • - :s or direct questions to OUNC by calling 503.246.6699 or 1.800.332.234 .
Issued : • . ��✓ -" — �,` Permittee Signature: J v IM /
-'.' W u�
y l
Building Permit Application RECEIVED
.. .
Residential F()li c)FFic:f: Hsi:. ()Nix
City of Tigard SEP 2 8 2010 Received q l/ �, / d� Permit No.: H5ra0/0 /6 ,
° 13125 SW Hall Blvd., Tigard, OR 97223 �� f •
C
Phone: 503.639.4171 Fax: 503.598.196 TY OF TIGARD P lan Date/B Resew CJ1J 11 0 1 Other Permit:
I
r 1 t; n i a Inspection Line: 503.639.4175 BUILDING DIVISION Date Read : 1uris: ® See Page 2 for
Internet: www.tigard- or.gov Notified � � /2 /� cu Supplemental Information
....-E0 `G
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.
iA1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ '3 ��
❑ 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: 94,7/4 51.1) 1/244, t tck. c4-, New dwelling area: square feet
City /State /ZIP: Ti(, $g'D 011-- -- 972Z3 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: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: (A../A$1.4 $o- TdPrc-s 3 Lot no.: 11 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: J ( fl 09 I p t 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.
6 AR -A1;>G / x , Valuation: $
f � � Existing building area: square feet
New building area: square feet
a- PROPERTY OWNER I ❑ TENANT Number of stories:
Name: 60,06-- GGA .t/e 11 Type of construction:
Address: /Col N 514.) L1,eAl-'C V Jdt_ C4 - Occupanc groups:
City /State /ZIP: 7 f412._ 6 I''- q 1 Existing:
Phone: ( ) Fax: ( ) New:
0 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: 1) Tr C,, ( 4 1 , x , G,L All contractors and subcontractors are required to be
Contact name: kit-2 �+Cat� l licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: ( - 7 7 4 C) W PLArre, g 9-_ jurisdiction in which work is being performed. If the
City /State /ZIP: 1. 3e0,, O Ai q ` C2 0 7 applicant is exempt from licensing, the following reasons
apply:
Phone: (So 3) 5 2. 7.-. 7c:i y Fax:: ( )
E -mail: g e' uwcodoso ` t i& c . co
U
CONTRACTOR
Business name: D 1 60_ �� O �, j a e(24 Se 5 BUILDING PERMIT FEES'
Address: I37 S E 9' RRK VIC uJ et ft le (Please refer to fee schedule)
City/State /ZIP:'I t � WAJ kis 01 9 77.x`7 Structural plan review fee (or deposit):
VCPho
( OJ ) 31 o - Z I Fax: ( ) FLS plan review fee (if applicable):
CB lic.: i ( 7 a 5 9 Total fees due upon application: `l _ 1 I Amount received: I f, g , . Z Authorized signature: //U This permiapplication expires if a permit is not obtained
� within 180 days after it has been accepted as complete.
Print name: re un v, _ J �6M'� Date: 7 1 /t , = Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -RES PermitApp.doc 10/01/09 440- 4613T(11/02 /COM/WEB)
Building Permit Application Checklist
One- and Two - Family Dwelling r(R Orrlcl.: t si: Owl.
City of Tigard R eceived Permit No.:
11 14 1 3125 SW Hall Blvd., Tigard, OR 97223 Date/By:
C Phone: 503.639.4171 Fax: 503.598.1960 Associated permits:
I' 1, A It L> 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard - or.gov ❑ Other:
THE ITEMS ARE R QUIRFI) FOR PLAN RREVI W 1 e No NLA
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 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.
JURISDICTIONAL ' I'I_:ClI ICS
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. ❑ 0. ❑
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(1l /02/COM/WEB)
�p 24 10 0 /:U /p U II- Consulting bUbt541i4tiyb p.1
Li - RECEIVED
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CleanWater e gRA S E P 2 7 2010 J Clean Water Services File Number
ITV OF TDMIG '� �Dj� , - OO
e
y oentitive Area Pre - Screening Site Assessment
1. Jurisdiction: e n&aA' -0
2. Property Information (example 1 S234AB01400) 3. Owner Information
Tax lot tD(s): iS 1 2.5 DD o9!DO Name: 61-01N"
Company:
Site Address: 9 G� Y ski lJ.ey i C Address: /Go 7y S W V , C
City, State, Zip: 7 p 012._ 12'Z3 City, State, Zip: ''�1 G�4�t. D O t2 9 7 7-1,3 Nearest Cross Street 4 u t1I Phone/Fax:
' E -Mail:
4, Development Activity (check all that apply) 6. Applicant Information
. Addition to Single Family Residence (rooms, deck, garage) Name: GED Fier W R.w NT—
❑ Lot Line Adjuslment ❑ Minor Land Partition
Q Residential Condominium ❑ Commercial Condominium Company: UT CSV l.Ti.t.1(�
Address: 17 7 Li 0 Se.J Fl a reKce S
❑ Residential Subdivision
a Commercial Subdivision
O Single Lot Commercial Q Multi LotCommercat City, State, Zip: t•3e.v41/ i2.-io�AJ 0 97001
Other • Phone/Fax: 503 -5ZZ - 2e'r
E -Mail: e LI14co t)5v j4i. j ken,
en,
6. Will the project involve any off -site work? Q Yes f S No 1] Unknown Q
Location and description of off -site work
7. Additional comments or Information that may be needed to understand your project
No Nat) 1 (M1 pat✓t av3 A- ,s, S'L 4,% ra RooF.
This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Devel DEQ
1200 -C Permit or other penults as issued by the Department of Environmental Quality, Department of State Lands and/or Department Perm
Andy
COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law.
By signing this foram, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water SeMces have authority
to ender the project site at all reasonable times for the purpose of tnspectng project site conditions and gathering information related to the project site. I certify
that I am familiar with the information contained in this document, and to the best of my knowledge and belief, this information is true, oomplele, and accurate.
Print/Type Nam /* C. C*i 0.1 allotsP Printfrype Title 0 WA/ S f}( ,� f(-
Signature / 10 �,y 1 —
_ G Date , /i*'l 1 d
FOR DISTRICT USE ONLY
I] Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OFA
SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feel on adjacent properties, a Natural Resources Assessment Report
may also be required.
f/4 Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200' of the she. This
Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and rotect water
discovered. This document will serve as your Service Provider letter as required by Resolution Order 0720 quality 02 . All y are subsequendy
approvals must be obtained and completed under applicable local, Slate, and federal law. required Permfts and
0 Based on review of the submitted materials and best avallable information the above referenced project will not significantly impact the existing or potentially
sensitive area(s) found near Mesita This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect addtional water
quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order
07-20, Section 3.02.1. All required penes and approvals must be obtained and completed under applicable local, state and federal law,
❑ This Service Provider Letter is not valid unless CWS approved site plan(s) are attached.
Q The proposed activity does not meet the definition of development or the lot was platted after 9/9195 ORS 92.040(2). NO SITE ASSESSMENT OR .
SERVICE PROViD - LETTER IS RE • ED.
Reviewed by Aim. 4 JAL._ ,s, _
D. Date /0 0
5 SW Hillsboro High lay Hill ho,e Orcc In � r 1 t i Phone one? 5u 3 b 1 LD ' T ,
Y. � ) �x i�0 i G 1 - <., )r! • ti V cl trate(services ripe,