Permit CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00286
COMMUNITY DEVELOPMEN' DATE ISSUED: 5/30/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 109 BA - 05700
SITE ADDRESS: 13750 SW MISTLETOE DR ZONING: R - 7
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 LOT: 043 JURISDICTION: TIG
PROJECT: GREGORY
Project Description: Inground pool.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: R3 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: $ 21,000.00
Owner: Contractor:
CANDICE GREGORY ROGUE VALLEY POOLS
13750 SW MISTLETOE DR 1923 DELTA WATERS RD
TIGARD, OR 97224 MEDFORD, OR 97504
Phone: 503 - 522 -8005 Contact #: PRI 541- 779 -7946
Reg #: LIC 1144290
FEES
REQUIRED ITEMS AND REPORTS
Description Date Amount
[BUILD] Permit Fee 5/30/2007 $244.90
[TAX] 8% State Surcha 5/30/2007 $19.59
[BUPPLN] Pln Rv 5/30/2007 $159.19
Total $423.68
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
issuanc- • ' ork is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the
Or::.n Utility Nob ' - .tion Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
• these rules or direct • - ti•n• to OUNC by calling 503.246.6699 or 1.800.332.2344.
ssued By: _ � Permittee Signature: 1...._ •
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 • RECEIVED FOR OFFICE USE ONLY
of Ti and Received Permit No.:
`� g Date B : , i
L Par1'1 41p_ .(o
13125 SW Hall Blvd., Tigard, OR (O 3 `3 0 2007 Plan Revie
0
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: 5•3v • 131 ef4 Other Permit:
T i G A R D Inspection Line: 503.639.4175 CITi 4' Sir CiGARD Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: -/ Supplemental Information
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. 1 , 0 C) 0
El 1- and 2- family dwelling El Commercial/industrial Valuation: $
❑ 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: 13 - )5 0 s W ii\%s'tipl b r New dwelling area: square feet
City/State /ZIP: T t t „k O Ck 9 1 x 1 "P 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: Lot no.: Permit fees' are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
`1 " DESCRIPTION OF WORK work indicated on this application.
t1 Tdr1k X001 C..tV\ rV(-, }10(. Valuation: $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: C 4).N. "�+ul�. t C r D r+ o f Type of construction:
E.:�
Address: 1 3`1 <1 s v_ v.\1 S.)-\ 0, r^ Occupancy groups:
City/State /ZIP: 1 oC t 0. 9 - 13.1-i 1 Existing:
Phone: (So3) V. irDb S Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
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
City/State /ZIP: applicant is exempt from lip sing, the following reasons
apply: cA ,I • q 0
Phone: ( ) Fax:: ( ) /C / - //
E -mail: l9 S��
CONTRACTOR �/
Business name: (k y t O P 1 D'` BUILDING PE FEES* ./ . '
Address: 19 ` ' 3 >\ W k .. es s \ , k (Please refer to fee scheduled ' � ice• 4 Structural plan review fee (or deposit):
City /State /ZIP: l 1) rt ` e) c 9 i s b ✓�
Phone: ( C "Ili _. 9.4 1 I Fax: ( l \ ) 1 FLS plan review fee (if applicable):
CCB lic.: ' � . o Total fees due upon application:
1 Amount received: / -) Z /
Authorized signature: \ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ` - t , 0 ^ ('\ ^ Date:' 30 /Q • Fee methodology set by Tri-County Building Industry
`' V 1 Service Board.
I: \Building\Permits\BUP -RES PermitApp.doc 02/23/07 440- 4613T(11/02 /COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received permit No.:
1111 . • 1 3125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 Associat
C Associated permits:
TI GARI)
24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard- or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
I 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 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 Oregon and shall be shown to be ap to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
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" indichtes 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(I1 /02/COM/WEB)
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CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: ZUI,P ancri - C»a.Csi.,,
PLANNING DIVISION:
Required Setb cks: Approved ❑ Not App
Side: 7 St�t Side: 0 ,,e
/,
Front. Garage: N A' e: >r ..4
• Visual Clearance: 1;21 App oved ❑ Not Approved
Maximum Building Height NN /4 feet
CWS S rv' rovider Letter Required: ❑ Yes ❑ No
❑ Re
B1: �-4 � Date: s /j�
EN INEERING DEPARTMENT:
Actual Slope: _% ❑ Approved ❑ Not _ Approved
Site Plan: 0 Approved ❑ Not Approved
By: Date:
Notes:
•
r _, , ( .
CITY OF TIGARD
BUILDENG"DIVISION - PERMIT #: BUP` 007 -00286
13125 Sall Blvd., Tigard, OR 97223 DATE ISSUED: x''30/2007
Phone: (503) 639 -4171 ., ypu�i'�I�
Inspection Requests (24 Hrs.): (503) 639 -4175 „._,
INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:O3AM PAGE: 11
SITE ADDRESS: 13750 SW MISTLETOE DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 LOT #: 043 TYPE OF USE:
PROJECT NAME: GREGORY
DESCRIPTION: Inground pool.
OWNER: GREGORY, CANDICE PHONE #:
CONTRACTOR: PB II ,L PeaSS° PHONE #: 5434294946
Inspection Request Scheduled For: Date: 6/22/2007 Pour Time: 2: 00
Code # Inspection Description Confirm # Contact # Message
270 Reinforcing steel (rebar) 050784 -01 641 - 210.2222 N
Corrections /Comments/ Instructions:
PASS n PARTIAL APPROVAL 1 I CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION 1 I ADDITIONAL FEES ASSESSED
i.\ /
Inspector: ; Date: — � 67' Phone #: (503) 718 - Z.4.17
CITY OF TIGARD
BUILDINt'DIVISION PERMIT #: BUP2007 -00286
13125 SVVHaII Blvd., Tigard, OR 97223 DATE ISSUED: 6/30/2007
Phone: (503) 639-4171 � �ii���
Inspection Requests (24 Hrs.): (503) 639 - 4175!
INSPECTION WORKSHEET FOR DATE: 6/21/2007 TIME: 7:03AM PAGE: 18
SITE ADDRESS: 13750 SW MISTLETOE DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 LOT #: 043 TYPE OF USE: .
PROJECT NAME: GREGORY
DESCRIPTION: Inground pool.
OWNER: GREGORY, CANDICE PHONE #:
CONTRACTOR: OnI900.RALEAVVERS PHONE #: 64347 6
Inspection Request Scheduled For: Date: 6/21 /2007 Pour Time: 12 :00
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 050674 -01 541-210-2222 N
Corrections /Comments /Instructions:
(7))
0 A/F:/7 .LG--,c7 -a .Y4L /'Ar" e7 . L 1
_i /fit..- - 7 - �,c' Co
,,__ -s 270
�,
1 ASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
1 I FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: ‘-- 7 Phone #: (503) 718 - 24 s---