Permit CITY OF TIGARD
•
BUILDING PERMIT
° . COMMUNITY DEVELOPMENT Permit #: BUP2007 -00275
T [GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/11/2007
Parcel: 2S110BA02400
Jurisdiction: TIG
Site address: 14570 SW MCFARLAND BLVD
Subdivision: Lot:
Project: HALE
Project Description: Replace deck and foot bridge. Approx. 500sf.
Owner: FEES
HALE, ROBERT R + Description Date Amount
HICKS, LEESA M, 14570 SW MCFARLAND [BUILD] Permit Fee 05/23/2007 $129.70
BLVD [TAX] 8% State Surcharge 05/23/2007 $10.38
PHONE: not available [BUPPLN] Pln Rv 05/23/2007 $84.31
Contractor:
OWNER
TIGARD, OR
PHONE:
FAX:
Specifics:
Type of Use: SF
Class of Work: OTR
Dwelling Units:
Stories: Height: ft
Bedrooms: Bathrooms:
Value: $0
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $224.39
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 -00 • oug • - 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calli51903.246.6699 or 1.800.332.2344.
Issue. By: Permittee Signatur . o z„.0
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.
II CITY OF TIGAIFD BUILDING PERMIT
P ERMIT #: BUP2007 -00275
COMMUNITY DEVELOPMENT DATE ISSUED: 6/11/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 110 B A - 02400
SITE ADDRESS: 14570 SW MCFARLAND BLVD ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT: 040 JURISDICTION: TIG
PROJECT: HALE
Project Description: Replace deck and foot bridge. Approx. 500sf.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: 500 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: 500 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: $ 8,300.00
Owner: Contractor:
HALE, ROBERT R + OWNER
•
HICKS, LEESA M
14570 SW MCFARLAND BLVD
TIGARD, OR 97224
Phone: not available Contact #:
Reg #:
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/23/2007 $129.70
[TAX] 8% State Surcha 5/23/2007 $10.38
[BUPPLN] PIn Rv 5/23/2007 $84.31
Total $224.39
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 thes- • - • ect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is • ed By: .4 f / i � Permittee Signature: ^�'}�'u -�C
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.
r
Building Permit Application .
Residential n FOR OFFICE USE ONLY
14 q R
City of Tigard • uECEIVE® Date/B . �/ I ii Permit N• —_r • .- ;,7
13125 SW Hall Blvd., Tigard, OR 972E Plan Review - .��
Phone: 503.639.4171 Fax: 503.5 0 3 1001 DateB : • Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
T I G A k D
Internet: www.tigard-or.gov CITY �y . . a GARD Notified/Method / Supplemental Information
BUILDI _ L W R O --
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
' r; Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
K1- and 2- family dwelling ❑ Commercial/industrial
Valuation: $ 8 300
❑ 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: l Li c C CO Mr i- rl a..,1 Ft . New dwelling area: square feet
City/State /ZIP: r J aj 1.--el ON 21-4 Garage /carport area: square feet
Suite/bldg. /apt. no.: f rProj ct name: HO, LC Covered porch area: square feet
Cross street/directions to job site: B v l ( fk in T Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this application.
-946 fe^t -a-'f 0 1' /� Q \fck 0 ...0 1 , d, - 4.1 1J v e ,�oo- p� f-1 Valuation: $
t� e
J Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: TZn e r-t- i4 . Je Type of construction:
Address: ( f t Sao S'( 4 l(i(C F t r /eJ 13( . Occupancy groups:
City/State /ZIP: T i Ave( 0 rejo q7)--2- Existing:
A Phone: (5o3) & SC•f Fax: ( ) New:
❑ APPLICtNT ❑ CONTACT PERSON NOTICE
Business name: G�
U V 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 licensing, the following reasons
apply:
Phone: ( ) Fax: : ( ) / �,, 4 r
E -mail: • �/
. /mo
CONTRACTOR la, ‘ 7— AA '
Business name: e2 4/ Ae__4 BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City/State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
fi� R Amount received: . uthorized signature: Thi perm app expires if a permit is not obtained .
' within 180 days after it has been accepted as complete.
Print name: j� 12 1' K ( e Date: S / �_3 I D7 * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -RES PermitApp.doc 02/23/07 440 -4613T(l I /02 /COM/WEB)
•
Building Permit Application Checklist
One- and Two- Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit No.:
1 3125 SW Hall Blvd., Tigard, OR 97223
C Phone: 503.639.4171 Fax: 503.598.1960 Associated permits:
24- Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing El Mechanical
T I G A IZ D Internet: www.tigard - or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No 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. ❑ ❑ ❑
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. 0 ❑ ❑
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 a . . licable 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" 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(I1/02/COM/WEB)
Construction Contractors Board
Permit #: 60 "M2;35
•
�� 700 Summer St NE Suite 300 Addre i l.3 r •
f' :. , .. P O Box 14140 -
I .- Salem OR 97309 -5052 Issu• d by: - /Jg!_, Date:
Phone: 503 - 378-4621
.1 www.ccb.state.or.us
Address: www.ccb.st e.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:
lig 1. I own, reside in, or will reside in the completed structure.
PEA 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
je3AB. 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.
lz&-t-- R 4-4,G__ d >> D -- )
(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 Own 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 existing
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 structure. 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 for 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.or.us /formspay.html1 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 employees' wages.
You will be 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.
Other 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, to 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
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.
ll Ili BUILDING DIVISION
C II
TIGARD TRANSMITTAL LETTER
a
TO: ..In DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FEB 0 4 2010
X FROM: iz4,6 .e--c-t- 14- t e CITY OF TIGARD
BUILDING DIVISION
COMPANY:
. X PHONE: 50 3 &, 2 -c Oc(5 y B J
RE: i h D 7 ~ O (7 Z'7 5
( Site Address) (Permit/Case Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOW ING ITEMS:
Copies: Description: . Copies: Description; .
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
X Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):
REMARKS:
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 I ❑ No ❑ Done _
Applicant Notified: Date: Initials:
l: \Building\ Forms \TransmittalLetter - Revisions.doc 4/4/07
CITY OF TIGARD
BUILDING DIVISION PERM& `, 77. eD.Z_c
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 aaptv� f i � �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
s ' -�
SITE ADDRESS: / v CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: ,151e-F----/ k '
OWNER: ONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
02 c / 1 /f6 0 c2.-7 (0 Z - 0/
Corrections /Comments/ Instructions:
PASS ❑ P• APPRafA ❑ CANCEL El NO ACCESS
❑ F AIL / /FALL •i P CTION ADDIT NAL FEE ASSESSED
,/ j Ai
Inspector: / 41 ∎ Ie Da Phone #: (503) 718
r
CITY OFrIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00275
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1112007
Phone: (503) 639 -4171 40I��
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.--4.61- `:....
INSPECTION WORKSHEET FOR DATE:. 7/24/2007 TIME: 7 :OOAM PAGE: 57
SITE ADDRESS: 14570 SW MCFARLAND BLVD CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 040 TYPE OF USE:
PROJECT NAME: HALE
DESCRIPTION: Replace deck and foot bridge. Approx. 500sf.
OWNER: HALE, ROBERT R +, PHONE #: not available
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 052563 -01 503- 620 -04F4 Y
Corrections /Comments/ Instructions:
T - t�vt `t t (... /L- gSt- A &AiT c5, I- -- S' zr
- ti 2 P - 714 S l /a.S'P c 7vry t S ■ �Ai4L.. "(I 5\4347
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Dater 27 to Phone #: (503) 718 -