Permit BUILDING PERMIT
CITY TIGARD PERMIT #: BUP2005 -00185
DEV W i
LOPMENT R 503-639-4171
DATE ISSUED: 4/28/2005
13125 PARCEL: 25111 BD -00505
SITE ADDRESS: 14940 SW 98TH AVE ZONING: R -3.5
SUBDIVISION: DARMEL LOT: 005 JURISDICTION: TIG
Project Description: Adding to existing deck.
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: 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: HT: 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: FRNT: 20 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 9,000.00
Owner: Contractor:
MOORE & TEPES OWNER
14940 SW 98TH AVE.
TIGARD, OR 97224
Phone: 503 - 626 -0575
Phone: 503 - 475 -3180
Reg #:
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/28/2005 $129.70
[TAX] 8% State Surcharl 4/28/2005 $10.38
[BUPPLN] Pln Rv 4/28/2005 $84.31
[CDCPLN] CDC Pln Re\ 4/28/2005 $42.00
(additional fees not listed here)
Total $272.39
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 these rules or direct questions to OUNC by
calling 503 -246- 9 or k 800-332-2.
Issued By: � �.l�Gc� Permittee Signature: ' l (� 1� ,
/ Pr
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that rusiness 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 A 1 tl) irwi ' I - F• FOR OFFICE°USE ry ONLY . ' :.
Received
Permit N•.. oo � .0 �
City of Tigard Date /B ► /
13125 SW Hall Blvd., Tigard, OR 97223 i 2 8 2005 /Clau . v Plan Revie Other Permit:
Phone: 503.639.4171 Fax: 503.598.19 '` AL, Date /By:
Inspection Line: 503.639.4175 CITY OFTIGARD °" Dat eReady /By: Juris: H See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: k t ` Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees *.are based on the value of the work performed.
_ /I � ee" Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement Other: •
(t((,(l id d� dQ equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ g ood
❑ 1- and 2- family dwelling ❑ Commercial /industrial him r
❑ Accessory building El Multi-family Number of bedrooms: 3 ix JW n5�- 2_
❑ Master builder CI O t her: Number of bathrooms: 2
JOB SITE INFORMATION AND LOCATION Total number of floors: 4
Job site address: 14 '7 4 Sw 9� � ' � /j_ -( 4- —0'La'^ New dwelling area: square feet
City/State /ZIP: ; / , CD 0 12J -Q oa- Q' 1 7 z 2 4 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 7IEpe S - /91,0 ® /eE Covered porch area: square feet
Cross street/directions to job site: Deck area: 1 S"H rl, i &D square feet 2p
Other structure area: Q 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
DESCRIPTION OF WORK work indicated on this application.
add' \91-‘ ( 111 , e ° I Valuation: $
l'• ' i J - -S /A.
C e
.� tt Q c�ccL'9� r1 � tJ�l� .9 -72_ m � �c�u.� � ' # Existing building area: square feet
jj// New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: / D79ili f}— M fat' -R 7as S; 71151 ko 0/2-F Type of construction:
Address: 14 q 4 0 SAM q1 4-4--- Occupancy groups:
City/State /ZIP: 776, /9-2) 902-- ---V72- 4 Existing:
Phone: (5 62 4 Q S7S Fax: ( 3) • GZ 4 - 36 4 New:
V APPLICANT ❑ CONTACT PERSON NOTICE
Business name: A y L u P Ci A te. All contractors and subcontractors are required to be
Contact name: / rr�t Qjj (� �t licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: rIa-mt cto CL .0 t t jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax: : ( )
E -mail:
CONTRACTOR
Business name: / 1 goe�� _ BUILDING PERMIT FEES*
Address: "�
r - Please refer to fee schedule.
City/State /ZIP:
- Fees due upon application
Phone: ( ) Fax: ( )
- Amount received
CCB lic.:
i V--- Date received:
Authorized signature: /,.. di _ - ' /����� / This permit application expires if a permit is not obtained
� _ .. within 180 days after it has been accepted as complete.
Print name: ,O 1 t IU '' , • 4 ['f' 4i/ {f pate: 21rp 5 * Fee methodolo set by Tri- County Building Industry
Service Board.
1:\Building\Permits\BUP- PermitApp.doc /03 440- 4613T(11 /02 /COM/WEB)
One- and Two - Family Dwelling ,o,
Building Permit Application Checklist . ,.. •. ; FOR OFFICE USE ONLY =
City of Tigard Received Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
Associated permits:
Phone: 503.639.4171 Fax: 503.598.1960 GH�e0 lk
24- Hour Inspection Line: 503.639.4175 ��'l) ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.ci.tigard.or.us °" ❑ Other:
.
: TIIEFOLLOWING'ITEMS ARE REQUIRED FOR PLAN REVIEW Y No "; : /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 la plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
in protection, etc.
10 3 omplete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state CI ❑ ❑
g.
bu ng 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
cop • ht violations exist. .
11 Site /plot lan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if 111 ❑ ❑
there ore 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. ❑ LI ❑
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 CI CI Cl
architect licensed in Oregon and shall be shown to be applicable to the project under review. .
JURISDICTIONAL SPECIFICS • ° , . _ ,
23 Five (5) s; e plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑
•. - 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. CI
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- PenmitApp.doc 2 -
„ 2005, 3 :0711, CLEAN WATER SERVICES 503 6814439 503 624 36 No.6362 P. 1 F,02
Ili) _ r i7 [i 'IT fr; ' -
1 1 1 APR 11 2005 � i,I . O- 00)16'
r j File Number
OOean 1��'oter Services 'y -- • -- -- -. -
Cur oaintrsrsmsnt i hzr. Senstfivs A rea Pre Screening Site Assessment
Jurisdiction et F '060124 Date 0
9dtap & 3arx LTA #” f l — f e 4 Olfftel 7l titrftfy mzote - -ivvir tr7 • r -
Site Address MIV . -r. ' •
- - ' 1 ' r ' Contact .. a4 O
Proposed Activity • y , S , `' _am' Address _
_.
e Phone D • V - 05
.� .._._ ; Y 03 624 - SC6
Meal use only below this line
Y N NA Y N NA
❑ g ❑ Sensitive Area Composite Map ❑ ❑ pi Storrnwater infrastructure maps
Map # _.2.6/0/ 141 Qs # ACS 9
— ❑ Locally adopted studies or maps ❑ ❑ ❑ Other d ftil ' I9
Specify ..__ Specifyy ,94,0;a.I
Based un a T V'I5W Ot the abave SstSur nail on and tine 7equYrements at Clean Water
Services Design and Construction Standards Resolution and Order No. 04-9:
El Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT
WA; istier4COM f4 MS ttiViYrltA3IO1i QR10'R'1O 1 155W V, Of A WrinCE
PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas
exist on the site or within 200 Peet on adjacent properties, a Natural Resources
Assessment Report may also be required.
gc Sensitive areas do not appear to exist on site or within 200' of the site. This pre-
screening site assessment does NOT eliminate the need to evaluate and protect
water quality sensitive areas if are subseque
property.
❑ The proposed activity does not meet the definition of development. NO SITE
ASSESSMENT OR SERVICE PROVIDER LETTER IS RLQUIRED.
Comments:
„ d i e d Y _rL a/ .
12s vrotir few.'liee etre4-5 dr !sue gear i . S - _SA ar.'rSiK
itei._ er � J1e s., 7 �� —
Reviewed By: - Cam A - bate: «/// /'7
Returned to Applicant
Post - it" Fax Note 7671 w,0 I to O 5
Fax Counter
1 ,cr
/i'NMI+i �at�► C � �k 6J4�4 � e�
Co/Dept r Co:
Phono# Phone #3' ` Q f 57 00
fax 11 ' 01'-4 - 3( (4 J F�xx # J V f '
************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* *
* T. RA.hISA.CT IOR REPORT *
* APR -18 -2005 03:15 PM *
* FOR: BASIL. ADULT. CARE. HOPTE 503 ,624 3664 *
* *
* SEND
* *
* DATE START RECEIVER PAGES TIME NOTE *
* APR -18 03:15 PM 5036241.901 0 * *' * *" CANCEL *
*
************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
•
i , . • ;1 BASIL ADULT CARE HOME
DECK 6
I J. 3 141i- �W 4$ TN AVE_
ei TIGftRD OIL. 9 4
72
2,2 •
f
/ 6 - 0 b r ° 11� tai ..' '-J� ° �s � � I PG i
SEE a
R ; _
Lin 1(._
Tb RL i ,t I Y : I i
' ; DECK lc
I Y I ; I if
X1-1 wit) � �� /__ ... - - ->-
— l— er — ( . . . ..
R 3.5 -- ' D
CITY OF TIGARD - SITE PLAN REVIE y
BUILDING PERMIT NO.: = RhN1Asq Pr.
PLANNING DIVISION: 21'E2
Required Setycks: [A Approved ❑ Not Approved
Side: J Street Side: 2 �"-
_
From. -L Garage: Rear: L
Visual Clearance: (2)SApproved 0 Not Approved z
Maximum Building Height 3o feet
CWS Service Provider Letter Required: ❑ Yes ❑ No N,.:: _
,.
❑ Received .__- .�-,-w -- . �______ _- = - --
C-7,----e Date: �' f s yc.)S — i 0
1 i:.N6 INEERING DEPARTMENT: ii
p ❑ App pp SCALE: = 1
Actual Slope: % roved ❑ Not Approved
Site :� ❑Approved ❑Not Approved
B ': Date: K — 2— 2 .
;\+Vi_o:
11
Ckfi,
--,
'11
F T 3.9v&
V J 4 ft V
21- s/ArYa
'51 '18 "6 1 .6.-
,T 15X v
FF=1
4, '1)0 i CIPii")1./.
- 3/V til$b M5 ° 111 ' 17 r
1
'31,40171 TelifD 1.11')C V ISV9
r•^3
agi ! 1" / 1
! 1
8
•IINJ,101
9
J C U c ,, ,/1(7)75'
\‘.
>4QQ
0,3Hs- --70cLL ,9 I
A .P1 d a
.<
r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: RUP2005 -00185
5 Hall Blvd. Ti DATE ISSUED:
1312 SW Ha I and OR 97223 E /
Tigard, 4 28/2005
Phone: (503) 639 -4171 /
Inspection Requests (24 Hrs.): (503) 639 -4175 W
INSPECTION WORKSHEET FOR DATE: 6/6/2005 TIME: 7:13AM • PAGE: 79
SITE ADDRESS: 14940 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: DARMEL LOT #: 005 TYPE OF USE:
PROJECT NAME: MOORE
DESCRIPTION: Adding to existing deck
OWNER: MOORE & TEPES, PHONE #: 503 - 626-0575
CONTRACTOR: OWNER PHONE #: 503 -475 -3180
Inspection Request Scheduled For: Date: 6/6/2005 Pour Time: 7t `/Z Dv
I1
Code # Inspection Description Confirm # Contact # Message k� )84
299 Final inspection 006473.01 503.624 -0575 Y 60 ,U1 i PO,
Corrections /Comments /Instructions:
•
•
•
C/
•
�►�� PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
• Inspector: Date: � Phone #: (503) 718-