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Permit 11011 CITY OF TIGARD SINGLE FAMILY v MANUFACTURED PERMIT li , C OMMUNITY DEVELOPMENT T I G A. R. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Permit #: SFM2011 00001 Date Issued: 03/04/2011 Parcel: 2S102AA03902 Site address: 8915 SW COMMERCIAL ST 27 Jurisdiction: Tigard Subdivision: Lot: 0 Project: Larson Project Description: Installation and set -up of replacement manufactured home. 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: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $0.00 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: Furn <100K: Vents: Woodstoves: Gas Outlets: Furn > =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 addl 500 sf: 20 1 -400 amp: 201 -400 amp: W/O Svc /Fdr: Mfd Home /Feeder /Svc: 401 -600 amp: 401 -600 amp: 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: ALT SFM 0 TOTAL FEES: $411.56 REQUIRED ITEMS AND REPORTS Owner: Contractor: LARSON, WAYNE BENT LEVEL CONSTRUCTION INC. 8915 SW COMMERCIAL ST #27 19379 S MEYERS RD TIGARD, OR 97223 OREGON CITY, OR 97045 -8921 PHONE: 503 - 332 -9308 PHONE: 503 - 650 -5883 FAX: 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 - • dance 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 'TTENTION: •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules ar: -et forth in OAR 95 - 001 -0010 through 0 ' - -, I ;1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. 987 1.800.332 344. I ued By: / _ �� Permittee Signature: �&. � .{�/ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. Manufactured Dwelling RECEIVED Placement Permit Application FOR OFFICE USE ONLY City of Tigard AR ° 1 ?iil Date /B : so Permit No.: arm ,, 0 - /x /.40 11111 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review i Phone: 503.718.2439 Fax: 503.598.14}TY OF TIGARD Date/B : — if / WV. Other Permit: T I G n R D Inspection Line: 503.639 BUILDIN DIV SIO Date Ready/By: Juris: ® See Plan Submittal i Internet: www.tigard - or.gov / Notifie. / ahod. A e b Requirements .10B SITE INFORMATION OWNER INFORMATION Site Address: s �}��/ 5 � zzi C9 ze 5T 7 7 Name: 9 , 7 f ,./15 I Park Name: 69 ,' Ly/ GP G %L-41i9 Address: Q ��� rzez 7 Subdivision & Lot #: .?2 7 v 7 Directions to inspection site: City: . f� 7 I State:�i I ZIP: zz Phone: 5.79r 3,Z 990 I Fax: Is property inside city limits? [Yes ❑ No E -mail: LOCAL GOVERNMENT APPROVALS Zoning Sanitation Signature: Signature: Jurisdiction: Jurisdiction: Date: Date: MANUFACTURED DWELLING PLACEMENT PERMIT FEES Installation/re-inspection Cost (each) No. Sum ( ) p Items (a) Placement (includes placement, electrical feeder, 30' of water /sewer connection) $ 275.50 $ (b) State surcharge at 12% $ 33.06 $ (b) Re- inspection (includes inspection and 12% state surcharge) $ 70.00 $ Placement permit to be obtained only by homeowner, or Oregon - licensed manufactured dwelling installer. (2) Electrical (a) Service and/or feeder (new service installation or alteration/relocation of existing service) $ See Electrical Permit Application Electrical service permit to be obtained only by homeowner performing work or signing supervisor of Oregon - licensed electrical contractor performing work. (3) Plumbing (a) New water service (for services over 30 lineal feet) $ See Plumbing Permit Application (b) New sanitation/storm sewer or rain drain (for services over 30 lineal feet) $ See Plumbing Permit Application Plumbing permit to be obtained only by homeowner performing work or Oregon - licensed plumbing contractor performing work. (4) Miscellaneous fees (a) Administrative fee $ 30.00 $ (b) System development fees (sewer connection, storm water, parks development & traffic impact). $ See Permit & System Development Fees SUB -TOTAL $ SET - UP OR INSTALLATION CONTRACTOR APPLICANT Name: 77 T :� ! / . Name: ,�r� Address: / 9 7 �S ,ge ! Address: (y / / /I /$ ,_ �/ $ 7 City:ef StateA� 1 ZIP: G' 7�r J / J City: ! i O iI�G{� ` State,/ I ZIP: 9.7z2,5 Phone: Fax: - Pho ne: Fax �®3,� -t�� So3 _5zo 3'g 3Z I CCB No.• o B�S i k��/ MDI No.: E -Mail: v SKIRTING CONTRACTOR Gam Name- ' �y> j I hereby certify that the information above is true and correct. All work to be performed shall be in accordance with all Address: governing laws and rules. City: I State ZIP: , �/ �S CL /( Phone' - Fax: fCuthorize Si nature Date� � g CC BCC B No.: - MDI/LSI No.: Print Name: (-1U 6/ j 4) 6 E Q r ©i / I:\ Building \Permits \SFM- PermitApp.doc 10/01/09 l 1 • ° Building Permit Application Plan Submittal Requirements T t A lz Manufactured Dwelling 1. SITE PLAN - Three (3) copies, fully dimensional and drawn to scale, labeled with: A. ❑ map & tax lot # ❑ subdivision name ❑ subdivision lot # ❑ site address ❑ zoning ❑ applicant name ❑ phone number Size requirement: 8 -1/2" x 11 ", to a maximum 11" x 17 ". All details listed below shall be incorporated into the site plan: B. North arrow. C. "Drawn to scale" indicates standard architect or engineer scale. D. Footprint of structure, including accessory structures, garage, carport and decks shall reflect actual building dimensions, including retaining walls. E. Finished floor elevations, all levels. F. Garage finished floor elevation. G. Corner lot elevations. If more than 4 feet elevation differential, plan must show contour lines at 2 -foot intervals. H. Location of all cuts and fills on the lot. I. Driveway corner elevations. J. Zoning setbacks (front, side and rear). K. The location of all public and private easements. L. The location, termination, and all invert elevations of all drainage piping (sanitary and storm) showing all elevations necessary to show positive gravity flow to the approved drainage device (i.e. peepholes, storm lateral, sanitary lateral). M. Residential driveways, sidewalks will be shown on site plans and will be in accordance with the City of Tigard standards. Driveway cuts shall not be permitted within 30 feet of intersecting right -of -way lines, nor within 6 feet of property lines. Weep holes /drain pipes will be installed 6 feet from adjoining property lines. Multiple driveways on individual parcels of land must have 30 feet of separation; joint -use driveways require a formal agreement. N. Show all erosion control devices proposed for site. Contact Clean Water Services (CWS) at 503- 681 -5113 for assistance. 0. Show location of existing facilities and new or relocated structures (utilities, well /septic systems, mailboxes, power poles, water meter, light pole, stop sign, etc.). P. Indicate property slope directions. Q. Existing and finished contours when slope in any direction exceeds 20% (additional requirements may apply - see grading policy). R. Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard Street Tree List. S. 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. 8 .`"v 2. BUILDING PLANS - Three sets for illustrating the manufactured dwelling foundation or basement construction (no redlines or tape -ons accepted). Size requirement: up to 24" x 36" maximum, folded into eighths (9" x 12 ") with the plans inside. No rolled, reversed or mirrored plans will be accepted. All details listed below shall be incorporated into the building plans: A. Scale (architectural or engineering only). B. Cross sections of the manufactured dwelling foundation or basement (every set of plans shall contain a minimum of two cross sections at mid -point of each direction). C. Exterior elevation (all views shall be shown). D. Basement wall, foundation and retaining wall sections. E. Documentation by manufacturer indicating that manufactured dwelling roof can support over - framing of garage roof. F. Driveway construction. I:\Building\Permits\SFM- PermitApp.doc 10/01/09 I IN _ ' Building Division Development Code Provision Review T i c. n Ez Residential Projects / Buildin g Permit No: 6 rM AO/ 1 -0000 r / "It}ot tei c_Tuk-b 1400 8, �( CWS Service Provider Letter Received: Yes ❑ No ❑ N/A /"' — Zi c p e M N T7 Routed Plans: 0'4! t el-t-1- roc TP,P , /J 7 ' Original Plan Submittal Date: 3// /// 1st Revision Submittal Date: ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review (contact at 503-718,9 or i e- -I%`j @tigard - or.gov) Land Use Case No. Name I-A Q. SO L\ Q' Zoning M it C ❑ Setbacks: Front r') Rear Side Street Side Garage ❑ yaximum Building Height Actual Building Height Visual Clearance ❑ / Easements I Sensitive Lands Type: Notes: Original Plan: Approved Not Approved ❑ Date: 3 (d ft ( Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov) ❑ Actual Slope: `3 Notes: Original Plan: Approved --0 Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) ❑ Street Trees ❑ Protected Trees Notes: Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes ❑ No ❑ Date Routed to Building: Page 2 of 2