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Permit
CITY OF TIGARD PERMIT PERMIT #: BUP2001 -00148 lr °� DEVELOPMENT SERVICES DATE ISSUED: saisl- - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14260 SW 114TH AVE PARCEL: 2S110AB -01800 SUBDIVISION: COLE'S ACRES ZONING: R -4.5 BLOCK: LOT: 005 JURISDICTION: TIG 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: 0.00 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: 98 7.00 Remarks: Addition of 8' x 8' deck and replace window with an energy efficient exterior door. Owner: Contractor: BLANK, ARDITH H OWNER 14260 SW 114TH AVE TIGARD, OR 97224 Phone: Phone: Reg #: FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing lnsp PRMT CTR 5/2/01 $62.50 27200100000 Final Inspection 5PCT CTR 5/2/01 $5.00 27200100000 PLCK CTR 5/2/01 $40.63 27200100000 Total $108.13 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 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 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -6699 or 1- 800 - 332 -2344. Pe mt ittee O � / z Signature: �y Issued By: It Alli1A� u_ Call 639 -4175 by 7 p.m. for an inspection the next business day Building Permit Application 2 /o/ Permitn Date received: 5 : . . , iy � City of Citf Tigard /� j3uf' 20a / oo /Y ' - Project/appl. no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 - 4171 Date issued: By: Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: 1 &2 family: Simple Complex: TYPE OF PERMIT 1 & 2 famil a ' g or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition A Additi e,, t 1 ration/ placement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION y Job address: a ( D (.v / /'f ,A V E Bldg. no.: Suite no.: Lot: Block: Subdivision: Tax map /tax lot/account no.: Project name: Description and location of work on premises/special conditions: p / ) ? ' 6c O1'1'NER FOR SPECIAL INFORMATION, ESE CHECKLIST Name: /42 D 1 T 1-f 61_,49A)1< (Floodplain, septic capacity, solar, etc.) Mailing address: 4L 4 ' .5c) /4 A2.!--"- 41)6 1 & 2 family dwelling: City: � -� 2 Q State: © /Z ZIP: 9 7A Valuation of work $ 7, Phone: 553-4 .t)-174s Fax: E -mail: — No. of bedrooms/baths Owner's representative: Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage/carport area (sq. ft.) Name: Covered porch area (sq. ft.) Mailing address: Deck area (sq. ft.) City: State: ZIP: Other structure area (sq. ft.) Phone: Fax: E- mail: CommerciallindustriaUmulti- family: CON'77tACTOR Valuation of work $ Existing bldg. area (sq. ft.) Address: New bldg. area (sq. ft.) City: State: ZIP: Number of stories Phone: Fax: E -mail: Type of construction CCB no.: Occupancy group(s): Existing: City /metro lic. no.: New: Notice: All contractors and subcontractors are required to be ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: ENGINEER Name: Contact person: Fees due upon application $ /0,F, /3 Address: Date received: City: State: ZIP: Amount received $ Phone: Fax: E -mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard work will be complied with, whether specified herein or not. Credit card number: I / Authorized signature: Z- ie "/ Expires ,) � �' QY // . ,C ^' Date: �zc Name of cardholder as shown on credit card / Print name: /4 2z7 / 7 ti At , .3 t Q /l /( $ Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6J00/COM) Bu /L.6 6.2, Sv gcu P/ LA/ ■u . 63 %¢ X S, o-z) One- and Two - Family Dwelling �" "•;, � ' Permit Application Checklist Building Permit Application Chkli Reference no.: Associated permits: City of Tigard City of Tigard `J g ❑ Electrical ❑ Plumbing ❑ Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 TIIE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A I 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. 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 applicable to the project 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 & 22 above. 25 Building plans shall not contain red lines or tape -ons. 26 No rolled, reversed or mirrored building plans will be accepted. 27 28 • Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440- 4614(Mn)0 icon) • Permit #: 4 w d/ - ©0 / yam' Address: /yar J'-3 / / y -= Issued by: ate: /a /v/ Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered 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 registration 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: f,P 1. I own, reside in, or will reside in the completed structure. y 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 11P 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered 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. i , (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) ' . . Information Notice to Property Owners About Construction Responsibilities Voter This hifbrination Notice u/ Property Owners about Construction Responsibilities was de by the Construction Contractors Board i/ accordance with ORS 70/.055(5). 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 areas of concern. EMPLOYER RESPONSIBILITIES: if you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement eta residential structure, you wiU. in most instances. be ruled to he an employer and the people you hire will be employees. As the employer, you must comply with the following: Orcgon'swithholding tax law: A/un employer, you must withhold incmmrtaxes from employee wages at thetime emploces 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 Oregon Dept. of Revenue at 945-8091. 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 378-3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers Compensation Law. and must obtain workers' compensation insurance for your employees. lfyou fail to obtain workers' compensation insurance, you may he subject to penalties and will be liable fora!' claim costs ifone ofyour employees is injured untbcjoh.Formorcinhonnuhon' call the Workers' Compensation Division at the Department ofConsumer and Business Services at 945-7888. u.S. Internal Revenue Service: As an employer. you must withhold federal income tax from employees' wages. You will be liable forthc tax pavmcnteven ifyou didn't actually withhold thetax. For more inforn the Internal Revenue Se at 1'800'829'1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: Aa the permit holder for this project, youur responsible for resolving any fui lure <o meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see ifyou have adequate insurance coverage for accidents and omissions such as falling tools. paint overspray, wate/dumugobnmpipcpuocturcy.firc,o,»nrkthotmom/hu re-done. Time to supervise employees: Make sure you have suffleient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-i n and finish trades, and to notify building officials at the appropriate tittles so they can perform the required inspections. If you have additional questio write or call the Construction Contractors Board (PO Box \4|40, Salem, (}R9730q-5O52. 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. pro p-owu.pm i -: _ V 4 . n E 1200 • •••• • .. • • • • $- 303 93 :•"•: It.T:• .... • p o' So' c.�,v • .. • CID d ?0 .... H .. • ,a 11 ... • . I ) .23 .: 4 6. . y ''Tv F .... . Q . . . .o .0 o s .4 1000 el Cr kvit----- � , 304 i s • ..... - 0 -- - 1 c . `t 1900 I0 0 s 4. 900 .46 AC. A . 23 AC: ...L 0 Q � 6 o 800 oh .23 AC e 3043 8 2000 700 .46 46 .23 Ar. . 0 7 , --- }... 6 00 i , ni in 304 � � 4 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hoyr Inspection Line: 639 -4175 Business Line: 639 -4171 1 BUP 2crr / -av /yam Date Requested - `� AM PM BLD Location / C(1-6 a S w O Suite MEC Contact Person Ph G / 7G S PLM Contractor Ph SWR BUILD Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler O 'c 4' fe-k ; 7 Jo a/! / a a r Fire Alarm Susp'd Ceiling f/Cc Roof Mi / • Ac,/ Cl TO ✓t/ AS PART FAIL iNG Post & Beam Under Slab ,//© (C i? el, Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach/Sidewalk /,-� � Other Date Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST • 24 -Hour Inspection Line: 639 -41 / [� Business Line: 639 -4171 BUP �/ —600 Date Requested c"[ l 1 AM PM BLD Location 4a&o 7 Suite MEC Contact Person Ph (0 / 1(Q PLM Contractor Ph SWR G Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear e [sulation / /� Int S h /Shear Z} `� �G a G V -t U Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: FA PART FAIL P • = ING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA � Approach /Sidewalk C .9 ( 47 0 Other Date Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP = Building Permit ELC - Electrical'Permit 11 Inspection Description Date Passed By 4 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab _ Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall _ Low voltage Tilt -up panel Electrical final Masonry /Reinforcement / Framing C91 4/o t MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Post/beam mechanical _ Suspended ceiling Gas line Engineered soils _ - Mechanical rough -in Welding Lab Final — Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final `1 Final inspection ( -2/-- e% PLM - Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final _ Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab _ Catch basin/Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits i :\dsts\ forms \InspRecordBUP.doc 04 /17/01 A CITY bF TIGARD BUILDING PERMIT PERMIT #: BUP2001 -00148 "�1 ; � DEVELOPMENT SERVICES DATE ISSUED: 5/2/01 Ail ' ,- II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 110AB -01800 SITE ADDRESS: 14260 SW 114TH AVE SUBDIVISION: COLE'S ACRES ZONING: R -4.5 BLOCK: LOT: 005 JURISDICTION: TIG 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: 0.00 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: Remarks: Addition of 8' x 8' deck and replace window with an energy efficient exterior door. Owner: Contractor: BLANK, ARDITH H OWNER 14260 SW 114TH AVE TIGARD, OR 97224 Phone: Phone: Reg #: FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing Insp PRMT CTR 5/2/01 $62.50 27200100000 Final Inspection 5PCT CTR 5/2/01 $5.00 27200100000 PLCK CTR 5/2/01 $40.63 27200100000 Total $108.13 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 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 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -6699 or 1- 800 - 332 -2344. Permitee Sign / 0 aur `�f1 _I 0 /� Issued By: d � a r goer Call 639 -4175 by 7 p.m. for an inspection the next business day to.