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Permit
r , ,'• CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00259 i DEVELOPMENT SERVICES DATE ISSUED: 6/4/2004 +L _.� I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13670 SW 114TH AVE PARCEL: 2S103DC -00810 SUBDIVISION: VIRGINIA ACRES ZONING: R -3.5 BLOCK: LOT: 008 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: 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: 1 FRNT: ft REAR: 15 ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,120.00 Remarks: Deck: 192sf. Owner: Contractor: KINSEY, PHILIP T + MELISSA L OWNER 13670 SW 114TH AVE PORTLAND, OR 97223 Phone: 503 - 624 -9119 Phone: Reg #: FEES REQUIRED INSPECTIONS Description Date Amount Footing lnsp [BUILD] Permit Fee 6/4/2004 $62.50 Framing Insp [TAX] 8% State Surcharl 6/4/2004 $5.00 Final Inspection [BUPPLN] Pln Rv 6/4/2004 $40.63 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -6699 o 1 -800- 332 -2344. Issued By: fi i �� i �7/ c � Permittee - / — c Signature: Call 639 -4175 by 7 p.m. for an inspection the next business day RECEIVED, r. Building Permit Application FOR OFFICE USE ONLY City of Tigard 1 4 200 ar RecDate eived y: 6 / / 7 B 13125 SW Hall Blvd., Tigard, OR 97223 P lan Review 111 d� Permit No.: B� IF w� g CITY OF TIG " Other Permit• Phone: 503.639.4171 Fax: 503.598.1960 "'" 'Hvi 11,',, Date/By: Inspection Line: 503.639.4175 BUILDING DI s._»�ia , II DateReadyBy: �'�) See Attach Checklistt'or Internet: www.ci.tigard.or.us Notified/Method: / / �( Supplemental Information 4 *C4IfTIR � TYJE iriliF REQUIRED DATA 1 - AND 2- FAMILY DWELLING Permit fees* are based on the value of the work performed. ❑New construction ❑ Demolition , Indicate the value (rounded to the nearest dollar) of all ,-/ ( ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. i s . it.,-4,,z,,,,' Y Y K CAT E GORY OF .CON {. S ` ` Va $ - 4:43., (120 ❑ 1- a 2- family dwelling ❑ Commerc /industrial Number of bedrooms: ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: Number of bathrooms: k 4 3 :A Total number of floors: :� :t1 :. JOB SITE INFORMATI AND LC � > +,_ Job site address: ` -(� s (� (I A ve A New dwelling area: square feet 1 City/State/ZIP: T ok ai ?- ZZ 5 Garage /carport area: square feet Suite/bidg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: 19 2 square feet Li Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the r"� � r x l cS5) work indicated on this application. 4 Valuation: $ Existing building area: square feet New building area: square feet x� ti € , <. ,, � P Y,Qi' w* . t , � 1 TE1+) Number of stories: Name: ? L'1 i I ic t K S-e- Type of construction: Address: (5 (.1-P S ' ikV-c Occupancy groups: City/State /ZIP: T `,r� � (3 2 £ Q -17.7-3 Existing: Phone: (563) C. ' ( _ I of Fax:( ) New: , 1 � C .0 ,i.. 2 , r it.° € ' '` : °$ . ' .. „ . NOTICE Business name: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/State /ZIP: apply: Phone: ( ) Fax: : ( ) E -mail: i " i f A - -i s, .�. Oa d : ..., i , 3, t - Business name: © (A N)elt, BUILDING PERMIT FEES* Address: Please refer to fee schedule. City/State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) Amount received CCB lic.: Date received: Authorized signature:_' ' 41m.. • This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Pifi I I p ; 1e-...t i- -e. l� Date: * Fee methodology set by Tri- County Building Industry 1 Service Board. i:\ Building 'Permits\BUP- PermitApp.doc 12/03 440- 46I3T(11/02/COM /WEB) One- and Two - Family Dwelling .. Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Date/By: No.: Y 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 "ill f°HP�N�11 \ ❑ Electrical ❑ Plumbing ❑ Mechanical 24- Hour Inspection Line: 503.639.4175 OA --e Internet: www.ci.tigard.or.us ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 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 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- ❑ ❑ ❑ in protection, etc. 10 \ 3 `c omplete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state CI ❑ ❑ bu tng 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. member sizing, spacing, and bearin El ❑ ❑ all floors /roof assemblies, indicating me bearing framing. plans for al g g 17 Floor/roof g P 1 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 Ore: on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 FiveJS e 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 \One - Two- FamilyChecklist.doc 12/03 me Jun. 3. 20040 2 :48PM $5CLEAN WATER SERVICES 503 6814439« LAB No.1761 . P, 1 Quo] 114 Jul!. 1..2004 8:36AM CLEAN WATER SERV CES 503 661 No.1557 P. • • • • F �L !� .� . L i ' i LA I 11 i • • 4 aria : \'1 JUN 0 1 LUU4 ' I Fi.lc Vumber r ClcanWater Services f ltIve Area :Pre -Sc vening Site Assessment 0'ua commitmetnt Ia etar. , , Jurisdiction GiTY of T'1 G49-0 Date of 01 04 11 5 Map & Tax Lot 2S 1o31)G op810 Owner 1)4t1r1P T. t 9 € Site Address r36. 5O 5 W I t4 t' 4V Tr64/2- D , cae 9?-n3 i3Clp 5W Proposed Activity latkil,D MEW "DEcK Address Phone (FAX) 503 229- 443e O'Nclel use only bebw This line Y N NA Y N NA Sensitive Area Composite Map — Stormwater Infrastructure maps ^ ❑ Map# o Jt�J/`1 — OS ft 4YI_g ❑ Locally adopted studies or maps y—' . Other ❑ lip U ' Specify Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order No, 04 - 9: ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. 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 they are subsequently discovered on your property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER 15 'REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STORMWATER CONNECTION PERMIT. ❑ The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Comments: Reviewed By: �.� Date: f7 � I a o ► — Returned to Applicant Post -it' Fax Note 7671 Dste 3 y PaQ f °° Mail Fax Counter To // From .• :._ ' Date By Co. /Dept. Co. a , 445 Phone # Phone 1503_6g/ 3505 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line, ( 9 -4171 MST P BUP — Received Date Requested o — / : AM PM BUP Location / 3 (p 7 0 / / LI - Suite MEC Contact Person P ( + 1p?-q - ' f / `j PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/She r t_s. _ ___ k try ` ` f nsulation Drywall Nailing S �� — - /I Ing A. a a!S aI Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof A- - /V Sr CLT�r��( t'� t2 DELL g fir) Other: \ S &err PART FAIL BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer 4 Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: 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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 111 Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date �` CJ Inspector . _ - �-- Ext Other: Final DO NOT REMOVE this inspection reco m the Job site. PASS PART FAIL