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Permit CITY OF TIGARD MASTER PERMIT ' COMMUNITY DEVELOPMENT Permit #: MST2011 -00044 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05!04/2011 Parcel: 2S103DC06300 Jurisdiction: Tigard Site address: 11210 SW FAIRHAVEN ST Subdivision: Lot: 0 Project: Walters Project Description: Addition BUILDING Floor Area Required Setbacks Required Stories: 0 Bedrooms: 0 First: 66 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 20 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors. Yes Total: 66 sf Value: $15,000.00 Rear: 15 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell- Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 2 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 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: ADD SF VB R -3 66 Owner: Contractor: WALTERS, LORRETTA J ALLAWAY CONSTRUCTION LLC Required Items and Reports (Conditions) 11210 SW FAIRHAVEN ST 16004 SW TUALATIN - SHERWOOD RD TIGARD, OR 97223 #147 SHERWOOD, OR 97140 PHONE: PHONE: 503 - 329 -3523 FAX: 971 - 228 -2645 Total Fees: $683.30 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: Ore on law requires you to follow the rules adopted by the Oregon Utility Notificat% - nter. Those rules • - set forth in O • R 952- 001 -0010 thro 952 - 001 -0090. You may ob a copy o _ - • direct questions to OUNC by calling .3.232. 987 or 1.800.3 Issued By: / _ // .ice . — i Permittee Signature: Cal 503 7:00 a.m. for the next available inspection da This permit card shall be kept in a conspicuous place on the job site until compl ` I • n of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Applicatio CEIVED Residential FOR OFFICE USE ONLY City of Tigard MAR 2 9 2011 Ra DateBy: p ) q i ° {� Permit No.: • } i `l td O • `J `'' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review I N i Phone: 503.718.2439 Fax: 503.01WOOF TIGARD Date/By: Mar I' _ / Other Permit: T I GARD Inspection Line: 503.639 BUILDING DIVISION Date Ready/By / / heir ®See Page 2 for Internet: www.tigard or.gov o�7 d/Method: `I a( �� Supplemental Information TYPE OF WORK iI147 / d i MRED 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 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ L� 1- and 2- family dwelling ❑ Commercial/industrial t Q� ❑ 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: 1 l aic sly Fot j ' Lie vt .i: New dwelling area: al square feet City/State /ZIP: ' - r Jdt mt tr-pl , OX \ �( I'�'.• -3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: IV of l-•e.e ' - „ Covered porch area square feet Cross street/directions to job site: 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. A err v A.,,,„ 't -1 wit`} f -e kit %(y e Vie . sse Valuation: $ / Existing building area square feet New building area: square feet ,J PROPERTY OWNER ❑ TENANT Number of stories: Name: Z.-j r r N� Wet j-ezet E Type of construction: Address: I `21 0 sw rri vein St- Occupancy groups: City/State/ZIP: '" 41 4 ' ! D- Existing: Phone: 'LdJ — !q 31 Fax: ( ) New: X APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* f (Please refer to fee schedule) Business name: A t i,, 1� Co t45. - f �, id_ Structural plan review fee (or deposit): Contact name: 0"6"ic O N 4g,„„„,,,,,. J FLS plan review fee (if applicable): ( Address: l e 0 ' S L/ -r-14-4 terthi -5� � *' aq g 4.' 1 - Total fees due upon application: , AO City/State /ZIP: .5 f w/,q eel 0 .17` Amount received: Phone: (v3) 3 ' L 3 ! Fax: : (6j/ -- Cr� E -mail: t ot 50 et `_- e( /let W t4C,— - r - f , frd�n ( PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof -top • • unted PhotoVoltaic Solar Panel Sys - :. . Business name: I ii 11, Ce irk 4 y G Submit two is of roof plan with • • • on details and fire departmen • .: ss, alon • • the 2010 Oregon 9 Address: / j/(,,/- `'r (,,, .t / r"-t — , r„t;:ol Solar Installation Specia • • - , • e checklist. " City/State /ZIP: 51el w el 7l ctc7 Permit Fee • • des plan . 'ew administrative fees $180.00 Phone: eZ3 327 -- Fax: (1) 2 ..15-- O"o t° .. - surcharge (12% of permit fee): $21.60 CCB lie.: f g 300 IP,/ // 1 Total fee due upon application: $201.60 Authorized signature: " ► This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 4 14W �.�/ Date: S /.q [ 1 / , * Fee methodology set by Tri -County Building Industry / Service Board I :\Building\Pemrits\BUP- RESPermitApp.doc 02/24/2011 440 -4613T(11 /02/COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY Mil City of Tigard Received Permit No.: Date/By: a 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits: o Phone: 503.718.2439 Fax: 503.598.1960 TIGARD 24- Hour Inspection Line: 503.639.4175 ❑ Electrical El Plumbing ❑ Mechanical Internet: www.tigard - or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1 e No N /:1 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. ❑ ❑ ❑ 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 Ore on and shall be shown to be applicable to the •ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". Cl ❑ ❑ 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 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. 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- RESPermitApp.doc 02/24/2011 440 4613T(I 1 /02 /COM/WEB) Grizzly Bea 360-694-8939 p . 1 ETieetIltaL giiciltp prrz7v 7 7:77" '' • .".2.,...., -.. V ....,...0 , City of Tigrird - ' t2I 25 aw i :oil: ilvti., Tifnor!,'. f.',72; (- :::-.: ,`,...-, 7 . 7 : i i liki ')_ P.m" "-: it1742ii -03*-Y 1 Ow gevit.o.v 1 f. Per:ait: - ' ' Plutne: 505.7!:t2-1,; Fa. : 196B I , latritt.: .. _ : 1 • .,.. ci•Vt 117,r; if 75 ...-,..,, - ,-,--",=-" • L, ■-■ ; Date 11..,:;dvilly: : .7.,x. I •-.: o.... -...... ,- • -- : A -. 1). ; ' . ssa. 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AP-11,11 IN Building Division Development Code Provision Review T i G n Ez o Residential Projects Building Permit No: H 1 I I —O0C 4 CWS Service Provider Letter Received: Yes No ❑ N/A ❑ J _ -� ( :,p Qifaku,vtr /5",...i Routed Plans: � /9//, a (� Original Plan Submittal Date: pt 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 ` — if at Q � at 503 - 718 - I- ( or c w t I V ��� @tigard- or.gov) Land Use Case � N3. Name W, k/ / EV (4 (k � + 1 ,,Zonin F ❑ Setbacks: `, Front 1 Rear j C Side Street Side Garage o.20 ❑ Maximum Building Height 3r) Actual Building Height ❑- Visual Clearance ❑ ,Easements / E1 Sensitive Lands Type: de -a 1 f A eof (d Dw- Notes: Original Plan: Approved I x Not Approved ❑ Date: 5(3' 1( 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) I Actual Slope: /0 Notes: Original Plan: Approved Not Approved ❑ Date: 3 ,/, Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard- or.gov) S treet Trees P rotected Trees Notes: Original Plan: Approved / Not Approved ❑ Date: 7 /2 Jl � pp pp � / 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 . I l'f r go1i -coo` c j - ij) N _r .0 W1 C T ___.______________ APR 4 7 2011 _L. Olean Water Services Fite Number ey GleanWate Services 1. i t— 0 c. VtiZi.k _ 1 Sensitive-Area rea Pre - Screening Site Assessment . - y— J 1. Jurisdiction; j, O l r �cf trd ' 2. Property Inform�t{an (exa43 a 13234001400) 3. Owner fn tion Tax lot 1D(s) : T ', t 0 4 j c ?1'y,) Name rie wa l -t ee C Address 0 .Sid .. 1 V : ,.l • Site Addres City, State, Zip is nr0r 7 • - a Cit State, Z ip; i�? y PhaWFa� S"0 - ,.�2 o - J2 'r . Nearest Cross Street E-Malt I . . 4. Development Activity (check all that apply) tl. Appftcant Information Addition to Single Family Residence (rooms, deck garage) Name '�p h j kJ V Cl Lot Line Adjustment Minor Land Partition �[ Company � (�r,ta/a. • kS•1'V'kG'f:1;e u Cl Residential Condotninlum t;ougrnerdel Condominium Address: , 0.r.. S / J s r''1_ • Sk 0 Residential Subdivision D Commercial Subdvision 0 Sin* Lot CoMMeNial i' Multi Lot Commercial CRYr State, ZIP: / � - m s • • 0 I r Other Phone/Fax: � � � • d . - • a UAW': • a o t • MI I s .. ',.....0 L = ' WI 6. W ill the project involve any off a tte worn pYesf $ 'NO Q Unknown Location and description of offeite %VOIR � 7. dltional comments of Information that may be ne tied to un qd your project Vp di? c &1aw7 y ksv (• ot 5 prt y he use to q 5r Ie k' VCt44 ,+ kd cc 165E -Pao' f p?gisk b''r This application dose NOT eroding and Erosion Centre! PennI s, / Connection Permits, Building Permits, Site Development Permits, DEQ 1200 -C Permit or other permits as Issued by the Department of Environmental Quality, Department of State Lands andfor Department of the Army COE, All required permits and approvals must be obtained and completed under applicable local, state, and federal law. By signing this form, the Owner or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable limes for the purpose of Inspecting project site conditions and gathering Information related to the projectsife. I certify that I am familiar AM the Information contained ■ document and to the best of my knowledge and belief, this information is e, wrrgleta, and accurate. Print/TypeNa r .c?Yt �t /D• W Print/Type Mtn . fl/4 Way. s rip, ..;,�e-� i Signature i .. /'lar :: bate / "/Y f / 1 { F , L DISTRICT USE ONLY *native areas potentially exist on site or within 200' of the sfie. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE CFA • BVICE PROVIDER LETTER, If Senaidve Areas a dst on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report . 7, ay also be requred. E d on review of the submitted materials end best available information Sensitive areas do not appear to exist on site or within 200' of the site This .,ansitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas If they ere subsequently ...covered. This document will serve no your SaMce Provider letter as required by Resolution and Order 07 - 20, Section 3.02.1. All required pen NO ' .. royals must be obtained and completed under applicable local, State, and federal law. e. Based on review of the submitted materials end best available information the above referenced project will not significantly Impact the existing or potentlaty sensitive erea(s) found near the site.lhis SensNveArea Pre- Screenkg Site Assessment does NOT eliminate the need to evaluate and protest addtionsl water quality sensllve areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution end Order / 6720, Section 9.02.1. All required permits and approvals must be obtained and completed under applicable local, state and federal law. Y1 This Service Pmvider Letter Is not valid unless CWS approved site plants) are attached. C) The proposed activity 1 • — not Meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NOSITEASSESSMENTOR SERVICE PROVI• gi" Eft15R .'• a. �— Reviewed by / el .nit—i L Date ! ' /, 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 • Phone: (603) 081 • Fax: (503) 661 - 4430 • wnw.oreanwatorservices.org z . Q v - G E. Q V Lii 0 , oz V co 1 1 c C,4--)0 e '' - g ,o 1 q `L 4 4.0 / - A44 1-ii-doN . _ _ y , ..� l yam+ .. di .. . s , •= LLI 0 I r "1 #- ,fvb.19 ( �, J 1 ©° ,.... i Z . 0 d - 02 .4 a0iCi`all i t s .1 -4 4 , 41) ( 1....Th -----...\ I Marl O , 1 - X.t�4 `r`a " 'I j 1 I }(,..,,, , 1/44 , 1-1,04, / i ) 4-. i 1 i 1 : a ,___ _ a j 1 0