Permit At BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2004 -00073
A,L 4 DEVELOPMENT SERVICES DATE ISSUED: 3/4/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S104DA 03300
SITE ADDRESS: 13452 SW 129TH AVE
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 019 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: 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: 15 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,500.00
Remarks: Stairway to second story deck.
Owner: Contractor:
WEINSTEIN, MIKE PRO LANDSCAPE INC
13452 SW 129TH 3045 SE 61ST CT
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503 - 246 -6699
Phone: 503 - 246 -6699
Reg #: 6(X3- 642 - 5606613
FEES REQUIRED INSPECTIONS
Description Date Amount Footing Insp
[BUILD] Permit Fee 2/26/04 $72.10 Framing Insp
Final Inspection
[TAX] 8% State Surchart 2/26/04 $5.77
[BUPPLN] Pin Rv 2/26/04 $46.87
[CDCPLN] CDC Pin Rel 2/26/04 $40.00
Total $164.74
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 • e , OAR 952 - 001 - 0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (50 246 -6699 or 800 -33 -7344.
op. I
Issue • By: '41.
•
Sgnit
Signature:
Call 639 -4175 by 7 .m. for an inspection the next business day
Buildiner6riiiit Applica r;T E I V , FOR OFFICE1USE ONLY
■ Received , ®�� /. Permit No.:. � �Q
City of Tigard Date/B �/ •r .iii 473
13125 SW Hall Blvd., Tigard, OR 97223 2 6 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ,¢ Other Pem
FEB rCD ", _
LNt>j;llr�!� Date /B </ ��
'S Date Read /B i �- ®See Attacked Checklist tor Insp ction Line: 503.639.4175 Y Y ��
Int% et: w.ci.ti 'rd.or.0 T� d -D Notified/Met .dz � � Supplemental Information
, �` � CITY OF
a4 /o Y i /mi l �i /�1 I � �.n �.A • .0. u � �. 'j. , - M MP, - v Aal ./
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's 0 Ps '; 4 , Ar ,i1kk' -- .ti�' p . + .- ` T Y PE' OF W ,. r i toS ,, 1... , :t ,rr' „� , . „ REQ UII2ED DAT <.AND 2= FAM .. I . L . Y ' 1 ELLING
.!1'44 Se a''t .: 1, Xr. �.4 .74j.:„ _ ^.k 0. n ,Y41U !:4 % ,..., , :?.+s`,06 v�, ' i 1 � '••�-,,:, ,
1:1 New construction 1=I Demolition
Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
i n Addition/alteration/replacement ❑ Other: e.ui.•• , materials, labor, overhead, . • • - •rofit for the
,, -k,} , .,, �.,�.,.,q�., '- r :.,;:.': ::; ; : ,., y , , r . ao, * a ;i ::; c' wo a4ed en_ this application.
�' �'�vV� VAidi r - ;" CATEGORY OF CONSTRUCTIO fl y{ �, i ' , g. h; < ,1
.W 3.1% �� r A.3i . ,-eir:�; :w. -ts,*t &ac .YLv:::,�z .xr+ :.r. ` :g.1 d .�, �.,„.z.: rr
1 Valuation: $ 2pO
14 1- and 2- family dwelling ❑ Commercial /industrial
Num'ero' • - .
❑ Accessory building ❑ Multi- family
❑ Master builder El Other: Number of bathrooms:
_ - z:�•• < ,".s•:. - , z,,.p, , . , ' u •.�nv ;«: +a'�.�i ".;it; &- '?.k? €:'i' ,: ar, `',i"; ^ ?:`:
' �` �` i � � JOB SITE -INFORIVIATION Nii LOCATION wt ' i
Job site address: 1 Total number of floors:
3 ! 5 Z yt/. Z q � 11 " New dwelling area: square feet
City/State /ZIP: �' D Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: W , Covered porch area: square feet
Cross street/directions to job site: C v - f - o [ 2 ( � ' Deck area: eet
\J� P t .J 3 fi o V .efr b l p c(. Other structure area: ) D square feet
1 9 a - h REQUIREDDATA CQMMERC a ST
Subdivision: of 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
zr. ors :' ,.o.a... K'�,t »;c,�:�� " _�;r.,*<; s:..���:, �. i i• ., ,�•�a f .,� ;y i; 'n. `.:'d
� i,„ : J x " t* 4 l it E ; , . � work indicated on this application.
,' n" lNi , , i' tz�� .S , DESCRIPTION OF R' -A ,. f....,. ,; ` . , .. . ' ° .t PP
A`4d Valuation: $ r
C CIS ', ' OI CCe_S.S + a G('c- y ay, . Existing building area: square feet
New building area: square feet
-:, '
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1,�; gPROPERTYOWNERVa' ' 1- 4
,® TENANT 4 R` r Number of stories:
Name: M l (Ce... V(�,j j - 1 I 1 Type of construction:
t Address: 3 �-5 z s (f (Z�'1 _ Occupancy groups:
City/State /ZIP: f 19 , 4 4 CY-- Existing:
i Phone: v 03) 'S 24 ,-40 7 � / Fax: ( ) New:
its :_;"¥?. °•al.l .r -:' "' .. ':4';, +, ,- .,�,,..e, -v „;ti ;.;�.;. ,,, ,,. < &ia rs ;,,^.. .I a. .
: s ,., t . I I A 1 CO NT ACT %PERSON ,, ,I 3 :.: -)0 2 ,,, ,,:-
APPLICANT NOTICE
t ` ��`.�•: ' .�+'v` � � Y . 1 '�'� " . S'� 7 . Ra > ,�.u. .� i^_ hk§�n s,. , . te.. - ��..,�. ` �-, � � OA* .. .}"'�.?:�+?"°�x.^S`i ..� �,;.,sa.� �- . -.,,_ ..4� �4r 2 , y ,., � "5. � „ #e ,u� �r ,.' „f ” c�" - �� � � -.� . ,
�,. : �%s.„,{ ova-....,+. w.."- 1, k- A...- :- .. "s ".a.;w_: :;�� - :.
Business name: p r O i---.4 0- ( ( S C 1 Z. j2J� All contractors and subcontractors are required to be
r tj licensed with the Oregon Construction Contractors Board
Contact name: ...-r, h.,..., r t 2 e lam( ��n� under ORS 701 and may be required to be licensed in the
Address: J 4-6 �, I S� Cfi , jurisdiction in which work is being performed. If the
O / applicant is exempt from licensing, the following reasons
City/State/ZIP: t '� �s Z 2 apply:
Phone: (5 r _. - e, Fax: : (5o ) G — I. 2
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.' - 2f, > i ti x - - °'aR ''dr° .4a`; , ;:a. +'l.,t t *s.:"y't "'`:;."k'';.° V kt3If'"Ia"',�x
Business name: A., btu/ < 'j , ;; Ni.'`s2, . ::ne rs r - t .- . ,� #.,, . _.. '. . . * y_ - . • , ..
1L r , ' #: BUILDING P :F EES
Address: Please refer to fee schedule.
City/State/ZIP:
Fees due upon application
Phone: ( ) Fax: ( ) ( �f' v . 7L6
Q 7 Amount received
CCB lic.: / J
Date received:
Authorized signature: "�,... Z--__cs, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
y
Print name: --' 7 . B f ; 22 0 ( t h•.,Q„ Date: 2. — .. 4 * Fee methodology set by Tri- County Building Industry
�� 11 Service Board.
•
i:\Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11 /02 /COM/WEB)
One- and Two - Family Dwelling • IA _-(,f,,,,../
Building Permit Application Checklist �° ' FOR OFFICE USE ONi* . -
Cit of Ti and R eceived
} g D ateBy: Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 A ssociated permits: Phone: 503.639.4171 Fax: ..503.598.1960 � u Nl " lit,
❑ Electrical ❑ Plumbing ❑Mechanical
24- Hour Inspection Line: 503.639.4175 ._ -111k ` I.
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•
Internet: ww.ci.tigard.or.tis • • ❑ 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- ❑ ❑ ❑
bast .rotection, etc.
10 3 I mplete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state , , ❑ ❑ ❑
I1: 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
right violations exist.
11 Sit plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑
r -- --
ere 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- ❑ ❑ ❑ .
prescri tive 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. El ❑ El
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 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 1 I" or 11" x 17 ". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
25 Building " lans 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
Approved plans .. . . I
. . thWi bfe on lob site. .
posted
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CITY OF TIGARD . , / ,' / / ///.... /
Approved _ .. r_:_ (>` / % ,,/ i ,' / a ; �� ` /!,
Conditionally Approved , ( ): / /' / y ��� ,' -
• For only the work as described in; j ` / r ` ,/ .' '
PERMIT NO. ?Wve -. C�U� - Coo 3 f ,•/ // / > ,/
See Letter to Follo''W- - - - - - - ( )' %� / /
Attach...-, •�, ): f /
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This permit does not authorize t e vio ation o any LIABILITY 1,A I1 % 114 Gs
rights of holders of private easements. The ap- ! , II The City of Tigard and its 4- .--= -- 5 - 2_ - -- •
plicant is urged to contact any such parties and y .
j secure thier approva b e f ore c ommencing wo rk..
employees shall not be ii
,Fl responsible for discrepancies `
ear herein. u - -- --,_ G o w ........., r
which may app fQ, . 13 1 -a''' .
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�'i. a3- ' -�-.�, c FEB 26 2004
�' DR AX r D3 -G11-9 �� ,, CITY OF TIGARD
BUILDING DIVISION
cr ThCT: 7 /rY1 BKIZIEN )M 5o3 -7D1 -687
CITY OF TIGARD - SIT PLAN ' EVIEW ..�
BUILDING PERMIT NO.: yxi rora off`
PLANNING DIVISION: Not Approved
Required Setbacks: ® Approved ❑
Side: Street Side: Rear: I +3 P'0d
N ot Approved
Garage: ____ --
Visual Clearance: PIA ❑ Approved ❑ pp roved
Maximum Building Height. 2 feet
CWS Service Provider Letter Required: ❑ Yes ,I No
0 Received
Q- ear Date: 3-07 - 04
ENGINEERING O D EPART EN ed ❑Not Approved
Actual Slope: ° AA roved 0 Not Approved
Site Plan: "" pp
: ate:
AZ � ~ ~ D vc .e a,�v� -• T . ,, ,...� - ,�
Notes: —yl o ova c c1��
DL Pre D e
; 6/16 0
P63, kk
`°-"%^— /-"° U3 C.K.t.t-
CITY OF TIGARD ;;- ' ' 24 -Hour
BUILDING ' Inspection Line: (503) 63S -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
• BUP 4- Y71
Received Date Requ sted ' //-- B4- AM /l% 3 PM BUP
Location / 3 S2_ 1 ? Q Suite MEC
Contact Person atic . Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
:Access:
Ftg Drain. ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
FFa
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
S PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
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 E Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date ? ' -" / Inspector - Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL