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Permit CITY OF TIGARD BUILDING PERMIT 'l __ - _ .: COMMUNITY DEVELOPMENT Permit #: BUP2011 -00085 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/18/2011 TIGARD 13125 Parcel: 1S134CB00500 Jurisdiction: Tigard Site address: 12185 SW SUMMER ST Project: Wilbur Subdivision: SUMMER HILLS PARK Lot: 3 Project Description: Installation of in- ground swimming pool, approximately 760 sq ft. Contractor: GENESIS POOLS & SPAS LLC Owner: WILBUR, ERIK J & JOANNA C 13740 SW SCHOLLS FERRY RD #102 12185 SW SUMMER ST BEAVERTON, OR 97007 TIGARD, OR 97223 PHONE: 503 - 524 -2502 PHONE: FAX: 503 - 524 -2502 FEES Specifics: Description Date Amount Type of Use: SF Permit Fee - Additions, Alterations, 05/18/2011 $597.21 Class of Work: OTR Demolition Dwelling Units: 0 Plan Review 04/28/2011 $388.19 Stories: 0 Height: 0 ft DC Provision Review, COM TI - Ping 05/18/2011 $64.00 Bedrooms: 0 Bathrooms: 0 DC Provision Review, COM TI - LRP 05/18/2011 $9.00 Value: $38,000 12% State Surcharge - Building 05/18/2011 $71.67 Info Process /Archiving - Lg Sheet (over 05/18/2011 $2.00 11x17) Floor Areas: Info Process /Archiving - Sm Sheet (up to 05/18/2011 $4.50 11x17) Total Area: 0 Erosion Control 05/18/2011 $26.00 Accessory Struct: 0 Erosion Plan Review CWS 05/18/2011 $8.45 Basement: 0 Erosion Plan Review COT 05/18/2011 $8.45 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,179.47 Required: Required Items and Reports (Conditions) Fire Sprinkler: Parapet: 1 Ersn Cntrl 681 -4444 Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: Accessible Parking: 0 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: 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 : 87 or 00.3 Issued c • . Permittee Signature: � . 0 .03.639.4175 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. Building Permit Application Residential � IV I • FOR OFFICE USE ONLY Received (y �l. / I — City of Tigard ti , '�' Dateiv d i Permit No.: .....-& g II ° 13125 SW Hall Blvd., Tigard,OR 97223 on Plan Revie: y C .. Phone: 503.718.2439 Fax: 503.598.! B il LU M DateBy:/ lb 1 y I Other Permit: 1 G A R D Inspection Line: 503.639.4175 Date Rea y. ]uris: la See Page 2 for Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: !p t , 677" 1:7117 Supplemental Information TYPE OF WORK y REQUIRED 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. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: S 3%000 ❑ Accessory building ❑ Multi - family Number of bedrooms: o Master builder Other: Me td 54.), a fov( Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 13 5k) 5 0-4 , 40 , 9 -. New dwelling area: square feet City /State /ZIP: T y q ral / 0 k. - e r 7007 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: WI l b utt Covered porch area: square feet Cross street/directions to job site: 121 k 5uwl;attr St: Deck area: square feet r Sort, t � vs 1 Z 1 5 �foM 5 � � e «S ',./.) Other structure area: square feet "C4- Oil CA PmN1oi / 5t hoksa On k` tut 6 REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 1 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. !L.; 10t. `ly A PA) topic reie- S w ...:j 16 t (76,04, Valuation: $ ) Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: ,., '( U>, i 1,, Type of construction: Address: I2J M S U,) Sic vhrvlp, ST Occupancy groups: City/State /ZIP: 1 1,c ,ok / op Existing: Phone: (50)) 701, —S G. L { c 4 Fax: ( ) New: ❑ APPLICANT ❑ CONTACT. PERSON BUILDING PERMIT FEES* 1 p. L t` t (Please refer to fee schedule) Business name: G .rte5'l5 1001 C .. 11 �k5/ L Structural plan review fee (or deposit): IV Contact name: icko 1Q9 P7iPaiticvl FLS plan review fee (if applicable): Address: 13740 5L0 %mot , flv7 gA, ( 0 a City /State /ZIP: gec,.Jer p OR C (700 7 Total fees due upon application: ' Phone: (!7l) DL( __ Fax: : (5C??) 52!--( -- 25oa Amount received: � �ggi �� 6 Q�'1 /� ^^ PHOTOVOLTAIC,SOLAR PANEL SYSTEM FEES* E -mail: 9 e 9 , IS roots Q. Trpo'liter. CO "1 Commercial and residential prescriptive installation of CONTRACTOR roof -to . ,s ounted Photo Voltaic Solar Panel Syst Business name: 1, /`/ Submit two sets of roof plan with con on details and fire departm access, along w' e 2010 Oregon Address: 1.• t / Solar Installation S P'• 1 Co - • checklist. City/State /ZIP: V' 1/ Permit Fee (Intl _ . - .nreview $180.00 and . .ministrative - • : Phone: ( ) ` r Fax: ( ) ‘ l States • . ge (12% of permit fee): - $21.60 CCBIic.: i 916 ti (/(( Total fee due upon application: i 1.60 ' .----- A tt i to i( 04. Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: N iG(/14l . i e ". Date: LI ..-246 - I I * Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\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 111 City of Tigard Received Permit No.: '+ 13125 SW Hall Blvd., Tigazd,OR 97223 Date/By: ssoci : C ; Phone: 503.718.2439 Fax: 503.598.1960 Associated permits T(GARD 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard- or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 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 Oreton and shall be shown to be as plicable to the Iro 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 ". ❑ ❑ ❑ 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, ❑ ❑ 0 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(11 /02 /COM/WEB) A Building Division Development Code Provision Review T rc n R D Residential Projects Building Permit No: - -p���! `Q� O s p, CWS Service Provider Letter Received: Yes ❑ No ❑ N/A V/ / / R C � f ' - t-+d 01°5 Routed Plans: VA'// Original Plan Submittal Date: � �/� t� �.1 1st Revision Submittal Date: ❑ Site Plan Only 0. Q , 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 - iii2c/ or @tigard- or.gov) Land Use Case a se No. Name CO � &kg-- "Zoning 12-4 • 5 Er Setbacks: Front _„,/17 Rear Side 5 Street Side � Garage a-V Qr Maximum Building Height 3D Actual Building Height 12" Visual Clearance a Easements r "Sensitive Lands Type: Notes: Original Plan: Approved ❑ Not Approved ❑ Date: 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) 51 Actual Slope: 5" Notes: Original Plan: Approved 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 orb rist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) tr eet Trees Protected Trees Notes: Original Plan: Approved I Not Approved ❑ Date: tilfP 1Ja i 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 A Date Routed to Building: ._ i , Page 2 of 2 )-( 'i &c //' ocb/ fi e' Clea Water Services File Number R L(,,..,t-iv I CleanWateServices 11- 000078 JAN 1 2011 Sensitive Area Pre - Screening Site Assessment Og 1, Jur's ph-a., : B'�D � LNG_ 2. Property Information (example 1S234AB01400) 3. Owner Information Tax lot ID(s): Name: Erik and Joanna Wilbur Company: Address: 12185 sw Summer St Site Address: 12185 sw Summer St City, State, Zip: Tigard, OR 97223 City, State, Zip: Tigard, OR 97223 Phone /Fax: --O Nearest Cross Street: NW 121st Ave E -Mail: 4. Development Activity (check all that apply) 5. Applicant Information ISI Addition to Single Family Residence (rooms, deck, garage) Name: Dean Duitsman ❑ Lot Line Adjustment ❑ Minor Land Partition c ompany: Manor Construction, Inc ❑ Residential Condominium ❑ Commercial Condominium Address: 3410 NW 118th Ave ❑ Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ID Multi Lot Commercial City, State, Zip: Portland, OR 97229 tr Other Phone /Fax: 503 -267- 6767/503- 533- 5337fx ,., E-m dean ©manorconstruction.net a D 6. Will the project involve any off -site work? ❑ Yes tgi No ❑ Unknown Location and description of off-site work V 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEQ ,,i,„ 1200 -C Permit or other permits as Issued by the Department of Environmental Quality, Department of State Lands andlor Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. C 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 times for the purpose of Inspecting project site conditions and gathering Information related to the project site I certify that I am familiar with the Information contained in this document, and to the best of my knowledge and belief, this Information Is true, complete, and accurate. Print/Type Name Dean Duitsman Print/Type Title President Signature Date Jan 13, 2011 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A 7 SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report ay also be required. t W Based on review of the submitted materials and best available Information Sensitive areas do not appear to exist on site or within 200' of the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, State, and federal law. D12Cr vue Gil: pecte 5 - Fo toe. ?, p CPS. P ❑ Based on review of the submitted materials and best available Information the above referenced project will not significantly impact the existing or potentially sensitive area(s) found near the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas If they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1, All required permits and approvals must be obtained and completed under applicable local, state and federal law. ❑ This Service Provider Letter Is not valid unless CWS approved site plan(s) are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROV I ,, -' LETTER IS R •,l IRED,_ Reviewed by 4,14./I ft i V14. -J Date II 3 A j 2550 SW Hillsboro Highway • Hillsboro Oregon 97123 Phone (503) 681 -5100 Fax (503) 681-4439 ■: www.cleanwaterservices org