Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2011 -00121
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/15/2011
Parcel: 2S 104ACO2700
Jurisdiction: Tigard
Site address: 12550 SW 134TH AVE
Project: WILDE Subdivision: MORNING HILL NO. 8 Lot: 171
Project Description: Change of occupancy.
Contractor: SPRINGER CONSTRUCTION LLC Owner: WILDE, ERIN DANIELLE
14845 SW MURRAY SCHOLLS DR STE # 110 12550 SW 134TH
PMB 105 TIGARD, OR 97223
BEAVERTON, OR 97007
PHONE: 503 - 209 -7959 PHONE:
FAX: 503 - 524 -4026
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 07/15/2011 $53.27
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 07/15/2011 $6.39
Stories: 2 Height: 0 ft Plan Review 07/15/2011 $34.63
Bedrooms: 7 Bathrooms: 3 Plan Review - Fire Life Safety 07/15/2011 $21.31
Value: $500 Info Process /Archiving - Lg Sheet (over 07/15/2011 $4.00
11x17)
Info Process /Archiving - Sm Sheet (up to 07/15/2011 $1.00
11x17)
Floor Areas:
Misc Administration Fee 06/23/2011 $5.00
Total Area: 0 Misc Administration Fee 06/23/2011 $1.25
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $126.85
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Yes Manual Pull Stations: Yes
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 ru es or direct questions to OUNC by calling 503. 32.1987 or 1.800.332.2344.
Issued By: -ermittee Signature:
C. 0 75 by 7:00 a.m. for the next available inspection date.
This permit card shall be ept 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 . , . 1 ;, �,M
Residential FOR OFFICE USE ONLY
City of Tigard ��- 1��FJ' DateBed / /�
A/ i %l/ Permit No.: / O V _ r1
III
° 13125 SW Hall Blvd., Tigard, OR 97223 Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date Plan Review ,� 1 UM
t' I G n l2 D Inspection Line: 503.639.4175 f 1 A 4 'Lai Date B Readyy: B ` Ig , / See Page 2 for
Internet: www.tigard - or.gov Notified/Method: ll' ifip r Supplemental Information
TYPE OF WORKµCli 1 DINAS REQUIRED DATA: 1 - AND 2- FAMILY DWELLING
❑ New construction ❑ Dem li ioonG 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.
�� dwelli g M Commercial /industrial Valuation: $ /(TJ'?/
El Accessory building El Multi-family Number of bedrooms: CJ
❑ Master builder ❑ Other: Number of bathrooms:
JOB ,SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ,a iyo S e ., / 3 y 7 i/ �- New dwelling area: square feet
City /State /ZIP: 7-/ G/94,0 / ow. 972 z 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: �yc j/ /L 4d ,A , _Tee ?. 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: ,.� Ddfoil/A, c 4 ,/, L G 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.
em. G C D F Q' C U 17,1-~ y Valuation: $
Existing building area square feet
II New building area: square feet
N
Dr PROPERTY OWNER ❑ TENANT Number of stories:
Name: E 6P/A AR N /eze E G/ /z AC Type of construction:
° ` Address: A2. Ss 0 s /3 v 7y� v Ee' Occupancy groups:
a City /State /ZIP: 77 6, / 0 5'7,22 Existing:
N Phone: ( ) Fax: ( ) New:
❑. APPLICANT . %CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
I Business name: .407, - ae C 6 f91v C 77.— ,Z <L . Structural plan review fee (or deposit):
Contact name: _r7 f>34j5te..., FLS plan review fee (if applicable):
+1 Address:
Total fees due upon application:
0 City /State /ZIP:
0 P hone: (,fd3 ) c ,2 Fax: (v3) s0 Amount received:
!� � -74s! y- ye -l.t:
E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM. FEES*
f7C6��. fctee �7 C� /L ,� Cd r-
Commercial and residential prescriptive installation of
CONTRACTOR •
roof -top mounted PhotoVoltaic Solar Panel System.
Business name: .5-6,,,.... Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: /yg''s ,rw nu.004Y Seif/i iet AA S9E.: //0 frobQ /0s Solar Installation Specialty Code checklist.
City/State /ZIP: 4 E,y g—� 7i,` an. 5'7 .0 07 Permit Fee (includes plan review $180.00
and administrative fees):
Phone: CV/ ) o20 S' _7 9 S9 Fax: (173 ) 0 -1 - 2 Y
-_ yO.2-G State surcharge (12% of permit fee): $21.60
CCB lic.: ?I
O Total fee due upon application: $201.60
Authorized signature �
This
wi within 180 days after it expires
ha s b been a n a cce p t e d permit is
s s co obtained
wi0 dys after has eeccete as complete.
Print name: f'/�� ,y f ly c Date :a .../..... A, /( * Service Board
set by Tri- County Building Industry
•
I:\ Building \Permits\BUP - RESPermitApp.doc 02/24/2011 4404613T(11/02/COM/WEB) A / Q/ L('tfi U
Building Permit Application Checklist
One- and Two - Family Dwelling FOR OFFICE USE ONLY
City of Tigard • Rec eived Permit No.:
q 13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
C ; Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24 Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical
T I G A R D 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 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 ". ❑ ❑ ❑
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(11 /02 /COM/WEB)
Debbie Adamski
From: Dianna Howse
Sent: Tuesday, June 21, 2011 10:21 AM
To: Albert Shields
Cc: Debbie Adamski; Mike White; Branden Taggart
Subject: RE: Wilde Adult Care, BUP2011 -00121
Hello Albert,
Kathy Gende informed me that Danielle Wilde's check for the PFI permit fee of $1,400.00 was returned due to a "stop
payment" that she placed on the check. I contacted Ms. Wilde this morning and she said that there was some confusion
about the check that she gave the contractor to deliver, so she put the stop payment on it and informed the contractor
before he brought it in for a receipt.
Below is an update and instructions on this project:
1) I have quoted and faxed all PFI fees due, which include reimbursement for the $1,400.00 plus a $20.00 returned
check fee.
2) Ms. Wilde is waiting for a call from Debbie to quote the building permit fees due.
3) Ms. Wilde may come in to the building permit counter for a copy of the building plans as she may change
contractors on this permit.
4) Ms. Wilde has been informed that due to the returned check, it is the city's policy that all future payments (on
this project only) must be made in the form of credit card, cash or cashier's check. No personal checks will be
accepted from Danielle Wilde's account.
5) Ms. Wilde said that she won't be in to pay the fees until July 1 or later.
Thanks and please let me know if you have any questions.
Dianna
From: Debbie Adamski
Sent: Friday, June 17, 2011 7:14 AM
To: Dianna Howse
Subject: FW: Wilde Adult Care, BUP2011 -00121
From: Albert Shields
Sent: Thursday, June 16, 2011 9:29 AM
To: Debbie Adamski
Cc: Mike White
Subject: Wilde Adult Care, BUP2011 -00121
Debbie, Daniele Wilde has called to say she would like to come in and pay her fees but doesn't know quite where she
stands. She asked that someone call her at 503 - 318 -1586 to let her know the total due.
In addition to the BUP fees, which probably haven't been calculated yet, there is at least $1400 due on PFI2010 -00023
for Fire Service Reimbursement.
Would you please call her and tell her what's due now and when the BUP fees may be ready?
Thanks, Albert.
1
CITY OF TIGARD FEE AND PAYMENT HISTORY
i ; 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
BUP2011 -00121 - 12550 SW 134TH AVE, TIGARD, OR 97223
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due
Permit Fee - Additions, Alterations, 2300000 -43104 $53.27 $53.27 $53.27
Demolition
12% State Surcharge - Building 1003100 -24001 $6.39 $6.39 $6.39
Plan Review 2300000 -43106 $34.63 $34.63 $34.63
Plan Review - Fire Life Safety 2300000 -43108 $21.31 $21.31 $21.31
Info Process /Archiving - Lg Sheet (over 2300000 -43135 $4.00 $4.00 $4.00
11x17)
Info Process /Archiving - Sm Sheet (up to 2300000 -43135 $1.00 $1.00 $1.00
11x17)
Totals for Fees $120.60 $120.60 $0.00 $120.60
Receipt # Payment Method Check # Payor: Receipt Date Receipt Amount
Total Payments: $0.00
Balance Due: $120.60
1