Permit l 1 CITY OF TIGARD BUILDING PERMIT
it COMMUNITY DEVELOPMENT Permit #: BUP2011 -00156
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011
Parcel: 2S102DC01500
Jurisdiction: Tigard
Site address: 9070 SW MCDONALD ST
Project: Gertz Homes Subdivision: Lot:
Project Description: Demolition of 500 sq ft house. Septic tank must be pumped and filled or removed. Upon building final, demo
credits can be applied to future new construction. Access is off Edgewood St (9070 SW Edgewood).
Contractor: GERTZ CONSTRUCTION CO INC Owner: GERTZ CONSTRUCTION CO INC
19200 SW 46TH AVE 19200 SW 46TH AVE
TUALATIN, OR 97062 TUALATIN, OR 97062
PHONE: 503 - 692 -3390 PHONE: 503 - 692 - 3390
FAX: 503 - 692 -5433
FEES
Specifics: Description Date Amount
Type of Use: SF Permit Fee - Additions, Alterations, 08/05/2011 $134.54
Class of Work: DEM Demolition
Dwelling Units: 0 12% State Surcharge - Building 08/05/2011 $16.14
Stories: 0 Height: 0 ft Info Process /Archiving - Sm Sheet (up to 08/05/2011 $0.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $3,500 Erosion Control 08/05/2011 $26.00
Erosion Plan Review CWS 08/05/2011 $8.45
Erosion Plan Review COT 08/05/2011 $8.45
Floor Areas: DC Provision Review, SF - Ping 08/05/2011 $65.00
DC Provision Review, SF - LRP 08/05/2011 $10.00
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $269.08
Required: Required Items and Reports (Conditions)
1 Ersn Cntrl 681 -4444
Fire Sprinkler: Parapet:
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 Notificatio • Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a c• • • • - les or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344.
I-
Issued By / �� rmittee Signature: `�
Call :03.63 XPOy 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 RECEIVED FOR OFFICE USE ONLY
City of Tigard Date/By: / �9 ��
Permit No.: ` sa '(�`
q 13125 SW Hall Blvd., Tigard, JUL 1. 9 d,OR 97223 2011 Date Plan Review /1
C Phone: 503.718.2439 Fax: 503.598.196 Date/By: Other Permit �U 0, n�7 ��/3
r G A R D Inspection Line: 503.639.4175 C a ITY OF TIGARD Date Ready/13y: 0,41 Juris: El See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION jottiiifiyedd//M�eth�od�:: O 7 ! � � Supplemental Information
O """�`4)( ∎
TYPE OF WORK 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
El Addition/alteration/replacement ❑ Other: equipme - . . , abor, over , e rofit for the
CATEGORY OF CONSTRUCTION w • indicated on this application.
o
1- and 2- family dwelling ❑ Commercial /industrial aluation: $
CI Accessory building ❑ Multi- family tuber of bt oms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Hebot.)/VCID Total number of floors:
Job site address: g.ty 7 0 /1 SC , New dwelling area: square feet
City /State /ZIP: .77 7 6A., ) .2_2-y Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: •,i`� Covered porch area square feet
Cross reet/directions to job site: cc�� / Deck area: square feet
/ ice 5 S �o�. No Pe t rr IS °Cc Other structure area: square feet
e� � GC.Y O� d7 REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: r � I Lot no.: Permit fees* are based on the.value of the work performed.
Tax map /parcel no.: a lQx (j 500 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.
Valuation: $
11-t10 V v ( �'/ �G� Existing building area square feet •
I 1 Z New building area: square feet
VI PROPERTY OWNER ❑ TENANT Number of stories:
Name: 6 „fa_ 4. . , _ �� c Type of construction:
Address: / 7 L < c.<) 41 /C Occupancy groups:
City /State /ZIP: 'Lc'fe- (ie_____ q .0C, / . Existing:
Phone: (57.;) G T Z J !- — 5 e, Fax: (,5-(3 c 2.- - s 3 New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
I n Business name:
(Please refer to fee schedule)
\(_) Structural plan review fee (or deposit):
W Contact name:
FLS plan review fee (if applicable):
1 Address:
Total fees due upon application:
`�� City /State /ZIP:
W Phone: ( ) Fax: : ( ) Amount received:
E -mail: PHOTOVOLTAIC -SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System.
63 n Business name: r'7tC Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: • Solar Installation Specialty Code checklist.
City /State /ZIP: Permit Fee (includes plan review $180.00
and administrative fees):
Phone: ) Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: t ot,/ .5
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: / * Fee methodology set by Tri- County Building Industry
�� Dat
L/ � {� "lU � � ���/ 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
City of Tigard Received Permit No.:
n 13125 SW.HalI Blvd., Tigard, OR 97223 AssoBy:
tilli 2 Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24- Hour Inspection Line: 503.639.4175 la Electrical 0 Plumbing 0 Mechanical
TIGARD •
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 -f1. 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)
i 1K0 PEI2HIT k'
Building Ip
Division
Development Code Provision Review
TIGARD Commercial Projects with Approved Land Use
Building Permit No.: u. c o9 11— O O 1 5
Land Use Casefile No.: o &) A,00-7- coo I-2-
Routed Plans: /
Submittal Date: 7/ 19 l //
Submittal Date:
Submittal Date:
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 only mark those items on the left side that are' approved
Planning Review (contact 114 at 503 -718 V l/ or 4 @tigard- or.gov)
❑ Land is: AGs.oval
❑ B I. • g 1: 0 . ch Approved Plan: Yes ❑ No ❑
❑ 1.: . '. uf, ding Height
❑ •n s M-t
Notes:
Original Plan: Approved If( Not Approved ❑ Date: 7 --,2,/---//
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)
„Er Actual Slope: S
❑ PFI Permit #
„Cr Conditions Met
Notes:
Original Plan: Approved,EK" Not Approved ❑ Date: - 7 21 ' j
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)
trees Trees
Protected Trees /!
Notes: ice. --,l c�l�.,,LJ
Original Plan: Approved [2 Not Approved ❑ Date: 7 .2i �01/
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)
❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit
❑ Engineering Okay to Issue Permit
Notes:
i
i
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes G No ❑ ■
Date Routed to Building: A . 1
•
Page 2 of 2
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NOTES:
LEGEND
POSE OF THIS MAP IS TO SHOW THE EXISTING CONDITIONS FOR TAX LOTS 1400,
EXISTING
1501 IN WASHINGTON COUNTY. .— — EXISTING
IS OF BEARINGS IS PER SURVEY NO. 30.206 WASHINGTON COUNTY RECORDS. % / / / //% EXISTING
• EXISTING
ATUMN WAS ESTABLISHED: BY USING WASHINGTON COUNTY BENCHMARK NO. 41 V•='' •'' '
BRASS DISK SET IN CONCRETE SIDEWALK NW CORNER OF BRIDGE OVER FANNO EX. VEG
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ACT 1111 11 10 �� 11 11 0 �c-� P /-00 / 5-6
Date 08/09/11
Scheduled On0 /11 Septic Service Work Order# WO130619
Ri or City Environmental, tunic.
503 - 252 -6144 Complete Industrial
P.O. Box 30087 Salem 503 - 363 -2464 Vancouver 360- 896 -5256 Waste Removal
Septic Tank Cleaning
Portland, OR 97294 Sump Line Cleaning
Site lnformatio.n '
Hewett Construction Hewett Construction
PO Box 2212 907,SW Edgewood, Tigard
Hillsboro, OR 97123 -2212 AlKyt 9o749 Su) Mavlom.DrtLv
Contact: Scott Hewett 971- 246 -0501
971- 246 -0501 PO#
Type . . . Description of Work' ' '' 'Units and Price
Septic Service @
Septage Overage @
Notes Lid exposed, pump for decommission -CALL SCOTT WHEN ON THE WAY 971 - 246 -0501
/62 tfi C " i"-r/"
f & P 1 . ' 7
•
Total Charges - 2-13 - ` `°"
River City Environmental, Inc. is in no way responsible for damage to any vehicles, personal or real property.
Terms: Net 10 days. 1.5% per month will be charged on past due accounts (18% per annum).
C \, Terms and Conditions The Right to Lien
\ I - he customer agrees to pay all invoices arising out of services, and any other special services herein within 10 days.
The customer agrees to pay such extra and overtime charges as may be invoiced from time to time for services rendered, over and above the normal servicing
schedule, on behalf of the customer
The customer agrees to assume responsibility damage to customer's real or personal property arising from services which take place
on customer's premises, where the drivers and vehicles of River City Environmental, Inc. have been instructed to enter.
This includes, but is not limited to driveways, trees, power lines or poles and building structures.
If River City Environmental finds it necessary to add liquid to the tank on jobsite, customer will be charged for the additional gallonage resulting from these condidtions.
I Customer agrees to reimburse River City Environmental for all reasonable attorney's fees court costs and other expense incurred by said company to enforce
collection or to serve their rights under this agreement.
If this work order is not contested in writing within 10 days the full amount is considered due and payable.
Customer agrees to the above conditions. A fax on the work order is considered an original. Redeemable in Multnomah County
Check # Visa MC Amex Card # Exp Date Vcode
Work Authorized by (please print) 1/ �_,�o / �% Q Date 85 //O / /
Signature ,I'Q #1�
Service Tech #1 / C (i // Service Tech #2 Date r /' D / // Time
f — .
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PERMIT NO. BU P 2. o/ — 0015'4
CleanWater Services
Our commitment is clear. LOT Dzilo
EROSION CONTROL INSPECTION REPORT
DATE - % // INSPECTOR SJve. ive`Y SUBDIVISIONZrtz1- S at Ed r �.
/ p
OWNER/PERMITEE (r1��fz. 4 5 erns r uc ca ti . I 1 C,
SITE ADDRESS goo s, c l] Mc hi, A -� 5 �4 a 1 `a1.J t r e o rj
APPRovED
THIS SITE MEETS THE POST - CONSTRUCTION
EROSION CONTROL REQUIREMENTS SET
FORTH IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST - CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING
EMPLOYED -ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION,
THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE
OR PERMANENT GROUND COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE
FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES
THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL.
OTHER
THANK YOU FOR YOUR COOPERATION!
INSPECTOR Yirtte. CR1 b-e , PHONE Aft- 518
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.
NOTES: • LEGEND
____-----_
------------'
POSE OF THIS MAP IS TO SHOW THE EXISTING CONDITIONS FOR TAX LOTS 1400. EXISTING
1501 IN WASHINGTON COUNTY. — * EXISTING
IS OF BEARINGS IS PER SURVEY NO. 30.206 WASHINGTON COUNTY RECORDS. r 4 EXISTING
ATUMN WAS ESTABUSHED BY USING WASHINGTON COUNTY BENCHMARK NO. 41 ...../...:1 EXISIING
)
BRASS DISK SET IN CONCRETE SIDEWALK NW CORNER OF BRIDGE OVER FANNO EX. VEG
.., - - IIAI I Ittl ‘fi1 Ci rVATIMJ ia: IR. cv ACP