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Permit a CITY OF TIGARD MASTER PERMIT II COMMUNITY DEVELOPMENT Permit #: MST2009 -00100 T,1GARD' 13125 SW Hall Blvd. Tigard OR 97223 503.639.4171 Date Issued: 06/09/2009 Parcel: 2S103BA00116 Jurisdiction: Tigard Site address: 11705 SW ANN ST Subdivision: LERON HEIGHTS Lot: 16 Project: Vanoumey Project Description: Install beam to open wall. BUILDING Floor Areas Required Setbacks Required Stories' 0 Bedrooms' 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: Q Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units. 0 Third: 0 sf Right: 0 Detectors: Total: sf Value: $500.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains' 0 Bckflw Prevntr. 0 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 20 1 -400 amp. 0 201 -400 amp: 0 1st W/O Svc /Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir: 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: Owner: Contractor: Required Items and Reports (Conditions) • VANOURNEY, STEVEN WILLIAM OWNER 11705 SW ANN ST TIGARD, OR 97223 PHONE: PHONE: FAX: Total Fees: $110.63 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. • NTI• N. •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -1.1 -0010 through OA" 9 r r, -010A You may obtain copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344 Issued By: ' __ Permittee Signature: Building Permit Application yE Residential FOR OFFICE USE ONLY Tigard Date /B : ) 1.�7 2 �.J� , k J of 1 City of Ti and M AY 1 1 2 009 � Permit No " " ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re view � � �•• Other Permit: . ' Phone: 503.639.4171 Fax: 503.598.1960 Date/B : �� [Il Inspection Line: 503.639.4175 Date Read /B / n Q 7, Juris: ® See Pa e 2 for TIG ARD Internet: www.tigard- or.gov CITY OF TIGARD N 'fied /Meth o d: 5 0'29 D / �" S Sup plemental Information DIVISION , , • / 7 - - _ / 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 'Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ©(21) / 1 - and 2- family dwelling ❑ Commercial /industrial ` J ['Accessory building ❑ Multi - family Number of bedrooms: All cmildiU b (..r ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION - ' . Total number of floors: Job site address: New dwelling area: square feet City /State /ZIP: '7 64 x) o� Garage /carport area: square feet Suite/bldg. /apt. no.: �/' Project name: 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. Valuation: $ Existing building area: square feet New building area: square feet ❑, PROPERTY OWNER ❑ TENANT Number of stories: Name: ice. ,Z.,_.., Type of construction: Address: ..19/71, A S S'-7-1--- Occupancy groups: City /State /ZIP: Existing: Phone: W 5 6, % FaX. (-------) New: ❑ AP PLICANT El ' PERSON NOTICE Business name: �/�/�� %o /n ` , � � All contractors and subcontractors are required to be Contact name: N " licensed with the Oregon Construction Contractors Board « � under ORS 701 and may be required to be licensed in the Address: ^ ` jurisdiction in which work is being performed. If the /�° ' U��'� -7 applicant is exempt from licensing, the following reasons City/State /ZIP: �`f X7 1 �2 97/ ./ apply: Phone: (5 zo 9t C/ � / Fax: : ( 2,` � 9 2 E -mail: /��. / U " / / ` G Ge) I >fi/7,as5T CONTRACTOR Business name: /f � /a BUILDING PERMIT FEES* Address: l /�� d� (Please refer to fee schedule) • Structural plan review fee (or deposit): City /State /ZIP: FLS plan review fee (if applicable): Phone: ( ) Fax: ( ) CCB lic.: Total fees due upon application: 1--t 0 . (3 Amount received: Authorized signature: This permit application expires if a permit is not obtained fff within 180 days after it has been accepted as complete. Print name: Date: Fee methodology set by Tri- County Building Industry Service Board. 1: \Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02/COM /WEB) Building Permit Application Checklist ' One- and Two - Family Dwelling FOR OFFICE USE ONLY ` City of Tigard Received Permit No.: iill - Date/By: 13125 SW Hall Blvd., Tigard, OR 9722 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 T I GAR ' 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard- or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR P LAN 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- 1=1 ❑ ❑ 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 ❑ El ❑ 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 Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS 23 Five (5) 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 accompanied by 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- RES- PermitApp.doc 03/21/06 440- 4613T(11/02 /COM/WEB) La l Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or .' I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor • who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. �'�!� ✓� Vl jJ 6 Print Name of Permit Applicant 7 7 Signature of Permit Applicant Date Permit #: 1-11 61' 00 9 - (3 0 / 0 0 . F Address: ;r *N1174 , N/2D OQ- 97, a3 • 1 - sued by Date: 6/9 /6. f 5g This Copy for Permit Offices