Permit ,.. _,._ , PS_ Pr ki\*
COTY s F TOGA ® MASTER PERMIT
.14,-1$.1&:1, : rl
: t ,., COMMUNITY DEVELOPMENT Permit #: MST2009-00148
' ' i, 13125 SW Hall Blvd„ Tigard OR 97223 503 639 4171 Date Issued: 08/14/2009
Tj�"pR Parcel: 1S125DCO3500
Jurisdiction: Tigard
Site address: 7071 SW BARBARA LN
Subdivision: THE RAZBERRY PATCH Lot: 28
Project: Jackson
Project Description: 2nd story addition to existing - residence 11/2/09 ADDED heat pump minim 3' from sideyard
setback.
BUILDING
Floor Areas Required Setbacks Required
Stories. 2 Bedrooms, 0 First. 0 sf Basement 0 sf Left: 0 Parking Spaces. 0
Height. 0 Bathrooms 0 Second: 788 sf Garage. 0 sf Front: 0 Smoke
Dwelling Units' 0 Third 0 sf Right 0 • Detectors No
Total sf Value: $80 337 00 Rear. 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach. 1 Laundry Trays. 0 Rain Drain: 0 Catch Basins' 0
Lavatories: 1 Dishwashers. 0 Floor Drains 0 Sewer Lines: 0 SF Rain Other Fixtures 0
Tubs /Showers' 1 Garbage Disp: 0 Water Heaters. 0 Water Lines. 0
Drains: 0
Bckflw Prevntr 0
MECHANICAL
Fuel Types Air Conditioning N Vent Fans: 2 Clothes Dryers. 1
Heat Pump' N floods: 0 Other Units: 0
Furn<100K 1 Vents 0 Woodsloves 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 1 0 -200 amp. 0 W/ Svc or Fdr. 4
Ea add'I 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'l Br Cir
601 -1000 amp. 0 601 +amp- 1000v: 0
1000 +a m p /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)
JACKSON, SCOTT M 8 RHONDA A OWNER
7071 SW BARBARA LN
TIGARD, OR 97223
PHONE. PHONE
FAX:
Total Fees: $2,378 83
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 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503 246 6699 or 1.800,332 2344.
Issued By: Permittee Signature: x
CO A C6t Il 04,fi
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•
Mechanical Permit Application 4, � zr`I;caa r7�t'It�1 :,t.,1 �r�:o�Ll 1! �* . w�p � -Pi l �
:��'s- .• i a�'r.ai��, ����ltv. ��. �t��,: �: �' gtyvet "�'+��;
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r � p rn , ;t � o.: rnST Zoo,4 - 4:
,^ a 1: I.5 • SW Hall Blvd., Tigard, OR 97223 Plan Rcyncw
z.:,.. • � s ' ti - Phone, 503.639,4171 Fax: 503,598.1960 Other Permit, Ds te/By . _
TI G A kL inspection Linc: 503.639,4175 , • • , ' Date Rz. ay /B ;r:' :. I )(ids E See Pagc 2 for
aE lntcrnet: WWw.tigF,rd r.gov NOtifrcdMlcthod: Supplemental Information
i ..... , ,- ._., .,.,,,,,. ,. ., . C'H
„._. ,.. t .., ......_.. bI`, ,E OF'..�VOR'K .... . ... . A'IT'iE - EI
.. ..,,. i,`Ct? ' RCJ�i ;).FE�..
D Ncw construction Addition/alteration/replacement
Mechanical permit ices are baeed on the value of the work
' performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials. e.ui.ment. labor. overhead, and rcrfit.
;:< :..........:.. „..........:,....: ..,.,,,.:,: : .OF:0NfiTRLE'Cd'IQN.. - -
1- and 2-family dwelling REs ENTL E UrPMENTISY
y Ming ❑ Commerci ustrial (C A ccessory building
l.. r F_or special information use check list,
Q Multi - family ❑Master builder Other. i pescription Qty. Ea, ■ Total
::.:. ....:.........:..:: .....: . Jos. �srrE4i+ 1F:EaxIM, I • - T lcatirrg/comling
Job site address: 1n i Air conditioning
AFJ I � ��-r,b �r �y (cecpntCS site pl showing pllCCmCnt) _, 46.75
City /State/ZIP % Qr OR 9'� 2 Furnace 100,000 BTU (duct %vent) - 46.75 - a .,_
Furnace 100.000+ BTU (duots/vcnts) 54.91
Suite/bld /a t. no.: Project name: n //�� r� 41-- /;
S• P 1 I ` TJ ! Q :: Heat pump A 61.06 (Oh � (�
Cross streeUdirections to Job site: Duct work 2332 1
I Iydronic hot water system 2332
A G Residential boiler (radiator or
� �/f �j hydronic) 2332
r / �� ` � Unit heaters (fuel -type, not electric),
. in -wall, in -duct, suspended, etc. 46.75
Subdivision: r ,. Ara e • - t / ' 41 ., ,• - 0 4 - Fiuclvcnt for any of above 2:x_32
r Other 2332
Tax leap /parcel ',Il �”, Other fuel appliances
�„u "'.",'';'' 'tt ,'r, Wuserh J 23.32
: ;,..w,,, t r r,�..., a11E^�,�I�It�'�t?�1 c�F�w ,,, , , � --
"i (ias fireplace 3339
_ r Flue vent for water heater of gas
j' / i, „ ¢- Pa , ' ( /J� � i 1 fireplace 23.32
� AG� y� Wafer' // �� [�,(� / � � ll ��Gt Loa lighter ( za ;) 23.32 T
R€A fie& Te1 J Vent •�'eyei ; Woo /p stove 33.39 .
Y e C bat .--cut „ ' 6/0 23..3_ ,
• :.::.:......,.........:. . �]yy /� fireplace/insert . suer /flue /vent _ .�
. .,,,,..,. .a . w..,..,. 'J T ,� G . , ..... .. ... .... : , u ,.,..,r.,.i ::.::: J : . .: : A :: ,, .�.�ph:' :Y.�p^"
•..... - rY. r,, .t...,..,. .... . �.' - 23 ,32
r,� 2
Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 3339 _
City / State/ZIP: / Clothes dryer exhaust 3339 -
Single -duct exhaust (bathrooms, I • •
Phone: ( ) Fax: ( ) toilet compartments_ utility rooms) — 23.32 _ ' .
..... .,.........., .. crawls
,..,:. � ...., ,.:. r,;'. - :ass: 1t `per
...:..:..: ,..... ,. ...... . w .. ,,,, ARP,LrIC'�l�I'T_t'::- :::.:: ..:.::, . ;.� " „)('ER - - ;:� -- -
..:. :
i�� Other: 23.32
Business name: .f / I. // d =L 1 ( _ r pct nipi .._
Contact name: 514.15 for first four: $4.03 for cacti additional • / N' �1 Furnace. etc
Address. ?2 (p ;
L , �' :: .. / ( !00 eras heat pump
City / State/ZIP: Aj/7 f / '' 911 2 1 - Wall/suspended/unit heater
Phone: el • )ifY1p'' y , - Fax: ,00,640g-& 4 , / Water heater
E- mail: - Zit' :,_ effn� h /f L/• C mn Range
Business name: Clothes dryer (gas)
Other:
Address:
:/ c'.., cc: a A1ECfltC]?TIC '::
4
City /State/ZIP: • Subtotal 1 ' -0((J
Minimum permit fee (590.00)
Phanc: ( ) Fax: ( )
Plan review (25 % of permit fee) � p � —g � i7,- �
CCB lie.: / - •• State surcharge (12% of permit fee) I ft 5 7. 33
• TOTAL PERMIT FEE i
This permit application expires if a permit is not obtained within 180 s
Authorized sigoatur days after It bas been accepted as complete. s
Print name: Ville, L 7 !�� Date: /p -0a .. d 61 � ' Fee methodology set b Tri- County Building Indn :try Scrvii x; Board •
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IN u CITY OF TIGARD MASTER PERMIT
:g-. COMMUNITY DEVELOPMENT Permit #: MST2009 -00148
.,
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/14/2009
TCrA`h Parcel: 1S125DCO3500
Jurisdiction: Tigard
Site address: 7071 SW BARBARA LN
Subdivision: THE RAZBERRY PATCH Lot: 28
Project: Jackson
Project Description: 2nd story addition to existing residence.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 788 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right. 0 Detectors: No
Total: sf Value: $80,337.00 Rear: 0
PLUMBING
Sinks. 0 Water Closets. 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs /Showers 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 1
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 4
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 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
Ecom Other: N Other Description:
N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
JACKSON, SCOTT M & RHONDA A
7071 SW BARBARA LN
TIGARD, OR 97223
PHONE: PHONE:
FAX:
Total Fees: $2,310.44
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 throu.h OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.•699 or 1 :.0.332.2344.
Issued By: \ e, f. . . l t . k , L 1 Permittee Signal - -�
C
B uil d ing Permit Application
Residential FOR OFFICE USE ONLY
City of Tl and RECEIVE � R eceived Q M Permit No.: / p /
Ili
g Date/By: t��/ l %� �� l ���( �
- ° 13125 SW Hall Blvd., Tigard, OR 97223 2009 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JUL 15 J DateB / Other Permit:
TIGARD Ins Line: 503.639.4175 Date Ready/By: i t Q I 8 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: r ' 9 1._/-1 _ J Supplemental Information
.. - . _ BUILDING G DIVIS�ON �m
.TYPE OF !ORK '� t REQUIRED DATA I= AND 2 F 1 DWEL LING
❑ 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
° A 4 ", ''` CATEGORY'O CONS RUCTION , , work indicated on this application.
[ ri_ and 2- family dwelling CI Commercial/industrial Valuation: $ ��0 35
❑ Accessory building El Multi-family Number of bedrooms: 2
CI Master builder 111 Other: Number of bathrooms: ✓ /
,. }. JOB . SITE IN ION AN i C}CATI®N 4 : Total number of floors:
,� ............. a <.. :.�. �.� F ..�. �> � � .� 2
Job site address: 7077 6‘ covAsiztja 4 ,, L t i0 . 4 New dwelling area: square feet
City /State /ZIP: /( Gieb/a.l�� ,�J2 c:7 - 72z3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name:: 4'A41 4 . 4 gesiv_ . 0/T, .l Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
A �UL E' .c5 6j ,F L �e t 7 �
_. Other structure area: square feet
jJ,/T'e" i i OF ab.lI?AJ� -.C:24 L N YeN.T .XIs 'VP*, ° REQUIRED DATA 'CO 3VIEROIAL CILEGKUSr
Subdivision: g . - Lot no.: ge, 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.: As/ z547GO.jG"a
equipment, materials, labor, overhead, and the profit for the
" - ° DESCRIPTION OF WORK . work indicated on this application.
Valuation: - $ `
. .e9�.r.1a � LeaR1z At�v /T / ,2ri T )■l' EIS/. sT/ 1.45 - -
Existing building area: _ square feet
/ .113^7)4 New building area: - square feet
'KP ROPC OWNER ' TENANT Number of stories:
Name: (5c 1 fAck,5v Type of construction: ` s
Address: 7a v C Sw egibezmitizas6 e ,4.6.• Occupancy groups:
City/State /ZIP: 77 �� 9 7223 Existing:
Phone: ( 5 0 3 ) / 77_ !a 0a Fax: ( )
New:
'"- - ' 'APPLICANT' = CONTCTt,RERSON q 0, bfi 4-0
�... ,." _ .,. - __ , r ,...4 OT
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
G � under ORS 701 and may be required to be licensed in the
Address: 0 SW ���� z�r�
jurisdiction in which work is being performed. If the
� G
City/State/ZIP: 773 applicant is exempt from licensing, the following reasons
p (792. apply:
Phone: (.5p / 77 9bZ8 x:: ( )
E -mail:
,c CONTRAC1tQR = a
Business name: e) E- z, BQILIDI FEES *. -
Address: �� x -..a k,-,�(Pieae re fee:'schedule :ti,. ,,
Structural plan review fee (or deposit):
City/State /ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
I . Amount received:
Authorized signature:
/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:
mil, _ mot Date: . �= * Fee methodology set by 1'ri- County Building Industry
Service Board.
I: \Building \Permits \BUP -RES PermitApp.doc 11 /t /07 440- 4613T(1I /02 /COM /WEB)
'a
Mect anical•Permit Applicatio FOR OFFICE USE ONLY
'
I En
City of Tigard bE!! Date/By: / q Permit No.: y� :22
13125 SW Hall Blvd., Tigard, OR 97223 E CENEI
D Received Plan Review c
.��r
Phone: 503.639.4171 Fax: 503.598.1960 JUL 15 2009 Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: .lures: H See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: /6 Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
— RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
1j �� �� n� Air conditioning or heat pump
Job site address:
7c�7/ C51N ` -- T 4.3.4 (requires site plan showing placement) 14.00
City /State /ZIP: V� �, C.� I 7 ��� Furnace 100,000 BTU (ducts /vents) 14.00
!! // Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
��
j Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
�,/ Wood fireplace /insert 10.00
E PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: T - , r� Environmental exhaust and ventilation
Address: �J Range hood/other kitchen
7 , 7/ rsw L. h/ equipment 10.00
City /State /ZIP:/f', :� �� C97z�i3' Clothes dryer exhaust 1 10.00
✓ / / Single -duct exhaust (bathrooms,
Phone: (5077 5 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR e Barbecue
OVA-' C /l Clothes dryer (gas)
Business name: L./� -� Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee)
...e<" TOTAL PERMIT FEE
Authorized sign. ',W� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 6 y _ Date: . - . 1 * Fee methodology set by Tri- County Building Industry Service Board
I: \Building\Permits\MEC- Permit• .... I ' . 440 -4617T (I 1 /02 /COM/WEB)
J ,
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or •
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 2
i.
Electrical Permit Application rErcTED FOR OFFICE USE ONLY '
Ell Received City of Tigard 1 �� Date /By: 7 5 09 r Permit No.: 5r 9 --,:90/( f Q'
13125 SW Hall Blvd., Tigard, OR 97223 y r�Q09 Plan Review v
Phone: 503.639.4171 Fax: 503.598.196\ - I " Date/By: Other Permit:
gin Inspection Line: 503.639.4175 AQD Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Crt O FTI v i3loN
, _ Notified/Method: Supplemental Information
TYPE OF :0'J PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: c IooHP or more. occupancy.
7/ =SW C/' ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP:
El Health-care facilities. ❑ Supply voltage for more than 6, , O.g �7ZZ3 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
114=' J j�v_77�y-p( residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less / 80.30 2
[PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 4.---.40/1" li&ive,/ 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 707/ ,w .t _„ r . Over 1,000 amps or volts 454.65 2
City /State /ZIP: / / � C#-7r Temporary services or feeders installation, alteration, and /or
/ / ,� Z relocation
Phone: (53)777 , 7bZe Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
•
Business name: 0 IAD Gv e Signal p t(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) I Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lie.: I Electrical Lie.: I Suprv. Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: I Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signat , 'r TOTAL PERMIT FEE:
�,,.� -- 77/ _ This permit application expires if a permit is not obtained within 180
Print name: « ' / . '0- �� Date: ` 707 days after it has been accepted as complete.
/ * Number of inspections allowed per permit.
C\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1 t /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Building\Permits\ELC- PermitApp.doc 03/23/06
Plurnliing Permit Application
Building Fixtures ,�. ~ ... FOR OF USE . \r Y .
RECEIVE
City Of Tigard REEiew d / IF) permit No.: r i
V 53125 SW Hall Blvd., Tigard, OR 97223 2009 D�� j t�G/ i �/ 7 11 1
11 Phone. 503.639.4171 Fax: 503.598.1960 JUL J V L Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639
Internet: www.tigard- or.gov C ITE' OF TIGARD Date Ready/By: )uric. ® See Page 2 for
IONotified/Method: Supplemental Information
'- : 1e�<` ��"={'�`h -:'�; r � ;2 " - g a i "' if L r .•:2 e ur;! w :.s + ro, •
, ,<: ; : .,TYPE, . WO[ttIE.- , .. - r. y : ., l } A ,
���, - -r- " .:� � #,, x,.� , .� �.._ a�.`�;,._ {: �'.-s;$ FEE... `� ,
;s' « *� , ,... x� '�.,�,"....�i`Y+`�.�� �Cf.�t�.�*,...,,.�.'S�.� -:a ::"�. » ,x�:m� Ws. r.^ri'$ . a +5.2.°::t ;: _ �w, ;ii.> ::,e. '`�'^'�;''m..: ..'a. .� :. �`4; «�
r F'
� �. .,.m ,»xi ..�a., .. ,.., a`i ��; .,.,..�?.oe�. �r";Yr.. c -, ti. ,...- ..�5 ". ss�.�.: �.,'S�.. = �ti:,;a. =�, a. r.- srrda.�- ,:.:ra<, �?Y�'e���' .���`,
❑ New construction ❑ Demolition For special information use checklist
Description I Qty, Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
µtit °,"; „>,�,�,�.tr,`�t,*.;, a.:; ::r_q���'r''�,��; a�� >,�,���„� �r? a�..» ��<; �. a ,zrx:�s'��:>�ts� °.�°•��r"�,<`�- .'f:�`<�;r.: .$:.
'k *„ trek CAT } EGORYsOF k CONSTi2iJCTTON ,r ¢ tk t`''' SFR (I) bath 249.20
❑ 1 - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
air _rq , -,�v: ;:, >r -�...; ,,,.<. t.:., >., .r *, , Fire sprinkler ( sq ft.) Page 2
�; JOB SITE) tN SI ArT)iQN'�RKEI7C cia ,: k ' '`' �
7 :- iN . rr ,.?r '��, --:..vi6c"mc,Y': ',,,,, ,, .fret ai.';3Iksw. srs ; ,-... .i=i i1 4 ,;q'°'i$e'f;:A's, S ut
Job site address: 70 71 6 Y,, ��� 4, Catch basin or area drain 16.60
City /State /ZIP: f 6, Q.)2.. c 7 2 , Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: P roject name: Footing drain (no. linear ft.: ) Page 2
Cross streeUdirections to job site:
Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: - ) Page 2
Subdivision: l Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.:
Fixture or item
:' µ "a:� ^: � °:.- >wm�s =: +' <`�«`k+s&:?:gF:'.� w:�i�. >. ^t "��:am, ��s�5x " ; � i��� >
. , .�"w: x " ;; ; ,
Absorption valve 16.60
m , s , t bE CRIPTi'O`N7 OF VAMPW S
ow? ,, k4.._- fift... -s .. „� -, x_,, � „. ,Ni ,_.. 't Isq„ Backflow preventer Page 2
2 1 ` / z :P/T) ,4 Backwater valve 16.60
Clothes washer 1 16.60
Dishwasher 16.60
•
xi:° ` "r _ ". < - >° w „;: :.- :...14 i Z >.'_':�-; ;z ,'„ 1•�,.,; =tr, ,. ;,� : x;� :.,.r , ;. ;�- Drinkin fountain 16.60
:. K'.,.,_,. i p„ PROPERT] O - A , gl x f ` `:a. T ENAI S T ` g 6
�' H .- 'sas -�; r..-?k��t . ...u.,, � ¢s.,c � <r.,�'�8` nix, ,.m- mx �a�
Ejectors /sump 16.60
Name: (5-C•11*.. - J Ste,( Expansion tank 16.60
Address: 7‘, 7/ 5W igeNgEg.Auzz . Fixture /sewer cap 16.60
• City /State /ZIPs77 ] q Floor drain/floor sink/hub 16.60
P (50S ', 87 9 7, < 2 � / Fax: ( )
{ Garbage disposal 16.60
ky -�f" :;`.�• .y;:.aamw��z. ".�I a / t,�q: ".:��.'.. pxAi;; c 3 �.4,
} ;_`� : r=. .„ .5.,:' : .i V : t : < :rp , sizi_nw Hose bib 16.60
r A C ONT�C T PE RSON
t�: „~..�., ® ; APPLT CA NT �.�. rtr :�`� .,�� .. �, � :t�.�- ...�,.�:i .,rc,mx:x,:._,0 43
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory / 16.60
Phone:
( ) l Fax::( )
Tub /shower /shower pan / 16.60
E -mail:
$',..- ,s', r .r. ; t :. .r. Urinal 16.60
.v f,x
C ONTRA "CTO t : ', ": s
kN�'s �.,,..,,a,>sa. gs� k,.dvh. t�>�a v, s._.��_...,c,+y8�st „ a_ �'z ..,.°`-- �i'�, -�k , ;.
�. �_ Water closet � 16.60
Business name: CD 0 Water heater LL 16.60
Address: Other.
City /State /ZIP:
Subtotal
Minimum permit fee $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee. $36.25
CCB Lic.: , Plumbing Lic. no.: Plan review (25% of permit fee)
Authorized si ...... •k State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Print nam r �, Date:7 f S This permit application expires if a permit is not obtained within
wit, , 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1 \ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /02 /COM/WEB)
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: :
Residential Fire Suppression Systems:
? u.: : ..h .p �. , `�">r
�� - � � ` :� Feel ea � ; - :_:���4w�
S"><te, LTt ilities ty
( roo tage Perm.�tee -
kp
Footing drain - I 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46 40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309 00
Sewer - each additional 100' 46.40
•
Water Service - 1st 100' 55.00
Medical Gas Systems:
Water Service - each additional 100' 46.40
Storm & Rain Drain - 1st 100' 55.00 a� '€ � raPel m,t Fee . e a r ;
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
F ,lx�ll °rC�Or � QtY .., Fee (ea)� T - �o�tar additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46 40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100 00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Commercial Fixture Work:
,
toe Plan Rey�ew for Plumb zl,g , pnstallat><on _ „
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
" ` < ; ; :_; :: ;t uanfity Dy (Fizture)" V1 or,k Perforiiiea?;; greater, except systems designed and stamped by licensed
�u
r 1 engineer.
en
eFt�Cture"Type � e � ,«��� 1 ,� a a Replace .� g
a d
�. ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font - as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash - Each Stall ❑ Any complex structure as defined in OAR918 780 - 0040.
-Drive Thru
Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial •
- Domestic
Drinking Fountain ,_ a , "�,l3Y50Ine1ftr1C 0 - 1S,cr lA ; and ?� � °' � ',
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink - 2" that meet the qualifications above.
•
-3"
4 „
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach. /Refrig. Drains ,
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
is \Building\Permits\PLM- PermitApp doc 12/27/06
. • , .
,,. •
. 11. a@ \ w
• • -- RECEIVED
1 uN 1 5 2009 D ..:,.: _...,.., .... • ..,.,,,•,,..,.....
-,...
• . •,- .( ClearrWater Sentices File Numilk 1 5 2009
1 y __..---.------- ClearlWatr . . Services in-0009c1 CITY 13F TIGARD
,
Sensitive Area Pre-Screening Site Assessment BUILDING DIVISION
• •
: t Jurisdiction: Tigard . . •• -
. . .
• ..
, .
2. Property Information (example 1,52.34AB01400) 3 Owner informati
Tax lot.lb(s): 1,S1,25DCO3500 . ••: N Scott datkson
. . •
. . . .. .. .
..
.
"Company: NIA
. .. ...
Address: 7 SW Barbra Lane 1 .
site 7071 SW Barbara Lane Tigatd, OR 97223:
. , . . City, State, zip':
City, Stale, --- ' - "
210 Tigard, OR 97Z23 .
Phone/Fax: 503
• !
. , .... . . . .. .
• Ventura ._
Nearest Cross Street • P.P Court E-Mail: strijaCkson@Otatohltects.COPI
. •
. • ,
4. Development Activity .(check all that apply) 5. Applicant Information . .
•
5i)
Addition to 'Single Family Residence (rooms, deck Name: ,Scott Jackson . .
, . , . . .
0 Lot Line Adjustment '• ID Minor Land Partition - Company ; N/A '' - * • * ' . .
D Residential Condominium 0 CotertnerCial COndcitnirilum.. Address: 7071 SW Barbara Lane • .
_ „ .
El Residential Subdivision Ell Commerdal 8ithcilvision .' • .• • :•••
• : . .
: ID Single Lot Cornmercial 0 MOO Lot Cornmerctal . . . .
.. city, State, Zip: TIgard,.OR .972a..
6031077
Other. . . , .... .. .. , .. . . , Phone/Pax:.
•
..... ..... ,... ... .. , ..... ,... . ..... . . ., .
E.:M611; srrijaOkson@prerchitects:corn
. . . . . ... . . .
• • .
6. Will the project Involve any off-site *6th? 0 Yes 531 No 0 Unknoiwn
• Location and description of offsite work . •
.. . . . .... . .. .. .. . .... • ..
.. . . .
. 7. Additional comments or information that may be needed to understand your project
This .1s a second : story •addition with no Changps, at grade.
. .
This application does•NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Perrnits, DEQ
.1200 Permit or other permits as Issued by the Department of Environmental QtralitY, Department of State Lamle and/Of Department Of the Army
COE. All required permits and approvals must be obtained and completed under applleablelocal and federal !aim
By signing this form Owner or Owner authorized agent or representative, acknoWledges and agrees that employees of Clean Water Services have authority
to enter the project site at all reaeOnatitetlinet for the of InaprietiliciOrOjedt Site conditions and gathering information related to the project site I certify
that I am familiar with . the irderniation contained in this doCtimerit, and to the best of my knowledge and itioii0, this infoim0110 is tare, complete and eCeurele.
Print/Type Name Scott Jac son Prinifrype Title Owner
.. •
Signatur- ..:.: „ : ':::;" 7E1-';' ..... .• • - . - Date 12 June 2009
. .. . ... .. . ... . .. .
. . „. .. . . . . „ . .. . . . .. . .. .. . . .,,
. ' - 0." - ' , rtitt il . LY
FOR DIST ,
Li SaiisitiVisereris'po Otial 1 xlit on a e or within2titY of the site THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE oF A
SERVICE PROVIDER i.tifER. :Ir.. enSitive Areas exist bathe site or 200 feet on adjacent properties Natural Resources Assessment Report
. . .
may also' be required. . .
. 0 Based on review Of the Subbiltiedinaterials 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 sensitive areas if they are subsequently
d.IPCIWared. This document will 0.0.10.700r Service Provider letter as 'required byReseltition and Order ,07-20, 'SeCtieri1.9.2.1; All required permits and
i must be obtained and completed under applicable local, State, and federal law,
.131 BOO on review of the submitted materials and best available information the above referenced project will not siOriii impact the existing ' or potentially
sensitive area(s) found near the site This SensitiveArea Pre-Screening Site Assessment does NOT eliminate the neerftooValuate and protect additional Water
quaitty sent*e areas if they are subsequently discovered. This,docurnent witiserve as your Service Providerlitter as required by Resolution and Order
07-20.,•Seetion 3.02.1; All required perrnita.arid:apProVald must tiebbtained and completed under applicable local, State end federal jak
, . . •. . •- • • . . . ,
1:1 This Service Provider . 460 is not valid unless .CM. approved site platt(s), are attached.
: 12I The proposed activity does not meet the definition Of development or the lot was platted after 019195 ORS 92,040(2). NO SITE ASSESSMENT OR
SERVICE PROVIDER LETTER is REQUIRED.
•
Reviewed by r „A.....----)- bate . c (Z
. .
. . - - - • • - • . - , -
*,,,Aogip,,,
2550 SW Hillsboro lildhwaw ivHill6tioro;Oteijorf 97123A:, 510 Fax 3):681
m.45i:
. • I
I
11 11' . _ , . .
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
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.
--5C4C:07 j le _J--,..,(-7iNt
Print Name of Permit Applicant
T►,•i_ E�i��o7
Signature of Pew- ;.licant Date
Pe ' I/ 4•IL,•001
— o f
z.,4,..---,V,,•_.■.• s
Address. a I t • . [�_ _� �� �ti7',i`
l� r T,c -,.5 *:
r.," rF
i • ri V R.7 23 .
Issued by: o-i' Date: p- (cp• 09
This Copy for Permit Offices
. r
•
Building Permit Application Checklist
One- and Two - Family Dwelling FOR OFFICE USE ONLY
Received
111 - City of Tigard Date/By: Permit No.:
n 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960
24- Hour Inspection Line: 503.639.4175 ❑Electrical ❑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. ❑ ❑ u
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑
3 Verification of approved plat /lot. E ❑ ❑
4 Fire district approval required. Name of district: . ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ I
6 Sewer permit. ❑ ❑ [V
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ 12 (
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ E f
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 E1 ❑ ❑
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 E ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, E ❑ ❑
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- iir ❑ ❑
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. Ei ❑ ❑
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- MI ❑ ❑
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 , 0 ❑ ❑ .
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered V❑ ❑ ❑
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 0 ❑ ❑
over 10 feet long and /or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. I ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required Z ❑ ❑
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 Er ❑ ❑
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 ". In ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. 2 ❑ ❑
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. El ❑ ❑
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 ❑ ❑ V
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, iir ❑ ❑
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.doe 03/21/06 440- 46t3T(t /02 /COM/WEB)
•
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.' HIP-51
PLANNING DIVISION:
, ti Required Setbacks: Approved ❑ Not Apnrno ' :,!
l ' _ 5 89E 353 1] / ‘2,
2,6' Side: Street Side:
/ is From. Garage: Rear' . �__
/ /
�' Visual Clearance: �❑ Approved ❑ Not Apprmed
, ,/ § rs Maximum Building Height• feet
h
e / / / , ived
0 , CWS v•' Provider etter Required: e Yes Q No
Rcf //t 5 -- - - /'__ /( %: . Date: - 7 R oy
5 , - �_ �y //
,.�', EN INEERING DEPARTMENT:
Actual Slope:__ -_ Yo Q Approved
f / 4 t. ;1l►,• ❑Not Approved
�� / � . 0 . *s �.: t;� � ry Site Plan: Q Approved ❑ Not Approved
� �� �;i l at ,... � BY Date:
i NNote ::: e------
7 \ � : 3� :z: / AMMO / / rye 6Y � AvrnnoN \ / / � / \ \/ d / �o Yee-tQ do - - 1A (, r-v E ..
/ ►� iN
/
/
"� �vl O S11I Vi/ / / \ p m
�;� \
/ EX1571NG SINGLE FAMILY RESIDENCE 4 ( ll -
�-, �'� / / \ o CITY OF TI GARD - SITE PLAN RE VIE W
�/ % / \ , ✓ / \ BUILDING PERMIT NO:
/
b , Street Trees:
�, y / L ZE 7 ) / I , , Protected Trees: '-iii APProv.O . �o o t t APPro amo ���� Date:
�i,► 4', . / / / /
/ / � '�' E coNCREre vwvaw�
a /
" � K BARBARA LANE
/
1 /
/ \ N I / N
/ IA rya 0.s 0
1 /
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tpi--, / i
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- , a'
7
,.l
,o,
I
TAX LOT NUMBER: I5125DG03500
CODES: I.B.C. 2003 EDITION W/ STATE
OF OREGON 2004 STRUCTURAL
SPECIALTY CODE AMENDMENTS
ZONE: R -4.5
OCCUPANCY: R -3 0 ____
TYPE OF CONSTRUCTION: V -B
ASSUMED TRUE
LOT AREA: 10,513 5F
LOT COVERAGE: 24%
NOTE: FLOOR AREA: EXISTING = 2,012 5F
GRADES, CONTOURS AND ELEVATIONS NEW = 1SS SF
ARE APPROXIMATE AND NOT BASED TOTAL = 2,860 5f n
ON CERTIFIED SITE SURVEY DATA. C C rri
SCALE G) -n r- c.,
1 = 20 , _ 0 , SITE PLAN o . N rri
Oc
JOB NUMBER SHEET NUMBER
JOB TAE
JACKSON
•
09-002 09-002 SP -
RESIDENCE SITE PLAN
071 SW BARBARA LANE
DATE OF SHEETS
BGARD, OREGON 97223 14 JULY 200q I