Permit CITYOF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00327
�
� DEVELOPMENT SERVICES DATE ISSUED: 7/11/2005
�= --' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136DD-04100
SITE ADDRESS: 06775 SW CLINTON ST ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 007 JURISDICTION: TIG
Project Description: Demolition of 875 sq ft house and 200 sq ft garage. Sewer is to be capped. Possible SDC fee credit
available for future development.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Owner: Contractor:
PACIFIC NW PROPERTIES DAN OBRIST EXCAVATION INC
ATTN: PAUL GRAM 6431 SE JENNE RD
P.O. F BOX 2206 R 7p75 PORTLAND, OR 97236
R N AV E RTO 503O626 9 - 00
Phone: 503 - 667 -4042
FEES Reg #: LIC 105618
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/11/2005 $62.50 Ersn Cntrl 681
[TAX] 8% State Surcharl 7/11/2005 $5.00
[ERPRMT] Erosion Con1 7/11/2005 $26.00
[ERPLN] Erosn Pln Rv C 7/11 /2005 $8.45
(additional fees not listed here)
Total $110.40
Th is 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 than 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 -08 :u I 'ugh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli - g 503 - 246 -669' • 1 0 0- 332 -2344.
Iss ed By:N, , / f Permittee Signatu /' / (
•
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
- Dt a , 4 1 -, COGY/
Building Permit Application , . ; FOR OFFICE "USE ONLY ' ` ' 0s °
City of Tigard Date/By: D Permit No.: AV
Y
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 'N4,1 $11 j Date/B : Other Permit.
Inspection Line: 503.639.4175 ci Date Ready/By: kris El See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information • fix:': „> t TYP "O:ra..O � TJIRED, D ATA: °:I ;At�1D2'`lyIIL'Y ?DWELLING .
>...x.:a ��,zea _''' a�=, �::', ci^''=` �' a�, t4z�. a.. r�' �: a` u�4''.'^ �.." �. �'".-..* k� s.;� „€::= xxy'�',:_<. -. >n .."a':a?�',�s..R.. r., °: ::;; ,' >"7 +";..m's �"� � ^s � - u ?tE�*^v =.: >"�,.�:. n�u "r�'S:: °t.��:. .,.. �, : - ...
,:k3x x
❑ New construction 3 olition 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
:t^ ,, W i 1 ; - ,` C. , " %'%U.. C e . work indicated on this application.
., e _ _ ^w ..4 i A%'; - 4 i v4 . RY , OI+ COQ STRUCTIO�0 < >..r .r• , a K . ,.t 404.....:1
Valuation: $
❑ 1- and 2- family dwelling ❑ Commercial/industrial
❑ Accessory building El Multi-family Number of bedrooms:
El Master builder • ❑ Other: Number of bathrooms:
-v sy„ ;;,.s . f ' ;; ,I °,, 4U::: ITE TN'E6RIVIATION!t' 4 : Total number of floors:
AN ;D' L =®GATION_ °
r`-
.:. 4 � : �' a�; ��s�;��b' R:�`.��.�.';�! -g;;� a�*�.:. 7....::'�; �$;v?,4tt:. °�s:c ; .�a:.xs;.� ,. _ �*z.���'�a.c.... „c.. � - : _ , . . , -
Job site address: « "7 75 ~ 5 (.! �,/ i , ,ea ,� . New dwelling area: square feet
•
City /State /ZIP: 77,, .--ot eV' Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: /a" Q 11/47c,.. t , Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
R.E UmED DATA;;- tcOMMERCIA USE�CIIEC'KLIST.
€” c<`; v i4.4 ,.8t. ^'' 5g.40 0. 4', a , ,
Subdivision: 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
, r x
� t .4 � � Y DESG IP SON OF WORK . , z i „ application.
� - � � work indicated on this a
u S -e a „ e h G Valuation: $
Existing building area: square feet
New building area: square feet
k /'PROPERTY O ' ° . W ''� . t TENANT . Number of stories:
a ,�,e..� -s'% ..�.� *,€ r A �,i'.z.�„-, 9^ a te..., .mo �^. .. ,^
Name: A-c 0)7(/". c A �7'*-- P,434 ® ,,,. l e S' Type of construction:
Address: e ' d if 5 ,i// I 4,t/ ."y ) J S Occupancy groups:
City/State /ZIP: /lee? 4-- e 0. Ao „ Q, 4 ;/ . 2 3 Existing: A-,)
Phone: ( 03) 2 6 gJ e7 0 Fax: (505) 6 77 » - ' 2J l
V ' ' ' ' ' '' +',44'13 rh; ;s :3�:3, �.�, x.. "`f. .� � . * ,; °u" c��+' " ^y =i!�;;, Wiz' --,,,,,,,,,;,,,,,--k,- w:
.a r.�±":;�fs,,: t -� �:��,
,'.�,"`>,. . r.., ..?a: 1,`5..' . ::?`.,,
' "� T ^. z<:� ar..,, �O- TACT' "PERSO .;�,
-APPI IGAN.: >, C l �Iz.
: - g,.: °�_ TIC
,., ,..:" ., �.. �. „_..: .�,� ^;,., �- ',tea..., , ,..t... .• § - :�'v. ,_.a : x ...�..�.,�- �s,:�..: s...yrwsc .. .,, x �'' y� ..,.p��^.�. == 'use;?., ;t �"
- �':�aa�zx�'�.a +:� v'� #,": „ua;, „� c# r� .,,�s'�Jiw .. .. .-
' ..
Business name: All contractors and subcontractors are required to be
Contact name: 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 ,
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
Business name: ��..r' 5 f E;” _ >; "Vta„, x:.x 3 °, ; m , , " ...-.':d:;:1: ti f :., °-.',
•Go vt Liel b. 'j„ ��. S, ' RIN PEE E i
Address: 4`3
City/State/ZIP: / �', /-' , ien /� e Please refer
� 72 y �v q 72 �? f er to fee schedule.
r � `� Fees due upon application.
Phone: ( ) 6 J- ' " Q 7 2 Fax: ( )
� fJ / / j _ Amount received
CCB lic.: .
.7 / Date received:
Authorized signature: MY O ! 7"41111 This permit application expires if a permit is not obtained
within 180 days after. it has been accepted as complete.
Print name: J 14100 ,.. >. �-- Date: / of/ * Fee methodology set by Tri- County Building hndustry
1/ � �� a e �� / / Service Board ^ L tT � C
A
i.\ Building \Permits \BUP- PermitApp.doc 12/03 rJ ' 4V - 4613T(I l /02 /COMN✓EB) Q L 0 7
�q ..-', alb
One- and Two - Family Dwelling f .
Building Permit Application Checklist . .
,.. . ' FOR OFFICE, USE, ONLY
City of Tigard' •' . Received Permit No
13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
Associated permits:
Phone: 503.639.4171 Fax: 503.598.1960 /1x,rdl "c ....... w tt
24- Hour Inspection Line: 503.639.4175 ill+ CI Electrical ❑ Plumbing ❑ Mechanical
Internet: www.ci.tigard.or.us ❑ 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 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 Oregon and shall be shown to be a to the .roject 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 tree protection measures as required by conditions 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\One-Two-FamilyChecklist.doc 12/03
I
1
I
I t
1
\ . .,:,
IS
C j
4 ...
1 0 it 1 1
t isi NZ in
#—
ib -"": "■,1
-- 1; '
C)Akilkik „ - 3
, A
cs- ks.,
7-4—w-t1 c .... I
... .
. ,
. .
------------ - - ------,..........--- --------•
CITY OF TIGARD
Approved ............... . ...................................... 'vq-.
'Conditionally App' e............ I
For
ythe
5
Seal etter to: Follow .............................. .. ..... ......1 j:
Att ach ..... .... ..... . ............ .. ......
.1-4-) .....,, mm , ,
' 0 • ,' Date: Mir i
. .
CITY OF TIGARD
BUILDING DIVISION"
PERMIT #: BUP200S-00327
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 7/11/2005
Phone: (503) 639-4171 zwilifivillii'\
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: . 7/29/2605 TIME: 7:07AM PAGE: 104
SITE ADDRESS: 06775 SW CLINTON ST CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Demolition of 875 sq ft house and 200 sq ft garage. Sewer is to be capped. Possible SDC fee credit
available for future development.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503-626-3500
CONTRACTOR: DAN OBRIST EXCAVATION INC PHONE #: 503-667-4042
Inspection Request Scheduled For: Date: 7/29/2005 Pour Time:
Code # Inspection Description Confirm # • Contact # Message
299 Final inspection 012394-01 603-936-1723 Y
Corrections /Comments/ Instructions:
•
— Alt k
- .4..: If
i v MEI
-.
PASS 0 PARTIAL APPROVAL 0 CANCEL El NO ACCESS
0 FAIL Li CALL FOR INSPECTION [1] ADDITIONAL FEES ASSESSED
' P
A If
Inspector:
110 DateT7 - 65— Phone #: (503) 718-
. _