Permit CITY ®F TIGAR® MASTER PERMIT
PERMIT #: MST2005 -00289
4
DEVELOPMENT SERVICES DATE ISSUED: 8/11/2005
`" 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
�� _r PARCEL: 2S112BC -00100
SITE ADDRESS: 1453 St- .."- ZONING: R -4.5
SUBDIVISION: DURHAM ACRES LOT: 069 JURISDICTION: TIG
Project Description: For purpose of "Final Inspection" Old permit #MST98- 00448.
BUILDING
REISSUE: STORIES. FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT' FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE. SF FLOOR LOAD. SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: DWELLING UNITS: THIRD sf RIGHT'
VALUE:
OCCUPANCY GRP: R3 BDRM• BATH. TOTAL: 0 sf 0 00 REAR:
PLUMBING
SINKS' WATER CLOSETS' WASHING MACH' LAUNDRY TRAYS: RAIN DRAIN: 1 TRAPS
LAVATORIES. DISHWASHERS: FLOOR DRAINS. SEWER LINES: SF RAIN DRAINS: CATCH BASINS.
TUB/SHOWERS' GARBAGE DISP: WATER HEATERS. WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES'
MECHANICAL
FUEL TYPES FURN < 100K: BOIL /CMP < 31-IP: VENT FANS: CLOTHES DRYER:
FURN > =100K• UNIT HEATERS' HOODS: OTHER UNITS:
MAX INP btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp' 0 - 200 amp: W /SVC OR FOR' PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp. 1st W/O SVC/FDR. SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY. 401 - 600 amp. 401 - 600 amp' EA ADDL BR CIR: SIGNAL /PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v. MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL' CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO' VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM. OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER. CLOCK: INSTRUMENTATION: MEDICAL: OTHR•
HVAC' DATA/TELE COMM' NURSE CALLS: TOTAL # SYSTEMS.
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR Specialty Codes
BROOK KNOWLTON OWNER and all other applicable laws. All work will be done in
14537 SW DEKORTE TERR. accordance with approved plans This permit will expire
TIGARD, OR 97224 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION Oregon law requires you to follow rules
Phone: 503 - 515 - 4476 Phone: 503 475 - 3180 adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080 You may obtain copies of these rules or
Reg #: direct questions to OUNC by calling 503 - 246 -6699 or
TOTAL FEES: $ 125.00 1 - 800 - 332 - 2344
REQUIRED ITEMS AND REPORTS
Issued By : AA -_ �= li . _ Permittee Signature :
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.
Building Permit Application, � , 7 �° FOR OFFICE USE ONLY
City g
Cl of Tigard I� Receive,, ^ ^ _e:) � ��, � 7 Q
Date /By:� l t / ' Permit No' ap
S • /
13125 SW Hall Blvd., Tigard, OR 97223 I �� Plan Revie
. ' l
Phone: 503.639.4171 Fax 503.598.1960' ` ` I / //P '
• l' I Date/By. Other Permit JQ 4'
u � � > r• hrl Ili -
Inspection Line. 503.639.4175 Date Ready/By. 0 See Attached Checklist for
Internet www ci.tigard.or.us NonfierVINethods Nall Supplemental Information
GM OF TEGAfD
r..." nt1PMEMI
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
- and 2 -family dwelling ❑ Commercial /industrial
Valuation: $
CI Accessory building ❑ Multi- family
Number of bedrooms:
CI Master builder El Other:
Number of bathrooms:
. JOB SITE INFORMATION AND LOCATION Total number of floors.
Job site address: 1 445 3 7 S n '':to_ 4 -1C � .c - New dwelling area: square feet
City /State /ZIP: L LC U 2 9 1 t � T "( 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: 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.
�'�J \ . ? CF Valuation: $
T144r Existing building area. square feet
New building area: square feet
----t OPERTY OWNER ❑TENANT Number of stories:
) Name: \kk N Type of construction
Address: VAS -7 < 4c)12...\4-4e.- Lo-C( Occupancy groups:
City /State /ZIP: "7 (_j q - .4
. - ( Existing:
Phone: ( II Li --- Fax: ( ) � New
' .❑ APPLICANT ❑ CONTACT PERSON - NOTICE
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:
"CONTRACTOR
Business name: BUILDING..PERMIT FEES* .
Address •
Please refer to fee schedule.
City /State /ZIP: Fees due upon application
Phone ( ) Fax:( )
Amount received
CCB lie.: .
Date 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: (fib ^' � ,) Date F-- l (^ Es * Fee methodology set by Tri- County Building Industry
'�Y' 1 Service Board.
i \BwldingU'ertmts\BUP- PemiitApp doe 12/03 440- 4613T(11/02/COM /WEB)
One- and Two - Family Dwelling •
Building Permit Application Checklist FOR OFFICE USE ONLY
City of Tigard Received Permit No
Date /By
13125 SW Hall Blvd., Tigard, OR 97223 Associated permits
Phone: 503.639.4171 Fax: 503.598.1960 / /N ; " Ip e G �:i "IOW"
❑ Electncal ❑Plumbing ❑Mechanical
24- Hour Inspection Line: 503.639.4175 . L ; 1
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 -fl. 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 . to the .ro'ect 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\BUP-RES-PermitApp.doc 2