Permit CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2004 -00486
4 1A DEVELOPMENT SERVICES DATE ISSUED: 10/7/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07925 SW DURHAM RD PARCEL: 2S112CD -01100
SUBDIVISION: DURHAM ACRES ZONING: R -12
BLOCK: LOT: 004 JURISDICTION: TIG
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:
Remarks: Demo 1200 sq.ft. house and 500 sq.ft. garage. Sewer line to be capped & inspected. Credits may apply for TIF,
sewer, parks SDC, water quality & quantity
Owner: Contractor:
KEYSTONE DEVELOPMENT, INC OWNER
P.O. BOX 476
LAKE OSWEGO, OR 97034
, Phone: 503 - 635 -4736
Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 10/7/2004 $62.50
[TAX] 8% State Surchaq 10/7/2004 $5.00
[ERPRMT] Erosion 10/7/2004 $26.00
[ERPLN] Ero Plck -CWS 10/7/2004 $8.45
(additional fees not listed here)
Total $110.40
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 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 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By:
Permittee
Signature: _• 4AII AI
Ca 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application FOR OFFICE, USE ONLY ' a.
— 7
City of Tigard Date/13y � / �G Permit No BgP�60 4 o z
13125 SW Hall Blvd , Tigard, OR 97223 Pl an Review
Phone 503.639 4171 Fax: 503.598 1960 , 1 ' , 1 Date/B : Other Permit /6
Inspection Line 503.639 4175 ,411 Date Ready/By An is El See Attached Checklist for
Internet www ci.tigard or.us Notified/Method Supplemental Information
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❑ New construction tg 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
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" �� I- and 2- family dwelling 4�5Q, i2.600 E] Commercial/industrial
Valuation: $
}! Accessory building -- 6Ag.A8 i ❑ Multi - family Number of bedrooms.
52)0 It
❑ Master builder 1 ❑ Other: Number of bathrooms.
`=) 4',O :, F,"4r z, I;N , Total number of floors
P dOB SITES P A`IIO - '
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Job site address: . j t '(, rv..) p c-- f -1. 4 New dwelling area. square feet
City/State /ZIP: -II ) f o 11 2'2 Garage /carport area. square feet
Suite/bldg. /apt. no.: Project name: Covered porch area square feet
Cross street/directions to job site: SW 161`11.1 90P1 /1 Deck area: square feet
Other structure area: square feet
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Subdivision: p-fi fi(.'A P1 t ( S 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
*_' ,t 3; .i ' ' r •: ,.. :, " 1:` ° °= >7 ` '< wo rk indi cated on this application.
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R- - UUF-- \5 rtoo.Se 44 i ` Iv Valuation $
r() ' r �T o 0 Existing building area: square feet '
A New building area square feet
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Name: V- ..sit)N pN &i,p fm �i , t lr `I G Type of construction:
Address: Po 1575) Occupancy groups.
City /State /ZIP: V-f / 0,5w � %I Q ��f”' 6 f1 , o
, Existing:
Phone: ( )3) 63i0 r 9'1 J Co Fax: ( 93) tAi _17 h New
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Business name• s /.1.0 ft- j K J All contractors and subcontractors are required to be
Contact name: JAdVI E 5 Po IA r- licensed with the Oregon Construction Contractors Board
under ORS 701 and maybe required to be licensed in the
Address: junsdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply. gL.P & R.517
Phone. ( ) Fax:: ( ) - x 5r
E -mail: / &� flfl " .:R (v . D 0
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Address: _ ; ',•
Please refer to fee schedule.
City/State /ZIP
Fees due upon application I / (j • L/ 0
Phone: ( ) Fax: ( ) !
„) 5 Amount received I f 0. Ito
CCB lic.:
Date received / 0 —7-011
Authonzed signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: oier 1"W S P° LA Date. 1 0/61 0 * Fee methodology set by Tn -County Building Industry
Service Board
I \Budding\Permits \BUP- PermitApp doc 12/03 440- 4613T(1 I /02 /COM/WEB)
One- and Two - Family Dwelling
Building Permit Application Checklist FOR OFFICE U ONLY
' City of Tigard Received Permit No .
13125 SW Hall Blvd.; Tigard, OR 97223 Date/By permits
Phone: 503.639 4171 Fax: 503 598.1960 tftlig " ❑ Electrical ❑Plumbing ❑ Mechanical
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24- Hour Inspection Line 503 639 4175 e71
Internet: ww 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 -fl. 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, foists, 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, roofmg, 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 ❑ ❑ ❑
' ar c h i tect licensed in Oregon and shall be shown to be a.plicable 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 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.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: `. Lke . 2-400 F .-0 `6F
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 / Vlpdjt
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 2,s �U-- 6 1. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
CD- o)
Corrections /Comments /Instructions:
1
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/ ,
•
PASS PARTIAL APPROVAL ❑ CANCEL (l NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 /
Inspector: `� Date: �A co G C Phone #: (503) 718-
. .
CITY OF TIGARD ..
A
BUILDING DIVISION PERMIT #: BUP2004-00486
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/2004
Phone: (503) 639-4171 i4.101 Pliplii i\
Inspection Requests (24 Hrs.): (503) 639-4175 ,c-c',4 t.....
INSPECTION WORKSHEET FOR DATE: 3/15/2005 TIME: 7 : 13 AM PAGE: 76
SITE ADDRESS: 07925 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: DURHAM ACRES LOT #: 004 TYPE OF USE:
PROJECT NAME: REBECCA MEADOWS SUBDIVISION
DESCRIPTION: Demo 1200 sq.ft. house and 500 sq.ft. garage. Sewer line to be capped & inspected. Credits may
apply for TI F, sewer, parks SDC, water quality & quantity
OWNER: KEYSTONE DEVELOPMENT, INC, PHONE #: 503-635-4736
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 3/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 001671-01 503-635-4736 N
Corrections/Comments/Instructions:
12-vC- (1- 0--ell- -- lik--1A Kid + 2 Q .:
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, I PASS fl i PARTIAL APPROVAL El CANCEL Ei NO ACCESS
FAIL ,„' I I CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED
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Inspector: ', Phone #: (503) 718-
. ,