Permit CITY OF TIGARD BUILDING PERMIT
! COMMUNITY DEVELOPMENT Permit #: BUP2011 -00226
TEGAR_ 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/15/2011
Parcel: 1S136DCO3800
Jurisdiction: Tigard
Site address: 7080 SW CLINTON ST
Project: TVF &R Subdivision: ISAACS SUBDIVISION Lot: 5
Project Description: Demo existing house, approximately 2,098 square feet & pole barn structure, approximately 900 square feet.
Septic tank is be pumped & filled or removed. Upon final inspection demo credits will be available for future
construction.
Contractor: FLYING H CONSTRUCTION CO Owner: TUALATIN VALLEY FIRE & RESCUE
PO BOX 2533 ATTN: GUZMAN, DEBRA
WILSONVILLE, OR 97070 11945 SW 70TH AVE
TIGARD, OR 97223
PHONE: 503 - 925 -1280 PHONE:
FAX: 503 - 678 -4221
FEES
Specifics: Description Date Amount
Type of Use: SF Permit Fee - Additions, Alterations, 11/15/2011 $210.59
Class of Work: DEM Demolition
Dwelling Units: 0 Erosion Control 11/15/2011 $26.00
Stories: 0 Height: 0 ft Erosion Plan Review CWS 11/15/2011 $8.45
Bedrooms: 0 Bathrooms: 0 Erosion Plan Review COT 11/15/2011 $8.45
Value: $9,000 Info Process /Archiving - Sm Sheet (up to 11/15/2011 $1.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $254.49
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet: 1 Ersn Cntrl 503 - 681 -4444
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes an 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 issuanc o if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification 'ent . Th•- ties are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the . es or direct questions to OUNC by calling 503.2 2/ 1 • 1.: • 44.
Issued By: Permittee Signature:
cal 41C1 by 7:00 a.m. for the next available inspection Ire.
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
.�. ' ,
Residential F OR OFFICE USE ONLY
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Ci ty of SW Tigard
Tigard, OR 97 ! \ Q'\� Received P No..
' � y, Daty: /J �5 (.l __ � - i
-
d 4 y � o Plan eB Review
Phone: 503.718.2439 Fax: 503.5'8:1`60 x t �� Other Permit:
TIGARD Inspection Line: 503.639.4175 ' <'` 4 1` 14 +� q5 Date Ready /By: j / orris ® See Page 2 for
Internet: www.tigard - or.gov . w d � c , `V Notified/Method: / /AA Supplemental Information
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TYPE OF WORK c � �, �� 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 applicati
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DD
® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ / f!i
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7080 Sw Clinton New dwelling area: square feet
City /State /ZIP: Tigard Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: clinton .Covered porch area: square feet
Cross street/directions to job site: sw 70 ave Deck area: square feet
Other structure area: square feet
. REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: ISAACS Lot no.: 6 Permit fees* are based on the value of the work performed.
Indic. e the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipm: t, materials, labor, overhead, and the profit fo e
DESCRIPTION OF WORK work indi : ed on this application.
demo house t ; ;Z O 9$ ..„ "ft • t , = ref, Valuation: $
(y Existing building are.. squ.. e feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
4
Name: Tualatin Valley Fire & Rescsure Type of constructio..
Address: 11945 SW 70 ave Occupancy ., pups:
Cit /Sta / • Ti and Oregon 97223 • . sting:
4
Phone: (503)2097312 ,/)�� • Fax: (503)5911435 New:
APPLICANT CI CONTACT PERSON BUILDING PERMIT FEES*
(Please iefer to fee schedule)
Business name: Structural plan review fee (or deposit): L I 9
Contact name: �'
FLS plan review fee (if applicable): ,
Address: ��
City /State /ZIP: Total fees due upon application:
- Phone: ( ) Fax:: ( ) Amount Nee' ed:
v E -mail: PHOTOVOLTAIC SOLAR P • L SY M FEES*
CONTRACTOR - Comm- ial and residential prescriptive installatis s f
roof -top me... ed PhotoVoltaic Solar Panel S em.
Business name l 1�/ Submit two (2) s of roof plan with con. tion details
n /1_ Cer''� and fire department ac along wit. e 2010 Oregon
', Address:. Y• o, A s-33 Solar Installation Specialty .e ,. ecklist.
City /State /ZIP: t< w. • Permit Fee (includes pl.- -w
11�, �i 7� and admini $180.00
Phone: (503) '.9 -- i Fax: (503) 62r, , p f State surcharge (1, ' o of permit fee): $21.60
CCB lic.: /Oil 6,91
/ /// To a - due upon application: $201.60
Authorized signature: , This permit application expires if a permit is not obtained
I' I , within 180 days after it has been accepted as complete.
Print name: / U HI / OW D ate: /Q — / 1.. / / * Fee methodology set by Tri- County Building Industry
Service Board.
L:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(1 1/02 /COM/WEB)
Building Permit Application Checklist
One- and Two- Family Dwelling . , ,FOR OFFICE' USE ONLY'
City of Tigard Received
Permit No.:
Date/By:
. 'I 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
- Phone: 503.718.2439 Fax: 503.598.1960 A
TIGARD
24- Hour Inspection Line: 503.639.4175 ❑ Electrical ID Plumbing ❑Mechanical
Internet: www.tigard- or.gov ❑ Other:
- THE FOLLOWIN ITEMS ARE REQUIRED FOR,PLAN REVIEW •Yes No } lvA
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 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 Oregon and shall be shown to be applicable to the project under review.
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JURISDICTIONAL SPECIFICS
23 Three (3) 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 must include 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.
L \Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(I 1/02 /COM/WEB)
IN 41 Building Division
Development Code Provision Review
TIGARD Commercial Projects with Approved Land Use
Building Permit No.: �� Pao, t -ia4
Land Use Casefile No.:
Routed Plans:
Submittal Date: /0/0/ c///
Submittal Date:
Submittal Date:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies
to the Building Division. Only checked (V) items are approved. Items not approved and those listed in the
notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed
above each section.
STAFF: please only mark those items on the left side that are approved.
Planning Review (contact at 503 -718- or @tigard- or.gov)
❑ Land Use Approval
❑ Building Plans Match Approved Plan: Yes ❑ No ❑
❑ Maximum Building Height
❑
Con.. i ons ►4 -
Notes: �� ' V `Q- Del.L tfa. V �9` /C► � .A
fo , C. ./ - c l ••• ' me s
Original Pla : Approved ❑ 4 Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date: •
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov)
❑ Actual Slope:
❑ PFI Permit #
❑ Conditions Met
Notes:
Original Plan: Approved ❑ Not Approved ❑ Date:
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov)
13
Street Trees
0( Protected Trees
Notes: / %'
d `` AA'"-, --1 AA Sens.( / iik-i)( 4.,/' / I) kb LArmmit
Original Plan: Approved Z Not Approved ❑ Date: /e/r?7o70/1
Revision 1: Approved ❑ Not Approved ❑ Date:
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Revision 2: Approved ❑ Not Approved' ❑ . • Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard-or.gov)
❑ Planning Okay to Issue Permit ❑ Arborist Okay.to Issue Permit
❑ Engineering Okay to Issue Permit
Notes:
Original Plan: at n t Applicant:
Revision 1: Date Se to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes ❑ No ❑
Date Routed to Building:
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Page 2 of 2
10/21/2011 FRI 13:29 FAX 5035911435 Facilities 0004/005
L 0CT 2 1 2011 / Clean Water Services File Number •
Cleal Services it- 0
By Sen..e Area Pre - Screening Site Assessment
1. Jurisdiction: Tigard
2. Property Information (example 1S234AB01400) 3. Owner Information
Tax lot ID(s): Is136DCO3800 Name: Tualatin Valley Fire & Rescue
Company: TVF &R
Address: 211945 SW 70th ave
Site Address: 7080 Clinton City, State, Zip: Tigard Oregon 97223
City, State, Zip: Tigard Oregon 97223 Phone /Fax: 503 - 209 -7312 fx 503 - 591 -1435
S W 72nd ave mcdowerm@tvfr.com
Cross Street: E -Mail: tvfr.com @
4. Development Activity (check all that apply) 5. Applicant Information
I ] Addition to Single Family Residence (rooms, deck, garage) Name: Rod McDowell
o Lot Line Adjustment O Minor Land Partition Company: TVFR
] Residential Condominium ID Commercial Condominium Address: same as above
L� Residential Subdivision I] Commercial Subdivision
same as above
I) Single Lot Commercial ❑ Multi Lot Commercial City, State, Zip:
Other Demo existing house Phone /Fax: same as above
E - Mail: same as above
6. Will the project Involve any off -site work? 13 Yes 2S) No E] Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
We are demo existing house
This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site Development Permits, DEQ
1200 -C Permit or other permits as issued by the Department of Environmental Quality, Department of State Lands andlor Department of the Army
COE. All required permits and approvals must be obtained and completed under applicable local, state, and federal law,
By signing this form, the Owner or Owner's authorize. t ent or representative, acknowledges and agrees that employees of Clean Water Services have authority
to enter the project site at all reasonable times for • pu one of Inspecting project site conditions and gathering information related to the project site. I certify
that I am familiar with the information contained in th'. d: umerit, and to the best of my knowledge and belief, this information is true, complete, and accurate.
Print/Type Name Rod McDowell ' Print/Type Title Facilities Operation Manager
/
signature -- '► / Date/t /")////
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FOR DISTRICT USE ONLY
❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A
SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report
/may also be required.
Based on review of the submitted materials 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 quality sensitive areas if they are subsequently
discovered. This document will serve as your Service Provider letter as required by Resolution and Order 07 -20, Section 3.02.1. All required permits and
approvals must be obtained and completed under applicable local, State, and federal law.
Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially
sensitive area(s) found near the site. This Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water
quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order
07 -20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state and federal law.
❑ This Service Provider Letter is not valid unless CWS approved site plan(s) are attached. I i
(] The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed b ,;, ' � ' ' t f�
Y f� f ,. � �! �lYf�`'r"`` Date l • /i ti f
2550 SW Hillsboro Highway Hillsboro Oregon 97123 Phone (503) 681 5100 Fax ?(503) 681 -4439 ww va cleanwaterservrces org
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