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Permit CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit #: BUP2011 -00225 Date Issued: 11/15/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S136DCO3700 Jurisdiction: Tigard Site address: 7050 SW CLINTON ST Project: TVF &R Subdivision: ISAACS SUBDIVISION Lot: 6 Project Description: Demo house, approximately 1,692 square feet. 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: DEBRA GUZMAN WILSONVILLE, OR 97070 20665 SW BLANTON ST ALOHA, OR 97007 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 Into Process /Archiving - Sm Sheet (up to 11/15/2011 $1.00 Stories: 0 Height: 0 ft 11x17) Bedrooms: 0 Bathrooms: 0 Erosion Control 11/15/2011 $26.00 Value: $9,000 Erosion Plan Review CWS 11/15/2011 $8.45 Erosion Plan Review COT 11/15/2011 $8.45 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) 1 Ersn Cntrl 503 -681 -4444 Fire Sprinkler: Parapet: 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 _ dill 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 work is s ' ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cente' ' hos- les are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 .1 : 1•'• , .2�. Issued B . �i � Permittee Signature: • 1 1 , 4175 by 7:00 a.m. for the next available inspection da e. 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 n/ - FOR OFFICE USE ONLY Received City of Tigard Date /B / T - M Permit No.: - 1 � /l 13125 SW Hall Blvd., Tigard, OR 97223 `� Plan Review w'_ Er Phone: 503.718.2439 Fax: 503.598.1960 ' �d Plan Re : Other Permit: _ �D Qi�0 7• able) TIGARD Inspection Line: 503.639.4175 ' `' ryD>Itg Ready/13y. Juris. 0 See Page 2 for Internet: www.tigard- or.gov < " C` 0 � ���` a ( tified/Method: if /„/, / Supplemental Information TYPE OF WORK "� � \ T l , REQUIRED DATA: 1 -AND 2- FAMILY DWELLING A. \ C ' Permit fees* are based on the value of the work performed. 111 New construction ® Demolition ` � y � P Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ID Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION O work indicated on this applicatj 4114) � ® 1- and 2- family dwelling 111 Commercial /industrial Valuation: $ / CI Accessory building CI Multi-family Number of bedrooms: 1:1 Master builder 111 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 7050 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 • EQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: ISAAC5 Lot no.: 6 Pe •'t fees* are based on the value of the work perfo . Tax map /parcel no.: Indica - the value (rounded to the nearest dollar) of . equipme materials, labor, overhead, and the p •. it for the DESCRIPTION OF WORK work indica . 4 on this application. 4 demo house aff.iPle Valuation: $ • Existing building . ea: square feet New building area: . square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Tualatin Valley Fire & Rescsure Type of cons action: Address: 11945 SW 70' ave Occupa • groups: I City /State /ZT Tizari Oregon 97223 'xisting: • Phone: (503)20973 Fax: (503)5911435 New: v • APPLICANT El CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) ,- , 9 Structural plan review fee (or deposit) ' 4p ' y l Contact name: 4 Address: FLS plan review fee (if applica /'4 ill City /State /ZIP: Total fees due upon application: �' V ,� ii. Amount re eived: Phone: ( ) Fax: : ( ) E - mail: PHOTOVOLTAIC SOLAR P • YSTEM FEES* '1 CONTRACTOR Commercial and residential prescriptive installation of roof -top mounted PhotoVoltaic Solar Pa System. Business name: J` Submit two (2 •ts of roof plan wi . onnection details `C Ill ��' �� and fire departme • access, alo t with the 2010 Oregon p Address: 1 Ca a 3 Solar Installation Sp. ial . 'ode checklist. a City /State /ZIP: 41 (sSaki∎ i i `c (0 v.7� Permit Fee (incl plan review $180.00 and -.4minis .tive fees): Q Phone: (503) 91.--- - Fax: (503) ( ti ,..,)) State Burch. le (12% of pe •'t fee): $21.60 CCB lie.: 101 (? t p - 1 Total fee due upon application: $201.60 Authorized signatur : 4 / This permit application expires if a permit is not obtained t 0 within 180 days after it has been accepted as complete. J / J��" C v Print name: / {��-y ,t /y,,e Date: / _ l ( f ` / * Fee methodology set by Tri- County Building Industry Service Board. 1:\ Building \Permits\BUP - RESPermitApp.doc 02/24/2011 440- 4613T(11/02/COM /WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR O F FI CE `USE ONLY City of Tigard Received Permit No �� 13125 SW Hall Blvd., Tigard, OR 97223 soBy Et As Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: TIGARD 24- Hour Inspection Line: 503.639.4175 ❑Electrical ❑Plumbing El Mechanical 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. ❑ ❑ ❑ 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. 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. I` \ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(11/02/COM /WEB) ti Building Division Development Code Provision Review TIGARD Commercial Projects with Approved Land Use Building Permit No.: -72- t-i-Paol (-60 a2 Land Use Casefile No.: "y"ig`4 ',CL/1 (1,1c* •122,rrte I 1;,, ,6)? CMitltQ /) t Routed Plans: V Submittal Date: l o/P 161// ete.-Goef2 Aof Submittal Date: i�, &L-B- pAd-foartri 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 ❑ Condition Me /1� �p�� (r` Notes: t ( i � @Jl C,_ ika.. i A C _ 2 O L&J&u l(ll `l C94.MA4) P-40 Original Plan: Approved ❑ 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: % 1 ❑ PFI Permit # ❑ Conditions Met Notes: Original Plan: Approved ❑ of 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) ©/, treet Trees 1' Protected Trees /�— Notes: lid 7 ACC, fe..O�.�w - ( �A )EA,), /t J) ,��` ui / ) '� `'L e . / . y Original Plan: Approved MI Not Approved ❑ Date: ( /c'7/ Revision 1: Approved ❑ Not Approved ❑ Date: 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 ssue Permit . Notes: 1 Original Plan: Date Se t to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes ❑ No ❑ Date Routed to Building: • • , Page 2 of 2 • 10/21/2011 FRI 13:28 FAX 5035911435 Facilities 0002/005 OCT 2 1 2011 �� Clean Water Services File Number Cean\Vate Services I 1( B ----- -- SOMS - tive Area Pre - Screening Site Assessment 1. Jurisdiction: Tigard 2. Property Information (example 1S234A801400) 3. Owner Information Tax lot ID(s): Is136DCO3700 Name: Tualatin Valley Fire & Rescue Company: TVF &R Address: 211945 SW 70th ave Site Address: 7050 Clinton City, State, Zip: Tigard Oregon 97223 City, State, Zip: Tigard Oregon 97223 Phone /Fax: 503 - 209 - 7312 fx 503 591 - 1435 Nearest Cross Street: SW 72nd ave E -Mail: mcdowerm @tvfr.com 4. Development Activity (check all that apply) 5. Applicant Information Addition to Single Family Residence (rooms, deck, garage) Name: Rod McDowell ❑ Lot Line Adjustment L Minor Land Partition Company: TVFR [] Residential Condominium ❑ Commercial Condominium same as above Address: l� Residential Subdivision I.] Commercial Subdivision lj Single Lot Commercial City, State, Zip: same as above g ❑ Multi Lot Commercial other Demo existing house Phone /Fax: same as above E-m same as above 6. Will the project involve any off-site work? f:) Yes lj No U 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 and /or 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 authorized agent or representative, acknowledges and agrees that employees of Glean Water Services have authority to enter the project site at all reasonable times for the purpos of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this d t nd 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 Manag Signature ----- Date /v AWE FOR DISTRICT USE ONLY Ci 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, a 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. Li 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. (j This Service Provider Letter Is not valid unless CWS approved site plan(s) are attached. ] 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 REQ IR' D. Rev iewedby'Z°� '. ' - i.V14/ Date /,L2 6 / 2560 SW Hillsboro Highway Hillsboro Oregon 97123 Phone (503) 681 5100 Fax (503) 681 -4439 www cleanwaterservices org JOB INVOICE (RV%LL T, 3F,F7¢C TAW., ;=. P,O. BrA "49 CUSTOMERS ORDER NO DATE ORDERED 15U? Z—O 1 0 zz- Okft-IION ern :-.1 SIC/45 (03) ItS4-3326 ORDER TAKEN BY DATE PROMISED 0 AM j2 P M BILL TO r1V. WORE r f - ADDRESS MECHANIC - CITY HELPER JOB NAME AND LOCATION DAY WORK 7 I,- • f c CONTRACT • DESCEITP9 ION OF WORK D EXTRA 1 . 141 01 (7 OUANT. DESCRIpTION OF MATERIAL USED PRICE AMOUNT 7 _ _." p 1.101_1FtS AMOUNT TOTAL MECHANICS MATERIALS TOTAL HELPERS 0 LABOR A I hereby acknowledge The satistaClory TOTAL LABOR TAX compieton of the above descrlbed work SIGNAT LIRE DATE COMPLETED TOTAL