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Permit CITY OF TIGARD MASTER PERMIT ilii 1 t Permit #: MST2011 -00212 ` � : ' - COMMUNITY DEVELOPMENT T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/12/2012 .. . Parcel: 2S102CCO2000 Jurisdiction: Tigard Site address: 10195 SW HILLVIEW ST Subdivision: FRELEON HEIGHTS NO.2 Lot: 23 Project: Cabe Project Description: Construct 528 sq ft carport. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right. 0 Detectors: Total: 0 sf Value: $10,300.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers. 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 0 201 -400 amp 0 201 -400 amp: 0 W/O Svc /Fdr: 0 Mfd Home /Feeder /Svc: 0 401 -600 amp' 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp -1000v 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System. N Garage Opener: N All Other. N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ACS SF VB U 0 Owner: Contractor: CABE, CLIFFORD C & SHARON M OWNER Required Items and Reports (Conditions) 10195 SW HILLVIEW ST TIGARD, OR 97223 PHONE: 503- 704 -1514 PHONE: FAX: Total Fees: $504.59 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 r'c ^r• - ice with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ENTION: Ore• • la . -quire you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952- 1 -0010 through OAR 9' - 001 -0190. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.:00.332.234 . / / % �f�A e� 11/`/ // Issu By: C ry'� Permittee Signature: y // f Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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 RECE I VE 7 '-', . Residential FOR OFFICE USE ONLY DEC 2 0 2011 Received City of Tigard Date/B A % O AD Permit No.: / - ,,, 42 q 13125 SW Hall Blvd., Tigard, OR 97223 �� �' • g CITY OF TIGA D Plan Review _1 fl /01M Other Permit: Pho ne: 503.639.4171 Fax: 503.598.1960 Date/B : �'� /L T [ G A R D Inspection Line: 503.639.4175 BUILDING DIVISIO Date Ready ) �� ® See Page 2 for Internet: www.tigard- or.gov N. ified/Method: / l /�� ■ I Supplemental Information • J TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING IZ 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. Valuation: $ //0 300 111 1- and 2- family dwelling ❑ Commercial /industrial -I }. Accessory building I=1 Multi-family Number of bedrooms: I=1 Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND .LOCATION Total number of floors: Job site address: /j/q5 ski / /,. // e ai 5:1- New dwelling area: square feet City /State /ZIP: '`. , 02 9 77_2 3 Garage /carport area: 5 square feet Suite /bldg. /apt. no.: J Project name: Cap1oovt Covered porch area: square feet Cross street/directions to job site: L /Q Z h / /1 j ��(/j E, - 1,! / / Deck area: square feet b/D(� � n ovttt O/' /0 Zi / lio cha-/l Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Fie /co,/ /� . Ra t Lot no.: 23 Permit fees* are based on the value of the work performed. ` /•) '') Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: S i P'4 5e 2 , 'r 2S , R / K✓ j W , l equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. / / Valuation: $ ni, -frtG . h6.) 2� k ZZ CSZG R6 Fla - 'z tf caves -t Existing building area: square feet L'/ CC New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: C // c0rd G Type of construction: Address: I90 V) Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: [s APPLICANT [ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: / a ,6 o ve ) Cf', cCojrd C�6 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: (5-03) 70 + - (VIZ Fax:: ( 503) G 3 g _ 3( 3 2 — //l E - C ea,66 / e G6dt/1 . CONTRACTOR • Business name: OLIJ tJ €f2-- BUILDING,PERMIT FEES* , Address: • (Please refer to fee. schedule) City /State /ZIP: Structural plan review fee (or deposit): ' FLS plan review fee (if applicable): Phone: ( ) Fax:( ) CCB lic.: Total fees due upon application: �n / // Amount received: 1756.6'Q Q Authorized signature: / L �� l/' This permit application expires if a permit is not obtained �- within 180 days after it has been accepted as complete. Print name: C7 fr -d Ca b G Date: )71c 20 2-0/ * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits\BUP -RES PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB) I,3uildin2 Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY Received City of Tigard Date/By. ive Permit No.: IN a 13 125 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.639.4171 Fax: 503.598.1960 G A R D 24- Hour Inspection Line: 503.639.4175 El Electrical El Plumbing ID 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: ❑ CI CI 5 Septic system permit or authorization for remodel. Existing system capacity ❑ CI 6 Sewer permit. El ❑ ❑ 7 Water district approval. El ❑ ❑ 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 a 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 El ❑ ❑ 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 ❑ El ❑ 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- El ❑ ❑ 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. ❑ ❑ El 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 ❑ ❑ . El 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 applicable to the . ro'ect 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, ❑ El ❑ 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. 1: \ BuildingVPermits \BIJP- RES- PermitApp doe 03/21/06 440- 4613T(11/02/COM /WEB) /oI at' eie/t -- 1. Building Division Development Code Provision Review [ I G A R D Residential Projects Building Permit No: CWS Service Provider Letter Received: Yes ❑ No ❑ N/A •-41 = GK. � G / 1GL1 &nip Routed Plans: / Original Plan Submittal Date: lA /6toll/ 1St Revision Submittal Date: ❑ Site Plan Only 2nd Revision Submittal Date: ❑ Site Plan Only 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 (✓) 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 check items along left only / if approved. / Planning Review (contact r! 2 - 2 ' at 503-718- 02 `I - or ,�'it.A.A0A @ tigard- or.gov) Land Use Case Name L A6( -7 / ❑ Zoning Y ❑ Setbacks:_, Front o6 Rear � Side Street Side Garage ❑ Maximum Building Height Actual Building Height ❑ Visual Clearance ❑ Easements _ ❑ Sensitive Lands Type: hL.J.5 �P�i'S" Ge6 . T L c2S % Notes: S 3'1 Original Plan: Approved Not Approved ❑ Date: /2-(21/// 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) Jzi Actual Slope: 0,0 Notes: Original Plan: Approved Not Approved ❑ Date: 1 `LZI ( t Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City� Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard- or.gov) City street Trees ❑ Protected Trees Notes: Original Plan: Approved 121 Not Approved ❑ Date: i 3 P-/OLD o 1 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) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yexitr No ❑ Date Routed to Building: / i3 -- I Page 2 of 2 I Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing per mits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that a II subcontractors who work on the structure must be licensed with the Construction Contractors Board. ✓� or I will be performing work on property I own, a residence that I reside in, or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. el//'air0f Gahe Print Name of Permit Applicant dr A- ///-//?-- Signature i r it Applicant Date Permit #: H 9 T .9 00 r) - ( c, ` aw GL •:117,45. ; Address: tol 6- l f • - 1 - 7( A 02 ? •I• Issued byE Date: /4 f `L This Copy for Permit Offices