Permit ` • BUILDING PERMIT
C ITY TIGARD PERMIT #: BUP2005 -00239
Hall DEVELOPMENT OR 503-639-4171
DATE ISSUED: 6/3/2005
— 13125 SW PARCEL: 2S 104AB -08300
SITE ADDRESS: 13169 SW CHIMNEY RIDGE ST ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 4 LOT: 112 JURISDICTION: TIG
Project Description: New deck.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: 5: 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: $ 1,800.00
Owner: Contractor:
BOYUM, GERALD OWNER
13169 S2 CHIMNEY RIDGE ST
TIGARD, OR 97223
Phone: 503- 939 -0684 Phone: 503 - 475 -3180
FEES Reg #:
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/3/2005 $62.50
[TAX] 8% State Surcharl 6/3/2005 $5.00
[BUPPLN] Pln Rv 6/3/2005 $40.63
Total $108.13
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: � ^ pt1�1 ti Permittee Signature: Q )
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.
4•
• Building Permit t at� sh _ kP, -tea �t� rf� h
� 7 FOR;OFFICE USE ONLY t. i 4, " yy ' ` .
City of Tigard Received _ !,
Y g Date/By: 6 0 - PermitNo.: , eA06! 6,p '3e'
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review J
Phone: 503.639.4171 Fax: 503.598 j�6b, 0 3 2005 ¢HAltg4Nl p I , DDate/By: J { I �� Other Permit.
Inspection Line: 503.639.4175 s a 7 d !' I Date Ready/By: p See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TIGARD
��,�:..� �:r�.���.u:��n.. `��� .> 6:� :� �,° "1 >;;;`' % Q. A ANA Z "FAVIIL'Y DWELLING •
X 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
.� d k l ,. i i K s `"r h e 5 . ;T < "°'„ai+ B h. sa
- Ri 1 v. N . , �„ CATEGORY OE GO STIt v wr - .s ^ ~ s work indicated on this application.
❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder Other: Number of bathrooms:
_,„ JO SITE Th ORl)1ATIO AND,.LOC Total number of floors:
Job site address: i 3 1, 1,0 5 4 ) L �4 -jU/ c y ' 21�,L. 7 6: . S New dwelling area: square feet
7
City/State /ZIP: )C7,f 2 OP_ 9 7- ZZ3 Garage /carport area: square feet
' w
Suite/bldg. /apt. no.: Project name: p� �k Covered porch area: square feet
Cross street/directions to job site: Deck area: 1 1 <00 feet 1 ( 0
G aarcI'Q ' idot L._ aye. (Al ( V, (l t Miy c . Other structure area: square feet l
�) IM ril r 3i s+. I i ; / sio N. "2 O TF <S T 1ti 1 IrRED'`DATA;kCOM1VIERGIAI -USE CHECKLIST
Su a r il i R it, if if 4 ! Lot no.: 112_ Permit fees* are based on the value of the work performed.
Tax map /parcel no.: T Indicate the value (rounded to the nearest dollar) of all
) t ' A D � oO equipment, materials, labor, overhead, and the profit for the
;ma - t 4 'D E $CRIP ' TZVYOF . ORK M F ' P 140 A ; work indicated on this application.
, k c- d _ _ i Valuation: $
l � �• Existing building area: square feet
New building area: square feet
. PROPER tiOWNER v . A ,
. � A Number of stories:
Name: 6_ (oak t r „„ . � Type of construction:
Address:
SQ IMQ. CO Gt . Occupancy groups:
City/State /ZIP:
Existing:
Phone: (,'t)3) 7 ,5 6 .2 p y Fax: ( ) New:
i 4 "� 3. #r: . -., :i''`'' h .. g r `. ` 5' P xis " g5iy'
i � 1 ` 1LIC1T : i t ,.._, .. tom- _, P 'S 1 : , :11 �, :; .
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NOTIOE `=`' .
,� -: ^ � , � �� ��� .��� o .�. -tea �,< �'�.,.� , : �� ...
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: ' j/ (.1+6 C,0 0 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:
}»i V Ws f � g C®N'fRACTOR� ' � �" t �_ ��
~...,. ;.< . , L ' 3 .... ,4: _,.. ,_ ..<x ` =, ...-e .'te' 441,3e , 4,, °'' .4aF,. ..al
Business name: 0 /p--
.. inli Ittak �PERMIT'FEES * "
Address: ,.'. s`Ys . ? �.,.. »�.1, . ,, �, "� ;, .w._, <.. . -
Please refer to fee schedule.
City/State /ZIP: 2'J
Phone: ( ) Fax: Fees due upon application ,
CCB lic.: Amount received
,
1 Date received:
Authorized signature: - I - - - This permit application expires if a permit is not obtained
,/�,� '60,..../ 1r within 180 days after it has been accepted as complete.
Print name: �-7 f_, �'l b-o tk AA Date: t / i l
. * Fee methodology set by Tri- County Building Industry
( Service Board.
i:\ Building \Permits \BUP- PermitApp doe 12/03 440- 4613T(1 l /02 /COM/WEB)
One- and Two - Family Dwelling
Building Permit Application Checklist - ' $ : � FOR OFFI US ON LY r `
City of Tigard Received
Y g an Permit No..
13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
Phone: 503.639.4171 Fax: 503.598.1960 //ie,ijIy� I Al. Associated permits:
24- Hour Inspection Line: 503.639.4175 ��' f ❑ Electrical Plumbing ❑ Mechanical
Internet: www.ci.tigard.or.us °'' 1:1 ❑ Other:
' ..,•, • THE ; , F,OLL ;OWING ITEMS °ARE :REQUIRED FOR PLAN REVIEW , <` ` ` t� .NItr W l No. F r N /A' i
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. ❑ ❑ 0
4 Fire district approval required. Name of district: ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ Ki
6 Sewer permit. ❑ ❑ [N '
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 J ❑ ❑
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 a , ❑ ❑
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 Cl ❑ ❑
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 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 \One - Two- FamilyChecklist.doc 12/03
rrom: -•L/ I I tLtlr I KIC: i o: 5036814439 c:leanvvater Msg #99189.0.901 05/17/2005 08:26:02 Page 3 of 4
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s '� f r � File Number
PtiO��
CleanWate S
Our commitment is clear. +, Sensitive Area Pre- Screening Site Assessment
Jurisdiction C. ill o F -- CI 61 A-Q- a IL. Date MAI 1 [ 2D0 5
Map 8 Tax Lot 2.F404A Banos Owner ..04.t., 'Rol um
Contact 6,oreA Nei uf%
Site Address ILIA u) Cifibidalf Linf s cr Company SaLE -.two' s rate x „u(
IN caacko i e0.- sa.2.2_3 Address - — s iiI —
Proposed Activity pGe_,,S ct„,a srkus._- ,n k City State Zip — Sire- —
Phone STA –9 3 `r–Wo 4 9
Fax M/4
Official use only below this line — -- - --
Y N NA Y N NA
r ❑ o _. Sensitive Area Composite Map ❑ ❑ ® Stormwater Infrastructure maps
Map # .51 )33 as # 1 .137
n o w Locally adopted studies or maps im n ❑ Other
Specify Specify -ZOO y /q - v.i.!
Based on a review of the above information and the requirements of Clean Water
Services Design and Construction Standards Resolution and Order No. 04 -9:
❑ Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT
MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE
PROVIDER. If Sensitive Areas exist on the site or within 200 feet on adjacent
properties, a Natural Resources Assessment Report may also be required.
►ri Sensitive areas do not appear to exist on site or within 200' of the site. This 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
04-9, Section 3.02.1. All required permits and approvals must be obtained and
completed under applicable local, state, and federal law.
n The proposed activity does not meet the definition of development. NO SITE
ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.
Comments:
P o to w r:a atV 5g Q ✓ e e� 4707 e 4.1 i ,k ,e /✓,?
Revie By: � Date: 7,:z_5 / .0_,
Returned to Applicant
Mail ,' Fax Counter
Date 7/Z 5/ 5 B y _ .
2550 SW Hillsboro Highway • Hillsboro, Ore 97123
Phone: (503) 681 -5100 • Fax (503) 681 -4439 • www.cleanwaterservices.org .
•
, . . •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005-00239
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/3/2005
Phone: (503) 639-4171 . , _,,,, i „p, tiiii l,
Inspection Requests (24 Hrs.): (503) 639-4175 ,...J911.- ..1...
INSPECTION WORKSHEET FOR DATE: 8/26/2006 TIME: 7:06AM PAGE: 45
I NI.toee.
SITE ADDRESS: 13169 SW CHIMNEY RIDGE ST CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 4 LOT #: 112 TYPE OF USE:
PROJECT NAME: BOVUM
DESCRIPTION: New deck.
OWNER:
CONTRACTOR:
17 BOYUIVI, GERALD, PHONE #: 603.9394684
OWNER
PHONE #: 503-475-3180
Inspection Request Scheduled For: Date: 8/2612005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection • 014377-01 503.939-0684 N
Corrections/Comments/Instructions:
-----
. e. PASS 6 "ARTIAL APPROVAL 0 CANCEL EI NO ACCESS
I I FAIL II2 C' t FOR INSPECTION n ADDITIONAL FEES ASSESSED
---
Inspector: ____ ..Alhomium■s■ Date: 2 -- c) - 6 - 0 #: (503) 718-
Mil