Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00500
,114-41 DEVELOPMENT SERVICES DATE ISSUED: 9/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S109DA -12000
SITE ADDRESS: 12968 SW KOSTEL LN ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 109 JURISDICTION: URB
Project Description: 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: : 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: $ 2,324.00
Owner: Contractor:
CHUONG PHAN OWNER
12868 SW KOSTEL LN.
TIGARD, OR 97224
Phone: 503 - 968 -0931
Phone:
FEES Reg #:
Description Date Amount REQUIRED ITEMS AND REPORTS
[UBUILD] Permit Fee 9/28/2005 $72.10
[UTAX] 8% State Surchu 9/28/2005 $5.77
[UBUPLN] Pln Rv 9/28/2005 $46.87
[UCDC] URB CD Revie' 9/28/2005 $42.00
(additional fees not listed here)
Total $172.74
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 diNect questions to OUNC by
calling 503 - 246 -669 or - 800 - 332 -2344.
Issued By: Permittee Signature: `~� I : A,; �� _S �jar' 1
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.
Building Permit ...
roa OFFICE USE ONLY
City of Tigard p Q 00 Receive.' Dc. Permit No.: 60 F01005 —'S
13125 SW Hall Blvd., Tigard, OR Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 � ��� * ��' � h� 4 1�1 � ` � Date /B . Other Permit:
Inspection Line: 503.639.41' CITY OF TIG t1�,1 Date Ready/By: '� El See Attached Checklist for
Internet: www.ci.tigard.o T � ��� ® �. Notified/Method: N Supplemental.lnformation
• - TYPE : , PE OF WORK, - REQUIRED DATA:.I -•AND 2- FAMILYDWELLING -" .
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
lit.Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the • . • 4 1 - " • , C ATE G ORY O F , CONSTRUCTION .
work indicated on this application.
❑ 1- and 2- family dwelling ID Commercial /industrial Valuation: $ S 00 - -t30
CI Accessory building El Multi-family Number of bedrooms:
❑ Master builder C1 Other: Number of bathrooms:
_, . =JOB,SITE INFORMATION AND LOCATION - , _ ° Total number of floors:
• Job site address: I A16. `d S W , Ko - L Lw , New dwelling area: square feet
City /State /ZIP: T'' Cr : 7 o _ ell 2 2 4 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch.area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
'REQUIRED DATA: COMMERCIAL-USE CHECKLIST.
Subdivision: 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
' DESCRIPTION OF WORK work indicated on this application.
V C. ! -T � 0 sc d F Valuation: $
p Existing building area: square feet
New building area: square feet
❑.,PROPERTY OWNER ❑ TENANT Number of stories:
Name: . k) C N ct _. . ., . Type of construction:
Address: 11.'051'6'4g S ,vj_ 140s ;,_$ J _ Occupancy groups:
City /State /ZIP:. 71 I 6.4 -Q 0 R.. C AA 4 Existing:
Phone: (G03) 96 cpv i °Sa j 31$ '
(I( Fax ( ) New:
❑ APPLICANT , ❑ CONTACT PERSON NOTICE
• 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: 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:
- CONTRACTOR .
Business nanie: 09 w'1v
B UILDING PERM_ IT FEES *°
• Address:
Please refer to fee schedule.
City /State /ZIP:
•
Fees due upon application
Phone: ( ) Fax:( ) .
Amount received
CCB lie.: _ _ _
is Date received:
Authorized signature: e. v IA.63/�� tl�k3 ' This permit application expires if a permit is not obtained
ii: �! h within 180 days after it has been accepted as complete.
Print name: C44 i0 ) e4`ti-F_ I Date: 9. 1 4. 05 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits\BUP- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB) 0
i
t
One- and Two - Family Dwelling
Building Permit Application Checklist FOR OFFICE USE ONLY
City of Tigard Received
g Date/By. Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Associated permits:
Phone: 503.639.4171 Fax: 503.598.1960 /n �.� il r ;
24- Hour Inspection Line: 503.639.4175 I I ❑ Electrical la Plumbing ❑Mechanical
Internet: www.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 fill-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 Ore on and shall be shown to be . • u livable to the sro'ect under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required f o r Item I I 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\BUP- RES- PermitApp.doc 2
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s � � � ' TTY OF TIGARD - SITE PLAN REVIEW
t �•� �" BUILDING PERMIT NO.:
I U I PLANNNG DIVISION:
#i Require. Setbacks: Approved ❑ Not Approve.
Sid : S Street Side: l°
Frot ...42.._ Garage: 2-- Rear / >
Visual lea ance: Approved ❑ Not Apps .
1 Maximum Building Height S feet
f CWS Serv''e Provider Letter Required: N =-
l
Date: `� /zV t�S
t l' 9 64 Su`) k s7 �L EN INEERING DEPARTMENT:
Actual Slop : % ti Approved ❑ Not Approved
Site Ean` `Approved ❑No Approvea
B ( Date: o f (2-0 5S ----
Notes:
CITY OF TIGARD
... __
., ,
BUILDING DIVISION PERMIT #: BUP2005-00500
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/28/2005
Phone: (503) 639-4171 . / ontilliTi
Inspection Requests (24 Hrs.): (503) 639-4175 .-_-_,. - - —
INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:00AM PAGE: 87
SITE ADDRESS: 12968 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 109 TYPE OF USE:
PROJECT NAME: PHAN
DESCRIPTION: Deck •
OWNER: PHAN, CHUONG PHONE #: 503-968-0931
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 017450-01 503-781-0374 Y
Corrections/Comments/Instructions:
.--.
PASS 0 PARTIAL APPROVAL _____ 0 CANCEL Ell_NO ACCESS
FAIL rh CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED .
7
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Inspector: - Date: /0- 5 ----0- Phone #: (503) 718-
•