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Permit
err CITY OF T BUILDING PERMIT PERMIT #: BUP2005 -00050 �i� DEVELOPMENT SERVICES DATE ISSUED: 2/10/2005 ; --" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 09705 SW LAKE SIDE DR PARCEL: 2S111 CA -03600 SUBDIVISION: SUMMERFIELD NO.12 ZONING: R -7 BLOCK: LOT: 656 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N : sf N: S: E: W: OCCUPANCY GRP: R3 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: $ 200.00 Remarks: Window add. Owner: Contractor: DICK, MAVIS SCOTT ELLOTT CONSTRUCTION 9705 SW LAKESIDE DR PO BOX 326 TIGARD, OR 97224 • OREGON CITY, OR 97041 Phone: 503 - 598 -1206 Phone: 503 - 516 -1001 Reg #: FEES REQUIRED ITEMS AND REPORTS Description Date Amount [BUILD] Permit Fee 2/10/2005 $62.50 [BUPPLN] Pln Rv 2/10/2005 $15.00 [TAX] 8% State Surcharl 2/10/2005 $5.00 Total $82.50 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: ( Permittee Signature: e f, -- - Call 639 -4175 by 7 p.m. for an inspection the next business day Building Permit A :. - TAU. 1 VED ` FOR OFFICE USE ONLY ' - City of Tigard Date/By: v o' i =W. ' .SOP S -02,60 13125 SW Hall Blvd., Tigard, OR 97223rrp 1 ® 2005 0 J PlanRevie - Phone: 503.639.4171 Fax: 503.598.19 fi fth OA Date/By: Other Permit: Inspection Line: 503.639.4175 •A I ' Date Ready/By: Q See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF TIGA my- Notified/Method: Supplemental Information TV1 SIO N • x ti x , {P OF WO S ,-',A,t % R i b 1-. ,, . . 2 F WELLING ❑ 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 � r � >, T „'�' 7 CATEGORY OF CONS`I#R IO * ,: .na~ tf: work indicated on this application. t : ;z �.� _„ '.CM - `.M .•e.,_�...,. - �,, Valuation: 2 and 2- family dwelling ❑ Comm $ ercial /industrial �(9 I=1 Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: ' :g3 v . -' cT SaN NFORMATI01' >AND L® A IO ,af,,, 4 , :, Total number of floors: n Job site address: / " o. ,d .4 A✓6- ` ; pg V / /I/e New dwelling area: square feet City/State /ZIP: 7i �1 �e� ( 0 9 ? ) ..... 2 _ e7 Garage /carport area: square feet Suite/bldg. /apt. no.: / Project name: Covered porch area: square feet Cross street/directions to job site: C7- 14 Deck area: square feet // cT Other structure area: square feet P ' REQ UIRED ,� DATA COM �'fE RO I. J U SE C Subdivision: /, e 2 s [ ' / 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 i ,430 " `. „,v, ° Ir D ESCRIP'Z�ION OF WOR r � ,. , . . t work indicated on this application. t,. Valuation: $ '� �i DC �/� /.Vi AL' Lf% D C lJ / A/7 Existing building area: square feet New building area: square feet - :_z ��:;:>° .�= - .. "?¢:t : :�•; :, :°fix „ , , =1 4,. « k::,''; 711: ..,�: 40, `[PROPERT O \VNER • i ❑ . TE ;t1M Number of stories: ,�,� ., _.�" ; �r sz.�.;� .,�,�.- �...;.:... ;, ate.. � . ��s . Name: / 7 A , v / c- j' ( , r Type of construction: Address: � 7 p c -,) 4 , S . , , 72)_z_ Occupancy groups: City/State /ZIP: . / ( I 7 -2-t-- ( Existing: Phone: (03) 7 ,f" 7 , 6 Fax ( ) New: ^yap 1 . ,,. t °yak 6117A =i' ...�s,. . p er.` • -41 € 4 � < :,„ . , ,,.,,,,.• , �' ry:;•. AR # [ ]� CO r!CT PERSON . s; " #. � S i � es. �x� - �tF�'1 s,:w`« 4.rli*:5i - °.ri. .,:YtY- w;'Ra , >e, "Uba'. �i >�.a�e , ... � .,.u.. , � i _ .„ � S-a. ,. =t ... ... 0. ti ° ` A TIC Business name: All contractors and subcontractors are required to be Contact name: ---)- licensed with the Oregon Construction Contractors Board -..-- -,C under ORS 701 and may be required to be licensed in the Address: • k...,-:„. �� jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from I j.ens3 he following reasons p apply: ,) Y Phone: ( ) I Fax: : ( ) 64/ 7 ,-- /, E -mail: a A 57 .0 E 4e A Corgi RA q . , . zu, ,t: v t i0 ,s Business name: • ,a »: ., *; . �� � I // G �i tn.l r bZ < P• � 4 n � & ,., BUILDII O - Wiff , h ' s; a. .":''..--;.4''':::,,' Address: /� , , :., . ., .. „, _1,: . ._" _ : . 3 ..),,6 Please refer to fee schedule. City/State /ZIP: 0.42_,, I 2 / a 0 `77e y',i Fees due upon application Phone: (�-7 J /6, O p / I F ax: ( ) Amount received CCB lic. '_.`! LI c-. J 1 - - Date received: K Authorized srgnat / t This permit application expires'if a permit is not obtained i . within 180 days after it has been accepted as complete. Print name: t . ) C--: ` - Date: / .0' * Fee methodology set by Tri-County Building Industry Service Board. i:\Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(I1 /02/COM/WEB) One- and Two- Family Dwelling Building Permit Application Checklist FO OFFICE USE O■LY•• , w " ' City of Tigard Received Permit No : 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Phone: 503.639.4171 Fax: 503.598.1960 7 rµt�° Associated permits: �. 24- Hour Inspection Line: 503.639.4175 ' _ ( I � ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us — ❑ Other: THE FOLLO WING ITEMS All REQUI ED FOR PLAN REVIEW. 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 Ore: on 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 CITY.OFTIGARD BUILDING DIVISION - . ' PERMIT #: BUP200S.00060 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/10/2005 Phone: (503) 639 - 4171�.." "'r ",,���0 °y�ii�61ij� ;i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/6/2006 TIME: 7 :16A1v1 PAGE: 3 SITE ADDRESS: 09705 SW LAKE SIDE DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.12 LOT #: 656 TYPE OF USE: PROJECT NAME: DICK DESCRIPTION: Window add. OWNER: DICK, IMIAVIS, PHONE #: 603 - 698-1206 CONTRACTOR: SCO ELLOTT CONSTRUCTION PHONE #: 603.5516 -1001 Inspection Request Scheduled For: Date: 6/6/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Framing 006196.01 503 - 616 -1001 V 1 ;11 F1 NFL Corrections/ omments /Instructions: O .r.___ ,_________ I2-4 (P )G-- I 1 r( . ,'-- - - - 1 ' - ‘ . y . W_ . . . . 1 1 W ASS __ ❑_PARTIALAPP_ROVAL_ - ❑ _CANCEL _ - _ _ _ _ ACCESS_ ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITION L FE S ASSESSED _t:537k___io ,_ , ,. Inspector: Date: Phone #: (503) 718-