Permit C ITY OF TIGARD BUILDING PERMIT
II PERMIT #: BUP2007 -00107
° COMMUNITY DEVELOPMENT DATE ISSUED: 2/27/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136DB
SITE ADDRESS: 11645 SW PACIFIC HWY ZONING: R -12
SUBDIVISION: WHITE OAK VILLAGE LOT: JURISDICTION: TIG .
PROJECT: WHITE OAK VILLAGE
Project Description: Demo 1488 sq ft residential dwelling on septic. UPON FINAL DEMO CREDITS MAY APPLY.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM 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:
Owner: Contractor:
• DALTON GANG HOMES
7955 SW HALL BLVD
BEAVERTON, OR 97008
Contact #: PRI 503 209 - 8869
Phone: FAX 503 - 626 - 8485
Reg #: LIC 166410 .
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/27/2007 $62.50
[TAX] 8% State Surcha 2/27/2007 $5.00
[ERPRMT] Erosion Con 2/27/2007 $26.00
[ERPLN] Erosn Pln Rv C 2/27/2007 $8.45 .
(additional fees not listed here)
Total $110.40
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: p Permittee Signature:
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 Application DThO
Reside tial - FOR OFFICE USE ONLY
Received q
City of Tigard DateBy: �7 G 7 ?x : ; Permit N 7 — vd) Q 7
° 13125 SW Hall Blvd., Tigard, OR 97223 i -.- J 3;A 2007 7 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 - L Date/By: Other Permit:
T I G A li D Inspection Line: 503.639 t l Y %.•1 - Date Ready/By: kris. la See Page 2 for
Internet: www.tigard - or.gov 7 , 9 all tipAIP�,
l ra ..) lar'," ir,., Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ta 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.
lst 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ —
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: i l4:1.l 15 SW T'AUF t L W New dwelling area: square feet
City /State /ZIP: 7\ (:: 1 1 8e. q/-2.2..-5 Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: Covered porch area: square feet
Cross street/directions to job site: (n J LC, IJ C_.. Deck area: square feet
1 ) al v EW Px( N EX l 173 R, p1/4 Z z V s 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
DESCRIP'T'ION OF WORK work indicated on this application.
j�EMr'L.I'ilot.1 ek 1 -i'WO- 5 -tutu. ti-cue- c> Valuation: $
8" I l.-1 I tJ 938 4\ \-)•) r i S k-kOF l 4 6ic Existing building area: square feet
_
0 . f (02 _ 1 „1 5. l New building area: square feet
ti( PROPERTY OWNER ❑ TENANT Number of stories:
Name: WI-it E (')AIL v l l-L A 6 E t l-l-G- Type of construction:
Address: ' 1 q 6.5 6v I4# i.l. Bui j) Occupancy groups:
City /State /ZIP: 13E, ‘f 1 � - �N OR._ 91008 Existing:
Phone: (J603) to2�p _ 5 '+P3 Fax: ( 603) G24, - Bt.I B5 New:
14 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: -_�� Le - 0 � a I 1 a c 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: - lg55 - SW NA- 'g,. Jj) jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
�e- Q � � �T� v O Q 9 1 t O f3 apply:
Phone: (.5 2 ) 2_09 - e)12, to q Fax: : (513) b24, - eo..1 85-
E - mail: L FD t rrs,J &r IEDA�- rolJCa. CoM
CONTRACTOR
Business name: Set 0.4 GLS �r 1 I l GQ Y1 + BUILDING PERMIT m FEES•
Address: (Please refer fee schedule)
City /State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: ' (} p Total fees due upon application:
Amount received: I (D 140
Authorized signature: _e This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: LE NI F_�� m kJ Date: Z(o i 0 1 • Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -RES PermitApp.doc 02/23/07 440 -4613T(I I /02 /COM/WEB)
Building Permit Application Checklist
One- and Two - Family Dwelling FOR OFFICE USE ONLY
74 City of Tigard Received
Date/13y: Permit No.:
a 13 125 SW Hall Blvd., Tigard, OR 97223
C • Phone: 503.639.4171 Fax: 503.598.1960 Associated permits:
TIGARD
24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑Mechanical
Internet: www.tigard- or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW "es 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 •ro'ect 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\BUP- RES- PermitApp.doc 03/21/06 440- 46I3T(I1 /02/COM/WEB)
CITY OP TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00107
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/27/2007
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 _' `'I I ..
INSPECTION WORKSHEET FOR DATE: 419/2007 TIME: 7:34AM PAGE: 1
SITE ADDRESS: 11645 SW PACIFIC HINNY CLASS OF WORK:
SUBDIVISION: WHITE OAK VILLAGE LOT #: TYPE OF USE:
PROJECT NAME: WHITE OAK VILLAGE
. DESCRIPTION: Demo 1488 sq ft residential dwelling on septic. UPON FINAL DEMO CREDITS MAY APPLY.
OWNER: PHONE #:
CONTRACTOR: DALTON GANG HOMES PHONE #: 503 - 209 -8869
Inspection Request Scheduled For: Date: 4/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final initipection 046155 -01 503-209-8869 N
Corrections /Comments /Instructions:
e — '1 e
&I PASS re PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL / LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4■•.:.. Date: . b Phone #: (503) 718 -Z‘