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Permit • A CITY OF TI BUILDING PERMIT PERMIT #: BUP2004 -00006 �i DEVELOPMENT SERVICES DATE ISSUED: 4/30/2004 - ,- II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S109AD -08200 SITE ADDRESS: 12713 SW ROCKY MOUNTAIN CT SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7 BLOCK: LOT: 026 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: 1431T 6 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: 40 psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET: . DWELLING UNITS: 1 FRNT: 15 ft REAR: 15 ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 7,800.00 Remarks: Add multi -level covered deck and stairs to existing deck. Owner: Contractor: DAVE SIEBOLD BRYANT BUILDERS 12713 SW ROCKY MOUNTAIN RD 18320 SW DELORIS TIGARD, OR 97224 ALOHA, OR 97007 Phone: 503 - 620 -5389 Phone: 503 - 318 -5031 Reg #: LIC 96965 FEES REQUIRED INSPECTIONS Description Date Amount Footing Insp [BUPPLN] Pln Rv 1/8/2004 $78.07 Framing Insp [BUILD] Permit Fee 4/30/2004 $120.10 Final Inspection [TAX] 8% State Surcharp 4/30/2004 $9.61 Total $207.78 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You m- • • an a 3 •y of these rules or direct questions. to OUNC by calling (503) 246 -6699 or 1- 800 - 332 -2344. Is u�ed By: ` A , `��l X Pe e— Signature: ,�.-- /L. I.--..N Call 639 -4175 by 7 p.m. for an inspection the next business day . Building Permit A>m VW : FOR OFFICE USE ONLY City of Tigard Received �. P e mu t No 7U N O 8 2oo�'' it� D ate B : /$' Q '��G i 13125 SW Hall Blvd., Tigard, OR 972121A Plan Review � Phone: 503.639.4171 Fax: 503.598. 41N t 4N ,'11' B © Date : d•` I Other Permit: . �a ' ' Inspection Line: 503.639.4175 ^_ Date Ready/By: !1l ,9 py Supplemental See A Checklist for Internet: www.ci.tigard.or.us CITY OFTIGAp Notified/Method: Supplemental Information RUILNG DIVISION . TYPE OI OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. _ ...i Indicate the value (rounded to the nearest dollar) of all U Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION El work indicated on this application. J Valuation: $ g O 1- and 2- family dwelling El Accessory building El Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: i . JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: IZ.'113 s ta.7 RecAcr/ ) l '1 New dwelling area: square feet City/State/ZIP: � 1 ., e.,,,,, a le,, 91?-1.--4 Garage/carport dwelling area: square feet • Suite/bldg. /apt.no.: Project name: F .11- C .tr s� - « Covered porch area: squarefeet/60 Cross street/directions to job site: ' j u‘k } '?.% eg-A, Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST 4 Subdivision: Lot no.: 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.: equipment, materials, labor, overhead, and the profit for the �' DESCRIPTION OF WORK work indicated on this application. v Valuation: $ Adc! CoUte _ r- S Q s esvte, E)( -1.4, DelE,l,. Existing building area: square feet I j New building area: square feet v U ❑ PROPERTY OWNER ❑ TENANT Number of stories: S Name: Svc. d D r V �. cllic,old Type of construction: "v Address: t 7_7 1 3 Flbdc. / %'V1.4 r.► R t. Occupancy groups: City/State/ZIP: (i A mol ore, q Existing: Phone: ( S a )5 6 zo - S 3 Ir y Fax: ( ) New: 3 APPLICANT ❑ CONTACT PERSON NOTICE Business name: -6,71 t t , � s All contractors and subcontractors are required to be .4 licensed with the Oregon Construction Contractors Board Contact name: � e i ( e-Yet 0 -t - under ORS 701 and may be required to be licensed in the 1 Address: 1 F t ZO S W DC,) s �� C jurisdiction in which work is being performed. If the Ci /State/ZIP: applicant is exempt from licensing, the following reasons apply: ty A l o �,.� O Cif o O Phone: (Sb3 ) c I& S I r Fax: : ( ) E -mail: 1 . CONTRACTOR Business name: r e...yall,.zt , :. c ke 4c--S BUILDING PERMIT FEES* Address: 1 ?I, to S v,i del ate -% L. J Please refer to fee schedule. lit: City/State/ZIP: A l a (,�,,k O 12... C1.1 Ob 1 Fees due upon application Phone: (s03) 3! r-self Fax: ($ a3) 3 s'6-a6 S Amount received CCB lic.: Re,C1‹ S .,_" D-iS$ — 0 it Date received: Authorized signature: ,p /? This permit application expires if a permit is not obtained /C C J within 180 days after it has been accepted as complete. Print name: — T" " c..., /? pNi— Date: l - p - A * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Pemtits\Bl1P•PamitApp.doc 12/03 440- 4613T(II /02/COM/WEB) ti One- and Two - Family Dwelling Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Receive DateB Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 //.ysn 24- Hour Inspection Line: 503.639.4175 ul I ❑ Electrical ❑Plumbing 0 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. ❑ 0 0 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 0 plan 0 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 iro'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 \One- Two- FamilyChecklist.doc 12/03 / / 01'/i2/2004 04 :24 5033561165 BRYANTBUILDRSE PAGE 02 01/12404 1$:22 FAX 5038483525 CLEAN ',A'I'LS nhKVicEb rw " "• al /11/"4004 :A 159 5833561165 : = BUILDR5E` FArat 02 II JAN 1 2 2004 Ht.; Number [ 3 ' 7 1 Water Service B -- -^ -.�— [ C,aeat Sensitive Area Pre-Screening Site &amassment 0.1r commti,rowt i► Jurisdiction /.gy►d Date �-.li.i *iv Map & Tax Lot 2,,5( U 9AD O $moo Owner D.;uil.. t, ---. Site Address- i e " 1 r ""dadc 'g- Contact Proposed Activity M4 @ •�: - r .a .- Address ���;.. mR Q 1 , � A — �" .1'.d0oa_ Phone A Mfi __ _ Se. 34- ...Sal* (mall ur. un ow ie ns Y N NA Y N NA a) 0 ❑ Sensitive Are Composite Map El El Stom>r►later infrastructure maps Map # ,_ !w r w _____._. . a3 a _m3its__ O 0 Locally adopted studies or maps El El Other Specify _____- _._ Specify J_ Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order No. 0311: ❑ Sensitive areas potentially mast on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OR A SERVICE PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assosorrnent Report may also be required. fAi Sensitive areas do not appear to exist on sits or within 100' of the sits. This pre - scr'eeiilnd site assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas If they are subsequently discovered on your property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REOU;RED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STOP MWATER CONNECTION PERMIT, • The p : .,posed activity doss not meet the definition of development. NO SITE ASSE : OR SERVICE PROVIDER LETTER IS REGUIRED- Comments: _ .� 4 . a r °d a. 26 er 9 Os M g e �'w 1, as p _apes. Aar- r ., Reviewed 6d: • — _.. .. _. _ , Date: 1 4 4 - - - - -- _. • _ ____. Rammed to Applicant Post-Its Fax Note 7611 Pale / Mail Fork_ Counter - 11 1 Date., l By.— cn.D.p4 ORMIIIIIIIMII • nti i Plums 0 l L: m` 503-35 ex a . If ,' V1/03/03 FR1 13:31 FAX 503 885 7840 E2 MGC FAX Z ool. . 36•-0• .. d _. ,.-•--•—.,-----,_-....,1.7- -:.7--L:=7--_-_-.".:.,...:-=•-_=,..—...---.--. 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''':."):',''':..'.--.;.`;] *.W -. ,,,,...!, .... ... ..,.., r,.....1t. !' • ,, "•. , 11 - • • ..^,....,, -r,- -,' .r... , A • - • • ' , ' c ' ---1 •■ , I -I I [ 41-6 1/16" l• 11 11 1 I , 1 11 11 • i 11 11 I l i I, • ; I 1! ;1 1 • 1 11 ; • • I • .. 14411111 — ._. 'JAN 08 2004_ CITY OF TIGARD BUILDING DIVISION • CITY OF TIGARD - Mir PLAN } REVIEW • • BUILDING PERMIT NO.: � �T r O`t — 000�c�I �►�-�0 PLANNING DIVISION: Required Setbacks: ifrApproveD ,Not Approved Side: S Street Side: Front. Garage: Rear: l5" Visual Clearance:NJA ❑ Approved ❑ Not Approved Maximum Building Height• feet CWS Service Provider.Letter Required: , Yes ❑ No M.. ❑ Received B : Date: i ENGIN DEPARTMENT: Actual Slope: _% � ❑ Not Approved Site Plan: 13 Approved Not Approved 24' °" By: N1.4r, 4( Date: / L> /or s6 Noes: 17Sj I r 2 pr e S er a � , e 0 eas rr e �-I -1-E3 - e 4- 0_10,11 sou _441 s e oo --hie- proper -4-c - . 7,02482 No C-" e n C r o ae h ► (1-h) * e a.J e.r N e n 4-. A6 arya �jp�h�$ p • d e-e4c pe rnn ; 14e d e ea,cc s e r �5ina o cu -k d 6+d 2 �I h e_ ea e.,-\ .e,,, 4- • S a• r. -,.cr L& 441 odd ; -k o-L S - n v 5 c u•-eX 41'1' €4.30,,e C c 1L p S o i(1 r✓2 d . CITY OF TIGARD). 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION ' Business Line: (503) 639 -4171 BUP , • 0 d Odd Received Date Re uested 7- q AM • PM BUP Location / -11 (711: J Suite MEC Contact Person Ph ( ) 3 lt.s 31 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: • t SIT Post & Beam Shear Anchors Sheath/Shear --el; �i� Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other PAS _BART FAIL MBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE fl Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA S7-- • 4 - - D / A Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL r