Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00088
Al, DEVELOPMENT SERVICES DATE ISSUED: 3/25/02
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12701 SW SORREL DOCK CT PARCEL: 1S133AD -13900
SUBDIVISION: SUMMER LAKE ZONING: R -7
BLOCK: LOT: 020 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ACS 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: 0.00 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: $ 4,500.00
Remarks: 92 s.f. storage shed.
Owner: Contractor:
FERNANDEZ, JUAN + MELANIE OWNER
12701 SW SORREL DOCK CT
TIGARD, OR 97223
Phone: Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing lnsp
PLCK CTR 3/12/02 $59.35 27200200000 Foundation Insp
Post/Beam Insp
PRMT CTR 3/25/02 $91.30 27200200000 Framing lnsp
5PCT CTR 3/25/02 $7.30 27200200000 Rain Drain Insp
CDCB CTR 3/25/02 $20.00 27200200000 Final Inspection
(additional fees not listed here)
Total $197.95
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 -1987. • may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 o =! ! .4 -2 • 4.
ittee
Signat O rs, x-45
ur !�/ �
Iss d By: . lb I / 4/jA v4;
Call 639 -4175 by 7 p.m. for an inspection the next business day
d r
Building Per 1 it a 1 1 lication
City of Tigard 1 11 Date received: � Z /o — Permit no.: 5 (1��Upa 0 Ff g
'1 Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 MAg 1 2 2002 Date issued: By R-0 Receipt no.:
Fax: (503) 598 -1960 C ♦ Case file no.: Payment type:
�� b4 ilrn 14 Land use approval: r ' ' ' , ON I &2 family: Simple Complex: oft
o..
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
El ddition/alteration/replacement Cl Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: r
• JOB SITE INFORMATION
Job address: Ia 7D a 5(5 {1 f , poeii OA_ Bldg. no.: Suite no.:
Lot: I Block: ISubdivision: I Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions: FtC1Y�5c, cShPA Ok. rh l At c
9 P
• OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: pQ , jl (e, ......(14 T
(14 7 , (Flood plain, septic capacity, solar, etc.)
Mailing address: 109 y So{ ((L., d -�, - I & 2 family dwelling: , ` �,
City: — TTC' I State�� I ZIP: q 7�' 3 Valuation of work $ ^�17j , b
Phone: 7)3 SZ.f -4 Fax: b pd E - mail•kitjMs pkZ iiZJ No. of bedrooms/baths
Owner's representative: _/jam" • rt e' r Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Name:.mP.„, Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.) ,yam ;
City: I State: I ZIP: Other structure area (sq. ft.).
Phone: Fax: E -mail: Commercia llindustrlallmulti - family:
CONTRACTOR Valuation of work $
Business name: N E Existing bldg. area (s ><xistin'
New bldg. area (sq. f
Address:
City: I State: I ZIP: Number of stories
Phone: I Fax: I E -mail: Type of construction
CCB no.: Occupancy group(s):
New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARC' I ITECT/DESIGN ER , licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: `Plan no.:
Phone: Fax: E -mail:
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: VIP: Amount received $ -
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions if laws and ordinances governing this p visa 0 MasterCard
work will be complie , w' ., 1 r ther specified • . - in or n t. Credit card number: /
Expires
Authorized si a /, • . _ �`_,._ / - / � / Date: /� d2 Name of cardholder as shown on credit card $
Print name: ///e/&19( i "././
/ �GGUI/ l zi Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (fioo/COM)
One- and Two - Family Dwelling
Building Permit Application Checklist Reference no.:
City of Tigard Associated permits:
Ci
Cilty of Tigard ❑ Electrical ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639-4171
•
Fax: (503) 598 -1960
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.
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 Cl 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 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 & 22 above.
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not 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 & location per approved project street tree plan (if applicable), and COT Street Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440-4614 (6100/COM)
Permit # :1A P O) d\ — cnosg
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0 ..47,,
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Issue% by: b„.._ dr 100 -1 t - Date: 45 6/
1= 5 9
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required '
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
vREI- 1. I own, reside in, or will reside in the completed structure.
.4d 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
(1 3A. My general contractor is
I I (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
€. 4n 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above infor : ion is correct and that I have read and do understand the Information
Notice to Prop I . 1 . about onstruction Responsibilities on the reverse side of this for .
X 1 ,<Ciatc>4-" AS, 1.A OA
• / (Signat of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
CITY OF TIGARD 24 -1 - s
WILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171 BUP D 8e?
Received Date Requested VeRa AM PM BUP
Location 1 7 / nn . Suite �j MEC
Contact Person I l - -1 _C , Ph ( ) RD 7 "6 clek PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: // SIT
Post & Beam !�
Shear Anchors •
Ext Sheath/Shear �' %� .�i L! �/ � !
Int Sheath/Shear f
, p
Insulation � V •
Drywall Nailing AK) CL = c772[C'/J L-
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fi..
PART FAIL
PL U ' BING
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 El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date � L � �__ Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF 1, D 24- uur •
'BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
C� BUP �jh Z '60 6 o
Received Date Requested / ' AM PM BUP
Location / Z70/ Sc'-) Sore -t uck_ Suite MEC
Contact Person 06 Ph ( ) g c/ 0 PLM
Contractor / Ph ( ) SWR
Tenant/Owner G t#P S l Io o lws.� �`fr, d o ELC
.. i
ELC
a '' " Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Ina Sheath /Shear t Y4 � / � C 5 7 � //
Framing / ��J
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fin
PASS ART FAIL
PLUMBING
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
Anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA L� / ! 9'4 �_
Approach/Sidewalk Date Inspector - Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF MI OP 24 - H lsur _ INV
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP oZ -DD
Received Date Requested 9` / 7' // AM PM BUP
Location /L-70 t SW _So? ✓-eL cf G 7 Suite MEC
Contact Person 06a / y Ph ( ) 9 7 - C a PLM
Contractor Ph ( ) SWR
�lILDIN7� Tenant/Owner e i tt Sit cti h o S.e AiG ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl D in
Inspection Notes: SIT
ost & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing 4 C, C L _ 0 /4 Air
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART E FAI
PLUMBING
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 ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / O` Inspector - Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
•
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 0 ?" 0 6 d
Received Date Requested ! AM PM i -d 1 BUP
Location / .;` 7 ( 44 Suite MEC
Contact Person Ph ( ) F67 -6 9 4'" PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation , .
Ft Drain �
n �, � . ' `L° ��� /no 0. S/ ELR
Crawl Drain : .
Slab Inspection otes: SIT
Post & Beam
Shear Anchors 1 Ext Sheath/Shear
Int Sheath/Shear
AA jt-Le9"---
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler /
Fire Alarm f/
Susp'd Ceiling
Roof
Other:
PASS PART
PLUMBING
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 ❑ Please call for reinspection RE: E Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 1 0 '1 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
.r.
CITY OF TIGARD 24 -Hour :
BUILDING Inspection Line: (503) 6394175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST Q�
BUP — �T68 1
Received Date Requested /d /9 AM PM BUP
Location l ? 1 t) _ Suite MEC
Contact Person Ph ( ) �f O PLM
Contractor Ph ( ) SWR
BUILDING. Tenant/Owner ELC
Footing ELC
Foundation Access
Ftg Drain , - ELR
Crawl Drain y , e4
Slab Inspec o J ote : — -- - -- - _ - _ SIT
Post & Beam `� - d 'U[
Shear Anchors
Ext Sheath/Shear A !.f , •
Int Sheath/Shear - — ---
Framing ._I _1 ! _ 1 1 4 _ iIL
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fina
PART FAIL
CHANICAL
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 ❑ Please call for r inspection RE: Unable to inspect - no access
Fire Supply Line
ADA �
Approach/Sidewalk Date Inspector i' �� Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 _
• INSPECTION DIVISION Business Line: (503) 639 -4171 MS
/ BUP 6 D g�
Received Date Requested /b 6 �� AM PM BUP
Location )' 7 ? - 76 41t- s(%t Suite MEC
Contact Person Ph ( ) ge 7 `" 6 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear �
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: �C1�1'CJLO�� i
in
Ai gP PART FAIL
BING
Post & Beam Under Slab b r 1
R ough -In
Water Service\ V f
Sanitary Sewer I^c
Rain Drains
Catch Basin / Mar4tole
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 1 ��
UG/Slab '1
Y p i . )`•
Low Voltage
Fire Alarm 0
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA \ `
Approach/Sidewalk Date l " (� Z3 0 Inspector 1/� �!' `� Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL