Permit I
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CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00085
,' f it, DEVELOPMENT SERVICES
�
SERV IICES 639 -4171 DATE ISSUED: 3/3/2005
Hall
SITE ADDRESS: 11759 SW SWENDON LP PARCEL: 1S133CD -06100
SUBDIVISION: COTSWALD MEADOWS ZONING: R -25
BLOCK: LOT: 059 JURISDICTION: TIG
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: 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: A 7 5 O
Remarks: Replace existing deck with new, 240 square feet.
Owner: Contractor:
MINDY & RYA KING JERRY SIEVERT CONSTRUCTION INC
11759 SW SWENDON LP 3075 SW 234TH STE 209
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503- 590 -8797 Phone: 503 - 681 -8521
FEES Reg #: LIC 113876
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/3/2005 $120.10
[TAX] 8% State Surchari 3/3/2005 $9.61
[BUPPLN] Pln Rv 3/3/2005 $78.07
[CDCPLN] CDC Pin Rel 3/3/2005 $42.00
(additional fees not listed here)
Total $255.78
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
hot 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 ( 3) 246- 99 or 1 00- 332 -2344.
Issued •
Permittee IM g
Signature: ,C V/I4M
c II 639 \ 5 by 7:00 p.m. for an inspection the next 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 FOR OFFICE USE ONLY
City of Tigard
Received / yy� <
131 SW Hall Blvd., Tigard, OR 97223 Dat : /�i O _ -� % /`���' 1 J
g & Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 JJ I Date/B
Inspection Line: 503.639.4175 Ai l Date Ready/By: ` 0 See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Ij Supplemental Information
TYPE OF WORK • .. REQUIRED,DATA: 1 -. AND •2- FAMILY DWELLING . .
❑ 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
. CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling El Commercial/industrial Valuation: $ , 1 OS 0 . 6 O
El Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
, :: t ' Total number of floors:
- JOB SITE INFORMATION AND LOCATION�;s:;j ;= ;-
Job site address: IL 166 9 SW S W.eamq LOO p New dwelling area: square feet
City/State/ZIP: - \c4 ,,,, rd , Q 2.. g -11,23 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Vi... • Covered porch area: square feet
Cross street/directions to job site: v Deck area: 244 0 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.
Valuation: $
C "V\a ?;v. -y 4tictstZ n9 ae014
Existing building area: square feet
New building area: square feet
• g PROPERTY OWNER ❑ TENANT Number of stories:
Name: WA
\h,3 4 ( `t'C.ye... An V i Type of construction:
Address: 1 I 1 S G 1 S W S W C V∎A* h 160 yo Occupancy groups:
City/ State/ZIP: Ticv,rd O n 17 Z 2 3 Existing:
Phone: (003) 590 * 8 7 q '? 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 name: 312 Y Yy S \t ‘J,42,, C +I.YLS,4'Ytw d- i CSI/ BUILDING PERMIT FEES*
Address: g07 �j q d C9 Please refer to fee schedule. y
City/ State/ZIP: t,4 u_s / pa_ C7712.
Fees due upon application
Phone: (G' IaJ— i5aI Fax: ( ) Amount received
CCB lit:.: 1,13q 74 9/2D (0 /
`(
� (` Date received:
W
Authorized signature: •t 0�/S�I�. „n;. / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: M i ndV k t K�j ` Date: 3/.3/63 * Fee methodology set by Tri-County Building Industry
Service Board.
i:\ Building \Permits\BUP- PcrmitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
One- and Two - Family Dwelling • t .V.
Building Permit Application Checklist FOR OFFICE USE ONLY
City Of Tigard Received Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 AssoBy:
Associated permits:
Oa,:�
Phone: 503.639.4171 Fax: 503.598.1960 . A
24- Hour Inspection Line: 503.639.4175 II l ❑ Electrical 0 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. ❑ ❑ ❑
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 reference's 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 ap plicable 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, ❑ .0 ❑
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
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CITY OF TI,GAR,D A
BUILDING DIVISION PERMIT #: BOP2005 -00085 I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/3/2005
Phone: (503) 639 -4171 i"°t
Inspection Requests (24 Hrs.): (503) 639 -4175 ��I ":�i
_..
INSPECTION WORKSHEET FOR DATE: 3/15/2005 TIME: 7 :13AM PAGE 68
SITE ADDRESS: 11759 SW SWENDON LP CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 059 TYPE OF USE:
PROJECT NAME: KING
DESCRIPTION: Replace existing deck with new, 240 square feet.
OWNER: KING, MINDY & RYAN PHONE #: 503- 590-8797
CONTRACTOR: SIEVERT CONSTRUCTION INC, JERRY PHONE #: 503. 681 -8521
Inspection Request Scheduled For: Date: 3/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 001713 -01 503- 590 -8797 N
Corrections/Comments/Instructions:
I
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • Date: .1- /S 6f Phone #: (503) 718-