Permit •
c.
CITY O F TIGARD SITE WORK PERMIT
A llx DEVELOPMENT SERVICES PERMIT # : SIT2005 -00014
-141
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED : 7/6/2005
PARCEL : 2S104BD -05200
SITE ADDRESS: 13788 SW WALNUT LN ZONING : R -7
SUBDIVISION: ROSE MEADOWS LOT: 011 JURISDICTION : TIG
Project Description: Retaining wall.
CLASS OF WORK: OTR PAVING ?: RESO. NO:
TYPE OF USE: SF GRADING ?: VALUE: 2,000.00
EXCV VOLUME: cy LANDSCAPING ?:
FILL VOLUME: cy SITE PREP ?:
ENG FILL ?: STORM DRAINS ?:
SOILS RPT REQD ?: IMPERV SURFACE: sf
Owner: FEES
•
ALLEY, BARRY A + DUSTINA Description Date Amount
13788 SW WALNUT LN [BUPPLN] Pln Rv -Valu 7/6/2005 $40.63
TIGARD, OR 97223 [BUILD] Prmt Fee -Valu 7/6/2005 $62.50
[TAX] Valu 8% State Surcharg 7/6/2005 $5.00
Phone: Total $108.13
Contractor:
OWNER
Phone: 503 - 475 -3180
REQUIRED ITEMS AND REPORTS
Reg #:
This permit is issued subject to the rggulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. 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 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 copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: ` !�-�•� Permittee Signature),- ' ‘ , 7
\
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit cans 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 S CENE® Received _ �7 r
13125 SW Hall Blvd , Tigard, OR 97 3 ��JJ DateB : A. l� r • F — �� ��,."•=
w11 II } Plan Review _
Phone: 503.639.4171 Fax: 503.598.1960 Y: r Other Permit: Q (V OI
/ ,
Inspection Line: 503.639.4175 , `; 200 c: . . Ready /By: II� 1 Da Read /B o' 7- 6 5 _ 0 See r � Attached for
g w
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
CITY OF liGARD
4'_ -. , , - ' • fir W t.' _
- ,: REQUIRED DATA: 1- AND2- FAMILY
❑ 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.
Valuation: $
11 1- and 2- family dwelling El Commercial/industrial
ZQ°p�
❑ Accessory building ❑ Multi- family Number of bedrooms
❑ Master builder ❑ Other: Number of bathrooms:
:::',..'h' t . -. - ' =JOB' SITE INFORMATION,'AND TA ATIOIV ,!,,••... Total number of floors:
Job site address: d 37' $ ( c ( KN \- Lo, 11A.. New dwelling area: square feet
City/State/ZIP: -- 77 o VA, — � 91 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: G 4S1- 0.1\ \ Covered porch area: square feet
Cross street/directions to job site: rr•o w• 1 3 S +lam *�, y=, Deck area: square feet
4 t", c 50 W•-S. (-• 0 i \ tA)G.1 •v,k 1,--Goys-k... 2 5 / ics.,yA. Other structure area: square feet
o'. -(k .
, REQUIRED 1)ATA 'COIVIIVIE .. . 11SE 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. $
Existing building area: square feet
New building area: square feet
' PROPERTY OWNER ❑ TENANT Number of stories:
Name: lZ ,../ A(1,„., Type of construction:
Address: ' S 1, i 1►.) c,1 q ,,,,- 1, k Occupancy groups:
City/State/ZIP: gara DR. x1 723 Existing:
Phone: ( 503 ),31-7_- Fax: ( )
New:
APPLICANT ' , `': ❑ , CONTACT PERSON
-•' ' ' •'- NOTICE •.1r _ . - •:,;.,';
Business name: All contractors and subcontractors are required to be
Contact name: 'r Al licensed with the Oregon Construction Contractors Board
h { under ORS 701 and may be required to be licensed in the
Address: (31 td S 4J J 41' J 1_,,,,., jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
I iyc%I oR. `� 1 app
Phone: (U 'Z.c
3) 3 (7 - 0 Fax:: ( )
E -mail: bG,,r,7 a ( (.. 4 0 ✓1n S A . C.co
.- J, CONTRACTOR ;
Business name:
BUILDING PERMIT FEES* -i ' :
Address:
Please refer to fee schedule
City/State/ZIP:
Phone: ( ) Fax: ( ) Fees due upon application
CCB lic.:
Amount received
Date received:
Authorized signature: )14Ifil
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:
!1 trr A . Date: C (0- 0 * Fee methodology set by Tn -County Building Industry
Service Board.
, \Building\Penniu \BUP- PernutApp doe 12/03 440- 4613T(11 /02/COM/WEB)
One- and Two - Family Dwelling
Building Permit Application Checklist FOR OFFICE USE ONLY
• City of Tigard Received
Date/By.
Associated permits Permit No.:
13125.SW Hall Blvd., Tigard, OR 97223
• Phone" 503'.639.4'171 Fax: 503.598.1960 /�.� � r '\
24- Hour Inspection Line: 503.639 4175 • {� E ' I ❑ Electrical ❑Plumbing ❑ Mechanical
Internet: www.ci.tigard.or.us — " "" ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
I 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 a. •licable 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 \One - Two- FamilyChecklist.doc 12/03
CITY OF TIGARD - SITE PLAN REVIEW
. . n BUILDING PERMIT NO.: .3'1" c ,,x)5 - -c.ic20/ 1 1
•
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34/05
t S X0 0d.) - o o OP/
y ,Building P ZW '" a sp t e ' T •
Name:ALLEY, BARRY A + DUSTINA Updated: 06/0612005 BLD General
Address:13788 SW WALNUT LN Jur: TIG
Specifics &
Description: Master # IBUP2005- 00242_ , Project !ALLEY
i 4 ..,
Areas
Retaining wall. p
Setbacks `
N
) Const
lass of Work I � ,Q/ 1 Dates
Type of Use: t `I Received: 106/06/2005 Required
Items
Type of Construction: pi r p , Target !
Occupancy Group: Issued: !
Occupancy Load: 1 ei Expired: I
Valuation: ! $0.00 P Finaled:
ti
A
_ .
!Building Pernnt (BM) ,,.,Ht i_ '' . _ NA!
Name:ALLEY, BARRY A + DUSTINA Updated: 06!0612005 BLD General
Address:13788 SW WALNUT LN Jur. fria
Description: Master*. (BUP2005 -00242 Project !ALLEY Specifics & 1
Areas
'Retaining wall.
Setbacks
Reissue: !-- Const l ^
Class of Work Dates " d `
Type of Use: r Received: 106/06/2005 Required 1 �,
Items cl
Activity for BUP2005-00242 P' g �J j
Menu Code I Description Datel Date2 Date3 Disp Done By Notes ' 1
1020 Permit created 06/06/2005 DONE DER '
1030 Check for parcel tags /CWS 06/06/2005 DONE DER Faxed site plan & a
1060 Building plans routed to PE 06106/2005 DONE DER Homeowner will st
1010 Application received 06/06/2005 RECD DER
a;. •�
100 R FYI 5 ion s /lrifo routed to PE 06 DOME BE Engineering and E
1
l�aurlArlrl Artivitioa
��
l' ° &.a e /e_.. 'z S/ / c 4-4-e� 6/3__e_
7 Llii --- Q/ t.. a-e vi rae 7 %/7i 7! /e0 / /.624-- 74- - .)
40�///
�er,;(-e 'z' 4,21a deed__, /D . Sa--i-?"--
«'
Case Activity Listing 7/6/2005.. 10:10:45AM
TIDEMARK Case #: BUP2005 -00242
COMPUTER SYSTEMS. INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
BUP 1020 Permit created 6/6/2005 None DONE DER 6/6/2005
BLD
BUP 1010 Application received 6/6/2005 None RECD DER 6/6/2005
BLD
BUP 1030 Check for parcel 6/6/2005 None DONE DER 6/6/2005 Faxed site plan & app. to CWS.
tags /CWS DER
BUP1060 Building plans routed 6/6/2005 None DONE DER 6/6/2005 Homeowner will submit engineering
to PE BLD ASAP.
BUP 1080 Revisions/Info routed 6/30/2005 None DONE BB 6/30/2005 Engineering and site plan.
to PE BB
Page 1 of 1 CaseActivity..rpt
tillhlk 7/2005,
10:00
Payment History For
Tidemark -
SOLUTIONS- Case #: BUP2005 -00242
Recorded
(Type Fee ID # Description Fees Paid Date Paid Check # Receipt # By Due History
PLCK 200506061226032100 [BUPPLN] Pln Rv 40.63 40.63 6/6/2005 27200500000000002549 CTR 0.00
Total Fees: $40.63 Paid: $40.63 TOTAL REMAINING DUE: $0.00
Page 1 of 1 CasePaymentHistory..rpt
,QCC�o�ODS - C O? %cL
EXAMPLES FOR SINGLE - FAMILY PERMITS .
PROJECT PERMIT TYPE TYPE OF USE , CLASS OF
DESCRIPTION WORK .
New house MST SF NEW
New manufactured MST SFM NEW
dwelling (Note: all
other permits for
these are like SF,
replace SF with
SFM)
Addition to house MST SF ADD
Alteration to house MST SF ALT
(primarily interior alts)
where a bid permit or
multiple trade permits
are required)
New accessory MST SF ACS
building, detached
•
(garage, shop,
carport, etc)
Addition to accessory MST SF ACS
building
Alteration to MST SF ACS
accessory building
Fence (no retaining) BUP SF OTR
Retaining structure SIT SF OTR
(no other site work)
Grading and other site SIT SF NEW
work; may include a ADD
retaining structure ALT
• ACS
OTR
Re -roof • BUP SF OTR .
Repair (minor) BUP SF REP
Repair (major, MST SF REP
involving multiple
trades)
Towers, poles, etc BUP SF OTR
Deck (attached or BUP SF OTR
detached)
Pools BUP SF OTR
Plmb, mec, elc for a PLM,MEC,ELC SF OTR
pool
Electrical work only ELC OR ELR N/A N/A
Plumbing work only PLM SF ALT
•
Mech work only MEC SF ALT
Sprinklers or alarms BUP SF FPS
Add or enclose patio, BUP SF ADD
no subtrades MST (if subtrades)
Tennis/Sport courts BUP SF OTR
CITY OF TIGARD
6/6/2005
13125 SW Hall Blvd. 12:35:26PM
Tigard, Oregon 97223
! �� (503) 639 -4171
Receipt #: 27200500000000002549
Date: 06/06/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
BUP2005 -00242 [BUPPLN] Pln Rv 245- 0000 - 433000 40.63
Line Item Total: $40.63
Payments:
Method Payer User ED AcctJCheck No. Approval No. How Received Amount Paid
CreditCard ALLEY, BARRY DER 162111 In Person 40.63 •
Payment Total: $40.63
•
cReceipt.rpt Page 1 of 1
CITY OF TIGARD r -i
'BUILDING DIVISION PERMIT #: SIT2005 -00014 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/6/2005
Phone: (503) 639- 4171N
Inspection Requests (24 Hrs.): (503) 639 -4175 ".11_..
INSPECTION WORKSHEET FOR DATE: 9/9/2005 TIME: 7:07AM PAGE: 29
SITE ADDRESS: 13788 SW WALNUT LN CLASS OF WORK:
SUBDIVISION: ROSE MEADOWS LOT #: 011 TYPE OF USE:
PROJECT NAME: ALLEY
DESCRIPTION:
031 a,':;
OWNER: ALLEY, BARRY A + DUSTINA, PHONE #:
CONTRACTOR: OWNER PHONE #: 503 - 475 -3180
Inspection Request Scheduled For: Date: 91912Q05 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 015299 -01 503 -317 -2407 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Q.--9---es Phone #: (503) 718-
CITY OF TIGARD . .� r
BUILDING DIVISION PERMIT #: SIT200S -00014
13125 SW Hall Blvd., Tigard, OR 97223 e z DATE ISSUED: 7/6/2005
Phone: (503) 639 -4171 A+, o , �e� �`i�' I
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 0/302005 TIME: 7:07AM PAGE: 20
SITE ADDRESS: 13788 SW WALNUT LN CLASS OF WORK:
SUBDIVISION: ROSE MEADOWS LOT #: 011 TYPE OF USE:
PROJECT NAME: ALLEY
DESCRIPTION: Retaining wall.
OWNER: ALLEY, BARRY A + DUSTINA, PHONE #:
CONTRACTOR: OWNER PHONE #: 503 - 475.3180
Inspection Request Scheduled For: Date: 9!3012005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
410 Fill 014592 -01 503- 317 -2407 N
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Vtt, (AzL___.--.
Inspector: Date: Phone #: (503) 718-
r'
CITY OF TIGARD . - " .'` -----,
BUILDING DIVISION PERMIT #: SIT2005 -00014
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/6/2005
Phone: (503) 639 -4171 4'°fiIiIlli
Inspection Requests (24 Hrs.): (503) 639 -4175 - : ! � � ..
INSPECTION WORKSHEET FOR DATE: 8/11/2005 TIME: 7:09AM PAGE: 18
SITE ADDRESS: 13788 SW WALNUT LN CLASS OF WORK:
SUBDIVISION: ROSE MEADOWS LOT #: Q11 TYPE OF USE:
PROJECT NAME: ALLEY
DESCRIPTION: Retaining wall.
OWNER: ALLEY, BARRY A + DUSTINA, PHONE #:
CONTRACTOR: OWNER PHONE #: 503- 475.3180
Inspection Request Scheduled For: Date: 8/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
215 Footing drain 013352 -01 503 - 317 -2407 N
Corrections /Comments /Instructions: .
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . Date: g—/l.---e Phone #: (503) 718-
W
I-
O
'CITY OF TI�GARD � t, �'
BUILDING DIVISION PERMIT #: SIT2005 -00014
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/6/2005
Phone: (503) 639 -4171 /1 "kl'l'�
Inspection Requests (24 Hrs.): (503) 639 -4175 - . °'I I
INSPECTION WORKSHEET FOR DATE: 7/28/2005 • TIME: 7 :08AM PAGE: 7
SITE ADDRESS: 13788 SW WALNUT LN CLASS OF WORK:
SUBDIVISION: ROSE MEADOWS LOT #: 011 TYPE OF USE:
PROJECT NAME: ALLEY
DESCRIPTION: Retaining wall.
OWNER: ALLEY, BARRY A + DUSTINA, PHONE #:
CONTRACTOR: OWNER PHONE #: 503-475-3180
Inspection Request Scheduled For: Date: 7/28/2005 Pour Time: gee
Code # Inspection Description Confirm # Contact # Message
205 Footing 012331 -01 503-317 -2407 N
Corrections/Comments/Instructions:
I o01 dcIC� Q �N
ele4SC C Q � --, a I f( r0/ 1 f P.10 -T-elS e_a d✓I
re I W To 8 a ek F; II
KPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
► /
Inspector: Date: — 0'0r Phone #: (503) 718-
,•
U
CRY PlEARD
BUILDING DIVISION PERMIT #: SIT2005.00014
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/6/2005
Phone: (503) 639 -4171 7/ :p $��l�h
Inspection Requests (24 Hrs.): (503) 639 -4175 -_
INSPECTION WORKSHEET FOR DATE: 7/18/2005 TIME: 7 :07AM PAGE: 40
SITE ADDRESS: 13788 SW WALNUT LN CLASS OF WORK:
SUBDIVISION: ROSE MEADOWS LOT #: 011 TYPE OF USE:
PROJECT NAME: ALLEY
DESCRIPTION: Retaining wall.
OWNER: ALLEY, BARRY A + DUSTINA, PHONE #:
CONTRACTOR: OWNER PHONE #: 503 - 475.3180
Inspection Request Scheduled For: Date: 7/1812005 Pour Time: 2:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 011608 -01 503-317-2407 N
Corrections /Comments /Instructions:
Atlf" --22.- 1 7/9
❑ PASS _ ' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ? / Phone #: (503) 718-