Permit '.11p
,
IVII! CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00550
COMMUNITY DEVELOPMENT DATE ISSUED: 10/12/2005
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 104AC -00200
SITE ADDRESS: 13280 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: 12/18/06: REINSTATED FOR PURPOSE OF FINAL INSPECTION FOR A PERIOD OF 30 DAYS.
Demo 1,743 sq. ft. residential dwelling on septic. DEMO CREDITS APPLY FOR SDC FEES. Septic
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:
PACIFIC N.W. LAND DEV. LLC. SITE TECH
2800 NE WAGNER 15875 SE 114 AVE. STE C
MCMINVILLE, OR 97128 CLACKAMAS, OR 97015
Phone: 503 - 307 - 0235 Contact #: PRI 503 887 - 1549
FAX 503 - 650 -7378
FEES Reg #: LIC 102415
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/12/200E. $62.50
[TAX] 8% State Surcha 10/12/200: $5.00
[ERPRMT] Erosion Con 10/12/200E $26.00
[ERPLN] Erosn Pln Rv ( 10/12/200E. $8.45
(additional fees not listed here) t .� L S pC f
-- ..:�.4.
Total $172.90
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: .✓, . i Permittee Signature: A:d Ili. (
,/
Call 503.639.4175 by 7:00 a.m. for an inspection th. t 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.
'w
CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00550
4 = DEVELOPMENT SERVICES DATE ISSUED: 10/12/2005
I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 104AC -00200
SITE ADDRESS: 13280 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Demo 1,743 sq. ft. residential dwelling on septic. DEMO CREDITS APPLY FOR SDC FEES.
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:
PACIFIC N.W. LAND DEV. LLC. SITE TECH
2800 NE WAGNER 15875 SE 114 AVE. STE C
MCMINVILLE, OR 97128 CLACKAMAS, OR 97015
Phone: 503 - 307 -0235 Phone: 503 - 887 -1549
Reg #: LIC 102415
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/12/200E $62.50
[TAX] 8% State Surcha 10/12/200E $5.00
[ERPRMT] Erosion Con 10/12/200E $26.00
[ERPLN] Erosn Pln Rv C 10/12/200E $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: ) Permittee Signature: 5 ) / 71---2 ' -`-
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.
' a odO07
Building Permit OFFICE USE ONLY Applicatio D holi
City of Tigard i EC hl�� Receid '
t + D ate/B ve . D I _ vi Pemut No iF�Q 3 5 ()
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1 p.^ 1 4 ',' 2005 � � r�li'� • DateB . Other Pernut.
Inspection Line' 503.639.4175 ��e _s 4.. __ Date Ready/By: ® See Attached Checldist for
Internet: www.ci.tigard.or.us Nohfied/Method NIEI Supplemental Information
CITY OF TIGARD ON
B 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.
g 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ID Multi-family Number of bedrooms:
El Master builder ❑ Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address /32gO 5" to !Na 1 n f S-F . New dwelling area: square feet
City /State /ZIP: - 7 - 1� 04 ,.d D � £7 22 i Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name' Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: /'f/'',y' 1 ft s Lot no.: Permit fees* are based on the value of the work performed
Tax map /parcel no.: �` Zoc) 7- 2S R l So 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.
•
Di ? .Art J x,`, S'7'1 h om..'t. / 793 1 _ , Valuation: $
- n R�� c_, Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER . ❑ TENANT Number of stories:
Name J'f / aC t` , c No r-4tt t S-F Lahot Deg L L C Type of construction:
Address: TgeO NF �G 9il0 r Occupancy groups:
City /State /ZIP: fe n hh Vr le of 97/ 2'g Existing'
Phone: (.Thr) S39 'GIs Fax: (SD3) S,r'g - / yG 0 New:
APPLICANT i3I CONTACT PERSON • NOTICE '
Business name: a C it /14/ L _ a r ' d . AQ i f. L L C All contractors and subcontractors are required to be
r r On !� •� licensed with the Oregon Construction Contractors Board
Contact name: �Q
p � 7 under ORS 701 and may be required to be licensed in the
Address: "Opp() II/ E W i t f nF r- jurisdiction m which work is being performed. If the
/,J p .� / Z p applicant is exempt from licensing, the following reasons
City /State /ZIP: �if� /14,-„,„ y ,, ( U apply:
P h o n e : ( ) 30) -0 2 ?S Fax:: (fD.') SS' 39 -/ c/l' 0
E -mail:
CONTRACTOR •
Business name. S %fe ,'-e c /-t ' kick go Ns- f e 1r
BUILDING PERMIT FEES*
Address: /J-R 7J' f E // y /1fre ,TU; f e C Please refer to fee schedule.
City /State/ZIP: [/4 l e K 9 ?Di r
? Fees due upon application i �a y 0
Phone: (,rd3) 617- /3' Cf pp Fax: ( � -7 7 6'
CCB tic.: /0Z / -e ,r y Amount received
k 11 / Q - ii G 6 Date received'
Authorized signature: S,f.,r/ p/, J This permit application expires if a permit is not obtained
%% �� //''�� within 180 days after it has been accepted as complete.
Print name: SfC J/e h le Koski Date: /p -r.os- * Fee methodology set by Tri- County Building Industry
Service Board.
1 \Bwiding\Permits\BUP- PermiApp doc 17/03 44046I3T(I1 /07/COM/WEB)
One- and Two - Family Dwelling
Building Permit Application Checklist FOR OFFICE USE ONLY
•
City of Tigard Received Permit No.
13125 SW Hall Blvd., Tigard, OR 97223
Date/By
Associated permits:
Phone: 503.63 Fax 503.598.1960 ❑ Electrical ❑ Plumbing ❑ Mechanical
24- Hour Inspection ction Line: 503.639.4175
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 . r r licable to the r o'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. ❑ El ❑
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.
1:\Bui Iding\ Perm its \BUP -RES- PermitApp.doc 2
'''', ik7FT
\fli., r,1
P.O.BOX 1130 1/ �L - T
0
L OR 97ti7_
- (503) 5624323 FAX ( E tit) 01
. -- — , -�� -
CUSTOMERS ORDER NO. I PHONE V AT T
�� F 'ski <� ,.--, -7, � .....1 ,...,..7 .�-
NAME (-5"
ADDRESS
SOLD R1f CASH C.O.D. CHARGE ON ACCT. MDSE. REVD. I PAID OUT
=P E-‘'‘ii )
QTY. DESCRIPTION PRICE AMOUNT • FIC
f- 4 __.a^ 6 f --7,-- / 4- 2 1- 2001
t Q - - - e , - �.• . jl �� �
OeCO iii A_+, 5 / 04 - �` 5�' -�''
...„-9, i ) i ,-.,, ---------cf: .....,djj ,
TAX
RECEIVED BV Gd 6j -,-
i TOTAL
- All claims and returned goods MUST be accompanied by this bill. •
i ( 'C ° Pi - i7.'.�r. V . THANK YOU- ,
. - SS ¢T r'.'.k7.t - '
i - 3
Bra '' )ji/)14 `
5aa - ao
60 39tid
:ads
506LEb9ERq
7R:7T GRR7/7T /RT
CITY OF TIGARD z oo‘_00
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ''IL
INSPECTION WORKSHEET FOR DATE: V' 5/0 6 TIME: PAGE:
SITE ADDRESS: k 7 �£ 1 Tl * �� + CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: -
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description., Confirm # Contact # Message
G I 1e.1/14
Corrections/Comments/Inst uctions: Q Q
(A c (24,1exAvev J
c( cr2-(r ‘2
fi e x - rz - 5-'!,S 1 -e _ •1 -Q
EXPIRED.
`nom 5 ✓�5 c— - --�,�� �S
vl "(---
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
j FAIL ❑ CALL FOR INSPECTION ' ❑ ADDITIONAL FEES ASSESSED
Inspector: " `� ' Date:
W �/� Phone #: (503) 718- �Y�