Permit Building Permit Application ,, EXPIRED /o$ -,4 . A' r,200,--o0/9 7
Residential i
r �, ECEV i FOR OFFICE USE ONLY
City of Tigard JUL 13 ZOOg DateBed jii Permit No • . 114'.— AA O • ' i
j : � ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
• C Phone 503 639 4171 Fax 503 598 1960 DateBy Other Permit
TIGARD
Inspection Line 503 639 4175 CITY O F TIGARD
w Date Ready /By Juns 0 See Page 2 for
Internet wwtigard -orgov BUILDINGDIdISIO- Notified/Method 1 `� 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.
p (- Valuation: 2- family dwelling ❑ Commercial /industrial Valuation: S / 3 000 -
❑ Accessory building ❑ Multi - family Number of bedrooms: /
❑ Master builder ❑ Other: Number of bathrooms.
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 L 3 5 vv, ( I b t1 P1, New dwelling area: 6 square feet
City /State /ZIP: T vu-- / 02 (7-7 Garage /carport area square feet
Suite/bldg. /apt. no : Project name Covered porch area: square feet
Cross street/directions to job site. ,4 GG � �^ Deck area 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.
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.
P iKotti n1 9 (e tk W 0. \ l Valuation: S
)^ ar,Vt n 5 l / v (`,� .�`�� Existing building area square feet
1/ New building area: square feet
[/ PROPERTY a OWNER ❑ TENANT Number of stories: ��
Name: -f i j . ea . 114 Type of construction.
_ Address I L 4 3 -g S W 11 la pL Occupancy groups.
City /State /ZIP ( ` Qf ^� D 2 Existing:
Phone • (503 o 'Zc 4-o7 Fax: ( ) New •
X$ APPLICANT ❑ CONTACT PERSON NOTICE
Business name i'm A_ C K 5 C y% It, All contractors and subcontractors are required to be
Contact name 2 e Cool( licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: po t3 0 x (1''l a 'r3 `7 ( -_5(-:% jurisdiction in which work is being performed. If the
City /State /ZIP: OI 0A ail, DI x'704 r applicant is exempt from licensing, the following reasons
r " J q/, apply.
Phone: ( 65.7. b Fax : (503) 6 57 .4-084 -
E -mail
CONTRACTOR
Business name: 5 a � 46 o v� BUILDING PERMIT FEES*
Address: / (Please refer to fee schedule)
City /State /ZIP: Structural plan review fee (or deposit): I (g • O
Phone: ( ) Fax:( )
FLS plan review fee (if applicable).
CCB lie • 18 , Total fees due upon application
vv �v �/� Amount received.
Authorized signature:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name b e_ Co0% Date: 7_13 — O9 * Fee methodology set by Tn- County Building Industry
Service Board
I \Building \Permits \BUP -RES PermitApp.doc 1 1/6/07 440- 4613T(I1 /02 /COM/WEB)
Building Permit Application Checklist -
One- and Two - Family Dwelling Foll oFFlcE USE ONLY
City of Tigard Received Permit No.
Associated y
q 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits
C Phone. 503 639.4171 Fax: 503.598.1960
0 Electrical 12 Plumbing 0 Mechanical
1' 1 c; 1t U 24- Hour Inspection Line 503 639 4175
Internet• www.tigard -or gov ❑ 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. ❑ ❑ ❑
''-•-___,4 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 ❑ ❑ ❑ ■ 1
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 U ❑ ❑
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 .roject under review.
JURISDICTIONAL SPECIFICS
23 Three (3) 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 trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature 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 \ Budding \Permits\BUP- RES- PermitApp doc 03/21/06 440- 4613T(1I /O2/COMM'EB)
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
1114 BUILDING DIVISION
TIGARD TRANSMITTAL LETTER
a
TO: �__ DATE RV MED
DEPT: BUILDING DIVISION
OCT 0 8 2009
FROM: _ CITY OF TIGARD
1 '� (00 rc _ BUILDING DIVISION
)OMPANY: -(��� S Co � e
PHONE: 50 3 7 $ , 5-071 By
RE: I cy 3 �W ( 1 6 1 t— tip �� � � ��� (Site A ress) rmit/ ase Number
= =tea I
a me or su. . ivision name an• of num•er
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: • . Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):
REMARKS: '5 - 1 -- e- FL" et na■ I o I ■ Ac s C haryeel
3p fs Cire-s, r. An"q a
FOR OFFICE USE ONLY
•
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I. \Building\ Forms \TransmittalLetter - Revisions doc 4/4/07
4
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
II BUILDING DIVISION
TIGARD TRANSMITTAL LETTER
a
TO: •(r) DATE RECEIVED:
DEPT: BUILDING DIVISION
RECEIVED
FROM: it be 0610 S E P 2 2 2009
COMPANY: 5'/1/k AC K 5 Cow 5� l CITY OF TIGARD
BUILDING DIVI 10N
k PHONE: 54 ? j , 7 ?5 , 5 ( B
RE: (191, 6 11 ( *h. P1. I Zo.- • c31L
tdress) ermi► ase lum.er
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: . Copies: Descriptions
Additional sets) of plans. Revisions:
Cross sections) and details. Wall bracing and/or lateral analysis.
i �/� Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain): 1
REMARKS: r/ect-■5 real i ® . /1"e.e� ��� beke fC a e\ al eat c'et0
. FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I' \Building\ Forms \TransmittalLetter - Revisions doc 4/4/07
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EXISTING PLYWOOD
•
j FLOOR SHEATHING OVER
JOISTS PER PLANS
I
PLYWOOD SHEATHING OR I
DECKING OVER JOISTS .
PER PLANS -\
I ►
i I I I
1 111 11 __
• Hill
• III tIII
JOISTS AND HANGERS
1>
PER PLANS, TYP.
I
PT. 2X LEDGER WITH
SIMPSON Y4 SDS X •=i)' I
SPACED AT 12° O.G. I .
I • 2X6 STUD BEARING WALL
NOTE: SEE ARCHITECTURAL PLANS
FOR ALL DIMENSIONS AND ALL
OTHER INFORMATION NOT SHOWN.
•
FL,FR JOIST LEDGER DETAIL
Si SCALE = I° = 1' -0°
•
•
fir
EXPIRED
•
CITI_{fF TIGARD, SITE -PPtAN REVIEW
.BUILDING PERMIT NO_: 1Y1 r it.ij
PLANNING DIVISION:
Required Setbacks: IN Approved. O . • CITY OF.TIGARD - SITE-PLAN REVIEW
Side: S Street Side
Front. BUILDING PERMIT NO: f t 2-004 ' C- )/3. k t , "'9
flat �l � r. �' /S.
Visual Clearance: (l Approved (. • • •,
Street Trees:
4pproved 0 Not Approved
Maximum Building Height — feet
Protected T A ❑- Not Approved
CWS Service Provider Letter Required: 0 e. ! /� Date: /0/y01
B Notes: •
Dat e: /a /9 �JS
ENGINEERING DEPARTMENT:
Actual Slope-2-__E% TA Approved ❑ Not Approved
Site PI n: / El Approved ❑ o pproved
BY: , (� Date; AI j o 9'
Notes:
i
o d.� -C 412- - /rr
•