Permit CITY OF TIGARD 1 MASTER PERMIT
''- a - COMMUNITY DEVELOPMENT / Permit#: MST2013-00210
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2013
Parcel: 2S 103C 805700
Jurisdiction: Tigard
Site address: 12213 SW HOLLOW LN
Subdivision: QUAIL HOLLOW-EAST Lot: 6
Project: SCHAEFER
Project Description: Repairing existing 6 ft retaining wall 10/22/13, reprinted to add contractor to permit.
BUILDING
Floor Areas Required Setbacks Required
Stories 0 Bedrooms: 0 First 0 sf Basement 0 sf Left 0 Parking Spaces: 0
Height 0 Bathrooms 0 Second 0 sf Garage 0 sf Front 0 Smoke
Dwelling Units 0 Third' 0 sf Right 0 Detectors'
Total. 0 sf Value $10,000 00 Rear 0
PLUMBING
Sinks 0 Water Closets 0 Washing Mach 0 Laundry Trays 0 Rain Drain 0 Urinals 0
Lavatories 0 Dishwashers 0 Floor Drains 0 Sewer Lines' 0 SF Rain Storm Sewer. 0
Tubs/Showers 0 Garbage Disp 0 Water Heaters. 0 Water Lines 0 Drains 0 Catch Basins 0
Bckflw Prevntr 0
Footing Drain 0 Ice Maker 0 Hose Bib' 0 Backwater Value 0
Drywell-Trench Drain' 0 Other Fixtures: 0
Other Fixture Units.
MECHANICAL
Fuel Types _ Air Conditioning. N Vent Fans 0 Clothes Dryers 0
Heat Pump N Hoods 0 Other Units, 0
Furn<100K 0 Vents: 0 Woodstoves 0 Gas Outlets 0
Furn>=100K 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less. 0 0-200 amp 0 0-200 amp 0 W/Svc or Fdr 0
Ea add'I 500 sf 0 201-400 amp 0 201-400 amp 0 W/O Svc/Fdr 0
Mfd Home/Feeder/Svc 0 401-600 amp 0 401-600 amp 0
601-1000 amp 0 601+amp-1000v: 0
1000+amp/volt 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio 8 Stereo' N HVAC: N Security Alarm' N Vaccuum System. N Garage Opener. N All
Other N Other Descnption Ecompasing N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
SCHAEFER,CHRISTOPHER J 8 TRIPLET PRODUCTIONS INC/TRIPLE T INC Required Items and Reports(Conditions)
KATHLEEN M 15233 OTTOWAY RD NE
12213 SW HOLLOW LN AURORA,OR 97002
TIGARD,OR 97223
PHONE. PHONE: 503-678-5474
FAX
Total Fees: $482.67
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 the 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 throe -OAR 952-001-0090,You may obtain a copy of the rules or direct questions to OUNC by callin '17.1987 or 1 800 332 2344
Issued y: d-1( Permittee Signature: ' r - ,
Call 503.639.4175 by 7:00 a.m.for the next available Inspection da
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.
v CITY OF TIGARD MASTER PERMIT
II a .,`.. COMMUNITY DEVELOPMENT Permit#: MST2013-00210
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2013
Parcel: 2S103CB05700
Jurisdiction: Tigard
Site address: 12213 SW HOLLOW LN
Subdivision: QUAIL HOLLOW-EAST Lot: 6
Project: SCHAEFER
Project Description: Repairing existing 6 ft. retaining wall.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $10,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add"500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: ' 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
SCHAEFER,CHRISTOPHER J& Required Items and Reports(Conditions)
KATHLEEN M
12213 SW HOLLOW LN
TIGARD,OR 97223
PHONE: PHONE:
FAX:
Total Fees: $482.67
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 d in acco•a with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
d s. ATTENTION: Oreg... law := ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52-001-0010 rough OAR 95 111-0090. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 :00.332.2 •4.
Issued By: L Permittee Signature: / 4/`�%' aOr
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
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
Residential ck\i►) FOIi oFFICI: usl�:(.)NI.\
�`�� '"' Received
City of Tigard • ty Date/13 : _ I ill Permit No.: 5, 0 / .►UVa V
13125 SW Hall Blvd.,Tigard,OR `}y". \r5 Plan Review i�
Phone: 503.718.2439 Fax: 503.598.1960 �3 �' .�u� 10 I (3 Other Permit:
Date/B
Inspection Line: 503.639.4175 �j�Q Date Ready:y: Q� Loris: ® See Page 2 for
I'I C.i1 It D OG�r 1J�o Notified/Method:/o% / ', Supplemental Information
Internet: www.tigard-or.gov T_ v 1 1` (( PP
TYPE OF •..ty; 1 RI fQ RED 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
•DAddition/alteration/replacement ❑Other: _ equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
,❑ I-and 2-family dwelling ❑Cornmercial/industrial Valuation: $
❑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: /gal 3 s k, cr//ot✓ i.r New dwelling area: square feet
City/State/ZIP: T 4ar,a OljCr,,, q'1 79 at/ Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: C GGuF,Tz,— Covered porch area square feet
Cross street/directions to job site: /01!sot Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.D {. Valuation: $ /0 (/Oc)
rY C.Ayrrk tw)O(' : PO{�a;r.vt `0 -ft rAawy 1.4).4
J �J Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: C t-ri 5 C ,�,�. t— / Type of construction:
Address: l�I a 41 3 n 5(, Pc,110, Lc Occupancy groups:
City/State/ZIP: bE,/Gfry /1l 7 7,3.1V Existing:
Phone:(S-6 3) �a L{ _ 3I S 2 Fax:( ) New:
-9-APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
p (Please refer to fee schedule)
Business name: Tr t ptc T f vO 1 li (
/� Structural plan review fee(or deposit):
Contact name: 36-e F t GCc '6 FLS plan review fee(if applicable):
Address: 1 n j7, /LI s( gd At e
Total fees due upon application: /ii (o,7
City/State/ZIP: tnrr/J� q)002_ 1((111
/ Amount received:
Phone:(5 7)) ) (�90)-- sll 2y Fax: :( )
A PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
WTI,Ix 7 f 2 401. U Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: two(2)sets of roof plan with connection details
��h 1 6 5 �a and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
SOB Inc.. 40) Total fee due upon application: • $201.60
Authorized signature: P —........------------- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
`U �- Date: *Fee methodology set by Tri-County Building Industry
Print name:
c 4 h'�C. q^ ,23"l? Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling roll Orrlcl.: Usl.: ()NIA
City of Tigard Received
Permit No.:
II a 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
C Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 903.639.4175 ❑ Electrical ❑ Numbing ❑ Mechanical
I.l A li D Internet: www.tigard-or.gov ❑ Other:
.1-IE FOLLOWING ITEs'IS ARE REQUIRED FOR PLAN REVIEW is 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 ❑ El
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- El ❑ ❑
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 iro'ect under review.
URISDICTION'AL 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. _
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
Building Division
Development Code Provision Review
T G'\ri° Residential Projects
Building Permit No.: f)), Tho 13—ovd.1 v
Project/Subdivision Name: ScL c *c,_ , Lot #:
Site Address: LW 3 SW As//A,.i [,A1
CWS Service Provider Letter:
Required:Yes ❑ No ❑
Received:Yes ❑ No ❑
Plans Routed:
Original Plan Submittal Date: 4413//3 Routed By: 87---
1St Revision Submittal Date: ❑ Site Plan Only Routed By:
2nd Revision Submittal Date: ❑ Site Plan Only Routed By:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (1) items are approved. Items not approved and those listed in the notes must be
revised prior to re-submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review(contact G-le.ri I CQ.i At/ at(503) 718- Lei/ or di Ic- @tigard-
or.gov)
Land Use Case No.
Zoning
59 Setbacks: 14/F1
Front Rear Side Street Side Garage _
Lia Maximum Building Height: N JA Actual Building Height
al Visual Clearance N/A
I2i Easements
a Sensitive Lands Type: N 0 ^e-
. Street Trees wit\
0 Protected Trees ►•fiA
Notes:
Original Plan: Approved Ig Not Approved ❑ Date: 9'.13 -13
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13
Engineering Review(contact Mike White at 503-718-2464 or MikeW @tigard-or.gov)
Actual Slope: VA/14t6 %
Notes:
Original Plan: Approved 0/ Not Approved ❑ Date: / /24/i 3
Revision 1: Approved ❑ Not Approved ❑ Date:
■
PP PP
Revision 2: Approved ❑ Not Approved ❑ Date:
•
Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albert@tigard-or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
•
Revision 1: Date Sent to Applicant •
Revision 2: Date Sent to Appli t
Okay to Issue Permit: Yes. No ❑
Date Routed to Building:
47avotter
•
•
•
. •
Page 2 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13
•
v CITY OF TIGARD MASTER PERMIT
II a .,`.. COMMUNITY DEVELOPMENT Permit#: MST2013-00210
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2013
Parcel: 2S103CB05700
Jurisdiction: Tigard
Site address: 12213 SW HOLLOW LN
Subdivision: QUAIL HOLLOW-EAST Lot: 6
Project: SCHAEFER
Project Description: Repairing existing 6 ft. retaining wall.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $10,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add"500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: ' 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
SCHAEFER,CHRISTOPHER J& Required Items and Reports(Conditions)
KATHLEEN M
12213 SW HOLLOW LN
TIGARD,OR 97223
PHONE: PHONE:
FAX:
Total Fees: $482.67
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 d in acco•a with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
d s. ATTENTION: Oreg... law := ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52-001-0010 rough OAR 95 111-0090. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 :00.332.2 •4.
Issued By: L Permittee Signature: / 4/`�%' aOr
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
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
Residential ck\i►) FOIi oFFICI: usl�:(.)NI.\
�`�� '"' Received
City of Tigard • ty Date/13 : _ I ill Permit No.: 5, 0 / .►UVa V
13125 SW Hall Blvd.,Tigard,OR `}y". \r5 Plan Review i�
Phone: 503.718.2439 Fax: 503.598.1960 �3 �' .�u� 10 I (3 Other Permit:
Date/B
Inspection Line: 503.639.4175 �j�Q Date Ready:y: Q� Loris: ® See Page 2 for
I'I C.i1 It D OG�r 1J�o Notified/Method:/o% / ', Supplemental Information
Internet: www.tigard-or.gov T_ v 1 1` (( PP
TYPE OF •..ty; 1 RI fQ RED 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
•DAddition/alteration/replacement ❑Other: _ equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
,❑ I-and 2-family dwelling ❑Cornmercial/industrial Valuation: $
❑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: /gal 3 s k, cr//ot✓ i.r New dwelling area: square feet
City/State/ZIP: T 4ar,a OljCr,,, q'1 79 at/ Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: C GGuF,Tz,— Covered porch area square feet
Cross street/directions to job site: /01!sot Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.D {. Valuation: $ /0 (/Oc)
rY C.Ayrrk tw)O(' : PO{�a;r.vt `0 -ft rAawy 1.4).4
J �J Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: C t-ri 5 C ,�,�. t— / Type of construction:
Address: l�I a 41 3 n 5(, Pc,110, Lc Occupancy groups:
City/State/ZIP: bE,/Gfry /1l 7 7,3.1V Existing:
Phone:(S-6 3) �a L{ _ 3I S 2 Fax:( ) New:
-9-APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
p (Please refer to fee schedule)
Business name: Tr t ptc T f vO 1 li (
/� Structural plan review fee(or deposit):
Contact name: 36-e F t GCc '6 FLS plan review fee(if applicable):
Address: 1 n j7, /LI s( gd At e
Total fees due upon application: /ii (o,7
City/State/ZIP: tnrr/J� q)002_ 1((111
/ Amount received:
Phone:(5 7)) ) (�90)-- sll 2y Fax: :( )
A PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
WTI,Ix 7 f 2 401. U Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: two(2)sets of roof plan with connection details
��h 1 6 5 �a and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
SOB Inc.. 40) Total fee due upon application: • $201.60
Authorized signature: P —........------------- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
`U �- Date: *Fee methodology set by Tri-County Building Industry
Print name:
c 4 h'�C. q^ ,23"l? Service Board
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling roll Orrlcl.: Usl.: ()NIA
City of Tigard Received
Permit No.:
II a 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
C Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 903.639.4175 ❑ Electrical ❑ Numbing ❑ Mechanical
I.l A li D Internet: www.tigard-or.gov ❑ Other:
.1-IE FOLLOWING ITEs'IS ARE REQUIRED FOR PLAN REVIEW is 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 ❑ El
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- El ❑ ❑
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 iro'ect under review.
URISDICTION'AL 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. _
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
Building Division
Development Code Provision Review
T G'\ri° Residential Projects
Building Permit No.: f)), Tho 13—ovd.1 v
Project/Subdivision Name: ScL c *c,_ , Lot #:
Site Address: LW 3 SW As//A,.i [,A1
CWS Service Provider Letter:
Required:Yes ❑ No ❑
Received:Yes ❑ No ❑
Plans Routed:
Original Plan Submittal Date: 4413//3 Routed By: 87---
1St Revision Submittal Date: ❑ Site Plan Only Routed By:
2nd Revision Submittal Date: ❑ Site Plan Only Routed By:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (1) items are approved. Items not approved and those listed in the notes must be
revised prior to re-submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review(contact G-le.ri I CQ.i At/ at(503) 718- Lei/ or di Ic- @tigard-
or.gov)
Land Use Case No.
Zoning
59 Setbacks: 14/F1
Front Rear Side Street Side Garage _
Lia Maximum Building Height: N JA Actual Building Height
al Visual Clearance N/A
I2i Easements
a Sensitive Lands Type: N 0 ^e-
. Street Trees wit\
0 Protected Trees ►•fiA
Notes:
Original Plan: Approved Ig Not Approved ❑ Date: 9'.13 -13
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13
Engineering Review(contact Mike White at 503-718-2464 or MikeW @tigard-or.gov)
Actual Slope: VA/14t6 %
Notes:
Original Plan: Approved 0/ Not Approved ❑ Date: / /24/i 3
Revision 1: Approved ❑ Not Approved ❑ Date:
■
PP PP
Revision 2: Approved ❑ Not Approved ❑ Date:
•
Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albert@tigard-or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
•
Revision 1: Date Sent to Applicant •
Revision 2: Date Sent to Appli t
Okay to Issue Permit: Yes. No ❑
Date Routed to Building:
47avotter
•
•
•
. •
Page 2 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13
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