Permit CITY OF TIGARD MASTER PERMIT
III
s.. COMMUNITY DEVELOPMENT Permit#: MST2013 00222
T E GARO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2013
Parcel: 2S104DA03700
Jurisdiction: Tigard
Site address: 12959 SW GALLIN CT
Subdivision: QUAIL HOLLOW-WEST Lot: 23
Project: Lau
Project Description: Add 316 sq ft deck.
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: $6,400.00 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
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 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
Fum>=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&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:
LAU,JOHN CHUN YU OWNER Required Items and Reports(Conditions)
MA,YILAM GINN JOHN LAU
15549 SW STONERIDGE CIR 12959 SW GALLIN CT
BEAVERTON,OR 97007 TIGARD,OR 97224
PHONE: 503-476-4616 PHONE: 503-476-4616
FAX:
Total Fees: $415.90 /
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and a 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 ru s are set forth in OAR
952-001-0010 through OAR 952-001-0090. Yau may obtain a copy of the rules or�direct• estions to OUNC by calling 503.232,1987 •r 1.800.332,2 44.
Issued By: `�—r c ���AA—,�-o- •- i ittee Signature: _ -
7:00 a.m.for the next available Ins�ecyery d1att'r
This permit card shall •. :p in a conspicuous place on the Job site until cofh—pleti• • .•:project.
Approved plans are required on the job site at the time of-'. spectlon.
Building Permit Application .
Residential FOR,
OFFICE USE ONLY ,,
RECEVED Rece ived City of Tigard Date/I3 : l0 3 �. Permit No.: „sr-a24,7...651:33..„9,_Z
114 q
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1 "!jl � 1
11 ' Phone: 503.718.2439 Fax: 503.598.0)�IJ 2 3 2013 DateB : new, l D ar Other Permit:
Inspection Line: 503.639.4175 Date ReadyBy:
El See Page 2 for lI L1 R D Notifi et : /a/ �3�� u
Internet: www.tigard-or.gov CITY OF 'S ?iRD Supplemental Information
rmation
131 111 '1 I 3CA' //if r-
TYPE OF WO K
t 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 l
/ ��
Valuation: $work indicated on this application.
t.Y 6/00,° -
❑ 1-and 2-family dwelling ❑Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
El Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: i z4-R Su.) 6- i-01 ,-1 T(lit l> OR New dwelling area: square feet
City/State/ZIP: C 1,2.' Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: ' t,,k/mike k Covered porch area - square feet
Cross street/directions to job site: Deck area: -/4 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: $
�.
„1 teir, , 0, opt k ;r -Kt_ ria,0- L .
I X 2_Z {� Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: -Z Drl, L 6,,v Type of construction:
Address: bA c Gia1 1",-/., C i 1-7,10,1,k OK Occupancy groups:
City/State/ZIP: 17.22 c.1 Existing:
Phone:(73 ) 4-76 46 1 6 Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)Business name: c_5-• r1,2_ a S (cr./ye— Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received: /7/ !/
Phone:( ) Fes: :( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR- roof-to.mounted Photo Voltaic Solar Panel System.
Business name: 010/kJ-GC Submit t . sets of roof plan with connection.- s
and fire dep., • access,along wi 1 I 0 Oregon
Address: Solar Installation Spe .•• c ecklist.
City/State/ZIP: Permit Fee •• •es . • review $180.00
and administrative =-s :
Phonc: Fax:(• )
fate surcharge(12%of permit fee): $21.60
CCB lic.: /
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Ba1iriaJ�•d Y *Fee methodology set by Tri-County Building Industry name: 3 •‘ h I il Z Z Z°
t 3 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 -'\ 440-4613T(l 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling holz ti)FFIC1 USE''ONLY
City of Tigard Received Permit No.:
Ili q 13125 SW Hall Blvd,Tigard,OR 97223 Date/By:
C Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
I'I G A`R'D
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ,'es 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 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. . 0 ❑ ❑
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..Iicable to the .ro'ect 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"buildingplans 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:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
Building Division
Development Code Provision Review
r i c n R Residential Projects
Building Permit No.: H /T02,0 "moo 9-
Project/Subdivision Name: L_A- Lot #:
Site Address: 12,`l5 a c o G ui ,J
CWS Service Provider Letter:
Required:Yes ❑ No ig et —
Received:Yes ❑ No IE
Plans Routed:
Original Plan Submittal Date: /o/a 3/i 3 Routed B .
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 (✓) 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 W�( at(503) 71802-7 or 1/f 10-k @tigard-
or.gov) �J
Land Use Case No.
Zoning R,�-S (f)
El Setbacks: I 7)\-"7)\-rFront IJ I Pr Rear I Side S Street Side .�O Garage N/Pr
L" Maximum Building Height: ;l7 Actual Building Height 'Pc
Er-Visual Clearance N /1k
❑ /Easements �1,,,_
CM/„Sensitive Lands Type: S P S)DAPS
IJ Street Trees It) (A
❑ Protected Trees IIn�,. ''ww
Notes: I(SS Thal L��C uk c, tvc1 I Sien9 SiDfLZ
Original Plan: Approved ( Not Approved ❑ Date: /0/25 2
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
l:\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)
,V'Actual Slope: SID
Notes: N
LaP6. . Z-1L2 7z II.7)(1JC D l a m( }
1��7_. goe- Y, S LoP� G 7Th)a. 12 er7g go."4- ?E 7t -t_ DerxJ
W.Y .
Original Plan: Approved .E( Not Approved ❑ Date: /6/2-i/t
3
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: . Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review(contact Albert Shields at(503) 718-2426 or albeit @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 Applicant
Okay to Issue Permit: Yes No ❑
Date Routed to Building:
70 Z 7-5
•
Page 2 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_RES.doc Rev.01/16/13
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325 (2))
This statement is required for residential building, electrical,mechanical,and plumbing per mits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not
submit this statement.This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that a II subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
I will be performing work on property I own, a residence that I reside in, or a residence that I w ill
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
1_0.0
Print Name of P it Applicant
)O- -28 —zo/3
Signa - of Permit Applicant Date
Permit#: �-lx0T01•0(3-Z.)0 o`La 2-
Address: la-9S9
Issued by: eV; Date: 16/1-9/ !�1
This Copy for Permit Offices