Permit Support Document City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ! D
Request Permit Action 4/,z ,y ,
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
.v,
1'0: CITY OF TIGARD
REf,4.91,14,Building Division Services Supervisor
13125 SW Hall Blvd.,Tigard,OR 97223 11114 2
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov T,� 2 2014
c/
FROM: xi. Owner ❑ Applicant ❑ Contractor [i( e 4%
.sip^,
REFUND OR Name:
INVO IC E TO: (Business or Individual) 1()ViltC ) LA Y (12--
4 Mailing Address: 3 S�(�3 S C) - /s fi v e_
City/State/Zip: C Cu/ 6 4,2 97 Z i 3 c-Q
Phone No.: C S-"b — 6 0 /6 D
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
a CANCEL/VOID PERMIT APPLICATION.
n REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: H'3Tc90
Site Address or Parcel #: 135-6 et,4-fiv Cf.{)-e,
Project Name: ("16 4- v
Subdivision Name: Lot #:
EXPLANATION: 41A p ?VLA se--L s C c2 o 4- Plii-kA S•
Clf S - i )---ci` Co/Kt. %
Signature: CL c Date: S 2 Z zo(y
Print Name: (3 OA 0. s Y ?-
Refund Polio
1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 80°'o of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80•,'o of the land use application fee for issued permits.
d) not more than 80°,i,of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80%of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds.
( 1( I I -I °'\I )
Rte to Sys Admin: Date 5 , /1 Y" Rte to Bldg Admin: Date G /L /y By r
Refund Processed: Date /4-- By 'A Invoice Processed: Date By
Permit Canceled: Date /%yl/f/ By 4 _ Parcel Tag Added: Date By
Receipt# Date / Method Amount$
l:\Building\Forms\RegPesmitAction.doc Rev 05/25/2012
., .., V 0 1 D fiz/iylica
Building Permit App \N-
R e s i d e n t i a l �� I t 1 1 t ■1 1 I I t I i ',l r l\I 1
1�� 14 Received
City of Tigard p �'t0 Date B : fi fL►7 • , :
III II 13125 SW Hall Blvd.,Tigard,OR 972R.10' f� Plan Rev i
Phone: 503.715.2439 Fax: 503.59 `(� Da �J� �� Other Permit:
�,V Date Rea ]►i�� >itis: ® See Page 2 for
T 1 G A R
Inspection Line: 503.639.4175 C1 dy• �L
Internet: www.tigard-or.gov CNISI Aw,J O Notitied/Mettaat / % N� Supplemental Ldormation
t ‘SV1 ►7 1/it1 &c/r7feM4S
TYPE OF� 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.
Valuation: $ yS (� ()t7 •9-:-
..1-and 2-family dwelling ❑Commercial/industrial
/
EPAccessory building
❑Multi-family Number of bedrooms: A/�.
❑Master builder ❑Other: Number of bathrooms: /1/r4
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13 c 6 S n 5,w. 4 SIn AO New dwelling area: square feet
City/State/ZIP: T c�a.f J. 0 t2. 1n 7 z Z 3 Garage/carport area: square feet
Suite/bldg./apt.no.: �J I Project name: L f ft,A R42,4-0 c.0-e-12- Covered porch area: square feet Se c
Cross street/directions to job site: ck J 1..i Sr Deck area: square feet
Other structure area: square feet 1-,(3 Z
I �n1 ( REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: �-(C,,J;,,,�s O(GL ..Q ( R Ac is I Lot no.: ( C., 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.
�O i J P v,_n- v t,` Valuation: $
b e f-A-L e L2 a C C e y • S r r u...4-u:' Existing building area: square feet
/ New building area: square feet
la PROPERTY OWNER I ❑I TENANT Number of stories:
Name: ( 14 o vv A t P, L r(<-�l (LA ci c.-(4 L,u;µ` ?L 4-- Type of construction:
Address: 1 3 5 A S S ,Vi, A s L /1 J e �S Occupancy groups:
City/State/ZIP: T i
(��c c, l9 C)(Z-e_vt,, 9 7 Z Z3 Existing:
e7
Phone:(9)5) 6 - ' 6,0 Z 1Q'ax:( ) New:
APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES"
(Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit):
Contact namelTii O 1k a, 1 , L J}.Snnf t,,,t i FLS plan review fee(if applicable):
Address: 1.1 5 �j.i,J Fi LL A J Total fees due upon application: ( 3 - 33
City/State/ZIP:) ( 1 et ,„,Q. 0 ��4 •� cr 7113
Phone:( ) 6660 . I fvOZ I ::( )
Amount received:j tr
jr 3
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: -}14.p zt1 iz (e) Co Jn C c._st- , 14 4 Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
74,0 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
ty and administrative fees):
Phone:( ) I Fax:( ) State surcharge(12%of permit fee): $21.60-
CCB lie.: Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
Y ( 0y✓ld0 Pte- within 180 days after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry
Print name: D c S L ,�+. I Date: - _ lc/ Service Board.
I:\Building\Pemrits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
. .
Building Permit Number: /1.67--0/y.-6066k
71 Building Permit Review
Residential Projects
rIG.ARD
Site Address: 156-5 St") A s h Avt.
Verify site address is valid. ,
Project Name & Lot #: A_c, n Z
Clean Water Services—Service Provider Letter: (lot platted prior to 9/10/1995)
Required: Yes Xi No ❑ Received: Yes ❑ No ❑
Site Plan Elements:
XSite plan must be on 8-1/2"x 11"or 11"x 17"paper RThree(3)copies of site plan
[V Drawn to scale(standard architect or engineer scale) .eNorth arrow
[ 'Map and tax lot number,site address,project or subdivision ®'Footprint of new structure(including decks)with finished
name,lot number,and zoning floor elevations
®'Applicant information(name and phone number) la Lot and building setback dimensions
,,,p‘"Property corner elevations(2 foot contour lines if more than Lot area,building coverage area,percentage of coverage and
4 foot differential) impervious area.
%Utility locations Location of wells/septic systems.
'Existing structures on site "Surface drainage
,treet names ,treet tree size,type and location
Erosion control(including drainage-way protection,silt fence "Existing trees to be retained with drip line,and tree
design,location of catch basin,etc.) protection measures
Planning Review
NIPS 2T"Land Use Case Number: NO
A
ci Zoning: R - 4. 5
C I Setbacks: 0. c• s,ru.GA*re 0,117
Front — Rear 15)55- Side 5 Street Side Garage
.12' Landscape Requirement:
7 Lot Coverage Maximum:
Building Height: Maximum Height 3 0//5.S c e ca,..,a-
)2r Actual Height "-/3 //1
Visual Clearance
Easements
J2'Sensitive Lands: ❑ Yes Type t.Ji f
gUrban Forestry Plan
,1'Conditions Satisfied
Approved by: i J a. C„,4„4:,,-,,s-,./ Date: `.{J 9��/
Notes:
Revisions (after Building Submittal only) Reviewer Date
Revision 1 Approved ❑ Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
I:\Building\Forms\I3ldgPermitRvw_RES_123013.docx
t
Building Permit Submittal
Original Plan Submittal: Date: ifidOgi By: /5 7-P
Site Plans: #
Building Plans: #
Create Case Record#: IIJ�En r case#�aboovv for Building Permit Number.
Workflow Routing: [ p]a g ZEngineeringrmit Coordinator 13-13ding
Workflow Sign-off: for Planning staff,including notes from planning review(page 1)
Route Application Documents: CEngneering. (1) copy of permit application, (1) site plan, (1)building plan and
on al plan review routing form.
Ila" wilding. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Reviewed By: Date: Li .2 8, "1
Notes: �� c mss
Engineering Review—reviewed by: � [C-
Actual Slope:
❑ Conditions Satisfied
Notes: o N a l `u es nJ 6 ) S'S
Approved by: .r Date: .2 0 L t f
Revisions (after Buildi Submittal only) Reviewer Date
Revision 1 Approved Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
Notes:
Revision Notice 1: Date Sent to Applicant
Revision Notice 2: Date Sent to Applicant
Revision Notice 3: Date Sent to Applicant
Okay to Issue Permit- Date:
I:\Building\Forms\B i dgPermitRvw_RES_123013.docx
(..‘
c
PROJECT
PORCH 4 SHOP
OWNERS TOM LAFRANZ
503-680-1602
I ADDRESS 13565 SW ASH ST.
@ „• ! TICsARD,OR 91223
I , (E)HOUSE STATE ID" INIEI1BB 9200 i&I $1
I(E)GRASS ► (E)GRAN ZONE R 4.5 g
coN..RETE • -,
�� ��n ANrn _— LOT SIZE 8,615 50.FT.
caNC RAMP\ r_
,- I
CN)SHOP
''� 20' (I)CONCRETE DRIVE INDICATES PROPERTY LINE
b n)GAR�c+1 INDICATES EXIST'G. BLDG. LINE 1 1
7 1 INDICATES (N) BLDG. LINE 44 e
..C.--� CONCRETE �
" 4 0N)ASI.IPAI,T INDICATES (E) ROOF O.L.
I.POLYETHYLENE PLO-WELL — — ,� — — Cdr...WALK re16yE — — — — — — — —
7'Hlyr DY J'0. PLANTING DTRI 1/
2,GRAVEL 1 — INDICATES (N)ROOF OL.
P 11'-6' t 3@'-@' Y
LACED AROUND THE r
M.O•U ourece oP THE PROPOSED ADDITION
RECEyD
PLO-WELL,THE INSIDE i�/1 1 E �fMt OP THE PLO-WELL le lour r-r NOT FILLED WITH
GRAVEL. USE 14.21!'•RIVER Roar OR INDICATES CONTOURS
CRUSHED GRAVEL. APR 2 8 noF., D.FILTER FABRIC
A•T W"T r' CERREX 2S OR fYIwrilcs DUPONT TYPAR 180A7 t I o�1'
e a
WIL CC'tR(I'pup) 1,MUM PLOP=
°�'�"'OIL ��°� DECK COVER 586 M 1-
/ % ° ° T CITY OF TIGARD
SHOP FOOTPRINT 432 *
��%r ( NEW CONCRETE 1238 5 \
��
0 Q \ (E)FOOTPRINT 2251 * \ Approved by Planning i,i
- Date: 4 azs -
pitiaIs:
TOP VIEW "�� I / 1
W \
� �— CO. I z / I
Gua'Ren- RUN DRAINS TO D ‘If '
L n.o4aL OW (E)D! TWELL OF IF REG O. 'D_ '','1111 a1 (E)HOU6E V.
F'ROVIbE(N)FLO-WELL 4 I �. \
FOR ROOF AREAS LESS THAN 1,@00 t I 24'-0' I \ TA u
DRY WELL (FLO-WELL) I 1
Mr I
9 ,
NOT TO SCALE o/ r 7 r— '.,T——A \
I \ W
I a I — _ �_. �.' I I (E)aARAa�E
I i I r "_ I I I \
I I I I L- ■ hi�
I I
, I0,_0. I ————, 1 L-0——-�-———�1 plan
,q 1
• — — Ty — — — — — — — — — — — — — •SITE"LAN
MA'
SITE FLAN
la
SCALE I' • 20'
(3S(D5 S Pt In Pmt . J
PP-
. \‘‘ it, ,.. ..
T
13'1 ,I ,, �.
r i ivy r • le �\
1, 0 p 1 3- a� �. . 4 f � .�•' �•=n 5(1
. , R 2 ` 962,
Tv-
se
•
..e. ---' r'.... . .. - , _), "41Xiliiik. .- , \ ...- ,A
•,895r.k ; ' `.r j f 13.170 ;J �'� 1
_ .. ' 9610
4 .._ .- �• � r• y �„. � 1, f.1 \ .. r .'"irir"...
9885 _ IAA f . l!k. t J.,\ iiikr ..
`-� I~! ./ � . / - 9620
. r it - •� ► _ /Os F r ,, ( $.
Si.. - el r v ,I I •^. . i. x•
•. ,../...- .. •.,I,',,mi.......: ,4. . 4,..... i v.,. .. ,... , 1 Oki**, '
4/44 $ qf.
• • -n` ri 96 00, . . ,.,,. e4,44,--, rt.!"..4,_..,,,,,,,...:-4, .,
riit
I , :` 13605 �+ fi x' - !:,. I ; 35;•." .c--,0,7--'7 i i. :0 ,•�:•
.. -<,4.... c_.:1'' / -:- A
# r :, 4t4,,,,„ , • I.#
. .,- 41);(4t• 4••••••11(inti . ./ , - - . - , 3. ••
1 iffhlre`'‘. /.... .
\a•ks 111
•• . •-,- • ''„ 24.,:r\' X .... efl.i1:7•!Pir '
P.' '- t 10*, 4 foil- - *&••••" -.. ,s!:e'
Feet 1363 ' 4 ••••41:14"'n. ...r, . . r *.r. ..1's.'''*) • '•or'
4:17:.'. ,•,:ll..1'fi 4111° 1,-- N • 1.-- 4.10.