Permit CITY OF TIGARD MASTER PERMIT
11111 COMMUNITY DEVELOPMENT Permit#: MST2015 00042
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/24/2015
Parcel: 1 S134CB03100
Jurisdiction: Tigard
Site address: 12330 SW SUMMER CREST DR
Subdivision: SUMMER HILLS PARK Lot: 30
Project: SAMSON CONSULTING
Project Description: Deck replacement and bathroom addition.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: Yes
Total: 0 sf Value: $8,000.00 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
Fum<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!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:
SAMSON CONSULTING LLC SCHLOEDER CONSTRUCTION Required Items and Reports(Conditions)
ATTN:JENNIFER ORNELAS 7878 MOSIER ST SE
12705 SW KATHERINE ST SALEM,OR 97317
TIGARD,OR 97223
PHONE: PHONE: 503-949-4466
FAX:
Total Fees: $438.83
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes a •all oth- -,pli•=ble 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 w• i s spe ded for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. ose r =s :re set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 800.33.23�.
Issued By: Lam° — Per Signature:
C..41.1 9.4175 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 ` 109 I ()It OI I It 1 I tile 0NI.1
City of Tigard Ge\\I Received
DateB „l Permit No.:V ' I.i
II • 13125 SW Hall Blvd.,Tigard,O^IF• 9 +� Plan Revie��.
■ ^�` Aftiki Other Permit:
Phone: 503.718.2439 Fax: 503. 9:.1960 O L Date/B
t 1 ti 1� Inspection Line: 503.639.4175 `►PR AAQ Date ReadyB n ��� See Page 2 for
Internet: www.tigard-or.gov lr\ ‘G N ified/Meth�•:d o�y ���b� rl� Supplemental Information
TYPE OF Sim' 011 REQUIRED DATA:1-AND 2-FAMILY DWELLING
CI
construction ■ Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
At Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
K1-and 2-family dwelling CI Commercial/industrial Valuation: $ b'ldo n
ID Accessory building 11 Multi-family Number of bedrooms:
❑Master builder CI Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: `Z'3-"S(] S(j s O,-h 1'ne1 Lrz 5- -D New dwelling area: square feet
City/State/ZIP: I-19G ^A Z 972 2 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area square feet
Cross street/directions to job site: \Z\ 5 4 /S ti*ti7,,,.,t~ LJ 5.4 p r Deck area:
,&ein square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Ljt..,�, Nr/6 a( b 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.
t �i c`-` / Valuation: $
R Existing building area square feet
New building area: square feet
1 MI PROPERTY OWNER ❑ TENANT Number of stories:
Name: L-`t/N„SUrl Cu r,-,S u b IN/I ,,,, Type of construction:
Address: 11.4 q_`y 5 c) A(,? rrc\ <(r!►U L/S Dr— 4 . 1/a p,4036cpei Occupancy groups:
t. City/State/ZIP:' .< i'cr i.ct, 1 0 . 7O('7 Existing:
Phone:(5;3)C�L/( ^ Fax:( )
� v 7v�� New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to feeschedale)
1 Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Fax: :( ) Amount received: 7,hone:( )
E-mail:
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
IP
Commercial and residential prescriptive installation of
CONTRACTIOR rr roof-top mounted PhotoVoltaic Solar Panel System.
Business name: � 'd map f �In S} fv C t e u v1 Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 7171 MQ�/{-J- Sr" SE Solar Installation Specialty Code checklist.
3� Permit Fee(includes plan review $180.00
�1 City/State/ZIP: gf'J , e� and administrative fees):
1 Phoneiltg ) 41 99-/-11-1(0(c Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 1 t CJ� ����717s Total fee due upon appication: $201.60
Authorized signature` This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri County Building Industry
Print name: ��{ Oro P 1 S Date: '3/�, ��' Service Boazd
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLI
Received
IN City of Tigard Date/By: Permit No
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
I Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 50)3.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I G A R D
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es 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 licable to the ro'ect under review.
23 Three(3)site plans arc 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 440-4613T(11/02/COM/WEB)
•
City of Tigard
74 COMMUNITY DEVELOPMENT DEPARTMENT
•
T l c n li Building Permit Review — Residential
Building Permit #: i115 J i s_ yJ
Site Address: 12330 SW Summer Cre sir 'Dr.
Project Name: Or n e\ Lot t #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: rebuI1d cl on eaeIs+lnr - o�•jrl-.s , c BIZ hc+h wI+h1 +n
�f/ ex i s-Vk nn low t y,c - oo-1-Ir el-j- �J
L/ Verify site address/suite #exists and active in permit system.
Si Plan Elements:
rA'r ree(3) copies of site plan sting structures on site
et.ite plan must bg on 8-1/2"x 11"or 11 x 17"paper otprint of new structure(including decks)with finished
v awn to scale(standard architect or engineer scale) floor elevations
• 6.76 • th arrow - +Jtility locations(required for new,may apply for additions)
• CP, e address,project or subdivision name and lot number $tocation of wells/septic systems
9, f rf� .plicant information(name and phone number) -$1?rosion control(including drainage-way protectiov,silt fence
OPI:1.t dimensions and building setback dimensions • sign,location of catch basin,etc.) nO (3fovlv0 ci isiurio.r eo
DLot area,building coverage area,percentage of coverage and 4.treet names
,pervious area(applicable if R-7,R-12,R-25&R-40) $street tree size,type and location
0[JProperty corner elevations(2 foot contouslines if more than -$Existing trees to be retained with drip line,and tree
4 foot differential) protection measures
12/Clean Water Services—Service Provider Lytter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified g No ece ved: ❑ Yes ❑ No
no 3roUn, i rba►nce
ti Public Facilities Improvement(PFI) Pe t:
Required: El Yes,applicant was notified M'No Applied For: ❑ Yes ❑ No,stop intake
$Land Use Case#:
giZoning: R-1-1.5
[ Setbacks: Front 20 Rear 1 B Side 5 Street Side -- Garage 20
$Landscape Requirement:
$Lot Coverage Maximum:
-g--Building Height: no cAe, Maximum Height Actual Height
-$Visual Clearance
'•1=1,- Easements
❑ Sensitive Lands: n,,.��° 3ro ❑ Yes ❑ No Type
$ Urban Forestry PlansYttr
$Conditions Met
Notes:
p 1
Approved By Planning: 1 IA A_1 .a_ A _ Date: 3 10 15
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1 1:\Building\Forms\BIdgPermitRvw_RES 020415.docx
4
Building Permit Submittal
Original Submittal Date: 3/i15/5"
Site Plans: # 3
Building Plans: # 3
Building Permit#: �1 rater building permit#above.
Workflow Routing: [CSI nning engineering —Permit Coordinator ding
Workflow Sign-off: -off for Planning(include notes from planning review)
Route Application Documents: L - Bering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
0--B'icling: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: r'�,� _ .J.-4011L
Date: .3/(�/T'
Engineering Review g w
f?Actual Slope: to 10
❑ Conditions Met ' K'r N L,7 f fame.
❑ Easements (encroachments) AP370 _
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee: ❑ Yes •E'No
Assess Water Quantity Fee: ❑ Yes .P' No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: A l Date: -3/(13/1 C.
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ OK to Issue Permit / /
Approved by Permit Coordinator: 41 AV _, Date: (577
I:\Bui Iding\Forms\Bl dgPermitRvw_RES_020415.docx
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CITY OF TIGARD
/ \s/ Approved by Planning
Date: 3 i 1
;' (��L Initials:
_/r RECEIVED
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Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12330 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00042
David Young
Provide approved final inspections for all open permits not on this MST permit. PLM,
ELC, and MEC on separate permits prior to final inspection.
Provide smoke detector outside existing downstairs sleeping rooms.
Provide permit or add kitchen hood vent to MEC permit.
This MST permit for deck and bath framing only.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12330 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Master Permit
199 Electrical final
FAIL
MST2015-00042
David Young
No electrical on this permit.
Recall correct ELC permit inspections.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12330 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Master Permit
699 Mechanical final
FAIL
MST2015-00042
David Young
No mechanical on this permit. Recall on the correct MEC permit. Add kitchen hood vent
if not on original permit.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12330 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Master Permit
399 Plumbing final
FAIL
MST2015-00042
David Young
No plumbing on this permit.
Recall under the correct PLM permit.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12330 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00042
David Young
Provide approved mechanical and electrical final inspections.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12330 SW SUMMER CREST DR, TIGARD, OR,
97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00042
David Young
Violation Summary:
Inspector Contractor