Permit y p CITY OF TIGARD BUILDING PERMIT
I'1 3 COMMUNITY DEVELOPMENT Permit#: BUP2015 00087
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/08/2015
Parcel: 251118801800
Jurisdiction: Tigard
Site address: 10390 SW AMANDA CT
Project: Harbick Subdivision: TIGARDVILLE HEIGHTS Lot: 1
Project Description: Demo 1200 sq ft house on sewer. Detached shop to remain. Demo credits for new SF available upon approved
final inspection.
Contractor: PACIFIC NORTHWEST EXCAVATING LLC Owner: HARBICK,CHARLES C
PO BOX 61 16057 SW 2ND ST
WILSONVILLE,OR 97070 SHERWOOD, OR 97140
PHONE: 503-329-5007 PHONE: 503-522-4768
FAX: 503-651-1443
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 04/08/2015 $164.96
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 04/08/2015 $0.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development-Eng 04/08/2015 $80.70
Bedrooms: 0 Bathrooms: 0 DC Provision Review,SF-Ping 04/08/2015 $75.00
Value: $5,800 DC Provision Review,SF-LRP 04/08/2015 $11.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $332.16
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors'
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 acc. •: ce 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. • NTION: Ore!•• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-4,1-0010 through OAR 952-'• *090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ued By: 1111 / Permittee Signature:
EI
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 RECEIVED I Ol i>I Il( I I "I (i\1.1
City of Tigard rived. smAgrapm
# Permit No.: n % ) dx g
13125 SW Hall Blvd.,Ti[ $I�DR �72n15
��''���r`"'33 ttffgg Plan Review
t3 Phone: 503.718.2439 ax: 0 .5 .1960 Date/By: Other Permit:
T I G A R I) Inspection Line: 50 'OF Date Ready/By: Avis: ® See Page 2 for
Internet: www.tigaf�j, , vl ^ D'V S i 0 N
Notified/Method: Supplemental
is pplementalInformation
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.
El 1-and 2-family dwelling ❑Commercial/industrial Valuation: S
❑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: 10390 SW Amanda Ct. New dwelling area: square feet
City/State/ZIP:Tigard,Or 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Charles and Peggy Harbick Covered porch area: square feet
Cross street/directions to job site: 103rd Ave. 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.
Demolition of original house located on property Valuation: $5800
ef—st— g Existing building area: square feet
11:,/{4 _ 49op, / "j F r ItC firo JAiai T hN,q0ti=, New building area: square feet
TTY ® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Charles and Peggy Harbick Type of construction:
Address: 16057 SW 2"Street Occupancy groups:
City/State/ZIP:Sherwood,OR 97140 Existing:
Phone:(503)522-4768 Fax:( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please r
Business name:Same as above efnmfee scMeitle)
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:( ) Fax::( )
Amount received:
�j f (� n� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:P No,stb tc,K Cl/ . Li( /
ti/ Commercial and residential prescriptive installation of
CONTRACTOR roof-top m. I PhotoVoltaic Solar Panel System.
Business name: Pacific Northwest Excavating,LLC Submit two(2)se •f roof plan with connection details
and fire department ac.-ss,along with the 2010 0 ,:on
Address:P.O.Box 61 Solar Installation Specia ode checklist.
Permit Fee(includes p •1 -v
City/State/ZIP:Wilsonville,OR 97070 and administra' $180.00
Phone:(503)329-5007 Fax:(503)651-1443
State surcharge( '. of permit fee): $21.60
CCB lic.: 161119 id,// f/( • .1 ee due upon application: $201.60
r
Authorized signature: , , _ r This permit application expires if a permit is not obtained
• A ICJ a ..v ,.../ within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name:Charles Harbick Date: Service Board. /
7 (c
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) .f,5,30� -
City of Tigard
lig COMMUNITY DEVELOPMENT DEPARTMENT
■
T I G A R[) Building Permit Review — Residential
Building Permit #: E D a 90/ 5 -6o 0 87
Site Address: 103°10 StjJ Asvnancl o. CA.
Project Name: \-Ao,rbk .k Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review -
Proposal: demo SV home, `" gy-,_„„j, d hey) 7c •-� ile-e
0
. Verify site address/suite# exists and active in permit system.
IK. River Terrace Plan District: ❑ Yes Et No
Site Plan Elements:
P: ree(3)copies of site plan Existing structures on site
ite plan must b2 on 8-1/2"x 11"or 11 x 17"paper $Footprint of new structure(including decks)with finished
$Drawn to scale(standard architect or engineer scale) floor elevations
North arrow motility locations(required for new,may apply for additions)
Site address,project or subdivision name and lot number —Etocation of wells/septic systems
litApplicant information(name and phone number) W4Erosion control(including drainage-way protection,silt fence
`, Lot dimensions and building setback dimensions design,location of catch basin,etc.)
f,ot area,building coverage area,percentage of coverage and lgStreet names
impervious area(applicable if R-7,R-12,R-25&R-40) 'Street tree size,type and location
)gtProperty corner elevations(2 foot contour lines if more than - Existing trees to be retained with drip line,and tree
4 foot differential) protection measures
Er Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified , No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI)Permit:
Required: ❑ Yes,applicant was notified 'No Applied For: ❑ Yes ❑ No,stop intake
-Band Use Case#:
-6 Zoning: R- S ,S
$-Setbacks: Front Rear Side Street Side Garage
'Landscape Requirement:
€1-Lot Coverage Maximum:
-El-Building Height: Maximum Height Actual Height
$Visual Clearance
$Easements
Sensitive Lands: -a Yes CI No Type S69 e S 7 2..S�lb owls i d e {o t e&.-
Urban Forestry Plan
-g-Conditions "Met"prior to issuance of building permit
Notes:
/
Approved By Planning: j$ A.—A r 0/ CJ A Date: 3 31 15
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\BldgPermitRvw_RES_031015.docx
Building Permit Submittal
Original Submittal Date: c4' 7/�
Site Plans: # 3
Building Plans: #��—
Building Permit#: [ ranter building permit#above.
Workflow Routing: Manning D--Engineering B"Permit Coordinator $Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
� o ginal plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: t 1 Date: ?/S—
Engineering Review
❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit ` )
❑ Easements (encroachments) per engineering conditions of approval and pla N .
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: i/■ 1. /3.
e7:......
Revisions (after Building 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
❑ 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: / i.s// Date: /1
I:\Building\Fonns\BldgPermitRvw_RES_031015.docx
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
10390 SW AMANDA CT, TIGARD, OR, 97224
Residential - Building
299 Final inspection
FAIL
BUP2015-00087
David Young
Sewer to be capped within 5' of property line. 722.0
Provide approved final erosion control prior to BUP final inspection.
Violation Summary:
Inspector Contractor