Permit CITY OF TIGARD MASTER PERMIT
III I . COMMUNITY DEVELOPMENT Permit#: MST2015-00089
Date Issued: 06/03/2015
T t G A R p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CA04700
Jurisdiction: Tigard
Site address: 9600 SW LAKESIDE DR
Subdivision: SUMMERFIELD NO.12 Lot: 667
Project: Van Kleek
Project Description: Remove wall section and add beam.
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: $750.00 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
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&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:
JIM&LANORE VAN KLEEK STEPHENS HOMES LLC Required Items and Reports(Conditions)
9600 SW LAKESIDE DR 311 B AVE STE F
TIGARD,OR 97224 LAKE OSWEGO,OR 97034
PHONE: PHONE: 503-929-5944
FAX:
Total Fees: $113.29
This pe ' ' ' sued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all ■ h- /applicable law. All work will
one in accordan with approved plans. This permit will expire if work is not started within 180 days of issuance, or , k suspended for more the 180
days. ATTENTION: Oregon I- requires you to follow the rules adopted by the Oregon Utility Notification C- .,e/r - set forth in OAR
952-001-0010 through OA' : 2-00 •*!.0. You may obtain a copy of the rules or direct questions to OUNC by callin! 03. • ./•'• ,dr`8 .2344.
Issued By:I i• t✓; e!-' Permittee Signature: �� 1(4,/
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 j,
RECEIV
Residential 1'� L()R ()I I I( I I 'I ()\I 1
City of Tigard MAY 2 8 2015 0 `� 5� 2g�� Pemut No.: 4W376 5�O1�gel
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
: f �`' Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/13 : �i,�
T I i�It l� Inspection Line: 503.639.4175 �,11 OF 1(�AK Date Ready/13y: � ��� ® See Page 2 for
Internet: www.tigard-or.gov
BUILDING D1VISI otified/Method: _��/ Supplemental Information
7*rr , 44.47 °
i
TYPE OF ‘..0' All 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 ►d-thg the
CATEGORY OF CONSTRUCTION work indicated on thi��p 'cat'
Ell-and 2-family dwelling ❑Comercial/industrial Valuation: $ `Z Cr.)m
❑Accessory building ❑Multi-family Number of bedroo _i'
❑Master builder ❑Other: Number of bathrooms:
JOB SITE'INFORMATION AND LOCATION Total number of floors:
Job site address: '7/gø O 601 1, &-si De Dv_ New dwelling area: square feet
City/State/ZIP: 1' oil 91 ZZ.A( Garage/carport area: square feet
Suite/bldg./apt.no.: ( 1 Project name: Vaj b,/ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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.
r'01 G 51�1L� W - � CMD.v /��0 Valuation: $
G Existing building area square feet
fix L't
-Fp01.t ''wl
! New building area: square feet
❑ PROPERTY OWNER TENANT Number of stories:
Name: ji t44 d L. O Jiw • Type of construction:
Address: gOe' Sit) i
p9;::
D r� Occupancy groups:
roups:
City/State/ZIP: 7Y it,./t4 `6(1 11Z Z Existing:
Phone:( )
Fax:( ) New:
I CONTACT PERS!,
Business name: .? S i..-p114, 5( u� ' Structural plan review fee(or deposit):
Contact name: 'Srl�1C�s 1
Address: v i ' 4i/.6-.. 7 FLS plan review fee(if applicable):
City/State/ZIPt���:JJJJ MAC:- Total fees due upon application:
L 05 wU t D 0311 Amount received: — ''
Phone:( . ) `/,?.tJ'` !i(� Fax::( ) ors:.--*", ,
E-mail: l[ £S �� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Comme ial and residential prescriptive installation of
roof-top nted Photo Voltaic Solar Panel System.
Business name: Submit two sets of roof plan with conne '. •etails
y and fire departm- • access,along wi - 2010 Oregon
Address: Solar Installation S.•: 1 Code • ecklist.
City/State/ZIP: Permit Fee(inclu.—.review $180.00
and a. stra i - fees):
Phone:( ) Fax:( ) State surch. .- (12%of permit fe- • $21.60
CCB lie.: 2)34, I Lai l to
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: S�Gt�I �S Date: c°f/a�/��� 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 FOR OFFICE USE ON L1
City of Tigard Received Permit No
111111 13125 SW Hall Blvd.,Tigard,OR 97223 Associat
■ Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
I I�, vIn
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITFI\IS ARE REQUIRED FOR PLAN REVIEW 1 c No y/.k
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. ❑ ❑ ❑
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 ro'ect under review.
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.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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
9600 SW LAKESIDE DR, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00089
David Young
Violation Summary:
Inspector Contractor