Permit CITY OF TIGARD MASTER PERMIT
III .I COMMUNITY DEVELOPMENT Permit#: MST2015 00071
T!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/23/2015
Parcel: 2S 10X004700
Jurisdiction: Tigard
Site address: 9405 SW EDGEWOOD ST
Subdivision: 1991-073 PARTITION PLAT Lot: 2
Project: MITCHELL
Project Description: Carport addition.
BUILDING
Floor Areas Required Setbacks Reauired
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: $9,101.40 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
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
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvclFeeders 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 8 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:
MITCHELL,MICHAEL H&KIMBERLIE OWNER Required Items and Reports(Conditions)
9405 SW EDGEWOOD ST MIKE&KIMBERLIE MITCHELL
TIGARD,OR 97223 9405 SW EDGEWOOD ST
TIGARD,OR 97223
PHONE. PHONE: 503-341-8951
FAX:
Total Fees: $404.67
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 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is surtpended for more the 180
day . ATTENTIO : •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 -001-0010 through 0 - 9 -40 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5r;.232.1987 or 1.800.332.2344.
,, � 4 I
Is ued By: , ti Permittee Signature: AM k&Ali'__ II ,1k . .tt A i( .
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 FOR OFFICE USE OT%I
Received
City of Tigard G� Date/By S , �y Permit No.: -a + r
• 13125 SW Hall Blvd.,Tigard,OR 97223 ,v V Dhan
Phone: 503.718.2439 Fax: 503.598. GS• Date'B :Review—gift (p �jl �� Other Permit:
l l c;,�RI)
Inspection Line: 503.639.4175 q V\S Date Ready/B,. - !iris: ® See Page 2 for
Internet: www.tigard-or.gov '1� [. Notified/Method: Ljl� 6 Supplemental information ail`. TYPE OF WORK `.N C*�-` REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑Ne construction ❑D5 ' 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: 6 I dl�,,
1 and 2-family dwelling ❑Commercial/industrial ) 0 LAN • AiltscI6
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder Other: CpcR Q°R'—. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION 1 Total number of floors:
Job site address: Itji5� 5w o&au000 S'r New dwelling area: square feet
City/State/ZIP: 'n G ft Z.D OR 97223 Garage/carport area: X26 square feet
Suite/bldg./apt.no.: Project name: in;-1_,A,,,e I I Covered porch area: square feet
Cross street/directions to job site: (31- Il fr#d) -a O6cwO Deck area: square feet
j Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the%clue 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.
Ci-R p 4 P-r- ADDOI U1J Valuation: $
Existing building area: square feet
New building area: square feet
PROPERTY OWNER l ❑ TENANT Number of stories:
Name: 01 i I k to u 1-U1. CA *Alai Type of construction:
Address: q�6c 5ij W(7( f(f QO sr Occupancy groups:
.City/State/ZIP: 1-16b2.0 az. 9'7273 Existing:
Phone:(503) 3''I I-'5-1 Fax:( ) New:
❑ APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
�/� (Please refer to fee schedule)
Business name: SAME
"r Structural plan review fee(or deposit):
,`, Contact name: ) l ItvL�P2L FLS plan review fee(if applicable):
• Address:
Total fees due upon application: 7• ys
City/State/ZIP:
Phone:653 )5 77 _ 8?0-73 Fax::( Amount received:
E-mail: f� k i 44,--i M / PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
I ��tt I�CL'T 4 Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: �/Gr�/)/ s C c '1 Submit two(2)sets of roof plan with connection details
( and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP: and administrative fees): $180.00
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.: Total fee due upon application: $201.60
Authorized signature: . A This permit application expires if a permit is not obtained
r) V ■_!`� i A A. " ,1 within 180 days after it has been accepted as complete.
Print name: . i : Date: *Fee methodology set by Tri-County Building Industry Ais IA �� V .11•_ a -�� Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(i l/02/COM/WEB)
Building Permit Application Checklist j
One- and Two-Family Dwelling FOR OFFICE USE ONLI
City of Tigard Received Permit Na
1111 Assoc iat
Date lat
13125 SW Hall Blvd.,Tigard,OR 97223 ed permits:
■ Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
TIGARD Internet: www.tigard-or.gov ❑ Other
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ' es No N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. _ ❑ 1:1 El
2 'Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0' ❑
3 Verification of approved plat/lot. 2' ❑ ❑
4 Fire district approval required. Name of district: _ . ❑ (I' ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ a ❑
6 Sewer permit. ❑ R' ❑
7 Water district approval. ❑ R' ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ Uf ❑
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
basin protection,etc. �/
10 �Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state led ❑ ❑
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 Er ❑ ❑
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 ❑ [a' ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ 0' ❑
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- Et/ ❑ ❑
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- ❑ (ti ❑
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 a ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ El ❑
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 IT ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load. /
20 Manufactured floor/roof truss design details. I2d ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ L' ❑
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 Er ❑ ❑
architect licensed in Ore:on and shall be shown to be ..•licable to the •ro•ect under review.
JURISDICTIONAL SPI:( 11:1( S
23 Three()site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 1 ❑❑ ❑❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. E
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 ❑ 2 ❑
Street Tree List. _
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ E( ❑
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, ❑ [r ❑
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)
L
I
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
` �*; I Building Permit Review — Residential)
Building Permit #: STo201 —OCIY71
Site Address: 91-10S S\i Ed 3ewo-\ Si
Project Name: M.1 i-cine,\1 Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: neVJ co,fpad' OM It On
,L�_J/Verify site address/suite#exists and active in permit syste .
Ltd River Terrace Plan District: ❑ Yes DNo
Sit Plan Elements: Id
Existing ree(3)copies of site plan 114 Existing structures on site
I i1e plan m1121 12e on 8-1/2"x 11"or 11 x 17"paper LiFootprint of new structure(including decks)with finished
f[ rawn to scale(standard architect or engineer scale) floor elevations
orth arrow -BtJtility locations(required for new,may apply for additions)
L11 ite address,project or subdivision name and lot number -9tocation of wells/septic systems
pplicant information(name and phone number) $Erosion control(including drainage-way protection,silt fence
LvJLot dimensions and building setback dimensions design,location of catch basin,etc.)
8Lot area,building coverage area,percentage of coverage and Street names
impervious area(applicable if R-7,R-12,R-25&R-40) -R-Street tree size,type and location
-Property corner elevations(2 foot contour lines if more than $Existing trees to be retained with drip line,and tree
4 foot differential) protection measures (al read/ A fence wo,(1< area art 5
d
�f neighbor
I2d Clean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): trees
/Required: ❑ Yes,applicant was notified Ni No Received: ❑ Yes ❑ No
Intl Public Facilities Improvement(PFI) Permit: r
Required: ❑ Yes,applicant was notified g No Applied For: ❑ Yes ❑ No,stop intake
�4 Land Use Case#: LL A 2.0 1
-Zoning: R-14 ,5 \
m Setbacks: Ca,c ta) Front 1(Z rj)tear , (7(�').Side 5' (9 `')Street Side — Garage 1
(z�'
&Landscape Requirement:
-El-Lot Coverage Maximum: cyo
--9 Building Height: Maximum Height 3'j Actual Height no 1 nCre e 5 ei
-$Visual Clearance
Easements
NIA Sensitive Lands: ❑ Yes Yi(No Type
-,Urban Forestry Plan
Lid' Conditions "Met"prior to issuance of building permit
Notes:
1I
Approved By Planning: A, nail 4 ,0 Date: S t 2,1 t 5
Revisions (after Building S e mittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I
1:1Building\Forms\BIdgPermitRvw_RES_031015.docx
4
Building Permit Submittal
Original Submittal Date: 51/, /,
Site Plans:
Building Plans: # 5,
Building Permit#: [center building permit#above.
Workflow Routing: C nning B gineering 0-15-ermit Coordinator ding
Workflow Sign-off: D.-Sift-off for Planning(include notes from planning review)
Route Application Documents: Lz�;ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
❑_Hfi�ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: _ _ ! _ Date: .-
y
Engineering Review
LL � �
0
-11r Slope at building pad: SS -42/401 / v
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
El 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
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 42.7 l� Date: 6'1—/Z /--
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: CAL 4/ a Date: 5 H a —(s.
_ D
1:\Building\Forms\BldgPermitRvw_RES_031015.docx
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 permits.
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 all 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 will
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.
•
)k).\fi\b(aAVe.. (1S) -cS\11
Print Name of Permit Applicant
Signa re of Permit Applicant Date
Permit#: H sralsi S-c)OO 7 / QQ
Address: Z74S Ljoi Lx'ob
ev,)20 G2 c?-7. 2.-.5
Issued b,Gb Date: 1.141•31//5 t447
This Copy for Permit Offices
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
9405 SW EDGEWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00071
David Young
Install LSTA 24" straps beam to house at both sides per engineering.
Recall final after correction complete.
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
9405 SW EDGEWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00071
David Young
Correction complete.
Final approved.
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
9405 SW EDGEWOOD ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
FAIL
MST2015-00071
David Young
Install LSTA 24" straps beam to house at both sides per engineering.
Recall final after correction complete.
Violation Summary:
Inspector Contractor