Permit CITY OF TIGARD MASTER PERMIT
III Permit#: MST2015-00090
• • COMMUNITY DEVELOPMENT
Date Issued: 06/29/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S110BA07700
Jurisdiction: Tigard
Site address: 11591 SW COLE LN
Subdivision: EVERGREEN SPRINGS Lot: 2
Project: BLOUIN
Project Description: Patio cover addition.
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: $9,000.00 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
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
F u rn>=100 K: 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'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&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:
BLOUIN,PAUL F&SHELLEY S RIVER CITY CONTRACTING Required Items and Reports(Conditions)
11591 SW COLE LN 4843 SW GREENSBORO WAY#25
TIGARD,OR 97224 BEAVERTON,OR 97007
PHONE: PHONE: 503-828-6600
FAX.
Total Fees: $477.24
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes a • ,ill of - 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, • wor - suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cent= Th•j- rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Y. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1.8' •r .80'.332.2344.
Issued By: All -ir■I1// --- Permittee Signature: i 1
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 ONLY
74 City of Tigard Received ,i� Permit No.:MST�I�I�—mil�jr7
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie•
Phone: 503.718.2439 Fax: 503.598.1960 1„ Date/By: AI�'r -ZZ Other Permit:
TI G A K D Inspection Line: 503.639.4175 ,• 4 1 Date Ready/By: lwis ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: a3 /c "!Y Supplemental Information
TYPE OF WORK .0\A ' v ` REQUI D DATA:1-AND 2-FAMILY DWELLING
53 New construction ❑Demolitiot) , ,+, ' *''''. t Permit fees*are based on the value of the work performed.
,�.. Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Othet ` \;„ equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTR work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ ��
El Accessory building ❑Multi-family Number of bedrooms:
ID Master builder ID Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11 5-1( 5 w, GO J e L.,¢rt a New dwelling area: square feet
City/State/ZIP: 1--(p fd q'7, it Garage/carport area: square feet
Suite/bldg./apt.no.: J Project name: LA-i Covered porch area square feet
Cross street/directions to job site: 640 f e 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.
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.
475 c) CeVee-- ekeeelf*JA..0
Valuation: $
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: y,, — 5)C II y 6
pi �j�DUt rl Type of construction:
Address: /1 51/ 4. Cdde 4,1, Occupancy groups:
City/State/ZIP: 7,4 ehed ort• 172' if Existing:
Phone:(1503 ) in --- 37 30 Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*p ���A-' (Please refer to fee schedule
Business name: 1�–t VC�L 4 / "� t' Structural plan review fee(or deposit):` .Q p'
Contact name: -Dt9 pp 'b/'t,v
V / FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:( ( 3) 8„8 - (,COO Fax::( ) Amount received:
E-mail: % /5 p IA.std Lam* PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: gt,JC 4»17f Ccxtif,.1F Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: y9 93 S,c: 6/terp5 -• , l - • a5- Solar Installation Specialty Code checklist.
City/State/ZIP: 3x. 6 4 eve r,.7 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(spy ) ici a -66,0 F. State surcharge(12%of permit fee): $21.60
CCB lic.: / 3I pO J!' it It 1.1 4 , / Total fee due upon appication: $201.60
/r
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: )t! .., 7fe Date: C--3.-/,5— *Fee methodology set by Tri-County Building Industry
J 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 ONLY
City of Tigard Received Permit No
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T 1 G A R n 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet www.tigard-or.gov ❑ other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No \i,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 3y 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, ❑ ❑ El
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 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 ❑ ❑ ❑
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 Ion and shall be shown to be applicable to the •ro'ect under review.
.It RItil)I("I'IONAL SPECIFIC'S
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. El ❑ ❑
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, El ❑ ❑
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 440-46131(11/02/COM/WEB)
City of Tigard
IIIi O''' COMMUNITY DEVELOPMENT DEPARTMENT
►; Building Permit Review — Residential
Building Permit #: /i STAR i S=Dcvqt c)
Site Address: 115/I SW 6k Ln
Project Name: .Bi ou',vl Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Pptlip Ga„t.1 .
Verify site address/suite# exists and active in permit system.
❑ River Terrace Plan District: ❑ Yes TNo
AS e Plan Elements:
( hree(3)copies of site plan tglExisting structures on site
11 ite plan must ha on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
►:lo rawn to scale(standard architect or engineer scale)d1� floor elevations
* orth arrow t3 tJtility locations(required for new,may apply for additions)
ate address,project or subdivision name and lot number 61' , Location of wells/septic systems
►7 Applicant information(name and phone number) Erosion control(including drainage-way protection,silt fence
[SKot dimensions and building setback dimensions design,location of catch basin,etc.)
tot area,building coverage area,percentage of coverage and l Street names
impervious area(applicable if R-7,R-12,R-25&R-40) reet tree size,type and location
Property corner elevations(2 foot contour lines if more than Jxisting trees to be retained with drip line,and tree
4 foot differential) protection measures
W.Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified I 'No Received: ❑ Yes ❑ No
Public Facilities Improvement(PEI) Permit:
Required: ❑ Yes,applicant was notified e No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#:
'Zoning: R.—_ 1I . 5
Setbacks: Front — Rear AC) Side .5 Street Side — Garage
Zl Landscape Requirement: NSA % p,v d
.(Lot Coverage Maximum: op, % `7
Building Height: Maximum Height 30 Actual Height 15.(-n
Visual Clearance
kEasements
,0 Sensitive Lands: ❑ Yes ir-No Type
tiIp,-X Urban Forestry Plan
N`a� Conditions "Met"prior to issuance of building permit
1 Notes:
Approved By Planning: C"`""D_ Q . (1 Date: (42 ' 3 --I S
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fortes\BldgPermitRvw_RES_031015.docx
Building Permit Submittal
Original Submittal Date: C 73//5"-
Site Plans: # /I/
Building Plans:
Building Permit#: 0-.-Eilter.building permit#above.
Workflow Routing: �l�p ing Lid nguiecring ermit Coordinator ding
Workflow Sign-off: SL7 i ff for Planning(include notes from planning review)
Route Application Documents: eering: (1) copy of permit application, (1) site plan, (1) building plan and
on al plan review routing form.
Ire'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ✓�� _ c Date: (."7/S
Engineering Review
Slope at building pad: 7 D
Conditions "Met"prior to issuance of building permit
eEr Easements (encroachments) per engineering conditions of approval and plat
.l (Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes -ErNo
Assess Water Quantity Fee in-lieu: ❑ Yes Zi No
LIDA Facility on lot: ❑ Yes ,B No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: (,J . Date: # 8//S
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:
7)S:'OK to Issue Permit ,
Approved by Permit Coordinator: Date: 79) )--5--
I:\Building\Forms\BldgPermitRvw_RES_031015.docx
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
IN Transmittal Letter
I : , I d,I; H 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO:
AV DATE RECEIVE
DEPT: BUILDING DIVISION '�{ �'� �
��Y� JUN 22 2015
be,�FROM: CITY OFTI(ARD
COMPANY: _ f i,3c" c4' 6D ,4 464.f BUILDING DIVISION
PHONE: _ 5-6 -. eg,a e '60.(:e By/
RE: if 5-9! Se-✓ CO Ce GN S Nwntie�,5—ctid yU
(Site Address) 'A.1
jecrname or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: I Copies: I Description:
Additional set(s)of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. x Engineer's calculations.
Other(explain): `
REMARKS: L 04 f L • I)-4 ey
FOR 9 FFIC USE ONLY
Routed to Permit Technician: Date: ,® r Initials
Fees Due: • Yes I1r o Fee Descri stion: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes I ❑No ❑ Done
Applicant Notified: Date: Initials:
1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
REVISIONS #
1
W
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31.29' Z---Gr ..7- 0
_t_ 3 1 v)----7.82'1-- I w W
Z20"-0'SETBACK 1
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1 I
1
1_044
20'-0'SETMICK I 1
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1 I
23'-5' y Di 916'
J • 11 P.O.BOX 8713
NEW COVERED PATIO
BEND.OR.97708
I ` 00 PHONE:
I 1 541-408-6212
W b I
r I § �-
o EXISTING
ID
I
I HOUSE
I
I EXISTING
ENTRY I
I I
J
L____ _____________---
1V-0"SETBACK
1
EXISTING / f/ C ♦ld C/(1 O
---c/!,- (Lt
Lt _ ___ _ __ _ ___ . _.___ ___-- - ---- - —r-i:forici oe H
17,7761 <
DRIVE i 1 J �O1 C
SW COLE LANE Z
She//ey 3/0 /10 n Z
SO3 - o
H
SITE PLAN �N\
7�3 _ 57 30
„ DATE: 5.25.15
CITY OF TIGARD S`A`E:I =10
DRAWN:CEB
Approved by Planning los: CD567
Date: (o -3 -15 SHEET: 1
Initials: c,
OF 3 SHEETS
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
11591 SW COLE LN, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00090
David Young
No electrical installed at time of final inspection.
Violation Summary:
Inspector Contractor