Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00028
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/29/2016
Parcel: 1 S136CB03700
Jurisdiction: Tigard
Site address: 11085 SW 83RD AVE
Subdivision: STEVE& HUGHIE'S PLACE Lot: 9
Project: Simser/Arnsberg
Project Description: Removing load-bearing wall and installing 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: $4,800.00 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
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0
Bckftw 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'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-1 000v: 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:
SIMSER,SARAH N ANDREW CHARLES JOHNSON Required Items and Reports(Conditions)
ARNSBERG.ERIC 2724 SE 70TH AVE
11085 SW 83RD AVE PORTLAND,OR 97206
TIGARD,OR 97223
PHONE: 503-913-7630 PHONE: 907-687-5058
FAX:
Total Fees: $270.56
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 i ante 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
da TTENTICN: n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
2-001-0010 through OAR 0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19,87 o`r 1.800.332.2344.
ssued By: Permittee Signature: &�/'�— Z'1
Call 503.639.4175 by 7:00 a.m.for the next available inspection a e.
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
6
City of Tigard Received C�Q\ Date/By: Pennit No.: �""
13125 SW Hall Blvd.,Tigard,OR 972 1V rr n Rev.ewq
Phone: 503.718.2439 Fax: 503.598.1960 `4e y Vr /By: £ Other Permit:
Inspection Line: 503.639.4175 ` '1 �` S ate Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov ��G��� Notified/Method:a� Supplemental Information
TYPE OF WORK REQUIRED DATA:I-ANIS 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
E9 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ goo
❑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: New dwelling area: square feet
City/State/ZIP: ��,c, d' 7Z j Garage/carport area: square feet
Suite/bldg./apt.no.: Pro Project name: rn�; porch area:
Covered square feet
P j ,5�r�'1��
Cross street/directions to job site: o 6 Deck area: square feet
Other structure area: square feet
i,
REQUIRED DATA;COMMERCIAL[ USE CWCKLIST
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 WORT{ work indicated on this application.
t Valuation: $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: r ,` E„� Type of construction:
Address: Ilog$- SvvP,3 "E Occupancy groups:
City/State/ZIP: Existing:
Phone:(yt3) cjl 76 0 Fax:( ) New:
...,
91 AP�,ICANT �CONTACT PERSON � WILDING PERMIT FESS* I,
ase refer to fee schedule
Business name:
Structural plan review fee(or deposit):
Contact name: r �� S FLS plan review fee(if applicable):
Address: jlogy' jw � ��,
City/State/ZIP: '722-'7-3 Total fees due upon application: .3H
r
Phone:(5'6,3) I _-�� O Fax: :( )
Amount received:
E-mail: rhs 6, C vv*a,� ,�.r Pi �'D)GTAICSO)�,AItPANEL SYSTEM FUS#
-
Commercial and residential prescriptive f
er p0
... kA roof-top mounted Photovoltaic Solar Panel System.
Business name: r rew ^G�„� `,l ,� 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.: 204A4 O S Total fee due upon application: $201.60
Authorized signature: �r A-r ns This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: �� `Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\BUP-RESPennitApp.doc 011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling
City of Tigard Received Permit No.:
� 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
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 approvedplat/lot. ❑ ❑ I ❑
4 Fire district approval required. Name of district: ❑ ❑ I ❑
5 Septic sstem permit or authorization for remodel. Existing system capacity ❑
6 Sewer permit.
7 Water district approval. ❑ ❑
8 Soils report. Must carry original applicable starnp 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.
1 1 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- ❑ ❑ ❑
rescri live 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 ❑ ❑ ❑
fpr 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 El
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
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, ❑ El
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:ABuilding\Pennits\BUP-RES PennitApp.doc 02/24/2011 4404613T(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
11085 SW 83RD AVE, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00028
Jeff Grove
Violation Summary:
Inspector Contractor