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Permit CITY OF TIGARD BUILDING PERMIT 114 COMMUNITY DEVELOPMENT Permit#: BUP2016-00057 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2016 Parcel: 1S135CC03300 Jurisdiction: Tigard Site address: 10060 SW TIGARD ST Project: CSC CAP HOLDING LLC Subdivision: GREENBURG HEIGHTS ADDITION Lot: 11 Project Description: Demolition of a 2,606 sq.ft.house. Contractor: GROW CONSTRUCTION LLC Owner: CSC CAP HOLDING LLC 7900 SW HUNZIKER ST BY GRAY,TIMOTHY TIGARD, OR 97223 22846 SW LODGEPOLE AVE TUALATIN, OR 97062 PHONE: 503-597-2425 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: SF Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 02/24/2016 $225.80 Demolition Occupancy Grp: Occupancy Load: Erosion Control w/Development 02/24/2016 $80.70 Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 02/24/2016 $0.50 Stories: 0 Height: 0 ft 11x17) Bedrooms: 0 Bathrooms: 0 Value: $10,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $307.00 Required: Required Items and Reports(Conditions) 1 ,Ersn Cntrl 503-639-4175 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 accordance 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 232.1987 or .800.332.2344. � � r Issued By: Permittee ig • e: `wv� '40 r9.4175 by 7:00 a.m.for the next available inspecti• ate. This permit card shall be kept in a conspicuous place on the job site until co ,letion of the project. Approved plans are required on the job site at the time of each inspection. j Building Permit Application CIT,/ Residential d'i�' a k FOR OFFICE: USE ONLY b City of Tigard Received � `1 DaterBv: gij Permit No.: ii" ,0 0/67 4 C' 13125 SW Hall Blvd.,Tigard,OR 97223Plan Review 2 Phone: 503.718.2439 Fax: 503.598.1960;r R iQ DateBv: Other Permit: .' T 1 G A R D Inspection Line: 503.639.4175 Date Ready:By: ® See Page 2 for Internet: www.tigard-or.gov , 116ty s Notified,Method: Supplemental Information liN TYPE OF �„� REQUIRED DATA:1-AND 2-FAMILY DWELLING, ❑ New construction 14 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1-and 2-familydwellingValuation: S ❑ 0 Commercial/industrial 1 /U t>l5 ❑ Accessory building 0 Multi-family Number of bedrooms: 3 ❑ Master builder Other: Number of bathrooms: , JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /00 iv c S U.' /"4,,,,S".7L7 New dwelling area: pq� square feet City/State/ZIP: '77 4,-.4/ OGS- 5 7 2 Z 3 Garage/carport area: 41.00 square feet Suite/bldg./apt.no.: Project name: jG, rJ (yi f 4 Covered porch area: y,J square feet Cross street/directions to job site: Deck area: square feet /3?-/LV-t'v, /1 h -5-/--. 4 a lie,-{. c+1 rive: 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. PValuation: S Existing building area: square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name: Type of construction: Address: /0667,r7-.‘,/ 7T t,,,,,,r $T,' Occupancy groups: City/State/ZIP: / C�� //, ✓ L J 7-z-Z3 Existing: Phone:(5--(..'3 ) 4 3--cis---i?? Fax:( ) New: 0 APPLICANT A CONTACT PERSON BUILDING PERMIT FEES* Business name: L l�S be 4/4 c C,C (Please refer to fee schedule) - �_ Structural plan review fee(or deposit): Contact name: /6 A.( C'�"- FLS plan review fee(if applicable): Address: /0(94 f w 777 .k.;...c s ' City/State/ZIP: �' Total fees due upon application: % t c1.,n/ Oze 7 Z Z 3 Phone:(S 03) 5613— , 3 Fax: :( ) Amount received: E-mail: 7 Z' y r✓4-i 2 4e ,,t,—,/, e,,�v� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*. / / Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: 6-9....o s--c-/Lo q � Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: —7�G-6 S.,1H �Z k-c <_. ST Solar Installation Specialty Code checklist. City/State/ZIP: (�Yq,�� q L Z 3, Permit Fee(includes plan review S 180.00 / 7 and administrative fees): Phone:(.3 ) `1 40—7 3 4 o Fax:( ) State surcharge(12%of permit fee): 521.60 CCB lic.: / 1-/`if Z Total fee due upon application: S201.60 Authorized signature: ��' / This permit application expires if a permit is not obtained /,. !J .'�b¢� J�f/Ot within 180 days after it has been accepted as complete. Print name: . Date: (3//4, / *Fee methodology set by Tri-County Building Industry -� / Service Board. I:Building'Permits'BUP-RESPermitApp.doc 02'242011 440-4613T(I 102!COM'WEB1 Clean Water Services File Number C1eanWater Services 16-000689 � �tl Sensitive Area Pre-Screening Site Assessment ,U% ht 1. Jurisdiction: Tigard L U l O 2. Property Information (example 1S234AB01400) 3. Owner Information Tax lot ID(s): 1S135CC03300 Name: tommy gray 4)i^ 1 itiAtW Company: • t ?' ;. Address: 10060 sw tigard st ;'x'11` '' � ' ... Site Address: 10060 sw tigard st City, State,Zip: tigard,Oregon 97223 City, State, Zip: tigard,Oregon 97223 Phone/Fax: 503-863-9583 Nearest Cross Street: main st E-Mail: tommygray)@msn.com 4. Development Activity (check all that apply) 5. Applicant Information U Addition to Single Family Residence(rooms, deck,garage) Name: tommy gray ❑ Lot Line Adjustment ❑ Minor Land Partition Company: ❑ Residential Condominium ❑ Commercial Condominium Address: 10060 sw tigard st ❑ Residential Subdivision ❑ Commercial Subdivision ❑ Single Lot Commercial ❑ Multi Lot Commercial City, State, Zip: tigard,Oregon 97223 Other Phone/Fax: 503-863-9583 demo sfr E-Mail: tommygrayl@msn.com 6. Will the project involve any off-site work? ❑Yes XI No ❑Unknown Location and description of off-site work 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ 1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name tommy gray PrintiType Title ONLINE SUBMITTAL Date 2/23/2016 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Reviewed by elf-woe, Date 2/24/16 2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • Phone:(503)681-5100 • Fax: (503)681-4439 • www.cleanwaterservices.org City of Tigard IIICOMMUNITY DEVELOPMENT DEPARTMENT T 1 G A R D Building Permit Review — Residential Building Permit #: e,20/67-fy)5 7 Site Address: 10060 SCJ 711.3aTA S'. Project Name: Gray Lot #: (New citing= subdivision name;.Addition or.Alteration= last name of owner) Planning Review Proposal: demo ex1th\nanSF house. P Verify site address/suite # exists and active in permit system. River Terrace Neighborhood: ❑ Yes No Sit- lan Elements: 0 P ree(3) copies of site plan 'Existing structures on site u . e plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure (including decks)with finished raven to scale (standard architect or engineer scale) or elevations demo on` rth arrow 6d Utility locations (required for new may apply for additions) YMto address,project or subdivision name and lot number 7. .cation of wells/septic systems plicant information (name and phone number) V Erosion control(including drainage-way protection, silt fence C Lot dimensions and building setback dimensions sign,location of catch basin,etc.) W.ot area,building coverage area,percentage of coverage and LYStreet names ypervious area (applicable if R-7,R-12,R-25&R-40) XStreet tree size,type and location IIroperty corner elevations(2 foot contour lines if more than XExisting trees to be retained with drip line,and tree 4 oot differential) protection measures v/ofClean Water S rvices—Service Provider Letter(lot platted prior to 9/10/1995): Required: Yes,applicant was notified E No Received: Yes ❑ N )X Public Facilities Improvement (PFI) Permit: 1/81° • Required: E Yes,applicant was notified No Applied For: E Yes ❑ No,stop intake Land Use Case#: '� 11 Soning: R-"1•S etbacks: d€xi o 0,14 Front 2 Rear Side Street Side Garage -g 9 Landscape Requirement: �,{ g �� h Lot Coverage Maximum: o Building Height: Maximum Height Actual Height Visual Clearance Easements Sensitive Lands: ❑ Yes No Type ig Urban Forestry Plan Conditions "Met"prior to issuance of building permit Notes: demo only — ne -fotoj on anA home. tndey SeFara e. perm i+ ` Approved By Planning: V �1 (fl Lp hrbae ) Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved _ Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved L\Building\Forms\BldgPennit Rvw_R ES_0709I 5.docx Building Permit Submittal Original Submittal Date: _ /(o /1, Site Plans: # _ Building Plans: # 4 Building Permit#: n nter building permit# above. Workflow Routing: [ening Q ng�ineering LkI'ern it Coordinator ❑ Building Workflow Sign-off: :7-off for Planning(include notes from planning review) Route Application Documents: C�'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Cuil 1 ng: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: 4)( 1100 a'v'>. , By Permit Technician: �� Date: ,//1//(p _ 1 J a.e Engineering Review Slope at building pad: _; 7 onditions "Met" prior to issuance of building permit asements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: E 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: ,L Date: ...0:11'744 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved E 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: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A ?640K to Issue Permit "Vrf7r---T;ate: Approved by Permit Coordinator: -2/)'11114.1 L\Building\Fonns\BldgPermit Rvw_R ES_0709 I 5.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 10060 SW TIGARD ST, TIGARD, OR, 97223 Residential - Building 205 Footing FAIL BUP2016-00057 David Young Inspection for footing called in on wrong permit #. Foundation permit is MST2016-00034. BUP permit not ﬁnaled per previous inspection, requiring pump and ﬁll receipt for septic. Provide ﬁnal approval for BUP permit prior to footing and foundation inspection. Schedule footing and foundation inspection on correct MST permit. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 10060 SW TIGARD ST, TIGARD, OR, 97223 Record Type: Residential - Building Inspection Type: 299 Final inspection Result: PASS- NoCofO Comments: Violation Summary: Inspector Tel: 503.718.2439 Inspection Date: Record ID: BUP2016-00057 Inspector: Chip Barnett Contractor