Permit (9) CITY OF TIGARD MASTER PERMIT
•
III • COMMUNITY DEVELOPMENT Permit#: MST2016-00109
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/11/2016
T I ;.4 R 17 g Parcel: 2S104DC01100
Jurisdiction: Tigard
Site address: 13798 SW BENCHVIEW PL
Subdivision: BENCHVIEW ESTATES Lot: 11
Project: LLOYD
Project Description: Ramp and handrail construction for residential care home.
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: $12,000.00 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
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=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 addl 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:
LLOYD,LEYENDA SOS PLUMBING INC Required Items and Reports(Conditions)
13798 SW BENCHVIEW PL 8565 SW 80TH AVE
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: PHONE: 503-488-0588
FAX:
Total Fees: $548.01
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 ••R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calli,ud503.232.1987 or 1.810.332.2344.
Issued By: Permittee Signature: 4IllIllb ;r _ . p
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.II I
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 RtCEIN
l()Itt)lII< 1 l .1 ().l l
City of Tigardvataed j Permit No.: '
G 1� iv-6r?) �o-vowel
111 IN 13125 SW Hall Blvd.,Tigard,OR 97223 s plan Ry :`, p
a Phone: 503.718.2439 Fax: 503.598.1960 16 ZU IU Date/By: l`'f 'lt44_ l Other Permit: 1
Inspection Line: 503.639.4175 MAR Date Ready: Jaris: la See Page 2 for
i I i \E:f fied/Method: u Supplemental Information
Internet: www.tigard-or.gov �`` / �p �(p PP
Y V ,
TYPE OF WORK 050 r a REQ 1' D DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
AAddition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ig 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ a` CO 0
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ( 7j?C g Sul 13E71/444A Vs C w P L I New dwelling area: square feet
City/State/ZIP: `r,(5--AA 0 O R_ 72:4D-3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: L i Covered porch area: square feet
Cross street/directions to job site: 1--()RM R i ' h C) F F Deck area: square feet
Pat; C, Vv (X i n t , ¶)2 n O() Other structure area: square feet
&i:IRNYE. , ( on 6-e-e. .n -i.e.id . 6erGhVi 1 (e , REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: () on 6erolv 1 eu.t p 1 A&e I Lot no.: 1 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.
creek- �1cc- c S c S.1 ems+ �o _Valuation: $
ra - ps '1 eVQ`�-_l c 0 p __-- t-rn 1_ der)`- . Existing building area: square feet
1 (Jl.l I V Y C' New building area: square feet
PROPERTY OWNER 0 TENANT Number of stories:
Name: 1,em.eockt_ L'0 y a., Type of construction:
Address: 37 q 2 S W n ch f I'&'(J PL , Occupancy groups:
City/State/ZIP: VI rQ/ OA, q7 aa,3 Existing:
Phone:(3 41'1 5''Os-4C) Fax:503 59 -.1- 31-t - New:
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: Cx,I 1C.+1 u;6-t1 f Kul. C�i d � 1-4-z} (Meese refer � �)
Structural plan review fee(or deposit):
Contact name: M
/, ,. cQ Li D
FLS plan review fee(if applicable):
Address: \' -'1 CI i Suj i eigt 1 Teo.) pt $Ih4 �/
,� �,1 Total fees due upon application: 5 /
City/State/ZIP: 1 l�av U` 0-, cor).93
�7 Amount received:
Phone:( .p 40 Fax::( _22--1-52_,
E-mail: HOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
1 v I42 G ( mal , COCOr✓1
/ y�� ` Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
F U ch Submit two(2)sets of roof plan with connection details
Business name: H I 51-Fi n SLn �n L 1 and fire department access,along with the 2010 Oregon
Address: TO E F o h e f `' Solar Installation Specialty Code checklist.
City/State/ZIP: J Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503) 4g v — O sg I Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 112 a$i
/� Total fee due upon application: $201.60
Authorized signature: r9-, /� This permit application expires if a permit is not obtained
___ yyy within 180 days after it has been accepted as complete.
Print name: — Date:
*Fee methodology set by Tri-County Building Industry
� L� "] - � D 1�
��f:N A � � p � I � Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
71COMS
MUNITY DEVELOPMENT DEPARTMENT
T 1 c n R D Building Permit Review — Residential
Building Permit #: /15719/6-00/0 Y
Site Address: (3- 9c SW Bencinv i ew Pi .
Project Name: LJ o�d Lot #:
(New welling=subdivision name;.Addition or.Alteration=last name of owner)
Planning Review
Proposal: c,fea*e access 4fom s4acee+ +n ra-n k ead in j uf) -1-0 $COt* Joa(
riVerify site address/suite# exists and active in permit system.
River Terrace Neighborhood: No ❑ Yes, See RiverTe,raie Review.Addendum Attached
S to Plan Elements:
II Three (3)copies of site plan Existing structures on site
II Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
•Drawn to scale (standard architect or engineer scale) floor elevations
•North arrow Utility locations (required for new,may apply for additions)
■Site address,project or subdivision name and lot number Location of wells/septic systems
II Applicant information(name and phone number) Erosion control(including drainage-way protection, silt fence
II Lot dimensions and building setback dimensions design,location of catch basin,etc.)
II Lot area,building coverage area,percentage of coverage and E'treet names
impervious area (applicable if R-7,R-12,R-25&R-40) ❑'treet tree size,type and location
II Property corner elevations(2 foot contour lines if more than Existing trees to be retained with drip line,and tree
foot differential) protection measures
❑ 0 lean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: XYes,applicant was notified SNo Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified NI .No Applied For: E Yes E No,stop intake
. and Use Case#: '40,13 r
r Zoning: -- P —L1,3
lg Setbacks: j j(A, Front Rear Side Street Side Garage
,I Landscape Requirement: 0
Er Lot Coverage Maximum: °j0
Building Height: Maximum Height Actual Height
Visual Clearance i 1
00 Easements -- st PU e
Sensitive Lands: ❑ Yes ❑ No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
otes: Sy =f4 s aril cri-ho( dpuzlc i e s rds do nod-- appl./ i no+e
--t-hat rampc r oa.chPR
as on '�S E oc-k- -l=r an-l- 1 a-i- I i ntJ
Approved By Planning: _ -71 11 - Yba A Date: 3\11 6
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: E Approved ❑ Not Approved
l:\Building\Fonns\BldgPennitRvw_RES_0121 16.docx
Building Permit g Submittal
Original Submittal Date: 3/161/5-
Site Plans: # 3
Building Plans: # 3
Building Permit#: -'F,nter building permit above.
Workflow Routing: ing Ly'Engineering ermit Coordinator ui ng
Workflow Sign-off: LEPYSign-off for Planning(include notes from planning review)
Route Application Documents: neering: (1) copy of permit application, (1) site plan, (1) building plan and
oriill plan review routing form.
Qiwilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: _
By Permit Technician: Date: 3/,A
Engineering Review1
Slope at building pad: "44
Conditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: E YesNo
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: .1 MI Mr Date: , -- -.--
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:
SDC Fees Entered:
Wash Co'Trans Dev Tax: ❑ Yespilll/A
Tigard Trans SDC: ❑ Yes /A
Parks SDC: ❑ Yes 7. /A
( OK to Issue Permit
Approved by Permit Coordinator: Date: 543A'
1:yBuilding`FonnsVBldgPennitRvw_RES_0121 16.docx