Permit 111 CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2016-00220
T[GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/22/2016
Parcel: 2S103BD10800
Jurisdiction: Tigard
Site address: 11710 SW WALNUT ST
Subdivision: 2003-045 PARTITION PLAT Lot: 1
Project: FURLOTT
Project Description: Converting detached garage into habitable space.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 828 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 15 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: No
Total: 828 sf Value: $15,000.00 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
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 Srvc/Feeders 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-3 828
Owner: Contractor:
FURLOTT,RYAN C OWNER Required Items and Reports(Conditions)
KATO,ALYSHA C RYAN FURLOTT 1 Will need
11710 SW WALNUT ST 11710 SW WALNUT ST Electrical/Mecanical permit
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: PHONE: 503-816-0951
FAX:
Total Fees: $1,536.87
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 95522-001-0090. Yo copy of the_rules or direct questions to OUNC by calling 5 3.232.1987,, 1.800.332.2344.
•
Issued By: ✓� ' ." Permittee Signature:
C 9.4175 by 7:00 a.m.for the next available inspectiorf 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.
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 CCM Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed w. h 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.
7�,,,� IQrIo-r-t-
Print Narf a of Permit Applicant
Sign re of Permit Applicant Date
Permit#: / 772ø/b--c>`% r)
115.4.
Address: //7/d SJ /;1,6/447/4-354,-
`;
Issued by: /5 -/- Date: 64//e.,
This Copy for Permit Offices
Building Permit Application
Residential
City of Tigard feCfOle Received S ^_ e `(0����
Date/By: IYl PermitNo.:/� \ D �
lig13125 SW Hall Blvd.,Tigard,OR Plan Review
I Phone: 503.718.2439 Fax: 503.59 . 960 1a 2...);\% Date/By: 6)C l I C -tt Other Permit:
Inspection Line: 503.639.4175 aA\ Date Ready/By: Juris: ® See Page 2 for
I I C A R D P 1`t` -y �� Notified/Method: t Supplemental Information
Internet: www.tigard-or.gov ®� \,G� gnt,i PP
crsi
`! x.11`9 r
V` t �I
TYPE OF �, REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
,Q Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ rr
❑ 1-and 2-family dwelling ❑Commercial/industrial 15 1000
"Accessory building ❑Multi-family Number of bedrooms: D
0 Master builder 0 Other: Number of bathrooms:
JOB=SITE INFORMATION AND LOCATION Total number of floors:
`
Job site address: ' t n S�nl td &,.1v, -� ty.
., t New dwelling area: square feet
City/State/ZIP: t I'r/, fn i 912:.3 Garage/carport area: square feet 7011,
Suite/bldg./apt.no.: Project name: �� .ult.- Covered porch area: square feet
Cross street/directions to job site: ac,u, 4. \-2_:\5.1" 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.
Valuation: $
F(.4 i' \ wet- (�.(d v-y( tri 1 ivisu�t4I w\ t
cvo Existing building area: square feet
i) y uir,tc
pa
New building area: square feet
Ef PROPERTY OWNER 0 TENANT Number of stories:
Name:
R.tf,
`r�/(i l7. -" TYPe of construction:
Address: ((7i ) 1nArDikv,j. 5f': Occupancy groups:
City/State/ZIP: Ctt crd ( AK 0`7225 Existing:
Phone:( 3 ) 6tb 0,-t, k Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
SieGGl g Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address: Total fees due upon application: //6 r
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: iiw 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.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(l2%of permit fee): $2L60
CCB lic.: Total fee due upon application: $20 L60
Authorized signature: - - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: �\`uM cv,(l ar Date:5- z,5- i Service Board.
1:ABuilding\Permits\BUP-RESPertnitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE LSE oNLV
Cityof Tigard
Received
Permit No.:Date/By:
, 4 13125 SW Hall Blvd.,Tigard,
OR 97223
Associated permits:
I Phone: 503.718.2439 Fax: 503.598.1960
TIGARD
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1'es No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 • 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: . 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0
6 Sewer permit. 0 0 0
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0
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 ❑ 0 0
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 ❑ 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 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- 0 0 0
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. 0 0 0
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- 0 0 0
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 0 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
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 ❑ 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
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 0 0 0
architect licensed in Ore_on and shall be shown to be a..licable to the .ro.ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 1 1"or 11"x 17". 0 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0
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, 0 0 0
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.
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