Permit (7) IN ,-44 CITY OF TIGARD BUILDING PERMIT
' • COMMUNITY DEVELOPMENT Permit#: BUP2016 00231
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2016
Parcel: 1 S 125DA03800
Jurisdiction: Tigard
Site address: 6618 SW WALNUT TER
Project: Kovalev Subdivision: KINGS VIEW Lot: 23
Project Description: Demolition of(1)house,874 sq ft&(1)detached garage,748 sq ft,on sewer. SDC credits available upon
approved final inspection.
Contractor: UNITED WASTE DISPOSAL INC Owner: MUMBY, GEORGE D SR&MARGARET E
15034 SW 91ST AVE 6618 SW WALNUT TER
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503-516-7475 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 08/22/2016 $225.80
Occu Demolition
anc Gr
P Y p Occupancy Load: Erosion Control w/Development 08/22/2016
Dwelling Units: 0 $80.70
Info Process/Archiving-Sm$0.50(up to 08/22/2016 $0.50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $9,500
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)
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
952-00 •3 i through• 952-00 .!e e0. You may obtain a copy of the rules or direct questions to OUNC by calling 503 2. 8 r 1. 0.332.2344.
Is ued By: . , `// Permittee Signature:
a t<`
L
Call 503.639.4175 by 7:00 a.m.for the next available ins ection d
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 RE ` V� Iay Received �/
City of Tigard /�Date/By: O 7 16„
Permit (t �l&�g3Z
4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ,
II I Phone: 503.718.2439 Fax: 503.598.*€ 07 016 Date/By: Other Permit: /J,peap i lO—‘5QQ 32'
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: G Juris: See Page 2 for
Internet: www.tigard-or.gov (ATI" : ( Notified/Method: g1/ 16, I H Supplemental Information
et
r 1071
1' TYPI FI 6 DIVISION `ir REQUIRED IIATA:1-AND 2-FAMILY DWELLING
El New construction jg 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
'� CATEGORY OF CONSTRUCTION work indicated on this application.
p 1-and 2-famil dwellin Valuation: $ C� 43.°Y g ❑Commercial/industrial /9 '
1 ElAccessory building ❑Multi-family Number of bedrooms:
zy0 Master builder 0 Other: Number of bathrooms:
'ii JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: CG i g J Wq iv, 04- -1-1- ,..v-,,,,..‹..._GNew dwelling area: square feet
City/State/ZIP: ';'tt Av..`� (JR 722 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: �/
J f"-lCp\j/". Le kj Covered porch area: square feet
* Cross street/directions to job site: W 61+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.
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.
re v-,J l;4-i tom. DF- +Le_ k Du%-e-- .i <_54 v'tiJc C____
Valuation: $
/4-i,tt‘ = b 711 Existing building area: square feet
C 0,1044-64-E = 7q Lt o-i,L L }.e.,/ New building area: square feet
PROPERTY'OWNER 0 TENANT Number of stories:
Name: V, • -AI> IV Mev Type of construction:
le Address: 6440J
‘,.0 ....,„,,.6 ,.. 5#- Occupancy groups:
ilCity/State/ZIP: p,,,4-t G,,� \ 0k., 1 72 Z3 Existing:
Phone:()3) 522.-7trq 4 Fax:( )
.6 New:
pg.APPLICANT- 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer rofee scheduleJ
/ Structural plan review fee(or deposit):
Contact name: l(t-1-,.,\,_,. kk.ay Arte-V
.'J Address: 61q q 0 /5� I i Ga, 6 5-4- FLS plan review fee(if applicable):
City/State/ZIP: 0 `�t c.,,, S t_ q 722.3 Total fees due upon application:
Phone:(�3 ) Amount received: —ea—
' sz27 #gj Fax::( )
4,1bE-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
WI Comme ial and residential prescriptive installation of
CONTRACTOR roof-top m. ted Photo Voltaic Solar Panel Sy
Business name: LA,,,,,.. — J � .��1 ,P �],C� Submit two(2 ets of roof plan with co • 'ion details
�"` and fire departure .ccess,along wi • e 2010 Oregon
Address: /57 03 4 rt.� g7 t Solar Installation Spe '.lty Cot• ecklist.
City/State/ZIP: �4� 1) Permit Fee(include.i an review
O2 g 7 a and ao••'"istrati_ fees): $180.00
Phone:O 5/6..7 Fax:( ) State surch. :- (12%of permit fee $21.60
CCB lic.: asc,C.1/9 7 ( 9/ `L�o otal fee due upon application: $201.60
Authorized signature: ( LThis permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: q / *Fee methodology set by Tri-County Building Industry
Ut /4'1y �JV GvkG�/ Date: 08/0 g///6
/ 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 OFFl(l: 1SI. am.)
City of Tigard Received
Permit No.:
13125 SW Hall Blvd.,Ti ard,OR 97223 Associated Associated permits:
_ Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T[C ARD Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l es No y','
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. 0 0 0
4 Fire district approval required. Name of district: • ❑ 0 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 0
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ 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 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 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 ❑
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
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 ❑ ❑ ❑
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. 0 ❑ ❑
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 ❑ 0 0
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
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. 0 0 0
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. 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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
1,1 a
T l c A R D Building Permit Review — Residential
Building Permit #: — (C'1.A. d l(o -00 c9-3/
Site Address: 0 (6 S vV W(l l n v rt- -re 1.--col
Project Name: VoVci1ev Demo Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: [)£e f Y)0 kv10 kik Cl n a C.i a,
Verify site address/suite# exists and active in permit system.
/ig.River Terrace Neighborhood: (r No E Yes,See River Ten-ace Review Addendum Attached
Site Plan
ree(3El)coements:pies of site plan
structures on site
Oite plan must be on 8-1/2"x 11"or 11 x 17"papereetprint of new structure(including decks)with finished
brawn to scale(standard architect or engineer scale) floor elevations
gNorth arrow Altility locations(required for new,may apply for additions)
8Sittddress,project or subdivision name and lot number bion of wells/septic systems
61Xpplicant information(name and phone number) ❑LAisting trees to be retained with drip line,and tree
EfEtsrMiensions and building setback dimensions protection measures
Ct area,building coverage area,percentage of coverage and ❑Sheet tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) (Street names
9. eperty corner elevations(2 foot contour lines if more than
4 foot differential)
EFClean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received:
❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
9--laid Use Case#:
,P� Zoning: g- 4 S
/�--gethacks: Front Rear Side Street Side Garage
❑ Landscape Requirement:
P--L--ot Coverage Maximum: (Yo
--13—Wiulding Height: Maximum Height Actual Height
Usual Clearance
$1 asements
-EFThrisitive Lands: ❑ Yes El No Type
._.10-13rban Forestry Plan
--Conditions "Met"prior to issuance of building permit
Notes: j J S 1) P.' 0 eni I -I—
Approved
I-Approved By Planning: /1/1 0 vl 0,., 6 1 I o Date: 9/ c2 / 1 L
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved El Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: El Approved El Not Approved
I:\Building\Forms\BldgPermitRvw REs 060116.docx
Building Permit Submittal f
Original Submittal Date: q( q e
Site Plans: # a
Building Plans: # 9-
Building Permit#: [ Enter building permit#above. �-
Workflow Routing: X Planning - -a-Permit Engineering Coordinator X� Building
Workflow Sign-off: L7' Sign-off for Planning(include notes from planning review)
Route Application Documents: ID Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
L�Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: CDate: cc/9//
Engineering Review
Slope at building pad:
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: ❑ Yes El No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ) No
El NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: A(Z„ ...„PDate: #1:5---1(
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
El 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:
DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes K-' N/A
Tigard Trans SDC: ❑ Yes eN/A
Parks SDC: ❑ Yes ( N/A
(tPOK to Issue Permit
Approved by Permit Coordinator: Date: �/q/ f)`/7„
I:\Building\Forms\BldgPermitRvw_RES 060116.docx