Permit (23) CITY OF TIGARD MASTER PERMIT
III '4
18 , . COMMUNITY DEVELOPMENT Permit#: MST2016-00313
T EG A.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2016
Parcel: 2S 110 BA12000
Jurisdiction: Tigard
Site address: 14223 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 13
Project: Medallion Meadows, Lot 13
Project Description: New 8'fence on rear property line.
BUILDING
Floor Areas Reauired 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: No
Total: 0 sf Value: $500.00 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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 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 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-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:
OTR SF VB R-3
0
Owner: Contractor:
FOUR D CONSTRUCTION CO FOUR D CONSTRUCTION Required Items and Reports(Conditions)
PO BOX 1577 PO BOX 1577
BEAVERTON,OR 97075 BEAVERTON,OR 97075
PHONE: 503-720-7445 PHONE: 503-720-7445
FAX: 503-590-1751
Total Fees: $186.79
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 throu R 952-001-0090. You may obtain a co v of the_rules or direct questions to OUNC by calling 503.232. 87 . 00.33 .;44.
Issued By: =i. Permittee Signature:
9.4175 by 7:00 a for the next available inspection date.
This permit card shall a kept in a conspicuous place on the job site until completion o he project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application Ls 8 g i ,
Residential RECEIVED FOR 0F41( 1 (SF 0y1.1
City of Tigard Received 3 /4,
l� ,
Permit No.:l�ti role)16--C6 313
f' Date/By: 25
13125 SW Hall Blvd.,Tigard,OR 97' $(; 3 20%
I Phone: 503.718.2439 Fax: 503.59 . Dan Review _5 1
Date/By: Other Permit:
I 1 G n R D Inspection Line: 503.639.4175 'TY OF TI �'A D Date Ready/By: !, ) / funs I Ea See Page 2 for
Internet: www.tigard-or.gov G DIVISION
(`��! Notified/Method: Gy/ ✓/��
BUILDING V SION /� . Supplemental Information
044.4
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
ONew construction ❑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.
Valuation: $ 5:.//, 6C)�1-and 2-family dwelling 0 Commercial/industrial
al
❑Accessory building ❑Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 l-{ 9_2_'SS, ,-3. ' ) 0 ..j-y Lrt - New dwelling area: square feet
City/State/ZIP: -r' i� e_b Cr)\2---- 9-1 ZZ 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 744,1 III J s,/mti.l I LOY- /3 Covered porch area: square feet
Cross street/directions to job site: )`B -4-4\ ! G W ��� Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: XdL� IN,LL1 Q 13 1...A, ..10,D,,_. Lot no.: I. 3 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.
P) , E L G N. � �Z L 1' cl ni C Valuation: $
Existing building area: square feet
New building area: square feet
a PROPERTY OWNER 0 TENANT Number of stories:
Name: FYL j Cc)NS-TILL(Lfi 1.13 Id Type of construction:
Address:
C-•)' • IS'-'')‹ I S 7 7 Occupancy groups:
City/State/ZIP: .P V�1` /•3 Q- 7 C.Y Existing:
Phone:(503) 72-ea -- ?y L_s Fax:(5;3) S 7° - 17 S ,
New:
0 APPLICANT
0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: 5p �S 1'4 6uu (P/easerejertojeesc/reduk�
Contact name: 1,U I p �E .41Z�p oc�._
Structural plan review fee(or deposit):
Address: FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Amount�received: --- '
Phone:( ) Fax::( )
E-mail: P -l�--D S-` c-, 4A S t- co \ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel Syste
Business name: -AM-c 14 S 4.\1 u,1Submit two(2) - of roof plan with conn- 'in details
Address:
i' and fire department ac - s,along wi e 2010 Oregon
Solar Installation Special '.• checklist.
City/State/ZIP: Permit Fee(inclu.= plan iew $180.00
and .nistrative fees".
Phone:( ) Fax:( )
State sur -.rge(12%of permit fee): x $21.60
CCB lic.: 7 1 p-S
-
o a - . e upon application:
,201.60
Authorized signature: This permit application expires if a permit is not obtained
��-�^ -t- within 180 days after it has been accepted as complete.
Print name: -3----... `�- Date: *Fee methodology set by Tri-Cour Building
�,„u S I D U )_-11 PP.�✓z%f 6-Z9_/( Tri-County g Industry
-a 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 OR OH'ICE tSF oyL'
City of Tigard
Received Permit No.:
Dateive
13125 S W Hall Blvd.,Tigard,OR 97223 Associated permits:
_ Phone: 503.718.2439 Fax: 503.598.1960
0 Electrical 0 Plumbing 0 Mechanical
T(G A R I) 24-Hour Inspection Line: 503.639.4175
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1" No yi,1,
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 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 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 0
basin protection,etc. 0 0 0
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.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 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. 0 0 0
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size
and location. 0 0 0
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- 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. 0 0 0
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. 0 0 0
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non-
prescriptive path analysis provide specifications and calculations to engineering standards. 0 0 0
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 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 0
over 10 feet long and/or any beam/joist carrying a non-uniform load. 0 0 0
20 Manufactured floor/roof truss design details.
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. 0 ❑ 0
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
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". ❑ ❑❑ 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above.
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❑ ❑
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 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. 0 0 0
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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
RECEIVED
City of Tigard
IN
p COMMUNITY DEVELOPMENT DEPARTMENT AUG 3 2016
CITY OF TIGARD
T I G A R D Building Permit Review — Residential BUILDING DIVISION
Building Permit #: .-1‘--51-.,=3#5,t 10- co 31 -5
Site Address: /yc? S'4) //. (74
Project Name: /41 ///1,) 'L ,ik 4oebbv f Lot #: /
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Pro osal: �. J e- 4,4,4 .// 4nc! n pleat-- fb /,pl_
Verify site address/suite# exists and activ to permit system.
ri/ Giver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
ree(3)copies of site plan ❑Existing structures on site
'1A bite plan must be on 8-1/2"x 11"or 11 x 17"paper ❑Footprint of new structure(including decks)with finished
,'9Wrawn to scale(standard architect or engineer scale) floor elevations
V'orth arrow ❑Utility locations(required for new,may apply for additions)
e address,project or subdivision name and lot number )\MILocation of wells/septic systems
V plicant information(name and phone number) 1 ❑Existing trees to be retained with drip line,and tree
Lot dimensions and building setback dimensions protection measures
II ii t area,building coverage area,percentage of coverage and ❑Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) ❑Street names
operty corner elevations(2 foot contour lines if more than
4, foot differential)
14 lean Water Services-Service Provider Letter(lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified ❑ No Received: CI Yes ❑ No
V Public Faciliti Improvement(PFI) Permit:
/Required: Yes,applicant was notified ❑ No Applied For: P<s ❑ No,stop intake
-
Pei-and Use Case#: SW, 0"3
I da�
�
Zoning: e- L,,S'
Setbacks: Front Rear Side Street Side Garage
3 Landscape Requirement: 0/0
�o�H-`hMaximum: % �
g eIg t: Maximum Height g Actual Height E:52,
El Visual Clearance
Easements
t-lt
Sensitive Lands: ❑ Yes ❑ No Type
CIklrban Forestry Plan
/Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: ..._ Date: J
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPermitRvw RES 060116.docx
Building Permit Submittal 3',
Original Submittal Date:
40
Site Plans: #
Building Plans: #
Building Permit#: 2"-Enter building permit#above. /
Workflow Routing: ❑-Planning Ld Engineering Permit Coordinator 3/Building
Workflow Sign-off: 2 Sign-off for Planning(include notes from planning review)
Route Application Documents: [.T Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
,,,original plan review routing form.
Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: �� 4-( Date: g/5/44
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 I No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: tiL--3) Date: 84;4,,
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:
DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A
Tigard Trans SDC:
CI Yes N/A
Parks SDC: ❑ Yes 7.N/A
4p0K to Issue Permit
Approved by Permit Coordinator: Date: 'VI A"
I:\Building\Forms\BldgPernvtRvw_RES_060116.docx