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13320 SW ASH AVE
CITY
�� �'���D BUILDING PER"/IIT
C
PERMIT#: BUP2004-00246
DEVELOPMENT SERVICES DATE ISSUED: 5/28/2004
13125 SW Hall Blvd.. Tiqard, r..,R 97223 (503) 639-4171 PARCEL: 2S102CA-00904
SITE ADDRESS: 13320 SW ASH AVI
SUBDIVISION: VILLAGE GLENN ZONING: R-4.5
BLOCK^ LOT: 004 _ JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK ACS FIRST_ Sf N: S: E: W:
TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: f, GARAGE: sf OCCU SEP. RATED:
BSMT?- MEZZ?: READ SETBACKS _ REQUIRED —
FLOOR LOAD: psf LEFT: ^ft RGHT: ft FIR SPKL SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP S'JRFACE: PRO CORR: PARKING:
VALUE: $ 1,200.00
Remarks: Storage shed.
Owner: Contractor:
BURGESS, ROBERT OWNER
13320 SW ASH AVE
TIGARD, OR 97223
Phone: 503-449-5771
Phone:
Reg #:
FEES REQUIRED INSPECTIONS _
Description Date Amount Final Inspection
BUILD] Permit Fee 5/28/2004 $62.50
(TAX]81/n State Surcharl 5/28/2004 $5.00
IBLIPPLN] Pln Kv 5/28/2004 $25.00
Total $92.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all otrter 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, :ir if work is suspended for more than 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 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by
calling(503)246-6699 or 1-800-332-2344.
/7
Issued By: y
/
Permittee \ ��
Signature:
C 175 by 7 p.m. for an inspection the next business day
MffildinL, Permit Application 1,Ok OFFICE USE ONLV
/—
City of Tigard D;eWSY
d C Pertrut N vv6CJ
13125 SW Hall Blvd.,'rigard,OR 97223 Plan Revie Other Permit
Phone: 503.639.4171 Fax: 503.598.1960 D&WIl _
Inspection Line: 503.639.4175 Date Ready/lily— Jura 0 See Attached Checklist for
Internet- www.ci.tigatd.or.us Notified/Method: — supplemental information
TYPE OF;1IV,ORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
New construction —� ❑Demolition- W Permit fees`are based on the value of the work performed
----- --- — Indicate the value(rounded to the nearest dollar)of all
❑Addition/alter;ulon/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUC'T'ION work indicated on this application.
• PP
_—. _--- ---T------ -- Valuation: $ 7 do
❑ I-and 2-family dwelling - ❑Conuneiclalindustrlal
Accessory building ❑Multi-family Number o e rooms:
❑M-ister builder ❑Other Number of bathrooms:-
JOB SITE INFORMATION AND LOCATION _ Total number of floors
Job site address ` 3'7 (j —T New dwelling area: square feet
City/State/ZIP: I `� 1 ZZ 3 Garage/carport area: square feet —
Suite/bldg./apt.no.: I Project name: _ — _ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
IREQUIRED DATA:COMME$CIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees•are based on the value of the work performed
Tax ma p/parcel no.: Indicate the value(rounded to the nearest dollar)of all
P P equipment,materials,labor,overhead,and the profit for the
II -- DESCWTYON O — r f �: work indicated on this application.
Valuation: $
Existing building area: square feet
New building arca• _ square feel
—_ jiOkRTY 0RNE12 — _T❑ TENANT Number of stones:
Name: �� � �Z(GC S S _ _ _-__- Type of construction: --
Address: 1 O S l,J AstiU LOccupancy groups:
City/State/ZIP: T q 2 Z Existing: —
Phnnc Fax:( 1 New: -- ----- —-
t3 APPLICANT CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempOom licensing,the following reasons
_ apply:
Phone:( ) — - -— Fax::
rte.,.
E-mail 7
CONTRAC'rQR
Business name ,."' -
13U YIVC PER1•'EP:S•
Address:
Please refer to fee schedule.
City/State/ZIP: --' ----
-- -- Fees due upon application
Phone:( ) Fax_( ) ---
Amount received —
CCB lie.: ---�
— — Date received:
(�At.iorized signature:j 'j This permit application expires if a permit is not obtained
within 180 days after it has been accepted m complete.
Print Mame: Date: _� • Fee methodology set by Tn-County Building Industry
Service Board
"8uildin{\Pe,.iu\BUP-PemtApp doc I V03 440-4613TI I 1/02/COM/WEB)
- J
One- and Two-Family Dwelling
BuildinLy Permit Application Checklist FOR e e
Cit f Tigard
Received
Y oDate, —t No.:
13125 SW Hall Blvd.,Tigard,OR 97223 ---LL-- - ---
Phone: 503,639.4171 Fax: 503.598.1960 Associated perrmts
24-Hour Inspection Line: 503.639.4175 O Electrical O Plumbing O Mechanical
Internet: www.ci.tigard.or.us O Other
REVIEWUIIE FOLLOWING IT EMS ARE REQUIRED FOR PLAN
I 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. _ ❑
4 Fire district approval required. Name of district:
5 Septic permit or authorization for remodel. Existing syster..capacity _ ❑
6 Sewer permit. ❑
7 Water district approval. F1 ❑
8 Solis report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control ❑plan ❑permit required. include drainage-way protection,silt fence design and locahun of catch- ❑
basin protection,etc.
10 _J_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.
I I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(it'
there is more than a 4-ftelevation 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 ❑
and location.
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 ftaming-member sizes and spacing such w floor beams,headers,joists,sub- [�
floor,wall construction,roof construction. Mote 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. El
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-
prescriptive
on- _A
rescri tiP ve path analysis provide specifications and calculations to engineering standards. JJ
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 ❑ ❑
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 to ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
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.,cheat wall,roof truss)shall be stamped by an engineer or
architect licensed:n Oregon and shall be shown to he armlicable to the UroeCt under review,
JURISDICTION�kL
23 Five(5)site plans are required for item I i abuve. Site plans must be S-1 2"x I I"or I I"x 17". ❑
77F
.24 Two 2 sets each ore required for items 16, 19,20 and 22 above. _
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑
26 "Reversed"build;ng plans must meet criteria outlined in the Permit&System Development Fees document.
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type and location per approved project sheet tree plan(if applicable).and City of Tigard ❑ ❑
Street Tree List.
29 Site plan to include tree protection measures as re uired by conditions of approval,
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 Sc)tember 9, 1995.
i.\Building\Permits\One-Two-FamilyChecklist.doc 12/03
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CITY OF TIGARD 24.-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171BUIP
----
Received ___�_. ___ Date Re ,Sted— �M /PM ___-_ BUR
. / �P Suite_- MEC
Location _1__3 3Z(�
Contact Person
C Ph( ) SWR - -
DING Tenant/Owner _ - -_._ _ ELC
Footing ELC
Foundation Access:
Ftg Drain . �tF-/fir ELR ---- -- -
Crawl Drain
Slab Inspection Notes. SIT _
Post&Beam - - - - - -- _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - - - - - ---- - -
Insulation
Drywall Nailing - - --
Firewall
Fire Sprinkler ----
Fire Alarm
Susp'd Ceiling ---- -- - -- - - -
Roof
_ASS ART FAIL
BING ---�.--- —
Post& Beam
Under Slab — -
Rough-In
Water Service ---- --— "'
Sanitary Sewer
Rain Drains — — —
Catch Basin/Manhole
Storm Drain —- --'-� -- —
Shower Pan
Other: _
Final _
PASS PART FAIL v
MECHANICAL ----
Post& Beam
Rough-In -------- -- — - ------ _�—
Gas Line
Smoke Dampers - - - ------- --
Final
PASS PART FAIL ---- -- - ----- -'-- — -- -
ELECTRICAL _
Service _--
Rough-In
UG/Slab
L-)w Voltage -
Fire Alarm
Final u Rein^pection fee of$_ _ _required before next insp n. Pay at Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE L] Please call for r inspe on RE:__-. -_- able to inspect-no cess
Fire Supply Line /�2
ADA - W
Approach/Sidewalk Dab_ Insp•eto --
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS FART FAIL
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