8640 SW INEZ STREET curt OE' rwARV - SITE: PLAN REVIEW
BUILDING E'E M I 1 N 0u .rua
KANNING DIVISION: '� y S
•
Required Setbacks: Approved ❑ Not Approved
Side: ;;'ect Side: __LLQ__.
C,arutr e: a;40 Rear.
L..�
'..Mill Clearaiice: OApproved t'`1-, Not Approved
flxinwm 13110(ling. «eiglit•� feet
CNVS Scr--icr Provider L�:tter Required: V Yes C3 No
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1 _ too— �.� I Actual Slope:.__._ % O Appro vcd ❑ Not Approved
Site Plan: ❑ Approved ❑ Not Approved
13% • Date:
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shall be on job site
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rights of holders f private easements. The 3P-
,,plicant is urged to contact any such patties and
secure thier approval before commencing work.
LIABILITY
The City of Tigard and its
employees shall n
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responsible for discrepancies
y which may appe—ar herein.
AV
CITY OF TIGARD
Approved ----------------------------- ----- 0(y.
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For only thewo as described in.
PERMIT NO. g2 a d'?- MAWR —
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8640 SW INEZ ST
�►RD BUILDING PERMIT
CITY OF TIG
PERMIT#• BUP2003-00602
DEVELOPMENT SERVICES DATE ISSUED: 10/17/03
'13125 SW Hall Bivd.,Tipard, OR 97223 (503) 639-4171 PARCEL: 2S111AA-04800
SITE ADDRESS: 08640 SW INEZ ST
SUBDIVISiON: GREENSWARD PARK ZONING: R-4.5
BLOCK: LOT: 026 JURISDICTION: TIG
REISSUE: CUSTOM FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: NONE sf N: S: E: W: _
OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 1 NT: 10 ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: R1'QD SETBACK:._ _ REQUIRED
FLOOR LOAD: 40 psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET:Y
DWELLING UNITS: FRNT: 20 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 6,900.00
Remarks: Addition of 35 sf, to front of house. Glass enclose at house porch
Owner: Contractor:
SIEVERS, WILHELM V WESTCOAST HOME IMPRCVEMENTS
MONICA 5405 SW TAYLORS FERRY RD.
8640 SW INEZ STREET r'ORTLAND, OR 97219
TIGARD, OR 97224
Phone: 503-620-9544
Phone: 503-892-3296
Reg #: LIC 122922
FEES REQUIRED INSPECTIONS
Description Date Amount Footing Insp
113UILD] Permit Fee 10/6/03 $71.83 Foundation Insp
13UILb Permit Hee 10/11/03 $110.50 Framing Insp
� ]
I AX] 80/0 State Tax 10/17/03 $8.84 Final Inspection
�CDC131.1)J CDC Bid Re 10/17/03 $20.00
(additional fees not listed here)
Total $231.17
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 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.
Issued By:
Permittee i !"
Signature:
Call 639-4175 by 7 p.m. for an inspection thf, next business day
� �
Building Permit Application Building
Received i
Date/By: k emtit No.: V
t V Plannini pproval Other
City of Tigard Date/B : Permit No.:
13125 SW Hall Blvd. f jc` Plan Review Other
Tigard,Oregon 97223 Date/B : M Permit No:
se
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review ( Land
0 3 Case No.
0
Internet: www.ci.tigard.or.us „, Contact nae See Page 2 for
24-hour Inspection Request: 503-09-4175 Name/Method: 1' Supplemental Information J
F\lyORh.�ti;',
New construction _ Demolition . + G
Addition/ ationAe lacement Other:
Q]Z• g (y Note: Permit fees*are based'on the total value of the work performed. Indicate
I &2-Family dwelling ❑Commercial/Industrial the value(rounded to the nearest dollar)of all equipment, ,aterials,labor,
overhead and profit for the work indicated on this application.
_ AccessoryBuildin Multi-Family ��®O
Master Builder Other: Valuation......................................................... 5__
�' : B [ E i11�6 O nd..LO '-N No.of bedrooms: No.of baths:
Job site address: Total number of floors..................................... 4 _ -
- Y New dwelling area(sq.ft.).............................. _
Suite#: Bld ./A t.#: Garage/carport area(sq.ft.)............................
Project Name: Covered porch area(sq.ft.).............................
Cross street/Directions to job site: Deck area(sq. ft.)............................................ -
Other structure area(sq.ft,)............................
0"(i, bA C�
Subdivision:
.. ; .
Tax map/parcel #: —` Note: Permit fees"are based on the total value of the work performed. Indicate
,-, �a l,. Q; r) the value(rounded to the nearest dollar)of all equipment,materials,labor,
-- . overhead and profit for the work indicated on this application.
Valuation......................................................... S
Existing building area(sq.ft.)........................
a ---- New builo:ng area(sq. ft.)................... ...........
Number of stones............................................
� - Type of construction...............................
Name: Occupancy group(s): Existing:
�: New:
Aldress: qFWC7 $W Z
City/State/zip: A
, r " -- NOTICE: All contractors and subcontractors are required to be
PhoAl-
Business
— $'�`'� Fat:
•; ANT Fax
licensed with the Oregon r_ .sttuction Contractors Board under
--•- - provisions of ORS 701 aiw may be required to be licensed in the
Name V jurisdiction where work is being performed. If the applicant is exempt
Contact Name: '� from licensing,the following reason applies:
Address: S �'
City/state/Zip P_a�XrQQ1
Phone: b --
-- �,���/- 1 FaX: BiJH,D�NC PERt11i;'FEES*
S� t ` er
Aleme refto fee schedule.,�+
"CO TRACT!(? �• _ ..__-_. .._ —_-
Business Name:_ Fees due upon application..... ....... ....... S.
_Address:
City/State/Zip: _ l Amount received.............................. .............. S
Phone: Fax: J Date received:
CCB Lic. #: \0' J -
Authorized ---– Notice: This permit application expires if a permit is not obtained within
Slgnfltttre: IRO days after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
(Please pnnt name)
i DstsNPerr,it Formv\BldgPemiitApp.doc 0003
One- and Two-Family Dwelling
Building Permit Application Checklist Referenceno.
:
--`-"�—"
City of Tigard City of Tigard Associatedpennits:
Address: 13125 SW Hall BIvd,1'igard,OR 97221 ❑Electrical O Plumbing O Mechanical
Phone: (503) 639-4171 ❑Other;
Fax: 15031 599-1960
THE FOLLOWING 1 FOR PLAN REVIEW
1 baud use aclious compleled. .Sce jurisdiction criteria for concurrent rr%1ckt s,
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved plat/lot.
4 Fire district_ approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
9 Soils report.Must carry original applicabl,:stamp and signature on file or with application. _
9 Erosion control U plan J permit required.Include drainage-way protection,silt fence design and location of
c (Il-ha,;in protection,etc.
10 (-,L,,,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 comer elevations(if
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 stricture(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.
-IF2 Foundation plan.Show dimensions,a,c"nr bolts,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,roc,n 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•noor,
wall construction,roof construction.More than one cross section may be required to clearly portray consttuctiot],Show
details of all wall and roof sheathing,roofing,roof slope.,ceiling he`ght,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.
Exterior elevations must reflect the actual grade if the change in grade is greater than tour 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 plana.Must indicate details and locations;for
_ non 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
locations.Show attic ventilation.
19 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/cr any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
21 Energy Code compliance. Identify the prescriptive dh 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
architect licensed in Oregon and shall be shown to be applicable to the project under review.
.11 MSDICTIONALSPFCIFICS
23 Five(5)site plans are required for Item 11 above. Site plans must he 1, 1'2"x 11"or 1 I"x 17"
24 Two(2)sets each are required for(terns 16, 19,20&22 above. -� Y
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted.
26 "Reversed" building plans trust 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&location per approved project street tree plan(if applicable),and COT Street Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440-4614 t6,1001canta
10/14/03 14:48 FAX 5038483R25 CLEAN WATER SERVICES 4001
OCA !? �, 2003 File Nina 34 d0
CleanWater Servi ,E p V Le D
Our Commitment is clear. Sensitive rea Pre-Screening Site Assessment
BY--- —_`
7 tu03
Jurisdiction Tigard Date _1 )/6/03 _ _.__ r.�l.TIGARD
Mep&Tax Lot 2S111AA04800 _ Owner Wilhelm Sievers
Site Address 8640 SW Inez St. -- --- - OIVISIQN
Tigard, OR 97?_?_4 _ Contact Vc;1 :. Breitenmoser
Proposed Activity Address 5405 SW Taylors Fy. mid;
knclose existing breeze way -Portland, OR 97219
- _^---�--- -- - Phone 503 SS(}-1579
___._50.3e2ssF-An u _
01llcini usa only bolow this line
Y N NA Y N NA
I --� Ma itSensitive m
tive Area Composite Map n ® Stormwater Infrastructure ap:;
� _-� p _-g3Z-� -- - l_'1 CIS 0_-Y XQ____
Locally adopted studies or maps Other
LJ n UN
Specify Specify - —
Based on a review of the above information acid the requirements of Clean Water
Services Design and Construction Standards Resolution and Order No. 03-11:
L1 Sensitive areas potentially exis•on site or within 200' of the site.THE APPLICANT
MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SF_RVICE
PROVIDER LETTER OR STORMWATi R CONNECTION PERMIT. If Sensitive Areas
exist on the site or within 200 feet on adjacent properti.s, a Natural Resources
Assessment Report may also be required.
Sensttivt• areas do not appear to exist on site or within 200' of the site.This pre-
screening site assessment does NOT eliminate the need to evaluate and protect
water quality sensitive areas if they are subsequently discovered on your
;property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS
REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A
STORMWATER CONNECTION PERMIT.
The proposed activity does not meet the definition of development, NO SITE
ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.
Cc mments: J
CI R-_—
Reviewed By: Date: _r el
Post-it'Fax Note 7671 54116 �/y o5 t+aDs•� Returned to Applicant
To mom Mail Fax-_T Counter_
er e�7c►rhpSer � � , ve/4.d..• Date
Co/Oepl
Phos• -- Pta�rear�. --
_ ___
Ion
SEE 35MM
ROLL# 23
FOR
LARGE
DOCUMENT
Oct IP 03 04: 59p Volker Breitenmoser 15031 092--3296 P. 1
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