13305 SW FISCHER ROAD I
13305 SW FISCHER ROAD
-- BUILDING PERMIT
CITY OF TIGARQ
PERMIT#. BLIP2003-0J302
DEVELOPMENT SERVICES DATE ISSUED. 5/23/03
13125 SW Hall Blvd., Tiqard, OR 9723 (503', 639-41 i 1 PARCEL: 2S116AC-00900
SITE ADDRFSS: 13305 SVS' FISCHER RD
SUBDIVISION: PEACHVALE ZONING:
BLOCK: _ LOT: 020 �A —JURISDICTION: KIN
REISSUE: FL'JOR AREAS _ EXTERIOR WALL CONSTRUCTION,
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: _ E: W:
CCCIJ`'4NCY GRP: TOT 41- AREA: 0 sf ROOF CONST: FIRE RET?
OCCI:i1;',NCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOW HT: ft GARAGE: sf OCCU SEP. RATED:
BSMI? MEZZ?: _R_EQD SETBACKS _ _ REQUIRED___
Fi..00R LOAD: psf LEFT: ft RGHT: �ft it!P. SPKL.: SMOK DET•
D'NE.L LING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC.
BEDRM.": BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE-
Remarks: If property is connected, sewer must be caped and inspected. If property is on septic, soptic must be pumped,
filled and inspected. All debris must be removed.
Owner- Contractor:
MATRIX DEVELOPMENT NORTHWEST ENVIRONMENTAL_
12755 SW 69TH AVE #100 1045 N. 4TH AVE.
TIGARD, OR 97223 CORNELIUS, OR 97113
Phone: 620-8080
Phone: 620.8080
Reg #: 603-992-2239502
FEES _ REQUIRED INSPECTIONS
F::�
i
Descriptic•,n J Date Amour•t Cap Sewer Line Insp
Pump/Fill Septic Tank Insp
I BUILD] Permit Fee 5/28/03 $62.50 Final Inspection
I AXI 8'%,State'Tax b/28/03 $5.00 i
I:RPRM'r] Erosion 5/28/03 $26.00
�1:RIILNI EroPlck-USA 5/28/03 $8.45
(additional fees not listed here)
Total $110.40
This permit is issued subject to the regulations contained in the 1-Igard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for I,:-rr`than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification uta :er. Those rule-, are set faith :n OAR
952-001-0010 through OAR 952-00.1-0100. You may obtain a copy of these rules or direct questions t,I JNC by
calling (503)246-6699 or 1-800-332-2344.
Issued By:
Pe mi it tee
Signature: '� .� �
Call 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Application Received � , � Building �
Date/By: ; )• f$'. PCnmtNo:
City of Tigard Planning Approval Other
Dat&B : :'ennit Nc._
13125 SW Hall Blvd. Plan Iivi4w Other — R!-`-
Tigard,Oregon 97223 Date/By: Permit No
Phone: 503-639-41-7: Fax: 503-598-1960 Post-Review -- LandUUse
Internet: www.ci tigard.or.us Date/By: -ase No. _ _
Contact Juns.: See Page 2 for —�
24-hour Inspection Request: 503-6394175 Name/Method: 5u icmcntal tnformatior�
TYPE OF WORK REQUIRED DATA:
New construction Demolition — I &2 FAMILY DWELLING
Addition/alteration/replacement Other: —
__ CATEGORY OF Cf)NSTRUC ION t.
Access�Building Multi-Tamil Note: Pennit fees•arc based on the total value of the work performed. Indicate
i11 1 &2-Famil dwellin Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor,
— overhead and profit for the work indicated on this application.
r
[�Master Builder = Other: _ Valuation......................................................... 3
�- ,84'' 0H'SITE'INFORMATION an%f'LOCA TION No.of bedro, ms: N,.of baths: _
Total number of floors.�
Job site address: 1 3J c,_1 -'-Sc,/ Aisr�ycrz /'cq - ,,✓' l�Y —_
New dwelling area(sq.fl.)..............................
Suite#: Bort ld ./A t.#: Gara age/carport s
Project Name: ! m area( q ft.) .................. _
Covered porch area(sq.tt.).............................
Cross streeVDirer:ions to job site: Deck area(sq.ft.)............................................ -
J`�1 f< /lit, ,QQ .t, �/ l` r Other structure area(sq.ft)...........................
eqn
:7[[ 1 f1 1.�'ra /1 r vim*/-*z% V 9 f 1 tt 'E.r A '�t1tl QUIRED DATA y :r
MICIA L '1SE c n iLckLIST 5
Subdivision. Lot#:
fax map/parcel#: Z f 1 f Note: Permit fees'are based on the total value_of the work performed. Indicate
� 4r vs 1` +�bD.SCRIPTION OF: the value(rounded to the nearest dollar)of all equipment.materials,labor,
overhead and profit for the work indicated on this application.
Valuation....................................................... S
T` �+ Existing building area(sq.R.)......................... - _ --
__.— New building area(sq.R.)...............................
_ Number of stories............................................
PROP'ER'TY,OWNER TEPrNT -^; Type of construction......................................
_Name: ��',�_/2,.VC ,r�r,�c�. /, ti Occupancy group(s): Existing:
Address: z?,L-1-- � ��' New: — - -
City/State/Z,tp: ��� �, � ,�_
Phone: NOTICE: All contractors and subcontractors Pse required to be
(�t r ,
LEL�UN-TiF
_ _
licensed with the Oregon Construction Contractors Board undo:
Al'PLICIANT;., T P.E1250N F•'. provisions of ORS 701 and may he m)uired to be licensed in tltc
Business Narrte: jurisdiction where work is being I;trfotmed. If the applicant is exempt
Contact Name:'— y M from licensing,the following rew.on apples:
Address:
Cit f State/Zip: __ --– -----Phone, _FF
Fax:
'CONTRACTOR a hie rer'
te
L�
Business N tmeLt. t ,, IrFees due upon application ..... . .................. S //'O.
Address: /�✓ ,�
.__=AJ
Cit /State/1.ip: C,)•c�✓'t r 4J_ �'71G1Amount received........................ .................
fir...
\ Phone:J c,r 3.1•Z- 60q, rax: of .y^z 22-z Nte received:---..__..-._._....._._.___.._�
CCB L_ic. 1 LJ�o Z' —_
Authorised '
/ Signature. '� _ Date:J z) j No":e: Thi;permit soPlIcation evlr•-,ft a rerrnk Is not nhta;ned within
190 days after it has t-tv accepted ea Complete.
*Fee methodology set .w'rri ('ornty Building Industry Service Board.
(Please print name) Vi ysr ('"t�
r•'D�t.gTemtit Fortml)31dgPermitApp.dec 01103
One-and Two-Family Dwelling
Building Permit Application Checklist Rcterenceno.:
Associated permits:
City of Tigard City of Tigard s U Electrical U Plumbing O Mechanical
Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Other: _
Phone: (503) 639-4171
Fax: (503) 598-1960
1111E FOLLOWING 61,MS ARE
I Land use actions completed.Sec jurtsdicty)n 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 rejulred. _
5 Eept4c system permit or authorization for remodel.Existing system capacity
6 Sem er permit.
7 N/afer district approval.
8 'lulls report.Must carry original applicable stamp and signature on file or with application.
9 Er•oslon control U plan U permit required.Include drainage.-way protection,silt fence design and location of
catch-basin protection,etc. _.
10 ..'L Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
huilding codes.Lateral design details and connections must he 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 comer elevations(if
there is more than a 44t.elevation differential,plan must show contour lin,s at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septie systems;utility locations;direction indicator;lot
rr.a;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
1; I,uundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
Sze and location.
? 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 secdon(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-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.
Pi Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevat;ons 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.
Iii Well bracing(prescriptive path)and/or literal analysis plans.Must indicate details and locations;for
nonj+rescriptive path analysis provide specifications and calculations to engineering standards.
17 Hloor/roof framing.Provide plans for all Hoots/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,"Erigineer'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 anllor any beam joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
21 Energy Corse compliance Identify the prescriptive path or provide calculations.A gas-piping schematic is required
for four or more appliances.
22 Enlllneer's calculations.When required or provided.(i.e.,shenr wall.roof truss i shall be stamped by an engineer c
architect licensed in Oregon r.nd shall be shown to be applicable to the project under review.
7i .11 IRIS1111](1110NAL SPECIFICS
23M.,ve(5)site plans are requiredft7r: cmllabove. Site plans mustbe 8-1/2"x 11"or I I"x 17".o(2)sets each arc required for items 16, 19,20&22 above.ilding plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted.
26 "Rei crsed"building 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&location per approved project street tree plan(if applicable),and COT Street Tree List.
Checklist roust be completed before plan review start date. Minor changes or notes on submitted plans may be in blu_ or black ink
Red ink is reserves' for department use only. W-4614 WtCowt
r = � ' 805 . 0 '
189 . 0 '
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67 Qo.
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CITY OF TIGARD 24-Hour
BUILD!�.� Inspection Line: (503) 538-4175 MST — --
INSPECTION D?V�510N Business Line: (503) 639-4171 6U �C,3-- 00 ; 1
/ 1a AM__ BUP —
Date Fe nested--___ PM -
Receiwd ---- q
e-' s 2 r✓�: Suite - MEC --
Locatlon _ --
- ( PLM
Contact Person —__— Ph
( SWR — -
_ - - -
Contractor_ -- -- --- Ph ELC -Tenant/Owner _ __ -- �"—---
BUILDING El-C, --
Footing
Foundation F
cess: ELR
Fig Drain
Crawl Drain SIT
Slab pectio7.oles:
Post&'deam w
Shear Anchors -Ext F.ieath/Shear
Int S'Beath/Shear
Framing
Insulation — - —T
Drywall Nailing
Firewall —
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof -
Other: __ --— __—_—_-----
PART FAIL --
_PLUMBING -
Under Slab _
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: -_- --_ -
Final
PASS PART FAIL
_MECHANICAL _ -----
Post&Beam - - --
Rough-In ------- ---- __ -----
Gas Line —
Smoke Dampers —
Final -- —
PA5s PART FAIL
IcLECTRICAL --
Service _----- -
Rough-Ir, _--
UG/Slab --
Low Voltage --- J�—
Fire Alarm
Final U Reinspection fee of$_ required before next inspection. Pay et City Hail, 13125 SW Hall Blvd.
PASS PART FAIL F_11 unable to inspect-no access
31TE •-- —_`_ ❑ Please call for reinspection RE:� - •-----
Fire Supply Line C / 2 �'0Ext
ADA _ Da1b._ -1 - Inspector -----J
Approach/Sidewalk
Other: —_-----_ DO NOT REMOVE this Insrection (record from the Job site.
Final
PASS PART FAIL
t