Permit (84) INCITY OF TIGARD
v MASTER PERMIT
�. 3
COMMUNITY DEVELOPMENT Permit#: MST2017 00002
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/05/2017
Parcel: 1S134CD05100
Jurisdiction: Tigard
Site address: 12000 SW SUMMER CREST DR
Subdivision: BURLWOOD Lot: 11
Project: Campbell
Project Description: Replacement and addition to existing deck. Total deck is 554 sq ft.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5
Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 15
Smoke
Dwelling Units: 0 Third: 0 sf No
Right: 5 Detectors:
Total: 0 sf Value: $12,365.00 Rear: 15
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
0 Storm Sewer 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains:
Bckflw Prevntr: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 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: Occup: Square Feet:
ALT SF VB
R-3 0
Owner: Contractor:
CAMPBELL,MICHAEL A&CARMEN K MICHAEL CAMPBELL Required Items and Reports(Conditions)
12000 SW SUMMER CREST DR 12000 SW CUMMER CREST DR 1 Special inspection
TIGARD,OR 97223 TIGARD,OR 97223 required...Structural welding
PHONE: PHONE: 503-521-8761
FAX:
Total Fees: $691.23
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
: :Z0u9520d1009
You may obtainacopr direct questions to OUNC by 787 or1•
Permittee Signature:94175 by 7:00 a.m.for the next available inspe
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 i "'A 5
FOR 0141( t si. O\l.l
City of Tigard r Al 4 , , Received / 3 /7
71
r 13125 SW Hall Blvd.,Tigard,OR 97223 `} i e� Date/By: Permit No.:/l/5 A/7-yO�bi
Plan Review ,
Phone: 503.718.2439 Fax: 503.598 1960
Inspection Line: 503.639.4175 Date/By: 3,p ',� Other Permit:
1 I t ARU p . s ` Date Read/B I lff See Pae 2
Internet:www.tigard-or.gov o� `s Notified/Method: // f X7^7- kris g Informationnr
.`,, � WC-dated /�/r7 'I/// _ Supplemental
TYPE OF WORK t Carol
REQUIRE 1-AND 2-FAMILY DWELLING
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Addition/alteration/replacement ❑Other: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
•
_/ CATEGORY OF CONSTRUCTION work indicated on this application.
El 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ a 3 / C, 7 GY
El Accessory building 0 Multi-family Number of bedrooms: (�' 7 0�#3
El Master builder
0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 190 by 5 W 5'i,,t iN►yv.v Cvas k /i New dwelling area:
square feet
City/State/ZIP: •1 k_L 00 ti��/ ` 0 a 41) Garage/carport g arport area: square feet
Suite/bldg./apt.no.: I Project name:
Covered porch area: square feet
Cross street/directions to job site: v
�A I^ ,,1� Deck area: square feet
t"I GV 2fy
U.I Other structure are thquare feet
REQUIRED DATA:COMMS - SE CHE KLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work..erformed.
Taxtirtap/parcel no.: Indicate the value(rounded to the nearest dol: )of all
r equipment,materials,labor,overhead,an• e profit for the
DESCRIPTION OF WORK ' work i •'cated on this application.
,�Ie C 1 S d Okit P�t/�f f�� Valuation:.
11 ,�" �'1r'lt� $
Existing�� building' .: square feet
'D L= SC/// New building area: '- square feet
EPROPERTY OWNER I ❑ TENANT Number of storie
Name: m ichae/) . eatal 611410b,fm • Type of co •ruction:
Address: 471 t E 4 ,41-/ -
Occupancy groups: `,
City/State/ZIP:
Phone:(503) - .f - g-74,/ INew:
Fax:( ) Existing:
❑ APPLICANT 0 CONTACT PERSON BUILDING
(Pleaserefer PERMIT FEES*
Business name: to fee schedule)
Contact name: Structural plan review fee(or deposit):
Address: FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
^i/
Phone:( ) I Fax::( ) Amount received: `I/ 76,zi3
E-mail PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-topfrttunted Photo Voltaic Solar Panel System.
Business name: Q t�',E2 Submit two(( )sets of roof plan with connection details
Address: / and fire departm .t access,along wit} 0T0 Oregon
Solar Installation i: ial c ecklist.
City/State/ZIP: Permit Fee(i s Ian review
Phone:( ) I Fax:( )
. •administra`` fees): $180.00
CCB lic.:
surcharge(12%of permit fe $21.60
a Total fee due upon application: $201.60
Authorized signature: ` 'I'
x � (( This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:v/1 fti.1W, f /l / I *Fee methodology set by Tri-County Building Industry
�'/�[i I Date: / 317 7 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 OFFICE 1:SI. OyI.I
Received Permit No.:
City of Tigard Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960 0 Electrical 0 Plumbing 0 Mechanical
24-Hour Inspection Line: 503.639.4175 ❑ Other:
T 1�'A R D Internet: www.tigard-or.gov
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW
lcs \n 1Lk
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot.
4 Fire district approval required. Name of district: • 00 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity • 0
0
0
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin . otection,etc.
10 3 C,mplete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 0
...r: g 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 a1pyright violations exist.
te/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0
ere 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;utilitylocations;direction
(j 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, 0 0 0
vent size
and location. (] 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
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
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 ❑ ❑
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 applicable to the .ro'ect under review.
JURISDICTIONAL SPECIFICSIIIIIII
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 0 0
24 Two(2)sets each are 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. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 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
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)
City of Tigard
1114 ■ 'l COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: H‘DT-D-0 l 7-0000
Site Address: rl2COO ,Si ) Ste,— '
Project Name: `. ca-m , # e, Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: c, jr) r4 C
Verify site address/suite#exists and actio permit system.
TOIver Terrace Neighborhood: Id No ❑ Yes,See River Terrace Review Addendum Attached
SitIPlan Elements:
VJ ree(3)copies of site plan
"4 sting structures on site
(e plan must be on 8-1/2"x 11"or 11 x 17"paper i• 'Atprint of new structure(including decks)with finished
I
VD ,wn to scale(standard architect or engineer scale) floor elevations
IR .rth arrow N!Aiity locations(required for new,may apply 1 for additions)
X S. address,project or subdivision name and lot number g I t.anon of wells/septic systems
•plicant information(name and phone number) ptAting trees to be retained with drip line,and tree
��Mwet dimensions and building setback dimensions •rotection measures
ey.Ld 1t.area,building coverage area,percentage of coverage and 1:I".et-tree size,type and location
ervious area(applicable if R-7,R-12,R-25&R-40) I1 Street names
operty corner elevations(2 foot contour lines if more than
4 foot differential)
❑ Clean 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: E Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
16 i' and Use Case#:
M oning: p_4/
Oa Required Setbacks: Front Rear ic Side Street SideV)iptGarage
(pl.pc
Landscape Requirement: 0/0
Lot Coverage Maximum:
Building Height: Maximum Height Actual Height h
Visual Clearance
Easements
Sensitive Lands: El Yes El No Type
Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
otes:
Approved By Planning: '----,-- - "
Viz. Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved El Not Approved
I:\Building\Forms\B1dgPermitRvw RES 091216.docx
Building Permit Submittal
Original Submittal Date: //5/1,7
Site Plans: #
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: Er Planning ❑Engineering 0-'Permit Coordinator E7 Building
Workflow Sign-off: "Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
Aegirial plan review routing form.
di Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
ByPermit Technician: i .,JiA ..� __ _ Date: /- 4( '7
A_ � -
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 No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ 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 P /A
Tigard Trans SDC: ❑ Yes ►A N/A
Parks SDC: ❑ Yes I N/A
)a---13K to Issue Permit
Approved by Permit Coordinator: /
Date: i ' '/ i'2--
I:\Building\Forms\B1dgPermitRvw_RES_091216.docx