Permit (29) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00095
Date Issued: 04/24/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109AC01200
Jurisdiction: Tigard
Site address: 14920 SW 133RD AVE
Project: Madeline Heights Subdivision: None Lot: None
Project Description: Demo(1)residence:2,389 sq ft on septic and(1)shop: 144 sq ft. Demo credits for future SDC fees(not sewer)
available upon final inspection.
Contractor: K&G CONSTRUCTION CO Owner: SAGE BUILT HOMES LLC
26090 NW TIMBER CO 1815 NW 169TH PLACE, SUITE 1040
FOREST GROVE, OR 97116 BEAVERTON, OR 97006
PHONE: 503-681-2370 PHONE: 503-969-8298
FAX:
FEES
Specifics:
Description Date Amount
Type of Use: SF
Permit Fee-Additions,Alterations, 04/24/2017 $453.95
Class of Work: DEM Type of Const:
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 04/24/2017 $1.00
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 04/24/2017 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $25,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $535.65
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: z.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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 Applicat' �.y
Residential ECEI�l ro iz(„h i c t: t s i o,t.1
City of Tigard Received 4/ 4� 17 Ii 9 PermitNo.: "e90/7 Oc9J
II g R 1 2 ?017 Plan y:
� 13125 SW Hall Blvd.,Tigard,OR 9Z�� Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
�`•� ry•�j�y TIGARD Date Read/B /�+j`r/ kris: la See Page 2 for
7.i C,A li D Inspection Line: 503.639.4175 CITY l i V T1lI 11h1J Ready/By: l
Internet: www.tigard-or.gov Notified/Method:7 /7 Supplemental Information
BUILDING DIVISION lrn' A/ -C_-,
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New 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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ 2-
0 1-and 2-family dwelling ElCommercial/industrial
5 00
Number of bedrooms:
IDAccessory building
❑Multi-family
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: LA ck 2_0 e..•`) L - it A ofe.,
New dwelling area: square feet
City/State/ZIP: •-- 0(,-1 N 1 o O q7 Z Z 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: /1J\o e'\ '�-ei \A.1-j Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
—.0 \\. AA QkJ cLA'I\ ® k Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: J1 \nom per, I Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: Z5 1 O y.A'C O 12 0 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
5 6-)Pe- 0 i 6(;e' 56 /i•r Existing building area: square feet
(6-1-.._ �� 1J New building area: square feet
( PROPERTY OWNER ❑ TENANT Number of stories:
Name: 6 Ac_i�� 60 0vvt eS1,„ L.6 C Type of construction:
Address: d g (5- /0() I b 7 ' t^(,e,t, `jut 0/0 Occupancy groups:
City/State/ZIP: G,eo v01,-A.07 ), 0/2._ 9/CC Existing:
Phone:(,�03) 76 9-- O'Z 7( Fax:( ) New:
g APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: 5 Awl e, A-S .t 7 (1 gid Structural plan review fee(or deposit):
Contact name: f?��-e— Q Vl FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Amount received: ""`
Phone:( ) I Fax::( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:
Commercial and residential prescriptive installation of
CONTRACTOR roo .. mounted PhotoVoltaic Solar Panel Syste
Business name: ..k...�� Jn e� -aj `'0 (i0,
Submit t sets of roof plan with connectio etails
and fire departme : ess,along with the i 0 Oregon
Address: 2 6 0 9 V L ) r Y W)b.et/ ( i7 Solar Installation Srecia `!de c - +ist.
City/State/ZIP: Fe rr'5 Ci row--` ce 97// Permit Fee(includes es . $180.00
and ad '" alive fees .
Phone:(503) &5/ - 2_3 7® Fax:( ) State surchar. 12%of permit fee): $21.60
CCB lic.: a g 7/I/ T: al fee due upon application: I .60
Authorized signature: .� This permit application expires if a permit is not obtain•
•
within 180 days after it has been accepted as complete.
Date: /Z /7 *Fee methodology set by Tri-County Building Industry
Print name: 6A(-6,-- DON, Date: 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 Foiz orrlci i ,,l. oy l.'
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223
Associated Permit No.:
Date/ByI Phone: 503.718.2439 Fax: 503.598.1960 permits:
T.l G A R 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No N/.s.
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. U U U
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ 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
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 ❑
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0
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
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.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
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.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0
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- 0 0 0
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 0 0 0
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
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ ❑ 0
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.
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 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".
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 ❑
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. ❑ ❑ 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ 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.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 ❑
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
11 ■ M COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Residential
Building Permit #: L&-P o 17 -6)6095Site Address: /17/9 \'1 ) lar-if itiLe
Project Name: /Ind 0,14. A k Lot #:
(New dwelling=subdivision at ;Addition or Alteration=last name of owner)
Planning Review
Proposal: �027r) 0/7/6/_,
Verify site address/suite# exists and activ in permit system.
) ver Terrace Neighborhood: LVJ No ❑ Yes,See River Terrace Review Attached
Si Plan Elements:
rree(3)copies of site plan 'sting structures on site
o plan must be on 8-1/2"x 11"or 11 x 17"paper ��.tprint of new structure(including decks)with finished
raven to scale(standard architect or engineer scale) oor elevations
ifarrow T` tility locations(required for new,may apply for additions)
to address,project or subdivision name and lot number ' l' tt ation of wells/septic systems
plicant information(name and phone number) Existing trees to be retained with drip line,and tree
Lot dimensions and building setback dimensions {otection measures
tot area,building coverage area,percentage of coverage and 0 &et tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
Property corner elevations(2 foot contour lines if more than
4 foot differential
U t lean Water Services—Service Provider Lett- (lot platted prior to 9/10/1995):
equired: ❑ /Yes,applicant was notified I No Received: ❑ Yes ❑ No
A Public Faciliti (PFI) Permit:
equired: Yes,applicant was notified ❑ No Applied For: A Yes ❑ No,stop intake
/and Use Case#: alCQ J —
0000 3
Zoning: /2-3_
Required Setbacks: Front Rear Side Street Side Garage
Landscape Requirement: %
'\C'` Lot Coverage Maximum:
N.
Building Height: Maximum Height Actual Height
Visual Clearance
Easements
Sensitive Lands: ❑ Yes No Type
Urban Forestry Plan
❑ Conditions "Met"priory)issuance of building vermit ayi
Notes: A,f le in,trafct f/
Approved By Planning: c== /A J . Date: 4/a//
Revisions (after Building Submittal only) ReviewerDate e
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPermitRvw REs 091216.docx
Building Permit Submittal
Original Submittal Date: `7 /•
Site Plans: #
Building Plans: #�/
Building Permit#: Yd Enter building petit#above. 1
Workflow Routing: Planning .D Engineering Permit Coordinator -I�I3uilding
Workflow Sign-off: C2-Sign-off for Planning(include notes from planning review)
Route Application Documents: C-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: C �_ i Date: /'- /
Engineering Review
El Slope at building pad:
Cl Conditions "Met"prior to issuance of building permit
El Easements (encroachments)per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes El No
Assess Water Quantity Fee in-lieu: ❑ Yes El No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: 46/0-11
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Permit Coordinator Review
El Conditions "Met"prior to issuance of b • ding permit �,t
d NOT Released:, �V ► Date: 4/�r1 /
proved, �� �l(/ �}
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:
►:�: C Fees Entered: Wash Co Trans Dev Tax: ❑ Yes Me /A
Tigard Trans SDC: Cl Yes 61- /A
Parks SDC: Cl Yes N/A
OK to Issue Permit
pproved by Permit Coordinator: / , � Date: / �—
I:\Building\Fonns\BldgPermitRvw_RES 091216.docx
Albert Shields
From: Albert Shields
Sent: Thursday,April 20, 2017 9:34 AM
To: 'Cale Doney'
Subject: RE: Madeline Heights (SUB2016-00003)
Thanks for forwarding the arborist's report, Cale. I'll release the application and you should get a call from one of our
Permit Technicians within a day or so about coming in to pick up the permit.
Albert Shields
From: Cale Doney [mailto:caled@sagebuilthomesllc.com]
Sent:Thursday,April 20, 2017 8:22 AM
To:Albert Shields<albert@tigard-or.gov>
Subject: Madeline Heights(SUB2016-00003)
Good morning Albert,
Please see the attached arborist inspection letter from Ryan Neumann with Multnomah Tree Experts confirming and
approving the installation of the tree protection measures at the Madeline Heights subdivision. I received your message
last week regarding the demo permit applications for this project. Now that you have the letter from the arborist, I
would like to come in and pick up the demo permits if they are ready. Please let me know. Thanks.
Cale Doney
Development Manager
Sage Built Homes, LLC
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14920 SW 133RD AVE, TIGARD, OR, 97224 December 15, 2017 at
10:40:52 AM
Record Type: Record ID:
Residential - Building BUP2017-00095
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Pump and fill receipt received.
House gone and new houses being built at this time.
Violation Summary:
Inspector Contractor