Permit (94) CITY OF TIGARD MASTER PERMIT
- COMMUNITY DEVELOPMENT Permit#: MST2017-00263
T t clARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2017
Parcel: 2S 111 CA00600
Jurisdiction: Tigard
Site address: 9884 SW SATTLER ST
Subdivision: ALDERBROOK FARM Lot: 10
Project: BARACKMAN
Project Description: 320 sq. ft. accessory structure.
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 Right: 5 Detectors:
Total: 0 sf Value: $7,216.00 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 Storm Sewer: 0
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 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'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: Occupancy Group: Square Feet:
ACS SF VB R-3 0
Owner: Contractor:
BARACKMAN,RYAN OWNER Required Items and Reports(Conditions)
SCHAEFER,GINA M
9884 SW SATTLER ST
TIGARD,OR 97224
PHONE: PHONE:
FAX:
Total Fees: $428.67
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. AT ION: I :.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0 -0010 through OAR'52-0' -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
,��Is ued By: / l}�`�[�4 ��-/ Permittee Signature: XL \`�-
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 Application
Residential 1 o iz o i i lc is I s I: ()NI.)
• City of Tigard � patsy
!Eiew7
T Ic n K D
Inspection Line: 503.639.4175 2017�y 97 Date Read/B Jur s: See Pa e 2 for
Internet: www.tigard-or.gov JUL 10 20`( otifi d/Method ���L�/1? 2 4.. I Supplemental Information
TYPE OF 4
e OF TI RD
REQ DIREDD DATA:1-AND 2-FAMILY DWELLING
❑New construction ITeIN( DIVISION molition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
[j'Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling 0 Commercial/industrial i �
['Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I?illy cS Ar:Nk New dwelling area: square feet
City/State/ZIP: Tcsk.,rat i O p,.( q- 22_4 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:�...f-Gjek...00..A, 5id.¢,re(�... Covered porch area: square feet
Cross street/directions to job site: Deck area ....p C.att1d- square feet
Other structure area: `) square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Sk r3+ Indicate the value(rounded to the nearest dollar)of all
I equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
�., CI V\, 0.,C ..-QTi ` ..,4.t.).-re l4)` 112,01 ,1 Valuation: $
Etc-0r,zf& cox,c> 1(4)5 Existing building area: square feet
New building area: square feet
[PROPERTY OWNER 0 TENANT Number of stories:
Name: ��o..r.., ' )4:34-rl-(Y.(- Type of construction:
Address: 9 y (1 Q,t. Si* Occupancy groups:
City/State/ZIP:,c d % (3 P----!j'1 22--t Existing:
Phone:( `aj)'l`ci3 j Fax:( ) New:
APPLICANT CONTACT PERSON BUILBING PERMIT FEES*
Business name: S'J�Cr\R-- �c-s f\V y J L i (P[e¢se refer to fee scheduk�
' \ Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application: l 7. ,y
Phone:( ) Fax::( )
Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: SzW "? fit Submit two(2)sets of roof plan with connection details
Ok ��/h and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:
Authorized signatur:: Total fee due upon application:
4------ This $201.60
\ 1 . ilypermit application expires if a permit is not obt9'
within 180 days after it has been accepted a.
Print name: r`a/+r\ �4,,,t-� Date: -7 ; 9,i--/
Board.
methodology set by TriCounty Building I
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling Folz orrll: tl: 0y1.1
City of TigardIN Received
Permit No.:
ul 13125 SW Hall Blvd.,Tigard,OR 97223 Associat
e Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
IIGARD
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No y '
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ •
II
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 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
7 Water district approval. 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
protection,etc.
°basin
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
jj copyright violations exist.
/ 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;foot i int 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
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 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 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 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. 0 0 0
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. 0 0 0
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 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 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.
uilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
.11111 q COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A R D Building Permit Review — Residential
Building Permit #: i �7-, )C 7-c c7,;(.‘;, 3 jj
Site Address: 9 �'Y)( SO ," -l62.- S+
Project Name: 6 a f ,k. ,,,,4, .4 c es;So,.„yy s 4, 8,,16.e_ Lot #:
(New dwelling=subdivision name;Addition or Altefation=last name of owner)
Planning Review
/ J
Proposal: l 0' ki 1 rvc /6 ''; O 4O'i Gicc'g 50-7/- .5 -: cr�/
v:,--e-
2erify site address/suite#exists and activeia permit system.ry
River Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
SitetePlan Elements:
CJS e(3)copies of site plan ..2 xisting structures on site
a S��i--te plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure(including decks)with finished
ya 5 awn to scale(standard architect or engineer scale) floor elevations
forth arrowtility locations&easements(required for new and additions)
9.Stte address,project or subdivision name and lot number ,dewalk/driveway approach
* 4.,licant information(name and phone number) ocation of wells/septic systems
Pa t dimensions and building setback dimensions ❑ i.,tmg b cs to be retained with drip line,and tree
.:•• .. .:e of buildings to be demolish&'d protection measures
, 'Lot area,building coverage area,percentage of coverage and ❑Street tree size,type and location /1/4-P,_iie.
impervious area(applicable if R-7,R-12,R-25&R-40) ❑Strect names tf/A --Pe-,'
_erty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? ❑Yes 12.1‹
4 foot differential) If yes,is a storm water quality facility shown? ❑Yes ❑No
An Clean Water Services-Service Provider Letter.(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified dNo Received: ❑ Yes ❑ No
la-Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified 12 No Applied For:
PP� ❑ Yes ❑ No,stop intake
❑ Laud Use Case#: ✓UVAL
.0'Zoning: "j_,7
Required Setbacks: Front 15- Rear 15 Side < Street Side #4 Garage if,),/,40 Landscape Requirement: S V
O'Lot Coverage Maximum: % � �C Scr��
Building Height: Maximum Height d s Actual Height
,vim Clearance
-' Sensitive Lands: ❑ Yes Zr-No Type
,'`Urban Forestry Plan
❑ Conditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: <- ".': Date: /U
Revisions (after Building Submittal only Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Forms\BldgPemritRvw REs 061417.docx
Building Permit Submittal
Original Submittal Date: 7/011 7
Site Plans: # `�
Building Plans: # 3
Building Permit#: 0— neer building permit#above.
Workflow Routing: arming engineeringt Coordinator Lam- Mg
Workflow Sign-off: -off for Planning(include notes from planning review)
Route Application Documents: [ —Etlineering: (1) copy of permit application, (1) site plan, (1) building plan and
ori 'nal plan review routing form.
atuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ( T Date: 7/a/® )
Engineering Review
❑ Slope at building pad: Y'l
❑ Conditions "Met"prior to issuance of building permit ift.rfUll C,Ii 6,j �'4/l mil- moll
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Q No
Assess Water Quantity Fee in-lieu: ❑ Yes y3 No
LIDA Facility on lot: ❑ Yes iC No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: _ Date: 7/13/17
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 tr N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes N/A
rOK to Issue Permit
:ed by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
N
Information Notice to Owners About
i7 ' `- Construction Responsibilities
r
r=r- (ORS 701.325 (3))
Homeowners acting as their own general contractors to construct a new home
or make a substantial improvement to an existing structure, can prevent many problems
by being aware of the following responsibilities:
• Homeowners who use labor provided by workers not licensed by the Construction Contractors
Board, may be considered an employer, and the workers who provide the labor may be considered
employees. As an employer, you must comply with the following:
• Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages
at the time employees are paid. You will be liable for the tax payments even if you don't actually
withhold the tax from your employees. For more information, call the Department of Revenue at
503-378-4988.
• Unemployment Insurance Tax: Employers are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment
Department at 503-947-1488.
• Oregon's Business Identification Number(BIN): is a combined number for both Oregon
Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or go to
http://www.oregon.gov/DOR/BUS/docs/211-055.pdf for the appropriate forms.
• Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation
Law, and must obtain Workers Compensation Insurance for their employees. If you fail to obtain
Workers Compensation Insurance, you could be subject to penalties and be liable for all claim costs
if one of your workers is injured on the job. For more information, call the Workers Compensation
Division at the Department of Consumer and Business Services at 503-947-7815.
• Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from
employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax.
For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their website at www.irs.gov.
Other Responsibilities of Homeowners:
• Code Compliance:As the permit holder for a construction project, the homeowner is responsible
for notifying building officials at the appropriate times, so that the required inspections can be
performed. Homeowners are also responsible for resolving any failure to meet code requirements
that may be found through inspections.
• Property Damage and Liability Insurance: Homeowners acting as their own contractors should
contact their insurance agent to ensure adequate insurance coverage for accidents and omissions,
such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not
otherwise covered as employees by Workers Compensation Insurance.
• Expertise: Homeowners should make sure they have the skills to act as their own general
contractor, and the expertise required to coordinate the work of both rough-in and finish trades.
CONSTRUCTION CONTRACTORS BOARD
700 Summer St NE, Suite 300, PO Box 14140,Salem, OR 97309-5052
Telephone: 503-378-4621 —Fax: 503-373-2007
Website Address:www.oregon.gov/ccb
f/property_owner adopted 9-23-08 This Copy for Permit Applicant
RECEIVED
Property Owner Statement
Regarding Construction ResponsibilitiesJUL 10 2011
Oregon Law requires residential construction permit applicants who are not lic4,9 I IGHR�1
Construction Contractors Board to sign the following statement before a buildin �f c- -'
issued. (ORS 701.325(2))
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010 (7), need not
submit this statement. This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
Mi I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
Print Name of Permit Applicant
Signature of P it Applicant Date
Permit#:
•1
4� �
Address:
itutia
Issued by: Date: f;-
This Copy for Permit Offices