Permit (70) ll CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2017-00357
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/26/2017
T f Alt f f g Parcel: 1S136CB09600
Jurisdiction: Tigard
Site address: 11300 SW 81ST AVE
Subdivision: HERB AND PEGGIE'S PLACE Lot: 18
Project: WOO
Project Description: 520 sq.ft. accessory building.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 14 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $23,446.80 Rear: 0
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'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: Occupancy Group: Square Feet:
ACS SF VB R-3 0
Owner: Contractor:
WOO,SANG KIL AND OK SON OWNER Required Items and Reports(Conditions)
11300 SW 81ST AVENUE GK SON WOO 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97223 11300 SW 81ST AVENUE
TIGARD,OR 97223
PHONE: PHONE: 503-442-3513
FAX:
Total Fees: $709.65
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 w 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 001-009 . You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1,
Issued By: // Permittee Signature: ,A .%'- ---- w
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 o the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential
City of Tigard ., �� Received
r / 7 Permit No.: STo?0 �6
13125 SW Hall Blvd.,Tigard,OR 9 a ' ti, , M tt ?•' Date/By: f'�- t 7
p #� � r Plan Review
Phone: 503.718.2439 Fax: 503.598: .rT Date/By: j O--.3.4--.) 7 ...11 Other Permit:
T 1 GA R D Inspection Line: 503.639.4175 I Date Ready/By: Juris. 0 See Page 2 for
Internet: www.tigard-or.gov `'E r) & /`11'x /Nottiifie./Method� U ., j I Supplemental Information
TYPE OF VYO lt��+ REQUIRED DATA:1-AND 2-FAMILY DWELLING
lY
❑New construction 4 1.!* r1 CI Permit fees*are based on the value of the work performed.
'" Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement J Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
1-and 2-family dwelling7 Valuation: $
El
❑Accessory building ❑Multi-family Number of bedrooms: a3 Li, 4, 6
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 0 G) -.'117' l 5;7 6'` New dwelling area: square feet
City/State/ZIP: 1- 7-/(. �, /0 72_ Garage/carport area: O square feet
Suite/bldg./apt.no.: Project name: /Vacs Covered porch area: square feet
Cross street/directions to job site: Deck area: 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.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
2( 2 C7 / )( •.-tic / >4a,/ Valuation: $
Existing building area: square feet
New building area: square feet
,544ROPERTY OWNER 0 TENANT Number of stories:
Name: 9 /C ."--. 7.A/. tri-- , Type of construction:
Address: //3 c. ) `y c / -s"' r..9 c.— Occupancy groups:
City/State/ZIP: —7-1 . P2 12 �a-1. Existing:
Phone:(5-,;77)( hq — zS 73' Fax:( ) A/,, -"9
New:
0 APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
57,e/en Q` S a�`? t.--e-- Structural plan review fee(or deposit):
Contact name: Z0V., `'LkO VA _
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application: 77s
t
C'' Phone:(1 ) L3 l s-102 Fax::( ) Amount received:
�1 E-mail: 1 PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
_ roof-top mounted Photo Voltaic Solar Panel System.
Business name: /1.// Submit two(2)sets of roof plan with connection details
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 lie.:
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
�( Print name: ..t . �� Date: �.: - *Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits1.a'-RESPertnitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR orrICE tSE ()NIA
City of Tigard Date/BReceived
Permit No.:
• 13125 SW Hall Blvd.,Ti ard,OR 97223 Y
g Associated permits:
= Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I G A R D Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No "h'
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ■ • •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 0 ❑
4 Fire district approval required. Name of district: • 0 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 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 0
0basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0
3 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.
. (1..i.) 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;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."
- 1 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.
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 ❑ ❑ ❑
for four or more appliances.
9 I Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0
L- architect licensed in Ore on and shall be shown to be a licable to theproject 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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
IIIN COMMUNITY DEVELOPMENT DEPARTMENT
T1cARD Building Permit Review — Residential
Building Permit #: 7))57-20/7.-c b 35.7
Site Address: //k- e9() c2i ) e/5 - i2
Project Name: A3d6 Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: /��'� �G ' S:g%A)-i- '- 44
cvrrPSSD^ X-7� 1C /--C_
Vrify site address/suite# exists and active permit system.
lover Terrace Neighborhood: IIa No ❑ Yes,See River Terrace Review Addendum Attached
Sit 1an Elements:
V?:11ree(3)copies of site plan ALlExisting structures on site
i,te plan must be on 8-1/2"x 11"or 11 x 17"paper j otprint of new structure(including decks)with finished
awn to scale(standard architect or engineer scale) �1 oor elevations
1 .arrow , ill�d; ty locations&easements(required for new and additions)
Site address,project or subdivision name and lot number P idewalk/driveway approach
Vpplicant information(name and phone number) tO ation of wells/septic systems
m of dimensions and building setback dimensions 0 sting trees to be retained with drip line,and tree
II . are footage of buildings to be demolished protection measures
igI o, area,building coverage area,percentage of coverage and •';i.et tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) T Street names
r perty corner elevations (2 foot contour lines if more than >1,000 sf of impervious area created or replaced? EYes VJNo
4 foot differential) If yes,is a storm water quality facility shown? Yes IE No
❑ Clean Water ervices—Service Provider Letter(lot platted prior to 9/10/1995):
Required: Yes,applicant was notified ❑ No Received: ❑ Yes Z\To
Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified Permit:
Applied For: ❑ Yes
❑ No,stop intake
rnd Use Case#:
Hing: ,2- y.s
yr Required Setbacks: Front O Rear Side , Street Side .3- 1 arage � �\
I vT l
►111 andscape Requirement:
X11 Ai of Coverage Maximum:
la Building Height: Maximum Height i J //-t Actual Height � pee-2k_
1111' isual Clearance
WJ ensitive Lands: ❑ Yes ❑ No Type
0UondV rban Forestry Plan
tr
itions "Met"prior to issuance of building permit
Notes:
Approved By Planning: ---_ ___- .___ ,I. _ Date: 400A
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\BldgPermitRvw RES 061417.docx
Building Permit Submittal
Original Submittal Date: 4/4)41 t7
Site Plans: # j
Building Plans: # A
Building Permit#: filer building permit#above. ��.-�
Workflow Routing: ar4 ''p ming ngineering mtt Coordinator [ tsu 1ding
Workflow Sign-off: [gn-off for Planning(include notes from planning review)
Route Application Documents: [ ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
o al 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: ,19rte- Date: e/ /)
Engineering Review
diZ Slope at building pad: 7D
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat
.Z 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 o
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 1 k lJ t Date: /6/ \2-://7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved El 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:
C Fees Entered: Wash Co Trans Dev Tax: III Yes /A
Tigard Trans SDC: CI Yes N/A
Parks SDC:
CI N/A
LIDA ❑ Yes 1 i' N/A
Mde to Issue Permit , l y
/,?—'--
Approved by
r ved Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw_RES 061417.docx
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
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.
0
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 Perfnit Applicant
Signature of Pe Applicant Date
Permit#:
Address:
Issued by: Date: f i.
This Copy for Permit Offices
le-1-,'
Information Notice to Owners About
` -.'''' Construction Responsibilities
+hre, ;y
-k*„--,,-
(-1-17 (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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11300 SW 81ST AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2017-00357
Inspection Type: Inspector:
205 Footing David Young
Result:
FA I L
Comments:
Provide approved initial erosion control inspection prior to footing inspection as noted on
approved plans and inspection checklist sheet received with approved plans.
No inspection done at this time.
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11300 SW 81ST AVE, TIGARD, OR, 97223 June 24, 2019 at 11 :18:08 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00357
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor