Permit (70) RECEIVED
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. 0EC `2, 2017
. _ Request for Permit Action CITY OF MARI)
T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • ww�u.tigatdfnt rA
YG DIVISION
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard, OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor `City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) De 9/ heti J e j /tea Co / ti c
Mailing Address: ,.. 3/9 iL144-s7-6-,49-7-- - 2 e
City/State/Zip: 4-77.41A.,/
Phone No.: So t c(w ---S ? 7
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
❑ CANCEL/VOID PERMIT APPLICATION.
ozp REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
J INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). )
Permit#: "f7T9-0/7 r- Cc)i/
93
Site Address or Parcel#: 11/5.3 5 .Sc,) 7/2. 9 i L
Project Name: ,C:)/c.'-C7i/A
Subdivision Name: Lot#:
EXPLANATION: 09- (( , ,770 rJ X-7CS e e %7 64
/A/ C'JL 4 2 A7t-ie / s, /2- 1-6
Signature: Date: /c2/� -//
Print Name: j ,A7 f , n.7tia;
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to Sys Admin: Date By Route to Records: Date 6 /s B F c
Refund Processed: Date/p2/,2J /2 By t-ice Invoice Processed: Date By
Permit Canceled: Date N/ By r' Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_092314.doc
11111111 q
TIGARD
City of Tigard
January 18, 2018
Oakwood Remodeling Co. Inc.
5319 SW Westgate Dr. #225
Portland, OR 97221
Re: Permit No. MST2017-00493
Dear Applicant:
The City of Tigard has processed a refund for fees on the above referenced permit(s) as
follows:
Site Address: 11535 SW Terrace Trails Dr
Project Name: Brown
Job No.: N/A
Refund: ® Check#227197 in the amount of$294.75.
❑ Credit card"return"receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account"deposit"receipt in the amount of$ .
Comments: Refund overpayment of permit fees resulting from reduction of project
valuation.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
INII
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the_Request for Permit Action form (if applicable) must
und requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Oakwood Remodeling Co. Inc. DATE: 12/28/2017
Portland, OR 97221 REQUESTED BY: Dianna Howse
93.2O SA) €' �4u. 4cV,2 /yc,
TRANSACTION INFORMATION:
Receipt#: 414309 Case#: MST2017-00493
Date: 12/6/2017 Address/Parcel: 11535 SW Terrace Trails Dr
Pay Method: Check Project Name: Brown
EXPLANATION: Reduced project valuation resulted in a reduction of permit fees. Refund difference.
3 ya' '" z�sn`{' f}t""' n[e-;'-. ,`',j'.. -,-1..,,"e �r,.a�azo�,'.- d' .."'y --01°N e2"',1100C" '�. '''' F'`k n l ''l'''i
a F1!.t r
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..aL,Y i 't„ 1.. v "?. ' l 3 .. S z t % A " 'l- .6 I X'' a' G i g t r.?k
Cash Over 100_0000_48001
00 0000 48001 $294.75
TOTAL REFUND: $294.75
APPROVALS: SI ATURES/DATE:
If under$5,000 Professional Staff
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
. � I$TRA O ONS ,,,,421::4........_....::
t 's-'4....' , , .
Case Refund Processed: Date: 4X0, i By: ,��
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
1114CITY OF TIGARD RECEIPT
I . 13125 SW Hall Blvd.,Tigard OR 97223
- 503.639.4171
TIGARD
Project Name: BROWN
Site Address: 11535 SW TERRACE TRAILS DR / e794 A,/,6
Receipt Number: 416602 - 04/06/2018
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2017-00493 $-294.75
Total: $-294.75
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 227197 DHOWSE 04/06/2018 $-294.75
Payor: Oakwood Remodeling Co. Inc.
Total Payments: $-294.75
Balance Due: $294.75
•
Page 1 of 1
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Project Name: BROWN
Site Address: 11535 SW TERRACE TRAILS DR
Receipt Number: 414309 - 12/06/2017
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2017-00493 Building Permit-Additions,Alterations, 230-0000-43104 $134.54
Demolition
MST2017-00493 Plan Review 230-0000-43106 $87.45
MST2017-00493 12%State Surcharge-Building 100-0000-24001 $16.14
MST2017-00493 - Cash Over 100-0000-48001 $294.75 tr✓
Total: $532.88
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 10030 BTAGGART 12/06/2017 $532.88
Payor: IBI Construction
Total Payments: $532.88
Balance Due: $0.00
Page 1 of 1
�
I • CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2017-00493
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 12/14/2017
T[C�1RJ7 9
Parcel: 2S103CA03200
Jurisdiction: Tigard
Site address: 11535 SW TERRACE TRAILS DR
Subdivision: TERRACE TRAILS Lot: 4
Project: BROWN
Project Description: Floor framing modification in living room.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $4,000.00 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
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0
Catch Basins: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 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: Occupancy Group: Square Feet:
ALT SF 0
Owner: Contractor:
BROWN,RIAN T OAKWOOD REMODELING CO INC Required Items and Reports(Conditions)
DIBBLEE,PATRICIA C 5319 SW WESTGATE DR#225
11535 SW TERRACE TRAILS DR PORTLAND,OR 97221
TIGARD,OR 97223
PHONE: PHONE: 503-646-5376
FAX:
Total Fees: $532.88
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 -- - Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You ma tTttiRS< of the rules or direct questions to OUNC by calling 503. >r+.-.-
Issued B Permittee Signature: iO.P''
all 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 .� FOR OH 1( I is o\l.l
City of Tigard �� Received
,� 41 Date/By: �� /try1'7 Permit No.: M�.-....�_aI7 �71
13125 SW Hall Blvd.,Tigard,OR 97223 l aCEJ
Phone: 503.718.2439 Fax: 503.598.1960 f� Plan Review _
t�� Date/By: �� C J / Other Permit:
T 1,; ‘n n Inspection Line: 503.639.4175
Date Ready/By: Kris: ® See Page 2 for
Internet: www.tigard-or.gov , i( �C1 1 otified/FM�elthod/07 I�/1 I Supplemental Information
TYPE OF WOR
� r,- ,A iSION +C� LZin�t,,,////V'-7 .i 1/''ti G' �y
{ A1� REQUIRED D A:1-AND 2-FAMILY DWELLING
Cl New construction Cl Demolition Permit fees*are based on the value of the work performed.
Indicate the valuerounded to the nearest dollar of all
®Addition/alteration/replacement 0 Other: ( )
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1-and 2-family dwelling ❑Commercial/industrial Valuation: 69 4 4 Q O
❑Accessory building ❑Multi-family Number of bedrooms: 3
0 Master builder 0 Other: Number of bathrooms: 2
JOB SITE INFORMATION AND LOCATION Total number of floors: 1
ItievittJob site address:11535 SW3 i aem Trails DR
New dwelling area: ontk,„ square feet
City/State/ZIP:Tigard/OR/97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Brown Residence Covered porch area: square feet
Cross street/directions to job site:SW 115'AVE Deck area:
square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Terrace Trails Lot no.:4 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:W258555 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.
Floor framing modification. Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER 0 TENANT Number of stories:
Name:Rian Brown
Type of construction:
Address:11535 SW Terrace Trails DR
Occupancy p y groups:
City/State/ZIP:Tigard/OR/97223
Existing:
Phone:(503)544-4247 Fax:( )
New:
la APPLICANT
® CONTACT PERSON BUILDING PERMIT FEES*
Business name:IBI (Please refer to fee schedule)
Contact name:Jim Cleghorn Structural plan review fee(or deposit):
Address:9320 SW Barbur Blvd.,Suit 146 FLS plan review fee(if applicable):
City/State/ZIP:Portland/OR/97219 Total fees due upon application: 3 2 r iy
Phone:(503)451-4544 Fax::( ) Amount received: 0
E-mail:jim@iibii.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name:IBI Submit two(2)sets of roof plan with connection details
Address:9320 SW Barbur Blvd.,Suit 146 and fire department access,along with the 2010 Oregon
Solar Installation Specialty Code checklist.
City/State/ZIP:Portland/OR/97219 Permit Fee(includes plan review
Phone:(503)646-5376 Fax:( )
and administrative fees): $180.00
State surcharge(12%of permit fee): $21.60
CCB lic.:32734
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.
*Fee methodology set by Tri-County Building Industry
Print name:Jim Cleghorn Date:11/27/2017
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 Folz OFFICE USG oyl.l
City of Tigard Received Permit No.:
IIIAssociat
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
l l,A 1` Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les NO "/,k
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 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 0
6 Sewerpermit. 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.
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc. 0 0 0
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state
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 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. 0 0 0
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size
and location. 0 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 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. 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 0 0
for four or more appliances. 0 0 0
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oreton and shall be shown to be a s.licable to the .ro'ect under review.
JURISDICTIONAL SPECIFICS
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 0
26 "Reversed"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 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. 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\Peimits\BUP-RESPermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11535 SW TERRACE TRAILS DR, TIGARD, January 4, 2018 at
OR, 97223 10:26:21 AM
Record Type: Record ID:
Residential - Master Permit MST2017-00493
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Wrong inspection scheduled.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11535 SW TERRACE TRAILS DR, TIGARD, January 5, 2018 at 9:41 :39 AM
OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2017-00493
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Finish floor covering to follow.
Violation Summary:
Inspector Contractor