Permit (45) ,, CITY OF TIGARD BUILDING PERMIT
a ti COMMUNITY DEVELOPMENT Permit#: BUP2017-00285
Date Issued: 12/21/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25115A600500
Jurisdiction: Tigard
Site address: 16380 SW 113TH AVE
Project: Willow Brook Subdivision: WILLOW-BROOK-FARM Lot: 23
Project Description: Demolition of a 1,772 sq.ft.house on septic. UPON FINAL INSPECTION,DEMO CREDITS FOR SDC FEES
WILL APPLY.
Contractor: REVCON INC Owner: MISSION HOMES NORTHWEST LLC
21420 NW NICHOLAS CT PO BOX 1689
HILLSBORO, OR 97124 LAKE OSWEGO, OR 97035
PHONE: 503-848-7300 PHONE:
FAX: 503-356-5599
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 12/21/2017 $225.80
Demolition
Occupancy Grp: Occupancy Load: Erosion Control w/Development 12/21/2017 $80.70
Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 12/21/2017 $0.50
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $10,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $307.00
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: .i / Permittee Signature: 0� Hqj
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 RECEIVE I [oR OFFICE LSI. 011.1
Cl Of Tiand Received r
Ty g Date/B : do / 4ll Permit No.: „!J y,,f`;'
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Or,T 2 4 2017 Date/B : Other Permit:
TI G A i D Inspection Line: 503.639.4175 Date Ready/By: gl See Page 2 for
Internet: www.tigard-or.gov �q ii CA D Notified/Method: >of").1 7 f� ` Supplemental Information
.9 �p�T1r1 DIVISION
1�iJ��i ir42e"\41<% ..A`A A.
TYPE OF LD1N(J Vfl y ISIO Ni 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
0 Addition/alteration/replacement Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ i 0 ( C0 0 0
❑ 1-and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: Lb 1 -, Jw it 3 , t. a New dwelling area: square feet
City/State/ZIP: T t 03
c:_� (' Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Jj ••t () `! VD(' )(J\(,_„ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
5 L ) 0 ,i\k.Cx r.t a o L.k ) \ �j'--h Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.: a S L i A.--4, equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
\-'
l-A o me e cj o S' o c f- L v c Existing building area: square feet
u�� csi C(:> c� C?AiC-? 7/ New building area: square feet
t
El PROPERTY OWNER 0 TENANT Number of stories:
Name: A`'1�LL c- \A 0 Z�e5 Type of construction:
Address:"`2 q?met cJ i 1 C , c u j c Occupancy groups:
City/State/ZIP: GeCt(e (_k_0 S c)ca___ C.-LOG ,- Existing:
Phone:(t5-21 1 L4(7- "..(.2_61 S Fax:( ) New:
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: j C'c.„,e tL) e -:: \Gr,, h
Structural plan review fee(or deposit):
Contact name: S7.- C,)__\'� v'Z.• 0
j ,� 1 ` FLS plan review fee(if applicable):
1.,
Address: e�( `i 5 `'�.. ., T C3 W�3C CAC�( PL-- t- 00
Total fees due upon application:
City/State/ZIP: �-''COL) CC -\--Or--- U L. T C)0 c
-�1 rount received:
Phone:(z(J--) -7�—1 t/0._(Sc..:� t Z Fax: :( )
; PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail: '� �� �\ ��. C O' 1� Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: ,e -vvL7A1 Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 9/yac' MI/ Air C`&iv L is Cr- Solar Installation Specialty Code checklist.
City/State/ZIP: / /3, e,ie_ 9 7/, J►° Permit Fee(includes plan review $180.00
t3 GezS j and administrative fees :
Phone:(Sr,) 13 6 --4,30d Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: t/ C v tr 7 Total fee due upon application: $201.60
Authorized signature: ( t �a.-c');' This permit application expires if a permit is not obtained
Civ��� \ within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: `p � .---,c1�( A Date: `( . Z`-(^ (-7 Service Board.
I:\Building\Permitts\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
i
Building Permit Application Checklist
One- and Two-Family Dwelling Folz order usl: O\l.1
City of Tigard Received
Date/By: Permit No.:
_ A 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
T t G A R D 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 1 es No '/<'
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. • I 0
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: . ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 ❑
6 Sewer permit. ❑ 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 ❑ ❑
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.
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
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- ❑ ❑ ❑
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 ❑
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
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 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 ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 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". ❑ ❑ 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ 0 ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑
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 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.
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
III " COMMUNITY DEVELOPMENT DEPARTMENT
0
TIGARD Building Permit Review — Residential
o
Building Permit #: 1t4/Y-0/7--(5)0
Site Address: 1 6 5$ 0 s w .1 1 3 1 k of ve.
Project Name: VV it IOvI 1of'bolti PetY)0 Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: Demo Oni i_y
Verify site address/suite# exists and active in permit system.
,ft River Terrace Neighborhood: g' No ❑ Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
ree(3)copies of site plan Existing structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper ❑Footprint of new structure(including decks)with finished
t)rawn to scale(standard architect or engineer scale) floax,elevations
North arrow ❑Utility locations&easements (required for new and additions)
71 Site address,project or subdivision name and lot number ❑Sidewalk/driveway a proach
�/Applicant information(name and phone number) ❑Location of wells/septic erns A
!■ of dimensions and building setback dimensions ,Existing trees to be retained with line,and tree
Atquarefootage of buildings to be demolished protection measures
❑Lot ar ,building coverage area,percentage of coverage and ❑Street tree ' e,type and location
impervi us area(applicable if R-7,R-12,R-25&R-40) ❑Street name
❑Property orner elevations (2 foot contour lines if more than >1,000 sf of imp 'ous area created or replaced? El Yes ❑No
4 foot dif rential) If yes,is a storm w er quality facility shown? ❑Yes ❑No
I"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: ❑ Yes,applicant was notified /`J No Applied For: ❑ Yes ❑ No,stop intake
/ Land Use Case#: So 6 Zo( (p --0 00 I
Zoning: O. -1
Required Setbacks: Front Rear Side Street Side Garage
Landscape Requirement:
r
1- i p( Lot Coverage Maximum:
� t Building Height: Maximum Height
❑ Yes ❑ No
Actual Height
❑ Visual Clearance
❑ ensitive Lands: Type
CIrban Forestry Plan
❑ C nditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: Date: 10/2.9 I 1"7
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\BldgPennitRvw_RES 061417.docx
Building Permit Submittal
Original Submittal Date: to(Ali/17 •
Site Plans: # r
Building Plans: # NO
Building Permit#: writer building permit#above.
Workflow Routing: nning gineering 4;;-Permit Coordinator ❑ Building
Workflow Sign-off: Ct7.-3ign-off for Planning(include notes from planning review)
Route Application Documents: LLEngineering: (1) copy of permit application, (1) site plan, (1) building plan and
ori ' plan review routing form.
uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: iOtine O i 4.1-
By Permit Technician: . r C ° Date: 1;x/361/7
d f
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: l (O muLTug-e (5) es7JL-✓ /JO Ciefthr/JL7
Approved by Engineering: /114 /A-) Date: /(/
( /7/7
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
pproved,NOT Released:( .'v P it-N. -, � ,'`Q
Date: /6/5 /1-7-
Notes: °-7—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:
7 SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: ate: /Z />° /i'7—
I:\Building\Forms\BldgPennitRvw RES 06141 7.docx
Albert Shields
From: Albert Shields
Sent: Tuesday, October 31, 2017 11:37 AM
To: 'pam@emeriodesign.com'
Cc: Gary Pagenstecher
Subject: Willow Brook Demos, BUP2017-00283, -00284, & -00285
Pam, on reviewing your plans and applications for these three demo permits we noted that condition of approval #1,
tree protection, for the underlying land use case,SUB2016-00011, has not yet been met. We do require that tree
protection be in place before we issue demo permits for subdivisions. Please have your tree protection installed and
have your arborist certify same in an email or letter to us. Thanks for your cooperation. Please let me know if you have
any questions.
Albert Shields
Permit Coordinator
City of Tigard
A I bert@tigard-or.gov
503-718-2426
Branden Taggart
From: Jill Bentley
Sent: Monday, October 30, 2017 4:12 PM
To: Branden Taggart
Subject: RE: Sewer Connections
Attachments: J i I I.vcf
Hi Branden,
All three lots are not being billed sewer, and address 16285 is on a well and not connected to water either.
Kind Regards,
Jill
Jill`
1City of Tigard-Utility Billing
8 ,i u, Senior Accounting Asst
TIG.A (888)826-1211 Payments
(503)718-246a UB Mair
pia i mrd-or gore
(503)718-2494
13125 SW Hall Blvd,
Tigard,OR 97223
From: Branden Taggart
Sent: Monday, October 30, 2017 3:57 PM
To:Jill Bentley<JILLB@tigard-or.gov>
Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject: Sewer Connections
Hi Jill,
Can you check to see if the following addresses are billed for sewer?
__=216380 SW 113th Ave
16325 SW 113th Ave
16285 SW 113th Ave
Thank you. I appreciate it.
Branden Taggart
1 °, a City of Tigard
"`'1 # Permit Technician
Community Development
TIC;A RD
13125 SW Hall Blvd
Tigard,OR 97223
(503)718-2449
brandent rtigard-or.gav
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16380 SW 113TH AVE, PORTLAND, OR, 97224 November 20, 2018 at
8:33:35 AM
Record Type: Record ID:
Residential - Building BUP2017-00285
Inspection Type: Inspector:
299 Final inspection David Young
Result:
FA I L
Comments:
Provide approved final erosion control prior to building final.
Provide septic tank pump receipt for building final.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16380 SW 113TH AVE, PORTLAND, OR, 97224 November 21 , 2018 at
11 :40:51 AM
Record Type: Record ID:
Residential - Building BUP2017-00285
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Demo complete, septic tank removed per contractor.
Pump receipt received.
Violation Summary:
Inspector Contractor