Permit (105) CITY OF TIGARD MASTER PERMIT
IN ■ COMMUNITY DEVELOPMENT Permit#: MST2018-00261
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2018
T I r_; R.i7 9 Parcel: 2S104AD03401
Jurisdiction: Tigard
Site address: 12828 SW WALNUT ST
Subdivision: None Lot: None
Project: LEWIS
Project Description: New detached 528 sf two car garage and 220 sf new asphalt. Electrical permit required.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 15 Bathrooms: 0 Second: 0 sf Garage: 528 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $25,238.40 Rear: 5
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
0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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:
LEWIS FAMILY REV TRUST TUFF SHED Required Items and Reports(Conditions)
BY LEWIS,BRIAN C&CHRISTINE 2950 SE 73RD AVE 1 Ersn Cntrl 503-639-4175
C TR HILLBORO,OR 97123
12828 SW WALNUT ST
TIGARD,OR 97223
PHONE: 503-459-6365 PHONE: 503-848-6088
FAX:
Total Fees: $1,140.88
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 uires y•u to llow the rules adopted by the Oregon Utility otification Center. Those rul re set forth in OAR
952-001-0010 through OAR 952-0 ''90. • may o, in a copy of th=/ules or dire- estions to OUNC b cal g 503.232.1987 or 1.800.332.23
Issued By: iAlr`�/ ` ...411ffe Signature:i!, 'Y (\n( s
mittee
/ s
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 Cy 1 o►z o i i i i I s►: 0 y I..y1III p
City of Tigard Date/BReceivea 6 Pe/�'L�/ j�6 -c- �l
• 13125 SW Hall Blvd.,Tigard,OR 97223 ( � � � `j Plan Review Q /A ill
i Phone: 503.718.2439 Fax: 503.598.1960 Date/By: , � J g Other Permit:
t_1(,A R I) Inspection Line: 503.639.4175 - Date Ready/By: Juris: I ® See Page 2 for
Internet: www.tigard-or.gov N.'pedMetho,: ,. er il Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
LaNew 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. 2c- aZ,,3co
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $-C -'
J
stAccessory building ID Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: '? Z ,f.:: &) W-PxL'-r LS "', New dwelling area: square feet
City/State/ZIP: —V\ Pi-P...,1::) 012_ (:: -7 Ze- Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: ;__\)j 1at5S-fi`Ti- Deck area: c-�q,-tt,�J...-- square feet
Other structure area: '3 square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.:2 Si 01-No 0 3--' i01 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
- 3 -TL1 ES�, c�i 6 Valuation: $
—
1 S� .2- _� -1:1 x - NC\k)1 Existing building area: square feet
--- „ i _ .1 New building area: square feet
®,PROPS TY OWNER ❑`TENANT itiv Number of stories:
Name: ^^S 1 \K.) Type of construction:
Address: 1 Z% c S ___N'T 'r, Occupancy groups:
City/State/ZIP:-'C'‘G(N-L, C_ 9.72123 Existing:
Phone:(5O3) 4-r_;1") .- € y Fax:( ) -- New:
APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:
r -
�-�C
',\l' -FLS plan review fee(if applicable):
Address:
Total fees due upon application:
City/State/ZIP:
Phone:( ) Fax::( ) Amount received:
E-mail: br t tA1\1 Q.,tk j pd x C C3Z`('(�C i i , '(Y� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
2cmai and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: -1"' V- rC--( ��( d'- Submit two(2)sets of roof plan with connection details
' and fire department access,along with the 2010 Oregon
17 Address: ?r- _S �1�, 1-)-if_Qsz,1v0N, cs.L.-1-J Solar Installation Specialty Code checklist.
City/State/ZIP: -NjQ20 Permit Fee(includes plan review $180.00
] and administrative fees):
Phone:a03) .----r --- s&- 3 F.aK-4—_;.__.. x 0) '�Cs State surcharge(12%of permit fee): $21.60
CCB lic.:/(.6"- // s .2.2 n I Total fee due upon application: $201.60
Authorized signature: t ^ This permit application expires if a permit is not obtained
! / within 180 days after it has been accepted as complete.
Print name: C4 �. Q _ Date: o� *Fee methodology set by Tri-County Building Industry
��� *\`c�1 /�� /-7/� d t 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 FoR OFFICE I sF oyl.l
City of Tigard Received
Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
• Phone: 503.718.2439 Fax: 503.598.1960
t I(;ARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
'1IE: FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les No y k
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 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: . 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity . 0 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 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 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."
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/orany_beam/joist carrying .
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 6 a licable to the a ro'ect under review.
JURISDICTIONAL. SPE:CIFIC'S
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
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-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
it COMMUNITY DEVELOPMENT DEPARTMENT
ill i
T I G ARD Building Permit Review — Residential
IP
Building Permit #: "67-20/8- e 72 Lo)
Site Address: t'2Z ,' ry U T S . 'T\c {- 0...0. ,QRZ 9-T2a3
Project Name: INI NI C)��N 1 F-M F._ Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review
Proposal: - --.0_._.-C...-1 i . i1 �( -C-'� �C-- -C,(�r a -(,�R C" zPE E
'vii../ t,..,el u11- {y/ jcv-Q9t ape,7'7: 7_U )�. f -f-
Verify site address/suite# exists and active inrpermit system.
.0--River Terrace Neighborhood: .No ❑ Yes,See River Terrace Review Addendum Attached
'!Site Plan Elements: R
Three(3)copies of site plan Existing structures on site
Site plan must be on 8-1/2"x 11"or 11 x 17"paper rFootprint of new structure(including decks)with finished
IgDrawn to scale(standard architect or engineer scale) floor elevations
North arrow iglUtility locations&easements(required for new and additions)
1lSite address,project or subdivision name and lot number ki4lSidewalk/driveway approach
ig Applicant information(name and phone number) Nfocation of wells/septic systems
121,Lot dimensions and building setback dimensionsExisting trees to be retained with drip line,and tree
Njs uare footage of buildings to be demolished 'protection measures
E Lot area,building coverage area,percentage of coverage and I4treet tree size,type and location
V'rpervious area(applicable if R-7,R-12,R-25&R-40) Street names
operty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? YeAll No
4 pot differential) If yes,is a storm water quality facility shown? �Y'Y-'s IN No
r.... Clean Water S ces—Service Provider Letter(lot platted prior to 9/10/1995):
Required: Yes,applicant was notified ❑ No Received: ❑ Yes 1U No
4 Public Facilities Improvement (PFI) Permit:
14 + Required: ❑ Yes,applicant was notified IA,No Applied For: ❑ Yes ❑ No,stop intake
04 i �J' Land Use Case#:
Zoning:-.J
N Required Setbacks: Front Rear S Side S Street Side Garage
f)W4 Landscape Requirement: 1\i/4
0/0
Mt\'ig of Coverage Maximum: (�i/>c % 'c
Q L1J" Building Height: Maximum Height 1 > Actual Height 15
isual Clearance
L1 Sensitive Lands: ❑ Yes Ly' No Type
\Ut ,-Urban Forestry Plan
(\1P\Conditions "Met"prior to issuance of building permit
Notes:
Jpproved ByDate: "(y� -(,
Planning: 1-AnAvvaC,c
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:
Site Plans: #
Building Plans: #
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ 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: Date:
Engineering Review
,0" Slope at building pad: ti 0A,
e Conditions "Met"prior to iIsuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
7 Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Er No
Assess Water Quantity Fee in-lieu: ❑ Yes 2 No
LIDA Facility on lot: ❑ Yes Er No
0 Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Q'Approved by Engineering: -6,...4/ ye, e....14• Date: q • 20 • / 8
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:
vDateRev' ion Notice 3:
Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ►. ;/A
Tigard Trans SDC: ❑ Yes C' /A
Parks SDC: ❑ Yes ,1 N/A
LIDA ❑ Yes N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: Zv ,
I:\Building\Forms\BldgPermitRvw_RES_010118.docx
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
III
_ Transmittal Letter
1 C,A k n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.go
TO: Pc'LLY„Sd►t\( DATE RECE i :
DEPT: BUILDING DIVISION ) 0 A
;. ED
` �1 p OCT 23 2018
'
FROM: 'f24 - V LJ CITY OF llGARD
COMPANY: A,A.r- N� _, BUILDING 11/lSiO
N
PHONE: c` � + 4-56J ' F By.7
RE: )2.. -2 ) U) Lim T -4:T t r IS- aDa61
(Site Address) (Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWIN TE t 4 4.
Copies: Description: Nt opies: Description:
Additional set(s) of plans. . i l/ Revisions: i f(1e5H-T ' .tz: )V\Tifffioi1i
Cross section(s) and details. t j Wall bracing and/or lateral analysis.
Floor/roof framing. N ' Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY A,�
Routed to Permit Techni• . Date: } dJi / (' Initials: %�"f 1
Fees Due: Yes '� No V Fee Description: Amount Due:
❑ p
$
h....) (-) C< ss gl
Special
Instructio s:
Reprint ermit(per PE): ❑Yeso ❑ Done
Applicant Notified: Date: /0.67-N Initials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc