Permit (80) litCITY OF TIGARD MASTER PERMIT
-1 COMMUNITY DEVELOPMENT
• Permit#: MST2018-00310
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/07/2019
TIGARD 9 Parcel: 2S111 BA01600
Jurisdiction: Tigard
Site address: 14405 SW 97TH AVE
Subdivision: Lot:
Project: Adamamy Terrace
Project Description: Addition of 786 sf to existing home to include 2 story garage with master bedroom and bathroom
above. Trade permits submitted separately.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 1 First: sf Basement: sf Left: 5 Parking Spaces:
Height: 22 Bathrooms: 1 Second: 786 sf Garage: 786 sf Front: 20 Smoke
Dwelling Units: Third: sf Right: 5
Detectors. Yes
Total: 786 sf Value: $130,672.50 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
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!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 I
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 VB R-3 786
Owner: Contractor:
MITCHELL,PATRICIA OWNER Required Items and Reports(Conditions)
14325 SW 97TH AVE MICHAEL&PATRICIA MITCHELL 1 Ersn Cntrl 503-639-4175
TIGARD,OR 97224 14405 SW 97TH AVE
TIGARD,OR 97224
PHONE: PHONE: 971-777-4043
FAX:
Total Fees: $3,269.07
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 suspen• for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati/ Center. Those rules :r set forth in OAof R
952-001-0010 through OAR 9 -001-00 . You ay obtain a co of the rules or direct questions to OUNC by calling 50:.2 .32.1987 or 1.800.332.234/��
Issued By: i(� /1 [- — /Permittee Signature: � }AA ,61/66(..A" L
Call 503.639.4176 by 7:00 a.m.for the next available insp. ion date.
This permit card shall be kept in a conspicuous place on the job site• til completion of the proje .
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential .v FURUIIK I: tSt:0\1.1
Cl Tyof Tigard Received
Date/By: ( l //1 g P /y x 1/
13125 SW Hall Blvd.,Tigard,OR 97223 t r y Plan Reviewt 03
Phone: 503.718.2439 Fax: 503.598.1960 ' 4 Date/By: lA ' Other Permit:
Inspection Line: 503.639.4175 r Date Ready/By: Oris. I H See Page 2 for
I 1 G A R D k t, Notified Method: ) Supplemental Information
Internet: www.tigard-or.gov ' r,� l`rf} p
~'�i96 as1 'V'id it'Ul.4 i .- l', LI^uL.0 ,,,,,�
TYPE OF REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑Demolition Permit fees*are based on the value of the work performed.
0 New construction Indicate the value(rounded to the nearest dollar)of all
X.Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION
work indicated on this application. ,'7,0,I L'7---
Valuation: $
R_1-and 2-family dwelling 0 Commercial/industrial i
r Number of bedrooms:
❑Accessory building 0 Multi-family
❑Master builder 0 Other: Number of bathrooms: I
JOB SITE INFORMATION AND LOCATION Total number of floors: r2
Job site address: / Ll 410, - 5,=.i' 9 7/ AI,Z,,. uC / -Zai—/7 New dwelling area: 776 square feet
City/State/ZIP: (x / �,e Garage/carport area: C square feet
f
Suite/bldg./apt.no.: Project name!--Vit-r.,) .("7/-)4K. Covered porch area: square feet
Cross street/directions to job site: ,i') ' ./j Deck area: square feet
f Other structure area: square feet
(.69
fff REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 7. Sit fri��//Arlt- 6)1 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.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
n n ittratiz_ Valuation: $
44 „ Existing building area: square feet
L 5/ Oi' ' ( �: 4. %� �" /7-
c/ g4—(:F- New building area: square feet
Cgi PROPERTY OWNER 0 TENANT Number of stories:
Name:/14)(/-1,,,,,,17, PAT- 44 j l;6 Type of construction:
Address: 77 yySW j
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFI. 1; CSI: Oml.v
City of Tigard Received
r 13125 SW Hall Blvd.,Tigard,OR 97223 Dateciat Permit No.:
• Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
0Electrical 0 Plumbing 0 Mechanical Hour Inspection Line: 503.639.4175T I[;ntp
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 'es No v/'
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 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
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
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 Manufactur�c 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 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". 0 0 0
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 ❑
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\Pennits\BUP-RESPermitApp.doe 02/24/2011 440-4613T(11/02/COM/WEB)
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.
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.
/(tlfi ' u /"l / -
Print Name of Permit Appli - t
Z 7 /7
Signature of Per pplicant Date
Permit#: /)?57- 1f-061/20204- Gt5)0
'711
.4
Address: � �_Ski `�7 r
JJ,,e
Issued by: Date: p? (7/1 t-.147
This Copy for Permit Offices
City of Tigard
i . 7 COMMUNITY DEVELOPMENT DEPARTMENT
IIIII
T l cARD Building Permit Review — Residential
Building Permit #: /'91J,T�rt�1, —tAi
Site Address: Z/Cr
Project Name: ¢7647 f� -c1/, i1/i IVa Lot #: �!
(New dwelling=rSy(bdivision name;Addition or Alteration=last name of owner)
Planning ReviewJ
71: h (5
II
y site address/suite#exists and activ ' permit system.
kiver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Side Plan Elements:
017hree(3)copies of site plan
�te plan must be on 8-1/2"x 11"or 11 x 17"paper sttng structures on site
�rawn to scale(standard architect or engineer scale) r ootpri elevt ations new structure(including decks)with finished
orth arrow
al2r1").ty locations&easements (required for new and additions
!1Q e address,project or subdivision name and lot number )
idewalk/driveway approach
0 .plicant information(name and phone number)
I''10.cation of wells/septic systems
11)Lot dimensions and building setback dimensions la:*,sting trees to be retained with drip line,and tree
." are footage of buildings to be demolished otection measures
Oilkt area,building coverage area,percentage of coverage and
$ treet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) Street names
roperty corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced? IdYes ❑
)16
4 foot differential)
If yes,is a storm water quality facility shown? yes ViNo
aKean Water Services—Service Provider Lett (lot platted prior to 9/10/1995):
IZ(Iquired: ❑ Yes,applicant was notified No Received:
Public Facilt'tievImprovement(PFI) Permit: ❑ Yes ❑ No
Required: Yes,applicant was notified ❑ No Applied For: �0°/Q-°Yes i No,stop ntake
jand Use Case#: (5000'9—
/Zoning: (5000'9—
/Zoning: 96.204-
- -C—
Required Setbacks: Front ....20 Rear
//c– Side Street Side 'Garage
Wandscape Requirement:
of Coverage Maximum:
ge
Building Height: Maximum Height gO Actual Height 2Q
•sual Clearance
bf:-nsitive Lands: 0 Yes 0 No
Type
7 Urban Forestry Plan
0 Condition "Met"prior to issuance of building permit
Notes: - b rn j _71--- --
0 Approved By Planning: /j1V g
—'�' ' sir Date:
Revisions (after Building Submittal only)
Revision 1: 0 Approved 0 Not Approved Reviewer Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\Building\Forms\BldgPermitRvw_RES_061417.docx
Building Permit Submittal
Original Submittal Date: #//.5/f8
Site Plans: 3
Building Plans: #
Building Permit#: � nter building permit#above. �/.
Workflow Routing: an . g L'`I��.ngineering Ef Permit Coordinator uildtng
Workflow Sign-off:
ffPlanninginclude notes from planning review)
�- for (
Route Application Documents: L,J�'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
i4,....q1inal plan review routing form.
uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date //4"V
Engineering Review
Er-S.-lope at building pad: .„2D
Conditions"Met"prior to issuance of building permit
E//Easements (encroachments)per engineering conditions of approval and plat
Ld' Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes C]'No
Assess Water Quantity Fee in-lieu: 0 Yes 'No
LIDA Facility on lot: 0 Yes a No
0final Plat Recorded: Date:
0 NOT Approved by Engineering:
Notes:
BrApproved by Engineering: 4, r51I- .
Date: .. 34.0—(
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 Condition`Met"prior to issuance-of building permit
0 Approved,NOT Released:
Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
ision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes !B"-N/A
Tigard Trans SDC: 0 Yes Er N/A
Parks SDC: 0 Yes /A
4:11-:21K
LIDA 0 Yes N/A
OK to Issue Permit q
Approved by Permit Coordinator:
Date: f 3`) / 1
IABuilding\Forms\BldgPemutRvw_RES 010118.docx