Permit (90) CITY OF TIGARD MASTER PERMIT
�• COMMUNITY DEVELOPMENT
Permit#: MST2019-00010
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/11/2019
T I i; I<.r g Parcel: 2S103AA01905
Jurisdiction: Tigard
Site address: 12350 SW TIEDEMAN AVE
Subdivision: COTTONWOOD PLACE Lot: 8
Project: Ford
Project Description: Repairing front and side walls of foundation, removing and replacing finishes, and repairing and
reconnecting interior walls.
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: $50,000.00 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: 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
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Ecompasing: N
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 0
Owner: Contractor:
FORD,TIMOTHY W HAR BRO WEST Required Items and Reports(Conditions)
12350 SW TIEDEMAN AVE 2750 SIGNAL PARKWAY
TIGARD,OR 97223 SIGNAL HILL,OR 90755
PHONE: PHONE: 562-528-8000
FAX:
Total Fees: $1,306.12 •
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work 's suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati• Center T o - les s forth in OAR
952-001-0010 through OA 952-001-0090. Y may obtain a c py of the rules or direct questions to OUNC by cal • 5r 32.19: • 1.:10.3 •• <44.,
Issued By: Permittee Signature: A l L
Call 503.639.4175 by 7:00 a.m.for the next available inspect• e.
This permit card shall be kept in a conspicuous place on the job site until c• ion of the project.
Approved plans are required on the job site at the time of each i .ection.
Building Permit Application..
Residential P P FOR OFFICE USE ONLY
' 'City of Tigard 0 ft Received ] _ y
s ,1`� 3 Date/By: v .i� /7 4f.,e..'i S7—(7 /7' '' f. * �
IN . r. 13125 SW Hall Blvd.,Tigard,OR 972/x Plan Review xice ! A Other Permit:
• `Phone: 503.718.2439 Fax: 503 598.1960 Rs0 Date/B
Y:
TIGARD Inspection Line: 503.639.4175 CITY UtI (sAc
Date Ready/By: / Juris: El See Page 2 for
Internet: www.tigard-or.gov � N$ Oi\.!S ( .+ ...Notified/Method: ( 7 .0 Supplemental Information
3 s 4 `• TYPl )F";' iik R Q i DATA:1 AND 3 F MILY HEELING
,
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
IX Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
T " work indicated on this application." FF,„ Zidi)E,GORY O CON TRUCION
1-and 2-family dwelling 0 Commercial/industrial Valuation: $ Q` 0 0 a
ElAccessory building 0 Multi-family Number of bedrooms:
ElMaster builder ❑Other: Number of bathrooms:
s.
JOB SITL I OR TIO I E •o CATI,01,1 f ,, , _ Total number of floors:
Job site address: ('L21 0 4Q..) (r(rZ 7 -"AN /)--li ei New dwelling area: square feet
City/State/ZIP: ,r,C`1 Dt of-c. Ot1 Zv7 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
€71I1.ED 1 OMIV ERCT. ikSE + 1 k,,
Subdivision: Lot no.: Permit fees*are based on the value of the work performed. V
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,
labor,overhead,and theprofit for the
P R .D CIPTION OF work indicated on this application.
'i_et)-7FRQN( W�m..L I. _` 1f7 - VJ i, Q p .o i� D Valuation: $
4i
�
• p
� „f ( gs, Eistmg building area. ll suadeir r ,
1Ot6, hcLL4P , e_ ®v G EP/
ALC
NI lc7 ft-n top T�t,r t a New building area: square feet
i1 PIfi RTY OWN ,• \ ❑ TENTNumber of stories:
Name: (( NA kr Type of construction:
Address: (`L 2)l0 U`} ri1 1L1),2_,Mn� Ay Occupancy groups:
City/State/ZIP: 1t Cal n f 0 t ^12!
9 5 Existing:
Phone:( ) Fax:( ) New:
tri 'PI.I � ` € ONTA I' PI+R$()l4I �r�. ,i �BIIfI. E" "
m
W f f t DENG PERM, '
Business name: 5 g pc,'N ecK.1�1 G�
'f0A Flensere er tofoe$cliedal', ,
Structural plan review fee(or deposit):
Contact name: D 1.1. �'fY tv) (3 )fZ.
FLS plan review fee(if applicable):
Address: j 41(1 v J N IJt-1'T
City/State/ZIP: 0 p,a. IGS \T11 0 el-7 t 1 t
, Total fees due upon application:
/ r�( [ Amount received:
Phone:(�C5) (41 I IJ®l Fax::( )
• PHOTO 1 f t LAR,PANFIL SI}k4i F"E
E-mail: r� 5 @h L t CO :� z�, ;
• 7, ,, »> Commercial and residential prescriptive installation of
.;CONTRA TOR fs
y,,;� ,�•>• '' <•, , : '' roof-top mounted Photovoltaic Solar Panel System.
Business name: /4/4(� 3ice,O 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.
Permit Fee(includes plan review
City/State/ZIP: {` - ( `� and administrative fees): $180.00
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 1.0°1
61) ti-. Total fee due upon application: $201.60)Authorized signature: adt. /
Thispermit application expires ifapermitis not obtained
✓h/ within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: J 01 -1.., Q p({ ,J 'ilEA,A 13f�►', Date: 1t. .;0 1 rf Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City Of,TigardIIIIII Received Permit No.:
- H 1312;5 SW Hall Blvd.,Tigard,OR 97223 Date
/By:Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
TIGARD 24-Hour Inspection Line: 503.639.4175 (3Electrical 0 Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 000
3 Verification of approved plat/lot. 0 ❑ 0
4 Fire district approval required. Name of district: . ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. 000
7 Water district approval. ❑ 0 ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. 000
9 Erosion control ❑plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ODD
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 000
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 ODD
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 ODD
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 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- ODO
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
1 rsidf ::eatiStrilatioiiriShow dstdfls al•7 l hdnd-roof-sheath ng,roofing;Tobf slope,ceiling'height; til g rr a't~e t al,f6elI1 4 ',
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 000
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- 000
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 000
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 000
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 DOD
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 000
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 ❑ ❑
architect licensed in Ore!on and shall be shown to be a..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". 0 ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 000
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 000
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 000
27 "Drawn to scale"indicates standard architect or engineer scale. 000
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, DOD
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, 000
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
Tel: 503.718.2439
Location: Inspection Date:
12350 SW TIEDEMAN AVE, TIGARD, OR, 97223 June 19, 2019 at 10:08:30 AM
Record Type: Record ID:
Residential - Master Permit MST2019-00010
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor