Permit (213) CITY OF TIGARD MASTER PERMIT
'IllCOMMUNITY DEVELOPMENT Permit#: MST2019-00332
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2019
Parcel: 2S103BD02300
Jurisdiction: Tigard
Site address: 11760 SW CARMEN ST
Subdivision: CARMEN PARK Lot: 8
Project: SMITH
Project Description: New 20x26 ft garage, structure only. Foundation completed under MST2018-00263.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: First: sf Basement: sf Left: 5 Parking Spaces:
Height: 11 Bathrooms: Second: sf Garage: 520 sf Front: Smoke
Dwelling Units: Third: sf Right: 5 Detectors:
Total: sf Value: $25,339.60 Rear: 5
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Urinals:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Storm Sewer:
Tubs/Showers: Garbage Disp: Water Heaters: Water Lines: Drains: Catch Basins:
Bckflw Prevntr:
Footing Drain: Ice Maker: Hose Bib: Backwater Value:
Drywell-Trench Drain: Other Fixtures:
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Furn<100K: Vents: Woodstoves: Gas Outlets:
Furn>=100K:
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0-200 amp: 0-200 amp: W/Svc or Fdr:
Ea add!500 sf: 201-400 amp: 201-400 amp: W/O Svc/Fdr:
Mfd Home/Feeder/Svc: 401-600 amp: 401-600 amp:
601-1000 amp: 601+amp-1000v:
1000+amp/volt:
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
Owner: Contractor:
SMITH,ROSS JAY OWNER Required Items and Reports(Conditions)
' 11760 5W CARMEN ST 11760 SW CARMEN STREET
n 151S-4
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: PHONE: 503-521-0727
FAX:
Total Fees: $1,053.60
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 cop, of jhe_u Iesor_direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
t
Issued By: it _�_ - • , ittee Signature: (4"—g—" . „
Call 5,- 75 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 f ..( ° ',%- 4 zs. 14.-
,�'• . "'' & -.;,,-:, 10120111( 1: lSl: o\I.1
City of Tigard2019
0�y C Received / /
�U 7 (_tJ t� Date/B : �� '' • /ai ''.. 6, ?,02, —
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �,,
Phone: 503.718.2439 Fax: 503.598.16Q `c,”. Date/By: • 1Z /1 ' ,r 9"'3 ' 'a'• r ../
TI G A R D Inspection Line: 503.639.4175 f7,:.:,:\.! Date Ready/By: 4,,oris ® See Page 2 for
Internet: www.ti and-or. ov
g g �/' A� Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
VI New construction 0 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 0 Other: equipment,materials,labor,overheadand_1�profit
CATEGORY OF CONSTRUCTION work indicated on this application. 2.5 1
Valuation: $ P , v(,)
0 1-and 2-family dwelling 0 Commercial/industrial /�.
i Accessory building 0 Multi-family Number of bedrooms:
—
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I/ 7%D c t~/ 0'-n ri Ex., S .:T New dwelling area: square feet
City/State/ZIP: T-- .41, � / c9/1- q 7 z3 Garage/carport area: 5-2.,0 square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: G./.,L/t/,.-rT .-ti� // 4 •74:1-7 Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 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.
N In/ G 4-rt 4-c )5'7"%f t f e__:7-4,14-.,• ' n s-'1, Valuation: $
Existing building area: square feet
New building area: square feet
at PROPERTY OWNER 0 TENANT Number of stories:
Name: gC s' S M/771 Type of construction:
Address: `7 7 "e2 s-,1^/. [.44-,z.r ,%_,/ 51-7-Z4=-.../53,— Occupancy groups:
City/State/ZIP: "7—/G xyzo i2 '9 7...1-..2..„? Existing:
Phone:(3"0-,,;) S -i, _O 7 ,7 Fax:( )
New:
® APPLICANT 0 CONTACT PERSON
BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
�n J c%r{-l7�" 1 i 0.&."7"../`",e" Structural plan review fee(or deposit):
Contact name:
Address:
FLS plan review fee(if applicable):
City/State/ZIP: Total fees due upon application:
Phone:-(._ __5__ - _ _ Fax:: -- amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: e, � � 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.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:
Total fee due upon application: $201.60
Authorized signature: ✓7 /f -42,--7 This� This permit application expires if a permit is not obtained
,� within 180 days after it has been accepted as complete.
Print name: / i5 S S ti ``/� Date: *Fee methodology set by Tri-County Building Industry
/��/� 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 l O R 01 1 1( 1.. 1 SI 0\1.1
City of Tigard DateReceived
Permit No.:
IP/ 13125 SW Hall Blvd.,Tigard,OR 97223 Associated Associated permits:
■ Phone: 503.718.2439 Fax: 503.598.1960
0 Electrical ❑ Plumbing ❑ Mechanical
TI G n R n 24-Hour Inspection Line: 503.639.4175
Internet: www.tigard-or.gov 0 Other:
"HIE FOLLOWING ITE\IS ARE REQUIRED FOR PLAN REVIEW lcs 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
3 Verification of approved plat/lot. 0 8
4 Fire district approval required. Name of district: • 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0
6 Sewer permit. 0 0
7 Water district approval.
8 Soils report. Must carry original applicable stamp and signature on file or with application. 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 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
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. - 0 Ei 9
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 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.
,It RISDICTIO\AL 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 0
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. ❑
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. 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-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
r Clean Water Services File Number
CleanWaterr Services 18-003049
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: Tigard F t1 ,( ar_��'"` A 1'
2. Property Information(example 1 S234AB01400) 3. Owner Information AUG .N ,1 C;
Tax lot ID(s): 2S103BD02300 Name: Ross Smith zC
Company: owner si
Address: 11760 S.W.Carmen Stre4t
Site Address: 11760 S.W.Carmen Street City,State,Zip: Tigard,OR,97223
City,State,Zip: Tigard,OR,97223 Phone/Fax: 503-521-0727
Nearest Cross Street: 116th Ave. E-Mail: ross.smith@rogers-machinery.com
4. Development Activity(check all that apply) 5. Applicant information
Addition to Single Family Residence(rooms,deck,garage) Name: Ross Smith
❑ Lot Line Adjustment ❑ Minor Land Partition
Company: Owner
❑ Residential Condominium ❑ Commercial Condominium
❑ Residential Subdivision Address: 11760 S.W.Carmen Street
❑ Commercial Subdivision
LiSingle Lot Commercial LiMulti Lot Commercial City,State,Zip: Tigard,OR,97223
Other Phone/Fax: 503-521-0727
E Mail: ross.,smith@rogers-machinery.com
6. Will the project involve any off-site work? Li Yes kl No ❑Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
I want to add a detached garage. The set back will be 100 feet from Carmen Street.
This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ
1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army
COE. All required permits and approvals must be obtained and completed under applicable lo�al,state,and federal law.
By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority
to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify
that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate.
Print/Type Name Ross Smith Print/Type Title
ONLINE SUBMITTAL Date 9/25/2018
FOR DISTRICT USE ONLY
❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A
SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report
may also be required.
❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This
discovered.This document will serve as your Service Provider letter as required by Resolution and,Order 17-05, Section 3.02.1. All required permits and
approvals must be obtained and completed under applicable local,State,and federal law.
Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially
sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water
quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order
07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law.
This Service Provider Letter is not valid unless 1 CWS approved site plan(s)are attached.
❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed by . • ,d ( Date 10/2/18
2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • Phone:(503)681-5100 • Fax:(503)681-4439 • www.cleanwaterservices.org
City of Tigard
■ COMMUNITY DEVELOPMENT DEPARTMENT
IN
T I G A RD Building Permit Review — Residential
Building Permit #: O/1 "GY 33Z`_
Site Address: /j b D R/4 ) ( irrte it . Q.Y---
Project Name: -- .7712).-71-k_ �r Lot #:
(New dwelling=subdivision na ddition or Alteration=last name of owner)
Planning Review
Pro os al: A)/k) c iav I
Verify address/suite# active in Accela. 1 . .-v err e: LvJ No ❑ Yes,River Terrace Review Addendum
Sit ,Plan Elements: F osion Control
NJ opies of site plan on 8-1/2"x 11"or 11 x 17"paper V ained trees with drip line and tree protection measures
a yawn to scale(standard architect or engineer scale) ri Fog tprint of new structure(including decks)and FFE
rth arrow -f i,' ty locations&easements(required for new and additions)
v46e address,project or subdivision name and lot number !I Sid-walk/driveway approach
plicant information(name and phone number) 1.1 .tion of wells/septic systems
It
VLot dimensions and building setback dimensions •. -et tree size,type and location
0:•uare footage of buildings to be demolished iTj reet names
4 Existing structures on site Comer elevations(2'contours if more than 4'differential)
IV•t area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? El Yes
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes Zo
Clean Wateret-vices—Service Provider Letter(lot platted prior to 9/10/1995): C/
Re.uired: Yes,applicant was notified Elf [ld YeNo Received:7/7 s ❑ No
*'ublic Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified L✓J No Appli.. For: ❑ Yes ❑ No,stop intake
0.4 and Use Case#: LvA Zoning: e-
J 'equired Setbacks: Front: 131Pr Rear: Side: Street Side: 03/4)-- Garage: 2O
I Building Height: Max. Height: 4,..,c—ir Actual Height: /1
A *.andscape Area: % f Coverage Max: 0/0
Entrance 1 ; •ack no more than 8'from street-facing wall ❑ Parallel to street or offset 45 de t --. . ess
Windows ❑ Minimum — . • area of all street-facing facades �
Garage ❑ Garage door is behind eet-facing wall 1V ❑ Yes ■ '-.,one of the following is met:
❑ Door extends no more than 5' r• - all and there is a c• - -• porch extending beyond garage.
❑ Door extends no more than 5'from wall an . - 's a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or les a 50%or less of faca.- • 60%or less and includes 7 of following:
❑ Covered porch ■ ' -cessed entrance ❑ Wall offset ❑ 1' •o. ; e ❑ Roof offset
w -r- ii.'::_ 1E1 -rxp ---El,. pd ch -LJ • -, 1•; • • - •• ..it Doer
ccent siding ❑ Window trim ElWindow recess 1=1Window projection ■ ,ny
r isual Clearance �� Jrban Forestry an
'I'i ►.ensitive Lands: ❑ Yes No Type:
r ��onditions met prior to issuance of building permit
„,;.74, :
Approved By Planning: ------ Date:
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_022819.docx
Building Permit Submittal ^�
Original Submittal Date: 7! l(3
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planningengineering �ermit Coordinator ` Building
►
Workflow Sign-off: Sign-off forPlanning(include notes from planning review) /
Route Application Documents: j2' Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
( original plan review routing form.
H Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: _
By Permit Technician: / /� ate:
Engineering Review
Q"Slope at building pad: 4
D Conditions "Met"prior to issuance of building permit
[I Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ErNo
Assess Water Quantity Fee in-lieu: ❑ Yes ErNo
�� LIDA Facility on lot: ❑ Yes D No
Li- Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:��
Ll Approved by Engineering: j Date: g/ //cj
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:
Revision Notice 3: Date Sent to Applicant: /
tC Fees Entered: Wash Co Trans Dev Tax: El Yes E N/A
Tigard Trans SDC: ❑ Yes ZCN/A
Parks SDC: ❑ Yes Er-N/A
LIDA ❑ Yes ErN/A
OK to Issue Permit ?4, 2
Approved by Permit Coordinator: Date: 79/
I:\Building\Forms\B1dgPermitRvw_RES_022819.docx