Permit CITY OF TIGARD SINGLE FAMILY
;, MANUFACTURED PERMIT
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: SFM2020-00001
Date Issued: 02/12/2020
Parcel: 2S102BC00111
Site address: 12528 SW BROOKSIDE AVE Jurisdiction: Tigard
Subdivision: WALNUT ACRES v 7 : 10
Project: Arms
Project Description: ADU: Detached 310 sf manufactured structure. Trade permits pulled separately.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 1 First: 310 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors. Yes
Total: 310 sf Value: S0.00 Rear: 5
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temo Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea addl 500 sf: 0 20 1-400 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:
NEW ADU VB R-3 310
TOTAL FEES: $9,306.56 REQUIRED ITEMS AND REPORTS
Owner: Contractor:
ARMS,STEVEN TIMOTHY&EMILY WOLF INDUSTRIES INC
CLA 1601 SE COMMERCE AVE
12530 SW BROOKSIDE AVE BATTLE GROUND,WA 98604
TIGARD,OR 97223
PHONE: PHONE: 360-608-2119
FAX:
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 OA -00 -0090. may obtain a of the ru or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: PermitteeSignature: ,S` Jh,b -t/�\
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.
CITY OF TIGARD SINGLE FAMILY
E •r MANUFACTURED PERMIT
111
2 COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718,2439 Permit#: SFM2020 00001
TIGARD 9 Date Issued: 02/12/2020
Parcel: 2S102BC00111
Site address: 12528 SW BROOKSIDE AVE Jurisdiction: Tigard
Subdivision: WALNUT ACRES Lot: 10
Project: Arms
Project Description: ADU: Detached 310 sf manufactured structure. Trade permits pulled separately. NO FINAL INSPECTION
UNTIL WATER METER UPSIZED TO 3/4".
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 1 First: 310 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 310 sf Value: $0.00 Rear: 5
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
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 20 1-400 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:
NEW ADU VB R-3 310
TOTAL FEES: $9,306.56
REQUIRED ITEMS AND REPORTS
Owner: Contractor:
ARMS,STEVEN TIMOTHY&EMILY WOLF INDUSTRIES INC
CLA 1601 SE COMMERCE AVE
12530 SW BROOKSIDE AVE BATTLE GROUND,WA 98604
TIGARD,OR 97223
PHONE: PHONE: 360-608-2119
FAX:
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 rules or direct questions to OUNC by calling 503:23 .1987 or 1.800.332.2344.
Issued By: ittee Signature: �/
Call 503.639.4175 by 7:00 a.m.for the next available lSpection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the proj .
Approved plans are required on the job site at the time of each inspection.
Manufactured Dwelling
Placement Permit Application ...,, , FOR OFFICE USE ONLY
City of Tigard Received /
II - g AN 22 2020 Date/By: i Z.41 �� PermitNoS r��� a cool
13125 SW Hall Blvd.,Tigard,OR 97223 cool
Plan Date/By:Rev I /n 7 n
Phone: 503.718.2439 Fax: 503.598.1960- ��y 1<//L� /�"LU Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 p ;�q OFnp 11 'Pl Date Ready/B .runs: ® See Plan Submittal
Internet: www.tigard-or.gov dUIL ING LII�6jit�1�' N Notified/Me o Requirements
! t d90.
Site Address: ;2--.1245 `S%J okSiOa AoR_ . i tl c�-O,Ok:1,Nl t. c•V✓Gr AiriA^-S
Park Name: 0
Subdivision&Lot#: 1z Address:
ln�k-try �crcS t o t2.630 5w P-,Y-1021(.5i1-t fk,a.- .
Directions to inspection site: City: I Stat I ZIP�.-2�,,
Phone: Ja i l-9 41 15 I Fax:
Is property inside city limits? [ Yes ❑ No E-mail:
Zoning Sanitation
Signature: Signature:
Jurisdiction: 43k ; Jurisdiction:
Date: Date:
MANUFACTURED DWELLING PLACEJ1EN'T PERMIT FEES
Cost(each) No.of Sum
(1) Installation/re-inspection Items
(a) Placement(includes placement,electrical feeder,30'of water/sewer connection). $ 275.50 $
(b) State surcharge at 12%(of placement fee only). $ 33.06 $
(b) Re-inspection(includes inspection and 12%state surcharge) $ 100.80 $
Placement permit to be obtained only by homeowner,or Oregon-licensed manufactured dwelling installer.
(2) Electrical
(a) Service and/or feeder(new service installation or alteration/relocation of existing service). $ See Electrical Permit Application
Electrical service permit to be obtained only by homeowner performing work or signing supervisor of Oregon-licensed electrical contractor
performing work.
(3) Plumbing
(a) New water service(for services over 30 lineal feet). $ See Plumbing Permit Application
(b) New sanitation/storm sewer or rain drain(for services over 30 lineal feet). $ See Plumbing Permit Application
Plumbing permit to be obtained only by homeowner performing work or Oregon-licensed plumbing contractor performing work.
(4) Miscellaneous fees
(a) Administrative fee(State of Oregon). $ 30.00 $
(b) System development fees(sewer connection,storm water,parks development&traffic impact). $ See Permit&System Development Fees
SUB-TOTAL $
Sl T-UP OR INSTALLATION CONTRACTOR APPLICANT
Name: • Name:
,00tc I rAd..k_S 1YtL S rtie t.-+t-it , Li.L, I r-i✓ISL a-iN It1p t/•-S
Address: Add
(WaW I Catr te-/A mac. ress:
, ty)311 A• fit. " G,u-tt O P
City: I State: ZIP: City: I State: I ZIP I
Phone:;� , 2r.n Fax: Phone: Fax:
-71 '' �lJ t 30,9 -Eno Litt. q
CCB No.: T) MDI No.: E-Mail:
� � v1r5tt,olD vwt i.—1� . rJM-
Name: NI
hereby certify that the information above is true and correct.
All work to be performed shall be in accordance with all
Address: governi laws and rules.
City: State: ZIP: l/2.-z/70
Phone: Fax: Authorized ra—.'_ Date
CCB No.: MDl/LSI No.: Print Name: I/. y�5
\ \I:\BuildingPermitsSFM-PennitApp.doc 10/16/2014 1�
114
Building Permit Application
Plan Submittal Requirements
T I GA RD Manufactured Dwelling
1. SITE PLAN-Three (3) copies, fully dimensional and drawn to scale,labeled with:
A. ❑ map&tax lot# ❑ subdivision name ❑ subdivision lot# ❑ site address
❑ zoning ❑ applicant name ❑ phone number
Size requirement: 8-1/2"x 11",to a maximum 11"x 17".
All details listed below shall be incorporated into the site plan:
B. North arrow.
C. "Drawn to scale"indicates standard architect or engineer scale.
D. Footprint of structure,including accessory structures,garage,carport and decks shall reflect actual building
dimensions,including retaining walls.
E. Finished floor elevations,all levels.
F. Garage finished floor elevation.
G. Corner lot elevations. If more than 4 feet elevation differential,plan must show contour lines at 2-foot intervals.
H. Location of all cuts and fills on the lot.
I. Driveway corner elevations.
J. Zoning setbacks (front,side and rear).
K. The location of all public and private easements.
L. The location,termination,and all invert elevations of all drainage piping(sanitary and storm) showing all
elevations necessary to show positive gravity flow to the approved drainage device (i.e.peepholes,storm lateral,
sanitary lateral).
M. Residential driveways,sidewalks will be shown on site plans and will be in accordance with the City of Tigard
standards. Driveway cuts shall not be permitted within 30 feet of intersecting right-of-way lines,nor within 6 feet
of property lines. Weep holes/drain pipes will be installed 6 feet from adjoining property lines. Multiple
driveways on individual parcels of land must have 30 feet of separation;joint-use driveways require a formal
agreement.
N. Show all erosion control devices proposed for site. Contact Clean Water Services (CWS) at 503-681-5113 for
assistance.
O. Show location of existing facilities and new or relocated structures (utilities,well/septic systems,mailboxes,
power poles,water meter,light pole,stop sign,etc.).
P. Indicate property slope directions.
Q. Existing and finished contours when slope in any direction exceeds 20% (additional requirements may apply- see
grading policy).
R. Site plan to include tree size,type and location per approved project street tree plan (if applicable),and City of
Tigard Street Tree List.
S. Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,
driplines,and protection measures must be drawn to scale and must include the project arborist's signature of
approval.
2. BUILDING PLANS-Three (3) full sets for illustrating the manufactured dwelling foundation or basement
construction (no redlines or tape-ons accepted).
Size requirement: up to 24"x 36"maximum, folded into eighths (9"x 12")with the plans inside. No rolled,
reversed or mirrored plans will be accepted.
All details listed below shall be incorporated into the building plans:
A. Scale (architectural or engineering only).
B. Cross sections of the manufactured dwelling foundation or basement(every set of plans shall contain a
minimum of two cross sections at mid-point of each direction).
C. Exterior elevation (all views shall be shown).
D. Basement wall,foundation and retaining wall sections.
E. Documentation by manufacturer indicating that manufactured dwelling roof can support over-framing of
garage roof.
F. Driveway construction.
I:\Building\Permits\SFM-PermitApp.doc 10/16/2014
LL
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Residential
Building Permit #: . S fM - 0000 i
Site Address: iiS a s i„/ Irk Ave.
Project Name: Arr-S A- i1 Lot #:
Planning Review
Proposal: —2S6-77)-ell-VN 4/ 1L — 2//
❑ Verify address/suite#active in Accela. 0 In River Terr e: ❑ No 0 Yes,River Terrace Review Addendum
Site Plan Elements: LTE�osion Control
L copies of site plan on 8-1/2"x 11"or 11 x 17"paper L Stained trees with drip line and tree protection measures
rawn to scale(standard architect or engineer scale) Elitootprint of new structure(including decks)and FFE
L 6orth arrow ' Utility locations&easements(required for new and additions)
L to address,project or subdivision name and lot number l l walk/driveway approach
[1(pplicant information(name and phone number) Ly'i.ocation of wells/septic systems
L t dimensions and building setback dimensions [treet tree size,type and location
M4Hare footage of buildings to be demolished lietreet names
[ Existing structures on site co rner elevations(2'contours if more than 4'differential)
pl-ot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes [ 'o
imervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Yes ❑No
I!d Clean Water Se ces—Service Provider Letter(lot platted prior to 9/10/1995):
IZ1Xqwired: Yes,applicant was notified ❑ No Received: P'Yes ❑ No
Vater Meter F e Unit Worksheet—Additions,Remodels and ADUs Avr b-cc.[ o�� J Lhi 9-j7
4 _ quired: es,applicant was notified ❑ Received: [i s ❑ No
L S C Exemption for ADU applied for: Yes ❑ No Received: 1/Yes ❑ No
PE'Public Facilities Improvement(PFI)Permit: (--) I-21-may , ,( "AVID
quired: ❑ Yes,applicant was notified LQ' No A lied For: ❑ Yes ❑ No,stop take 3),
W' Land Use Case#: A0u1,614—utioi 6 L" Zoning: ,L9r`1•j
Squir'Squired Setbacks: Front: Zd Rear: S Side: g Street Side: IS Garage:_ Za,
ed
Height: Max. Height: 1 S Actual Height: j d S'
[Landscape Area: % 0 Lot Coverage Max:
trance ❑ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all street-facing facades
Garage ❑ Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
��) ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
' 1�" ❑ Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess CIWindow projection ❑ Balcony
Ef Visual Clearance LS' Urban Forestry P)an
2-.1Susitive Lands: ❑ Yes No Type:
D Conditions met prior to issuance of building permit
Note :
[pproved By Planning: ql-f2/- (14k Date: 1-1.1--Lr(y
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Forms\B1dgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: lfa'��
Site Plans: # 3
Building Plans: # `'
Building Permit#: a-Enter building permit#above.
Workflow Routing: U.—Planning {;:i" ngineering t9'"Tfermit Coordinator B—$wilding
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
99riginal 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: Z.(7 �, Date: 1,7r/
Engineering Review
Slope at building pad: '/d
O Conditions"Met"prior to issuance of building permit
O Easements (encroachments)per engineering conditions of approval and plat
C'Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes Er-No
Assess Water Quantity Fee in-lieu: 0 Yes ErNo
LIDA Facility on lot: ❑ Yes I No
O Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:��
[ Approved by Engineering: � Date: 1/27/z o 20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Permit Coordinator Review
O 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:
6Dc Exemption: ❑ Received l"Does not apply %7
V SDC Fees Entered: Wash Co Trans Dev Tax: 'Yes 0 N/A
Tigard Trans SDC: 0 N/A
Parks SDC: Yes 0 ,NIA
LIDA 0 Yes P'�N/A
L! OK to Issue Permit
Approved by Permit Coordinator: /kr Date: / YJ�
I:\Building\Forms\BldgPermitRvw_RES_122419.docx