Permit CITY OF TIGARD MASTER PERMIT
I. 1' COMMUNITY DEVELOPMENT Permit#: MST2020-00055
Date Issued: 03/11/2020
T j{;;'yj;[) 13125 SW Hall Blvd.,Tigard OR 97223 503,718.2439 Parcel: 2S109D806300
Jurisdiction: Tigard
Site address: 13260 SW HAZELCREST WAY
Subdivision: SEQUOIA HEIGHTS Lot: 11
Project: SELLMAN
• Project Description: Replacing existing 19'x9'6"deck with a 32'x9'6"deck and adding deck cover.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $22,000.00 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
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 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
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 0
Owner: Contractor:
SELLMAN,ROBERT K&ATHINA E STANLEY DEWAYNE MOORE Required Items and Reports(Conditions)
13260 SW HAZELCREST WAY 6107 SW MURRAY BLVD#263
TIGARD,OR 97224 BEAVERTON,OR 97008
PHONE: PHONE: 503-522-0047
FAX:
Total Fees: $834.73
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.<ou may obtain - r direct questions to OUNC by calling 503.2 ,Center`�987 0 1 00.332.2344,
Issued By::" .• / • Permit! 9igeatuze y
c fR: 9.4175 by 7:00 a.m.for the next available inspection dat..
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 FOR orrlcl. i. SI.OA'I.Y
City of Tigard Received c ( /. J I a 'C 7
111111 . plan Review
1h1ne SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.7182439 Fax: 503.5981960 Other Permit:
Date/By:
T I G A R U Inspection Line: 503.639.4175 Date Ready/By: /�_ , 1 -Tunis: ® See Page 2 for
Internet: www.tigard-or.gov relotified/Method: /v:L�l/' Supplemental Information
' i' 'mod[
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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
Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. -
Valuation: $ 2
M 1-and 2-family dwelling ❑Commercial/industrial _
El Accessary building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13'L(o 0 Sim 14.0 z e.I t.its f W a y New dwelling area: square feet
City/State/ZIP: ri if ar d 0/2 q-1 2_2 t{ Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Sell r n on a te..k Covered porch area: square feet
Cross street/directions to job site: FjU 1 I typot4+1 he,I h Deck area: 3 e 9- square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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.
,i t t �t Valuation: $
Al,pI act x ti.I S h no r? x ) -ln c1 e c1G a,+,F11 .t 3z x 9 -i.
A GO 2 Y S s i a,S- Fry 4 f j 1 ✓f t r it Existing building area: square feet
� 1 J O
(,' (c n t New building area: square feet
IBI PROPERTY OWNER 0 TENANT Number of stories:
Name: 'Robe }- Se 11,n a rj Type of construction:
Address: 13Z{v0 5 t-. r12 .- v
14 e.)c s s f t. 1 Occupancy groups:
T t
City/State/ZIP: S o rd D 2 ' j Zz
O � t't Existing:
Phone:( ) Fax:( ) New:
R APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: S+Qyj �,b1}t� +
Co
Co .� De? {Please refer to fee schedule)
Contact name: o Structural plan review fee(or deposit):
`� r FLS plan review fee(if applicable):
Address: (o i o 7 SIAy Our-6 13 LVd• /'Zi.
City/State/ZIP: '[3�vp,C�yy11 02- e/7 OUb Total fees due upon application:'
Phone:(5D) -_ ce o q7 Fax::( NA Amount received:
E-mail: at-an p W o t-q,cl e�k 3.t-c,.y� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: 5}kn PI cm f> . Co n5 t t c-he 0Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 11.a 11' 7 54..., h'j urret 3►,Id- ,3 Solar Installation Specialty Code checklist.
City/State/ZIP: 5Qaalit( Virrt, 1Dit 61Z0027 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:
(507j)5a-z- 0 o y-7 Fax:( 4)Oru-- State surcharge(12%of permit fee): $21.60
CCB lic.: 10 c822r
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: j-I-4� ,v F 0 a r il.r Date: /-2 7-2 O *Fee methodology set by Td-County Building Industry
Service Board.
I:1Bui►ding\Pernuts\BUP-RESPemutApp.doc 02/24/2011 440-4613T(I l/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONI.I
City of Tigard Received
• 13125 SW Hall Blvd.,Tigard, Permit Na.:
OR 97223 Datoci
IIIAssociated permits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical
IIGAItU
Internet: www.tigard-or.gov 0 Other:
I'lli FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW' Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 ❑ 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. El 0 0
4 Fire district approval required. Name of district: • El 0 0
5 Septic system permit or authorization for remodel. Existing system capacity . ❑ 0 0
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ 0 ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ ❑
9 Erosion control 0 plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ ❑
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 ❑
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- 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- El 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 El
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ El El
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 Manufactured floor/roof truss design details. 0 ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 El El
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 El ❑ ❑
architect licensed in Or-,on and shall be shown to be ap p licable to the •ro'ect under review.
JURISUICIIONAL 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. 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 El
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ El
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, ❑ El El
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
COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Residential
c-
Building Permit #: S/ — bb 0 s
Site Address: t�j2(a0 SW { 2e.tCXes-t- vvaNt
Project Name: cry'-f Iman l Lot #:
Planning Review
Proposal: peth r/,0ep,,,,,pt
.Verify address/suite# active in Accela. l .In River Terrace: ,,g( No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: fmErosion Control
CA-3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper pI.-Retained trees with drip line and tree protection measures
,Drawn to scale(standard architect or engineer scale) ;Footprint of new structure(including decks)and FFE
.North arrow n, tility locations&easements(required for new and additions)
ite address,project or subdivision name and lot number 4: idewalk/driveway approach
,Applicant information(name and phone number) PI •cation of wells/septic systems
'Lot dimensions and building setback dimensions R. treet tree size,type and location
li Square footage of buildings to be demolished ro. treet names
jegAxisting structures on site .XCorner elevations(2'contours if more than 4'differential)
of area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes.. No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? DYes ❑No
K. Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ' Yes,applicant was notified ❑ No Received: , Yes ❑ No
4-Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified ❑ No Received: 0 Yes ❑ No
t SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
IS(Public Facilities Improvement(PH) Permit:
Required: ❑ Yes,applicant was notified X No Applied For: 0 Yes ❑ No,stop intake
IILA-Land Use Case#: '4 Zoning: -
Required Setbacks: Front: t /A Rear: 15 Side: S Street Side: 1J A Garage: Nil
Building Height: Max. Height: 'S Actual Height: \ Si
Landscape Area: 20 % ,lam Lot Coverage Max: SD
Entrance r1 Set back ,o more an 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows II Minim 12%o area of street-facing facades
Garage II ..arage d,or is b hind wi, t street-facing wall ❑ Yes ❑ No,one of the following is met
I Do.r exte ds no • - . : 5'from wall and there is a covered porch extending beyond garage.
• D..r ext ds no . - .,an 5'from wall and there is a 12 sq ft.window above garage on 2"a floor.
II Garag: ..or dth is ■ 12' • less ❑ 50%or less of facade 0 60%or less and includes 7 of following:
❑ Cover porch ■ Recessed entrance 0 Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fires . gles ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent 'ding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
lei-Visual Clearance Urban Forestry Plan
Sensitive Lands: ❑ Yes ,k No Type:
Kk.Conditions met prior to issuance of building permit
Notes:
Approved By Planning: � Date: 2 ID
Revisions (after Building Submittal o ly) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\BuildinglForms\BIdgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: Planning gineering ❑ t Coordinator �$uilding
Workflow Sign-off: Sign-off for Pla g(include notes Mom planning review) / —
Route Application Documents: f Engineering (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
10 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
Slope at building pad: 3°0
14 Conditions "Met"prior to issuance of building permit
VI Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ® No
Assess Water Quantity Fee in-lieu: 0 Yes ® No
LIDA Facility on lot: 0 Yes ® No
VI Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
X Approved by Engineering: gr,ti/ S Date: Z -I $ ' 2o20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 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:
14 SDC Exemption: 0 Received M. Does not apply
SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes NI N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: 0 Yes N/A
I.IDA 0 Yes Ir N/A
OK to Issue Permit
Approved by Permit Coordinator: 00�- Date: 2-1
I:\Build ng\.Forms\BldgPennitRvw_RES_122419.docx