Permit CITY OF TIGARD BUILDING PERMIT
E" . <'' COMMUNITY DEVELOPMENT Permit#: BUP2020 00121
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14l2020
Parcel: 2S112CA03800
Jurisdiction: Tigard
Site address: 15570 SW 79TH AVE
Project: BROOKSIDE SUBDIVISION Subdivision: DURHAM ACRES Lot: 19
Project Description: Demolition of a 1,000 sq.ft.house on sewer and a 150 sq.ft.detached garage. UPON FINAL INSPECTION,
DEMO CREDITS FOR PARKS,TRANSPORTATION,AND SEWER FEES WILL APPLY.
Contractor: RYCHART EXCAVATION INC Owner: LAYTON, RONALD J
2790 SE 73RD AVE 15630 SW 79TH AVE
HILLSBORO, OR 97123 TIGARD, OR 97224
PHONE: 503-848-8819 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 05/1.4/2020 $149.75
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 05/14/2020 $0.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 05/14/2020 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $5,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $230.95
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � ittee Signature: •
Ca 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.
Building Permit Application _ ,
Residential FOR OFFICE USE ONLY
City of Tigard '► i-- Received ��Q"""��— /�
D
e 13125 SW Hall Blvd.,Tigard.OR 72' " " � 'm Date/By: .5-j/ 7— Permit No.: {.Y P� 2 /a
III 8 plan Review v/ Other Permit:
lJ III
Phone: 503,718.2439 Fax: 503.598.1960 Date By: //��
TIGARI) Inspection Line: 503.639.4175 jit A J,2 ,2112.Q Date Ready/By: �' kris. ® See Page 2 for
Internet: www.ligard-or.gov Notified/Method:5fr11/20 497X7 Supplemental Information
TYPE Q UMJ ING rnymikm REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction cmolition 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: $
I-and 2-family dwelling ElCommercial/industrial �ODU r
❑Accessory building ❑ Multi-family Number of bedrooms: Z
❑ Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: !Cs.7 6 5 j�J -?1- J?/ New dwelling area: square feet
City/State/ZIP: •-n 67175149 b k S 7 z -y Garage/carport area: /50 square feet
Suite/bldg./apt.no.: Project name: f? l L5/O ' Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
79
//LC-7i5 J Cr 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.
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 p work indicated on this application.
,lg.Qpyt. �.-f. 3/;lit' , vs ` Valuation: $
Jt H en
.P Lie-t Existing building area: square feet
.! �fL•". New building area: square feet
'
cis PROPERTY OWNER '/ ❑ ENA T Number of stories:
Name: 47. 7 Type of construction:
Address: 01,30 5(V 2$ / -Le Occupancy groups:
City/State/ZIP: 'n,(y , 2 A. 5 7ZZ
I Existing:
Phone:( � ) y �3 �lf Fax:( )
New:
[g APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:
3, /$/ -- Oes/ 4 Z-71"
Structural plan review fee(or deposit):
Contact name: gal. n Grp frO-N
FLS plan review fee(if applicable):
Address: 17, J . (.))4 2_3 V ?3 4,
!,,q�.� C� Total fees due upon application:
City/State/ZIP: •n6 (/d,"C� ��� /22,2 y
-5 5' rg- 'r Amount received:
Phone:( o ) D Fax::( )
E-mail: , i--ph,f�'5J e' 4[�'�19C,/,)RJ PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
COl�TRACTOR Commercial and residential prescriptive installation of
root-top mounted PhotoVoltaic Solar Panel System.
Business name: &'L ,k � �U• s Submit two(2)sets of roof plan with connection details
Y � and fire department access,along with the 2010 Oregon
Address: r ) tT - 3,,,,...4A
� Q Solar Installation Specialty Code checklist.
City/State/ZIP: %! )L ,__a e' f�/�� Permit Fee(includes plan review
^40C! $180.00
and administrative fees):
Phone:(RA )��sr, Fax:( ) State surcharge(12%of permit fee): $21.60
CCI3 lie.: �U
104130� Total fee due upon application: $201.60
Authorized signatur . 2-L-1c2�/ This permit application expires if a permit is not obtained
/ within 180 days after it has been accepted as complete.
Print name: f2f)- �f. .7 , 6�C- Date: /J{� *Fee methodology set by-Fri-County Building Industry
f �!!/ Service Board.
I:\Building\Permits1BUP-RESPermitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
City of Tigard
711 .- +a COMMUNITY DEVELOPMENT DEPARTMENT
l_1�, f{r % Building Permit Review — Residential
Building Permit #: / e?j94:2-- -___oCii4a,i
Site Address: 15570 SW 79th Ave
Project Name: Brookside Demo Lot #:
— --Planning Review
Proposal: Demo house
T Verify address/suite# active in Accela. 1 In River Terrace: ® No ❑ Yes,River Term e Review Addendum
Site Plan Elements: nErosion Control
]l3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper ❑Retained trees with drip line and tree protection measures
Nn•Drawn to scale (standard architect or engineer scale) ❑F-•it tint - ew s .cture ' eluding decks)and FFE
NlNorth arrow ❑U.t .ca ons& sem (required for new and additions)
1 SSite address,project or subdivision name and lot number ❑Si. .e appr
®Applicant information(name and phone number) 0 . .;on o • /sep ' s
Na•Lot dimensions and building setback dimensions ❑Street tree size,type and location
]Square footage of buildings to be demolished 3itiStreet names
)CExisting structures on site NlACorner elevations (2'contours if more than 4'differential)
N jfl.ut area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes PiCNo
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? DYes ❑No
N Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes LI No
17 Water Meter Fixture Unit Worksheet—Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified )7 No Received: ❑ Yes ❑ No
❑n SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes ❑ No
Public Facilities Improvement (PEI) Permit:
Required: 0 Yes,applicant was notified ® No Applied For: ❑ Yes ❑ No,stop intake
Ti Land Use Case#: SUB2018-00006 in Zoning: R-12
(j Required Setbacks: F nt: Rear: Side: Street Side: Garage:
Building t: x.Height. Actual Height
Z1 Landscap ICI Lot Coverage Max: %
Entrance Set h mor m street-facing wall 0 Parallel to street or offset 45 degrees or less
Windows ❑ Minimum 12%of area of all street-facing facades
Garage 0 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 mo n 5 m w d , e is a 12 sq ft.window above garage on 2°d floor.
❑ Garage door width is 0 1 ' s ❑ 0% .11, -of facade O 60%or less and includes 7 of following:
El Covered porch ❑ cess ntra e • offset ❑ 1'Roof eave ❑ Roof offset
O Fire shingles ❑ p Siding ❑ Roo pa , 0 Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding [ Window trim ❑ Window recess 0 Window projection ❑ Balcony
X] Visual Clearance r AUrban Forestry Plan
2g Sensitive Lands: ❑ Yes TO No Type:
f1 Conditions met prior to issuance of building permit —
Notes: OK TO ISSUE PER TOM.NOT TRRES ARE BEING PRESERVED ON-SITE.
I7 Approved By Planning: Date: 5/14/20
Revisions (after Building Submittal only Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
1:\BuildingTorms\B1dgPennitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: S ab
Site Plans: #
Building Plans: # --iV/t
Building Permit#: ❑ Enter building permit#above. _�� //''
Workflow Routing. arming [g• Permit Coordinator diaiiiSairtr
Workflow Sign-off: IEd. -off for Planning (include notes from planning review)
Route Application Documents:tug, Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
ajg5'al 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:
Engineering Review
0 Slope at building pad:
O Conditions "Met"prior to issuance of building permit
O Easements (encroachments)per engineering conditions of appro' d plat
Li Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ ❑ No
LIDA Facility on lot I Yes ❑ No
❑ Final Plat Recorded:
❑ NOT Approved by E : •ering: Date:
Notes:
❑ Approve• •y Engineering: Date:
Revisi. = . (after Building Submittal only) Reviewer Date
- .sion 1: ❑ Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Permit Coordinator Review
1] Conditions "Met"prior to issuance of building permit OK,TO ISSUE NO TREES ONS-ITE
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant: _
Revision Notice 2: Date Sent to Applicant:
SDC Exemption: ❑ Received Does not apply
E SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 01 N/A
Tigard Trans SDC: ❑ Yes C N/A
Parks SDC: ❑ Yes CI N/A
LIDA ❑ Yes X] N/A
n OK to Issue Permit J� _�XT , ,- �)
Approved by Permit Coordinator: t 0 Date: 5/14/20
I:\nuildinglForms\B ldgPermitRvw_RES_122419.docx