Permit CITY OF TIGARD BUILDING PERMIT
Ilhi ,p COMMUNITY DEVELOPMENT Permit#: BUP2020-00083
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/29/2020
Parcel: 2S104AA90011
Jurisdiction: Tigard
Site address: 12666 SW KAREN ST 1
Project: BELLWOOD TERRACE Subdivision: BELLWOOD TERRACE CONDO Lot: 1
Project Description: Replacing wood steps with pre cast concrete treads and metal railings.
Contractor: RELIABLE HOME IMPROVEMENT INC Owner: BELLWOOD TERRACE LLC
PO BOX 230815 PO BOX 189
TIGARD, OR 97281 YAMHILL, OR 97148
PHONE: 503-481-0240 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: ME
Class of Work: ALT Type of Const: VA Permit Fee-Additions,Alterations, 04/28/2020 $119.33
Demolition
Occupancy Grp: R-2 Occupancy Load: 0 12%State Surcharge-Building 04/28/2020 $14.32
Dwelling Units: 0 Plan Review 04/28/2020 $77.56
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 04/28/2020 $4.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $2,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $215.21
Required: Required Items and Reports(Conditions)
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: �� �{ 'Permitfee Signature: e//�7��
���jjj��� , Call 503.639.4175 by 7:00 a.m.for the next available inspection date. C/ //
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
FOR OFFICE USE ONLY
City of Tigard RECEIVE Iv eceived ,./ ,
Date/B / U1litl �
N . ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 MAR 2 6 2020 Dates : 3- c ,1' Other Permit:
T I(i ri R D Inspection Line: 503.639.4175 Date Ready/13y: ® See Page 2 for
Internet: www.tig ard-or.gov CITY OF TIGARD NoGBed/Method:-II / Supplemental Information
BUILDING DIVISIO bi-jq-i[, TD/1
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.
❑ 1-and 2-family dwelling ElCommercial/industrial Valuation: $
Number of bedrooms:
❑Accessory building $1 Multi-family
❑Master builder ❑Other: Number of bathrooms:
JOB SUE INFORMATION AND LOCATION Total number of floors:
Job site address: /Z 6 4, C 5t� -r-Gin. 5 't New dwelling area: square feet
City/State/ZIP: T i J n c„_0t 6-� q 7 Z 7---.37---.3Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: r� IF C Z-r-11 Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL USE CHECKLIST
Subdivision: 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 work indicated on this application.
rC 1 14Gt y,-.y r✓bn 04
"S �Qv G✓t�1_ Valuation: $ 7/ D 6)t-a f�
5 Gortr • -i-f rstJ.$ 4" /1/ / r t'i Existing building area: square feet
( New building area: square feet
0 PROPERTY OWNER ❑ TENANT ' Number of stories:
Name: &l ltr,o... l ,f ra z L l%G 6- Type of construction: re..p LAC`
Address: 1: 0. B p 1
/ 7 q 7 Occupancy groups: /
City/State/ZIP: C c -14-ny� 6 ( / 1' Existing:
Phone:( ) Fax:( )
New:
'0 APPLICANT 0 CONTACT PERSON
p� j NOTICE
Business name: T32jjr✓�v� 'j'er-r�a k' 11.0A tell dm (bf \All contractors and subcontractors are required to be
Contact name: Tom i `�L ,d- I Ceised with the Oregon Construction Contractors Board
l under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax: :( )
E-mail: re) is () ff.ii,,,e0,1,2_ 1 vvL cc -.1 ,a ,A,v.
CONTRACTO BUILDING PERMIT FEES*
Business name: �,1 c.�i� �,f.,,,,,,y_ "'—,�, L,r�J,� .^ t5 (Please refer to fee schedule)
Address: I �0a go Nt_ 3 7 'V V^ Y Y^� 1 v '-�C✓t �, Permit fee:
City/State/ZIP: C krr t.1}.� 0 I� R 7 i aState surcharge(12%of permit fee):
t plan review(40%of permit fee): 7
Phone:(503 ) 8 — y 3 q Z Fax:( ) (Due upon application submittal.) �r��
�5
CCB lic.: C(g'ts 3 7 Total permit fees:
Authorized signature: ✓'f Amount received:
-� ,J/, 7 This permit application expires if a permit is not obtained
Print name: "I�A a,( -Y� J Z 6 '$D within 180 days after it has been accepted as complete.
Date:
* Fee methodology set by Tri-County Building Industry
Service Board.
1:1BuitdiagPermits\FPS-PeemitApp_031016.doc 44046132(l1/02/COWWEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: Number of alarm devices:
❑ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A,B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12%of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
I:\Building\Permits\FPS_PermitApp_031016.doc 2
City of Tigard
IIIIC ® COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Residential
Building Permit #: ,Q t.{,j°o2D o ^Q0Ot3
Site Address: IalPCO(A SW -tv- St,
Project Name: Pje\1N C& -7—ex—race.., Lot #:
Planning Review
Proposal: iZepk2rG eo�S-hylel Cx,l- .f S--irtl►5
XVerify address/suite#active in Accela. f, In River Terrace: KNo ❑ Yes,River Terrace Review Addendum
Site Plan Ele ents: ❑Erosion Control
03 copies of ite plan on 8-1/2"x 11"or 11 x 17"paper ❑Ret ' ed trees with drip line and tree protection measures
❑Dra to s e(st .dard architect or engineer scale) ❑ oo rin . new.. cture(including decks)and FFE
0 orth rro ❑ till loc: I I,.s&easements (required for new and additions)
❑ ' ad ess, roje. . s.bdivision name and lot number 'dew . 've' ay approach
❑ p t in rma• .n ame and pne number) catio of wells/septic systems
❑L t dimensio s an. building setback dimensions ❑Street tree size,type and location
❑Square footage of buildings to be demolished ❑Street names
❑Existing structures on site 0 Corner elevations(2'contours if more than 4'differential)
❑Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? a/II No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? .: El No
,Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): ',
Required: ❑ Yes,applicant was notified X No Received: ❑ Yes ❑ N.)
Vr-Water Meter Fixture Unit Worksheet-Additions,Remodels and ADUs
Required: ❑ Yes,applicant was notified X, No Received: ❑ Yes ❑ No
Ni DC Exemption for ADU applied for: ❑ Yes El No Received: ❑ Yes El No
Public Facilities Improvement (PFI)Permit:
Required: 0 Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake
t=' and Use Case#: Zoning: 2-'
►= Required Setbacks: Front: 20 Rear: 2 c0 Side: 10 Street Side: 20 Garage: 1•)1 Pr
Building Height:fMax. Height: 3 Actual Height- -
Landscape Area: % — Lot Coverage Max: 0
Entrance 11 Set back . more than 8' rom str t-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows II Minim 12%of area all street-facing facades
Garage ■I k.,arage d.or is b ' d est street-facing wall ❑ Yes ❑ No,one of the following is met:
• Do.r exte s no re than 5'from wall and there is a covered porch extending beyond garage.
■ Do.r exte ds no e than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
■ Garag< de or wi th is 2'or less ❑ 50%or less of facade 0 60%or less and includes 7 of following:
❑ Co ered orch ❑ ecessed entrance ❑ Wall offset 0 1'Roof eave ❑ Roof offset
❑ Fire shin les ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess 0 Window projection ❑ Balcony
2/41 •isual Clearance Urban Forestry Plan
:1 Sensitive Lands: 0 Yes )(No Type:
Conditions met prior to issuance of building permit
Notes:
[, Approved By Planning: �� Date: /2)D17,0
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
I:\Building\Fomvs\BldgPermitRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date: 3/�{vfr�
Site Plans: #
Building Plans: #
Building Permit#: 0-Enter building permit#above.
Workflow Routing: Planning ❑ Engineering ❑ Permit Coordinator �l�uilding
Workflow Sign-off: t2I'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
original plan review routing form.
6.,2"Bnilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: (/ ,�[�,� �� Date: ,//20
Engineering Review
❑ Slope at building pad:
❑ Conditions"Met"prior to issuance of building permit
❑ 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: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes: N (
❑ Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building perfnit
❑ Approved,NOT Released: / Date:
Notes:
Revisions (after Building Submittal)
Revision Notice 1: Date S t to Applicant:
Revision Notice 2: Dat ent to Applicant:
❑ SDC Exemption: Received ❑ Does not apply
❑ SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes 0 N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
LIDA 0 Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Forms\BldgPermitRvw_RES_122419.docx