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Permit
q CITY OF TIGARD MASTER PERMIT ' g , COMMUNITY DEVELOPMEN Permit #: MST2010 00212 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2011 Parcel: 2S110AB01600 Jurisdiction: Tigard Site address: 14070 SW 114TH AVE Subdivision: COLE'S ACRES Lot: 2 Project: Wagner Project Description: Construction of accessory structure. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 13 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: No Total: 0 sf Value: $12,000.00 Rear: 5 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 0 Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 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 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =10OK: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvcFeeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 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: ACS SF VB U 0 Owner: Contractor: WAGNER LIVING TRUST PARKER BUILDINGS INC Required Items and Reports (Conditions) BY WAGNER, MICHAEL A & 3540 2ND ST DONNA M TRS HUBBARD, OR 97032 14070 SW 114TH AVE TIGARD, OR 97224 PHONE: PHONE: 503 -981 -0890 FAX: Total Fees: $569.41 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 rule - dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 throug • - • 52- 001 -0090. You ma - • ._ - - • • - e rules •r direct questions to OUNC by calling 503.232.1987 or 1.801 32.2344. • --_----__7__.. / Issued B • � /�_ / _ Permittee Signature: /�� L � / 0—,!41A..../ Call,E 5 by 7:00 a.m. for the next available inspection date. This permit card s all 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 RECEIVED FOR OFFICE USE ONLY City of Tigard Received 4 /V / ✓f Permit No ro/D DO o21 a III • 13125 SW Hall Blvd., Tigard, OR 97223 DEC 14 2010 Plan Review FM II Phone: 503.639.4171 Fax: 503.598.1960 DateB : NE= Other Permit: - F I G A It a Inspection Line: 503.639.4175 GIT1 OF TIGARD Date ReadyBy ©� t ugs ®See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION _ _', t .. Supplemental Information RIM .. L' . TYPE OF WORK REQ IRED DATA: 1 -G, D 2- FAMILY DWELLING ❑ New construction El Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all E l Addition/alteration/replacement El Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $ /07 El El Accessory building El Multi-family Number of bedrooms: 1:1 Master builder El Other: Number of bathrooms: JOB SITE INFORMATION !1 AND , LOCATION Total number of floors: Job site address: i70 7o s W ill V' New dwelling area: square feet City /State /ZIP: 7 6 // fq,Q, ©/Q 70702 y Garage /carport area: square feet Suite/bldg. /apt. no.: I Project name: N// 6 �' �� Covered porch area: square feet Cross street/directions to job site: 'N�' Deck area: square feet Other structure area: square feet 4 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. C' X c26. X 1I CO p ©I,' f3O / L D/A(d Valuation: $ Ci. Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER 0 Number of stories: Name: if //r $ WI)6n/E Type of construction: / 4/0 Q 5 14/ f( Li v Occupancy groups: Existing: ity /State /ZI 77 6'A �� j 04, ''7aa P hone: (y p3) 637 73 y g Fax: ( ) New: ID APPLICANT / ❑ CONTACT PERSON NOTICE usiness name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the I 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: c / CONTRACTOR Business name: Pf r I h(J ' 9��GS ,� C � B UILDING PERMIT FEES* O Address: `3 p/D e a AW .5 (Please refer to fee schedule) - City/State /ZIP: /7t v1844P 67 f 77C Structural plan review fee (or deposit): `' ( �� FLS plan review fee (if applicable): Phone: 4,6�j 7.. 05-70 Fax: ( ) CCB lic.: g 6 go c ! 9A5b Total fees due upon application: / Amount received: 4 /66.51/ Authorized signature: This permit application expires if a permit is not obtained �� within 180 days after it has been accepted as complete. Print name: t/l. Date: Aa /ty //e? * Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\BUP -RES PermitApp.doc 10 /01/09 440- 4613T(11/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received li Date/By: No.: 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical T I G A It D Internet: www.tigard - or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ 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 ❑ ❑ ❑ 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 ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2-fl. 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 ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ 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- ❑ ❑ ❑ 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. ❑ ❑ ❑ 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- ❑ ❑ ❑ 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 ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ 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 ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. • 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ 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 ❑ ❑ ❑ architect licensed in Ore. on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL 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 ". ❑ ❑ ❑ 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. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 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. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ 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- RES- PermitApp.doc 03/21/06 440-4613T(11/02/COM/WEB) c 141010:26a Mace & Donna Wagner 503- 639 -7349 p.1 nF r.FI U �11 r I Clean Water Services File Number CaeanWaier S DEC 14 2010 - � I'0- 0 0 21 By - - r - e Area Pre - Screening Site Assessment 1. Jurisdiction: C. r TY O (- i 6 121 2. Property Information (example 13234AB01400) 3. Owner Information Tax lot ID(s): oZ `J I 1 O A664 l ioO0 Name: n / Ch k 7/ . it wF' Company: Address: / 7o S' / s/ ,IV Site Address: 1101 5tnl 114-' A' City, State, rp / 0 7 City, State. Zip: 1A- X0 r nit- ' - f Phone/Fax .5-03 _ 63 - Nearest Cross Street: C --Mail 1t1 W0V „ a r -- -e4# CO'$f . 4. Development Activity (check all that apply) iii. Applicant infonmatiotn a Addition to Single Family Residence (mom deck, garage) Name: Sri ME ❑ Lot Une Adjustment ❑ Minor Land Partition Company. ❑ Residential Condominium ❑ Commercial Condominium Ad dress : ❑ Residential Subdivision ❑ Commercial Subdivisiion City. State. zip: 1 la Single Lot Commercial ❑ Multi Lot Commercal Phone/Fax: Other S - • E-Mail . 6. 1N ill the project involve any off -sloe work? ❑Yes ® No ❑ Unknown Lodation and description of off-site work i 7. Additional comments or information that may be needed to understand your project 20'x e.6' P64E swfv This application does NOT replace Grading and Erosion Control Permits, Connection Permits, Building Permits, Site DesdePment Permits, 1200 -C Permit or other permits as issued by the Department of Environmental Quality, Department of Stets Lands andlor Department of the Army COE All required permits and approvals must be obtained and completed tmder applicable local, state, and federal law. By signing this form, the Owner or Owner's authored agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for he impose of inspecting project site oondt5ons and gathering information related to the project site. l oably that I am familiar with the information cantribed In this document, and to the bed of my knoeledge and belief, this information's true, complete. and accurate. PL. u/"elliFq Prinfrrype� HOiri- OwkF/� Print/Type tYame AI C v � ' / , ,1 /� o i �. Date ; / 7 ( Signature , , J `i , l FFR DISTRICT USE ONLY • 0 Sensitive areas petenmtialy exist on site or within 207 of Ito ste. T EAPPLiCANT MUST PERFORM A SITEASSESSIENT PRIOR TO ISSUANCE E OF A I Et. SERVICE PROVIDER LETT if Sensitive Areas artist on the site or within 200 baton adjacent properties. a Natural ' may also be required 13 Based on review of the submkted sus and hest available intonation Sensitive areas do not appromlo exist an sae amain 207 olihe site. This ny Sensitive Area Pre - Screening Site Assessment does NOT eliminate the need to evaluate protect O � quay Section 3.02.1. Au perm e discovered This document wit serve as your Service Provide: letter as required by Resolution and approvals must be obtained and completed tamer applicable local, Stale, and federal last ri Based on review of the submitted materials end best evelabbinformalian the above referenced projeclvral rot stgles:an y knpactthe edging or potentially sensitive area(s)found near the site. This SensiiveArea PmSoreenig SmleAssessment does NOT eliminate the need to evaluate and protect addlional water quality sensiTive areas If they are subsequently discovered. This doaunerd will serve as your Service Provider letter as required by Resolution mid Order 07-20, Section 3.02.1. AI required permits and approvals must be obtatned and completed under applicable local. state and federal lam This Service PtroyllO/ Le{ r 0 net ys110 is approved site plants) we Matted. a The proposed adivipr date not meet Tire lion . , - — . rd or the lot was platted alter 919195 ORS 92040(2). NO SITE ASSESSMENT OR SERVICE PRO JO ', '.i. 1 R IS • + -" ; - tom. Reviewed by ii .i. A i. a.=_ - Date 2 / ■AmsolluniMMIlmr AM MAY 2550 Su',! H Highi� • HIIIs: io. Crc• on 9712`_ • Pnoce. f503) Ce i -5100 • Pa;: ;f .4 -39 • V: Vn:'. claans, 1ers °r ces.orl