Permit TIGARD BUILDING PERMIT
C ITY O F PERMIT #: BUP2002 00427
.�I 1, , fly;'' DEVELOPMENT SERVICES DATE ISSUED: 10/1/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135CD -02700
SITE ADDRESS: 11725 SW 95TH AVE
SUBDIVISION: BOETCHERS ADDITION ZONING: R -4.5
BLOCK: LOT: 006 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Remarks: Demolition of 900 square foot house and 900 square foot shop. All demolition debris is to be removed and septic
tank is to be pumped, filled and inspected or removed. Applicable SDC fee credits to apply to new construction.
Owner: Contractor:
VISTA NORTHWEST INC VISTA NORTHWEST, INC.
PO BOX 91459 PO BOX 91459
PORTLAND, OR 97291 PORTLAND„ OR 97291
Phone: 503 - 531 -0505
503 - 531 -0505 Phone: 503 - 531 -0505
Reg #: LIC 75507
FEES REQUIRED INSPECTIONS
Description Date Amount Pump /Fill Septic Tank lnsp
[TAX] 8% State Tax 10/1/02 $5.00 Final Inspection
[TAX] 8% State Tax 10/1/02 $0.00
[BUILD] Permit Fee 10/1/02 $62.50
[BUILD] Permit Fee 10/1 /02 $0.00
(additional fees not listed here)
Total $110.40
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 than 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503)-246 -6 99 or 1- 800 - 332 -2344.
Issue By: Lk.
Pe rm ittee
Signature: � � (L 't i C c. . 0 - -
Call 639 -4175 by 7 p.m. for an inspection the next business day
B ,
Building Permit Application
Date received: 4 / /Via- Permit no.: , ,, a
° v hi' City of Tigard
Project/appl. no.: • e date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By . , Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial Cl Multi - family ❑ New construction ❑ Demolition
Cl Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: / /7AS _ ` ' � 4 % Bldg. no.: Suite no.:
Lot: ( Block: Subdivision: I Tax map /tax lot/account no.:
Project name:
r
Description and location of. work on premises /special conditions: ,7,j,''7// ' ,4 - .. ��1�/� -
iiiic - )_. __ -:; �'/
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: 45 A/ iP5 fe /4 i lip
(Floodplain, septic capacity, solar, etc.)
Mailing address: j 9A,. ' " -7 1 & 2 family dwelling:
City: , , •�j 'L.Cf�/ (State', C' ZIP: '/ Valuation of work $
Phone:�,3/ c .i ax: (E-mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commerciallindustriallmulti- family:
CONTRACTOR Valuation of work $
Business name:, ....5;d9--A_____ Existing bldg. area (sq. ft.)
Address: New bldg. area (sq. ft.)
City: I State: I ZIP: Number of stories
Phone: I Fax: 1E-mail: Type of construction
CCB no.: Occupancy group(s): Existing:
�t 7,� 7 New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person:. Fees due upon application $
Address: Date received:
City: (State: IZIP: Amount received $
Phone: (Fax: 1E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information
attached checklist. All provisions of • an. ordinances governing this lU Visa U MasterCard
Credit card number:
work will be complied wi • J ;.;;,.... .. • ed h or not. 7 Expire/
Authorized sign e: ,01 / . - • /e7 / —/ Name of cardholder as shown on credit card
Print name: '�i / S7_i--.4 /._�1���'� Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/COM)
410 One- and Two - Family Dwelling
•
. Building Permit Application Checklist Reference no.:
�,�
,,
Associated permits: •
City of Tigard City Of Tigard ❑ Electrical ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Cl Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 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.
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 -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 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 Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) 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 & 22 above.
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not 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 & location per approved project street tree plan (if applicable), and COT Street Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (6/00/COM)
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