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Permit CITY OF T I GA R D BUILDING PERMIT PERMIT #: BUP2003 -00649 r � l + DEVE H O PMEN Tigard, SERVICES o SERV 2 1 639 CES 639-4171 DATE ISSUED: 11/12/03 13125 / SITE ADDRESS: 16455 SW 108TH AVE PARCEL: 2S1 15AA -01400 SUBDIVISION: WILLOWBROOK FARM ZONING: R -4.5 BLOCK: LOT: 029 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: : sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: 0 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: Demo barn, garage and residence. Septic system must be pumped, filled or removed. All debris to be removed. Owner: Contractor: CASA TERRA LLC GVS CONTRACTING 9600 SW OAK, SUITE 230 PO BOX 760 PORTLAND, OR 97223 SHERWOOD, OR 97140 Phone: 503 - 452 -8003 Phone: 625 -6832 Reg #: LIC 00054340 FEES REQUIRED INSPECTIONS Description Date Amount Erosion Control Insp 846 -8 [BUILD] Permit Fee 11/12/03 $62.50 Pump /Fill Septic Tank Insp [TAX] 8% State Surchari 11/12/03 $5.00 Final Inspection [ERPRMT] Erosion 11/12/03 $26.00 [ERPLN] Ero Plck - USA 11/12/03 $8.45 (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 -6699 or 1- 800 - 332 -2344. Issued By: f& A__ Pe rm ittee Signature: (77) � �6��,� �iC t. �yl/ Call 639 -4175 by 7 p.m. for an inspection the next business day Buildin Permit Application FOR OFFICE USE ONLY Received Building Date /By: ( / / / ?/) Permit No.:7J RWO3 -.00 5� City of Tigard RECEIVED Planning Approval Other Y g Date /By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 ' t� 1�9 �y.� Date /By: Permit No.: Phone: 503- 639 -4171 F!? 5 08ii1 1 44*/ A il�!!t ■I ' `' Post- Review Land Use .' I I Date/By: Case No Internet: www.ci.tigard.or.us g Contact Juris.• El See Page 2 for 24 -hour Inspection Re � 4 ® Name/Method: Tc1 Supplemental Information ILDING DIVISION TYPE OF WORK REQUIRED DATA: New construction 6 Demolition 1 & 2 FAMILY DWELLING ❑ Addition/alteration/replacement Other: CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate 1 & 2- Family dwelling ❑ Co Multi-Family aUlndustrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. Accessory Building El Multi- Fam ❑ Master Builder ❑ Other: Valuation $ JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths: Job site address: / 6, S L,J 108 �,, d/ Total number of floors / New dwelling area (sq. ft.) Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: Covered porch area (sq. ft.) Cross street/Directions Z site: Deck area (sq. ft.) 5 t� ' ©e n, l ) a , � .tx Lame._ Other structure area (sq. ft.) REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: Lot #: Tax map /parcel #: es I J 6/1-A01 Note: Permit fees* are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor, Da. I a�. cir e.1M.o lJ n overhead and profit for the work indicated on this application. .06 Valuation $ Existing building area (sq. ft.) New building area (sq. ft.) Number of stories Z. PROPERTY OWNER • r ❑ TENANT Type of construction Occupancy group(s): Existing: Name: Ca, S 4 7 v v + q C. L New: Address: ?t oo St..a._D O q 1 L S ....- - E , z!... o City /State /Zip: cv- T-LAS., 0;2 4 V zz Phone: So3 -45.2 - gop g Fax: s 3 - 4S'� Ss�o -3 NOTICE: All contractors and subcontractors are required to be licensed w the Oregon Construction Contractors Board under (a APPLICANT ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: l\- leltA, L,S�kQ.etr tst�e i •L.A. L jurisdiction where work is being performed. If the applicant is exempt Contact Name: p., i J 1e.., from licensing, the following reason applies: Address: q( 5 w 0 a. K 1 ;,Ga__ �3 O City /State /Zip: - N iica 1 O-.• . q* L z 3 Phone:5o i sa -1 Fax: sc. 3_ VSZ - Ts . o E -mail: w cite (t 0. - e,K Co 144 Please refer to fee schedule. BUILDING PERMIT FEES* COTRACTO Business Name: G VS C-tna_C,;._, Fees due upon application S Address: +Op Al. c/( _ Sl City/State /Zip: )t/to 6.0..t Q L _ ? s Z Amount received S l Phone:S 3 -53' ax:5 03- 3 - r7' T y Date received: CCB Lic. #: If �'�, 1 - N o Authorized A� �/ � � I D /I r/ / I QNotice: This permit application expires if a permit is not obtained within Signature: ate ! 7 180 days after it has been accepted as complete. 4 t-4r tip *Fee methodology set by i- County Buildi �Industry Service Board. as pint name) py �U i -.. r „. C4 cot - r # //6 • S /) d`, 7 PLifer . /tic, is \Dsts\Permit Forms \BidgPe it App.doc 01/03 gee s/eAi CoeUr- sia)iie. #) It T ) 3 c.i )a-5 `Y c FT, One- and Two - Family Dwelling , :�,� Building Permit Application Checklist Reference no.: Associated permits: City of Tigard City of Tigard 0 Electrical 0 Plumbing 0 Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 0 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 platllot. 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 D 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 (6IOOICOM) J ___ • IEGINY 41 1 / Et (-FT CONTOUR o // 9 p�� . - , \ DRAINAGEcmw ARROW S S I 10-0. g I§ ! .. , • / // �< / 10 P — — $D ik A \ I ! Nl(s ,147.56 \ \\ // (` 1 / \ 1 WT(N}. ♦785 \t g I g / ' / 4' , . / I �' / I CD \ 24 / \ 16 1 1 8 I ;;s56o \ / ' ( I „ B5E WT(5)- t49.t5 rm / 11 I I I % / 1 ! 1 a 1 , \ 1 \ <, \ \,\ 23 i a l f CC � \ 'l� _ \. I • A CEDAR 1 \ i / \ \ I z , 13 \ 14 \ \\ ��' 20 / 1 21 \ T i - />i • \ ' • TRACT "A" I \ / / 5A l I / / I \ ' / � ' 1.41 411 B SLOPE ' . 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I I g \ \ 1 r�R \ y .0 so MN ^ \ { 7 �1 ..„, FII��- - FlR \r _ — I I MATER • .(c FIR + \ \ ® �R x ea. 35 CEDAR 16- n 4APfF `. ) , +T \ T 38 -;1 : 125E 114(E).142.15 \h' ( t" . 76'IE WT 1 \\ \ \ \ \. ` �� ` 11,1 `! f fl♦ { /-' S l �9" RR J \ �`21' CEDAR f"-"- J' -S {� — i btu / 21 �; I - k (w) .38.80 \ / \ E CEDAR \\ 1 33 - Fl� /� �' FlR 19' Fine/ ` / A I lY ''.} { .•. 1 0- 9' Fl / lid SPRUC� / t2 I - 121E WT(51h 142.98 \\� \\ (\ \ 10' FIR FI .. lit 9" RR FIR / �_ 1 OT 1 / " 4 Fl 3 '. 1 {2 i,)0 A - \\ . f \\ .� \ a M \ � 20 FIR 1 G X15. / �,µy (U "'"D) � - I, 5 / 44;447; �:�I� \ �` 17• EVERGREEN � " CEDAR / T X LV 1 3p• FIR x �� l f> \ �'�- '? ' rte Y / " \ I 19 - DAR 036 - RR W Ft� F"` \ 20 DECWU u. 1 ' SD SO � (`_� \ 2 ��I \ \\ fi \ 40 FIR 9" 4A%F \ \ 1 4� � ' 1 — � 1 46� ��" / - lYj,� ' g S. W. KENT ` \ 1 I — FIR •••. 217/36' EVERGREEN - 1 • y 26 MAPLE FENCE ' ACR f f �9� CEDAR w .9✓ _ _ t � - 1'� \ \— 8' GIR aWt_ _ _ 4lA r x CEOAR� _ ' . h Ba" �\ \ �(/I \ C `' 10' F. 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SHEET; P1444446 As 21 2003 - lapis Al I ` TYPE punpc , • + - - - . - - _ - - - - -_ • CITY OF TIGARD 24 -Hour BUILbING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP 2 CO M - 1 Received Date Requested (a4-- AM PM BUP Location (& (, (Ca +I ' Suite MEC Contact Person Ph ( ) PLM Contractor --- Ph ( ) SWR UILDING Tenant/Owner ELC Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear i �/ G Framing ■ti's` ∎,�!�� Insulation _ ' ` FCC Drywall Nailing vv �� Firewall 4 1 Fire Sprinkler vas Fire Alarm • / Susp'd Ceiling Roof Ot� - • 1 PART FAIL . ., I ' BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL MIL FiX NU. 50.3E449444 Sep. 09 2004 0 P1 $ .. .. _ .-7 .4 Sc hed u led 09609/04 . < ///z. a 7 / e'-.:,/, Date O iC9/Ca , 61 i Work Order x W02Q012 giver City Environmental, Inc. op� IiTaustrN3t P Box 30087 503-252-6144 + Waste Removal Portland, Oragvn Sepiic Tank cleaning 97294 s Lute Cleaning Gochenour i;xcavation,. L L C Site Information 12635 NW Newell Pi PO Forest Grove, OR 9711$ �-�- g / �f a sirios Ave P -133 ) ,2 - _ , bescription UnItS Amount Pump Septic Tank - f 0 (§ V c 'f Instructions, Driver Notes L - ' ' . �. Vacant nemoittioa Tigard, OR 97224 .Mark 503.793 -8175 River City ertvlrehraen=l, int. is In no way responsible for damage to the septic tank ar tine on the system. Tam's: Nifit 1a days. tS'h per mnrtttt will be t:hrzrre4 on pest due at<counte, (ia% per sn:x.vn). Terms and CondJtlons The Right to lien The Customer agrees td Fqyr if invoice's arming out ei pumping .hr and any 7ttor special eow10a6 herein Witt-in 10 dgys, Thn auetam9r agrees to nay such extra and overtime charpci as may be invotcCA from time to time for a.:rvi re ndered,. over and abaft fire normal Sarvlcilir =hackie, art oshoir of to cu Cr:tet, The auatorne' agtdea to onions re porralnU* damage is cuaten,er'a rerat or pyrsana I flrndsrty oriRing from oumplrss Fervices Ninth take &ace On cuatzmer's pnamlxes, wrmre the drivers and venr6;tet of R1ve; Gary Er+vlrsmrnsn4al have been 1 rletijatQd m artier. Thu li .i oe, but is not limited to drtvewaya, troop, pawnor linos or pale ant building ;tru'/trot tf RiV9r City E,vlrohm9ntal, Ina, rmde it rleC0 sary to add K to the tank m iobsr'td. customer win be Chemed for the a dtzitional carioriapc =Lilting from those nditIllohe, Customo r agrooa 16 reimburse River t ErwirprtRtentai. Inc, for sil raaeanzble tittarn_y's fees Court Cosh and otrior en3prse Irrcurrcd by nit company to .antorc cof<acoon or to wire then ra3Hf: weror this agrcemant. Cuibam r *graft to me atone canerttana. Radom -n =pin in Nlursrprrrah County work Authorized by _ Data ( / Dover SI 3 ture � . Q 8n % f-- 4 �,i ms s. _ Data _ _ 4 ._ f C r/ � 5 Trine i_p2 : DPW 1 'd 0690' Wd09:6 1700Z '0l'deS