Permit il 3" ii' CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00184
COMMUNITY DEVELOPMENT DATE ISSUED: 3/28/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 C D -01400
SITE ADDRESS: 13565 SW ASH AVE ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT: 016 JURISDICTION: TIG
PROJECT: ADAMS
Project Description: Remove debris from burned house. Homeowner will build new ouse. /�
TIFF CREDITS will apply. io -6 104(36..„ iz.
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: 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: •
Owner: Contractor:
ADAMS, VERNE E EWING OSBORN EWING II
13565 SW ASH 5239 SE 115TH AVE
TIGARD, OR 97223 PORTLAND, OR 97266
Phone: 503-701-7200 Contact #: PRI 971 - 222 -4042
Reg #: LIC 160975 .
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/28/2007 $62.50 Ersn Cntrl 681 -4444
[TAX] 8% State Surcha 3/28/2007 $5.00
[ERPRMT] Erosion Con 3/28/2007 $26.00
[ERPLN] Erosn Pln Rv ( 3/28/2007 $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: ,� Permittee Signat� �.--e-- <2:a
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 Received 2 v 0 Per N
g Date /B . ✓ C L� . _�i� 4 e ,
II
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T I GA RD Inspection Line: 503.639.4175 Date Ready/By: Juris: HI See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 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
❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling El Commercial /industrial
Valuation: $
1:1 Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: a '24 6.S $� GI � New dwelling area: square feet
City /State /ZIP: 7 ' 012_ 2o- 3' Garage /carport area: square feet
Suite/bldg./apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: 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.
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.
r n ' / Valuation: $
'2 .0.../vv\
J , � e 1/ , l , s i / Existing building area: square feet
P-� '� M 4 , New building area: square feet • i
% PROPERTY OWNER ❑ TENANT Number of stories:
Name: Vg,_ jt—v° I. IA-04.s' Type of construction:
Address: `?4?b /SW �' / t) Au O / Occupancy groups:
City /State /ZIP: - 7 7 1,7 ;r .. / D, e ??. Z y Existing:
Phone: i 3) '76 /- • (2 O Fax: ( ) New:
❑ APPLI ❑ . CONTACT PERSON NOTICE
■ Business 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
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:
CON
Business name: L 4 K ( j aj g BUILDING PERMIT FEES*
Address: ..--.....,7 l .S % (S f _A_ Ave (Please.iefer to fee schedule)
/ Structural plan review fee (or deposit):
City /State /ZIP: p0 'YL,4 N d Dk '"Z2I
Phone: (V/ ) 2 �i7117 Fax: ( ) FLS plan review fee (if applicable):
i 6 vQ 7s-- �/ , / / ' per Total fees due upon application:
Amount received: I 1 0 7//
Authorized signature: ••"""")
This permit application expires if a permit is not obtained
,/ within 180 days after it has been accepted as complete.
Print name: . ~ £ s Date: 3 '- 07 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP =RES PerrnitApp.doc 02/23/07 440- 4613T(11/02/COM /WEB)
Building Permit Application Checklist
One- and Two - Family Dwelling . FOR OFFICE USE ONLY
City of T igard Received Permit No.:
7 4 - a 13125 SW Hall Blvd. Tigard OR 97223 Date/By: Phone: 503.639.4171 Fax: 503.598.1960 Associated permits:
TIGARD 24- Hour Inspection Line: 503.639.4175 1:1 Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard- or.gov ❑ Other.
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. 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 -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 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 tree protection measures as required by conditions 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(I I /02 /COM/WEB)
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Warren ,' Invoice
DEMOLITION & EXCAVATION Date Invoice #
5239 SE 115th Ave.
Portland, OR 97266 0 4/6/2007 146
9"*-C' p1
4 � GI RD
9U1°
Bill To
Verne Adams
1356 SW Ash Ave.
- Tigard, 0 P.O. No. Due Date
4/30/2007
Description Amount
Excavate for an Adair 1702 side garage. 1,200.00
Fill septic tank with 3/4 minus rock and compact. 1,500.00
Removal of trees along fence line next to the garage. 500.00
Dispose of damaged house and foundation. 9,500.00
Total $12,700.00
, -- ,e, Po� - n igV
OR CCB# 147355 WA CCB# RrvERCE981 BT
River City Environmental, Inc. lliIi!IIlIJJI llIIJOIOfliOl
P.D. Box 30087
Portland, OR 97294
Phone: 503 - 252 -6144 D INVOICE 36095
Fax: 503- 288 -3658 'g�
Vil Account 1086985
r �y � Date 04/03/07
�I,.` �R
Bill To: O \ ( a pN
Reference
Verne Adams G \NO\v \5
13565 SW Ash ��
Tigard, OR 97223
Site Address SW Ash, 13565 Tigard
C Date Service Description Work Order #
PO # Units Amount 0_O0)
04/03/07 S - .
eptic Service W055132 1.000 275.00 275.00
Locate & Dig WO55132
•• - - -• .• 1.000 75. 350.00
04/04/07 ' Payment, Thank You 2523 1. - 350.00 0.00
0.00
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River Cit ' Environmental
Working Together For A Clean Environment h ( 14
0 I P.0 Box 30087 - ‘. *.!:,
Portland, OR 97294
CCB# 147355
WA CCB# RIVERCE981 BT
Tel (503) 252 -6144 Fax (503) 288 -3658 fax
From: l / /�, ;mi i
� . :1 al. Date Sent g 1_2_07
Regarding
Company: )igf �,
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Dept: i �._ ,,, _ �
Tel: _
Fax: d - ' , 960
Number of pages __,Z__,
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Nates: (77)e..."226, --
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Grease Traps • Septic Tanks • Water Truck Services •Catch Basins Filters • Pressure Washing
Industrial Vacuuming � Sweeping •Striping • Line Cleaning
g Oil/Water Separators • Complete Storm Water Run -off Programs • Complete Parking Lot Maintenance
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CITY OF.TIGARD
BUILDING D JVISION PERMIT #: BUP2007-00184
13125 SW Hall Blvd; Tigard, OR 97223 DATE ISSUED: 3/2812007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 4
INSPECTION WORKSHEET FOR DATE: 9/11/2007 TIME: 7 :00AM PAGE: 52
•
SITE ADDRESS: 13565 SW ASH AVE CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 016 TYPE OF USE:
PROJECT NAME: ADAMS
DESCRIPTION: Remove debris from burned house. Homeowner will build new house.
TIFF CREDITS will apply. Septic to be pumped and filled or removed if owner hooks up to sewer. If
OWNER: ADAMS, VERNE E, PHONE #: 503- 701 -7200
CONTRACTOR: EING OSBORN EVVING II PHONE #: 971 -222 -4042
Inspection Request Scheduled For: Date: 9/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 055455 -01 503- 701 -7200 N
Corrections /Comments /Instructions:
a PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Q -11-o 2 Phone #: (503) 718 - 1.�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007-00184
13125 SW Hall Blvd Tigard, OR 97223
DATE ISSUED: 3128/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 IL
INSPECTION WORKSHEET FOR DATE: 8/22/2007 TIME: 7:01AIVI PAGE: 25
SITE ADDRESS: 13565 SW ASH AVE CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 016 TYPE OF USE:
PROJECT NAME: ADAMS
DESCRIPTION: Remove debris from burned house. Homeowner will build new house.
TIFF CREDITS will apply. Septic to be pumped and filled or removed if owner hooks up to sewer. If
OWNER: ADAMS, VERNE E, PHONE #: 503-701-7200
CONTRACTOR: EWING OSBORN MING II PHONE #: 971-2214(112
Inspection Request Scheduled For: Date: 8122/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
798 Final inspection 054465-01 . 503-701-7200
Corrections/Comments/Instructions:
1 a Si- Ar
■ "..t /2 tr- k A 10 r'y '/ — I Apr – fike 0.t.it,
.-77*-$04 N/a1-462 6,4" ,-,41-■176 ‘...4
•
I I PASS I I PARTIAL APPROVAL El CANCEL fl NO ACCESS
AIL 1 I CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: lig Date:. e-2,z.„, Phone #: (503) 718-
•