Permit r
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00515
� DEVELOPMENT SERVICES DATE ISSUED: 8/27/03
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 11854 SW GREENBURG RD PARCEL: 1S135DD 04300
SUBDIVISION: ZONING: R -
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: MF 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:
Remarks: TRI -PLEX INCLUDES ADDRESSES 11850, 11852 AND 11854
DEMO CARPORT ONLY
Owner: Contractor:
PATHFINDERS HOMES INC OWNER
20055 SW PACIFIC HWY STE 105
SHERWOOD, OR 97140
Phone: 503 - 625 -9151
Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 8/27/03 $62.50
[TAX] 8% State Tax 8/27/03 $5.00
[EROSN] Ero Plck -COT 8/27/03 $8.45
[ERPRMT] Erosion 8/27/03 $26.00
(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 -6699 or 1- 800 - 332 -2344.
Issued By:
Pe rm ittee ���� G✓bL���/
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
L ‘4,
Building Permit Application
Received -FO OFFICE USE ONLY
Q Building /
_ Date/By: (J 71d 3 ( Permit No.Lz�1 C 5/�
Planning Approval Other
City of Tigard E' f lanni y: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax 503 - 598 -1960 b��� �lIi Post - Review Land Use
Date/By: Case No.
Internet: www.ci.tigard.or.us Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information
many MUM IP�.C'�. ®lb�€sY...�*,° .:_.1.�e�@' � w,s..;..`4 �°.C� .�Y 4 &- ,� �+� n Y� �'� � a-. `�
New construction Demolition ti„ � *- E w ]v m�°y Il LI3 G,Imto ' % � Ti
El Addition/alteration/replacement Other: �� � � � �
lnt� �,kcgmeGon:,at„ O „NSTaMag,- ' - ALM Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
A�' °
i�„ �', �' SiTOB�t�'' �i�'- 0]2�'0,1`andy- aI- ;Q;CA00:* , . <. i
No of bedrooms: No of baths:
Job site address: // /l � ,_; -- 'L f depLee,n i J Total number of floors
_' i V � New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
-e;:� E;SCR�_I' �>7COl�T�O ® .,. the value (rounded to the nearest dollar) of all equipment, materials, labor,
� .. , :` ; e11R�K °s�, �, ,. ui
overhead and profit for the work indicated on this application.
7;i - f &-2(- 1) -Z ()1,
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
Z; M 12 _ �O , , � �* Type of construction
_ ° � .. �PLRE`L> .,1 >.,”. W�1:B'I2> -`�� .�� .3A�_�,1�'_�� :....� _ , 7'v"'.: yP
ame: t V �l. /� L _ a a---4 J Occupancy group(s): Existing:
New:
Address: oZ 0 n s ,0 _
City /State /Zip: p
Phone: f a S -3-4 7 Fax: NOTICE: All contractors and subcontractors are required to be
%� r,£ ,. __ _t__..,.,_< _ . _ ,> . ,,_ as* licensed with the Oregon Construction Contractors Board under
4 APPI I AN 1,�° r i i �, C oNtw , tito ost y o provisions of ORS 701 and maybe required to be licensed in the
Business Name: � ,e y - 14A Q '4 4_2 jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip: e,2 --
Phone: 3 3 - 6 9 v Fax: ii "
E-mail: rl'n R V EE
r .. « W . `� P & refE t e C i a ,. _, . 1; s..
Business Name: ,, Fees due upon application $
Address:
City /State /Zip: Amount received $
Phone: Fax: Date received:
CCB Lic. #: XL Authorized
Signature: Date: dV,,, Q /..3 Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) 4-}'---
/,/�
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 /t ' - 4 1 s'_ } I /
Az '_ -D-
One and Two _ Family Dwelling v
% r = Building Permit Application Checklist Reference no.:
Associatedpermits:
City of Tigard City f Tigard y O Electrical ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ 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 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)
CITY OF TIGARD 24 -Hour
tIOILDING Inspection Line: (50 , •
INSPECTION DIVISION Business Line: 50 '* ° `71 MST
( BUP 3- b 67'5/5—
g -- a
Received Date Requested 9 AM PM BUP
Location I I 's ! i Suite MEC
Contact Person (l� Ph ( _') � �RV7 PLM
Contractor Ph ( ) SWR
BUILDING t/Owner 77 -- f ELC
Footing ELC
Foundation Access a
Ftg Drain Qp QJ1�0� L •
Crawl Drain a
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceilin
Roof , Cr
0 t h - : a • -� �, '�
PART FAIL
•��J!f'= ING
Post & Beam
Under Slab r `
Rough -In '
- f
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 . raft
Approach /Sidewalk Date Inspector P .Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
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