Permit CITY OF TIGARD MASTER PERMIT
it 1 B. COMMUNITY DEVELOPMENT Permit#: MST2014-00066
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2014
T l[,A R f� g Parcel: 2S104AC13700
Jurisdiction: Tigard
Site address: 12856 SW 133RD AVE
Subdivision: HILLSIDE ESTATES Lot: 2
Project: Knell
Project Description: Basement remodel
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right 0
Detectors: Yes
Total: 0 sf Value: $70,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals 0
Lavatories: 1 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0
Drains: 0
Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvoes Air Conditioning: N Vent Fans: 3 Clothes Dryers: 1
Heat Pump: N Hoods: 0 Other Units: 0
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders 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:
ALT SF VB R-3 0
Owner: Contractor:
VARDON PROPERTIES LLC LARSON CUSTOM HOMES INC Required Items and Reports(Conditions)
PO BOX 4025 17850 SW PHEASANT LN
TUALATIN,OR 97062 BEAVERTON,OR 97006
PHONE: PHONE: 503-312-1774
FAX:
Total Fees: $1,926.57
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 th= - adopted by the Oregon Utility Notificatio Center. Those rul are set forth in OAR
952-001-0010 through OAR 952-001-0090. You . • the rules• •irect questions to OUNC by calling 503. .1987 or 1.800. .2344.
. /
Issued By:/`l ■l Permittee Signature:
Ca dilirE 5 by 7:00 a.m.for the next available inspection date.
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 Applicatioi
_Residential FOR OFFICE USE ONLI
City of Tigard ate B 1e
_ Permit No.:
13125 SW Hall Blvd.,Tigard,O'. ' Lam, • ^��
S g t,' Dan Review/,T I a ' Permit.
Phone: 503.718.2439 Fax: 503. � Date/13 : t
r i - it I Inspection Line: 503.639.4175 1 �Q'�4 Date Ready/B / ice: 0 See Page 2 for
Internet: www.tigard-or.gov �J S. Notified/Method:5 `3 1y J � Supplemental Information
TYPE M \ RC+ ,v
OF WORK.
New construction
Permit fees*are based on the value of the work performed.
❑ 1<� '
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement Ter: equipment,materials,labor,overhead,and the profit for the
t_ CATEGORY OF CONSTRUCTION
work indicated on this application.
❑ 1-and 2-family dwelling [1 Commercial/industrial Valuation: S 70) (JC1.)
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
r — Total number of floors:
Job site address:12856 SW 133rd New dwelling area: square feet
City/State/ZIP:tigard,Or Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: (/( 11 Covered porch area: square feet
Cross street/directions to job site:Walnut Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
r r ; y / work indicated on this application.
add 4 windows and a door in basement, add an opening in an existing wall Valuation: S
Existing building area: square feet
New building area: square feet
Number of stories:
Name:Pam and Leland Knell Type of construction:
Address:12856 SW 133rd Occupancy groups:
City/State/ZIP:Tigard,OR Existing:
Phone:(503)526.8566 Fax:( ) New:
Business name:Larson Custom Homes
Structural plan review fee(or deposit):
Contact name:Dean
FLS plan review fee(if applicable):
Address: 17856 SW Pheasant Lane Total fees due upon application: S70/ ,03
City/State/ZIP:Aloha,Or 97006
Phone:(503)312.1774 Fax::( )
Amount received:
E-mail:deanlarson@ldlarson.com
x ---' Commercial and residential prescriptive installation of
_ roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Larson Custom Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 17856 SW Pheasant Lane Solar Installation Specialty Code checklist.
City/State/ZIP:Aloha,Or 97006 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)312.1774 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:37426 -O/l— Total fee due upon application: $201.60
Authorized signature: + This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Dean Larson Date: 5_` - 0 \ *Fee methodology set by Tn County Building Industry
1 Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Applicatik F( -- OFFICE I SE ONE).
City of Tigard `tV Date/Bed
13125 SW Hall Blvd.,Tigard,OR 972 t1 r��! y V "a
III a
rr�t/L' Plan Review
Phone: 503.718.2439 Fax: 503.598.1 Date/By: Other Permit:
T t G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov 1 V14 Notified/Method: Supplemental Information
MaV
y — _ 1 • Mechanical permit fees*are based on the value of the work
104❑New construction ®Addition/alteratio {• ,•• ,4t V performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other:
��1 1 mechanical materials,equipment,labor,overhead,and profit.
Value:
gallir
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. I Total
Heating/cooling:
Air conditioning 46.75
Job site address:12856 SW 133rd Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:tigard,Or Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name:
Duct work 1 23.32
Cross street/directions to job site:Walnut Hydronic hot water system .. 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32- Gas fireplace/insert 33.39
_- P
.�.__ _ ___-_ --_ Flue vent for water heater or gas
add 5 runs to heat system in basement fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
.. - • _ ._ - - _ Environmental exhaust and ventilation:
Name:Pam and Leland Knell Range hood/other kitchen
equipment 33.39
Address:12856 SW 133rd Clothes dryer exhaust 1 33.39
City/State/ZIP:Tigard,OR Single-duct exhaust(bathrooms, 2
toilet compartments,utility rooms) ) 23.32
Phone:(503)526.8566 Fax:( ) Attic/crawlspace fans . 23.32
- - Other: 2332
Business name:Larson Custom Homes Fuel piping:
$14.15 for first four,$4.03 for each additional
Contact name:Dean Furnace,etc.
Address:17856 SW Pheasant Lane Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Aloha,Or Water heater
Phone:(503)312.1774 I Fax::( ) Fireplace -
Range
E-mail:deanlarson @Idlarson.com Barbecue
Clothes dryer(gas)
Business name:Comfort Sone Heating&Air Conditioning inc. Other:
Address: 1032 NW Corporate Dr Subtotal
City/State/ZIP:Troutdale,OR 97060 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)267.9949 Fax:( ) State surcharge(12%of permit fee)
CCB lic.:110091 TOTAL PERMIT FEE
_ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: { * Fee methodology set by Tri-County Building Industry Service Board
Prin t name:Dean Larosn Date: kM
^20\1, -
1:1 Building lPermits\MEC_PermitApp_040I 13 doc 440-4617T(11/002/COM/WEB))
Plumbing Permit Applicatir
Site-Utilities FOR OFFICE I si ONFN
City of Tigard C��v� Roceived
14 • 13125 SW Hal Blvd.,Tigard,OR 97223 1v SS DateBy: r "� '
= Plan Review
Phone: 503.718.2439 Fax: 503.598.1 Date/By: Other Permit No.:
41 Inspection Line: 503.639.4175 Q t't0�� Date Ready/By: Juris: See Page 2 for
Internet: www.tigard-or.gov `1 1 Notified/Method: Supplemental information
❑New construction ❑Demol`�t r�{ t r t�`'
For s aal in ruination use checklist
nt Oth V l►��l�v Vw , Description Qty. Ea. Total
®Addition/alteration/replacement ❑ eRI New 1-2-family dwellings(includes 100 ft.for each utility connection)
SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchcn 25.02
0 Master builder ❑Other: q ft.) Page'1, r Fire sprinkler( s .ft. P e
Site utilities:
Job site address:12856 SW 133rd - Catch basin or area drain 18.76
City/State/ZIP:Tigard,Or Drywell,leach line,or trench drain 18.76
Footing dram(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: l Project name: Manufactured home utilities 50.03
Cross street/directions to job site:Walnut Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:, ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
7.- 7-" Backwater valve 12.51
_... ... Clothes washer / 25.02 d..5-.0-.
add bathroom in basement,add sink, diswasher and icemaker supply
_ Dishwasher ) 25.02
finish existing bathroom(roughed)in basement Drinking fountain ` 25.02
Ejectors/sump 25.02
Expansion tank 12.51
Name:Pam and Leland Knell Fixture/sewer c 25.02
Floor drain/floor sink/hub 25.02
Address:12856 SW 133rd
Garbage disposal 25.02
City/State/ZIP:Tigard,OR Hose bib 25.02
Phone:(503)506.8566 Fax:( ) Ice maker ( 12.51 ! ,51
r; ''' `' _ Interceptor/grease trap r 25.02
Business name:Larson Custom Homes
Medical gas(value:$ ) Page 2
Contact name:Dean Primer 12.51
Roof drain(commercial) 12.51
Address: 17856 SW Pheasant Lane Sink/basin/lavatory ( 25.02 )) 0h
City/State/ZIP:Aloha,OR 97006 Solar units(potable water) 62.54
Phone:(503)312.1774 Fax::( ) Tub/shower/shower pan 1 12.51 a..5---/
E-mail:deanlarson@ldlarson.com Urinal 25.02
•Y= _, -,.: '...7-' .tF -7 Water closet j 25.02•
Water heater 37.52
Business name:Alder Plumbing Water piping/DWV 56.29
Address:2775 N Clark Ct Other: 25.02
City/State/ZIP:Cornelius,OR 97113 Subtotal
Phone:(503)515-5920 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:200809 Plumbing Lic.no.:34-411PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: / TOTAL PERMIT FEE
Print name:Dean Larson Date: `,\,2a4 This permit application expires if a permit is not obtained within 180 days
J after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1.\Building\Permiu\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Building Permit Number:
" Building Permit Review
Residential Projects
TIGARD
Sise Address: j 25J ' Ave,
Verify site address is valid.
Project Name & Lot #:
Clean Water Services—Service Provider Letter: (lot platted prior to 9/10/1995)
Required: Yes ❑ No Received: Yes ❑ No ❑
Sit Plan Elements:
2: ite plan must be on 8-1/2"x 11"or 11"x 17"paper �e(3)copies of site plan
Drawn to scale standard architect or engineer scale) North
( gm ) arrow
. Map and tax lot number,site address,project or subdivisionootprint of new structure(including decks)with finished
name,lot number,and zoning floor elevations
"Applicant information(name and phone number) • .t and building setback dimensions
2roperty corner elevations(2 foot contour lines if more than .t area,building coverage area,percentage of coverage and
4 foot differential) impervious area.
tility locations ... Location of wells/septic J2Sxisting structures on site -(Surface drainage
2treet names .Street tree size,type and location
Erosion control(including drainage-way protection,silt fence .oxisting trees to be retained with drip line,and tree
design,location of catch basin,etc.) protection measures
Planning Review
❑ Land Use Case Number:
Wing. R -G
R'Setbacks: 1
Front 2(3 Rear ,' Side 5 Street Side N J Garage 21�
C��Landscape Requirement: /A
Iig'L`ot Coverage Maximum: N/A
[uilding Height: Maximum Height 30 Actual Height /
[ 'Visual Clearance
❑ Easements
dd' Sensitive Lands: DrCres Type 6Jer \LAO& 19t iat f-
Drtrban Forestry Plan
conditions Satisfied
Approved by: Date: 5. ).
Notes:
Revisions (after Building Submittal only) Reviewer Date
Revision I Approved ❑ Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
1:1Building\Forms\BldgPermitRvw_RES_123013.docx
Building Permit Submittal
Original Plan Submittal: Date: ',5-/-7/,�-( By: B.
Site Plans: # 3
Building Plans:
71V1*-73s,p,t Cre ate Case Record#: cae#abov for Building Pemiitypinber.
Workflow Routing: R4 g gineering a' ermit Coordinator ding
Workflow Sign-off: a�"S�-off for Planning staff,including notes from planning review(page 1)
Route Application Documents: L'- Engineering: (1) copy of permit application, (1)site plan, (1)building plan and
oal plan review routing form.
I luilding. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Reviewed By: Date:
Notes:
Engineering Review—reviewed by: 2 e-J
Actual Slope:
❑ Conditions Satisfied
Notes: /lJ 0 V,✓ C c,.) S c-., J'
Approved by: Date:
Revisions(after Building Submittal only) Reviewer Date
Revision 1 Approved El Not Approved ❑
Revision 2 Approved El Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
Permit Coordinator Review
/Conditions Met-Prior to Issuance of Building Permit
Notes: No eon4:4; bet S De Rai v I p-v.d U.S-C. .
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant
Revision Notice 3: Date Sent to Applicant�^l �[
Okay to Issue Permit- C/ � (�lt��rtL-� Date: 5 I.3- r 7
k,,,. Al 12-4 J if O
1:\Buildingl Fonns\BldgPermitRvw_RES_123013.docx
Of' M
ZgOL AG ( 370D RECEIVED
1�s6 1 3312 MAY 0 7 2014
CITY OF TIGARD
-71Ctila_ 1 ore__ PLANNING/ENGINEERING
4 4 02 Piz.oef ° v not getv,zt-c-le
c=G � �
'afi
"�"" °� �` CITY OF TIGARD
ICI s ef�edt yr Approved by Planning
�iRa: ,9zf� Date: ly
��.�
rust t493-o—`-. 'f` �r Initials:
e. ti c
Famify P
a
3Gta+er
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Direnc M�f
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.."7".-1 c 3 CarAtbthed
[Aria:ii5Ofti
D•r
,pp� 21ft
r=te:rill
-`U
(4‘
1
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33121
it
Larson Custom Homes, inc
503.312.1774 RECEIVED
Knell Deck
fasten deck to house with Simpson HDU5 at 3 locations MAY 0 7 2014
Fasten ledger with simpson SDS Y4x3 " or equal 12' OC staggered
CITY OF TIGARD
8' PLANNING/ENGINEERING
-
,z _I ME it 20 diaxl8'ftg Existing
II 2r10 PT joists & ledger (typ) Dec k
--i p 16" di; +ft Match exising composite
G� d g ■ i l 20'diax18" deck throughout
a \-_./ IN
12SI , " J ftg,
I 13 -4 / 4.- ""-----existing guard rail—.
■ --�
Existing footing
/ 6\-103/4"-----,
Feeney "Alumarail"this area
solid rail system deck
this area and 2x10 pt led er—•-
stairs (2X4 16 oc p g ,Strap both sides
1 ::,(l. 6x10 pt beam ' l_ Exisiting 6x10 pt beam
W Hardie siding) \ ' i ' \ /7_j f
I
Simpson Post to
beam brackets typ.
1 I 4x4 pt —6x6 posts
posts
Provide lateral support with diagonal
Grade I cross bracing both directions
slab- -
Deck height from grade varies from 9' to 9' 11" �'
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
$111 Transmittal Letter
r l c,A It D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: %t1 DATE RECEIVW
DEPT: BUILDING DIVISION R .Lit.-"' 4
MAY 0 7 2014
FROM: ■ l 1 _AFSeD/J CITY OF T►GARDRING
COMPANY: ILSW-SOA (v S70/N1 �Oyvlr(_, 69N) PIANNINGIENGINEE
PHONE: - 4 2- 17 "gf By: _
RE: Z S L� s (�J Z�v S'���� fzt—rX o
(Site Address) emit Nurn er
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: I Description: I Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
X Other(explain): j4 fra,rn 0-J
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: I Initials-rt
Fees Due: ❑ Yes o Fee Description: Amount Due:
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012