Permit CITY OF TIGARD MASTER PERMIT
1 • COMMUNITY DEVELOPMENT Permit#: MST2015 00049
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/27/2015
Parcel: 2S103BD10800
Jurisdiction: Tigard
Site address: 11710 SW WALNUT ST
Subdivision: 2003-045 PARTITION PLAT Lot: 1
Project: Furlott
Project Description: Demolish old shed style roof at back of garage and rebuild roofline to match front of shed.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 12 Bathrooms: 0 Second: 0 sf Garage: 323 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: No
Total: 323 sf Value: $13,995.59 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn<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'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: Ecompasin 9 N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ACS SF VB U 323
Owner: Contractor:
FURLOTT,RYAN C OWNER Required Items and Reports(Conditions)
KATO,ALYSHA C RYAN FURLOTT
11710 SW WALNUT ST 11710 SW WALNUT ST
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: PHONE: 503-816-0951
FAX:
Total Fees: $508.86
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 the rules adopted by the Oregon Utility Notification
2222 Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5032.1987 or 1.800.332.2344.
Issued By: tr.-Al � _ Permittee Signa rre: w�
Call r ,175 by 7:00 a.m.for the next available inspection-Ate.
This permit card shall be ept 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 RECEIVED I Ol. ()I I It f I SE ONLI
Received
City of Tigard DateB : Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 9R 1 2015 Plan Revie , /ijrrs
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: ���� ' Other Permit:
T I G A R I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: j/27/r S /q,- Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees* are based on the value of the work performed.
Indicate the value(rotnded 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 appli on.
Valuation: $� .
❑ 1-and 2-family dwelling ❑Commercial/industrial / �3/ 9 .
CI Accessory building CI Multi-family Number of bedrooms:
❑Master builder CI Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ( 1110 bk..) L cki N,i t s fi New dwelling area: square feet
City/State/ZIP: 1 It Tit i nia, 977 2-7> Garage/carport area: 3 23 square feet
Suite/bldg./apt.no.: Project name: CJk,r,,j1 164. 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.
Delp.n( k k Os Stvcr) -4{- f �■- lcr -r._ Valuation: $
C ' 5,f"-rje1 cunt) Cr-pail(, 1'00F lld( irl Ilh Existing building area square feet
Ptl i,` a, d (,`(--kp New building area: square feet
El PROPERTY OWNER ❑ TENANT Number of stories:
Name: ■y& [ ti flp-tk Type of construction:
Address: ii 7 10 SIJJ tn)t.,1 V.iJ A Sk-. Occupancy groups:
City/State/ZIP: n CO tf rt n.. I Q 1� L 2� Existing:
Phone:( ) zAQ u octs Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone: Amount received:
( ) Fax::( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive instal ion of
CONTRACTOR roof-t mounted Photo Voltaic Solar Pan- system.
Business name: Submit (2)sets of roof plan with : nection details
Address: f and fire dep ent access,alon: , th the 2010 Oregon
( ) j1&...) Solar Installation ' 1 .,e checklist.
—
City/State/ZIP: Permit Fee(inc .-s • view $180.00
an. .•ministrative fees .
Phone:( ) Fax:( ) a
State s urge(12%of permit fee): $21.60
CCB lie.:
'Iota!fee due upon appication: $201.60
•
Authorized signature: This permit application expires if a permit is not obtained
�% within 180 days after it has been accepted as complete.
i *Fee methodology set by Tri-County Building Industry
Print name: r, V./ _t,-(; Date: —l —I� Service Board
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 4404613T(I1/02/COM/W EB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLI
City of Tigard Received Date/By: Permit No
13125 SW Hall Blvd.,Tigard,OR 97223
111
U Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
T I GARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mech;uuc;,l
Internet: www.tigard-or.gov ❑ Other
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW v es No N/A
1 Land use actions completed. See jurisdiction criteria tor 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 gradc 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 Ore•on and shall he shown to be a r.licable to the •ro'ect under review.
JI RISDI( TIONAL SPECIFICS
23 Three(3)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 trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature 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.
1:\Building\PermitssBUP-RESPerrnitApp.doc 02/24/2011 440-4613T(I 1/02/COM/W EB)
City of Tigard
I COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G n iz D Building Permit Review - Residential
Building Permit #: N1S T a2016 - vcxY4- 1
Site Address: 1 111 0 -SO W t v 54
Project Name: F),( I o Lot #:
(New dwelling= subdivision name;Addition or.\Iteration= last namc of owner)
Planning Review
Proposal: DL'wto old St'te, d S-}ik_ ruJC 6L4- bask- of 14'--` e- 4- (e-b"" (d
r v o-C(i A-e -to ,-,&-.4--4— -n-t_ -6-0 n I of -f1.4. s ti.e d .
a(Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: ❑ Yes No
Site Plan Elements:
%Three (3)copies of site plan 5lecisting structures on site
mite plan must lie on 8-1/2"x 11"or 11 x 17"paper of new structure (including decks)with finished
Drawn to scale(standard architect or engineer scale) floor elevations
CErNorth arrow ,,[;11:ftilit}•locations(required for new,may apply for XI/Site address,project or subdivision name and lot number cation of wells/septic systems
plicant information (name and phone number) Erosion control(including drainage way protection,silt fence
t dimensions and building setback dimensions design,location of catch basin,etc.)
Lot area,building coverage area,percentage of coverage and ..Street names
impervious area (applicable if R-7,R-12,R-25&R-40) Street tree size,type and location
roperty corner elevations(2 foot contour lines if more than 2(xisting trees to be retained with drip line,and tree
4 foot differential) protection measures
.R Clean Water Services -Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified -87 No Received: ❑ Yes ❑ No
,,_/
!�9 Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified 41 No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case #:
Zoning:
IV Setbacks: Front Rear 5 Side 5" Street Side -- Garage —
'Landscape Requirement:
"Lot Coverage Maximum:
tkr Building Height: Maximum Height f J Actual Height 11
Visual Clearance
❑ Easements
,*}"Sensitive Lands: ❑ Yes N. No Type
Urban Forestry Plan
0 Conditions "Met"prior to issuance of building permit
Notes: E{�j�1s fie' f ck cy�eiS d t'1 CS�kvrt.cc ht.-e- I `7 C1 A, scywa.c c A2k, OK-- p-e-- J u h.)
t l J 4d I 1 f -1 *•� Sell- -f A "`S< i s ✓1 of i v,CA-CG4J-e d , f
Approved By Planning: c4,4, A . ca.C.-ty. ' Date: !0 .-.6-IS"
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fors\B IdgPennitRvw_RES_070915.docx
Building Permit Submittal
Original Submittal Date: g/B/1
Site Plans: #
Building Plans: #
Building Permit#: a-linter building�pperm��it--#above.
Workflow Routing: ❑1ning Li- ngtneering t Coordinator ❑ Building
Workflow Sign off: g',� 5`i. -off for Planning(include notes from planning review)
Route Application Documents: IrE'Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
_2.,6ginal plan review routing form.
1`1 Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: //1 Y r-e ic 5 y Cr f7t.r- ii/G/J`A "Y„..c ,4,.,, d Si .�
By Permit Technician: ✓ Date: ;a /r�if- ��'' ��a/`�
1
Engineering Review
2<pe at building pad: ea
-fie tions "Met"prior to issuance of building permit
asements (encroachments)per engineering conditions of approval and plat
uality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes I No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes: j $4 -.5-d_fer - di /Qse P/
Approved by Engineering: I Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes7N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes iN/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Ai� Date: AO Z/<5-
I:\Building\Forms\BldgPermit Rvw_RES_070915.docx
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11710 SW WALNUT ST, TIGARD, OR, 97223
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2015-00049
Chip Barnett
Violation Summary:
Inspector Contractor