Permit CITY OF TIGARD BUILDING PERMIT
Ill r-. COMMUNITY DEVELOPMENT Permit#: BUP2016-00084
T f GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 • I Date Issued: 04/28/2016
Parcel: 2S104AC00300
41101EMAI Jurisdiction: Tigard
Site address: 13230 SW WALNUT ST
Project: Csokas Partition Subdivision: None Lot: G
Project Description: Demolition of 2545 sq ft house on sewer service. Upon approved final inspection SDC credits available for Wa Co
TDT,Tigard TDT,Parks&Sewer SDC's.9/27/16 REPRINTED TO NOTE HOUSE ON SEPTIC, NOT SEWER.NO
SEWER SDC CREDITS.
Contractor: HT REMODELING&DESIGN LLC Owner: GRAY, GARY R ELISABETH
12520 SW GEM LANE APT 1104 2621 SE LAUREL CT
BEAVERTON, OR 97005 HILLSBORO, OR 97123
PHONE: 503-887-8247 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 04/28/2016 $377.90
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Lg$2.00(over 04/28/2016 $2.00
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 04/28/2016 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $20,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $460.60
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 enter. Those rules are set forth in OAR
952-001-00111 - ••=•OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OU NC by calling 503 3 .1.87 or 1.800.332.2344,
Issued y: `4 / / � / Permittee Signature:
Call 503.639.4175 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 Joject.
Approved plans are required on the job site at the time of each inspection.
• CITY OF TIGARD BUILDING PERMIT
III •' COMMUNITY DEVELOPMENT Permit#: BUP2016-00084
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2016
T t c;A R 1-) g Parcel: 2S104AC00300
Jurisdiction: Tigard
Site address: 13230 SW WALNUT ST
Project: Csokas Partition Subdivision: None Lot: G
Project Description: Demolition of 2545 sq ft house on sewer service. Upon approved final inspection SDC credits available for Wa Co
TDT,Tigard TDT,Parks&Sewer SDC's
Contractor: HT REMODELING&DESIGN LLC Owner: GRAY, GARY R ELISABETH
12520 SW GEM LANE APT 1104 2621 SE LAUREL CT
BEAVERTON, OR 97005 HILLSBORO,OR 97123
PHONE: 503-887-8247 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 04/28/2016 $377.90
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Lg$2.00(over 04/28/2016 $2.00
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 04/28/2016 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $20,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $460.60
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 Center. Those rules are set forth in OAR
952-001-0010 • - • OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issu:d By: , / e ,,. -t Permittee Signature: j -• (--1---
Call 503.639.4175 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 e project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential FOR OH I( I I '11 (,N I
II � " Received
City of Tigard YJ JL: Date/B :
FE 16, Pennit No.: �`'!Cf/_! �r�:'
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : - Other Permit:/11/47/6/lo—/0".
l I t,,\R I0 Inspection Line: 503.639.4175 MAR 2 8 2016 Date Ready/By: ��� Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY 01f 61.0 65SPoLie w/ #6:4 I-
TY `', • T N REQUIRED DATA:I.AND 2-FAMILY DWELLING
13$6' e 1 Y 1��)1"+ Permit fees*are based on the value of the work performed.
❑New construction ��Demolition
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
�� CATEGORY OF CONSTRUCTION work indicated on this application.
I1J 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ �/� /Y,O
El Accessory building 0 Multi-family (1 "rv'�
El Master builder 0 Other: ' ' '1'" '
JOB SITE INFORMATIONAND LOCATION Tot. . ••- . '
Job site address: ' 3 2-30 SW W A Lni VT New dwelling area: square feet
City/State/ZIP: 1', 12..p 1 A P., Garage/carpo .rea: quare feet
Suite/bldg./apt.no.: Project name:csj/r iie, PRa� a z Covered po ch area: square feet
Cross street/directions to job site: S,4 i3'L-t`°( A,..e 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
—0e/l(6 °ZI 154/5 MOLLS C)N) 5uotk_ eeigdi Cf._ Valuation: $
Existing building area: square feet
New building area: square feet
ei PROPERTY OWNER 0 TENANT;, Number of stones:
Name: 'r-pcM PIS „TAY p Type of construction:
Address: 24 2:3-1 SW R.ACK (Z...D Occupancy groups:
City/State/ZIP: A-LPHA 1 0 9- S-3403 Existing:
Phone:(S03 k8'-7 .- lti. Fax:( ) New:
APPLICANT 4 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
A 3 A � \ �,�A s Structural plan review fee(or deposit):
Contact name:
C(`) 1 OI J FLS plan review fee(if applicable):
Address: Z Z..-3-I Sw p.oC RD
City/State/ZIP: �- o k..�� ' 0K 9-3.,00 3 Total fees due upon application:
Phone:(,5-02) .a&�- g2.9.- Fax: :( ) Amount received:
PHOTOVOLTAIC SOLAR PANEL SYSTEM.FS*
E-mail: .HCSOK-A-5& G-HP‘I • G iv\ . ,
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: .„7 tU AJO, g `7)f 6/a A) Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: /A.Sap otit.A3 c2 -j Air log_ Solar Installation Specialty Code checklist.
City/State/ZIP:�.�es1-1.2 _7?-„t) D/L 97c05-- Permit Fee(includes plan review S180.00
and administrative fees):
Phone:(5p•D 4�,t7 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 99 941 ��2.//7
Total fee due upon application: $201.60
Authorized signature: Ci/-
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: .1.1 ASN p LK-A Crso\.A S Date: 512.....8I I ,G *Fee methodology set by Tri-County Building Industry
Service Board.
1:A Building\Permits\BUP-R ESPennitApp.doc 02/24/2011 440-4613T( 1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling 1.0R (lrrl( i. t sf: ()\I.\
Cityof Tigard i
Receved
Date/By:vePermit No.:
II/ ■ 13125 SW Hall Blvd.,Tigard,OR 97223
• Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
i I<; \l:1) 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
Internet: www.tigard-or.gov 0 Other:
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. 0 ❑ 0
4 Fire district approval required. Name of district: . 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity . CI 0
6 Sewer permit. ❑ 0 0
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0
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 ❑ ❑ 0
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 ❑ 0 ❑
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- ❑ ❑ 0
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. 0 ❑ ❑
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 0 0 ❑
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 ❑ 0 ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ❑ 0 ❑
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 0 ❑ ❑
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
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. ❑ ❑ 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"buildingplans will not be accepted. 0 ❑ 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 ❑
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, 0 ❑ ❑
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.
I:ABuilding\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
/`--1 c.P 901(0- 2_.
City of Tigard
IIr COMMUNITY DEVELOPMENT DEPARTMENT
II
T I G A R D Building Permit Review — Residential
Building Permit #: — LA.joQ_,o I (G-ODO$ 4
Site Address: /3;2S6 . 't( /kg_ cS
Project Name: CgOLJS '12th) AgriT ,J Lot Lot #:
(New dwelling=subdivision name;A dition or,Alteration=last name of owner)
Planning Review
Proposal: ‘3,e_ino eyny_,
Verify site address/suite#exists and action permit system.
i .'iver Terrace Neighborhood: eNo ❑ Yes,See River Terrace Review Addendum Attached
1< Sit Ian Elements:
Three (3) copies of site planisting structures on site
P.O.- plan must be on 8-1/2"x 11"or 11 x 17"paper PlAlprint of new structure (including decks)with finished
7 raven to scale (standard architect or engineer scale) i•or elevations
rth arrow h Utility locations(required for new,may apply for additions)
r S. e address,project or subdivision name and lot numberL T. '.: ation of wells/septic systems
1pplicant information(name and phone number) Y E osion control(including drainage-way protection, silt fence
ij. t dimensions and building setback dimensions esign,location of catch basin,etc.)
area,building coverage area,percentage of coverage and treet names
pervious area (applicable if R-7,R-12,R-25&R-40) et tree size,type and location
Property corner elevations (2 foot contour lines if more than Existing trees to be retained with drip line,and tree
4 foot differential) protection measures
td1glean Water Services—Service Provider Lette (lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified No Received: E Yes ❑ No
P1Aublic Facilities Improvement (PFI) Permit:
Required: E Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
Pi t, and Use Case#: Mi--PQCYCi2 —
• Y. Zoning: ie_L/.S—
pl�(etbacks: Front ,..QQ Rear /5" Side Street Side /5 Garage ,:12(D
, PI kandscape Requirement: %
plat Coverage Maximum: °10
c� 'uilding Height: Maximum Height Actual Height
usual Clearance
(UI asements
II. Sensitive Lands: ices E No Type /Da) e. /-J
, ,•. S.,krban Forestry Plan
,. )I. nditions "Met"prior to issuance of building permit
t r' Notes:
Approved By Planning: "i„ Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Fonns\BldgPennit R vw_RES_012116.doc x
r
Building Permit Submittal
Original Submittal Date: Z/9 -g'//6
Site Plans: # S
Building Plans: # /i'
Building Permit#: VEnter building permit# above.
Workflow Routing: Leff'Planning C ngineering Permit Coordinator wilding
Workflow Sign-off: L!d'sign-off for Planning(include notes from planning review)
Route Application Documents: "ngineering: (1) copy of permit application, (1) site plan, (1) building plan and
,9,tiginal plan review routing form.
Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: i, A Date: 8'4,
Engineering Review
I ❑ Slope at building pad:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date:
Notes: C,¢ ,,vlY-," 7---70,45_70. L
Approved by Engineering: 4 Z 1 Date: /—Iter___
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
to ,12r Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes: 1)e o 0C‘I.1 -
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: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
kr OK to Issue Permit
Approved by Permit Coordinator: CALLA,P a - CGw,,ey Date: Lf-4 H tip
1:\Building\Forms\B1dgPeimitRvw_RES 0121 1 6.docx