Permit CITY OF TIGARD MASTER PERMIT
11111 I ' '- COMMUNITY DEVELOPMENT Permit#: MST2016-00188
Date Issued: 05/18/2016
T[G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110BA13100
Jurisdiction: TIGARD
Site address: 14053 SW 118TH CT
Subdivision: MEDALLION MEADOWS Lot: 24
Project: Medallion Meadows Lot 24
Project Description: Construction of a new stairway and rock wall.
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: No
Total: 0 sf Value: $3,000.00 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
Other Fixtures: 0
Drywell-Trench Drain: 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'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:
JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION Required Items and Reports(Conditions)
FOUR D CONSTRUCTION CO 12600 SW 72ND AVE#200
12600 SW 72ND AVE#200 TIGARD,OR 97223
TIGARD,OR 97223
PHONE: PHONE: 503-639-2639
FAX: 503-624-0239
Total Fees: $314.01
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 through OAR 952-001-0090. You ma •••'n a co... - - - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
c--
Issued
Issued By: se► _ Permittee Signatur•• — ���ia— k
Call , V 175 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 completio :'' e project.
Approved plans are required on the job site at the time of each Inspection.
Building Permit pp mi Application
Residential 1 O (11'f l( I.. t S I t,vl 1
City of Tigard ‘1,8•C't-'8S Date/B: /(gyp j Permit No.: r , `
13125 SW Hall Blvd.,Tigard,OR 97223 Q = sly,
" ��
., ■ ,u - 'i Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 `�P� V p i ,
IN, It I Inspection Line: 503.639.4175 C1`i^ 11 1.' lea. By: ® See Page 2 for
Internet: www.tigard-or.gov �-r 0 1 R i y`, hod: IMI Supplemental Information
`c1V 1
TYPE OF WORK . t. Q JIRID DATA:I.ANTI:2.FAMI(f Y ;<'w
❑New construction ❑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
C'ATE Y OF C IS�ION` work indicated on this application.
Al-and 2-familydwelling ., Valuation: $ it u ,
El
E1Accessory building ElMulti-familyNumber of bedrooms:
9 Master builder 12Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: //a5) 521/ HH6 E el/ New dwelling area: square feet
—
City/State/ZIP: TrMite 7 7L2.7 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 7)2444/4,M-0v 7')....,044,./1 byit4At. Covered porch area: square feet
Cross street/directions to job site: • Deck area: square feet
(10)'✓. ); fe7ii-7 4e-¢lf 45 ,Jce.e'1 Other structure area: square feet
QS S. REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I 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
SCRIPTION OF WORK work indicated on this application.
//!; ./ihlffG Op w�. / 1f/pliA/ Valuation: $
,'/ /70eli 1� Existing building area: square feet
�� 7 New building area: square feet
;r PROPERTY ,,,..,,„...4.,' ❑ TENANT: Number of stories:
Name: J 7, /70,-77) C✓ ,�/(e-' Type of construction:
Address: /2-,2 J)A./ 92 Occupancy groups:
City/State/ZIP: 7'"f Ile Jffj 2',7_,3 Existing:
Phone: ) 6.i„,f.-,24j C � Fax:( )
New:
f ( APP ,'''' - . CONTACT PERSON BUILDING PERMIT FEES*
Business name: U - ]_ g /yam (Please refer to schedule)
/ _ { Structural plan review fee(or deposit):
Contact name: ,�j1G/Jj JGi/S
FLS plan review fee(if applicable):
Address:
City/State/ZIP:
Phone:5d3 ) M-0/(2).., Total fees due upon application: /7i 3(,
Fax: :( ) Amount received: (!
E-mail: alt( �. e tp-0 4tom Ap
t
PHOTOVOLTAIC SOLAR PANEL S1'SI°E :TySe*,
[ Commercial and residential prescriptive installation of
"` ACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: - Submit two(2)sets of roof plan with connection details
( e 5 about. and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: / Total fee due upon application: $201.60
l
Authorized signature: This permit application expires if a permit is not obtained
�/y// ,r, within 180 days after it has been accepted as complete.
Print name: �'y� J� 3 Date: �j C ay *Fee methodology set by Tri-County Building Industry
/ Service Board.
I:ABuilding\Pennits\BUP-RESPennitApp.doc 02/24/2011 44 -4613T(1 I/02/COM/WEB)
,
Building Permit Application Checklist
One- and Two-Family Dwelling 1.OI2 OFrl( 1. I s1 Oyl.1
Cityof Tiand Received
ll Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223
I Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
I t R l) 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 0
4 Fire district approval required. Name of district: . ❑ 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 ❑ 0
6 Sewer permit. ❑ ❑ 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 0 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 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 ❑
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 0 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 0 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- 0 0 0
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 0 ❑ 0
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 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
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 ❑ 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". 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building_plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale'indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 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, 0 0 0
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:A Building\Pennits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
1
:. . "
'PI City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Residential
Building Permit #: f►1ST /b--Oj`a
Site Address: /1/0s3 sk) // 2 ur-7L-
Project Name: `%T £p f Ciur_ ort. .eeL Lot #: 072/
(New dwelling=subdivision name;:Addition or Alteration=last name of owner)
Planning Review M��a-11; °Y' Me 00)s
Proposal: dirk
L/J Verify site address/suite# exists and activ 'n permit system.
Verify
jiver Terrace Neighborhood: No E Yes,See River Terrace Review Addendum Attached
Sit Ian Elements:
ree (3)copies of site plan fisting structures on site
e plan must be on 8-1/2"x 11"or 11 x 17"paper ootprint of new structure (including decks)with finished
TA It awn to scale(standard architect or engineer scale) or elevations
IF► orth arrow Utility locations (required for new,may apply for additions)
IP to address,project or subdivision name and lot number I�� ation of wells/septic systems
plicant information(name and phone number) i1 rosion control(including drainage-way protection,silt fence
of dimensions and building setback dimensions sign,location of catch basin,etc.)
area,building coverage area,percentage of coverage and eet names
i pervious area (applicable if R-7,R-12,R-25&R-40) ret tree size,type and location
roperty corner elevations (2 foot contour lines if more than xisting trees to be retained with drip line,and tree
4 foot differential) protection measures
Olklean Water Services—Service Provider Letteri(lot platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified VNo Received: E Yes ❑ No
Public Faciliti (PFI) Permit:
equired: Yes,applicant was notified ❑ No Applied For: � Yes ❑ No,stop intake
I/.
and Use Case#: j3- �(,��j
oning:
Setbacks: Front =QC, Rear /5"-- Side 5 Street Side 09 Garage 2Q
PiSLandscape Requirement: % //
t Coverage Maximum:
Building Height: Maximum Height `� Actual Height F3
‘1 1 isual Clearance
LTi asements
ensitive Lands: Yes ❑ No Type L1 wilt/ Azaki4D+"
Crban Forestry Plan
onditions "Met"prior to issuance of building permit
Notes:
Approved By Planning: I, A Date: s� ,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved E Not Approved
Revision 3: E Approved ❑ Not Approved
I:\Building\Forms\BldgPennit Rvw_RES_012116.docx
Building Permit Submittal
Original Submittal Date: 5/7//
Site Plans: # 3
Building Plans:
Building Permit#: L�Enter building permit ve.
Workflow Routing: E l'1 'ng ngineeringermit Coordinator
Workflow Sign-off: IV—Sign-off for Planning(include notes from planning review)
Route Application Documents: LeJiEntneering: (1) copy of permit application, (1) site plan, (1) building plan and
ori • plan review routing form.
uilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: /L _ Date:
Engineering Review
X Slope at building pad: .7�
❑ 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:
Approved by Engineering: ,g(L Date: _g—//-46,
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: ❑ Yes 2'N/A
Tigard Trans SDC: ❑ Yes E'f N/A
�
/ Parks SDC: ❑ Yes N/A
L OK to Issue Permit
Approved by Permit Coordinator: CaAnA..€/z..) Date: 5 - a -1(v
1:ABuilding\Forms\BldgPennitRvw_RES_0121 16.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
14053 SW 118TH CT, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
PASS - No C of O
MST2016-00188
David Young
Ok per engineers approval.
Violation Summary:
Inspector Contractor