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Permit (162) CITY OF TIGARD MASTER PERMIT ! " COMMUNITY DEVELOPMENT Permit#: MST2016-00398 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/16/2016 Parcel: 2S103BD09400 Jurisdiction: Tigard Site address: 12985 SW 116TH PL Subdivision: HUNTER'S WOODLAND Lot: 6 Project: Robinson Project Description: 520 sq ft addition, single story. Trades will be under separate permit. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 520 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: No Total: 520 sf Value: $58,578.00 Rear: 15 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 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Drains: 0 gWater Lines: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 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: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R-3 520 Owner: Contractor: ROBINSON,KEVIN H&KATHRYN E KR NELSON CONSTR LLC Required Items and Reports(Conditions) 12985 SW 116TH PL 6282 HOLMES ST TIGARD,OR 97223 WEST LINN,OR 97068 PHONE: PHONE: 503-348-4822 FAX: Total Fees: $2,294.98 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 uspended for more the 180 days. AT \: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. (Tose rules are set forth in OAR 952-0 -0010 through c A R 95 :/1-P4190. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 1 or 1.80.332. 344. Issu By: Permittee Signature: </r- i( j R` ' 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 project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential . City of Tigard `i x) Received Permit No.: )150 /!v��3`�S 4 v Date/By: /� CP /� A O�� 13125 SW Hall Blvd.,Tigard,OR 97 i- ` Plan Review I Phone: 503.718.2439 Fax: 503.598� :J" f� Date/By: /t0-*iQ - Other Permit: Inspection Line: 503.639.4175 + ..k la See Page 2 for T I G A P p Date Ready/By: Jur s:.-- Internet: www.tigard-or.gov r•{ Notified/Method/0 // V > Wirt t �t�/, �j' � Supplemental Information cis lU✓ �GL1/v� TYPE OF WORK. S, c 1 SS- \' A. REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demglitoir Permit fees*are based on the value of the work performed. ,� s > Indicate the value(rounded to the nearest dollar)of all 1 t.Addition/alteration/replacement ❑Wilk equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. oil and 2-family dwelling 0 Commercial/industrial Valuation: $ / d �jZ$ 0 Accessory building ElMulti-familyNumber of bedrooms: 0 12Master builder ❑Other: Number of bathrooms: 0 JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1"2_.9 s s S . I ( CD fi\ P New dwelling area: 5-19 S square feet City/State/ZIP: -r l CY 1%VL Q ICD 12 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: p 131,..),so-yam A-4Ao1.rl ark Covered porch area: square feet Cross street/directions to job site: "`� 1 ��c7 N N L.YZ g"� � 1 1 fo T 1, fLitit.- Deck area: square feet cam-) 0$2, I ) 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. Nam 7 2 x 2 0 1 d r— ? O t rI LIN) Valuation: $ t�uvw. Existing building area: square feet i b g 5 (,(1Jb fg- hailed-r� Pa Iv//7-- New building area: square feet ROPERTY OWNER Q TENANT Number of stories: Name: K EA)1 t•• t �,S\f tA) Type of construction: Address: t 19 �5"" ...Is c....) //6-r`` ,pLli Occupancy groups: City/State/ZIP: ',--1 j 4 FJ 0-1Q,.._. n 7 Existing: Phone:( ) Fax:( 7) New: 0 APPLICANT 44' CONTACT PERSON BUILDING PERMIT FEES* _ (Please refer to fee sehedule) Business name: \Q"-€7 r.,- -=?q21‘ v ' 1..-1—°— Structural plan review fee(or deposit): Contact name: ,�� FLS plan review fee(if applicable): Address: LSS 2 17�2 Lw\2 S 5 l / Total fees due upon application: City/State/ZIP: ( e 1-......„)l w-r-. �_ 9 7o6 ccS Amount received: ��22 c���,, ".-z� ) ( ) J . �� Phone:(7 � �`-f 5'�-�} �l ZZ Fax: — PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: R_ Ci � 1L� ` Gi t3t.-, Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: ./\ Submit two(2)sets of roof plan with connection details Address: Nind fire department access,along with the 2010 Oregon �%,\ I ]L- �'a __ 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.: 'S7 t o/(o I/ Total fee due upon application: $201.60 Authorized signature: .\ Jl���� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: K. kl`,tj 1`)Ec_s`.., Date: /0-- — *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) -53U - Building Permit Application Checklist One- and Two-Family Dwelling rolz orrice. t sl: OM1.1 illCity of Tigard Date/By:Received Permit No.: 13125 SW Hall Blvd.,Ti ard,OR 97223 Associated Associated permits: ■ Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical T 1 G A R D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les yo y/'A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 • • 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 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 ❑ 0 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 ❑ 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ El ❑ basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 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 El ❑ 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 ❑ El 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 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 ❑ 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 ❑ ❑ 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 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 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 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 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 ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ El ❑ 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:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) City of Tigard II COMMUNITY DEVELOPMENT DEPARTMENT 111111 C T 1 G A RD Building Permit Review — Residential Building Permit #: 1 -161-"c3-0/1, -00 39 8 Site Address: /Z. T Y S $ LA-) 1 / b / 4 . Project Name: ` 6(3/IUSo-7v it (0t('?7o Lot #: 6 (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: .46105/7Di)/"rt cl E'w To (� j/i4( .b Verify site address/suite# exists and active in permit system. ,River Terrace Neighborhood: l No ❑ Yes,See River Terrace Review Addendum Attached Site Plan Elements: I�Three(3)copies of site plan ,xisting structures on site ❑Site plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished Drawn to scale(standard architect or engineer scale) floor elevations .LANorth arrow Ttility locations (required for new,may apply for additions) ]Site address,project or subdivision name and lot number ,ocation of wells/septic systems .1Applicant information(name and phone number) xisting trees to be retained with drip line,and tree -Lot dimensions and building setback dimensions \ protection measures R-145 4T of area,building coverage area,percentage of coverage and — treet tree size,type and location `�impervious area(applicable if R-7,R-12,R-25&R-40) Street names Property corner elevations (2 foot contour lines if more than 4 foot differential) Clean Water Services-Service Provider Letter(lot platted prior to 9/10/1995): Required: c'es,applicant was notified ❑ No Received: E.Yes ❑ No Public Facilities Improvement(PFI) Permit: Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No,stop intake NSB Land Use Case#: Zoning: -lk h-�, Pf Required Setbacks: Front Z© Rear /S" Side Street Side f $- Garage .5 J-1144E1 Landscape Requirement: tiPt-❑ Lot Coverage Maximum: l 1Buildin Height: Maximum Height 30 Actual Height /Z /J4-G] Visual Clearance iA ❑ Easements kt Sensitive Lands: ❑ Yes 'R" No Type iV1 1 Urban Forestry Plan A*-1- Conditions "Met"prior to issuance of building permit Notes: � t-r-�� �4. , nr�� Approved By Planning: 'lMA Date: L ps o / Revisions (after Building Submittal o� ) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved I:\Building\Forms\B1dgPermitRvwREs 091216.docx Building Permit Submittal Original Submittal Date: 4/4//0 Site Plans: # 3 Building Plans: # 3 Building Permit#: [ Enter building permit#above. Workflow Routing: [Planning -engineering I:We mit Coordinator /Building Workflow Sign-off: a-Sign-off for Planning(include notes from planning review) Route Application Documents: [-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original 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: h, . i 01L ! ,- Date: jd (Q/ik Engineering Review ope at building pad: g):: . /,/g/t onditions "Met"prior to issuance of building permit asements (encroachments)per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes o Assess Water Quantity Fee in-lieu: El Yes LIDA Facility on lot: El Yes %�j El NOT Approved by Engineering: G�� Date: Notes: Approved by Engineering: Date: (2,-7--/4 (Z____,32_ Revisions (after Building Submittal only) Reviewer Date Revision 1: El Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review El Conditions "Met"prior to issuance of building permit El 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: El SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A Tigard Trans SDC: El Yes A- N/A Parks SDC: ❑ Yes ,V N/A -F.- OK to Issue Permit Approved by Permit Coordinator: CALL4-- &LAt.o Date: t(.7 ` 7- l b I:\Building\Forms\B1dgPermitRvw_RES 0912 16.docx