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12'-2" (INCLUDED IN THESE DRAWINGS) JOB No.
PHASE II — VERIFY EXISTING 040346
UNDERPINNING AT FOUNDATION AND
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EXISTING BASEMENT PLAN NOTE,
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BUILDING PERMIT
CITY OF T I GA R D
PERMIT#: BUP2004-00220
DEVELOPMENT SERVICES DA'rE ISSUED: 5/17/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 PARCEL: 2S104BD-04200
SITE ADDRESS: 13725 SW FERN ST
SUBDIVISION: ROSE MEADOWS ZONING: R-7
_ _BLOCK: LOT: 001 JURISDICTION: TIG
REISSUE: �(� FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: jYf v FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. FATED:
BSMT?: MEZZ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 4,000.00
Remarks: Fortify foundation retaining wall and structural beam.
Owner: Contractor:
K!L^ul.1URN, NANCY PEPSIL CONCRETE
13725 SW FERN ST. 11890 SW 3RD.
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: 503-524-2320
Phone: 503-754-7073
Reg#: LIC 148010
FEES REQUIRED INSPECTIONS
Description Date Amount Footing Insp
�I;t ill.l�j Prr nit 1-cc 5/17/2004 $81,70 Foundation Insp
Framing Insp
(TAXI R%Statc Surrhvl 5/17/2004 $6.54 Final Inspection
lit il'I'LNI Phi R% 5/17/2004 $53.11
Total $141.35
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 wi"expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law
requires you to follow the rules adopted by the Oregon Utility Notificatir i Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain a copy c these rules or direct questions to OU'JC by
calling (503)246-6699 or 1-800-332-2344
Issued By: ✓�. 1. C ( �� �. rt` • . f �
Permittee �� ~
Signature: MAL U
Call 631-4175 by 7 p.m. for an inspection the next business day
Building Permit AnBljcajiop FOR OFFICE USE ONi'V
I --....,
('it Of Tigard 7D.
eivedpennit 14"
13115 SW Hall Blvd.,Tigard,OR 97223 1ul�i, n Re%lePhone: 503.639.4171 Fax: 503.598.1960 t eBy. other Permit
Inspection Line: 503.639.4175 e Ready/By — J.is" 0 See Attached Checklist for
Internet: www.ci.tlgard.ot.us -'I I Y t-" i Il.rAl Notified/Method — _ Supplemental Information
�,i nl �,p.�r•, r11vI�lU�
TYPE OF WORK• REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Indicate
tees*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
CATEGORY OF CONSTRUCTION work indicated on this application.
I-and 2-family&%ellwg ❑conmierclal,irdustrial i Valuation:
ElAccessory building ❑Muhl-family Number of bedrooms: T
❑Master builder ❑Other Number of bathrooms '—
JOB SITE INFORMATION AND LOCATION Total number of floors
Job site address: �J"�o� uL� ( �-h r - New dwelling area square feet
City/State/ZIP: / ' 74- Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site. heck area: square feet
Other structure area: square feet
r fQUMED 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,matenals,labor,overhead,and the profit for the
IASCRIP�ION OF Wdik work indicated on this application.
FOY+-i Fv fT-,LLr,&Gi c-y, r'4_t-Ctit to t n V cL o Valuation: S
Existing building area: square feet
New building area: square feet
[I PROPERTY dWIVER + ' (]'1ENANT Number of stones:
Name: K�cli l LL- KI Type of construction
Address: ?j-J s VJ 1--v r v� S 1 —-- - — Occupancy groups:
Ciry/State'Z � � C( ' 1 7 4-� 3 ---- - Existing:
Phone � i�� - ---
Fax:( ) _ New
❑ NMICANT ❑ CONTACT PERSON (NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: junsdiction in which work is being performed.If the
City/Slate/ZIP: - applicant is exempt from licensing,the following reasons
- -
apply ----Phone:( ) Fax -
E-mail: _ T
-coNCRACTOR - - -- --
Business name: IL" CBUILDING I'Ett11i1T FEES*—
Address:
- -- Please refer ro jee schedule.
City/State/ZIP: { ��
Phone: CV 1� L)r'; —-_ —
( SOL 7 5� - 7 u- 3 Fees due upon application —
-
- — Amount received
CCB lie.: ° 010 —
�_ -- Date received:
Authorized signature: /� �� �''� This perinit application expires if a permit is not obtained
`�-J�/�+�' ►�"— — ssithin 180 days after it has been accepted as complete. i.
Print name �Lth�� 1�1 u� to Date: 5 1 7 0 * Fee methodology set by Tri-County Building Industry 1
Service Board.
ftBmldina\Perrmu,BUP•PerrrutAppdoc 12103 /40.4613T(II/02/COWWBB)
One- and Two-Family Dwelling
Buildine Permit Application Checklist MR OFFICE-USE ONLV
City of Tigard Rere1tei' Perri'
13125 SW Hall Blvd.,Tigard,OR 97223 Date/Br'
- -
Phone: 503.639.4171 Fax: 503.598.1960 Ascnciated perms
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ t'I,m,bu., ^• ;; .
Internet: www.ci.tigard.or.us ❑ Other _
PI,AN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 ZonlnlS. Flood plain,solar balance points,seismic soils designation,historic district,etc. _ _ ❑
3 Verification of approvedplat/lot.
4 Fire district approval required. Name of district:
5 Septic systemep rmit 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 viol-lions exist.
I I Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 11 El
there is more than a 44 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 d'inensions,room identification,window size,location of smoke detectors,wattr heater, El F-1 El
furnace,ventilation fans, Aurnbing fixtures,balconies and decks 30 inches above grade,etc. _
14 Cross section(s)and details. Show alt,taming-member sizes and spacing such as floor beams,headers,joists,sub LJ
-
floor,wall construction,roof construction. More than or.,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 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• 'T
prescriptive path analysis provide specifications and calculations to en ineerin 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 11 ❑ ❑ I
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current cede design values for all beams and multiple joists
over 10 feet long and/or any beamfoist 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 to Ore on and shall be shown to be a licable to the riroicct under review.
23 Five 5 site Inns are re wired for Item 1 I above. Site plans must be 8-1/2"x 17 or 17 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 tree protection measures as required by conditions 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\Pemuts\One-Two-FamilyChecklist.doc 11'03
SEE 3 5MM
ROLL# 23
FOR
LARGE
DOCUMENT
CITY OF TIGARD 24-Hour
BUILDING Lispection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171
Received __ __ Date Requested '.-'— AM PM P
Location --Suite-- MEC —
Contact Person PLM
tt��>:— P Contractor h ( Ii,77 6' 7 3 SWR
ILD _ Tenant/Owner _ ELC _—
g ELC
Foundation ACC6S
Ftg Drain ELR _
Crawl Drain
Slab Inspection Notes: SIT ----
Post&Beam
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear — i —
Framing --__--_--- -_----.________- ------__--_. �—
Insulation
Drywall Nailing Q_ (L _ --------- _._.. -- --------- --.--._
Firewall ��''"' � —
Fire Sprinkler/�'�(R - --- —_ .. ----- _---—------ ---- --
Fire Alarm 7 YIa
Susp'dCeiling y ----- -- --- -- —
Root
Othe ----
Other(n 1 ''ati✓)�W,, I
-� A �- --___ __._ ------ ---- ---- ----
s PART_FAIL
PLUMBING -
Post& Beam _--__---- - ------------------ ------.
Under Slab
Rough-In
Water Service
Sanitary Sewer _
Rain Drains --- -- ----
Catch Basin/Manhole
Storm Drain - - -- — _ —. -- ------- --
Shower Pan
Other-
Final
therFinal
PASS PART FAIL
MECHANICAL
...Post& Beam -- ---- --- —..____--- -- -- --- --------
Rough-In —
Gas Line
Smoke Dampers ---- ---- -
Final — —
PASS PART FAIL -- --- --- -. - - - -- -- -- -- --------- --
ELECTRICAL
Service
Rough-In
IJG/Slab
----- — ----
Low Voltage
Fire Alarm —�
Final F1 Heinspection fee of$ ---- required'before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE— _ U Please call or reinspection RE: — Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date--��—`- I -CJ's----- Inspector ter_ _ _---- ---- -- Ext ------
Other:
Final DO NOT REMOVE'this Inspection record from the job site.
PASS PART FAIL