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For only the work a described in:
PERMIT NO.
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13995 SW MISTLETOE DRIVE
CITY OF TI 'ARD -- BUILDING PERMIT
PERMIT#: BUP2003-00319
DEVELOPMENT SERVICES DATE ISSUED: 6/3/03
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S104CD-01600
SITE ADDRESS: 13995 SW MISTLETOE DR
SUBDIVISION: HILLSHIRE ESTATES ZONING: R-7
BLOCK: LOT: 016 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION_
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf _ _ PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: �E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 0 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REOD SETBACKS _ REQUIRED
FLOOR LOAD: 40 psf LEFT uft RGHT: �ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,500.00
Remarks: Replace post & beams on existing deck.
Owner: Contractor:
CHESNEY, JOSEPH L + LINDA M OWNER
13995 MISTLETOE DR
TIGARD, OR 97224
Phone-
Phone:
Reg #:
FEES REQUIRED INSPECTIONS �^ _
Description Date Amount Footing Insp
111111t111,0111. � I'rrnu� I rr 6/3/03 $72.10 Frarning Insp
I'AX] 8%0 State ay 6/3/03 $5,77 Final Inspection
l
RiIPI'LNJ I'ln R\ 6/3/03 $46.87
Total $124.74
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 he 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 than 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 952 001-0100. You may obtain a copy of these rules or direct questions to OUNC by
alling (503) 246-6699 or 1-800 32.-2344.
i
Issued By:
Permittee
Signature CLIA
S _
Call 639-4175 by 7 11
m. for an inspection the next business day
low 111111 -
Building Permit Application Reeeived Building Q 22 n
-------
Date/B �� 3 Pcrmit No.:
Planning Approval Other
City of Tigard Date/By Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-5911-1960 Post-Review Land Use
Datc/B : Case No,
Internet: www.ci.tigard.or.us R Contact Rg See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: / Supple ental Information
TYPE OF WORK _ REQUIRED DATA:
New construction _— I H Demolition_ I &2 FAMILY DWELLING
_Addition/alteration/replacement Other:
CATEGORY OF CONSTRUCTION Note: Permit fees*are based on the total value of the work performed. Indicate
1 8c 2-1'amlly dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor,
overhead and profit for the work indicated on this application.
Accessory Building Multi-Fam _�—
Master Builder Other:
Valuation........................................................
_ ON No.of bedrooms: No.of baths:
JOB SITE INFORMATION and LOCATI _
Total number of floors..................................... _ ^_
Job site address: _ K b New dwelling area(sq.fl.)..............................
Suite#: _ _ Bld ./A to Garage/carport area(sq.fl.)............................
Project Name: 1 f Covered porch area(sq.fl.)...................#.......
Cross streetiDired.jota to job site: Deck area(sq. fl.)......................5..1 ...........
1 Other structure area(sq.fl.)............................
REQUIRED DATA:
COMMERCIAL-USE CIIECKLIST
Subdivision: mom, d ;t--1 Lot#: /69 — —
Tax map/parcel #: Note. Permit fees'are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor,
overhead and profit for the work indicated on this application.
W,
Valuation......................................I.................. S—
p Existing building area(sq.R.).........................
---- —� _ New building area(sq.ft.)............................... --
Number of stories............................................
JraT PROPERTY OWNER TENANT Type of construction.......................................
Occupancy group(s): Existing: — —.
Name: E JNA SNL N — New: ---
Address: I' f'-, 5.,A) a, qart �' — --
CitY/_State/'Lip: t �.` i r
^t I r r r. �� L NOTICE: All contractors and subcontractors are required to be
Phon 5� ) ( �.t Fax:
r S licensed with the Oregon Constructiun Contractors Eioard under
1 ,APPLICANT CONTACT P SON provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: --� from licensing,the following reason applies:
Address: — ------ -- - - — ------
/State/Z -- -- -
Phone: _I Fax: — —._-. _-- - - — BUILDING PERMIT FEES* —
E-mail: Please refer to fee schedule.
CONTRACTOR —--- ---- - -
Business Name: I �— -----___ Fees due upon application..............................
Address: � , �UAr'�
- -- Amount received.......................
City/'tatc/Zip_
Phone: Fax_ -_-_ Date received:--
CCB
eceived:_CCB Lic. #: L------ ------" ---- -- -
Authorized — — Notice: This permit application espim If a permh is not obtained r�ithin
Signature: _._ _ Date:_, 18o dais after it has been accepted as complete.
✓" —`i *Fee methodologt set hs t ri-( oonh Building Indoor) Ser%ice Hoard.
— (Please pr tt name)-
0Dsu\Pcrmit FormsWdgPerrnitApp.doc 01/03
One- and Two-l�amily Dwelling
Building Permit Application Checklist Referenceno.:
- I' -- —
Associatedpermits
City((fTigard City of Tigard J I:Iccotcal J Plumbing J MCChamcad
Address: 13125 SW Hall Blvd,Tigard,OR 97223 J 011u-1
Phone: (503) 639-4171
Fax: (501) 598-1960
THE 1 t FOR PLAN REVIEW Ves No NIA
I Land use actions completed.See jw'isdirtion criteria Ion concurrent reviews.
2 Zoning.Flood plain,solar balance points,scrsmic u(ils designation,historic dh,•u I,i ,i,
3 Verification of approved plat/lot. _
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Iixisting system capacity
6 Sewer permit.
7 Water district approval.
8 Solls report.Must carry original applicable stamp and signature on file or with application.
9 Erosion control U plan U pemut required. Include drainage-way protection,silt fence design and location ui'
catch-basin protection,etc. _ —
IU 3 Complete sets of legible plans. Must he drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must he 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 he completed
if copyright violations exist.
I Sitelpint plan drawn to scale.The plan mint sir.m 6 it;Ind huldinp'.cthack dinuensi(im;property comer elevations Of
there is more than a 4-11.elevation differential,plan nnrst show contour I1110 al 2 11. uncrvals);location of easements and
driveway;footprint of structure(including decks):location of wells/sepuc systems;utility hwcations;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 hulls,any(told-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,room idcntiflr ition. k%iM41 Y size,location of smoke detectors,water heater,
furnace,ventilation fans, plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 ('rose sections)and details.Show all framing-niemtx.r sizes and spacing such its floor hearts.headers,joists,sub-floor,
wall constriction,roof cm m�truction. More than one cross section may Im required to clearly portray construction.Show
details of all wall and root sheathing,roofing,ro of'slope,ceiling height,siding material,footings and foundation,stairs,
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimunn of two elevations for additions and remodels.
Exterior elevations must reflect the acral grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showitir foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
nun-prescriptive path analysis proccilications and calculations to engineering standards.
17 Floor/roof framing.Provide plans rot all floors/roof assemblies,indicating member sizing,spacing,and hearing
locations.Show attic ventilation. _ _
18 Easement and retaining walls, Pros Ide cross sections and details showing placennent of rehar. For engineered
systems,sec item 22."Engineer's calculations.
19 Beam calculations.Provide two sets o1'calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any heam/joist carrying a non-uniform load. —
20 Manufactured Ooorlroof 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 pr(,%Ord. (i r . .heam wall.roof truss)shall he stamped by an engineer or
architect licensed in Oregon and shall he .i t t t ti.•il lr to the project under rc%1r\\
JURISDIMONAL
23 Five(5)site plans are required for Item I I above. Site plans"lust he 8-1/2' x I ! .,r I I" x I
24 Two(2)sets each are required for Items 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plan\%ill he not accented.
26 "Reversed" building plans must meet criteria outlined in the Permit& System Development Fees document.
27 "brawn to scale" indicates standard architect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree plan Of applicable),and COT Street Trcc List.
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. Our 4614(610WCosU
1 crnlit#: L��
Is(ued by:� , tit Date: "�5 n
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS -01, requires residential construction perinit ctppli-
cants who ore not regisferecl with the Construction Contractors Roard to sign the
.follo►ring.statemertl befrn'e a huilcling pei-trtit can he issues/. This.state rnent is requires/
./)r resiclential building, electrical, mechanical, and plumhing 1wr►nits. Licenced
architect and engineer applicants, exempt from registration under ORS 'U 1.010("),
►reed not slibatit t11is.slatentent. This statement will he filed 10111 the permit.
Fill in tho appropriate blanks and initial boxes 1 and 2, and either box 3A or 313:
I own, reside in. or will reside in the completed structure.
n 2. i understand that I must register as a construction contractor if the structure is sold or offered for sale
ILEA before or upon conll►leticm.
f 3A. My general contractor is --- - ---` -- -_- _— _--_- _--—
1 (Name) Contractor regis. #
i will instruct my general contractor that all subcontractors who work on the structure must he
registered kith the Construction Contractors Board.
OR
313. 1 will he nl\ o�sn general contractor.
If I hire subcontractors. 1 will hire only subcontractors registered with the Construction Contractors
Board. III change Ill\ mend and hire a general contractor. I sill contract stiith a contractor %%ho is
registered kith the CUB and will inlnmdiatelc notify the office issuing this building permit of the
name of the contractor.
herek certifi that the above information is correct and that I hace read and do understand the Information
Notice to 1'r pert- 0 • •rs about C truction Responsibilities on the re%erse side of this form.
Signature of mit applicant) (Date)
(White colty to issuing agency lwi-ntit tilt-,
pink copy to applicant)
Information Notice to Property Owners
About Construction Responsibilities
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (50)639-4175
MST —
INSPECTION DIVISION Business Line: (5133)639-4171 BUP 3 _ a0 -XI
Received I Date Requested AM_ . -- PM----. BUP -__ ----
Location JSuite--.----.--- MEC -
Contact Person Ph(_�__) . �=_���_ _ PLM _
Contractor --- --- - - - Ph(--) ------ - SWR _----
BUILDING Tenant/Owner ELC
Footing - - ELC __.------------..-- -
Foundation Access:
Ftg Drain ELR —
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam --- - -- --- _ -- ---- ----
Shear Anchors - --
Ext Sheath/Shear
Int Sheath/Shear
Framing ---- ---- - -- ----- --
Insulation
Drywall Nailing -- - - --- ------ -- - -------.. -
Firewall
Fire Sprinkler -_ --- -- ----- -- - -- --- -- .. -
Fire Alarm
Susp'd Ceiling
Roof
Other. ----- ---- _ - -- ----- -- ___ _ __- - - - -
PASS PART FAIL
PLUMBING - --- - - - - --- - -
Post& Beam---_-__
Under Slab ------- - --- -- -
Hough-In
Water Service --- ----- - -- ---..---- - --- ----- _
Sanitary Sewer
Rain Drains -- - ---- ---- - - -- --- -------- �.
Catch Basin/Manhole
Storm Drain -- _ - ------- ---- — _-------------__ _-
Shower Pan
Other: .-- --
Final
--PASS PART-----FAIL --- _-_-T-- __ --�..--------------
- - --
MECHANICAL _ -- --_ __ ---- --- -_--_ -- --
Post&Beam
Rough-In ----- --
Gas Line
Smoke Dampers - ---- --- - -- - --- --- - - - - -...----
Final
PASS PART FAIL - - - -----
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage - - -- ------ -------
Fire Alarm
Final Reinspection fee of$_ __--__. . required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE — ❑ Please call for reinspection RF::_ ___ _ ____ Unable to inspect-no access
Fire Supply Line �-
ADA � rr
Approach/Sidewalk Date_-L�._ -- �--���,-- Inspector—.-�----.__ ______Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL