Permit (100) CITY OF TIGARD BUILDING PERMIT
` ' COMMUNITY DEVELOPMENT Permit#: BUP2017-00069
[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2017
T'
Parcel: 1 S 135DA02400
Jurisdiction: Tigard
Site address: 11035 SW HALL BLVD
Project: Brookside Memory Care Subdivision: METZGER ACRE TRACTS Lot: 7
Project Description: Demolition of a 3,544 sq.ft.house and a 1,320 sq.ft.shop. UPON FINAL INSPECTION,DEMO CREDITS FOR
SDC FEES WILL APPLY.
Contractor: PR DESIGN &GENERAL CONTRACTORS LLC Owner: BROOKSIDE RCF LLC
2120 SW CERIS WAY 5987 SE ROBHIL DR
TROUTDALE, OR 97060 MILWAUKIE, OR 97222
PHONE: 530-680-1791 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 10/02/2017 $195.38
Demolition
Occupancy Grp: Occupancy Load: Erosion Control w/Development 10/02/2017 $80.70
Dwelling Units: Info Process/Archiving-Lg$2.00(over 10/02/2017 $2.00
Stories: Height: ft 11x17)
Bedrooms: Bathrooms: DC Provision Review,COM TI-Ping 10/02/2017 $90.00
Value: $8,000
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $368.08
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
.r
Issued By: y� Permittee Signature: Tom
al 3.639.4175 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 FOR OFFICE l'SE ONLY
h Received
11 City of Tigard �" Date/B : ) 7 17 e',j Permit No.: �� ,/
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ,
e Phone: 503.718.2439 Fax: 503.59$1 60 Date/B : Other Permit: ,* ^ —_ dam
T I G A R p Inspection Line: 503.639.4175 , Date Ready/By: ® s See Page 2 for
Internet: www.tigard-or.gov 4' Notified/Method: - Supplemental Information
TYPE OF W '* v' 'I REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
kl-and 2-family dwelling 0 Commercial/industrial Valuation: $
0 WOl
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms: 2-
JOB
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11035 5W 1111-14/ iAwP New dwelling area: square feet
City/State/ZIP: (9/1e 1 Ug- &177j3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: A4II45U city C44c Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Cppcir 1' 6,/ied ,- Other structure area: square feet
AA/ria ,N 61,8_ 3/i1.-- / 7 67:7. 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.
'0 oalw) 5r(z' Valuation: $
Existing building area: square feet
New building area: square feet
1 )(PROPERTY OWNER 0 TENANT Number of stories:
Name: Ravor DAV WA) '` Type of construction:
Address: 5 ' 7 sr 120r IU Dg Occupancy groups:
City/State/ZIP: A(1LW4(,44 , 04 11 Zii Existing:
Phone:(spa) cm 1 q .- L4Q7j Fax:( ) New:
V iiit APPLICANT of CONTACT PERSON BUILDING PERMIT FEES*
�t/ A' I ' G (Please refer to fee schedule)
Business name: 819/1LG/_ U- Structural plan review fee(or deposit):
Contact name: W 4 , C csrAt.
FLS plan review fee(if applicable):
Address: Oil q it,6 MA * 5't 155
City/State/ZIP: pos�' o e �?22 Total fees due upon application:
Phone:(503) 2.-(e5-4144:41 Fax: :( ) Amount received:
E-mail: eidie e pe Gs�g4,, God PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
"r' Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: Pg DOW' ? 66-4,0i/(, 4.0Aeredlocrif ac Submit two(2)sets of roof plan with connection details
� / and fire department access,along with the 2010 Oregon
Address: 611 q Aor ittis Al‘ 155 Solar Installation Specialty Code checklist.
Permit Fee(includes plan review
City/State/ZIP: D�1 0� �il� and administrative fees): $180.00
Phone:(5043) „24,,r.--$i4(01 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: Jf3s,3Vi
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: aliAlitO Llig-SCIAL Date: ;S a *Fee methodology set by Tri-County Building Industry
Service Board.
I:ABuilding\Pernits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(I1/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE oNl.\
City of Tigard Received Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223
illh
Dated
Phone: 503.718.2439 Fax: 503.598.1960 Associated permits:
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
TIGARD
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 ■ _
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 ❑ _ ❑
5 Septic system permit or authorization for remodel. Existing system capacity . 0 ❑ 0
6 Sewer permit. 0 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 _
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 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 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 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 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 0
architect licensed in Ore:on and shall be shown to be as I licable to the sro'ect under review.
JURISDICTIONAL SPECIFICS
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 0 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:ABuilding\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(II/02/COM/WEB)
City of Tigard
III COMMUNITY DEVELOPMENT DEPARTMENT
■
T r c n K U Building Permit Review — Commercial - With Land Use
Building Permit #: 6/4,2)/7— '(
Site Address: ii C 5" 5'W t'[ )14 X3(1141 Suite/Bldg#: av4
Project Name: Qfzov(r S1 OE /11614107f 41 etig .
(Name of commercial business occupying tv space. If vacant,enter Spec Space.)
Planning Review
Proposal: ouc' .3 2, (245, 1 .1 01 tD v''j C012,C F i -4-1
Petco �l i c�-- V Ll
K Verify site address/suite#exists and active in permit system.
J. River Terrace Neighborhood: 0 Yes 11$ No
V Land Use Case#: 40P 2O)S —c19C)U
2--
2-Plans Match Approved Land Use:
IS Site Plan Landscape Plan ❑ Other:
W. Urban Forestry Plan ❑ Elevation Plan
1 Building Height: Maximum Height 7 Actual Height 3 3 -T, C((
LX Conditions Met: fa Prior to Submittal 0 Prior to Permit Issuance
6 Business License:
Exists: ❑ Yes I. No,applicant notified to obtain business license
t$. Public Facilities Improvement(PFI)Permit:
Required: KJ Yes,applicant was notified 0 No Applied For: N Yes ❑ No,stop intake
Notes: t 6 r .)7'Jz awk" 1 fre s o,re'.s l'Ap-ip itU
Approved by Planning: r---- Date: .3-2-3 '' 17
Revisions (after Building Subm�ti al only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved 0 Not Approved
IIIIIIIIWSIIIIIIINIIIIIIMIIIIIIIINIIIIIIR
Building Permit Submittal
Original Submittal Date: 3f 3/ 7
Site Plans: # 3
Building Plans: # 3'
Building Permit#: n `r-buuilding�per�mit bove. � �-�-'
Workflow Routing: L Planning L�Engineering ErVernut Coordinator ❑ Building
Workflow Sign-off: R''Sign-off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
�� le,1 ie-+..%-✓; ei;bt- ,�,Gh-r- C 11t,�'/e-rzaA—m! �� 2(?) C,.C.t�
By Permit Technician: V _ Date: 3/27//7
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 060116.docx
Engineering Review
Slope at building pad: _
`"r PFI Permit#: , s :4 - ' ,`/
Conditions"Met"prior to issuance of building permit -- / '
❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: 0 Yes ❑ No
LIDA Facility on lot: CI Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
` Approved by Engineering: dj, J9 Date: ♦ 7
Revisions(after Building Submittal only) Reviewer Date
Revision 1: CIApproved CINot Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
i ❑ Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
''P' 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:
'SZ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes (>3'=14:1/A
44 Tigard Trans SDC: CI Yes �T/A
Parks SDC: ❑ Yes /`J N/A
OK to Issue Permit }
Approved by Permit Coordinator: / `` Date: 3 ! 4-------
I:\Building\Fonns\BldgPennitRvw COM_WithLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11035 SW HALL BLVD, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Building BUP2017-00069
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor