Permit (108) CITY OF TIGARD MASTER PERMIT
1114
• COMMUNITY DEVELOPMENT Permit#: MST2018-00263
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2018
T f c.; I.Dg Parcel: 2S103BD02300
Jurisdiction: Tigard
Site address: 11760 SW CARMEN ST
Subdivision: CARMEN PARK Lot: 8
Project: SMITH
Project Description: Foundation only for new 520 sq.ft.detached garage.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 11 Bathrooms: 0 Second: 0 sf Garage: 520 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 5 Detectors:
Total: 0 sf Value: $1,200.00 Rear: 5
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 addl 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
Ecompasing: N
Other: N Other Description:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ACS SF VB R-3 0
Owner: Contractor:
SMITH,ROSS JAY OWNER Required Items and Reports(Conditions)
11760 SW CARMEN ST ROSS SMITH
TIGARD,OR 97223 11760 SW CARMENT STREET
TIGARD,OR 97223
PHONE: PHONE: 503-521-0727
FAX:
Total Fees: $239.29
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 y to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952- 1-009o y obtain a .py of the rul>.•r - • - '_- _ 'UNC by calling 503.232.1987 or 1.800.332.2344.
/ 'r
Issued By: / ��/ Permittee Signature: /!- , ...4917,64(7
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.
a
Building Permit Application Checklist
One d f Two FamUy:DwAra g
FOR OFFICE USE ONLY
Received
. City of Tigard Date/By: Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223
g Associated pennits:
Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
T I GA R D
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: • ❑ ❑ ❑
5 Septic system permit 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 violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ ❑ ❑
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 ❑ ❑ ❑
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- ❑ ❑ ❑
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. ❑ ❑ ❑
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 ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
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 ❑ ❑ ❑
over 10 feet long and/or any beam/joist 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 in Oregon and shall be shown to be applicable to the project 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". ❑ ❑ ❑
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 trees and tree protection measures as required by conditions of approval. Tree locations,driplines. ❑ ❑ ❑
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:ABuilding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
•
Building Permit Application
R-0 „ al
51, 4.0FOR OFFICE USE ONLY' ��ryyy
City of Tigard RECEIVED DRate/B d e?
iff PennitNo.: f[ IFF. l7fr ,-
,N . 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review ` 1` v
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit:
TI GA RD Inspection Line: 503.639.4175 SEP 2 2018 Date Ready/By: See Page 2 for
Internet: Www.ttgard-OGgov Notified Method: i Supplemental Information
CITY OF TIGARD _
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Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the
,;;:r-
j� work indicated on this applicatio�ig '
,� :O �1 . �, ! :
-+�
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ Os ASTAC
sit
Accessory building ❑Multi-family Number of bedrooms: /iZ4o-FQ0arWel twe..h/
❑Master builder ❑Other:. Number of bathrooms:
5 / ' a*; 'I ,Z r '
' ' � �t� ;€ p (N Total number of floors:
Job site address:1174.0 S w e A/LMEN S7RE&—f— New dwelling area: square feet
City/State/ZIP: 77&,,p/to , Ori_ 9 7.2�3 Garage/carport area: 4'2 0 square feet
Suite/bldg./apt.no.: I Project name: Of 4c c4 G.slit.,gG4. Covered porch area: square feet
Cross street/directions to job site: L' I,V[,y 3-/16. - hJ,ESy, Deck area: • square feet •
S O n., //O A W. D N C.0/t./"1Lriv S7; Other structure area: square feet
Subdivision: I 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
• r .. 1 i$ = , - . � work indicated on this application.
Valuation: $
COAiST/1ael7on, dF /Vied✓ Z70"TA cAhi2ro
G//gn-•1-6+.E $ .0 ' Zap 7 W/TN 9 X .Z 9-
VExisting building area: square feet
/Z r APIA'd. . New building area: square feet
� =nM '`7.;!''�4i �� Number of stories:
Name:
/241 S S T s'/'7,Tly Type of construction:
Address: //7C.o S,L✓. Chi.cA, S�j2EET Occupancy groups:
City/State/ZIP: 7-7 a,„,,,:, d,'l- 9y72.2 3 Existing:
Phone:(5-03) 5.2 /. e:)7,2 7 Fes �
O
:( - r60 " 9 7 New:
Business name:
� 9
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total fees due upon application: 05d,Vy
City/State/ZIP:
Phone:( ) I Fax::( )
Amount received:
E-mail: v i �,mi s
s, W Commercial and residential prescriptive installation of
3 ,5 i:[?Via: p ! , / i"Z r,
g_„va ;= roof-top mounted Photovoltaic Solar Panel System.
Businessae: /h y S M.L ,7 IA Submit two(2)sets of roof plan with connection details
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
Authorized signature: /9___ / /17/
This permit application expires if a permit is not obtained
`���'- 4e7within 180 days after it has been accepted as complete.
Print name: g ss 3--, S/y /T/ Date: 9 *Fee methodology set by Tri-County Building Industry
/ /�O/�>/ Service Board.
I:\Building\Penn its\BUP-RESPennitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
r .
RECEIVE
OCT 3 2018
f ITY 01-TI aABD Clean Water Services File Number
CleanWater , ervices
\� iLDItyG Dlvjlonl 18-003049
Sensitive Area Pre-Screening Site Assessment
1. Jurisdiction: Tigard
2. Property Information (example 1S234AB01400) 3. Owner Information
Tax lot ID(s): 2S103BD02300 Name: Ross Smith
Company: Owner
Address: 11760 S.W.Carmen Street
Site Address: 11760 S.W.Carmen Street City, State,Zip: Tigard,OR,97223
City, State,Zip: Tigard,OR,97223 Phone/Fax: 503-521-0727
Nearest Cross Street: 116th Ave. E-Mail: ross.smith@rogers-machinery.com
4. Development Activity (check all that apply) 5. Applicant Information
Exj Addition to Single Family Residence(rooms,deck,garage) Name: Ross Smith
• Lot Line Adjustment ❑ Minor Land Partition Company: Owner
❑ Residential Condominium ❑ Commercial Condominium Address: 11760 S.W.Carmen Street
❑ Residential Subdivision U Commercial Subdivision Ti ard,OR,97223
❑ Single Lot Commercial U Multi Lot Commercial City, State,Zip: g
Other Phone/Fax: 503-521-0727
E-Mail: ross.smith@rogers-machinery.com
6. Will the project involve any off-site work? ❑Yes j No ❑Unknown
Location and description of off-site work
7. Additional comments or information that may be needed to understand your project
I want to add a detached garage. The set back will be 100 feet from Carmen Street.
This application does NOT replace Grading and Erosion Control Permits,Connection Permits,Building Permits,Site Development Permits,DEQ
1200-C Permit or other permits as issued by the Department of Environmental Quality,Department of State Lands and/or Department of the Army
COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law.
By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority
to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify
that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate.
Print/Type Name Ross Smith Print/Type Title
ONLINE SUBMITTAL Date 9/25/2018
FOR DISTRICT USE ONLY
❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A
SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report
may also be required.
Li Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This
Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently
discovered.This document will serve as your Service Provider letter as required by Resolution and Order 17-05, Section 3.02.1. All required permits and
approvals must be obtained and completed under applicable local,State,and federal law.
1.
Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially
sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water
quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order
07-20,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law.
This Service Provider Letter is not valid unless 1 CWS approved site plan(s)are attached.
❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR
SERVICE PROVIDER LETTER IS REQUIRED.
Reviewed by ,, .,,i,,,,„-:::„ ,„,_,,_,,_, Date
10/2/18
2550 SW Hillsboro Highway • Hillsboro,Oregon 97123 • Phone:(503)681-5100 • Fax:(503)681-4439 • www.cleanwaterservices.org
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ofTigard
11 7 COCityMMUNITYTigDEVELOPMENT DEPARTMENT
T Building Permit Review — Residential
Building Permit #: /..7�f-- rr- �`i _�`
Site Address: c
Project Name: '
S;hr-k 14,64a�` Lot #:
li -
(New dweng=subdivisio�namf;Addition or Alteration=last name of owner)
Planning Review
Proposal: CCA-i6i� n cc' r k rare /01 x L6 .- SU ; 4 4. Gam( �,�
$`x2R' = 2,31‘ S L, p�
,I (/Verify site address/suite#exists and actio in permit system.
LTJ River Terrace Neighborhood: y
C No 0 Yes,See River Terrace Review Addendum Attached
Sit Plan Elements:
ree(3)copies of site plan
S. plan must be on 8-1/2"x 11"or 11 x 17"paper sting structures on site
No awn to scale(standard architect or engineer c ie) i•ore 1 va eleof vations structure(including decks)with finished
Vorth arrow v1
to address,project or subdivision name and lot number tg • tY locations&easements(required for new and additions)
idewalk/driveway approach
O` •plicant information(name and phone number)
(if t dimensions and setback dimensions '�A ' anon of wells/septic systems
buildingi xisting trees to be retained with drip line,and tree
11 quare footage of buildings to be demolishedfii
protection measures
171± •t area,building coverage area,percentage of coverage and 1,T4. eet tree size,type and location
pervious area(applicable if R-7,R-12,R-25&R-40) treet names
e.roperty corner elevations(2 foot contour lines if more than i
>1,000 sf of impervious area created or replaced? ❑Yes
4 foot differential) p 113<o
( If yes,is a storm water quality facility shown? ❑Yes ❑No
`Ll�f Clean Water S rvices-Service Provider Letter(lot platted prior to 9/10/1995):
, /Required: Yes,applicant was notified 0 No Received:
ID' Public Facilities Improvement(PFI) Permit: ❑ Yes LTJ No
Required: 0 Yes,applicant was notified !Ia No Applied For:
0 Yes 0 No,stop intake
Ikg-pand Use Case#:
MI/Zoning: g.-1.S
'
� ��..pRequired Setbacks: Front 114 Rear S Side S Street Side 5 Garage e A
M� Landscape Requirement: -To—
,Lot
,Lot Coverage Maximum:
Building Height Maximum Height IS Actual Height 1,
Visual ClearanceEr g
Sensitive Lands: 0 Yes Ci
No IA/Urban Forestry Plan
Conditions "Met"prior to issuance of building permit
Notes:
ttld' Approved By Planning: j t ( n
`-YAO✓'� Date: ct-2-0-4
Revisions (after Building Submittal only) Reviewer
Revision 1: 0 Approved 0 Not Approved Date
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
I:\BuildingWorms\BldgPermitRvw RES_061417.docx
Building Permit Submittal
Original Submittal Date: #4/ Ji�
Site Plans:
Building Plans: # 3
Building Permit#: `]tenter building permit#above.
Workflow Routing: el'lanning gineering mit Coordinator E.. trilding
Workflow Sign-off: 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
on al 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: �� Date
s xT<✓x^�'RSN'Y"', —s(., - rr,_ _,- �06�s�- ...<a.f�. ry.
Engineering Review
3 Slope at building pad: 2_%
[a Conditions"Met"prior to issuance of building permit
[1, Easements (encroachments)per engineering conditions of approval and plat
LJ Water Quality/Quantity Facility: [/j No
Assess Water Quality Fee in-lieu: 0 Yes
Assess Water Quantity Fee in-lieu: 0 Yes E(No
LIDA Facility on lot: 0 Yes 11 No
Final Plat Recorded:
Date:
0 NOT Approved by Engineering:
Notes:
�,
21' Approved by Engineering: ij,,.a.o( 6,4Date: q.,25-/g
Revisions (after Building Submittal only)
Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
0 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:
❑ DC Fees Entered: Wash Co Trans Dev Tax: 0 Yes /A
Tigard Trans SDC: 0 Yes N/A
Parks SDC: 0 Yes N/A
LIDA 0 Yes N/A f
Apt?2OK to Issue Permit *‘te: GJ ,Z //�—
proved by Permit Coordinator:
I:\BuildineForms\BldgPermitRvw_RES 010118.docx