Permit (167) N.a.„. „ CITY OF TIGARD MASTER PERMIT
. '� COMMUNITY DEVELOPMENT Permit#: MST2019-00093
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/20/2019
Parcel: 2S109AD09600
Jurisdiction: Tigard
Site address: 14631 SW 126TH AVE
Subdivision: 2000-066 PARTITION PLAT Lot: 1
Project: BERNARD
Project Description: A new 60 sq. ft. dormer.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 60 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 60 sf Value: $7,632.80 Rear: 0
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 add'I 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:
ALT SF VB S-1 60
Owner: Contractor:
BERNARD,WADE JOSH JONES CONSTRUCTION LLC Required Items and Reports(Conditions)
CASTILLO-BERNARD,MARGARITA PO BOX 5777
14631 SW 126TH AVE ALOHA,OR 97007
TIGARD,OR 97224
PHONE: PHONE: 503-568-3937
FAX:
Total Fees: $557.60
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 Notificatio Center. Those rules re set forth in OAR
952-001-0010 through 0 952-001-0090. You may obtain a c•• • •- ales or direct questions to OUNC by calling 50 . 32.1987 or 1.800. 2.237‘.
Ok--
"r11°A
Issued By: �i Permittee Signature: � �; j t Il4A+ t ' ' 'j3.639.4175 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 pians are rRquired en the job site at the time of each inspection.
Building Permit Application
Residential roiz of i i 'i: I 1. oyl.v
City of Tigard E€iew
3/
' { 4-41,— Permit No.: fi -201 l o cc s ct
1,1 . 13125 SW Hall Blvd.,Tigard,ORRECEIVED DP
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: $ Other Permit:
Inspection Line: g 03.639g4175MAR 2 5 2019 Date Ready/By !' /�j Juris' S See Page l for
T I G A K D p .ified/Method: i l / , Supplemental Information
Internet: www.ti and-or. ov PP
ITY • ;:I AL(...de a r
TYPE O'="� II NG B IVISION 1 WIRED DATA:1-AND 2-FAMILY DWELLING
■ New construction ■ D. , , Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Ea'Addition/alteration/replacement ■ • equipment,materials,labor,overhead,and the profit for the
work indicated on this application. —71(j3'4..,
CATEGORY OF CONSTRUCI1ON
Valuation: $ -=;257e."--.'
V1-and 2-family dwelling 12 Commercial/industrial
■ ■ Number of bedrooms:
Accessory building■ _ ■ Other: Number of bathrooms:
J OBS ITE INFORMATION AND LOCATION Total number of floors:
address:Job site New dwelling area: 60 square feet
I' 6 I Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 5 jt Irl'YI eCovered porch area: square feet
Cross street/directions to job site: I a t 41 1. A ek 13‘,1,1, b'ilevi ICU 1) Deck "2 Z square feet
' Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: l 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 a..lication.
L 01161 a Xt, c.tc (Qi C i\ t 4:•.,i la Sib's U Valuation: $
ct d 1' Q (CO i- ,y , eA I S I-)L , bat Lulti , Existing building area: square feet
U New building area: square feet
#PROPERTY OWNER p 0 TENANT Number of stories:
Name: 11,1c0C1 Cv'I i CO f �) })' (ll.iE;t ♦ Type of construction:
k.Address: ! `t(03 1 5Ni )�C(ci k `"1LQ Occupancy groups:
City/State/ZIP: -I @ rigid t (P G j')' I
Phone:(56)) 4 31 61-F1-1 Fax:( )
0 APPLICANT 0 CONTACT PERSON BUILDING PERIM'
Business name: Sa >A,lit, t� p L'L p u H L vv
Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
Total .. application:
City/State/ZIP:
Amount received:
Phone:( ) Fax::( )
E-mail:
PHOTOVOLTAIC
"" J( a �e1e.1 �� I �m Commercial and residential prescriptive installation of
CO CTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: -- � , Submit two(2)sets of roof plan with connection details
L_ S r l � °� C i1 SIT}t L lei) L L and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: .A10 h Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(5o3) 5 3--1- Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 2 0 5 a 31 3 /1 g, )./
1` Total fee due upon application: $201.60
Authorized signature: Y .0,V 0'� _t ( i i\}o This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Itkiiii üi "i44
/t Date: j Z()j cf_ *Fee3crvicc methodologyl3vtnd set by Tri-County Building Industry
/
I
I:\Building\Permits\BUP-' SPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFi i i. t sI: (Y\I.\
Cityof Tigard Received
INg Date/B : Permit No.:
r 13125 S W Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
TIGARD
24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEWlcs yo N
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 0 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 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 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 detiuls --_ 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 a••licable to the •ro'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
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.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
1
City of Tigard
v COMMUNITY DEVELOPMENT DEPARTMENT
11111 III
T 1 G A R D Building Permit Review — Residential
IN
Building Permit #: /f? y 90 i q_ t1C�C)4/3
Site Address: I ( � i � d.{\ i
Project Name: y Lot #:
(New dwelling=subdivision name;Addition or Alteration=last name of owner)
Planning Review ,����`` ,^ ���
Proposal: mot- c iat-1 (tO r of v i/1 ra,[(l�G j
JVerify address/suite#active in Accela. In River Terrace: '*, No ❑ Yes,River Terrace Review Addendum
Site Plan Elements: rosion Control
>3 copies of site plan on 8-1/2"x 11"or 11 x 17"paper 4.ARetained trees with drip line and tree protection measures
Drawn to scale(standard architect or engineer scale) VA-Footprint of new structure(including decks)and FFE
North arrow 8 Itility locations&easements(required for new and additions)
Site address,project or subdivision name and lot number 11, idewalk/driveway approach
,Applicant information(name and phone number) 1N 'cation of wells/septic systems
Lot dimensions and building setback dimensions •.Street tree size,type and location
Square footage of buildings to be demolished re Street names
, /Existing structures on site r'S. •rner elevations(2'contours if more than 4'differential)
Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? l No
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ■ ', s No
Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified "A/No Received: ❑ Yes ❑ No
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified X No Applied For:
PP ❑ Yes ❑ No,stop intake
.and Use Case#: ❑ Zoning: P`-i
Required Setbacks: Front: 15 Rear: 1 S Side: 5— Street Side: \0 Garage:2)
Building Height: Max.Height: 3S( Actual Height: 1 (1
71 Landscape Area: % X Lot Coverage Max: OD
Entrance/ Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less
Windows Minimum 12%of area of all street-facing facades — !U-7<r
Garage Garage door is behind widest street-facing wall ❑ Yes ❑ No,one of the following is met:
f���❑ Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor.
'tiA Garage door width is ❑ 12'or less ❑ 50%or less of facade ❑ 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset ❑ 1'Roof eave ❑ Roof offset
❑ Fire shingles 0 Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding ❑ Window trim ❑ Window recess ❑ Window projection ❑ Balcony
9? isual Clearance ❑ Urban Forestry Plan
:7 ensitive Lands: ❑ Yes ..-1Et No Type:
IConditions met prior to issuance of building permit
Notes: (� g
'l.
❑ Approved By Planning: ^�,., - Date: 37_
Revisions (after Building Submittal on Reviewer
I` Reviewer
Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\BuildingTorms\BldgPermitRvw RES 022819.docx
Building Permit Submittal
Original Submittal Date: ..1V2-5/./ 1
Site Plans: # 3
Building Plans: # ..
Building Permit#: []'Enter building permit#above.
Workflow Routing: 2"Planning a--Engineering h'e'rmit Coordinator C nilding
Workflow Sign-off: [-Sign-off for Planning(include notes from planning review)
Route Application Documents: U.-Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
i2'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
. 4 .1
By Permit Technician: A - Date:
Engineering Review
g. Slope at building pad: 5;4;
Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
cis Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes No
Facility on lot: ❑ Yes No
O Final PlLIDAat Recorded:
❑ NOT Approved by Engineering: Date:
•
Notes:
pi. Approved by Engineering: .4 /... ,..(7...:__-
. Date: V/2//9
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Metprior-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:
e •:.on Notice 3: Date Sent to Applicant:
i DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes w /A
Tigard Trans SDC: ❑ Yes G N/A
Parks SDC: CI Yes '2( ' /A
LIDA ❑ Yes u N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: _ 'y
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
FOR OFFICE USE ONLY—SITE ADDRESS: /
This form is recognized by most building departments in the Tri-County area for transmitting informatio
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
='PI N Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www igard-or.gov
TO: DATE ECEIVED:
DEPT: BUILDING DIVISION
ECEIVED
MAR 2 2020
FROM:
CITY OF TIGARD
COMPANY: S1n \ cm crdiA/ ((I BUILDING DIVISION
PHONE: 5-03 57,3 3/3 ? By:
RE: l q(Ca3/ SW ( C€a- CA J-e /,�'� 5T�,'/7 -coo
(Site A dress) (Permit Number)
w
(Project name or subdivision ame and lot nu )
ATTACHED ARE THE FOLL s • E,Copies: Description: op>i. Description:
Additional set(s)of plans. \ Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. ' Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: r✓c-kl ) 4SITIVIDej by 44ASoltleeC
FOi/FFICE USE ONLY
Routed to P Technician: Date: 5Zo27) Initials:
Fees Due: Yes ❑No Tee Descri tion: Amount Due:
1/2 ( 4{, .( $ l{c I
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions 061316.doc