Permit l VV
CITY O TIGARD
SITE WORK PERMIT
COMMUNITY DEVELOPMENT PERMIT #: SIT2005 - 00005
T'G"ti 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 4/18/2005
PARCEL : 25101 BD - 00105
SITE ADDRESS: 12805 SW 77TH PL ZONING : I -
SUBDIVISION: LOT: JURISDICTION : TIG
PROJECT: TEREX UTILITIES WEST
Project Description: Site work for 4,992 square foot addition.
CLASS OF WORK: ADD PAVING ?: RESO. NO:
TYPE OF USE: COM GRADING ?: Y VALUE: 5,000.00
EXCV VOLUME: 211 cy LANDSCAPING ?: U
FILL VOLUME: 0 cy SITE PREP ?: Y
ENG FILL ?: STORM DRAINS ?: Y
SOILS RPT REQD ?: IMPERV SURFACE: 5,724 sf
Owner: FEES
B R + G CO LLC Description Date Amount
PO BOX 23009 [FLS] FLS Pln Rv 3/9/2005 $36.52
TIGARD, OR 97223 [TAX] Valu 8% State Surcha 4/18/2005 $7.30
[ERPRMT] Erosion Cntl 4/18/2005 $80.00
Phone: [ERPLN] Ersn Plck -CWS 4/18/2005 $26.00
[EROSN] Ersn Plck -COT 4/18/2005 $26.00
Contractor: [BUILD] Prmt Fee -Valu 4/18/2005 $91.30
[BUPPLN] Pln Ck -Valu 4/18/2005 $59.35
OWNER [HRBLD] Hourly Building Ra 6/19/2008 $62.50
[HRTAX] Hrly 12% State Sur 6/19/2008 $7.50
Total $396.47
Contact #:
REQUIRED ITEMS AND REPORTS
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notif - '•n Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rule •r direct que- ions - • NC by calling 503.246.6699 or 1.800.332.2344.
�/, I
I- sued By: .� Penn ittee Sign: ture: G�,'' G ��
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
CIT'OF TIGARD "-A-r-
BUILDING DIVISION PERMIT # :Z0r _
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Ai Requests (24 Hrs.): (503) 639 -4175 .. IL.
INSPECTION WORKSHEET FOR DATE: 7/30 (CS TIME: PAGE:
SITE ADDRESS: (2e j 7? CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
' 11
Corrections /Comments /Instructions:
•
6
SS 1 1 PARTIAL APPROVAL n CANCEL n NO ACCESS
FAQ 1 1 CALL FOR INSPECTION ❑ ADDITI NA FEES ASSESSED
Inspecto �%e/ Date: L Phone #: (503) 718 - 9--4-Yc7:,
CIT OF TIGARD
I A
BUILDING DIVISION PERMIT #: 3l12(105.00t105
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 4/1EV2005
Phone: (503) 639 -4171 /
Inspection Requests (24 Hrs.): (503) 639 -4175 a e .... r
INSPECTION WORKSHEET FOR DATE: 7/1/2000 TIME: 7 :OOAM PAGE: 31
SITE ADDRESS: 12805 SW it PL CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TEREX. UTILITIES WEST
DESCRIPTION: 11:1'.teh r 4,992 square foot addition.
OWNER: 3i R - G CO LLC, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/1/ 100€ Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 072039 -01 503 - 699.3500 N
Corrections /Comments /Instructions:
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Inspector: `•° Date: �� Phone #: (503) 718
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> T Advantage 'Rick Bo en a'RBI v
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, Work Permit 5IT2005- 00005 , ;Status F; ., ,. ...
Name: R + G CO LLC Updated: 4.115.'2005 VSH General - ,
Address:12805 SW 77TH PL J ur: IG
Site
Description: Master # IMMD2005-00002 Project: ITEREX UTILITIES WEST * : .
Specifics . ,
Site av`ork foi - 992 square foot addition:
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Class of Work: DD 1 ,
! Type of Use: COM Dates
Dat
Resolution Number: 1 x.
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�� ,a Received: 3/92005 p
Zoning:
Target:
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Total Valuation: 1 $5 , 000.00
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Issued: 14/18/2005
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Expired: 110/15/2005
Finaled:
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Trden� Advant4e [Rick Bolen -FRB] g
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Name: R + G CO LLC Updated. 4/15e2005 VSH General
Address:12805 SW 77TH PL Jur: IG .,,,
1 Site t
Description: Master # IMMD2005 -00002 Project: JTEREX UTILITIES WEST
Specifics -
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Class ' � I i ec ic; a : tiS •1i7��0 , 4 -i' 00 ,.. pp DE S , _ t 4.1,
i i Building plans routed tc1060 31'9/2005 DONE DEB
Type: Application received 1010 319t2005 DONE DEB Per at
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I Permit created 1020 3/9t2005 DONE DEB , .-
1 Resolution
_ Revisions Info routed t 1080 415/2005 DONE DEB 3 set{ , °
I I H HOLD for (see note) 1420 4/7/2005 HOLD VSH planni # f
14 I i Total �J. Building plans approve1100 4/7/2005 APRV VSH
1- t Post- review completec1240 4115/2005 DONE DEB {: 4�
I i Approved plans routec1110 4/15/2005 DONE VSH r ,"
Ready to issue permit 1270 4/15/2005 REDY DEB Conti': ;; A '
Return to "P" status 1450 411 5x2005 DONE VSH
'14 I Issue permit 1280 4118x2005 DONE BB
1 i - --rmit expired - 16 1 n — ' —' 7/19/2006 DON Ra
1 - update (see noftl730 7/24/2006 —DONE JMT rolled ; - •.
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