Permit _ ,
A CTGARD BUILDING PERMIT
PE RMIT #: BUP2005 -00632
F, �I k D DEVELOPMENT SERVICES DATE ISSUED: 1/6/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109AC 00200
SITE ADDRESS: 13400 SW BULL MOUNTAIN RD ZONING: R -7
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Demo 2370 sq. ft. residential dwelling on septic. DEMO CREDITS APPLY FOR SDC FEES.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Owner: Contractor:
CASA TERRA LLC NORTHWEST EARTHMOVERS INC
9600 SW OAK ST. #230 PO BOX 1467
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: 503 - 452 -8003 Contact #: PRI 503 - 624 -0363
FEES Reg #: LIC 62761
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/12/200E $62.50
[TAX] 8% State Surcharl 12/12/200E $5.00
[ERPRMT] Erosion Cont 12/12/200E $26.00
[ERPLN] Erosn Pln Rv C 12/12/200E $8.45
(additional fees not listed here)
Total $110.40
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility_ Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copy of_these rules_ or direct questions to OUNC by
>___.:,,Im...___L,___. calling 503 - 246 -6699 or 1- 800 - 332 -2344.
P®rrreitte S ig natte
Issued By:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit An6iiialtion `\,l`' FOR OFFICE USE ONLY
City of Tigard Received 2 _ � )� -2 �' A J � /
Date /By: I, Pemm No.: V \ (32
13125 SW Hall Blvd., Tigard, OR 97;$' (' Plan Review
Phone: 503.639.4171 Fax: 50503.598_0:J604' "tl" Ail Date Date /By: Other PermitSbk � .,JQ45
-,'
Inspection Line: 503.639.4175 e, Date Ready /By: J uris' el See Attached Checklist for
Internet: www.ci.tigard.or.us �u ji ‘( U , �birt Notified/Method: 6, Supplemental Information
Aj d T \Tr " Iirq'
TYPE OF WORK 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
❑ Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1- and 2-family dwelling ❑ Commercial /industrial
Valuation: $
❑ Accessory building El Multi-family Number of bedrooms: 2
❑ Master builder El Other:
Number of bathrooms: 1
JOB SITE INFORMATION AND LOCATION Total number of floors: 1
Job site address: 13400 SW Bull Mountain Rd New dwelling area: square feet
City /State /ZIP: Tigard OR Garage /carport area: 480 square feet
Suite/bldg. /apt. no.: Project name: Wilson Ridge Covered porch area: square feet
Cross street/directions to job site: SW Bull Mountain Rd and SW 133" Deck area: square feet
Other structure area: 2370 square feet C/. igr!e
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: 100 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S109AC, R0485861 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.
Demolition of the existing single family residence and garage Valuation: $
aet ��°Y
� , , T Y Dr./� n off" e _ Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Casa Terra, LLC Type of construction:
Address: 9600 SW Oak St, Ste. 230 Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: (503)452 -8003 Fax: (503)452 -8043 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Alpha Community Development, INC All contractors and subcontractors are required to be
Contact name: Al Jeck licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 9600 SW Oak St, Ste. 230 jurisdiction in which work is being performed. If the
City /State /ZIP: Tigard, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 452 -8003 Fax: : (503) 452 -8043
E -mail: amj @alphacommuntiy.com
CONTRACTOR
Business name: etrbiid A, �' J
�`�✓ � BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City /State /ZIP:
Fees due upon application / ` /a vo
Phone: ( ) Fax:( )
Amount received
CCB lic.:
Date received:
Authorized signature:
C:1) This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Jerry M. Palmer Date: t tlii OS * Fee methodology set by Tri- County Building Industry
Service Board.
is \ Building \ Permits \BUP- PermitApp.doc 12/03 440- 4613T(11 /02 /COM /WEB)
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1 _ E COPY PLAN
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CITY OF TIGARD - - \ - - — - 1 - / j ; ^ , i / ' ; 1 I
Approved �41�® I . , ' 1 " / / `;l. 1 / / I j I t 1
Conditionally Approved' I I I I �i il i 1 j ! 1 I' 1 11
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For only the work as described in: ; 1 r \ 1
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PERMIT NO : Lk.. 0 O 6,3.2, 1 \ i l ; 1 •
Sae Letter to: Follow I • . ' ° 1
Attach � I I I (2) as: /3 � 5 `\ M � \ wewEarNa: >.
I' I -- Da; . [ L�Q.)- ' i i ! j Job Addre S C ALE ao eo
°y CONSTRUCTION ii
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CITY *., QF TIGARD
BUILDING DIVISION PERMIT #: • BU1^ .d. 0 11.:; -00 ,' ;
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . I /6 /20(1€;
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 1/2€/20(j6 TIME: 7 :03AM PAGE: !)'
SITE ADDRESS: 134 00 :;1`v B it Mc1.JIJfI AIIJ RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: OAL SON RIDGE SUBDIVISION
DESCRIPTION: Deno 2370 deritial d ellii ?n c 00/1 GREL)11 S APPLY FOR SDC FEES.
OWNER: CASA T[: :PRA LLC, PHONE #: 60:3
CONTRACTOR: NOR i HVV ST EAR:1'1-1MO :HERS 1NC PHONE #: a0.: -C 2.4 -O3G3
Inspection Request Scheduled For: Date: 1/2612006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
aril, Mis;c.:. in ;pectiou 0267Y,..01 603-849.1: MO IJ
Corrections /Comments/ Instructions:
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PASS n PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
FAIL ❑ CALL FOR I SPECTION ❑ ADDITIONAL F S ASSESSED
Inspector: wA Date: , Phone #: (503) 718-
09 Z60,5 e ctoC.
‘ LOAA ANITARY SERVICE
INVOICE NO.
8600 SW Hillsboro Hwy., Hillsboro, OR 97123 10379
503 -644 -2797 503 -648 -6254 503 - 639 -5188
NAME: A/ /1//
ADDRESS:
CITY; STATE: ZIP:
HOME: WORK: CELL: d /
Q—S:S O
JOB SITE: ) 3 '? 4 ,§ 1 p u; % i ' /r" 7/ca P.O. #: %
PAID BY CHARGE °.) CHECK ❑ CASH ❑ CREDIT CARD ❑
DATE / - L.J Q DRIVER r\ - (%;, 7 / AMOUNT
PUMP SEPTIC TANK % \ '(-1 k l ( Li
❑ INSPECTION FEE
❑ SERVICE CALL
❑ LABOR, LOCATING, DIGGING, BACKFILL
TOTAL $ 0.0
- THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT -
- REMARKS - -
TYPE OF TANK: STEEL ❑ CONCRETE ❑ PLASTIC ❑ HOMEMADE ❑
HORIZONTAL ❑ VERTICAL ❑ RECTANGLE ❑ ❑ OTHER
SIZE OF TANK: 350 ❑ 500 ❑ 750 ❑ 1000 ❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑
LID LOCATION: INLET ❑ OUTLET ❑ MIDDLE ❑ ENTIRE TOP ❑
TANK CONDITION: GOOD ❑ FAIR ❑ POOR ❑
FITTINGS: BAFFLES ❑ CONCRETE ❑ CAST IRON ❑ PLASTIC ❑
NEEDS NEW LID? YES Q SIZE
GROUND COVER OVER TANK
COMMENTS ON CONDITION OF DRAINFIELD ETC.
SIGNED BY // //t *aO/ DATE A Z471-0'1