Permit ;M1 rs11.1xlq CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 -00075
Date Issued: 05/12/2010
TtGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103CB01300
Jurisdiction: Tigard
Site address: 12355 SW JAMES ST
Subdivision: Lot: 0
Project: Tabor
Project Description: Demo existing 1900 sq ft residence on septic. Demo credits to apply to new construction.
Owner: FEES
TABOR, KRISTEN E Description Date Amount
12355 SW JAMES ST Permit Fee - Additions, Alterations, 04 /14/2010 $87.17
TIGARD, OR 97223 Demolition
PHONE: 503- 807 -8789 12% State Surcharge - Building 04/14/2010 $10.46
Erosion Control 05/12/2010 $26.00
Erosion Plan Review CWS 05/12/2010 $8.45
Contractor: Erosion Plan Review COT 05/12/2010 $8.45
BRENT HILLMAN & ASSOCIATES INC
PO BOX 3188
TUALATIN, OR 97062
PHONE: 503 - 209 -1794
FAX: 503- 590 -8962
Specifics:
Type of Use: SF
Class of Work: DEM
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $1,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $140.53
Required: Required Items and Reports (Conditions)
1 BUP Ersn Cntrl 681 -4444
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 -0100. You ma : • - • . •py of the rules or . rect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / Permittee Signature: dil
Call 13.•39.4175 b 7:00 a.m. for an inspection pection 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 Application , t on sfi
"� . T5 RmM„ neon u'Y +'� � m w tl Pr �7 iel' Sort.iOi 7,,b J vI la ,,p A.r 0 :', i , Eil t � I;1 ,I IA
Residential T ° �� � t ' : q �oa � i a �t
� l ' 1C)R OI C I I liS It' r,On t(p : ?t i�r °�y
Y n 3 1F�f1+NVf. 494 :.j.A ? , �. 1 7 ;'.aBl..,:LI:'1�.6 Permit No.: Ya ,- ct,
" t:sk '. , a iu�e 1 i� :`a , . Pb
4 4 it ° 0 Tigard
13125 S W Hall Blvd., / f
Tigard, OR 97223AP R 1 2" 10 DateBy� � ! (,�i. / 1 it , f
u 49 - 01 , 76
Plan Review
4 k C A; Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
4 . Inspection Line: 503.639.4175
T T `� OF TIGARD Date Ready /By: luris: El See page 2 for
A.,...,,,„ M,i, Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: /�C /4:#7 Supplemental Information
/ &M
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: $ / 5 0
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION . Total nu mber.of floors:
Job site address: 12355 SW James Street New dwelling area: square feet
City/State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: SW 124th Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Willamette Plat 2 Lot no.: 12 Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
major remodel/replacement dwelling
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Kristen Tabor Type of construction:
Address: 12355 SW James St. Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: (503)807 -8789 Fax: ( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name: Patrick Schmitt, designer Inc. All contractors and subcontractors are required to be
Contact name: Patrick Schmitt licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 8695 NW Ryan St. jurisdiction in which work is being performed. If the
City /State/ZIP: Portland, OR 97229 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 768 -4573 Fax: : (503) 297 -4290
E -mail: patrick@psdesignerinc.com
• CONTRACTOR
Business name: Brent Hillman & Assoc. BUILDING PERMIT FEES*
Address: PO Box 3188 (Please refer [o fee schedule
City /State /ZIP: Tualatin, OR 97062 Structural plan review fee (or deposit): g7. /
Phone: (503) 209 -1794 Fax: (503) 590 -8962 FLS plan review fee (if applicable): g )--
CCB lic.: 159399 Total fees due upon application: le `* ii31 Amount received: K 7. G3
Authorized signature: / ii/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Patrick S mitt Date: 4/12/2010 * Fee methodology set by Tri- County Building Industry
Service Roard.
1 - ..• \ . - • .
• • • ,t1 INVOICE
r.. .. ' :,..: ,- ,,,,:.• - • • 5 - • -- . ,.::::::,,, ..,: . : . ', . . . ,, - .. '. . : •-,,''''':!;. • .• , , . ,-...r..., . ',' ! : i - : ; , , • - : . : ; , - , : • . . • . : . • • • ,' ,• • :-.'-::.•••:•• •....:: ••'.• -':•r;: ..,.' - ••:, r• , ..i: i l ,..,•,:'2' .:::',:. -,:' 'i. .
'.:',,::.:‘'!:':•.';'.,...:•,..:'-.,,;,•;:',:.':,,.;9:1':''.-.);'.6::..,::',i,.::fzi.:,',-;‘,.g:',•:i''gi.-..:K:j-!...,"*;:i.:.,.;;.„.?::,•-;;;., ,.,.,.•".1:';: .F-*:.,
''. '''!"1 ' :,:,s ".:•::'::""-.':'•:::.''''-'::':''''.il'!1's-i'''.:,-':*'7:..'4''''.4:,;;-•:::....::.;:',...;,:;,"':'...'i';'.%::.',.7C=,..441407.4::§‘..,'; .r•r,•.:.'•;,:,,.:R:,' , ';'..f 1: 1 .
:':-. - . - I • .::': :, 1 -:;' , ., 1 ,; , : „ :. ,,,.,,.; ,.
i , • (- •• - ,'•:- •,_. • , _, - ?",‘,..••.:-;,•-, , ::.• " -.::• .-:fill-4::'4 , -ei.iinWf ;' ''...'*'-,j'i•"'; ' ..:,.; :i::::' . ::', q;:i
Pi.0grjn•.':CitY;''., ,004,3e '-'-. l'. 7. i., -:"• . irte,, ,::Vflii*,,
1 , „...,,/
" 1
r, ''':', ':1; , ,•:::,. :.,.:, I 970 .. ),' ',:. 1 ,. - *:;fZ''.:k 4 ,. - ,: .., • Tg'117 zin , : , , , ; : ..i , '•( ., ,' , ..,.... -, :.:;' , ...'W!:: : :',';'N'' ,,- ; , :;;': : :• -.) '.:'•' ,, ': .
,.- - -..: - . .. : , ..,..,::_n‘..::. , :. , '- - .: ,. '..:.v. , :•-•.!' , .,-.q.„ -,„ ,..,;:. , ,,,*,,, 7 ).,: t . it.,; e.110,rie,* .,,t... ,',T ?-1;.'''•:. , r Complete r" • ':::•.- ' ':!...;,•,':•..' -'f.'.:',. l eP
' - ' „ :.,...:. •:•• ':• - --: . ' : : •''''''; ::' 1.::§4 .•_,4 ,,.-:', 'g: fv.,.,A.,:', ..f ''. ' ' N. • -.., .1 ',„1 '''.:•'. : "r:... ---.'."' . .=' 'i''
riJ '
E , -,..:.:. '.....
New Installations . • .. „ tr ra . i, , , ii .. ca 4iiiii .:. . . : '.: • '. -, :,...'.;
kJ '
Repair.ExiSting.Systems ' 'illo ''''. 'AO.: 'M !,:',: IF '.!;,, - *Ili ' ' 1 . r . : • WaSte.
c k /
.. .
Sewer ConneCtiOns .:7' m u ' 11' r. a i m ' :: r Sr , 7 I Removal
el ea Ea is es is • Ea E me . es • ea .
Drainfields . gg mg 0 ei gi Ea is Septic Tank Cleaning
I - Cesspools ' Sump
if Excavating Line Cleaning
• Richmond Construction Ent., Inc.
(503) 253-7587
T ": , .:F •
Customer P.O. # Date,J 2 :, 2 0I0
I . Billing Name F.i.r e - a t i 11 irit a 3:`, •::::, A :. f.40:4J. t• ,,,... s ' ,
Address Zza PO Br.:•; x 3188
I:.. . • '
Job Site # --
.....
. • . ,
. •
. .
'...- City . ft tz i l') State01?, Zip Code 97 22:::',
.-,fr•
':- Ordered By Phone # ()3 - 209 - 1.794_ Date5 12 7/ 1 Ci
.- •
. .
. .
. .
. • Job Location 12355 Sli.7 Jan St. i, '1'.1J2.. a. r d. 07223 , •
. ,
. . ,
t: T.ij .---: 1 n 1.! t St
•. Service Call . c,
4) ,..
::- Labor $
... Pumping .:,)epi: lc gallons 1 ()(1) .0 $ 20000
Misc $
••• Conditions of tank/Distribution Box .
•
• ,./,,,,, , _,
TOTAL CHARGES
. .
' -
Enviroclear is in no way responsible for damage to the septic tank or lids on the s te
•
.., TERMS: Net 10 days. 1-1/2% per month will be charged on past due accounts. (18° per um).
..•
,
.,
. ,
. .
. .
Customer's Signature: -, ..-- - I) '----
' .9 / . 67 ;" t.. , 4i / 4 )
/ „ ..... , . :$ 1 . ..5, (.14;,,..,t•
6 1-' ; I'''
Service Driver's Signatiiref.79f2,4.4e.“',"'. - i. „." Time 1 , 9 Date k 4 . . ....
/ e ir / 1
.4;
f
TERMS AND CONDITIONS ON REVERSE SIDE REDEEMABLE IN ALL COUNTIES
. •,1
:. = ; ..31= 0 ,=: alkali
. P;: 6 rcigroci. ret°13` 'cl."tima2
• ,
. 1
.. .