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Permit } `CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00530 �, DEVELOPMENT SERVICES DATE ISSUED: 10/6/2005 s=` , ,m 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S136DD -03100 SITE ADDRESS: 11800 SW 69TH AVE ZONING: MUE SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 009 JURISDICTION: TIG Project Description: Demo 840 sq. ft. residential dwelling, on septic. 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: SPECHT DEVELOPMENT, INC. COFFMAN EXCAVATION LLC 15400 SW MILLIKAN WAY PO BOX 687 BEAVERTON, OR 97006 OREGON CITY, OR 97045 Phone: 503 - 646 -2202 Phone: 503 - 656 -7000 Reg #: LIC 146689 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 10/6/2005 $62.50 [TAX] 8% State Surcha 10/6/2005 $5.00 [ERPRMT] Erosion Con 10/6/2005 $26.00 [ERPLN] Erosn Pln Rv C 10/6/2005 $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 a copy ' of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: Permittee Signature: el i �I�I 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 Application FOR OFFICE USE Gi\'I..\ City of Tigard - DateB : Received I v • I / Permit No.: A oo fie ®® "" 13125 SW Hall Blvd., Tigard, OR 97223 �� E'� r ^,; r Plan Review Phone: 503.639.4171 Fax: 503.598.1960 7 }j' ,, i . ' i s Date/By: Other Permit: Inspection Line: 503.639.4175 6 ! L 'I I Date Ready/By: ® See Attached Checklist for Internet: www.ci.tigard.or.us OCT 0 6 . I I Notified/Method: lG Supplemental Information TYPEOIntIGARD REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction b UI f $ o N 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. ® m 1- and 2- family dwelling ❑ Comercial /industrial Valuation: $2,500.00 ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 11800 S. W.51iktun K 4) .— New dwelling area: square feet City/ State/ZIP: Tigard, Oregon Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Specht Dartmouth Site Covered porch area: square feet Cross street/directions to job ste: S. W. 67 and Clinton Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: T. L. 3100 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. Demolish existing single family residence and accessory building S JLI Nt \ CJ Valuation: $ WO S a Y )r , Existing building area: square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Specht Development, Inc. Type of construction: Address: 15400 S. W. Millikan Way Occupancy groups: City/State/ZIP: Beaverton, Oregon 97006 Existing: Phone: (503)646 -2202 Fax: (503)626 -8903 New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: Specht Development, Inc. All contractors and subcontractors are required to be Contact name: Joe Curran licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: As above jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: y: Phone: ( ) Fax:: ( ) E -mail: JCurran @spechtprop.com CONTRACTOR Business name:-TBl3 C' 7 yA/ .1 Coq Yi97 0/\/ BUILDING PERMIT FEES* Address: ?. e, goat,' dp877 /3o /Y CL4LKcOw7AJ' � 1479_ ,a2 / ✓� i Please refer to fee schedule. City/State /ZIP: Z 4 a"/ c, Ty, 6Q g VS" Fees due upon application $110.40 Phone: (fox) 6 Cn. Fac, a Fax: (S'OJ) ex s'LL. O !1, 862 Amount received CCB lic.: /4/ (d'e&; CaMg cT - ,/,04. 0yJ Any 1 Date received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Joe Curran Date: October 5, 2005 • Fee methodology set by Tri-County Building Industry Service Board. i:\ Building \Pmnits \BUP- PemntApp.doc 12/03 j //�ijl,1, eed Ar i/!i 440- 46]}T91/0L )OM/WEB) :4-2-4- $' / 7-7--/ CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP200S -00 i30 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/612005 Phone: (503) 639 -4171 A u�e�,ir ,..l�lla Inspection Requests (24 Hrs.): (503) 639 -4175 ? '— INSPECTION WORKSHEET FOR DATE: 10/11/2006 TIME: 7 :02AM PAGE: 56 SITE ADDRESS: 11800 SW 69TH AVE CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: QQ9 TYPE OF USE: PROJECT NAME: SPECHT DARTMOUTH DESCRIPTION: Demo 840 sq. ft. residential dwelling, on septic. DEMO CREDITS APPLY FOR SDC FEES. OWNER: SPECHT DEVELOPMENT, INC., PHONE #: 503 - 646.2202 CONTRACTOR: COFFMAN EXCAVATION LLC PHONE #: 503_656.7000 Inspection Request Scheduled For: Date: 10/11/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 037974 -02 603 - 718.2423 N Corrections /Comments /Instructions: r c 4C' .... i , /1 0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r Inspector: Date: 1 OA 0 co Phone #: (503) 718 - Z 7 z `10/ 15:31 5036560686 COFFMAN EXCAVATION PAGE 02/02 ALOHA SANITARY SERVICE INVOICE NO. 8600 SW Hillsboro Hwy., Hillsboro, OR 97123 10 6 5 6 503 -644 -2797 * 503 - 648 -6254. 503 -639 -5188 NAME: ADDRESS: ? I gr, .± Q IYX9 ii f OAP °-''' 4 i. a 1 S CITY: STATE: Zip: HOME: WORK: //�� __ • - CELL: "7IQ o qL-5 JOB SITE: i g I / eN Pa , Y" i I Ci! >`.le-r 1 P Q. #: �G! G Ar PAID BY CHARG = 0 CHECK ❑ CASH ❑ CREW* CARD ❑ DATE IJ -O.� Z 006, DRIVER 74441 i! I AMOUNT PUMP SEPTIC TANK , ., I 0 . / - . 1 _ /Lid 4 Al ❑ INSPECTION FEE , ❑ SERVICE CALL ❑ ' LABOR, LOCATING, DIGGING, BACKRLL . TOTAL $ u1 - - THIS Is NOT A SEPTIC SYSTEM INSPECTION REPORT - - if/ , u - REMARKS - - TYPE OF TANK: f . TEEL CI CONCRETE CI PLASTIC • HOMEMADE CI ' ' H oiu • , AL ❑ VERTICAL Q RE •• GLE ❑ ❑ OTHER SIZE OF TANK: 350 ❑ • , ■ 750 ❑ c I I ❑ 1250 ❑ 1500 ❑ . 2000' d 3000 ❑ LID LOCATION: INLET ❑ OU 11 . MIDDLE ❑ ENnRE ToP U TANK CoNDmoN: GOOD ❑ F ❑ _ , •.• R ❑ FITTINGS: BAFFLES ❑ NCREri:_❑ 1 VasTeliZ A-I RAWITC ❑ 2ETA ?1 "- —. P►l'I',: : NEEDS NEW LID? YES • SrZE —1' _ .. . GROUND COVER DV • ANK \ 0. /b .. ��„±..._._ �, `. ...,,..„. IP MMENTS • • • NDmoN of DRAINFIELD ETV .,..ti • - 1 .� ,. ; F;lt. �s ¢ '' .):, ». 4, ~ r ' = SIGNED I j 'O� - -- DATE V • +.I :O .. Pr