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Permit .71 CITY OF TIGARD SITE WORK PERMIT COMMUNITY DEVELOPMENT Permit #: SIT2010 -00018 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/28/2010 'TIGARD 9 Parcel: 2S103DC01100 Jurisdiction: Tigard Site address: 11075 SW GAARDE ST A Subdivision: Lot: 0 Project: GRACE POINT COMMUNITY CHURCH Project Description: Remove and replace concrete block stairs with poured concrete stairs. Owner: FEES FIRST BAPTIST CHURCH OF Description Date Amount TIGARD, THE, 11075 SW GAARDE Permit Fee - Site Work 09/21/2010 $166.76 TIGARD, OR 97223 Plan Review 09/21/2010 $108.39 PHONE: 12% State Surcharge - Building 09/28/2010 $20.01 Contractor: SIDEWALK SOLUTIONS 26045 SW GRAHAMS FERRY RD SHERWOOD, OR 97140 PHONE: 503 - 218 -4172 FAX: 503 - 685 -9647 Type of Use: COM Class of Work: ALT Site Specifics: Excavation Volume: cu. yd. Fill Volume: cu. yd. Impervious Surface: sq. ft. Engineered Fill: Soil Report Required: Paving: Grading: Landscaping: Site Prep: Stom Drains: Retaining Wall: Fire Underground: Accessible Parking: No Fence: Total $295.16 Required Items and Reports (Conditions) 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 95 - ; ; ; rough OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to • C by calling 503.246.6• • • • .t_i Issued By: / Permittee Signature: C\ d "• L�t/� /� 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 Applicatioq O : _l. __ 1 k ;:4i;; Site Work WV9 FOR 01 I SI: °NI.) City of Tigard CVJ Received , DateB : eM j �� I • 13125 SW Hall Blvd., Tigard, OR 9722.3y•- 't(j\ Plan Review • ': • Phone: 503.639.4171 Fax: 503.598.1960 O L Date/B : � W wain�� Other Permit: r i c . n It i Inspection Line: 503.639 : - b. R� 1` Date Ready/By: 0 See Page 2 for Internet: www.tigard or.gov ' S 1 Q Notified/Method: v 4 1, 7 BM Supplemental Information f l 0 \AG- yd c-// ' TYPE OF WO R>�lL REQUIRED DATA: I- 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 Ix 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 la Commercial /industrial ) Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: �` JOB SITE INFORMATION AND LOCATION Total number of floors: Q Job site address: ' 1b7 Jam" ti ( __ ) ; C aary "'"1"--, New dwelling area: square feet City/State /ZIP: "T v A etc) c 677ZZ4 Garage /carport area: square feet ..Suite/bldg. /apt. no.: Project name: ,U x„. Po 1WT L , ( L y . Covered porch area: square feet Cross street/directions to job site: I i d, 4I+ 4 tJletLO. ez,.. Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 1 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 application. v , �' �M �r� '4 2- IP �tigs,L C 7!- tr -. ht 4 C., K.- Valuation: $ L c.c.4.� Sty, i'r$ ► -a. raJ 4'tarZ_ el)t,JC_i+-t. #� , Existing building area: square feet 5 - - u . ` „ S , New building area: square feet E' PROPERTY OWNER l ❑ TENANT Number of stories: Name: G (, C-G fia, i i-> `f C'.0 -v►v /h c.) t..P 04 `1 t^ 4 - 4 J el P _ Type of construction: ' Address: 1 ((07 5 ; , J . G .C1. A e_ © ,-'r.. Occupancy groups: City /State /ZIP: -Tu. exylot C�� '?7 2 -24 Existing: Phone: ( ) _ g Fax: (�j�) � ?4 r �� r New: ❑ APPLICANT I$ CONTACT PERSON NOTICE Business name: _.3 ' C (`!S OK_ All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: / 1 3 5 7 ' 4I. 4=1U ptit , jurisdiction in which work is being performed. If the City /State /ZIP: - ? �/..� Qe T '7 2 Z4 applicant is exempt from licensing, the following reasons apply: ' Phone: 643 ) 3 (Y - 73 43 I Fax:: ( ) iii E -mail: Jf: 0.g, 0 3- 0 . f_c. )7 r x ' 6 , /1'1 �vJ CONTRACTOR Business name: S e L.- 't&c-.k+C__ V - k!ct)S BUILDING PERMIT FEES* Address: 26045 S. et) G vANAItS Ft "i GPI • (P/earereertojeeschudtle� Structural plan review fee (or deposit): I 0 K 3Ci City/State /ZIP: S24 y.t de_. c:?' "7 t C ) Phone: (.. ) 2 ( Fl - L{ 1 7 z_ Fax: (5(j3) 6, K5 ! to 4 .7 FLS plan review fee (if applicable): CCB lic.: / fc 33 4 3 7 .q/ Total fees due upon application: a. / Amount received: Authorized signat� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ISR./'CN ITIpLL„ q•■10 (Z■I►... Date: 0 A IS j1.0 (d . Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\SIT- PermitApp.doc 10 /01/09 440- 4613T(11/02 /COM/WEB) 4?-7 j , 15'