Permit n , m OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00599
COMMUNITY DEVELOPMENT DATE ISSUED: 11/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 109AC -02100
SITE ADDRESS: 14850 SW 132ND TERR \\ ZONING: R -7
SUBDIVISION: ALBERTA RIDER ELEM. SCHOOL\ LOT: JURISDICTION: TIG
PROJECT: ALBERTA RIDER
Project Description: Erosion Only Permit
v
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: E2 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:
TIGARD/TUALATIN SCHOOL DIST. INTEGRATED HOME SYSTEMS
14850 SW 132ND TERR. 15765 SW 74TH AVE. #100A
TIGARD, OR 97224
Phone: .
Contact #: PRI 503 - 820 -1651
Reg #: LIC 174010
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcha 11/19/2007 $6.40 Ersn Cntrl 681-4444
[ERPRMT] Erosion Con 11/19/2007 $80.00
[ERPLN] Erosn Pln Rv C 11/19/2007 $26.00
[EROSN] Erosn Pln Rv ( 11/19/2007 $26.00
Total $138.40
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: ' .
41L.- Permittee Signature: / ' y----_.
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.
1
Building Permit,A pplication
Site Work IV IEOR OFFICE U ONLY '
III 0 City of Tigard Receive + Permit No.: p Cat - `J g p� 7 Date /B : Iij� ! dt #0
13125 SW Hall Blvd. T OR 9 7223 V 1 200
a Plan Review
Phone: 503.639.4171 Fax: 503.59011 0 ® I Date/By: Other Permit:
• Inspection Line: 503.639.4175 r '� Date Ready/By: Juris: ® See Page 2 for
T I (i,9CkD alit Nt DIVISION Notifi ed/Method: Supplemental Information
• -� - Internet: www.tigard- or.gov PP
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.
dwelling Valuation: $
❑ I- and 2-family g ❑Commercial /industrial •
111 Accessory building ❑ Multi - family Number of bedrooms:
111 Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ) 4 SW I, �Ce New dwelling area: square feet
City /State /ZIP: T re O(2_ ��a L Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: R be.r i x 1200x- Covered porch area: square feet
Cross street/directions to job site: 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.
fax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overh ad, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Ev c r Ac 1 , - and. p -re _ P `� Valuation: $ A.-
\^ a v-0 E _ � . Existing building area: square feet
ggc. S / O w 0---ko L oQ Ly New building area: square feet
❑ PROPERTY OWNER r t Cr TENANT Number of stories:
Name: 7--1 q �Y
,‘ — � . L (\ S O \ O 1 -lS ■CV Type of construction:
Address: ! i. f'85O f ) 1&9 n/D 1..eviv Occupancy groups:
City/State /ZIP: kp Existing:
Phone: (5 Fax: ( ) New:
❑ APPLICANT" _ D CONTACT PERSON` NOTICE
Business name: 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: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the flowing reasons 0
apply-. ,[lh 0
Phone: ( ) Fax:: ( ) � ( �•
�,eos PMT Q[J � 1
E -mail: do r J ,
CONTRACTOR PLO 2� Jr CW S 00
Business name: t �--Ve rc AeA �I, s s - - s LI C BUILDING PERMIT EE S*
Address: 1. (oS� S ' -14\-kA { k i \ D A . (Please re ( (or d ee schedule)
j Structural plan review fee (or deposit):
City /State /ZIP: --- j\wck 0 Q1 - 1ZZ `i
Phone: ( 3 ) 5c7_,-0 " ` ' . 11, 1 Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: 1.--7 q 0 I 0 1--.7, j ,0Q Total fees due upon application:
/ Amount received: / 3 g, ! v
Authorized signature:
This permit application expires if a permit is not obtained
Print name: \ ,f �6v () Date:' i 1I * within 180 days after it has been accepted as complete.
I I Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building \Permits \SIT- PermitApp.doc 12/27/06 440- 4613T(II /02 /COM/WEB)
•
City of Tigard: Site Work Permit Checklist
Page - Supplemental Information
Commercial, Multi - Family and One- and Two - Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below, unless otherwise noted.
Excavation Volume: cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be
compacted to 90% of maximum density) cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all
buildings, sidewalks, and paving: sq. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements"
attached. The following must accompany this application:
❑ Site Plan with Vicinity Map showing ❑ *Parking (including ADA) and
ADA compliance Lighting Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report (if required)
❑ Retaining Structures
*Does not apply to One- and Two - family dwellings.
W of Plans
' TYPE OF SUBMITTAL' Required at
(Includes New, Additions of Alterations) . Submittal,
Commercial 2
Multi- Family R -1 Occupancy 2
One- & Two - Family Dwelling 2
l: \Building \Permits \SIT- PcrmitApp.doc 12/27/06 2