Permit CITY T I G A R D SITE WORK PERMIT
i4 DEVELOPMENT SERVICES PERMIT # : SIT2005 -00026
f � ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED : 11/10/2005
PARCEL : 2S109DA -11400
SITE ADDRESS: 12994 SW BLACK WALNUT ST ZONING : R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 103 JURISDICTION : TIG
Project Description: 7' cornerstone block retaining wall.
CLASS OF WORK: NEW PAVING ?: N RESO. NO:
TYPE OF USE: SF GRADING ?: Y VALUE: 29,553.00
EXCV VOLUME: 50 cy LANDSCAPING ?: Y
FILL VOLUME: 150 cy SITE PREP ?:
ENG FILL ?: Y STORM DRAINS ?:
SOILS RPT REQD ?: Y IMPERV SURFACE: 8,929 sf
Owner: FEES
DON MORISSETTE COMMUNITIES, LLC Description Date Amount
4230 GALEWOOD ST. STE. 100 [BUPPLN] Pln Rv 11/1/2005 $208.52
LAKE OSWEGO, OR 97035 [BUILD] Prmt Fee - Valu 11/10/2005 $320.80
[TAX] Valu 8% State Surcharg 11/10/2005 $25.66
Phone: 503 - 387 - 7538 Total $554.98
Contractor:
LANDSCAPE OREGON INC
12200 SW MYSLONY RD
TUALATIN, OR 97062
Phone: 503 - 692 -5945
REQUIRED ITEMS AND REPORTS
Reg #: LIC 7804 Engineered soils
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. 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 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 copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: - p Permittee Signature: ,
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.
10/31/2005 15:36 FAX 5035981960 CITY OF TIGARD 0 001
Site Work
BuildAn Permit ' t t 1 •
1`012UfFfCk 1 ti ONLY �� Received � � / PcniuiNo / � -.40.9..„
City of Tigard / /�
.•
13125 SW Hall Blvd., Ti es OR PIat' Review `I J, /or Other P t
Phone: 503.639.4171 Fax; 50 1 �005 -111 ,•'J.. Date uate� / �� rW 18 See nage 2 for
Intern t .: www.ci 503.639.4175
igatd. r.u43 CITY O TI(`GA J / _ SupplemeAtal Infuriation -
[ntemet .tigardnr. ` .
w ti U ILf WG / _ : : .: I by }: *igii.i4 " -,t; : -. ..! • 'ir` i '�.I Q ht },rp t i:}tl'fD ' - ' : tavi Ll+l�s: .
;: :;! :s a i ; c :• ''4 .• ' . ...'' . ... i > a ... • ■i il'I:1 • Permit fees* are based on the value of the work performed.
I'1 New construction ❑ Demolition Indicate the value (rounded to the nearest dollar) of all
lnccment ❑ equipment, materials, labor, overhead, and the profit for the
❑ Addition/alteration/rop Other: � 1: ; ,:: < .s: ; work indicated on this application. _
;a;: ,I ;s! - : 6 ;:` -rj .I N ,16 'dP'-?E ikt bFiti ••.., 0 , i ..':r1...4...,.:.: p
;,:: .', , � . , ;:= •: ;s:r ;' ; °_ . s• "" :' Valuation: S Zq tJ 3 .019 •
❑ 1 - ' and 2 family dwelling ❑ Commercial/industrial , i .
Number of bedrooms: e -
❑ Accessory building ❑ M.ulti- family
Number of bathrooms:
` N(aetelbuilder ❑Other ^;
,,, .`,•.: , , I r - •- v''" -L• '' t 1 s ,•': Total number of floors:
F ,;: f i :r I ' ,, ; t:r y j I b.., `I:, New dwelling area: -. square feet
rob site address: Z'� 5,..7,1917M71-i,71_ "e-4' _
City /Statc/ZIP: . , 1 _ — / tm4 Garage/carport arm: - ' square feet
/.. Covered porch arcs i square feet .
Sttitdbldg /apt no.: Project Dame: �� „ ' e / . : /� // r
��_ Deck area: I' /;� square feet
Cross street/directions to job site: ► i � -
C J � �� /A ,e1) Other structure area- square feet
ii'iii***17IIATA CEO ' 4 dAST ; , '
Subdivision
/r A/06.6- Lot no.: id Pert fees* arc 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 .
;i,li;: : _ - '•s ''i iI 'ip,:;f : LON pF 0 "t r, ' I•c3 #i "' !' ' '
•' c'4 i;: work indicated on this application.
; .tom_ ?ds'r,. ..::::1••.7.: V
Existing building area: square feet
New building area: square feet
. 1 . , -- I :r .
., .,._�: , ., ;1 • „i ;. ' rt :, ;:'gi'; ::; €3: Number or
xy'; ,,II v :��a� �pg I: r a5� o;pr:
Name: 1 0 L 4:3I111 .1 I Lf. Type of construction:
Address: ' 2_30 d _ .1, .a .. 8 sT Occupancy groups:
City/State/ZIP: S :r i 0 0 Existing_
Phon= (56 s) 3; -76Bo fax' ( New:
sa5)) �: 715 NC •
rl: - � r ��� +S : �. JJ17i lr � '.2o- "' :I.- ,.... f.,„,,... . ' �} __ p a l ,: .hr: ...... ...
:� �`-1'ra ? :•`•?: III- , : =t r�; • 3�'ea: ' , E:4 , 1 6 '' , !':' _
Business name: � p - e4 E �! i� Ail conttaetors and subcontractors are required to be
licensed with the Oregon ConsCuction Contractors Board
Contact name: /4 ii I , / i 1 1 ' r— _ under ORS 701 and may be required to be licensed in the
Address: �7 '_ / r/ �/ juris d I diction in which work is being performe the
l !/7 sf� 7 s .' applicant is exempt from licensing, the following reasons
City/State/ZIP: : . Ai / / / / / Ti ,Z p 0 apply:
EM: 1/ / �� Fax:: (i/ ) / 7 70
—
E.mail:Lj6LIl1/l9/Ce _. . L — : =:
� �:•Ii��� _ e 4 :;ai� b . 4 " tacL�1k� ; °i:` ;c�r�: : 1: i • : I: ;�I� -:: :��: ;i��
Business name:
.iy1':i.f :�:: 'j. ; +• - . . _ i� .., . .. .. � .:..
- / h ' _ o , i `, A. : : : '„ i E =. ,BU . 111 N R M[S Y F$E
Address: f • // u __,A4 • Please refer ro fee schedule-
City /State ZYP: ' ' i /l i
/ 7 _ r / / _ Fees due upon application 5.9. Phone: (�)— Fax: (ID ) 6 / Z / j Amount received
CCB lie.: 7 / j Q 0‘ Dote received:
Authorized signature: This permit application expires if a permit is not obtained
. within 180 days attcr it has ben accepted as complete.
Print name: Vr Date: (l i o • Fee methodology set by Tti- County Building Industry
i � 1 . ., � Service Hoard,
i -Perm APP.duc 12/03 N0- 46137(1I102,COM/WBB)
i
• DON MORISSETTE OBE: 3496
HOMES ' INCORPORATED
6 2 3 0 G A L E W O O D S T R E E T LOT: 103
LAKE OSWE GO, OREGON 97095
(503)987 -7598 FAY (509)987 -7815 DATE: 03/31/2005
PROPERTY: SUMMIT -RIDGE
S.W. IBLACK WALNUT Si. CITY: TIGARD
EI NI 1 SCALE. 1"=20
gI PLAN NO': 199
1 ° � O • - - roach OPTION 2 ELEVATION
e ��. _
.•41 . .... , . ... '•.6 b5' LOT COVERAGE
EL ■ 425 I - 1 I
s
�' •.'• 433 E .432' LOT AREA: 8,929 SQ. FT.
I 1-1--- --- et e : . ` 1 — - PILE. BUILDING AREA: 2,234 SQ. FT.
I � -' I_
/
TW 439' / 9 o' PERCENTAGE: 25.0%
N - - - -- -
� •�. •.�. \ 432 LEGEND 1- •431'.`.' :' _: .• :
430' zo' I( O - STREET TREES T.B.D.
I '
1
522 eq. ft. ! 5' -0'
.1141111111 2 car gar.
ME. 431
m!
-1 0 I o ` eu
y Z u a�i v
.'. 5 � f Q >: > > ,
I O
1' ;- ) 3 ,332 e -. t 1 o
1 4 bdrtn. ' , ' a a �° a. a I
'•, _�• ; �; 2 1/2 bath 1 a r ,. >. a a ti
- ya L '.`. PPE. 4315' I ';> 0 5. Q v) u - , _F _> .., . N'--..•N --,
! � 4 z ° a, y o 0
� — 7 >-. Ce )- Z Z i
.-- z, f 423'1 /.1 -7: 1 I 'D 13 17 1
4J 1 r
1 DE 1 ` L L / O O
i I 1 ' I - a L ...-laai
__ . I oon _ O ' 1 � - ``'
i ••• - o. ( �s 1 I! fl fl i il o z 2 s. U - - n 0 -; . kE:14'0....1
_. , i_771 �Jt - 50 > .?V c�7QcnC • •
TW 498'
BW 4m6' \ I. 4 L--- i -- - - - -- •
412 W D N
I U-1
_ c1 - 408 A
0zz
— 1 - 496
u_4z
nl W.E. Z
04
. Z >-
m' .E. 1
• TW 403' 6' PL E.
BW 393' e ' W (7) >
C. TW 493' � I Q W Q
> 9 . .- ,t: 'y.•.:•, c.. ,. . • 15W 398' 1 /; { y � E �
J
E ■99 ,... > • • 6 0.11 . - - .a: <:EL ® ., ; 0 Q
LOT 5 103 -1 w
0� ( ° 8,929 s ft. Z =l >--
CITY OF TIGARD
BUILDING DIVISION„, PERMIT #: SIT2005 -00026
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/2005
Phone: (503) 639 -4171 // u uUlA
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/18/2005 TIME: 7:17AM PAGE: 102
SITE ADDRESS: 12994 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 103 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: 7' cornerstone block retaining wall.
OWNER: DON MORISSEI IE COMMUNITIES, LLC, PHONE #: 503 -387 -7
CONTRACTOR: LANDSCAPE OREGON INC PHONE #: 503 -692 -5945
Inspection Request Scheduled For: Date: 11/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 021777 -02 503-692-5945 N
Corrections /Comments /Instructions:
l
•
*ASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
0 576 Inspector: ' � Date: S Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT2005.00026
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/18/2006 TIME: 7:17AM PAGE: 103
SITE ADDRESS: 12994 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 103 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: 7' cornerstone block retaining wall.
OWNER: DON MORISSEI I E COMMUNITIES, LLC, PHONE #: 503- 387 -7538
CONTRACTOR: LANDSCAPE OREGON INC PHONE #: 503- 692 -5945
Inspection Request Scheduled For: Date: 11/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
495 Mlisc. inspection 021777 -01 503-692-5945 N
Corrections /Comments/ Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1i//13/-o
Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION. - '''' PERMIT #: SI 12005 -0002
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/10/2005
Ph ne! (503) 639 -4171 / �mi v 'n��iV �°
Inspection Requests (24 Hrs.): (503) 639 -4175 1J-
I
...' g
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 164
SITE ADDRESS: 12994 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 103 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: 7' cornerstone block retaining wall.
OWNER: DON MORISSETTE COMMUNITIES, LLC, PHONE #: 503-387.7538
CONTRACTOR: LANDSCAPE OREGON INC PHONE #: 503 - 692 -5945
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
215 Footing drain 021029 -02 503.692 -5945 N
Corrections /Comments/ Instructions:
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t ►A/ Dater �� �' o � Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION.. -- "' PERMIT #: SIT2005 -00026
I 13125 Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/2005
Phone: (503) 639- 4171 @y�h�6��
Inspection Requests (24 Hrs.): (503) 639 -4175 . � __..
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 166
SITE ADDRESS: 12994 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 103 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: T cornerstone block retaining wall.
OWNER: DON MORISSE1TE COMMUNITIES, LLC, PHONE #: 503 -387 -7536 •
CONTRACTOR: LANDSCAPE OREGON INC PHONE #: 503 - 692 -5945
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time: 9:00
Code # Inspection Description Confirm # Contact # . Message
205 Footing - 021021.01 503- 692 -5945 N
Corrections /Comments/ Instructions:
C'.N�ck Pfg_ e �� eaftA.3 ~ � 'r,vspecr9b..) Ptioryer,
N ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: AAA Date: 11— 19--6-c Phone #: (503) 718-