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Permit £ CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00290 41, DEVELOPMENT SERVICES DATE ISSUED: 6/22/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12780 SW BULL MOUNTAIN RD PARCEL: 2S109AD -01500 SUBDIVISION: ZONING: R -7 BLOCK: LOT: JURISDICTION: URB 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: R3 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: $ 2,000.00 Remarks: Demo 3334 sf. dwelling. Septic tank to be pumped and filled or removed and inspected. All debris to be removed. NO EDU CREDIT TO APPLY. Owner: Contractor: WEST HILLS DEVELOPMENT COMPANY K & G CONSTRUCTION 15500 SW JAY ST 922 W MAIN ST. BEAVERTON, OR 97006 HILLSBORO, OR 97123 Phone: Phone: 503 - 681 -2370 Reg #: LIC 28711 FEES REQUIRED INSPECTIONS Description Date Amount Ersn Cntrl 681 -4444 [UTAX] 8% State Surchu 6/22/2004 $5.00 Pump /Fill Septic Tank Insp [UBUILD] Permit Fee 6/22/2004 $62.50 Final Inspection Total $67.50 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001- 0010_thr-ou.gh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling 3) 246- 6699'or 1- 800 -332 -2 44. Issue By: r P 1, , i , Permitte I t Signature: j( 4/ ' 4�' /L Call 7f Call 639 -4175 by 7 p.m. for an inspection the next business day 110.40 D ' Z 672 7 t Buildi g'Mrmlt Application FOR OFFICE USE ONLY of t � ! , City Ol Tigard Date/By: !/ / Jy . Permit No.:: 1900 4 ..._ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review / Phone: 503.639.4171 Fax: 503.598.1960 4$ �0�4 I Date/By: Other Permit: Inspection Line: 503.639.4175 i Al l Date Ready /By: /u is � El See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: U ' WJ Supplemental Information e °. ..:a �_. ,�� � a � �� «,:,.,;x� tea° � a ... ,�,, I NN tTYPE"O WORIC^� ° ' REQUIRED,D:AT 1' AND 2- FAMILV D WEL 16 - _..'�u.a.�r ��'. n.--.. _�.-.:,..4 a __. � -n�.v ..._'- ae .iB�'� .. ��., -� .a. r,k..:4W' r ��4 , N <„ >selifY1/°�'k^' i -- ❑ 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 OFD CORU NSTCT N .40-1,i,,;,- i' , 3 v 1 si , work indicated on this application. Valuation: $ Z 36,, lo( DO /> ❑ 1- and 2- family dwelling ❑ Commercial /industrial lVu ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: 4 #' : ' . JOB SITE' IFORA NMT1ON��'AND LOCATION t i - ;. Total number of floors: Job site address: 0 -1 n j � (k2- � ) \ / -k T d New dwelling area: square feet City /State /ZIP: 1 \' ( 6 t 0 Garage /carport area: square feet Suite/bldg. /apt. no.: J Project name: c ) C S O k \:" 'I Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet :4111 REDIDATA : C AECKLiST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 0 () q A `J 1 l s O / \ Indicate equipment, the value alou labor, to the nearest , an d the profit of all � � �4 A ` J � l / � �� equip materials, labor, overhead, and the profit for the i � DESCRIPTION OF ,WORK � - -� work indicated on this application. �?A:. - «.� „ ( _ fi . .,- _ re4. ,� >.,T.., . 1 Wag #! De c� O\ l V' U Vv Y C Y• - S A- y c S N\ g e Valuation: $ V-CSI �\ \ \\ (\ \� k\ il j Existing building area: square feet N ew building area: square feet q -�� � nga s u i 7-1( PROPERTY OW $ors ° z; , a , 77 ® TENANT g'1 Number of stories: f ., ,_,e � 1- ,. s, ,- a:,,,; ; - = � - _ 1� v at is , ... ..,. 6 ,�(_ =..„ 6 , a . Name: U e \- l-\\'\\ Le Ue 1 me ''\—' Type of construction: Address: 15 �W SW \ ,\� " \ Occupancy groups: City /State /ZIP: ` X UC''C k O a lOo e Existing: Phone: ( 5O3) ( e L( I - 1 l `t 7 t Fax: (( ) 6 C'( (- 7( ) New: r� I AP PLICAN T ' - CONT ACT PERSON ; :s ,:;, g ° :f z . :. . i l .. i ` e'er � e �� , , C,IFI.N4 g, M - - -: ,', - ,,,, ...._. r _> . ' Z.-- _*,. 3 ,-; . 4 NOTICE ` € t . t . Business name: L. 0 C 'es ` c\ G c nu? All contractors and subcontractors are required to be )ra ` licensed with the Oregon Construction Contractors Board Contact name: e �� 7 under ORS 701 and may be required to be licensed in the Address: .0___0() W `aci \\ Q < • jurisdiction in which work is being performed. If the City /State /ZIP: 1---\ \-, c- ( r) VL q 7 (2 U ap is exempt from licensing, the following reasons r\ c� 5- C QQ )- `�l r Z L F ax:: ( x ) `/ " C8 / L 1 I� ' . C a I Phone: (50� 2)� C ). c yl J E -mail: ; f - �, . Mme° .., f ° a- °t F ir : - 4 � - . # .'� ,.. ,: . ,€ CO ,. ..., � . '_., : , U, .. , . . 3 ,. € Business name: y., s E ( r c\ c l) Ck\ C) i -�. . , 6 1 � , �� °�BUILDIN,�sPERMIT�FEES t � ; s�7 i � Address: q 22_ W J ` e� � ` 1 r 2- Please refer to fee schedule. City /State /ZIP: ` n co O l UL _ / 1 7() �J G Fees due upon application Phone: ( SO ' N \ ' ,)� ( (� Fax: ( ) t / PS [ �7 I -•� -•� Qom Amount received CCB lie.: �L l ' —62v/ Date received: Authorized signature: �` This perm if a permit is not obtained within 180 it days application after it expires has been accepted as complete. Print name: , d -,t?JC .Z Date: e i ei,e . "Ott * Fee methodology set by Tri- County Building Industry i °r Service Board. 1: \ Building \Permits \BUP- PermitApp doc 12/03 440.46! 3T( I 1 /02 /COM /WEB) _ / I iN / / + � \ I \ O __ _ • I x ' 24 a NI ,— { i 5 ✓� 10 I .k- 18 / / O . .. a / / � \ \ \ J. --* I il \ / J 1 INCH a ao Fr. $ x . , \ / r. ,� 23 \ .. 11 ' x17 ' O HALF SCALE a 0 i �. o . c �J.I W \ ' 19 \ > W O La x 6 9 \ \ \ �. ,"ARLINGTON J ' or, \\\'\'''... ''' :..C� J Z Q � i - / \ -i �'����`l.'t \ .: \ �� _ :x � / \ :` .. ! HEIGHTS N0 . 2'' Nx° I r 5 - I ` A R L I N G T 0 N HEIGHTS d ' 1 \ CO a o I � .� / \ \ 49 s ...�� '. 22 \ CY I1 1 o i a \ \' \ 1 t r + I I x % \ - \ t 20 �.I 'i ' . 734 .24 \ _ – d SO e _ 1 _ \ \ �x ` g °' 0 * . � D No x a a• 4B V) 04 ~o 0 �, c v� CC a- J Z N 21 /, /' m x ? x. �. 00 / /// Q x 1- 3 O . co F d' 2- / 1 ' \\\\ x _ XSDXSD 4- J / g x.. CP n CITY OF TIGARD JJ '. o - Approved [ 1 ' n' •nditi onally Approved (- 1 1 F.yr only the w�k &scribed i F .` PERMIT NO. a Z TING BUILDING See Letter t0: Follow o 1 • v ' EXISTING HOUSE I • t_ ,J � O /' • 1 3,334 S.F. Job Ad • • �LXY ur x► �. py _ pate �/ NINN\ ' X ... '' EXISTING SEPTIC TANK AND WATER WE'LL a _ � 30 r � TO BE ABANDONED PER OREGON STATE m T r . HEAL IN DEPT. REGULATIONS AND REQUIREMENTS -. f r X H 1V X v I � FUTURE '�. E XISTING BUILDING / ~�1 ._'. ` 1 ") x 70 BE REMOVED __ n S U M M I T R I D C� E rn ' o.. X< Z .0 q c .I 11:' I1 L L `y vi 8 ° 7 1 1 a w � m � : PROPOSED g c c $ s 3 O t• - SW GREENFIELD _ _ n s %.. a "sap DRIVE 11_. —Dx 4 sp d 8 0 ::.��.� .. O T - ■ T J SyV GREEN'IEI -- - - - - – -- -- – – -- -- -- v •°�% I 712.37 \ ��1 x .. NO2 00'00 E • \ 0 O. DRIVE � ' N."...t. I J � a �� p + I I \ I I �l� @RlQ�iJ� 1 , E 0 / LEGEND n�. v) - 1 / ' o\ . EX. TELEPHONE LINE E E r I / 17 1 1' - 1% / /.. EX. BUILDING -- K - - - - - -- EX. FENCE — T — T X ELEC METER 18 / I ' \ I / y, COM —COM — EX. TV/PHONE LINE —G —G — EX G AS LINE O EX TELEPHONE MANHOLE EX. UTILITY POLE T Y p � v VI - N / � '� - E X . Q OF RO W Da EX. GAS V ALV E ® EX. TELEPHONE PEDESTAL -) EX. GUY WIRE O1 . . / °� 11.\i ►� , •---- - - 5Ta - EX. MAJOR CONTOUR © E X. GAS METER XW —XW— EX. WATER UNE O EX. GUY POLE " WOOD FORD x.. "' EX MINOR CONTOUR O EX MAILBOX EX HYDRANT EX SIGN -a . - , EX. CURB EX. PROPERTY/ROW LINE A EX WATER VALVE �'[ EX STREET LIGHT .IOB N .: d E S T A T E S " ' "" EX. EASEMENT — XSO — XSD — EX. STORM UNE ❑W EX. WATER METER - - - -' - EX FLOWUNE SHEET NO. I V ' F. I / - EX. EDGE ASHPALT 'D` EX. STORM MANHOLE —XSS —XSS— EX. SANITARY LINE // 19 % I E —E EX. ELEC LINE • •. EX. CATCH BASIN EX. SANITARY MANHOLE „ 1 .I I ...I, I XCON CITY OF TIGARD 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Busi ss Line: (503) 639 -4171 MST BUP -20 Received Date Requested ( ( (obik---- AM PM BUP Location (2- 60 (),) OLD --- IAA TSuite MEC Contact Person Ph ( ) PLM Contrac or 6S Ph ( ) SWR UILDI Tenant/Owner ELC I- noting Foundation ELC Access: Ftg Drain ELR Crawl Drain . Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear c [/ Framing Tet Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm -� Susp'd Ceiling • Roof hobo _ PART FAIL ING :,'� r . Post & Beam Under Slab Rough -In Water Service - - Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain • Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 111 Please call or rein - ection RE: N Una nspect — no access Fire Supply Line � I` ADA Approach/Sidewalk Date L Insp ®ctor. / 0111 r�► t Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST .,ii IBC 1j- -cei ;wi Received '71 6 e Date quested //--- / AM PM BUP Location /` v 6''e /A . EA • Suite MEC Contact Person 44 Ph ( ) PLM Contractor Ph ( z9b3 ) g/' - I 0 SWR (UILDIB Tenant/Owner ELC Footing ELC Foundation Access: �! Ftg Drain '`• LR Crawl Drain Slab Inspe ion Notes: f SI Post & Beam �et Y?° /�Vda74" s 1 -<' ' Shear Anchors 111 "' Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire , • ler ..� ire All Susp'd Ceiling Roof 7 Other: in I PASS PART FAIL V oia, PLUMBING Post & Beam Under Slab Rough-In� Water Service Sanitary Sewer ' , Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service • Rough -In UG /Slab Low Voltage Fire Alarm Anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA Approach /Siaewalk E' Bffielpector Fat Other: Final - - DI r ®T • E VE this ansp vedIDED AMC <' ° vci two s the job site. PASS P: FAIL Nov 15 '04 04:12p K &G CONST 5036812385 p.1 pt, (1 ( 0 922 W. Main Street _ Hillsboro, Oregon 97123 Phone: 503 -681 -2370 CCB tl 28711 Mh'I RO l,L 1155 Fax: 503-681-2389 FAX TRANSMITTAL To: Dan Nelson, City Inspector November 15, 2004 City of Tigard -- Building Department 'FOP 2-0 ( % 4 °C) FAX Number: 503- 624 -3681 We are sending you a total of 2 pages, which include this cover sheet. Comments: Mr. Nelson: We, K &G Construction Co., are the General Contractors for the site work improvements at the Arbor Summit subdivision located near the intersection of SW Bull Mountain Road and SW Greenfield Drive. On November 4, 2004 we hired Aloha Sanitary Service to pump an existing septic tank that we encountered on the job site at 12780 SW Bull Mountain Road. Please refer to the attached invoice no. 9124 from Aloha Sanitary Service. Subsequently, we removed and properly disposed of the empty septic tank. Please call me if you have any questions. Thank you, Tom Curtis K & G Construction Co. Nov 15 04 04:12p K &G CONST 50368 p.2 ' . ALOHA S AN RVIC� :1,. INVOICE NO. • t 8600 SW Hillsboro Hwy., Hillsboro, OR 97123 9 503-644-2797 • 503 -648 -6254 • 503 -639 -5188 _ 124 + NAME: K C C --, U1,1; ` U �.`I Q ∎1 - /- ! (0 OC¢ ADDRESS: - pump -rxv K ("-) CITY: STATE: `` �� -_ SIP: HOME: WORK: CELL: 0 Q- 6 K r JOB SITE: 1.t „i l l Y'''',7 I. ; VA ; A / P.O. #: _ k.- PAID BY CHARG CHECK ❑ _ -`- CASH ❑ .. ._. • • - -- — � C _ CREDIT CARD ❑ DATE //_ 0 Li - J0() L 1 DRIVER 0 ) %wk vpu AMOUNT ❑' PUMP SEPTIC TANK 2`r} LI LINE O PENING - c � - ❑ INSPECTION FEE C:1 SERVICE CALL ❑ LABOR, LOCATING, DIGGING, BACKFILL ` ❑ MATERIAL l V - - THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT - - TOTAL $ 2 U - '' REMARKS — TYPE OF TANK: STEEL ❑ CONCRETE PLASTIC ❑ HOMEMADE ❑ HORIZONTAL ❑ VERTICAL ❑ RECTANGLE ❑ ❑ OTHER SIZE OF TANK: 350 CI 500 ❑ 750 ❑ 1000 ❑ 1250 ❑ 1500 LI 2000 LI 3000 ❑ LID LOCATION: INLET ❑ OUTLET MIDDLE ❑ ENTIRE TOP LI TANK CONDITION: GOOD ❑ FAI POOR ❑ FITTINGS• BAFFLES LI ❑ CAST IRON ” _._�__._� ___.._. -.- . ....._., — .._. ..._..... -. _ ...-.. ❑ PLASTIC 0 ` NEEDS NEW LID? YES SIZE GROUND COVER OVER TANK COMMENTS ON CONDITION OF DRAINFIELD ETC. / SIGNED BY /`. DATE / L f - V /r _ •