Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00633
'1 ^�I DEVELOPMENT iBr SERVICES - 639 -4171 DATE ISSUED: 1/6/2006
PARCEL: 2S 109AC -00200
SITE ADDRESS: 13350 SW BULL MOUNTAIN RD ZONING: R -7
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Demo 1152 sq. ft. residential dwelling, on septic. DEMO CREDITS APPLY FOR SDC FEES.
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:
CASA TERRA LLC NORTHWEST EARTHMOVERS INC
9600 SW OAK ST., STE 230 PO BOX 1467
TIGARD', OR 97223 TUALATIN, OR 97062
Phone: 503 - 452 -8003 Contact #: PRI 503 - 624 - 0363
FEES Reg #: LIC 62761
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/12/200f $62.50
[TAX] 8% State Surchari 12/12/200E $5.00
[ERPRMT] Erosion Con1 12/12/200f. $26.00
[ERPLN] Erosn Pln Rv ( 12/12/200E $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: J /j St Nominee 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.
Bu Permit App,tieation F c FOR OFFICE USE ONLY
City of Tigard DateB y D • PermitNolh`1�j�0'0a3
Tigard, g
13125 SW Hall Blvd., Ti d OR 972 / �
Phone: 503.639.4171 Fax: 503.598.1 l C L005 � t� I (
Date/By: Permit y: P l an Review � kn�
inspection Line: 503.639.4175 - � eT1 Date Ready /By: hvis' 0 See Attached Checklist for
Internet: www.ci. tigard.or. us l Y Flu p t Notified/Method: j 1(r Supplemental Information
tr C)� lv >,
1 1Th I ,.:,r ' I
� r = , TYPE, O F W O R K'?: ° R EQUIRCD ; DATrC: l r�ND F ±IILY,IWELLING'4
❑ 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
s` -: € :� : wor indicated on this application.
C OF,CONST;RUGTION : "'.; ; = : '
Valuation: $
E I- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building El Multi-family Number of bedrooms: 3
❑ Master builder ['Other:
Number of bathrooms: 2
Total number of floors: 1
�'�; ,;���,;, ,JOB�°SIT�' ::INFORIVIATIQN AND,,.LOCATION z,� _
Job site address: 13350 SW Bull Mountain Rd New dwelling area: square feet
City /State /ZIP: Tigard OR Garage /carport area: 780 square feet
Suite/bldg. /apt. no.: Project name: Wilson Ridge Covered porch area: square feet
Cross street/directions to job site: SW Bull Mountain Rd and SW 133' d Deck area: 240 square feet
Other structure area: 1152 square feet
tae;;.¢'- ¢I1. - c <,; > s•,,, .�;
REQUIRED=DATA COMMERCIAL- USE i M
Subdivision: Lot no.: 200 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S109AC, R0955185 indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
M> DESCRIPTION:OF'VVURK,- - .;. work indicated on this application.
.,a'�?�?�,., _ ^ ,., ' ;2x ,' eat `3a,san:._a �;;;.. ,. n✓ - � r; ^ ✓(. a� -e:. a„ . � ^ "�,,,; :, .. � "r.•,�''x' ^�ii,
Demolition of the existing single family residence on septic system and garage Valuation: $
Existing building area: square feet
New building area: square feet
i'ROPFRT�Y OWNER, -` Via` ; ®''1 EIVANT ,. Number of stories:
Name: Casa Terra, LLC Type of construction:
Address: 9600 SW Oak St, Ste. 230 Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: (503)452 -8003 Fax: (503)452 -8043 New:
Business name: Alpha Community Development, INC All contractors and subcontractors arc required to be
Contact name: Al Jeck licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 9600 SW Oak St, Ste. 230 jurisdiction in which work is being performed. If the
City /State /ZiP: Tigard, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 452 -8003 Fax: : (503) 452 -8043
E -mail amj @alphacommuntiy.com
;, CON1 °RACTOR
Business name: on bid ^ Id'L .a �'" _ q4, ,r ° °i°�'�f.-, ,. •,�.
Address:
tl `� 4 �C -wv6 �v ` �:��13UI - IDiNG �PER11iITr:P)✓ES* r �;���'� °'
. � •��'.�a�_l,
Please refer to fee schedule.
City /State /ZIP: a
Fees clue upon application jJQ y
Phone: ( ) Fax: (
CCB lie.: /„a? /�/ Amount received
w Date received:
Authorized signature: \ \ This m expires a permit is not obtained
1 within per 180 it days application after it has been if accepted as complete.
Print name: Jerry M. Palmer Date: t14 (oc * Fee methodology set by Tn - County Building Industry
Service Board.
i\ Building \Pei snits \BUP- PerntitApp dec 12/03 440- 4613T( I l /02 /COM /WEB)
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L I \ I PROJECT NO.: - 3211-coT
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I I I SCALE TYFIC.: CONSTRUCTION
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II.V2n54 \ 222-027 \d••0`,C:Vgl.VEMP \ 320)270W° PERAlt :NAB. ST - EAR rkAg 15 2005 - 10110A5 gm'
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UILDING DIVISION • PERMIT #: BtiP2006-0063
• '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/612006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 A.Ath i
. —frolill*
,,- -.
INSPECTION WORKSHEET FOR DATE: 1/2612006 TIME: 7:03AM PAGE: 64
SITE ADDRESS: 13360 SW BULL. MOUNTAIN RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WiLSON RIDGE SUBDIVISION
DESCRIPTION: Demo 1152 sq. ft. residential dwelling, on septic. DEMO CREDITS APPLY FOR SDC FEES.
OWNER: CASA TERRA LLC, PHONE #: 603-462-8003
CONTRACTOR: NORTHWEST EARTHIvIOVERS INC PHONE #:
Inspection Request Scheduled For: Date: 1/2€V2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
296 Misc. inspection 02673401 603-849-8640 N
Corrections/Comments/Instructions:
11 i
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PARTIAL APPROVAL El CANCEL fl NO ACCESS
I I FAIL ----- --E] CALL FOR IN ,pECTION fl ADDIf1ONAL F ES ASSESSED
1111 ,
Inspector: ( Ill Date: [ : . 'fra
' Phone #: (503) 718-
\../
A LOA SANITARY SERVICE INVOICE NO.
8600 SW Hillsboro Hwy., Hillsboro, OR 97123 10 37 9
503 -644 -2797 * 503 - 648 -6254 * 503 - 639 -5188
NAME: /1/ ///' k -- ;1,C 7-161 /Z -1
ADDRESS:
Cln: STATE: ZIP:
HOME: WORK: CELL: ? 1- Q -SS
JOB SITE: 1 27 - c G' 1 III 1 Al/ /1 / i c=7(2,12- •. P.O. #: 7 1
PAID BY CHARGE , 67 CHECK ❑ CASH ❑ CREDIT CARD ❑
DATE / - Z q - 0 DRIVER ^ ://- 744.4 'Iiou,/ AMOUNT
PUMP SEPTIC TANK / l ' l : _ \ r {.`) t r 2 , S2' - ' _ . Li SJ
❑ INSPECTION FEE
❑ SERVICE CALL
• ❑ LABOR, LOCATING, DIGGING, BACKFILL
1
I TOTAL $ L A --j
- - THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT -
- - REMARKS - -
TYPE OF TANK: STEEL ❑ CONCRETE ❑ PLASTIC ❑ HOMEMADE ❑
HORIZONTAL ❑ VERTICAL ❑ RECTANGLE ❑ ❑ OTHER
SIZE OF TANK: 350 ❑ 500 ❑ 750 ❑ 1000 ❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑
LID LOCATION: INLET ❑ O UTLET ❑ MIDDLE ❑ ENTIRE TOP ❑
TANK CONDITION: GOOD ❑ FAIR ❑ POOR ❑
FITTINGS: BAFFLES ❑ CONCRETE ❑ CAST IRON ❑ PLASTIC ❑
NEEDS NEW LID? YES Q SIZE
GROUND COVER OVER TANK
COMMENTS ON CONDITION OF DRAINFIELD ETC.
J 0 b -9 / SO Q l ?' 10 :i s''. W cf /i r ' f 71
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SIGNED BY q,:------ir6�/ DATE // Z Li T I