Permit CITY OF TIGARD BUILDING PERMIT
' COMMUNITY DEVELOPMENT Permit #: BUP2011 -00199
Date Issued: 09/22/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 2S109ACO2100
Jurisdiction: Tigard
Site address: 13030 SW BULL MOUNTAIN RD
Project: Tigard - Tualatin School District Subdivision: Lot:
Project Description: Demo 800 sq ft residential dwelling on sewer. UPON FINAL INSPECTION, DEMO CREDITS FOR SDC FEES
MAY APPLY.
Contractor: LAUZON CONTRACTING LLC Owner: TIGARD - TUALATIN SCHOOL DIST 23J
13577 SE WILLINGHAM CT ATTN. BUSINESS MANAGER
CLACKAMAS, OR 97015 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503 - 482 - 5445 PHONE:
FAX: 503 - 482 -5446
FEES
Specifics: Description Date Amount
Type of Use: SF Permit Fee - Additions, Alterations, 09/22/2011 $377.90
Class of Work: DEM Demolition
Dwelling Units: 0 12% State Surcharge - Building 09/22/2011 $45.35
Stories: 0 Height: 0 ft Info Process /Archiving - Sm Sheet (up to 09/22/2011 $1.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $19,750 Erosion Control 09/22/2011 $26.00
Erosion Plan Review CWS 09/22/2011 $8.45
Erosion Plan Review COT 09/22/2011 $8.45
Floor Areas: DC Provision Review, SF - Ping 09/22/2011 $65 00
DC Provision Review, SF - LRP 09/22/2011 $10 00
Total Area: 0
Accessory Struct 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $542.15
Required: Required Items and Reports (Conditions)
1 Ersn Cntrl 681 -4444
Fire Sprinkler. Parapet.
Fire Alarm: Protected Corridors
Smoke Detectors: Manual Pull Stations:
Accessible Parking 0
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
952 - 001 -0010 through OAR 952- 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1 800 332 2344.
Issued By: Permittee Signature:
.�� _ /'_�_ ✓ice_ ii
b .639.4175 by 7:00 a.m. for the next available inspection date. '
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 Application
Commercial "Aa <,, FOR 01-1'It 1: :I.;SEON1.5
Recanted
II q Tigard �, ` �, F % p Dale OTT" y: �
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13125 SW Hall Blvd., Tigard, OR 97223= ;:' `\, Plan Review
II Phone 503.718.2439 Fax: 503.59,8 ?T9fi0" '-, : /iCt Other Permit.
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T! r, - D, Inspection Line: 503.639.4175 V� �, c �('; `c....1 ;= Q z ' / /� / ol /} � km: - Supplemental Information
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CI New construction !a Demolition �'� Indicate to the value a ba sed o the value of the work performed.
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fees* are based on the
(rounded to the nearest dollar) of all
❑ Addition /alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
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:A - and 2 dwelling 0 Commercial/industrial
'Valuation: $ q ' -- 1C) .b0
0 Accessory . Number of bedrooms: 1
■ Master builder Number of bathrooms:
u. I o r. Total number of floors: 1
If iff ir () R_ct New dwelling area: square feet
Garage /carport area: square feet
Suite/bldg. /apt. no.: ~ Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: 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
” mr ",r,rr" n in „ : equipment, materials, labor, overhead, and the profit for the
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Valuation: $
Existing building arca: square feet
New building area: square feet
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Address: 4 0 , i . Occupancy groups:
Existing:
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Business name: 1 1.....„ (N. � � �. ��� 1 �,�r p review fee (or deposit):
Contact name: `� Or D , s t
Address: , ? 5 FLS plan review fee (if applicable):
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City /State/ZIP: kl c1i�..rn - • be,_ C)-1(31 Total fees due upon application:
ILA Fax:: ( nn� Amount received:
Phone: (
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` �.� � $ a., 5,445 � c� 1, L I j�, Y � � W/� : �{ ' {�� .,, r 1; Ill, i 1' , 1 w t " g},
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)i' i',' Ib :, Hoof -top mounted Photo Voltaic Solar Panel System.
�,��� , ki/J Submit two (2) sets of roof plan with connection details
Business name:
and fire department access, along with the 2010 Oregon
Address: \- - -y 5 1 o, k 1 to h G-k--- Solar Installation Specialty Code checklist.
q�o1 Permit fee (includes plan review
City/State /L1P: , � e - a and administrative fees): $184,00
Phone: ( 5t,1 Fax: ( ? t-1 State surcharge (12% of permit fee): $21.60
CCB lie.: ` _ cJ _ (1 - _ �”
$20]_60
T o t al fee due upon application:
Authorized signature: ' ■ I ' This permit application expires if a permit is not obtained
— .--, within 180 days after it has been accepted as complete.
Print name: �� i( 0 i `!":k/ Date; q/62/2Q r/ * Tee methodology set by Tri- County Building Industry
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1:1Building\Pcrmits\BUP -COM PcmtitApp,doc 02/ 24/2011 440- 4613T(11 /02 /COM/WEB)
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" Building Division
Development Code Provision Review
T[GA>zD Residential Projects
Building Permit No: .eLilerst v 1I - t) 640* 1 9 9
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A E
Routed Plans:
Original Plan Submittal Date: f 164/ Oj
1st Revision Submittal Date: ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked ( ✓) items are approved. Items not approved and those listed m the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review (contact \ e at 503- 718-� or @ tigard- or.gov)
Land Use Case No. / Name
❑ Zoning .
❑ Setbacks:
Front Rear Side Street Side Garage
❑ Maximum Building Height Actual Building Height
❑ Visual Clearance
❑ Easements
❑ Sensitive Lands Type:
Notes:
Original Plan: Approved ®,. Not Approved ❑ Date: - .. 1 4J —l/
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard- or.gov)
.EKActual Slope: 7
Notes:
Original Plan: Approved Not Approved ❑ Date: R 1
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
. (Review Continues on Page 2)
• Page 1 of 2
City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
EP Street Trees
❑ Protected Trees
Notes: ���� o.- (et-00J oi• 'vu ti flu<) c..1
Original Plan: Approved Not Approved ❑ Date: /(9-q!
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @ @ard- or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes KO No ❑
Date Routed to Building:
•
Page 2 of 2
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