Permit CITY TIGARD SITE WORK PERMIT
DEVELOPMENT SERVICES PERMIT # : SIT2004 -00030
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 11/29/2004
SITE ADDRESS: 11860 SW GREENBURG RD PARCEL : 1S135DD-04401
SUBDIVISION: ZONING : C -P
BLOCK: LOT: JURISDICTION : TIG
CLASS OF WORK: ADD PAVING ?: RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 8,250.00
EXCV VOLUME: cy LANDSCAPING ?:
•
FILL VOLUME: cy SITE PREP ?:
ENG FILL ?: STORM DRAINS ?:
SOILS RPT REQD ?: IMPERV SURFACE: sf
Remarks: Replace existing retaining wall with new wall and fence.
Owner:
FEES
FRAHLER, WILLIAM M TRUSTEE
14990 SW 137TH PL Description Date Amount
TIGARD, OR 97224 [BUILD] Prmt Fee -Valu 11/29/2004 $129.70
[BUPPLN] Pln Ck -Valu 11/29/2004 $84.31
[TAX] Valu 8% State Stu 11/29/2004 $10.38
Phone:
Contractor: Total $224.39
FRAHLER ELECTRIC CO.
11860 SW GREENBURG RD
TIGARD, OR 97223
•
Phone: 639 -4627
Reg #: LIC 00037410
Required Inspections
Final Inspection
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. /2 �
Issued By: "5-e1.2.7.44.
Permittee Signature: l
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
\ r .
Site Work
t
Building Permit Ap 1' v,S FOR OFFICE USE ONLY
City of Tigard (��� Received permit No.: !� L
13125 SW Hall Blvd., Tigard OR 97223 ( �,00 ` P1 vi
v�r ��
Phone: 503.639.4171 Fax: 503.598.1960 01 - J I. !t,taf.,l V i•',1`, Date/By. Other Permit: Inspection Line: 503.639.4175 c,,.-, (�GP _ i! , . . . ' f 1 ReadyBy El See Page 2 for
Internet: www.ertigard.or.us • 0 1 \i O V Notified/Method: / 9- � - y Supplemental Information \ gka- S, /9 k-eJ - 'c, 1 c,1c,- \
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING N
❑ 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 El Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2 -family dwelling El Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms: 1
El Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: //86 SLJ CT0G6-,,ris �ilvcT ,eJ n^ New dwelling area: square feet
City /State /ZIP: // 6,424 v/` 9 7 2.2 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: t4//, - 6 k [C 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.
Tax map /parcel no.: • Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
. DESCRIPTION. OF WORK work indicated on this application.
/26644C-41,447- - )4 7/iii � C � Af / Valuation: $ 825%)
C � Id / G v C / , a y�A im/ 9 U ICJ AC -e Existing building area: square feet
v New building area: square feet
0 PROPERTY' OWNER .. . ' ❑ TENANT Number of stories:
Name: /A// rgl -Lf� Type of construction:
Address: / 4--5'45 St,/ 7 ? 7 `71 "ark". Occupancy groups:
City /State /ZIP: Z7 i O q 72 Z ¢' Existing:
Phone: (5t.); ) 5 o .. 7609 Fax: ( New:
❑ APPLICANT . ' . - , ►'! CONTACT PERSON NOTICE `
Business name: All contractors and subcontractors are required to be
Contact name�> C r l lr -�f licensed with the Oregon Construction Contractors Board
i 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 following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR :
Business name: zej,Yjc_ BUILDING PERMIT FEES*
Address: //866 Ea (�r/� , 2 Please refer to fee schedule.
City /State /ZIP: 77 `7O Coe_ 97 2 Z3
Fees due upon application
Phone: ( D ) 6g9 _ 4,2_7 Fax: ( )
CCB lic.: 37 4/J Amount received
Date received:
Authorized signature: /t� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: // ciowio 6.� Date: // /2. 3/0 * Fee methodology set by Tri- County Building Industry
Service Board.
is \Building\Permits \SIT- PermitApp.doc 12/03 440-4613T( I I /02/COM/WEB)
City of Tigard: Site Work Permit Checklist
Page 2 - 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
S 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 ap lication:
CI 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.
• # of Plans
TYPE OF SUBMITTAL Required at
(Includes New, Additions or Alterations) Submittal
Commercial 2
Multi - Family R -1 Occupancy 2
One- & Two - Family Dwelling 2
1:\Building\Forms\SIT- PermitApp.doc 1/13/04 2
CITY CIF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION Business Line: (503) 639 -4171 MST
BUP
Received Date Res ested / / J 3 6 AM PM BUP
Location A - a o Suite MEC
Contact Person Ph ( ) G. 3 T �oL PLM •
Contractor Ph�( ) SWR
9-
BUILDING Tenant/Owner - e---A ) ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT old y O� 6
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation Aip ______
Drywall Nailing �
Firewall jra 76tJ'5
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final 44 J
PASS PART FAIL AWlPLUMBING
Post & Beam
Enrati ®ro
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 J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call •*r reinsp: tion RE: - ❑ Unable to inspect - no access
Fire Supply Line , � J, - r • ADA Date �� Inspect° / Ext
Approach/Sidewalk
•
i./' DO N • T REMOVE this inspection record from the job site.
PASS PART FAIL