Permit CI TY OF TIGARD BUILDING PERMIT
10 DEVEL OPMENT SERVICES PERMIT #: BUP2001 00392
,..
I DAT ISSUED: 10/25/01
''` —' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 1.0540 SW HALL BLVD PARCEL: 1 S135AA 02800
SUBDIVISION: METZGER ACRE TRACTS ZONING: C -P
BLOCK: r • LOT: 052 JURISDICTION: TIG
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: 0.00 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:
Remarks: Demo existing duplex. All debris to be removed. Sewer to be capped and inspected.
Owner: Contractor:
WALL, GEORGE + PAMELA J GEORGE WALL CONSTRUCTION
11620 SW BULL MT RD 11600 SW BULL MOUNTAIN RD
TIGARD, OR 97224 TIGARD, OR 97224
Phone: Phone: 503 - 670 -7814
Reg #: uc 52392
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Cap Sewer Line lnsp
PRMT CTR 10/25/01 $62.50 27200100000 Final Inspection
5PCT CTR 10/25/01 $5.00 27200100000 •
EROS CTR 10/25/01 $26.00 27200100000 •
ERPC CTR 10/25/01 $8.25 27200100000
(additional fees not listed here)
Total $110.00
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe rm ittee
Signature: „ 9] C c
r
Issued By: ,(t,�.�,C- f,7j1 -el-- ZI6A)
Call 639 -4175 by 7 p.m. for an inspection the next business day
� E 0 q1) (:.- 2— ��
-' " ° Permit Application
"i`I_I 1.- 1__1'_11 1 1,► /
'v= '�iii" City of Tigard • `i Datereceived: /0 g.5/0 1 Permit no.: f, e7 0 03 9
" Pro 1 Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard, 0 ' 223 pp no.: p
Phone: (503) 639 -4171 Date issued: By:4) Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
TYPE OF PERMIT
,4.1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm - 0 Other r _-- - — 3
JOB SITE INFORMATION
>" Job address: � iJ A- G.- ( j3 1-/ Bldg. no.: Suite no.:
Lot: 1 Block: 'Subdivision: 'Tax map /tax lot/account no.:/ ' / 3,5 74A Zd'G,,1,
Project name: / f 530
Description and location of work on premises /special conditions: O
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: ()7L 6_ /—r ¢� /G `j lip Z.—C._ (Floodplain, septic capacity, solar, etc.)
Mailing address: // p� ' 5 c) j`uxe, — „( /.-,Q I & 2 family dwelling:
City: - 7---7,-- (d r> , ,,,...-,p State:0 /x. ZIP: 1�7z. L � f Valuation o w. ... $
I Phone: 47p —2 ,?/ 'Fax: / 24--- CTS - mail: No. of bedrooms/baths .
Owner's representative: f 6._(.<---.— Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) ...
APPLICANT Garage /carport area (s..
Name: . 5- 4 .. . Covered porch are sq. ft.)
j Mailing address: Deck area (s•. .)
City: I State: I ZIP: Other stru re area (sq. ft.)
L Phone: Fax: E -mail: Commercial/industrial /multi- family:
CONTRACTOR Valuation of work $ ,--
J
Existing bldg. area (sq. ft.)
Business name: ,c . i -� �.
Address: New bldg. area (s .�
Number of stories r
City:
Phone: I Fax:
I State: I ZIP: Type of constru�Ction
I E -mail:
CCB no.: - ;'-jQ1 '�� ( /��/ � � Occupancy groups) Existing:
( New:
City /metro lic. no.: Notice: A contractors and subcontractors are required to be -- ARCHITECT /DESIGNER - licensed with the Oregon Construction Contractors Board un. gram
Name: provisions of ORS 701 m required to b- • - -nsed in the
Address: jurisdiction where work is being . ' . go -:. f the applicant is
exempt from licensing, the fol awing reason ..ahes
City: l State: I ZIP:
Contact person: 1 Plan no.: -
Phone: Fax: E -mail: •
Name: Contact person: Fees due upon application ...
Address: Date received: �' --..._
City: 'State: 'ZIP: Amount received ..� ----------„. __ $
Phone: I Fax: I E-mail: lease refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for mom information.
attached checklist. All provisions of laws and ordinances governing this CI Visa ❑ MasterCard
work will be complied wi hether specified herein or not. Credit card number: / /
Expires
,
Authorized signature: ij7 7: Date: - 2- 1 .-7& Name of cardholder as shown on credit card
Print name: g- °Y., -4—/ L4 C- $ •
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has beeifaccepted complete. auto -4513 (5/00/COM)
t i — he -LO-o /J (cQ 47 k)-f 4'A ":41: ` . e9- A 0 l CY t(0,1/0
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COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan review is dependent upon submittal of a completed appli ion and plans.
After plan review approval, the Plans Examiner will contact the/applicant to
request additional plan sets for distribution purposes (for Corptractor, City of
Tigard, Washington County, and Tualatin Valley Fire & Re cue).
TYPE Total1 #of
OF SUBMITTAL. - Plan i s FEY:
"s Submitted:
S = Site Work (must include
' S (New, Add or Alt)\ 4 location of all accessible parking)
B (New, Add or Alt) . 1* / B = Building
F (New, Add or Alt) 3F = Fire Protection System
M (New, Add or Alt) / 2 M = Mechanical
P (New, Add or Alt) 1 2 P = Plumbing
E (New, Add, or Alt) 2 E \Electrical .
New = Ni e Building
Add = Addition
.Alt = Alteration to existing
building
*For over - the- counter commercial tenant improvements, submit 2 sets of plans.
** "New" requires that plans bear the original seal of an Oregon licensed fire
suppression engineer, or NICET level "3" technicians. .
I: \dsts \forms \matrxcom.doc 10/27/00
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e \
>r ` FACE OF NOTES: LOCATION: ..
1 CONTOUR wrPRVALe ARE EVERY FOOT, .
NE 1/4 OF SECTION 35, T. IS., R.1 W., W.M. '
■ 7 30' I 0 L THE VERTICAL DAIWA IS RASED DRWASnWOTON COUNTY 6ENCIW.RI N0. 76 WASHINGTON COUNTY, OREGON
J J NISCH HAS AN flFVATIWN OF Nigro'
GAS LINE LOCATIONS ME BASED ON 46 ,911E PAINT SPOTS AND NORTHWEST NATURAL CLIENT. DATE: NOVEMBER 2, 2000
1 OAS MAPS.
I WATER LINE LOCATIONS ARE BASES'ON TIED WATER VALVES AND HAPS PROVIDED BY DAN - STMONS - SCALE: I ' • 20' .
TLAA1.1TIN VALLEY WATER DISTRICT.' '.NOB NUMBER: • 00 - 2699
L09d LAND SURVEYS. INC.
'P.O. 801 307 OLADSTONS, OA 67027 (603)- 666 -4616