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Permit r CITY OF TIGARD SITE WORK PERMIT I DEVELOPMENT SERVICES PERMIT # : SIT2002 -00029 ` !I - =' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 1/6/03 SITE ADDRESS: 10832 SW KABLE ST PARCEL : 2S110DA 04200 SUBDIVISION: ERICKSON HEIGHTS ZONING : R -3.5 BLOCK: LOT: 003 JURISDICTION : TIG CLASS OF WORK: OTR PAVING ?: RESO. NO: TYPE OF USE: SF GRADING ?: VALUE: 8,240.00 EXCV VOLUME: cy LANDSCAPING ?: FILL VOLUME: 240 cy SITE PREP ?: ENG FILL ?: STORM DRAINS ?: SOILS RPT READ ?: IMPERV SURFACE: sf Remarks: Rock retaining walls rear of property with 240 cu yds or more of fill supporting a swimming pool. Owner: FEES JAMES S HE RMAN 10832 SW KABLE ST Description Date Amount TIGARD, OR 97224 [BUILD] Prmt Fee - Valu 1/6/03 $129.70 [BUPPLN] Pln Ck - Valu 1/6/03 $84.31 Phone: [TAX] 8% St Tax -Valu 1/6/03 $10.38 Total $224.39 Contractor: RENAISSANCE CUSTOM HOMES 1672 WILLAMETTE FALLS DR WEST LINN, OR 97068 Phone: 557 -8000 Reg #: LIC 130449 Required Inspections Excavation Insp Grading Insp Engineered grading final reprt 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. y� Issued By: Permittee Signature: '1O1/ ( 34- Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day ' Site Work , • A . .Buildin Permit Application Date received: (O. o _g D Z Permit no. fr.2 •0'©6a "' 1' 1'(' City of Tigard "`--' ' Projecdappl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd. Tigard, OR 97223 Phone: (503) 639 -4171 Date issued11:90 Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: 1 &2 family: Simple Complex: TYPE`OF.'PERMIT - ❑ I & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ New construction ❑ Demolition Cl Addition /alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm Other: RCS - =—( L.Ls . } . j . ; -`1 , ry_, 1JOB SITE INFORMATION ' . 1 - Job address: /0 3� 5 /a p1- 5-0----- Bldg. no.: Suite no.: Lot: 3_ I Block: Subdivision: y!{l0 ay) J Tax map /tax lot/account no.: Project name: Description and location of work on premi e /spec conditions: K ditions: P oC Wks( R 2 of' oerp..- �.��r c 7 -r Air /':, l.: fi�r -;-'.:•:,, . F . •. FOR SPECIALINFORMATION, `USE CHECKLIST 4 Name: , • ' i A iM6 -i✓`'1 (Floodplain, septic capacity, solar, etc.) Mailing address: , O7 3 a `ate ‘.- - I & 2 family dwelling: //, City: 4,0_, V I State: ZIP: y 7 ! • t Valuation of work r � $ 7 Phone: S !Fax: I E -mail: }� / V Owner's representative: Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) _ . APPLICANT - Garage /carport area (sq. ft.) Name: Covered porch area (sq. ft.) Mailing address: Deck area (sq. ft.) City: I State: I ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial/industrial /multi - family: - ii CONTRACTOR .. Valuation of work $ Business name: a Existing bldg. area (sq. ft.) M 4z !"— • CU M 171/7146-5 New bldg. area (sq. ft.) Address: /672 W 7 �s i_ S A2_ Number of stories City,: (iJ — )//V State: I ZIP: cr70 s—�7 O I mss / I Type of construction Phone: Fax 60 Email: 3y�1� Occupancy group(s): Existi CCB no.: -- New: City /metro lic. no.: Notice: All contractors and subcontractors are required to be ___- R __ ' PAM..CT/DE3IGNER :; licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: I State: I ZIP: exempt from licensing, the following reason applies: Contact person: I j Plan no.: Phone: Fax: E -mail: ENGINEER . . Name: egatsopi Gce tfej . Contact person: 137VA" / (QTY Fees due upon application $ Address: Aaeox z3 $/9 // Date received: City: 776, Statezk ZIP: ?7 j Amount received $ Phone: 6'y 3460 Fax:67c ,Vii-7 E -mail: . Please refer to fee schedule. i I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws . d ordinances governing this ❑ Visa ❑ MasterCard work will be complied with, w tether s , fi - - in or not. Credit card number: I / Expires Authorized signature: �// NA /CLo/ 2--- Name of cardholder as shown on credit card Print name: ' 7 ). V _ ,i)( I / Cardholder signature $ Amount Notice: This permit application expires if a permit is not obtained within 180 da after it has been accepted as complete. 440 - 4613 (6ro0 /COM) i 1D,"t1 .1931 0 SITE WORK PERMIT CHECK LIST Commercial, Multi- Family (R -1 occupancy) and Residential: Please complete all items below, unless otherwise noted. Excavation Volume: cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) 0 + cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) cu. yds. Retaining structure? (Check one) ock ❑ CMU ❑ Concrete ❑ Other *Total new impervious area including all buildings, sq. ft. sidewalks, and paving: a w Lam.. aa.. ,. Site Utilities Plumbing Work: Complete the "TAN" Plumbing Permit Application for site utilities plumbing work. ^Q ; °-�•...,< -- - :`e.r; -�� ., ,,, �.. , , .ax:.a�,,,� -- -, ;�. >; .,.� _ ..,,_. - ^.:,m�:t :Maar.,s „'s�. Plans T quired See `Site W ork Perm tt Appliccation Pla n Submi Requirements, `att achehe following must a ccompany th application: Site Plan with Vicinit Map sho 01911014 FADA ompliance i l ,a Lighting Plan i ” *Landsca in Plan' Grading �Plan andfdetails; � �� , p �g _ � _ � A a Erosio Control Plan and details SoilsiReport (if required) r .Retaining Structures .' Ite7,0 w a h. .. ;: *Does not apply to 1 and 2- family dwellings. .,3 # of�Plans � TYPE OF SUBMITTAL , Require Includes New Additions or Alterations) ; � l n tnA 'at,* :.. :Q Submitt V , Commercial 4 Multi - Family R -1 Occupancy 4 One- & Two - Family Dwelling 4 NOTE: Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). i:\dsts \forms\sitecheckiist.doc 09/24/01 CITY OF TIGARD 5/23/2006 Mk 13125 SW Hall Blvd. 1:47:48PM Activity Listing Tigard, OR 97223 503- 639 -4171 Case #: SIT2002 -00029 Primary Name: SHERMAN Project Name: SHERMAN Site Address: 10832 SW KABLE ST w cNxn. >mr, s � ATE DO k ,. I� v h10a • 740:11.*: , , . , • r.�,3 es endin " Orde'r a� r y 799 Final Inspection 8/29/2003 PASS AMS Final acceptance letters from GeoPacific Engineering, Inc., dated 8/22/03, received 8/25/03 (addressing walls) and 8/29/03 (addressing fill.) 800 Case Finaled 8/29/2003 DONE AMS 018 Revised Plans Received 6/6/2003 DONE DEB GeoTech report 092 (F) Issue permit 1/6/2003 DONE BB 021 Plans Approved/Routed to PT 12/31/2002 DONE HAP 070 (F) Ready to issue 12/31/2002 DONE DEB 032 Post - review completed 12/31/2002 DONE DEB 008 Permit Created 11/5/2002 DONE JMT 012 Plans Routed to Plans Examiner 11/5/2002 DONE JMT 005 Application received 10/28/2002 DONE DEB received by deb, entered by jeanne 702 Excavation Insp See Notes under Final Inspection, 8/29/03. 720 Grading Insp See Notes under Final Inspection, 8/29/03. 775 Engineered grading final reprt See Notes under Final Inspection, 8/29/03. • CaseActivityShortForm.rpt Page 1 of 1 Al f\I V\ V - oV v, • 1 -• • • 0 • • :•. •• R V6 ki `j co CID i drit z. • 5 � JI % $4,•,, \ • • • • ul t IA P ••••• W i i 4' • ?o •50 1 . O 1% l soo�ti I' JSO o o CI? -a it) ti . r� 1 o °� ' s • °O.:: 10 I 1111. of C \-.) � n S ?1 1 1' � ,� O ff/ •� 6 1 IV la d / ,o, . ,v ^ 1-7, -.<. o � J n. 1 O NJ se U y Q 1N W 0 a CI D D fTi jm _ z P �� W / Z 0 0 0 r n n 0 m 0 = C _-I M Cm z0 r• n -r L p � r� 0 ° ° CD r -f 0 o 0 c"") FIL COPY 0 11 CD - rn , 3. U r 1 V orn cn n_ co o - � /\ - --------- 9 co cn co 5 . 0 N 0 Immazszlzi ti CITY OF TIGARD w D Approved (i;‘‹ m (D ` � Conditionally Approved , ( r o,o D For only the work as described in: o ; D �+ (n.1 PERMIT NO. -i, •r�-o o�Sa q (n See Letter to: Follow �-7;�� 3 ( ). `o o r — Attac . ..� 9 `K J Job Ad s: 0 ' 7 0 D 0 By: Date: M - 31 —0