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Permit
• 0` CITY TIGARD SITE WORK PERMIT DEVELOPMENT SERVICES PERMIT # : SIT2003 -00012 fl 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 5/1/03 SITE ADDRESS: 13646 SW LEAH TERR PARCEL : 2S1096A 08100 SUBDIVISION: DAFFODIL HILL ZONING : R - BLOCK: LOT: 007 JURISDICTION : TIG CLASS OF WORK: OTR PAVING ?: RESO. NO: TYPE OF USE: SF GRADING ?: VALUE: '0780 EXCV VOLUME: cy LANDSCAPING ?: a Soo FILL VOLUME: cy SITE PREP ?: ENG FILL ?: STORM DRAINS ?: SOILS RPT READ ?: IMPERV SURFACE: sf Remarks: Owner: FEES HEIGHTS CONSTRUCTION 1 Description Date Amount PO BOX 91249 [BUILD] Prmt Fee -Valu 5/1/03 $72.10 PORTLAND, OR 97291 [BUPPLN] Pln Ck-Valu 5/1/03 $46.87 Phone: 503 - 291 - 2550 [TAX] 8% St Tax -Valu 5/1/03 $5.77 Contractor: Total $124.74 • HEIGHTS CONSTRUCTION LLC PO BOX 91249 PORTLAND, OR 97291 Phone: 503 - 291 -2550 • Reg #: LIC 133745 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. Issued -By: - - ,�Q _ = �� Permittee Signature: , jj A� Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Site Work . . FOR OFFICE USE ONLY Building grmit Application Received Building Date/By:.� / -03 1318 Permit No.:Z I,'raUO 3 o 7f m... City f Tigard Planning Approval Other y g r , Date/By: Permit No.: 13125 SW Hall Blvd. R EC d P © Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: � (� �\ Post - Review Land Use Phone: 503-639-4171 Fax: 503 - 598 196 a '' �I Date /By: Case No. ww Internet: w.ci.tigard.or.us ��i uy�y, - -;Ij Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639- 41E51TY OF TIGARD Name/Method: Supplemental Information BUILDING DIVISION ;' ..... �.'!s, T,Y,PV OF , s .w 7:''.11., . _ # ' REQUIRED DAT ,,M New construction ❑ Demolition ' _# '' & 2'F�A DWELLING Addition/alteration/replacement ❑ Other: e the total value of work performed. Indicate ._,.,. __ `R r Note: Permit fees* are based on th pe ;�.� �.? y ° " . ; ;.� �, CATEGORY'OF CONST,RLJCT�QIV .': � - ��3:,::���;e,. jAri .. & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ❑ Accessory Building ❑ Multi- Family a v ❑ Master Builder ❑ Other: Valuation $ a5bo_ r, „ J,OBfSTTE°INFORMATI®N,and LOano n No of bedrooms: No of baths: — - Job site address: / C, S. tr,,)r 1 m a Total number of floors � New dwelling area (sq. ft.) Suite #: 1 Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: .F# I.)t, .4' e Covered porch area (sq. ft.) Cross street/Directions to job site.: Deck area (sq. ft.) ' Other structure area (sq. ft ) L i�iC/iCt e �'' NL ice`' i REQUIRED DATA , �� //yy , 11 0 COMMERCIAL USECHECKL�:IST� 2)149 cgoi(., ' / ,. , s . , .x ,_ , ,.s , � F . Ate. , "„g�. . . b Subdivision: Lot #: 7 Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate n_ 1 ;„ :�_- �: •::ma=r' „N the value (rounded to the nearest dollar) of all equipment, materials, labor, , ; , 'srESCRIPTIQOFWORK,: ` ., r . ;. .,,a,., work indicated this application. -- �`' overhead and profit for the woe in ieate on is applica ion. Valuation $ Existing building area (sq. ft.) New building area (sq. ft.) Number of stories iall OPERT i"r= �° UWSM ail T,E o n' *f ` 3 � . Type of construction Name: m/ , ` jdZ(/ ") Occupancy group(s): New: Address: ,%9 d , ,e ,, 9/2 , City /State /Zip: 0R. 9 7.7j • Phon ,,// �.. F : �; ac? „� NOTICE: All contractors and subcontractors are required to be �F i licensed with the Oregon Construction Contractors Board under :, I APP4LIo.� ._g.: x''P � r :s. �' NT..,`Cl4PER$ON v provisions of ORS 701 and may be required to be licensed in the Business Name: nfe ittf��i jurisdiction where work is being performed. If the applicant is exempt Contact Name: 4 7 - / � /� i✓ from licensing, the following reason applies: Address: A, . J P4, e . 9 /2y, City /State /Zip: . ,e7-.i dee 9729/ • r B .P�ER1 S ,.- E-mail: p as erLo ee schedule. ' A & z #s `= N..� F '�` � '° , *` r ,�°� _ _ �, 5 4ra.�.1 .IC , ;--, 4..n� :=�k�A=Z-�Fik''' ' ''F4-411''''14;i114 Business Name: #' 6,, Fees due upon application $ Address R O, 4 o x � / se y'P $ City /State /Zip: Awl- en r 7eq f Amount received Pho :5b71 s) / -A55b Fa : So pl1I G9/7 Date received: CCBc. #: J 3 3 "'7 < — Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 da after it has been acceptedtas complete. 3 RD- Ai. "4.1"/ *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 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.) 60 et at, 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 ❑ Concrete ❑ Other *Total new impervious area including all buildings; sidewalks, and paving Site Utilities Plumbing Work: . Complete the Plumbing Permit Application for`site'`utilities'plurhbi'r g work`: �";,s���,�'; -, �,_ ° s PlansrRequir�ed j " Site�W k Permit Appl cation Plan •Sub ifttttal: .attached ; The following must accompany this applioatron t � Site Plan w c m Ma parking (in I dl g ADA) Vitt - `tip . jADAxcompli }Grading Plan a d detailal- , ,iii *ands aping Plank , � A fi 7 Erosion (Control Planrand details igf Soils Report, (if required =)' ''$' h E Retaining Structures t .. - ``,.' ` M r ` v f *Does not apply to 1 and 2- family dwellings. a s' TY PE OF S U B M I T T A L S 'Vrii4 Require! t ( New Adiditions or Alt ) , Su bmi t ta l Commercial 4, • Multi - Family R -1 Occupancy 4 One- & Two - Family Dwelling 4 NOTE: Plan review is dependent upon submittal of a completed application.and plans. After plan review approval, the Plans Examiner contact the applicarit request additional sets'of plans for distribution purpo (for, Contractor, City of;Tigarrd,: Washington County, and Tualatin Valley Fire & Rescue): {, a is \dsts \forms \SIT- checklist.doc 01/29/03 o - - 48 , - LOT � i ,. ao .. � L.:�- . . 17_ _ FE _ r i�� . ,, ,. ! Tow - 8:55.00 FENCE i -' - - - - - .� °� � C�N$TR� I , . ' , ,,, AV . •• e es g l 1 ." ,, „43.1' TRANCE p ...,.\ N v r~ I .. �\ F.F. ..:00 1 4 3 1 1 857.70 SIGNA D T R E ES TO . 4 . F.F. 674.00 F.F. .74.00 FF. 6 00 F.F. 67 • Co STRUC ON Q I 'KING BE REMOVE F 0 • 1 tt L 0 co !`:1.•■ [ = Ow- 855. _ - I • � �' r �TO 659.00 00 �� 1 1 0 I 17 I �. 1 F.F. FF. 6 •.00 (/) I I ‘ ,.. 3. F. 6 .00 7 _ \ � 1 � • F 15 I F.F. 674.00 00 F.F. x 874.00 4 9 I I � V cSIZC 1 , l. , • 4/ N � I BO 57.90 .--C-..., i , TOW- :1.50 -- - - 1 F.F. 668. • • � ► • ' t- i BOW-B'� 70 0 O 07 - 0 71 ra D - ��� i I 1 . OW- 270 ZB a.l - B� 6% P! p o I - 4, I ?� F.F. 888 00 F.F 670.00 • T , -- D C C7 --1 = p F.F. 673.00 sy a < F.F. 674.00 i? Q ro 5 T F. 67ar r F.F. 573.00 3 4' 5 o �� a I 49. ^� :. 7.00 �O 887.': �70.C�TO 9.00 �.-- iayy7�/ � e . . • I i hA r�'��r•o.��w �� BO W- 6SS.�70 n �(�7 f a r •871.00 , • =f C l l.. �. war �.s�• •1 � ni ® e� - 66300 -_ -. TOW-568.00 It.. _ A .� .. � _ � . _�..._.f� ".�. .� TOW - 659:0 �7 c 0 _ � = - te a- " '�- 880 a •W- 658 00 W- 660.00 ®TOW- 884.00 TOW- 663.50 - - 1 "160.00w t• �lOW- 668.00 !Ow- 886...E - - ^ I C II O T Ow- 886.001AE'1E�' 1 ...1 \ Bo57.00 - C R . 147 7 �2) ... tiro ` w - 6 T -86,x - - S.W. BULL MOUNTAIN ROAD CITY OF TIGARD 24 -Hour BUILDING Inspection Line: 9 -4175 INSPECTION DIVISION Business Line: 4 -r -4171 MST BUP Received Date Requested AM PM BUP Location 3 (o 4 -e l -e_ _-'L Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: - 3` 00 0 12.— Post & Beam Shear Anchors • �—„ Z ` -.o Ext Sheath/Shear Int Sheath/Shear Framing i Insulation (.� Drywall Nailing Fi rewall Fire Sprinkler . Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam • Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole • Storm Drain 7 k^ 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PAS PART FAIL t°SITE ❑ Please call for reinspection RE: Unable to inspect – no access Fire Supply Line ADA 1 / 4 -( Approach /Sidewalk Date , y � Inspector Ext Oth - Ina, / DO NOT REMOVE this Inspection record from the job site. PART FAIL a CITY OFIGARD 24 -Hour BUILDING Inspection Line: ° 39 -4175 J — MST 3 ' ads INSPECTION DIVISION Business Line. .,, . , ' , e• - BUP Received Date Re ested I — f3 AM <' PM BUP Location /3 4 (P - 7-(A/I Suite MEC Contact Person 4.1.4 Ph ( ) -241-1'794 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain 00D 7 2— Slab Inspection Notes: I �� �,_v �A "' SIT 3- Post & Beam � Shear Anchors 1 Ext Sheath /Shear hit Sheath /Shear a-,0 � - 1 /1 ' / q (f ,(L _ t SS Framing `"1 ✓`� Insulation v Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Vv 1, tN, -� g 1! .A.& k S q C 7 C> 414P-Ap PART FAIL 1 l d 11 BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole i Storm Drain Shower Pan Other: i ce ` PART FAIL / ,, ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL , t Service Rough -In UG /Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: Unable to inspect - no access -- - - Fire Supply Line / ADA ,/ 1 c-KO �i C/ � _ cJ Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL