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Permit Y CITY OF TIGARD SITE WORK PERMIT 41 '"4 i DEVELOPMENT SERVICES PERMIT # : SIT2005 -00025 ca II 13125 S W Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED : 11/4/2005 PARCEL : 1S136AB-04200 SITE ADDRESS: 07119 SW LOCUST ST ZONING : R -4.5 SUBDIVISION: PP1991 -029 LOT: 002 JURISDICTION : TIG • Project Description: Retaining wall. CLASS OF WORK: OTR PAVING ?: RESO. NO: TYPE OF USE: SF GRADING ?: VALUE: 1,900.00 EXCV VOLUME: cy LANDSCAPING ?: FILL VOLUME: cy SITE PREP ?: ENG FILL ?: STORM DRAINS ?: SOILS RPT REQD ?: IMPERV SURFACE: sf Owner: FEES RUBEN AHUMADA Description Date Amount 7119 SW LOCUST ST [BUPPLN] Pln Rv -CuYd 10/18/2005 $40.63 TIGARD, OR 97223 [BUILD] Prmt Fee-Valu 11/4/2005 $62.50 [TAX] Valu 8% State Surcharg 11/4/2005 $5.00 Phone: 503 - 245 -3123 Total $108.13 Contractor: OWNER Phone: REQUIRED ITEMS AND REPORTS Reg #: 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 or 1- 800 -332 -2 Issued By: 4GG1AZ / �fe4 Permittee Signature • 1� --4 Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit cans 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. P Site Work Building Permit Apnlid' ON 101t 01 1 ICL JSfONLY E IV . City of Tigard I e - ■ - , OCT I • P e rm it No.: GO�DaU 1 – 13125 SW Hall Blvd., Tigard, OR 97223 C 1 S 1011 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 i `' ' 1 '' -. f Date/B . r/ t/ 0- 3 /-of Other Permit: Inspection Line: 503.639.4175 .044' j, r, '� Date Ready/By: , �� ® 71/ See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method / Supplemental Information BUILDING DIVISION 1 -e. t---e-SSC 0.4. TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling . ❑ Commercial /industrial Valuation: $ 900 ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1 `ie; s u ,, Lo C k s -L New dwelling area: square feet City /State/ZIP: 7,56,3 a, O c 1 1 27.E Garage /carport area: square feet • Suite/bldg. /apt. no.: I Project name: 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: I 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 OF WORK work indicated on this application. RGTAIN114 ce W ALL c' cl et Cti 1 }I Or,vtw,,,V Valuation: $ Existing building area: square feet New building area: square feet 1 PROPERTY OWNER I ❑ TENANT Number of stories: Name: • f yl AANvk.n1cit IAA Type of construction: Address: .' WI CAA- Lac tA4T S7. Occupancy groups: • City / State/ZIP: c ‘Cra o it_ 1112.3 Existing: Phone: (v3 ) 24 S 3) 23 Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board W he ~ 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:( ) I Fax::( ) E -mail: CONTRACTOR Business name: 0 1A1 n e r BUILDING PERMIT FEES* Address: Please refer to fee schedule. City /State/ZIP: Phone: ( ) I Fax: Fees due upon application 41g, 4 3 ( ) Amount received CCB lic.: Date received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: I Date: 10 _ IS –as— • Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permits\SIT- PertnitApp.doc 12/03 440-4613T(11/02/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. xcavation Volume: cu. yds. • • . ding Volume: (Sol report required for >5,000 cu. yds.) cu. yds. Fill VI ume: . (Fill exc- - ding 12" in depth shall be . compacted • 90% of maximum density) cu. yds. • Retaining stru• e? (Check one) ❑ Rock ❑ CMU ❑ Concrete ❑ Other: *Total new impervious are including all . buildings, sidewalks, and pay • .: sq. ft. Site Utilities Plumbing Work: Complete the Plumbing Permit Applicatis • for s' e utilities plumbing work. Plans Required: See "Site Work Permit Ap s :cation - Plan Submittal Requirements" attached. The following must accompany P■ s ape 'cation: ❑ Site Plan with Vicinity Map showint • 'arking (including ADA) and • ADA compliance Lig' • I Plan ❑ Grading Plan and details ❑ *Landsc • g Plan ❑ Erosion Control Plan and de . • s ❑ Soils Report equired) ❑ Retaining Structures *Does not apply to On , 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 i:\Building\Forms\ .SIT - PermitApp.doc 1/13/04 2 • J CITY OF TIGARD 5 BUILDING DIVISION PERMIT #: ?2 OS —=-- O v 0 ZS 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: Phone: (503) 639 -4171 ' ( ' Inspection Requests (24 Hrs.): (503) 639 -4175 1.L. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: l i t C I e Lk_s CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Correctio s /Comments /In ructions: fLd-0 U--j 4— "D - . 9 ..)..--1' . p P' SS 111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \ V ' ( /t Date: 3/ (0/6 Phone #: (503) 718 - k i 2 i CITY OF TIGARD.- BUILDING DIVISION PERMIT 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: - CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: ' - Inspection Request Scheduled For: Date: r : ' Pour Time: Code # Inspection Description Confirm # Contact # Message r•� Corrections /Comments /Instructions: • O IF (A i (y) � I • ' A G AAJa A 3gro --- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #c:5 , 2D» -o W$ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 "II INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / / ( CLASS OF WORK: SUBDIVISION: ( LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #:2 —_3 / a 3 Inspection Request Sc duled For: Date: / /'o 3 – AS Pour Time: Code Ins ction Description Confirm # Contact # Message 0oS a /d 6aa�la - oa. Corrections/Comments/Instructions: / ' _ ° N/ Zis u2 ' Ar �' ►r __ F) NS "e4 all VD D: /SLAVA l kiOi t per 0� on/c____ �4-S Dive' . / ti K �, „, ---,--o-__ • G2)1 -04/ ..,. • A/4/-1.-1___ ue” J d& — c e s D - 1 35S/ .71Eb 77) it 405 -- / 41 vu �a1/ i,e-vte 34.0-1-te ce---#71LeCee____ . PASS ❑ PARTI APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ C' L FO' N i'41111 ❑ ADITIO AL FEE ASSESSED r 4,10 D 23 6 Inspector: Date: v hone #: (503) 7112 2.--, . - L ,. CITY OFTIGARD BUILDING DIVISION PERMIT #: SIT2005 -00025 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/4/2005 Phone: (503) 639 -4171 n Inspection Requests (24 Hrs.): (503) 639 -4175 . °_ INSPECTION WORKSHEET FOR DATE: 11/22/2005 TIME: 7:02AM PAGE: 102 SITE ADDRESS: 07119 SW LOCUST ST CLASS OF WORK: SUBDIVISION: PP1991 - 029 LOT #: 002 TYPE OF USE: PROJECT NAME: AHUMADA DESCRIPTION: : aimn• w. OWNER: AHUMADA, RUBEN PHONE #: 503 245 - 3123 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 215 Footing drain 022136-01 503 -245 -3123 N Corrections /Comments /Instructions: r - / O — /AI-- / r/1/4/ .10Il • ❑ PA El PARTIAL APPROVAL 111 CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: Date: // 25---c ne #: (503) 718- CITY OTIGARD BUILDING DIVISION PERMIT #: SIT2005 -00025 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/4/2005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 _ INSPECTION WORKSHEET FOR DATE: 11/22/2005 TIME: 7:02AM PAGE: 103 SITE ADDRESS: 07119 SW LOCUST ST CLASS OF WORK: SUBDIVISION: PP1991 -029 LOT #: 002 TYPE OF USE: PROJECT NAME: AHUMADA DESCRIPTION: "' r OWNER: AHUMADA, RUBEN PHONE #: 503 - 245 -3123 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 11/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 495 Misc. inspection 022133-01 503 -245 -3123 N Corrections /Comments /Instructions: �� 0 l..�• / C. • C!(-'J - . 5c i — i.✓ff 1 n A !ate Ari0 G i A4 205 — /o 7 i < c.v/4-1-t-7 • ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: // 2 k Phone #: (503) 718-