Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00090
�yek DEVELOPMENT SERVICES DATE ISSUED: 2/17/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S134DB-03700
SITE ADDRESS: 11030 SW NORTH DAKOTA ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Demo 1,800 sq. ft. residential dwelling, on sewer. UPON FINAL, DEMO CREDITS FOR SEWER, TIF
& PARKS APPLY.
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 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:
Owner: Contractor:
VENTURE PROPERTIES N E I
4230 SW GALEWOOD ST #100 16850 SW UPPER BOONES FERRY RD
LAKE OSWEGO, OR 97035 #A
TIGARD, OR 97224
Phone: 503 - 387 -7600 Contact #: PRI 503 - 624 -0363
FAX 503 - 639 -1634
FEES Reg #: LIC 62761
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/17/2006 $62.50
[TAX] 8% State Surcharl 2/17/2006 $5.00
[ERPRMT] Erosion Conn 2/17/2006 $26.00
[ERPLN] Erosn Pin Rv C 2/17/2006 $8.45
(additional fees not listed here)
• Total $110.40
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503 -246 -6 9 o 1-800- 332 -2344.
Issued By: Permittee Signature: __X--
Call 503 - 639-4175 by 7:00 a.m. for an inspection that business day.
This permit card 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.
` r �IVED
� >,
Building Permit A o � �� � 1.0k ()I r i c I. I.sr_ 0.1.,
City of Tigard D Received n 1 m
PeitN..: j '
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13125 SW Hall Blvd., Tigard, OR 97223 FEB 10 2006 Plan Review Other Pew:
Phone: 503.639.4171 Fax 503.598.1960 ' hp } i Date/By:
Inspection Lane: 503.639.4175 �] OF TIG A ' Date Ready/By: 7 J 113 See Attached Cheeldbt for
Internet: www.ci.tigard.or.us CITY Notified/Method: ) / Supplemental Information
BUILDING DIVISION
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.
Valuation: $
® 1- and 2 -family dwelling ❑ Commercial/industrial
❑ 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: 11030 SW North Dakota New dwelling area: square feet
City/State/ZIP: Tigard, OR Garage/carport area: square feet
Suite/bldgJapt. no.: I Project name: Dakota Glen Covered porch area: square feet
Cross street/directions to job site: 100 feet west of 109 on south side of North Dakota Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: n/a I Lot no.: Permit fees' are based on the value of the work performed.
Tax map/ parcel no.: Tax lot 3400 Indicate the value (rounded to the nearest dollar) of all
�P l equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Demolition of existing house Ao Valuation: $
(, 0 6 Existing building area: square feet
d New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Venture Properties Type of construction:
Address: 4230 SW Galewood Ste 100 Occupancy groups:
City/State/ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7600 Fax: (503)387 -7617 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Venture Properties All contractors and subcontractors are required to be
Contact name: Jim Delmore licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4230 SW Galewood Ste 100 jurisdiction in which work is being performed. If the
City/State/ZIP: Lake Oswego, OR 97035 applicant is exempt from licensing, the following reasons
Ry �+ apply:
Phone: (503) 387 -7600 I Fax:: (503) 387 -7617
E-mail: jdelmore@donmorissettehomes.com
CONTRACTOR
Business name: NEI
BUILDING PERMIT FEES'
Address: 16850 SW Upper Boones Ferry Rd Ste A
Please refer to fee schedule
City /State/ZIP: Tigard, OR 97224
Fees due upon application
Phone: (503) 624-0363 I Fax: (503) 639 -1634
Amount received
CCB lic.: 62761 -
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: Jim re Date: C j / Cab a‘ I ' Fee methodology set by Tri- County Building Industry
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OFFICE COPY
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CITY OF TIGARD
BUILDING DIVISION PERMIT #:81.4,10.2_00 C, 005C
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: H 0 30 /V St" CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: 50 (031 U4
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 1_f — --C) (=) Pour Time:
Code # Inspection Description Confirm # Contact # Message
(irn) NOVOCC1-ie"'
Corrections/Comments/Instructions:
We V
•
/PASS PARTIAL APPROVAL E CANCEL 111 NO ACCESS
E FAIL • CALL FOR INSPECTION ADDITIO AL F ES ASSESSED
Inspector: MW I Date: 0 6 Phone #: (503) 718- 2A-: