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Permit
CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2001 -00376 j yl DEVELOPMENT SERVICES DATE ISSUED: 11/8/01 ` "" 13125.SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14050 SW RIDGEFIELD LN PARCEL: 2S109AA 05900 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7 BLOCK: LOT: 037 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: RETWL : sf N: S: E: W: OCCUPANCY GRP: R3 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: $ 11,500.00 Remarks: Construction of a joint -use driveway with retaining wall serving lots 37 and 38. GeoPacific shall perform a special inspection for the installation of the designed segmental wall Owner: Contractor: ELK HORN RIDGE ESTATES, LLC FLOWLINE EXCAVATION P.O. BOX 60051 12685 NW NEWELL PL SEATTLE, WA 98160 FOREST GROVE, OR 97116 Phone: 503 - 294 -2150 Phone: 503 - 992 -7473 Reg #: LIC 87649 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Footing Insp PLCK CTR 10/11/01 $103.03 27200100000 Rain Drain Insp Misc. Inspection PRMT CTR 11/8/01 $158.50 27200100000 Final Inspection 5PCT CTR 11/8/01 $12.68 27200100000 CDCB CTR 11/8/01 $20.00 27200100000 (additional fees not listed here) Total $337.11 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. Pemiittee / Signature:/ _ems. i____d _ 01 i 4 Ire/ _A A I Issued By: x i /il4 - / /%L .(!�,l.li2J / ' Call 639 -4175 by 7 p.m. for an inspection the next business day . Q___S' / -- ` A . Building Permit Application: Date received: /0 // 0 / Permit no. :4 a jv3 +� l'lill'i'' City of Tigard o - ^ -_ .:. Project/appl. no.: Expire date: CiiyofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 - 4171 Date issued: By :,b Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: 1 &2 family: Simple Complex: s `' TYPE OF PERMIT • ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinlder /alarm 0 Other: 3 ) T P/;ii ro / JOB SITE INFORMATION Job address: / Li o y , . 5 ;„), 1 i o c .,..: /z l f ;, z. i ,„ / Ati ti.; i i e. 4, a 4 , Bldg. no.: Suite no.: Lot: 37 Imt, I Block: (Subdivision: F p 14 R, c , ,,.- E. m f /- s Tax map /tax lot/account no.: 4 ® r s 37 Project name: OA i ✓ r " t - ✓ , : w 0 R + t c t_I A R s . : . i o ( . 0 / : / _ R , . . ; ( e_ o T 3 7 ) Description and location of work on premises/special conditions: Jo/rvr U s / i. Pis / V/; Lvi y k/ t 7 t- f S i i l A f N/ A/ 6- I r 1 3 i z. 5 / s . A t w t_ L. o T S 3') l' w,•r� 3 g. O%%NER FOR SPECIAL INFORMATION, USE CHECKLIST Name: i'< HO A N R/p t /. - j ; / r f_ y" , 6. L (Floodplain, septic capacity, solar, etc.) Mailing address: R G„ 43 6 G o se-, I & 2 family dwelling: City: 5,,, (State: Wiq ( ZIP: y {:?/ 6 D Valuation of work�n �A inipVG Ma k. G. 4, $ i 1 5 Oct Phone: 29 (, • 3 Y d -,3 9 O I Fax :206 - - 27591 E -mail: No. of bedrooms/baths 001 d/� WA y Owner's representative: o r 4,Ll yMr -1Ai Total number of floors ' Phone:,e0c - 7,eve . ,$?' 9 c Fax:2, s y2.21 E 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: Commerciallindustrial/multi- family: . , . CONTRACTOR Valuation of work $ Existing bldg. area (sq. ft.) Business name: l • ko w 6. / N/_ k. .s c- /a ✓A T New bldg. area (sq. ft.) Address: 1 .z ti 0,5' N " Ni.5 kv ci. c. / C /' Number of stories City: Coil I' r 6 v14 I State: 0A,!1 ZIP: 9 7116 Type of construction Phone:5 v3 - 9 9,g - 7'f73I Fax: ci 9a —2.631E-mail: Occupancy group(s): Existing: CCBno.: g7 6 `l t 9 New: City /metro lic. no.: Notice: All contractors and subcontractors are required to be ARCHITECT/DESIGNER 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: State: ZIP: exempt from licensing, the following reason applies: I Contact person: ' Plan no.: . Phone: Fax: E -mail: ENGINEER Name: 6:_t. o F. / /_/ f, 1.7,, Contact person: 3 f A9 Z'•,im t : Fees due upon application $ /0 3 • 0_3 Address: / 3 exp 5 y,/ Ur• h' , 5 00,,,i, 1=fr Ry # i o c , Date received: City: p G,A/vr, (State: 0 /1ZIP:. 9 )tea y Amount received $ Phone: 5o_S - . . 6yy Fax: 5 B. , t E -mail: Please 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 more information. - attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard work will be complied with, whether specified herein or not. Credit card number: Expires Authorized signature: - . /.I `r 4 �,�;, pate: /0/ ( Name of cardholder as shown on credit card Print name: So,s i ; 1-/ . - 4,. A Y 3 \/ � - Cardholder signature $ Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6ro0/coNo Cokr7�y -zr .�DsEPff C 4264-51.2 - 5 gds Q io 3 03 &h.,. maize _ . ` • ' ,1 1 • SITE WORK PERMIT CHECK LIST Commercial, Multi - Family (R -1 occupancy) and Residential: Please complete all items below, unless otherwise noted. Excavation Volume: a a b cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) is a cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) /6 cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU I If a l s x /_ Y5 i oNi� ❑ Concrete �R ❑ Other 306 30 k,0 4o.-w /3 .oc,( ❑ *Total new impervious area including all buildings, sidewalks, and paving: / ©b sq. ft. Site Utilities Plumbing Work: Complete the "TAN" Plumbing Permit Application for site utilities plumbing work. PI ns Regluired See `S e Work Perm Applic atioon - Pia Sub al. Re ,attached The followingmust accompanythis ,cation. b • Site Plan, with Vicinity Maps *P ( including ADA) $and, • . show n A ® A c mpliance`" Lightin Plan Grading Plan,and details� d .= , • Er > o sion Control Plan and details � Retaining Str ctures _} Site Utility Plan and details , Soils required)° (showiing'connectio to app roved x � « g -pct"; ' . sy m:' ,x,. , „ ....aq,:< ...... A'< }p m a S�/�Ste.rll ). -. � , - s�T� �- �� ? h _.a - -a . ... au. *Does not apply to 1 and 2- family dwellings. is \dsts \forms\sitechecklist.doc 05/31/01