Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 -00009
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/08/2010
Parcel: 1 S 135AD01100
Jurisdiction: Tigard
Site address: 8807 SW SPRUCE ST
Subdivision: Lot: 0
Project: Moon
Project Description: Demo fire damaged portions of stucture.
Owner: FEES
MOON, BRETT A & SHERRIE A Description Date Amount
8807 SW SPRUCE Permit Fee - Additions, Alterations, 01/08/2010 $53.27
TIGARD, OR 97223 Demolition
PHONE: 12% State Surcharge - Building 01/08/2010 $6.39
Contractor:
OREGON HOME IMPROVEMENT CO INC
17255 SW PILKINGTON RD
LAKE OSWEGO, OR 97035
PHONE: 503 - 635 -6248
FAX: 503- 636 -7183
Specifics:
Type of Use: SF
Class of Work: ALT
Dwelling Units:
Stories: Height: ft
Bedrooms: Bathrooms:
Value: $0
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $59.66
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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 the 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 thr u OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 0.1L Permittee Signature: e�
���-- Call 503.639.4175 by 7:00 a.m. for an Inspection that busIness da .
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.
Iguii'ti ng Permit Application
Residential RECEIVE -
ro ll orrice use O i
74 Cl g of Tigard Received
JAN 0 8 2011 Date /B
° 13125 SW Hall Blvd., Tigard, OR 97223 _ 1
Plan Review Permit No. L f r J l � ' 0� 7 � (�Q
Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit:
1I G A R D Inspection Line: 503.639.4175 CITY OF TIG ' ' i .. to Ready /By: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVIS lllc' ified/Method: KM Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING
❑ New construction tg 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
lEr
Valuation: $
❑ 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: •Cri 5W pY- (kr...e° New dwelling area: square feet
City/State /ZIP: —FActo At Oat. GI Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: -' boa e sz, 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: 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 WORK work indicated on this application.
< fi
,1.1 �IA 0-c- t Vl Tv ior- .c A 16I 11e-g% Valuation: $
CM CA StYtkcAAA.ve. clammy d 'by C 1 G Existing building area: square feet
New building area: square feet
X PROPERTY OWNER 1 ❑ TENANT Number of stories:
ye
Name: , i4 4 skexYt Morin Type of construction:
Address: S.F07 '5VV Spr r SN' . Occupancy groups:
City/State/ZIP: o.nct t Ej � r c Z2 Existing:
Phone: (To) 4 6 -2.,/ O2 . Fax: ( ) New:
XAPPLICANT ❑ CONTACT PERSON
NOTICE
Business name:''"rM t `
10 � AV 1 Sb, ,'41 � ;1�{l II�Pe�1' S All contractors and subcontractors are required to be
�
Contact name: pV► YM10a U licensed with the Oregon Construction Contractors Board
c _ under ORS 701 and may be required to be licensed in the
Address: 1'L 50 s� k , e l a t - s, 1112
l + RD O jurisdiction in which work is being performed. If the
City/State /ZIP: ; 011 ci C �, Gt 7 2 2 applicant is exempt from licensing, the following reasons
y p3 4 . 3a no l I (5 Q3) 4 3 - 370 0 apply:
Phone: ( ) Fax:: / ^' "^
E -mail: 1(t v vi b t ct44' a4 Yt T - / Co t44
CONTRACTOR
Business name: OV !. i DVe.ln� (..c). A -4 -). BUILDING PERMIT FEES*
1 .
Address: (1 `1010. toy, ct . (Pleaaerofisaoh+ k�
1 CU T._ „ l a W Q O , D 9 i D �S.--.
Structural plan review fee (or deposit):
City /State /ZIP: I
(� ) W 624 1 Fax: ( .b ) / Q 2 FLS plan review fee (if applicable):
Phone: I l9 1) 6- , ( d J
CCB lic.: % L{ c 6 Total fees due upon application:
Amount received: 59.
Authorized signature:` . • \ . 0: This permit application expires if a permit is not obtained
/ within 180 days after it has been accepted as complete.
Print name: \ p� \ ' C7 Date: ' . p • Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building \Permits\BUP -RES PermitApp.doc 10/01/09 440- 4613T(I 1 /02 /COM /WEB)