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CITYOF TIGAR� Bl.'tLI,!•;�; PERMIT
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DEVELOPMENT SERVICES DATE ES ISSUED: 1;0/5 010, 00355
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE.ADDRESS: 09450 SW CORAL S PARCEL: 1S126DC-04400
SUBDIVISION: LEHMANN ACRE TRACT ZONING, C-P
BLOCK: LOT: 007 JURISDICTION: TIG
REISSUE: —_ FLOOR AREAS _EXTERIOR WALL. CONSTRUCTION
CLASS OF WORK. DEM F!RST: sf N: S: E: VV:
TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS? _
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: st REA SEP. RATED:
STOR: HT: ft GARAGE: sf OCXU SEP. RATED:
BSMT?: MLZZ?: _ REQD SETBACKS _ _ _R_EQUIRED _
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:
Remarks: Demolish 500 sq.ft. single family residence. All debris to be removed. Sewer to be capped and inspected.
Owner: Contractor:
RENAISSANCE CUSTOM HOMES
1672 WILLAMETTE F--4,LLS DR
WEST LINN, OR 97068
Phone: Phone: 557-8000
Reg#: uc 049955
FEES — �� REQUIRED INSPECTIONS_ _
Type By Date Arnowit Rece pt Cap Sewer Line Insp —
PRMT CTR 1;,''1/01 $75.00 27200100000 Final Inspection
5PCT CTR 10/5/01 $5.00 2 7200100000
Total $$0.00
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 none in accordance with approved plans. This perm,t 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 ob',ain a ropy of these rules or direct questions to OUNC by
calling (503)245-6699 or 1-800-332-2344
Permittee / f
Signature:
Issued By:
Call 639.4175 by 7 p.m. for an inspection the next business day
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 'Business Line: 639-4171 MST
_
Date Reauesteed_� ILi �' AM BUP PM BLD
Location_ – "l y.�7 L' L !`� Lam_ Suite _ MEC
Contact Person Ph /`� �l�/<' PLM
Contractor_ _ Ph _ SWR _
BUILDING � Tenant/Owner _ �`— ELC
Retaining Wall ELR
Footing
Foundation AGCP.SS: ? yy�
Ftg Drain FPS
Crawl Drain Inspection Notes: .r 11 SGN
Slab �'�
___C � ( . — ------
Post&Beam ' '' SIT _
Ext Sheath/Shear
Int Sheath/Shear i
Framing
Insulation G
Drywall Nailing LI1 _ C/O C v kev"
Firewall -
Fire Sprinkler -Q 'Wc* -� �.�w
Fire Alarm /
Susp'd Ceiling ,; —fir✓{� _ G �r �e.vt i
Roof y(� —
Mi=. —
PASS PART F 1L --
Post 8 Beam
Under Slab t� �� ��� 4 ` / �
Top Out t1-- AA-A 0`�
Water'�Rrvice
Sanitary ;ewor '-- -
Rair.Drains
Final
PASS PART FAIL 'i
MECHANICAL - I --1}--- --
Post&BePm
Rough In
Gas Liie _
Smoke Car.,.ors - / ` '29
Final
PASS PART FAIL \ `
ELECTRII,'AI. -- ----� —_
Service _
Rough In --�
UG/Slab
Low Voltage
Fire Alarm
Alarm
Final ---- -----
PASS PART FAIL
SITE
Backfill/Grading -- —_--- --__
Sanitary Sewer
Storm'gain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
(;etch Basin
Fire Supply Line [ 1 Please call for reinspection RE: [ ]Unable to inspect-no access
ADA
Approach/Sidewalk
Other _ Date _ �� / -- Inspector Wd -Z f�iJ e
y._ Ext
Final —
PASS_ PART FAIL DO NOT REMOVE this inspection record from the job site.
Building Permit Application
Date received: �
City of Tigard i l' "5 G( Permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 ProjecUappl.no.: Expiredate:
City o/'Tigard Phone: (503) 639-4171 Date issued: By: I Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: �. /—6000",' 1&2 family:Simple Complex_
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction 41 Demolition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
Job address: 5 S Y-Ak I lildg.no.: Nude no.:
Lot: Block: Subdivision r< Tax map/tax lot/account no.:
XProject name: Mar f;n Iii - -- -
Description"and location of work on prermses/special conditions: r_A 42Yh o I`)k_��f TrL _ �
c r r l lypy.'=I_L712 6WWL ? _A4—bb 0 Il"r i rr r'2.l b U.i lal t,yt
Name: Ter)Lli3SAttU -'_DQ U'erhef'f'
Mailing address: I(p'��-SO d' Q Q r. 1 &2 family dwelling:
xCity: I Al _ State: Z P: 118 Valuation of work........................................ $
Phone F x: 3 E-mail: No.of bedrooms/baths............................... . ---
Owner's representmive: t "J-C j,., JL1 Total number of floors.................................
Phone:$15.4 6115 lFaxU3.6%.140l E-mail: New dwelling area(sq. ft.)
Garage/carport area(sq.ft.)......................... _
Name: (�Sc - Covered porch area(sq.
f.).........................1
Mailing
address: Deck area(sq. ft.)........................................ _
City: Q �,� State:v� ZIP: Other structure area(sq. ft.).... ................... _ v—
Phonc:
1601 E-mail: CommerciaUindtntrial/multi-family:
Valuation of work........................................ _
Business name:
Existing bldg.area(sq. ft.) .................. ......
-
----
Address: New bldg.area(sq.ft.)
................................
— -—--- Number of stories
City: _ State: ZIP: ....................................... —
—�_. _ Type of construction..........................I.........
Phonc: aa. E-mail:
—
----I ---
CCB no.: Occupancy group(s): Existing:
------ -- -� New:
City/metro lie.no.: Notice:All contractors and subcontractors are required to be
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: Istat e ZIP: W exempt from lice g,tb:following reason applies:
Contact person: I Plan_no.: _ — - -'
Phone: Fax: E-mail - --- -- ---� —
Name: Contact person: Fees due upon application ..................
Address: _ �.i :received:
City: State: ZIP: A..tount received ......................................... $
Phone: —_— Fax: E-mail: Please refer to fee schedule.
1 hereby certify 1 have read and examine this appli• on and the Not all jurisdictions accept credit card!,(Heise call jurisdiction for more information
attached checklist. All provisions of ii—mines governing this U Visa u MasterCattl
work will he complied 1 killed hetein tit noi. Credit card number:
Expires
Authorizedm
signature: Date: 10 y �� Nae of cardlmlder as shown on credit card
Print name: L._ s5. ,`4-t? —),lab a*--, Cindholder si`nuun S Amount
Notice:'this permit application expires if a permit is not obtained within I g0 days after it has been accepted as complete. IIaJ613(69WOM)
COMMERCIAL PIAN 3"UBMITTAL
REQUIREMENT MATRIX
Plan revie'N is dependent upon submittal of a completed application and plans. After
plan ieview approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribiltion purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
TYPE OF SUBMITTAL.
Total # of��
(Includes New, Additions or Plans
Alterations) Submitted
Site Work (must include location of 4
all accessible parking)
Plumbing - Site Utilities 2
I
Building
i
Fire Protection System 3**
Mechanical 2
Plumbing - Building Fixtures 2 {
Electrical 2
*For over-the-counter commercial tenant improvem,3nts, submit 2 sets of plans.
New' fire protection systems require that plans bEar the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
I:Wsts\forms\COM-matiix.doC 914101