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9205 SW Burn",3m Street
CITYOF TIGARD _ __ BUILDING PERMIT
PERMIT#: BLIP2002-00244
DEVELOPMENT SERVICES DATE ISSUED: 6/19/02
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 2S102AB 05100
SITE ADDRESS: 09'205 SW BURNHAM ST
SUBDIVISION: ZONING: CBD
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AR_E_AS _ 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: C. E:OCCUPANCY GRP:GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: EASEMENT: ;f AREA SEP. RAI-ED:
STOR: HT: ft GARAGE: sf OCCIJ SEP. RATED:
BSMT?: ME7.Z?: _ _REQD_SETBACKS_ _ _REOUIRED _
FLOOR LOAD: psf LEFT: ft RGHT: ft Flk SPKL: —SMOK DFT:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATH0- IMP SURFACE: PRO CORR: PARiUNG:
VALUE:
Remarks: Demolition of 999 square foot house. All demoiition debris is to be removed and the sewer line capped.
Owner: Contractor:
CITY CF I I'jARD 0WiJF_'R
13125 SW HALL BLVD
TIGARD, OR 97223
Phone: Phone:
Reg#:
_— FEES _ REQUIRED INSPECTIONS
Type By Dati3 — Amount Receipt Cap Sewer Line Insp —W
EROS DEB 6119/02 $26.00 JE# Final Inspection
ERPC DEB 6/19/02 $8.45 JE #
ERP2 DEB 6/19/02 $8.45 JE#
Total $42.90
This permit is issued subject to the regulations contained in the Tigard Municipal Codc, State of OR. Specialty Codas
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throuilh OAR 952-001-1987 You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-6699 or '1 .800-332-2.344.
Pe ml ittp^
Signature: < G 19
Issued By: I
Call 639-4175 by 7 p.m. for an Inspection the next business day
1111jr
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Building Permit Application
Datereceive�d:�' /j,,'� Pennit no.; j����lCl
City of Tigard — —
Address: 13125 SW Hall 131vd,'1'igard,OR 97223 Project/appl.no.: Expi date:
City of Tigard -
Phone: (503) 639-4171 Date issued: B 1) Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ 1&2 family:Simple Complex:
MEMMUMM
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-fafnily U New construction U15emolition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alami U Other:
It SITE NfORMATION
Job address: �c_` 6,�t' i i' / I Bldg,no.: Suite no.:
Lot: Block: Subflivision: _- Y� -- x map/tax lot/account no.: -
Projl!ct name'
Descri n and lox tion of work on premiscs/special conditions.
_.r ���U � . ll✓ ��- __
1:011 SPECIAL 1N'FO61ATI0N,'U$E' EFKLlgt
Name: t� _ t� 127J t
Mailing address: 1&2 family dwelling:
City: State: Z,IP:- 7 Valuation of work........................................ $
Phone: 11 Fax: i mail: No,of bedrooms/baths....................... . .......
Owner's representative: I tTotal number of floors.................................
------
Phone: 17ax- f? mail New dwelling area(sq, ft.) ..........................
APPOCAW Garagelcarport area(sq. ft.).........................
Name: Covered porch area(sq. ft.) ................... .....
Mailing address: Deck area(sq. ft.)...............................•........
_��- -- -- - Other structure area(s . ft.)•................. ......
City_ Sv r.; Z1P: - -
Phone: lax: -" - I?-mail Commercial/industrial/multi-family:
1 , Valuation of work.......•................................ $
Business name:
Existing bldg.area(sq.ft.) ...................... ... -- -----
--- New bldg.area(sq.ft.)
Address: Number of stories
City: State: ZiP: rype of construction
Phone: Fax: — &mail:
— ----
CCB no.: Occupancy group(s): Existing:
- _
--- -- - -- New: _
City/metro lic.no.: Notice:All contractors and subcontractors are required to be
t licensed with the Oregon Construction Contractors Board under
Nance: provisions of ORS 701 and may be required to be licensed in the
Addresf
-- - --- -- jurisdiction where work is being performed. If the applicant is
--- ---- —- exempt from licensing,the following reason applies:
City: State: LIP:
Contact person: Plan no.:
Phone: e Paxi F mail: - - ---
Name: t'tmt,tct pvft ,,n: Fees due upon application ........................... $----_-----_--
Address: Date received: -
City: State:�IP_ Amount received .........................................
Phone: - rax: E-mail` -_ Please refer to fee sehdule.
I hereby certify I have read and examined this application and the Not all jurisdiction accept credit cards,plena call jurisdiction for more infnnnntion.
attached checklist.All provisions of laws and ordinances governing this U Viae G MasterCard
work will be complied 4ith,wheth r s Pied herein or not./ t Credo c%rd number.
lL•t Expires.Authorized signature: ' .- r o Date: Naito u(cardholder a{{hrvn nn CRdll Card
Print name:__ rr);z_{tt,
_- _ _ cardholder si riture Amount
Notice:This permit application expires its permit is not obtain ••ithin 18'1 days ager it has been accepted as complete. 49n-us11 MMICOM)
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711
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECT1100 DIVISION Business rine: (503)639-4171 MST
BLIP
Received -__ Date Requested�'� _/�ZJ AMPMBt;P
i_ocation _.-134�5 11 MEC -
Contact Person —__�——_--- Ph(--_____—) __._--- _ -- PLM —`
Ph SWR
LIILDIN Tenant/Owner --____-------_------------_-_._— ELC
POing
Foundation �-----�--�— ELC _-------__--
Ftg Drain Access:
Crawl Drain cLR ---_ _ - --
Slab Inspection Notes: SIT
Post R Beam
Shear Anchors G '
Ext Sheath/Shear
Int Sheath/Shear
- -- ---
Framing ---_-_ ---_
Insulation
Drywall Nailing -
Firewall - --- - -
Fire Sprinkler -_--- --- -
Fire Alarm
Susp'd Coiling
Roof
C) De*4
1SS PART FAIL
Under Slab - --__
Rough-Ir, --
Water Service -__--
sanitary Sewer - Y ------_---
Rain Drains
Catch Basin/Manhole
Storm Drh.n _ - --- �- -_--_
Shower Pan
Other: -----._— __ — -- -- ---- -- - -- —
Final
PASS PART _FAIL
MEC_HANICAL_
Post&Beam �.----_—. — ----- ------------
Hough-In
Gas Line --------Smokc Dampers
Dampers --
Fina!
PASS PART FAIL ------ —_-- - -- ------ - --- ---
ELECTRICAL -
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm --.-_---_-----.---_--_--
Final F] Reinspection fee of$__-___ - require:,before next inspection. Pay at City Hall, 1'1125 SW Hall Bivd.
PASS PART FAIL
'SITE_- _— _ [] Please cab for reinspection RF- -- _ L� UnpNe to inspect--no access
Fire Supply Line
ADA
Approach/Sidcn+vnik Daite___-7 —____-- Inspector --_ __-- Ext
----
Other:
Final ( DO NOT REMOVE this Inspection record from the Ioh %Its.