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JOB SITE: 7,4.57/75 „dilf...t.,,i . lei jiil lg./Ts _ ., ,, P.O.#:72-e, - 737
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COMMENTS
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Customer Signature DATE V-75-70/ i
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SITE COPY
iiiA' CITY OF TIGARD BUILDING PERMIT
I COMMUNITY DEVELOPMENT Permit#: BUP2O1 -
500217
T j;G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 VIDate Issued: 07/11/2016
pc( w WG}s' Parcel: 2S1070000101
2Os Jurisdiction: TIGARD
Site address: 16515 SW BULL MOUNTAIN RD 11
Project: Polygon at Roshak Ridge Subdivision: CHURCHILL FOREST
Project Description: Demolition of 3,612 sq ft residential structure;all debris to be removed and septic pumped/filled prior to final Lot: C
inspection. DEMO credits for transportation and parks SDC apply.
Contractor: WILLIAM LYON HOMES INC Owner: ROSHAK, KEVIN A
109 E 13TH STREET 16515 SW BULL MOUNTAIN RD
VANCOUVER,WA 98660 TIGARD, OR 97224
PHONE: 360-695-7700 PHONE:
FAX:
Specifics: FEES
Type of Use: SF Description Date Amount
Permit Fee-Additions,Alterations, 07/22/2015 $453.95
Class of Work: DEM Type of Const:
Occupancy Grp: Occupancy Load: Demolition
Dwelling Units: 1 Info Process/Archiving-Sm$0.50(up to 07/11/2016 $1.00
11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development-Eng 07/22/2015
Bedrooms: 0 Bathrooms: 0 $80.70
Value: $25,000
Floor Areas:
Total Area: 3612
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $535.65
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 t OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50. - .1987 or 1.800.332.2344.
i
Issued '
_) fr.4 r♦ Permittee Sign.ture: tie4 6g ,�� L
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.