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Permit 14 CITY OF TIGARD BUILDING PERMIT 8= COMMUNITY DEVELOPMENT Permit#: BUP2520-00059 !GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/23/2020 T Parcel: 1 S125DA04600 Jurisdiction: Tigard Site address: 6715 SW ALFRED ST Project: Alfred Street Partition Subdivision: KINGS VIEW Lot: 31 Project Description: Demolition of a 2,030 sq.ft. house on sewer,(1) 101 sq.ft.shed,and(1)133 sq.ft.shed. UPON FINAL INSPECTION DEMO CREDITS FOR SDC FEES WILL APPLY. Contractor: SUBCOM EXCAVATION &UTILITIES LLC Owner: MITCH, JOHN H &MARY BETH PO BOX 4055 6715 SW ALFRED ST HILLSBORO, OR 2022 TIGARD, OR 97223 PHONE: 503-648-9310 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: SF Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 04/23/2020 $225.80 Demolition Occupancy Grp: Occupancy Load: Erosion Control w/Development 04/23/2020 $80.70 Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 04/23/2020 $0.50 Stories: 0 Height: 0 ft 11x17) Bedrooms: 0 Bathrooms: 0 Value: $10,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $307.00 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: 1 Ersn Cntrl 503-639-4175 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 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: all 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. '-: Building Permit Application Th- s Residential FOR 014.1(14;USE()NIA \' City of Tigard Received ) / - ��� . 1-'. /, 1114 • 13125 SW Hall Blvd.,Tigard,OR 97223 p�Review Date/B g Phone: 503.718.2439 Fax: 503.598.1960 Date/8r. N.j¢ Other Permit \ T G A It D Inspection Line: 503.639.4175 Date Ready/By: (� , brie ® See Page 2 for Internet: www.tigard-or.gov /�� Notified/Method: —g ,i��,�71 i'T`" Supplemental Information � R Ij�, _ �, ■ :Iji!Till t,: (4)Er1A1 TYPE - ' REQUIRED DATA:1-AND 2-FAMILY DWELLING 1 Permit fees*are based on the value of the work performed. I ❑New construction Indicate the value(rounded to the nearest dollar)of all '' ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the 7 CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ 1-and 2-family dwelling ❑CommemiaUindustrial (01006 0 Accessory building 0 Multi-family Number of bedrooms: 1 0 Master builder ®Other: 3 1o4-Par VI i0 n Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: is, Job site address: (o 1 1 S S 1 . 1 A\ �r a Q. -, New dwelling area: square feet 4.City/State/ZIP: T l G�e-A `. 0 R ,0.t l Z.�2.3_� Garage/carport area: square feet ,Suitelbldg./apt.no.: Project name: `r�/"t_ �t i fr�J e fte2 j Covered porch area: square feet In Cross street/directions to job site: 11 Deck area: square feet �''. C('O SS S lt(�2T' \ S S 1 (O l AN A V e Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST t�\\� _Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. 1 ), Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: k 3 k a1 S OF Z L. G Lk 4300 equipment,materials,labor,overhead,and the profit for the 40 36 S.r DESCRIPTION OF WORK work indicated on this application. Valuation: $ 1., c.(1-V C e \CI V p a e t roc\. . Q61 C 5 rq/ Existing building area: square feet 4 _A 7't c 6c .- -f {s /)s f��-- New building area: square feet a PRO RTY OWNERC /H cx 0 TENANT/ S ,r Number of stories: Name: Sri h(1 s Ma e-A'(_1 2. e k h c \ �Gh Type of construction: Address: (0-1 ( 5 `S t 4) /T ` '1-e e 6. 5 • Occupancy groups: saa. 4 City/State/ZIP: "I' ;�i t-d R T-2 ?, Existing: Phone:( ) Fax:( ) New: ;,-, 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* 4 (Pkare refer to fee*thdale) .Business name: ,(•S1 - \ .) ) e S\ t;-\ Structural plan review fee(or deposit): ��Contact name: u n FLS plan review fee(if applicable): , Address: CO L"l L-1 S S LAJ Cc t\ c r C)t'1\L. \�`. .4', � Total fees due upon application: �City/State//ZIIP: ,.)P a_t) eC Q ,f 0 CI 0 0 S Amount received: \J Phone:(5S 7 *--1l (p -c Gs-,‘2,. Fax::( ) E-mail. PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. -business name: .) h[ r.A..,� Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon )'--:.-Address: t t, J,, Solar Installation Specialty Code checklist. ti Permit Fee(includes plan review city/statelzlP: //1�J/� LJ 7/�3 and administrative fees): $180.00 Phone:(56) /'[rFy f)/eJ 4 Fax:( ) State surcharge(12%of permit fee): S21.60 CCB lio.: /27�7(,fj I Total fee due upon application: $201.60 Authorized signature: p/oag� � This permit application expires if a permit is not obtained /�pow,V' within 180 days after it has been accepted as complete. Print name: ,J n leer\ c 0� Date: 2-Z' �zO *Fee methodology set by Tri-County Building Industry x 5` V Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB) r REr‘r`'wvr) • * ` MAR 1 6 2020 Building Permit Application r. Residential 1t11z mPFFi( t aL ONl , City of TigardDatedB Received Permit No.: • 13125 SW Han Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit' I'/(,A It p Inspection Line: 503.639.4175 hate Ready/By: Row B See page 2 for Internet: www.tigardor.gov Nodded/Method: Supplemenrallnformaden TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction 1g Demolition Permit fees*arc 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. Valuation: S ) nOU El 1-and 2-family dwelling ElCommercial/industrial 0 t ElAccessory building El Multi-familyNumber of bedrooms: ❑Master builder ®°tiler: 3 'O-`- ?a-r VI jr k.0(\ Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: (p ' ) S ,,,LA) A \ T re c\ C.-sly.. New dwelling area: square feet City/State/ZIP: T t C 0,`6 ` 0 (L C1'1 2 Z 7j Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area square feet Cr c 0 SS S-e-e e- C S S u 1 (°Ck* A v e Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Inll Tax map/parcel no.: 1. 3( 01 S c /; -V L (') U,(D 0 v equipment, p the valuer(rounded to the nearest,and dollar)the of of equipment,materials,labor,overhead, the profit for the DESCRIPTION OF WORK work indicated on this application. n n e c U h O rn Q CL tN d. S 11 P rL S c Cl c" Valuation: $ c-t.]�`v C e \n p C_e i k c o e\ Existing building area: square feet New building area: square feet Hip PROPERTY OWNER 0 TENANT Number of stories: Name: S R S (1(\a('\( iS e It\h c1iN\ �-ch Type of construction: Address: ( --I. / LA) A` S ) , `1 l f-c e U S T- Occupancy groups: City/State/ZIP: T i� a(^d (L ct12'Z", Existing: Phone:( ) Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* Mew refer Wee ere wad Business name: cr.,.e. C \ 0 V) e S\C.n Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: CO LI L L S S IJU Ca\.\1C1 c f1 c1 t- V)` �7 Total fees due upon application: City/State/ZIP:,, (I ea u e e-k o s 0(1. -1 00�3 Amount received: Phone:(--�u„y ,, ‘-i 60 -c-8,‘Z. Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: f� pe..�yj/r X Y 3 Submit two(2)sets of roof plan with connection details ✓�/� lak" [/ and fire department access,along with the 2010 Oregon Address: / ) A.( h j 3r Solar Installation Specialty Code checklist. Permit Fee(includes plan review City/Slate/Z2TP: ,tad (f✓� p 74a and administrative fees): $180.00 Phone:MI)Co.it /_T.oi , Fax:( ) State surcharge(]2%of permit fee): $21.60 CCB lie.: /f�-4 Lam)^ Total fee due upon application: $201.60 Authorized signature: (7 poulA (1, dt This permit appilatlon expires if a permit is not obtained W V`1 � within 180 days after it has been accepted as complete. Print name: t-t!" c)j U,,,l1 Date: Z-,Z,.�Lc/Zo •Fee methodology set by Tri-County Building Industry Service Board. I:\Building\PermitslBUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COMIWEB) City of Tigard ■ COMMUNITY DEVELOPMENT DEPARTMENT 71 l��n D Building Permit Review — Residential Building Permit #: Atc, - ` / Site Address: 6P-IS SV AID ,S1. Project Name: )efto l d 4" S 14 (`L '41 2-D Lot #: ---- Planning Review ,, � II r Li-- I 1 Pro sal: Dena kv- G.n�. S, Od ii,�c 3 L - 1- � (j,(,4 ZO(-(j._0(lda) J Verify address/suite #active in Accela. tll In River Terrace: No ❑ Yes,River Terrace Review Addendum SityPlan Elements: C1Zosion Control [^I �3 IIQ pies of site plan on 8-1/2"x 11"or 11 x 17"paper Retained trees with drip line and tree protection measures ILO wn to scale (standard architect or engineer scale) IL" .,tprint of new structure(including decks)and FFE C rth arrow If tility locations&easements(required for new and additions) cite address,project or subdivision name and lot number l dewalk/driveway approach C/'plicant information(name and phone number) 'I►.` .cation of wells/septic systems r . dimensions and building setback dimensions 1 tr et tree size,type and location �iI uare footage of buildings to be demolished names sting structures on site [Ueorner elevations(2'contours if more than 4'differentiaall)/ 'Mot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? ❑Yes ',WI irpervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑) No di Clean Water 5 ces—Service Provider Letter (lot platted prior to 9/10/1995): Required: V Yes,applicant was notified ❑ No Received: es E 1 No Pr AJA Water Meter Fixture Unit Worksheet—Additions,Runodels and ADUs rZ d")" Required: ❑ Yes,applicant was notified ❑ No Received: ❑ Yes 0 No ' fit. SDC Exemption for ADU applied for: 0 Yes ❑ No Received: 0 Yes ❑ No 'Public Facilities Improvement(PFI)Permit: 2/Zoning: 0 Yes,applicant was notified 0 No _ Applied For. ❑ Yes 0 No,stop intakeO Land Use Case#: Zoning: R-445.- equired Setbacks: Front ZA Rear: I S Side: S. Street Side: Garage: 2A) Building Height. Max. Height: 30 Actual Height. 0 id—Landscape Area: % El Lot Coverage Max: % ntrance 0 Set back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees or less Windows ❑ Minimum 12%of area of all street-facing facades Garage 0 Garage door is behind widest street-facing wall 0 Yes 0 No,one of the following is met: El Door extends no more than 5'from wall and there is a covered porch extending beyond garage. ❑ Door extends no more than 5'from wall and there is a 12 sq ft.window above garage on 2nd floor. ❑ Garage door width is 0 12'or less 0 50%or less of facade ❑ 60%or less and includes 7 of following: El Covered porch 0 Recessed entrance ❑ Wall offset ❑ 1'Roof eave 0 Roof offset 0 Fire shingles El Lap Siding 0 Roof pitch 0 Gable,hip,or gambrel roof ❑ Dormer 0 Accent siding Window trim 0 Window recess 0 Window projection 0 Balcony di tsual Clearance 1.2i Urban Forestry P n lariSensitive Lands: 0 Yes [p3 No Type: alf Conditions met prior to issuance of building permit No, et: Approved By Planning: r L l Av,4 _ Date: 7—1-/- —7.0L0 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved El Not Approved Revision 2: ❑ Approved 0 Not Approved I:\Building\Fonns\BIdgPermitRvw_RES_122419.docx Building Permit Submittal / Original Submittal Date: 241 7 1. j Site Plans: # Building Plans: # Building Permit#: ❑ Laster building permit#above. Workflow Routing: Planning engineering Permit Coordinator ,Building Workflow Sign-off: /[1 Sign-off for Planning(include notes from planning review) Route Application Documents: 16 Engineering. (1) copy of permit application, (1) site plan, (1)building plan and original plan review routing form. .,--original original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: ��r�/�- By Permit Technician: /fa, Date: Engineering Review D.-Slope at building pad: 2.7 0"-Conditions "Met"prior to issuance of building permit N/A LQ Easements (encroachments)per engineering conditions of approval and plat torn Er Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: ❑ Yes No a-Final Plat Recorded: /d i i) ❑ NOT Approved by Engineering: Date: Notes: �/ 2-Approved by Engineering: Jpey,J-p. Date: 3/3/20Z0 Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved ❑ Not Approved Permit Coordinator Review 0 Con ass "Met"prior to issuance of building permit /J��y Approved, NOT Released: /j4470er�4 j H. /Tv"/ mate: 3 9/)(-9 Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: 15- C Exemption: 0 Received 0 Does not apply SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes CK/A Tigard Trans SDC: ❑ Yes laimr, I A / Parks SDC: ❑ Yes LIDA ❑ Yes N/A ❑ OK to Issue Permit 3 7/42/2-<- Approved by Permit Coordinator: //,Date: L:\Building\Forms\BIdgPermitRvw_RES_122419.docx Albert Shields From: Albert Shields Sent: Monday, March 9, 2020 12:12 PM To: pam@emeriodesign.com Subject: BUP2020-00058 & -00059, 6685 & 6715 SW Alfred St., Mitch Partition Attachments: Albert Shields.vcf Pam, in reviewing your applications for these two demo permits I noticed that the site plans call for tree protection but we have not received a letter from your arborist confirming that the needed tree protection is in place. Would you please have your arborist confirm that in a letter to me? Pending receipt of such a letter I will code these applications as "Approved (for Plan Review) but Not Released." They will be on hold until we receive the arborist's letter. Please let me know if you have any questions. Albert Shields City of Tigard Permit Coordinator i5031 718-2426 Work A1bcrttgard-or.gov 13125 SW Hall Blvd. Tigard,Oregon 97217 www.tigard-or.gov 1 Branden Taggart From: Branden Taggart Sent: Wednesday, April 8, 2020 9:59 AM To: Pam Boyd Cc: #Building Permit Technicians Subject: Alfred Street Partition Demolition Permits: BUP2020-00058, 59 - 6685, 6715 SW Alfred St. Attachments: Branden Taggart2.vcf;Alfred Street Demolition Permit Invoices.pdf Hi Pam, The Alfred Street Partition demolition permits are ready to issue now. I have attached invoices above for you to reference, and the fees are listed below: Alfred Street Partition Demolition Permits Permit# Fees Due BUP2020-00058 $ 307.00 BUP2020-00059 $ 307.00 Total: $ 614.00 You can pay the above fees online now through our website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit numbers in the Record Number field, and click Search. Once paid, please notify us at TigardBuildingPermits@tigard-or.gov, and I will email the permit paperwork to you. Please note that we will need to receive contractor license information and Clean Water Services Service Provider Letters for both permits prior to issuance. Thank you, Branden Taggart y , City of Tigard .*, Senior Permit Technician Ttt,r) Community Development 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brande nt@tigard-or,gov DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." t Clean Water Services File Number CeanWater ' Services 19-003560 Sensitive Area Pre-Screening Site Assessment RECEIVED 1. Jurisdiction: Tigard dJ 1! 2. Property Information (example 1S234AB01400) 3. Owner Information APR 2 2 2020 Tax lot ID(s): Name: Bruce Howard ;Ili[)1- fPUIk ® 1S125DA04600and 1S125DA04700 Company: PDX Business Investrtlteilis,NGDIVISION Address: 8213 SW Kingfischer WAy 23 Site Address: 6685 and 6715 SW Alfred City, State, Zip: Portland, OR, 97224 City, State,Zip: Tigard , OR, 97223 Phone/Fax: 503 989 9417 Nearest Cross Street: Ventura Court E-Mail: brucehoward222@gmail.com 4. Development Activity(check all that apply) 5. Applicant Information ❑ Addition to Single Family Residence(rooms,deck,garage) Name: Eric Evans © Lot Line Adjustment ❑ Minor Land Partition Company: Emerio Design ❑ Residential Condominium ❑ Commercial Condominium Address: 6445 SW Fallbrook PL, 100 ❑ Residential Subdivision ❑ Commercial Subdivision El Single Lot Commercial ❑ Multi Lot Commercial City, State,Zip: Beaverton, OR, 97008 Other Phone/Fax: 5038531910 E-Mail: eric©emeriodesign.com 6. Will the project involve any off-site work? Ix]Yes ❑No 0 Unknown Location and description of off-site work Half Street Improvement on site's frontage 7. Additional comments or information that may be needed to understand your project This application does NOT replace Grading and Erosion Control Permits,Connection Permits, Building Permits,Site Development Permits, LIE41200-C Permit or other permits as issued by the Department a1 Environmental Quality, Department of State Lands and/or Department o1 the Army COE. All required permits and approvals must be obtained and completed under applicable local,state,and federal law. By signing this form,the Owner or Owner's authorized agent or representative,acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. I certify that I am familiar with the information contained in this document,and to the best of my knowledge and belief,this information is true,complete,and accurate. Print/Type Name Eric Evans Print/Type Title Signature ONLINE SUBMITTAL Date 11/9/2019 FOR DISTRICT USE ONLY ❑ Sensitive areas potentially exist on site or within 200'of the site. THE APPLICANT MUST PERFORM A SITE ASSESSMENT PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties,a Natural Resources Assessment Report may also be required. ❑ Based on review of the submitted materials and best available information Sensitive areas do not appear to exist on site or within 200'of the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 19-05, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,State,and federal law. Based on review of the submitted materials and best available information the above referenced project will not significantly impact the existing or potentially sensitive area(s)found near the site.This Sensitive Area Pre-Screening Site Assessment does NOT eliminate the need to evaluate and protect additional water quality sensitive areas if they are subsequently discovered.This document will serve as your Service Provider letter as required by Resolution and Order 19-05,Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local,state and federal law. ❑ This Service Provider Letter is not valid unless CWS approved site plan(s)are attached. ❑ The proposed activity does not meet the definition of development or the lot was platted after 9/9/95 ORS 92.040(2). NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.UI � Reviewed by �.��� '" ... � ,�� "�� Date 11/25/19 Once complete, email to: SPLReview@cleanwaterservices.org • Fax: (503)681-4439 OR mail to: SPL Review, Clean Water Services, 2550 SW Hillsboro Highway, Hillsboro, Oregon 97123 Revised 6/2017 4/20r2020 CCB Contractor Search BUSINESS DETAIL Address:PO BOX 4055 HILLSBORO OR 97123 Licensee:SUBCOM EXCAVATION&UTILITIES LLC _.. License Status:Active . d "`"�R, License No.:195965 �9 ti��.'.�P6. Expiration Date:2/7/2022 Date First Licensed:2/7/2012 Phone:(503)648-9310 APR 3 2020 Entity Type:Limited Liability Company nn 2 y r-�r�1�f�, Endorsement Type: �!� (r.��f'" 6�i�l'1T3rJ Commercial General ontraat r Level 2 3(JuL-DING DIVISION; Residential General Contractor E_d 9 Yt11lV i„� Workers'Compensation/Independent Contractor Status:Nonexempt ADDITIONAL BUSINESS LICENSES AND CERTIFICATIONS ' CERTIFIED LEAD-BASED PAINT RENOVATION(LBPR)CONTRACTOR LICENSE: NO Required to bid and work on pre-1978 residential structures. OTHER BUSINESS INFORMATION WORKERS'COMPENSATION INSURANCE INFORMATION policy No. Carrier Cov age 888105 Employee SAIF None Personal Election None The CCB does not receive automatic notification of changes to workers'compensation coverage status.Current Oregon coverage status can be confirmed through the Oregon Workers'Compensation Division LIABILITY INSURANCE INFORMATION(History) E�cpiration Date ompar y. Amount OHIO SECURITY INSURANCE COMPANY $1,000,000.00 3/25/2021 i SURETY BOND INFORMATION(History)TYM A un Rey Continuous until Residential OHIO CASUALTY INS CO $20,000.00 cancelled Continuous until Commercial OHIO CASUALTY INS CO $20,000.00 cancelled PUBLIC WORKS BOND INFORMATION(History) Company. Effective Dates OHIO CASUALTY INS CO 02/01/2013-(UNTIL CANCELLED) Exemption Expiration Date N/A ASSOCIATED INDIVIDUALS MALLORY,JOSEPH DENNIS RMIMemberOwner (Limited Liability Company) MALLORY,JOSEPH DENNIS RMI Click here to see past associated individuals'names. I ASSUMED BUSINESS NAMES($) None Click here to see past assumed business names. BACK BACK TO CCB HOME BACK TO SEARCH ©2020 Oregon Construction Contractors Board vmaay-Terms 1/1 • RECE . ; J MAR 16 2020 FOR OFFICE USE ONLY—SITE ADDRESS: " .r This form is recognized by most building departments in the Tri-County area for transmitting information. 'ING Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter T I G A it I) 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION FROM: Po_rn bpYd COMPANY: r me c-t'c t>e 5 ies t\ By: PHONE: SO 3 - LNG-S3i31?_ RE: t, c rc.- 4 Co Sz S w l F red OtP2-02.0 0°°5=' (Site Address) (Permit Number) e) S� i�ai (-r +-t'af\ roject name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: Pt e& e See ki cec..airecK s < ke Q\ [`S re c -OU t. r\ C t( gees . yo FOR OFFICE USE ONLY Routed to Permit Technician: Date: Initials: Fees Due: ❑Yes ❑No Fee Description: Amount Due: $ $ Special Instructions: Reprint Permit(per PE): 0 Yes El No ❑Done Applicant Notified: Date: Initials: I:1Huilding\Forms\TransmittalLetter-Revisions.doc 05/25/2012