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Permit CITY TI GAR® BUILDING PERMIT PERMIT #:LBU P2005= 01.00 ; At DEV W OP r S O R9 ICES -639 -4171 DATE ISSUED: 10/3/2005 PARCEL: 2S102DC -02400 SITE ADDRESS: 09125 SW MCDONALD ST ZONING: R -4.5 SUBDIVISION: EDGEWOOD LOT: 014 JURISDICTION: TIG Project Description: Demo 1600 sq. ft. residential dwelling, on septic & 1 out building w /possible address of 9155. REISSUE: FLOOR AREAS 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: S: E: W: . OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED 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: Owner: Contractor: WINDRIDGE HOMES, INC. DONALD LEAHY 11401 NW SKYLINE BLVD 16880 NW GERMANTOWN RD PORTLAND, OR 97231 PORTLAND, OR 97231 -2796 Phone: 503 - 978 -0830 Phone: 503 - 645 -7343 Reg #: LIC 69712 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 10/3/2005 $62.50 [TAX] 8% State Surcha 10/3/2005 $5.00 [ERPRMT] Erosion Con 10/3/2005 $26.00 [ERPLN] Erosn PIn Rv ( 10/3/2005 $8.45 (additional fees not listed here) Total $110.40 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 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. • Issued By: 2 lx" . _ D Permittee Signature: I Q,p \ Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. 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. P • Building Permit Application lix- � 011101utilUl '44 *_ ' j ` City of Tigard CRV D Date /B Received P Nd.Rt ?Or ij )) f'u 13125 SW Hall Blvd., Tigard, OR ' Plan Review Phone: 503.639.4171 Fax: 503.598.1960 0. ' ,•*�ri?��� Date/By. Other Permit: Inspection Line: 503.639.4175 OCT 0 3 2005 _ _ A ' Date Ready/By: !uris: ® See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: !1-' V Supplemental Information CITY OF TIGARD ' BUILDINGI il`?Mi • REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction IB 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. -F1... and 2- family dwelling El Commercial /industrial 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 addres • y`5 5 9/ L S)' M c Lon a., L New dwelling area: square feet City /State /ZIP: j 6--,4. - €4 © 2 97 Z Z c, Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: h,(O N ,o, La (Ajo °IS 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. b-&-' 'ri O C-: 'F' cJ � O'C 3 5-i- t-,,c- -e i O � Valuation: $ P ro �� Existing building area: square feet I New building area: square feet 31 PROPERTY OWNER ❑ TENANT Number of stories: Name: ;64 ; Ai v :AA, A f/0►i as Type of construction: Address: /1 70 1 P ,..J S4 ye; n e LA_ !/J Occupancy groups: City /State /ZIP: lao eri * /G2 r e.1 O' ' 7 Z 31 Existing: Phone: (- ) 97c..? 0 30 Fax: ( ) New: ® APPLICANT • ❑ CONTACT PERSON . NOTICE : Business name: k ; !1 " ' �1 r y ,` (I e -/-2 u - i eJ All contractors and subcontractors are required to be v rvv Contact name: -e- y ✓, - e 6,1. 0 563 78 ({ a Y licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: /1 f/O 1 N'.,-) S K y t ,1-- Gel, c //,Q jurisdiction in which work is being performed. If the ' - ! / a 97a , applicant is exempt from licensing, the following reasons o City /State /ZIP: T 4 L apply: Phone: (563 ) 9 y 0 S3 Fax:: ( ) • E -mail: • CONTRACTOR Business name: ,i).� L Q ti /1-61.1 BUILDING PERMIT FEES* • - Address: Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: (513 ) (o -1 S 7 3 ._ ( 3 Fax: ( ) Z, q /-?__ Amount received CCB lic.: L'! Date received: Authorized signature: . This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: yo' c' - y„," - e v`cs Date: /a —O r * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits\BUP- PermitApp.doc 12/03 4404613T(11/02/COM/WEB) One- and Two- Family Dwelling Building Permit Application Checklist 1,.:'. w1 O1 .��l 1 l �s o ... '� ' Cd P ree Se:< City of Tigard Received g Date /By Permit No 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 k,. 24- Hour Inspection Line: 503.639.4175' ih`hI ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us''` ❑ Other. rk al H!C F�QLLOi�IIV� I�I+�I i\1�� 121 1 RI UIRI I)� Ul2�lL�ll'[ gill '� �` "" "`t�, t a u � �i� - >' _ j g 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -11. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam /joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore•on and shall be shown to be . • . licable to the .ro'ect under review. t � "^ " °� ".'-' " a f�l'k � ^, ,. _ � mew r r .r^ L -' �� +sx !e�+ s ' a IURIcT9176 I P'ON -6. 'C I I ' r i W - �z s t ' �" �" v J . _ . .. �.� >SJF ' �a � r � aiti,t .i �;:. ia�aii *k4s � 1 ' 1 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑. 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre- Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\ Building \Permits\BUP- RES- PermitApp.doc 2 • FROM : Leahy Spec Exc FAX NO. : 5032971899 Feb. 23 2006 11:50AM P5 Scheduled D6 Date // !.� • • Work Order # y River City Environmental, Inc. .3 i (_-- P.O. Box 30087 5034524144 Complete Industrial Waste Remove! Portland, OR 97294 OR CCB# 147355 - WA CCB# RIVERCE981BT . Septic Tank Cleaning Sump 'x,,1 • 4`4 p frc/ Line Cleaning 7 jw) SO f Information 4g 1 el %IS T 6- ,_. q •1 a p p i 1TIGARD Units Amount . • - -- .-- _ -.._.: ,Eg• c-- 7dt _—_ .. - • 1, ._ .. @•- -- ® . Instructions: Driver Notes r • 45 -____ as b o i 42bis..._29zif.c._ • River City Environmental, Inc. is in no way responeible for damage to the septic tank or lids on the system. Terms: Net 10 days. 1.5% per month will be charged on past due accounts. (18% per annum). Terms and Conditions T h e customer agrees t o pay all imetoes arising out o f pumping s e f v l o e s , and any other special cervices herei n within 10 days. The customer agrees to pay such extra end overtime charges as may be Invoked from time to time for services rendered, over end abo b the normal servicing schedule, on behalf of the customer. The customer agrees to assume responsibility damage to customer's real or personal properly arising from plunging services which Me place on customer's premises, where the drivers and vehicles of River City Environmental have been instructed to enter. This includes, but is not limited to driveways, trees, power Imes or poles and building structures. If River City Environmental, inc. finds it necessary to add liquid to the tank on Joliette, customer will be charged for the additional gallonage resulting from these condidtlons. Customer agrees to reimburse River City Environmental, Inc. for 50 reasonable attorneys fees court costs and other manse incurred by said company to enforce collection ohs serve their rights under this a Customer agrees to the above c/. t i ors. Redeemable In Multnomah County Work Authorized by ! Date 1 i / f 1/ 5 Driver Signature go , - Da �/ ' /A ' Time CITY Of TIGARD BUILDING DIVISION PERMIT #:0•LP�0 DS 0 D3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 9 v.-v. CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: 505 OWNER: PHONE #:tD3.)7 CONTRACTOR: S+e, /e_ PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments/ Instructions: (kJ &S Q/ 1E-IC:;• i 1- it ems d 4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL L FOR INECTION ❑ ADDITI NAL FEES ASSESSED Inspector: Date: J JO a' Phone #: (503) 718 - INEW