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Permit n CITY OF TIGARD BUILDING PERMIT rr� COMMUNITY DEVELOPMENT Permit #: BUP2010 -00063 Date Issued: 04/21/2010 :41 G A.kb 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101 BC00800 Jurisdiction: Tigard Site address: 12340 SW HALL BLVD Subdivision: KNOLL ACRES Lot: 3 Project: The Knoll at Tigard Project Description: Demo SFR. DEMO CREDITS APPLIED TO BUP2010- 00033. Owner: FEES CLICKENER, ROBERT R & PATRICIA A Description Date Amount 8485 SW HUNZIKER Erosion Control 04/16/2010 $26.00 TIGARD, OR 97223 Erosion Plan Review CWS 04/16/2010 $8.45 PHONE: Erosion Plan Review COT 04/16/2010 $8.45 Permit Fee - Additions, Alterations, 04/16/2010 $225.80 Demolition Contractor: 12% State Surcharge - Building 04/16/2010 $27.10 LMC INC 8324 SW NIMBUS BEAVERTON, OR 97008 PHONE: 503 - 646 -0521 FAX: Specifics: Type of Use: SF Class of Work: DEM Dwelling Units: 0 Stories: 0 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $9,091 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $295.80 Required: Required Items and Reports (Conditions) 1 BUP Ersn Cntrl 681 -4444 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 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. 1 Issued By: ,. "/ AN, Permittee Signature: c z %7,/ 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. Building Permit Application F+� t r v ni as 7't 1 0; a t ,,, , Residential ' FOR ' OFFICI U'F ONLY � ' dr, Clt of Ti aC(1 sima ogl R eceived _ ,�, ,,, F t o ∎ Nb , 1111—''' , AT y g l'� q tt Permit No.: , '7 � .LA� Date /B L G ` . ti` � ° 13125 SW Hall Blvd., Tigard, OR 97223(1� �� Plan Review Phone: 503.639.4171 Fax: 503.598.1960 \, Ill Date /B : Other Permit: ,,T I G R ' Inspection Line: 503.639.4175 '1 f ,� 7 rrJJ Cld 9 Date Ready /By: ® See Page 2 for M1;� „,' ,,zr,; , tvi Internet: www.tigard - or.gov �� Notitied /Method: Supplemental information TYPE OF W t ..11, �� ��� REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ® 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. ® I- and 2- family dwelling ❑ Commercial /industrial Valuation: $ Accessory building Number of bedrooms: ❑ y g ❑ Multi - family ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 12340 SW Hall Blvd. New dwelling area: square feet City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Intersection of SW Hall and SW Knoll Dr 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.: 2S101BC00800 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. Demolition of Single Family Residence Valuation: $ O q t7 O Existing building area: 19' 0 square feet New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name: The Knoll at Tigard Apartments, LP c/o Sheila Fink Type of construction: Address: P.O. Box 23206 Occupancy groups: City /State /ZIP: Tigard, OR 97281 -3206 Existing: Phone: (503)293 -4038 Fax: ( ) New: ® APPLICANT ❑ .CONTACT PERSON NOTICE Business name: Carleton Hart Architecture All contractors and subcontractors are required to be Contact name: Ben White licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 322 NW 8 Ave jurisdiction in which work is being performed. If the City/State /ZIP: Portland, OR 97209 applicant is exempt from licensing, the following reasons apply: Phone: (503) 206 -3174 Fax::( ) E -mail: ben.white @carletonhart.com CONTRACTOR Business name: LMC Construction BUILDING PERMIT FEES* Address: 8324 SW Nimbus Ave. (Please refer to fee schedule) City /State /ZIP: Beaverton, OR 97008 Structural plan review fee (or deposit): FLS plan review fee (if applicable): Phone: (503) 646 -0521 Fax:( ) CCB lic.: 161282 Total fees due upon application: Amount received: Authorized signatur e: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Ben White Date: 03/26/2010 * Fee methodology set by Tri- County Building Industry Service Board. 1:\Building \Permits \BUP - RES PerinitApp.doc 10/01/09 440- 4613T(11/02/COM /WEB)