Permit d CITY OF TIGARD
SITE WORK PERMIT
e- COMMUNITY DEVELOPMENT PERMIT # : SIT2008 -00015
. _ . DATE ISSUED : 6/5/2008
13 125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL : 1S133AD
SITE ADDRESS: 11143 SW SUMMER LAKE DR ZONING : R - 7
SUBDIVISION: SUMMER LAKE LOT: 034 JURISDICTION : TIG
PROJECT: MCNEILL
Project Description: Retaining wall
CLASS OF WORK: OTR PAVING ?: N RESO. NO: 41
TYPE OF USE: SF GRADING ?: N VALUE: JY.9fl X500 . DD
EXCV VOLUME: cy LANDSCAPING ?: N
FILL VOLUME: cy SITE PREP ?: N
ENG FILL ?: N STORM DRAINS ?: N
SOILS RPT REQD ?: N IMPERV SURFACE: sf
Owner: FEES
RANDY MCNEILL Description Date Amount
11143 SW SUMMER LAKE DR [BUILD] Prmt Fee -Valu 6/5/2008 $73.33
TIGARD, OR 97223 [BUPPLN] Pin Rv -Valu 6/5/2008 $47.66
[TAX] Valu 12% State Surchar 6/5/2008 $5.87
Phone: 503 - 684 - 3588 Total $126.86
Contractor:
A BETTER CHOICE CONSTRUCTION
4755 MEHAMA LP NE
SALEM, OR 97305
Contact #: PRI 1 503 - 463 - 1322
FAX 1 - 503 - 463 - 1355 REQUIRED ITEMS AND REPORTS
Reg #: LIC 169718
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued B : , / 'OaAAAJA Permittee Signature:
\ c.
Cali 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
3uiIg Permit Application
Site N. ork FOR OFFICE USE ONLY
City of Tigard RECEIVED Date/B 0 ao �f Permit No.: „ �5
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �.
: a 1 ` _ Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 DateB
TIGARD Inspection Line: 503.639.4175 JUN 0 4 2008 Date Ready : y ,, _// Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Q$ i•' Supplemental Information
CITY OF TIGARD -
-
TYPE OF B&jik)ING DIV IS1UN .t ij
C 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, overhe , nd ihE profi
CATEGORY OF CONSTRUCTION work indicated on this appffy ��
Valuation: $
❑ 1- and 2- family dwelling ❑ Commercial /industrial
El Accessory building ❑ Multi- family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / j (tiT so SU m tex_r j i' . �c New dwelling area: square feet
City /State /ZIP: / 1 e a O g G� }� .z� Garage /carport area: square feet
t
Suite/bldg. /apt. no.: / ' Project name: /214 tn n U,E,,( 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: 1 Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
.72(- -47 1.1)CM Valuation: $
Existing building area: square feet
New building area: square feet
[PROPERTY OWNER ❑ TENANT Number of stories:
V3 Name: 2 Name: n A Y itch, t C 1 l Type of construction:
Q Address: 1 (I L.1 S() in Mt Y t-cv ); J/ f • Occupancy groups:
City /State /ZIP: r Icrt QQ 9 ?tea -2-f Existing:
N Phone: (5-01) 3 i.- ' JSS Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
6:41(411/C
Business name: �� P o: CC All contractors and subcontractors are required to be
' / / licensed with the Oregon Construction Contractors Board
Contact name:
t C k Jam+ I A zc I C/ G, under ORS 701 and may be required to be licensed in the
Address: ("7-5 /' le-iur>1r^ L N F jurisdiction in which work is being performed. If the
O Cit /State /ZIP: _ applicant is exempt from licensing, the following reasons
y Set ( e v �a S apply:
___L Phone: ( 503) GEC Z — i 3 ,,,, Fax: : ( ".63) L fG3 — 1 S 5-
E -mail:
CONTRACTOR
Business name: 5 C 4�i)f BUILDING PERMIT FEES*
Address: Cr (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP: FLS plan review fee (if applicable):
Phone: ( ) Fax: )
i Total fees due upon application:
y_ CCB lic.: ju /, !0
/ Amount received:
Authorized signature: X / 2�_.-- This permit application expires if a permit is n obtained
within 180 days after it has been accepted as complete.
Print name: ( ( /L) ( "fir A .r) vtti nil t je, 1 . c.‘ Date: G -4- oq * Fee methodology set by Tri- County Building Industry
Service Board.
I:\ Building \Permits \SIT - PermitApp.doc 12 /27/06 440- 4613T(11 /02 /COM/WEB)
City of Tigard: Site Work Permit Checklist
Page 2 - Supplemental Information
Commercial, Multi- Family and One- and Two - Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep
and will not be supporting a structure. If a building will be constructed on the fill, it must be
engineered fill. If fill is in a flood plain, drainage way, or wetland, the applicant must apply for
a sensitive lands review (SLR).
Please complete all items below, unless otherwise noted.
Excavation Volume: cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be
compacted to 90% of maximum density) cu. yds.
Retaining structure? (Check one) ❑ Rock
/Cd- en rC s ; L wc,A CMU
Concrete
10i 'Tee b`'( ❑ Other:
*Total new impervious area including all
buildings, sidewalks, and paving: sq. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements"
attached. The following must accompany this application:
❑ Site Plan with Vicinity Map showing ❑ *Parking (including ADA) and
ADA compliance Lighting Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report (if required)
❑ Retaining Structures
*Does not apply to One- and Two - family dwellings.
# of Plans
TYPE OF SUBMITTAL Required at
(Includes New, Additions or Alterations) Submittal
Commercial 2
Multi - Family R -1 Occupancy 2
One- & Two - Family Dwelling 2
1 \Building \Permits \SIT- PermitApp.doc 12/27/06 2
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11143 SW SUMMER LAKE DR - TIGARD Explorer 1 Property ( Maps,'" Cnmeij ens - Trarisi? , , .,.7 •
Summary 1 Assessor Permits /Cases 1 Block 1 Schools Parks 1 Businesses 1 CIPS 1:p e -1 - 4. . ater8
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` VISIIN
11143 SW SUMMER LAKE DR } I . -, -� 1 , eft -• 1I 5 F ''
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Description „ 7- Lj] —
Size 2,984 square feet a
, i
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Number of Bedrooms — r - w 11 — ...f
Bathrooms , ,k' , ..:.1.'- :: ; r `. .. I 'l-T� 1=i ,:-.L . ^ gyp! ' ..,. ,,
Property Map
{ 1 enA imiNG WALL
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Property Value (2007)
Market Value $376,980.00
Assessed Value $0.00
Taxes ()
Property Taxes $0.00
Total Taxes $0.00
Misc Info
Year Built 1955
Foundation Type
Interior Finish
Roof Style
Roof Cover Type
Flooring Type
Heating /AC Type
City of Portland, Corporate GIS Assessor Data Updated 5/26/2008
THE GIS APPLICATIONS ACCESSED THROUGH THIS WEB SITE PROVIDE A VISUAL DISPLAY OF DATA FOR YOUR CONVENIENCE EVERY REASONABLE ETFORT HAS BEEN MADE TO ASSURE THE ACCURACY OF
THE MAPS AND ASSOCIATED DATA. THE CITY OF PORTLAND MAKES NO WARRANTY. REPRESENTATION OR GUARANTEE AS TO THE CONTENT. SEQUENCE ACCURACY. TIMELINESS OR COMPLETENESS OF ANY
http:// www .portlandmaps.com/detail.cfm ?x= 7610385 &y = 655034 6/1/2008
4
CITY OF TIGARD - SITE PLAN REVIEW e
BUILDING PERMIT NO.: ., r'&,a $ — 00 l 6 -
PLANNING DIVISION:
Required Setbacks: er Approved ❑ Not Approved
Side: Street Side:
Front. Garage: - Rear: � f7 7
Visual Clearance: ErApplyved ❑ Not Approved
Maximum Building Height• feet
t' W'. service Provider Letter Required: s Yes ❑ No
0 Received
t3 s : &LA Date: ( is Y
ENGINEERING EPARTMENT:
Actual Slope: _% ❑ Approved 0 Not Approved
Site Plan: ❑ Approved ❑ Not Approved
By Date:
Notes: 4 - e
CITY OF TIGARD • SITE PLAN REVI yv
BUILDI G PERMIT NO:
Street rues: pi Approved ❑ Not Approved
Protected Trees: ❑ Approved 0 Not Approved
Notes:
Date:
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i REZAR OIRAVe: L. ST+?uCTt..i is Assessor Data Updated 5/26/2008
(Mtn Vic -
E VO(Y REASONABLE EFFORT FUS BEEN MADE TO ASSURE THE ACCURACY OF'
• I}IE CONTENT. SEQUENCE, ACCURACY. TIMELINESS OR COMPLETENESS OF ANY
6/1/2008
naAINF,IPE 4 OFFICE COPY
CITY OF TIGARD '
BUILDING DIVISION PERM /e —‘9D/ 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ,, ^ r ,1 , l A,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 1/3 6hicofy����h'" ` -E__- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: /,16/6 labifm( X.
OWNER: He L�-- PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message 7
01 33390/
Corrections /Comments/ Instructions:
e'ir►/irl/E— As S .
/ — ilkDk
- amp v( ,AA&■=4.•....
U PASS ► PARTI APPROVAL ❑ CANCEL 111 NO ACCESS
FAIL
El INSP:r. ❑ ADDITIO AL FEE ASSESSED
A ir
Inspector: Date: Phone #: (503) 711W)1:4;,.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT200B-000Th
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/512008
Phone: (503) 639 -4171 -
Inspection Requests (24 Hrs.): (503) 639 -4175 °'I �..
INSPECTION WORKSHEET FOR DATE: 6112/2008 TIME: 7:02AM PAGE: 58
SITE ADDRESS: 11143 SW SUMMER LAKE DR _ - CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 034 TYPE OF USE:
PROJECT NAME: MCNEILL
DESCRIPTION: Retaining wall .
OWNER: MCNEILL, RANDY PHONE #: 503- 684 -3588
CONTRACTOR: A BETTER CHOICE CONSTRUCTION _- PHONE #: 1 -503- 463 -1322
Inspection Request Scheduled For: _ . Date:. 6/12/2008 Pour Time: 9:00
Code # Inspection Description [Confirm # -- Contact # Message
210 Foundation walls 071238 -01 . . 503.463 - 1322 N
Corrections /Comments /Instructions: // ',
i -a.4.4 - 0 IV ALGA 17 6 1 reiVider___
�.61A `C.1, . ..
PASS ❑ PAR AL APPROVA ❑ CANCEL ❑ NO ACCESS
❑ FAIL 4114LL FOR ii ❑ ADDITIONAL FEES ASSESSED
/ /Y
Inspector: DatT Phone #: (503) 71;17/...
CITY OF TIGARD -
BUILDING DIVISION • PERMIT #: SIT2009-00015
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6.
Phone: (503) 639-4171 A,
BLA
Inspection Requests (24 Hrs.): (503) 639-4175 V
INSPECTION WORKSHEET FOR DATE: 6/12/2008 TIME: 7:02AM PAGE: 57
SITE ADDRESS: 11143 SW SUMMER LAKE DR CL SS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 034 TYPE OF USE:
PROJECT NAME: MCNEILL
DESCRIPTION: Retaining wall
OWNER: MCNEILL, RANDY PHONE #: 603-694-3598
CONTRACTOR: A BETTER CHOICE CONSTRUCTION PHONE #: 1-503-463-1322
Inspection Request Scheduled For: Date: 6/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
215 Footing drain 071239-01 503-463-1322
Corrections/Comments/ Instructions:
SS 1 P - TIAL APPRO El CANCEL 0 NO ACCESS
0 FAIL J 'ALL FO r . • TION ADDITIONAL FE ASSESSED
Inspector:
DatO
Phone #: (503) 74-,7)6
CITY OF TIGARD _ 7;"
...-----
BUILDING DIVISION PE' ■ �-Q� -0/
13125 SW Hall Blvd., Tigard, OR 97223 DATE IS • -.
Phone: (503) 639 -4171+
Inspection Requests (24 Hrs.): (503) 639 -4175 1I
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: i /// V ���'!/ GSZ 1-19/4„...-- 1-19/4„...-- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: , tC /
hia./ PHONE #:
CONTRACTOR:' PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
- 2 e , . , //16*- Tag-/A/4464/
Corrections /Comments/ Instructions:
1 , 4•ASS ❑ P RTIAL AP" • . ' ❑ CANCEL n NO ACCESS
FAIL P; ' - • • I)•SPE •N . ;.ITIONAL FEES ASSESSED
/
1 Inspector: Date #: (503) 71g?