Permit CITY TIGARD SITE WORK PERMIT
DEVELOPMENT SERVICES PERMIT #: SIT2006 -00012
-n•��1 DATE ISSUED : 8/10/2006
13125 SW Hall Blvd., Tigard, OR 97223 503-639-4171 PARCEL : 2S104CA -01400
SITE ADDRESS 13165 SW ESSEX DR ZONING : R -7
SUBDIVISION: HILLSHIRE LOT 014 JURISDICTION • TIG
Project Description• Segmental block wall
CLASS OF WORK' OTR PAVING ?. RESO. NO:
TYPE OF USE SF GRADING ?: VALUE' 24,675 00
EXCV VOLUME cy LANDSCAPING ?:
FILL VOLUME: cy SITE PREP ?:
ENG FILL ?: STORM DRAINS ?•
SOILS RPT READ? IMPERV SURFACE' sf
Owner FEES
RALPH /LISA FARGO Description Date Amount
13165 SW ESSEX DR [BUILD] Prim Fee -Valu 8/10/2006 $283 30
TIGARD, OR 97223 [TAX] Valu 8% State Surcha 8/10/2006 $22 66
[BUPPLN] Pln Rv -Valu 8/2/2006 $184 15
Phone. 503 - 579 -3399 Total $490.11
Contractor.
MATT SANDER LANDSCAPING
21350 NW FARM PARK DR STE A
HILLSBORO, OR 97124
Contact #. PRI 503- 647 -0800
FAX 503 -647 -0900 REQUIRED ITEMS AND REPORTS
Structural observation
Reg #. LIC 5703
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 'nu may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344
ote
Issued By. t _ ` Permittee Signature: / a" W
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
Site Work
Building Permit Anp MailliTill VED FOR OFFICE,USE.ONLY
li Y i....'✓.......
City o f Tigard Re`e "ea
r 2 2006 g / , „
Permit No t.20v6 -0 /-
13125 SW Hall Blvd , Tigard, OR 97223,0 G
Plan
Phone 503 639 4171 Fax 503 598 1960 � " - *tmgr ryjill Date/B .. „/ 2 - n
$ -oa Other Pet ■
Inspection Line 503 639 4175 CITY OF TIGARD ', Date Ready/By ® See Page 2 for
Internet www cI ngard or us BUILDING DIVISION "'" Nonfied/Method Mg Supplemental Information
TYPE OF WORK 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 CY
❑ Add Mon/alteration/replacement ❑ Other equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application
❑ 1 - and 2 -family dwelling El ci
Commeral /industrial Valuation $ 2-4, V 5 .4.6 ^ n
❑ Accessory building ❑ Multi -family Number of bedrooms „(
❑ Master builder EMI -vi Nlh6 WALL, Number of bathrooms
JOB SITE INFORMATION AND LOCATION Total number of floors
Job site address k.. k 6,5 S J Essex. b New dwelling area square feet
City /State /ZIP .-C` 4,c, 9• b / ((1_, e172- z 3 Garage /carport area square feet
Sulte/bldg /apt no Project name ter FR R&10 eat> ENCt Covered porch area square feet
Cross street /directions to job site Deck area square feet
Other structure area square feet
r
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
� /('S J � O , / �� ��� �,� Valuation S
r3 `V f ` + - t. - ('vA 1 ( Existing building area square feet
New building area square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories ti
Nalhe K -.- j L . e - A F G Type of construction 1
Address I ?TAIR 5 ,c--AA) F SSE c:42-- Occupancy groups ..• - •
City /State /ZIP 'T` C4IRa 1 n 1J ei 7 Z'1_3 Existing .
Phone (5,-3) — 33 11 1 Fax ( ) New
0- APPLICANT ❑ CONTACT PERSON NOTICE
Business name ( 4 , 55 1 3 E - Lo a) All contractors and subcontractors are required to be
Contact name licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address jurisdiction in which work is being performed If the
City/State/ZIP applicant is exempt from licensing, the following reasons
apply
Phone ( ) Fax ( ) C
E-mail
CONTRACTOR
Business name Ma f 5T ` lA I r� A t4De'c4p ',A G p L %ZLick" • .. BUILDING PERMIT FEES*
2
Address 1350 Mu.) \ PARK- ✓>\1VF i S1e 7' d `
City/State/ZIP q Please refer la fee schedule.
�u.6 f�1` 11 t 2-4- Fees
due upon application
Phone (5,3) ( -ago° Fax (503) 647- - aqa a
A received y j 1pc 1 b
CC I73 he La, 6 10 -3r - ob `/
Date received D )_ J o b
Authonzed signature / This permit appl cati n expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print n. • - / r � OG Dale ' 2 ayolb • Fee methodology set by In- County Building Industry
Service Board
I \Buildsng\Pemuu \51 r- PenmtApp doe 12/03 440-1613TO 1 /O2/COM/WPB)
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
❑ CMU
❑ Concrete
❑ 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 ap lication:
U Site Plan with Vicinity Map showing *Parking (including ADA) and
ADA compliance Lighting Plan
Grading Plan and details El *Landscaping Plan
El 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
i \Buddmg\Forms\SIT- PermitApp doc 1/13/04 2
CITY OF*'IGARD
BUILDING DIVISION PERMIT #: SIT2006- 03012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2036 -
Phone: (503) 639 -4171 °j ➢'
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/24/2006 TIME: 6 :59AM PAGE: 59
SITE ADDRESS: 13166 SW ESSEX DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE LOT #: 014 TYPE OF USE:
PROJECT NAME: FARGO
DESCRIPTION: Segmental bock wall. • OWNER: FARGO, RALPH /LISA PHONE #: 503.519.3399
CONTRACTOR: MATT SANDER LANDSCAPING PHONE #: 503.6647 - 0800
Inspection Request Scheduled For: Date: 8/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 035460 -01, 971- 246.2218 N
Corrections /Comments /Instructions:
. • _ - -
- �d P�
❑ PAS ' ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ (/ Date: g- Z.--e& Phone #: (503) 718-
pv4v11,1
CITY OETIGARD L
G y PERMIT #: SIT2005- 000112
BUILDING DIVISION Q ���
13125 SW Hall Blvd., Tigard, OR 97223 L DATE ISSUED: 8/1012006
Phone: (503) 639 -4171 1 �*
Inspection Requests (24 Hrs.): (503) 639 -4175 �� ¶ I
INSPECTION WORKSHEET FOR DATE: 8/18/2006 TIME: 7 :03AM PAGE: e5
SITE ADDRESS: 13165 SW ESSEX DR
CLASS OF WORK:
SUBDIVISION: HILLSHIRE LOT #: 014 TYPE OF USE:
PROJECT NAME: FARGO %
DESCRIPTION: Segmental block wall. I , t' /
OWNER: FARGO, RALPH /LISA PHONE #: 503 -579 -:399
CONTRACTOR: MATT SANDER LANDSCAPING PHONE #: 503. 647-0800
Inspection Request Scheduled For: Date: 8/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 035213-01 971-246-2218 Y ,9 � 'r/rit,tWA z -
Corrections /Comments /Instructions: -
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
a FAIL ►/ CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: (6 ; O Phone #: (503) 718
CIT�-OF T IGARD _
BUILDING DIVISION PERMIT #: 51T2006-00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639 -4171 q ru
Inspection Requests (24 Hrs.): (503) 639 -4175 �' ua " ^„ 1L.
INSPECTION WORKSHEET FOR DATE: 8/17/2006 TIME: 1:01AM PAGE:
SITE ADDRESS: 13165 SW ESSEX DR j CLASS OF WORK:
SUBDIVISION: HILLSHIRE LOT #: 014 TYPE OF USE:
PROJECT NAME: FARGO
DESCRIPTION: Segmental block wall.
OWNER: FARGO, RALPH /LISA PHONE #: 503-579 -3399
CONTRACTOR: MATT SANDER LANDSCAPING PHONE #: 503 - 647.0800
Inspection Request Scheduled For: Date: 8/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
410 Fill 036175.01 971-246-2218 Y
Corrections /Comments /Instructions: �`+
LASE Mc @ D
■
i..' mss , Alp my/
1 ASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION 7 ADDIT ONA FEES ASSESSED
Inspector: ` , / Date. (Tl V Phone #: (503) 7187 `1 --
CITY OF TIGARD r- _
BUILDING DIVISION PERMIT #: SIT2006-00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/7006
Phone: (503) 639 -4171 gt
Inspection Requests (24 Hrs.): (503) 639-4175 s __..
INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7 :05AM PAGE: 3
SITE ADDRESS: 13165 SW ESSEX DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE LOT #: 014 TYPE OF USE:
PROJECT NAME: FARGO
DESCRIPTION: Segmental block wall.
OWNER: FARGO, RALPH /LISA PHONE #: 503.579 -3399
CONTRACTOR: MATT SANDER LANDSCAPING PHONE #: 503 - 647.0800
Inspection Request Scheduled For: Date: 8/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
410 Fill 035091 -02 1 971-246-2218 N
Corrections /Comments /Instructions:
-:,.
❑ PASS __ ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , ...1 4/
Date: • -.�--z7L' Phone #: (503) 718 - "2-1-4(
CITY OF
BUILDING DIVISION PERMIT ##: SI12006 -00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ''''I
INSPECTION WORKSHEET FOR DATE: 8/1612006 TIME: 7:05AM PAGE: 4
SITE ADDRESS: 13166 SW ESSEX DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE LOT #: 014 TYPE OF USE:
PROJECT NAME: FARGO
DESCRIPTION: Segmental block wall.
OWNER: FARGO, RALPH /LISA PHONE #: 503-579-3399
CONTRACTOR: MATT SANDER LANDSCAPING PHONE #: 503 -611 -0800
Inspection Request Scheduled For: Date: 8/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
215 Footing drain 035091 -01 971-246-2218 N
Corrections /Comments/ Instructions:
m - /4- i .-R - c../ - Li .sri3
•
PASS �TIAL APPROVAL CANCEL NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: -8 !(o —l✓G Phone #: (503) 718 - 2---1-4%-- .94
CITY. OF.TIGARD
BUILDINIG'DWISIOIN ' PERMIT # SIT2006 -00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: am 0/206
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ;1''L:
INSPECTION WORKSHEET FOR DATE: 8/14/2006 TIME: 7:01AM PAGE: a
SITE ADDRESS: 13165 SW ESSEX DR CLASS OF WORK:
SUBDIVISION: HILLSHIRF LOT #: 014 TYPE OF USE:
PROJECT NAME: FARGO
DESCRIPTION: Segrnental block wall.
OWNER: FARGO, RALPH /LISA PHONE #: 503 - 579-3399
CONTRACTOR: MATT SANDER LANDSCAPING PHONE #: 503-617-0800
Inspection Request Scheduled For: Date: 8/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
405 Excavation 0349230/ 971 - 246-2218 N
Corrections /Comments /Instructions:
I
PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION n 'ADDITIONAL FEES ASSESSED
1
Inspector: Date: g— Li-- -d & Phone #: (503) 718- ?.4 -4'S-----
CITY- OF.TIGARD _
BUILDING` 3IVISION ' PERMIT #: S1T2006 -00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639 -4171 ^ ^ , p 'litl
Inspection Requests (24 Hrs.): (503) 639 -4175 ._'
INSPECTION WORKSHEET FOR DATE: 8/11/2006 TIME: 7:06AM PAGE: 5
SITE ADDRESS: 13165 SW ESSEX DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE 'LOT #: 014 TYPE OF USE:
PROJECT NAME: FARGO
DESCRIPTION: ogrnental block wall.
OWNER: FARGO, RALPH /LISA PHONE #: 503 - 579.3399
CONTRACTOR: MATT SANDER LANDSCAPING PHONE #: 5O3-647.0800
Inspection Request Scheduled For: Date: 8/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
405 Excavation 034840 -01 ()71- 246.271 Y
Corrections /Comments /Instructions:
421 'c,::-'2, - 17-c 4 #-R1 el. 4J a) , A , n -2. i t 4 — 6‘)P '1 7 !I.)
ff PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: _ F /j.-pr,6 Phone #: (503) 718 - 2.,4-44-