Permit BUILDING PERMIT
CITY TIGARD PERMIT #: BUP2003 -00352
��,; DEVELOPMENT SERVICES DATE ISSUED: 6/11/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101AD -01000
SITE ADDRESS: 12705 SW 67TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 033 JURISDICTION: TIG
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 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:
Remarks: Demolition of 1150 sq ft SF residence & 700 sq ft garage. All debris is to be removed from site, the septic tank is
to be pumped, filled & inspected. SDC credits to be applied to new construction.
Owner: Contractor:
SPECTRUM DEVELOPMENT JOSEPH HUGHES CONSTRUCTION,INC
25117 SW PARKWAY AVE STE C 7035 SW HAMPTON
WILSONVILLE, OR 97070 TIGARD, OR 97223
Phone: 503 - 570 -8828
Phone: 624 -7100
Reg #: LIC 45645
FEES REQUIRED INSPECTIONS
Description Date Amount Erosion Control Insp 846 -8
[BUILD] Permit Fee 6/11/03 $62.50 Pump /Fill Septic Tank Insp
[TAX] 8% State Tax 6/11/03 $5.00 Final Inspection
[ERPRMT] Erosion 6/11/03 $26.00
[ERPLN] Ero Plck -USA 6/11/03 $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 • - • •r 1- 800 - 332 -2344.
Issued B : ,I l% 1• , . C Qi- , /,
Pemiittee - ,
Signature: A � L�,` � i 1 � '
i' Call 639 -4175 p.m. for an inspection the next business day
Building Permit Application OFFICE LSE ONLY
Date received: G // 0A Permit no.:Aeahtel.dO0.5✓
■ + �> City of Tigard
Project/appl. no.: date:
City ojligard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Mr mar
Phone: (503) 639 -4171 Date issued: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORNIATION
o• . • . - ss: 2 0 c Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.: Q5/ 0IAm(), . ��
Project name: . - - Al — _ NY A. E
Description and 1 ation of work on premises/special conditions: 4 /l/X/ /(I ' v
• VC _ . /—
#0006 A G e,tts // Z 4 7, Too
OWNER FOR SPECIAL INFORMATION. USE CHECKLIST
Name: I' ` � r �� ( Floodplain , septiecapacil�..solar. etc.)
Mailing address: ' • - y4YME C 1 & 2 family dwelling:
BEM State: ZIP: 0 0 Valuation of work $
Phone: - 0 - ;,;. Fax: 70- ; E -mail: No. of bedrooms/baths
Owner's representative: _ _ - V a. _ _ Total number of floors
Phone: A N( . i . 7 E -mail: New dwelling area (sq. ft.)
A P 1' L I C A N 1 Garage/carport area (sq. ft.)
Name: V; c> 13i_1T Covered porch area (sq. ft.)
Mailing address: j2, N N( 5TH' Ave =21 . 3 Deck area (sq. ft.)
City: Teti: t C) IZIZM ZIP: Other structure area (sq. ft.)
' r one: 5/2:3 % • . :',1 =ME E -mail: Commercial /indostriallmuli- family:
CON I - RAC 1 012 Valuation of work $
1 ���� �� New bldg. area (sq. ft.)
Existing bldg. area (sq. ft.)
Business name.
�� �� �'
Address: i Number of stories
State: ZIP: Type of construction
Phone: Fax: E -mail: Occupancy group(s): Existing:
CCB no.: New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: DM/ D a isevr - . ' , - i 'itTe5S provisions of ORS 701 and may be required to be licensed in the
Address:822, M1I∎1 . ` c • jurisdiction where work is being performed. If the applicant is
7� r � ZIP: et7 . - exempt from licensing, the following reason applies:
Contact person: v ' . 131" . n Plan no.:
Phone: y, -1 , Fax: 4-2,30 E -mail:
ENGINEER OFFICE LSE ONLY
Name: V(-. 'j j _ N Contact person: Fees due upon application $
Address: ' ci ,,,, 54■1 �-.4 ,- -_ , (p ( Date received:
[i ► = IP: • 2. • Amount received $
Phone: .� -(( - L1ottr.-sgA.: Please refer to fee schedule.
I hereby certify I have re. ' :.: d examined this a ' $ lication and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All 4_411 ons of l . .r • &ices governing this v visa 0 Mastercard
work will be compli - - her ; , , ,,. 0 54 4r
,,,. ' - i _ : or not. Credit card number. / i
i / �i _ 2 Expires
Authorized siyr . , :. ��� A � , �� 41_ � A 'SA te: & /�D� J Name of cardholder as shown on credit card
Print name: A. !i/i'/►� r Mi% t/ J Cardholder signature $
Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -0613 (6/Oe /COM)
CITY OF TIGARD 24- Hour,
BUILDING Inspecti .Y (503) 639 -4175
INSPECTION DIVISION Busines (503) 639 -4171 MST
BUP 3 '°e )3 S"D.
Received Date Requested AM PM BUP
Location / o S Suite MEC
Contact Person Ph ( ) -. - 7 33 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain i3? ELR
Crawl Drain
Slab : Inspection Notes ` � '/f SIT
Post & Beam p O y is r P Td " „C�'
Shear Anchors .• k /►
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: �� W
�b PART FAIL
P MBING
Post & Beam
Under Slab
4 -2
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pa
Other:
. - PART FAIL
CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: 1=I Unable to inspect – no access
Fire Supply Line
Approach/Sidewalk Date //& /0 `/ Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
EROSION CONTROL
FENCING, TIP.
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EXISTING HOUSE
I TO SE REMOVED • 1
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EXISTING GARAGEI •
1 TO 13E REMOVED I
( +/— 100 SF.) •
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i \ SITE PLAN m '°' 8 ' '6'
N 11111011.91111111.1.1i