Permit C ITY O TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00531
lir A A DEVELOPMENT SERVICES DATE ISSUED: 10/6/2005
. -+ L ..� I - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S136DD -03000
SITE ADDRESS: 11770 SW 69TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 009 JURISDICTION: TIG
Project Description: Demo 1,896 sq. ft. residential dwelling, on septic. DEMO CREDITS APPLY FOR SDC FEES.
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:
SPECHT DEVELOPMENT, INC. COFFMAN EXCAVATION LLC
15400 SW MILLIKAN WAY PO BOX 687
BEAVERTON, OR 97006 OREGON CITY, OR 97045
Phone: 503 - 646 -2202 Phone: 503 - 656 -7000
Reg #: LIC 146689
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/6/2005 $62.50
[TAX] 8% State Surcha 10/6/2005 $5.00
[ERPRMT] Erosion Con 10/6/2005 $26.00
[ERPLN] Erosn Pln Rv C 10/6/2005 $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: f Permittee Signature: C �� cal 0
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.
4
Building Permit Application Fo►z OFFICE USE ONLY
City g of Tigard ECEIV D Received — • /� Penult Nd l ..... � I GtJ
/�
Date/B •
13125 SW Hall Blvd., Tigard, OR 9722 Pion Review
Phone: 503.639.4171 Fax: 503.598.1960 AV � a Rr�'I1i' ' \ Date/By: Other Permit:
Inspection Line: 503.639.4175 OCT 0 6 200 _ 0__. Date Ready/By: 3 ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TIGARD
EtlitIllN tA MASI0N 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.
0 1- and 2- family dwelling El m
Comercial /industrial Valuation: $2,500.00
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11770 S. W. 69` Avenue New dwelling area: square feet
City/State /ZIP: Tigard, Oregon Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Specht Dartmouth Site Covered porch area: square feet
Cross street/directions to job site: S. W. 67 and Clinton 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.: 3000 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.
Demolish existing single family residence Valuation: $
T O ! S (, )-"/"4 Existing building area: square feet
co, Y New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name: Specht Development, Inc. Type of construction:
Address: 15400 S. W. Millikan Way Occupancy groups:
City/State /ZIP: Beaverton, Oregon 97006 Existing:
Phone: (503)646 -2202 Fax: (503)626 -8903 New:
0 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Specht Development, Inc. All contractors and subcontractors are required to be
Contact name: Joe Curran licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: As above jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax: : ( )
E -mail: JCurran @spechtprop.com
CONTRACTOR
Business name:*BS— eo, F/ 7,9A/ £)cc /4 Ti o' / BUILDING PERMIT FEES*
Address: A G. 30X 4,8? - / 3 o /'/ C L AC K.4hopOS RIVER- ?>.% ✓t please refer to fee schedule
City/State/ZIP: Q,z.Ec o es/ Ci 7Y, c» 97o yS
Fees due upon application $110.40
Phone: (SG.?) (a, 57t 7D O 0 I Fax: ( 3 -0 , A 6 o &As-
Amount received
CCB lic.: /5 c r o A 1 1 1 1 C r l / ,9 AE7 /9<S a7 N
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: Joe Curra'i Date: October 5, 2005 * Fee methodology set by Tri-County Building Industry
J Service Board.
i:\ Building \Permits \BUP- PertnitApp.doc 12/03 440- 4613T(l1/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION ERMIT #: BUP2005-00531
13125 SW Hall Blvd., Tigard, OR 97223 ATE ISSUED: 10/6/2005
Phone: (503) 639 -4171 zetosfo
Inspection Requests (24 Hrs.): (503) 639 -4175 .. '1
INSPECTION WORKSHEET FOR DATE: 10/11/2006 TIME: 7 :02AM PAGE: J7
SITE ADDRESS: 11770 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 009 TYPE OF USE:
PROJECT NAME: SPECHT DARTMOUTH
DESCRIPTION: Demo 1,896 sq. ft. residential dwelling, on septic. DEMO CREDITS APPLY FOR SDC FEES.
•
OWNER: SPECHT DEVELOPMENT, INC., PHONE #: 503 -646 -2202
CONTRACTOR: COFFMAN EXCAVATION LLC PHONE #: 503-656 -7000
Inspection Request Scheduled For: Date: 10/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 037974 -01 503718-2.423 N
Corrections /Comments /Instructions:
(,
ii 1
(Alit .
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
f � �
Inspector: _ (/t Date: 6 ` Phone #: (503) 718 2YL"Li
'' :4'09/2006 15:31 5036560686 COFFMAN EXCAVATION PAGE 02/02
•
s
ALOHA SANITARY SERVICE
INVOICE NO.
8600 SW Hillsboro Hwy., Hillsboro, OR 97123 1065 6
503 -644 -2797 * 503 - 648 -6254. 503- 639 -5188 -
NAME: C 6 Fria aJ
ADDRESS: 6 d2th- D 06,m0-01x 1 -8 - eos
CITY: STATE: ZIP:
HOME: WORK: CELL: 7 /Q--O qL-5
JOB SITE: ( 1 / Lt Yh 4th /SdiT 6d.1'+'vi P.O. #: ta-c 7e .
PAID BY CHARG =y CHECK ❑ CASH ❑ CREDIT CARD ❑
DATE 120Y— Q Z 0V DRIVER 174 f • AMoUNT
PUMP SEPTIC TANK , v ! 0 / , . ' f _ lad /./ rks
❑ INSPEcnoN FEE
❑ SERVICE CALL
❑ ' LABOR, LOCATING, DIGGING, BACKFILL
r.-
■ 0 t 0 A � P $ 1
I TOTAL 7(2
- THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT - - +
11 - — REMARKS - -
TYPE OF TANK: r. TEEL ❑ CONCRETE ❑ PLASTIC • HOMEMADE ❑
' ' HORI ■ • AL ❑ VERTICAL ❑ REN • GLE ❑ ❑ OTHER
SIZE OF TANK: 350 ❑ • , • 750 ❑ : I I ❑ 1250 ❑ 1500 ❑ : 2000:0 3000 ❑
LID LOCATION: INLET ❑ OU • - MIDDLE ❑ ENTIRE Top 0
TANK CONDITION: GOOD ❑ F•. - ❑ ' ••• ❑
FITTINGS: BAFFLES ❑ C�ONCRi -❑ 1 Vi F R. 5 tiC ❑ RETA�r :;�:aL
NT" co E:; I Q
NEEDS NEW L.ID? Yrs ■ Sty- ~....�1 `` D . .._,.
GROUND COVER OV • ANK MI �� _ � , ,,; .._ �.~ _ .
i'•MMENTS •.• •NDITION OF DRAINFIELD ETp'',; , 9 Few. 4_ f ^_ ::..,,..:_.;:• ., ....,_... 4- 7:1 :: ,.....
r j - V jj
ar�I w _ .7��rr :6‘61,
. •
SIGNED : 0 I "(V ' DATE (J • — / . .
7