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Permit SITE WORK PERMIT F - " CITY OF TIGARD ,2•Fit _• COMMUNITY DEVELOPMENT Permit #: SIT2011 -00008 �dt Date Issued: 06/10/2011 TIGARD', 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S111AC01100 Jurisdiction: Tigard Site address: 14650 SW 92ND AVE Project: Caputo Subdivision: PINEBROOK TERRACE Lot: 52 Project Description: Installation of combination fence and retaining wall and erosion control. Contractor: OWNER Owner: CAPUTO, HUNTER 14650 SW 92ND AVE TIGARD, OR 97224 PHONE: PHONE: 503 - 793 -5948 FAX: • FEES Description Date Amount Specifics:. Permit Fee -Site Work 06/10/2011 $123.72 Plan, Review 06/09/2011 $80.42 Type of Use: SF 12% State Surcharge - Building 06/10/2011 $14.85 Class of Work: OTR Info Process /Archiving - Sm Sheet (up to 06/10/2011 $1.00 11x17) Project Valuation: $5,000.00 Erosion Control 06/10/2011 $80.00 Erosion Plan Review CWS 06/10/2011 $26.00 Erosion Plan Review COT 06/10/2011 $26.00 Site Specifics: Excavation Volume: cu. yd. Fill Volume: cu. yd. Impervious Surface: sq. ft. • Engineered Fill: Soil Report Required: Paving: Grading: • Landscaping: Site Prep:. Storn Drains: Retaining Wall: Yes Fire Underground: Accessible Parking: Fence: Yes Total $351.99 Required Items and Reports (Conditions) 1 Ersn Cntrl 503 - 681 -4444 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 -0090. You may obtain a copy of the rules or direct questions to • C by calling 503.232.1987 or 1 Issued By:� ittee Signature. Call 50 by 7:00 a.m. for the next available inspection date. 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. 06/08/2011 WED 12: 31 FAX 503 526 1708 WEDOHR. COM 12002/007 Building Permit Application (nos -p 40e,e- Site Work RECEIVED FOR OFFICE USE ONLY City of Tigard U N 8 j �' 1 " R Dat e/B e : 69gimmpi i i_ Wii r.40tT,;:,_ • r i• - !' 13125 SW Hall Blvd., 97223 Plan Review C Phone: 503.718.2439 Fax: 503.598. NMI et ' / Other Permit: T i G A R D Inspection Line: 503.639.4175 I Date/By: OF TIGARD Date Ready/By: Ms: 6d See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION No" etho' " /0 �,, ji" Supplemental Information . TYPE OF WORK R QUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Pennit fees* are based on the value of the work performed. ` ,�, ° ` Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement lilt Other: l 00 4 ;1jy 1 , equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this applicati , 1 - and 2-family dwelling Valuation: $ 5 � °`--' y g ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ... ❑ Master builder ❑ Other: Number of bathrooms: • �=-- -- JOB SITE INFORMATION AND LOCATION Total number of floors: -res -- Job site address: 1140S .... C .,n New dwelling area: . -__ square feet City /State/ZIP`�'t ei f- 617.12-- Q (A Garage /carport area: . --- square feet Suite/bldg. /apt. no.: J Project name: '1:4is :10" Covered porch area: _.�, -- square feet Cross street/directions to job site: t � � vri' area: t)� j square feet t A t-",ifT1'`!_- k ' 2 Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rotnded 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. c A#�•t \W� C .. 1. 1f? .. k . - . 17\ &.)' `kli` •...C�IV.V.._.- Valuation: $ . (d r " 1 J 4 "":r• \ ' —al.- c y Y 'c Existing building area square feet t2,, (3t /to 'Of 1,,e, ,` New building area: square feet ROPERTY OWNER ❑ TENANT Number of stories: Name: t 04i9 A.--6 0, Type of construction: Address: y(t(r,tC) ` (7�� 1 ) _ Occupancy groups: City /State/ZIl'r � T ' �y fit ;; tt ((� C �, ��. .Z72�' Existing: Phone: ) - ._ g -to Fax: ( ) New: 0 APPLICANT ❑ CONTACT PERSON NOTICE Business name: 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 lcensed 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: ( ) I Fax: :( ) E -mail: o � Business name: BUILDING PERMIT FEES* Address: (Please refer to fee schedule) City /State/ZIP: Structural plan review fee (or deposit): FLS plan review fee (if applicable): Phone: ( ) Fax: ( ) fgO . /0� • CCB lic.: Total fees due upon application: Amount received: Authorized signatu�; . - T . "" This permit application expires if a permit is not obtained i n i n t within 180 days after it has been accepted as complete. Print name: ,. { G� „ I Date: (, _ 9 - * Fee methodology set by Tri County Building Industry Service Board. I:\Buiiding\Pennits \SIT- PermitApp,doc 10/01/09 440- 4613T(11 /02 /COM/WEB) -c,.--- akr\e,.\-ti .•`• -1 ,...x...) C,-- 7,31,---, ............— --... co V - '\.. - t.., .., ,\! v, i.- ._.,-, _ _...5.... ----1— _..-- - —1 1- ■-• 1.331A.LS 3{00183N1d AAS• 0 •••••./ r r..., (..., / --. .i \ . 1 I -...„,... i ..___ -,, I V j ■,... ,, ■••=i .....:::1 . .---. 40,_ _ --- Ak.., ) f- .. - Ilw- 11FAMMEWIlltat - ,- X Ln c7, L.., .. _ ..\--4 7.7)1,?•1 Ul IV s :, i•-• 40 ' 'lie 1 s,,. cc • ... ' 10-_____/ . - IN I ,,./ .. '''..• „, RECeiV .r.. ._ ._ . • ..- f`r'--c Q : t.,) .11 71 '......... '.• 4 Alla .. •- xi ' • t (-- i•2.-.. ti ..(v. -7 ?•-1 JUN 9 2011 ....... i o i o ... i ii 1 , I 1 Gr) CITY OF TIGARD --.1-- ,2 . .." / _., BUILDING DIVISION ; 7, ' c.,-Kkvp_ / i 1,.., I z 1.-'11 Von.I'Vl ' • -• • • • • - ' • ' I 1 (/) ) 1- LA 7134 On: •-•i • • •"*.: . . 'NN-••••- ....... / .. • . . ;.: .. ....: :=.;,./. i X' f - / • .. • E. ( ... 0 M ' ..: -4- .-)..":c11:2 - i . , / . VI" r I rn ..- 1 - 1 - ..1...T , i ,- -- ..... , .'" 19 • r■r■-• . . . . 7- 1.1:-. • ....„.. • ( --", 1 1 I / :s-c_oi.t.,. • .,./ ___.. •:,/-\ ,...,-..)■. - ,c 0 ) .,s. co _74c-114 - :-•- ';' --- . .', .... . _ , • ... . :. ., .,...:....; :-...-:. 1 i...: _;-: ,,.: //. . \\ :rlf '. ?'• 0 -- )k,:l•-rw's ) " 0 - • • 1 - - . ---- 4 I I 1 .. a. z' ' (1 fi-t' L.:).. • 0 °4 ,, ;. - 11. -, •Nr • . ' A. ,, * . • - -.-- -, 1 , 11 " I N ..... ..• -....1 Building Division ' Development Code Provision Review IA'; A it b' Residential Projects Building Permit No: ( // — 0 0 00 CWS Service Provider Letter Received: Yes ❑ Np_ N/A. ❑ Routed Plans: , 0/1 1st Original Plan Submittal Date: / 1St Revision Submittal Date: ❑ Site Plan Only 2 °d Revision Submittal Date: ❑ Site Plan Only • To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (V) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For,questions please contact the appropriate staff person(s) listed above each-section. Staff: please check items along left only if approved. • • Planning Review (contact ?e h at 503- 718 - LY ,-Zor @i or. . Land Use Case No. Name _ P�.,,. -� hy- tr�,k- '��.. r'c i c J2 ❑ Zoning .N /A' ❑ Setbacks: //k • Front. _ Rear Side Street Side Garage - i !Maximum Height g 4 tL Actual Beileling Height Q ' . ©''Visual Clearan ee' E7 /Easements ❑ Sensitive Lands Type: Notes: • • • Original Plan: Approved ©— Not Approved Li Date: 6 //13/ 1 / Revision. I: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard- or.gov) ❑ Actual - Slope: Notes: • Original Plan: Approved ❑ Not Approved ❑ Date: Revision 1 : Approved ❑ Not Approved ❑ Date: Revision. 2: - Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) • Page 1 of 2 • • City �r borist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov) L_ / f Street Trees Protected Trees Notes: Original Plan: Approved / Not Approved ❑ Date: C 0- oo44 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: • Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or abert@tigard- or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent .to Applicant: Revision 1: Date Sent to Applicant . Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes ❑ No ❑ Date Routed to Building: ' • Page 2 of 2