Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 00584
I DEVELOPMENT SERVICES DATE ISSUED: 11/1/2005
� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25111 AD -06300
SITE ADDRESS: 14815 SW HALL BLVD ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Demo (2) residential homes, 14815 & 14825 SW Hall, and (3) outbuildings, all on same parcel. SDC
credits for the one parcel to apply to new construction.
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:
Owner: Contractor:
BEACON HOMES NW INC BEACON HOMES NORTHWEST
12703 SW 67TH AVE 12703 SW 67TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 503 - 570 -8828 Phone: 503 - 570 -8828
FEES Reg #: LIC 151251
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/1/2005 $62.50
[TAX] 8% State Surcharl 11/1/2005 $5.00
[ERPRMT] Erosion Conn 11/1/2005 $26.00
[ERPLN] Erosn Pln Rv C 11/1/2005 $8.45
(additional fees not listed here)
Total $110.40
This permit is issued subject to the regulations contained in the Tigard Muniapal 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 -6 ='• or - 800 -332 -2 )4. n
Issued By: .i / _ / Permittee Signature: v J
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.
Building Per Application FOR OFFICE USE.ONLY
City Of Tigard Received /
g Date /B Permit No.: / � i 4, ,..4.68 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.196,9 +//"t/� ''� Date/13 : • Other Permit:
Inspection Line: 503.639.4175 ® K All " I Date Ready /By: �� El See Attached Checklist for
Internet: www.ci.tigard.or.us q {oV Notified/Method: �If Supplemental Information
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❑ New construction 130S 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
Wy�x .�' °, work indicated on this a
T., ;F;,, i application.
GA `G .I
< -�`:. ORY _O ..CONSTRU ON °• r,� "�=
® 1- and 2- family dwelling ❑ Commercial/industrial Valuation: .10750'0"
® Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other.` Number of bathrooms:
<' ' w= °e JOB i,SITE` I : FOR ' ' T ` ' i Total number of floors:
:F DI MA O N'�AND ° :IoCATI :;; € , ,
Job site address: 14815 SW HALL BLVD e m tit gas t�� /4 ,4 1.4.. R, - it New dwelling area: square feet
City/State /ZIP: TIGARD, OR 97224 ' Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: LADY APPLE Covered porch area: square feet
Cross street/directions to job site: HALL, BETWEEN SATTLER & BONITA Deck area: square feet
4 , Other structure area: square feet
IREQUIRED,DATA COMMERCIAL -USE CHECKLIS
2 Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: R0501326 Indicate the value (rounded to the nearest dollar) of all
overhead, and the profit for the
,, h,: r . _ , , .:;DES RIPTION OF -W= K' :; s'z :r,,,;, :: ''2' . work indicated on this a labor, tion
rr nn ,
., a .� 1 5�:��� W - C OR � �� ,�„
.,,, -. -. ,: - „3a:. .. s . ..^. _:. , . ^ �, - .,.eat.. .a,, d ,� -.. u,, w xa.�k �f , 0
/ DEMOLITION OF S.F.R. AND OUTBUILDING Valuation: $
`��/� Existing building area: square feet
41
New building area: square feet
E y �.1'.a�'.
®., O .E 'CYO °DO °` = .`TENANT °`” °' r` € 7 Number of stories:
Name: BEACON HOMES NW, INC. Type of construction:
Address: 12703 SW 67' AVENUE Occupancy groups:
City/State /ZIP: TIGARD, OR 97223 Existing:
N. Phone: (503)570 -8828 Fax: (503)570 -8869 New:
.. a ..na..,., .•: >at_ Ft''':',:' ¢,., .;? ..: £° '.'cam. -�'e
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.4111::.' APPLICANT . r,,.u, , 'i >C , ' r.'.. -il ..
�€::;.'.,,.: �,h -..� .<. ONTACT•'PERSON,
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Business name: BEACON HOMES NW, INC. All contractors and subcontractors are required to be
Contact name: DAVID DALBEY licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12703 SW 67 AVENUE jurisdiction in which work is being performed. If the
1 ���111 ^ »J City/State /ZIP: TIGARD, OR 97223 applicant is exempt from licensing, the following reasons
1 - apply:
e0 Phone: (503) 570 -8828 Fax: : (503) 570 -8869
E -mail: ddalbey @BeaconHomesNW.com
••ONY `CTUR
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Business name: BEACON HOMES NW, INC. $:= q�• � , q ?• - - - -,� - A..r , ^-
-,° .F� =' :� -,' BUILDIN :FEE < - , ,;"'° ;-,_
h Address: 12703 SW 67 AVENUE
f-� Please refer to fee schedu e.
City /State /ZIP: TIGARD, OR 97223
4,
Fees due upon application 16 ..
Phone: (503) 570 -8828 Fax: (503) 570 -8869 fiV
Amount received
CCB lie.: 151251
Date received:
Authorized signatur • / r This permit application expires if a permit is not obtained
r within 180 days after it has been accepted as complete.
Print name: KURT DALBEY Date: 10/31/05 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Pernits\BI)P- PermitApp.doc 12/03 440- 4613T(I l /02 /COM/WEB)