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Permit C ITY OF TIGARD BUILDING PERMIT PERMIT #: BUP20D.5,01004_ A. DEVELOPMENT SERVICES DATE ISSUED: 10/4/2005 s - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 102DC - 02400 SITE ADDRESS: 09265 SW MCDONALD ST ZONING: R -4.5 SUBDIVISION: EDGEWOOD LOT: 014 JURISDICTION: TIG Project Description: Demo 1800 sq. ft. residental dwelling on septic. 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: WINDRIDGE HOMES, INC. DONALD LEAHY 11401 NW SKYLINE BLVD. 16880 NW GERMANTOWN RD PORTLAND, OR 97231 PORTLAND, OR 97231 -2796 Phone: 503 - 978 -0830 Phone: 503 - 645 -7343 Reg #: LIC 69712 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 10/3/2005 $62.50 [TAX] 8% State Surcha 10/3/2005 $5.00 [ERPRMT] Erosion Con 10/3/2005 $26.00 [ERPLN] Erosn Pln Rv C 10/3/2005 $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: Jregon 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: �, ;I r y ,Q J Permittee Signature: Sjvc, Q�p`(� _ \ v 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 Permit Application FOR OFFICE USE ONLY City of Tigard Received �' g an �� PermitNo.: ► c -- / 0 i 00 13125 SW Hall Blvd., Tigard, OR 97223 ' " �L Plan Review . Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /ov....np ,:: 1 cis. Dates Other Permit: Inspection Line: 503.639.4175 i ; ' :l ' s` is is �J Ready/By: El See Attached Checklist for :, : : - D ate Internet: www.ci.tigard.or.us - ' Notified/Method: Supplemental Information r ESBJBLQt REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction V 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. 1 -and 2-family dwelling Valuation: $ Y g ❑ Commercial /industrial El 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: J L65 . M t 1:= tz. L a New dwelling area: square feet City / State/ZIP: D � 6-4,€4 0 2 97 Z Z t•( Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: • n,G Do A. Lc( Li,/c,nee,.S Covered porch area: square feet Cross street /directions to job site: 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.: 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. 0 h � (. c $--:,..9 h o'C- 3 cS -1e ✓Gy-, i,-P. J oil Valuation: $ P iro ,(e.r -1-- . Existing building area: square feet Pe.---1--) New building area: square feet 9 PROPERTY OWNER I ❑ TENANT Number of stories: Name: t,,,.1 A. i tr:d 4,2, ).- e S Type of construction: Address: /1 VO l N ,.,J y L.: it e 64, UI Occupancy groups: City /State/ZIP: fb rt4t,- d D2 7 Z 3 j Existing: Phone: ( 33) 97a ( 3 0 Fax: ( ) New: El. APPLICANT ❑ CONTACT PERSON NOTICE Business name: !L ; fl .� r � � ,Q y c "Nl4.n eJ All contractors and subcontractors are required to be Contact name: .51-e- y ,,r'PV 563 7 8 S/.!/j Z- d' licensed with the Oregon Construction Contractors Board yf ``)) under ORS 701 and may be required to be licensed in the Address: // (- /C) Sk y L, cut Q L (Ai jurisdiction in which work is being performed. If the City / State/ZIP: ��-LC applicant is exempt from licensing, the following reasons `'.,,4 © 2 972 3 i app Phone: (5733 ) 9 $ 0 330 Fax :: ( ) E -mail: CONTRACTOR Business name: 5a La et /-K BUILDING PERMIT FEES* Address: City /State /ZIP: Please refer to fee schedule. Fees due upon application Phone: (5Z3 ) G, j 7 '3 -f 3 Fax: ( ) /, Amount received (, CCBlic.: q7 /z_ 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: S7ze 4_4e_ C% c a d Date: 10 ;3 — O r * Fee methodology set by Tri- County Building Industry Service Board. is\ Building \Permits\BUP- PermitApp.doc 12/03 440-4613T(11 /02/COM/WEB) FROM • Leahy Spec Exc FAX NO. : 5032971899 Feb. 23 2006 11:49AM P3 • • st-liskluled 11/09105 61 u ,,pace E - -0100./ Date 11/08/05 08:00:00 Work Order # W032493 River City Environmental, Inc. Complete Industrial P.O. Box 30087 503- 2524144 waste Removal Portland, Oregon OR CCB# 141355 WA CCB# RIVERCE981BT Septic Tank Cleaning 97294 Sump Line Cleaning - Tom & Sean Leahy tteiV ED Site Information 155 NW Miller Rd PO# Portland, OR 97229 MAR 17 2006 8265 sw Mcdona/d 503- 297 -1899 • CITY OF TIGARD Description Units Amount BUILDING DIVISION . Septic . .. 6 e n i i c e . . . . j b 5 6 • ' . . . .g'5"-t) (ti 6 co Instructions: Driver Note ` C.3(... Tigard _ Demo ... • ... I �' bh •603 2- O4t't't ' . i8:OOAM / % (ill 5 • River City Environmental, ine. to in no way responsible for damage to the sepde tank or lids on the system. Tenna: Net 10 days. 1.5% per month will be charged on past due amounts. (18% per annum). Tarim and Conditions The Right to Lien . • The customer agrees to pay 81 imioiaes analog out of pumping eenrioes, end any other special services .... . within . . . .. . s. . • The customer agrees to pay such effia and overtime charges as may be invoked from time to time for services rendered, over and above the normal servicing schedule. on behad of to miner. The customer agrees to assume response ny damage to customer's real or personal property arising Com pumping services which talal place on customer's premises, where the drivers and vehicles of River Cdr Envhonmereel have been instructed to enter. This includes, but is not limited to driveways. Gees, parer lines or poles and building structures. If River City Emdronmkntal, Ina finds It necessary to add liquid to the tank on Jobsi% customer will be charged for the'additional gallonage resulting from these oondidthuts. Customer agrees to reimburse River City EnvIrornnental. Inc. for 811 reasonable attomey's fees court costs and other expense incurred by sad company to conferee collection or to salve their rights under this agreement Customer agrees to the above cond>dons. Redeemable In Multnomah County :. Work Authorized by _ c6 Date ji_f� C.( Driver Signature _>4t' 6' — Date 1 { l Time ! , :I/fir-1:. afilk OFFICE COPY 1 r � I / b I f 1 1 1 \ \ 2 S� 02 DC 0180 r S102DC 1 01700 t \ 1 _r (N l W 1 N 42.'0315` E \ ;ter- 1 r _ s ,. 259. 25.719 2S102DC 01900 3. • - -_ ,_ . ; -. \ I , .;, , ., / I / E 3 5 , / / / / A. / — "' / / / / / ) I 1 tt) / 1 / / I / / / Z 1 - :.. 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Vii_ ... ,,:. . ... - ...... ... • . , .f. , N r AV ale a.Y r >(�fv. ;. n ., _._ - . .. .,.• : _1• ':7 :. _ , a.. � ;. •�,�• ::'. r...e a . +t ^ J" .. — - j • en CITY OF TIGARD BUILDING DIVISION • PERMIT #: 2OOS,o1OO Lt 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 /true Inspection Requests (24 Hrs.): (503) 639 -4175 'I I.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: C J C j o a • CLASS OF WORK: SUBDIVISION: a LOT #: TYPE OF USE: PROJECT NAME: {� DESCRIPTION: OWNER: c I "' PHONE t�� 7O p ( -mod CONTRACTOR: 0 'C— PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 295. (L't- Corrections /Comments /Instructions: Cv& - S • PE-P Nab A I C 444 7 , 11111PW Nir �Ih PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL — ❑ CALL FOR INSPECTION ❑ ADDITIO AL EES ASSESSED Inspector: G l I Date: Phone #: (503) 718- z-4-2-3 3