Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00088
r DEVELOPMENT SERVICES DATE ISSUED: 2/17/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134DB -03700
SITE ADDRESS: 10970 SW NORTH DAKOTA ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Demo 2,900 sq.ft. residential dwelling on sewer. UPON FINAL, DEMO CREDITS FOR SEWER, TIF &
PARKS APPLY.
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:
VENTURE PROPERTIES N E I • 4230 SW GALEWOOD ST #100 16850 SW UPPER BOONES FERRY RD
LAKE OSWEGO, OR 97035 #A
TIGARD, OR 97224
Phone: 503- 387 -7600 Contact #: PRI 503- 624 -0363
FAX 503 - 639 -1634
FEES Reg #: LIC 62761
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/17/2006 $62.50
[TAX] 8% State Surcharl 2/17/2006 $5.00
[ERPRMT] Erosion Coni 2/17/2006 $26.00
[ERPLN] Erosn Pin Rv C 2/17/2006 $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 9 or 1-800- 332 -2344.
Issued By: ffl,�� Permittee Signature:
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 Pe rO di tiO.n' , . ... I () R 0E1 I I ; .S I O I
„ A L�r _
City of Tigard 1 " � /6 K l PermitNo.13� �6 "oc�o�7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503p5EB961 2006 a . - I I Date/By: Permit:
Inspection Line: 503.639.4175 -4,.- - . 1 i.. Date Ready/Ely: SI See Attached Cheeldist for
Internet: www.c tigard on U `Y us, Notified/Method: )l (r I Supplemental Information
OF l'Iu t L
BUILDNIIIIINF 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.
Valuation: $
® 1- and 2 -family dwelling ❑ Commercial/industrial
❑ 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: 10970 SW North Dakota New dwelling area: square feet
City/ State/ZIP: Tigard, OR Garage /carport area: square feet
Suite/bldg /apt. no.: I Project name: Dakota Glen Covered porch area: square feet
Cross street/directions to job site: 100 feet west of 109 on south side of North Dakota Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: n/a I Lot no.: Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: Tax lot 3400 equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Demolition of existing house Valuation: $
,2./GO Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Venture Properties Type of construction:
Address: 4230 SW Galewood Ste 100 Occupancy groups:
City /State/ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7600 Fax: (503)387 -7617 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Venture Properties All contractors and subcontractors are required to be
Contact name: T® Delmore licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4230 SW Galewood Ste 100 jurisdiction in which work is being performed. If the
City/ State/ZIP: Lake Oswego, OR 97035
applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 387 -7600 I Fax: : (503) 387 -7617
E -mail: jdelmore@don morissettehomes.com
CONTRACTOR
Business name: NEI BUILDING PERMIT FEES*
Address: 16850 SW Upper Boones Ferry Rd Ste A Please refer to fee schedule
City/ State/ZIP: Tigard, OR 97224
Fees due upon application
Phone: (503) 624-0363 I Fax: (503) 639 -1634
Amount received
CCB lic.: 62761 .e • '
I '`f Date received:
Authorized signature: ' This permit application expires if a permit is not obtained
I ` within 180 days after it has been accepted as complete.
I Print name: Jim r i ore C I Date fG�_ J OG I • Fee methodology set by Tri- County Building Industry
xprvirp Retard
•
1 OFFICE COPY
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COMMUNITY DEVELOPMENT
--- DAKOTA GLEN
^— fEr ,tee
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ALOHA SANITARY SERVICE . J
INVOICE NO.; .
8600 SW Hillsboro Hwy., Hillsboro, OR 9712 e. 10 8 4 8
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503 - 644 -2797 503 - 648 -6254 • 5037639-5188'
NAME: !y. a g4 hlLl -sJ L
ADDRESS:
, / �1
CITY: /017 SIVA ORTFI AT ZIP: • ?M _
HOME: WORK: CELL: GS 1- 1Q, -g ` U10
JOB SITE: JC QIL 1 n 6 p 1•() \ Y4 . 7 , , ■ (-,apt( O (QV iI P %� C. #: 47 .
PAID BY CHARG CHECK ❑ CASH ❑ CREDIT CARD ❑
DATE (9 -Z i - Z 666 DRIVER C A Il`� 7 ?pal AMOUNT
PUMP SEPTIC TANK z7�
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❑ INSPECTION FEE I
❑ SERVICE CALL
❑ LABOR, LOCATING, DIGGING, BACKFILL
■
7 4,!/e A4
•' '• THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT - - I TOTAL $ �%(
- - REMARKS - -
TYPE OF T TEEL ❑ ^ CONCRETE ❑ PLASTIC ❑ HOMEMADE ❑
HORIZONTA ❑ VERTICAL ❑ RECTANGLE ❑ ❑ OTHER
SIZE OF TANK: 350 ❑ 5 ❑ 750 ❑ 1000 ❑ 0 ❑ 1500 ❑ 2000 ❑ 3000 ❑
LID LOCATION: INLET ❑ UTLET ❑ MID ' E ❑ ENTIRE TOP ❑
TANK CONDITION: GOOD ❑ FAIR III • OOR ❑
FITTINGS: BAFFLES ❑ CONCRE C CAST IRON ❑ PLASTIC ❑
NEEDS NEW LID? YES ❑ SI
GROUND COVER OVER TANK
. COMMENTS ON CONDITION OF P - AINFIELD ETC.
SIGNED BY / DATE • �J /_��
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T P4 « CQ.&4
CITY OF TIGARD , 0: 2,-*
BUILDING DIVISION ' PERMIT #: BUP2006- 00088
13125 SW Hall Blvd., Tigard, OR 97223 ■•• DATE ISSUED: 2/17/2006
Phone: (503) 639 -4171 , �,p ? l
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I �..
INSPECTION WORKSHEET FOR DATE: 7/12/2006 TIME: 7:05AM PAGE: Q
SITE ADDRESS: 10970 SW NORTH DAKOTA ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: DAKOTA GLEN PD
DESCRIPTION: Demo 2,900 sq.ft. residential dwelling on sewer. PON FINAL, DEMO CREDITS FOR SEWER, f IF
& PARKS APPLY.
OWNER: VENTURE PROPERTIES, PHONE #: 503.387 -7600
CONTRACTOR: N E I PHONE #: 503
Inspection Request Scheduled For: Date: 7/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 032953 -01 503- 849 -8540 Y
Corrections /Comments/ Instructions:
cf t( -1- eL4 ku, ew+a p e 4 t i-
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CO -e____- , WF'
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector. Date: 7 ii 0 ° Phone #: (503) 718- 27b