Permit CITY OF TIGARD BUILDING PERMIT
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" . ' COMMUNITY DEVELOPMENT Permit #: BUP2009-00052
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/27/2009
Parcel: 1S135DD00500
Jurisdiction: Tigard
Site address: 11825 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Young's Funeral Home
Project Description: Demo existing 1,350 sq ft residential home. Sewer is to be capped. Upon final inspection, System
Development Fees credits are available for future development
Owner: FEES
ALDERWOODS (OREGON) INC Description Date Amount
BY SERVICE CORP & SUBSIDIARIES, ATTN: Permit Fee - COM 03/27/2009 $62.50
PROPERTY TAX -9TH FLOOR, PO BOX 130548 Erosion Control 03/27/2009 $26.00
PHONE: Erosion Plan Review CWS 03/27/2009 $8.45
Erosion Plan Review COT 03/27/2009 $8.45
Contractor:
OWNER
PHONE:
FAX:
Specifics:
Type of Use: SF
Class of Work: DEM
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $0
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $105.40
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet: CP , D 6 CO ZT12 -0C.. I �J�x 1 10 '
Fire Alarm: Protected Corridors: 503 ` Iscc' -- q-!1•/1
Smoke Detectors: Manual Pull Stations: TT �
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable I- All v
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if • ' is suspe' ■ ∎ • • f• , e
the 180 days, ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. ose Jules ar • • _ • ' h i OAR
952- 001 -001 rough 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 51 .246.:699 0 ,42lr
►
Issued B Permittee Signature: / \
Call 503.639.4175 by 7:00 a.m. for an inspection that business d : y.
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
Residential R EC' N ' 0 FOR OFFICE USE ONLY
City of Tigard q ' Date /B Ego Permit No. I pip
1114
- , 13125 SW Hall Blvd., Tigard, OR 9 `��►R !� Plan Review
Phone: 503.639.4171 Fax: 503.598. 960 �Q� DateB : Other Permit:
T I GARD Inspection Line: 503.639.4175 pF T10 Date ReadyBy: Juris• QI See Page 2 for
Internet: www.tigard- or.gov cm Notified/Method: Supplemental Information
BU IL
TYPE OF WORK 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.
. ® 1 - and 2- family dwelling ❑ Commercial /industrial
Valuation: $
171 Accessory building ❑ Multi - family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 11825 SW Pacific Highway New dwelling area: square feet
City /State /ZIP: Tigars, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Demo of house & Garage Covered porch area: square feet
Cross street/directions to job site: Off Ramp of 217 Deck area: square feet
Pacific Highway 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.
Clear the partial of Land of tree and building Valuation: $
Existing building area: square feet
-
ilD us� 7� i New building area: square feet
r `/ ® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Ypung's Funeral Home Type of construction:
Address: 11831 SW Pacific Highway Occupancy groups:
City /State /ZIP: Tigard, Oreogn 97223 Existing:
Phone: (503)639 -1206 Fax: (503)620 -5773 New:
Z APPLICANT ® CONTACT PERSON NOTICE
Business name: Young's Funeral Home All contractors and subcontractors are required to be
Contact name: David Hinton licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 11831 SW Pacific Highway jurisdiction in which work is being performed. If the
CitylState /ZIP: 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 639 -1206 Fax: : (503) 328 -7012
E -mail: david.hinton @sci- us.com
CONTRACTOR
Business name: Young's Funeral Home BUILDING PERMIT FEES*
Address: 11831 SW Pacific Highway (Please refer to fee schedule)
City /State /ZIP: Tigard, Oregon 97223 Structural plan review fee (or deposit):
Phone: (503) 639 -1206 Fax: (503) 620 -5773 FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received: # /06.
___ Authorized signature ) This permit application expires if a permit is not obtained
�t� C within 180 days after it has been accepted as complete.
Print name: David E. Hinton Date: / 2/6 C I' * Fee methodology set by Tri- County Building Industry
Service Board.
I:\ Building \Petmits\BUP- RESPermitApp.doc 11/6/07 440- 4613T(11/02/COM /W EB)
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