Permit CITY OF T I GA R D BUILDING PERMIT
PERMIT #: BUP2002 -00309
4 ' DEVELOPMENT SERVICES DATE ISSUED: 7/17/02
. - II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13021 SW RAPTOR PL SITE 2S104DA -07600
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 062 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SFA SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 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: $ 15,000.00
Remarks: Engineered retaining wall for lots 62 -73.
Owner: Contractor:
BROWNSTONE HOMES PRO LANDSCAPE INC
3045 SE 61ST CT
HILLSBORO, OR 97123
Phone: Phone: 503 - 642 -5696
Reg #: LIC 140613
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing Insp
PRMT CTR 7/17/02 $187.30 27200200000 Misc. Inspection
5PCT CTR 7/17/02 • $14.98 27200200000 Final Inspection
n
Final n
PLCK CTR 7/17/02 $121.75 27200200000
Total $324.03
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 - 234•.
Perm ittee
Sig (A
S ignet : - _,.,,f-C...•■•__
Iss ed By: � I.� y �, /
- " Call 63' - 4175 by 7 p.m. for an inspection the next business day
r .
A - Building Permit Application
Date received:1 /7 Q Z. Permit no.:,� _a,30
, j ^ City of Tigard
Project/appl. no.: x ' date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: B Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm %Other: Rip /// /u6 7-Mt—
JOB SITE INFORMATION
Job address: /3 &9.. I SW ' pr-OA t— Bldg. no.: Suite no.:
Lot: 4, 2- I Block: (Subdivision: 411.4 1 / J ' neYse) 1.11.€.61 I Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions: E/1/la1 N £ 7»i .0 /d/C' 144-44—
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: 'g - , (Floodplain, septic capacity, solar, etc.)
. Mailing address: 1 & 2 family dwelling:
City: IState: IZIP: Valuation of work $
Phone: IFax: I E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name:
P2 4A D '6,- L Covered porch area (sq. ft.)
Mailing address: •p 4'� .6 3 4 5f C f Deck area (sq. ft.)
City: 14 ' I State:OR I ZIP: 4-2/Z3 Other structure area (sq. ft.)
Phone: a- 0'(o Fax: ,`. I E -mail: Commercial!mdustriaUmulti- family: fro
- CONTRACTOR Valuation of work $ / 5 OOd
Business name: �oyjn i ' / G /GAT Existing bldg. area (sq. ft.)
�T New bldg. area (sq. ft.)
Address:
City: I State: I ZIP: Number of stories
Type of construction
Phone: I Fax: I E -mail:
Occupancy group(s): Existing: _
CCB no.: /1 , / 3 New:
City /metro lic. no.: .3 57
Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: ., » L /t/ � ri provisions of ORS 701 and may be required to be licensed in the
Address: Lf / D ,(/ /U jurisdiction where work is being performed. If the applicant is
City: P/. 1o1.� v State: /2 I ZIP: q- y/ 2 exempt from licensing, the following reason applies:
Contact person: Plan no.: .
Phone: , sa_ 74/$Z Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: IZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all 'urisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this Ursa ❑ MasterCard
work will be complied with,
( eth spec d herein or not. Credit card number: e: Expires
) ��
Authorized signature: I G- // Date: 1 /I 7 / 2 ' Name of cardholder as shown on credit card P
Print name: MANUE A. CAS 7A 'UEDA $ •
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (M)0/COM)
•
Commercial Plan Submittal
y.yl Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking) •
Plumbing - Site Utilities 2
Building 1
Fire Protection System • 3 *
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
. ** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \forms \COM- matrix.doc 9/24/01