Permit (4:.
BUILDING PERMIT
PE CITY OF TIGARD RMIT #: BUP2001 -00213
Abe In DEVELOPMENT SERVICES DATE ISSUED: 7/30/01
---- r �� 11 r 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16240 SW WOODCREST AVE PARCEL: 2S114BA -07700
SUBDIVISION: COPPER CREEK STAGE 2 ZONING: R-4.5
BLOCK: LOT: 017 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: 0.00 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: $ 9,500.00
Remarks: Remove existing window /door, install new existing french door with (2) fixed glass side lights with new framing &
header
Owner: Contractor:
DURFEE, DAVID A AND SHIRLEY VAN GUARD CONSTRUCTION LLC
16240 SW WOODCREST AVE 12915 SW HAWKS BEARD STREET
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 503 - 887 -3488
Reg #: - L1C 136013
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PLCK CTR 6/11/01 $40.63 27200100000 Insulation lnsp
Final Inspection
PRMT CTR 7/30/01 $139.30 27200100000 ��0� �®
5PCT CTR 7/30/01 $11.14 27200100000
PLC2 CTR 7/30/01 • $49.92 27200100000
Total $240.99
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 •r 1- 800 - 332 -2344. .
Pe rm ittee
Signat - , / n ! _aft
WIMP . .
, Iss , ed By: i ,, _ , Mb - 624,0r_d4i_2,4 _.,, ,
�— Call 639 -4175 by 7 p.m. foran inspection the next business d ay
05/14/01 MON 08:17 FAX r "" " "" ' "° 1. ,
L I ,,^ ) --/- Q� rnl ! ' I�j002
•
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A.
Ci ty of T. - sceived: _ - 0 Permit no.: 4 P GYJ/ - • • -
Project/appl no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigar I, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
cal & 2 family dwelling or accessory O Common sal/industrial O Multi - family O New construction O Demolition
121 Addition/alteration/replacement O Tenant it tptovement O Fire sprinkler /alarm O Other.
- -- -- -- - - - - - - - - --- - -- - -- - JOB ITE -INFO i IY ION
Job address: • • 0 ` , 11D 00 : I AJAX , Bldg. no.: Suite no.:
Lot: Block: Subdivision: I Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions: a we E).- \ I inn: era 41" ',ova ¢ l w- Ykt-L i Jn)
L - -- - - .. - ■tt C • IA .4' v - ...2. C. _ • _ __ _'C V) 1 . ._ - C :t ild , - �1f... ,
__ OWNEH— - FOR =SP-I CI AL-AN I•'OP�IATI0N- USE-CHLCKL-IST_—
Name: D , tJ_ _ _ (Floodplaimsepticcapaeity,sulat ett.)
Mailing address: I (47A-0 Sin) , '00Ct2E -r MjE.. 1 & 2 family dwelling: q
City: IA . /to State: 02 21P: Col 2..24- Valuation of work $ l 1 500 . e
Phone: (oAo - Fax: E -mail: No. of bcdrooms/baths
Owner's representative: . . G. •E ave. Total number of floors
Phone:$$ . . • • ax:'a L'.I I E -mail: New dwelling area (sq. ft.)
... _ _ APPLICANT Garage /carport area (sq. ft.)
IIMEMIN
a NST• L� I.. , c . f— Covered porch area (sq. ft.)
1 :.,- -
Mailing address: 12 IS id _ �1,, kl. S_ a 612 -1J '-,T-. Deck area (sq.R.)
_
City: C i S 0 'e;IP:C17 Z Other structure area (sq. ft)
r LJr ^ ConunercialllndustrliaUmulti- family:
' one: .,,1 Fax: 5 - $13 i E-mail:
CO TRACTOR Valuation of work $
Business name: 41 1L D u . 0A/ L. L Existing bldg. area (sq. ft.)
Address: New bldg. area (sq. f .)
Number of stories
�� � ) 5 5 /� tCFIn11L r ' Ga'�. `�1" .
City �`� 1 Type of construction
Phone: $ liliggEnta Fax: 5 - s - E -mail:
Occupancy gruup(s): Existing:
CCB no.:
City/metro tic. no New:
Notice: All contractors and subcontractors are required to be • , • • • • •
licensed with the Oregon Construction Contracteisac$ t l under' • • • • • • • •
Name: en — c piovisioni of ORS 701 and may be requited to be licensed in the • • • •••,
Address: • s • • • d '3 jurisdiction where work is being performed. If t$c is • • , •
exempt from licensing, the following reason applies: • •••I
■
! C• I LI r State:D . 2l 11_3 ••••
Contact person: 5 • y4 E Plan no.: - • • • • • • •
:
Phone:6 i _ _0_4, ,_ Fax: 1,40 _ E-mail: ;
ENGINEER •
oCCoo" '''(..(.•:•
Name: AO Contact , • rat in: • Fees due upon application $ • • • • • . • • • •
Address: ` �� Date received: •••• • • • •
1P Amount received $ • • •
City: State: ....
Phone: Fax: E -mail: Please refer to fee schedule. • •
•-•-._••• ••••
I hereby certify I have read and examined this application and the Not all lunadicdoot accept credit cards. please call jurisdiction for more utfonnatioa. •
•••
attached checklist. All provisions of laws and ordinances governing this ❑ visa ❑ MasterCard
work will be complied w' , wh • specified hereir or not. Credit cam number: / /
� Expires
Authorized signature: A ... - a te:(' - I 1 ' 0 ) Name or molder as shown en credit card
S
Print name: OenJ •, o S -
Cardholder aignamre Amount
Notice: This permit application expires if a permit is not d gained within 180 days atter it has been accepted as complete. 4404613 (6110/COM)
P tj
0 1(`
EXPMEED
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