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Permit CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit #: BUP2013 -00061 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/03/2013 Parcel: 1 S135BD00500 Jurisdiction: Tigard Site address: 10865 SW 95TH AVE Project: Gertz Fine Homes Subdivision: MEADOW VIEW Lot: 8 Project Description: Demo single family house Contractor: GERTZ CONSTRUCTION CO INC Owner: GERTZ FINE HOMES 19200 SW 46TH AVE 19200 SW 46TH TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: 503 - 692 -3390 PHONE: FAX: 503 - 692 -5433 Specifics: FEES Description Date Amount Type of Use: SF Class of Work: DEM Type of Const: Permit Fee - Additions, Alterations, 03/20/2013 $149.75 Demolition Occupancy Grp: Occupancy Load: Erosion Control w /Permit - Ping 03/20/2013 $75.00 Dwelling Units: 0 DC Provision Review, COM TI - Ping 04/03/2013 $67.00 Stories: 0 Height: 0 ft DC Provision Review, COM TI - LRP 04/03/2013 $10.00 Bedrooms: 0 Bathrooms: 0 Value: $5,000 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $301.75 Required Required Items and Reports (Conditions) Fire Sprinkler: Parapet: Fire Alarm: Protected Corridors: Smoke Detectors: Manual Pull Stations: 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 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 the 180 daysC _________ NTION�Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 0 through OAR 952 -111 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. ' 2.1987 or 1.800.332.2344. Ism, K _ / z#,i Permittee Signature: Call 603.639.4176 by 7:00 a.m. for the next available Inspecti., 'date. 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 RECEIVED FOR OFFICE USE ONLI RECEIVED FOR - City of Tigard Received �� Date/B : - Permit No.: 6a i1�p r 1(�/3 - 000 (, I • 13125 SW Hall Blvd., Tigard, OR 9723 MAR 2 0 2013 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/By •S ` /3 C Other Permit: Inspection Line: 503.639.4175 Date Read �// 3 Ions:: ' ® See Page 2 for TI GARD Internet: www.tigard- or.gov CITY OFTIGARD Notified/Met �l 5 l� ( p Supplemental Information BUILDING DIVISIO Le c , TYPE OF W OI;IC REQUIRED DATA: 1- AND 2- FAMILY DWELLING j New construction 1Demolition 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. dwelling Valuation: s S6Z1 d K1- and 2-family g ❑ Commercial /industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: 3 El builder ❑Other: Number of bathrooms: 2-- JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10 84 S .5 9 5 New dwelling area: square feet City/State /ZIP: Tigard OR 97224 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 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.: /5/Y5 0 CO $'dC• 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. N -.c e x) ki i!elc `Yi (1) Valuation: $ � f .f I :r l00 r r ��,trq �� fl Existing building area: square feet New building area: square feet c -PROPERTY OWNER El TENANT Number of stories: Name: 6 ei , L /v6- 2:0 4. r Type of construction: Address: /f (jp s/a) � "r"-4 Occupancy groups: —1 City /State /ZIP: �_ ,c 6 {r !a Q 72 O6 Z Existing: � 7 Phone: ( 573)6, 9 ! � L 3 3 r D Fax: (.,C 3) C 9z- S' Y 3 3 New: ID APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: �-L , �' " _ 'T � Structural plan review fee (or deposit): Contact name: e ,v ‘.04.1 Address: /1 Z- -sue City /State /ZIP: �(LmC FLS plan review fee (if applicable): / r, �� w 82 O� Total fees due upon application: Phone: (50 4) C.1 `3,7 fa Fax: : (S03)C f 2,3- y3 i Amount received: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E -mail: c,00 r.tiO ,CQS's Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System. Business name: Ge4 fZ Fes, e , Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: / 7 z,p-Z s rc..) �/C Solar Installation Specialty Code checklist. City/State/ZIP: 0 Z Permit Fee (includes plan revie y �� 0 ? and administrative fees): $180.00 Phone: ( 40,72 - if r6 Fax: ( ) (' Q 2 -.. `Zr' 3 State surcharge (12% of permit fee): $21.60 CCB lic.: 3 3 Total fee due upon application: $201.60 Authorized signature: / — This permit application expires if a permit is not obtained J/ _ within 180 days after it has been accepted as complete. Print name: 4t 6 - Date: 3-26-13 * Fee methodology set by Tri -County Building Industry Service Board. :\ Building \Permits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(I I /02 /COM/WEB) 0/1 s e v PE tit TE Building Division Development Code Provision Review TIGARD Residential Projects Building Permit No.: &IPdo I 3 000 0 REH l� Site Address: b S (oS ) 9s " - 4 Project Name & Lot No.: t L &T Z (L.�C_. C _ CWS Service Provider Letter Required: Yes ❑ No ❑ Received: Yes ❑ No ❑ Routed Plans: _ Original Plan Submittal Date: 3, J/3 �f 1st Revision Submittal Date: ❑ Site Plan Only 2 "d Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left only if approved. Planning Review (contact at 503 - 718+2 V or ZW____@tigard-or.gov) Land Use Case No. Zoning /2— ❑ Se tacks: Fro ' t Rear Side Street Side Garage ❑ Ma u : uilding Height: Actual Building Height ❑ Visu. C arance ❑ Easem•i is ❑ Sensi'.v ands Type: ❑ Stre tTre•s ❑ Pr. tected ees Notes: /Atka! C1� Original Plan: Approved 1k Not Approved ❑ Date: ' S Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard - or.gov) Actual Slope: f3 0A) Notes: Original Plan: Approved ,0 Not Approved ❑ Date: 3/ /3 Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @ tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applicant Okay to Issue Permit: Yes ❑ No ❑ Date Routed to Building: Page 2 of 2 O RECEIVED -Er7-- EX!S17NC m 1 TO REMAIN ...• i EX R OFFICE COPY MAR 2 0 2013 ro • CITY OFTIGARD BUILDING DIVISION 510'2 �� J' - - - ■74.24 . ��� - 2.1 c�`�\2 0 r \ 9 s. ./11110 i %4- 1 Si /tfe I HOME DEMO PLAN I I S 1 I c 1 L / EXISTMG HO TO BE REMOVE I' ( I N 1 'co Lt N J co Ioo ., L Im COi.p I I NI(p_ I 1 1 �� -.'1111111111111N. .C.') 1 I , SI. S n 1 .i � . 1 1 • • • � 1 I ` � . \ ) 30 , `�� ', ' "II, 1:" .` (470) 18 •,`5 / s. 1 CLUSTER 22 410) , 20 `�/�\�' `• ice' i / i • i Ir ` 103.46 4_10 I � �� i \ i ` CCUSTER`� 20 Gravel Drive `� � `� � `. for Erosion . . SW 95TH AVE CITY OF TIGARD Approved .......... f I Conditionally Approved ( I See-Lefterio:-Fofferw r__ - Attached 04 MAR 2013 KG Per nit IQn* E - LPAO /3.- d , 41 . ME CON ALAN MASCORD D E5GN ASSODA1 PAL IS NOT CITY O F TIGARD � ����� UA BIE FOR IT I ACCt1RACY aF IHE ES, tI1POCRAPNY 10865 SW 95TH A p "- `'' '� ,... 2111 � GUIDER TO bERIF'Y ALL SSIT gTNINS, INCLUDING VIP FILL PLACED ON 1110 SI1E AND NOTIFY 1140 011NERS co MY POIENIIAL FELD NOUFlCATIONS '. .t+ COLLECTION ALAN MASCO DESIGN ASSOCIATES. INC. BY: KEN GERTZ ( 9,062 S0. f7.)