Permit II CITY OF TIGARD BUILDING PERMIT
` I COMMUNITY DEVELOPMENT BUILDING
BUP2015 00031
T I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/03/2015
Parcel: 2S103AA00100
Jurisdiction: Tigard
Site address: 12060 SW TIEDEMAN AVE
Project: Metro Regional Parks Subdivision:)O SUPPLEMENTAL PLAT NO.1:ANNE Lot: 7-6
Project Description: Demo existing 2,000 sq ft house and 800 sq ft accessory building. Sewer is to be capped. UPON FINAL
INSPECTION,DEMO CREDITS FOR SDC FEES MAY APPLY.
Contractor: JSE LABS INC Owner: METRO
3315 SE HARRISON ST SUITE#C 600 NE GRAND AVE
MILWAUKIE, OR 97222 PORTLAND, OR 97232
PHONE: 971-275-6041 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: DC Provision Review,COM TI-Ping 03/03/2015 $75.00
Occupancy Grp: Occupancy Load: DC Provision Review,COM TI-LRP 03/03/2015 $11.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 03/03/2015 $256.22
Demolition
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 03/03/2015 $0.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $11,800 Erosion Control w/Development-Eng 03/03/2015 $80.70
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $423.42
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, o ' work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N.•'ication Ce• Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by call g 503.23 : „a.80•.332.2344.
•Issued By: . , ■ �` Permittee Signature: eilo1i.l
Call 503.639.4175 by 7:00 a.m.for the next available Inspection 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
Site Work RECEIVED FOR OFFICE USE ONLY
III City of Tigard haters .rAZ �� Permit No.: ,t� 145:ter3
• 13125 SW Hall Blvd.,Tigard,OR 97223,- Plan EB 1 7 2015 Review
Phone: 503.718.2439 Fax: 503.598.194E3 Date/By: Other Permit:
FIG:1 R D Inspection Line: 503.639.4175 Date ReadyBy: Q� Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Me . �/� ����" Supplemental Information
BUILDING DIVISION A,_, I'M w,rim 4.%/1---" (---
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 Valuation: WIN //I 80 0
Z,on 5y Fr. ❑Commercial/industrial
®Accessory building El Multi-family Number of bedrooms:
4306 5s/ f •
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address:12060 SW Tiedeman New dwelling area: square feet
City/State/ZIP:Tigard/Oregon/97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:.S>tan / ryZ) i(E 61 D 0.4` Covered porch area: square feet
Cross street/directions to job site: PA 044,S Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 Lot no.:00100 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S103AA 00100 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.
Demolish/deconstruct single family dwelling and garage coo FFr Nous6 Valuation: $
t f goo Sf<rgcecil Existing building area: square feet
Aui"/dir
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:Metro Regional Parks and Natural Areas Type of construction:
Address:600 NE Grand Ave Occupancy groups:
City/State/ZIP:Portland,Or 97232 Existing:
Phone:(503)797-1554 Fax:(503-)797-1849 New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Metro Regional Parks All contractors and subcontractors are required to be
Contact name:Laurie Wulf licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:600 NE Grand Ave jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,Or 97232 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)797-1554 Fax::(503)797-1849
E-mail:laurie.wulf @oregonmetro.gov C.€// 5o? -74'3-fJ/.4 Z
CONTRACTOR
Business name: 15 LA 6S I 00.-- BUILDING PERMIT FEES*
Address: 3315- 5E (-Garrison Sf Sit gi` C (Please refer to fee schedule)
City/State/ZIP: 14 Wit(,f feet /p ref on 7 972.7 Z Structural plan review fee(or deposit):
FLS plan review fee(if applicable):
Phone:(ill ) 2.15- 4.041 Fax:( )
CCB lic.: I R W.95 9l-//i Total fees due upon application:
/ �� Amount received:
Authorized signature: ``/7-`/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Laurie Wulf Date: * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Permits\SIT-PermitApp.doc 10/01/09 440-46131(11/02/COM/WEB)
IIIII
City of Tigard
i 41
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: ��k)ao l5 -0003 /
Site Address: l ao(p o bk....) El-hi /3 Suite/Bldg#:
Project Name: - (`(ci (PA ColorJA-L- Pei-Q1415
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 6110 d14 u ,c cvC s
Existing Business Activity: 1/4 C.„t, l BL S
Proposed Business Activity: ope,,,, S'/,tic
❑ Verify site address/suite #exists and active in permit system.
❑ Zoning:
❑ Permitted Use: w Yes ❑ No El Spec Space
1Z Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: Date: ` -c —76.+,1 Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: .21/7/47-
Site Plans: #
Building Plans: # 2
Building Permit#: Erfnter building permit#above.
Workflow Routing: Manning 0--f'ermit Coordinator
Workflow Sign-off: P--Sign-off for Planning(include notes from planning review)
Route Application Documents: Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: C_ C er Oe z __ Lam' Date: ��/g /5'
I:1Building\Forms\BldgPerm itRvw_COM_NoLandUse_020415.docx
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to A.. ant:
Revision Notice 2: Date Sent to ' ..licant:
Revision Notice 3: Date Sent . Applicant:
C7 OK to Issue Permit
Approved by Perm' oordinator: Date:
I:\BuildinglForms\BIdgPermitRvw_COM_NoLandUse 020415.docx
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Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12060 SW TIEDEMAN AVE, TIGARD, OR, 97223
Residential - Building
299 Final inspection
FAIL
BUP2015-00031
David Young
Provide initial and final erosion control prior to BUP final inspection.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12060 SW TIEDEMAN AVE, TIGARD, OR, 97223
Residential - Building
299 Final inspection
PASS - No C of O
BUP2015-00031
David Young
Per contractor, sewer line capped off by lateral and inspected by CWS as the sewer
main is Clean Water Services.
Violation Summary:
Inspector Contractor