Permit CITY OF TIGARD BUILDING PERMIT
III = COMMUNITY DEVELOPMENT Permit A: BUP2020-00209
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/15/2020
TIGARD g Parcel: 1 S 126CD00100
Jurisdiction: Tigard
Site address: 9925 SW GREEN BURG RD
Project: Crescent Grove Cemetery Admin Subdivision: None Lot: None
Project Description: Demolition of an existing 1,025 sq.ft.office building on septic. Septic tank will be removed. UPON FINAL
INSPECTION, DEMO CREDITS FOR PARKS AND TRANSPORTATION WILL APPLY.
Contractor: DON TANKERSLEY CONSTRUCTION LTD Owner: CRESCENT GROVE CEMETERY ASS
1927 NW KEARNEY ST CRESCENT GROVE CEMETERY
PORTLAND, OR 97209 9925 SW GREENBURG ROAD
TIGARD, OR 97223
PHONE: 503-232-0918 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 10/14/2020 $210.59
Demolition
Occupancy Grp: Occupancy Load: DC Provision Review,COM TI-Ping 10/14/2020 $102.00
Dwelling Units: 0 Erosion Control w/Development 10/14/2020 $80.70
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 10/14/2020 $0.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $8,250
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $393.79
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
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
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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: \,y y (t A' (_/ Permittee Signature: C *t_q df''\
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
U 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
I
commercial RECEIV - I r'f:t" I tr I t ., I r,1 1
City of Tigard 23q p q >i�r1+r: 09 ? 20 Permit No Val- ��}20� Sr
—
a Phone: 503125 SW -a11 fll439TiF SR 9721960 AUG 2 4 2020 jyY iw �,�, Reload hcrmc
t I t..l AR 1-4lnapectiaa Lire: SO3-6394175 Dior:keadwhy: Jr* 0 Sae eine 2 for
Intoner: a
www.tigtrd-or,gov CITY OF TIGARDNeirlakee: A /�//A Suppler/weldtrr�.ties
BUILDING DIVISION nL e44_
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING
❑New construction N[Demolition Permit fees'are based on the value of the work performed.
— Indicate the value(rounded to the nearest dollar)ofall
❑Addition+alterationrepiocernrnt 0 Other. equipment,materials,labor.overhead.and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application
Valuation: S
❑ I.and 2-family dwelling N Caniner+ciaLindastual
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
lob site address.: 9925 SW Greenburg Rd. New dwelling area: square feet
City+State21P: Tigard,OR 97223 Garegekarport area: square feet
Suitcbldg./apt.N: E Project name:Crescent Grove CemeteryAdmin Bldg Covered porch area square feet
Cross street/directions to job site: From HWY 217,north on SW Greenburg Rd on Deck area: square feet
on west side of road between SW Washington Square Rd.and SW Lehman St. f>ther suceeue area; square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot N: too and 500 Permit fees`arc based on the value of the work performed.
Tax map+parcel a: VYCTM 15126CD,Tax Lots 100 and 500 Indicate the value(rounded to the nearest dollar)of all
equipment.materials.tabor.overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Demolish existing 1,020 SF office building and remove existing underground
Valuation: S 8250
septic holding tank Existing building ara: 1,020 square feet
New building area: square feet
X PROPERTY OWNER ❑TENANT Number of stories: 1 ..
Name Crescent Grove Cemetery&Masoleumdba Crescent Grove Cemetery Association Type of construction: VB
Address:9925 SW Greenburg Rd. Occupancy groups: B
CityfStatelZIP: Tigard,OR 97223 Existing: B
Phone:l 503)639-5347 Fax:( ) New:
0 APPUCATTT lit CONTACT ransom BUILDING PERMIT FEW ......_.
Busincssname (Nem,mAvrefetstinfols)
tiiulietti/Schouten AIA Architects,PC Structural plan review fee lot deposit):
Contact name: Jake Weber FLS plan review fee(if applicable):
Acidness: 2800 NW Thurman St.
City/Suite/MP: Portland,OR 97210 Total fees due upon application:
Phone:( 503 ) 975-3376 I Fax::( ) Amount received:
f-mail jaketv@gsarchitects.net PftOTOVOLTAIC SOLAR PANEL SYSTEM flE8°
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System
Business name: Don Tankersley Construction LTD Submit two{2)role of roof plan witfi connection details
and lire department access,along with the 2010 Oregon
Address: 1927 NW Kearney St. Solar Installation specialty Cede checklist.
Permit fee(includes plan review City/S 5180 00
mealP: Portland,OR 97209
and administrative fees):
Phone:( 503)232-0918 Fax:( 1 State surcharge(12%of permit fee): S21 61)
CCB Lie.: 88663 Taal fee due upon application: S2_tt1.6i1
Authorised si um: //I-JO'r L�'r This permit application expires it a peemh ts ant obtained
grmr ��s
CAA within fig days alter it has bees accepted as complete.
Print name: Don Tankersley Oslo e2/sl P'��nRd .
sFee mice
Boar agy seO by Tel-Coutry Building bd.urn
/rr f Servicee Botud.
tAturildis Pcnmits;BUP Ct)M_PcmitApp.doc Rev.012212014 440.4613T(11/02ICOWWEB)
N.
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - With Land Use
TIGARD
Building Permit #: BUP2020-0020/9
Site Address: 9925 SW Greenburg Rd Suite/Bldg#:
Project Name: Crescent Grove Cemetery
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Demolish existing 1,020-square-foot admin building
❑. Verify site address/suite# exists and active in permit system.
ElRiver Terrace Neighborhood: ❑ Yes Q No
El Land Use Case #: ADJ2020-00013 (See MMD2020-00021 for conditions)
0 Plans Match Approved Land Use:
❑ S. e Plan tV . dscape Plan •ther:
0 rban Forestry Plan 1 .levation Plan /
NO':uilding Height: Maximum Height A al Height
FA Conditions Met: 0 Prior to Submittal Prior to Permit Issuance
4Business License:
�\ Exists: ❑ Yes ❑ No, applicant was provided a business license application
Public Facilities Improvement(PFI) Permit:
Required: ❑ Yes,applicant was notified No Applied For: ❑ Yes ❑ No, stop intake
Notes: Do not issue until tree protection fencing is up (ask Lina), and erosion control is in place (ask
Mark or Joe).
Approved by Planning: Date: 9/23/20
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: %/ /y1)
Site Plans: #
Building Plans: # _
Building Permit#: ntex building ermit# above. kLf r r
Workflow Routing: [- l ng LI Engineering exmtt Coordinator .,
Workflow Sign-off: 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: Date: /�1ZS�
I:1Building\F'orms\BIdgPermitRvw_COM_W ithLandUse_111819.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes o
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engine• ng: Date:
Revisions (afte :uilding Submittal only) Reviewer Dare
Revisio : ❑ Approved ❑ Not Approved
R- ton 2: 0 Approved ❑ Not Approved
Revision 3: 0 Approved 0 Not Approved
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 Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
OSDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
ElOK to Issue Permit
Approved by Permit Coordinator: Date: A)//3e2.6
l:\Building\Forms\BldgPetmitRvw_COM_WithLandUse 111819.docx
Branden Taggart
From: Branden Taggart
Sent: Wednesday, October 14, 2020 9:13 AM
To: 'Jake Weber'
Subject: Crescent Grove Cemetery Demolition Permit: BUP2020-00209 - 9925 SW Greenburg Rd.
Attachments: Invoice.pdf
Hi Jake,
The demolition permit for Crescent Grove Cemetery is ready to issue now. The balance due is$393.79, and I have
attached an invoice above for you to reference. The permit fees can be paid online through our
website: https://aca.accela.com/tigard/Default.aspx. From there,click on the Building tab, enter the permit number
(BUP2020-00209) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and I will email the permit paperwork to you.
Thank you,
Branden Taggart
IIIw City of Tigard
o,,% Senior Permit Technician
a Community Development
TIGARD
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449'
brandent@tigard-or,gov
1