Permit CITY OF TIGARD SITE WORK PERMIT
Fil 11 COMMUNITY DEVELOPMENT Permit#: SIT2022-00004
Date Issued: 2/3/2022
-TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S126CC00200
Jurisdiction: Tigard
Site address: 10065 SW CASCADE AVE
Project: Tesla Subdivision: None Lot: None
Project Description: Erosion control only for utility improvements.
Contractor: WESTERN CONSTRUCTION SERVICES INC Owner: 10065 SWC LLC
2300 E 3RD LOOP SUITE 110 BY ALSTON&BIRD LLP
VANCOUVER,WA 98661 BANK OF AMERICA PLAZA
101 SOUTH TRYON ST STE 4000
CHARLOTTE, NC 28280
PHONE: 360-699-5317 PHONE:
FAX: 360-694-7818
FEES
Description Date Amount
Specifics: Erosion Control Only 02/03/2022 $922.80
Info Process/Archiving-Lg$2.00(over 02/03/2022 $2.00
Type of Use: COM 11x17)
Class of Work: OTR
Project Valuation:
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Soil Report Required:
Paving: Grading:
Landscaping: Site Prep:
Storn Drains: Retaining Wall:
Fire Underground: Accessible Parking:
Fence:
Total $924.80
Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
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
Issued By: �� f� Permittee Signature:
a
Call 5 3.639.4175 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 Ri PI
Site Work FOR OFFICE USE ONLY
Received �yaJ�^�
City of Tigard R E E I V E D Date/By: d iji a ,7) Permit No.: S"TY—"}„3 _. Oct
.11114 • 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review j
e Phone: 503.718.2439 Fax: 503.598.1960 ii 9 DatcBy: Other Permit: /-/J l _/Ll a
1. t_, �,o Inspection Line: 503.639.4175 FEB 1�LL Date Ready/By: r , Tons: S!eee at,
i2/for rN(/
Internet: www.tigard-or.gov Notified/Method: /a,-- ,J l i[,' Supplemental Information
CITY OF TIGARD (PEr d� r"
TYPE OF waitiliDING DIVISION 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.
Valuation: $
❑ 1-and 2-family dwelling 1514 Commercial/industrial
0 Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: OvC0ti w C`a -,icuC� J kjc.L, New dwelling area: square feet
�
City/State/ZIP: TQ FA-vs, ; U `nl 1 2_2-- Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: "ct sl,,C T- Ct CJ Covered porch area: square feet
Cross street/directions to job site: ` Deck area: square feet
c) .\ > e 4\{ U Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: l S \ 2 (_ C c -v-u, U U Z O Indicate the value(rounded to the nearest dollar)of all
� overhead,and profit for the
equipment,materials,labor, the ro
C work indicated on this apphcation.
Valuation: $
La 4^P A Existing building area: square feet
v 1
New building area: square feet
11 PROPERTY OWNER 0 TENANT Number of stories:
Name:cbc he `��U e`er'p Ne_\`\ ' CO Type of construction:
Address: 570 Oekot.JO re A(,)€ Occupancy groups:
City/State/ZIP:\)Dt_)-ftk U I J\ i 42 0 2- Existing:
Phone:( i I(c,) j G --0 2_t I Fax:(-1 LE)c . - 1 O �C New:
tyI APPLICANT ❑ CONTACT PERSON NOTICE
Business name: --x; (VI r:4---•O(\ '04:_:,( ' \,L' \e \-- Le All contractors and subcontractors are required to be
Contact name: (--{\ ` c)r licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: l- 1 0 (O e^�Q i-p J�Ue jurisdiction in which work is being performed.If the
City/State/ZIP: `��r - l0 t Y t�w Z applicant is exempt from licensing,the following reasons
Phone:("7 KO C6J-6 \ Fax::(l«p) %%CO- 0 2-� apply:
E-mail:(`n(.A-V-C,Cl.rtC S (£ \CX e kv-�(7 R ,C C) f .
CONTRACTOR
Business name: p- er rra om" ` /,_J , J BUILDING PERMIT FEES*
Address: ya.) fivio ,/_'r/`l'v (Please rein Structural plan review fee(or deposit):
1 City/State/ZIP:
64,1 FLS plan review fee(if applicable):
Phone:( ) Fax:( )
CCB lic.: 6 .. _ Total fees due upon application:
Amount received:
Authorized signature: i��. Y/� J/[,/,
� r This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: -S'L� U`l WI Date: 7 - `. 2 2.- * Fee methodology set by Tri-County Building Industry
1 Service Board.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 440-4613T(11/02/COM/WEB)
BENDERSON 570 DELAWARE AVENUE
1 BUFFALO. NEW YORK 14202
DEVELOPMENT 716.886.021 1.P : : 716.886.1026.F
January 20,2022
City of Tigard RECEIVED
Building Department
13125 SW Hall Blvd FEB 12022
Tigard,OR 97223
CITY or I t hL
Re: Proposed Tesla(BDC#5226) BUILDING DIVISION
SW Cascade Ave
Dear Sir/Madam:
10065 SWC, LLC is the owner of the above referenced property. This letter shall confirm that James Boglioli,
Courtney Adamo,Matthew Oates,Emerio Design and Tesla is authorized to appear on our behalf and to submit,sign and
process applications in connection with the above referenced development,to file any and all related applications,and to
file other such documents as may be required in connection with the proposed applications. Should you require and
additional information,please contact James Boglioli at(716)878-9626 or by e mail at iamesboglioli ?benderson.com,.
Sincerely,
10065 SWC, C
S hen C. Scahone
anager
RETAIL: :OFFICE ::INDUSTRIAL::HOTEL::RESIDENTIAL I www.benderson.com