Permit CITY OF TIGARD SITE WORK PERMIT
s. COMMUNITY DEVELOPMENT Permit#: SIT2022-00003
Date Issued: 5/4/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AC01100
Jurisdiction: Tigard
Site address: 11300 SW BULL MOUNTAIN RD
Project: Bull Mountain Marijuana Subdivision: None Lot: None
Project Description: Parking lot,stormwater,and site upgrades for existing commercial building.
Contractor: RUBICON CONSTRUCTION LLC Ow
ner: BULL MTN LLC
PO BOX 1583 10685 SW CLAY ST
WOODINVILLE,WA 98072 SHERWOOD, OR 97140
PHONE: 509-341-4198 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 05/04/2022 $1,258.42
Plan Review 01/31/2022 $817.97
Type of Use: COM 12%State Surcharge-Building 05/04/2022 $151.01
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 05/04/2022 $10.00
Project Valuation: 11 x17)
$200,000.00 Info Process/Archiving-Sm$0.50(up to 05/04/2022 $32.50
11x17)
Erosion Control w/Development 05/04/2022 $236.40
Site Specifics: DC Provision Review,COM TI-Ping 05/04/2022 $434.00
Excavation Volume: 86 cu.yd.
Fill Volume: 16 cu.yd.
Impervious Surface: 300 sq.ft.
Engineered Fill: No Soil Report Required: Yes
Paving: Yes Grading: No
Landscaping: Yes Site Prep: No
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: No
Total $2,940.30
Required Items and Reports(Conditions)
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 Cente�e rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: (-PY1/ Permittee Signature: 7_.ri/.7
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.
I
'� Building Permit Application
on ; -12022
Site Work FOR OFFICE USE ONLY
RECDV E Received '''jjam� �h ��))Q,,
City of Tigard Date/By:a 3' 2, �`_- ;ne l�f.J f 3
Permit No.V r
13125 SW Hall Blvd.,Tigard,OR 97223 s+ 41 net") Plan Revie v
Phone: 503.718.2439 Fax: 503.598.1960 �� L. t Date/By: ,p1._,2,2 j Other Permit:
Inspection Line: 503.639.4175 t Date Ready/By: / 7 H See Page 2 for
I I(;ARI) l�wires �� �
/ Internet: www.tigard-or.gov �b 'r # :f �J.� No d/Method: l r . Supplemental Information
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
v�addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling [<ommercial/industrial
Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: II SOO Si,‘) 61,/14_ rt 0 v NTh.il•tJ New dwelling area: square feet
City/State/ZIP: —7740A p i 0 2- 17 Z ZLf • Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:.(,4U,(,. moil/UT AI&J FI(WIWI t'SCovered 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
?Ak2�tN(a LaT t Sro i-t NftiTlE lZ i SI Tr- u Paiz Valuation: $ ZOO OOb
t=oz_ k I sr!N e?^' �RL 1 AL 0co I r►O i/�/L, Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER [ TENANT Number of stories:
Name: Jn E-l4,4-viNaS Type of construction:
Address: ,Og 5Z ism_ A jpj rr W p. y Occupancy groups:
City/State/ZIP: &e-E3 �q " / D(L 41`7Z3o Existing:
Phone:(50s) '6 S .1/Z g- Fax:( )
New:
,,,,.!
g APPLICANT 0 CONTACT PERSON
NOTICE
Business name: .gAr-t& . _t-ti TEcV'.- -E. I s'=S i isj All contractors and subcontractors are required to be
Contact name: 5PM tie eke_ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7350 S. i-t i Lt JAw1_1 E At/E jurisdiction in which work is being performed.If the
City/State/ZIP: li'bR-nAN OR. L)r7Zv Z applicant is exempt from licensing,the following reason
apply:
Phone:(505) 15 s_y2 raj Fax: :( )
E-mail: Ser%en a Ste- A"oest(y/J. CO An
Business name: IP\A C. ) C +-� 8 BUILDING PERMIT FEES*
Address: ��JJ ��
(\C) )y _Jx 15 15 3 (Please refer to fee schedule)
Structural plan review fee(or deposit): gg417
City/State/ZIP: � t^ ,1`1 `��,
Phone:(s �t 1 , toi k9V� \ Fax:( )
CCB lic.: FLS plan review fee(if applicable):
�a? 3 J Total fees due upon application:
Amount received:
Oeef
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name. /!y./‘ 1-16-017- Date: !Ito/ZZ * Fee methodology set by Tri-County Building Industry
/ Service Board.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 440-4613T(I1/02/COM/WEB)
City of Tigard: Site Work Permit Checklist
Page 2 -Supplemental Information
Commercial,Multi-Family and One-and Two-Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain, drainage way, or wetland,the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below,unless otherwise noted.
Excavation Volume: g( cu. yds.
Grading Volume:
(Soils report required for>5,000 cu. yds.) 70 cu. yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to rr
90%of maximum density) 10 cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
'M Concrete
Other:
*Total new impervious area including all buildings, .)®
sidewalks, and paving: r sq. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See"Site Work Permit Application-Plan Submittal Requirements"attached.
The following must accompany this application:
Site Plan with Vicinity Map showing ADA 'E;14 *Parking(including ADA) and Lighting
compliance Plan
Grading Plan and details *Landscaping Plan
Erosion Control Plan and details Soils Report(if required)
Retaining Structures
*Does not apply to One-and Two-family dwellings.
Plan Submittal: Permit Fee:
TYPE OF SUBMITTAL #of Plans Valuation:
Permit Fee:
(New,Additions or Required at $.00 to$500.00 $51.09 minimum permit fee
Alterations) Submittal $500.01 to$2,000.00 $51.09 for the first$500.00 and
$2.69 for each additional$100 or fraction
Commercial 3 thereof,to and including$2,000.00.
$2,000.01 to$25,000.00 $91.44 for the first$2,000.00 and
Multi-Family R-1 Occupancy 3 $10.76 for each additional$1,000 or
fraction thereof,to and including
$25,000.00.
One-&Two-Family Dwelling 3 $25,000.01 to$50,000.00 $338.92 for the first$25,000.00 and
$8.06 for each additional$1,000.00 or
fraction thereof,to and including
$50,000.00.
$50,001.00 to$100,000.00 $540.42 for the first$50,000.00 and
$5.38 for each additional$1,000.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and over $809.42 for the first$100,000.00 and
$4.49 for each additional$1,000.00 or
fraction thereof.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 2
11111
Site Work Permit Application
Plan Submittal Requirements
I I G A R D Commercial, Multi-Family and One- & Two-Family Dwellings
A site work permit is required for all commercial projects including new buildings, additions,
accessory buildings larger than 120 square feet, modular structures and multi-family R-1
occupancies. A site work permit is required for excavation, fill,grading, paving,retaining walls,
fire hydrants and fire department access on private property for work on individual lots not
covered under the subdivision development.
Note: A separate "plumbing"permit for site utility plumbing work is required for sanitary
sewer, storm sewer and potable water systems on private property. Please see the Site
Utilities - Plumbing Permit Application for plan submittal requirements.
1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic
location labeled with:
A. XI map & tax lot# M project name eir site address ❑ suite number
zoning applicant name 1' applicant phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads (drawn to scale) with project location.
2. BUILDING PLAN submittal requirement: Three (3) complete sets, Civil only.
All details listed below shall be incorporated into the plans:
A. Site :plan showing:
g
1) Required parking spaces and driveways.
2) A route, accessible to persons with disability,leading from the public way to an
accessible building entrance.
3) Accessible spaces and access aisle connectingwith the accessible
parkingadjacent
route.
4) Curb ramps along the accessible route, curb, sidewalk and gutter.
5) Finish grade elevations along the accessible route.
B. Topographic survey plan showing grade elevations crossing the entire site.
C. Overall grading plan.
D. Utilities plan showing:
1) Fire hydrant location and pipe size if on private property.
2) If the building is to be protected with an automatic fire sprinkler system, show
location of the water service vault and the fire department connection (FDC)
within 70 feet of a fire hydrant.
3) Size of underground water service for the sprinkler system.
E. Erosion control withthe requirements
an complying P l of the Clean Water Services
(CWS) agency sh
owing:
:
1) Silt fence locations.
2) Bio-filter bags/other approved barrier material surrounding catch basins.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 3
1
3) Illustrations detailing the correct installation of the silt fencing and catch basin
protection.
4) Any other measures to ensure compliance with CWS standards.
F. Landscaping plan.
3. ADDITIONAL REQUIREMENTS:
A. Soils (geotechnical) report. A soils report is required for new buildings and additions
to contain the following:
1) The report shall address the potential of soil liquefaction and instability (OSSC
Sec. 1804.2).
2) Fills to be used to support foundation of buildings (OSSC Sec. 3301.1).
3) Foundation and lateral pressures exceeding 1,500 lb./sq. ft. (OSSC Sec. 1805).
B. Fire flow and hydrant worksheet.
C. Plan review deposit based upon project valuation.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 4
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
r
TG, R Building Permit Review — Commercial - With Land Use
Building Permit #: S I T2022-0000 3
Site Address: '/ 300 S 1d M ti(J Suite/Bldg#:
Project Name: 11 ?Do 5i.J ly u1.c_, M of rAiry ev30
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Sire- GtDQ
2 Verify site address/suite#exists and active in permit system
❑ River Terrace Neighborhood: ❑ Yes Y No
,2""ca Use Case#: YVI CYZ Z ' oto 3(/11/412 94)21—(A)CO I
Plansdatch Approved Land Use:
0 Site Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
11 Building Height: Maximum Height Actua eight
conditions Met: ❑ Prior to Submittal rior to Permit Issuance
Business License)'
Exists: [ Yes ❑ No,applicant was provided a business license application
2/Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes,applicant was notified Er-No Applied For: ❑ Yes ❑ No, stop intake
Notes: , ' G71S 1 A 0 UJt JCL- peer) e i- p(loe
a CAPinCy
Approved by Planning: Date: //0 "--X
Revisions (after Bu' ing Submittal only) Reviewer Date
Revision 1: Approved ❑ Not Approved Ni- q//1/it
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 4D1/20/202.2-
Site Plans: # .3
Building Plans: # 3
Building Permit#: [lEnter building permit# above.
Workflow Routing: [VPlanning Er Engineering [ Permit Coordinator L uilding
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: Q! 31/ZD2f2-
I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_111819.docx
Engineering Review
Slope at building pad:
2-ITT Permit#: µ '�
2- Conditions "Met"prior to issuance of building permit
E ements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP)
IV-Water Quality/Quantity Facility: ^ /
Assess Water Quality Fee in-lieu: ❑ Yes
Assess Water Quantity Fee in-lieu: ❑ Yes la--No
��LIDA Facility on lot: 2-Yes, ❑ No
.0 NOT Approved by Engineering: j 5��. Date ,,2--i-Z07-2
Notes: L 1.,. Cw 4\ I S 10 P t .J
rAS 9/444-0-f_J 0 y /-4/4 41).4p iwi /hri 1Zi -t 4 fe-T r2r vt�"�'E
a 4c. �✓�-s i►.c f ' rku•, C S &erAi l �� e+los��f � .L tA.N: re, G2 (.
Approved.by E � w
Engineering:
ate:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: Approved ❑ Not Approved 'Kowa "f('L►z2
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
%Conditions "Met"prior to issuance of building permit
fd' Approved, NOT Released: Date:
Notes: heac1 SY1dvJ ii)r U-t 2A g,i -f1-f 1 14; 11,,irti
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:
4 SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes ,i N/A
r OK to Issue Permit
Approved by Permit Coordinator: Date: 411 3 I ZZ
I:\Building\Forms\BldgPennitRvw_COM_W ithLandUse_111819.docx
Agnes Lindor
From: Agnes Lindor
Sent: Thursday, February 3, 2022 1:39 PM
To: sam@bamadesign.com
Cc: #Building Permit Technicians; Kenny Fisher; Nikki Tuason
Subject: SITE2022-00003 11300 SW Bull Mountain
Good afternoon-
Your permit has not been approved and requires additional information.
Comments from Engineering(Kenny Fisher):
LIDA(WQ)is across property line. Provide proof of permission or easement granted by neighboring property to connect to private catch
basin.
Also,just a reminder that prior to building inspection the following is required:
2. Prior to occupancy, the applicant must submit documentation of approval from the State of Oregon
Recreational Marijuana Program.
3. Prior to occupancy, the applicant must submit an evaluation certified by a registered engineer, or architect that
the proposed development will meet the off-site odor impact standard.The evaluation must provide a description
of the activity, equipment, processes, and the mechanisms, or equipment used to avoid or mitigate off-site
impacts.
Thanks,
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard,Oregon 97223
Phone:503.718.2429
Email:AgnesL@tgard-or.gov
1