Permit p CITY OF TIGARD SITE WORK PERMIT
p " COMMUNITY DEVELOPMENT Permit#: SIT2022-00007
Date Issued: 6/27/2022
TE G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DB01500
Jurisdiction: Tigard
Site address: 11375 SW NAEVE ST
Project: Pacific Ridge Apartments Subdivision: PACIFIC RIDGE APARTMENTS Lot: 2
Project Description: Site work for(2)apartment buildings.
Contractor: JTSC LLC Owner: TIGARD COVENANT CHURCH INC
5285 MEADOWS RD, SUITE 171 11321 SW NAEVE ST
LAKE OSWEGO, OR 97035 TIGARD, OR 97224
PHONE: 503-308-7324 PHONE:
FAX: 503-684-0102
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 06/16/2022 $1,532.31
Plan Review 05/12/2022 $996.00
Type of Use: MF 12%State Surcharge-Building 06/16/2022 $183.88
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 06/16/2022 $70.00
Project Valuation: 11x17)
$260,085.00 Info Process/Archiving-Sm$0.50(up to 06/16/2022 $12.50
11x17)
Erosion Control w/Development 06/16/2022 $311.40
Site Specifics:
Excavation Volume: 20834 cu.yd.
Fill Volume: 7377 cu.yd.
Impervious Surface: 72555 sq.ft.
Engineered Fill: Yes Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall: Yes
Fire Underground: Yes Accessible Parking: Yes
Fence: Yes
Total $3,106.09
Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
2 Special Inspection(see plans)
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 952-001-009 -~You may o ain a copy of the rules
-7
Issued By: Permittee Signature:
h
Call 503.639.4175 by 7:00 a.m.for the next available ins action date.
This permit card shall be kept in a conspicuous place on the job site til completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application _ • Z ZZ 7-�
Site Work RECEIV . FOR OFFICE USE ONLY
City of Tigard DRate ved
By: 3 Permit No.:S:1^reia ,th_
,-'r 13125 SW Hall Blvd.,Tigard,OR 97223 � 2 1�Y Plan Review cub
It Phone: 503.718.2439 Fax: 503.598.1960 n {�a�/gy; — c^.2� Other Permit:
T I G.A R I Inspection Line: 503.639.4175 CITY OF TI U„ wDate Ready/By: rw s: ® See Page 2 for
Internet: www.tigard-or.gov 1II SlING VISI' °;ified/Method: Supplemental information
TYPE OF WORK? 1 D I !y DI REQUIRED DATA:1-AND 2-FAMILY DWELLING
IX]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.
El1-and 2-family dwelling ❑Commercial/industrial Valuation: $
ElAccessory building ®Multi-family Number of bedrooms:
❑Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:4 &NIL_ 1 t 315 J(I- mart) Svc) NQPve. S{t- New dwelling area: square feet
City/State/ZIP:Tigard,Oregon 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Pacific Ridge Apartments Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Lots directly behind Tigard Covenant Church on corner of 99W&SW Naeve Street. 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.: 2S110DB1500,2S110D61400 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.
Two multi-family buildings with parking lot. Valuation: $ 260 0$5.00
°. Existing building area: square feet
New building area: square feet
i y ® PROPERTY OWNER ❑ TENANT Number of stories:
•
,tk
Name:Tigard Covenant Church Type of construction:
Address:11321 SW Naeve Street Occupancy groups:
City/State/ZIP:Tigard,Oregon 97224 Existing:
Phone:( 503 )639-3084 Fax:( ) New:
IN APPLICANT ❑ CONTACT PERSON
NOTICE
Business name:JTSC,LLC All contractors and subcontractors are required to be
Contact name:Jesse Nemec licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5285 Meadows Road,Suite 171 jurisdiction in which work is being performed.If the
City/State/ZIP:Lake Oswego,Oregon 97035 applicant is exempt from licensing,the following reasons
apply:
Phone:( 503 )730-8620 Fax::( )
E-mail:jnemec@jtsmithco.com
CONTRACTOR
Business name: JTSC, LLC BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee(or deposit): $1,532.31
City/State/ZIP:
FLS plan review fee(if applicable):
Phone:( ) Fax:( )
Total fees due upon application:
CCB lie.: 2p237
Amount received:
Authorized signature`
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Je' a Nemec Date: 2/16/2022 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 440-4613T(11/02/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: 20834 cu.yds.
Grading Volume:
(Soils report required for>5,000 cu. yds.) cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90%of maximum density) 7,377 cu.yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks,and paving: 72555 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 ❑ *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
■
Site Work Permit Application
Plan Submittal Requirements
1 I t"A R 1) 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. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ 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:
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 parking spaces and adjacent access aisle connecting with the accessible
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 plan complying with the requirements of the Clean Water Services
(CWS) agency showing.
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
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
•ill
e COMMUNITY DEVELOPMENT DEPARTMENT
TIcaRD Building Permit Review — Commercial - With Land Use
Building Permit #: 7--,9-021_
Site Address: 11375 SV\i- Novi& stiff- Suite/Bldg#:
Project Name: Pacific Ridge Apartments
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Site Work only
Xi Verify site address/suite# exists and active in permit system.
® River Terrace Neighborhood: ❑ Yes ® No
A Land Use Case#: SDR2021-00006
XPlans Match Approved Land Use: • �a�
K Site Plan Rf Landscape Plan Ur Other: '16'ri1YLj
X Urban Forestry Plan na Elevation Plan
nral Building Height: Maximum Height Actual Height
® Conditions Met: ® Prior to Submittal O Prior to Permit Issuance
in Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
® Public Facilities Improvement (PFI) Permit: PF12022-00063
Required: ® Yes, applicant was notified ❑ No Applied For: ® Yes ❑ No, stop intake
Notes: Meet conditions prior to issuace.
Approved r by Planning: a Date: qjes 120ZZ
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: C / 7;,1.
Site Plans: #
Building Plans: #
Building Permit#: En�r building permit above.
Workflow Routing: l Planning SEngineeringmit Coordinator iilding
Workflow Sign-off: ELLS -off for Planning(include notes from planning review)
Route Application Documents: L Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: - e''''''`%Z' Date: (3X .
I:\Building\Forms\BldgPermitRvw COM_WithLandUse_111819.docx
Engineering Review •
12//Slope at building pad:
IcFI Permit#: ZdZZ 3
onditions "Met"prior to issuance of building permit
Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP)
[ /Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ZYNo
Assess Water Quantity Fee in-lieu: ❑ Yes V No
LIDA Facility on lot: ❑ Yes 'No Add Fee: ❑ Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ 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:
,2SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes / N/A
Tigard Trans SDC: ❑ Yes %N/A
Parks SDC: ❑ Yes N/A
LIDA Fee: ❑ Yes N/A
jZOK to Issue Permit
Approved by Permit Coordinator: P OVV) Date: lU 2 ZZ
I:\Building\Forn s\BldgPermitRvw COM_WithLandUse_111819.docx