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Permit
71 ,r CITY OF TIGARD SITE WORK PERMIT ``�1 l; COMMUNITY DEVELOPMENT Permit#: SIT2022-00013 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/18/2022 Parcel: 2S1060003301 Jurisdiction: Tigard Site address: 13580 SW ROY ROGERS RD Project: River Terrace Town Center Subdivision: None Lot: None Project Description: Early grading. Contractor: TNHC OREGON LLC Owner: ROSHAK,DON E 15231 LAGUNA CANYON ROAD 11300 SW RIVER RD SUITE 250 HILLSBORO,OR 97123 IRVINE, CA 92618 PHONE: 503-312-6213 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-Site Work 08/18/2022 $2,345.00 Plan Review 06/27/2022 $1,524.25 Type of Use: SF 12%State Surcharge-Building 08/18/2022 $281.40 Class of Work: NEW Info Process/Archiving-Lg$2.00(over 08/18/2022 $46.00 Project Valuation: 11x17) $441,589.50 Info Process/Archiving-Sm$0.50(up to 08/18/2022 $43.50 11x17) Erosion Control w/Development 08/18/2022 $461.40 Site Specifics: Excavation Volume: 196262 cu.yd. Fill Volume: 103492 cu.yd. Impervious Surface: sq.ft. Engineered Fill: Yes Soil Report Required: Yes Paving: No Grading: Yes Landscaping: No Site Prep: Yes Storn Drains: Retaining Wall: No Fire Underground: No Accessible Parking: No Fence: No Total $4,701.55I 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 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: - 9171 .(663)4 Permittee Signature: ��`�+ 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 FOR OFFICE USE ONLY City of Tigard Received 'J Per=No.: 41,.....600 t 13125 SW Hall Blvd.,Tigard,OR RECEIVED Plan Revie �� iy i Phone: 503.718.2439 Fax: 503.598.1960 Date/By: tt ^cal i : Other Permit: Inspection Line: 503.639.4175 1'IIu e� g Date Ready/By: - / teris: RI TIGARt? Internet: www.tigard-or.gov 'JVN � LULL j tifed/Method: / / / if . SSSuppemental Information TYPE OF REQUIRED DATA:I-AND 2-FAMILY DWELLING I31it7pmo t ton1N .RIVl4I0h' Permit fees*are based on the value of the work performed. 0 New construction Indicate the value(rounded to the neaee,st dollar)of all ❑Addition/alteration/replacement faKher equipment,materials,labor,overhead,„and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling ElCommercial/industrial ,Valuation: $��f/� p' ❑Accessory building 0 Multi-family Number of bedrooms: 7 ❑Master builder Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: it 3 79ti/ /33�d SW Q1 New dwelling area: square feet City/State/ZIP: ���/r„r_r v Garage/carport area: square feet Suite/bldgJapt.no.: Projecfname: PrVrr T J%rIA Covered porch area: square feet Cross street/directions to job site: / A Deck area: square feet 64, 'Trams LO£1 /iJ r 0pp's Jed, Other structure area: square feet \/ V REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: 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. Valuation: S GY/1 "Ivwiellr ®cl esi�" Existing building area: square feet New building area: square feet �ROPERTY OWNER 0 TENANT Number of stories: Name: ,774/ .� ©f Ir 44G Type of construction: Address: a/ �o �an e'if /)•'1. Occupancy groups: City/State/ZIP: /20,,,.. 2 _I 9 7' / Existing: Phone:(3jj ) 3,,a lsa,..; Fax:( ) New: ❑ APPLICANT J2 CONTACT PERSON NOTICE Business name: C 04" �7e � 4 All contractors and subcontractors are required to be Contact name:�� w� or./ —. licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 024-?15, Om� - Dr, jurisdiction in which work is being performed.If the City/State/Z1P: 3,-// 47p�r�/ applicant is exempt from licensing,the following reasons al>p Y Phone:( ) -34? G...1/3- Fax: :( ) � E-mail: GLf1.5yG7j�r/e_�!V .14 4 4„ L>a...^, 7.13D CONTRACTOR Business name: / l,://7,- ��P T�(f Gr7 L'Ll BUILDING PERMIT FEES* Address: /` 3/ 1'111, `nY� a� �_ / /G; �� (Please refer fa deposit)ee : schedule) City/State/ZIP:—Tv � / /!ti/�( 3 Structural plan review fee(or deposit): iditt FLS plan review fee(if applicable): Phone:( J 3/7- rf.,3 Fax:( ) CCB lie.: ay//0 Total fees due upon application: � Amountp received: Authorized signature: __// Thia ertnit a GGG---Oflfl"' p pplication expires if a permit is not obtained Print name: r j�1 { within 180 days after it has been accepted as complete. 7r : ; I / Date:���-�y * Fee methodology set by Tri-County Building Industry / Service Board. I:\Building\Permits\SlT-PernitApp.doc 08/022016 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: /ga)r ‘9401:: cu.yds. Grading Volume: (Soils report required for>5,000 cu.yds.) j3, 731 cu.yds. Fill Volume: (Fill exceeding 12"in depth shall be compacted to 90%of maximum density) / 73 cu. yds. Retaining structure? (Check one) 0 Rock ❑ CMU 40- 0 Concrete ❑ Other: *Total new impervious area including all buildings, sidewalks,and paving: 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 ❑ *Packing(including ADA)and Lighting compliance Plan Er 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 s.0o to$500.00 $51.09 minimum permit fee Alterations) Submittal $500.01 to$2,000.00 $51.09 for the first S500.00 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 of fraction thereof. 1:\Building\Permits\SIT-PermitApp.doe 08/02/2016 2 City of Tigard ; ' C COMMUNITY DEVELOPMENT DEPARTMENT 7 TIGARD Building Permit Review — Commercial - With Land Use Building Permit #: S ( 1 Z07Z_OCn Site Address: i3-7911 -1' 13 580 SW f 4f3 Suite/Bldg#: Project Name: I VeiV -orrace_. 1-0,-Dyl (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: PAyt1 COrt cpe,vv1 i~ 1J Terify site address/suite# exists and activ,in permit system. I River Terrace Neighborhood: aiYes ❑ No Er Land Use Case #: "Pp I — 00064-1 E flans Match Approved Land Use: L`7 Site Plan ❑ Other: ❑_Urbau F�rPstry Plan eva o lan m g e Maximum Height Actual Height 0 Conditions Met: 0 Prior to Submittal ❑ Prior to Permit Issuance Business License: /Exists: ❑ Yes ❑ No,applicant was provided a business license application Lv1 Public Facilities mprovement (PH)Permit: ^ i Required: Yes, applicant was notified 0 No Applied For: Ili'Yes ❑ No,stop intake �•• '11.4 Notes: -CC , ►� 2 a� IZ -b 0 — r S ml h an urCS. Approved by Planning: c) i r V� �% Date: (p j 2`7 1 ZZ- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved 0 Not Approved Revision 3: ❑ Approved 0 Not Approved Building Permit Submittal f Original Submittal Date: Cp/��/).2 Site Plans: # // Building Plans: Building Permit#: .r building�pem i above. Workflow Routing: almming l�Engineering I/ ernut Coordinator LBtg Workflow Sign-off: I�,d.�ff 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: c� ? eckei 4 By Permit Technician: te: `7/c./ "'J S . I:\BuildingTomvs\BldgPermitRvw COM_WithLandUse_111819.docx Engineering Review LC Slope at building pad: L.- r Y""' '24 7 Z.�� VPFI Permit#: 2.022 /27 &AI ❑ Conditions "Met"prior to issuance of building permit �l� 0 Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP) ,/t/0/� 0 Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: 0 Yes ❑ No Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No LIDA Facility on lot: 0 Yes D No Add Fee: 0 Yes ❑ No 0 NOT Approved by Engineering: / Date Notes: ��"/ � re .- �e. 'tT Ip�tcOQ71 54;e: c.�ste/ i4 /Z C'- Approved by Engineering: ''7 Date: 7 2z Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: ❑ Approved 0 Not Approved Permit Coordinator Review eeConditions "Met"prior to issuance of building permit Approved,NOT Released: Date: i/13I1)Z2, Notes: TreeqnrieCtitiel i Dal 1 lz.z -G.,CGA'S Oeeot t • 'Al' 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: SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes N/A Tigard Trans SDC: ❑ Yes )2(N/A Parks SDC: ❑ Yes .i N/A LIDA Fee: ❑ Yes XN/A OK to Issue Permit //�� Approved by Permit Coordinator: Date:01 11 I 14 z I:Building\Fomts\BldgPermitRvw_COM WithLandUse_111819.docx