Permit CITY OF TIGARD SITE WORK PERMIT
"7 �.' ' COMMUNITY DEVELOPMENT Permit#: SIT2022-00015
Date Issued: 12/15/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S112DA01100
Jurisdiction: Tigard
Site address: 6600 SW CARDINAL LN
Project: Spec Space Subdivision: 1995-098 PARTITION PLAT Lot: 2
Project Description: Landlord work prior to TI:A new drive-through window lane and parking lot modifications.
Contractor: WALEN CONSTRUCTION Owner: PACIFIC REALTY ASSOCIATES LP
20915 SW 105TH AVE ATTN: N PIVEN
TUALATIN, OR 97062 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-718-6680 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 09/01/2022 $2,219.28
Plan Review 07/13/2022 $1,442.53
Type of Use: COM 12%State Surcharge-Building 09/01/2022 $266.31
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 09/01/2022 $42.00
11x17)
Project Valuation: $413,700.00 Erosion Control w/Development 09/01/2022 $461.40
Site Specifics:
Excavation Volume: 20 cu.yd.
Fill Volume: 580 cu.yd.
Impervious Surface: -1556 sq.ft.
Engineered Fill: No Soil Report Required: No
Paving: Yes Grading: No
Landscaping: Yes Site Prep: No
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: No
Total $4,431.52I
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 e 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 of the rules
Issued By: 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 RECEIVE)4 ` Received FOR OFFICE USE ON1.1
City of Tigard Datedy: 7�/i b-z- (/ A 2 a o' --
13125 SW Hall Blvd.,Tigard,OR 97223 1012
. JUL��� 3 Plan Review 7 -�-I Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
1 t,11 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: ,,'J'/' Judo: SSee Page t far
Internet: www.tigard-or.gov Notified/Method: 2 if Supplemental Information
M..IN !11NG D /ICIr?f t
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
Permit fees*are based on the value of the work performed.
❑New construction ❑Demolition Indicate the value(rounded to the nearest dollar)of all
4Z Addition/alterationlreplacemcnt ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ig Commercialiindustrial Valuation: $
Number of bedrooms:
ElAccessory building ElMulti-family
El Master builder ID Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 6600 SW Cardinal LN New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 w�'ry 'Se�GI Garage/carport area: square feet
f
Suite/bldg./apt.no.: Project name: P �
CC 6.`' 4 a enOVation Covered porch area: square feet
Cross street/directions to job site: Job site is east of SW 72ND AVE On SW Deck area: square feet
CARDINAL LANE Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1995-098 Partition Plat Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 2S112DA01100 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.
Site renovation to accomodate change from single use restaurant to multi tenant Valuation: $ 413,700
use. Maintaining building footprint while adding a drive thru window and lane, Existing building area: 6,813 square feet
and altering parking lot to better serve the proposed usage change. New building area: 48 square feet
iir PROPERTY OWNER 0 TENANT Number of stories: 1
Name: Pactrust Type of construction:
Address: 15350 SW Sequoia Parkway, Suite 300 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing:
Phone:( 503) 624 6300 Fax:( 503) 624 7755 New:
IVAPPLICANT - 0 CONTACT PERSON NOTICE
Business name: Pactrust All contractors and subcontractors are required to be
Contact name: Ryan McGuire licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 SW Sequoia Parkway, Suite 300 jurisdiction in which work is being performed.If the
City/State/ZIP: Portland, OR 97224 applicant is exempt from licensing,the following reasons 1
apply:
Phone:(503) 624 6300 Fax: :( 503) 624 7755
E-mail: RyanM@PacTrust.com
CONTRACTOR
Business name: /,, i 0"C BUILDING PERMIT FEES* I
� ,/J ,,, (Please refer to fee schedule
Address: LLLL�Y/5� P--,1 /fif Air Structural plan review fee(or deposit): 0
City/State/ZIP: T(.aa1Li4.Id OK 47r>46�
IFLS plan review fee(if applicable): 2,217.93
Phone:(5�I7) 7�— �6� Fax:( )
� Total fees due upon application: 2,217.93
CCB lic.: 2- �d
Amount received:
Authorized signaturci: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Rya4tic Date: 07.08.22 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\SIT-PermitApp_doc 08/02/2016 440-4613T(11/02/COMIWEB)
{ S
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: 20 cu.yds.
Grading Volume:
(Soils report required for>5,000 cu. yds.) 600 cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to 580
90%of maximum density) cu.yds.
Retaining structure? (Check one) ❑ Rock
NA ❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings, Note: impervious area is
sidewalks, and paving: a reduction. -1,556 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
0 Grading Plan and details Q *Landscaping Plan
[r 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.
S100,000.01 and over $809.42 for the first$100,000.00 and
$4.49 for each additional$1,000.00 or
fraction thereof
F 1Building\PermitslSIT-PermitApp.doc 08/02/2016 2
i
Er, Site Work Permit Application
Plan Submittal Requirements
TIGARD 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.
"plumbing"Note: A separate permit for site utilityplumbingwork is required for sanitary
9
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# [a project name ® site address suite number
zoning [R' 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 (r'DC)
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\Perrnits\SIT-PermitApp.doc 08/02/2016 4
City of Tigard
ligI li COMMUNITY DEVELOPMENT DEPARTMENT
T 1 c A n Building Permit Review — Commercial - With Land Use
Building Permit #: S AU -.CO 9/ S----.
Site Address: ‘2 ') Slt'J 1(,gE.0) L kij Suite/Bldg#:
Project Name: PCC 'WC()1 i( O?,C=.
(Name of commercial business occupying the space. If vacant,enter Spec Space.) 1
Planning Review
Proposal: c7-r (iclblK t i. -110T. 1,
I Verify site address/suite#exists and active in permit system.
❑ Ri er Terrace Neighborhood: 0 Yes D�o
eidUseCase#: MMD2-0'-2 -CCU f
"alllans)kafeh Approved Land Use:
Site Plan 0 Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
0 Building Height: Maximum Height /VA Actual Height /I//l-
,fistriditions Met: ❑ Prior to Submittal 0 Prior to Permit Issuance
Business License:
Exists: 0 Yes No,applicant was provided a business license application
'blic Facilities Improvement (PFI)Permit: ?Ft 2022 7-00301
Required: ❑ Yes, applicant was notified 0 No Applied For: s 0 No,stop intake
Notes:
Approved by Planning: —Date: -4-%7/Z?
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: 7//3/2_Z
Site Plans: # 3
Building Plans: # 3
Building Permit#: oa-'Enter building permit#above.
Workflow Routing: .2-Planning _ID-Engineering 0 Coordinator _ Building
Workflow Sign-off -a-Sign-off for Planning(include notes from planning review)
Route Application Documents: r Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: X-4
.ifS/4///j*_---- Date: 7//�3/.z,›
I:1Building\Fomis\BldgPermitRvw_COM_W ithLandlJse_111819.docx
Engineering Review
g Slope at building pad: 2 Z
21'I FI Permit#: P14l - 049 7
lQ l.Onditions "Met"prior to issuance of building permit
lasements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
Fr Y ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes E N
Assess Water Quantity Fee in-lieu: ❑ Yes a-No
LIDA Facility on lot: ❑ Yes CY�10 Add Fee: 0 Yes ❑ No
0 NOT Approved by Engineering: Date
Notes: L>00hlc^T 155 ri L- 156 L 44c rDA Pie/ e .-l%I
Approved by Engineering: . S r]4(t., Date: 7-24 _
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
Approved,NOT Released: Date:
Notes: \ (NIP Kcua hq( 2021,
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: ❑ Yes /121/N/A
Tigard Trans SDC: 0 Yes grN/A
Parks SDC: ❑ Yes N/A
LIDA Fee: 0 Yes API N/A
OK to Issue Permit
°-
Approved by Permit Coordinator: Date: 3`Q,J22i
I:\Building\Forms\B Id gPermitRvw_COM_W ithLandU se_111819.docx