Permit (2)wiw
CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit#: 3-00010
9/7/20
Date Issued: 9/712023
T I GA.R..D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25101 BA00500
Jurisdiction: Tigard
Site address: 7600 SW DARTMOUTH ST
Project: Walmart
Subdivision: HERMOSO PARK Lot: 8
Project Description: Site work for 5,050 sq.ft.addition.
Contractor: DUKE CONSTRUCTION&EXCAVATION LLC Owner: WAL-MART REAL ESTATE BUSINESS TRUST
17860 SE FOSTER RD ATTN PROPERTY TAX DEPT
DAMASCUS,OR 97089 PO BOX 8050 MS 0555
BENTONVILLE,AR 72716
PHONE: 503-492-0530
PHONE:
FAX: 503-492-0760 FEES
Description Date Amount
Specifics: Plan Review 07/14/2023 $94.41
12%State Surcharge-Building 07/14/2023 $17.43
Typeof Use: COM Permit Fee-Site Work 07/14/2023 $145.24
Info Process/Archiving-Lg$2.00(over
07/14/2023 $36.00
Class of Work: ALT 11x17)
Project Valuation: $6,500.00 Info Process/Archiving-Sm$0.50(up to 07/14/2023 $17.50
11x17)
Erosion Control w/Development 07/14/2023 $80.70
Site Specifics:
Excavation Volume: 90 cu.yd.
Fill Volume: 180 cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Yes Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: No
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: No
Total $391.28
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 R. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire'if ork is not started within 180 days of
issuance, or if work is su ended for more the 180 days. ATTENTION: Oregon law requires yori t follow the rules ed by the Oregon
Utility Notification Cent . h e rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo ay obtain a co the rules
Issued By: 2 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 sitepntil completion of the project.
Approved plans are required on the job site at the time f each inspection.
I
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: 90 cu.yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) 270 cu.yds.
Fill Volume:
(Fill exceeding 12" in depth shall be compacted to
90%of maximum density) 180 cu.yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:N/A no retaining walls proposed
*Total new impervious area including all buildings, Reducing the imperviousness of the site by
sidewalks,and paving: 0 175 sf by adding larger landscaped areas 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
Commercial 3 $2.69 for each additional$100 or fraction
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-I Occupancy 3 $10.76 for each additional$1,000 or
fraction thereof,to and including
One-&Two-Famil 3 $25,000.00.
y Dwelling $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.
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