Permit CITY OF TIGARD SITE WORK PERMIT
NI COMMUNITY DEVELOPMENT Permit ft: SIT2023-00018
Date Issued: 9/12/2023
T I G A it.1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S126DC00902
Jurisdiction: Tigard
Site address: 9500 SW GREENBURG RD
Project: Crown Oaks Apartments Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Site work for a 272 sq.ft.addition to leasing office.
Contractor: ERIN ISLE CONSTRUCTION INC Owner: WS-JP LLC
11120 SW INDUSTRIAL WY BLDG 9 BAY 2 BY CAMBRIDGE REAL ESTATE SERVIES
TUALATIN,OR 97062 PO BOX 2968
PORTLAND,OR 97208
PHONE: 503-691-9096 PHONE:
FAX: FEES
Description Date Amount
Specifics: Permit Fee-Site Work 09/12/2023 $123.72
Plan Review 08/07/2023 $80.42
12%State Surcharge-Building 09/12/2023 $14.85
Type of Use: COM Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 09/12/2023 $0.50
11x17)
Project Valuation: $5,000.00 Erosion Control w/Development 09/12/2023 $80.70
Site Specifics:
Excavation Volume: 3 cu.yd.
Fill Volume: 0 cu.yd.
Impervious Surface: 300 sq.ft.
Engineered Fill: No Soil Report Required: No
Paving: No Grading: Yes
Landscaping: No Site Prep: Yes
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: No
Total $300.19
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 Cent se rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
�', ,� Permittee Signature:
Issued By: ?SY°
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.
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: j cu.yds. 1--
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) cu.yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and .avin,: s•. ft.
.,'1
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.
Th ollowing must accompany this application:
Site Plan with Vicinity Map showing ADA *Parking(including ADA)and Lighting
compliance Plan
❑ Grading Plan and details El *Landscaping Plan
,Erosion Control Plan and details ❑ Soils Report(if required)
El 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 $.oO 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-FamilyR-1 Occupancy 3 $10.76 for each additional$1,000 or
P Y 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.
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