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Permit
6 SITE WORK PERMIT lir CITY ®F TIGAR® Permit #: SIT2010 -00001 COM MUNITY DEVELOPMENT Date Issued: 04/20/2010 T f GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110BC00900 Jurisdiction: TIG Site address: 12475 SW BULL MOUNTAIN RD Subdivision: Lot: Project: Tigard 10 MG Reservoir Transfer Pump Station Project Description: Site work for replacement of pump station. Owner: FEES TIGARD WATER DEPT. Description Date Amount 8777 SW BURNHAM ST TIGARD, OR 97223 Permit Fee - Site Work 04/20/2010 $8,173.02 Plan Review 04/20/2010 $5,312.46 PHONE: 639 -4171 395 12% State Surcharge - Building 04/20/2010 $980.76 Erosion Control 04/20/2010 $80.00 Contractor: Erosion Plan Review CWS 04/20/2010 $26.00 JAMES W FOWLER CO Erosion Plan Review COT 04/20/2010 $26.00 12775 WESTVIEW DRIVE Water Quality - Com / Multi family 04/20/2010 $225.00 DALLAS, OR 97338 -9632 Water Quantity - Com / Multi family 04/20/2010 $275.00 PHONE: 503 - 623 -5373 FAX: 503- 623 -9117 Type of Use: COM Class of Work: NEW Site Specifics: Excavation Volume: 1205 cu. yd. Fill Volume: cu. yd. Impervious Surface: 1910 sq. ft. Engineered Fill: Yes Soil Report Required: Yes Paving: Yes Grading: Yes Landscaping: Yes Site Prep: Yes Storn Drains: Yes Retaining Wall: Yes Fire Underground: No Accessible Parking: No Fence: Yes Total $15,098.24 Required Items and Reports (Conditions) 1 SIT Ersn Cntrl 503 - 681 -4444 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 -0100. You may obtain a copy of the rules or direct questions to OUNC/b callint 503 or 1.800.332.2344. Issued By: - i Permittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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 NH 0 Q600/ Site Work RECFIVF FOR OFFICE USE ONLY City of Ti and Received � Permit No • 1111 g 2 7 2 010 Date /Bv / ffd .! /I Orf�p�0/Q' /II / . ° 13125 SW Hall Blvd., Tigard, OR 97 N Plan Rev Phone: 503.639.4171 Fax: 503.598.1960 Date /Br - 1 Other Penmt: TIGARD Inspection Line. 503.639.4175 CITY NO G TIGARD Date Ready Juns ® See Page 2 for Internet www.tigard -otgov QUfLal Notified /Method. Supplemental Information U c L/ VI>1� TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING Permit fees* are based on the value of the work performed. �Iew construction ❑ Demolition 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. Valuation: S ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building ID Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: t Z S � `� I -<'N...4/ /4 1 t.,..:1, New dwelling area: square feet City /State /ZIP: r ;t) c,, CI 7 r_ / Garage /carport area: square feet Suite /bldg. /apt. no.: ' / Project name: /6) ` Covered porch area: square feet �U /� J � �#� rr Cross street /directions to job site: Deck area: square feet J j 7r( �--� Ac. 1 /) 1 :. ft ' - /-\ u C Other structure area: square feet / REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: S 10 A c )C) 90c, equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. 1 Valuation: 8 rr / " ` 1 Existing building area: sq feet 1 '^`',Iii- « ,lc� u , ,. ,c „-,- „ , •. i ,1- ,� New building area: / ); f square feet [/PROPERTY OWNER ID TENANT Number of stories: / f Name: ( t .F. C, / .:�, � e -,, Type of construction: t /6-t `w l. -."� .-J .. l�� Address: / J ` Z SL Sc � J f1L, / JJj .•, . Occupancy groups: Y � f. ' 1�•” City/State /ZIP: i ' Z `/ 72 2 Existing: - JG - Phone: ( Sol ) 6 -7 ` `// / / Fax: ( ) New: U [/APPLICANT IONTACT PERSON NOTICE J' Business name: (i 1-, -t / ; • c . ; J All contractors and subcontractors are required to be Contact name 7 ` \ /' lk/ , � licensed with the Oregon Construction Contractors I3oard j � / under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons �� -L.. ll C' ` 77Z 2 Z apply: Phone: ( J 1) 6 s y , 4 / / - 7/ Fax:: ( ) E -mail: / t , .Ki ')t•, . ,.� — - � ' „GI/ J CONTRACTOR Business name: ; ' BUILDING PERMIT FEES* yr , Add ress: f j )� L o (Please refer to fee schedule / 77 (c� uk , „e J j L j-.),,_,,_ /�, -/ City /State /ZIP: 1 `1_._i/c,,, ciic. c.,,,-. Structural plan review fee (or deposit): FLS plan review fee (if applicable): Phone: ( s) (,, _/ , , .. ' .\ Fax: ( SCj ) L 21 - ` -// 7 CCB lie.: Total fees due upon application: _ C � 7L) / ” / / Amount received: Authorized signature: // /: / /7/ 1/ This permit application expires if a permit is not obtained • C j r �. within 180 days after it has been accepted as complete. Print name. % Date. * Fee methodology set by Tri-County Building Industry Service Board. I:ABuilding \ Permits \SIT- PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM /WEB) I City of Tigard: Site Work Permit Checklist Page 2 - Supplemental Information I ( Commercial, Multi - Family and One- and Two - Family Dwellings: No permit is required if fill is less than 50 yards (5 dump tlruck 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: I /,C� 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) cu. yds. Retaining structure? (Check one) ❑ Rock n CMU ❑ Concrete n Other: *Total new impervious area including all buildings, sidewalks, and paving: ] c l / U 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 n *Parking (including ADA) and Lighting compliance Plan I i Grading Plan and details ❑ *Landscaping Plan ❑ Erosion Control Plan and details n Soils Report (if required) ❑ Retaining Structures *Does not apply to One- and Two - family dwellings. Plan Submittal: Permit Fee: TYPE OF SUBMITTAL # of Plans Variation• Permit Fee: (New, Additions or Required at $.00 17) $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 2 I thereof, to and including $2,000.00. $2,003.01 to $25,000.00 $91.44 for the first $2,000.00 and Multi - Family R -1 Occupancy 2 510.76 for each additional $1,000 or fraction thereof, to and including 525,000.00. One - & Two - Family Dwelling 2 $25,00.01 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. 550,001.00 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. $100,900.01 and over $809.42 for the first $100,000.00 and $4.49 for each additional $1,000.00 or fraction thereof. 1: \Building \Permits \SIT - PermitApp.doc 12/27/06 2 ■ ti� ., - , k:- .o Site Work Permit Application 1 Plan Submittal Requirements TFIG 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 n 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: Two (2) 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. 1: \Building \Permits \SIT- PermitApp.doc 12/27/06 3 t • 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 12/27/06 4 REC -- -- JAN 272010 CTY OF Yi BUILDING DIVISION Murra; Smith &Associates, Inc. Engineers/Planners 121 S.W. Salmon, Suite 900 o Portland, Oregon 97204 -2919 o PHONE 503.225.9010 0 FAX 503.225.9022 LETTER OF TRANSMITTAL To: City of Tigard Date: December 3, 2009 Public Works Job No. 08- 0985.215 13125 SW Hall Blvd. Re: 10 MG Reservoir Improvements Tigard, OR 97223 and Transfer Pump Station Attn.: Mr. Robert M. Murchison, P.E. WE ARE SENDING YOU: © Attached ❑ Under separate cover ❑ Shop Drawings ❑ Prints © Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ❑ Copies Date Description Dec -09 10 MG Reservoir Improvements and Transfer Pump Station, Volume 3 (full Size Plans) — Bound 2 Oct -09 10 MG Reservoir Improvements and Transfer Pump Station, Structural calculations I Oct 09 10 MG Reservoir Improvements and Transfer Pump Station, Geotechnical report THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit_copies for approval © For your use ❑ Approved as noted ❑ Submit_copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return_corrected prints ❑ For review /comment ❑ Dear Rob: Please find the attached copies of the documents referenced above for the building permit submittal. . Please contact us if the building department needs MSA to meet with the plan reviewers. Thank you! r • COPY TO: SIGNED: Daphne Marcyan, P.E. (1: - Element 1.2 Detailed flans and Specilkalionsi Fransmittals' '009 -L2 -3 Frans 10 Cite of Tipatd.doc I 1 MAP EXPLANATION 1 x ,° r 'r i �{ ' - -` I ` T �r TIME OF MOST RECENT SURFACE RUPTURE STRUCTURE TYPE AND RELATED FEATURES / 1 i,�j k t < ' - �, �. Holo (<10.00 years) or post last gladatio ( <i 5.000 years: 15 ka): FAULT Normal ahigfault h -angle reverse fault • s ' '�.. Tx. _ - $, 1 - ; .. k , ,� no historic rvp in O regon Iodate --�— Stnke•stlp • `r r fJ Late Oua toma ry ( < post ponuliun g ladat on —"• Thrust fault •v y f ' ♦ _ l . '. , i - ( -_ ti 1 I . _ - Late and middle Ouatemary (Q50.000 years: 750 ka) Anticlinal fold '* s. ` { \ J 1 — - - Ouatemary• undifferentiated ( <1.600.000 years: <1.6 Ma) t Synclinal fold I' - r Class B stnuture (age or origin uncertain) Monodinal told b <, , , k { , \, 1 , ' ,A �-••-''-- 'y �' - t ♦ ♦ - "`_ -- - - f.. ..--- Plunge direction of fold • •' Y >. r l '' \ - - . ..- ! ♦ 'r - SLIP RATE y f - _ f Fault section marker r S \ - r — >5 m ear an ` ` Va couver \` - 1 mmtyear t�� JJ ETAILED STUDY SITES S. j r r , _ 1 ♦\ 7 02 - 5, mmfyear 73 -2 - D Trench site 1 r �� ' 7 y <0.2 mm/year -- f Subductbn zone study to • et ,qtr' . ti ♦ ♦SS� r„" °^..a '"."_" TRACE ��. ! . - - . `^� . b*» - -- 1 \� CULTURAL AND GEOGRAPHIC FEATURES ,r • • •-�. . ti ♦ - Mostly continuous at map state • - -� ' �$ti ' ``.,,. } – `` _ " •' Must dis at map scaly -- Divided highway - second ad - ", a .' f• , 0 L "`♦ Interred of conoea d s Pnmary or any ro •.t ` ♦ . - � ..� ••^`: ' •' '`'.! . - Permanent mrer or stream . 8 2 -� Camas ♦ Was hougal • r , t,T 4 �� ° d, _ ♦♦ : _ ,J - Intermittent river or stream I ----^ r N_. • \ -.,!• , j \ { " \, �` '• Permanent or intermittent lake „J 75 <,....\''',. �. -23:,..:, „ ... . 876 '' ___-� 1 ♦ : . - -, ■ Q . +E • i, �, �° - FAULT NUMBER NAME OF STRUCTURE , ---.- ♦ ♦ ,; ; . r '1 , — ' -� � } . �, = 715 BEAVERTON FAULT ZONE Hillsboro � ,. r - ♦ • � � °"1°�I �' `°� at. 1 ' �' CAN ONE } . r Pokl l and 716 BY MOLLALA FAULT Z � ) i 1 i�` `,• . � ' _, 875 OATFIELD FAULT � � 8 � . , - Bea erto "- � . 1 I $78 t �/• 876 EAST BANK FAULT r e_ �`\ / 877 PORTLAND HILLS FAULT ` ,� v .; ( '-''' ' r ii ...; '' -- - - . - * ------ . \ ' ' ' '' 1, i 1 fr "C — h, el ‘ r \ \ e h ‘ ...1.; ./ V\ k - p k . � 8. 75 '' 9 `. p��. �'. . • • /i f f f; ` ' .• .,• - *0 21 i 879 .- t >‹: t ` -- 1 1____ ,,,,: \‘' ' _ . ' 7: --------'( '' .SITE .L ake Osweg ♦ ` �� , - , � �ti �'' ?`� %' r �~ 4 ��> • f I J'- ~8T4 , � ` _ _ r * . y8 79 =� ��� �E; r� F'r / f - FROM: PERSONIUS, S.F., AND OTHERS, 2003, MAP OF QUATERNARY FAULTS L ' *) I ©: i ; `, AND FOLDS IN OREGON, USGS OPEN FILE REPORT OFR -03 -095. r tf .'. r 7161 ' \ 0 5 10 MILES t Newberg. tv� r - 1 - ': ,---- � ,L ` i K 1 \ 0 5 10 KILOMETERS �q1<< m \ f } 1 1 '