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Permit r' CITY OF TIGARD SITE WORK PERMIT Vr% DEVELOPMENT SERVICES PERMIT # : SIT2005 -00009 '�I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED : 7/15/2005 PARCEL : 1S136DA -02600 SITE ADDRESS: 11140 SW 68TH PKWY ZONING : C -G SUBDIVISION: MLP1999 -00011 LOT: 002 JURISDICTION : TIG Project Description: Site work for new veterinary clinic. CLASS OF WORK: NEW PAVING ?: Y RESO. NO: TYPE OF USE: COM GRADING ?: Y VALUE: 110,000.00 EXCV VOLUME: 1,600 cy LANDSCAPING ?: Y FILL VOLUME: 140 cy SITE PREP ?: Y ENG FILL ?: STORM DRAINS ?: Y SOILS RPT REQD ?: Y IMPERV SURFACE: 31,500 sf Owner: FEES WEBSTAR VI LLC Description Date Amount 610 GLATT CIRCLE [BUPPLN] Pln Ck -Valu 4/18/2005 $509.15 WOODBURN, OR 97071 [FLS] FLS Pln Rv 4/18/2005 $313.32 [TAX] Valu 8% State Surcharg 7/15/2005 $62.66 Phone: 503 - 981 -0155 [ERPRMT] Erosion Cntl 7/15/2005 $80.00 [ERPLN] Ersn Plck -CWS 7/15/2005 $26.00 Contractor: [EROSN] Ersn Plck -COT 7/15/2005 $26.00 [BUILD] Prmt Fee -Valu 7/15/2005 $783.30 TRIPLETT WELLMAN INC PO BOX 160 Total $1,800.43 WOODBURN, OR 97071 Phone: 503 - 982 -4188 REQUIRED ITEMS AND REPORTS Reg #: LIC 43496 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and -II other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not s• rted within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you • follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throug • ' • 52 -001 -0100. You may obtain copies of these rules or direct questio s to OUNC y calling 503 - 246 -6699 or 1 - :- • 0- 332 -23 • • Iss - d By: / l ip 3. Permittee Signature: CaII 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. r N ' / / /,a 5w 4 ►- P. y Site Work RECE q , ; 1/, crAar Building Permit Aonli � on 1 / , I (►R (►l l c,I.: I1, I : ON1.1 City of Tigard t( 1 8 2005 t 1ed ,: ! 1,�1 Permit No.: • 13125 SW Hall Blvd., Tigard, OR 972 r - "'�1 iT � • � �� / P Pl an R eview r11). Phone: 503.639.4171 Fax: 503.59 OF TIGARD ' ' " �� Other Permit: Inspection Line: 503.639.4175 puitt G O "`` ^� � - ® Date Re ady/By: See Page 2 for Internet: www.ci.tigard.or.us IO Notified/Method Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING )giNew construction ❑ Demolition Permit fees* are based on the value of the work performed. 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. ❑ 1 -and 2- family dwelling m Comercial /industrial Valuation: $ El Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 1/! L{ o S 6 81.- pme1ewA. y New dwelling area: square feet City / State/ZIP: 116412D / ne 9722-3 Garage /carport area: square feet Suite/bldg. /apt. no.: ` � l Project name: (•p ODE PEThrwAe( *now ere Covered porch area: square feet Cross street/directions to job site: c sir IS 991 Deck area: square feet FAST 6 9qb✓ 1p /4rDS 1 / 12161-11- 12161-11- ON SV / f 2 v 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. 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 ap I�ication. _ Valuationf $ > / WO t' kiEW 2 4teQ1 WOO12 Fie #w►6 t/m2-1Ainie V t2Eregaep1 -t- C6A 711 _ . S t- Pt-note. Existing building area: �� square feet . New building area: q ( / y square feet PROPERTY OWNER I ❑ TENANT Number of stories: 'L Name: 1/tfE V R4TA►? J (.' Type of construction: Address: 6 [ 0 & i-r e. i a CLIr� Occupancy groups: City /State/ZIP: WorsvaiA,t124V i OR_ 4r 01 1 Existing: Phone: (rj03) q a ( Ol S Fax: (SO) 9b 1 015 e New: 3 APPLICANT ArCONTACT PERSON NOTICE Business name: - -" w 1, / i c , All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: Mce i f e-L 6qit/ under ORS 701 and may be required to be licensed in the Address: it 17 r/I (f1.4 Ali' �cP FE Qa AJ WI jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /State/ZIP: 4 /?1J; O _ 97 0 apply: Phone: ( 563) qg r 2 LJ!� I Fax: : (!0'3) qg 2- 031 0 E -mall: r idea - 162 Le tf,tia .(b/ii CONTRACTOR Business name: i (Z1PLEA - 7 - fr1&W s AyV j wC- BUILDING PERMIT FEES* Address: 1717 MOvW ( kj sow AV,E Please refer to fee schedule. City /State/ZIP: &t O _, q 101 I ( y 992 qi eg, / I Fa ( `v2) 962 0340 Amount due r upon application Phone: 7 �'f D x: 7 / D CCB lic.: I f 0 A mount received �� D ate received: Authorized signature: i �� '//�', e � This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: N i d U / I Date: y// S Q C I • Fee methodology set by Tri-County Building Industry " "" ��7 Service Board i:\ Building \PermitsAS1T- PennitApp.doc 12/03 440-4613T(II /02/COM/WEB) r 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: 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 ❑ CMU ❑ 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 *Parking (including ADA) and ADA compliance Lighting 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. # of Plans TYPE OF SUBMITTAL Required at (Includes New, Additions or Alterations) Submittal Commercial 2 Multi - Family R -1 Occupancy 2 One- & Two - Family Dwelling 2 i:\Building\Forms\SIT-PennitApp.doc 1/13/04 2 - CITY Off= TIGARD BUILDING DIVISION PERMIT #: S!T20OWr00O09 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/15'200Ei Phone: (503) 639- 4171d'I�I Inspection Requests (24 Hrs.): (503) 639 -4175 `__.. INSPECTION WORKSHEET FOR DATE: 5130/2006 TIME: 7:15AM PAGE: 27 SITE ADDRESS: 11140 SW 60TH PKWY CLASS OF WORK: SUBDIVISION: MLP1999 -00011 LOT #: 002 TYPE OF USE: PROJECT NAME: CASCADE VETERINARY REFERRAL GE DESCRIPTION: Site work for new veterinary clinic. OWNER: WE.6STAR VI LLC, PHONE #: 503 - 981 - 0155 CONTRACTOR: TRIPLE1T WELLMAN INC PHONE #: 503- 932•418i3 Inspection Request Scheduled For: Date: 5/30/2006 Pour Time: Code # . Inspection Description Confirm # Contact # Message 499 Final inspection 030751 -01 971- 235 -1353 N Corrections /Comments /Instructions: <<Ti el �. _ S I:i/ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL F R INSPECTION ❑ ADDITI NAL F S ASSESSED Inspector: Date: hone #: (503) 718 -9 CITY OF TIGARD BUILDING DIVISION PERMIT #: SIT2005 -00009 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/16/2005 Phone: (503) 639- 4171tj�i� Inspection Requests (24 Hrs.): (503) 639 -4175 � _.. INSPECTION WORKSHEET FOR DATE: 12/2/2005 TIME: l :19AM PAGE: 22 SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK: SUBDIVISION: MLP1999 -00011 LOT #: 002 TYPE OF USE: PROJECT NAME: CASCADE VETERINARY REFERRAL CE DESCRIPTION: Site work for new veterinary clinic. OWNER: WEBSTAR VI LLC, PHONE #: 503 -981 -0155 CONTRACTOR: TRIPLETT WELLMAN INC PHONE #: 503 - 982 - 4188 Inspection Request Scheduled For: Date: 12/2/2005 Pour Time: 9:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 022845 -01 503-481 -7310 Y Corrections/Comments/Instructions: \ 0 - CO - P (__CII k)eCE SSkR- ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR I SPECTION ❑ ADDITIO AL FEES ASSESSED 'IV . Ins ector: Date / � Phone #. 503) 718 - p c 7 CITY OF TIGARD BUILDING DIVISION PERMIT #: SIT2005 Ogg09 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7115!2005 Phone: (503) 639 -4171 d Inspection Requests (24 Hrs.): (503) 639 -4175 : -� INSPECTION WORKSHEET FOR DATE: 9/2812005 TIME: 7:08AM PAGE: 67 SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK: SUBDIVISION: MLP1999 00011 LOT #: 002 TYPE OF USE: PROJECT NAME: CASCADE Vt ItRINARY REFERRAL CE DESCRIPTION: Site work for new veterinary clinic. OWNER: WEBSTAR VI LLC. PHONE #: 503.981 -0155 CONTRACTOR: TRIPLETT WELLMAN INC PHONE #: 503-982 -4188 Inspection Request Scheduled For: Date: 9/28/2005 Pour Time: 9:00 Code # Inspection Description Confirm # Contact # Message 205 Footing 016816 -01 503-481-7310 N Corrections /Comments/ Instructions: ---- all f / A Lle" MilitIMMERS-L —...- - ' -----..cCji-- 1--AP--- VCCC-0 .0 ' ; — 021 - I ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL IN CALL FOR SPECTION ❑ ADDITIONAL F ES ASSESSED Inspector: ` / , Date: ,�XJ Phone #: (503) 718 - CITY. OF TIGARD BUILDING DIVISION PERMIT #: SIT2005 000Q9 13125 SW Hall Blvd., Tigard, OR 97223 1 D ATE ISSUED: 7/15/2005 Phone: (503) 639-4171 l Inspection Requests (24 Hrs.): (503) 639 -4175 !� �'I �.. INSPECTION WORKSHEET FOR DATE: 9/21/2005 TIME: 7 :03AM PAGE: 86 SITE ADDRESS: CLASS OF WORK: SUBDIVISION: 11140 SW 68TH PKWY LOT #: TYPE OF USE: PROJECT NAME: MLP1999 -00011 002 DESCRIPTION: CASCADE VETERINARY REFERRAL CE Site work for new veterinary clinic. OWNER: WFBSTAR VI LLC, PHONE #: 503-981-0155 CONTRACTOR: TRIPLETT VVELLMAN INC PHONE #: 503 -982 -4188 • Inspection Request Scheduled For: Date: 9/2112005 Pour Time: Code # Inspection Description Confirm # Contact # Message 405 Excavation 016212-01 503 - 481 -7310 N Corrections/Comments/Instructions: fir 4' a C-M 0 ■i'liii IU JOS- 1./(9-.4 mi. ---- _ & ' ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED Inspector: lAk\-) Date: ? Phone #: (503) 718-