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Permit . _. CITY TIGARD SITE WORK PERMIT r DEVELOPMENT SERVICES PERMIT # : SIT99 -00017 �' J 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 5/4/99 SITE ADDRESS: 12123 SW 69TH AVE PARCEL : 2S101AA -TTOOA SUBDIVISION: TIGARD TRIANGLE OFFICE COMPLEX ZONING : MUE BLOCK: LOT: OOA JURISDICTION : TIG CLASS OF WORK: NEW PAVING ?: RESO. NO: TYPE OF USE: COM GRADING ?: Y VALUE: EXCV VOLUME: 0 cy LANDSCAPING ?: FILL VOLUME: 30.000 cy SITE PREP ?: Y ENG FILL ?: Y STORM DRAINS ?: Y SOILS RPT REQD ?: Y IMPERV SURFACE: 0 sf Remarks: Site work permit - (Note) No water quality or water quanity fees collected - This permit is for grading only. Street Opening Permit Required Owner: FEES POLLOCK, DONALD + JULIA Type By Date Amount Receipt 1834 SW 58TH AVE STE 202 PORTLAND, OR 97221 PLCK BON 4/1/99 $484.58 99- 314045 FIRE BON 4/1/99 $298.20 99- 314045 EROS GEO 5/4/99 $80.00 99- 315094 Phone: ERPU GEO 5/4/99 $26.00 99- 315094 Contractor: ERPC GEO 5/4/99 $26.00 99- 315094 BAUGH CONSTRUCTION OREGON INC PRMT GEO 5/4/99 $745.50 99- 315094 PO BOX 14135 Total $1,660.28 SEATTLE, WA 98114 -0135 Phone: 641 -2500 Reg #: Required Inspections Excavation Fill • Grading O This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. c, Permittee Signature: -• /l ei-e—/r -- (1 C 41 /■ Issued By: �'- '' ,f ___ Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day C ITY OF TIGARD Site Permit Application pt4 N) 04' # J J SC_ • 13125 SW HALL BLVD. Commercia Comp lete ENTIRE form C _ TIGARD, OR 97223 Residence: Complete SHADED areas ' � ,_ e (503) 639 -4171 x304 Print o r Type l)1 \'t' >� Incomplete o r illegible applications will not be accepted , °t !Y �I`► 99 - G�p�7 c;,}_<; is ;;. } ". .s3isi ?:ic5i:'i ±is:: ? >i i<: %iii i �' � ' >•�•��• �� °� �� � °��° �•P '" : cf ,. rne .. •, .,... Utilities Compl all that a : . : .: . >. ... ( p i�.ii:.i:.:::.:. ...::.:::.:.;.: <::• ...eS :'': >cj : : : >> .. ; : :- . .;.;.;. 1 : .::... 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TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 — -- 3 (j,o,u) -- -- B (New or Add) 1 1 — — 3 (j,o,w) -- -- F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f) M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- — B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- — P (New, Add. or Alt) 2 -- 2 -- — 2(j,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) — E (New, Add, or Alt) 2 -- -- 2 — — 2(j,o) B & M & P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,c) ....... .. .. . . . . .. .. . .P.. A .. .;:<.:; NOTES: KEY: a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP number of revised plans from applicant, stamps and o = Office M = MEC completes, updates and adds actions. f = Fire P PLM u =USA E =ELC :b >ha::afs < ii � �ii�; A�.`:: ��bm�l; y.:. or�..:...;:.;:;:.>;; ::.::.:: <:.::::.:::.:':::.:::.: w = County = ............................... ....::::,:.:::: ::.. :;. �'.;:; C u ty F FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. . Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. I:Vnatrix.Doc VLMK Consulting Engineers 3933 SW KELLY AVE. / PORTLAND, OR 97201 4393 ykki (503) 222-4453 / FAX 248-9263 ,' Job � , �� le, V4c-t, "eixtp`( Job No. Date i 749c1 Phone ❑ with Conference ❑ with Field ❑ with Memo ❑ to Subject: ,-+ r g eavioffA rteikklomevii -- - -- - -- -- -- - - - t 0 Oft 6 11' 0 34 4 1' - - - - - -- 'Ri alwe a. ('4! pct 4-6( 5i k , pg 6 1/1 -11 1 Distribution: By