The URL can be used to link to this page

Permit CITY OF TIGARD SITE WORK PERMIT COMMUNITY DEVELOPMENT Permit #: SIT2010 -00020 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2010 Parcel: 2S112DC00701 Jurisdiction: Tigard Site address: 15951 SW 72ND AVE Subdivision: OREGON BUSINESS PARK III Lot: 38 Project: Carmen Center Project Description: Replacement of 13,577 SF of pavement and overlay at main drive of building. Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 Permit Fee - Site Work 10/13/2010 $621.12 PORTLAND, OR 97224 Plan Review 10/13/2010 $403.73 PHONE: 503 - 624 -6300 12% State Surcharge - Building 10/13/2010 $74.53 Erosion Control 10/13/2010 $80.00 Contractor: Erosion Plan Review CWS 10/13/2010 $26.00 EAGLE ELSNER INC Erosion Plan Review COT 10/13/2010 $26.00 PO BOX 23294 TIGARD, OR 97281 PHONE: 503 - 628 -1137 FAX: Type of Use: COM Class of Work: ALT Site Specifics: Excavation Volume: 500 cu. yd. Fill Volume: 500 cu. yd. Impervious Surface: sq. ft. Engineered Fill: Soil Report Required: Paving: Grading: Landscaping: Site Prep: Storn Drains: Retaining Wall: Fire Underground: Accessible Parking: Fence: Total $1,231.38 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 rul- : • • opted b • - Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You • • • stain - opy of t - rules or direct questions NC by calling 503.2.. • ! ! - ..t _ ah4. Issued By: • - Perm ittee Signature: / ,e 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 Site Work $ FOR OFFICE USE ONLY e � � Received City of Tigard Date : 0 Permit No.. ._ 13125 SW Hall Blvd., Tigard, OR 972.1 c Plan Review 11 Phone: 503.639.4171 Fax: 503.598.10 a \ n �© �� ® DateB : ` �>l� �® (0 Other Permit: / J. o i O , / T I G A K D Inspection Line: 503.639.4175 • �� p, A ate Ready/By: luris: El See Page 2 for Internet: www.tigard- or.gov O G� � " 1 otified/Method: 7 Supplemental Information C TYPE OF WORK v REQUIRED DATA: 1- AND 2- FAMILY DWELLING ` ❑ New construction ❑ Demol Permit fees* are based on the value of the work performed. �f ii � iri Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement Other: ()Ave Rawl 1 fa.. equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $ ID Accessory building ❑ Multi- family Number of bedrooms: 1:3 Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: IS`!S/ 5C4J ?2' A New dwelling area: square feet City /State /ZIP: 77 d 2 5 z Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: ( N canna. 68p li 211J Covered porch area: square feet Cross street/directions to job site: 10296 ( c FW2Y 4411 .72 Ate - Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 1 S 1 12 OLL p Indicate the value (rounded to the nearest dollar) of all 1 . equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ REPAta- °P 41(44 REA art*,�Vlbntr Og ExiSTiAk r'Alt.1ai& Parrm&vr � cTOA) AT fifklotI 1)/2.1)/2.16% r2 ISt.E WJi cJV�J ANA Q • .,/ Existing building area: 3s0 square feet ANO P4autnlr: t r A u - &Omar Z . Pau.onrc. F a o e f T . v ✓E2uty OP O n e ) Evrrii,t, PAaKt &ft AvrA AWO NEW C.4Trd QAsiN Ar Eidn4✓6 Lo..) RIINT New building area: -- square feet ® PROPERTY OWNER I ❑ TENANT Number of stories: Name: Pact TM RE.at. r5r ASS:4141ES L.P. Type of construction: Address: 1 St./ S&aKem4 Pf mot' •c..wtr1= 300 Occupancy groups: City /State /ZIP: '-r 6042o o2 c 17 2-2. Lt Existing: Phone: (5'63) GZti GSec, Fax: (e3 ) G 2 735 New: Jj APPLICANT ❑ CONTACT PERSON NOTICE Business name: 54,,E As All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: J., t tJ4 r 7.4 Lq 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 apply: Phone: ( ) Fax::( ) E -mail: Ju.+N W Q Riezaus .Ctry CONTRACTOR Business name: EAG[.Is F�SN6JL, (NC. BUILDING PERMIT FEES* �,1 a � 1 (Please refer to fee schedule) Address: �" ` ' �l Structural plan review fee (or deposit): City /State /ZIP: T! C2 57z-n FLS plan review fee (if applicable): Phone: (503) GZ — Fax: ( 73) 62S' 11,3 ? CCB tic.: Total fees due upon application: 4J �� ' � Amount received: 4 Authorized signature: 4 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print na : ' 1 I • 4 • Date: �J ei * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits \SIT - PermitApp.doc 10/01/09 440- 4613T(1I /02 /COM/WEB) 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 f . PPp and will not be supporting a structure. If a building will be constructed on the fill, it must be engin ered fill. If fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive nds review (SLR). —? Please complete all items below, unless otherwise noted. ( , ...aI- 4NO RePIACe^16vtrr 12'4" 131517 s F of Egrsn PAreMwAvr SlSereo I IS 1 ►Y REP Excavation Volume:Op? cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) ,r ? cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) SOO cu. yds. Retaining structure? (Check one) t j„ 46 ❑ Rock ❑ CMU ❑ Concrete ❑ Other: *Total new impervious area including all buildings, �{ sidewalks, and paving: 1� 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 5.00 to $500.00 $51.09 minimum permit fee Alterations) Submittal $500.01 to $2,000.00 $51.09 for the first $500.00 and $2.69 for each additional $100 or fraction Commercial 2 thereof, to and including $2,000.00. 52,000.01 to $25,000.00 $91.44 for the first $2,000.00 and Multi - Family R - 1 Occupancy 2 $10.76 for each additional $1,000 or fraction thereof, to and including $25,000.00. One & Two - Family Dwelling 2 $25,000.01 to 550,000.00 $338.92 for the first 525,000.00 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 550,000.00 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. 1: \Building\Permits \SIT - PermitApp.doc 12/27/06 2 1 Site Work Permit Application 1= Plan Submittal Requirements T I G A R D 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. Er map & tax lot # Ej project name a site address ❑ suite number 12' zoning []applicant name [applicant phone number B. North arrow. _r 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. I: \Building \Permits \SIT - PermitApp.doc 12/27/06 3 • 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 1,5001b. /sq. ft. (OSSC Sec. 1805). B. Fire flow and hydrant worksheet. C. Plan review deposit based upon project valuation. 1: \ Building \Permits \SIT- PermitApp.doc 12/27/06 4 U PI 0 ° Building Division Over- The - Counter (OTC) Building Permit TIGARD Check List Description of Project: S (TE_ (.¢ GENERAL INFORMATION Class of Work:* 4\L-1 Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* CCUA First floor: N: S: Type of Construction: Second floor: E: W: Occupancy Group: Third floor: Openings Protected Y /N ?: Occupancy Load: Total sq ft.: N: S: Stories: Note: Combine total floor area for E: E: — Height: _ all floors above third floor and Roof Construction: Floor Load: add to the third floor s . ft. Fire Retardant: Basement: Basement: Area Separation Rated: Mezzanine: Garage: Occu. Separation Rated: REQUIRED ITEMS Fire sprinkler: Handicap access: ( 1 ) --j Smoke detector: Protected corridors: • Fire alarm: Parking spaces ( #): Notes: Total Valuation: $ 117� ) . . INSPECTIONS 1 FEES DUE Footing /foundation Firewall $ foil , I Zi Permit Fee Post /beam structural Smoke detector $ - 74,53 State Surcharge Shear wall Misc. inspection $ 4I .73 Plan Review Fee Masonry Approach /sidewalk $ FLS Plan Review Fee Framing $ Additional Permit Fee Insulation Sprinkler rough -in $ Additional Plan Review Fee Gyp board Fire alarm $ Metro Construction Excise Tax Suspended ceiling Sprinkler final $ School Construction Excise Tax Final inspection $ Misc. Fee $ eO,0C> Hourly Rate Fee $ 'Zio , CO Hourly Rate State Surchar e $ `,Q0 Other: R0•101� ($ 512( , Total Fees Due . *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo; FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. I: \Building \Forms \OTC - BUP.doc 08/19/08