Permit •
CITY OF TIGARD SITE WORK
t,,,,,,yi, . ,,,\ DEVELOPMENT SERVICES PERMIT � ,
.!+� A '� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 PE RM I T # S i T96 - 0053
DATE ISSUED: 03/14/97
PARCEL: 2S112AD -00600
SITE ADDRESS...: 14750 SW 72ND AVE
SUBDIVISION • ZONING: I —L
BLOCK . LOT •
TYPE OF WORK: COM PAVING? ▪ Y RESO. NO.:
EXCV VOLUME: 0 cy GRADING ?..... N VALUE...$: 216000
FILL VOLUME: 0 cy LANDSCAPING? Y
ENG FILL? • N SITE PREP? ▪ Y
SOILS RPT REDD ?: N STORM DRAINS ?...: Y
IMPERV SURFACE: 67227 sf
Remarks: Regrading, repaving, and adding /relocating catch basins to existing
parking lot of 67,227 sq. ft. (excludes existing building)
Owner: FEES
RYDER TRUCK RENTAL type amount by date recpt
PROPERTIES & CONSTRUCTION PRMT $ 723.00 JMH 03/14/97 97- 291786
3600 NW 82ND AVE 5PCT $ 36.15 JMH 03/14/97 97- 291786
MIAMI FL 33166 PLCK $ 469.95 JMH 10/09/96 96- 284958
Phone #: 305- 593 -3924 EROS $ 100.00 JMH 03/14/97 97-291786
ERPC $ 32.50 JMH 03/14/97 97- 291786
Contractor: ERPC $ 32.50 JMH 03/14/97 97- 291786
HAL'S PAVING /CONSTRUCTION INC SWM $ 2750.20 JMH 03/14/97 97- 291786
20666 S. MOLALLA AVE SWM $ 1527.89 JMH 03/14/97 97- 291786
OREGON CITY OR 97045
Phone #: $ 5672.19 TOTAL
Reg #..: 34434
REQUIRED INSPECTIONS
This persit is issued subject to the regulations contained in the Erosion Control.
Tigard Municipal Code, State of Ore. Specialty Codes•and all other Excavation Insp
applicable laws. All work will be done in accordance with S t r m Drain I n s p
approved plans. This persit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for sore
than 180 days.
Permittee Signature: "�( C. AP
Issued B y:
'Watt cJitm/L d —
Call for inspection — 639-4175
CITY CAF TIGARD Site Permit Application Plan check # — .-6C9
Recd By
1;3 srll NALL 8L11i . Private Gracing, Paving, Site Accessibility Date rZec'd 4 S /o /9/
TIGARD, OR 97223 Retaining Structures, Utilities and Relate • ork Date to P.E. Jr - r4•gb �9 g
(503) 639 -4171 x304 �/ � ( Permit # Date to DST
-7L� 7 ��9C �eG.+ �E.
II �IT� -( ,
•
�' l I Called
Print or Type / fL
Incomplete or illegible applications will • of be accepted
Project Name Lc IV IL, Utilities (Complete all that apply)
Job ga D 'P\ - rRock R #1111. I L1 ;
Address Address Storm Sewer
1 'W "13. *TI G RRD j Jf E o N Alio Linear Ft.
Name V POP Q,S y Sanitary Sewer
Y D P\ rtRuCk R A•L co,�n„ti Y, A' Linear Ft.
0 er Mailing Address Fresh Water
��� is 6tcon N.W. $a. - verve.
) C Zip Phone _ Catch Basins Linear Ft.
I (Yl1flm i f l L. mi6b ( ,5)s 39 1 #
Name •444 . �NSTRUCtio �11� Clean Outs !
Mailing Address Describe work to be done: .
General a1:A.,vk4 s molGA to, ft� New° Addition° Alteration° Repai
Contractor City /State p � r ,. Phone Additional Description of Work:
ortCrOW CIkyi 91045 lost M941 R, . , ; . . ,; k .. ki L1s ou►a ,
Attach State onst. Cont. Board Lic. # Exp. 7 ate
copy 6 445 4 g )3 / 9% 4 ha- w s . , � rl � ra
of current COT Business Tax or Metro # Exp. Data •
licenses 00o o 1 ,•o bI 1 191 i. 0XPA4 PGV PAVE(V EOT Al EA, (',
Name
Project
1-4 \ / CR A- u D F{' u_ Valuation s
o 00
Architect Mailing Address Plan Submittal: (3) sets containing each of the
tor) C 1-4 b LI br Ve. following, must accompany this application:
City/State Zip Site plan with Vicinity Map Parking (including
ios4n �l ( C4 4000) [Phone
t J5$ -.$3OO Showing ADA compliance 1 ADA) & Lighting Plan
Name Grading Plan and details Landscaping Plan
{ Engineer Mailing Address Erosion Control Plan and Retaining Structures
details including calculations
City/State Zip Phone Site Utility Plan and details Soils Report
(showing connection to (if required)
approved system)
' Excavation Volume 1 hereby acknowledge that I have read this application. that the
(Soils report required for >5,000 cu. Yards information given is correct. that 1 am the owner or authorized
1 500 cuy y agent of the owner, and that )mitted , are in compliance
Fill Volume with Orego • tate laws
(Soils report required for >5,000 cu. Yds.) 5 Sigma e • = Date
°O cu. yds. ar /,f � �
.te r- /0 9
`Nfl the fill support a structure C • ntac - erso Name Phone
Iltl
(Engineer required if answer is yes) YES°
Retaining structure? (check one) °Rock FOR OFFICE USE ONLY ., , • ..
p ptv, D CMU Notes: PiUmf3 CT > 5' FpoM F ,llt,p(o r.£r
DConcrete
° C o n c I ` / INU,U D eD.. AS P r bF 7#f £:
9T PL AO PER. PE. .
Total new impervious area including all Q Land Use Cas t. ' Map/TL#
buildings, sidewalks. and paving l L / Sq. Ft. M15Q 3 UU'•'S ' 1�-3 f la A13-0Q7
:'asts.siteapp.doc 'iaAD C
3196
I
Permit # Account Description Amount Amt. Pd, Baf. Due
1Z3
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC /ELR Permit (ELPRMT)
State Tax (TAX) - ri ,1
Bldg:
Plumb:
Mech:
ELC /ELR:
Plan Check yi MENU l
b5
Build: (BUPPLN) 41 I.5 '
Plumb: (PLMPLN)
646 00 (MECPLN)
00
CDC Review (LANDUS)
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Commercial TIF (TIF -C)
Industrial TIF (TIF -I)
Institutional TIF (TIF -IS)
Office TIF (TIF -O)
Mass Transit TIF (TIF -MT) �����3��
Water Quality (W '"�-
QUAL) - -E3' sT t , /54120
Water Quantity (WQUANT) = 1 5 2 -1r ff2 �9
Erosion Control Permit (ERPRMT) / d U 7_ I DD -
Erosion Planck/USA (ERPLAN) .g- _ __ _
Erosion Planck/COT (EROSN) ?2 S i , 7 5 SD
Fire Life Safety (FLS) 0 0
TOTALS: `p 11 116 471.50 407E211, • )
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