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Permit !' • CITY OF TIGARD SITE WORK „w,gyp 1 A, DEVELOPMENT SERVICES PERMIT 6 ' • I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # .......: S I T 99 - 0007 DATE ISSUED: 03/11/99 PARCEL: 26101BD -00105 SITE ADDRESS...: 12805 SW 77TH PL SUBDIVISION - ZONING: I -L BLOCK LOT ° JURISDICTION: TIG CLASS OF WORK..: ADD PAVING? Y RESO. NO.: TYPE OF USE :COM GRADING? N VALUE...$: 9500 EXCV VOLUME: 237 cy LANDSCAPING ?:`...: Y FILL VOLUME: 0 cy SITE PREP? Y ENG FILL? . • N STORM DRAINS ?...: Y SOILS RPT RECD ?: N IMPERV SURFACE: 6400 sf Remarks: Expansion of parking lot Owner: FEES ROY GEOCKS type amount by date recpt 12805 SW 77TH PL PLCK $ 40.63 B 02/09/99 99- 312799 TIGARD OR 97223 FIRE $ 25.00 B 02/09/99 99- 312799 PRMT $ 80.50 DEB 03/11/99 99- 313623 Phone #: PLCK $ 11.70 DEB 03/11/99 99- 313623 SPCT $ 4.03 DEB 03/11/99 99- 313623 Contractor: FIRE $ 7.20 DEB 03/11/99 99- 313623 GFC CONSTRUCTION INC EROS $ 80.00 DEB 03/11/99 99- 313623 17017 CANAL CIRCLE ERPU $ 26.00 DEB 03/11/99 99- 313623 LAKE OSWEGO OR 97035 Additional fees not shown here Phone #: 685 -9702 $ 1513.18 TOTAL Reg #.. 000884 REQUIRED INSPECT This permit is issued subject to the regulations contained in the St r m Drain Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Culvert /Catch Ba applicable laws. All work will be done in accordance with Landscaping Insp approved plans. This permit will expire if work is not started Final Inspection _ 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. Your may obtain copies of these rules or direct questions to OUNC by calling 1503)246 -9187. ( Iss'_ed by: L� �� Permittee Signature: r +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + ++ + + ++ + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Site Permit Application � Recd ey'rJbV� v� Date Recd 2.- 11 13125 SW HALL BLVD. Commercial and Multi - Family: Complete ENTIRE form Date to P.E. 2- (l 11 TIGARD, OR 97223 Residence: Complete SHADED areas Date to DST ) Z v 7 (503) 639 -4171 x304 Permit# 1 t — OQDY Related SWR # Called A -2)22 q (L)p • - - j Print or Type J Incomplete -o ill applications will not be accepted 7 ) Project Name= _ Utilities (Complete all that apply) Job G� �'l�.� lLll1 s Address Addre Storm Sewer 2 _;�U a' -'�.J. .�— q �Linear Ft. , Na e "'. w - Sanitary Sewer Owner Mailin dress X ` Linear Ft. 9 ° .. ..- ._, -: T Fresh Water 4 ` %0 �a� t ` tcL Linear Ft. City /State , Zip,. Phone Catch Basins ' Z223 .G.'L,C 'b(n1,�. # t General Nam a n : := � Clean Outs Contractor - � ��` # Prior to permit Mailing Address Describe work to be done: issuance a '',:] /"` /� New Additio Alteration Re air copy:of all ' � � l �J• r . ❑ � ❑ P ❑ license are . City /St Zip,, Phone Additional Des o W equ ir ed if f ork , r t i l - G `ions' 9c l EyCf?O� .Cp g ' n a ` Z ot` expired in COT State°.Const.. Cont rd Lic;# Ex Date database f ' �� ';;:. , . " "_. Nam �"'% .,` Protect l ��Y �� Va l ua $ t .: Architect Main Address Plans _Required See Matrix on back ( 3 N� � The following, must; accompan this application, Cit /State Zip Phone Site plan :with Vicinity Ma:p • Parking (including le Q"'(Zpl, 20 � - Showing ADA compliance :ADA) & Lighting n Pla . Name '''Grading: Han and ils 'deta ' 'Land s caping'Plan Engineer Mailing Address 1 E rosion Control Plan and' ; Retaining Stru es ctur - .'- d ncluding calculation City /State Zip PhoneSite Utility PIan and details :Soils Report . . (showing" connection to (lf required) approved: system); a: Excavation Volume 1 hereby that 1 hav this application that the (Soils report required for >5,000 cu. Yards) information given is correct that,, am the: owner orauthorized 231 cu. yds. . agent of the owner a plans submitted are in compliance with. State•laws.; Fill Volume Signature of.0 e/r Agent D at e (Soils report required for >5,000 cu. Yds.) '� cu. yds. '.: Im, Will the fill support a structure Con c e � _ `�"' P 22hon 3 e 1 3 5' (Engineer required if answer is yes) YES❑ NO Retaining structure? (check one) ❑Rock FOR OFFICE USE ONLY ❑ CMU Notes: ['Concrete l ` dtc e DOther �_ �n� Total new impervious area including all Land Use Case # � Map/TL# buildings, sidewalks, and paving (,4 Sq. Ft. (v1 Ab - tc k, . (eth ` r f c& k&, a $e si,t,r e -Fo ct'.eJe v i i.ldsts\forms\site- app.doc 10/30/98 MO ,/ COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Ian Review is dependent upon subr tttal a BOTH plans AND a COMPLETET ;: ::: o g ».;.»:.... :.. » f tl supervising eleotrrotan befiore plan review 4#111 k e contlucte Afte plan revie approval, .Plans Examiner will c onct t t ahe applicant to request additional :: lan<:sets:for::distribution:< > ur .: Washington �:f {:t.,,. :, o n : : To :. a . i :':' :.` ' n .>:.;> > :; :. e ' > <> .;> ; P g::.111 KEY: d.. S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System • M (New or Add or Alt) 1 M = Mechanical .B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) Building NOTES: I: \dsts \forms\matrxcom.doc 12/17/98 CITY OF TIGARD COMMERCIAL SITE WORK PERMIT APPLICATION /PLANS SUBMITTAL REQUIREMENTS Applicants: Please complete APPLICANT 1. APPLICANT NAME: - .E_ PHONE #: 22.3 2. SITE ADDRESS: 1 2-f 1 FAX # 22-3 2 (3 0 NOTE: A Site Work Permit is required on all additions, accessory buildings larger than 120 square feet, modular structures and new buildings. 1. SITE PLAN and vicinity map (Fully dimensional, drawn to scale) showing the geographic location labeled with: ❑ map & tax lot #, ❑ project name, ❑ site address ❑ suite number • ❑ zoning, ❑ applicant name, ❑ phone number, and identifying: A. North Arrow. B. Scale (Any standard, architectural or engineering only). C. Street Names. D. Building pads (drawn to scale) with project location. 2. BUILDING PLANS (no red line revisions or tapeons). Number of plans based on type of submittal. See Matrix on back of application. 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. Site Detail sheet showing a detail and specifications for each of the following: 1) Accessible parking and adjacent access aisle 2) Pavement markings showing the international symbol of accessibility and; 3) Accessible parking stall signage 4) Stairway, ramp and handrail within an accessible route C. Topographic survey plan showing grade elevations crossing the entire site D. Overall grading plan is \dsts \forms\site- app.doc 10/30/98 • E. Storm drainage plan showing: 1) Finish elevations throughout the developed site 2) Grade breaks determining area serving each catch basin 3) Location of catch basins 4) Pipe size 5) Type of material 6) Slope of piping 7) Manholes and field drains 8) Cleanouts provided for each 100 feet or fraction 9) Roof drain laterals specifying cleanouts at each upper terminal F. Utilities plan showing: 1) Sanitary sewer line location, pipe size, type of material, slope of piping, manholes and cleanouts provided as required for storm 2) Size and location of domestic water piping and drainage 3) Fire hydrant location and pipe size if on private property 4) 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 5) Size of underground water service for the sprinkler system G. Erosion control plan complying with the requirements of the Unified Sewerage Agency showing: 1) Silt fence locations 2) Bio- filter bags /other approved barrier material surrounding catch basins 3) Illustrations detailing the correct installation of the silt fencing and catch basin protection H. Landscaping plans 3. Additional Requirements: A. Soils (qeotechnical) report: A soils report is required for new building and additions. 1) The report shall address the potential of soil liquefaction and instability (OSSC Sec. 1804.2) and: • 2) Fills to be used to support foundation of buildings (OSSC.Sec.3301.1) and: 3) Foundation and lateral pressures exceeding 1,500 lb./sq. ft (OSSC.Sec. 1805) B. Plan review deposit is \dsts \forms\site - app.doc 10/30/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 API/ BUP 1 13 Date Requested AM PM BLD Location -77 Suite MEC Contact Person Ph 53 5-6 PLM Contractor Ph SWR BUILDING Tenant/Owner _ _ 1 ELC Retaining Wall ELR Footing Access: r — Foundation � Y CA FPS Ftg Drain 4 – SGN Crawl Drain Inspec i n Notes, ,�¢. Slab 7 � c,� ' i FLAL) SIT ��� 7 Post & Beam / Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall 4 " 'e (3, .5 /i S ` / Fire Sprinkler Fire Alarm ✓ 0 n cam- ) /1.1 ` 4 Susp'd Ceiling / 'T • Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer • ` Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PA PART FAIL ackfill /Grading Sanita Sewer *no .5_ - -: [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire upply Line ADA l�1I Approach /Sidewalk "5/4/? Other Date "I Inspect° Ext f Fi PART FAIL DO NOT REMOVE this inspection record from the job site.