Permit CITY OF TIGARD
SITE WORK PERMIT
dil j� DEVELOPMENT SERVICES PERMIT # : SIT2003 -00037
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 6/10/2004
SITE ADDRESS: 14650 SW 97TH AVE PARCEL : 2S111AC -02700
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING : R -4.5
BLOCK: LOT: 037 JURISDICTION : TIG
CLASS OF WORK: NEW PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: Y VALUE: 337,603.00
EXCV VOLUME: 3,460 cy LANDSCAPING ?:
FILL VOLUME: 1,860 cy SITE PREP ?:
ENG FILL ?: N STORM DRAINS ?:
SOILS RPT READ ?: Y IMPERV SURFACE: 11,649 sf
Remarks: New addition, reconfigure existing parking, add new parking & water treatment.
Owner:
FEES
TIGARD TUALATIN SCHOOL DISTRICT
6960 SW SANDBURG ST Description Date Amount
TIGARD, OR 97223 [BUPPLN] P1nCk - Valu 12/24/2003 $1,084.27
[FLS] FLS Pln RAT 12/24/2003 $667.24
[BUILD] Prmt Fee - Valu 6/10/2004 $1,668.10
Phone: [TAX] Valu 8% State Stu 6/10/2004 $133.45
Contractor: [ERPRMT] Erosion Cntl 6/10/2004 $80.00
CIPRIANO & SONS CONSTRUCTION INC [ERPLN] Ersn Plck USA 6/10/2004 $26.00
27905 SE HALEY RD [EROSN] Ersn Plck - COT 6/10/2004 $26.00
BORING, OR 97009 Total $3,685.06
Phone: 503 - 663 -1279
Reg #: LIC 43502
Required Inspections
Ersn Cntrl 681 -4444
Paving lnsp
Sprinkler supply lines
Fire system test
Final Inspection
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 -010 Y u may obtain copies of these rules or direct questions to OUNC by calling (503)
246 -6699.
Issued y: • 4,„„ aV' � � �yL
Permittee Signature: j I .AC)
Call (503) 639 -4175 by 7:00 P.M. for an insiaection needed the next business day
"t! S? 5 w F TH
, Site - ,
Work
t
-" •L +• FOR OFFICE USE ONLY
'O
Pu><ldling Permit Itl�Cation Received Building
• r in r , Date/By: /'1 6 3 ab Permit No.: p er ? /T 7 3 -Qco 3j 7
of TI i I l ` ll "mom Planning Approval ` Other
City
g bate/By: /—Z9-0 / 48 $ IIIPP Permit No.:
13125 SW Hall Blvd. �� Q 2 ' Plan Review Other
i igard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 - VO1 ' 8 1 � '� 't tr ti I i r Post - Review Land Use �((� C�OrJr7
`• �L��t e• Date/By: Case No. l7Hi7Of�
Internet: www.ci.tig QI �� Contact Jur CO See Page 2 for 0
24 -hour Inspection R I es • .. V3 Name/Method: f /l$ • Supplemental Information
;x•. , :.x _ _ -�:r .,�.,., .;:+: ; •ss:F, - �� . iz;,• =-. w.�„•. S�!-. ,. ' .� , ?:,�,:+o s -`: �i' K`. �'-✓="=':` ��- a'; T2?=R s�i'�";2:?'s'-�astswr +,ri �:. >:t"`
•;WII t . ^dw:`T. ''.;T "• }x,. _ x%•` _m ' a.. : r.., _. - - : «ut. : se,: r
.,a `_�-''�"..:�;�.. „TYPEUEWORICfi ��„ .. ,...r �x , ,'� -_ �:.
t ,. -_. ., ,.„ REQUIRED . fi ; -:
w New construction ❑ :r :: r ; ' .'"'''.=_.,'":''''''''' ~, ~� .
❑ Demolition a ii8i 2 EAMII Y DWEI;LING .:: .,fi. ,
E Addition/alteration /replacement ❑ Other:
'. +,'.: >;-ilV.MAZ 1ATEGORY °OFLiCQNSTRUCTIONfift ";'='' � , r ;,: Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling g Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi - Family
....'\
❑ Master Builder ❑ Other: Valuation $
. ' raJOB SITE INF MATIUN ind LOATION;:r'= =: . :' {' ' No. of bedrooms: No. of baths:
. - Job site address: 14 65 D SW 1 6 Av6 Total number of oors
New dwelling area (sq. ft.) •
Suite #: N)4 . • Bldg. /Apt. #: A0/4 Garage /carport area (sq. ft.)
Project Narne:TWAL T M5' A00 /t2>✓ to' D L Covered porch area (sq. ft.) ' F .
Cross street/Directions to job site: Deck area (sq. ft.)
WALL It WO TO SW M C 0 NALV Other structure area (sq. ft.)
M 1 10O10 AUL? To 4 7 (43 i1 IS ,arm :. 3 ,, a °. ,. �:., kry . k ; :, :
T,.=' C ..,, .;.•: *REQUIRE) DATA.. h r .ta :g:tr;; a�, ~'.
' •'_�.aGODRCIAL- USErCHEGIL= IST,<if
Subdivision: Lot #: 27p0
Tax map /parcel #: 2 `2 III Ar('i Note: Permit fees* are based on the total value of the'work performed. Indicate
` '' -, 2 DES.GRIPTIONiOF WORiviatO n ' 2resi the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.337� 645.60
l ptYJi'Jrflb -I OF 1J' MuLTI - VSe,
STut'✓ Eitir CO NM D FY, • REVI DI/oC_ VtT C,I{r.) Valuation . $
Existing building area (sq. ft.) I ZZr St1a +l
L � «��� , �o 4 � I New building area (sq. ft.) S t 9 D
L $ ; Apt, t$� — - N&414,
2O umber of stories I
PROPER1 Y;aOWNER ' °_ it el .1001'01Zifleireidarail Type of construction 1/ - !V
Name: -n &Av.) - TO Pd-A -) 561'rDOL YJISTieicr- Occupancy group(s): Existing: E-1
New: 6 -1
Address: 6/6.0 SI.J SU1 SA J% & f- .
City/State /Zip: Tt G-AYLO c - 7 27-3
Phone: 503 - 4'51 -400b Fax: 43 I - 4-0.41 NOTICE: All contractors and subcontractors are required to be
. licensed with the Oregon Construction Contractors Board under
t: ® `APPLICANT;x„iJ- �, ..a provisions of ORS 701 and may be required to be licensed in the
Business Name: CULL 0 LSDN Wt%LS jurisdiction where work is being performed. If the applicant is exempt
• Contact Name: 1Ttic tTbH`N 4 oto from licensing, the following reason applies:
Address: 311 SW WaserIN(>ToN 4T. ' us() -
City /State /Zip: ( Dom- `t ? Z71,4
Phone: 503 - 2Z6,- b cCb Fax: 2 3 - 914 2 o = - ; , -=�=4 -gam C x = °ale
,ii _ '' . ;,47 : s B D - ,r," = =
E-mail: Yti i J C c� W d co w%
E; t � t ,t F
,� •a � ` Please�refer o- feegschedule: kA
•..' . • k: �,, K w -tom= k;:,- r?:7;.r 4.,4''4'sk, '. .�. -Vi ., P ,ei ' r:
�,. «. .....,.�;r�• -. ,..4 vC 3 : t _�. r 9 ,i":` -. .0 ..: xw• tS?•_ n,.<> : "Na:...� .
Business Name: 3 l P 2( P1 /O tL ON Fees due upon application • $
Address:
City /State /Zip: Amount received $
Phone: Fax: Date received:
CCB Lic. #:
Authorized Sier&Viri"rill /1/ 2t Notice: This permit application expires if a permit is not obtained within
Signature: a'te 180 days after it has been accepted as complete.
z may; 11 VCJ -- wX/A , *F set by Tri- County Building Industry Service Board.
- (Pie. print name)
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 1"/ (/ lL../
.R
N r
SITE WORK PERMIT CHECK LIST •
Commercial, Multi - Family (R -1 occupancy) and Residential:
•
Please complete all items below, unless otherwise noted. . -..
3,x{,40.. ,y
Excavation Volume: yAvti . / -.`cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) 5 U cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be compacted to 90% of
maximum density) 1, `abp cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
Other - KE fsrbut-
111
*Total new impervious area including all buildings, �j
sidewalks, and paving: /I/ v., / s q.'ft.
.
Site Utilities Plumbing Work: 141, 7 4re,a5 Ste! /
Complete the "TAN" Plumbing Permit Application for site utilities plumbing "work.
- S.a- '+ -+re wtid+uv r. �',:.`X `fa. 'A.:. ,ft L . j ,. .� is,.s'>' {.'6i ¢i+'&';.w .1":':J_t. Y;::3 •:b•M.�§ .,. .,. .�...,..,,..�:. f1:
�Plans�IZequired:�See: ,Sitet�UVock§Permlt } Application Plan Sutimlttal�Requiremenfs-
x ,•'v�;,;:- �Ths „x;,.,�c,,a �
.- attached e follo wingInust accompany applica
o5 ,tion:=# Q � A. ,;
.x, � �v:aa sg..r .� -�_�. �.�,., �a� r�x- '�.,
Stteviarmith Vicinity$Maposhowingr Parking (including A ®A) and
.t' pM ,n :•: ': , � �" r ':rte °�' " e. �x .;�,. ° 9;; ., x." e ' - 5010,
p ®AicornplIance � l F
q Li ht �Pl a te
ry .�.,�. �: dk .r „��.xa ",ra xu -r,•r �:..� ,��- , "��. 1'�F 2'a"% �,q. .� Y. ?. ^.±.v,,,'€'�`ua f f: a` T2; ts � �x •° r�er�" .+. q „�.��i,% 't -zc. ��
�Gradir ?lan and details ' ” I t Landscaping P w , f i s >£A . .
s. a yx_. m+° mac. �' ss* M -,rc' a sxr„x � � :� :s;,n f v' LePC.,�d^" ����
• Ero ionCo_ntr6IPlan and 5detall,'s°��� Solls'Report(tfregwred) ;; .7 �rv� .� .
Retainln t:SfRi tares : .4.1' 2 ,... $"° A !WIZ, ._ . -fati :
• *Does not apply to 1 and 2- family dwellings.' • ' - •
4z ,'� o f , fi t 9g
w - #�ofPlans
TYPE O PSUBMITTAL �� ` Re red at ;
,�(Includes A orIAlt � �`
Suim
Commercial 4
Multi - Family R -1 Occupancy 4
•
One- & Two - Family Dwelling 4
NOTE: Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
is \dsts\forms\sitechecklist.doc 09/24/01
• ,
AREA
CALCULATIONS
NEWLY CREATED IMPERVIOUS 315 SF (PARKING)
'4 r
I'
if AREA 717 SF (BIKE PARKING) *
3,735 SF (BUS LANE)
331 SF (SIDEWALK)
173 SF (ROOF)
1,000 SF (ROOF)
+ 5,378 SF (PARKING)
TOTAL 11,649 SF
.,,
ALTERNATIVE BID TEMS 1,213 SF (PARKING)
+ 1,079 SF (PARKING)
13,941 SF
Ofk
CREATED PERVIOUS AREA 322 SF (LANDSCAPE ISLAND)
— 784 SF (LANDSCAPE ISLAND)
TOTAL 835 SF IF 411:r PAR,A46
TREATED IMPERVIOUS AREA 4,877 SF (UPPER DRIVE) IS POltsr
1,728 SF (LOWER DRIVE)
1,213 SF (ADDITIVE BID PARKING)
+ 5,378 SF (PARKING)
13,196 SF
NET DIFFERENCE OF TREATED (+) 361 SF
IMPERVIOUS
CITY OF TIGARD • 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received
13,/,e Request ~- t / ` CO � AM PM BUP
Location (46h W ( +t-
Suite MEC
Contact Person Ph ( ) PLM
Contractor � Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain 2 3" 3 '7
Slab Inspection Notes: SIT ((
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm /1
Susp'd Ceiling
Roof •
Other:
I A "— .
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please . :II for rein .•ection RE: �^ Unable to inspect — no access
Fire Supply Line f ,L.� �. • �/I
ADA t J �
V 4J • I (
Approach /Sidewalk Date Inspe , r _ Ext
Ot
DO NOT REMOVE this inspection record from the Job site.
ASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Busines Line: (503) 639 -4171 MST
BUP
Received Date Requested (e PM BUP
Location 14-(0 "5C 5 7 Suite MEC
Contact Person Ph ( ) PLM
Contractor �� Ph ( ))> SWR
BUILDING Tenant/Owner T � � ('" ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR -7
Crawl Drain SIT
Slab Inspection Notes:
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal l WarlaMM11,12 �
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Mfg Roof
Other:
Final
PLUMBING FAIL � � � _- I;M=Z■s% , t
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
IT.E Please call •r reinspec on RE: Unable to inspect - no access
Line
ADA )101
Approach/Sidewalk Date Inspect r J> Ext
Other:
DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Busingss Line: (503) 639 -4171 MST
9M-7104—A-M BUP
Received Date Re uested PM BUP
Location I S 7 Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR '
Crawl Drain
Slab Inspection Notes: . SIT Z^
Post & Beam
Shear Anchors
Ext Sheath/Shear ,
Int Sheath/Shear
Framing - r
Insulation ��
Drywall Nailing ■ `� ���o■ _. � ,
Firewall 7 411111 y
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ; 0, ' 0
Roof
111/ i Other: - �- A'.
Final /
PASS PART FAIL
PLUMBING ' „ ,
Post & Beam T WO -
Under Slab ` �_ � , I liriA t , _�
Rough -In V 1 r ,G f �
Water Service
Sanitary Sewer �'
•
Rain Drains I \ '�
Catch Basin / Manhole I, ,\
Storm Drain —
Shower Pan
Fri -
Other: ,
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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
S Please call for reinspection RE: Unable to inspect — no access
Fire R Li
Lti�i ne
ATJ
Approach/Sidewalk Date Inspector Ext
Other: 10lt?!
Fi X0 • DO NOT REMOVE this inspection record from the job site. P SSA PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTtbN DIVISION Business Line: (503) 639 -4171
BUP
Received Received Date Requested / - An AM V PM BUP
Location _ l 742 $ Suite MEC
Contact Person , _. ..0 Ph ( ) L/ g/ — 0, 3 3 7 PLM
Contractor Ph ( ) SWR
r
BUILDING Tenant/Owner tor . Ars_ = - ELC
Footing /
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT 3 - 60 0.3
Post & Beam
Shear Anchors
Ext Sheath/Shear ,
Int Sheath /Shear
Framing �r------
Insulation
Drywall Nailing \ gif AO i. is - ail 0
Firewall
Fire Sprinkler
Fire Alarm
I
Susp'd Ceiling T ��
Roof �l ��\i(� � 1�``.
Other: v
Final
PASS PART FAIL
PLUMBING ,_ : _i 1 � =j „ i
Post & Beam
Under Slab
Rough -In
( ■
—
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / 1 e) TV P 26-1 `�
Storm Drain �� f �/ r,I Nob �/� �^
Shower Pan E i a M V LL- o3 1 L)b MT � 1�= - -E-
Finar: ( 7 - "J O 'R ) .“A 17 1
MECHANICAL. FAIL 0 D - - A ' I J ME--5A ME-t
e
Post & Beam J� S A ' w TLl k ^,�r>C :► \ /
Rough -In �"C ) ] �, —7 � (/'`= 1� -{C_ �l kyEs
Gas Line G Smoke Dampers `� < <� ��� ` < < v �--� �� ��
Final ,N / <=�x-� ^ W l U ,Part-t- ( E -�, �--V E
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ 0 Please call for reinspection RE: D Unable to inspect — no access
F upply Lin
A
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL