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Permit \' CITY OF TIGARD SITE WORKPERMT COMMUNITY DEVELOPMENT PERMIT # : SIT2008 -00008 DATE ISSUED : 4/10/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL : 2S111AC 02700 SITE ADDRESS: 14650 SW 97TH AVE ZONING : R -4.5 SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 037 JURISDICTION : TIG PROJECT: TWALITY MIDDLE SCHOOL Project Description: Site work for relocating portable moved from Tigard High School. CLASS OF WORK: OTR PAVING ?: N RESO. NO: TYPE OF USE: CMS GRADING ?: U VALUE: 0.00 EXCV VOLUME: cy LANDSCAPING ?: N FILL VOLUME: cy SITE PREP ?: Y ENG FILL ?: N STORM DRAINS ?: Y SOILS RPT REQD ?: N IMPERV SURFACE: 2,000 sf Owner: FEES TIGARD- TUALAT1N SCHOOL DISTRICT Description Date Amount 6960 SW SANDBURG ST [BUPPLN] Pln Rv -Valu 3/21/2008 $54.57 TIGARD, OR 97223 [FLS] FLS Pln Rv 3/21/2008 $33.58 [BUILD] Prmt Fee -Valu 4/10/2008 $83.95 Phone: 503 - 431 - 4000 [TAX] Valu 12% State Surchar 4/10/2008 $10.07 [ERPRMT] Erosion Control 4/10/2008 $80.00 Contractor: [ERPLN] Erosn Pln Rv CWS 4/10/2008 $26.00 [EROSN] Erosn Pln Rv COT 4/10/2008 $26.00 WILLIAMS SCOTSMAN INC 7933 N UPLAND DR Total $314.17 PORTLAND, OR 97203 Contact #: PRI 503 - 285 -6165 FAX 503 - 285 -5029 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 - 4444 Reg #: LIC 145907 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246 .••• or 1.800.332.2344. / Issued By. • / � /( P ermittee Signature: _,1� �� j . � r - Call 503.639.4175 by 7:00 a.m. for an inspecti• hat business day. This permit card shall be kept in a conspicuous place on the j 'r • site until completion of the project. Approved plans are required on the job site at the time of each inspection. '� Building Permit Application �(' 08 - j , -- Site Work RECEIVED FOR OFFICE USE ONLY 14 ' . ° City of Tigard Dat /B .- R-T— Permit No.: ` 1 �,pp1— fig aR 2 20 y )11117,9,00e6--- 3 13125 SW Hall Blvd., Tigard, OR 97 1 08 Plan Review ,, I� Phone: 503.639.4171 Fax: 503.598.1960 Date/By: � � ` © Other Permit: T I GAR Inspection Line: 503 Date Ready /By'. lu H ee Page 2 for Internet: www.tigard -or. ov CITY OF TIGAR® Notifie. /thod: ! / ,, el t l I ,,plemental ,formation g BUILDING DIVISION iii 1/1 A' . i%/i '�/�1��1P 'D ., . TYPE OF WORK ,P Ari . RE 1 1��D 1 DATA: 1- AND =F • 4,11 Y DWE L1 2 El New construction ❑ Demolition P Permit f e based on the value of the work performed. ` U1 Indicate t alue (rounded to the nearest dollar) of all ' 4ddition/alteration/replacement 111 Other: equipment, materials, labor, overhead, and the profit for the • CATEGORY OF CONSTRUCTION work indicated on this application. El 1 -and 2- family dwelling Valuation: $ ❑ Commercial /industrial Accessory building El Multi-family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: (.-1 4-Q , q'�4 New dwelling area: square feet l ��Q - City /State /ZIP: lt 1..,N4) ( 0 �,3 2'L c Garage /carport area: square feet C \ L s..., Suite/bldg. /apt. no.: Project name: ( )/ - Ll7 / CD-43(4.0 k Covered porch area: square feet Cross street/directions to job site: D1l.-1.'E V 7 j F Deck area: square feet l ` 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.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the `\ 1 %J a DESCRIPTION OF WORK • work indicated on this application. F . �ocal f ? '�'i� f�Lt, `l Valuation: $ c (jZ1t7 • - t ` l -� ( rik 6C � t-o Existing building area: T„,,,6(96 square feet t`"- New building area: square feet \7 16 PROPERTY OWNER ❑ TENANT Number of stories: _ k \ Name: �r � �� �� �� Q9 t Type of construction: 14 Q Address: O S w D �-. l Occupancy groups: City /State /ZIP: Cl ��D ere ZZV -- Existing: Phone: ( SO) ` f 3 e cm( V`-- Fax: 6 ) 3(— 4 4 i New: l [APPLI ❑ , CONTACT ,PERSON NOTICE kl\ Business name: t( DC��)_ ,��� � / - All contractors and subcontractors are required to be Contact name: ` �t ti tX - , ,) ( V al( / licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the ..., Address: O)I 15(41 ' n -Nee -- „ T 1-"C° jurisdiction in which work is being performed. If the -- --- City /State /ZIP: `.�. ` DV-- �" '• applicant is exempt from licensing, the following reasons • apply: j Phone: (C Z 22. ( " <o,,p I Fax:: ( of .y7 ',. 7 t z -- E -mail: r W r J (t (Q �� W 1. L 144, , _ J CONTRACTOR W . Business name: 6 Z (Ct a4,,, L C� {6 s BUILDING PERMIT FEES* • , Address: � 2 C) (Please refer to fee schedule) l � 71 2 Structural plan review fee (or deposit): �- City/State /Z1P: % t (((///C2 9 / 2U jj r FLS plan review fee (if applicable): .,5 • ; ) c D Phone: (L 03 /4-Cr _ ! i .. COt ro Fax: ( c D3) n- 5- — 58 Total fees due upon application: I ( , 15j CCB lic.: \\ v" Amount received: n S y) t ,,,.,/— f Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: * a � _ t Date: 2,4 0 * Fee methodology set by Tri -County Building Industry Service Board. I: \Building\Permits \SIT - PermitApp.doc 12/27/06 440- 4613T(11 /02 /COMIWEB) 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 feet deep and will not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review (SLR). Please complete all items below, unless otherwise noted. Excavation Volume: cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ❑ Other: *Total new impervious area including all buildings, sidewalks, and paving: 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 ❑ *Parking (including ADA) and ADA compliance Lighting 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. # of Plans TYPE OF SUBMITTAL Required at (Includes New, Additions or Alterations) Submittal Commercial 2 Multi- Family R -1 Occupancy 2 One- & Two - Family Dwelling 2 l:ABuilding \Permits \SIT- PerniitApp.doc 12/27/06 2