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Permit C ITY OF TIGARD SITE WORK PERMIT DEVELOPMENT SERVICES . PERMIT #: SiT2006 -00017 DATE ISSUED : 9/8/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL : 1S136DD-02100 SITE ADDRESS: SW NO ADDRESS ZONING : MUE SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 010 JURISDICTION : TIG Project Description: Dartmouth Office Bldg. Erosion Control Only. Tree removal & stump grinding. Lot 2100. CLASS OF WORK: OTR PAVING ?: RESO. NO: TYPE OF USE: COM GRADING ?: VALUE: 500.00 EXCV VOLUME: cy LANDSCAPING ?: FILL VOLUME: cy SITE PREP ?: ENG FILL ?: STORM DRAINS ?: SOILS RPT REQD ?: IMPERV SURFACE: sf Owner: FEES SPECHT DEVELOPMENT, INC. Description Date Amount 15400 SW MILLIKAN WAY [ERPRMT] Erosion Control 9/8/2006 $80.00 BEAVERTON, OR 97006 Total $80.00 Phone: 503 - 646 -2202 Contractor: COFFMAN EXCAVATION LLC PO BOX 687 OREGON CITY, OR 97045 Contact #: PRI 503 - 656 -7000 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Reg #: LIC 146689 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 -6699 or 1- 800 - 332 -2344. Issued By: __ d('/) " Permittee Signature: 3/ 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. _ Site V S- ��6_1d00 I Bu i l ding Permit App � - �Y ' Lo OWED FOR OFFICE USE ONLY d II City of Tigard Received ateB / q - ^ - 06 � �61 Z Permit No.:5 \ ' ( - G /lA a il 0 i 13125 SW Hall Blvd., Tigard, OR 97223 S E P O I q 2006 Plan Review / UtJ V Phone: 503.639.4171 Fax: 503.598.1960 y ' 4 r + ' P Date/By: Other Permit: Inspection Line: 503.639.4175 CITY OF TIGARD �� � I y � „ Date Ready/By: Juris' See Page 2 for Internet: www.ci.tigard.or.us BUILDING DIVISIO Notified/Method: " Supplemental upplemental Information ., . : >' , r TYPE �OFyW RK (, D ' � �... � ., < e :;' ` � : y_.,, ° " RE.QUIR 1` 2 FAM1hY:DWEI:L;ING „1 ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. - Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration /replacement ❑ Other: Tree and stump removal equipment, materials, labor, overhead, and the profit for the ;e t " . ' ' M , ,., - Po , ba work indicated on this application. 111 I- and 2- family dwelling ® Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: g," t `. ' { JOB'SITE "IN ATI , F . ORMON AND ( OC A TTON p , T # Total number of floors: Job site address: No address, SW 69 and Clinton New dwelling area: square feet City /State /ZIP: Tigard, Oregon Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Specht Dartmouth Office Building Covered porch area: square feet Cross street/directions to job site: 69 and Clinton Deck area: square feet • Other structure area: square feet ,REQUIREth ATA :COMM ERCIAL USE'- CHECKLIST `j Subdivision: Lot no.: 2100 Permit fees* are based on the value of the work performed. Tax map /parcel no.: T 1 S R 2 W Section 36 Indicate the value (rounded to the nearest dollar) of all e ;..` °Ar i ui ment, materials, labor, profit or the ; b overhead, and the rofit f '� , s, " DESCRIPTI N O OF,� WORK v * ;" t '.= y 6 ' � work indicated on this application. Erosion control fencing, inlet protection, and construction entrance for removal of fallen Valuation: $$500.00 trees and stump grinding. Existing building area: square feet New building area: square feet .',,, . °" ° Z' PR ;, ,. i g '; ,,` ® /ANT ' -g . , "„ Number of stories: Name: Specht Development, Inc. Type of construction: Address: 15400 SW Millikan Way Occupancy groups: City /State /ZIP: Beaverton, Oregon 97006 Existing: Phone: (503)646 -2202 Fax: (503)626 -8903 New: ` . d ° ' '�.1EirAPPI xt C PE :, 4 ° ,, ,f . s � 'a .. ; _" ,m � t . ,. ° NA CT R SON� a a _ , , �' : ` ' "7 , ' � ,: ` . ¢ �_ ;� , Business name: TM Rippey Consulting Engineers All contractors and subcontractors are required to be �� licensed with the Oregon Construction Contractors Board Contact name: Karl Koroch, PE under ORS 701 and may be required to be licensed in the Address: 7650 SW Beveland Street, Suite 100 jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /State /ZIP: Tigard, Oregon 97223 apply: Phone: (503) 443 -3900 Fax: : (503) 443 -3700 E -mail: kkoroch @tmrippey.com >., e-a. v:CONTRACTORs,,:; :. N ,A,' ' -, q :-, ( t, , ' Business name "'4. GOf-FM/at,1 GP.cioFrlON l►J C -I— . . " C: BUILDING " PERMIT FEES* s Address: Please refer to fee schedule. City/State/ZIP: Fees due upon application ^ C 3 Phone: (SC:›3) C. ---7000 Fax: ( ) Amount received CCB lic.: /Vic 67? Date received: Authorized This permit application expires if a permit is not obtained • 41110 within 180 days after it has been accepted as complete. Print name: Karl Koroch, PE Date: September 7, 2006 * Fee methodology set by Tri- County Building Industry Service Board. 1 : \Building \Permits \SIT- PermitApp.doc 12/03 440- 4613T(I I /02/COM/ WEB) 'tAn ° 2006 12:53PN1 CLEAN DATER SERVICES 503 68144:39 No.3441 P. 2 yam CleanWater Services Our':onunitincnt is clear. June 20, 2006 Schott and Associates 11977 S. Tolliver Road Molalla, OR 97038 RE: Service Provider Letter for Dartmouth Phase II (1S136DD06100, 6200, 6300, 6600, 2100, 2200, 2300, 2500), CWS ER File 06 -001599 Clean Water Services has received your Sensitive Area Certification for the above referenced site. District staff has reviewed the submitted materials including site conditions and the description of your project. Staff concurs that the above referenced project will not significantly impact Sensitive Areas found near the site. In light of this result, this document will serve as your Service Provider letter as required by Resolution and Order 04 -9, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. This letter does NOT eliminate the need to protect Sensitive Areas if they are subsequently identified on your site. If you have any questions, please feel free to call me at 503 -681 -5106. Sincerely, t,f4d. Damon W. Reische Environmental Plan Review • 2550 SW Hillsboro Highway • Hillsboro, Oregon 97123 Phone; (503) 681.3600 • Fax: (503) 681 -3603 • www.CleanWaterServices.org naiooionna uon 79.C9 rTV,r>v ,Tn .,0091 8002