Permit IC ji, 11
4 f CITY OF TIGARD SITE WORK PERMIT
l DEVELOPMENT SERVICES PERMIT #: SIT2006 -00018
''' �r I) 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED : 9/8/2006
PARCEL : 1S136DD - 02200
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 2200.
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 MILIKAN 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: e mod. Permittee Signature: �� ,
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.
N
N4 Se Work
- ioea 1
_. • .,,_. jT "
' Building Permit Appliation—
h.IVELO) FOR OFFICE USE ONLY
City of
13125 SW Hall Blv Tigard Received c _ 4
Dat : i -- 4, .81 5 ic
d., Tigard, OR 97223 S EP Plan Review 0 • r - --00 i 1.
Phone: 503.639.4171 Fax: 503.598.1960 .' Dat e/By' /B Permit No.:
e Other Permit:
Inspection Line: 503.639.4175 0 7 2006 ,..,
CITY OF TIGAR --V.- r'n- Date Ready/By: Juris: li1 See Page 2 for
Internet: www.cistigard.or.us
BUILDING DIVISI
Notified/Method: --r ) ( Supplemental Information
.
'TYPE. OFAWORK ' — :' ',.. ' t ,,,i REQUIRED,DATA:1- AND I DWELLING ' .,,
0 New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 Addition/alteration/replacement 0 Other: Tree and stump removal equipment, materials, labor, overhead, and the profit for the
74.76 4.7,77, 7 1 7 ' 6 1 6 ''' : 1 '11 '"1 7 ' 7 7 . ":".'1. .
-4, .CAT„CCORY` OF V work indicated on this application
- - .T ° ,- ....`--*--.`" ' --
t, 4 ■, , V , , ',I, , % _ 0 ', 4 .,., ; ,, ,,,,
Valuation: $
El 1 - and 2-family dwelling Z Commercial/industrial
El Accessory building 1=1 Multi-family Number of bedrooms:
El Master builder 0 Other: Number of bathrooms:
. '.' , J. 011 iSITE. , IINFORMATION,ANWIOCATION-'.'4 . .`,.. - `, 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.: I 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
k.:40i44:0
Subdi vision:
I Lot no.: 2200 Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.: T 1 S R 2 W Section 36
equipment, materials, labor, overhead, and the profit for the
- 41)WPRIPTIM ,:0119111SpV;,': , 4, k , ., , - ., 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
t f 'Fil'eftiEiTY5 '1'.7 Tt` " '''''': 'II' TENANT?' - :-- . ''',.` '1 Number of stories:
- :'...% - .: - -;- Al '..,.. nl ; — ,„?,-, ,1,,, ,, • ,,,, , , t , ! ,,,
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:
ti
41 6
N: :v ''''' :,':- '' ',-,,;%--,,- , la ' . i''iR S61■1 I I'? ' : I ' ' 4: - ',1 ::'''' :: r 4 I ' ; ' , IVOTIC E " ;,.: „,' ' -, '';':. • `-` `': '
', ' -",-C: '..: '",,,,,,7 'e-
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 I Fax: : (503) 443-3700
E-mail: kkoroch@tmrippey.com
CONTRACTOR ' n 'i- ' -$ ..,,, ,, . ' -'-.' .,-.: .„' e, , ,
Business name. T-o-be-tleter-mined c ...0E - r4.4 , 14 , 0 E xcA‘LwamoN, tx.3c. ' ',"- _ , ''. ,' BIJEOING.PEttMiT2 FEES s
Address:
Please refer to fee schedule.
Z
City/State/ZIP:
Fees due upon application
C W -
Phone: (::.-3)&.,.-- I Fax: ( )
Amount received
1
CCB lie.: p../4 C 769
. Date received:
Authorized signature:
. ..-.-. Ik This permit application expires if a permit is not obtained
- within 180 days after it has been accepted as complete.
Print name: Karl Koroch, PE I Date: September 7, 2006 * Fee methodology set by Tri Building Industry
Service Board.
i: \Building \ Permits \SIT-perrnitApp.doe 12/03
440-4613T(11/02/COM/WEB)
•
Jrun•28. 2006 12:53PM CLEAN WATER SERVICES 503 6814439 No.3441 P. 2
yam
C1eanWater Services
Our is clear.
June 20, 2006
Schott and Associates
11977 S. Tolliver Road
Molalia, OR 97038
RE: Service Provider Letter for Dartmouth Phase fl (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,
JeJ,
Damon W. Reische
Environmental Plan Review
•
2550 SW Hillsboro Highway • Hillsboro, Oregon 97123
Phone: (503) 081.3600 • Fax: (503) 681 -3603 • www.CleanWatarServices.org
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