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Permit
f + CITY OF TIGARD SITE WORK PERMIT 4440 A� DEVELOPMENT SERVICES PERMIT # : SIT2004 -00014 l DATE ISSUED : 10/1/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 07307 SW BEVELAND RD PARCEL : 2S101A6 01604 SUBDIVISION: HERMOSO PARK ZONING : MUE BLOCK: LOT: 016 JURISDICTION : TIG CLASS OF WORK: NEW PAVING ?: RESO. NO: TYPE OF USE: COM GRADING ?: VALUE: 62,500.00 EXCV VOLUME: 1,000 cy LANDSCAPING ?: FILL VOLUME: 300 cy SITE PREP ?: ENG FILL ?: STORM DRAINS ?: SOILS RPT READ ?: N IMPERV SURFACE: 13,924 sf Remarks: Site work for new office building Owner: FEES PAT GILROY 5100 SW MACADAM SUITE 240 Description Date Amount PORTLAND, OR 97239 [BUPPLN] Pln Ck - Valu 4/21/2004 $352.24 [FLS] FLS Pln Rv 4/21/2004 $216.76 Phone: 503 - 225 -5559 [BUILD] PrmtFee - Valu 10/1/2004 $541.91 [TAX] Valu 8% State Sui 10/1/2004 $43.35 Contractor: [ERPRMT] Erosion Cntl 10/1/2004 $80.00 DIVERSIFIED CONSTRUCTION COMPANY [ERPLN] Ersn Pick 10/1/2004 $26.00 12448 SW ORCHARD HILL RD [EROSN] ErsnPlck - COT 10/1/2004 $26.00 LAKE OSWEGO, OR 97035 Total $1,286.26 Phone: 503 - 293 - 1226 Reg #: LIC 103025 Required Inspections Ersn Cntrl 681 -4444 Retaining Wall /Footing Paving Insp 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: j Permittee Signature: / ; C,2 Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day 7301- • r: a. . . sw � �v�� -r+ND Site Work E® Building Permit Application � FOR OFFICE USE ONLY ° City of Tigard pp 2 i 200 Date/B d II/ Of' 1% Permit No.: / _ 13125 SW Hall Blvd., Tigard, OR 97223 f \ Plan Review / Phone: 503.639.4171 Fax: 503.598.1960 ��G�[� rboo ll ingi�yp,tiii I� Date/By: / ' y / Other Perm Inspection Line: 503.639.4175 Ct TY OF , `' j J . Date Ready /By: // Juris: ® See Page 2 for Internet: www.ci.tigard.or.us BUILDING D Iv +� _ - Notified/Method: --irec. Supplemental Information ,mi- a•.r s� a "_ .4t '•..<=a.�: , .,�y ,'rs; ' +1.• aM'� n.:, .;�a;;:,e �e-�. lr e f 40 - �; bss;. �i'x: 5. °y:• �s ;�:,,: >:� .xa. � :� -xn a�at&s x � � r o- ^ � a� t »:� ,� bk,aN { ..,I<. ,.: a M PP at`�;4�` gr,'1. R ,:: t, �i D,'D T , l ' h ' IA:, `A1 it,i DWELLING r al, . .,:,., ," ;' �� E„ +O WORI, " i 'a; , : ' .:1. , ..r . ;.. ; ",.,.. RE,QU ,-, .A i� I� ,i �. �a',. 4��. A°. a' �:: �; �r` .r`k� ='�.: »�y��;7::S�..�.�','^. u^.� ^ "�,�^ "�- :ki:... ,,s.:� =:r.� � -:. �:"�. �, .;'.V:r »:n���, 's ,_-.. .... _.. ,r .ss::�C,.t S' ;E a -r': o-k. r. -,v Hsu � �. +a.'. , r,.. , r , ris. —,r,..,-A.:::', ..,,...- . _ , - ® 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: equipment, materials, labor, overhead, and the pre • for the I r" , :: ra " ,,: egr5 'rte., ` � u:, .,�: ir6` a� : reag k,_, - p' ri : t.f. :s`s s If :;lair; i =t..l work indic. ed on this application. r .I r r �" 1 CATEGORY =6, . ltr. s¢s 1 to - '�._��_�;�.� P- a��s��-.» �, ��! r�+ ���a� ;�.r,.�°sk^ .1. . �; a, a;.��.� '�r � .�r� �_� ��s Valuation: $ ❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ❑ Multi - family Number of bedro: s: ❑ Master builder - ❑ Other: Number of bathrooms: -^ � t �:rue.S, " <: =r'.;; .�;. , - •,. :e�;< ,. .,� .M,n. �,;: x - r.;:•..;.sdP�M €,rt; �^- a� -,�' - ,., 2 =$ Total number of floors: ,,,6 r1 ; gym ",' , JOB SITE INF ©RMATIO ' ,L , : ,4_ qk g; � t'���� -ik. , ;,� rr..m ":r� Jr�*c_x_ „e.^a �.� ' �e �ai� y�v�'m. ' °".'� .. ,.r €,".nndm,���u 3:. te. =, ., -t s�, il�� ` Job site address: 7 3 077' S w A ev L.A„ �� New dwelling area square feet City/State /ZIP: TI E] AKb I OR, 9 - 1 22.3 Garage /carpo area: sq : e feet Suite/bldg. /apt. no.: Project name: la/ L n, l Qr`yJ� 627)6. Covered ..rch area: square k- et Cross street/directions to job site: "^ [ De, area: square feet -7 'L. * kS vg .L A. - N Other structure area: • square feet 4141 ;- ,AU-4,01,na ,. .,... . ,,„ ,,,..,:, *r.r ,,,,:, 'll,; ?.;•1„`.; .a:'k.:s , Q. , sr1,4 ^,; rant.+ ED {RE D : A 4 Ar ).C , Subdivision: Lot no.: 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.: equipment, materials, labor, overhead, and the profit for the < : . j i. e- _ 2wa,_ ,U i ; .c;-. »-'4i: ;�: 's< < «t� ..� a':i;Po * `W. "4: u =;' ;`-. =`• *:. ''w » � t t r "DESCRII'TION OF W f h Y 1 work indicated on this application. - r. - I S PA c - 4 O t: h t-E. +� tt� Valuation: $ (SJ4ti / J Vd Existing building area: square feet New building area: square feet V : ;.'”- - ��_- - sx.-�;�:�?= .'�.e,. sa;� ;�sl ` v: i' .�,- at,�:i:���x .x,. � 'l,?�"`�i}w% -,'pia i 'ice ' ® PROPERTY, OWNERS ' 4. Ei r ® TENANT' ° i . _ , f'� .; ra a rl Number of stories: �_ -x.11 ? � ga„ , =- .:k.: .� �a .< ,;-i, 4x, .44.0 .,, -A. v.e. -- �d_ i �. 4,., Name: p E I L-rZDY Type of construction: Address: 51 1 > c a Pi W •v. 21O Occupancy groups: City/State /ZIP: c,ia- Lp,l. , aa_ 9 - 7 2 Existing: Phone: ( 503) 2 - 2 - 5 - 555 Fax: ( ) New: ` ' APPLICANT " 0 f:.,;,, ^;: T I0 C ONACT: EERSON :� r ;. ;a ,,f: .., >`.; :, �? a ? .; . ,s q , l. .A y ,. i,, t „ .° ? e NOTICE;; >u � ,,,�.. r. , s ' a7��:� T �C3b��,vi�:iw � �:�,.:�- *au...r 3�: "�*- 4wr...«.. ;vu�s'..�+t...:. w,: � 'f",a., ,-,., a4s;a atira �, a?� s - ;' °.'tu -a ,^ .� r . •, �fl�,.' ;� �� gg�, - s . ,. :a ^� >� a? ' a3 §s ti i9 6`�.u:P ;: �'"u 3a��:. _ `,a't,�4r - 73. "3. -�', der;- ... . , Business name: tvt?rZir Co tt= CDA t All contractors and subcontractors are required to be Contact name: t21� - licensed with the Oregon Construction Contractors Board o C _ L AE.. under ORS 701 and may be required to be licensed in the Address: 12.-1- 61- Es 'vs,/ d e_c_L -I /�.t2� HI L` 2_d , jurisdiction in which work is being performed. If the City/State /ZIP: Lai£ vS\,�tt p c.)12_.. 9 7 a apply: 35- applicant is exempt from licensing, the following reasons Phone: 79 3- 2e.ZI Fax::(5 253 - /,5 E -mail: . U4 g a 3`".' �a z# '�`°s'*3+s f u.r.'.k #Zv - §'' s p " P+ Inc ,;� �� rtu d. f`� cONTRACT®R ' �: , '� a �, $z � -� � ,�s,.x 4H, �,��.�47�a� �r� ,.,A.�tf��^.,- ��.'m:>. ,ra ; -- �s� ,�� _ "� r _ . x'.< �s�ae ., Business name: tv l Ti2.JLTt co t:1 Z 1� . s ° q - �. -. 'n .3 tsv. z < =F .:x,., .. roz.:,aa;.,,�. F Z a r ► �i (r �" , , '''.04 :.,1; ,.._ . r.EERMITr . , ,,; : a �:.: � y, F � F BiTILDIN FEES p �#� �� "�°i 't- ,= Address: 1 e S W O t�.} 7 14-, L t— 1 Please refer to fee schedule. City/State /ZIP: L/a.e_a_ b w a b� g - 7 a 3.3 l Fees due upon application Phone: (S 733 - Z(v 2_1 Fax: ( 5d) z - 3 — /.S 4, Amount received CCB lic.: O 103 02_ Date received: Authorized signature: c This permit application expires if a permit is not obtained f.,_. v within 180 days after it has been accepted as complete. Print name S . �p C- �4�►��d. Date: 9 - I Z I * Fee methodology set by Tri- County Building Industry Service Board. i:\ Bui lding\ Permits 'SIT- PerrnitApp.doc 12/03 440- 4613T(1 l/02 /COM/WEB) City of Tigard: Site Work Permit Checklist ". Page' 2 - Supplemental Information Commercial, Multi- Family and One- and Two - Family Dwellings: No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review (SLR). Please complete all items below, unless otherwise noted. Excavation Volume: / t.7c9k... cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) -2_0_>.0 cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) .3 cu. yds. Retaining structure? (Check one) "❑ Rock ' • ❑CM ' M Concrete S Other•:. . • • *Total new impervious area including all buildings, sidewalks, and paving: sq ft « a,'�; "..-�y. � �Y" ��,��,::ss xd ,;« :�$ �' °i' i �`',�a- 7;. °t'' � >'�,14 �`r. ��F i �7• "� ��. �' � H r� �� . 5 ���' k � �. y, ��� a.�.� ,•mss .,� .,�,":�'. ��.,, ye .,��...��i,.�' E.±�:d"R� ?�� �,.� ° „hb:R _�', �. _�d. ... 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. JP #�`t, .. ., �� �•?�;a,.:^ y `.� •.e rt,�`. "..�.i� �N � : K�;, :� ;:�� _ �; 1", ^, �.fit's:e ?��r� ..,a. �� � 5# of�Plans - � { � sy 4 � .arm, *� C S'�xu � �. �#: . TXPE O S M , f 1 AL � , � 3 ,1 ' Re quir ed at u °i (Includes '.New,> Ad0ons or 4lterat> ons) ,Subm><ttal ' Commercial 2 Multi - Family R -1 Occupancy .. , , . 2 • One- & Two - Family Dwelling 2 i:\Building\Forms \SIT - Checklist.doc 12/29/03 • - „ `. CITK OF TIGARD BUILDING DIVISION PERMIT #: SI (2004 -00014 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1/2004 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 Ja __.. INSPECTION WORKSHEET FOR DATE: 12/1612005 TIME: 7 :06AM PAGE: 50 SITE ADDRESS: 07307 SW BEVELAND RD _ CLASS OF WORK: SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE: PROJECT NAME: GILROY OFFICE BUILDING DESCRIPTION: Site work for new office building OWNER: GILROY, PAT PHONE #: 503-225 CONTRACTOR: DIVERSIFIED CONSTRUCTION COMPANY PHONE #: 503- 293 -1226 Inspection Request Scheduled For: Date: 12116/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 499 Final inspection 023615 -03 603.793 -2621 N Corrections /Comments /Instructions: { ( ( 10 A—(.,- v. , , . (-__ ,‘-- a ..._...--- --. .7 ASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS FAIL • CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED i Inspector: W� Date: t • c Phone #: (503) 718-