Permit q`. - CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT PERMIT # : SIT2008 -00009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 4/4/2008
PARCEL : 2S114AA - 00100
SITE ADDRESS: 09000 SW DURHAM RD ZONING : R -4 5
SUBDIVISION: LOT: JURISDICTION : TIG
PROJECT: TIGARD HIGH SCHOOL
Project Description: Site work for portable moved to different location on same parcel.
CLASS OF WORK: OTR PAVING ?: N RESO. NO:
TYPE OF USE: CMS GRADING ?: U VALUE: 5,000.00
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 - TUALATIN SCHOOL DISTRIC Description Date Amount
6960 SW SANDBURG ST [BUPPLN] Pin Rv -Valu 3/21/2008 $54.57
TIGARD, OR 97223 [FLS] FLS Pin Rv 3/21/2008 $33.58
[BUILD] Prmt Fee -Valu 4/4/2008 $83.95
[TAX] Valu 12% State Surcha 4/4/2008 $10.07
Phone: 503 - 431 -4000 [ERPRMT] Erosion Control 4/4/2008 $80.00
Contractor: [ERPLN] Erosn Pln Rv CWS 4/4/2008 $26.00
[EROSN] Erosn Pln Rv COT 4/4/2008 $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 d z - : - - tions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue• By: /. (L. . Permittee Signa e: 1F' /% / 11 ���G�`�/
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.
cc tT Hs 6
Biiai T ddin� Permit Application ,. H r3a(�jg -p(��
Site W(r-l� � FOR OFFICE' ONLY
k1 ry -
Q Received ,�+ Q f�' Q
13125 SW Hall Blvd., Tigard, OR
City of Tigard ���
Date/By ( 6 Permit No O ` / (/�� U �V"�V /
I
'. `, \ �, �g� Plan Review LA
Phone 503 639 4171 Fax 50 �' \1'�0 P � t ® D ate/B ' 3 " 8 c.& Other Permit �J � �ef
T LGQRD Inspection Line. 503 639 4175 * ���` l ` �� Date Ready /By ed in 1 ® See Page 2 for i
Internet www tigard -or gov 0 S e�� ND
M ethod • � fj Supplemental Information
aA 01% 71_!: 0 .1M
TYPE. OF WOI O ( _ x r QUIRED DATA: 1- AND.2- FAMILY,DWELLING `
CI New construction ❑ D' t \ b 'lition 'T T t fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
wA Addition/alteration /replacement El Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ID Commercial /industrial Valuation: $
4ccessory building 111 Multi-family Number of bedrooms:
❑ Master builder [r Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION . Total number of floors:
Job site address: y`) ( vim V,., d-(A,a,,,,,t, 3 New dwelling area: square feet
City /State /ZIP: Tl 4 (`) c?"-- t ` 7 7 - Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Ty 5 ?fr+�A per. -v o ( _ Covered porch area: square feet
v (
Cross street/directions to job site: 17 9 rt�7 14 t` Deck area: square feet
Other structure area: square feet
REQUIRED DATA:,COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this application.
� �� "° p Valuation: $ 4 7 D d
• C...ITra -� t.I t r qz.L 40 Pv l
Existing building area: /, 0)-0 suare feet — '
New building area: ,-- square feet —
71- PROPERTY OWNER ❑ TENANT Number of stories: 4
Name: 711 ) / eCuz�a,4 2 . 4-(A et l G _ y , Type of construction: ',
�-al Address: „ p S�s V y ) 0 ,. 1 Occupancy groups:
City /State /ZIP: 7— .e terA 0 «7 , 2 65 , Existing:
Phone: (� )
7 6 3 4 3( 4 Fax: ( 93. zioj ( - 4 oxit I New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE "
Business name: LJV l t 7 l �., tc)--ele-li5 II eA, , All contractors and subcontractors are required to be
Contact name: r ��Lti -Ak—� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: "2DfiGt_ (u1, t.,0a-,2-,(M C.
-` . a - po jurisdiction in which work is being performed. If the
City /State /ZIP: (l°13Ye� , b q ` 7 ' 4 applicant is exgmexempt from licensing, the following reasons
( apply: 3 i
Phone: (t p7 ) 2_2,6 .. c 9 c Fax: : ( c63 & I-3 - q 17 v L
E -mail: lrl.) e_s{ 1. U e_ el 1,.,t )1 - cerfilA--
CONTRACTOR
Business name: d(
tCc . �e-t> ,'4 I BUILDING PERMIT FEES* .
Address: ' 3 U - 0 p r ` (Please refer to fee schedule) 5
7 � 3 , 7
City /State /ZIP: 7N. OP P g ZD
c Structural plan review fee (or deposit): j
Phone: (p3) _ 6 p G Fax: (SD' 1 $' s - ' Z Q FLS plan review fee (if applicable): 5 �
l ef G ( Total fees due upon application: 4 i • i 5
CCB lie.: 1 y590 "7 � 1( t3" ,
J Amount received: Authorized signature: This permit application expires if a permit is not obtained
� � 4 (r within 180 days after it has been accepted as complete.
*
Print name: �O `OCA d- (C
Date: �
C Z��� d O Fee methodology set by Tri- County Building Industry
Service Board
I \Building\Permits\SIT-PermitApp doc 12/27/06 440- 4613T(11/02 /COM/WEB)
A
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 SLTBIVIITTAL ' Required at
(Includes New, Additions or Alterations) Submittal
Commercial 2
Multi - Family R -1 Occupancy 2
One- & Two- Family Dwelling 2
I \Building \Pernuts \SIT- PernutApp doc 12/27/06 2
CITY OF TIGARD 4 . 7$0a o 000q
BUILDING DIVISION PE RMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �ou�41uN"
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1 b / v-I / 0 TIME: PAGE:
SITE ADDRESS: 060 bv, rz.(46. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT TI ON: `6 cam' % e < � G I DESCRIPTION: VI �� � � '.JJV�J� l Qj
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
() IA wf
Corrections /Comments / Instructions:
PASS I I PARTIAL APPROVAL ❑ CANCEL II NO ACCESS
FAIL I I CALL FOR INSPECTION P ADDITIONAL FEES ASSESSED
Inspector: ktk Date: I 0 7 7A % r Phone #: (503) 718- 2)(24 4
CITY ������8����&����
��om n OF mnn�m��n���
BUILDING DIVISION DIVISION .. PERWi|T#: S3T2000-00009
13125 SW HoHall B|vd..Tigard, OR 97223 DATE ISSUED: 4/42008
Phone: (503) 639-4171
Inspection Requests �4Hmj:(GO3)63A4�175 ~ .0m�� " ' .
�� �
INSPECTION WORKSHEET FOR DATE: 4U7/2008 TIME: 7:01A1v1 PAGE: 26
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD HIGH SCHOOL
DESCRIPTION: Sit work for portb!e moved to different location on ain parcel.
OWNER: llGAFfD SCHOOL DISTRICT 23.], PHONE #: 603
CONTRACTOR: WILLIAMS SCOTSMAN INC PHONE #: 5O3'286.6105
Inspection Request Scheduled Fo Oa1 4/712008 � Po T| nspa on eques r� e� Pour Time: �� �
�
Code # Inspection Description . Confirm # Contact # 04e P
496 kAiso.innpection Pt4 tir 087969-01 503-519-8773 Y
Corrections/Comments/Instructions: ~-
�
.�
V (43s p• -3
lj -..\-51-
•
\N �J-
r0 _
I I PASS PARTIAL APPROVAL XCANCEL NO ACCESS
I | FAIL CALL FOR INSPECTION | | ADDITIONAL FEES ASSESSED
Inspector: A o ^^~~-
Date: 4 / i 2/ *' Phone #� (5O3\ 718'7- " /