Permit CITY OF TIGARD SITE WORK PERMIT
1
COMMUNITY DEVELOPMENT Permit #: SIT2011 -00011
13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued: 10/20/2011
TIGARD
g Parcel: 2S 101 CA00400
Jurisdiction: TIGARD
Site address: 7930 SW HUNZIKER ST
Project: Coe Manufacturing Subdivision: 2007 -064 PARTITION PLAT Lot: 1
Project Description: Erosion control only for removal of contaminated soil
Contractor: VARCHAN ENVIRONMENTAL CONSTRUCTION Owner: GOULD FAMILY PROPERTIES VI LLC
PO BOX 2830 527 ATANDO AVENUE
HILLSBORO, OR 97123 CHARLOTTE, NC 28206
PHONE: 503 - 693 -7111 PHONE 800- 951 -4140
FAX
FEES
Description Date Amount
Specifics: Info Process /Archiving - Sm Sheet (up to 10/20/2011 $2.00
11x17)
Erosion Control 10/20/2011 $80.00
Type of Use: COM Erosion Plan Review CWS 10/20/2011 $26 00
Class of Work: OTR Erosion Plan Review COT 10/20/2011 $26.00
Project Valuation: $0.00
Site Specifics:
Excavation Volume. cu. yd.
Fill Volume cu. yd.
Impervious Surface sq ft
Engineered Fill. Soil Report Required
Paving Grading
Landscaping: Site Prep
Storn Drains Retaining Wall -
Fire Underground: Accessible Parking:
Fence
Total $134.00
-. - • - and Reports (Conditions)
1 Ersn Cntrl 503 -681 -4444
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or ' •ended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility • ification Center. T •se •.es are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 Yo - •stain a copy of the rules
or di -ct quest] ns to OUNC by :i ing 5P 32.1987 or 1.800.332.2344
Is- uedBy: 4 " Permittee Signature: .a....
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Site Work � � , FOA,OFFIGE'USE ONLY
qq : iew JA 14 1\\ DateB � J PemrtNo " ., , OR9-' 0 Q
1 Phone. 503 718.2439 Fax 503.598. 960 r �F` Aq' Dt.teB Other Permit
T1
Inspection Line: 503.639.4175 O \c: S °' Date Ready/By hos RI See Page 2 for
;GARp' O
Internet: www.hgard- or.gov � �.\��� Noafied/Method Supplemental Information
....c t <5," .
a;;�a'�d,a, „�,• •, "�`�x7 ^r ;�;� ° „_ .�_ ^'�__,. „'. -+�. � :-- .:�,,, »_n�•:�, -.: ,;� - ,�,- .r;.�.-.;�.^,; wry=, �_, °.r.,�'-.�.- � . . :;.. , �:i�����.�— ;are:• ^��: ..sv; , ; • . ,
e ' 'a MS ; T :9 .„ - yM
:77P°.7, " ∎A :," ' , ' l _;, = = T,I?I?E OF t i WO t, ',: ,,:' ' ', AA ,AAA 6 ' ,wREQUIRED' DATA:$ 1 - AND 2 F.A M'ILY= D : ,
� � s a�j�Y��_ ;��r�s.� •,r�fi�t��i�.t ��u� sc� � �� - a���aa , z , x� - u.�a,��,,a,Knr�•a+ ^.� _��.•�.�e = ��a n r ��„
❑ New construction ® eMolition 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: Remediation equipment, materials, labor, overhead, and the profit for the
1P ,:iti ^� pt:G a . k.i rr"s+py.,,.,,,; r� i ,r - - - - - -r„ ;. - . ,:�,.a a 'iO ,::. : , ' ! 9' x,r.-
ti 7
�r,, i vh y' ~hhh , ..CATEGORY :�OF C h„,,t ' ', a V . � Nn ` NN work indicated on this application.
��`, ,J�&l,'�ai °Far� =-- ,.,.�!�r xia���a�a�aa^IiAr'= , e��_�sss?a,� a:ro�+^#k;c "��r•�� .
❑ 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $
❑ Accessory building ID Multi-family Number of bedrooms:
❑ Master builder ® Other: Excavation
Number of bathrooms:
ds -',,. ' , ,•, JOB" iSITEINFORIVIATIONFAND��LOCATION` t,F,:- ' "''' "`�'''' * ?' i a, Total number of floors:
Job site address: 7930 SW Hunziker Street New dwelling area. square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg, /apt. no.: Project name: Coe Mfg Removal Action Covered porch area: square feet
Cross street /directions to job site: SW Wall Street Deck area: square feet
Project site is located approximately 500 feet to the west - southwest of the Other structure area: square feet
SW Hunziker and SW Wall intersection ' REQTIIREDDATA COMMI RCIA U E`CHEGHIiIST'
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S101CA /400, 700 Indicate the value (rounded to the nearest dollar) of all
'- g°"F=- --`-aa T_' i ' r6 '' ; ^,. a.4';` air r il,enr•i.i, ii�ikaio� •idi °�!ou ��e4s�^o-T^- = dw- °s a,,i - -r a; "r sa— �a, W�, a, e - :� rx #awr i il.i�a m overhead, and the profit for the
-:k' 1 ", d = --- �',••I ' a , �.'�'t !L DESCRIPTION OF WO RK` l "�° l� , f I nij'' ° �) work indicated t on thislapplication. pp ea
w an e r
1 'II i i , :,,,,I i Xi11. %r.l 4''w! �tIANAt=- ' �-_ L A A, • , •t ;,. A P, g, t r k " „,'. $w,migkild ,N
Removal of approx. 51 cubic yards (CY) of contaminated Redrock creek sediment Valuation: $
and approx. 72 CY of contaminated upland soil for DEQ- approved remedial action. Existing building area: square feet
Total removal area < 5,000 sq feet. Max. excavation depth = 1 ft. New building area: square feet
ii •E,%• r " *ri�„t !7m - - �,a ° tu> �: i {.�. - - ^r' rte' ; r�ru•mke� €� -, zra.. , �, 7'
t ; :fit ®�I'ROPERTY OWNER- " ' ' ` ') ` ' "' ''" ® f° °' ', ` ° ! " Number of stories:
r =� ,�9i!� , b, -` ., ,.. " ; , i. �” . - , r Y�,,« ' `��;�t` TE'NA'NT' �: "'t':�.1,"`
.w. �.. rt �.�-_ ;� ' ��,a.« �^ ��k�s,,�a,xz'.^'%:�,` =�strarr � a r�
Name: Gould Family Properties VI, LLC Type of construction:
Address: 527 Atando Avenue Occupancy groups:
City /State /ZIP: Charlotte, NC 28206 Existing:
Phone: (800)951 -4140 x 416 Fax: (704)342 -0325 New:
�, - ., °v �- ,..- ,;.�.,- ... °� _ = �
Ill9 OTP :A ','`- t . �; a 'a s -*--_n �`_-li'i;` ,_ .,• •: .0 arx „: .. - ^, ,— - - - ,�.;�.,,w,n,w; _n�!w�a ,7,�; -,� _, 1145-'"''-- -_
� , itz' ' , -, ® -AP PLI CANT , _ ❑ „CONTACT:, Ii =,„ ' ” - T a
j M1 1 ��9° _' ; a �.k:< ``d,'F «��� ,.” �!,,�„ sNOTICE °: ' , 't
Business name: RealNet Investments, LLC All contractors and subcontractors are required to be
Contact name: Art Johnstone licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 9570 SW Barbur Blvd, Suite 311 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97219 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 459 -4732 Fax: : (503) 210 -0401
E -mail: artj @hevanet.com
. ;11x "; . °- ° tl «�- irti .., P : '. f 4 ;„
k , ° : "CO; n s : ,6 ' g ",_ We;;' : I . k ,.t. «
��--- �...�te�. :, ���`f„ ,a x.� ; �.�"�.�� -%�� e s« =_c Y ^,:-a;.�„� =: r'a' &' �2E- .P�'!�ti�'k� „'au „rra �' �i�';t�`�«`;rs �''•y!
Business name: Varchan Environmental Construction °�7 ) hr} r BUIE,DING,PERM IT��FEESN V4''I r
Address: P.O. Box 2830
i, K7(Please,refertafee'schedule) ax it � ., f „ rte `
City /State /ZIP: Hillsboro, OR 97123 Structural plan review fee (or deposit):
Phone: (503) 693 -7111 Fax: (503) 693 -7254 FLS plan review fee (if applicable):
a //t Total fees due upon application: CCB lie : /a2 �� l /3�--
/ . Amount received:
Authorized signature j ' • j A
This permit application expires if a permit is not obtained
C'/ee within 180 days after it has been accepted as complete.
Print name: 4 ,- , A d f " A . , / `/OJ _N � Date: f /'). `f'/ * Fee methodology set by Tri- County Building Industry
Service Board
I.\ Building \Permits \SIT- PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB)
503 925 8969
Nov, 9. 2011 2:4 8PM �f No. 1906 P, 1/1
PERMIT NO. S OI I —` noo / 1
CleanWater Services
Our commitment is Clear. LOl. J 1
EROSION CONTROL INSPECTION REPORT
rM
DATE / I c-7-11 INSPECTOR 5 R1 I/1
SUBDIVISION ( � amic c,rL ,
O WNER/PERMITEE �c�,i - ! (LC.
SITE ADDRESS 7
FINAL INSPECTION
•
THIS SITE MEETS THE POST - CONSTRUCTION
EROSION CONTROL REQUIREMENTS SET
FORTH IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST - CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING
EMPLOYED ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION,
THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE
OR PERMANENT GROUND COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE
FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES
THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL.
OTHER
THANK YOU FOR YOUR COOPERATION!
INSPECTOR :1 . 7 PHONE (5 (F!—