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Permit l I � CITY TIGARD SITE WORK PERMIT A ( DEVELOPMENT SERVICES PERMIT # : SIT2001 -00014 I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 6/26/01 tP �W�i SITE ADDRESS: 12325 SW KATHERINE ST PARCEL : 1S134CC-01700 SUBDIVISION: MARY WOODARD SCHOOL ZONING : R -4.5 BLOCK: LOT: JURISDICTION : TIG CLASS OF WORK: PAVING ?: RESO. NO: TYPE OF USE: COM GRADING ?: VALUE: $1,500.00 EXCV VOLUME: cy LANDSCAPING ?: FILL VOLUME: cy SITE PREP ?: Y ENG FILL ?: STORM DRAINS ?: SOILS RPT READ ?: IMPERV SURFACE: 1.792 sf Remarks: Two classroom portables Owner: FEES SCHOOL DISTRICT #23 JT 13137 SW PACIFIC HWY Type By Date Amount Receipt TIGARD, OR 97223 PRMT CTR 6/26/01 $62.50 27200100000 5PCT CTR 6/26/01 $5.00 27200100000 PLCK CTR 6/26/01 $40.63 27200100000 Phone: FIRE CTR 6/26/01 $25.00 27200100000 Contractor: EROS CTR 6/26/01 $80.00 27200100000 WILLIAM SCOTSMAN INC ERPU CTR 6/26/01 $26.00 27200100000 DRIVE #3 ERPC CTR 6/26/01 $26.00 27200100000 6107 N MARINE D PORTLAND, OR RIVE QUL o /o CTR 6/26/01 $225.00 27200100000 WQUN CTR 6/26/01 $275.00 27200100000 Phone: 503 - 285 -6165 Total $765.13 Reg #: LIC 145907 Required Inspections Erosion Control Insp 846 -8444 Misc. Inspection 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 . • penned for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Ores U ility No fication Center. Those rules are set forth in OAR 952- 001. -0010 through OAI, •52 -00 00; ` r, ma: obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. - - -- P-ermittee Signature:- Issued By: Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day 1. % , J . ;Y Bu Permit Applicat � .:g�O Date received: ‘ Permit no.5 d,UoI oo ILI °� ^y �„ � City of Tigard :_.. Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 - 4171 Date issued: By:. Receipt no.: .6a[ Fax: (503) 598 -1960 ' V ��" ! " U I - Case file no.: Payment type: Land use approval: t y. ' 1 / ) 1 &2 family: Simple Complex: TYPE OF PERMIT _ ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolit ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ,.Other: IOC TA3L JOB SITE INFORMATION . Job address: / Z 32.c S cJ ...{h 577 Bldg. no.: Suite no.: Lot: Block: Subdivision: Tax map /tax lot/account no.: Project name: j W a C- LA3S12ece1 - PD (2 A3 L6 Description and location of work on premises/special conditions: . . OWNER . . FOR SPECIAL INFORMATION, USE CHECKLIST : Name: . 77 6 A�t� - - TIM - 5 a4OD L b i C (Floodplain, septic capacity, solar, etc.) . Mailing address: , jIP � I 1 & 2 family dwelling: FEZWingMININEMETMEMEIMII Valuation of work $ P • a' ai nirMiliffilMEM E -mail: No. of bedrooms/baths Owner's representative: i A rMAZIIIIMI Total number of floors Phone ,., - ., . F .- /ZQ E -mail: New dwelling area (sq. ft.) ..: _ APPLICANT Garage/carport area (sq. ft.) Name: 5a41,-.L, Covered porch area (sq. ft.) ' Mailing address: Deck area (sq. ft.) City: State: ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial /industriallmulti- family: CONTRACTOR Valuation of work $ Business name: /V/ / /a eO Existing bldg. area (sq. ft.) Address: /l Aaa rut. 1 p. - New bldg. area (sq. ft.) EMEIP fl- Ln State r / r� Number of stories Type of construction Phone. ,. E -mail: Occupancy group(s): Existing: CCB no.: 4 0 New: City /metro lic. no.: , 7 Tto Notice: All contractors and subcontractors are required to be ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under IMEIMMINMErja provisions of ORS 701 and may be required to be licensed in the Address: ,, / 1 • M 2t jurisdiction where work is being performed. If the applicant is j Sti0I ZIP: ., 0 exempt from licensing, the following reason applies: Contact personMWIfffal Plan no.: • Phone: . - �� E -mail: ENGINEER Name: Contact person: Fees due upon application $ • Address: • Date received: City: State: ZIP:. Amount received $ Phone: Fax: E -mail: Please refer to fee schedule. I hereby certify I have read and examin • • .•'s application and the 'Not all jurisdictions accept credit cards, please call jurisdiction for more information - attached checklist. All i rovisions of I . t ordinances governing this ❑ Visa ❑ MasterCard work will be complied wi ' w �tr • ed herein or not Credit card number: I / . ` Date: Expires - Authorized signature: - Date: 6" n/ Name o f cardholder as shown.on credit card Print name: / J2 . S 04) Cardholder signature _ $ Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/oOICOM) i . SITE WORK PERMIT - CHECK LIST - Commercial, Mu Family (R -1 occupancy) and Res 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 MU ❑ 90 % of maximum density) cu. yds. Retaining structure (Check one) 1:1 Rock C CI Concrete ❑ Other . • • *Total ew impervious area including all buildings, sidewks, and paving: sq. ft. Site Utilities P lumbing Work: Complete the "TAN" Plumbing Perm Applica for site util ities plumbing ::: 10 1A-6- Re wir te Work Per Application Plan Submi ` ` Requirements" attached The following musty accomp th iSIP pplication v , a = °Site Plan Vicinity Map * ADA) a nd -i v h g � a ' 4 q i 1 k M ; ` ,z�s H k , t "3 d 3 A ' «5-- � �; sho win g „A DA4compl iance l . „ :Ligh Plari o zw` G Plan an dde t a i ls Lan Plan te . E r o sion Control Pl , - details ,,z.,-,--, , , , ' R e ta i n ing Str ' 'as S i t e U tility Plan a nd 4 details S Report ( if re quired) ( sh o �wi ng conn ; to�appro. � fi �� a stem .t_ • 2- family dwellings. I *Does not apply to 1 and is \dsts \forms\sitechecklist.doc 05/31/01 SITE WORK PERMIT APPLICATION - PLAN SUBMITTAL REQUIREMENTS Applicants: Please complete APPLICANT �� = NA.-A7 J SC4 DbL t�IST2r� PHONE #: L131 - 466 1. APPLICANT NAME: � 2. SITE ADDRESS: IZ3z Ste) 4A5)1 JNc� 3 FAX # 43/ 4/Zb NOTE: A Site Work Permit is required on all commercial additions, accessory buildings larger than 120 square feet, modular structures, new buildings, and multi - family R -1 occupancies. 1. SITE PLAN and vicinity map (Fully dimensional, drawn to scale) showing the geographic location labeled with: ❑ map & tax lot #, ❑ project name, ❑ site address ❑ suite number ❑ zoning, ❑ applicant name, ❑ phone number, and identifying: A. North Arrow. B. Scale (Any standard, architectural or engineering only). C. Street Names. D. Building pads (drawn to scale) with project location. 2. BUILDING PLANS Submittal Requirement — Four (4) complete sets, Civil only. ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS A. Site Plan showing: 1) Required parking spaces and driveways 2) A route, accessible to persons with disability, leading from the public way to an accessible building entrance 3) Accessible parking spaces and adjacent access aisle connecting with the accessible route 4) Curb ramps along the accessible route, curb, sidewalk and gutter 5) Finish grade elevations along the accessible route B. Topographic survey plan showing grade elevations crossing the entire site C. Overall grading plan D. Storm drainage plan showing: 1) Finish elevations throughout the developed site 2) Grade breaks determining area serving each catch basin 3) Location of catch basins 4) Pipe size 5) Type of material 6) Slope of piping 7) Manholes and field drains 8) Cleanouts provided for each 100 feet or fraction S„1 24,n) TO 9) Roof drain laterals specifying cleanouts at each upper terminal d-aw 10) Location of existing or proposed connection to a public sewer line is \dsts \forms\site - appreq.doc 05/31/01 Page 1 of 2 �y 7 E. Utilities plan showing: N _ _ pA 1) Sanitary _. sewerline- location, pipe size,,type.of material, slope of piping, manholes and cleanouts provided as required for storm NA 2) Size and location of domestic water piping and drainage 3) Fire hydrant location and pipe size if on private property /ON- 4) If the building is to be protected with an automatic fire sprinkler system, show location of the water service vault and, the fire department connection (FDC) within 70 feet of a fire hydrant NA- 5) Size of underground water service for the sprinkler system 10,- 6) Proposed location of connection to a public water or sanitary sewer line F. Erosion control plan complying with the requirements of the Unified Sewerage Agency showing: 1) Silt fence locations 2) Bio- filter bags /other approved barrier material surrounding catch basins 3) Illustrations detailing the correct installation of the silt fencing and catch basin protection 4) Any other measures to ensure compliance with United Sewer Agency standards. G. Landscaping plans • 3. Additional Requirements: A. Soils (geotechnical) report: A soils report is required for new building and additions. 1) The report shall address the potential of soil liquefaction and instability (OSSC Sec. 1804.2) and: 2) Fills to be used to support foundation of buildings (OSSC.Sec.3301.1) and: 3) Foundation and lateral pressures exceeding 1,500 lb. /sq. ft (OSSC.Sec. 1805) B'. Plan review deposit COMMERCIAL & RESIDENTIAL SITE PLAN SUBMITTAL REQUIREMENT MATRIX Plan review is dependent upon submittal of a completed application and site plans. After plan review approval, the plans examiner will contact the applicant to request additional plan sets for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). TYPE OF SUBMITTAL TOTAL # OF PLANS SUBMITTED Commercial 4 Residential 4 i:\dsts\forms\site-appreq.doc 05/31/01 Page 2 of 2 CITY -,iDF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour InspE ion Line: 639 -4175 Business Line: 639 -4171 ,to„ • BUP De Re:uested AM PM s 'BLD Location / 2 3 25" 5 w / 4'k/ Al o Suite MEC Contact Person Ph - 0 5 c 7 PLM Contractor Ph SWR Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: " Slab SIT 2 /— DOU /G/ Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: ,4CG#6 $ Final PASS PART FAIL - PLUMBING, Post & Beam Under Slab • Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Post •Beam Rough In • Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL _ Service • Rough In UG /Slab Low Voltage Fire Alarm - Final PASS PART FAIL • ac ill /Grading - Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Approach /Sidewalk pp�� Other Date - si4 ( Ins Ext • S = PART FAIL DO NOT REMOVE this inspection record from the job site. 0 . ITY OF TIGARD BUILDING INSPECTION DIVISION 3 7/2 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested S Z3 Z ,Sc 4pv/ AM PM BLD Location 5 . /C � Suite MEC J� / Contact Person S'Gh DG-'' Ph G Sl Z 2 / - L e" PLM Contractor Ph SWR BUILDING Tenant/Owner ELC 2i U/ - e 3 J Retaining Wall�� Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post& -Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler . Fire Alarm Susp'd Ceiling Roof Misc: Final / /— PASS PART. FAIL PLUMBINGP`t °..° " Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL ME0 f F" a -k Post &Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL LECT ervice Rough In UG /Slab Low Voltage Fire Alar PASS RT FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA — -- Approach /Sidewalk ?-\67--- Other Date 6) 7 Inspector � o Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job. site.