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Permit
A CITY OF TIGARD SITE WORK PERMIT DEVELOPMENT SERVICES PERMIT # : SIT1999 -00021 .��1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 09/16/1999 SITE ADDRESS: 11686 SW PACIFIC HWY PARCEL : 1S136CD-01700 SUBDIVISION: ZONING : C -G BLOCK: LOT: JURISDICTION : TIG CLASS OF WORK: NEW PAVING ?: Y RESO. NO: TYPE OF USE: COM GRADING ?: VALUE: $42,000.00 EXCV VOLUME: 800 cy LANDSCAPING ?: FILL VOLUME: 300 cy SITE PREP ?: Y ENG FILL ?: Y STORM DRAINS ?: Y SOILS RPT REQD ?: Y IMPERV SURFACE: 23,802 sf Remarks: Site and grading permit Note! See the Misc Fee for Fire and Life Safety fee. Owner: FEES P & F PROPERTIES 834 W ST CLAIRE Type By Date Amount Receipt PORTLAND, OR 97205 PLCK BON 05/21/1999 $160.55 99- 315550 MISC BON 05/21/1999 $98.80 99- 315550 SWM GEO 09/16/1999 $1,893.34 99- 318360 Phone: 225 -0700 SQWM GEO 09/16/1999 $2,614.61 99- 318360 Contractor: PRMT GEO 09/16/1999 $247.00 99- 318360 T M CONSTUCTION 5PCT GEO 09/16/1999 $12.35 99- 318360 EROS GEO 09/16/1999 $80.00 99- 318360 PO BOX 20820 ERPU GEO 09/16/1999 $26.00 99- 318360 SEATTLE, WA 98102 ERPC GEO 09/16/1999 $26.00 99- 318360 Total $5,158.65 Phone: Reg #: LIC 61240 Required Inspections Erosion Control Insp 844 -8444 Fill Grading Retaining Wall /Footing Strm Drain Insp Culvert/Catch Basin San Sewer Insp R l G I NA L Domestic water line inspect. Final Report Eng'd Grading 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 b- done in accordance with approved plans. This permit will expire if work is not started within 180 days of issu�nce, or if ork is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the • _ s • Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -00 -0080. I u ay obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Permittee Signature: 1, ►' Issued By: Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day CITY Of TIGARD Site Permit Application 4 13125 SW HALL BLVD. Commercial and Multi-Family: Complete ENTIRE form Decd By i y' p Date Recd 5 02 C( -i TIGARD, OR 97223 Restlence: Complete SHADED areas Date to P.E. — 2 1 - 19 (503) 639 -4171 x304 Date to DST �-' ‘-'46: g f -.*H Permit # - �iT1 — Z ( Related SWR # Print or Type Called Incomplete or illegible applications will not be accepted Project Name Utilities (Complete all that apply) Job ,M (- 421.-DO L. \iN 1, ` r l Address Address l { Storm Sewer 70 t.szZ e h ) , l L l t.0 Lt: k r 1 70 Linear Ft. _blame _ Sanitary Sewer 3 'f{ --- - C't�Z 101 Linear Ft. Owner Mailing Address Fresh Water ' ' `3 Lk 6,_) _ 4 0 L LA 1R1 b 10 Linear Ft. Ity /State Zip Phone (e.- Catch Basins tc) t. t 1 ORE_ Cj,Z 1C v, . - ( Di CSC # General Name Clean Outs Contractor i 'L C,,.; t `' l .., C.-- 'v h--) # 3 Prior to permit Mailing Address Describe work to be done: issuance, a (���� New Addition❑ Alteration❑ Repair❑ copy of all � • L. - ��x ••(...5 ��+ licenses are City /State Zip Phone Additional Description of Work: required if -,. expired in COT State Const. Cont. Board Lic. # Exp. Date database .,E° t a r^(, _ (1 ,,, tA,L o,„:„..l�F 1 , L. ' _4 Name Project - e_62.0 �- , ( � Architect Mailing Address Plans Required: See Matrix on back 1 b I r 1( - L`67--- kLA, }J ( The following, must accompany this application: City /State Zip PhoneLac .\ Site plan with Vicinity Map Parking (including - ‘-'av1 -tL , t) Ct 6 IOct 2 5L ---1 --\: 7- 1- , C ) Showing ADA compliance ADA) & Lighting Plan Name Grading Plan and details Landscaping Plan ) l t-k E rv6all.it.U7 s Engineer Mailing Address ... Lop Erosion Control Plan and Retaining Structures 56.--(, k > - c4tiRsU \F _: - 1,-IJW - rQtf 1. Dig. 5. details including calculations City /State Zip Phone so 3 Site Utility Plan and details Soils Report (showing connection to (if required) 5lh e1(Yl , bv 9, 7 �v G:). 5B6 - 3 6 (i5i0 approved system) Excavation Volume I hereby acknowledge that I have read this application, that the (Soils report required for >5,000 cu. Yards) information given is correct, that I am the owner or authorized BO O cu. yds. agent of the owner, and th t plans submitted are in compliance v with Oregon State laws. Fill Volume Si. ature of'fawner /A t Date (Soils report required for >5,000 cu. Yds.) '� (..)cu. yds. l' . , ,� 1 3 k - al -tiq Will the fill support a structure Con - Person Na Phone aoG (Engineer required if answer is yes) YES❑ NOk Dtkor,o -L_ k )8 -(o)©5 Retaining structure? (check one) ['Rock FOR OFFICE USE ONLY ❑ CMU Notes: )Concrete ❑Other Total new impervious area including all Land # Map/TL# buildings, sidewalks, and paving �j, `(j(Y,S Ft. DT)F-,q ,q Case OavOLG ecoPpz'v /bg, s c is \dsts \forms \com- site.doc 10/29/98 FL S ! p 0 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review wifi be cond After plan review approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes. (Copy for Contractor, City, 1810$1ji0000:1C04nty7rtialatilt V Fire & Rescue) TYPE OF SUBMI1 IAL Plans KEY: Submitted S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) Building NOTES: I:\dsts\forms\matrxcom.doc 10/30/98 05/18/2000 Activities for Case #: SIT1999 -00021 3:28:55 PM Assigned Hold Updated - Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SITC005 Application received 05/20/1999 GEO RECD No Hold BON 05/21/1999 SITC008 Permit Created 05/21/1999 BON DONE No Hold BON 05/21/1999 SITC011 DST /mail Land Use Condition Lt 05/21/1999 BON DONE No Hold BON 05/21/1999 SITC013 Plans Routed to Plans Examiner 05/21/1999 05/21/1999 05/21/1999 BON DONE No Hold BON 05/21/1999 SITA015 Plan Rev. Ltr Sent to Ofc Svcs 05/25/1999 JHF PEND No Hold JHF 06/24/1999 SITA018 Revised Plans Received 06/24/1999 JHF No Hold JHF 06/24/1999 SITA021 Plans Approved /Routed to DSTs 06/25/1999 JHF APP No Hold JHF 06/24/1999 SITA026 Plans approved by CPE 06/24/1999 JHF APP No Hold JHF 06/24/1999 SITA027 Plans approved by Water Dept 05/28/1999 DONE No Hold JHF 06/01/1999 SITA028 Plans approved by Engineering 06/04/1999 COND No Hold JHF 06/04/1999 see comment sheet for items need to be completed before issuance SITA029 Plans approved by Planning 06/01/1999 HOLD No Hold JHF 06/01/1999 Mark allowed the applicant to submit prior to planning issues being met. i was not aware that this was being done. Hold until applicant catches up with our submittal requirements. Mark will advise SITC720 Grading 06/24/1999 06/24/1999 09/23/1999 RB PASS No Hold AKJ 09/23/1999 obtain USA erosion approved insp prior to calling for footing insp SITC740 Strm Drain Insp 06/24/1999 06/24/1999 10/07/1999 TLP PASS No Hold AKJ 10/07/1999 manhole SE corner of site 10' outlet 18" rib SITC744 Culvert/Catch Basin 05/02/2000 TLP PASS No Hold TLP 05/02/2000 SITC750 San Sewer Insp 06/24/1999 06/24/1999 11/02/1999 TLP PASS No Hold VT 11/02/1999 sanitary sewer from building to main. storm sewer perimeter of building. SITC757 Domestic water line inspect. 06/24/1999 06/24/1999 05/02/2000 TLP DONE No Hold TLP 05/02/2000 SITC775 Final Report Eng'd Grading 06/24/1999 06/24/1999 05/02/2000 TLP DONE No Hold TLP 05/02/2000 SITC799 Final Inspection 06/24/1999 06/24/1999 05/02/2000 TLP PASS No Hold TLP 05/02/2000 SITC700 Erosion Control Insp 844 -8444 06/24/1999 06/24/1999 No Hold JHF 06/24/1999 SITCO32 DST Post - Review Completed 07/06/1999 DEB DONE No Hold DEB 07/06/1999 SITCO50 Hold for 07/06/1999 DEB DONE No Hold DEB 07/06/1999 Hold until conditions of approval have been met and approved by Engineering and Planning. SITCO55 Hold Release 09/15/1999 GEO PASS No Hold GEO 09/15/1999 Per Eng & Planning, all conditions are now met. Ok to issue Page 1 of 2 05/18/2000 Activities for Case #: SIT1999 -00021 3:28:55 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SITC080 (F) Ready to issue 09/15/1999 GEO DONE No Hold GEO 09/15/1999 SITC092 (F) Issue permit 09/16/1999 GEO DONE No Hold GEO 09/16/1999 SITC740 Strm Drain Insp 10/10/1999 10/10/1999 10/08/1999 TLP PASS No Hold AKJ 10/10/1999 main storm drain lateral to manhole SITD720 Grading Insp 10/12/1999 10/12/1999 10/12/1999 TLP PASS No Hold JS 10/12/1999 2 catch basins & mise storm drain pipe to main hole 6" laterals. SITC750 San Sewer Insp 10/15/1999 10/15/1999 10/14/1999 TLP PASS No Hold JS 10/15/1999 1 catch basim 30" storm sewer to building. SITC740 Strm Drain Insp 11/02/1999 11/02/1999 11/02/1999 TLP PASS No Hold VT 11/02/1999 storm sewer perimeter of building. SITC770 Misc. Inspection 11/02/1999 11/02/1999 11/02/1999 TLP PASS No Hold VT 11/02/1999 footing drain - pass SITC740 Strm Drain Insp 11/10/1999 11/10/1999 11/10/1999 MRS PASS No Hold VT 11/10/1999 SITA800 Case Finaled 05/15/2000 JMT DONE No Hold JMT 05/15/2000 Page 2 of 2 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 1/W/00 AM PM BLD Location 1 1 Vd4 PC Suite MEC 6455-11 Contact Person Ph 2 1 qOL 5' PLM Contractor Ph SWR BUILDING Tenant/Owner WINEletriff. ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Slab Crawl Drain Inspection Notes: 46 l Q 9 J o 2s ( Post & Beam L l Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL , PLUMBING ; ..i _ / Post & Beam , _ Under Slab / {'� Y ' , . - dl Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam , - Rough In Gas Line Smoke Dampers Final Lam' PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL Backfill /Grading Sanit -.. Sewer u [ ] 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 l ' }/�> ir �j 2 s ;r Date ''1 `` Inspector / i, ' l 7li Ex , S ' PART FAIL DO NOT REMOVE this inspection record from the job site.