Permit i„
' . h CITY OF TIGARD SITE WORK PERMIT
11 e
COMMUNITY DEVELOPMENT PERMIT #: SIT2008 -00017
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 8/28/2008
PARCEL : 2.S102BD -00701
SITE ADDRESS: 12785 SW PACIFIC HWY ZONING : C -G
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 008 JURISDICTION : TIG
PROJECT: BURGERVILLE
Project Description: Reconfiguring parking area.
CLASS OF WORK: OTR PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 54,100.00
EXCV VOLUME: cy LANDSCAPING ?: Y
FILL VOLUME: cy SITE PREP ?:
ENG FILL ?: N STORM DRAINS ?:
SOILS RPT REQD ?: N IMPERV SURFACE: 0 sf
Owner: FEES
CATHERINE BENNETH Description Date Amount
CIO LAWRENCE K. PETERSON [BUPPLN] Pln Rv -Valu 8/11/2008 $253.96
8 NORTH STATE ST 301 [BUILD] Prmt Fee -Valu 8/28/2008 $390.70
LAKE OSWEGO, OR 97034
[TAX] Valu 12% State Surcha 8/28/2008 $46.88
Phone: 503-635-3546 [ERPRMT] Erosion Control 8/28/2008 $80.00
[ERPLN] Erosn Pln Rv CWS 8/28/2008 $26.00
Contractor: [EROSN] Erosn Pln Rv COT 8/28/2008 $26.00
Total $823.54
Contact #:
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 - 4444
Reg #:
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 or 1.800.332.2344. I.'
Issued B / Permittee Signature: ifr4 pli
•
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.
1 -.1.3'FAci,nr_ (Au
Building Permit Application .
Site Work FOR OFFICE USE ONLY
City of Tigard I
° 13125 SW Hall Blvd., Tigard, OR - e Received
- , He , .arla Permit No.: Itho ._.
!..,.....
11111 Plan Reviev7F - .
• Phone: 503.639.4171 Fax: 503.5`Q 17 ',) ' ' * Date/By: 4
,7 -,,.. 't f: ..,. Daie/B : A
/ I 8 El 0E , Other Permit:
TIGARD
Inspection Line: 503.639.4175 ' 4 ' 2) Date Ready/By El See Page 2 for
Internet: www.tigard 1 1 '611' Notified/Method: l Supplemental Information
7i , , , ,-04. ,,, .,=,:-,,,,,,-,„ A 4: 2-FAMILY oiVELLING" j
0 New construction i ''' '
Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
El Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
NC-A1 .' ::' 1:-;:"' -9.7 ' 'It' work indicated on this application.
Valuation: $
El 1- and 2-family dwelling CE Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
0 Master builder 0 Other: Number of bathrooms:
M':A# 'LocATIoN -:, , '7 14:11 Total number of floors:
Job site address: 12785 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP: Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt. no.: Project name: Burgerville Covered porch area: square feet
Cross street/directions to job site: SW Pacific Hwy & Mackenzie Street . Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHECKLIST.,.
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.: 2S102BD-00701
equipment, materials, labor, overhead, and the profit for the
i -'' : "- :--:' :411": work indicated on this application.
Ee.:eZt.iit.,:zT '-, , z- DE ' '' ', . ,, ,M ' ''' '' ' '4' . .:::. , V
Remodel of the exisiting Wendy's restauraunt. Site work includes replacement of Valuation: $$54,100.00
parking area with pedestrian features, installation of a rainwater cistern, Existing building area: square feet
overflow swale, and landscaping. New building area: square feet
1 6 iiibiiitiV6ER.,;-- :: -: -;, AA ;M1 , ;liiir-rx..:NRO Number of stories:
Name: Catherine Benneth c/o Lawrence K. Peterson Type of construction:
Address: 8 North State Street, Suite 301 Occupancy groups:
City/State/ZIP: Lake Oswego OR 97034 Existing:
Phone: (503)635-3546 Fax: ( ) New:
O#:t0(kl*Iiii,;;: .i.i)!i ' ' i":006, lt: lwair
" , .'.':':'' dai.if
Business name: Litmus Design & Architecture All contractors and subcontractors are required to be
Contact name: Alan Armstrong licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 206 NE 28 Avenue jurisdiction in which work is being performed. If the
City/State/ZIP: Portland OR 97232 • applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 731.5909 • Fax: : (503) 731.5911
E-mail: alan@litmust.com
1111:11:13Cagt.:::::t01:1:40.R111ri::S'Wirt-4,':;,:;: 1.
Business name: Lease Crutcher Lewis -',PlumP11$9.,:'?E4MITtfK
„,,,
•.•!.' e.Pte'tiii'i. - efiritig/iiikAele),
Address: 921 SW Washington Street, Suite 150
Structural plan review fee (or deposit): $253.96
City/State/ZIP: Portland OR 97205
FLS plan review fee (if applicable): N/A
Phone: (503) 223.0500 Fax: (503) 223.2874
CCB lie.: 92919 Total fees due upon application: $253.96
Amount received:
Authorized signature: ' ei .. ,
4 ........„
,
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Alan Armstrong Date: 8/6/08 * Fee methodology set by Tri-County Building Industry
• Service Board.
l:\Building\Perrnits\SIT-PerrnitApp.doc 12/27/06 440-4613T(11/02/COM/WEB)