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Permit CITY TIGARD SITE WORK PERMIT PERMIT # : SIT2002 -00002 DEVELOPMENT SERVICES L- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 1/7/03 SITE ADDRESS: 08530 SW PFAFFLE ST PARCEL : ISI35DA -01000 SUBDIVISION: METZGER ACRE TRACTS ZONING : C -P BLOCK: LOT: 020 JURISDICTION : TIG CLASS OF WORK: NEW PAVING ?: Y RESO. NO: TYPE OF USE: COM GRADING ?: Y VALUE: 19,098.00 EXCV VOLUME: cy LANDSCAPING ?: Y FILL VOLUME: 0 cy SITE PREP ?: Y ENG FILL ?: N STORM DRAINS ?: Y SOILS RPT REQD ?: N IMPERV SURFACE: 3,941 sf Remarks: Site work for new parking area.and drainage system Owner: FEES DAVE DALTON 17930 SW MCEWAN Description Date Amount TUALATIN, OR 97062 [BUILD] Prmt Fee -CuY 2/4/02 $152.95 [FLS] FLS Pln Rv 2/4/02 $94.12 Phone: 503 - 267 -4419 [BUILD] Prmt Fee -Valu 2/25/02 $235.30 [TAX] 8% St Tax -Valu 2/25/02 $18.82 Contractor: [ERPRMT] Erosion Cntl 2/25/02 $80.00 COAST SWEEPING SERVICES INC [BUILD] Investigation F 1/7/03 $235.30 10505 SW TIGARD ST Total $816.49 TIGARD, OR 97223 Phone: 620 -3291 Reg #: LIC 00066044 • Required Inspections Erosion Control Insp 846 -8444 Excavation Paving Insp Strm Drain Insp Culvert/Catch Basin Landscaping Insp 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 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. sued By: ° , /a 3/03 Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Building P .111' , i w • on , Date received: a de'9' Permit no.: dam' /vp _ xoO. N t, y ,i h City of Tigard Address: 13125 SW Hall Bl %EBgafd,4312 A23 Prolecdappl.no.: Expire date: City of Tigard Phone: (503) 639 -4171 Date issued: By:. Receipt no.: O Fax: (503) 598 -1960 �� 7�TA� BUILDING DIVISION Case file no.: Payment type: Land use approval: 51512. -0000+ l &2 family: Simple Complex: TYPE OF PERMIT �`-... 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family l] New construction 0 Demolition 0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm Q'Other: GA4P46fte Dl:19f1.1.JPAN JOB SITE INFORMATION Job address: e 360 5.14. rAp FIB - TtbAwn em Bldg. no.: Suite no.: Lot: I Block: I Subdivision: 'Tax map /tax lot/account no.: 15 135 1,A/ WOO Project name: to/.1,TOMS GA►T 4l ).t6t Description and location of work on premises/special conditions: P /t.IZ,IGI NG A -EA e €abt - ITHEt.. l POULT1 Ofd e* S1tiG . - Z. OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: DAV1 17ALTr7t} ( Floodplain ,septiccapacity,solar,etc.) IN1 Mailing address: 1-143 0 g do vme-Svim4 I & 2 family dwelling: `s City: _ . a a State: , ZIP: 9i O(o 2. Valuation of work $ a Phone: Se; -(.3q -,21,1 Fax: E -mail: No. of bedrooms/baths Owner's representative: Mewl D (7m - • t4 Total number of floors MA. Phone:5 Vol ..+41 ax: E -mail: New dwelling area (sq. ft.) , APPLICANT Garage/carport area (sq. ft.) , Covered porch area (sq. ft.) Name: 14 'Lou g 1461t N Gv 14.4 Deck area (sq. ft.) Mailing address: - %amm A:S µ City: M t a t e: IZZIp• Other structure area (sq. ft.) Commerclalrmdustrial /multi - family: Phone: Fax: E -mail: . .. CONTRACTOR Valuation of work $ 11101f, - Existing bldg. area (sq. ft.) 1 gli►st, - Business name New bldg. area (sq. ft.) ...-' Address: • : - • • ■ ' -' � - . 1... . N um b er o s City: /450:c Sl t) r I, , , s !` .G.4. ZIP: q 7 21 3 Type of construction Ni -µ Phone: I F • : I E -mail: Occupancy group(s): Existing: 2 - '3 CCBno.:6 (,0 New: e' 6 City/metro lic. no.: Notice: All contractors and subcontractors are required to be ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing, the following reason applies: Contact person: I Plan no.: � Phone: Fax: E -mail: - 4. 6. ENGINEER Name: J - .,, : _ Contact personii • . ; - a __ ees due upon application $ Address: P. D . s 237 e,4 Date received: _ r City: -1't b,p State• 2 IZIP:. ¶ n$ I Amount received $ 7 Phone ,- r=,p_ I Fax: - Vo3 E -mail: " Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more infarmanoo. attached checklist. All provisions of laws and ordinances governing this t] visa 0 MasterCard work will be complied with, whether specified herein or not, lb 96 5T Credit card number: I / ft�p , Expires s1t% ecllz Btp1Tl Authorized slgnatu ' ate: 2- 4 OV Name of cardholder as shown on credit card Print name: 3IM. biIt i G, cardholder signature $ ?.}�% Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been ccepted as complete. 440 -4613 (6.03/com) h „ ley" ay7 ,o � • X33 z, q, 1 a SITE PERMIT CHECK LIST Commercial and Multi - Family: Complete ENTIRE form. Residential: Complete SHADED areas only. Excavation Volume: cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) 2l, cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) 2 I 2, cu. yds. Retaining structure? (Check one) Li Rock ❑ CMU ❑ Concrete ❑ Other ❑ goNl✓ Total new impervious area including all buildings, sidewalks, and paving: et,bl*. = I289 + Sst4 qt: .'3941 (p a p sq. ft. t Txra. free. = I I cso Utilities (Complete all that apply) Storm Sewer: 1.1E,14 UI4L1b raw sT*M WAtter.r Ih1F7,Linear Ft. to Co Sanitary Sewer: — >at*nl4c4 To V mrsti Linear Ft. Fresh Water: — tsuxkTE V/trq MI` E12. Linear Ft. Catch Basins: # I e* ISod Clean Outs: # Plans Required: See "Application /Plans Submittal Requirements" attached. The following must accompany this application: Site Plan with Vicinity Map Parking (including ADA) and showing ADA compliance Lighting Plan Grading Plan and details Landscaping Plan Erosion Control Plan and details Retaining Structures Site Utility Plan and details Soils Report (if required) (showing connection to approved system) is \dsts \forms\sitechecklist.doc 10/05/00 Building P I - e • l ,, I ' �;. U '" ` :� City of Tigard Date received: a y '2` Permit no.: d am' /j ) ,9 _ 6 eY70 .. ); Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd;ligardrOR'i7223 Date issued: / - -0 Phone: (503) 639-4171 By: 6/5 I Receipt no.: Fax: (503) 598- 1960 �� T1�T ( ) BUILDING DIVISION Case file no.: Payment type: Land use approval: Sbt -- 2001- D000 1&2 family: Simple Complex: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm 8'Other: L14141461>G OP. f9UUPAN JOB SITE INFORMATION . Job address: a 30 5. I4. rA p I'1 - Ttf zb Atz. Bldg. no.: Suite no.: Lot: (Block: (Subdivision: I Tax map/tax lot/account no.: 19 DA/ too° Project name: 60-1.704 S cbr e,g,1 141 G..7 Description and location of work on premises/special conditions: Alzi -1 Nem ' - -A e SGU I'M 1EIz.H 1 OH 6. Sri E.. OWr'ER ` FOR SPECIAL INFORMATION, 'USE CHECKLIST Name: bAV I ID VAL I - } (Floodplain, septic capacity, solar, etc.) Mailing address: 114 3 o g , W pi G 'N I & 2 family dwelling: City: _ i , State:di , ZIP: 9l o(,2. Valuation of work $ Phone.:,o3 -431-1211 Fax: E -mail: No. of bedrooms/baths • Owner's representative: ipArviD DAL- ot4 Total number of floors (-VW Phone:503- Vol — '1 - 4 1 ax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage/carport area (sq. ft.) Name: Covered porch area (sq. ft.) ILOU e kt t t4gag � 44-4 _ Deck area (sq. ft.) Mailing address: — 1 e kg, 4µt Other structure area (sq. ft.) City: State: (Z IP; Phone: Fax: E-mail: Commercial industrial /multi- family: CONTRACTOR Valuation of work $ I'j f 09 fp Existing bldg. area (sq. ft.) 1 01vb Business name: NIbT f T1 t? -('4 H EI7 New bldg. area (sq. ft.) Address: - - City: State: ZIP: Number of stories Z Phone: Fax: E -mail: Type of construction V .µ CCB no.: Occupancy group(s): Existing: R.�'' New: a City /metro lic. no.: Notice: All contractors and subcontractors are required to be ARCIIITECT(DESIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: I State: ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E-mail: ENGINEER Name: a ou �,. _ .21 ; Contact perssonj • ...-a _, ees due upon application $ Address: P. D . B /.3-7t,4 Date received: City: . _ c.d State•# ZIP:. 172,2,1 Amount received $ Phone503 ,p -206` Fax:694 -' j f o 3 . E -mail: : Please refer to fee schedule. I hereby certify I have read and examined this application and the ' Not all jurisdictions accept credit cards, please call jurisdiction for more information' attached checklist. All provisions of laws and ordinances governing this ❑ visa 0 MasterCard work wil be co lied with, whether specified herein or not, Its 9@ Credit card number: I / , *V aim pla4pin- `` Expires I Authorized signatu • • ate: 2. 4 Dv Name of cardholder as shown on credit card Print name: JIM hemlt.1 Li Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been ccepted as complete. 440-4613 (6r00/COlrr) 15D, aye - .� '7 -- qLi . '1 — .J CITY OF TIGARD 24 -Hour BUILDING Inspection Lit a: - (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received LU Date Requested J 3 `6) C/AM PM BUP Location 8 5 3 0 • Suite MEC Contact Person 1�' .' Ph ( ) 7 ezi / 9 PLM Contractor �1 Ph ( /J SWR BUILDING Tenant/Owner /. UGC. n? C- x_11. 1 ELC Footing V ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT o l - - ( " z — 3 C) 2, Post & Beam • Shear Anchors Ext Sheath/Shear. Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SPAS PART FAIL �SJT ❑ Plea a call for reinspection RE: Unable to inspect — no access Fire Supply Line ,/1 / I ADA 7 Approach/Sidewalk Date Inspector Ext Other: ( I DO NOT REMOVE this inspection re • ord from the job site. PART FAIL