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Permit A CITY OF TIGARD SITE WORK atidi DEVELOPMENT SERVICES PERMIT J "� a. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # • SIT 98 -0021 DATE ISSUED: 07/30/98 (' 7019 PARCEL: 2S1O1DD -00600 SITE ADDRESS...: _0E600 SW SANDBURG ST SUBDIVISION • SALEM FREEWAY SUBDIVISION ZONING: C —P BLOCK • LOT :003 JURISDICTION: TIG CLASS OF WORK..: NEW PAVING? • Y RESO. NO.: TYPE OF USE •COM GRADING? • Y VALUE...$: 193115 EXCV VOLUME: 1935 cy LANDSCAPING? • Y FILL VOLUME: 1999 cy SITE PREP? • Y ENG FILL? • Y STORM DRAINS ?...: Y SOILS RPT READ ?: Y IMPERV SURFACE: 39490 sf Remarks: Site work for new office building. A two story 36, square foot office building. Owner: FEES WESTERN FAMILY FOODS INC type amount by date recpt 6700 SW SANDBURG ST PRMT $ 668.00 GEO 06/11/98 98- 306459 TIGARD OR 97223 5PCT $ 33.40 GEO 06/11/98 98- 306459 PLCK $ 434.20 GEO 06/11/98 98- 306459 Phone #: ERPU $ 26.00 GEO 06/11/98 98- 306459 ERPC $ 26.00 GEO 06/11/98 98- 306459 Contractor: FIRE $ 267.20 DEB 07/30/98 98- 307849 MCCORMACK PACIFIC CO EROS $ 12.00 DEB 07/30/98 98- 307849 7190 SW SANDBURG ST WOUN $ 1143.52 DEB 07/30/98 98- 307849 TIGARD OR 97223 EROS $ 68.00 06/11/98 98- 306459 Phone #: 624 -2090 $ 2678.32 TOTAL Reg #..: 000631 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Erosion Control Engineered gradi Tigard Municipal Code, State of Ore. Specialty Codes and all other Excavation Insp Final Inspection applicable laws. All work will be done in accordance with Fill Inspection approved plans. This permit will expire if work is not started Grading Insp within 180 days of issuance, or if work is suspended for more Retaining Wall /F than 180 days. ATTENTION: Oregon law requires you to follow rules St r m Drain Insp adopted by the Oregon Utility Notification Center. Those rules are Culvert /Catch Ba set forth in OAR 952 -0014010 through OAR 952 - 00180. Your may San Sewer Insp obtain copies of these rules or direct questions to OUNC by calling Manhole /C l can o ut 1583)246-9187. Sprinkler supply Domestic water 1 Fire system test Issued y: ��_ 4 / ii , Permittee Signatur /( 0�� +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + ++ Call 639 - 4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ ? m'i � �`-- 5 By CITY OF TIGARD Site Permit Application + r Ra e PP 7 � , Datt e e Rec (s d — // - P 13125 SW HALL BLVD. Commercial: Complete ENTIRE form / / Date to P.E. 6 + -- TIGARD, OR 97223 Residence: Complete SHADED areas / ✓ Date to DST z (503) 639 -4171 x304 Permit# .c/r 9 ,P - 00- Related SWR # 1 /( Called 1- 2-'? - D Print or Type Incomplete or illegible applications will not be accepted Project Name Utilities (Complete all that apply) Job Wes-re:gw - +4411.`1 .Tool>S Address Address .. Storm Sewer LAW 'r3' SV11. S',iu1�13URIA 9 . '1W∎JATE 'b 2 Linear Ft. - - Name - .. - 6 Sanitary Sewer �� We. At+► 3tw: �',QOD � L tvR S "PR zc Linear Ft. Owner Mailing Address Fresh Water (,'100 iu) Si D Td. uR6'1 ST• i. cm" tt l t lz' Is° Linear Ft. City /State • Zip' Phone Catch Basins 1 I Clibstra> ) ©• 002.1.3 4 4,3 'PRtuR1E StPnoN # 'S General Name , - : Clean Outs m 2 Contractor I`^ c,Coi2 1 � Auf.1( • �.O • . # Poor to permit Mailing Address Describe work to be done: issuance, a ewJ AdditionQ Alteration Re ai copy of all T I NO bV■1 5AuoBV� cSZ' • N ❑ p r❑ licenses are City/State Zip Phone Additional Description of Work: required ,if `TiOtP.P f ©R . ‘ In 7-. - 2- r -v I mo a 4 .FT • . e5 b tcE E 1 . expired in COT State Const. Cont. Board Lic. # Exp. Date ✓ lax -vttt orf atC"t database (. zAa . or ?000 Name Project AN\Cnow► tko \SAn1 kYA(.. 41-h1Wer 5 Valuation $ \ C 5 J 115 Architect Mailing Address Plans Required: See Matrix on back (0110 bw N1A(A .An\ 1 l- koo The following, must accompany this application: City/State Zip Phone Site plan with Vicinity Map Parking (including PO (LT t -AN>, ,(Siz- °t7 2.\ \ 2-i - i t o / Showing ADA compliance ' ADA) & Lighting Plan Name ✓ Grading Plan and details / Landscaping Plan +I APE - lit vF �trtKe'1.t�•t S , I . . - Engineer Mailing Erosion Control Plan and / Retaining Structures 62 W 00 , ANA (ADA M ) * 5g0 details v including calculations City/State Zip Phone Site Utility Plan and details 4 Soils Report "TeclttlW� 9'12 01 2. t - it -3 ,/ ' (showing connection to (if required) 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 / 11 S cu. yds. agent of the owner, and that plans submitted are in compliance with Oregon State laws. . Fill Volume Signature of Owne gent_ Date (Soils report required for >5,000 cu. Yds.) 111'1 ; !/1/� (c . It , 1 O cu. y � —� _ i Will the fill support a structure Contact Person Name . _ Phone (Engineer required if answer is yes) YES❑ NO)Rk •-S� • 2.A.5 -110 Retaining structure? (check one) °Rock FOR OFFICE USE ONLY D CMU Notes: ❑Concrete °Other 0% / - oaLo d Total new impervious area including all / 1 Land Use Case # Map/TL# l0 buildings, sidewalks, and paving �/ - 14 Sq. Ft. Sb/ 9? - O 00 6 siteapp.doc3 /98 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST EXAMINERS (Note a.) TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 -- -- 3 (j,o,u) -- -- B (New or Add) 1 1 -- -- 3 (j,o,w) -- -- F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f) M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- -- B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- -- P (New, Add. or Alt) 2 -- 2 -- -- 2(j,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) -- B (New, Add, or Alt) 2 -- -- 2 -- -- 2(j,o) B & M & P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o) .................:...:......... ..........:...........::.:..... > < : :::, ... .... ....... ..... .. `: NOTES: KEY: a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP number of revised plans from applicant, stamps and completes, o = Office M = MEC updates and adds actions. f = Fire P = PLM u =USA E =ELC §: h ct:;ar as >:d 0 : 1::A€> ':emit > Sul.::::::»>::>::,>:><>:<:>::>:<>::;«: <: >:: >:: >:::::<:>:::::<:: >:: > w = Wash. County F = FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. h:Unatric.Doc