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Permit Alk CITY OF TIGARD SITE WORK PERMIT DEVELOPMENT SERVICES PERMIT # : SIT1999 -00019 &..0,0,4, I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 6/25/99 SITE ADDRESS: 12144 SW SCHOLLS FERRY RD PARCEL : 1S134BC -00101 SUBDIVISION: ZONING : C -G BLOCK: LOT: JURISDICTION : TIG CLASS OF WORK: NEW PAVING ?: RESO. NO: TYPE OF USE: COM GRADING ?: VALUE: S QOC) EXCV VOLUME: 350 cy LANDSCAPING ?: Y FILL VOLUME: 25 cy SITE PREP ?: Y ENG FILL ?: STORM DRAINS ?: Y SOILS RPT REQD ?: Y IMPERV SURFACE: 626 sf Remarks: Site work permit Owner: • FEES WILLIAM W. SAUNDERS REVOCABLE TRUST Type By Date Amount Receipt 111 SW COLUMBIA STE 1380 PLCK BON 4/27/99 $232.70 99- 314775 PORTLAND, OR 97201 MISC BON 4/27/99 $143.20 99- 314775 PRMT BON 6/25/99 $358.00 99- 316404 Phone: 223 -4777 EROS BON 6/25/99 $80.00 99- 316404 Contractor: ERPU BON 6/25/99 $26.00 99- 316404 SILCO CONSTRUCTION CO. ERPC BON 6/25/99 $26.00 99- 316404 PO BOX 83299 5PCT BON 6/25/99 $17.90 99- 316404 PORTLAND, OR 97283 Total $883.80 Phone: Reg #: LIC 00033578 Required Inspections Erosion Control Insp 844 -8444 • Excavation Fill Strm Drain I ORIGINAL Cuulvert/CCatch k Basin San Sewer Insp Manhole /Cleanout - PVT Domestic water line inspect. 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 Or C n Utilit otification Ce er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. Y may ob in copies of '' se rules or direct questions to OUNC by calling (503) 246 -1987. Permittee Signature: J' z /l, 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 ° et l � 13125 SW HALL BLVD. Commercial: Complete ENTIRE form TIGARD, OR 97223 Residence: Complete SHADED areas P E `/ =- (503) 639 -4171 x304 y pSr y �� �� Print or Type elf -uvo1 Incomplete or illegible applications will not be accepted C 4 -,7 -99 V:.38P/k • ::.:c �e�: �a�e;:.;:.;;:.:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.::.;:.;:.>;:.;:.;:.;;:.;:.;:.;;;::. ;:.; Utilities (Complete all that apply) P <��#�.�. :: : :::: :.. Storm Sewer : >: ::. " :: l ... >::: ";:;:::r: >::::< !!!!: ::: >< » >:: »:: >: Lin r ::: ?x��::.I: ::: >:r::: >: »:: » : « ::<:: 220 ea Ft. .::::::::::::::::: :. ::: :::::::::.:::::::::::::::::::::::::::.. ::::::::::::::::::::.::::.::.:. 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'' ii '..-- ::....:. ::::...:...... „. . i:. i:. i:.i:.i:.i:.: >:.::.:::::.i;is.;.i:.;:.:•i i:.: :.i:.;:.;:.:;. i_..i. :.::.::....i „.. iii::; ».....: »::.i. i:•:•: : ... .i:.i:.i:.i::.: : •:i w.... • o tal ne i m • r viou s area including c udin a buildings, ' 626 sid ew Ik and sidewalks, a paving .F. .., Tax Lot 101 v • 0 � y3, a 6 �'► -�►�t /1 F 65 siteapp.doc9 /97 • COMMERCIAL PLAN SUBMITTAL • REQUIREMENT MATRIX application For an eiecfncal submitta1 the application must contar the signature of the supervising electnoian before plan review wdl be conducted After plan ievew apprva1, Plans Eamtner wdl contact flogegg E0:111::" 40111.0010000. tIMMgl000tig adthtional plan sets for disthbuflon pinposes (Copy ibr Contractor City. Washingtn County, Tualatin Valley Are & Rescue) Total # of .i:TypeaRlistfamrt.AEmi KEY: SubifiFUed 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\maxtrixl.doc 07/06/98 CITY OF TIGARD ENGINEERING PERMIT PERMIT #: ENG1999 -00018 � I;� DEVELOPMENT SERVICES PRIM. PERMIT #: PD98 -00012 r- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/25/99 • • SITE ADDRESS: 1 21 .44- SW_SCHOLLS_EERRY_RD-. PARCEL: 1S134BC -00101 • SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG o PERMIT TYPE: SOP PUBLIC IMPRV QUANTITY LIN FT VALUE AGREEMENT DATE: GRA/EROS: *' ASSURANCE EXPIRATION STREET: PERFORMANCE: SAN SEW: STM SEW: MAINTENANCE: PATHWAYS: ALL OTHER: * *" . $300.00 TOTAL: $300.00 Remarks: STREET OPENING, TO INSTALL A SANITARY SEWER SERVICE LATERAL AND TAP AN EXISTING PUBLIC SANITARY SEWER MAINLINE, IN AN EASEMENT. Owner: • FEES • Type By Date Amount Receipt • • OPEN BON 6/25/99 $12.00 99- 316403 MISD BON 6/25/99 $300.00 99- 316403 Phone: Total $312.00 Engineer: Phone: REQUIRED INSPECTIONS STM/SAN SEWER STREET Permittee / Applicant: MH /CB /CO CRB LINE & GRADE MEADOWLARK PARTNERS, LLC PIPE LN & GRD SUBGRADE 1750 S.W. SKYLINE RD. #224 BCKFLL & CMPCT BASE ROCK PORTLAND, OR 97221 AIR & TV TEST - LEVEL COURSE WEARING COURSE Phone: • GRADING TRAFF & PED CONT CONTOURS MONUMENTATION DRAINAGE STREETLIGHTING Pe rmittee/ EROSION CNTL. WALK/APRON /RAMP Applicant Signature: , REPR'S /ADJ'S PATHWAYS Issued By ' h a' — • • FOR INSPECTIONS, CONTACT THE CITY OF TIGARD, SPECIAL CONDITIONS: (SEE ATTACHED) ENGINEERING DEPARTMENT, AT: (503) 639 -4171 • 10/08/1999 Activities for Case #: SIT1999 -00019 12:16:06 PM - Assigned Hold Updated ' Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SITC005 Application received 04/22/1999 GEO RECD No Hold BON 04/27/1999 SITC008 Permit Created 04/27/1999 BON DONE No Hold BON 04/27/1999 SITC011 DST /mail Land Use Condition Lt 04/27/1999 BON DONE No Hold BON 04/27/1999 SITC013 Plans Routed to Plans Examiner 04/27/1999 04/27/1999 04/27/1999 BON DONE No Hold BON 04/27/1999 SITCO26 Plans approved by CPE 04/27/1999 04/27/1999 04/27/1999 RDP DONE No Hold RDP 04/27/1999 • • SITCO27 Plans approved by Water Dept 04/27/1999 04/27/1999 No Hold RDP 05/05/1999 Sent notice 4/27/99 5/4/99 Received email from • - Mike - He requires no action SITCO28 Plans approved by Engineering 04/27/1999 04/27/1999 No Hold RDP 05/05/1999 Sent notice 4/27/99 No reply - Sent plans to DST • this date 5/4/99 SITCO29 Plans approved by Planning 04/27/1999 04/27/1999 - No Hold RDP 05/05/1999 Sent notice 4/27/99 No reply - Sent plans to DST 5/4/99 SITCO30 Reviewed plans routed t� DSTS • - No Hold RDP 04/27/1999 SITC740 Strm Drain Insp 04/27/1999 04/27/1999 08/03/1999 • TLP PASS No Hold AKJ 08/03/1999 catch basin and rain drain and laterals to bldg south side SITC744 Culvert/Catch Basin 08/10/1999 . MS PASS No Hold AKJ 08/10/1999 SITC750 San Sewer Insp 04/27/1999 04/27/1999 08/25/1999 MS PASS No Hold AKJ 08/25/1999 1) sewer line in and tested tied • into 6" 30 -34 4" into a six 6" combo added to • main 2) sampling vault added to • . interceptor SITC757 Domestic water line inspect. 04/27/t999 04/27/1999 09/02/1999 TLP PASS No Hold AKJ 09/02/1999 • SITC760 Landscaping Insp 04/27/1999 04/27/1999 10/07/1999 JH PASS No Hold DST 10/08/1999 See note on final insp line of BUP SITC799 Final Inspection 04/27/1999 04/27/1999 10/04/1999 RB FAIL No Hold AKJ 10/05/1999 usa erosion final req final landscaping to be • completed by planning SITA021 Plans Approved /Routed to DSTs 05/05/1999 05/05/1999 05/05/1999 RDP DONE No Hold RDP 05/05/1999 SITA032 DST Post - Review Completed 05/10/1999 DRA DONE No Hold DRA 05/10/1999 . SITA050 Hold for 05/10/1999 DRA DONE No Hold DRA 05/10/1999 Hold for okay from Brian R, • applicant needs to obtain a SOP for the new sewer - connection prior to issuance of SIT & BUP. Page 1 of 2 . 10/08/1999 •Activities for Case #: SIT1999 -00019 12:16:06 PM • Assigned " Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. - Level By Updated Notes ' SITCO55 Hold Release 06/17/1999 DEB DONE No Hold DEB 06/17/1999 Planning has approved release of all permits. Engineering is requiring that the SOP be issued prior to, or at the same time, as the SIT & BLD. MUST IDENTIFY CONTRACTOR prior • to issuance. SITC092 (F) Issue permit 06/25/1999 BON DONE No Hold BON 06/25/1999 SITC770 Misc. Inspection 08/03/1999 08/03/1999 08/03/1999 TLP PASS No Hold AKJ 08/03/1999 grease interceptor SITC740 Strm Drain Insp 08/05/1999 08/05/1999 08/05/1999 MS PASS No Hold AKJ 08/05/1999 6" storm -3" laterals to bldg SITC740 Strm Drain Insp 08/10/1999 08/10/1999 08/10/1999 MS PASS • No Hold AKJ 08/10/1999 storm final ok SITC700 Erosion Control Insp 844 -8444 10/08/1999 10/08/1999 10/08/1999 HAP PASS No Hold DST 10/08/1999 Final approval delivered to Bldg Dept by Mike Staats. SITC800 Case Finated 10/08/1999 HAP PASS No Hold DST 10/08/1999 Activities reviewed. Case finaled. SITC799 Final Inspection 10/08/1999 10/08/1999 10/08/1999 HAP PASS No Hold DST 10/08/1999 Only outstanding item was USA final approval. Delivered to bulding department today. • • • • • • • • • Page 2 of 2 • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 G BUP Date Requested ZI Requested T' � q / AM PM BLD Location (2 / '7 I ` ' AS Suite MEC Contact Person Ph PLM Contractor NAIS Ph SWR BUILDING Tenant/Owner 3 R ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: / Slab Q WI 1 I pq� 1 y. SIT (99y- ,1 1 ` ; J�– Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof % ' .7405877- Misc: _ r _ / i� �� Final t.\ 6 _ PASS PART FAIL ! e / 1 �l Post & Beam Under Slab ,e _ 4P4 Top Out –" J Water Service ii /���/ ∎ -41/../111" anitary — Rain rains F e PART FAIL _ HANICAL Post & Beam _ _ /L / _ _ _ Rough In Gas Line Smoke Dampers Final • PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE 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 Other Date r Inspector / , Ext L, Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 . g Buussiness Line: 639-W1 �� r, � � I Date Requested 10' ` / AM PM qgq-002� Location Z I _ .A Ai IS _. Suite Contact Person iTl L.c , P 2.© /'tZ7O PLM vq Contractor Ph Alp / � ` - CO /S , UIL Tenant/Owner C S fie. ie. ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SG Slab Crawl Drain Inspection Notes: (sI / 7 Post & Beam Ext Sheath /Shear Ina Framing /, 0! e, -C ,SL O Framing ��" 4 11��� - � V � �� _' JI - S Insulation D Q O (1 n ' �'‘A., S \ 7 1 ��� — 000 \ 9 Drywall Nailing �+ --rj� }- � Firewall \`, (� Fire Sprinkler OV� J tip (� 0,- `_ G Z1 S l - 0 0 Z`' S S-2 , o/c 2 Fire Alarm Susp'd Ceiling Roof f n v-c-t \ O /C/9 (2A ( — 0- t — ■ i) Misc: �C '; PART FAIL / ,X Cie -t","\ #b ` A.A , 6 - � - e.. ,�S iiiip • Co ,y� 1 • BING r� Q -ct� < � SirA R \ e2. t `��- �. \ c.n P o s t & Under Slab Beam • Un / \ dl ��� �, S `'\/1, d � L Top Out Water Service S \ T vv... Jc . i DV, Sanitary Sewer Rain Drains _ J Final A c l S .l ^ n S I PASS PART FAIL +� �� MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Q 1L ,/ --- Tn OCCAe Final _ 1 PASS PART FAIL ELECTRICAL Service Rough In UG /Slab 0 Low Voltage Fire Alarm Final P� PART FAIL Backfill/Grading Sanitary Sewer Storm Drain V.) Ii7, [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin V ` Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA • • • ro. c -/ iy�ew�lk�.� L4,....' Date I 0 / -Q� / 6 I Inspector ‘ -- Ezt 3 H ar t ali FAIL DO NOT REMOVE this inspection record from the job site. ‹ D\ T - \ R C L G t - OW I ? 1, a�‘,\ k —A-INSs --; 0