Permit n CITY OF TIGARD SITE WORK PERMIT
1 1 a COMMUNITY DEVELOPMENT Permit #: SIT2012 -00008
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/27/2012
Parcel: 1 S134AB03300
Jurisdiction: Tigard
Site address: 10330 SW SCHOLLS FERRY RD
Project: Muslim Educational Trust Subdivision: ENGLEWOOD Lot: 88
Project Description: Site work associated with new 2 -story building and parking lot.
Contractor: PRECISION CONSTRUCTION COMPANY Owner: MUSLIM EDUCATIONAL TRUST INC
8025 NE KILLINGSWORTH ST PO BOX 283
PORTLAND, OR 97218 PORTLAND, OR 97223
PHONE: 503 - 253 -4827 PHONE:
FAX: 503 - 253 -5177
FEES
Description Date Amount
Specifics: Permit Fee - Site Work 09/27/2012 $2,955.64
Plan Review 05/24/2012 $1,921.17
Type of Use: COM 12% State Surcharge - Building 09/27/2012 $354.68
Class of Work: NEW Plan Review - Fire Life Safety 09/27/2012 $1,182.26
Erosion Control Only - Ping 09/27/2012 $600.00
Project Valuation: $578,000.00
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Site Specifics:
Excavation Volume: 1200 cu. yd.
Fill Volume: 3100 cu. yd.
Impervious Surface: 48787 sq. ft.
Engineered Fill: Yes Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Yes Retaining Wall: Yes
Fire Underground: Yes Accessible Parking: Yes
Fence: Yes
Total $7,013.75
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notificati n_ nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct q stions to O C by calling 503.232.1987 or 1.800.332.2344.
Issued B
( y Permittee Signature: t/� � k
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Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
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Building Permit Application
Site Work R ED FOR OFFICE USE ONLY
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City of Tigard Re eive / Permit No.: I �t"
° 13125 SW Hall Blvd., Tigard, OR �g p Plan Review • .. 1 C : ' Phone: 503.718.2439 Fax: 503. 196 66' 4 2012 Datc/By. 04, il q (., her Permit: At. 0/2
T I GA RD Inspection Line: 503.639.4175 Date Ready/ y: 9 , J: See Page 2 for /
Internet: www.tigard- or.gov `CITY OF TIGARD Notified /Method: /g 7 Jura : Ed / / Supplemental Information
BUll nI N1;, nil/>,'cl,, e Ay "M
TYPE OF WORK REQ RED DATA: I- AND 2- FAMILY DWELLING �-/
® New construction ❑ Demolition Permit fees' are based on the value of the work performed. (
Indicate the value (rounded to the nearest dollar) of all w
❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling ® Commercial /industrial Valuation: $ T'
❑ Accessory building ❑ Multi - family Number of bedrooms: O
❑ Master builder 0 Other: Number of bathrooms: O
JOB SITE INFORMATION AND LOCATION Total number of floors: 0
Job site address: 10330 SW Scholls Ferry Road New dwelling area: square feet 0
City/State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg./apt. no.: I Project name: MET Community Center Covered porch area: square feet
Cross street /directions to job site: SW Scholls Ferry & SW Conestoga Drive Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 1S134AB03300 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New 2 story, partial basement private school with new site utilities on -site Valuation: $$578,000.00
parking lot construe r n Existing building area: square feet
New building area: 36041 square feet
— E1 PROPERTY OWNER I ❑ TENANT Number of stories: 2
Name: Muslim Educational Trust Type of construction: II -B
Address: 10330 SW Scholls Ferry Road Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: (503)579 -6621 Fax: (503)590 -0201 New: E, A -3
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Otak Architects, Inc All contractors and subcontractors are required to be
Contact name: Jennifer Nye licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 17355 SW Boones Ferry RD jurisdiction in which work is being performed. If the
City/State/ZIP: Lake Oswego, OR 97035 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 699 -2456 I Fax: : (503) 635-5395
E -mail: jennifer.nye @otak.com
CONTRACTOR "'alp
Business name: Nac► t ,..t 6 1.. C v 4 . 105T' &tQ � 6 QC CPA- 3 V BUILDING PERMIT FEES*
Address: $ .S )k L-L 1 n.) �7 Lim a2 rl+ 5-1— (Please refer to fee schedule)
Structural plan review fee (or deposit): ,
City/State /ZIP: p O-TL- fi CDC 9 -7a -
Phone: ( 503 ) ').,5 14 Q ._ Fax: ( ) FLS plan review fee (if applicable):
CCB tic.: (pap 8 7 r [o ` (3 Total fees due upon application: $2,955.60
1 Amount received: sa 953% teo
Authorized signature:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: WAJDI SAID Date: 24/12
• Fee methodology set by Tri- County Building Industry
Service Board.
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City of Tigard: Site Work Permit Checklist
Page 2 - Supplemental Information
Commercial, Multi- Family and One- and Two-Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below, unless otherwise noted.
Excavation Volume: 1200 cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) 4300 cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be compacted to
90% of maximum density) 3100 cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: 48,787 sq. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements" attached.
The following must accompany this application:
❑ Site Plan with Vicinity Map showing ADA ❑ *Parking (including ADA) and Lighting
compliance Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report (if required)
❑ Retaining Structures
*Does not apply to One- and Two - family dwellings.
Plan Submittal: Permit Fee:
TYPE OF SUBMITTAL # of Plans Valuation: Permit Fee:
(New, Additions or Required at $.00 to $500.00 $51.09 minimum permit fee
Alterations) Submittal $500.01 to $2,000.00 $51.09 for the first $500.00 and
$2.69 for each additional $100 or fraction
Commercial 3 thereof, to and including $2,000.00.
$2,000.01 to $25,000.00 $91.44 for the first $2,000.00 and
Multi - Family R - Occupancy 3 $10.76 for each additional $1,000 or
fraction thereof, to and including
$25,000.00.
One- & Two - Family Dwelling 2 $25,000.01 to $50,000.00 $338.92 for the first $25,000.00 and
$8.06 for each additional $1,000.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $540.42 for the first $50,000.00 and
$5.38 for each additional $1,000.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and over $809.42 for the first $100,000.00 and
$4.49 for each additional $1,000.00 or
fraction thereof.
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4.' ,66 c l.e..s cgxey \
Mi5L /H c•ete. �.Pu'
III o ° Building Division
Development Code Provision Review
T I G A R D Commercial Projects with Approved Land Use
Building Permit No.: 61 T o 'fig
Land Use Casefile No.: HNh ao /9- -GYo /O
Routed Plans:
Submittal Date: 5 /0-
Submittal Date: :I® t' - ' ----
Submittal Date:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies
to the Building Division. Only checked ( items are approved. Items not approved and those listed in the
notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed
above each section.
STAFF: please only mark those items on the left side that are approved. '
Planning Review (contact '1 • s a C. . (at 503 -718- 2 L i ;ii or @tigard- or.gov)
a- Land Use Approval
.O Building Plans Match Approved Plan: Yes - .l3 No ❑
.ErMaximum Building Height -2 2S - ; 30 ' - y '' pfp'I
❑ Conditions Met .
Notes: 5o' S wi, e - IC ec.Ho /fl '$ In tilMO 2s /2 - COG /C „„f ec, 200 Z -ero002
1l1 'a <cn3 r►t 1T / /ufG3V Y1 I1 - OCyv 7 -a jue"E COQ® /776 / , t7 ' Z 1�v 1_ /14 atj
Thrtnb 13/ 12 Eor i� � - oP /'1/!-2 E J2 &'i eecse�t z �7 Tff t nvlk cc _ 1 ,_; 17
Original P Approved ❑ Not Approved Date: '7 ` - 1 Z
Revision 1: Approved,' Not Approved ❑ Date: 8 - z 1 - I (--
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov)
P' Actual Slope: Co
❑ PFI Permit #
❑ Conditions Met
Not s: WA- ■ - 5 L) 1• id.iiiixo f ' 4f142._
orck 4 '' i is i Ses044. inc.., (ST le D ee,NY cd 'Pt
Original Plan: Approved ❑ Not Approved Date: 7(2 5 / Z
Revision 1: Approved Not Approved ❑ Date: /) JO /2_
Revision 2: Approve ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
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City Arborist,Review (contact Todd•Prager at 503- 718 -2700 or todd @tigard- or.gov)
n>Street Trees
iJ Protected Trees
Notes: J'ao 671 co Mn,-.1
Original Plan: Approved ❑ Not Approved Q Date: '/0`5�l a-
Revision 1: Approve Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved "❑' Date:. • •
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard- or.gov)
❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit
❑ Engineering Okay to Issue Permit
Notes: •
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes*D No L q/Z
Date Routed to Building:
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