Loading...
Permit -17 n C ITY OF TIGARD SITE WORK PERMIT 1 °• COMMUNITY DEVELOPMENT PERMIT #: SIT2007 -00013 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 4/27/2007 PARCEL : 1 S135BB -00501 SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING : I -P SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION : TIG PROJECT: HEMCON Project Description: Addition of 5,812 sq ft to existing building. CLASS OF WORK: ADD PAVING ?: RESO. NO: TYPE OF USE: COM GRADING ?: VALUE: 115,000.00 EXCV VOLUME: cy LANDSCAPING ?: FILL VOLUME: cy SITE PREP ?: Y ENG FILL ?: STORM DRAINS ?: Y SOILS RPT REQD ?: Y IMPERV SURFACE: sf Owner: FEES HEMCON TECHNOLOGIES Description Date Amount 10575 SW CASCADE [BUPPLN] Pln Rv - Valu 4/3/2007 $521.82 TIGARD, OR 97223 [FLS] FLS Pln Rv 4/3/2007 $321.12 [BUILD] Prmt Fee - Valu 4/27/2007 $802.80 [TAX] Valu 8% State Surcha 4/27/2007 $64.22 Phone: 503 - 245 -0459 [ERPRMT] Erosion Control 4/27/2007 $80.00 Contractor: [ERPLN] Erosn Pln Rv CWS 4/27/2007 $26.00 [EROSN] Erosn Pln Rv COT 4/27/2007 $26.00 COFFMAN EXCAVATION LLC PO BOX 687 Total $1,841.96 OREGON CITY, OR 97045 Contact #: PRI 503 - 656 -7000 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Reg #: LIC 146689 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 rule r direct qu- - '•ns to • • by calling 503.246.6699 or 1.800.332.2344. ssued By: / e i � /. Permittee Signature: 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. Site ` or e � `co CASG � ? - c O(� f Building Permit Applic © 7' %I FOR OFFICE USE ONLY 11 1 !. =-J ir'^ 4-.— ° Received j City of Tigard Date/B CI Permit No r+ ° 13125 SW Hall Blvd , Tigard, OR 97223 �� ��� C g �'tVR O. 2001 Plan Revie P � O Other Permit: Phone 503.639 4171 Fax: 503 598. I 2001 DateB ` \ t - G A R D Inspection Line: 503 639.4175 Date Ready /By ® See Page 2 for Internet www tigard-or gov Q , 1 or Ho mo) Notified/Method 7a Supplemental Information TYP�'I�'i raga =TE 1 l3 �'I I p� REQUIRED DATA: 1- 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 ❑ 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: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ‘ '..c St,5 `...SC. R,. 'A' `3p New dwelling area: square feet City /State /ZIP: i-6 Sic` OZ. '\'i-.2-1. Garage /carport area: square feet Suite/bldg. /apt. no.: `"? b Project name: a g_ M ez ,L-/ Covered porch area: square feet Cross street/directions to job site: 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. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the 1l DESCRIPTION OF WORK 1 work indicated on this application. J2 KC- Ssec t,ov.. St CS J.. K\ \t \ 1 {� Valuation: $ `\ C 8 e' 4) .e.x .°t �o C a1 al 4 Ca�a �-,- Existing building area: s feet eko )T.4 r. c?- _ New building area: square feet ❑ PROPERTY OWNER TENANT Number of stories: Name: (•\QTA. Coti Jo-..G.—. Type of construction: Address: ` pS' - q-c - s C,t14_ ft,A. tc- Occupancy groups: City /State /ZIP: i c t.� _ 4 \ e 724 Existing: Phone: (Se)) 2��' OR Fax: ( ) New: ❑ APPLICANT %CONTACT PERSON NOTICE Business name: C_,4,-e� ..e.,. �L r All contractors and subcontractors are required to be Contact name. S �,St-.. licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( o ) '-\5F, LcRcc Fax::( ) E -mail: CONTRACTOR Business name: 0 e. y0 ILO J � ` BUILDING PERMIT FEES* Address: 1" 3 (Please refer to fee schedule) City /State /ZIP: Structural plan review fee (or deposit): 5 ga FLS plan review fee (if applicable): elar. Phone: ( ) Fax:( ) CCB lie.: Total fees due upon application: L ( Amount received: (64 p� . 9� Authorized signature: / \( L I ' l i( - This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ` Print name: S �q J.it. CS c& \-- Date: * Fee methodology set by Tri- County Building Industry Service Board I•\ Building \Permits\SIT- PetmitApp doe 06/26/06 440- 4613T(I I /02 /COM/WEB) • >W )i 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 applican t must apply for a sensitive lands review (SLR): • Please complete all items below, unless otherwise noted. Excavation Volume: • - 3 e cu. yds. . Grading Volume: _ (Soils report required for >5,000 cu. yds.) cu. yds-. - Fill Volume: • (Fill exceeding 12" in depth shall be ' V ' 4 =`-' . • ,, ' _ • _ compacted to 90 %.of maximum density) '.• - 20 0 . cu.Vds: ' ,Retaining structure? (Check one) ❑ Rock '. • V • s . • , ' ❑ CMU Concrete : V V ❑ Other: ' V - *Total new impervious area including all V - ' V buildings, sidewalks, - and paving: - • sq. ft. Site Utilities Plumbing Work: - • - _ Complete 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 ❑ *Parking (including ADA) and ADA compliance Lighting Plan - , a , i ,. • • • I ❑ Grading Plan and details a , ® . *Landscaping Plan - , , , ❑ Erosion Control Plan and details • ❑ Soils Report (if required) ; ,_ ❑ Retaining Structures ` -� *Does not apply to One -_and Two -family dwellings. , • ' # of Plans V - TYPE OF SUBMITTAL Required at . (Includes New, Additions or Alterations) Submittal Commercial . " 2. • . ` . - Multi - Family R -1 Occupancy 2 ti One- & Two - Family Dwelling - 2 , - � , y 1 \ Building \Permits\SIT- PermitApp.doc ,06/26/06 2- ' " ', • *, , .\ . . . , CITY OF TIGARD • BUILDING DIVISION PERMIT #: SIT2CO7 -00013 13125'SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/27/7007 Phone: (503) 639 -4171 �,. ' Inspection Requests (24 Hrs.): (503) 639-4175 • INSPECTION WORKSHEET FOR DATE: 4/30!01)6 TIME: 7:06AM PAGE: 16 • SITE ADDRESS: 10`x75 S, r� CASCADE AVE 130 , CLASS OF WORK: SUBDIVISION: CASCADE Ul)SINE` CENTER LOT #: TYPE OF USE: PROJECT NAME: E +EMCOW " DESCRIPTION: Ad:1itil)n t E, 3'I? sq it to �: sting an iI<tin� . OWNER: FHEi1iS'.flJ TECHNOLOGIES, PHONE #: r03 - 4&t CONTRACTOR: COFFMAN E "M AVA LION LLB: PHONE #: 03 55 `r 7000 V Inspection Request Scheduled For: Date: ij3W2CO3 Pour Time: - Code # Inspection Description - Confirm #, Contact # Mess - 499 Final in::pecti:RI - mon-02 F.63-62:1/2-B802 f5(3:7 Corrections /Comments/ Instructions: • • • • • • • • • • ! PARTIAL APPROVAL • ❑ CANCEL - ❑ NO ACCESS '' • FAIL CALL FOR "INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: D Phone #: (503) 718 - �