Permit q CITY OF TIGARD SITE WORK PERMIT
I a .. COMMUNITY DEVELOPMENT Permit #: SIT2013 -00003
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/05/2013
Parcel: 2S113B000300
' Jurisdiction: Tigard
Site address: 8040 SW DURHAM RD
Project: Durham Center Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Demo 3'x57' portion of damaged aspalt pad and replace with 10'x57' of new aspalt pad.
Contractor: S2 CONTRACTORS INC Owner: TIGARD - TUALATIN SCHOOL DISTRICT
6860 S ANDERSON RD 6960 SW SANDBURG ST
AURORA, OR 97002 TIGARD, OR 97223
PHONE: 503 -651 -4000 PHONE: 503 - 431 -4000
FAX: 503 - 651 -4004
FEES
Description Date Amount
Specifics: Permit Fee - Site Work 02/05/2013 $177.52
Plan Review 02/05/2013 $115.39
Type of Use: COM 12% State Surcharge - Building 02/05/2013 $21.30
Class of Work: ALT Info Process /Archiving - Lg $2.00 (over 02/05/2013 $2.00
11x17)
Project Valuation: $10,000.00 Erosion Control w /Permit - Ping 02/05/2013 $75.00
DC Provision Review, COM TI - Ping 02/05/2013 $67.00
DC Provision Review, COM TI - LRP 02/05/2013 $10.00
Site Specifics:
Excavation Volume: 8.53 cu. yd.
Fill Volume: 8.53 cu. yd.
Impervious Surface: 399 sq. ft.
Engineered Fill: Soil Report Required:
Paving: Grading:
Landscaping: Site Prep:
Storn Drains: Retaining Wall:
Fire Underground: Accessible Parking:
Fence:
Total $468.21
Required Items and Reports (Conditions)
1 Ersn Cntrl 503 - 639 -4175
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
issu , or if w• • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Ut' Notification Cen = . • .s.. rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
calling : or 1.800.332.2344.
o direct questi.ns to OUN b .alli. .232.1987 o
sued By: a 000: „ 1 Permittee Signature: 4
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.
• Building Permit Application'
Site Work RECEIVED FOR OFFICE USE ONLY
Receiv
City Of Tigard Date /B A 5 /9 . / Permit Nos ria3 j
1, . 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ► s+/�
Phone: 503.718.2439 Fax: 503.598.1960 FEB . 5 2013 Date /By: CI i w . Z Other Permit:
TIGARD Inspection Line: 503.639 Date Ready /B : Juris: @ See Page 2 for
Internet: www.tigard - or.gov CITY OFTIGARD Notified/Method: Supplemental Information
. BUILDING DIVISION
TYPE OF WORK 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:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 8040 SW Durham Rd. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97224 Garage /carport area: square feet
• Suite/bldg. /apt. no.: Project name: Durham Center AC Extensio Covered porch area: square feet
Cross street/directions to job site: SW 79 Ave. Deck area: ' square feet
Other structure area: square feet
. REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 21 S1 W 13NW Lot no.: 300 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S113B000300 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.
Demo 'of 3'x57' portion of damaged asphalt pad, and replace with 10'x57' of new Valuation: $$10,000.00
asphalt pad. New impervious area of 399 square feet. Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Tigard- Tualatin School District . Type of construction:
Address: 6960 SW Sandburg Rd. Occupancy groups:
City /State /ZIP: Tualatin, OR 97223 Existing:
Phone: (503)431 -4000 Fax: (503)431 -4020 New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
• • .Business name: Cardno All contractors and subcontractors are required to be
Contact name: Russell Montgomery licensed with the Oregon Construction - Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5145 SW Westgate Drive, Suite 100 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97221 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 419 -2500 Fax: : (503) 419 -2600
E -mail: russell.montgomery@yahoo.com
CONTRACTOR
Business name: S -2 Contractors Inc. BUILDING PERMIT FEES*
Address: 6860 S Anderson Rd. {Please refer to fee sclrer /rrle
City /State /ZIP: Aurora, OR 97002 Structural plan review fee (or deposit):
Phone: (503) 651 -4000 Fax: (503) 651 -4004 FLS plan review fee (if applicable):
CCB lic.: 67253 w// /, 5 Total fees due upon application: . .
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Russell Montgomery Date: 2/5/13 *
Fee methodology set by Tri- County Building Industry
Service Board.
l:\ Building \Permits\SIT- PermitApp.doc 10 /01/09 440- 4613T(11 /02 /COM/WEB) •
a .
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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 Toads), 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 items below, unless otherwise noted.
Excavation: Volume: • 8.53 cu. yds.
•Grading Volume:
(Soils report required for >5,000 cu. yds.) 0 cu. yds.
Fill Volume:
(Fill exceeding in depth shall be compacted to
90°A of maximum density) 8.53 cu. yds.
Retaining structure? (Check one) ❑ Rock
• ❑ CMU •
❑ Concrete
•
• ❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: 399 sq.
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 - ❑. Fire Line
*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:
•
I:\ Building \Permits \SIT- PermitApp.doc 05/25/2012 2
Er
Site Work Permit Application
Plan Submittal Requirements
TIGARD Commercial, Multi- Family and One- & Two - Family Dwellings
•
A site work permit is required for all commercial projects including new buildings, additions,
accessory buildings larger than.120 square feet, modular structures and multi- family R -1
• occupancies. A site Work permit is required for excavation, fill, grading, paving, retaining walls,
fire hydrants and fire department access on private property for work on individual lots not
covered under the subdivision development.
Note: A separate "plumbing" permit for site utility plumbing work is required for sanitary
sewer, storm sewer and potable water systems on private property. Please see the Site
• Utilities - Plumbing Permit Application for plan submittal requirements.
1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic
location labeled with: .
A. ® map & tax lot # ® project name ® site address ❑ suite number
® zoning ® applicant name ® applicant phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads (drawn to scale) with project location.
2. BUILDING PLAN submittal requirement: Two (2) complete sets, Civil only.
All details listed below shall be incorporated into the plans:
A. Site plan showing:
1) Required parking spaces and driveways.
2) A route, accessible to persons with disability, leading from the public way to an
accessible building entrance.
3) Accessible parking spaces and adjacent access aisle connecting with the accessible
route.
4) Curb ramps along the accessible route, curb, sidewalk and gutter.
5) Finish grade elevations along the accessible route.
B. Topographic survey plan showing grade elevations crossing the entire site.
C. Overall grading plan.
D. Utilities plan showing:
• 1) Fire hydrant location and pipe size if on private property.
2) If the building is to be protected with an automatic fire sprinkler system, show
location of the water service vault and the fire department connection (FDC)
within 70 feet of a fire hydrant.
3) Size of underground water service for the sprinkler system.
E. Erosion control plan complying with the requirements of the Clean Water Services
(CWS) agency showing:
1) Silt fence locations.
2) Bio- filter bags /other approved barrier material surrounding catch basins.
1: \Building \Permits \SIT- PermitApp.doc 05/25/2012 3
•
•
3) Illustrations detailing the correct installation of the silt fencing and catch basin
protection. •
4) Any other measures to ensure compliance with CWS standards.
F. Landscaping plan.
3. ADDITIONAL REQUIREMENTS:
A. Soils (geotechnical) report. A soils report is required for new buildings and additions
to contain the following:
1) The report shall address the potential of soil liquefaction and instability (OSSC
Sec. 1804.2).
2) Fills to be used to support foundation of buildings (OSSC Sec. 3301.1).
• 3) Foundation and lateral pressures exceeding 1,500 lb. /sq. ft. (OSSC Sec. 1805).
B. Fire flow and hydrant worksheet.
C. Plan review deposit based upon project valuation.
•
•
•
•
1: \Building \Permits \SIT- PermitApp.doc 05/25/2012 4
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° Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: er,A.\ Occupancy Load: Oregon Specialty Code: 2.C.)
SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback - Left Sideyard Setback - Front
Sideyard Setback - Right Sideyard Setback - Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ FEES DUE
$ 67 cc, DC Prov Rvw, COM TI - Ping
$ 0, CIO • DC Prov Rvw, COM TI - LRP
DC Provision Review Fee for COM TI $ r , S Permit Fee - Add, Alt, Demo
Project Valuation Planning LRP $ '2( 3 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ )1.57 ° .37 Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ .3.3.-2. TOTAL FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; O'IR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \ Building \Forms \OTC - BUP.docx 07/01/2012
1111 Building Division
° Dev elopment Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
0
Building Permit No: (/ 40 l — 0 0 60 )(Expedited Review
m
Project Nae: Gl /L�-14 -/L/ 0 P ,U7le
Site Address: ga C f r) 4.J Di&t2 t-f #-'t '>- , Suite /Bldg #:
Plan Submittal Date: P--/5"/
To the Applicant:
> If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact X1 ��0 t ly !' ' at 503 -718- . 4 or @tigard- or.gov) •
Proposal: f170.04,. o oe 1 04,..4".{,11 , 140h5 1 Ms Ions off gOifil oh "'Nimes" AV ...C
Zoning -7_ A
Permitted Use Yes Zi No ❑
Land Use Required: Yes ❑ No')
Notes:
Approved ❑ Not Approved Date: / -
I: \CURPLN\Masters\Development Code Provision RevievANo Land Use Comm.doc REVISED 10/4/12