Permit CITY OF TIGARD SITE WORK PERMIT
III e ,, , COMMUNITY DEVELOPMENT Permit#: SIT2013-00018
T[G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2013
Parcel: 2S112AD00700
Jurisdiction: Tigard
Site address: 14830 SW 72ND AVE
Project: Pioneer Waterproofing Subdivision: BONITA GARDENS Lot: 4
Project Description: Parking lot modifications, restriping including ADA stalls
Contractor: FINE LINE CONCRETE CUTTING INC Owner: UNION CENTRAL LIFE
PO BOX 66742 TREASURY SERVICES
PORTLAND, OR 97290 ATTN: DIANE THOMAS
PO BOX 888
CINCINNATI,OH 45240
PHONE: 503-793-1506 PHONE:
FAX: 503-465-9368
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 08/15/2013 $231.32
Plan Review 08/15/2013 $150.36
Type of Use: COM 12%State Surcharge-Building 08/15/2013 $27.76
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 08/15/2013 $2.00
11x17)
Project Valuation: $15,000.00
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
•
Engineered Fill: Soil Report Required: No •
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall:
Fire Underground: Accessible Parking:
Fence:
Total $411.44
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 ' ca ion =uter. 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 questions to OU` b -_ ' g 503.232.1987 or 1.800.332.2344.
Iss d By: #, 00_ 4.dmitiL,, Permittee Signature:
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 ` I D FOR OFFICE USE ONLY
ii��ll���� Received MOM. 6v D��
City of Tigard Permit No.: J
Date/B / /A/
'1 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 2 2 2013 flan Revie v r\
Phone: 503.718.2439 Fax: 503.598.1960 pa1e/B I.a ao j— M Other Permit: ►yly 0,9013 o / ,
TIGARD Inspection Line: 503.639.4175 CITYO�''nGA .D Date Ready/i turfs: S See Page 2 for
Internet: www.tigard-or.gov CITY Notified/Mthod 2 � Supplemental Information
BUILDING DNISION —,�j,•�; . ,�ri fig
sli TYPE OF WORK REQUIRED 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
i 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 '�Contntercial/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: ILL&30 ct -72fra Aoa... New dwelling area: square feet
City/Slate/ZIP: 'fi�h� + OIZ. 97ZZN Garage/carport area: square feet
Suite/bldg./apt. no.: 7 Project name:!opg ' . IJ Qn�LapAll Covered porch area: square feet
C6 Cross street/directions to job site: ( Deck area: square feet
4-_, 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.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
�7 1 / DESCRIPTION OF WORK work indicated on this application. l
�� z• plAca 1 y.pcwn De;orpAy Pppoo�l,,��s Valuation: $ �S OO
�Jr24.) SI0F CA1 K Existing building area: square feet
New building area: square feet
1.
a PROPERTY OWNER Xr TENANT Number of stories:
Name: `z r--F0 W Z�Oh1 CO, Type of construction:
Q Address: 1 t Gt SW 7Agin,
Occupancy groups:
City/State/ZIP: ( Fie r 02, 17z2 L/ Existing:
Phone:(9)7) Z3i-107.-.1 Fax:(5-03) z3'/—%77/7 New:
1 5 APPLICANT ❑ CONTACT PERSON
\ f /- NOTICE
h Business name: '?i jj�� wA..yry� �iam/j A. All contractors and subcontractors are required to be
4 Contact name: th`ekp.6.! L%k�►G�'a licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: itig7p SJ,J WI-0 la m. jurisdiction in which work is being performed. If the
City/State/ZIP:-.714,14442/9, o2, 972Z1t /L
applicant pp is exempt from licensing,the following reasons
"k9 Phone:(s�3)Z3 10Zv Fax: :(V03)2,34-6/703
2 /'�
E-mail: At,ri12,44) �(2D�l ohSrz l w p•COM-
CONTRACTOR
Business name: FiNrL Ljj epp,(,e/i . GNn 1 II' -• BUILDING PERMIT FEES*
(Please refer to fee schedule
,,• Address: P.O.�K (667417- J
J City/State/ZIP: p�A)A P . ej7Z90 Structural plan review fee(or deposit):
v -
Phone:(I3•=79;71S-0 ' Fax:(s-r3 )y- 93 8 FLS plan review fee(if applicable):
• CCB lic.: 60/11 a/, f, Total fees due upon application:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
7/Z;�/; within 180 days after it has been accepted as complete.
Print name:�1Z ^y) Ww(!j/J Date: * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\SIT-PennitApp.doe 10/01/09 440-4613T(I t/02/COM/WEB)
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
IN a " Transmittal Letter
T I G n R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DATE RECEIVED:
DEPT: ING DIVISION RECEIVED
FROM: RA. 6G.,. 304,,, fli) AUG 6 2013
COMPANY: PI '- & CITY OFTIG�
f���� BUILDING DIVISION
PHONE: SCJ3 2.1 - 20,0 BY
RE: IetS50 6Lit 79 /vE., ITc901 —000Lg
Site Address) (Permit Number)
\O €/. - -r-f2 koo�, ,.J =7
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: I Description:
Additional set(s)of plans. 3 Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑No Fee Description: _ Amount Due:
$
$
_ $
$
Special
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No • _ ❑ Done
Applicant Notified: Date: Initials:
1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
. ,
lig " Building Division
Development Code Provision Review
T I G A ii D Commercial Projects - With Approved Land Use
Buildin g Permit No.: e r T, o / - ono / g
Land Use Case FilNo.: HD (9013 — DOo/ �p
Project Name: V-'t o i /2- Lotet-T&/L PaaoFf t
Site Address: t q8 ? 709■ 40E- • , Suite/Bldg #:
Plans Routed:
Original Plan Submittal Date: 1 �2' r 3 Routed By:
1St Revision Submittal Datc: ri �P//3 Routed B :
2nd Revision Submittal Date: Routed By:
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 (1) 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 3 /
0Art ' '71 at(503) 718- x71111 9 or 10iot/ @tigard-
or.gov) V
Land Use Approval
Building Plans Match Approved Plan: Yes ❑ No
❑ Maximum Building Height
❑ Conditions Met
❑ Street Trees
❑ Protected Trees
0e 4 ' ?ha*, c ophe/ p/e+i pi.K 1)/ *lit l L
lfp t Notes:
paws*** re vvi
Original Plan: Approved ❑ Not Approved Er Date: -SO-ii
Revision 1: Approved Not Approved ❑ Date: via`45
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
1:\CURPLN\Masters\Development Code Provision Review\DCPR_COM_WithLandUse.doc Rev.01/16/13
Engineering Review(contact Mike White at(503) 718-2464 or MikeW @tigard-or.gov)
co
2(Actual Slope: ' `4r ct °A)
❑ PFI Permit#
❑ Conditions Met
Notes:
Original Plan: Approved 2 Not Approved ❑ Date: 7/22 1/)
E1 3
Revision 1: Approved, Not Approved ❑ Date: 6 /MLt
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: ei44 0 e
(
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant X
Okay to Issue Permit: Yes No Date Routed to Building.
-6/
•
•a `
Page 2 of 2
I:\CURPLN\Masters\Development Code Provision Reviev►4DCPR_COM_WithLandUse.doc Rev.01/16/13
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14830 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Site Work
499 Final inspection
2013-10-22 00:00:00
SIT2013-00018
FAIL
Planning and Engineering conditions not met at this time.
Not Ready
Violation Summary:
Inspector Contractor