Permit a CITY OF TIGARD SITE WORK PERMIT
•.. • COMMUNITY DEVELOPMENT Permit#: SIT2013-00021
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2013
Parcel: 25101 BCO2401
Jurisdiction: Tigard
Site address: 12650 SW HALL BLVD
Project: Snyder Roofing Subdivision: TIGARDIA TERRACE Lot: 3
Project Description: Modifications to parking lot,install new fire supply line.
Contractor: PRECISION CONSTRUCTION COMPANY Owner: JFK PROPERTIES OREGON LLC
8025 NE KILLINGSWORTH ST 12650 SW HALL BLVD
PORTLAND,OR 97218 TIGARD,OR 97223
PHONE: 503-253-4827 PHONE:
FAX: 503-253-5177
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 08/22/2013 $567.32
Plan Review 08/22/2013 $368.76
Type of Use: COM 12%State Surcharge-Building 08/22/2013 $68.08
Class of Work: ALT Erosion Control w/Permit-Eng 08/22/2013 $150.00
Project Valuation: $55,000.00
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Soil Report Required:
Paving: Grading:
Landscaping: Yes Site Prep:
Storn Drains: Retaining Wall:
Fire Underground: Yes Accessible Parking: Yes
Fence:
Total $1,154.16
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 yo o • •w the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 -0090. You may obt.•• - opy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' -- .. •gnature:
Call 503.; • by 7:00 a.m.for the next available inspection d e.
This permit card shall be kept in a conspicuous place on the job site until comp •tion •'th • • t.
Approved plans are required on the job site at the time of each inspection.
t
4 ,.Building Permit Application
Site Work FOR OFFICE USE ONLY
City of Tigard • RECEIVED Received
Date/By: 7 3r /3 A Permit No.:'5!7—,2/44/3-Oa)a/
• q 13125 SW Hall Blvd.,Tigard,OR 97223 Il ll 0 2013 Plan Review / �S
D Other Permit: ,�,
_ _ Phone: 503.718.2439 Fax: 503.598.19 Date/By: `� �Jt.t/�o�0�3'DD�
l I L.n It a Inspection Line: 503.639.4175 CITY OF TIGARD Date ReadyBy: p/�� tcri g: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Q I Supplemental Information
BUILDING DIVISION
TYPE OF WORK . REQUIRED DATA:1- -
AND 2-FAMILY DWELLING
❑New construction KDemolition 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: I'2h co c 1,4 HALL f71-1/17, New dwelling area: square feet
City/State/ZIP: fl6,6tRp D R. Garage/carport area: square feet
Suite/bldg./apt.no.: 1 Project name: I4.,/n(r Q Q DDp I t1 Covered porch area: square feet
Cross street/directions to job site: 11'✓I� r r Deck area: square feet
So v'rH or I i-trElz5 E.6-rintJ (# PAIL 't Other structure area: square feet
HV IJ-z-i IL jI2-. _ 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
DESCRIPTION OF-WORK work indicated on this application.
R i u ei o f d 16-ri & I�I t _I o I� �17 4 Valuation: $ q• o/�
.w r-
MOD I F I TIQ`1"I D s I-rG Existing building area square feet
7 C� New building area: square feet C
Z'PROPERTY OWNER ❑ TENANT Number of stories: ,2
Name: SN DEf1 BFI i & Gi
o Type of construction:
J
Address: 045-0 6 vi HALL f 7 ,\l D, Occupancy groups: 5 / 1 - I
City/State/ZIP: �I6A17~ I D ( oQ�' 9,
Existing:
Phone:( ) fFax:( ) New:
rek APPLICANT . ❑ CONTACT PERSON - NOTICE
Business name: CAMI X11 0� g p 0-2 H��� Lu, All contractors and subcontractors are required to be
Contact name: 'h'f`' i--, g Y licensed with the Oregon Construction Contractors Board
j? 1 I under ORS 701 and may be required to be licensed in the
Address: 1/,36)5. c v I o N S� jurisdiction in which work is being performed.If the
City/State/ IP: o D) AFL,
applicant is exempt from licensing,the following reasons
I— apply:
Phone:(5.03) 514- RQ 16,�t Fax: :( )
E-mail: c4I - IIu 0f tw ll IPA+ £ Orr!
CONTRACTOR
•
Business name: 61061i,1 BUILDING PERMIT FEES*
Address:
11015 N e, 1CII.L1rib5 vlo1TH Si review feeferr deeosit):le)
City/State/ZIP: pal-LA KI D, OP, (91 4-I B
Structural plan review fee(or deposit):
ss�� I nn a F` 1 FLS plan review fee(if applicable):
Phone:(‘03 '4.c 3-4 8 21 Fax:( )
CCB lie.: t e Q ep tl Li. Total fees due upon application:
I Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
A......y.------,a
within 180 days after it has been accepted as complete.
Print name: GAM�Q 7 V°'f-L Date: �I al - I.$ * Fee methodology set by Tri-County Building Industry
' N t `l )/ 1 I Service Board.
1:\Building\Permits\SIT-PermitApp.doc 10/01/09 440-4613T(11/02/COM/WEB)
l
1
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: cu.yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90%of maximum density) cu.yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks,and paving: 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 ❑ 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-1 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.
1:\Building\Permits\S1T-PermitApp.doc 05/25/2012 2
Building Division
Development Code Provision Review
T l G ARD Commercial Projects - No Associated Land Use Case
Building Permit N,Q: 17-9.0 t' —COO°1-/ ❑ Expedited Review
Project Name: d1.. ■/ tD 2
Site Address: I -w I -t_t_ 4l.Jj , Suite/Bldg #:
Plans Routed: l
Original Plan Submittal Date: ( 1 ) Routed By: C--- -9Q-J
1st Revision Submittal Date: Routed By:
2nd Revision Submittal Date: Routed By:
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 at (503) 718-2 VOor AAP @tigard-or.gov)
Proposal: t
ev xi' r.,e , I 6/ 41;e a)m✓l c
Zoning
Permitted Use Yes No ❑ /,
Land Use Required: Yes ❑ No ' F4 ',"" 7
� �
Notes: ,.iii�:.,�„ /
�,�.,.�. ■ -
r
Ili A roved Not Approved ❑ DCPR Not Required—No DCPR Fees Due
PP Pj� ` � q
Date Routed to Building: g— Co 5
I:\CURPLN\Masters\Development Code Provision RevieskDCPR_COM_NoLandUse.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
12650 SW HALL BLVD, TIGARD, OR, 97223
Commercial - Site Work
499 Final inspection
2014-03-18 00:00:00
SIT2013-00021
PASS - No C of O
Violation Summary:
Inspector Contractor