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Permit
CITY OF TIGARD SITE WORK PERMIT 111111- 11 COMMUNITY DEVELOPMENT Permit#: SIT2013 00023 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2013 Parcel: 2S102BA01201 Jurisdiction: TIGARD Site address: NO ADDRESS Project: Fanno Creek Trail-Main to Grant Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 53 Project Description: Site grading,excavation&embankment. Install concrete trail and retaining wall. Contractor: GREG SCHROEDER ENTERPRISES INC Owner: TIGARD, CITY OF 9812 SE WICHITA AVE 13125 SW HALL MILWAUKIE, OR 97222 TIGARD, OR 97223 PHONE: 503-654-4734 PHONE: 503-639-4171 FAX: 503-652-2333 FEES Description Date Amount Specifics: Permit Fee-Site Work 08/20/2013 $1,042.90 Plan Review 08/20/2013 $677.89 Type of Use: COM 12%State Surcharge-Building 08/20/2013 $125.15 Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 08/20/2013 $23.00 11x17) Project Valuation: $151,179.00 Site Specifics: Excavation Volume: 775 cu.yd. Fill Volume: 260 cu.yd. Impervious Surface: 8292 sq.ft. Engineered Fill: Soil Report Required: Yes Paving: Grading: Landscaping: Yes Site Prep: Storn Drains: Retaining Wall: Yes Fire Underground: Accessible Parking: Fence: Total $1,868.94 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 Notification Center. 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 OUNC ailing 503.232.1987 or 1.800.332.2344. Issued By: xr Permittee Signature: � �(( ,l/`t 0- )3il/l/1ti+ 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. .. r Building Permit Application RECEIVED Site Work Received ©/mg� 0l-r c)13.000.3 City of Tigard DateB : /`�i �, Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 AUG 5 2013 ' :n •eview -""'"IOL C Phone: 503.718.2439 Fax: 503.598.1960 Date13 : AMEN., Other Permit: (_IZ aoa"$0400 T I G A It I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready By: turfs: ® See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION Supplemental Information 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. ID 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ ❑Accessory building ❑ Multi-family Number of bedrooms: ❑Master builder ®Other.City Trail Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:city owned properties New dwelling area: square feet CitylState/ZIP:Tigard,OR.97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Fanno Crk Tr!:Main-Grant Covered porch area: square feet Cross street/directions to job site:Adj.to Grant Ave near Fanno Crk bridge Deck area: square feet Trail head near Tigard Cycle&Ski(12549 SW Main St) Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.:(2S102BA01201,2S102 BA 014 01 /Z3 I Ot AC,op$CA equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK ZS i bZ8 01500 work indicated on this application. Pouring an 8'-10'wide concrete trail with gravel shoulders,site grading Valuation: $151,179 excavation and embankment,storm drainage installation,retaining wall install, Existing building area: square feet enhancement of vegetated corridor New building area: square feet ® PROPERTY OWNER ❑ TENANT Number of stories: Name:City of Tigard Type of construction: Address: 13125 SW Hall Blvd Occupancy groups: City/State/ZIP:Tigard,OR 97223 Existing: Phone:(503)718-2466 Fax:( ) New: Trail Imprvmts ® APPLICANT ❑ CONTACT PERSON NOTICE Business name:City of Tigard All contractors and subcontractors are required to be Contact name:Jeff Peck licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 13125 SW Hall Blvd jurisdiction in which work is being performed.If the City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons apply: Phone:(503)718-2466 Fax::( ) E-mail:jeffp®tigard-or.gov CONTRACTOR Business name:Greg Schroeder Enterprises,Inc. BUILDING PERMIT FEES* Address:9812 S.E.Wichita Ave. (Please refer to fee schedule) City/State/ZIP:Milwaukie,OR.97222 Structural plan review fee(or deposit): Phone:(503)654-4734 Fax:(56S ) 69 G-2_ ,.3 3 3 FLS plan review fee(if applicable): Total fees due upon application: CCB lie.:99793 Cr /(o 7 Amount received: --- Authorized signatures r-- -.N_ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: '-'6r S o,vr e„,.... Date: 7--3/- /3 * Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits'SIT-PermitApp.doc 10/01/09 440-4613T(11,02.'COM/WEB) • 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: 775 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) 260 cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ® Other: Gravity Block *Total new impervious area including all buildings, sidewalks,and paving: 8,292 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. I:\Building\Permits\SIT-PermitApp.doc 05/25/2012 2 I Building Division Development Code Provision Review T I G A R D Commercial Projects - With Approved Land Use Buildin g Permit No.: <7--. 0 / 3-000 -5 Land Use Case File No.: 6 LP- D-o l.Q- OOOO / Project Name: rA,J NV) L12f E j 2i}I L - M'} 1,3 Ti, Coii jr Site Address: (Jo 4i i 2._css (Pc. _s Zs c) .-6+ o laoil , Suite/Bldg #: 51o24A ol'!ol 1 94Lv2.PraocKo0 w D.410 2. O/S6 6 Plans Routed: Original Plan Submittal Date: ) ,-3")) 5 Routed By: (`r2 1St Revision Submittal Date: Routed By: 2°d 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 Cher1j I C(2--;'le-1 at(503) 718- x 431 or "e'''l 1` @tigard- or.gov) Cii( Land Use Approval X Building Plans Match Approved Plan: Yes 11,4 No ❑ ❑ Maximum Building Height N//a B Conditions Met ❑ Street Trees N/f{ yi Protected Trees Notes: Original Plan: Approved g Not Approved ❑ Date: '- 13 — 13 Revision 1: Approved Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 I:\CURPLN\Masters\Development Code Provision RevieWDCPR_COM_WithLandUse.doc Rev.01/16/13 Engineering Review(contact Mike White at(503)718-2464 or MikeW @ tigard-or.gov) ,0r Actual Slope: v A111 C1' % ❑ PFI Permit# ❑ Conditions Met Notes: Original Plan: Approved.0r Not Approved ❑ . Date: Revision 1: Approved ❑ 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 '4 No ❑ Date Routed to Building: "Tr Page 2 of 2 1:\CURPLN\Masters\Development Code Provision Review\DCPR_COM_WithLandUse.doc Rev.01/16/13