Permit CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit#: SIT2013-00024
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/23/2013
Parcel: 2S 101 AC00800
Jurisdiction: Tigard
Site address: 7148 SW GONZAGA ST
Project: The Adrienne Subdivision: BEVELAND NO.2 Lot: 14
Project Description: Site work for new 10,900 square foot mixed-use building(2,600 ground floor commercial and 8 residential units-
8,300 square feet).
Contractor: CENTREX CONSTRUCTION INC Owner: ROGERS, ROY R
8250 SW HUNZIKER RD 13690 SW TWELVE OAKS CT
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503-684-0443 PHONE:
FAX: 503-620-6692
FEES
Description Date Amount
Specifics; Permit Fee-Site Work 10/23/2013 $899.22
Plan Review 09/09/2013 $584.49
Type of Use: COM 12%State Surcharge-Building 10/23/2013 $107.91
Class of Work: NEW Plan Review-Fire Life Safety 10/23/2013 $359.69
J $120,000.00 Erosion Control w/Permit-Eng 10/23/2013 $225.00
Project Valuation: Info Process/Archiving-Lg$2.00(over 10/23/2013 $38.00
11x17)
Info Process/Archiving-Sm$0.50(up to 10/23/2013 $7.50
Site Specifics: 11x17)
Excavation Volume: 921 cu.yd.
Fill Volume: 3 cu.yd.
Impervious Surface: 13107 sq.ft.
Engineered Fill: No Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Yes Retaining Wall: Yes
Fire Underground: Yes Accessible Parking: Yes
Fence:
Total $2,221.81
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
issuance, or i • • • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N. cation Cent . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-01.0. You may obain a copy of the rules
or dir- questions to OU b a ling 503.232.1987 or 1.800.332.2344. f /\
Iss ed By: giro UR1 i C Permittee Signature: /1 ` U
J"[
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.
, 111111
Building Permit Application
►� ot oce usSite Work run ONLY.
MillCity of Tigard "3 DateiB : 5 .� Permit No.:p),r, a j-c00,2
r 13125 SW Hall Blvd.,Tigard,OR 97223 Review ►
Phone: 503.718.2439 Fax: 503.598.1960 CJEQ , 1...1 ie/B : t`3 /w',Er Other Permit: /2,::9Oi j'lJLZ'a0?
Inspection Line: 503.639.4175 PP t/ci�.Ready/By. lugs:
TIGARD, °�V `m, SeePage2for
Internet: ww w.tigard-or.gov 10 •• ified/Method: Supplemental Information
-
TYPE OF,W ORK4 }" REQUIRL[)DATA:1=AND 2=FAMILY DWELLING:_-.
®New construction ❑Demolition Permit fees'arc based on the value of the work perfonned.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
:1=_-_''''::„,_17:_ ._. . . .-_ CATEGORY, ii.CONSTRUCTION- _ - L 7,1 work indicated on this application.
❑ I-and 2-family dwelling ®Commnercial/industrial Valuation: S
❑Accessory building ®Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
; '.JOB SITE INI?OR,\IATION-AND;I OCAT ION - -iTt Total number of floors:
1 Job site address:71,18 SW Gonzaga St New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
�!”` Suite/bldg./apt.no.: Project name:The Adrienne Covered porch area: square feet
N?' Cross street/directions to job site:SW Gonzaga St between SW 72od Deck area: square feet
Ave and SW 69th Ave.
Other structure area: square feet
REQUIRED DATA.'COl111E[RC1AL USE CIIECKLIST
Subdivision: Lot no.:0800 Permit fees'are based on the value of the work performed.
Tax map/parcel no.:2S101AC00800 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.
Parking lot to serve mixed use building mid Valuation: 5120,000
associated utilities. Existing building area: 0 square feet
New building area: square feet
®;7'ROPERTI'�_OWNER , _ _ ❑ TENANT:: ._ - Number of stories: 3
Name: P�.0( R q S CO y� Type of construction:
Address: / S� 'i � Ave, 1 Occupancy groups:
City/State/ZIP: '( a.4 ( o . g72Z3 Existing:
Phone:(5b3) 6 z_Doss. Fax:( ) New
❑APPLICANT _ - _. _- ® CONTACT PERSON
-- - _ _ =NO•r1cE - _
Business name:Cardno All contractors and subcontractors are required to be ..
Contact name:Seth Gage' licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:5415 SW Westgate Dr.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:seth.garcyt_n`•enrdno.com
_ . CONTRACTOR
Business name:Centres Construction Inc. - ,'- BUILDING PERl1IT FEES•;.=.
Address:8250 SW Aunziker Rd : - '(Pleasereferto fee schedirleej .,
Structural plan review fee(or deposit):
City/State/ZIP:Tigard,Oregon,97223
FLS plan review fee(if applicable):
Phone:(503)684 0443 I Fax:(503)620 6692
CCB tic.:56358
Total fees due upon application:
' 4 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: �St9.�s.5tr... Date: .113e//' ! Fee methodology set by Tri•County Building industry
Service Board.
1:\Building\PermitslS1T-PemritApp.doc 10/01/09 440-4613T(I1/02/COM/WEB)
City of Tigard: Site Work Permit Checklist
Page 2-Supplemental Lnfornmation
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 structre, 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: 921 cu.yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) 921 cu.yds.
Fill Volume:
(Fill exceeding 12" in depth shall be compacted to
90%of maximum density) 3 cu. yds.
Retaining structre? (Check one) ❑ Rock
❑ CMU
❑ Concrete
® Other: Landscape Block
*Total new impervious area including all buildings,
sidewalks,and paving: 13,107 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,
(New,Additions.or Required at- $.00 to$500.00 $51.09 minimum permit fee
Alterations) Subm ittal . . $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 S50,000.00 $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
S 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.
l:1 Building\Pemuts\SIT-PermitApp.doc 05/25/2012 2
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
a Transmittal Letter
T I.G n R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: /0aA/ DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
9 2013
FROM: 5e7- X2-ex CITY OFTIGARD
COMPANY: (mot r-/�p (,v2 J BUILDING DIVISION
By: �l.F
PHONE: 503_ `irq(
RE: '7( 6civ =
(Site Address) 'ermit 'urn i er
•
(Project name 74-4 or subdivision isid lot number) C��/ �_�OOa�
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 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 U E ONLY
Routed to Permit Technician: Date: 0 I 2-3 1 v3 lnitials:� �
Fees Due: ❑ Yes 0' 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
Building Division
0
r
Development Code Provision'Review
T 1 cA R p Commercial Projects - With Approved Land Use .
Building Permit No.: 1,T (9-012-D-660,9,4-
Land Use Case File No.: -DOC J�F
Project Name:
Site Address: ei , Suite/Bldg #:
Plans Routed:
Original Plan Submittal Date: _ 9h/3 Routed By: C
1" Revision Submittal Date: - M/3/ 13 Routed By: ,b-
2"d Revision Submittal Date: 10631/3 Routed By: `1)--
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 (✓) 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 t • • items on the left side that are approved.
Planning Review (contact itwlr_ I Ct. at (503) 718-2421 or G { e& @tigard-
or..�govv)
LW -04=0014 u
g4 and Use Approval Spp 2O 13
O Building Plans Match Approved Plan: Yes ❑ No ❑
E -Maximum Building Height 4 St
❑ Conditions Met
•
1.1Y Street Trees
El Protected Trees v •Li--(j /0..7 ./
Notes: COM t s no - 1'Yl� ' �t �4 1 1f� t�1't l/ J_ ' .Ple
Original Plan: Approved ❑ Not Approved Date: 13
Revision 1: Approved ❑ Not Approved 2r Date: �0 / /3
•
Revision 2: Approved- - Not Approved ❑ Date: l / 3//3
'N'N) ,
(Review Continues on Page 2)
Page 1 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR COM WithlandUse.doc Rev.01/16/13
Engineering Review(contact Mike White at(503) 718-2464 or Mike\V @tigard-or.gov)
. "Actual Slope: Co Yo
❑ PFI Permit# 24'11„.-arra 39
❑ Conditions Met
Notes: A fb•s 0"reea—S i-5-477 ea(. ifilOafiti/tt- (<d...- r77tn..%)
#5 '2.2" 2'-yL i i �1 Orj
Original Plan: Approved ❑ Not Approved IA Date: • 3— 1
Revision 1: Approved ' Not Approved ❑ Date: es 01W I .t%
Revision 2: Approv ❑ 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 Oka to Issue P9rmi
Notes: (4'-; L S O �.-- arp01.4.a�\Q`
i
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes No ( (d/3 l 3
Date Routed to Building: wif.........,„./
/ 23 /
Page 2 of 2
I:\CURPLN\Masters\Development Code Provision Review\DCPR_COM_WithLandUse.doc Rev.01/16/13
TRANSMITTAL WRG CaRrdno
Shaping the Future
To: City of Tigard Date: Oct. 8, 2013
13125 SW Hall Blvd Project: _ The Adrienne 5415 SW Westgate Drive
Suite 100
Tigard, OR 97223 Project#: 21302390 Portland,Oregon 97221
44-4-14: A l tot/4-4- S 1 eti4k Case/File#: USA
Phone (503)419.2500
Fax#: Total Pages: Fax (503)419-2600
From: Seth GaRey
www.cardnowrg.com
Transmitting Via: Purpose:
Messenger ® For your review and comment O
❑ Other: ❑ Other: i
DELIVERY SERVICE,INC.
Quantity Description 124, 3
5 Full-size Off-Site plan sets
5 Full-size On-Site plan sets
1 Urban Forestry Plan Report
Comments:
Attached are the above items for your review of the site work for The Adrienne. Please
let me know of any questions.
Thank you
c.a.).Avrfr.-
Signature:
C:
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United Arab Emirates • United Kingdom • United States • Operations in 60 Countries
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7148 SW GONZAGA ST, TIGARD, OR, 97223
Commercial - Site Work
499 Final inspection
PASS - No C of O
January 22, 2015 at 2:27:45
PM
SIT2013-00024
Chip Barnett
Violation Summary:
Inspector Contractor