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Permit
CITY OF TIGARD SITE WORK PERMIT • COMMUNITY DEVELOPMENT Permit#: SIT2014-00013 T I G A A D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/03/2014 Parcel: 251028800700 Jurisdiction: Tigard Site address: 10355 SW WALNUT ST Project: City of Tigard Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 1 Project Description: Construction of trail and boardwalk. Permit to include erosion control. Contractor: KERR CONTRACTORS OREGON INC Owner: TIGARD,CITY OF PO BOX 1060 13125 SW HALL BLVD WOODBURN, OR 97071 TIGARD,OR 97223 PHONE: 971-216-0050 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-Site Work 07/03/2014 $1,276.38 Plan Review 07/03/2014 $829.65 Type of Use: COM 12%State Surcharge-Building 07/03/2014 $153.17 Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 07/03/2014 $4.00 11x17) Project Valuation: $203,810.00 Erosion Control w/Permit-Eng 07/03/2014 $300.00 Site Specifics: Excavation Volume: cu.yd. Fill Volume: cu.yd. Impervious Surface: sq.ft. Engineered Fill: Soil Report Required: Paving: Grading: Yes Landscaping: Yes Site Prep: Yes Storn Drains: Retaining Wall: Fire Underground: Accessible Parking: No Fence: Total $2,563.20 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, suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility tification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-)D.L4090. You may obtain a copy of the rules or d b ct questions to OUNC • - in. 51 .232.1987 or 1.800.332.2344. `/ I ued By: , Permittee Sigrture: Call 503.639.4175 by 7:00 a.m.for the next available inspec' n 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. L 4 1 Building Permit Applicatio ECEIVED Site Work FOR OFFICE USE ON L1 City of Tigard JUN 12 2014 Received _, ® _,, Permit No.: )l ,_, X013 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revi •.,er Permit: Phone: 503.718.2439 Fax: 503.59 OF TIGARD Date/B : Sj I�yl� 4�t�13� Inspection Line: 503.639.4175 Date Ready ' See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION N. r i : fo 02 l�� ®Supplemental Information TYPE OF WORK 1 REQUIRED DATA:1-AND 2-FAMILY DWELLING El/New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(minded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF com mucriat work indicated on this application. ❑1-and 2-family dwelling ❑CommerciaVmdustrial Valuation: $ ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder I O her: Number of bathrooms: JOB SUE INFORMATION AND LOCATION Total number of floors: Job site address: 103 3'5' to A,L N tr.- New dwelling area: square feet City/State/ZIP: 7 co AiLic, Garage/carport area: square feet Suite/bldgJapt.no.: I Project name: D `rQ Ay DELL Covered porch area square feet Cross street/directions to job site: J o 4.40.x d A7 ,S 7.r Deck area: square feet Other structure area: square feet 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(minded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application.j 3,gtQ Qp Valuation: $ ' '- - . — _ . _ ' Existing building area square feet • ` New building area: square feet Tie.n.I f 4- BD A-' .a w a f_K, PROPERTY OWNER,* I ❑ TENANT Number of stories: Name: Cc.4-A AJ crJ se. &Avt c,e fG,7-Y ©P 7'(0 A t4 P Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: ,» o L %i C.4., All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board � '. � 0J ;Jr.59 l� under ORS 701 and may be required to be Itensed in the Address: /- /2....c. 5 t.ta mac.L ii3.�A./O jurisdiction in which work is being performed.If the City/State/ZIP: �,� c�7 22:3 apply: is exempt from licensing,the following reasons apply: Phone:(5D3)7:9- Fax::( ) E-mail: 7e_ri(•e-rgctf■cf—or. 5 cv CONTRACTOR Business name: j5,,to eo,v7.44 c.....no Q 5 BUILDING PERMIT FEES* Address: y� /7,0„/ /© � (Please refer to fee schedule) Cityre ste/ZIVP: o �, Structural plan review fee(or deposit): �A D B v fCA.)), ©Pr 9 7 FLS plan review fee(if applicable): Phone:(e '1l) 2/G. •O O SO j,Fax:( )CCB lic.: / 4 5 l 5& /PN//'7 Total fees due upon application: Amount received: Authorized signs This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: t�L Dati5,/d * Fee methodology set by Tri-County Building Industry Service Board. I:1Building1Permits1SIT-PermitApp.doc 10/01/09 440-46 13T(1 1/02/COM/WEB) r 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: ,25;0 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) 2,,0 cu.yds. Retaining structure? (Chec ❑ 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\SIT-PermitApp.doc 05/25/2012 2 ae A City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Commercial - No Land Use Building Permit #: 6 /" D/1 `DOD l 3 Site Address: /12355' l u `at"7r Suite/Bldg#: Project Name: yy L `/ 1'(Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: I resil t ' 4614.44 e k,t,"/c ❑ Verify site address/suite #exists and active in permit system. ❑ Zoning. P2 ❑ Permitted Use: dd'Yes ❑)lo ❑ Spec Space ❑ Land Use Required: ❑ Yes No Type Required Notes: F?"<ehip94 rciCr AC/ 77,} 00,40 42 (1- k p4 21 J Approved by Planning: ( <46 Date: Revisions (after�Buiing Submittal only) Reviewer Date Revision 1: Approved Approved ❑ Not A roved Revision 2: ❑ Approved ❑ Not Approved • Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: Site Plans: # Building Plans: # Building Permit#: ❑ Enter building permit#above. Workflow Routing: ❑ Planning ❑ Engineering ❑ Permit Coordinator ❑ Building Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review) Route Application Documents: ❑ Building. original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: I:\Building\Formsl BIdgPermitRvw_COM_NoLandUse_042914.docx DERRY DELL PATH & BOARDWALK Excavation 50cy $5,000 eA Ark t"` �t AC Pavement& Base 95tH $18,05 Boardwalk abutments $30,000 Timber boardwalk $173,810 Total $201,8& � 3, q/o Debbie Adamski From: Zen Dutson Sent: Thursday, June 12, 2014 9:14 AM To: Debbie Adamski Cc: Mark VanDomelen Subject: Deny Dell EC & Boardwalk Permit Attachments: Zen Dutson.vcf Debbie I believe the Path costs should be excluded from the summary I gave you, as it will be inspected by our Engineering inspector. Thanks, Zen DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 1