Permit CITY OF TIGARD SITE WORK PERMIT
111
COMMUNITY DEVELOPMENT Permit#: SIT2014-00014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2014
Parcel: 2S112CB00900
Jurisdiction: Tigard
Site address: 15000 SW HALL BLVD
Project: Bonaventure of Tigard Subdivision: WILSON ACRES Lot: 8
Project Description: Site work for a new 3-story senior living facility.
Contractor: BONAVENTURE CONSTRUCTION Owner: MWSH TIGARD LLC
3425 BOONE RD SE 3425 BOONE RD SE
SALEM, OR 97317 SALEM,OR 97317
PHONE: 503-566-5715 PHONE: 503-566-5715
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 10/28/2014 $4,850.42
Plan Review 08/05/2014 $3,152.77
Type of Use: MF 12%State Surcharge-Building 10/28/2014 $582.05
Class of Work: NEW Plan Review-Fire Life Safety 08/05/2014 $1,940.17
1 $1,000,000.00 Misc Administration Fee 10/28/2014 $16.00
Project Valuation: Erosion Control w/Development-Eng 10/28/2014 $836.40
Site Specifics:
Excavation Volume: 10000 cu.yd.
Fill Volume: 15000 cu.yd.
Impervious Surface: 153559 sq.ft.
Engineered Fill: Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall: Yes
Fire Underground: Yes Accessible Parking: Yes
Fence: Yes
Total S11.377 81
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 by calling 503.232.1987 or 1."‘00. . 44.
?
Issued By: rmittee Signature:
fit w
Call 51 3:639.4175 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.
MIIPPA
3ui► n6 Permit Application
Site Work ��V FOR OFFICE USE ONLY
IN Received
City of Tigard �Cj Date/B : • / '� Permit No.: _
■ 13125 SW Hall Blvd.,Tigard.OR 9722.,,,,— Plan •evie i'► • ,•
MI
�' Other Permit:
Phone: 503.718.1439 Fax: c+ ' S98 1960 A �01� Date/Bv4I Ei r r j. 1 - ,� 7
TIGARD Inspection Lute. �.o39.41 i5 \\� �i Date Re ': , saris ® See 'age2 for
Internet: www.tigard-or.gov w+ �AIVD Notified/Method: 0 ',3/�i f , Supplemental Information
TYPE OF WORIOrl�r_ R QUIRED DATA:I-AND 2-FAMILY DWELLING
11, New construction ❑ DiAatafion 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.
❑ 1-and 2-family dwelling J-Commercial/industrial Valuation: $
❑Accessory building ,e'Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ) 5-00(D 1,14L-(-- New dwelling area: square feet
City/State/ZIP: tS.by cg 1.1 2'S 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: P .tw.e✓I, .edE—'T'lsa,W Covered porch area: - square feet
Cross street/directions to job site: sr�rr�` Deck area: square feet
S S 1� k-1-l4.-L C-- Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: /Sad 0 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: ZS( 12. chi 6 o 1 00 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.
het,. 5/, (,U o'1'-/ rev- 3 S s Lei✓` Valuation: $ / eO
I► v 1 1 �./L' Existing building area: square feet
` 4- New building area: square feet
,2"-PROPERTY OWNER !!! ❑ TENANT //�� Number of stories:
Name: $rN�t�e�-P� p� ,� . [ L.L C._. Type of construction:
Address: '.)e.(Z S Bc.awy,p eL J Occupancy groups:
City/State/ZIP: (e_ ■ 1 01 Existing:
Phone:( 593 '56 cp •S'](3 Fax:( 1 New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: c e�iH L V L All contractors and subcontractors are required to be
Contact name: J p--% C licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3 L f .( gc_ir"(.Q (' jurisdiction in which work is being performed.If the
City/State/ZIP: e / applicant is exempt from licensing,the following reasons
lete.- l apply:
Phone:( *3 3?3. 3p y I FFax::( )
E-mail: J CAC/( C-.-%. e- /1 eSL'• c/v�, •
CONTRACTOR
Business name: fit/✓ , /,,1,7/ ,,V e'& i BUILDING PERMIT'FEES*
G' l� hcs�' (t'V7`/'Lc �
Address: (Please refer to fee schedule)
Structural plan review tee(or deposit):
City/State/ZIP:
FLS plan review fee(if applicable):
Phone:( ) I Fax:( )
CCB lie.: Inn Total fees due upon application:
-�P 1 i Amount received:
Authorized signature: This permit application expires if a permit is not obtained
:i�=_+y��� within 180 methodology after by it has been
unt accepted as complete.
Print name: Date:
� Fee methodology set by Tri-County Building Industry
Service Board.
I C\Building\Permits\SIT-PermitApp.doc 10/01/09 440-4613T(I1/02/COM/WEB)
..-' ,
City of Tigard: Site Work Permit Checklist ('51'60 aw4g.-LC,
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: 1 Ur MG cu.yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) 1.5 f)D 0 cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90%of maximum density) L SI o0D cu. vds.
~Retaining structure? (Check one) ❑ Rock
❑ CMU
\\,13't ❑ Concrete
❑ Other:
*Total.new impervious area including all buildings, 1,,
sidewalks, and paving: / `'3 5 5°) s ft. �or� '�Tt
. lit, . • ,;V; 253 976
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 ❑ i *Parking(including ADA)and Lighting
compliance I Plan
❑ Grading Plan and details ❑ *Landscaping Plan
^❑ Erosion Control Plan and details I ❑ I Soils Report(if required)
❑ Retaining Structures } ❑ Fire Line
•Does not apply to One-and Two-family dwellings.
Plan Submittal: Permit Fee:
I TYPE OF SUBMITTAL '#of Plans ' Valuation: . . . Permit Fee:
(New,Additions or Required at S.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
Commercial 3 $2.69 for each additional$100 or fraction
thereof to and including$2.000.00.
52,000 0I to 525.000.00 $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
One-&Two-Family Dwelling 2 $2`5.000.00.
522 5,000.01 to 530,000 00 5338.92 for the first$25,000.00 and
53.06 for each additional$1,000.00 or
fraction thereof,to and including
$50,000.00.
550,001.00 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 $309.42 for the first S100.000.00 and
$4.49 for each additional 51,000.00 or
fraction thereof.
1:1Building\Permits\StT-permitApp.doc 05/25/2012 2
September 9, 2014
RE: BONAVENTURE SITE PERMIT
Project Information
Building Permit: SIT2014-00014 Construction Type: 5A
Tenant Name: Bonaventure Occupancy Type: I-1 cond. 2
Address: 15000 SW Hall Occupant Load: ?
Area: 157067 Sq Ft Stories: 3
The plan review was performed under the State of Oregon Structural Specialty Code
(OSSC) 2014 edition. The submitted plans are approved subject to the following
conditions.
This plan review was done under the assumption of a type 5A, sprinkled, "I-1 condition
2 / A" occupancy building.
1) What type of underground sprinkler line joint restraint is to be used.
2) Please provide underground sprinkler vault drawing.
Respectfully,
Dan Nelson,
Senior Plans Examiner
(503) 718-2436
dann @tigard-or.gov
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
15000 SW HALL BLVD, TIGARD, OR, 97224
Commercial - Site Work
499 Final inspection
PASS - No C of O
SIT2014-00014
Chip Barnett
Violation Summary:
Inspector Contractor