Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2014-00283
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/01/2014
Parcel: 2S 110AA00700
Jurisdiction: Tigard
Site address: 14030 SW PACIFIC HWY
Project: 76 Station Subdivision: KING CITY TERRACE CONDO Lot: 3-6
Project Description: Demolition of 1160 sq ft gas station/convenience store and 1224 sq ft canopy
Contractor: 3 KING'S ENVIRONMENTAL Owner: KHAN OIL LLC
PO BOX 280 ATTN KHAN, SOHAIL
BATTLE GROUND,WA 98604 2919 BEACON HILL DR
WEST LINN, OR 97068
PHONE: 360-666-5464 PHONE:
FAX: 360-666-8202
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 12/01/2014 $119.33
Demolition
Occupancy Grp: Occupancy Load: Erosion Control w/Development-Eng 12/01/2014 $80.70
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $3,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $200.03
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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. ATTENTIQN: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- -0010 through• 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I sued By: 4://if/bib Permittee Signature:
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.
11/26/2014 15:01 3 Kings Environmental, Inc (FAX)360 666 8202 P.001/005
Building Permit Application
.... .. .
Ca: it [1 " '>irol�OFFIf 1H;USV ONLY
t Received
City of Tigard Date/B '. /ErNI reemlf No-. 4 APev J
--- 13125 SW Hall Blvd.,Tigard,OR 97223 2 6 2014 Rhin Review
M' ' Phone: 503.718.2439 Fax: 503.598.1960 'Date/B : Other Permit•.
1 16_.,11D Inspection Line: 503.639.4175 CITY Of-1 ICIAFID Date Ready/By: mom: Q See Page 2 for
Internet: www.tigard-0r.gev �1�J7 Notified/Method: Supplemental Information
1111!rAin �l'al + 1p},' .
TYTE OF WORK REQUf1RED,DATA:I-.AND 2-FAi4'1LY D WELIlING
Permit fees"'are based on the value of the work performed.
❑New construction Ni Demolition 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 explication.
Valuation: $
I-and 2-family dwellin g Commercial/industrial
Li 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: II-03o SW q t.CI f 14w.) New dwelling area: square feet
City/State/ZIP: qp. DR q 74/ Garage/carport area: square feet
Suite/bldg./apt.no.: J Project name: rcIdlc a 7( felno Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
I)R99 0 oar►d■ 514) rice,lalal., i ke Other structure area: square feet
r
_ RE UIRED 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.: !4 ��� % equipment,materials,labor,overhead,and the profit for the
! ,a IISORIPTION OF WORK - work indicated on this application.
1.�1`'�Qllworl 0. 1160 E ((l'1(}cole11c Valuation; s
�' rj�tyfe. Q �
Existing building area: I I(::0 square feet
1 yS 'i4 Alt"3,AS a •
New building arcs: /VA. square feet
ta PROPERTY OWNER LL ❑ TENANT Number of stories: I
Name:OrogOn I�Le1Q•,s',^ 1,1 T o f 'TccW s u1AIloi Type of construction: �t -r yr.>e
Address: I�//3�_ ow I"r OlY1Qlers 51- Occupancy groups: aVIOCC 1t°a
City/State/ZIP: Po/4) q?a oq Existing: Reid 1 e
Phone:(SQ3) ?I Fax:(�_yl) 2�'1 -1c633 7 New: OA-
it APPLICANT ❑ CONTACT PERSON BUILDING'PERIIIJ-FEES"
fPlcasKretr•ro. esikorbda
Business name: 3 J 11R�S /t13i soft ro l
Structural plan review fee(or deposit):
Contact name: (7.1_,.. ). r pt, C .. ,0( FLS plan review fee(if applicable);
Address: 490 120 . Q
City/State/ZIP: Ilrr 1.2.)A 9 Tx Ci/ Total fees due upon application:
7`� ��^^ Amount received: �e9 '.o3
Phone:( r�)�0 _ � Fax::(JCw) ii�-�r1V�
E-mail: . jaC�C/4o�7 K1ty.,,,c yIG,co l' PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES`
,// ,CONTRACTOR Cottunereial and residential prescriptive installation of
roof-top mountc PhotoVoltaie Solar Panel Syste
Business name: f{j , .0 yI Submit two(2)set f roof plan withconne- ' retails
and fire department at:agss,along with.eltt:2010 Oregon
Address: (D C . v . Solar Installation Specially Checklist•
I � t4 �+�(l Permit fee(inclu Ian '
City/State/ZIP. (J� ttl D ( $180.00
�`? and 'nistrative fees): .�
Phone:(),6.) &4::,6_s�,y6� Fax:(566)6 j-i.,)D- State surcha a(12%of permit fee): `•\21.60
CCB lie.: �j =+ _ Y1 Total fee due upon application: $281.60
Authorized signature: ��f} 19/1�i r This permit application expires If s permit is not obtained
`� / within 180 days after It has been accepted as complete.
Print name: • ,p1 Date f �`�I * Fee methodology set by Tri-County Building Industry
ri / ' Service Board.
I:1Bullding\Permita\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
11/26/2014 15:01 3 Kings Environmental,Inc (FAX)360 666 8202 P.0021005
Erosion Control Plan for ODOT OR99w Gaarde/McDonald 76 gas Station Demo
111:764161 UPD
Place socks in storm water catch basins. J V 26 2014
Cover all exposed dirt piles with plastic sheeting to protect from the elements.
Sweep streets to clean of any debris and dirt. �G iT 14flb
1
IIII Mr
w
—
,1� iis \
Protect extg.signal OR 99W = 7'�'
power tines — c....‘
1i- 11 V
Protect extq. 10'�NP 1
N E tg. arm inlet Protect extg. gos & lefe.lines _
, ,5� 12' water line I `- — 49 - __ I.
85 �..�.� — ,. 0
__. ____`- y��.jj 1��niiCcaie ---- -
-.�• Al. ,ar% •..... I..YYI !L. ..I. •SE 1 ... ..• ... . . ... ... .. . •• .. • rV^. --.�_ _ ‘c,
r_...._,____ __=._
'� •i AsAh. Gasu �(-, � ., \ \\
i J7urLI
Asph. ON �. . .„;\ s•i,„„. 4111 \ N.,... t,\.,
®� 1 Ext .monitoring `4 ''• `
9
p b
j 1 Two decor�iitissioned---' 8 o Product , t_� ;“01, Mz-
1 O
in-place 7.500 gel - line ` i° •<
�. ! (�i steel usrs (ExrgJ a aS Station r !� 0 , r...s.Fxr9 Buildin P.80
O o s. calords I g z�aar •
used p e
A fl. 1 (r p.) J1 • o O (Assumed ex,g) ?`
"�!_. i , '� • (� ` Extq.500 gal 1 �, 7 `y (� Q��
A et 1"F 1 t propane Conk ,._ I \\�- /”
o ' Fgprmer hydraulic ~' 12.000 gal G� oQ
1 1 lifts (2) �q fik,p�rg
� � � n ; I (Assume exists
s�. -� UST fExt �' � � r �
below, 1 1 550 got heotfng oil USF ��—' '�•
Io r (Assumed removed) l�'
= 1 1 550 gal used oil UST 7 -,, i� `� A+
Cl. (Assumed removed) \. / , __,-- -'" ! O
i •`* 1- 30'
1 Approx.pro)s'rty-tne r . rt
. --� , virl
Notes: tj
i r t ` / A
1 --------- 1. All extg.s+te condifions rpartbi be Hawn ,
—- _- �1 and shown in the site plan. See hazmot O
`1 60 90 reports and CEO for further detailed information.
.:
30 1 1 cord
2. Coll for and locate utilities before = * a i F I s construction demolition. iz
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