Permit 11111 CITY OF TIGARD SITE WORK PERMIT
s, COMMUNITY DEVELOPMENT Permit#: SIT2015-00002
Date Issued: 03/26/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S114AA00500
Jurisdiction: Tigard
Site address: 16375 SW 85TH AVE
Project: Clean Water Services Subdivision: 1993-078 PARTITION PLAT Lot: 2
Project Description: Primary Treatment&Hydraulic Capacity Improvements Project. Construct new headworks effluent structure and
new biofilter.
•
Contractor: 2KG CONTRACTORS INC Owner: CLEAN WATER SERVICES
4917 NE 185TH DR 2550 SW HILLSBORO HWY
PORTLAND, OR 97230 HILLSBORO, OR 97123
PHONE: 503-489-2020 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 03/26/2015 $2,587.46
Plan Review 03/26/2015 $1,681.85
Type of Use: COM 12%State Surcharge-Building 03/26/2015 $310.50
Class of Work: NEW Erosion Control w/Development-Eng 03/26/2015 $461.40
Project Valuation: $495,696.00
Site Specifics:
Excavation Volume: 595 cu.yd.
Fill Volume: 145 cu.yd.
Impervious Surface: 7000 sq.ft.
Engineered Fill: Yes Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: No
Fence:
Total $5,041.21
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 iLwork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility ification Ce -r. T •:e rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 Y-u may obtain a copy of the rules
or di ct questions to OU •y call • .43.232.1987 or 1.800.332.2344.
Iss ed By: 410 ilia / ` Permittee Signature: i
Call 503.639.4175 by 7:00 a.m.for the next available ins• 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.
' Building Permit Application
Site Work RECEIVED I 111: I)1 1 1( I I ,i t 1.1 1
ce
City of Tigard Re DateB ive:d "IMAM, Permit No.: .. r- 0 �40!/I
• 13125 SW Hall Blvd.,Tigard,OR 97t ; a 1 O 2015 Plan Re e► F7�
Phone: 503.718.2439 Fax: 503.59k. ':l 1 DateB : A`j70� ,�/���� Sher Permit:
I"I c.. K u Inspection Line: 503.639.4175 Date Ready c y: IWIe ® See Page 2 for
Internet: www.tigard-or.gov (,1T11 O} FIGAcRln�*' Notified/Method: 3 1,r B77- Supplemental Information
TYPE OFLWORK DIVIJIlll,r // 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 implication.
El 1-and 2-family dwelling ❑Commercial/industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 G 3 7s- S L) g.-ti A ve New dwelling area: square feet
7 �City/State/ZIP: , ,e rea 04 7 70/(4 y Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area square feet
Cross street/directions to job site: 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(rouided to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
�/ DESCRIPTION OF/WORK work indicated on this applicatio
Cro'�Str.let //r JL ,r4s f41. -4 �tr4LbYG Valuation: $ 9 �pq�
a H JExisting building area square feet
ale r 46/0 f;ter.
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
•
Name: (i/e4 n W, ter -SP r yr(r5 , Type of construction:
Address: f 6666 's i4/ Q C44 ✓7/VL Occupancy groups:
City/State/ZIP: ;it, o4 9 7c:7 a y Existing:
Phone:(503) 54 '7— 9/ 7s— Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax: :( )
E-mail:
CONTRACTOR
Business name: a k G 6 o,, tr./ to rs ,e, BUILDING PERMIT FEES*
Address: // ,y - AP S" .�L (Please refer to tee schedule)
Structural plan review fee(or deposit):
City/State/ZIP: /104....77/9-A1/ 02 9va3d
Phone:, Q3) 74 / -aG'a2 d Fax:( ) FLS plan review fee(if applicable):
CCB lic.: cf; a 5.
Total fees due upon application:
�
+ 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: T.e C 46 re 4rs Date: 3//Q -01.5 * Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\.SIT-PermitApp.doc 10/01/09 440-4613T(l1/02/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: _ 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) cu.yds.
Retaining structure? (Check one) ❑ 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.
I:\Building\Permits\SIT-PermitApp.doc 05/25/2012 2
i
111111 ■
Site Work Permit Application
Plan Submittal Requirements
I I G A R l) Commercial, Multi-Family and One- &Two-Family Dwellings
A site work permit is required for all commercial projects including new buildings, additions,
accessory buildings larger than 120 square feet, modular structures and multi-family R-1
occupancies. A site work permit is required for excavation, fill,grading, paving, retaining walls,
fire hydrants and fire department access on private property for work on individual lots not
covered under the subdivision development.
Note: A separate "plumbing" permit for site utility plumbing work is required for sanitary
sewer, storm sewer and potable water systems on private property. Please see the Site
Utilities - Plumbing Permit Application for plan submittal requirements.
1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic
location labeled with:
A. ❑ map &tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ applicant phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads (drawn to scale) with project location.
2. BUILDING PLAN submittal requirement: Two (2) complete sets, Civil only.
All details listed below shall be incorporated into the plans:
A. Site plan showing:
1) Required parking spaces and driveways.
2) A route, accessible to persons with disability, leading from the public way to an
accessible building entrance.
3) Accessible parking spaces and adjacent access aisle connecting with the accessible
route.
4) Curb ramps along the accessible route, curb, sidewalk and gutter.
5) Finish grade elevations along the accessible route.
B. Topographic survey plan showing grade elevations crossing the entire site.
C. Overall grading plan.
D. Utilities plan showing:
1) Fire hydrant location and pipe size if on private property.
2) If the building is to be protected with an automatic fire sprinkler system, show
location of the water service vault and the fire department connection (FDC)
within 70 feet of a fire hydrant.
3) Size of underground water service for the sprinkler system.
E. Erosion control plan complying with the requirements of the Clean Water Services
(CWS) agency showing:
1 1) Silt fence locations.
2) Bio-filter bags/other approved barrier material surrounding catch basins.
L\Building\Permits\SIT-PermitApp.doc 05/25/2012 3
3) Illustrations detailing the correct installation of the silt fencing and catch basin
protection.
4) Any other measures to ensure compliance with CWS standards.
F. Landscaping plan.
3. ADDITIONAL REQUIREMENTS:
A. Soils (geotechnical) report. A soils report is required for new buildings and additions
to contain the following:
1) The report shall address the potential of soil liquefaction and instability (OSSC
Sec. 1804.2).
2) Fills to be uscd to support foundation of buildings (OSSC Sec. 3301.1).
3) Foundation and lateral pressures exceeding 1,500 lb./sq. ft. (OSSC Sec. 1805).
B. Fire flow and hydrant worksheet.
C. Plan review deposit based upon project valuation.
1:\Building\Permits\SIT-PermitApp.doc 05/25/2012 4
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: 595 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) 145 cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: 7,000 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:1Building\Permits\SIT-PermitApp.doc 05/25/2012 2
Joel Borchers
From: Joshua.Koch @CH2M.com
Sent: Wednesday, March 25, 2015 11:22 AM
To: Randy Naef;Joel Borchers
Cc: Lynne.Chicoine @CH2M.com;Janelle.Booth @CH2M.com
Subject: RE: Second Page of the application
Joel/Randy,
I was able to track down most of this information in Janelle's absence. I'm unclear on what Tigard is looking for on
"grading volume" and "retaining structure". If you know and need something more from me, let me know. For
impervious area, I included all sidewalk, new paving(not overlay), HES, and biofilter fan structure (not biofilter).
Excavation Volume: 595 yards
Grading Volume: ?
Fill Volume: 145 yards
Retaining Structure: ?
Added Impervious Area: 7,000 sf
Thanks,
Josh
Original Message
From: Randy Naef[mailto:NaefR @CleanWaterServices.org]
Sent:Tuesday, March 24,2015 12:01 PM
To: Koch,Joshua/CVO
Subject: Re:Second Page of the application
Yes we would like you to provide the earthwork quantities for the permit.
Sent from my Verizon Wireless 4G LTE DROID
Joshua.Koch @CH2M.com wrote:
Randy,
Just want to be sure you'd really like me/us to do this since CWS had us take permit work out of our scope. I think Steve
might have helped with this on past projects in his CM role. I don't mean to be difficult, and I'm happy to do it, but I
want to be sure that's really the intent. Note that earthwork quantities are from Janelle, and she's out this week, so I
likely can't get those until next week.
Thanks,
Josh
Original Message
From:Joel Borchers [mailto:BorchersJ @CleanWaterServices.org]
Sent:Tuesday, March 24, 2015 10:08 AM
1
d.
STARLING
O R K T O G I T H I R I S T A N D A P A R T
Memorandum
To: Randy Naef,Clean Water Services
From: Basel H.Jurdy
Date: February 23,2015
Subject: CWS 6491
The District's Project 6491 includes two pieces of equipment that have the potential to
generate noise on the site. Mitigation measures have been taken as outlined below. The
attached site plan shows location of the equipment and plan district boundaries.
Odor Control Fans (350EF4101 and 350EF4102))
Odor Control Fans convey odorous air from head space at four primary clarifiers,the Primary
Effluent Pump Station and the Effluent Flow Distribution Structure to a new biofilter for
treatment. The specification for the fans requires a maximum overall A-Scale weighted sound
pressure level of 72 dBA at a distance of three feet from operating equipment. The fans are
housed in a three-sided covered enclosure. At the Owner's request,we have included sound
absorptive materials on the wall behind and the underside of the canopy over the fans. The
resulting noise level is anticipated to be 65 dBA at the adjacent roadway.
The closest property line is approximately 440 feet to the northwest. The predicted noise
levels from the Odor Control fans at this property line are less than 30 dBA. Therefore, the
noise level from the fans at the nearest plan district boundary will be significantly below the
standards outlined in Table 18.650.2 of the City of Tigard Code.
Alum Dispersion Pump (220P0801)
For this pump,the closest plan district boundary is to the north. The existing structure on
which the pump will be mounted includes a parapet wall that will mitigate noise from the
equipment. Given the anticipated noise level from the manufacturer, we anticipate a noise
level of 35—40 dBA at the plan district boundary.
Basel Jurdy
e
Principal Acoustical Consultant
Sparling
Cc: Lynne Chicoine,CH2M HILL
Josh Koch,CH2M HILL
Neal Forester,CH2M HILL
4100 194th St SW•Suite 400,Lynnwood,Washington 98036-4613
206-667-0555 800-667-0610 Fax:206-667-0554
www.spnrling.com
Map 18.650.A: Plan District Boundaries and Subdistricts
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Tigard City Boundary CO 1 Y
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
" Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
T 1 G n R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
1. SITE PLAN (3) copies - fully dimensional, drawn to scale and labeled with:
A. ❑ map& tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the"Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit-based on valuation of project.
4. ADDITIONAL INFORMATION AS FOLLOWS:
A. Fire Department Building Survey with (1) additional full set of architecture
drawings.
l:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
r 1 c;A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
Type of Submittal # of Plans
(Includes new,additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan is required showing location and square footage
of all buildings to be demolished,erosion control plan and
tree protection,if applicable)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Solar Photovoltaic 2
(Requires check list for prescriptive installation. If not
prescriptive installation,engineering is required.)
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington
County, and Tualatin Valley Fire & Rescue),if applicable.
I:\Building\Permits\BUP_COM_PermitApp.doc Rev.12/18/2014
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
16375 SW 85TH AVE, TIGARD, OR, 97224
Commercial - Site Work
499 Final inspection
PASS - No C of O
SIT2015-00002
Chip Barnett
Violation Summary:
Inspector Contractor