Loading...
Permit CITY OF TIGARD SITE WORK PERMIT 1111 ' ' • COMMUNITY DEVELOPMENT Permit#: SIT2015-00011 Date Issued: 09/29/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110BA02200 Jurisdiction: Tigard Site address: 14170 SW 119TH PL Project: Briley Subdivision: CANTERBURY WOODS CONDO Lot: 76 Project Description: Erosion control only for drive way area. Contractor: FAHLMAN HOMES INC Owner: BRILEY, DANIEL M& KRISTA L 13035 SW WEIR RD 14170 SW 119TH PL BEAVERTON, OR 97008 TIGARD, OR 97224 PHONE: 503-799-2818 PHONE: 503-577-1076 FAX: FEES Description Date Amount Specifics: Erosion Control w/Development 09/29/2015 $80.70 Type of Use: Class of Work: Project Valuation: $10,000.00 Site Specifics: Excavation Volume: cu.yd. Fill Volume: cu.yd. Impervious Surface: sq.ft. Engineered Fill: Soil Report Required: Paving: Grading: Landscaping: Site Prep: Storn Drains: Retaining Wall: Fire Underground: Accessible Parking: Fence: Total $80 70 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 t• olio t rules adopted • Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 •090. o ay ob .in a c■•, o the rules or direct questions to OUNC by calling 503.232.1987 or 1.:•u Issued By: Per- - ignature: AOCIO Call 50 .6 9.4175 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. - BUildin2 Permit Application Site Work \�� FOR OFFICE USE ONLY ��� Received City of Tigard t;� Date/8 : y1 �� �.�i Permit No.: r� • Eri 13125 SW Hall Blvd.,Tigard,OR 97223 p n 101 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 cQ p D Date/By: Other Permit: mST�6I lam—0)10 TIGARD Inspection Line: 503.639.4175 S` ���� �:teReadyBy: Juris 0 See Page 2 for Internet www.tigard-or.goV ��;` r1 �_`,C fied/Method: =Ci Supplemental Information TYPE OF WORK ��tVU,�G4 v a REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction ❑Demilition Permit fees*are based on the value of the work performed. p� Indicate the value(rounded to the nearest dollar)of all F�Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ /O Dvra] 1_and 2-family dwellin g ❑CommerciaUindusal ID Accessory building El Multi-family Number of bedrooms: ❑Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 'r-(170 A,u) 1 ( ? 1. New dwelling area: square feet City/State/ZIP: 1 16144 0 OIL L 7 Z Z, Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Covered porch area square feet Cross street/directions to job site: G 4 61,4)F. 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(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the j� DESCRIPTION OF WORK work indicated on this application. IC f.rl4 O tJ i; l)(2 T re, 1c /7E0✓ PQ!t t Valuation: $ Lt> y .t Existing building area square feet New building area: square feet ❑ PROPERTY OWNER I ❑ TENANT Number of stories: Name: Ono t- it IL tsFA 0it t L£l Type of construction: Address: (Yi 7 V 5,tom. I ? ry Occupancy groups: City/State/ZIP: T,'G.4 i-tO 0/2 Existing: Phone:(503) Fax:( ) New: et APPLICANT ❑ CONTACT PERSON NOTICE Business name: 641--U44414.0..) Ho 4.K4„1 All contractors and subcontractors are required to be Contact name: ��('� / /�NG�Atf*X-) under with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: ) s S, GO, 011-K S( jurisdiction in which work is being performed.If the City/State/ZIP: 7-,G,,t 412 02 g7Z z 3 applicant is exempt from licensing,the following reasons apply: Phone:(5-03) 1-7 2.9 z.,(?.( F Fax::( ) E-mail: T Cklw+c�.4_k-«-e5 ( /.h/Gb . Z-0'4-4-- CONTRACTOR Business name: /..--Am_nit Af-c) / - Ls' BUILDING PERMIT FEES* Address: Sn�s S. ©A.� s (Please refer to fee schedule) f Structural plan review fee(or deposit): City/State/ZIP: (l2�L J Q/L ''7z z FLS plan review fee(if applicable): Phone:(„v3) 7 F(Q 2 tf r t F Fax:( ) CCB lic.: 8 3D $: /j Total fees due upon application: p, 7v Amount received: Authorized signature: N/ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: v! L q Date: `�Z 05” * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\SIT-PermitApp.doc 10/01/09 440-4613T(11/02/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: j 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) O cu.yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete al Other: 62,40 ._ `iru t Nlake_ *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 A- • Grading Plan and details ❑ *Landscaping Plan /..10c. ▪ Erosion Control Plan and details ❑ Soils Report(if required) ,j& ❑ 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 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 14170 SW 119TH PL, TIGARD, OR, 97224 Residential - Site Work 499 Final inspection FAIL SIT2015-00011 David Young Provide approved final erosion control prior to SIT final inspection. Violation Summary: Inspector Contractor 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 14170 SW 119TH PL, TIGARD, OR, 97224 Residential - Site Work 499 Final inspection PASS - No C of O SIT2015-00011 David Young Violation Summary: Inspector Contractor