Permit "' CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permits SIT2015 00012
Date Issued 10/07/2015
13125 SW Hall Blvd•Tigard OR 97223 503 718 2439 Parcel 2S111A603100
Jurisdiction Tigard
Site address 14135 SW 93RD AVE
Project FRENI Subdivision ELROSE TERRACE Lot 27
Project Description Erosion control only for future flag lots
Contractor TRYON CREEK LANDSCAPE Owner FRENI, THOMAS E&TRACIE
11400 SW NORTH DAKOTA ST 9430 SW MCDONALD ST
TIGARD OR 97223 TIGARD, OR 97224
PHONE 503-824-2174 PHONE
FAX
FEES
Description Date Amount
Specifics: Erosion Control w/Development 10/07/2015 S80 70
Info Process/Archiving-Sm SO 50(up to 10/07/2015 SO 50
Type of Use. SF 11x17)
Class of Work OTR
Project Valuation• S17 220 00
Site Soecifics
Excavation Volume cu yd
Fill Volume cu yd
Impernous Surface sq ft
Engineered Fill Soil Report Required
Paving Grading
Landscaping Site Prep
Scorn Drains Retaining Wall
Fire Underground Accessible Parking
Fence
Total S81 20
Required Items and Reports(Conditions) 1
1 Ersn Cntrl 503-839-4175
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, or if work is suspended for more the 120 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 1 800 332 2344
Issued B '�'
Y Permittee Signature.
Call 503 639 4175 by 7:00 a.m.for the next available inspectio •a e.
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 CV FOR OFFICE USE ONLY
City of Tigard '` ' DatReceived I, Permit No J S
° 13125 SW Hall Blvd,Tigard,OR 97223 1 Plan Review �� ,
1 0 • Phone. 503.718 2439 Fax 503.598.1{�(tA� O 2415 Date/By Other Permit
T 1 G A R U Inspection Line: 503.639.4175 Vll�� Date Ready/By lures ® See Page 2 for
Internet www tigard-or goy Atkj No1I 6ed/Method % Supplemental Information
CO 43;0300
TYPE O i(1-4101W REQUIRED DATA:1-AND 2-FAMILY DWELLING
New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rotnded 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.
[Tic 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 11 `�)7 jj�
❑Accessory building ❑Multi-family Number of bedrooms: '�--�J
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION nA,ND LOCATION Total number of floors:
Job site address: )y 1-55` I'. !)I A New dwelling area: square feet
City/State/ZIP: ��C.„A r* �)�Z� Garage/carport area: square feet
Suite/bldg./apt.no.: "t Project name: Fre,r, Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
SI.J M C Do A j ,S\ • 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(rotnded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
14 ` ,jar j 1 � �1 Valuation: $
`wv L Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Th ll ev vt 1—�c;L E�N Type of construction:
Address:
Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
APPLICANT '0 CONTACT PERSON , NOTICE
Business name: —Fri of Cr e 4. (,,A.nd,Sr ,ten All contractors and subcontractors are required to be
Contact name: 5 �0 `�1C licensed with the Oregon Construction Contractors Board
"Y �_ under ORS 701 and may be required to be licensed in the
Address: WI UT S (4-19 %Aix 64 . jurisdiction in which work is being performed.If the
City/State/ZIP: Ti c'J,.
Fax:D on u) applicant is exempt from licensing,the following reasons
Phone:
( E^° f O,3 / ( ) apply:
E-mail:
•
CONTRACTOR
Business name: BUILDING PERMIT FEES*
Address: 30l WC__ (Please refer to fee schedule)
Structural plan review fee(or deposit):
City/State/ZIP:
Phone:( ) Fax:( ) FLS plan review fee(if applicable):
j,r53 ` Total fees due upon application:
CCB lic.: lN'�
Amount received:
Authorized signature: '
4i This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: k)
✓L ,�)� `> Fee methodology set by Tri-County Building Industry
/ Service Board.
I:\Building\Permits\SIT-Permit pp.doc 10/01/09 440-4613T(I1/02/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: .57) cu.yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) $(9 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, I 5?)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
Site Work Permit Application
Plan Submittal Requirements
TIGARD' 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) Silt fence locations.
2) Bio-filter bags/other approved barrier material surrounding catch basins.
I:\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 used 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