Permit CITY OF TIGARD SITE WORK PERMIT
It COMMUNITY DEVELOPMENT Permit#: SIT2015-00008
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/12/2015
Parcel: 2S102AD03000
Jurisdiction: TIGARD
Site address: 12850 SW ASH AVE
Project: Burnham&Ash Apartments Subdivision: BURNHAM TRACT Lot: 5
Project Description: Site work for(2)apartment buildings,168 units total and(2)retail spaces.
Contractor: JBA, LLC Owner: TIGARD,CITY OF
1645 NW HOYT ST 13125 SW HALL
PORTLAND, OR 97209 TIGARD, OR 97223
PHONE: 503=504-9596 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 11/12/2015 $8,321.19
Plan Review 06/29/2015 $5,408.77
Type of Use: MF 12%State Surcharge-Building 11/12/2015 $998.54
Class of Work: NEW Plan Review-Fire Life Safety 11/12/2015 $3,328.48
Erosion Control w/Development 11/12/2015 $1,436.40
Project Valuation: $1,772,980.00
Info Process/Archiving-Lg$2.00(over 11/12/2015 $24.00
11x17)
Site Specifics:
Excavation Volume: 14700 cu.yd.
Fill Volume: cu.yd.
Impervious Surface: 113454 sq.ft.
Engineered Fill: Yes 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 $19,517.38
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 C by calling 503.232.1987 or 1.800.332.2344.
�I�✓lid Issued By: Permittee Signature:
/
Call 503.639.4175 by 7:00 a.m.for the next available inspection di.
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.
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, Building Permit Application
Site Work RECEIVED FOR OFFICE USE ONLY L
City of Tigard DateBea p`7 Permit No.: 6i r�!° .)— Z O w
,IIIN I " 13125 SW Hall Blvd.,Tigard,OR 3P 2 9 2015 Plan Revie I�,� �M ae�/5
Phone: 503.718.2439 Fax: 503.5 1960 Date/B : Other Petmit:� Gb P
Inspection Line: 503.639.4175 C� .y: Jaris: la See Page 2 for
TIGARD and Or. OV I
Notified/Method: Supplemental Information
rmation
BUILDING DIVISION
TYPE OF WORK 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 application.
Valuation: S
❑ I-and 2-family dwelling ❑Commercial/industrial
❑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: 12800 SW Ash Avenue New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Burnham&Ash Apartments Covered porch area: square feet
Cross street/directions to job site:SE Corner of Burnham St.and Ash Ave. 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.:2S102AD 02800,02900 o3etap 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.
Excavation,grading,stormwater improvements and site utilities to support the Valuation: ti 7.729,Snn 00 1, �Z� �,
construction of 165 apartment units across(2)multi-family buildings Existing building area: square feet
New building area: /(4,ZZ1 square feet
® PROPERTY OWNER l ❑ TENANT Number of stories: 4
Name:Jeff Sackett c/o Premium Property-Tigard LLC Type of construction: VA
-X Address: 1015 NW 11th Ave. Occupancy groups:
14 City/State/ZIP:Portland,OR 97209 Existing:
Phone:(503)226-1972 Fax:( ) New: A-3,B,M,R-2,5-2
® APPLICANT 0 CONTACT PERSON NOTICE
Business name:SERA Design and Architecture,Inc. All contractors and subcontractors are required to be
Contact name:Josh Cabot licensed with the Oregon Construction Contractors Board
�) under ORS 701 and may be required to be licensed in the
,�T Address:338 NW 5'h Ave. jurisdiction in which work is being performed.If the
1' City/State/ZIP: Portland,OR 97209 applicant is exempt from licensing,the following reasons
apply:
0 Phone:(503)445-7898 Fax::(503)445-7395
E-mail:joshc @serapdx.com
CONTRACTOR
Business name:TBD 4 / L tie, BUILDING PERMIT FEES*
sk. Address: �/ (4 � (Please refer to jee schedafJ' Structural plan review fee(or deposit). 537,724
City/State/ZIP: �17� q Itz.Sfreet��
1 FLS plan review fee(if applicable): ,215
/Phone:(�7 S0 — 1 S I lo Fax:( )
CCB lic.: Q -7 , '2 S -7/v/7 Total fees due upon application: fg311
Amount received: �! l� 7, )4
Authorized signature: This permit application expires if a permit is not obtained
! within 180 days after it has been accepted as complete.
Print na < �� Date: �p/L5/Qb/e--� * Fee methodology set by Tri-County Building Industry
rr iii I Service Board.
1:\Building\Permit SIT-PermitApp.doc 10/01/09 440-4613T(I I/02/COM/WEB)
1
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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: 14700 cu. yds.
Grading Volume:
(Soils report required for>5,000 cu. yds.) 14700 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: 113,454 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.
•
L\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.
1:\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.
L\Building\Permits\SIT-PermitApp.doc 05/25/2012 4
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City of Tigard
III .' •� COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - With Land Use
'11 , , 11: I)
Building Permit #: S i T a.01 0000
lattss� /6t7
FD Address: SW Ash Ave. Suite/Bldg#:
Project Name: BuYrtham 2., Ash Apaci-met 6
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review W r
Proposal: 9xad'n9 and si+e ';'C,,-„; ,:,... -for two-bui 1ciiir9 mui-h.-,amiiy
dwellinls
❑/Verify site address/suite#exists and active in permit syste .
L/ River Terrace Plan District: ❑ Yes MrNo
Ri Land Use Case#: DDRiot 5 - 00002- J _
�G?8 Plans Match Approved Land Use: '”T Vivant- 4�3L.1& 9PRLE �'eee0 F�'"i A'ItI 1"°`t. lK 't, ls'
.0" Site Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan • ❑ Elevation Plan
/"/3-0-Building Height: Maximum Height Actual Height
❑ Conditions Met: /s./o (1-4) ❑ Prior to Submittal 41=1 Prior to Permit Issuance
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
,a Public Facilities Improvement(PFI) Permit:
Required: ,❑ Yes,applicant was notified ❑ No Applied For .0 Yes ❑ No stop intake
Notes: r%t ( € W 1-4' A v lyf -M � • �5� sat �
c1
Arc riot Ls b -ft, K i'� t/4( i 1 t24-
NDTApproved by Planning: ,., ,_ s ez,' Date: eof" 3�2r0l�
Revisions (after Building Submittal only) S S Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: LP/agIt c
Site Plans: #
Building Plans: #
Building Permit#: 0—Enter building permit#above.
Workflow Routing: n Planning Q Engineering O'Fermit Coordinator 0 Building
Workflow Sign-off: 2-Sign-off for Planning(include notes from planning review)
Route Application Documents: lfiBuilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Date: 9494
I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_0401 15.docx
Engineering Review 76
Slope at building pad: •
,2- PFI Permit#: 20 5^-- a oo fr 2—
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP)
2Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes .0-.No
Assess Water Quantity Fee in-lieu: .Er Yes ❑ No
LIDA Facility on lot: ,Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes: C Obt 710 QS (C L.-1 5 i LA-N N I N el -n L.— HA-tip- trzt
13C Ai E1 p(24077_ TO 195 04-L a F 51 re..
Approved by Engineering: Date: /es — c —kg-
.., Revisions{after Budding.Submittal otzly) t. Reviewer Date
i
,Revision 1: ❑ Approved ' . 0 Not Approved. - °
'Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit � ,(
Approved,NOT Released: �11(/(/ Date: /o/G/>S
Notes: •
Revisions'(after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
14 OK to Issue Permit
Approved by Permit Coordinator: Date: �l f G�
I:\Building\Forms\BldgPennitRvw_COM WithLandUse_040115.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12850 SW ASH AVE, TIGARD, OR, 97223 June 13, 2017 at 1 :25:34 PM
Record Type: Record ID:
Commercial - Site Work SIT2015-00008
Inspection Type: Inspector:
499 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor