Permit (120) ' ,� .; CITY OF TIGARD SITE WORK PERMIT
_'g COMMUNITY DEVELOPMENT Permit#: SIT2015-00015
'b R . 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/21/2015
t lb-ARO. Parcel: 1S134DC03001
der;
Jurisdiction: Tigard
Site address: 11130 SW TIGARD ST
Project: Dirkson Nature Park-Educational Center Improvement Subdivision: CHERRY HILL ACRE TRACTS Lot: 6
Project Description: Erosion control,tree protection and pedestrian fencing protection for Rain garden and 8 ft.wide concrete pathway.
Installation of 8 ft. pathway and hardscape at building.
Contractor: LEE CONTRACTORS LLC Owner: TIGARD, CITY OF
PO BOX 896 13125 SW HALL BLVD
BATTLEGROUND,WA 98604 TIGARD, OR 97223
PHONE: 360-852-2317 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 12/21/2015 $653.40
Plan Review 12/15/2015 $424.71
Type of Use: COM 12%State Surcharge-Building 12/21/2015 $78.41
Class of Work: ALT Erosion Control w/Development 12/21/2015 $161.40
Info Process/Archiving-Lg$2.00(over 12/21/2015 $10.00
Project Valuation: $70,800.00 11x17)
Site Specifics:
Excavation Volume: 40 cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Soil Report Required:
Paving: Grading: Yes
Landscaping: Site Prep:
Storn Drains: Retaining Wall: Yes
Fire Underground: Accessible Parking:
Fence:
Total $1,327.92
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, Lwo k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o direct questions to OU b Iling 503.232.1987 or 1.800.332.2344.
Issued By: y Permittee Signature: �/
,` IM.... Ci . eill°
Call 503.639.4175 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.
li t
r Building Permit Application
Site Work FOR OFFICE USE ONLY
City of Tigard g� Received / __ 3
g m Dale/B : /, G>� Permit No.: ism
13125 SW Hall Blvd.,Tigard,O. '?%* `•E Plan Reine
Phone: 503.718.2439 Fax: 50'.'r L..-6.6' Date/B : „mow. Other Permit: �� �
Inspection Line: 503.639.4175 Date Rea ® See Page -
TIGARD DEC 5 2 15 2fnr
Internet: www.tigard-or.gov 1 Notified/Method:/2Z/ �S L_IIIA-M Supplemental Information
175 CU
DIVISIONREQUIRED DATA:1-AND 2-FAMILY DWELLING
��11
®New construction Bv 'emolition 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: $
❑ I-and 2-family dwelling ®Commercial/industrial
ElAccessory building ❑Multi-family Number of bedrooms:
❑Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1113®SW TIGARD ST New dwelling area: square feet
City/State/ZIP:TIGARD OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Environ Education Center Covered porch area: square feet
Cross street/directions to job site:Tigard Street at SW Twin Park Place 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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.::2S103AA00200, i$i 3A-4 DC 6300 I 03 0 00 equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Erosion control,tree protection&pedestrian fencing protection,mobilization Valuation: $$70,8110.00
Excavation/Embankment for rain garden and 8'wide cone.pathway Existing building area: square feet
Installation of 8'conc.pathway and hardscape at building New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:City of Tigard Type of construction:
Address: 13125 SW Hall Blvd Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(503)718-2466 Fax:( ) New:
Z APPLICANT 0 CONTACT PERSON
NOTICE
Business name:City of Tigard All contractors and subcontractors are required to be
Contact name:Jeff Peck licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13125 SW Hall Blvd jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)718-2466 Fax: :( )
E-mail:jeffp@tigard-or.gov
CONTRACTOR
Business name: LE, ( /J1?_ - ( S BUILDING PERMIT FEES*
Address: (P/ease refer to fee schedule
r ox, G 9Structural plan review fee(or deposit): 1.9,11„_7
City/State/ZIP: B SL R-e) - sum W R 9 8 v
Phone:(3&O) 8 S a _ 23 1• Fax:( ) FLS plan review fee(if applicable):
CCB lie.: 3 Total fees due upon application:
Amount received:
Authorized signature: t._.----��r `► 1
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Jeff Peck Date:8/27/15 * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Pennits\SIT-PennitApp.doc 10/01/09 440-4613T(II/02/COM/WEB)
e 9
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: C 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) 15 cu. yds.
Retaining structure? (Check one) E] Rock
❑ CMU
Fl Concrete
❑ Other:
*Total nPw impervious area including all buildings,
sidewalks, and paving: jySSlhoev e.P.e/(Zuv 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:
F7 Site Plan with Vicinity Map showing ADA ❑ *Parking (including ADA) and Lighting
compliance Plan
n Grading Plan and details n *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report(if required)
n 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\Pennits\SrT-PermitApp.doc 05/25/2012 2
. .
City of Tigard
l� COMMUNITY DEVELOPMENT DEPARTMENT
M
T 1 c A R'D Building Permit Review — Commercial - With Land U s e
0
Building Permit #: --g- /�0601 s—
Site Address: WV l ® S J 71 g ara 5t . Suite/Bldg#:
Project Name: Envi (on 1 -0 J Educ. H On C-en-1-6(
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ST�"2 work pri +o S\+e- U-l'ili-t1R,5 and building irnproverootS
ECS -f rex, cyro-+-ecY)0In excavo 'ion, ala Farkin9
Verify site address/suite# exists and active in permit system.
',g/River Terrace Neighborhood: ❑ Yes { 1Z No
❑d Land Use Case#: Cu P 2013- XO 1
vti Plans Match Approved Land Use:
See no+e� Site Plan ❑ Landscape Plan ❑ Other:
❑ Urban Forestry Plan ❑ Elevation Plan
--B-"Building Height: Maximum Height Actual Height
❑ Conditions Met: �q Prior to Submittal Prior to Permit Issuance
Business License:
�Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Da Public Facilities Improvement (PFI) Permit:
Required: Yes, applicant was notified �No Applied For: ❑ Yes ❑ No, stop intake
otes: Gal approved site work only, on am voci Q S1--e-(`plan ; rfAt&l- :rlt,J Ai
Provide MOO•tr°, s repor�' W1`-t"1 •fcrk'ec 'lotf\ Vpfim( on
Approved by Planning: _ ' �a -,g •• �� A Date: (2_ 1 S l \S
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: ja 1 5—
Site Plans: # 3(AN/0/44/4)
Building Plans: # 3
Building Permit#: tenter building permit#above.
Workflow Routing: g �ngineeritig coordinator L Building
Workflow Sign off: ign- f for Planning(include notes from planning review)
Route Application Documents: wilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes: C___. -,
By Permit Technician: _40 , ��� Date: 42/51/3—
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2/y1/TI:\Building\Forrns\BldgPennitRvw_COM_WithL.andUse_07091 5.docx
Engineering Review
iz Slope at building pad: 51Z
12--PFI Permit#: AO
Ceonditions "Met"prior to issuance of building permit
Et-Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP) iJiik
13-Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes 'No
Assess Water Quantity Fee in-lieu: ❑ Yes 2r-No
LIDA Facility on lot: 2"-c es ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: j/ �/- ^- Date: /2--/ 7-lc
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
a.-
Approved,NOT Released: Date: / I � r S
Notes: ��? a, GN1.sA rv� /V�Pr—/t/ j a •
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:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
OK to Issue Permit
pproved by Permit Coordinator: / 6 Date: ��? !V )S-
I:\Building\Fonns\BldgPennitRvw_COM_WithLandUse_0709I 5.docx
MHA15080 Dirksen Nature Park-Tree Protection Monitoring
Morgan Nolen 1 12/16/2015
— —AZ/OCIATE/'L« Page 1 of 1
Inspection On Site Recommendation for Resolution
Inspector Item Condition or Comment
Date Contact Corrective Action Date
Tree
Morgan Protection measures satisfactorily in place and in
12/16/2015 Jeff Peck Protection None. N/A
Nolen good repair where needed prior to construction.
Verification
General Comments:
None.
Morgan Nolen &Associates, LLC
Consulting Arborists and Urban Forest Management
3 Monroe Parkway,Suite P220, Lake Oswego,OR 97035
morgan.holen@comcast.net I 971.409.9354