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Permit (37) CITY OF TIGARD SITE WORK PERMIT 34 •� COMMUNITY DEVELOPMENT Permit#: SIT2015-00006 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/21/2016 T IGARD Parcel: 1 S136CD00100 Jurisdiction: Tigard Site address: 11705 SW PACIFIC HWY Project: PACIFIC CROSSROADS Subdivision: 2006-016 PARTITION PLAT Lot: 3 Project Description: Adding(2)new parking spaces to parking lot. Contractor: ROBINSON CONSTRUCTION Owner: PACIFIC CROSSROADS PROPERTIES IN 21360 NW AMBERWOOD DR BY WYSE INVESTMENT SERVICES CO HILLSBORO, OR 97124-9321 1501 SW TAYLOR ST STE 100 PORTLAND, OR 97205 PHONE: 503-645-8531 PHONE: FAX: 503-645-5397 I FEES Description Date Amount Specifics: Permit Fee-Site Work 03/21/2016 $395.34 Plan Review 06/03/2015 $256.97 Type of Use: COM 12%State Surcharge-Building 03/21/2016 $47.44 Class of Work: OTR Erosion Control w/Development 03/21/2016 $107.60 Info Process/Archiving-Lg$2.00(over 03/21/2016 $12.00 Project Valuation: $32,000.00 11x17) Site Specifics: Excavation Volume: 60 cu.yd. Fill Volume: cu.yd. Impervious Surface: sq.ft. Engineered Fill: Soil Report Required: Paving: Yes Grading: Yes Landscaping: Yes Site Prep: Yes Storn Drains: Retaining Wall: Fire Underground: No Accessible Parking: Fence: Total $819.35 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 OUNC by calling 503.232.1987 • :is :' .44. Issued By: • ignature: —410/0 Call4175 by 7:00 a.m.for the next available inspection dat 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 Application14AS ‘ . Site Work , FOR OFFICE USE ONLY City of Tigard cy`L0� Received 403 /2 S'` Permic xo.: totylJam- CkIlk uv 13125 SW flail Blvd.,Tigard,OR 97223 �,� Rev! t ,�� J tiYOPicone: 503.718.2439 Fax: 503.598.1960 � � \N" 0 (-1( _.Other Permit:ryi.,0.�01S_ )/N '� , /Byf T t c;n u v Inspection Line: 503.639.4175 0. ql�� ' Date Rea 7wis: N2 See Page 2 for Internet: www.iigard-or,gov A.% Notified/method: I24)/l /3r- 7",,, Supplemental information TYPE OF WORK.;�' REQUIIZEp DATA:.1.AND 2 FAl1L4Y DWEI,L111G • 0 New construction 0 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 r • _ , work indicated on this application. CATEGORY OF'CONSTRUCTION . ❑ I-and 2-family dwelling IN Commercial/industrial Valuation: S ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB;SITE INFORMATION AND LOCATION Total number of floors: Job site address: 11705 SW Pacific Hwy New dwelling area: square feet City/State/ZIP:Tigard OR 97233 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:Pacific Crossroads Covered porch area: square feet Cross strect/directions to job site:N\'Corner SW Pacific Hwy&SW 78th Ave Deck area: square feet Other structure area: square feet REQUIRED.DATA:COM\IERC1AL=USE CI1ECKLIST Subdivision: Lot no.: Permit fees*are based on the value oldie work performed. Tax map/parcel no.:15136CD00100 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. Modification to On-site landscaping and parking lot area.Two(2)new parking Valuation: S32,000 spaces will beaded to the on-site parking lot. Existing building arca: N/a square feet New building arca: N/a square feet ® PROPERTY OWNER 0`TF.NANT Number of stories: N/a Name:Pacific Crossroads,Inc. Type of construction: Address:900 SW 5th Ave,Ste 2600 Occupancy groups: City/State/ZIP:Portland OR 97204 Existing: N/a Phone:(503)595-9685 Fax:( ) New: N/a 0 APPLICANT EY COTSTACT.PERSON NOTICE Business name:Barghuaseu Consulting Engineers,Inc. All contractors and subcontractors are required to be Contact name:An elo Bolo na licensed with the Oregon Construction Contractors Board g g under ORS 701 and may be required to be licensed in the Address:18215 72nd Ave South jurisdiction in which work is being performed.If the City/State/ZIP:Kent\\'A 98032 applicant is exempt from licensing,the following reasons apply: Phone:(425)251-6222 Fax::(425)251-8782 E-mail:abologna@barghausen.com barghausen.com CONTRACTOR..:' Business name: ieo ijAkick.a •BUILDING PERMIT FEES° (Please refer to fee schedule) Address: 02!j6L A/W GpG R a'• Structural plan review fee(or deposit): City/State/ZIP: / L,/fS/xyv ()rt/I7' 'i Phone:( 7) l/. / Fax:( ) FLS plan review fee(if applicable): CCB lie.: 63/Lt — Total fees due upon application: $395.34 Amount received: Authorized signature: This permit application expires if a permit is not obtained i within 180 days after it has been accepted as complete. Print name:Greg V.Close Date: (7i t 5 • Fee methodology set by Tri-County Building Industry Service Board. 1:1Building\Pcrmits\SIT-PermitApp.doc 10/01/09 440-4613T(I1/02/COMAVEB) y of Tigard COMMUNITYCitDEVE0.141 LOPMENT DEPARTMENT Building Permit Review — Commercial - With Land Use 1 ! , , \ l\I1 Building Permit #: .��o otc—r y j j C Site Address: //705 Ji Pac,'7 'c /lug Suite/Bldg#: Project Name: Ac fr-{-,L 0a,s-dex(S / (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review , (c.: ) ripk) ,s?/,a,rei, A Ag,,.....4 /01., Proposal: `IVerify site address/suite#exists and active in permit syste /r2 I's ver Terrace Plan District: ❑ Yes No ls' jAnd Use Case#: /14 LSC/ oc. /a Plans atch Approved Land Use: Site Plan Landscape Plan ❑ Other: ❑ Urban Forestry Plan ❑ Elevation Plan figAillding Height: Maximum Height Ac�al Height ❑ nditions Met: A/Q 111 Prior to Submittal I Prior to Permit Issuance Business Licens . � rent d / Exists: L�' Yes ❑ No,applicant notified to obtain business license 24ublic Facilities Improvement(PFI)Permit: Required: ❑ Yes,applicant was notified �o plied For: CI Yes � No,stop intake Notes: , J pa►/eC /nc,i_ re,1 , ,„ . - - Approved by Planning: Date: 6, kc-- 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: 67245- Site Plans: # Building Plans: # JL Building Permit#: Enter building permit#above. Workflow Routing: ming -sneering CTYCrmit Coordinator ^g Workflow Sign-off: -off for Planning(include notes from planning review) Route Application Documents: Lie-building: original permit application,site plans,building plans,engineer and / beam calculations and trust details,if applicable,etc. Notes: i�.f i)W 1J jf ite / t� 6/6//3— e. ./ .5441: -44e-p-/i' ? /".7)/4.-1/ fray, v_.,fCt is -.-: By Permit Technician: _ ---_ Date: ‘4,/,3--- I:\Building\Forms\BldgPermitRvw_COM_W ithLandUse_040115.docx 14glr--- /"TT.7-7-1.. 6.0 40 V;#)--) ) Engineering Review ❑ Slope at building pad: ❑ PFI Permit#: El Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP) ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ZrNo Assess Water Quantity Fee in-lieu: ❑ Yes B'No LIDA Facility on lot: 0 Yes ,-ErNo ❑ NOT Approved by Engineering: Date Notes: ND 644- 6,4 Nrirrm., i Elt- Approved by Engineering: Mt LA, Date: 6/Ki Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved Cl Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit /��/ pproved,NOT Released: /ri�1�� e��n-�r.L � It 4-N Date: � A•si . ' Notes: ..��12�C leo s2,i`��`rG•-w Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: evision Notice 3: Date Sent to Applicant: OK to Issue Permit Approved by Permit Coordinator: , - 4 Date: 3 ) . ---// ..' I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 040115.docx 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: 60 cu.yds. Grading Volume: (Soils report required for>5,000 cu.yds.) 60 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: N/a *Total new impervious area including all buildings, sidewalks,and paving: 3,075 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) ❑ RetainingStructures 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\'ermits\S1T-PermitApp.doc 05/25/2012 2 GHAV CIVIL ENGINEERING,LAND PLANNING,SURVEYING n U ° /tiG ENG, e May 27, 2015 STANDARD FEDERAL EXPRESS (503) 718-2644 Walter"Chip" Barnett IV Senior Building Inspector City of Tigard Building Division 13125 S.W. Hall Boulevard Tigard, OR 97223 RE: Site Work- Building Permit Application Pacific Crossroads Shopping Center 11705 S.W. Pacific Highway, Tigard, Oregon 97223 Our Job No. 6324 Dear Chip: We have completed the Site Work - Building Permit Application and associated plans for the above- referenced project. Enclosed are the following documents for your review and appro.,val 1. One (1) signed Site Work- Building Permit Application o, c SNb,rfe-cp9° 6111 r''� i 2. Three (3) sets of Improvement Plans, one wet signed - 0 3. Three (3) sets of Landscape Plans 4. One (1) check for Building Permit fees Please review and approve the enclosed at your earliest convenience. Should you have any questions, please contact me at (425) 251-6222, msuter(c�barghausen.com or Angelo Bologna at abolognaCa barghausen.com. Thank you for your prompt attention to this matter. lectfully, Mei E. Suter Design Engineer MES/dm 6324c.038.doc enc: As Noted cc: David H Rogers, Costco Wholesale Jay S. Grubb, Barghausen Consulting Engineers, Inc. Chris S. Ferko, Barghausen Consulting Engineers, Inc. Chris M. Tebaldi, Barghausen Consulting Engineers, Inc. Angelo A. Bologna, Barghausen Consulting Engineers, Inc. 18215 72ND AVENUE SOUTH KENT, WA 98032 (425) 251-6222 (425) 251-8782 FAX BRANCH OFFICES • TUMWATER, WA • LONG BEACH, CA • ROSEVILLE, CA • SAN DIEGO, CA www.barghausen.com ¢GHAu S CIVIL ENGINEERING,LAND PLANNING,SURVEYING , E O Z. - 2 sG i y: <,,N " G ENGEN June 3, 2015 STANDARD FEDERAL EXPRESS (503) 718-2644 Walter"Chip" Barnett IV Senior Building Inspector City of Tigard Building Division 13125 S.W. Hall Boulevard Tigard, OR 97223 RE: Site Work- Building Permit Application - Missing Sets Pacific Crossroads Shopping Center 11705 S.W. Pacific Highway, Tigard, Oregon 97223 Our Job No. 6324 Dear Chip: We have enclosed the two (2) missing sets for the Site Work - Building Permit Application for the above- referenced project. Please review and approve the enclosed with the original submittal dated May 27, 2015 at your earliest convenience. Should you have any questions, please contact me at (425) 251-6222, msuter@barghausen.com or Angelo Bologna at abologna@barghausen.com. Thank you for your prompt attention to this matter. R:I fitfully, - 7 1 i ‘.fr. ega . Suter Desi• ngineer MES/dm 6324c.040.doc enc: As Noted cc: Chris S. Ferko, Barghausen Consulting Engineers, Inc. Chris M. Tebaldi, Barghausen Consulting Engineers, Inc. Angelo A. Bologna, Barghausen Consulting Engineers, Inc. 18215 72ND AVENUE SOUTH KENT, WA 98032 (425) 251-6222 (425) 251-8782 FAX BRANCH OFFICES • TUMWATER, WA • LONG BEACH, CA • ROSEVILLE, CA • SAN DIEGO, CA www.barghausen.com 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 11705 SW PACIFIC HWY, TIGARD, OR, 97223 Commercial - Site Work 499 Final inspection PASS - No C of O SIT2015-00006 Chip Barnett Violation Summary: Inspector Contractor