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Permit (9) ' CITY OF TIGARD SITE WORK PERMIT ,101 COMMUNITY DEVELOPMENT Permit#: SIT2016-00016 T t G ART) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/05/2016 Parcel: 2S 104DC05800 Jurisdiction: Tigard Site address: 13950 SW ALPINE CREST WAY Project: Bull Mountain Park Subdivision: None Lot: None Project Description: Site grading,erosion control,paving&concrete flatwork. Contractor: GREG SCHROEDER ENTERPRISES INC Owner: CITY OF TIGARD 9812 SE WICHITA AVE 13125 SW HALL BLVD MILWAUKIE, OR 97222 TIGARD, OR 97223 PHONE: 503-654-4734 PHONE: 503-639-4171 FAX: 503-652-2333 FEES Description Date Amount Specifics: Permit Fee-Site Work 10/05/2016 $903.71 Plan Review 10/05/2016 $587.41 Type of Use: COM 12%State Surcharge Building 10/05/2016 $108.45 Class of Work: NEW Info Process/Archiving-Sm$0.50(up to 10/05/2016 $17.50 11x17) Project Valuation: $121,000.00 Erosion Control w/Development 10/05/2016 $236.40 Site Specifics: Excavation Volume: cu.yd. Fill Volume: 138 cu.yd. Impervious Surface: 1381 sq.ft. Engineered Fill: No Soil Report Required: No Paving: Grading: Yes Landscaping: Yes Site Prep: Yes Storn Drains: Retaining Wall: Yes Fire Underground: No Accessible Parking: No Fence: Total $1,853.47 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 N ''-ation Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0990. You m.,j obtain a copy of the rules or dir ct questions to`*UN 'y calling 503.232.1987 or 1.800.332.2344. // 1 1 Iss ed By: /2 Permittee Signature: 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. Building Permit Application r ,1 ,i Site Work r rill,/ , FOR OFFICE USE o\1,1' Cityof Tigard RecDateB : ((0 / (�� O`!/ �,/6 ^�D�� . g Date/B : Q Permit No.: fe J �.r/ 13125 SW Hall Blvd.,Tigard,OR 97223 3 Plan Revie C Phone: 503.718.2439 Fax: 503.598.1960 OCT 2015 Date/By: 4(6 Other Permit: 1 1 G A IL U Inspection Line: 503.639.4175 Date Reay I. / /�// /; kris' I ® See Page 2 for Internet: www.tigard-or.gov 9/�r ��:!r u d:"k /I1otifie.A e hod: t 0I/ 1 Supplemental Information 1,,lii .,, E „,..,,,,,A,._ / pP Th 6" .44!:f0:404" ,T,-,..; ',ii a 5 , la-,,,,,, 1 ►1 New construction ■ Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ■ ■ g equipment,materials,labor,overhead,and the profit for the � s ° t t s ..likAALwork indicated on this application. ■ dwelling /�/ Valuation: $ ■ AccessoryI.. Number of bedrooms: ■ ■ Other: Number of bathrooms: raft,ZiO 3: i§': e ° t 1= s ss Total number of floors: Job site address: I' 9''50 (DLL) /)_Lp,0 E..._ c/ New dwelling area: square feet Tigard OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.:N/A Project name:Bull Mountain Park Covered porch area: square feet Cross street/directions to job site:West on SW Walnut St from Hwy 99W Deck area: square feet Turn south onto SW 132"a Ave from Walnut. SW 132'Ave turns into SW Greenfield Drive Other structure area: square feet (Rt)or SW onto Morning Star Drive. West onto SW Woodshire Drive to terminus of roadway - �- QUIRED D TA: O EftK�, Subdivision:N/A Lot no.:N/A Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S104DC05800 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the 1 7 DESCRIPT10 OF ORK '.,17'1 work indicated on this application. Valuation: $121,000 Site Grading,Erosion Control,Pavement,Concrete flatwork Existing building area: 0 square feet New building area: 0 square feet ®'PRO,PERTY OWNER =TES Number •of stories: 0 Name:City of Tigard Type of construction: Site Work Address:13125 SW Hall Blvd Occupancy groups: City/State/ZIP:Tigard OR 97223 Existing: N/A Phone:(503)718-2466 Fax:( ) New: N/A SIC ■a �i � � i:„O A w , � i A g T PERp Business name: FQ 1 C 10 c op B u"..`mtmU.NTA-t N 'P All contractors and subcontractors are required to be Contact name: '�Qp,� licensed with the Oregon Construction Contractors Board Iu f �+k Q /A Q. under ORS 701 and may be required to be licensed in the Address: 13 it) 5u) AtpI L tj Aoy jurisdiction in which work is being performed.If the ��GJ- vJapplicant is exempt from licensing,the following reasons City/State/ZIP: T 1 . . 0 ©L q-3-22... apply Phone:(5D3 ) mak, 3v4,2_ Fax: :( ) E-mail: 'f 0 R ` . k h&W iMZ 8 1 MA 1 e.a/1/1 -- „,..:4 «� v ; , .c-. Business name: s e NC / Bt .j) 1 , 1 , , Address: Q r : .,°, .ini'w', Ar ,r , ',:, 1 W I I a "� Structural plan review fee(or deposit): City/State/ZIP: r i..u�1 ..t,f C 0 Q. "T 2S i 2 _ p FLS plan review fee(if applicable): Phone: (�)(as.q-if,3aJ Fax:( ) CCB lic.: �.� Total fees due upon application: Amount received:---(E) Authorized si ture: This permit application expires if a permit is not obtained /�, within 180 days after it has been accepted as complete. Print nam t�` Dat ` * Fee methodology set by Tri-County Building Industry 461, l l Service Board. I:\Building\Pennit T-PermitApp.doc 10 D S / -9' 41T-4'613T(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: cu. yds. Grading Volume: (Soils report required for>5,000 cu.yds.) 464 cu.yds. Fill Volume: (Fill exceeding 12"in depth shall be compacted to 90%of maximum density) 138 cu. yds. Retaining structure? (Check one) ® Rock ❑ CMU ❑ Concrete ❑ Other: *Total new impervious area including all buildings, sidewalks, and paving: 1,381 sq. ft. 1 . mlf- 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: YPE OF SUBMITTAL #of Plant : �n1 t. ee ' aluation Pe i New Additons or t ¥ � Required ate,..; $.00 to$500.00 $51.09 minimum permit fee Alterations). Subn ittal $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 3 $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\Pennits\SIT-PennitApp.doc 03/08/2016 2 U City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT I T I G A R D Building Permit Review — Commercial - No Land Use Building Permit #: * 7;i-o/Co-o0' / to Site Address: 139 o 6vJ P(P,nt Crejf 6Ja1 Suite/Bldg#: Project Name: -g,.l l }-l.E,n , ?ar<< (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: Si-te_ gradi ng 1 G 1 Y2V.ell t- Co etcrc-k c(G4 4c -PEA „:„ -.rte' -. Existing Business Activity: 0/A- Proposed Business Activity: t./ /a. Verify site address/suite#exists rand active in permit system. N-ltiver Terrace Neighborhood: CIYes o ki" Zoning: Pg 'l'Permitted Use: Yes ❑ No ❑ Spec Space Ar Confirm no land use required. VJ Business License: IExists: ❑ Yes ❑ No,applicant notified to obtain business license Notes: Approved by Planning: OALLAA, a. e to Date: /0 - 3 -1(0 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: 1013/ 1(0 Site Plans: # ?j Building Plans: # Building Permit#: 10/Enter building permit#above. Workflow Routing: Planning V Permit Coordinator [ "Building Workflow Sign-off: [ "Sign-off for Planning(include notes from planning review) Route Application Documents: V/Building: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: �� r( Date: /6/1//4, ©/1'/4 I:\Building\Forms\BldgPermitRvw COM_NoLandUse_070915.docx I i Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: 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: C Fees Entered: Wash Co Trans Dev Tax: ❑ Yes -161\1/A Ct./Y. - "1"- 130P Tigard Trans SDC: ❑ Yes L 'N/A Parks SDC: ❑ Yes N/A to Issue Permit Approved by Permit Coordinator: Date: /0/1-104, I:\Building\Forms\B1dgPermitRvw_COM_NoLandUse 070915.docx