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Permit CITY OF TIGARD SITE WORK PERMIT 14 8 COMMUNITY DEVELOPMENT Permit#: SIT2016-00014 13125 SW Hall Blvd.,Ti Date Issued: 03/23/2017 and OR 97223 503.718.2439 T[Ct .L 9 Parcel: 2S112DB00500 Jurisdiction: Tigard Site address: 15065 SW 74TH AVE Project: Interstate Roofing Subdivision: FANNO CREEK ACRE TRACTS Lot: 15 Project Description: Site work for new 16,893 sq.ft.two-story building. Contractor: YORKE&CURTIS Owner: INTERSTATE DEVELOPMENT LLC 4480 SW 101ST AVE 15065 SW 74TH AVE BEAVERTON, OR 97005 PORTLAND, OR 97224 PHONE: 646-2123 PHONE: FAX: FAX 643-5531 FEES Description Date Amount Specifics: Permit Fee-Site Work 03/23/2017 $1,752.32 Plan Review 03/23/2017 $1,139.01 Type of Use: COM 12%State Surcharge-Building 03/23/2017 $210.28 Class of Work: NEW Info Process/Archiving-Lg$2.00(over 03/23/2017 $32.00 11x17) Project Valuation: $310,000.00 Info Process/Archiving-Sm$0.50(up to 03/23/2017 $25.00 11x17) Erosion Control w/Development 03/23/2017 $386.40 Site Specifics: Excavation Volume: 420 cu.yd. Fill Volume: 774 cu.yd. Impervious Surface: sq.ft. Engineered Fill: Soil Report Required: Yes Paving: Yes Grading: Yes Landscaping: Yes Site Prep: Yes Storn Drains: Retaining Wall: Fire Underground: Accessible Parking: Yes Fence: Total $3,545.01 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 oC1'8BA332.2344. Issued By: ~� .._.. 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. nil ing Permit Application Site Work1't FOR OFFICE USE ONE\ n r a ,, City of Tigard i " t Date/B : /ifj4 411.-M PermitNo.:gj r II , .0,0,4 III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i /�� �7 ,d//� Other Permit: Phone: 503.718.2439 Fax: 503.598.1960., . Q Date/B Inspection Line: 503.639.4175 v'f-1 Date Ready/By: xgAL Jam. ® See Page 2 for T I G A R D p Notified/Method: 3 /7 Supplemental Information Internet: www.tigard-or.gov , C'PVC-- ,S r/C1 t-E' �r t TYPE OF y p l3G DIVISION REQUIRED DATA:1- 2-FAMILY DWELLING Demolition Permit fees*are based on the value of the work performed. New construction ❑ Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION Valuation: $ ❑ 1-and 2-family dwelling Commercial/industrial Number of bedrooms: ❑Accessory building 0 Multi-family Number of bathrooms: 1:1Master builder 0 Other: JOB SITE INFORMATION AND LOCATION Total number of floors: w Job site address: t S 0(0'S I0 ,4,-C t4 Akife,, New dwelling area: square feet City/State/ZIP: po .-7-LAtu D c c '1 22,2-4 Garage/carport area: square feet Suite/bldg./apt.no.: Project name: l 1,37-g ,_ z- r) Covered porch area: square feet Cross street/directions to job site: Deck area: square feet 1 U J— L Q9 a -r4 /N-11-0 'J)2-,t Other structure area: square feet Do. REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: —_ - I 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 ..: 2,5%t _yft)00'F.�0 'Lf-;\\ 4c., D►'�1 .tet= equipment,materials,labor,overhead,and the profit for the ry , 4 w ON a RIZ work indicated on this application. Valuation: $ Existing building area: square feet U)41449 It- JD9 �5New building area: square feet VillOPERTY OWNER f] TENANT Number of stories: H Name: )J )T)Rook 4 L4 Type of construction: Address: ,s-Q(n `k) `'] ,!/�. Occupancy groups: City/State/ZIP: ,PD -(L_ ljb 1 n(L, . 61-72„2..- Existing: Phone:( ) Fax:( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: Wit( iNC,a All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: l J... j( r) -^1-e(r ( under ORS 701 and may be required to be licensed in the Address: _A:4--.421.S..._" _441A t 5 ,C1S 5cti 1 2-.4.,I 1 jurisdiction in which work is being performed.If the 1 applicant is exempt from licensing,the following reasons City/State/ZIP: PE-,,71A - g 01) ©1 -i i2 apply: Phone:('3D2,).7;24_,, f 2- Fax::( ) E-mail: (lmi: e a2 r):. Gk(k 1 V1 L I rVL CONTRACTOR Business name: y/ A BUILDING PERMIT FEES* 1''V /�6'' �'���� (Please refer to fee schedule) Address: V q-1-0 S/4) /e/-(t /t/e- n --- Structural plan review fee(or deposit): City/State/ZIP: _?'`r-,,N 1 �j 2- -I 1 0 FLS plan review fee(if applicable): Phone:(SC j) 6 y y2J Fax:( ) Total fees due upon application: CCB lie.: s'54 y/ Amount received: Authorized signature:il� A This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 7� Hat, --c Date: 91g i'f to_ * Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\SIT-PernitApp.doc 08/02/2016 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: 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) cu.yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ❑ Other: *Total new impervious area including all buildings, 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 *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 3 $2.69 for each additional$100 or fraction Commercial 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. 1:\Building\Permits\SIT-PermitApp.doe 08/02/2016 2 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: 420 cu.yds. Grading Volume: (Soils report required for>5,000 cu.yds.) 354 cu.yds. Fill Volume: (Fill exceeding 12"in depth shall be compacted to 90%of maximum density) 774 cu.yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ▪ Other: Design Build *Total new impervious area including all buildings, 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: O Site Plan with Vicinity Map showing ADA 0 *Parking(including ADA)and Lighting - compliance Plan ❑x Grading Plan and details 0 *Landscaping Plan 0 Erosion Control Plan and details ❑X Soils Report(if required) ❑ Retaining Structures *Does not apply to One-and Two-family dwellings. Plan Submittal: TYPE OF SUBMITTAL #of Plans Permit Fee: (New,Additions or Required at Valuation: Permit Fee: Alterations) Submittal $.00 to$500.00 $51.09 minimum permit fee Commercial 3 $500.01 to$2,000.00 $51.09 for the first$500.00 and $2.69 for each additional$100 or fraction thereof,to and including$2,000.00. Multi-Family R-1 Occupancy 3 $2,000.01 to$25,000.00 $91.44 for the first$2,000.00 and $10.76 for each additional$1,000 or One-&Tw0-Family Dwelling 3 fraction thereof,to and including $25,000.00. $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 I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 3 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15065 SW 74TH AVE, TIGARD, OR, 97224 December 27, 2017 at 2:13:56 PM Record Type: Record ID: Commercial - Site Work SIT2016-00014 Inspection Type: Inspector: 499 Final inspection Chip Barnett Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor