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Permit (37) CITY OF TIGARD SITE WORK PERMIT Iv2- COMMUNITY DEVELOPMENT Permit#: SIT2017-00023 T EGA R Z 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/11/2017 Parcel: 2S103CD07400 Jurisdiction: Tigard Site address: 13800 SW 118TH CT Project: City of Tigard Subdivision: CREEKSIDE PARK Lot: 4 Project Description: Landslide repair to adjacent City of Tigard property. Work includes outfall repair to Derry Dell creek close to intersection of 118th and Gaarde. Contractor: ELTING NORTHWEST INC Owner: KLETTKE FAMILY TRUST P.O. BOX 1400 BY RICK UN RENEE KLETTKE TRS CLACKAMAS, OR 97015 13800 SW 118TH CT TIGARD, OR 97223 PHONE: 503-656-0954 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-Site Work 09/11/2017 $2,987.07 Plan Review 08/31/2017 $1,941.60 Type of Use: COM 12%State Surcharge-Building 09/11/2017 $358.45 Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 09/11/2017 $10.00 11x17) Project Valuation: $585,000.00 Erosion Control w/Development 09/11/2017 $536.40 Site Specifics: Excavation Volume: 1900 cu.yd. Fill Volume: 2133 cu.yd. Impervious Surface: 0 sq.ft. Engineered Fill: Soil Report Required: Yes Paving: No Grading: Yes Landscaping: Yes Site Prep: Yes Storn Drains: Retaining Wall: Yes Fire Underground: No Accessible Parking: No Fence: No Total $5,833.52 Required Items and Reports(Conditions) 1 Ersn Cntrl 503-639-4175 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 5Q3.232.1987 or 1.800.332.2344. Issued By: Ze_c`/4 �/1 �.. /� �;� Permittee Signature: �� �l�(���C /lYL� / /, -7 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 Site WorkFOR OFFICE USE ONLY ive City of Tigard , , ReceDate/Byd: 7 3I i7 PermitNo.: /7" j 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Revi- ►1' 9 = Phone: 503.718.2439 Fax: 503.598.1960 r� y q t� Date/By: 1 To / ter r Other Permit: ACI'0/2- 3S Inspection Line: 503.639.4175 t t. Date Ready : . 11 Auris: ® See Page 2 for T 1 G A R D � � Notified Method: el 7 I Supplemental Information Internet: www.tigard-or.gov i ICC" Beni P�aSR(3Co A REQUIRED DATA:1-AND 2-FAMILY DWELLING AI TYPE OF WORK 11ID . ❑ •ion 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 Other: l_;..�P�/�1� equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION "`��'��� p work indicated on this application. iii!!! Valuation: $ . 8C� Od=0 . 00 o 1-and 2-family dwelling 0 Commercial/industrial Number of bedrooms: ❑Accessory building 0 Multi-family ❑Master builder Other:t7(;04.4 £ 6 1) Repo 4 Number of bathrooms: \ JOB SITE INFORMATION AND LOCATION Total number of floors: \ Job site address: o ye,44‘ /3 90 ug d , New dwelling area: \ square feet City/State/ZIP: ., ,� , d�, 9 7 O2 3 Garage/carport area: \ square feet Suite/bldg./apt.no.: Project name: 61.4 P E 1 AND Covered porch area: \ square feet Cross street/directions to job site: p ki r��C Kt9 /ALg g-�-(j12� Deck area: square feet �rm (R� V0 r , (I g 4^�T. p-{-, f r -1 bin Other structure area: square feet 1�1e r* G PI I ' 4<- Cm:61 Til 1 0c-/c) ,QUBZED DATA CO RCIAL-USE CHEQKIAST Subdivisicki: Lot no.: i 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.: 'Z b i O ?'G rte) 0-77_0 0 equipment,materials,labor,overhead,and the profit for the DESCRIPTIONpWORKoI:Iwork indicated on this application. Valuation: $ LCAvN1*(t d i_ re7 a I r� dG w ns r-ec.ry, c liglb O- ArA -C• ,'� 5-to r Jr rot r'e ,r- Existing building area: square feet ��S ✓ �(%' f f1 © � New building area: square feet I ,, ' - •, 'PION. Number of stories: �a n Name: cry'Y d f �rL p (Z_/) ` Type of construction: Address: I i lis S l.td Acj i 61,0 Occupancy groups: City/State/ZIP: l l 9 a rd1 O ( g' 27/3 Existing: Phone:(50) 1/ 3 2 1 0 Faze ) New: It, i - . . � �� ‘it sr . Business name: All contractors and subcontractors are required to be r licensed with the Oregon Construction Contractors Board Contact name: Ca b./i‘,.‘, C�'-G � :..1,� rCl ; under ORS 701 and maybe required to be licensed in the , Address: 5 ✓ jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: �tl�" � .) apply: Phone:( ) (../\ p Fax::( ) Emailco,fl, e ! c cJ of . \ O`z Business name: g 1 . /NC Nic(-j-kvv Pic i(\C . 'ik . BUILDING 'ERMIT FEES* ,' 0 6 I C[ a S O R - " (Please refer w fee schedRleJ Address: to (G h �/11 l Structural plan review fee(or deposit): City/State/ZIP: ci 70 f 5 — �4-Q v / FLS plan review fee(if applicable): Phone:(5 ''3 G _ Fax:( ) Total fees due upon application: /t 11.'1 1_0 ::: (� 47 Signa ---... ..4 re: This permit application expires if a permit is not obtained (� ktyc within 180 days after it has been accepted as complete. Print name:C �7 t2 1 7 if (�4 AEo7 A Date: i3 ( ?/ `7 * Fee methodology set by Tri-County Building Industry � Service Board. I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 440-4613T(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: � 0 cu.yds. Grading Volume: (Soils report required for>5,000 cu. yds.) / 33 cu. yds. Fill Volume: (Fill exceeding 12"in depth shall be compacted to 90%of maximum density) -13 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 AL 4 ofF SUBM , Vgan Hxer> te g (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 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 2`�4( 1/ 2 fraction thereof,to and including $100,000.00. ��✓. S $100,000.01 and over $809.42 for the first$100,000.00 and l� $4.49 for each additional$1,000.00 or fraction thereof. I:\Building\Pennits\SIT-PenmitApp.doc 08/02/2016 2 City of Tigard q COMMUNITY DEVELOPMENT DEPARTMENT : C T1cAlzD Building Permit Review — Commercial - No Land Use Building Permit #: 5. 7:)017- � ,?: Site Address: //42O S/ // -ill (29 ,, L-_ Suite/Bldg#: Project Name: . ,f z ._ - (Name of ercial bus ,s occupying the space. If vacant,enter Sgc Space.) Planning Review/ f� 9 Proposal: ,L� c2lid e /2 ;A �?�- �gdii u� "arm- all -' Existing Business Activity: -1s, -- -;!.S Proposed Business Activity: / � Verify site address/suite# exists and active in permit syste tr • %' ver Terrace Neighborhood: > 111 Yes No T ring: 'Zyfrmitted Use: Yes ❑ No ❑ Spec Space V Confirm no land use required. tsiness License: Exists: ❑ Yes ❑ No,applicant notified to obtain business license Notes: Approved by Planning: �' Date: 0/37/23--- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved El Not Approved Revision 2: ❑ Approved El Not Approved Revision 3: El Approved El Not Approved Building Permit Submittal Original Submittal Date: 34117 Site Plans: # '3 Building Plans: # � Building Permit#: enter building permit#above. Workflow Routing: (racning ermit Coordinator EHraMig Workflow Sign-off: 8Sign-off for Planning(include notes from planning review) Route Application Documents: ding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: —7 By Permit Technician: : -z,,. _ Date: 53/1/7 I:\Building\Forms\BldgPermitRvw_COM NoLandUse_060116.docx 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 b./A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes L 1/A 70K to Issue Permit , Approved by Permit Coordinator: Date: /b/, �'— 7 I:\Building\Forms\BldgPermitRvw_COM NoLandUse_070915.docx