Permit (211) CITY OF TIGARD SITE WORK PERMIT
I COMMUNITY DEVELOPMENT Permit#: SIT2018-00023
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2018
T r "�I`.L� 9 Parcel: 2S102BB03200
Jurisdiction: Tigard
Site address: 12060 SW TIEDEMAN AVE
Project: Tiedeman Pedestrian Bridge Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 17,PT 1
Project Description: 395 feet of new 10-foot wide asphalt trail and new 85'steel pedestrian bridge with footings and abutments and
retaining wall.
Contractor: LEGACY CONTRACTING INC Owner:
PO BOX I
STAYTON, OR 97383
PHONE: 503-749-1818 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 09/17/2018 $2,767.06
Plan Review 08/14/2018 $1,798.59
Type of Use: COM 12%State Surcharge-Building 09/17/2018 $332.05
Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 09/17/2018 $17.50
11x17)
Project Valuation: $535,100.00 Erosion Control w/Development 09/17/2018 $536.40
Site Specifics:
Excavation Volume: 140 cu.yd.
Fill Volume: 370 cu.yd.
Impervious Surface: 4800 sq.ft.
Engineered Fill: Yes Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Stom Drains: Retaining Wall: Yes
Fire Underground: No Accessible Parking: No
Fence: No
Total $5,451.60
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 folio- the rules adopted by the Oregon
Utility Notification Center. Those rules e set forth in OAR 952-001-0010 through OAR 952-001-0090. "'ou ay obtain a copy of the rules
or direct questions to OU by ca %503 42.1987 or 1.800.332.2344. �
Permi ee Signature:j,� „ .
Issued By: // / CC��VVIL.-��w���w`�```����-
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 Application A lication ,
Site Work t',',',', ,_ FOR OFFICE USE ONLY
City of Tigard Received
ate/B: !Pe .it No.
13125 SW Hall Blvd.,Tigard,OR 97223 , �o y ��� / `� (e,L .. -.3
g ! P 5 C, Plan Review /
' tm Phone: 503.718.2439 Fax: 503.598.1960 a"'`' I' 1' °'i Date/By: `O Other Permit
T I(.A K 1) Inspection Line: 503.639.4175 rDate Ready/By: Juri. H See Page 2 for
Internet: www.tigard-or.gov of Notified/Method:4/amf 7�f�f�JS Supplemental Information
ire.
a..4 G 'L '5- "e41•*'- .t{:<
., _. 2-
TYPE.OF WORK REQUIREDzDA A:1-AND 2-F LY I]!WELILING,
®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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY:.OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other:Public Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:Woodard Park adjacent to Tiedeman Ave. /2e)66—r,,-,,...t., "fr, New dwelling area: square feet
City/State/ZIP:97223 `T c.l , 4... Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Tiedeman Ped.BYidge `i' Covered porch area: square feet
Cross street/directions to job site:Tiedeman Ave and Meadow Street Deck area: square feet
Project site is on Tiedeman Avenue 50 feet south of Meadow Street Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:N/A I Lot no.:N/A Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S102BB03200 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.
This project builds 395 feet of new 10-foot wide asphalt trail, Valuation: $$535,100.00
a new 85'steel pedestrian bridge with footings and abutment,s Existing building area: N/A square feet
and a retaining wall New building area: N/A square feet
CI PROPERTY OWNER 0 TENANT Number of stories: N/A
Name:Metro Type of construction: Steel/Concrete
Address:600 NE Grand Ave Occupancy groups:
City/State/ZIP:Portland,OR 97232-2736 Existing: 0
Phone:(503)797-1700 Fax:(503)797-1797 New: 0
0 APPLICANT 0 CONTACT PERSON NOTICE
Business name:City of Tigard All contractors and subcontractors are required to be
Contact name:Carla Staedter 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)718-2788 Fax::( )
E-mail:carla@tigard-or.gov
CONTRACTOR
Business name:Legacy Contracting,Inc. BUILDING PERMIT FEES*
Address:41850 Kngston-Jordan Rd.PO Box"I„ (Please refer to fee schedule)
Structural plan review fee(or deposit):
City/State/ZIP:Stayton,OR 97383
Phone:(503)749-1818 Fax:(888)249-2203 FLS plan review fee(if applicable):
C B lic.:185342 Total fees due upon application:
1 Amount received:
Aut rizesignatu ` j„,,,,k_ .--- This permit application expires if a permit is not obtained
((/�(( within 180 days after it has been accepted as complete.
Print name�� Date: `j— * 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)
I
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: 140 cu.yds.
Grading Volume:
(Soils report required for>5,000 cu. yds.) 477 cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90%of maximum density) 370 cu.yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
® Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: 4800 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
$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\Permits\SIT-PermitApp.doc 08/02/2016 2
Albert Shields
From: Albert Shields
Sent: Tuesday,August 21, 2018 12:27 PM
To: Carla Staedter
Subject: Tiedeman Pedestrian Bridge SIT2018-00023
Attachments: Albert Shields.vcf; Conditions - 08-21-2018.pdf
Carla, no reviewing your application and plans for SIT2018-00023 Engineering has noted that none of the required
Conditions of Approval have yet been met. Please see the attached list of conditions. Accordingly, I have coded this
application "Approved (for Plan Review) but Not Released." Plan Review will proceed but the permit will be on Hold
until the requisite conditions have been met. Please let me know if you have any questions.
Albert Shields
City of Tigard
Permit Coordinator
1503) 1e-2426 Work
lhert@ tigard-or.go v
13125 SW Halt Blvd.
Tigard„Oregon 97217
www.tigard-or.gov
1
City of Tigard
IIN COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 A 1zD Building Permit Review — Commercial - With Land Use
Building Permit #: \ -.. a 1-CCO23
Site Address: /2106'Q ,cii,L) 7,2,102(0,4_c e Suite/Bldg#:
Project Name: .4ha.;y,.l )P4�O ,,C7i,
(Name of commercial business occupying the space. If vacan,e ter Spec Space.)
Planning Review
Proposal: Ai-g4) c- 1 / ,c-,zed �P1L� 7 Al , t,
reii1 rte/
VerifypermitY site address/suit exists and active in s ste
Ii a er Terrace Neighborhood: ❑ Yes No
P2/and Use Case#: 010 6/9-- ( O1')(V/ gL2& 9- 6-0 a 1
Plan/Match Approved Land Use:
Ri to Plan Landscape Plan ether:
V Urban Forestry Plan elevation Plan
1 L b uilding Height: Maximum Height Actual Height
El Conditions Met: ❑ Prior to Submittal El Prior to Permit Issuance
':usiness License:
EL(Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Public Facilitiemprovement(PFI) Permit:
Required: Yes,applicant was notified El No Applied For: Yes El No,stop intake
Notes: elm Ati.1) Ytz _c-'4.1.// , io rs- 4 per'/2t i/- k...c,c�1r C
Approved by Planning: -----------..� Date: 3j liz�/)6
J
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 6 .k//7/-
Site Plans: #
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: ( PlanningEngineering 7 Permit Coordinator Building
Workflow Sign-off: C. ign-off for Tanning(include notes from planning review)
Route Application Documents: r► i uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: i
By Permit Technician: �✓/11I!� "."j 6 ate: /f _' ,
- r
I:\Building\Forms\B1dgPernutRvw_COM_WithLandUse_060116.docx
Engineering Review
❑ Slope at building pad:
El PFI Permit#:
❑ 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: El Yes El No
Assess Water Quantity Fee in-lieu: El Yes ❑ No
LIDA Facility on lot: ❑ Yes El No
El NOT Approved by Engineering: Date
Notes: ilk t 01"sS
20 I? - 000a
Approved by Engineering: Date: S 2--Vi
Revisions (after Building Submittal only) Reviewer Date
Revision 1: El Approved El Not Approved
Revision 2: El Approved El Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit(IFPA
pproved,NOT Released: CAtifV�„�, ,yam ate: J(V
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:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
C Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
OK to Issue Permit
APP Y roved b Permit Coordinator: 4/ Date: 1/4 / '
I:\Building\Forms\BldgPermitRvw COM_WithLandUse_070915.docx