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Permit (24) CITY OF TIGARD SITE WORK PERMIT 1,1 a COMMUNITY DEVELOPMENT Permit#: SIT2019-00018 TM All 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2019 Parcel: 2S102AD03200 Jurisdiction: Tigard Site address: 9045 SW BURNHAM ST Project: Taecorp,LLC Daycare Subdivision: 1998-032 PARTITION PLAT Lot: 2 Project Description: Striping of parking spaces to ADA standards and installation of bike racks. Contractor: ADVANCED LINE STRIPING Owner: TAE, MICHELLE 20401 SW PRINDLE RD TAECORP LLC TUALATIN, OR 97602 KWAN, IRWIN&JACKLYN LIVING TRU 16960 NW JOSCELYN ST BEAVERTON, OR 97006 PHONE: 503-2/20/2021 PHONE: FAX: FEES Description Date Amount Specifics: Permit Fee-Site Work 07/25/2019 $123.72 Plan Review 07/18/2019 $80.42 Type of Use: COM 12%State Surcharge-Building 07/25/2019 $14.85 Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 07/25/2019 $1.00 11x17) Project Valuation: $5,000.00 Site Specifics: Excavation Volume: 22 cu.yd. Fill Volume: 0 cu.yd. Impervious Surface: 53 sq.ft. Engineered Fill: No Soil Report Required: No Paving: No Grading: No Landscaping: No Site Prep: No Stom Drains: Retaining Wall: No Fire Underground: Accessible Parking: Yes Fence: No Total $219.99 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 sta -d wits 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires yo to follow the rule a,opt-,/"by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 IU r. You may •bta. - copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: 4 AL/ / /' 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 Work RECEIVED City of Tigard Received <� -del DateBy: � �� � Permit No.�S/rJ l/ Q 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 8 2019 �- Plan Revie Phone: 503.718.2439 Fax: 503.598.1960 JUL 1.)..2- I c41 ) Other Permit: T I G A R 1) Inspection Line: 503.639.4175 CITY OF TIGARD ?ad/Method: Ready/By: Juris: I See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISION j ""ed/Method" Supplemental Information --------2:—I----------- TYPE OF'WORK REQI ATA:1-AND 2-FAMILY DWELLING 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 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $ ElAccessory building ❑Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:9045 SW BURNHAM ST New dwelling area: square feet City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: Project name:TAECORP,LLC DAYCARE Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: 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. STRIPING OF PARKING SPACES TO ADA STANDARDS Valuation: $ 5,000 INSTALLATION OF BIKE RACKS Existing building area: square feet New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name:CATHY ROPER licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address:13795 SW IIARGIS RD jurisdiction in which work is being performed.If the City/State/ZIP:BEAVERTON,OR 97008 applicant is exempt from licensing,the following reasons ` Mom:( 318-o4z Fax::( ) E-mail:CATHY.ROPER46@GMAIL.COM CONTRACTOR Business name: Advanced Line Striping, Inc. BUILIjING PERMIT FEES* Address: 20401 SW Prindle Rd. (Piewe refer to fee schedule) City/State/ZIP: Tualatin, OR 97062 Structural plan review fee(or deposit): ©, X;1--- Phone:(503) 638-9040 Fax:( ) FLS plan review fee(if applicable): 1 CCB lic.: #157583 Total fees due upon application: Authorized signature: t Amount received: �� , — '�—AkThis permit application expires if a permit is not obtained Print name: �� ° Date: ---0-7-1-1within 180 days after it has been accepted as complete. �� 20 1 1 * Fee methodology set by Tri-County Building Industry 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: Less than or equal to 22 cu.yds. * Grading Volume: (Soils report required for>5,000 cu.yds.) 0 cu.yds. Fill Volume: (Fill exceeding 12"in depth shall be compacted to 90%of maximum density) 0 cu.yds. Retaining structure? (Check one) ❑ Rock ❑ CMU n Concrete ❑ Other: *Total new impervious area including all buildings, c_______ --., sidewalks, and paving: 53 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 -ttscttan-hereof,to and-including $25,000.00. r 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 * The areas potentially being excavated include the $50,000.00. landscape area under the location of the new $50,001.00 to$100,000.00 $540.42 for the first$50,000.00 and bike racks and the handicap space and accessible $5.38 for each additional$1,000.00 or fraction thereof,to and including route (if it is determined that parking lot hasc $100,000.00. insufficient base rock) . Amount being excavated is $100,000.01 and over $809.42 for the first$100,000.00 and less than or equal to 22 cubic yards. $4.49 for each additional$1,000.00 or fraction thereof. �/"L/ n/ t c i�3 7� '7/9-i 779-6-, 4-72-t-79- 7Z+ ,4'L" 6-Ke74e-t/. /� /i /cv-/ , L,c-- AJ/"C.- ,ma c GL/vc>€2 $O 0 sa c • 7//G/i7r Site Work Permit Application Plan Submittal Requirements TIG.\R D Commercial,Multi-Family and One- &Two-Family Dwellings A site work permit is required for all commercial projects including new buildings, additions, accessory buildings larger than 120 square feet,modular structures and multi-family R-1 occupancies. A site work permit is required for excavation, fill,grading,paving, retaining walls, fire hydrants and fire department access on private property for work on individual lots not covered under the subdivision development. Note: A separate "plumbing"permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. Please see the Site Utilities - Plumbing Permit Application for plan submittal requirements. 1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic location labeled with: A. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ applicant phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads (drawn to scale) with project location. 2. BUILDING PLAN submittal requirement: Three (3) complete sets, Civil only. All details listed below shall be incorporated into the plans: A. Site plan showing: 1) Required parking spaces and driveways. 2) A route, accessible to persons with disability,leading from the public way to an accessible building entrance. 3) Accessible parking spaces and adjacent access aisle connecting with the accessible route. 4) Curb ramps along the accessible route, curb, sidewalk and gutter. 5) Finish grade elevations along the accessible route. B. Topographic survey plan showing grade elevationssrossing the enrirc iter_ C. Overall grading plan. D. Utilities plan showing: 1) Fire hydrant location and pipe size if on private property. 2) If the building is to be protected with an automatic fire sprinkler system, show location of the water service vault and the fire department connection (FDC) within 70 feet of a fire hydrant. 3) Size of underground water service for the sprinkler system. E. Erosion control plan complying with the requirements of the Clean Water Services (CWS) agency showing: 1) Silt fence locations. 2) Bio-filter bags/other approved barrier material surrounding catch basins. 3) Illustrations detailing the correct installation of the silt fencing and catch basin protection. 4) Any other measures to ensure compliance with CWS standards. F. Landscaping plan. 3. ADDITIONAL REQUIREMENTS: A. Soils (geotechnical) report. A soils report is required for new buildings and additions to contain the following: 1) The report shall address the potential of soil liquefaction and instability (OSSC Sec. 1804.2). 2) Fills to be used to support foundation of buildings (OSSC Sec. 3301.1). 3) Foundation and lateral pressures exceeding 1,500 lb./sq. ft. (OSSC Sec. 1805). B. Fire flow and hydrant worksheet. C. Plan review deposit based upon project valuation. City of Tigard ill i q COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Commercial - With Land Use Building Permit #: c.5/ TCS/ ? ©W if Site Address: 104s S W (iJrniaa► SI, Suite/Bldg#: ---- Project Name: ta&cvrp, LLL Ou(Ve. (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: Sir�l;i 4- f rt.in�`1 sifik s L 40 S ,tr-A ,• �,,,s6IL At ()it rack E V,/V�rify site address/suite#exists and active in permit system.tem. L5�R.i er Terrace Neighborhood:II�� ❑ Yes pd No EI nd Use Case#: OPZZ,0lq--Q-O003 Plans atch Approved Land Use: Site Plan ❑ Landscape Plan ❑ Other: �/CI Urban Forestry Plan ❑ Elevation Plan LE B 'ding Height: Maximum Height kQ Actual Height 6 CVjc. L'1'Conditions Met: ❑ Prior to Submittalrior to Permit Issuance L' Business License: Exists: ❑ Yes LU' No,applicant notified to obtain business license Public Facilitiies provement(PFI) Permit: 2K Required: LE" Yes,applicant was notified LvJ No Applied For: ❑ Yes ❑ No,stopintake Notes: Approved by Planning: Sr-1,,e..- Clj_ Date: 7-1f-11 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 SubiriittatDate: . 7 /� Site Plans: #1 Building Plans: ## Building Permit#: 9—Enter building permit#above. Workflow Routing: 0—Planning [u--Engineering E— i mit Coordinator RBuilding Workflow Sign-off: El-Sign-off for Planning(include notes from planning review) Route Application Documents: D Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: r ,a Date: 06P:// I:\BuildingWorms\BldgpermitRvw COM_WithLandUse 060116.docx Engineering Review [Slope at building pad: it% ❑ PFI Permit#: ❑ Conditions "Met"prior to issuance of building permit n/'- Er-Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP) CEJ"Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes Er-No Assess Water Quantity Fee in-lieu: ❑ Yes Er/No LIDA Facility on lot: ❑ Yes Er No ❑ NOT Approved by Engineering: Date Notes: Approved by Engineering: d am' '� Date: 7712-,f? Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 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: DK 1 4C Fees Entered: Wash Co Trans Dev Tax: 0 Yes D N/A Tigard Trans SDC: ❑ Yes CYN A Parks SDC: ❑ Yes N/A OK to Issue Permit Z Q Approved by Permit Coordinator: Date: I:Building\Forms\BldgPermitRvw_COM_W ithLandUse_070915.docx