Permit 7 CITY OF TIGARD
SITE WORK PERMIT
� I ',II COMMUNITY DEVELOPMENT PERMIT # : SIT2008 - 00023
TIGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 11/12/2008
1 "' '' PARCEL : 25101 DA - 01700
SITE ADDRESS: 07130 SW FIR LP ZONING : C -P
SUBDIVISION: 72ND BUSINESS CTR -VARNS PARK LOT: 007 JURISDICTION : TIG
PROJECT: NELSON VIAL OFFICE
Project Description: Sitework for addition to west side of building.
CLASS OF WORK: ADD PAVING ?: RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 1,000.00
EXCV VOLUME: cy LANDSCAPING ?:
FILL VOLUME: cy SITE PREP ?:
ENG FILL ?: STORM DRAINS ?:
SOILS RPT REQD ?: IMPERV SURFACE: sf
Owner: FEES
A. RICHARD VIAL Description Date Amount
7130 SW FIR LOOP [BUILD] Prmt Fee -Valu 11/12/2008 $62.50
TIGARD, OR 97223 [TAX] Valu 12% State Surcha 11/12/2008 $7.50
[BUPPLN] Pln Rv -Valu 11/12/2008 $40.63
Phone: 503-684-4111 [ERPRMT] Erosion Control 11/12/2008 $80.00
[ERPLN] Erosn Pln Rv CWS 11/12/2008 $26.00
Contractor: [EROSN] Erosn Pln Rv COT 11/12/2008 $26.00
VIAL & PHAM LLC Total $242.63
7145 SW VARNS ST
l TIGARD, OR 97223
Contact #: PRI 503 - 597 - 2425
FAX 503 - 297 - 2428 REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 - 4444
Reg #: LIC 167458
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By Permittee Signature: ,2e, ____—
Cali 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
, E4iilding Permit Application
Site Work FOR OFFICE USE ONLY 5
City of Tigard RECe\I Received i ,, Pr �� Permit No.: i � ,,_ 3
13125 SW Hall Blvd., Tigard, OR 97223 v 0 Plan R eview
C Phone: 503.639.4171 Fax: 503.598.1960 � f ` , (1 (Z Other Permit:
Q V
T I G A R D Inspection Line: 503.639.4175 C C�G �`' Date DateBy: Ready :11/ 1 El See Page 2 for
Internet: www.tigard or.gov 011 O 10 Notified/Method: / t �, Supplemental Information
Q v 111OG v.a�
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling
_Valuation: $
❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7/ 3 5 w ,=,• ( Luz i i New dwelling area: square feet
City /State /ZIP: y , -- , 6 Gi , ^ 2_2 . 1 i Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: i_i_.60 3 // el. i) 1. 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.
lc- i4.4- ./ Sykiti ' / h Valuation: $ % 00 i2� (J'1
L L ,cc per 6 Existing building area: square feet
New building area: square feet
ja PROPERTY OWNER ❑ TENANT Number of stories:
Name: A . 1v4A_,1 l/.' C i../1 0 Type of construction:
Address: '7 / 3 r C CA-1 t f (1%---0 f Occupancy groups:
City /State /ZIP: . 4_e/ 0 "i 7.,2,' `1 Existing:
Phone: ( L-i; 4 k: , , of. 4 ii I Fax: ( ) New:
7°' APPLICANT ❑ CONTACT PERSON NOTICE
Business name: V , f E G L,. i All contractors and subcontractors are required to be
Contact name: c licensed with the Oregon Construction Contractors Board
H 4 /` �'�``�� under ORS 701 and may be required to be licensed in the
Address: . 7i..1 (» t; j 14 41 ; t j ./-. jurisdiction in which work is being performed. If the
City/State/ZIP: 9 C applicant is exempt from licensing, the following reasons
y 1 5 �,, / U 12., ? J 3 apply:
Phone: (5Z 5) 79, U C 1 5 Fax: : (5� 3 ) S t)) •- 4 .,,,2_<,1
E -mail: H ?a_ i/i A f11vtyy1 , L's
CONTRACTOR
Business name: t ie,t. ' ii; k t 1 c BUILDING PERMIT FEES*
Address: 747 00 3 C 1 1i (A yl L i tc -e-r. 5 t- . v Pleasere (or roje
City /State /ZIP: ` C . 1.` Structural plan review fee (or deposit):
' / FLS plan review fee (if applicable):
Phone: (5- ) .5 .y2_ G C Fax: ( j 3) j C(/ 2.4 ,,2 s
CCB lic.: 1 4 S li Total fees due upon application:
0 Amount received: -'
Authorized signature: �— This permit application expires if a permit is not obtained L within 180 days after it has been accepted as complete.
Print name: p _L ,4 f 11 4 Date: j I /dpi p y * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits \SIT- PermitApp.doc 12/27/06 440-4613T( I 1/02/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
11 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 ❑ *Parking (including ADA) and
ADA compliance Lighting 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.
# of Plans
TYPE OF SUBMITTAL Required at
(Includes New, Additions or Alterations) Submittal
Commercial 2
Multi- Family R -1 Occupancy 2
One- & Two - Family Dwelling 2
1:\ Building \Permits \SIT- PermitApp.doc 12/27/06 2
fl.;,', IJ
Site Work Permit Application
''' Plan Submittal Requirements
„T t G A R D G lr r.. 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: Two (2) 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 elevations crossing the entire site.
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.
1:\Building\Permits \SIT - PermitApp.doc 12/27/06 3
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.
1: \Building\Permits \SIT - PermitApp.doc 12/27/06 4
CITY OF TIGARD '-
•
BUILDING DIVISION PERMIT #: SlT200t1 -O0O23
13125 SW Hall Blvd., Tigard, OR 97223 ; DATE ISSUED: 11/12/2008
Phone: (503) 639- 4171 rgN;,�pyl
Inspection Requests (24 Hrs.): (503) 639 -4175 ` 'III
INSPECTION WORKSHEET FOR DATE: 26/2` �t TIME: 7 :00AM PAGE: 5
SITE ADDRESS: 07130 FIR LP CLASS OF WORK:
SUBDIVISION: 72ND BUSINESS CTR -VARNS PARK LOT #: 007 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE
DESCRIPTION: Sitework for addition to west side of bu
OWNER: VIAL, A. RICHARD PHONE #: 503.6B4 -4111
CONTRACTOR: VIAL & PHAM LLC PHONE #: 503 - 587 -242.5
Inspection Request Scheduled For: Date: 216/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 080383 -01 503-740-0125
Corrections /Comments/ Instructions:
it fr
/1--- Pte. - ?L /1 P 6 c v L-2- Pz.._ 71-r/
•
z PAS A P, RTIAL APPROVAL n CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date:2 0 Phone #: (503) 718- Z ___‘_Vy