Permit , F e CITY OF TIGARD
SITE WORK PERMIT
:13 . COMMUNITY DEVELOPMENT Permit #: SIT2010 -00002
Date Issued: 03/17/2010
:TIGARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S110DB00500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HVVY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant
Project Description: Site work for new drive -in restaurant.
Owner: FEES
MWF TIGARD LLC Description Date Amount
2123 NW ALOCLEK DR #1203
HILLSBORO, OR 97124 Permit Fee - Site Work 03/17/2010 $2,156.42
Plan Review 01/29/2010 $1,401.67
PHONE: 503 - 617 -0175 12% State Surcharge - Building 03/17/2010 $258.77
Plan Review - Fire Life Safety 01/29/2010 $862.57
Contractor: Erosion Control 03/17/2010 $100.00
MCOBEAN CONSTRUCTION LLC Erosion Plan Review CWS 03/17/2010 $32.50
PO BOX 16662 Erosion Plan Review COT 03/17/2010 $32.50
PORTLAND, OR 97292
PHONE: 503 - 936 -5119
FAX:
Type of Use: COM
Class of Work: NEW
Site Specifics:
Excavation Volume: cu. yd.
Fill Volume: cu. yd.
Impervious Surface: 39000 sq. ft.
Engineered Fill: No Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Yes Retaining Wall: Yes
Fire Underground: No Accessible Parking: Yes
Fence: Yes
Total $4,844.43
Required Items and Reports (Conditions)
1 SIT Ersn Cntrl 503 - 681 -4444
2 SIT Other Report (see note)
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 wit 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 -0100. You may obtain a copy of the rules
or direct quest ; ;J.c:;\ OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Y J\ z, Permittee Signatu . 050' ..0
Call 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.
Building Permit Application 6.(2 - 009 — o'ogo
Site Work • - • • FOR OFFICE USE ONLY
' , g I Received
City of Tigard '� Date /B�'. o � �6 �`I P No • glre94 t, " YJ2
1111
" 13125 SW Hall Blvd, Tigard, OR 97223
g Plan Review SI IN�
Phone: 50 3.639.4171 Fax: 503.598.1960 . Other permit
JAN 2 9 2010 Date/B �� �
TIGARD Ins ection Line: 503.639.4175 D ate Ready /By' 8 Se Page for
p I >
Internet: www. tigard -ocgov Date R d /Method. 7 , .►� S upplePage2Iorormation
t CITY OF i IC:A D
�
TYPE OF W47I;1.+NG Ul f ISIGN 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.
Valuation: $
❑ I- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATIO Total number of floors:
,rob site address: t S 3 to Cl r, g New dwelling area: square feet
City /State /ZIP: y,. J ( 77 Z ZL/ Garage /carport area: square feet
Suite /bldg. /apt. no.: Project name: 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.
t )<. tAJC'�- / / Valuation: $ �y_G2f)c
V � I' .df'v L.< -Ln+ ReL.6 ✓rs/t
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: pi `1,/ A 4 rGt L Lc_ Type of construction:
Address: z —‹ A/ L �/ cid , /✓r - izO Occupancy groups:
City /State /ZIP:: J ' j/ borv OR e=7 1 1 Zy Existing:
^j
Phone: (,A3) g/7-- D / 7S Fax: ( ) r New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors I3oard
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
('hone: ( ) Fax:: ( )
E-mail:
CONTRACTOR
Business t'4: 6 t....aN BUILDING PERMIT FEES*
Address: ec "Ka Z (Please refer to fee schedule) ,
City/State/ZIP: p �'7 L Structural pla review fee (or deposit) / d/ el. d' 7
y PD,1 /G
Phone: ( ) 93 ( - ' f / 9 Fax: ( ) FLS plan review fee (if applicable): kep�. 57
7 OOO Total fees due upon application:
CCB lie.:
received: 1 0 2 0 /4 1 / 44 /
Authorized si_. ure: / � Amount rece i
i � / This permit application expires if a permit is not obtained
1 � / within 180 days after it has been accepted as complete.
Print name: �"'� lM e.)-st4 Date: V J J * Fee methodology set by Tri- County Building Industry
Service Board.
1: \Building \Permits \SIT - PermitApp.doc 10/01/09 440- 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: cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) 3 cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be cgmpacted to
90% of maximum density) " "' ; •< =;1 �'. •'• cu. yds.
Retaining structure? (Check one) ❑ Rock
CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: 39,00fi 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:
n Site Plan with Vicinity Map showing ADA ❑ *Parking (including ADA) and Lighting
compliance Plan
1 1 Grading Plan and details ❑ *Landscaping Plan
n 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 2 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 2 $10.76 for each additional $1,000 or
fraction thereof, to and including
$25,000.00.
One - & Two- Family Dwelling 2 $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 12/27/06 2