Permit CITY OF TMGARt
SITE WORK PERMIT
COMMUNITY DEVELOPMENT PERMIT # : SIT2007 -00011
TI�GARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED : 4/27/2007
PARCEL : 2S102AA -04800
SITE ADDRESS: 08960 SW COMMERCIAL ST ZONING : CBD
SUBDIVISION: MORINS ADDITION LOT: JURISDICTION : TIG
PROJECT: COMMUTER RAIL STATION
Project Description: Site work for new commuter rail station.
CLASS OF WORK: NEW PAVING ?: RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: ....*3413—
EXCV VOLUME: cy LANDSCAPING ?: Y 700 000 , OD
FILL VOLUME: cy SITE PREP ?: j
ENG FILL ?: STORM DRAINS ?:
SOILS RPT REQD ?: IMPERV SURFACE: sf
FEES
Owner:
TRIMET Description Date Amount
710 NE HOLIDAY ST [TAX] Valu 8% State Surcharg 4/27/2007 $242.22
PORTLAND, OR 97232 [BUPPLN] Pln Rv -Valu 4/27/2007 $1,968.07
[BUILD] Prmt Fee -Valu 4/27/2007 $3,027.80
[FLS] FLS Pin Rv 4/27/2007 $1,211.12
Phone: 503 - 962 -2266
Total $6,449.21
. Contractor:
STACY & WITBECK INC
10700 SW TUALATINSHERWOOD RD
TUALATIN, OR 97062
Contact #: PRI 503 - 783 -5001
FAX 503 - 783 -5004 REQUIRED ITEMS AND REPORTS
Reg #: LIC 97081
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 Ore,. Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rul a. or direct questions to OU NC by
calling 50 3.246.66 1.800.332.2344.
Iss ed By:
Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that iness 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.
Site Work cP9OO 3 8 9 (O so (C'ti cjt i
Building Permit Application FOR OFFICE USE ONLY
City Of Tigard Date /B : �� � Penult No
° 13125 SW Hall Blvd., Tigard, OR 97223 — 5t ' � +a6 (/
g Plan Revi
_ b ` O ther P ermie
Phone: 503.639.4171 Fax: 503.598f1Dj� : 1 - qqry 0
Date/B : "JAL jr s /
Inspection Line: 503.639.4175 t ".l . ! 01 Date Ready /B • yr� IZI See Page 2 for
TIGARD
Internet: www.tigard Notified/Method: Y / : le /I(,P Supplemental Information
p. IA.) l • 0
TYPE OF WORK ' E f' ED DATA: 1- AND 2- FAMILY DWELLING
0 New construction ❑ Demolition Permit * 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 indicted on this applicon
al ion: 1
❑ 1- and 2- family dwelling ❑ Commercial /industrial _
❑ Accessory building ❑ Multi - family // Number of bedrooms:
❑ Master builder Other: Pn I L - 7 1 1. - Q/15 1 0. / f0t,tta* Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 8,9 /00 6,, 0_ )-I !-'1 ,G e i 4L. l New dwelling area: square feet
City /State /ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: l✓ash/..y�ayt C, porch area: square feet
Cross street/directions to job site: Se 7 ' E-' A44-7/1/ $ //A.`� / Deck area: square feet
-- �i�i i�/ C� '1 r rv,i e / �a ca .T Other structure area: square feet
LL
IXt/42G`L �44411.41 C.Ic,,P .t • 0'14 1 vt a.44.1 REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the valu- t -. - . .tined.
Tax map/parcel no.: Indicate the value (rounded to e nearest dollar) of all
equipment, materials, labo over -ad, and the profit for t •
DESCRIPTION OF WORK work indicated on this ap 7D 0 00 0
C� "lS 7'l4 ( 1 - (i \ 1 1 !- 411e- 4t. Valuation:
(I) . t .-/- � Existing building area: square feet
7! New building area: square feet
,f PROPERTY OWNER ❑ TENANT Number of stories:
Name: 7--R/Ai FT ( k.c.A/ K /25F / / Type of construction: �g .
Address: 7 ^ /r - f L-`P4 V S Occupancy groups: Ars-
City /State /ZIP: neie!'Cf}./VQ v/ / 723 2_ Existing:
Phone: ( 3) 94 Z - Z16 6 Fax: ( ) New:
❑ APPLICANT lo CONTACT PERSON NOTICE
Business name: # irv(7 ( , 6..._c_ All contractors and subcontractors are required to be
Contact name: m lZ g - •_ under ORS with the and may be required to Contractors license Boahel
"" under ORS 701 and may be required to be licensed in tt;e
Address: /0 7, s 7 ` ' _ ^ ,_ ,f" wc , t , o r 43e jurisdiction in which work is being performed. If the
��-• applicant is exempt from licensing, the following reasons
/
City /State /ZIP: (7,--- 17962- aPPIY� w
R ^ �
Phone: (Sp 3 76 S pO I I Fax:: (93) 7 e 3 cao 9-
E -mail:
CONTRACTOR
Business name: J'7 C it ( CK 1,c . BUILDING PERMIT FEES*
/ (Please refer to fee schedule)
Address: /p 7 S - w ,/ e«t.61 7 7 cilar vo o , Structural plan review fee (or deposit):
City /State /ZIP: r„ e ^ p2 9 7062_
r � V 1 Fax: FLS plan review fee (if applicable):
Phone:
( 7 83 - 5190 1 ( 1 3 ^ S e a Total fees due upon application:
CCB Iic.: 9 7 of/ 145( /I P 1k vu /L
r
k Amo. n re wed: ■
Authorized signatur - /' .1
This permit application ex Sl es if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 2btp l if. Date: W/cf/0 * Fee methodology set by Tri- County 13uilding Industry
Service Board.
I:\ Building \Permits \SIT- PermitApp.doc 06/26/06 440-461 3 T( 1 1/02/COM/WEI3)
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ;::-1 T2007-0001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 407 /2007
Phone: (503) 639 -4171 Mlo
I nspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/4/2. 8 TIME: 7: 00AM PAGE: 12
SITE ADDRESS: 08960 SW AL ST CLASS OF WORK:
SUBDIVISION: TRI MET COMMUJ - EP RAIL LOT #: TYPE OF USE:
PROJECT NAME: CO HAI, 1 RAIL SI'ATION
DESCRIPTION: Site work for new commuter. rail Citation,
OWNER: TRIMET, PHONE #: 603,962, 2266
CONTRACTOR: STACY & WITBECK INC PHONE #: 503-783-5001
Inspection Request Scheduled For: Date: . 11/4/20011 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 077E22 -01 603- 710 -6359 N
Corrections /Comments / Instructions:
PASS %� PARTIAL APPROVAL E] CANCEL 1 I NO ACCESS
(l FAIL VI CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
• Inspector: Date: II Y 46 Phone #: (503) 718- ___Ur&Y_