Permit Y
CITY TIGARD SITE WORK PERMIT
i DEVELOPMENT SERVICES PERMIT # : SIT2006 -00010
DATE ISSUED : 10/3/2006
13125 SW Hal Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL : 2S101 DA -01900
SITE ADDRESS: g W VARNS ST ZONING : C -P
SUBDIVISION: VARNS ACRES LOT: 003 JURISDICTION : TIG
Project Description: Site work
CLASS OF WORK: NEW PAVING ?: RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 7,500.00
EXCV VOLUME: 1,043 cy LANDSCAPING ?: Y
FILL VOLUME: cy SITE PREP ?: Y
ENG FILL ?: N STORM DRAINS ?: Y
SOILS RPT REQD ?: N IMPERV SURFACE: 29,055 sf
Owner: • FEES
NELSON VIAL, LLC Description Date Amount
7000 SW VARNS ST [BUPPLN] Pln Rv -Valu 7/28/2006 $78.07
TIGARD, OR 97223 [BUILD] Prmt Fee -Valu 10/3/2006 $120.10
[TAX] Valu 8% State Surcha 10/3/2006 $9.61
Phone: [FLS] FLS Pln Rv 10/3/2006 $48.04
[ERPRMT] Erosion Control 10/3/2006 $80.00
Contractor: [ERPLN] Erosn Pln Rv CWS 10/3/2006 $26.00
[EROSN] Erosn Pln Rv COT 10/3/2006 $26.00
OWNER
Total $387.82
•
Contact #:
REQUIRED ITEMS AND REPORTS
Reg #:
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: - 7)T/4 � .P-7 Permittee Signature: 1
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.
ll
Site mirk Tao 6 S&i a ri. S
Pe Application I FOR OFFICE ICI'. USI'. ONLY •
City of Tigard Received % i Per mit
13125 SW Hall Blvd., Tigard, OR 97223 P1 e/RB view' 5 Oh T I ..- /v
Phone: 503.639.4171 Fax: 503.598.1960 " ^, 4 � �� , D , other permit.
Inspection Line: 503.639.4175 �'1 j Date Ready :y ® See Page2 for
Internet: www.ci.tigard.or.us Notified/Method leE Supplemental Information
TYPE OF WORK .,c ",‘ ; .i '5 \\ ' REQUIRED DATA: 1- AND 2- FAMILY DWELLING
,ig New construction ❑ Demolit \ t pr: " ' r 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: A equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION 0 1 4 . 6\ 2446 work indicated on this application.
❑ 1- and 2-family dwelling Du Commercial /indus V [rial g' Valuation: $
e.eY 1'
❑ Accessory building ,; ❑iMulti- family A 1 kj ' r ., - ,` - s• 1' tl Number of bedrooms:
❑ Master builder 0 Other: Number of bathrooms:
. JOB SITE INFORMATION AND LOCATION Total number of floors:
' Job site address: 7000 S1/J Va rnS 9. New dwelling area: square feet
City /State /ZIP: Bdr T!iB4, Og 97 223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 1,1 e(so v► NI j A A Covered porch area: square feet
Cross street /directions to job site:. Fos ° , - o ff .2 Ave t„,„.6 vP rhf Deck area: square feet
Si . , Gor.{■nve i 'end 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
Valuation: $ 20)00.
Existing building area: square feet
New building area: 35p0 square feet .
0 PROPERTY OWNER - I ❑ TENANT , Number of stories: 2 W/ . �a1.nAee,f
Name: NC 15 V tk' L L C . Type of construction: B `�' ..
Address: 7000 ` SW V µAS Si Occupancy groups: , \ 1 J
City/State/ZIP: pp-41A nd , 0/2- 972223 Existing:
Phone: ( ) Fax: ( ) .
'New•:
❑ APPLICANT • - ' ❑ CONTACT PERSON NOTICE
Business name. V teLk * ,PhA , [ I C All contractors and subcontractors are required to be
Contact name: 14 Ga. �� licensed with the Oregon Construction Contractors Board m.
under ORS 701 and may be required to be licensed in the
Address: '71 4 .3 vArn s Sf ree f jurisdiction in which work is being performed. If the
�bY # in4 J e g7z23 applicant is exempt from licensing, the following reasons
City /State /ZIP: .„ Ott I apply
Phone: (503) 74 — 0125 Fax. (S03) s 24.2,8
E-mail: A D0 . e vl�1pfnaM. corn_
1 CONTRALTOI • --
Business name: VW( w ph ern L i
� BU ILDING PERMIT FEES* - ,
Address: 7/1-5 SW V6rn5 Sf f J
Please refer to fee schedule.
City /State /ZIP: j� 0/2 9 72 -3
port/Aft/ Fees due upon application
Phone: (5 5/7 - 242.5 Fax: (503) 577 - 2428
CCB lic.: 1 ( „,.. 7 . 4 . 5 4 /'
received
•
Date received:
Authorized signature: J I / > This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
'riot name: mast Hew .r ' Date: Q$ 25 0 6 . Fee methodology set by Tri- County Building Industry
Service Board.
i \Bu Iding\Permns\SIT- PennitApp doc 12/03 440- 4613T(11 /02/COM/WPB)
„_-
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: < 101 3 \cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) Q 'cu. yds.
Fill Volume: `
(Fill exceeding 12” in depth shall be
compacted to 90% of maximum density) Q Cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU n 6ne relrir"
❑ Concrete `�
❑ Other: ( r
*Total new impervious area including all
buildings, sidewalks, and paving: 21 0 S 5 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 applica ' n: —
��;
Site Plan with Vicinity Map showing *Parking (i
[] r ncluding ADA) and �
A compliance Lighting Plan
. Grading Plan and details " *Landscaping Plan
' \ - Erosion Control Plan an e ai _ s _ , ) ❑ Soils Report (if required) n. n re
- D Retaining Structures hone rerir
*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
i.\Building\Forms\SIT- PermitApp.doc 1/13/04 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: S!T2006 MOO10
t ' A
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/3120)O5
Phone: (503) 639 -4171
A ii i
Inspection Requests (24 Hrs.): (503) 639 -4175 .4 "'L
INSPECTION WORKSHEET FOR DATE: 11113/2007 TIME: 7 :01A1a1 PAGE: 75
SITE ADDRESS: 06996 SW VARWS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 0A3 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE ADDITION
DESCRIPTION: Site work
OWNER: NELSON VIAL, LLC, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 11/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa•e
499 Final inspection M9491-01 503 7.10-0125
Corrections /Comments /Instructions:
A-<:-' ���
Cif,. 1 . C-7 • _ • I L
,►A PA - / PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i 6 - ge/
Inspector AL_ Date: 0 Phone #: (503) 718- C�
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• 7/23/2007
q ‘CCEL.# Conditions Associated With 3:20:53PM
Case #: SDR2005 -00001
Condition Status Updated
Code Title Hold Status Changed By Tag Date By
0001 SITE PLAN 2 INDICATE MATERIALS None Met 7/27/2006 CAC 7/27/2006 CAC
1. Prior to site/building permit issuance the applicant must submit a revised site plan for review and approval that
indicates the materials to be used for the proposed decking connecting the addition with the existing site amenities.
0001 APPLY FOR A TYPE II ADJUSTMENT None Met 10/28/2006 CAC 11/16/2006 MSB
2. Prior to site/building permit issuance the applicant shall apply for a Type II adjustment to the access and egress
standards or comply with the minimum access requirements by providing a 30 foot access width with 24 feet of
pavement.
0001 SIGNAGE AT ENTRANCE OF FLAG LOTS None NOT MET KSM 9/18/2006 CAC
27. The applicant shall provide signage at the entrance of each shared flag lot driveway or private street that lists the
addresses that are served by the given driveway or street.
0001 COMPLY W /CWS DESIGN & CONSTRUCT. None NOT MET KSM 9/18/2006 CAC
28. To ensure compliance with Clean Water Services design and construction standards, the applicant shall employ the
design engineer responsible for the design and specifications of the private water quality facility to perform construction
and visual observation of the water quality facility for compliance with the design and specifications. These inspections
shall be made at significant stages, and at completion of the construction. Prior to final building inspection, the design
engineer shall provide the City of Tigard (Inspection Supervisor) with written confirmation that the water quality facility
is in compliance with the design and specifications. Staff Contact: Hap Watkins, Building Division.
0001 ENTER INTO MAINT. AGREEMENT None NOT MET KSM 9/18/2006 CAC
29. If a Stormwater Management product is selected and approved for water quality treatment, then prior to a final
building inspection, the applicant shall demonstrate that they have entered into a maintenance agreement with
Stormwater Management, or another company that demonstrates they can meet the maintenance requirements of the
manufacturer, for the proposed onsite storm water treatment facility.
0001 SUBMIT REVISED LANDSCAPE PLAN None Met 11/21/2006 CAC 11/21/2006 CAC
3. Prior to issuance of a site/building permit, the applicant shall submit a revised landscape plan for review and approval
by the City Forester that shows street trees placed along the private access drive to meet the standards of 18.745.040.C.
Tree size and species must be indicated.
0001 DUPLICATE OF #3 None Met DRL 6/21/2006 DRL
4. (Duplicate of number three.) Prior to issuance of a site/building permit, the applicant shall submit a revised landscape
plan for review and approval by the City Forester that shows street trees placed along the private access drive to meet the
standards of 18.745.040.C. Tree size and species must be indicated.
0001 ALL SERVICE FACILITIES SCREENED None Met 11/21/2006 CAC 11/21/2006 CAC
5. Prior to issuance of site/building permit, submit detailed plans for review and approval that show all service facilities
including air conditioning units, HVAC, and gas meters, are screened from public view.
0001 SUBMIT REVISED SITE PLANS FOR REV None Met 7/27/2006 CAC 7/27/2006 CAC
6. Prior to issuance of building /site permits, the applicant shall submit revised site plans for review and approval that
shows the following:
A. One of the parking spaces reserved for carpool /vanpool parking. These spaces shall be located as close to the
building entrances as possible, second in priority to ADA parking.
B. Two additional parking spaces to meet current standards. Dimensions of the spaces should be shown on the plan.
C. Six bicycle rack spaces for the proposed building along with an elevation showing the detail design for the rack.
D. One loading space that meets the standards outlined in 18.765.080.B.
E. Curbing or wheel stops in the parking area.
0001 SUBMIT REVISED TREE PLAN None Met 7/27/2006 CAC 7/27/2006 CAC
7. Applicant shall submit a revised tree plan that reflects the correct numbering and removal schedule.
0001 SUBMIT TREE MITIGATION PLAN None NOT MET CAC 6/21/2006 DRL
8. Applicant shall submit a tree mitigation plan for review and approval by the City Arborist.
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Condition Status Updated
Code Title Hold Status Changed By Tag Date By
0001 SUBMIT CASH ASSURANCE, BOND ETC None Met 9/15/2006 CAC 9/15/2006 MSB
9. Prior to commencing site work, the applicant shall submit a cash assurance, bond, or other means of ensuring
compliance with the required mitigation in the value of 24 caliper inches in mitigation (24 x $125= $3,000). If additional
trees are preserved through the subdivision improvements and construction of houses, and are properly protected
through these stages by the same measures afforded to other protected trees on site, the amount of the cash assurance
may be correspondingly reduced. Any trees planted on the site or off site in accordance with 18.790.060.D will be
credited against the assurance for two years following final plat approval. After such time, the applicant shall pay the
remaining value of the assurance as a fee in lieu of planting.
0001 INSTALL TREE PROTECTION FENCING None Met 9/15/2006 CAC 9/15/2006 MSB
10. Tree Protection - Prior to any site work the applicant shall install all proposed tree protection fencing. The fencing
shall be inspected and approved by the City Forester prior to commencing any site work. The tree protection fencing
shall remain in place through the duration of all of the building construction phases, until the Certificate of Occupancy
has been approved.
If the Builder is different from the Developer or initial applicant:
Prior to issuance of building permits, the applicant shall submit site plan drawings indicating the location of the trees that
were preserved on the lot during site development, location of tree protection fencing, and a signature of approval from
the project arborist regarding the placement and construction techniques to be employed in building the structures. All
proposed protection fencing shall be installed and inspected prior to commencing construction. The fencing shall remain
in place through the duration of all of the building construction phases, until the Certificate of Occupancy has been
approved. After approval from the City Forester, the tree protection measures may be removed.
0001 SUBMIT BLDG ELEVATIONS FOR REV. None Met 7/27/2006 CAC 7/27/2006 CAC
11. Prior to issuance of building permits, the applicant shall submit building elevations for review and approval showing
windows facing the area between the two buildings.
0001 SUBMIT LIGHTING PLAN None Met 7/27/2006 CAC 7/27/2006 CAC
12. Prior to issuance of building permits, the applicant shall submit a lighting plan for the area between the two
buildings.
0001 PFI PERMIT REQUIRED FOR PROJECT None Met 8/1/2006 KSM 8/1/2006 KSM
13. Prior to issuance of a site permit, a Public Facility Improvement (PFI) permit is required for this project to cover
half street improvements and any other work in the public right -of -way (ROW). Three (3) sets of detailed public
improvement plans shall be submitted for review to the Engineering Department. NOTE: these plans are in addition to
any drawings required by the Building Division and should only include sheets relevant to public improvements. Public
Facility Improvement (PFI) permit plans shall conform to City of Tigard Public Improvement Design Standards, which
are available at City Hall and the City's web page (www.ci.tigard.or.us).
0001 SUBMITTAL 2 INCLUDE LEGAL NAME None Met 8/1/2006 KSM 8/1/2006 KSM
14. The PFI permit plan submittal shall include the exact legal name, address and telephone number of the individual or
corporate entity who will be designated as the "Permittee ", and who will provide the financial assurance for the public
improvements. For example, specify if the entity is a corporation, limited partnership, LLC, etc. Also specify the state
within which the entity is incorporated and provide the name of the corporate contact person. Failure to provide
accurate information to the Engineering Department will delay processing of project documents.
0001 JOINT USE /MAINT AGREEMNT 2B EXEC. None Met 8/1/2006 KSM 8/1/2006 KSM
15. A joint use and maintenance agreement shall be executed and recorded on City standard forms for all common
driveways. The agreement shall be referenced on and become part of all applicable parcel Deeds. The agreement shall
be approved by the Engineering Department prior to recording.
0001 SEWERAGE CONNECTION PERMIT REQD None Met 8/1/2006 KSM 8/1/2006 KSM
16. The applicant shall provide connection of proposed buildings to the public sanitary sewerage system. A connection
permit is required to connect to the existing public sanitary sewer system.
0001 PUBLIC WTR LINES 2 BE SHOWN -PFI None Met 8/1/2006 KSM 8/1/2006 KSM
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Condition Status Updated
Code Title Hold Status Changed By Tag Date By
17. Any extension of public water lines shall be shown on the proposed Public Facility Improvement (PFI) permit
construction drawings and shall be reviewed and approved by the City's Water Department, as a part of the Engineering
Department plan review. NOTE: An estimated 12% of the water system costs must be on deposit with the Water
Department prior to approval of the PFI permit plans from the Engineering Department and construction of public water
lines.
0001 PROVIDE COPY/RECORDED PUB EASEMN None Met 8/1/2006 KSM 8/1/2006 KSM
18. The applicant shall provide a copy of the recorded public easement for the existing public water line on -site. The
easement shall be on approved City forms.
0001 PRIVATE WTR QUALITY FACILITY PLNS None Met 8/31/2006 KSM 8/31/2006 KSM
19. Final design plans and calculations for the proposed private water quality facility shall be submitted to the
Engineering Department (Kim McMillan) as a part of the Public Facility Improvement (PFI) permit plans. Included with
the plans shall be a proposed landscape plan and maintenance plan. The plans shall be revised to provide a minimum
100 foot swale length or the installation of a Stormwater Management filter system. The calculations shall include all
impervious surface area, existing and proposed.
0001 SUBMIT STORMWTR PLANS & CALCS None Met 8/31/2006 KSM 8/31/2006 KSM
20. The applicant shall submit stormwater plans and calculations to ODOT for review and approval prior to issuance of
permits.
0001 COPY OF APRVD PERMIT 4 ODOT ROW None Met 8/1/2006 KSM 8/1/2006 KSM
21. The applicant must provide the City with a copy of an approved permit for use of the ODOT ROW for access.
0001 COPY OF ODOTS REQUIREMTS FOR ROW None Met 8/1/2006 KSM 8/1/2006 KSM
22. The applicant must provide, in writing, a copy of ODOT's requirements for ROW dedication and improvements. If
ODOT is not requiring ROW or improvements a letter stating that from ODOT will be sufficient.
0001 PROVIDE AN EROSION CONTROL PLAN None Met 8/1/2006 KSM 8/1/2006 KSM
23. An erosion control plan shall be provided as part of the Public Facility Improvement (PFI) permit drawings. The
plan shall conform to the "Erosion Prevention and Sediment Control Design and Planning Manual, February 2003
edition."
0001 WRITTEN RPTS TO CITY FORESTER None NOT MET CAC 6/22/2006 DRL
24. Prior to any Certificates of Occupancy, the applicant shall ensure that the Project Arborist has submitted written
reports to the City Forester, at Least, once every two weeks, from initial tree protection zone (TPZ) fencing installation,
through the building construction phases, as he monitors the construction activities and progress. This inspection will be
to evaluate the tree protection fencing, determine if the fencing was moved at any point during construction, and
determine if any part of the Tree Protection Plan has been violated. These reports must be provided to the City Forester
until the time of the issuance of any Certificates of Occupancy. The reports shall include any changes that occurred to
the TPZ as well as the condition and location of the tree protection fencing. If the amount of TPZ was reduced then the
Project Arborist shall justify why the fencing was moved, and shall certify that the construction activities to the trees did
not adversely impact the overall, long -term health and stability of the tree(s).
If the reports are not submitted or received by the City Forester at the scheduled intervals, and if it appears the TPZ's or
the Tree Protection Plan are not being followed by the contractor or a sub - contractor, the City can stop work on the
project until an inspection can be done by the City Forester and the Project Arborist. Prior to issuance of any
Certificates of Occupancy, the Project Arborist will submit a final certification indicating the elements of the Tree
Protection Plan were followed and that all remaining trees on the site are healthy, stable and viable in their modified
growing environment.
0001 DEED RESTRICTION REGARDING TREES None NOT MET CAC 6/22/2006 DRL
25. Prior to issuance of any Certificates of Occupancy, the applicant/owner shall record a deed restriction to the effect
that any existing tree greater than 12" diameter may be removed only if the tree dies or is hazardous according to a
certified arborist. The deed restriction may be removed or will be considered invalid if a tree preserved in accordance
with this decision should either die or be removed as a hazardous tree.
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Condition Status Updated
Code Title Hold Status Changed By Tag Date By
0001 COMPLETE WORK IN PUBLIC ROW None NOT MET KSM 9/18/2006 CAC
26. Prior to a final building inspection, the applicant shall complete any work in the public right -of -way (or public
easement) and obtain approval from the Engineering Department.
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