Permit IL CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit #: SIT2011 -00001
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/23/2011
Parcel: 2S101AB00100
Jurisdiction: Tigard
Site address: 12023 SW 70TH AVE
Project: Red Rock Center, Phase II Subdivision: Lot: 0
Project Description: Site work for new office building.
Contractor: BONES CONSTRUCTION CO Owner: FRY, DOUGLAS
3508 S 209TH AVE 23077 SW NEWLAND RD
ALOHA, OR 97007 WILSONVILLE, OR 97070
PHONE: 503 - 649 -5682 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee - Site Work 06/23/2011 $1,707.42
Plan Review 01/25/2011 $1,109.82
Type of Use: COM 12% State Surcharge - Building 06/23/2011 $204.89
Class of Work: ALT Erosion Control 06/23/2011 $320.00
Erosion Plan Review CWS 06/23/2011 $104.00
Project Valuation: $300,000.00 Erosion Plan Review COT 06/23/2011 $104.00
Plan Review - Fire Life Safety 06/23/2011 $682.97
Info Process /Archiving - Lg Sheet (over 06/23/2011 $58.00
Site Specifics: 11x17)
Excavation Volume: cu. yd.
Fill Volume: cu. yd.
Impervious Surface: sq. ft.
Engineered Fill: No Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Yes Retaining Wall: Yes
Fire Underground: Yes Accessible Parking: Yes
Fence: Yes
Total $4,291.10
Required Items and Reports (Conditions)
1 Ersn Cntrl 503- 681 -4444
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 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 No' -. •. _- ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir- ::5t5 ion to O C . • allin. 503.232.1987 or 1.800.332.2344.
Iss ed , i 'i Permittee Signature:
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.
,
R.,r, °� •
.yu�lding Permit Application .
Li . , ,,, :
: w =1 ( - FOR OFFICE USE ONLY ' '°
Cit y Tigard Tl and N �a �, Recei Date /B I ved
f
A Permit No.: J 4
13125 SW Hall Blvd., Tigard, OR 97223 y
g ' Plan Review // __ daym
Phone: 503.639.4171 Fax: 503.598.T 0 Date /B : �P �5� Other Pernir
tI
GARD Inspection Line: 503.639.4175 �1 011 D. - R -.. •/B . Juris: 21 See Page 2 for
Internet: www.tigard- or.gov 6° 1� Notified ethod X /(410 F Supplemental Information
JP ,,p , � / . ms .
TYPE'OF "141 " °" G�'' -1�' Z REQUIRED :DATA I: ANDZ`- FANIft ` DWELL ° INGry':; :°M
- - - � i siM � 4 P
. ,. - - ,_r� . d.FF• _. m gca M ¢_e_ �•F=�' -- 5a ' . �= 1� > �� tom.
'New construction ❑ Detnohtio M 11' Permit fees* are based on the value of the work performed.
111 111 Indicate the value (rounded to the nearest dollar) of all
d -
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
` - -" - - „' work indicated on this application.
CA _ CsORY O F CONS ON pP
❑ 1- and 2- family dwelling .N,Comniercial /industrial
Valuation: $
•
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
J`OB SI : D. TSOC �'” ATIQ N. Total number of floors:
TE INFQRIYIAT� ION
Job site address: ,c 76 New dwelling area: square feet
City/State /ZIP: `G� Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: or q ' P / - Covered porch area: square feet
Cross street/directions to job site: d A A,4 4 M . Deck area: square feet
Other structure area: square feet •
RE a UIRED DATA CO.AS1v1ERCIAL -USE GHECKUIST.f
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
q overhead, and the uipment materials, labor, overhe d a e prof t for the
�` DESCRIPTION = ' O �1 O RK, g rr :1 .' work indicated on this application. t
„Q -p i- UJ ' \e f_ Valuation: $ - gcc � WO
JI� Existing building area: ■—• square feet
New building area: – =– square feet •
P `pF.ERTY.W O� NEit a '" ❑ TENANT Number of stories: —
Name: Type of construction:
Address: – 1 12d Occupancy groups:
City/State /ZIP: 14 00 4/V DR, . Existing:
Phone: ( aelsi3 - Fax: ( )
1 New:
, . Plik T, -i a CONTACT ' „ R S®
_,, i` , , ,_ ., :- iak,' 442w . - — : 65- x y " fia ,t �k
Business name: " "^"' � �4 arts required _ a
� • ( All c ontra ctors and subcontractors are re utred to be
Contact name: / ` licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: ow ;! , -3y !d , , jurisdiction in which work is being performed. If the
City/State /ZIP: f D 714 applicant is exempt from licensing, the following reasons
�lw �� 2l 'f� apply:
Phone: ( `s 271 - 7 2 77 I Fax: ( �IJ3 ) 2✓/ /. – 27
E atm 1J`jh1 P At N'{(1'e J c .
.W .. -.: C ONT'Re� C TO) 2 ,, . - :, ;_;- „._.t
I C2c 2 !1TloJ
Business name: B DING P
Address: .Z 5w A0 9-r-L- 4!
i' w = FP1ease effr o` /ee schediilef 4,-47
-- Structural plan review fee (or deposit):
City /State /ZIP: 4 0 2 gi -tag q
Phone: ( y j3) &(1 q .. 5 / Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: 7 ,b `f �1 � / .� Total fees due upon application: f. /�0 V
' Amount received: ll" I i1
Authorized signature:
�„� ��� ��___ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: L % A) [ '/� Date: / / /( * Fee methodology set by Tr- County Building Industry Service Board.
I: \Building \Permits \BUP -COM PennitApp.doc 10/01/09 440- 4613T(11/02/COM /WEB)
r
IN
" Building Division
Development Code Provision Review
TIGARD Commercial Projects with Approved Land Use
Building Permit No.: t 1 / / —6:000 Land Use Casefile No.: f Q9 /d --4000
Routed Plans:
Submittal Date: 145
Submittal Date:
Submittal Date:
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies
to the Building Division. Only checked (✓) items are approved. Items not approved and those listed in the
notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed
above each section.
STAFF: please only mark those items on the left side that are approved.
Planning Review (contact at 503 -718- or @tigard - or.gov)
❑ Land Use Approval
❑ Building Plans Match Approved Plan: Yes ❑ No ❑
❑ Maximum Building Height
❑ Conditions Met
Notes:
aK 6- i
Original Plan: Approved Not Approved ❑ Date: ( 2 2 - //
Revision 1: Approve ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov)
❑ Actual Slope:
❑ PFI Permit #
❑ Conditions Met �K e ` / J � '
Notes: K /�
Original Plan: Approved Not Approved ❑ Date: &AL //
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
City , borist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard- or.gov)
S treet Trees
Protected Trees
Notes:
Original Plan: Approved lJ Not Approved ❑ Date: 67r9Y).
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
•
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit
❑ Engineering Okay to Issue Permit
Notes:
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant X �f
Okay to Issue Permit: Yes N ❑
Date Routed to Building: / ` l /
Page 2 of 2