Permit CITY TIGARD SITE WORK PERMIT
DEVELOPMENT SERVICES PERMIT #: SIT2006 -00020
°�' I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED : 9/8/2006
PARCEL : 1S136DD -02500
SITE ADDRESS: SW NO ADDRESS ZONING : MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 010 JURISDICTION : TIG
Project Description: Dartmouth Office Bldg. Erosion Control Only. Tree removal & stump grinding. Lot 2500.
CLASS OF WORK: OTR PAVING ?: RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 500.00
EXCV VOLUME: cy LANDSCAPING ?:
FILL VOLUME: cy SITE PREP ?:
ENG FILL ?: STORM DRAINS ?:
SOILS RPT REQD ?: IMPERV SURFACE: sf
Owner: • FEES
SPECHT DEVELOPMENT, INC. Description Date Amount
15400 SW MILLIKAN WAY [ERPRMT] Erosion Control 9/8/2006 $80.00
BEAVERTON, OR 97006
Total $80.00
Phone: 503 - 646 -2202
Contractor:
COFFMAN EXCAVATION LLC
PO BOX 687
OREGON CITY, OR 97045
Contact #: PRI 503- 656 -7000
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Reg #: LIC 146689
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: 1/
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
She Work
Raiding Permit Applicatio 'J �1)
�` FOR OFFICE USE ONLY
City of Tigard Vit Received _ O i / 6 (/ �7
6 Date/By: 9 1 - ) Li
/mr�N y: Juris • 0 S ee Pa Permit No.:S l�C!`1t� O ‘ ,Z D
13125 SW Hall Blvd., Tigard, OR 97223 ® E ry 0
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960) Other Permit:
E
Inspection Line: 503.639.4175 Y o �IGABD V Date/13y: Date Ready/By: www.ci.tigard.or.us DS �V�$� C" � r � Page l Information
BUILDING D Notified/Method: �' V Supplemental nformation
``'A '; to TAPE, iOO I WORK , ` " REQUIRED DATA 1' AND 2 FAM1J Y, W ..,
❑ 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: Tree and stump removal equipment, materials, labor, overhead, and the profit for the
, r C ATEG OR Y ' *O CO N S TR U C T ION. ' work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
El Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
, � ° .' :'.'v'.,7. , JOBR' I AN LOC ^ g „N '+ i , , ,. Total number of floors:
Job site address: No address, SW 69' and Clinton New dwelling area: square feet
City/State /ZIP: Tigard, Oregon Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Specht Dartmouth Office Building Covered porch area: square feet
Cross street/directions to job site: 69 and Clinton Deck area: square feet
Other structure area: square feet
REQUIREDADATA., >COMMERCIAL-USE :CHECKLIST; 'i
Subdivision: Lot no.: 2500 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: T 1 S R 2 W Section 36 Indicate the value (rounded to the nearest dollar) of all
g , equipment, materials, labor, overhead, and the profit for the
° `sue „ zt , DESCRIPTIONOF -. ;' -# m . .-K.:. ;° ' work indicated on this application.
�� _ , . �
Erosion control fencing, inlet protection, and construction entrance for removal of fallen Valuation: $ 500.00
trees and stump grinding.
Existing building area: square feet
New building area: square feet
a ® PROPERTY OWNER - : 0' „TENANT, . - a ' Number of stories:
�.. � - :... 'I ... gy
Name: Specht Development, Inc. Type of construction:
Address: 15400 SW Millikan Way Occupancy groups:
City /State /ZIP: Beaverton, Oregon 97006 Existing:
Phone: (503)646 -2202 Fax: (503)626 -8903 New:
, ® APPII , , ` ,s F • : la, ._ k.ar, :a" - X 1 4 '' „ ',
. ,® �3CO PE , , ° rr " NOTIC
Business name: TM Rippey Consulting Engineers All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Karl Koroch, PE under ORS 701 and may be required to be licensed in the
Address: 7650 SW Beveland Street, Suite 100 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State /ZIP: Tigard, Oregon 97223 apply:
Phone: (503) 443 -3900 Fax: : (503) 443 -3700
E -mail: kkoroch @tmrippey.com
• • CONTRACTOR ,e d 4
Business name: C.a v4.0 ,(GAUAzTtpw) tNG. , ,,, 4'BUILDING PERMIT FEES *.
Address: `
Please refer to fee schedule.
City /State /ZIP: Fees due upon application C1‘
Phone: (50'4 C °� —' 7c o0 Fax: ( )
Amount received
CCB lic.: iy ((�^_(
u _ Date received:
Authorized signature: j This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Karl Koroch, PE Date: September 7, 2006 * Fee methodology set by Tri- County Building Industry
Service Board.
i. \Buildmg \Permits \SIT- PermitApp doc 12/03 440- 4613T( I 1/02/COM/WEB)
•
iJ u.,n . 2`3. 2006 12 : 53PM CLEAN WATER SERVICES 503 6814439 1 3441 P. 2
CleanWater Services
Our ':oniwitmcnt is clear.
June 20, 2006
Schott and Associates
11977 S. Tolliver Road
Molaila, OR 97038
RE: Service Provider Letter for Dartmouth Phase II (1S136DD06100, 6200,
6300, 6600, 2100, 2200, 2300, 2500), CWS ER File 06 -001599
Clean Water Services has received your Sensitive Area Certification for the
above referenced site. District staff has reviewed the submitted materials
including site conditions and the description of your project. Staff concurs that
the above referenced project will not significantly impact Sensitive Areas found
near the site. In light of this result, this document will serve as your Service
Provider letter as required by Resolution and Order 04 -9, Section 3.02.1. All
required permits and approvals must be obtained and completed under
applicable local, state, and federal law.
This letter does NOT eliminate the need to protect Sensitive Areas if they are
subsequently identified on your site.
If you have any questions, please feel free to call me at 503 -681 -5106.
Sincerely,
e-
Damon W. Reische
Environmental Plan Review
•
•
•
•
2550 SW Hillsboro Highway • Hillsboro, Oregon 97123
Phone: (503) 681 -3600 • Fax: (503) 681 -3603 • www.Cle,nWaterServices.org
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