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Permit al II CITY F TIGARD SITE WORK PERMIT COMMUNITY DEVELOPMENT PERMIT #: SIT2007 -00023 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 9/12/2007 PARCEL : 2S112AD - 01100 SITE ADDRESS: 06670 SW BONITA RD ZONING : I -P SUBDIVISION: PAUL SCHATZ FURNITURE LOT: 001 JURISDICTION : TIG PROJECT: PAUL SCHATZ Project Description: Parking. CLASS OF WORK: NEW PAVING ?: Y RESO. NO: TYPE OF USE: COM GRADING ?: VALUE: 19,500.00 EXCV VOLUME: 500 cy LANDSCAPING ?: Y FILL VOLUME: 500 cy SITE PREP ?: ENG FILL ?: STORM DRAINS ?: SOILS RPT REQD ?: Y IMPERV SURFACE: 92,996 sf Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 -WMI [BUILD] Prmt Fee -Valu 9/12/2007 $198.35 PORTLAND, OR 97224 [BUPPLN] Pln Rv -Valu 9/12/2007 $128.93 [TAX] Valu 8% State Surcha 9/12/2007 $15.87 Phone: [FLS] FLS Pln Rv 9/12/2007 $79.34 [ERPRMT] Erosion Control 9/12/2007 $80.00 [ERPLN] Erosn Pln Rv CWS 9/12/2007 $26.00 Contractor: [EROSN] Erosn Pln Rv COT 9/12/2007 $26.00 R & H CONSTRUCTION 1530 SW TAYLOR Total $554.49 PORTLAND, OR 97219 Contact #: PRI 503 - 228 -7177 FAX 503 - 224 -3638 REQUIRED ITEMS AND REPORTS Reg #: LIC 38304 • 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 4 Permittee Signature: 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 (a(`.0 Phi) (T7k Rt Site Work' D FOR OFFICE USE ONLY of Tigard Date /B : A ' Permit N o.: - .... 7 . 0 / , II ° 13125 SW Hall Blvd., Tigard, OR 9 Plan Revie;. /� O . O 6 001 Other Per t: Phone: 503.639.4171 Fax: 503.59 DateB : T I G Inspection Line: 503.639.41.7.,5 / D ate Rea By: I J ® See Page 2 for Internet: www.tigard -or.go .,iT OF j. Notified/Method:' y �� SL ' Supplemental Information BI' DIVISION Spite i ) ' . ' 4 UI 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 CONSTRU CTION work indicated on this application. Valuation: $ ❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder CI Other: Number of bathrooms: • JOB SITE INFO RMATION AND LOCATION Total number of floors: Job site address: (,1 (p -4- p 5INI jpINI 11 A -1=> • New dwelling area: square feet City /State /ZIP: -' . amp , O ©.4 ei 12_2.4 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: TAl lL tt•at,t _ T->ETAIL ISutt-Pthl, Covered porch area: square feet Cross street/directions to job site: Sys oti trtk. I SIN Q kp1.A Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL - USE "CHECKLIST Subdivision: l Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: W C l A l X>511 .2.A 12 �k X Lo -r l ( 0 © Indicate the value (rounded labor, to the nearest , an d the profit of all , equipment, materials, labor, overhead, and the profit f for the DESCRIPTION OF WORK - work indicated on this application. - ii-41c. rz --�I N J Valuation: $ sao TA 1� -- I2e tit O V clu Jt2- 8 — /\/€ N! Cin/i13 I PA v / tv/ r I Existing building area: 3 $ ' 52 feet P S t'NI t--•� / CON e /L re ,9 7 - 0 , 1 _/ 5 7 - 1 2 - / - Pp / I/ N1 New building area: 44 5 5 square feet Le PROPERTY OWNER ❑ TENANT Number of stories: Name: 4: " 1 / 4 C A 0, PE. p- €. S t l_ L. C Type of construction: (( ( Address: (..Q (2 Q o X1/4 13 „ t-r1e, P t Occupancy groups: J City /State /ZIP: Ti El A p - D . 0RE N RfiZ.,Z - . Existing: 13 1 0 ,4 1 s) Phone: ( ) Fax: ( ) , • . : S . �,� New: M l 1 P .�P PLICANT . ' � ❑ " , CONTACT PERSON NOTICE Business name: NI t t- D (2-g N liEs 1 �--(ic -O P All contractors and subcontractors are required to be Contact name: (� A N w t N licensed with the Oregon Construction Contractors Board 1 under ORS 701 and may be required to be licensed in the Address: 9 S1n( 13E- v i t ST 3 t - r E 1A. 0 jurisdiction in which work is being performed. If the City /State /ZIP: -1-1 A 12_1> 0 P-� c,/,./ 9'�� --3 applicant-is exempt from licensing, the following reasons apply: Phone: (50 3 ) /2 +¢ - OSSZ Fax: : (50 3) 2 4.4.- o 41 _- E-mail: y l p mdG�,�C . CoWI 0 0 CONTRACTOR Business name: I'- [4-- c N p_ l O t..( - BUILDING'PERMIT FEES* Address: I S' 3 6 SW �/It,1 L_ O (Please refer to fee schedule) Structural plan review fee (or deposit): City /State /ZIP: TO RTt_Nt4 n 1 n (=-+E' sr o NJ c f 7 2..05 FLS plan review fee (if applicable): Phone: (rj 0 ) zeg - 9-i 1-} I Fax: (SD a - 3 ti 3 a CCB lic.: 3 3 p Total fees due upon application: Amount received: Authorized signature: M ` e This permit application expires if a permit is not obtained , within 180 days after it has been accepted as complete. Print name: rl. PIA(J V Date: $' I O * Fee methodology set by Tri -County Building Industry Service Board. I:\Building \Permits \SIT - PermitApp.doc 12/27/06 440- 4613T(11 /02 /COM/WEB) - r 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. -4( S e - , �tir,sE - 1 Excavation Volume: cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) cu. yds. Fill Volume: , (Fill exceeding 12" in depth shall be ' . compacted to 90% of maximum density) cu: yds.' ' Retaining structure? (Check one) ' ' ••❑ ' Rock - . ' • ' . ❑CMU • . • • ❑ Concrete ❑ Other: *Total new impervious area including all buildings, sidewalks, and paving: • • • ; . s q. ft. Site Utilities Plumbing Work: Complete the .Plumbing Permit Application for site utilities plumbing work. Plans Required: See "Site Work Permit Application - Plan'Submittal Requirement's" attached. The'following must accompany this application: • R "Site Plan with Vicinity Map showing [r *Parking (including ADA) and ADA compliance Lighting Plan ' 1 ' • 2 Grading Plan and details Er *Landscaping Plan • Erosion Control :Plan and details [✓Soils Report (if required) , . . . Er Retaining Structures t4 -ir \IET CbMpt -g - old- P- - p#.N NMUs onr • *Does not apply to One- and Two - family dwellings. . ' , . ' `# of Plans • ' . • TYPE OF SUBMITTAL . - ,Required at' ° • (Includes New Additions or' lterations) Submittal ' • A • Commercial 2 1 • Multi- Family R -1 Occupancy 2 . : One- & Two - Family Dwelling 2 I: \Building \Permits \SIT - PermitApp.doc 12/27/06 • ' 2 ' , CITY OF ��uu m ��m nu��na�� BUILDING DIVISION ~~~~"~~~�""°~° ~�"°"~°"~~"° PERK4[T EUT2007-00023 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/12/2007 Phone: (503) 639-4171 ie Inspection Requests (24Hmj:(5O3)G3Q'4175 .J0w�` ^ �- P INSPECTION WORKSHEET FOR DATE: 21][1 JB TIME: 7:00Ah4 PAGE: 43 SITE ADDRESS: 06670 SYVBON|TARQ CLASS OF WORK: SUBDIVISION: PAUL SCHATZ FURNITURE LOT #: 001 TYPE OF USE: PROJECT NAME: PAUL SCHATZ DESCRIPTION: Phase 2-Parking. OWNER: PACIFIC REALTY ASS0QATES, PHONE #: CONTRACTOR: R & H CONSTRUCTION PHONE #: 603 Inspection Request Scheduled For: Date: 2/28/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 499 Final inspection 065785-01 503-939-7691 N Corrections/Comments/Instructions: __ drill -LIP /PARTIAL APPROVAL El CANCEL I | NO ACCESS | / FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- �--^c� /^ � �