Permit CITY OF TIGARD SITE WORK PERM T
COMMUNITY DEVELOPMENT PERMIT # : SIT2008 -00012
TIGARD DATE ISSUED : 5/8/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL : 2S101A6 01607
SITE ADDRESS: 07540 SW HERMOSO WAY ZONING : MUE
SUBDIVISION: HERMOSO PARK LOT: 009 JURISDICTION : TIG
PROJECT: LUBY BUILDING
Project Description: Site work for SF conversion to commercial.
CLASS OF WORK: OTR PAVING ?: Y RESO. NO: ft 7S?"60- Jb
TYPE OF USE: COM GRADING ?: Y VALUE: ,,QcOti
EXCV VOLUME: 691 cy LANDSCAPING ?: Y
FILL VOLUME: 39 cy SITE PREP ?: Y
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: Y IMPERV SURFACE: 3,860 sf
Owner: FEES
LUBY BUILDING LLC Description Date Amount
7360 SW HUNZI KER ST [BUPPLN] Pin Rv -Valu 4/22/2008 $316.36
SUITE 206 [FLS] FLS Pin Rv 4/22/2008 $194.68
TIGARD, OR 97223 [BUILD] Prmt Fee -Valu 5/8/2008 $486.70
Phone: [TAX] Valu 12% State Surchar 5/8/2008 $58.40
[ERPRMT] Erosion Control 5/8/2008 $80.00
Contractor: [ERPLN] Erosn Pln Rv CWS 5/8/2008 $26.00
[EROSN] Erosn PIn Rv COT 5/8/2008 $26.00
GVS CONTRACTING
700 N. COLLEGE Total $1,188.14
NEWBERG, OR 97140
Contact #: PRI 503 - 539 -2998
FAX 503 - 538 -9829 REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Reg #: LIC 54340 Structural observation
This pen 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 OU NC by
calling 51 . - -•• or 1.800.332.2344.
r
is - ued By: , /, % Permittee Signature: I4141
Call 503.639.4175 by 7:00 a.m. for an inspection t at 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.
LO
Building Permit Application Z. o J7 9
Site Work i FOR OFFICE USE ONLY
City of Tigard R eceived 1� �/�yn
� �an� V � ` Date /B 7 i Pemu[ No.: r , 1I I G(.G/ / b
.° 13125 S W Hall Blvd., Tigard, OR 970 ll'or •
2 p Plan Review
Phone: 503.639.4171 Fax: 503.598.196(A? R 6� �Q Date /Bv: (I A 0 Other Permit:
Inspection Line: 503.639.4175 a c� ;q Date Ready /By El See Page 2 for
TIGARD r FT i€ . Notified Method: Supplemental Information
Internet: www. ugard - or.gov (C T ,` L
�a�t�L tJ t4C L1 �L t�s9v r
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� -oz r aw A 'A— A t«-; .. 1 �'Z. A r m .; a ,.. AA� z:.'," >>r , ,.,,; %; , ,:a , 3 � ;
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- TYPE OE WORK ., e.. -� �„ lI REQL)IREl , .1 A 2 FAIVIILY
',. . ...." :<, _ m a =2 .. .4. . -, t .. _ . , u- - , kA . , yr .� ,,e" _: o� s ...-.� > » , ,
['New construction ❑ Demolition Permit fees* are based on the value of the work performed.
�
t Indicate the value (rounded to the nearest dollar) of all
J� Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
. , work indicated on this application.
_
lf; , .. 7-= 7-"..',,,,F.: CAT GOR OF (ONSTRUCT •6 ,...._49;',0 ' . ; ` .. � .
Valuation: $
❑ 1- and 2- family dwelling j Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
`- 11 f Total number of floors:
a A ; , JO SITE LN£tORM AND= `� ,: Viµ ., ,,
Job site address: 7540 SW Hermoso Way New dwelling area: square feet
City /State /ZIP: Tigard, Oregon Garage /carport area: square feet
•
Suite/bldg. /apt. no.: Project name: Luby Building Covered porch area: square feet
Cross street/directions to job site: SW Hermoso and SW 72" Avenue Deck area: square feet
Other structure area: square feet
„,.• - —, 4.v
REQUIRED DATA = :COMMERG1AL USECHECKLIST 4
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S101AB01607 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
xi rV , i5i , DESCRI'T ON OFJ"WORi�i m < work indicated on this application.
New commercial construction Valuation: $ .75 GOO
Existing building area: square feet
New building area: square feet
k ,.,r _Z PROPERTY OWNER TENANT E� r Number of stories:
Name: Luby Building LLC Type of construction:
Address: 7360 SW Hunziker St., Suite 206 Occupancy groups:
City /State /ZIP: Tigard, Oregon 97223 Existing:
Phone: (503)620 - 3342 Fax: (503)620 -3356 New:
A rani gr<:W r a„prAA',, Via . - .
Y. A - ' ' % . � , s ti " s ., , �, O :1 ^ ACT PERSOt�1''`b i 4 , .=� °+ ^ i , O:: : .•,.. ,,,, r
APP�LI
� .��� , = . , . ._ �. 4u a _.��: ®- „ ., , „s � �-� :
� � .. � -��� ,. _ NO � 'IICE ;.� t M � 1 " l " .
Business name: Westlake Consultants, Inc. All contractors and subcontractors are required to be
Contact name: Patrick Tortora licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15115 SW Sequoia Parkway, Suite 150 jurisdiction in which work is being performed. If the
City/State /ZIP: Tigard, Oregon 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 684 -0652 Fax: : (503) 624 -0157
E -mail: ptortora @westlakeconsultants.com .
?;e t- l a . C TRA TOR1 - e r
Business name: Dale Smith, GVS Contracting ,, ABUILDING PERNII , ° V , .;,
Address: 700 N. College Street, - =i -'� >- - fPt "!e' hed l Ya, . ;� _ q =.�4'
City /State /ZIP: Newberg, OR 97132 Structural plan review fee (or deposit): c 5/�p , %
Phone: (503) 539 -2998 Fax: (503) 538-9829 FLS plan review fee (if applicable): f 9q. (D 8
Total fees due upon application: 5
CCB lie.: 54340
Amount received: 57(.0q
Authorized signature:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: TI Pv fh . L ,-(---1 Date: Y. L/ 06 * Fee methodology set by Tri- County Building Industry
Service Board.
1: \Building \Permits \SIT - PermitApp.doc 12/27/06 440 4613T(11/02/COM /WEB)
CITY OF TIGARD .
II BUILDING DIVISION PERMIT #: SIT2Cl(l8 QO(li2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Jail 5/t3, 2t7t�8
Phone: (503) 639 -4171 I l Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/24/2008 TIME: 7:00AM PAGE 33
SITE ADDRESS: 07640 SW MIwRMt�SO WAY
OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: 009 TYPE OF USE:
PROJECT NAME: LUI3Y BUILDING
DESCRIPTION: Site work SF conversion to commercial.
OWNER: PHONE #:
LUBY BUILDING LLC,
CONTRACTOR: GVS CONTRACTING PHONE # 503 - 539
Inspection Request Scheduled For: Date: 7124/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspedion 073146-01 503 -620 -3342 N
Corrections /Comments /Instructions:
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❑ PASS I I PARTIAL APPROVAL F1 CANCEL ❑ NO ACCESS
Vf■FAIL [CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
■ 1.
' Inspector: 0 Date: q ( . , Phone #: (503) 718- ; V VO
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