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Permit ._ t. CITY OF TIGARD SITE WORK DEVELOPMENT SERVICES PERMIT _.,/ -!.- I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # S I T98-0009 DATE ISSUED: 04/15/98 PARCEL: 1S126DC -05203 SITE ADDRESS...: 09275 SW LOCUST ST SUBDIVISION • PP1997 -124 MLP96 -0014 ZONING: R -12 BLOCK • LOT • JURISDICTION: TIG CLASS OF WORK..: ALT : PAVING? • Y RESO. NO.: TYPE OF USE •SF GRADING? • Y VALUE...$: 17500 EXCV VOLUME: 0 cy LANDSCAPING? • FILL VOLUME: 0 cy SITE PREP? • Y ENG FILL? • N STORM DRAINS ?...: Y SOILS RPT READ ?: N IMPERV SURFACE: 0 sf Remarks: Extend utilities into site. Owner: FEES BERT LUNDMARK type amount by date recpt 3381 COEUR D' ALENE DRIVE FIRE $ 27.40 DLH 03/25/98 98- 304360 WEST LINN OR 97068 PLCK $ 44.53 DLH 03/25/98 98- 304360 PRMT $ 128.50 GEO 04/15/98 98- 304960 Phone #: 5PCT $ 6.43 GEO 04/15/98 98- 304960 Contract or: CONSTRUCTCO INC PO BOX 54 WEST LINN OR 97068 Phone #: 557 -7562 $ 206.86 TOTAL Reg #..: 000619 REQUI RED INSPECTIONS This permit is issued subject to the regulations contained in the Excavation Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Grading Insp applicable laws. All work will be done in accordance with Paving Insp approved plans. This permit will expire if work is not started Strm Drain Insp within 180 days of issuance, or if work is suspended for more San Sewer Insp than 180 days. ATTENTION: Oregon law requires you to follow rules San Sewer Insp adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 through OAR 952 - 0011080. Your may obtain copies of these rules or direct questions to OUNC by calling (503)246-9187. • Issued b /,L Permittee Signature: +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Site Permit Application s ‘'` 13125 SW HALL BLVD. Commercial: Comple ENTIRE fo • TIGARD, OR 97223 Residence: Complete SHADED areas S/T9P" 0.0.09 (503) 639 -4171 x304 3/25/9� f ( alitA t4),' [ Print or Type Incomplete or illegible applications will not be accepted . :.;;:;. ro± a Uti lities (Complete all that apply ?fit ;;: :::'�� ( P ) :. :: .......:....::::..::. . .' t ' . : A�ddE' ess : .:::::::::.::::;. : �. �:::::.:::::.;:;.::.;;: �:.::.;.;;;••.::.>:.;:,.;::.;; :.;:.;:.::� >;:.;:.;:.:.;:.;;:.; :;,.;:.;:.:.:::::::.; Storm Sewer :.; Linear Ft. : < ;: : : > >:: >:: <: <.; . t >><:?;`<< ; ....-.• . ...... :..........:11 . ............................ ...... Sanitary Sewer ':' . ry - • 'fr i ��'� i r F : : : : C : : :. <,: » Linear Ft. ': >'� °.F ?< > : Rtl d k ? qSS .: ::::::::::�:::::: :.�.::::::.:::: Fresh Water i . . . . . . lia.. :: .. .».: : :: .:: . 41 . :; .: :...:. ...: : :. :. ::.. ig : ::. ... b60:: Linear Ft. .. . . . .... tate':>:i<:: : ?:::::: »:::: >:::: >_:<:::<::::: • .:,;:.;;:. :..: +:::.:� ::.::.�:.::, :.�:�::::•:::�:. .. Catch Basins " I> ; : Ge�ei�......... . . . Clean Outs Cunt ...... ............................... .........................:..:.: 3 :m iji d :: : : : :::: : :: : : : : : :r::> :: ;; ::;; :;<;;::;:; :::: ::;2: :::; ::::;: : : : :; ; :::; { :s; <�':: "::;:; <; <;;:: .;:.;;;:.;:;:.;; ::.::.::.:::.::.:::::>;:.;:.;:.::.>:.;;;::.>:::::::.::: :::::::._:.;:.;:f: >:. >;:.;;:. >: Describe work to be done: ................ .. . on >�� » � > � • -• • >� � •• • • •• • � � �� New Addition Alterati R i .....: :..... ......... f�a€alte:: >: : ";. > :.::::;: :::.;;: :.: :phdrie...... :..::::: . : . old 1.. ............ i:::: ::.�::::::::.:::: :.::. Y .::: ::::..::::::::: ..:. .:......:: :.. dca..l? esban: vlFl fi pc l : . : ................... : :.... : .. . : ::: ................ . acs ... cret'. . ........ ........................... Name :: Hit .�MY�:i:: ::ry.........: �;;; Architect Mailing Address tarie:.. e: aired: :•See:li x o a: :::: ><€ : ::»:>:<:>:: :<::: »:<:: >:: : : :: »:: :;: :: :. :::: t etotfo.. iim tacco :. >any this :. :. ><:;>;. >! »> < City /State Zip Phone : :: : :? .....; :; la#?s,.. ith Vici : s: > : :» :.::::..:::.::> (in ..:. < °> • >< ><:: < >Sans± g: A ip : ........................ A} t g plan . Name ...tidltt()wPION ndPIa : ;:::: ,anttsr,ap i ;:;:; M r Engine er Mailing Add e ss Con trol .I IaR. :: : :�ietaifi3 € : :< : =: �iii�dT : eiis >; : >< <:' City /State Zip Phone :: »:> ::Site ti ` Plar a € , :. ::: ls:::::> :. <: it ::. ...:.: >: < : : : :: > : : >:: >::: >::::: P U.iRVA ::::::.:::: clef!:: :::.:::..: So.: ; :; : : :M .;:.::.;:.;:.:.:. ste m: =$Y Excavation Volume ::3::: r y.ackf ' . rn1 :t iii read .s.iv p . . t1 . :.: ::: ::: . ;.:: . . � :::: :: : teq� : t�t1S : �BGati�t���t�1�ttl�e >: (Soils report required for >5,000 i!mati i' • i va s> '' ire ( ed fo 5 Cu. cu. Yards g .. .... ... ...::cE, : l?tl a #t4uetoi au #tvi cu. Yds. < > oft a ow Mrs < attl€:t t(,a#:pla n s:s u bmitt ed ar lk1 >;;: Y Fill Volume na of €O � ri ierf .<:: eii #':'<� >: > :;`v < : >< <:.. . (Soils report required > orteur for ed fo >5,000 Yds.) ( 1 000 cu. d P 4 d. cu. s Y 'l� Will h rt e ill support a structure r it if required answer (Engineer 4 ed ans e i s es YES N Y O O :;:... Retaining structure? (check one) ® Rock FOR OFFICE USE ONLY - ° CMU Notes: ❑Concrete °Other • Total new impervious area including all Land Use Case # . Map/TL# buildings, sidewalks, and paving Sq. Ft. Mt x —670/Y fl_. S o 2 7, yd Bu /Gd /JLb'AJC.y, %9 siteapp.doc9 /97 � Ee - 9/' 30y3G1> S • COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST EXAMINERS (Note a.) TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 -- -- 3 (j,o,u) -- -- B (New or Add) 1 1 -- -- 3 (j,o,w) -- -- F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f) M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- -- B & M (New or Add) 1 - 1 -- -- 3 (j,o,w) -- -- P (New, Add. or Alt) 2 -- 2 -- -- 2(j,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) -- B (New, Add, or Alt) 2 -- -- 2 -- -- 2(j,o) B & M& P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o) iii :::::::: $:::::: �:: �:::::.::... ............. .::::: . . ..... . .... ......::::::::::: : NOTES: KEY: a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP number of revised plans from applicant, stamps and completes, o = Office M = MEC updates and adds actions. f = Fire P = PLM u =USA E =ELC <U: §:f : jaded st ::: > ><: w = W = .................. ...... aside.: t�:;;><: �. St��tits<: ct��::;::<:::<:::<::::<:»><:::: ::::<:::<:: <:::«: >;:,: >:: »..... ash. County F FPS c. FPS is a new permit category set aside for fire sprinklers and fire alarms. d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. h: matric.Doc