Permit CITY OF TIGARD SITE WORK
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # S I T97 -0032
DATE ISSUED: 09/26/97
PARCEL: 19136CD —CARTY
SITE ADDRESS...: 11710 SW PACIFIC HWY
SUBDIVISION • ZONING: C —G
BLOCK • LOT • JURISDICTION: TIG
CLASS OF WORK..: NEW PAVING? Y RESO. NO.:
TYPE OF USE -COM GRADING? Y VALUE...$: 32000
EXCV VOLUME: 0 cy LANDSCAPING? • Y
FILL VOLUME: 4500 cy SITE PREP? •
ENG FILL? • Y STORM DRAINS ?...: Y
SOILS RPT REOD ?: Y IMPERV SURFACE: 0 sf
Remarks: Grading, paving, utilities for PRIVATE site work for 5,580 sq. ft.
building.
Owner: FEES
BRETTLER REAL ESTATE INC type amount by date recpt
307 BROAD STREET PLCK $ 130.30 08/25/97 97- 298630
SEATTLE WA 98121 EROS $ 80.00 GEO 09/26/97 97- 299604
ERPU $ 26.00 GEO 09/26/97 97- 299604
Phone #: ERPC $ 26.00 GEO 09/26/97 97- 299604
PRMT $ 202.00 GEO 09/26/97 97- 299604
Contractor: PLCK $ 1.00 GEO 09/26/97 97- 299604
KENT LYLE CUMMING SPCT $ 10.10 GEO 09/26/97 97- 299604
2565 SW TOWLE AVE
GRESHAM OR 97080
Phone #: 665 -5168 $ 475.40 TOTAL
Reg #..: 012299
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Erosion Control
Tigard Municipal Code, State of Ore. Specialty Codes and all other Excavation Insp
applicable laws. All work will be done in accordance with Fill Inspection
approved plans. This permit will expire if work is not started Grading Insp
within 188 days of issuance, or if work is suspended for sore Paving Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules St rm Drain Insp
adopted by the Oregon Utility Notification Center. Those rules are San Sewer Insp
set forth in OAR 952- 881-8810 through OAR 952481 -8880. Your say Domestic water 1
obtain copies of these rules or direct questions to OUNC by calling Final Inspection
(583)246 -9187.
Issued by: Permittee Signatur= d . _
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + +-
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + ++
Plan check #
CITY OF TIGARD
Site Permit Application Rec +d By .,
13125 SW HALL BLVD. Commercial: Complete ENTIRE form Date Recd " ' �-
TIGARD, OR 97223 Residence: Complete SHADED areas Dace to P.E. '.
Date to DST '7 Q
(503) 639-4171 x304
,' Permit # 1 4�1
Called 0.49.4, S .- g-
- Print or Type ,, M
Incomplete or illegible ,applications will not be accepted ��� ✓ ���
Project Name Utilities (Complete all that apply)
Sewer
'.
Address Address : - . • •
rv1. \ ` \` . �� S ` ``\ .` ` 'f 7 '! 1e3 \ \' \`� •` `tea' \ \♦ ` \ \`
rr 36,„, Linear Ft.
1 Name `\ \ \ ��, \ ` Sanitary Sewer
MIMI
Owner' Marratg Rddress::*,\ ;': :;\ a \ `\\ \, . ` \ Fresh Water • MEM'
r �� \. . *.. ,'N, W.\W .. ``\ $ : Catch Basins
``� ,,�(. � �`` •‘.. . s`.�\ \ � \�\v�: :.......X... � ,� � .�; Clean Outs
Contractor \ Matlk7g. Address, aV. vim; : \ ` ` \'�� \N*.; \�
EPewr tQ R4::-'::Ai''.: ,;.,.`: . ` �\ `. wx F k. . • ` Describe work to be done:
\` \� \ \ \ ♦� \ \ ` ` `, \. \ `? \ NewJ�' Additionp Alterationp Repairp
Name `�- \ �. \ h �, ,r .:
. . ° <.
F:;':411 :i..$14itilk. L .• ' ' . ., . : . : . LI&.: . ...;..'',- , - .-. '..‘ s : H _ , ....f,i, NA: ..:'..,
5 ' —o Ai 2.o t - G� 5, eo /+7 x ni ,, * � �\ } ' : r ,::;,,,:::,,,,:%::::,:,;:,;.. " ` g ..
Architect Mailing Address �1 L G . .. / vietatg 4.
A-ve N.E 5 vi )-- / O / .• i .x..txvFa''.i• i• ; - : c \,....._q: \b :
� / / Z�y '- � < rne3t`aeeont - tEits avv ti ,.�
1 City/State Zip Phone E.. S t : Parking (induding
_ � Z i-1.-L- vo _t 14/4 , /54 - 32-03 - : _ ., >,tr `:', ADA) & - . - ,
Name �++�++�
/1 RI3 _ „, J�
. �'anddeta MI Landscaping Plan
TE,✓ SE•.✓ z },.../c. . ` o \w aq `>Y'l; M”. °i.
Engineer Meiling Address ,
7/ 5o ,w ,-1,51,s/OTrq/ 5 :._ ( aeld, .` t R
city/state /State Sl , ✓� r� 2 . 2 -• W - irs �` . ! `n � • F ty Zip Phone , Sde tJI PIOPA1 d eta1 a .° S ods Rep o rt, : .. ` �
2,Z3 503 59's , d ceG
: ' - L ..: :t �� . - :ti;:i 20. §-10 ..: \� de •s ♦ : kx::: (..
� ♦\ �\`ya\ c ♦\ w � \a k hereby acknowledge that I have read this application, that the
4 :
.. t .d ?.A \i"rt�i. \ ` y ` > .c , information
�� r \ �� :::: �: :. �ti given is that I am the owner or authorized
correct.
+' -"i 4. ;� : *,fi agent of the owner, and that plans submitted are in compliance
Ann with 0 on State laws
! �Or >5; c ¥ds: *::: ♦rk` Slg;iatxtr6 oiPOwnerfAgerit t�8
e t Support;a st� \♦ \ \ . ♦ Contact Person Name •
411 th
: >. :: :.: .,. ,� � . __,: ♦.,\ hon
'tg�n eeed if attsrrer is yes) YESI4 ♦VOC
etaig slre {cterae o`\ \:�\ `` a R ` ? ♦w 9
OFFICE U SE ONLY
, : <- -k:::> r ,.:;:: Notes:
1-
al new impervious area including all
L an d Use Case #y . Mapes
+dings, sidewalks, and paving l•®" Sq. Ft. \ 0 s 51 - I qr0
(...1... I..I, +1,44. A.iP.+ASP) _
- keapp.doc (DST) 5,97 1
1
.
Acct. COT WACO Amount Amt Pd. Bal.
Permit # Descritpion Due
SIT. Permit (BUILD) (UBUILD) t4 . le 2
Plumb. Permit (PLUMB) (UPLUMB)
State Tax (TAX) (UTAX) /o /6 1 0 . 1 0
BLDG:
PLUMB:
R ,
Plan Check
SIT: (BUPPLN) ( UBUPLN) 13l 9 d (. 3 . I
Plumb: (PLUMB) ( UPLUMB)
CDC Review
(BUILD) (CDCBLD) (UCDC)
CDC Review
(PLN) (CDCPLN) N/A
Reimbur. District ( ) ( )
Sewer Inspection (SWINSP) (USWINS)
Water Quality ( WQUAL) (UWQUAL)
Water Quantity (WQUANT) (UWQANT)
/
Erosion Control
Prmt (ERPRMT) (UERPMT) 0 :A At P L , , r i
Erosion im,4ar y
���
Planck/USA (ERPLN) (UERPLN) �i 1
1
a
Erosion
Planck/COT (EROSN) (UEROSN)
TOTALS: / 9 ;..._ •.�� .
V 4-
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CO 1 .. :1 1 C‘ - 1 r .
air
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I:sitcapp.doc (DST) 5'97 2 -
Page No. 1 CASE HISTORY FOR CASE NO.: SIT97 -0032
BRETTLER REAL ESTATE INC
11710 SW PACIFIC HWY
06/17/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
SITC005 Application received / / / / 08/22/97 RECD JSD 08/26/97 JDA
SITC008 Permit Created / / / / 08/26/97 PASS B 08/26/97 JDA
SITC011 DST /mail Land Use Condition Lt / / / / 08/26/97 SENT B 08/26/97 JDA
SITC013 Plans Routed to Plans Examiner / / / / 08/26/97 PASS B 08/26/97 JDA
SITCO30 Reviewed plans routed to DSTS 09/10/97 / / 09/10/97 APPR RDP 09/10/97 RDP
SITCO32 DST Post- Review Completed / / / / 09/12/97 PASS DRA 09/25/97 JDA
SITCO50 Hold for / / / / 09/12/97 Hold until released by Will D'Andrea HOLD DRA 09/25/97 JDA
after approval of minor modification.
Jill A to check to see if erosion needs
to be charged on sewer permit or
building instead of this site permit.
Per Jill A: Site Work Erosion is on the
SIT, and Building permit erosion is on
the BUP
9/25/97 WD released site. Still waiting
for BDR to release SIT, possibly on
9/26/97 per a phone conversation
SITC080 (F) Ready to issue / / / / 09/26/97 PASS JSD 09/26/97 JD
SITC092 (F) Issue permit / / / / 09/26/97 PASS GEO 09/26/97 DST
SITC093 (F) Reprint Permit / / / / 05/11/98 TEST HAP 05/11/98 DGW
SITC724 Retaining Wall /Footing / / / / 10/30/97 PASS TLP 11/06/97 J *H
SITC730 Paving Inap 08/26/97 / / 12/04/97 PASS TLP 12/04/97 J *H
SITC740 Strm Drain Insp 08/26/97 / / 10/31/97 2nd phase 8 storm PASS TLP 11/10/97 J *H
SITC799 Final Inspection 08/26/97 / / 12/04/97 PASS TLP 12/04/97 J *H
SITC800 Case Finaled / / / / 12/04/97 PASS TLP 12/04/97 J *H
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: (Z - C `t- `"I l A.M. O "3) P.M. 5f' { - -- -MSi: Bur q 7- Q 6
Location: I I/ I 0 PAU PA( Fl G I+ J y A-u BUP: 7 -
Tenant: GA-V-- TOY 5 Suite: Bldg: MEC:
Contractor: Phone: PLM:
Owner: Phone: ELC:
ELR:
SIT:g -OD 3-
BUILDING G c t) PLUMBING MECHANICAL ELECTRICAL SITE
Site os eam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire S.klr/Alm Crawl/Found Dr Heat Pump Low Volt
• Ii Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved
/- " i ` o f FINAL FINAL FINAL FINAL
•
e) , TO $(31 cc c.ipy
O Call for re's ky.. O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: ( Date: /2 77 Page of