Permit CITY OF TIGARD
SITE WORK PERMIT
0 • COMMUNITY DEVELOPMENT Permit #: SIT2011 -00009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/13/2012
Parcel: 25101 BD00200
Jurisdiction: Tigard
Site address: 8001 SW HUNZIKER RD
Project: Tigard Distribution Center Subdivision: Lot:
Project Description: Parking lot expansion
Contractor: DOW BROS INC Owner: TIGARD DISTRIBUTION CENTER
1045 N 4TH AVE 8001 SW HUNZIKER
CORNELIUS, OR 97113 TIGARD, OR 97223
PHONE: 503 - 357 -5804 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee - Site Work 06/13/2012 $2,605.42
Plan Review 07/29/2011 $1,693.52
Type of Use: COM 12% State Surcharge - Building 06/13/2012 $312.65
Class of Work: ALT Erosion Control 06/13/2012 $200.00
Project Valuation: $500,000.00 Erosion Plan Review CWS 06/13/2012 $65.00
Erosion Plan Review COT 06/13/2012 $65.00
Site Specifics:
Excavation Volume: cu. yd.
Fill Volume: cu. yd.
Impervious Surface: 96085 sq. ft.
Engineered Fill: No Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Yes Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: No
Total $4,941.59
Required Items and Reports (Conditions)
1 Ersn Cntrl 503 - 681 -4444
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N• • • -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir_ questions to O • • ing 503.232.1987 or 1.800.332.2344.
Iss ed By: / � Permittee Signature: X �!
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 '',;`k, �� \)-
Site Work ,00(''.,,: FOR OFFICE USE ONLY'
a City of Tiard r 'L0 \ Received .
`J b � 9 Date /B a g Permit No.: , : / .640 •
114 °I 13125 SW Hall Blvd., Tigard, OR 97223 0" ? �� Plan Review ►
C Phone: 503.718.2439 Fax: 503.598.1960 ��` c,' . Datc/B : 41111111D/O, Other Permit: /
T I G A R D Inspection Line: 503.639 p -(N9 0'. ®t\ � Date Rea 7''•.' Juris: ® See Page 2 for
Internet: www.tigard - or.gov �e \�� Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED 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 CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling 121 Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 8001 -8005 SW Hunziker New dwelling area: square feet
City /State /ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S1 O1 BDOO2OO Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 57er) 1
Proposed parking expansion
Existing building area: square feet
New building area: square feet
I ® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: TDC Type of construction:
Address: 8001 SW Hunziker Occupancy groups:
City /State /ZIP: Tigard, Or 97223 Existing:
Phone: ( ) Fax: ( ) New:
Gi APPLICANT ❑ CONTACT PERSON NOTICE
Business name: VLMK Consulting Engineers All contractors and subcontractors are required to be
Contact name: Jennifer Kimura licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3933 SW Kelly Ave jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, Oregon 97239 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 222.4453 Fax:: (503 ) 248.9263
E-mail: jenniferk @vlmk.com
CONTRACTOR
Business name: 7460 — . j tO ' 3 !pJe..., BUILDING PERMIT FEES*
Address: m e ,J (Please refer to fee schedule)
City /State /ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: Total fees due upon application:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Jennif imura Date: • Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \SIT - PermitApp.doc 10/01/09 440- 4613T(II/02/COM /WEB)