Permit CITY OF TIGARD SITE WORK PERMIT
• COMMUNITY DEVELOPMENT Permit#: SIT2012 -00010
T [GAR E ., 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/26/2012
Parcel: 2S109AB14200
Jurisdiction: Tigard
Site address: 14285 SW ALPINE CREST WAY
Project: Alpine View, Lot 23 Subdivision: ALPINE VIEW Lot: 23
Project Description: Retaining wall
Contractor: D R HORTON INC PORTLAND Owner: DR HORTON INC - PORTLAND
4380 SW MACADAM AVE SUITE 100 ATTN MELISSA TRUNNELL
PORTLAND, OR 97239 4380 SW MACADAM STE 100
PORTLAND, OR 97239
PHONE: 503 - 222 -4151 PHONE: 503 - 222 -4151
FAX: 503 - 222 -1304
FEES
Description Date Amount
Specifics: Permit Fee - Site Work 07/26/2012 $123.72
Plan Review 06/12/2012 $80.42
Type of Use: SF 12% State Surcharge - Building 07/26/2012 $14.85
Class of Work: OTR Info Process /Archiving - Sm $0.50 (up to 07/26/2012 $12.50
11x17)
Project Valuation: $4,500.00 Erosion Control 07/26/2012 $80.00
Erosion Plan Review CWS 07/26/2012 $26.00
Erosion Plan Review COT 07/26/2012 $26.00
Site Specifics:
Excavation Volume: 16 cu. yd.
Fill Volume: 8 cu. yd.
Impervious Surface: 1820 sq. ft.
Engineered Fill: No Soil Report Required: No
Paving: No Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Yes Retaining Wall: Yes
Fire Underground: No Accessible Parking: No
Fence:
Total $363.49
Required Items and Reports (Conditions)
1 Ersn Cntrl 503 - 639 -4175
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 f the ru = - adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -009, You m- o • ain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /I ♦ / / /
Issued By: Permittee Signature: At • • A :4 -
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 oft e project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential RECEIVED FOR OFFICE USE ONLY
City Tigard Date /B : (0 of Ti and Received Permit No.:c I0 O/02 _awe)
13125 SW Hall Blvd., Tigard, OR dim 1 2 2012 Plan Revie ��
a Phone: 503.718.2439 Fax: 503.598.1960 TIGARD Date /B : l�� a
- I c A R D Inspection Line: 503.639.4175 CITY OFTIGARI) Date Ready :y: Juris: ® See Page 2 for
Internet: www.tigard- or.gov
BUILDING DIVISION Notified/Method: 7 �y /2 1���'•
x/ � Supplemental Information
�� f "/1-�/
TYPE OF WORK REQUIRED BATA: 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.
0 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $
El 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: / ,, t/ �� L?eg� - 4� t.1 New dwelling area: square feet
City /State /ZIP: TIGARD, OR 97224 ( Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ALPINE VIEW Covered porch area: square feet
Cross street/directions to job site: SW ALPINE VIEW AND ALPINE CREST WAY Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: ALPINE VIEW Lot no.: vl Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 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. D
Valuation: $ L
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: D.R. HORTON INC. - PORTLAND Type of construction:
Address: 4380 SW MACADAM AVE, SUITE 100 Occupancy groups:
City /State/ZIP: PORTLAND, OR 97239 Existing:
Phone: (503)222 -4151 Fax: (503)222 -1304 New:
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: D.R. HORTON INC. - PORTLAND (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: GARY CULP
FLS plan review fee (if applicable):
Address: SAME
City/State /ZIP: Total fees due upon application:
Phone: ( ) Fax:: ( ) Amount received: ign
E -mail: gaculp @drhorton.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted Photo Voltaic Solar Panel System.
Business name: D.R. HORTON INC. Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: SAME Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee (includes plan review $180.00
and administrative fees):
hone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60
4 CCB lic.: 130859
1 , Total fee due upon application: $201.60
Authorized signature: * * / SP This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: GARY C t / I Date: 0 Fee methodology set by Tri- County Building industry
Service Board.
I:\ Building \Permits \BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(I 1/02 /COM/WEB)
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.
Excavation Volume: /6 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.
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Retaining structure? (Check one) 2 Rock
CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: -/SW sq. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements" attached.
The following must accompany this application:
❑ Site Plan with Vicinity Map showing ADA ❑ *Parking (including ADA) and Lighting
compliance Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report (if required)
❑ Retaining Structures ❑ Fire Line
*Does not apply to One- and Two- family dwellings.
Plan Submittal: Permit Fee:
TYPE OF SUBMITTAL # of Plans Valuation: Permit Fee:
(New, Additions or Required at $.00 to $500.00 $51.09 minimum permit fee
Alterations) Submittal $500.01 to $2,000.00 $51.09 for the first $500.00 and
$2.69 for each additional $100 or fraction
Commercial 3 thereof, to and including $2,000.00.
$2,000.01 to $25,000.00 $91.44 for the first $2,000.00 and
Multi Family R -1 Occupancy 3 $10.76 for each additional $1,000 or
fraction thereof, to and including
$25,000.00.
One- & Two - Family Dwelling 2 $25,000.01 to $50,000.00 $338.92 for the first $25,000.00 and
$8.06 for each additional $1,000.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $540.42 for the first $50,000.00 and
$5.38 for each additional $1,000.00 or
fraction thereof to and including
$100,000.00.
$100,000.01 and over $809.42 for the first $100,000.00 and
$4.49 for each additional $1,000.00 or
fraction thereof.
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1:\ Building \Permits \SIT- PermitApp.doc 05/25/2012 2
'PI �4 if' JE �fw
Z-67 3
o ° Building Division
Development Code Provision Review
T i c e R Residential Projects
Building Permit No: L, i 0.0 / ' r DOD 7 If
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A L
Routed Plans:
Original Plan Submittal Date: //,P1/ 2
1st Revision Submittal Date: ❑ Site Plan Only
2^d Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked ( items are approved. Items not approved and those listed in the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review (contact \l it fi at 503 - 718 - � a•i - y or @tigard- or.gov)
Land Use Case No. Name
❑ Zoning V .
❑ Setbacks: .
Front /' Rear l Side 5 Street Side l U Garage dQ
❑ Maximum Building Height 3'..) Actual Building Height
"Visual Clearance
❑ Easements
❑ Sensitive Lands Type:
Notes:
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Original Plan: Approved V Not Approved ❑ Date: C`l.3`/2_
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard- or.gov)
❑ Actual Slope:
Notes:
Original Plan: Approve Not Approved ❑ Date: L ((( 2
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
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City Arborist Review (contact Todd Prager at 503- 718 -2700 or todd @tigard - or.gov)
❑ Street Trees
❑ Protected Trees
Notes:
Original Plan: Approved Not Approved ❑ Date: 6. P 1 L
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date;
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Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to Applicant
Okay to Issue Permit: Yes yi No ❑
Date Routed to Building:
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