Permit CITY OF TIGARD SITE WORN.
et, DEVELOPMENT SERVICES PERMIT
�.L 13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 PERMIT # • S I 997 -0006
9 � � DATE ISSUED: 05/21/97
PARCEL: 1S134DC -03000
SITE ADDRESS...: 11130 SW TIGARD ST
SUBDIVISION • CHERRY HILL ACRE TRACTS ZONING: R -4.5
BLOCK LOT :1 JURISDICTION: TIG
CLASS OF WORK..: NEW PAVING? • N RESO. NO.:
TYPE OF USE •COM : GRADING? • Y VALUE...$: 23000
EXCV VOLUME: 300 cy LANDSCAPING? • Y
FILL VOLUME: 300 cy SITE PREP? . Y
ENG FILL? • N STORM DRAINS ?...: Y
SOILS RPT REOD ?: N IMPERV SURFACE: 7600 sf
Remarks : Site and grading permits for modular classroom. INCLUDES ROCK
Owner: FEES
TIGARD TUALATIN SCH DIST 23J type amount by date recpt
13137 SW PACIFIC HWY PRMT $ 0.00 B 03/13/97 97- 291689
TIGARD OR 97223 5PCT $ 0.00 J *H 03/13/97 97- 291689
PLCK $ 0.00 J *H 03/13/97 97- 291689
Phone #: SWM $ 292.31 B 05/21/97 97- 294834
PRMT $ 158.50
Contractor: 5PCT $ 7.93
BERRYHILL BROTHERS EXCAVATION PLCK $ 103.03
20897 SW SCHOLLS — SHERWOOD RD EROS $ 26.00 B 05 /21/97 97- 294834
SHERWOOD OR 97140 Additional fees not shown here
Phone #: 628 -3891 $ 605.07 TOTAL
Reg #..: 000621
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 Inspect ion
approved plans. This permit will expire if work is not started Grading Insp
within 180 days of issuance, or if work is suspended for more Strm Drain Insp
than 180 days. Reinforced concr
Structural mason
Engineered gradi
- 1 ,. �� Final Inspection
Permittee Sig atur - : ., P / yl/ ..
Issued By: ,_ t f / l^--
Call for inspection — 639 -4175
��w ,
.. . - /I)q7 q7 _• -2 2
CITY OF TIGARD .9/ 0,7
or P!a• check -' 7l
Site Permit Application -- ec By "p si ,
13125 SW HALL BLVD. Private Grading, Paving, Site Access!. Date Rec
TIGARD, OR 97223 Retaining Structures, Utilities and Related Work Date to P E. • -1
(503) 639 -4171 x304 Date to DS
Permit # . -
Called
Print or Type ty 7 _Ono
,. Incomplete or illegible applications will not be accepted (,/
Project Name Utilities (Complete all that apply)
Job Utility Connections/
Mnrtutar Classroom
Address Address Storm Sewer
11130 SW Tigard Street 100
Ti gA rc _ Linear Ft.
Name Sanitary Sewer
Tigard Tualatin School District 100
Linear Ft
Owner Mailing Address Fresh Water —
40
13137 SW Pacific Highway
Linear Ft.
City/State Zip Phone Catch Basins
Tigard, OR 97223 1 684 - 2235 # 0 -
Name Clean Outs
General Berryhill Brothers Excavation, Inc. # 1
Contractor Mailing Address Describe work to be done:
(Prior to 21400 SW Scholls Sherwood Road New Addition° Alteration° Repair°
Issuance
applicant must City /State Zip Phone Additional Description of Work:
provide all Sherwood, OR 97140 628 - 3891
I all contractors State Const. Cont. Board Lic. # Exp. Date
license 62191 Oct. '97
'ntom,aaon in COT Business Tax or Metro # Exp. Date
COT Metro License #00003714 10 - 1 - 97
Name Project I $
Selig/Lee/Rueda Valuation 23,000.0)
i Architect Mailing Address Plan Submittal: (3) sets containing each of the
213 SW Ash, Portland, OR following, must accompany this application:
City/State Zip f Phone Site plan with Vicinity Map Parking (including
I 224 - 0173 Showing ADA compliance ADA) 8 Lighting Plan
Name Grading Plan and details Landscaping Plan
as above
Engineer Mailing Address Erosion Control Plan and Retaining Structures
details including calculations
■
City/State Zip Phone S.te Utility Plan and details Soils Report
(showing connection to (if required)
, acoroved system)
Escavation Volume ; herecy acknowledge that I have read this application. that the
(Soils report required for >5.000 cu. Yards :nforrration given is correct. that I am the owner or authonzed
300 cu. yds. agent of :he owner. and that plans submired are in compliance
with Oregon State laws.
=iii Volume . Si ture of ner/ ent Date
;Soils report required for >5.000 cu. Yds.) I 6...ii 3 - / - z- ?7
300 cu. yds. I C
ure
;III the till support a struct
• Contact erson Name e7/1, rt 'Phone
(E'gineer required if answer is yes) YES[ NO2 Ron Hudson 684 - 2235
etaining structure? (check one) r?tRock FOR OFFICE USE ONLY
CMU Notes:
[Concrete ( Q,d. MtKar PAe►ritcic On c 'o
i _ ,, Other OC , •OVA doe e (SSUit/ r e
_ -
;cal new impervious area including all 7200 Lan • Use Case # , , � Map/TL #
I - ,..Adings. sidewalks. and paving I I Sq. Ft.
a ii evA..2. _tit ..! /_ ' A
r..sts■siteapp.doc '' `--- ' _ / 3 / � 7 o i 3-M
:'96 att.s2)...., A ova,(5: z
4 1 7 4J
Permit # Account Description Amount Amt. Pd.' BaI.'Due
6[111-o(2 -4 Build. Permit ✓ (BUILD) l r j$ ' 15 -�fi
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC /ELR Permit (ELPRMT) �.
State Tax ,(TAX) 7. 9 1 , 9 3 - 0 —
Bldg:
Plumb:
Mech:
ELC /ELR:
Plan Check
Build: • /(BUPPLN) /D 3. 3 / 03, 03
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review (LANDUS)
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Commercial TIF (TIF -C)
Industrial TIF (TIF -I)
Institutional TIF (TIF -IS)
Office TIF (TIF -O)
Mass Transit TIF (TIF -MT)
Water Quality (WQUAL)
Water Quantity (WQUANT) ago?. 2_17-_;(
Erosion Control Permit (ERPRMT) 2-6 210 0
Erosion Planck/USA (ERPLAN) g` c 6 •�
Erosion Planck/COT (EROSN) g (0S? 0 � Le2S
Fire Life Safety (FLS) !�
TOTALS: • .?(ac1.
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ENGINEERING PERMIT DATE ISSUED: 03/21/97 By: -- \
PERMIT # • ENG97 -0011
PRIM. PERMIT #.: ENG97 -0011 PARCEL: 1S134DC -03000
SITE ADDRESS...: 11130 SW TIGARD ST ZONING:R -4.5
SUBDIVISION • CHERRY HILL ACRE TRACTS �E'P�. cOP
BLOCK LOT 1 l
`�� �-b
PERMIT TYPE..: SOP PUBLIC IMPRV : QUANT. (LIN FT) VALUE
AGREEMENT DATE: / / GRAD /EROS - * * *- $
ASSURANCE EXPIRATION - -- STREET " $
PERFORMANCE: / / SAN SEW 11 $
MAINTENANCE: / / STM SEW $
PATHWAYS $
ALL OTHER - * * *- $
TOTAL $
Remarks: STREET OPENING, TO INSTALL A SIDE SANITARY SEWER (BUILDING) SERVICE
LATERAL AND MAIN -LINE TAP.
Permittee: FEES
BERRYHILL BROTHERS EXCAV., INC type amount by date recpt
21400 S.W. SCHOLLS - SHERWOOD RD. OPEN $ 80.00 DRA 03/21/97 97- 292098
SHERWOOD OR 97140
Phone #: 628 -3891
Engineer:
$ 80.00 TOTAL
Phone #:
REQUIRED INSPECTIONS
Permittee ,(4gent Sigy�ur -- -STORM SEWER -- STREET
✓t,wj �� /`/ ` l�
M.H. & C.B. CRB LINE & GRADE
C PIPE LN & GRD SUBGRADE
BCKFLL & CMPCT BASE ROCK
AIR & TV TEST LEVEL COURSE
City of Tigard, Oregon WEARING COURSE
13125 S.W. Hall Blvd. -- -SAN. SEWER - -- TRAFF & PED CONT
P.O. Box 23397 M.H. & C.O. MONUMENTATION
Tigard, Oregon 97223 PIPE LN & GRD STREETLIGHTING
Phone #: 639 -4171 BCKFLL & CMPCT WALK /APRON /RAMP
AIR & TV TEST
FOR INSPECTION, CONTACT: - - -- GRADING
Letha Thomas #639 -4171 (office) -- REPR'S /ADJ,S -- CONTOURS
#780 -2647 (mobile) DRAINAGE
- - -- PATHWAYS - - -- EROSION CNTL.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Z y Business Line: 639 -4171 MST
BUP f7- /0g 7
Date Requested U AM PM BLD
Location ///3 a G 7/*41 Suite MEC
Contact Person CGt b Ph 30- eo•-O PLM
Contractor Ph SWR
ILD ► Tenant/Owner 1'ir' 7i1.1li� iJ , c J U E LC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain S
Crawl Drain Inspection Notes:
Slab S 1 -di 1
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Mis •
inal
4450 - ART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
P PART FAIL
SIT
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date
r n 9Y Inspector Ext
PART FAIL DO NOT REMOVE this inspection record from the job site.
0 1.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MS
7
/ ( ,
, 97- DO cc-
`h\���
-ate Requested �.. AM PM BLD
Location / G /3 v S� l I �i�- -d Suite MEC
Contact Person Ph `-� 9 7- w-35
Contractor Ph SWR
pUri" Tenant/Owner ELC
e g all c LR J - 0 3/ '��
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab Ooe
Post & Beam 410 % '-
Ext Sheath /Shear
Ina Sheath /Shear �, nn
Framing 1/� '7
Insulation SW )29-7- . O �7 G 1 • - . � // ,/ 77/949 /� S
Drywall Nailing J C J
Firewall �--/ 01j / C J�
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Mi
anal
S ART FAIL
Post & Beam
Under Slab b
Top Out �
Water Service "V
Sanitary Sewer
Rain Drains
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
P S P T FAIL
ECTRICA
Service ry
Rough In 1 / \
UG /Slab at>'
Low Voltage
Fire Alarm t1/4,5
�inaJ
PASS PART FAIL
ITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Oth Date Inspector Ext
(ina�
S PART FAIL DO NOT REMOVE this inspection record from the job site.
3 'CIT r-OPTIGARD BUILDING INSPECTION DIVISION _ 06 C�
24 -Ho r Inspection Line: 639 -4175 Business Line: 639 -4171 7
1[2.e Requested UP' 97 - 06 ? 7
Date
4 / AM PM B LD
Location 1, l t 30 '(A.) 1 \ J'ck Suite MEC
Contact Person Ph - q2- 0013-C � OS- -
Contractor Ph q7- 3 3
�
E LC
IL � TenanUOwner
Retaining Wall CL : 9 7 - 0,2 S _
Footing Access:
Foundation I,(�/� 6 FPS
Ftg Drain 1 SGN
Crawl Drain Inspection Notes: C 7
Slab
& Beam / / O Ole 6
Ext Sheath /Shear
Int Sheath /Shear
Framing
P–•r-1/4 �� G C O� , 27t i" —
Insulation
1 l J � (]
Drywall Nailing y � l �- � Q (r �j a� g
Firewall
Fire Sprinkler
Fire Alarm � �� Z( A-, J.-,
Susp'd Ceiling ()U4K.cQ
Roof
Mis
final
PASS RT FAIL
Post & Beam
Under Slab V a
Top Out
✓ Water Service
Sanitary Sewer
✓ Rain Drains
• • SS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PAS PART FAIL
CSITE
Backfill1Gfading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA f�
A a s Date -- V q/q Inspector v ` Ext
in- L) v (_4_
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
Date: /(4-
T
• :ALAI
u
N. CM" OF TIGARD
•
k, k () �‘.&\ � ' � OREGON
Address J Permit #
To Whom It May Concern: RESEARCH C rcm
The permit listed above is currently inactive in our file and apparently went un- noticed,
either by never being inspected or it failed and was never re- checked by one of our
inspectors. Whether or not this be another attempt to make the required inspection, or the
first attempt, {or} creating a new permit, it is the responsibility of the owner to make the
necessary arrangements to obtain compliance and complete the inspection process.
Therefore, you are hereby advised to make these arrangements as early as possible, but no
later than 10- working days. I would be most please to assist you in any way that I can,
but you must contact me to do so. You may reach me at 639 -4171 ext. 319 between the
hours of 08:00 through 09:00 and at 3:00 through 4:00. If an emergency should arise you
may page me at 955 -5665 during the remaining hours. /
Issue Date: /t4/1 ?ZI/7 Original Notice Date: CI?s (See Inspection Card)
Theme following procedure shall apply: This is your-
VFirst Notice- Make the necessary arrangements as mentioned above; Call 639 -4175 or
for work without a permit(s) call 639 -4171 Ext. 310 (Jeanne).
_ Second Notice- Without consideration to the contents of the first notice, a
O re- nspection fee shall be assessed in the amount of $ , AND an investigation
6, " 1 4 fee shall be assessed in the amount of $ . The investigation fee shall be
I 100% of the permit fee. All fees shall be thereafter doubled.
TOTAL DUE: $
Third Notice - All fees mentioned above are payable before any inspection can be
made. If arrangements are not made within 10- working days from the day of this notice,
the City of Tigard Code Enforcement Agency will be notified and a Civil Infraction
notification will be delivered to the principles in ownership of the above noted address.
All prior fees shall be carried over and doubled and not withstanding any fees assessed by
the Civil Infraction Notice.
2 NOTICE: DUE $ (2) = TOTAL DUE $
It is with my deepest appreciation, that you help in any way that you can to bring closure
to this permit {or} lack of. If you wish to speak with me, please do not hesitate to call.
Thank you for your patience and pro rs: attention regarding this matter.
Rick Bolen
City of Tigard Inspector II
d.,OR 97223 503639 -4171 .TDD 503 684 2772:.
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