Permit ,t
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n CITY OF TIGARD SITE WORK PERMIT
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' '7 COMMUNITY DEVELOPMENT Permit #: SIT2012 00019
,TCGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/04/2012
Parcel: 2S 111 ACO2901
Jurisdiction: Tigard
Site address: 9500 SW MURDOCK ST
Project: Templeton Elementary School Subdivision: PINEBROOK TERRACE Lot: 67
Project Description: ADA ramp from school building to sports court.
Contractor: S2 CONTRACTORS INC Owner: TIGARD - TUALATIN SCHOOL
6860 S ANDERSON RD DISTRICT 23J
AURORA, OR 97002 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503 - 849 -2486 PHONE:
FAX: 503 - 651 -4004
FEES
Description Date Amount
Specifics: Permit Fee - Site Work 10/04/2012 $112.96
Plan Review 10/04/2012 $73.42
Type of Use: COM 12% State Surcharge - Building 10/04/2012 $13.56
Class of Work: OTR Info Process /Archiving - Lg $2.00 (over 10/04/2012 $2.00
11x17)
Project Valuation: $4,000.00
Site Specifics:
Excavation Volume: 3.85 cu. yd.
Fill Volume: 24.99 cu. yd.
Impervious Surface: 433 sq. ft.
Engineered Fill: No Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Site Prep: Yes
Storn Drains: No Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: Yes
Total $201.94
Required Items and Reports (Conditions)
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
issuan.. or if wor• suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili Notification Cente . Tho - rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or rect questi ns to OUNC calli . 03.232.1987 or 1.800.332.2344.
L
iss ed By: I ���7 i ! Permittee Signature: A k—J
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
Site Work CE�Ja FOR OFFICE USE ONLY
1114 City of Tigard ss �� Date /Be: .0 d Permit No.: 5/T , a
1 3125 SW Hall Blvd., Tigard, OR 97223 7 0 ZO 'tZ
♦ I�
Phone: 503.718.2439 Fax: 503.598.1960 Pla Date/B n Re : view i�� n Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY ( �.ri� ` D Date Ready / :y: Q kills: ® See Page 2 for
Internet: www.tigard- or.gov Ci� L aJ� N. ' /o of /1)-( Supplemental Information
TYPE OF WORK REQUIRED DATA: I- 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.
El I- and 2- family dwelling ® Commercial /industrial Valuation: $
CI Accessory building CI Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9500 SW Murdock St. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Templeton Elementary ADA Covered porch area: square feet
Cross street/directions to job site: SW Murdock St. / SW 96 Ave. Deck area: square feet
South on SW Hall Blvd., right onto SW McDonald St., left onto SW 97 Ave. bear Other structure area: square feet
left onto SW Murdock St. REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: Tigardville Heights I Lot no.: 2901 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S1 11ACO2901 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.
Construction of an accessible path from an existing school building to an Valuation: S4,000.00
existing basketball court with new impervious area of approximately 433 sf. Existing building area: N/A square feet
and approximately 12 linear feet of railing. New building area: 0 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: N/A
Name: Tigard - Tualitin School District Type of construction: N/A
Address: 6960 SW Sandburg Street Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing: N/A
Phone: (503)431 -4000 Fax: (503)431 -4047 New: N/A
ll APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Cardno All contractors and subcontractors are required to be
Contact name: Matt Lewis licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5145 SW Westgate Drive, Suite 100 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97221 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 419 -2500 I Fax: :(503)419 -2600
E -mail: matt.lewis@cardno.com
CONTRACTOR
Business name: 'MU — 6 CA) gig- CTo2 S / j BUILDING PERMIT FEES*
Address: 6g60 Au-DE/2-4(W (Please refer to fee schedule)
Structural plan review fee (or deposit): $112.96
City /State /ZIP: 41.e2.024 C ?7(50 V.
Phone: (52)3) I S4/ ? — C 241$4, Fax: (563) / _ Y FLS plan review fee (if applicable): N/A
CCB tic.: 6 7
Total fees due upon application: $112.96
S
Amount received:
Authorized signatur I A This permit application expires if a permit is not obtained
Y J �(/� within 180 days after it has been accepted as complete.
Print name: 1L./1 i (I �, ; C•' y, Date: hi {tp _ * Fee methodology set by Tri- County Building Industry
�./� � t`' 11G Service Board.
I: \Building \Permits \SIT- PermitApp.doc 10/01/09 440-4613T( I I /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: 3.85 cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) Net 21.14 cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be compacted to
90% of maximum density) 24.99 cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: 433 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 - 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.
I: \Building \Permits \SIT- PermitApp.doc 05/25/2012 2
Site Work Permit Application
Plan Submittal Requirements
TIGARD Commercial, Multi- Family and One- & Two - Family Dwellings
A site work permit is required for all commercial projects including new buildings, additions,
accessory buildings larger than 120 square feet, modular structures and multi - family R -1
occupancies. A site work permit is required for excavation, fill, grading, paving, retaining walls,
fire hydrants and fire department access on private property for work on individual lots not
covered under the subdivision development.
Note: A separate "plumbing" permit for site utility plumbing work is required for sanitary
sewer, storm sewer and potable water systems on private property. Please see the Site
Utilities - Plumbing Permit Application for plan submittal requirements.
1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic
location labeled with:
A. ® map & tax lot # ® project name ® site address ❑ suite number
zoning ® applicant name ® applicant phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads (drawn to scale) with project location.
2. BUILDING PLAN submittal requirement: Two (2) complete sets, Civil only.
All details listed below shall be incorporated into the plans:
A. Site plan showing:
1) Required parking spaces and driveways.
2) A route, accessible to persons with disability, leading from the public way to an
accessible building entrance.
3) Accessible parking spaces and adjacent access aisle connecting with the accessible
route.
4) Curb ramps along the accessible route, curb, sidewalk and gutter.
5) Finish grade elevations along the accessible route.
B. Topographic survey plan showing grade elevations crossing the entire site.
C. Overall grading plan.
D. Utilities plan showing:
1) Fire hydrant location and pipe size if on private property.
2) If the building is to be protected with an automatic fire sprinkler system, show
location of the water service vault and the fire department connection (FDC)
within 70 feet of a fire hydrant.
3) Size of underground water service for the sprinkler system.
E. Erosion control plan complying with the requirements of the Clean Water Services
(CWS) agency showing:
1) Silt fence locations.
2) Bio- filter bags /other approved barrier material surrounding catch basins.
I: \Building \Permits \SIT- PermitApp.doc 05/25/2012 3
3) Illustrations detailing the correct installation of the silt fencing and catch basin
protection.
4) Any other measures to ensure compliance with CWS standards.
F. Landscaping plan.
3. ADDITIONAL REQUIREMENTS:
A. Soils (geotechnical) report. A soils report is required for new buildings and additions
to contain the following:
1) The report shall address the potential of soil liquefaction and instability (OSSC
Sec. 1804.2).
2) Fills to be used to support foundation of buildings (OSSC Sec. 3301.1).
3) Foundation and lateral pressures exceeding 1,500 lb. /sq. ft. (OSSC Sec. 1805).
B. Fire flow and hydrant worksheet.
C. Plan review deposit based upon project valuation.
I: \Building \Permits \SIT- PermitApp.doc 05/25/2012 4
Building Division
Development Code Provision Review
Ti . c A R ° Commercial Projects - No Associated Land Use Case
Building Permit No: - FAO / a` -dool r ❑ Expedited Review
Plan Submittal Date: /P7i // a—
To the Applicant:
> If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact at 503-718- or @ tigard- or.gov)
❑ Zoning Permitted Use Yes D — No ❑
❑ Land Use Required: Yes ❑ No (explain below)
Notes: 000 P /U/0 (0 U-
❑ Approved ❑ Not Approved Date:
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert@tigard-or.gov)
Notes:
Routed back to Building Division Date:
L: \CURPLN
RECEIVED
0 z 2012
CITY0FT� C � Cardna
TRANSMITTAL BU LLDrr, uA N WRG
Shaping the Future
To: Buidling Division Date: October 1, 2012
City of Tigard Project: Templeton Elementary 5415 SW Westgate Drive
Suite 100
13125 SW Hall Blvd. Project #: 21201070 Portland, Oregon 97221
Tigard, OR 97223 Case /File #: USA
Fax #: Phone (503) 419 -2500
Total Pages: Fax (503) 419 -2600
From: Russell Montgomery
www.cardnowrg.com
Transmitting Via: Purpose:
Messenger ❑ As Requested
❑ Other: ® Other: Review and Approval
Quantity Description
3 Grading and Erosion Control Plan
1 Building Permit Application
Comments:
Please accept the attached Grading & Erosion Control plans and application for the
proposed ADA path work proposed for Templeton Elementary School. We confirmed
with the Planning Department last week that land use approval would not be necessary.
When the permit application fee has been calculated please contact us or The Tigard -
Tualitin School District, and payment will be arranged. Please let us know if there are
any questions or comments. Have a good day.
Signature: Lad/
C:
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