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Permit y y CITY OF TIGARD SITE WORK PERMIT t: COMMUNITY DEVELOPMENT Permit #: SIT2013 -00002 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/26/2013 Parcel: 1 S136DA00100 Jurisdiction: Tigard Site address: 11308 SW 68TH PKWY Project: Comcast Tech Ops West Subdivision: PFAFFLE PLAZA CONDO Lot: 2 Project Description: Altering existing parking lot, adding a "utility pole training" yard. Contractor: LEASE CRUTCHER LEWIS Owner: BENENSON 68TH PARKWAY KEY LLC, T 550 SW 12TH AVENUE BY PROVIDENCE HEALTH SYSTEM PORTLAND, OR 97205 ATTN: PROPERTY MANAGEMENT 1235 NE 47TH STE 160 PORTLAND, OR 97213 PHONE: 503 - 223 -0500 PHONE: FAX: 503 - 223 -2874 FEES Description Date Amount Specifics: Permit Fee - Site Work 02/26/2013 $1,123.72 Plan Review 01/31/2013 $730.42 Type of Use: COM 12% State Surcharge - Building 02/26/2013 $134.85 Class of Work: ALT Info Process /Archiving - Lg $2.00 (over 02/26/2013 $16.00 11x17) Project Valuation: $170,000.00 Erosion Control w /Permit - Ping 02/26/2013 $225.00 Site Specifics: Excavation Volume: cu. yd. Fill Volume: cu. yd. Impervious Surface: 216926 sq. ft. Engineered Fill: Soil Report Required: Paving: Grading: Landscaping: Yes Site Prep: Storn Drains: Retaining Wall: • Fire Underground: Accessible Parking: Fence: Total $2,229.99 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 with • 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow • .. • . e. by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. Y: ' •bta j/. co. of th- rules or direct questio OUNC by callin 503.232.1987 or 1.800.332.2344. Issued By: - C Permittee Signature: � .� - / -- 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. It..-- Permit Applicatio pELir n Site Work � C r J FOR OFFICE USE ONLY City of Tigard I qN 1 144...��� D ateB e a / '! ' ��- � 3 31 2013 0 Permit No.: I a 13125 SW Hall Blvd., Tigard, OR 9722 Plan Revie,� ,� �']. Other Permit. • S Phone: 503.718.2439 Fax: 503.59 Date/B IiL r TI G n R u Inspection Line: 503.639.4175 % O F ' TIGARD Date Read i y: 7 Juris: El See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: , RS � • Supplemental Information OyFi d� 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 (romded to the nearest dollar) of all X Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ID I- and 2- family dwelling izr Commercial /industrial Valuation: $ 1:1 Accessory building 1:1 Multi-family Number of bedrooms: E) Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: , t ,0f); SW tG/ tcArKwg' New dwelling area: square feet City /State /ZIP: 1G mrJ PIK 9722-3 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: Cc i J 1r L zcH as 141E5Povered porch area square feet Cross street/directions to job site: SIA PACIFIC 'W `r Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (romded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. f�( EK LTN T 11 -_ I to '�1��•GM L ti R—yr Valuation: $ /7 / V MLE '.V��t 1 +r�7 f � J tttiG � 7 / vl/t b Lal t Existing building area � square feet Y New building area: square feet ❑ PROPERTY OWNER v TENANT Number of stories: Name: GoM4[ ©F ruALAICN VALL f 16c Type of construction: Address: — 1 � g� \j l�0LS AVE. Occupancy groups: City /State /ZIP: e Ki OK 9-7005 Existing: Phone: Qo 3 • ixh© Fax: a73 Q 2? New: cil APPLICANT ❑ CONTACT PERSON NOTICE Business name: 1,,,Ig 1-.1--C All contractors and subcontractors are required to be Contact name: FlsSL ! V� licensed with the Oregon Construction Contractors Board `� under ORS 701 and may be required to be Icensed in the Address: 550 614 `s ta AVM , jurisdiction in which work is being performed. If the City /State /ZIP: 1/IV,,1tt tD v \ �,720� applicant is exempt from licensing, the following reasons e /� apply: Phone: E03 22✓. 0500 Fax: • 223 -2€74 L E-mail: s ?ri e. rew{✓G J 1Ids.c rn CONTRACTOR ��..''__ ttFF 5 L L ('� Business name: 1„....V .AS G LE.14Dv BUILDING PERMIT FEES* Address: b� � 12';* �Y � (Please refer to fee schedule) City /State /ZIP: • +J1 J'ot'4 ED �� 2 C J Structural plan review fee (or deposit): Phone: 1.• 223 . 0 ) 1 Fax: 5. 223. 2874 FLS plan review fee (if applicable): CCB lic.: 4: 12 4 9 1 1� 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:��� N Date: • * Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits \SIT- PermitApp.doc 10 /01/09 440- 4613T(11/02 /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: 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. Retaining structure? (Check one) ❑ Rock • ❑CMU • ❑ Concrete ❑ Other: *Total new impervious area including all buildings, sidewalks, and paving: 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: El Site Plan with Vicinity Map showing ADA ❑ *Parking (including ADA) and Lighting compliance Plan El Grading Plan and details ❑ *Landscaping Plan 111 Erosion Control Plan and details. ❑ Soils Report (if required) • • El Retaining Structures El 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. 1:\Building\Permits \SIT- PermitApp.doc 05/25/2012 2 v ` li le Building Division Development Code Provision Review TI G A R D Commercial Projects with Approved Land Use Building Permit No.: 1 T AO/ ?J -d coo 9, Land Use Casefile No.: M T ‘ 9O1 3" 0000? Routed Plans: / Submittal Date: 1/.3/ , 3 C Submittal Date: Submittal Date: 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 only mark those items J � oon the left side that are approved. Planning Review (contact -0Wa at 503-718-1A2/ or (/1 nfi C @tigard- or.gov) ICY nd Use Approval U LJ" Building Plans Match Approved Plan: Yes El No ❑ ximum Building Height w,) I Pr Conditions Met ❑ Street Trees ❑ Protected Trees Notes: IYIOr l 1 /, • f G/ 1 /I I; A . 1 4. g i. 1 . Original Plan: Approved ❑ Not Approved Date: ZI Il 113 Revision 1: Approved X Not Approved ❑ Date: - � C Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 Y Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov) ❑ Actual Slope: cyo ❑ PFI Permit # ❑ Conditions Met L Notes: ' .i I . y 11G�. �lJ [4 / ' _ At '� U . �f d_ d & o1 w` - w S Original Plan: Approved ❑ Not Approved %. %/ Date: 21 i/ /3 • Revision 1: Approved Not Approved 0 Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard- or.gov) ❑ Planning Okay to Issue Permit ❑ Arborist Okay to Issue Permit ❑ Engineering Okay to Issue Permit Notes: Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applic. t Revision 2: Date Sent to Ap. :c Okay to Issue Permit: _ Y s No ` `� Date Routed to Building: _ ) Page 2 of 2 Albert Shields From: Albert Shields • Sent: Tuesday, February 12, 2013 12:46 PM To: 'paul.riso @lewisbuilds.com' Cc: Agnes Kowacz Subject: RE: SIT2013- 00002, Comcast T.I. • Paul, same thing with the SIT pemit. Both the SIT and BUP are on Hold pending approval of the MMD. Albert. From: Albert Shields Sent: Tuesday, February 12, 2013 12:40 PM To: 'paul.riso @lewisbuilds.com' Cc: Agnes Kowacz Subject: BUP2013- 00024, Comcast T.I. Paul, on review of the plans submitted, Planning has noted that approval of a Minor Modification Land Use Application is required before the BUP can be released for Building. The Minor Mod application, MMD2013 -00008 has been submitted. If you have any questions about this please call Agnes Kowacz at 503 - 718 -2427 or me at 503 - 718 -2426. • Albert Shields • 11 u City of Tigard § ! & Permits /Projects �--. Coordinator tfvA \/14) Aber z@zigard-or.g dv (503) 713-2426 v4 ork (503) 624-3631 Fax • 13125 SW Hail Blvd. Tigard, OR 97223 3 , 1