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Permit CITY OF TIGARD SITE WORK PERMIT s COMMUNITY DEVELOPMENT Permit#: SIT2014.00004 Date Issued: 03/10/2014 TIGARD 13125 SW Hall Blvd.Tigard OR 97223 503.718 2439 Parcel: 2S102A604800 Jurisdiction: Tigard Site address: 12460 SW MAIN ST Project: Jeffrey Allen Subdivision: KINGSTON Lot: 2 Project Description: Site work for new sunroom addition. Contractor: RELIABLE CONTACTOR LLC Owner: LUONG, PETER & HIEU 4606 SE 115TH 113 KINGSGATE R PORTLAND. OR 97266 LAKE OSWEGO, OR 97035 PHONE: 503-319-3801 PHONE 503-481-3188 FAX FEES Description Date Amount Specifics: Permit Fee-Site Work 03/10/2014 $346 98 Plan Review 02/26/2014 $225 54 Type of Use: COM 12%State Surcharge-Building 03/10/2014 $41 64 Class of Work: ALT Project Valuation: $26,000.00 Site Specifics: Excavation Volume: cu.yd. Fill Volume: cu.yd. Impervious Surface: sq.ft. Engineered Fill Soil Report Required. Paving- Grading: Landscaping. Site Prep Storn Drains: Retaining Wall. Fire Underground: Accessible Parking: Fence. Total $614 16 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 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 No Stion Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direc questions to OU by lin 3.232.1987 or/1.800.332.2344. Issue By: f� J1�11j .^ Ili ; Permittee Signature: >( +^t i -t r1 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. I Building Permit Application Site Work g G i J 'D FOR OFFICE USE ONLY I City of Tigard A t 1�m Date/Bey ..� aS- /< Permit No:51 7�j 4 yr 1312 SW Hall Blvd. Ti ard, 97213 `' d 5 g Plan Review �F lON / Phone: 503.718.2439 Fax: 'SO3. 5 2014 Date/By: 3 (b I/�[)ther Permit: Ox+ 7Cb T I G A R I Inspection Line: 503.639.4175 Date Ready y: tuns. RI See Page 2 for Internet: www.tigard-or.gov my(); �(l'ARC) Notified/Method: 3//0//K 1-3% Supplemental Information • l TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate - value(rotnded to the nearest dollar)of all A.Addition/alteration/replacement ❑Other: equipment, terials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated . this application. ❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: S ❑Accessory building ❑Multi-family Number of bedroom ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors. Job site address/2460�5tiA,4,9/A( New dwelling are-. suare feet City/State/ZIP:7 9,4piD ! 7 .4 Garage/.: .5 area: squ. feet Suite/bldg./apt.no.:jj"" �,'1 Project name: Covere• ..rch area square fe-. Cross street/directions to job site:C4,Q ep 1►/1 a�� �RM i- area: square feet // //`` / � v 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.: 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: S 7 4 000 d 't/ G / //e /� � 4p f -C/ 9 Existing building area 40 f square re feet New building area: Q square feet r PROPERTY OWNER ❑ TENANT Number of stories: Name: ER' L&OA/el Type of construction:WO4/6cmcii"6". Address:1/3 ,,,, ,4T�c RD Occupancy groups: City/State/ZIP4 k������''c 7Q, 97,235 Existing: /e6/�t/L Phone:125- )4'g1�/d Fax: / /,1.6 F` Z? New /25-7-A/I- A APPLICANT "CONTACT PERSON NOTICE Business name: ( C�p,L" /� AzzEN-/limp 9k", Q,),/ All contractors and subcontractors are required to be Contact name: R LGLQ licensed with the Oregon Construction Contractors Board J -j� under ORS 701 and may be required to be Lensed in the Address:72 W j. /?u7—,4t jurisdiction in which work is being performed.If the City/State/ZIP: . OA* 9 7..2 z 3 applicant is exempt from licensing,the following reasons .�. 9g.—71Y 3l . 9-a 7 2 97, apply: Phone: 9 Fax: y E-mail / fft. c/f�-��h h f/Z��l/ lit-• C©/y1 �/ _ ` CONTRACTOR Business name: v46� � ?�?,9 7-0 p L L C BUILDING PERMIT FEES* Address: i/ 6 ,55 /4_5 1 - / 'J!\ (P/eare►e%rwfreschedxliJ City/State/ZIP: ,gT�A/Z) ?7� / Structural plan review foe(or deposit): �/77 / / b _ FLS plan review fee(if applicable): Phone:(03)3/7 - 3 0d! Fax:( 773L O/ Ci3 Total fees due upon application: CCB lie.:A//74\5-7 Co 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: Lila L _ 0 .0 Date: — , -• •/ * Fee methodology set by Tri-County Building Industry Service Board I:\Building\Permits\SIT-PermitApp.doc 10/0I/09 440-4613T(11/02/COM/WEB) 1 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 till 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: 1 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 ❑ 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 $50,000.00 550,001.0(1 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. 1:1Building\Permits\SIT-PennitApp.doe 05/25/2012 2 I n Site Work Permit Application ■ Plan Submittal Requirements I I G A R D 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. L 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:\BuildmgTermits\SIT-PermitApp.doc 05/25/2012 3 1 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 lateralpressures exceeding 1,500 lb./sq. ft. (OSSC Sec. 1805). B. Fire flow and hydrant worksheet. C. Plan review deposit based upon project valuation. I:1Building\Permits&SIT-PermitApp.doc 05/25/2012 4 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12460 SW MAIN ST, TIGARD, OR, 97223 Commercial - Site Work 499 Final inspection PASS - No C of O SIT2014-00004 Chip Barnett Violation Summary: Inspector Contractor