6840 SW DARTMOUTH STREET A
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6840 SW Dartmouth Street
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r? CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
i
Date Requested: I A.M. I'.M.
L BUP:
"oration: _ ' � � +J 1.'�.' el �i ' f��l� 1��L�i � —
I'Lnant: -- Suite:_ Bldg: MEC:
Contractor: \ (' ol- Phone. PLM:
Phone: ELC: _
ELR:
SIT: r �r
BUILDING BLDG(can't) PLUMBING MECHANICAL ELECTRICAL r—SITY
bite : Post/Beam Past/Beam Post/13eam Cover/Service �o
rooting Roof UndFl/Slab Rough-In Ceiling rwatlff Line
Slab Framing Top Out Gas Line Rough-In ,•-
Foundation Insulation Sewer llood/D ut Reconrxt Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath F' Alm Crawl/1'ound Dr I teat Pump Low Volt _
ro Approved Approved -� Approved r` --fit�pnwcd —
Appr/Sdwlk vcd Not Approved Not Approved Not Approved over:
FINAL FINAL FINAL FINAL FINAL
•' U a.Lf.1- U. -j
f7 c'all th in.l lig C7 Reinspection fee of Sregq►uired befot-next inspmtioi. O Unable to inspect
Date: lam ''' (,, Pege of
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CITY OF TIGARD SITE WORK
DEVELOPMENT SERVICES PFRM'1T
13125 SW Hall Blvd., Tigard, OR 97223 5US'X19.4171 GERM 1 T #. . . . . . . : S I T97-0010
9 ' DATE ISSUED: 10/14/97 I{
PARCEL. r'S 101 AA--01800
,SITE ADDRESS. . . : 06840 SW DARTMOUTH ST
SUBDIVISION. . . . : WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK. . . . . . . . . . L..OT. . . . . . . . . . . . . :019 JURISDICTION: TIG
CLASS OF WORK. . :NEW PAVING?. . . . . . . . . . Y RESO. NO. :
TYPE OF USE. . . . :COM GRADING!. . . . . . . . : Y VALUE. . . $ : Pr"000
EXCV VOLUME: 608 Uy 1_.11NDSCAPING?. . . . : N
FILL.. VOLUME: 519 cy SITE PREP!. . . . . . : Y
ENG FILL". . . . . . : N STORM DRAINS?. . . : Y
SOILS RPT READ? : N TMPERV SURFACE: 15372 sf
Remat-14s : Develop parcel for espleyee pe-king.
Owner: _._.____-------..___.._._________.___.______-----.--_..___.__-.---_-__-- FEES
..TIM CORLISS R. CORA CORLISS type amol.m+ h,y date r-t,cpt
PO LOX 23970 PLC[', 0, 00 DRA 30/01/97 97— '99698
-TIGARD OR 97281 PRMT q x,97. 00 JSD 10/14/97 97-300044
PL-CK 9> 258. 05 JSD 1.0/ 14/'37 97 - 7,00044
Phone #: 5PCT $ 19. 85 JSD 10/14/97 97-300044
PRMT $ '36. 00 JSD 10/ 14/97 97--:3Q0044
Contractor.: --_._____._.____._--- _—_----_.---_--_PECK 1, 22. 50 JSD 10/14/97 97--300044
BAUGH CONSTRUCTION OREGON INC 5PCT 4 4. L2(I .JSD 10/14/97 97-31710044
PO BOX 14135 EROS $ 100. 00 JSD 10/14/97 97-300044
SEATTI-E WA 98114---0135 Additional fees not shown here. . . . . . . . .
Phone #: 6 41 -x':500 2653. 38 TOTAL
Reg #. . : 0+00628
--- -- REQUIRED INSPECTIONS
This pereii is issued subject to the regulations contained rn the Erosion Control _
Tigard Municipal Code, State of Ore. Specia'ty Codes and all other Excavation Ins
applicable laws. All work will be done in accordance with Fill In,;pection
approved plans. This persit will expire if work is not started Grading Insp
within 180 days of issuance, or if work is suspended for sore o'aving Insp
than IN days. ATTCNTIONt 0,^egos law requires you to follow rules St r,m Drain Insp
adopted by the Oregon Utility Notification Center. Those rules are C,-il vert /Catr,�, Ba
set forth in OAR 952-PO1--O@1O through DAR 952 001 ('SAA. Your, say Misr. Inspect ion
obtain copies of these rules or direct questions to O1NC by calling Final In apect ion
(5@3)246-9187,
I -,S+Sed by : ,�=_..� _ --..�= ^.._..� Permittee Signat'.trei� \. ---
++++-F.+++++++++. +++++++++++++++++ -+++++++++ !-++++++++++... F++++++++.+++4++++++++ r
Call 639-4175 h,/ 7:00 p. m. for an inspection needed the next bl.ksiness day
-I +++f-++•+t 4-1 i•+++++++4++++-Vr++++++
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CITY OF TIGARD Site Permit Application Rec'check#
c'd qv .yn iiv y,
1J-.A.:. ;,rV rlAl_L BL v t.... r-rlva:a Graulf`g, raving, Site Accessibility Late Rec d (vim
TIGARD, OR 97::23 Retaining Structures, Utilities and Related Work Date to P E.
(603) 639-4171 x304 Permit T !D oq �I? �•
Called
Print or Type
Incomplete or illegible applications will not be accepted
P(olect Name t Utilities (Complete all that apply)
Job y�latl/9x'���Z1L� r �-
Address Address 7 Storm Sewer f( l'('p11C J ^rG :•'
—— L 5 5 f ��/ f'1 G / ' _l � 5 �;1, Linear rt.
Na 1 Sanitary Sewer
-4 � C'f••.r► �-I`�l c, j __ /��/t Linear Ft.
Owner Mailing Address Fresh Water
pi x J 7/ Nl� Linear Ft.
City/State Zip Phone Catch Banns I
_` CJScyName '
`L�.'tro �ONS' k^' Clean Outs #
Meiling Adidriass Describe work to be done:
General �" I'l / J+ Newp Addition Alterationp Repairp
Contractor City/State Zip Phone Additional Description of Work:
Attach State Const. Cont. Board Lic. # Exp. Date
copy 'I(.• )S '1 / S r1 s
of current COT Business Tax or Metro# Exp. Date
licenses /G• 1 ,_^ _% /
Name Projecti �y
�
Valuation d b G t
Architect Mailing Address �— Plan Submittal: (3)sets containing each of the
foliotoving, must accompa ty this application:
CityiState ZIP Phone Site plan with Vicinity Va I Parking(including
ShowingADA compliance ADA)& Lighting Plan
Name I /, r ^C ` �t)r�' Grading Plan and details Landscaping Plan
Engineer Mailing Address i�� n�,', Erosion Cold,c! plan and Retaining Structures
I i_ ` L,ti' h 1/� details including calculations
CityiState Zip Phone Site Utility Plan and details Soils Report
(showing connection to (if required)
l r_ 1 LNw 1 � - -I 1 ,202 7-3; a_oproved system) — — ---
Excavation Volume I hereby acknowledge that I have read this application that the
(Soils report requ•red for>S,OCO cu. YardsI ti nformat on given a correct.that I am the owner or authorized
i �JcU. yds. agent of the owner. and that plans submitted are in compliance
withOrigon State laws._
11 bolume ISi,dn re of Owner/Algenf, Date
Soils report required for>5.000 cu. Yds.) f + '( yds ti
'Will the 511 support a stntcture { — t�Ct Person sin• Phone(En 46-ear required if answer is yes) YES❑ NOo;
15 5
Retaining structure?(check one) ❑Rock FOR OFFICE USE ONLY
D CMU Notes:
i]Concrete
[]Other
Total new impervious area including all Land Use Case# MaprTL#
buildings, sidewalks. and paving Int 5q. Ft.
i:'Csts�siteapp duc
4166 ] A&V\tI) ' 1? -d�c)" C04I
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E AQccunt Description An= _AML ELL Bal. Due
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT)
State Tax (TAX)
Bldg:
Plumb:
Mech:
ELC/ELR-
Plan Check
Build: (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review (LANDUS)
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Mass Transit TIF (TIF-MT)
Water Qualih,, (WQUAL)
Water Quantity (WQUANT)
Erosion Control Permit (EF PRMT)
Erosion Planck/USA (ERPLAN)
Erasion PlanckiCOT (EROSN
Fire Life Safety (FLS)
TOTALIS.