Permit CITY OF TIGARD SITE WORK PERMIT
II-. COMMUNITY DEVELOPMENT Permit#: SIT2017-00001
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2017
TIGARD g Parcel: 1 S136CC00100
Jurisdiction: Tigard
Site address: 8200 SW PFAFFLE ST =
Project: Westside Christian HS Soccer Field Subdivision: None Lot: None
Project Description: Soccer fields for Westside Christian HS,located at8200 SW Pfaffle.
Contractor: GREGORY PACIFIC CORP Owner:
11650 SW 67TH AVE#130
PORTLAND, OR 97223
PHONE: 503-639-3887 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 02/16/2017 $3,727.92
Plan Review 02/02/2017 $2,423.15
Type of Use: COM 12%State Surcharge-Building 02/16/2017 $447.35
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 02/16/2017 $50.00
11x17)
Project Valuation: $750,000.00 Info Process/Archiving-Sm$0.50(up to 02/16/2017 $27.50
11x17)
Erosion Control w/Development 02/16/2017 $686.40
Site Specifics:
Excavation Volume: 4500 cu.yd.
Fill Volume: 4500 cu.yd.
Impervious Surface: 16000 sq.ft.
Engineered Fill: No Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall: Yes
Fire Underground: No Accessible Parking: Yes
Fence: Yes
Total $7,362.32
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 N.' •-r.; .• 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 di -ct questions to eU• ' • .Y 'ng 503.232.1987 or 1.800.332.2344.
Is-ued By: LIL ` _� 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.
sellilirimimmuips
I "
- Building Permit Application
Site Work
.1,1 vA.,r.)I, 4 •V-4 A' , FOR OFFICE LSE ONE)
City of Tigard Received
IliA A ,....,
Date/By: .0-4, Pt , ' Permit No.:6/I-caw 7.--etzbi
13125 SW Hall Blvd.,Tigard,OR 9732Plan Re ew 1-R 2 ?Di/ 4
hh.,,, , 2. k,
/
I Phone: 503.718.2439 Fax: 503.598.11961Y Date/By: 1 Other Permit: pkvey-7.-60017
1!GARD Inspection Line: 503.639.4175 Date Ready :\: .,.1 Juris gi See Page 2 for
Internet: www.tigard-or.gov IL, Ak 't#,:' t 1 vt.-t.al,t. Notified/Method: e/15--/7 4,7- Supplemental Information
luILDINGDrvictori r. ,-,,.., „., ,.
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
17: New construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
ID Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation: $
1=I 1-and 2-family dwelling El Commercial/industrial
El Accessory building l=I Multi-family Number of bedrooms:
Number of bathrooms:
El Master builder E Other:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ,1 1 cc ':: ,j p ca(41i c 5.1- T-,4„,,,,,k c. 1%1 New dwelling area: square feet
/ i
City/State/ZIP: -r.,34rd / C)?. 672e 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 1„„)( II S 50((.e r- Covered porch area: square feet
Cross street/directions to job site: C LI 1_4 c1‘ ?,I vA Deck area: square feet
Other structure area: square feet
-REQUIRED DATA:COMMERCIAI(uUSE CHECKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.:
Ilov equipment,materials,labor,overhead,and the profit for the
, DESCRIPTION OF WORK , ,, work indicated on this application.
Valuation: $ -7 9c), 60 0
(G(\ç\-C+A.C 4-091-, 0 -- 11 e‘,-.7 q 0-fy r e esti A r,of —
_ Existing building area: square feet
-- ,J, SoCCer 17. e i CI
,
ttl; New building area: square feet
t 0 PROPERTY OWNER ' 0 TENANT Number of stories:
tf Name: ujes1- .; Ae C l-' Or l.J1/4..-1 11/4"\i ik S C k ec i
_ Type of construction:
o ' Address: q-2_06 s,,,,) p cc,.(.4 it 5ir Occupancy groups:
it
City/State/ZIP: T i 5 c..r a f 0 R C' 7 123 Existing:
Phone:(5C1) 61 el 7_ LI 7 il Fax:(S3) CA,' '11 Lf(9 OS- New:
.1:T .r.. APPLICANT 0 CONTACT PERSON' — NOTICE 4
,' Business name: p e_\_ir cle, ei,i i n e V,'-'-;,1 to_ R e)c voirC e$ 4-L C
. ‘ All contractors and subcontractors are required to be
4i licensed with the Oregon Construction Contractors Board
Contact name: 1\)eil k ?; R..\-4-0 k-
under ORS 701 and may be required to be licensed in the
Address: )1132_ 1\J vj L,,, a
,,,,1 I t,,,1„.../ A d
jurisdiction in which work is being performed.If the
,i applicant is exempt from licensing,the following reasons
,;,'-',- City/State/ZIP: p( r 1.1a,e )0,$), 6-? i z i apply:
Phone:(co)2) --/c 3_ 3 G,ci Fax::( )
E-mail: ,ett € p —e
c - er, 5 ., (.0,....
CONTRACTOR
1.,
. ,
Business name: 6 re t,...? pcsr i C.,c c 0 r p BUILDING PERMIT FEES*
(Please refer to fee schedule)
-`- Address: 1 -
1 to S0 c l-I (s. '7 fk Ave i* )3 0 Structural plan review fee(or deposit):
City/State/ZIP: p or \-\Ay\A 1 og q112.3
FLS plan review fee(if applicable):
Phone:( b3 ) 63 q -3 ..,.-7 I Fax:( )
Total fees due upon application:
CCB lic.:
Authorized signature: i.. .4_,
, Amount received: 72-ei1 y /5
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: N.;e,\ ?Nt --r Or-- Date: i LI/qi zoge, * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\SIT-FermitApp.doc 08/02/2016 440-4613T(11/02/COM/WEB)
s •W
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.t,r Scc) yds.
Grading Volume:
(Soils report required for>5,000 cu. yds.) CIi cot; cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90%of maximum density) `(cco cu.yds.
Retaining structure? (Check one) ❑ Rock
0_ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings, ����� ��s�, (b,601 nem
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:
® Site Plan with Vicinity Map showing ADA ❑ *Parking(including ADA) and Lighting
compliance Plan
E1 Grading Plan and details 2 *Landscaping Plan
O Erosion Control Plan and details ❑ Soils Report(if required)
Q Retaining Structures
*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 3 $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-PennitApp.doc 08/02/2016 2
1
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
: .
71
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: 3/1-29- /7 —aCGO
Site Address:
0200 ,SUA) Pin-gte Siee-f' Suite/Bldg#:
Project Name: WeSiStd C C:haSfiairi i-IS I ',ids
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: C�n� .� �� ( NA,-,,, c.,
Ytv,i Yt.er�r( # SaCtic-fi.,C,Cd.S"
^Verify site address/suite# exists and active in permit system.
la River Terrace Neighborhood: ❑ Yes '1 No
Land Use Case#: M �( ((J _U�C�
3-7
Plans Match Approved Land Use:
❑ Site Plan ‘ '(' andscape Plan _VJ0 ❑ Other:
1 (�Urban Forestry Plan Elevation Plan
Building Height: Maximum Height Actual Height
X Conditions Met: 0 Prior to Submittal Prior to Permit Issuance
*Business License:
Exists: ,.K Yes 0 No,applicant notified to obtain business license
Public Facilities Improvement(PFI) Permit:
Required: )Yes,applicant was notified 0 No Applied For: Yes 0 No,stop intake
Notes:
Approved by Planning: r ,l,{;r) Date: 2-1-27_ II
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Building Permit Submittal /
Original Submittal Date: a/ 7
Site Plans: # 3
Building Plans: # 3
Building Permit#: DrEnter building permit#above.
Workflow Routing: ❑ -Planningngineering [ermit Coordinator .B-Building
Workflow Sign-off: @'S -off for Planning(include notes from planning review)
Route Application Documents: 2' Wig: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: Cti -__ . Date: ��4 7
1:\Building\Forms\B1dgPermitRvw COM WithLandUse 060116.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
E Easements (encroachments) per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by E ,ineering: Date _
Notes: _ t :4 !'-- — __ 4 iii —isAlei 0
Approved by Engineering: /4,� ,r2) Date: ...„ --7.-/7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
1
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes '.'4 N/A
Tigard Trans SDC: ❑ Yes P' N/A
Parks SDC: ❑ Yes V /A
OK to Issue Permit
PP
roved by Permit Coordinator: 4 I ate: O'Z ii,I .
I:\Building\Fonns\BldgPermitRvw_COM_WithLandUse 07091 5.docx