Permit (37) iliNCITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit#: SIT2017 00010
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/20/2017
T t t® 9 Parcel: 2S 112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN
Project: PacTrust Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: ADA improvements,sidewalk replacement for both 6650 SW Redwood Ln and 15350 SW Sequoia Pkwy.
Contractor: SSC OF OREGON I LLC Owner: PACIFIC REALTY ASSOCIATES
389 INTERPACE PARKWAY 5TH FLOOR ATTN: N PIVEN
PARSIPPANY, NJ 07054 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 973-753-3507 PHONE: 503-624-6300
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 06/20/2017 $2,605.42
Plan Review 06/20/2017 $1,693.52
Type of Use: COM 12%State Surcharge-Building 06/20/2017 $312.65
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 06/20/2017 $76.00
11x17)
Project Valuation: $500,000.00
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall:
Fire Underground: No Accessible Parking: Yes
Fence:
Total $4,687.59
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 • ' a ion ;•ter. 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 OU ,•c. lin. 503.232.1987 or 1.800.332.2344. _
Is=ued By: T / /i//� , Permittee Signature: L . . : �C/r i /�--
/j l4
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 Applicatioli KI
Y
D
Site Work rY
, 4 ,
n 7 FOR OFFICE USE ONE\14
Cl of Tigard 6 2017 1( Received /_ i ]� L
g Date/By: (.[� $ / 5 Permit No.: OI'll 7l/7-000/0
- 13125 SW Hall Blvd.,Tigard,OR 97, OF TIGARD e r
TIGARD SIO Plan Ryieiv (7 ( r� `fC)�l7�43
Phone: 503.718.2439 Fax: 503. �:. ',1 tt f /� Date/B : I3 I Other Permit:
TI G A R D Inspection Line: 503.639.4175 • f NG D�U1S4Q Date Read Jur;5:
Cd
-,, , Y Y: / / See Page 2 nr
Internet: www.tigard-or.gov �� / Notified/Method: �p p?p ) Supplemental Information
j ;is d."--e- lJl-e.--A-;
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling I=1Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
e address: C 4 S 0 S a-"l)t,vc.:k3 J £rq Al/ New dwelling area: square feet
C ttZIP: p,D`'e,—Te-7(,'-}Pr 't`-- `� 7°2 4- Garage/carport area: square feet
Suite/bldg./apt.no.: ,74-0 -N? 21 C
cyic ofL fl e--ft.l-{ .7--,ort Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
RE )AT.4 COMMERCIAL-USE`CIIECKLIST,.
QL�IREI� ,
Subdivision: 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.:
/AA,. i a25!/;:Docj-h/440 equipment,materials,labor,overhead,and the profit for the
.,,,, 4 a ' ,,! , ' work indicated on this application.
Valuation: ar,
$ .� ., t«
t�-ti,zd✓ �le^-�TS, SipE [t� ��fu'GtGcNIcN) /'
Existing building area: square feet
�- tL i So %W le�-DW�fl IL
mot,.)---t, d'J If-££a3 ,- f--- lot New building area: square feet
$, ,< n ' i xO � `r E►N1 ,'" Number of stories:
1r "t c ice( r S c C-C rt 7L�S Type of construction:
* ( 3 cO Shat` ‘.5F--7-4'✓c) I P W�t o
v c) Occupancy groups
IP: c 't a,it ()r 6 62- 7 2 Z"-- Existing:
So'S) Le,„ - G ao Fax:(S<>3) 62 4--7 75-5
New:
h 1 .LI PSO 'g -tif 444 * 44
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
" City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( )
PP Y
Fax::( )
E-mail:
co f ./ .
Business name: d RA_N!'104\19— UI 3N PE
Address: ' J LPsey�eriike S
fee :'
City/State/ZIP:
Structural plan review fee(or deposit):
Phone:( ) Fax:( ) FLS plan review fee(if applicable):
CCB lie.: g�f 5'� l 9 Total fees due upon application:
" ztt„-t-y gig 5gCt A-tc P Amount received:
o"i-ized signator : �rC i
I�y y c„•_,I (- L6 t--. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
P rile: (C(•(ra(2.-b (<12-I PRA--e-ti NC Date: G/' /2.,t7 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 440-4613T(11/02/COM/WEB)
* L'
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:
❑ 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
*Does not apply to One-and Two-family dwellings.
Plan Submittal: Permit Fee:
TYPE OF SUIIMITTAL #of Plans V11
. fl 3. hermit i+ e • y•ry
(New;Additions or Requited 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-FamilyR-1 3 $10.76 for each additional$1,000 or
Occupancy p Y 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-PermitApp.doc 08/02/2016 2
City of Tigard
w COMMUNITY DEVELOPMENT DEPARTMENT
■
TIcaRD Building Permit Review — Commercial - With Land Use
Building Permit #: c.,Z/ 7—c:96/ 7_ a00 /0
Site Address: 6 t 7 'j) Odkrat L Suite/Bldg#:
Project Name: / 7g J l�k)e�ie�- �s fhL,�
(Name of commercial business occupying the space. If variant,enter Spec Space.)
Planning Review
Proposal: `? Lt 9OP : fee1)nAiire roy .,re�C
�' �� C'�A/ S� Lrri7j, - 3, ��Sl
pc2
V('
Verify site address/suite#exists a 3rd'active in permit system.
14:11 ver Terrace Neighborhood: ❑ Yes ❑ No
and Use Case#: 4f// 7l 0 bi -- 6900
Plan/Match Approved Land Use:
ICJ Site Plan 4andscape Plan t1'Other:
\kban Forestry Plan (\Prevation Plan
Tuilding Height: Maximum Height Actual Height
onditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
II
Business Licens .
xists: Yes ❑ No,applicant notified to obtain business license
Public Facilities provement(PFI) Permit:
Required: ViYes,applicant was notified ❑ No Applied For: Yes ❑ No,stop intake
Notes:
Approved by_Planning:
�"-�---�-_ '
�?/ Date: _Ari
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal /
Original Submittal Date: Cp /� 7/7
Site Plans: # f 3
Building Plans: #
Building Permit#: ErEnter building pe #above. /
Workflow Routing: [ Planning Engineering Q-I nit Coordinator wilding
Workflow Sign-off: Design-off for Planning(include notes from planning review)
Route Application Documents: Q'luilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
`OQ
Notes: / CP�P'r/ / e_ue ("`"--/5-3 5-el) _ a, . =,,,,-,
By Permit Technician: /Ar / Date: ,
I:\Building\Forms\B1dgPermitRvw_COM_WithLandUse 070915.docx
Engineering Review
❑ Slope at building pad:
❑ PFI Permit#: 1-'1/0/-0/7-60103
Vg. Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
X' Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: Xi Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: 5Date: 647
•
Revisions (after Building Submittal only) Reviewer Date"
Revision 1: ❑ Approved El Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: El Approved ❑ Not Approved
Permit Coordinator Review
El Conditions "Met"prior to issuance of building permit
❑ 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:
DC Fees Entered: Wash Co Trans Dev Tax: CI Yes 2's. /A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes 45F.N/A
/OK to Issue Permit 7
Approved by Permit Coordinator: Date: �j Mfl
I:\Building\Forms\B1dgPermitRvw_COM_WithLandUse 070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6650 SW REDWOOD LN, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Site Work SIT2017-00010
Inspection Type: Inspector:
499 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor