Permit (57) INCITY OF TIGARD SITE WORK PERMIT
I COMMUNITY DEVELOPMENT Permit#: SIT2017-00027
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 11/01/2017
[ '' 9 Parcel: 2S 102 DA00800
Jurisdiction: Tigard
Site address: 13335 SW HALL BLVD
Project: Fanno Creek House Subdivision: 1992-069 PARTITION PLAT Lot: 2
Project Description: Paving 6 parking spots and removing excess soil. Approximately 1,000 sq.ft.
Contractor: OWNER Owner: TIGARD, CITY OF
CITY OF TIGARD 13125 SW HALL BLVD
13125 SW HALL BLVD TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-718-2583 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 11/01/2017 $134.48
Plan Review 10/19/2017 $87.41
Type of Use: COM 12%State Surcharge-Building 11/01/2017 $16.14
Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 11/01/2017 $1.00
11x17)
Project Valuation: $6,000.00 Erosion Control w/Development 11/01/2017 $80.70
Site Specifics:
Excavation Volume: 20 cu.yd.
Fill Volume: 15 cu.yd.
Impervious Surface: ggg sq.ft.
Engineered Fill: No Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Site Prep: Yes
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: No
Fence:
Total $319.73
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 Notification Center. Those rules .re set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to O C by calling 503,r2.1987 or 1.:00.3324.
Issued By: A4 4,...."-•>,,-----,== Permittee Signature: .4)Call ` /�"n��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.
--11111
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: Q 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) A5 cu. yds.
Retaining structure? (Check one) ❑ Rock
/14 ❑ CMU
IV, ❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: ,951 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 S"�". MITT #of Plans Val �', ° . o a
(News Additio*or Required at $.00 to$500.00 $51.09 minimum permit fee
+ terations), 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 fust$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\Pemrits\SIT-PermitApp.doc 08/02/2016 2
ip ,
Site Work Permit Application
e . q
I` Plan Submittal Requirements.
Ti 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.
1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic
location labeled with:
A. [3map &tax lot# a project name site address ❑ suite number
0" zoning Er applicant name 2-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: Three (3) 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:\Building\Permits\SIT-PermitApp.doc 08/02/2016 3
4, Ill
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 lateral pressures exceeding 1,500 lb./sq. ft. (OSSC Sec. 1805).
B. Fire flow and hydrant worksheet.
C. Plan review deposit based upon project valuation.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 4
City of Tigard
III " COMMUNITY DEVELOPMENT DEPARTMENT
: 1111
r1cARo Building Permit Review — Commercial - With Land Use
U
Building Permit #: ,tea f 7-C17
Site Address: I 33? S s v" i-f-oka B)vcL• Suite/Bldg#:
Project Name: F4 r no U&L U 1..Q.
(Name
Q-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: PGIV'e fin1, 1006 Sr-
Verify site address/suite# exists and active in permit system.
7 River Terrace Neighborhood: 0 Yes No
Land Use Case#: M (V)I 0"74 (1 - 000O cl A- DJ 20 \--1 —0 o 07
Plans Match Approved Land Use:
Site Plan 0 Landscape Plan 0 Other:
0 Urban Forestry Plan 0 Elevation Plan
g eigH—ftrrilEP.---- Maximum Height Actual Height
Cl onditionsMet• 0 Prior to Submittal 0 Prior to Permit Issuance
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
i - .: . 'n;:- . .. - -- A I) Permit:
Required: 0 Yes,applicant was notified ❑ No Applied For: 0 Yes ❑ No,stop intake
Notes:
Approved by Planning: s_, Gam--` Date: i 0/1 9 / 17
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: /0/t/rl 7
Site Plans: # 3
Building Plans: # 3
Building Permit#: nn r building ppermits above.
Workflow Routing: 4�P1 ningIs�JEngineering Itd.-"I'ermit Coordinator S—Birfi ding
Workflow Sign-off: E E''' -off for Planning(include notes from planning review)
Route Application Documents: L9'Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ,yye„_. Date: /4/i 4//)
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.6>L�Engineering Review 2 �
Slope at building pad:
❑ PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
❑ Easements (encroachments) per engineering conditions of approval and plat(not typical on SDR/CUP)
ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes "a'No
Assess Water Quantity Fee in-lieu: ❑ Yes ,O'No
LIDA Facility on lot: ❑ Yes ,No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: M `k, (.o- , Date: /D ZS— /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
❑ 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: ❑ Yes �` /A
Tigard Trans SDC: ❑ Yes I /N/A
Parks SDC: ❑ Yes K"'N/A
(±0
OK to Issue Permit
4Approved byPermit Coordinator: d Date:
i43Al -3-ern
1i
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