Permit (104) CITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT Permit#: SIT2017-00016
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/09/2017
T[ � Parcel: 2S113BA02200
Jurisdiction: Tigard
Site address: 7520 SW DURHAM RD
Project: Durham Square Subdivision: 2017-013 PARTITION PLAT Lot: 1
Project Description: Building 1:Site work for new commercial building.
Contractor: REVCON INC Owner: MISSION HOMES NORTHWEST LLC
21420 NW NICHOLAS CT PO BOX 1689
HILLSBORO, OR 97124 LAKE OSWEGO, OR 97035
PHONE: 503-848-7300 PHONE:
FAX: 503-356-5599
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 11/09/2017 $822.89
Plan Review 07/27/2017 $534.88
Type of Use: COM 12%State Surcharge-Building 11/09/2017 $98.75
Class of Work: NEW Info Process/Archiving-Lg$2.00(over 11/09/2017 $26.00
11x17)
Project Valuation: $102,992.00 Info Process/Archiving-Sm$0.50(up to 11/09/2017 $10.00
11x17)
Erosion Control w/Development 11/09/2017 $236.40
Site Specifics:
Excavation Volume: 80 cu.yd.
Fill Volume: 2220 cu.yd.
Impervious Surface: 30055 sq.ft.
Engineered Fill: Yes Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall:
Fire Underground: Yes Accessible Parking: Yes
Fence: Yes
Total $1,728.92
Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
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 are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OU by calling 503.232.1987 or 1.800.332.2344.
Issued By: sa4e Permittee Signature: ////1/7 41;17/1/.
�1 500��
CallAAC/IRgC
L3.639.4175 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.
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A R D Building Permit Review — Commercial - With Land Use
L.
Building Permit #: 5/7---,2e/ 7 QOO/eo
Site Address: `1 S2o SVJ DV 1\elut,' cL • Suite/Bldg#: I
Project Name: 0 J( 01 M Sb 1A are.-
(Name of commercial business occupying the space. If vacant,entcr Spec Space.)
Planning Review
Proposal: S t VV 0 (k- / 'I kiikLitny
yl Verify site address/suite# exists and active in permit system.
Z1 River Terrace Neighborhood: ❑ Yes ,e No
g-Land Use Case #: SD 22X) - 000 I
CMZ( Plans Match Approved Land Use:
zr Site Plan ❑ Landscape Plan Cl Other:
❑ Urban Forestry Plan ❑ Elevation Plan
❑ Building Height: Maximum Height Actual Height
61, onditions Met: ❑ Prior to Submittal OPrior to Permit Issuance
-. --- License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
fl Public Facilities Improvement (PFI) Permit: pc 2,0U 1 'C)0 1 1 0
Required: ❑ Yes,applicant was notified ❑ No Applied For: ❑ Yes ❑ No,stop intake
Notes: C/0 t l) Cj v n- (A 1n tV2 1-17b e
P i- n r -f-,� i 33 vet r1 `�
Approved by Planning: M, Date: 7/ (se,
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: "7/18/17
Site Plans: #
Building Plans: # 3
Building Permit#: —Enter building permit# above.
Workflow Routing: C'Planning E - gineering Q--Permit Coordinator 'Building
Workflow Sign-off: [r Sign-off for Planning(include notes from planning review)
Route Application Documents: ll uilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Date: / 2��
l:\Building\Forms\B1dgPermitRvw COM WithLandUse 070915.docx
En ineering Review
U
leiSlope at building pad: / /0
PFI Permit#: Pf/2d/7. pU//
[a/ onditions "Met"prior to issuance of building permit ul/.�pk �'oK ,4'/X+� �O 4�
LJ Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
❑ Water Quality/Quantity Facility: T�
Assess Water Quality Fee in-lieu: , ❑ Yes .<" ,o
Assess Water Quantity Fee in-lieu: ❑ s, [ No
LIDA Facility on lot: g"Yes 4 ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: I �oti,►/ �,2� Date: ��8' /7
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved E Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
Approved,NOT Released: (/vL�ey`-�1/�...,. /jam Date: &/d/'
Notes: . �������
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Itevision.Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
pDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N''''N/A
Tigard Trans SDC: ❑ Yes -N/A
Parks SDC: ❑ Yes :>'N/A
/A
411 K to Issue Permit ,/
Approved by Permit Coordinator: !e� � Date. !0A 3 y --
1:\Building\Fonns\BldgPennitRvw_COM_W ithLandU se_070915.docx
1
.lding Permit Application
Site Work REIEI.%TE
FOR OFFICE I. ONLY
City of Tigard Date/By a2; �7 texas� 'ermit No.S/7 /7'®��f�v
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revs
Other Permit
Phone: 503.718.2439 Fax: 503.598.1960 j' i 8 r/n1/ Date/By:III
:Q/�DQ/��
T[G A R D Inspection Line: 503.639.4175 Date Read Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY 411 TIGARD
Notified Method: / )f , /Q Supplemental Information
R J� s i�" �+ V � _,ter'
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I Xi New construction ❑Demolitions Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement El Other: equipment,materials,labor,overhead,and the profit for the
/ t , t , / r / r work indicated on this application.
El 1-and 2-family dwelling Pi Commercial/industrial Valuation: $
❑Accessory building ElMulti-familyNumber of bedrooms:
. r// rr r.`;•;lr ,r
Number of bathrooms:❑Other:
rr1�,� OOZ,/ 1rr /r f, et 4' , i, mo,, 1/ i� � /r Total number of floors::❑Master builder /s /i,� rfr,rr/r/ ;r w, r / r / y
4P,A �� /� � �' ;. 1„rr, % F .,Fi?r -,r,// .. ,, ,„ , r
'—
JobJob
site address: 7-S 2y 5 W \(.ti./2.} 1,2-, . New dwelling area: square feet
City/State/ZIP: —CIC4Na-.t>y 02_ 9 '2.2_.1/4-1 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: C) \i\ 5 �iNZE- Covered porch area: square feet
Cross street/directions to job site: S 1/Lkiz 12...p . ? S tN Deck area: square feet
c-iV Other structure area: square feet
tp/rA .,trYf' ,r•lr/rr�,'r/ /�//�r ,�9 ri r� e ( .r��^+
75G7 :, fie,,A,,,J/t„r„ rJ/r/r ,.Fr n`! .r 4/$E cLH KLt'ST ,
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
' Indicate the value(rounded to the nearest
earest dollar)
of all
Tax map/parcel no.: 2SI) BA 0 equipment,materials,labor:overhead,and theprofit for
r the
O cl rif / � rr ` workindicated on this application.20 rf 14 O ,� � ,r„ r. .
V e i- i/L 6 i AJ( /7 C:. A-Jegi�� Valuation: $ ( r' �)r
/
Existing building area: square feet
New building area: square feet
o ' r
' /W;2:.?;
�i rr ,® i.r 11 � '! *It ' te„i,/ /
,
Number of stories:
.Name:
I -`6 S('01- IV Cjt2.1 A.;{-S 1, L.L-C. Type of construction:
Address: pc, 13 cL y ( (cSs'9 Occupancy groups:
City/State/ZIP: U A K E cA W e� ?J Lk. C -tW S C Existing:
Phone:(51b3) I-- I c<It.-I Fax:( ) New:
'v, '
Business name: VL2/e- T-1-- I[...G C.caNS L - .-•?,NTS, 1 ivC_: All contractors and subcontractors are required to be
Contact name: `j-( D 1 ,\{\'\/ ten_ 1`i/9C/GE-N0/E y/s licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: (S(Lc-3 s UL. S G U.Ol 7 PIZA </7, , S'j”' 160' jurisdiction in which work is being performed.If the
City/State/ZIP: �l C-I -
10 , 012_ 9 L applicant is exempt from licensing,the following reasons
apply:
Phone:(5'03) La CL-I-- V LL 15 Fax: :( ) m Vi'S �G
E-mail: S t kwn ey Q,. civ 2.S-f-(0^ C'L�nSLI.( /\,*S.CUIt'L
r, �, r !` {Fri ''r r r rr� / �> r r r /� /
r / /� ON +0
-. .fir,..✓rte. � /<.. .,�., �/ ,. , ... ,, ,r
Business name: ��\J Cpm e 1,1•-..-C-. BUILDIN PEST 1+ *
Address: 2‘t-{2 0 it{.; 1 C LAS CT ,.. .,r:r;% PX c r�er ii+ r
Structural plan review fee(or deposit):
City/State/ZIP: .-f-(L,LSS(2)(2_U;;1 0a_ 97.1 2_
FLS plan review fee(if applicable):
Phone:(5 j j) C-I ij( --- C{ -(40 Fax:( )
Total fees due upon application:
CCB lic.: t LI IS y i 9-- _ _
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: J jf- rY„S G Date: 77( 7(--i____
* 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)
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: /6 cu. yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) Z, 00 cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90%of maximum density) 2 225Z cu.yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and paving: '3 (L, ,55 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 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
RECEIVED
JUL 182017
\/lJestlake CITY OF 1(GARD
consultants,inc ! UlL�JlNC DIVISION
TRANSMITTAL
ENGINEERING ♦ SURVEYING ♦ PLANNING Phone:503 6840652
Fax:503 524-0157
Date: July 18, 2017 Project No.: 2312-017
To: City of Tigard Project Name: Durham Square
Engineering Department SDR2016-00008
13125 SW Hall Blvd.
Tigard,OR 97223
From: Shad Haney CC:
Re: Durham Square Parcel 1 Site Dev. Permit
No. of
Copies Dated Description
1 7/18/17 Site Development Permit Application
3 7/12/17 Construction Documents
1 9/13/16 Geotechnical Report
1 7/12/17 Stormwater Report
1 7/18/17 Check No. 10886 for the amount of$534.88
Comments:
Erosion control sheets, C200 and C204 for an amendment to existing site work permit#SIT2096-
00020, are included for reference.
If you have any questions,please do not hesitate to call.
-Shad
Fax 0 No.of Pages(including cover) Fax No.
Mail 0 Messenger 0 Overnight 0 Hand Delivery •
Pacific Corporate Center, 15115 S.W.Sequoia Parkway,Suite 150,Tigard,Oregon 97224
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7520 SW DURHAM RD, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Site Work SIT2017-00016
Inspection Type: Inspector:
499 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor