Permit (149) CITY OF TIGARD SITE WORK PERMIT
11. COMMUNITY DEVELOPMENT Permit#: SIT2018-00014
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/26/2018
TIGARD 9 Parcel: 2S 102AB90001
Jurisdiction: Tigard
Site address: 9210 SW CENTER ST 1
Project: Willow Bend Condominiums Subdivision: Lot:
Project Description: (2)new drainage trenches. No pipe installed.
Contractor: NORTHWEST VENTURES GROUP INC Owner: IMPAC FUNDING CORP TR
2401 NE MLK JR BLVD BY EDMONDSON, SHARON
PORTLAND, OR 97212 19500 JAMBOREE RD
IRVINE, CA 92612
PHONE: 503-740-6917 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 06/26/2018 $123.72
Plan Review 05/24/2018 $80.42
Type of Use: COM 12%State Surcharge-Building 06/26/2018 $14.85
Class of Work: ALT Info Process/Archiving-Sm$0.50(up to 06/26/2018 $1.50
11x17)
Project Valuation: $5,000.00 Erosion Control w/Development 06/26/2018 $80.70
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: Soil Report Required:
Paving: Grading:
Landscaping: Site Prep:
Storn Drains: Retaining Wall:
Fire Underground: Accessible Parking:
Fence:
Total $301.19
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 OUNC by calling 503.232.1987 or 1 :.'. .
Issued By:
Letmittee Signature: ' f
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 Application
Site WorkRECEIVED
FOR OFFICE USE oNLI
City of Tigard Received
Date/By: 4''1 Permit No.: E �t ,y L I py
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review".S r Y dl
C Phone: 503.718.2439 Fax: 503.598.19 AY 2 4 2.01B ' G .- i q . Other Permit: ;V i $ O,f
Date/By: $
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Jam: ® See Page 2 for
Internet: www.tigard-or.gov 1r r/�� � Noatified/Metho�: �/ i �,,
+ I r it biiCCT Supplemental Information
CITY ,4"4
, 'TYPE I •k 1 ' 1 DIV# REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 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 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY SOF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling 0 Commercial/industrial $
D Accessory building ' Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB ITE INFORMATION AND'LOCATION Total number of floors:
Job site address: `7710 �, CetTE 2 5T. New dwelling area: square feet
City/State/ZIP: rj m p at '332%2-3 Garage/carport area: square feet
Suite/bldg./apt.no.: , Project name: /4/,//e /)__il /Gf`/:, ,,tomlwy4 Asn Covered porch area: square feet
Cross street/directions to job site: (� ( Deck area: square feet
00 Cfijt. - .CST 5 ttf7-k OF- ‘p.itsvictujet,. Other structure area: square feet
REQUIREDl'itE,91,06D'A*.liloi4MEitclAyii,CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and theP rofit for the
� ,
A t I -,1':'"1 t , 0m. . , .r A 4 ,- 'i work indicated on this application.
(05 t„, At'Pev)( `cf- 'DeAtot it /ttz ALO Valuation: $ 6"CCO
' t Et loc0 tPc)T e( 2.0t (MO Ptft ( \ Existing building area: f'(1� square feet
lI New building area: 4 f
kitoz
PROPERTY O •i:��
'�= ter; -.4. --fl �� '� TENANT :�,• Ar..{ Number of stories: �(,Y?La tiz).€ _
Name: F f.L'tt12.t.d: T Type of construction: tato t E
Address: Ian-544 O ti gz. Occupancy groups:
City/State/ZIP: 1R.0(1,X,, CA 474(1 Existing:
Phone:(fiZ ) 4114-3941 Fax:( )
New:
- PLIC r ,. ' .:�.� . C ONTA ERSON A , w ¢ _.;; * i
Business name: ` :.: >n N TIt� 1 *' ^<
'� 4-S 4!j n1,...(....
1^�. All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under 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
Phone:(Sjj) 1b`—>"61[J�4- v/(, Fax::( ) apply:
E-mail:
Ages_es_Ll it /4vr `C1u ,((4V7
.; H
CONTRACTOR
,
Business name: ,--GA S & a //(JC.
�v
l * BUILDING E1 AIT EES
Address: 011 /14/- - 814 D , rl (Ple se r+ to schg alel ;:
City/State/ZIP: V:,py.,�y,-�i er1�� Structural plan review fee(or deposit):
Phone:( )V8a ` 10 4 Fax:( )2.44-W3-
FLS plan review fee(if applicable):
CCB lic.: C yotat.�. Total fees due upon application: , �
Authorized signature:
iitiveitiezzO Amount received:
This permit application expires if a permit is not obtained
Prato 180 days after it has been accepted as complete.
���
Print name: - � Date: s.
q-2018
G(1/8 * Fee methodology set by Tri-County Building Industry
Service Board.
I:ABuilding\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: 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 SUBMITTAL #of Plans l tin .t Permit lice. t
(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
$10.76 for each additional$1,000 or
Multi Family R-1 Occupancy 3 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
Albert Shields
From: Albert Shields
Sent: Tuesday, May 29, 2018 10:03 AM
To: 'mark@MJPManagement.com'
Cc: Al Dickman
Subject: SIT2018-00014
Attachments: Albert Shields.vcf
Mark,on reviewing your application and plans for drainage work at 9210 SW Center St. under SIT2018-00014,our
Engineering Department has noted that per CleanWater Services Design Standards 5.05.5(a),this project requires
connection to the public storm system. Please revise the application and plans to show connection to the public storm
system. Because of that connection your project also requires a Public Facilities Improvement(PFI) permit.
Please let me know if you have any questions.
Albert Shields
City of Tigard
Permit Coordinator
(S03171e 2426 Work
Albert+; tigard-or.gov
13125 SW Mall Blvd.
Tigard,Oregon 97217
www.tigard-or.gov
/6—e...06"ek ‘11-rerit//—/.4
W / •te '
-7.f)c/tW1
City of'Tigard.
q COMMUNITY DEVELOPMENT DEPAR'T'MENT
s
-1.111111G A u n Building Permit Review — Commercial - No Land Use
Building Permit #: j y-a j o )/if
Site Address: 210 cwJ Ce l St , Suite/Bldg#:
Project Name: �/}'ll01� tic4 [a, upi�;,)
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review �j
Proposal: (1 S I 0)Pe �.S 0 G !) r i 110,4_
Existing Business Activity: Y l 0 dl) Ct nay-
Proposed
Business Activity:
1 t Verify site address/suite# exists and active in permit system.
'ever Terrace Neighborh od: ❑ Yes /No
/f_ Zoning: Z S
Permitted Use: ❑ Yes ❑ No 0 Spec Space
Confirm no land use required.
Business License:
Exists: ❑ Yes 0 No, applicantppnotified toobtain' business license [�
Notes: i � i5 N. A17. p\o�til'u n T6 Salt. 4V b 4.4, £4c ';e,- L' ",ti iv .Gvr��lv��C
Approved by Planning: 1V1 I OAA^. . Date: S7 l 0 / 1
46
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: / /`r
Site Plans: $#
Building Plans: ##
Building Permit#: nter building permit#above.
Workflow Routing: s�nhgt Coordinator Ceding
Workflow Sign-off: g'��"°ff for Planning(include notes from planning review)
Route Application Documents: L.�Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: Jam,,_ _` _ Date: _/).,./ �ii
I:13uilding\Forms\BldgPernutRvw COM_NoLandUse 060116.docx
Engineering Review
❑ 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)
❑ 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
KNOT Approved by Engineering:� erDate
Notes: _ _ii,of. i/f j'f'7 e /4,7 Al
Approved by Engineering: Date:
Revisions (after uilding Submittal only) R viewer ,lDate
Revision 1: Approved ❑ Not Approved 14L -b ,, �45
Revision 2: 0 Approved 0 Not Approved
Revision 3: ❑ Approved 0 Not Approved
Permit Coordinator Review
O Conditions"Met"prior to issuance of building permit
O Approved,NOT Released: Date:
Notes: eartiewCiskr., fr i L. 5“- .4730 72-epc V 1IZ s 2'
Revisions (after Building Submittal only) �� /
Revision Notice 1: Date Sent to Applicant:?61---,
6 L
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
*SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes /A
Tigard Trans SDC: 0 Yes /A
Parks SDC: 0 Yes N/A
OB to Issue Permit /
Approved by Permit Coordinator: e, Date: (Q(`Z 18
I:\Building\Forms\BldgPeimitRvw_COM_WithLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9210 SW CENTER ST 1 , TIGARD, OR, 97223 August 2, 2018 at 1 :01 :49 PM
Record Type: Record ID:
Commercial - Site Work SIT2018-00014
Inspection Type: Inspector:
499 Final inspection Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor