Permit (186) CITY OF TIGARD SITE WORK PERMIT
s' COMMUNITY DEVELOPMENT Permit#: SIT2018-00016
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2018
T l t;,h R I� g Parcel: 1S135BA01802
Jurisdiction: Tigard
Site address: 10101 SW WASHINGTON SQUARE RD
Project: Bank of America Subdivision: OAKBURG Lot: 27
Project Description: Modifying existing walkways to provide accessible from public right of way to building entry including accessible
parking.
Contractor: ASI STRUCTURES Owner: PPR SQUARE TOO LLC
PO BOX 6712 BY BANK OF AMERICA
PORTLAND, OR 97228 NC1-001-03-81
101 N TRYON ST
CHARLOTTE, NC 28255
PHONE: 503-283-6712 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 08/14/2018 $252.84
Plan Review 06/11/2018 $164.35
Type of Use: COM 12%State Surcharge-Building 08/14/2018 $30.34
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 08/14/2018 $10.00
11x17)
Project Valuation: $16,500.00 Erosion Control w/Development 08/14/2018 $80.70
Site Specifics:
Excavation Volume: .38 cu.yd.
Fill Volume: 0.34 cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: No Soil Report Required: No
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep:
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: No
Total $538.23
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 are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop of the rules
or direct questions to OUNC by calling 503.2 .1987 or 1.800.332.2344.
Issued By: ignature:
Call 503.639.4175 by 7:00 a.m.for the next available pection 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.
7
Building Permit Application
Site Work I"OR(11 FICF. USF fJNI 1"
City of Tigard ECEIvEri
Reoeiv, t! R_ _
Date1By, 6 u/1l 0 /�� Pcxmit No.: ' L),/r_O )6 IV
V
... 13125 SW Hall Blvd,Tigard,OR 972 Plan c
Review
Phone: 503.7182439 Fax: 503.598.1960 Date/By j Line: � t'(. )g 4 other Permit:
T t e,n,!k D Inspection 503.639.4175 I 2 Date R as See Page 2 for
Internet: www.tigard-or.gov otilie4lIM (9/ librit: ®'SupplementallnfarnaxEtan
CITY Off' IIGA G ^ ��7
t�err/'• # T
F" i Line"nn ic -:REQUIREDDTA 1-.AND2-`FAMILYDWELUING
❑New construction ■ s emnlition 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
" .,< work indicated on this application.
CATEGORY OF CONSTRUCTIONr.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
O Accessory building 0 Multi-family Number of bedrooms: N/A
❑Master builder 0 Ott: Number of bathrooms: N/A
, "JOB,SITE INFORMATION AND LOCATIOR' x::: Total number of floors: N/A
Job site address: 10101 SW Washingtown Square Road New dwelling area: N/A square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: N/A square feet
Suite/bldg./apt.no.: Project name: G'% .- 'to* Covered porch area: N/A square feet
Cross street/directions to job site: SW corner of SW Washington Square Road Deck area: N/A square feet
and SW Greenburg Road Other structure area: N/A square feet
RE UIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: MCC (Mixed used Commercial) Indicate the value(rounded to the nearest dollar)of all
, equipment,ment,materials,labor,overhead,and the profit for the
:xw
K..
t DESCRIPTION oFWORK i ;: :*"", work indicated on this application.
Modify existing walkways to provide accessible route from Public right of Valuation $ $18,500
way to building entry including accessible parking. Existing building area: No work done to building
New building area: No work done to building
0 PROPERTY owNER ® TENANT . Number of stories: 1
Name: JLL-Principle for Bank of America Type of construction: Sidewalk Replacement
Address: 800 5th Avenue Occupancy groups: B
City/State/71P: Seattle, WA 98104 Existing:
Phone:(206)348-7201 Fax:( )
New:
0.APPLICANT ( CONTACT PERSON N
r:
oTICE
Business name: KPFF Consulting Engineers All contractors and subcontractors are required to be
Contact name: Paul Dedyo licensed with the Oregon Construction Contractors Board
under ORS 701 and maybe required to be licensed in the
-Address: 111 SW Fifth Avenue, Suite 2500 jurisdiction in which work is being performed.If the
City/State/ZIP: 111 SW Fifth Avenue, Suite 2500 applicant is exempt from licensing,the following reasons
Phone:( 503)542-3859 Fax::( ) apply
E-mail:PaUi.Dedyo@kpff.com
R
CONTRACTO
Business name: TBD „07lr/C �.,J S �LJ"/es/2
BUILDING PERMIT
� FEES*
Addtess:/ 2 /7 /i �J' (--,-,..,<-
_ {Please refer
City/State/ZIP: f il '72 j� Structural plan review fee(or deposit): _
' j - C•7/e Fax:( ) FLS plan review fee(if applicable):
Phone:(5
—
Total fees due
CCB lie.: I upon apphioati �' '
JO
Authorized sign e. .r Amount received:
This permit application expires if a permit is not obis' ,a
within 180 days after it has been accepted as comp/
Print name: P41,01. K. �. Date:5.21 .j * Fee methodology set by Tri-County Building Industr
Service Board.
I:\Building\Pemtits\SIT-PermitApp.doc 08/02/2016 440-4613T(I1/02/COM/WEB)
S*ca r rS
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: Net:CUT:0.38 cu.yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) 0.71 cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90% of maximum density) 0.34 cu.yds`
Retaining structure? (Check one) 0 Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks,and paving: tsq.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 0 *Parking(including ADA)and Lighting
compliance Plan
R
Grading Plan and details H *Ldping Plan Erosion Control Plan and details Soils Report(if required)
❑ 1 Retaining Structures
*Does not apply to One-and Two-family dwellings.
Plan Submittal: Permit Fee:
TYPE OF SUB1%IITrAL #of Plans..... VSlUstlOn. 4 t9 Permit Fee• v '
x. --
(New,Additions or Required at. ; 5.00 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 die 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 $3308..922 for
the
6 for h fir additional .00 aand or
fraction thereof,to and including
$50,000.00.
S50,001.00 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
• S4.49 for each additional$1,000.00 or
fraction thereof.
li61:1BuildingTermits.Srr-PermitApp.doc 08/0212016 2
Site Work Permit Application
Plan Submittal Requirements
T i( K ! 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,modulnr 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. ❑ map&tax lot# ❑ project name 0 site address ❑ suite number
❑ zoning ❑ applicant name ❑ 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:1Buildingwermitsl.STI'-PermitApp.doc 08/02/2016 3
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:1Building,Pennits1SIT-PernritApp.doc 08,0212016 4
City of Tigard
114 ® COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: Si -r.,20 I e -000/ 4
Site Address: 101 D SV 'V\ik SQ . Rd Suite/Bldg#:
Project Name: L'DiIn - o` .A 1v lc V Gt
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ADAP6I.Yk (t,11 A YelCt-C
J ffv
Verify site address/suite# exists and active in permit system.
'River Terrace Neighborhood: ❑ Yes t No
Land Use Case#: MMDa)1(,,,, Oct'2 G
Plans Match Approved Land Use:
XSite Plan /-Landscape Plan ❑ Other:
NV-Urban Forestry Planlevation Plan
AUS :uilding Height: Maximum Height Actual Height
/\Conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
-Business License:
Exists: A-Yes ❑ No,applicant notified to obtain business license
�P"ublic Facilities Improvement(PH) Permit:
Required: ❑ Yes,applicant was notified -No Applied For: ❑ Yes ❑ No,stop intake
Notes:
Approved by Planning: -AMILAA0 - Date: ('((t I(s
Revisions (after Building Submittal o ly) Reviewer Date
Revision 1: El Approved ❑ Not Approved
Revision 2: El Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 4;7///i�C
Site Plans: # 3
Building Plans: # i
Building Permit#: Linter building permit#above. �/
Workflow Routing: [Planning E ngineering C -'Permit Coordinator '- l Building
Workflow Sign-off: ®Sign-off for Planning(include notes from planning review)
Route Application Documents: 8T3uilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: ,
,..„,. .,_ i
By Permit Technician: '7 e 7/ ef-3-e---.. Date: /y/
I:\Building\Forms\BldgPermitRvw COM_WithLandUse 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 !V
Assess Water Quantity Fee in-lieu: ❑ Yes ❑ No
LIDA Facility on lot: ❑ Yes ❑ No
❑ NOT Approved by Engineering:erS Date
'�'`
Notes: 1aT1 //J L-2 v �Li c' L• 7fr4iJ 4er0 o 4
1'V-1 u14-3-r. 024P El-TY a(i C T6) L-y
Approved by Engineering: M i k W • Date: /7-acil 5
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
opc 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:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes 0.N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes E N/A
)OK to Issue Permit
Approved by Permit Coordinator: 44i/ j Date: (( 1/2A.)
1'Q
I:\Building\Fonns\BldgPermitRvw_COM_WithLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10101 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Site Work SIT2018-00016
Inspection Type: Inspector:
499 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor