Permit (176) CITY OF TIGARD SITE WORK PERMIT
Ill. COMMUNITY DEVELOPMENT Permit#: SIT2018-00024
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/06/2018
Parcel: 2S102BD01600
Jurisdiction: Tigard
Site address: 9845 SW WALNUT PL
Project: Tigard United Methodist Church Subdivision: FREWING ORCHARD TRACTS Lot: I
Project Description: Retaining wall for bank stabilization.
Contractor: SUNRISE LANDSCAPE SERVICES INC Owner: TIGARD UNITED METHODIST CHURCH
26085 SW CHEHAL'EM STA RD 9845 SW WALNUT PL
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 503-538-2386 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 09/06/2018 $355.04
Plan Review 08/23/2018 $230.78
Type of Use: COM 12%State Surcharge-Building 09/06/2018 $42.60
Class of Work: ALT Info Process/Archiving-Lg$2.00(over 09/06/2018 $14.00
11x17)
Project Valuation: $26,500.00 Erosion Control w/Development 09/06/2018 $107.60
Site Specifics:
Excavation Volume: cu.yd.
Fill Volume: cu.yd.
Impervious Surface: sq.ft.
Engineered Fill: No Soil Report Required: No
Paving: No Grading: No
Landscaping: No Site Prep: No
Storn Drains: Retaining Wall: Yes
Fire Underground: No Accessible Parking: No
Fence: No
Total $750.02
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 fo i • 952-001-0010 through OAR 952-001-01•11 -. ."1 ay obtain a copy of the rules
or direct questions to OUNC by calling 5' - . -- . 1.800.332.234 . ''�
Issued By: .� Per ee Signatuf �'- _,g�; A. .
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.
lok
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 Valuation: At, , 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-PermitApp.doc 08/02/2016 2
k
'' 1 _ Site Utilities — Plumbing Permit Application
'` Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn
to scale) labeled with:
A. El map&tax lot# ❑ project name El site address ❑ suite number
El zoning El applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS-Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size, type of material, slope of piping,manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
I:\Building\Pennits\PLMF-PennitApp.doc 12/30/05
City of Tigard
IIet COMMUNITY DEVELOPMENT DEPARTMENT
I
r r c n uD Building Permit Review — Commercial - No Land Use
Building Permit #: '7" it Ca.y
Site Address: 962/C- ,c2'J /1 3j UJ 1t Suite/Bldg#:
Project Name: 4 kj,e4m 7L C/ ,rek_
(Ntpie of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review/� ``// / /
Proposal: `A% 4A0-, // an seNty77 s/W � C�f711r / — ft %n 71-e t e
Existing Business Activity: kQ(e7'e
USIN.S'7C77023
Pro.•sed Business Activity: // //
el Verify site address/suite#exists and active in permit syste .
it : er Terrace Neighborhood: El Yes No
oning: le-1,2
lo 'ermitted Use: qd Yes ❑ No ❑ Spec Space
IEC Irrn no land use required.
o
Business License:
Exists: Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: Date: '/2Sill P)
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date:
� 3�/�
Site Plans: # mss`
Building Plans: # 3
Building Permit#: Er-Enter building permit#above.
Workflow Routing: Manning Cid—i€init Coordinator .9 iiilding
Workflow Sign-off: ®'"Sign-off for Planning(include notes from planning review)
Route Application Documents: 42=$wilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
G
By Permit Technician: Date: (PA 7/f"
I:\Building\Forms\BldgPermitRvw_COM NoLandUse 060116.docx
Engineering Review
❑ Slope at building pad: OUill\--
❑ 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 X No
Assess Water Quantity Fee in-lieu: ❑ Yes 4 No
LIDA Facility on lot ❑ Yes No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: 14 l l , Date: S 7 l
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
I1 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
NSDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
'OB to Issue Permit
Approved by Permit Coordinator: Date: (211 i 8
I:\Building\Fonns\BldgPermitRvw_COM_WithLandUse 07o915.docx