Permit (210) CITY OF TIGARD SITE WORK PERMIT
r COMMUNITY DEVELOPMENT Permit#: SIT2018-00019
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2018
T t "� g Parcel: 1 S 136DC03200
Jurisdiction: Tigard
Site address: 11740 SW 72ND AVE
Project: 72nd Avenue Apartments Subdivision: 72ND AVE APARTMENTS Lot: 8
Project Description: Site work for new five story mixed-use building with commercial uses and parking on ground floor and(38)units on
upper floors.
Contractor: KEYWAY CORP Owner: 72ND AVENUE PROPERTY LLC
7275 SW HERMOSO WAY BY CASSINELLI, RICHARD
TIGARD, OR 97223 11720 SW 72ND AVE
TIGARD, OR 97223
PHONE: 503-684-5100 PHONE: 503-545-5217
FAX: 503-684-5500
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 09/18/2018 $3,862.62
Plan Review 06/19/2018 $2,510.70
Type of Use: COM 12%State Surcharge-Building 09/18/2018 $463.51
Class of Work: NEW Info Process/Archiving-Lg$2.00(over 09/18/2018 $34.00
11x17)
Project Valuation: $779,812.00 Info Process/Archiving-Sm$0.50(up to 09/18/2018 $100.50
11x17)
Erosion Control w/Development 09/18/2018 $686.40
Site Specifics: Additional Plan Review 09/18/2018 $90.00
Excavation Volume: 75000 cu.yd.
Fill Volume: 30000 cu.yd.
Impervious Surface: 21893 sq.ft.
Engineered Fill: Yes Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall: Yes
Fire Underground: Yes Accessible Parking: Yes
Fence: Yes
Total $7,747.73
Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
2 Final Observation&Acceptance
3 Special Inspection(see plans)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to 'UNC by calling 503.232.1987 or 1.800.332.2344. 11111111*.
Issued By: All Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
Buil.1ling Permit Application -,
Site Work FOR OFFICE USE ONLY
City of Tigard 1 U N 1, 9 2018 pares , X44 Permit P i "
lig - " 13125 SW Hall Blvd.,Tigard,OR 97223t�+ I" Ir- D Plan Review _
Phone: 503.718.2439 Fax: 503.598.19b(!I I I' 0l"• " , iif i.,, Date/13 - Other Permit: �I _ f
T I C A R D Inspection Line: 503.639.4175 BUILDING D I ISI r'`' a ate 'ea.y i y: 61 See Page for
Internet: www.tigard-or.gov Notified/Method: �f/ Supplemental Information
/
111, 11.111g.,1.,%/ .. '•,+ r,,illi(IDCy i�N+ - - a� _ 7 J... " — a "3 11 11�f z h ! ;3=.. f.r s
_ # 'E Off' ','ORK "I � i O- 1 6 1 TM " ' a DW_::. 1'
00
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
t' Itti 0 Irfizrtr-' ,1liMiris,0,$ 2,,,,,,.. 1,,zi work indicated on this application.
El1-and 2-family dwelling ®Commercial/industrial Valuation: $
Number of bedrooms:
❑Accessory building 1Multi-family
ElMaster builder ®Other:Mixed Use Number of bathrooms:
'''',2,-,,,,17,74'c.';' l d Y c i of r'.44'N.4-J. . UON J 1Total number of floors:
d ,xs=1 upfi riN z, '.., _
Job site address: SW 72'd Avenue New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:72"d Avenue Apartments Covered porch area: square feet
atstreet/directions to job site:Between SW Clinton Street and SW Baylor Deck area: square feet
vt e.144!2)4 eber.— UIF 6'ea YY 4el- L«C L.5* v 4&tei* Other structure area. square feet
v17-AS Pr-.34,4_114r-01 fr t� iv /f.*,9 /' it 40Gtt, , �s�-r gfiT , i..4--vi y - EC Kofi '
ision:EnolaeH fights Lot no.:3200 Permit fees*are based on the value of the work performed.
Tax map/parcel no WCTM 1S136DC Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
4� �P; 401 9�?d'r711 — ti,' �,�ii0i
Ai�� i1,,,��� $ ® ' work indicated on this application.
New five-story mixed-use building with commercial uses and parking Valuation: $779,812
on the ground floor and 38 residential units on the upper floors. Existing building area: 3,585 square feet
New building area: 49000 square feet
='P i r ,eta( rt t ,i Y --L-m-,-,Milt-7914 lair . 9 ,F
r ►� 1P, RT-i P� T i,),, --___ .. Number of stories: 1+4
ri.�s �,,�ir� i6 h ii�Ols.a elY'�ro. i ,✓�,_ � = cc a
Ni\ Name:72"d Avenue Property,LLC Type of construction: 1-A+V-A
Address:4804 NW Bethany Boulevard Suite 1-2 Occupancy groups:
City/State/ZIP:Portland,OR 97229 Existing: R-3
Phone:(503)545-5217
Fax ( { ) New: M/B/D/R-2/A-3
1� a' r , pa,�I �
110111190 _ p`I ® PL _ i ► t S AK 1 ,
W Business name:72 Avenue Property,LLC All contractors and subcontractors are required to be
Contact name:Richard Cassinelli licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:4804 NW Bethany Boulevard jurisdiction in which work is being performed.If the
City/State/ZIP:Portland,OR 97229 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)545-5217 Fax::( )
E-mail:rec65@me.com
1- . ..k1I _ ��� � v () � S9 ,',i1,:,,..._ = , � 5,� VNA. I
Business name:KeyWay Corp. Dat *
Address:7275 SW Hermosa Way ('de4rrrefer e sihednle 010"
City/State/ZIP:Tigard,OR 97223 Structural plan review fee(or deposit):
FLS plan review fee(if applicable):
Phone:(503)684-5100 Fax:(503)684-5500
Total fees due upon application:
CCB lie.:127522
Amount received:
Authorized signature:
Q/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Richard Cassinelli Date: 6/7/18 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pennits\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: 75,000 cu.yds.
Grading Volume:
(Soils report required for>5,000 cu. yds.) 105,000 cu. yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90% of maximum density) 30,000 cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
® Concrete
❑ Other:
*Total new impervious area including all buildings,
sidewalks, and pavin!: 21 893 sq. ft.
r' vim
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'O "SUBMITTAL #of Plans lA° 11 ' J, ® -�'d� F ,.,,,... =.v
(lsle u,Additions or Required at $.00 to$500.00 $51.09 minimum permit fee
Aiterat any) 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\Pemiits\SIT-PermitApp.doc 08/02/2016 2
a
114 Site Work Permit Application
Plan Submittal Requirements
TI GARD 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. ® map & tax lot# ® project name ►1 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:\Building\Permits\SIT-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:\Building\Permits\SIT-PermitApp.doc 08/02/2016 4
City of Tigard
" COMMUNITY DEVELOPMENT DEPARTMENT
IC
TIGARD Building Permit Review — Commercial With Land Use
N
Building Permit #: ,. -0Z 0/1E- 52 /�
Site Address: /9'1 ,S3 -747,1_ , ,e„ Suite/Bldg#:
Project Name: 9-24 , epi, e1 meek
(Name of commercial business occupying the. ace. If vacant,enter Spec Space.)
Planning Review
Proposal: Gle 4,or,C en'
7 ,
ICJ Verify site address/suite# exists and active in permit system.
ver Terrace Neighborhood: ❑ Yes No
M and Ue Case#: /9 .7-00 j—00001 Quv(c)-I dac' 7
Pl
a Match Approved Land Use:
iSite Plan Irl Landscape Plan ther:
I1 rban Forestry Plan P klevation Plan
ii uilding Height: Maximum Height Actual Height
❑ Conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
1111 i usiness License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Public Facilities provement(PFI) Permit:
Required: V Yes,applicant was notified ❑ No Ap.lied For: /Yes ❑ No,stop intake
Notes: _i�Alli 4 B /.. .i. ' /A / �0 i ' 1 , ./4- !..4� a . ,
QIm" /A AO '/i7 S
+ A _40 / LP :� 0/. /...C7 i
Approved by Planning: ----- /,� Date: '�
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: (// ?it-7 tf
Site Plans: # 3
Building Plans: # J
Building Permit#: W _ nter building permit#above.
Workflow Routing: r... Planning 'Engineering --Permit Coordinator Building
Workflow Sign-off: I Sign-off for Planning(include notes from planning review)
Route Application Documents: r2. Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
f/ ,:_
ByPermit Technician: f ' Date:
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse 060116.docx
Engineering Review
[ ")lope at building pad: 15J/b
ifPFI Permit#: P ri 'y®(g 00153
Q Conditions "Met"prior to issuance of building permit
Dr 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 0, No :-
Assess Water Quantity Fee in-lieu: ❑ Yes LI No N ,P
LIDA Facility on lot: _ ❑ Yes 0-No
O NOT Approved by Engineering: Date f�
Notes: De, /7,,,,. . i5'suG ecn4'/ PP/ is ;s, aid p444...13 dk„y:s ,-74
Approved by Engineering: army �L jj;,��er Date: (a - 25 --„2-61 8
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: 0 Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met”prior to issuance of building permit
i
4pproved,NOT Released: 3�, � � piay/ D ate: 'I
Notes: j
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:
?WI SDC Fees Entered: Wash Co Trans Dev Tax: III Yes W. /A
Tigard Trans SDC: Cl Yes !' N/A
Parks SDC: El Yes 0.1i /A
OK to Issue Permit
Approved by Permit Coordinator: )Date: 9 �g 1-5--
_74, wa Ppx,
I:\Building\Forms\BldgPennitRvw_COM_WithLandUse 070915.docx
FOR OFFICE USE ONLY-SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
1111 _ Transmittal Letter
1 !c;n u n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: '6 M 7-'-()(t 5TA T^ g, DATE RECEIVED:
DEPT: BUILDING DIVISIONR
RELI\o/Eu
AUG 1 6 201$
FROM: A tQ -D-E-g.5 C11-- L E
1 CiTY
OF .. T-I
BUILDNG !:73MS;('`N
COMPANY: i-\ l L (, "kg(H I re.C15
PHONE: 03 Q5 9 Q3 3 By:�
�
�
RE: 1 viz.to Sw 4\Y 511-201 ZS - 000 19
(Site Address) (Permit Number)
7-2_ AM5
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Z Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: �A C t<ik6 1 JsZL'J 5 t - O-xi E.Ez 9 T4 1L5 l L A
-sP Get Lc ATl 0 kr5 AS v- E LL &p--C-I-( LI OcfTci 1O M
Ly51S
FOR OFFICE USE ONLY
Routed to Permit Tec : Date: 9 . f • J f Initials: 3)
Fees Due: N Y No Fee Description: AmountD
j H v- dol vv, rcv; , $ 9 O ----
$
Special
Instructions:
Reprint Permit(per P3): ❑ Yeso/ ❑ Done
Applicant Notified: - Date: �J�/�li / - Initials:f J(-
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc