Permit q CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit #: BUP2010 -00131
T i G A R 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/04/2010
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Parcel: 2S114AA00500
Jurisdiction: Tigard
Site address: 16375 SW 85TH AVE
Subdivision: Lot: 0
Project: Clean Water Services
Project Description: Headworks addition and improvements.
Owner: FEES
CLEAN WATER SERVICES Description Date Amount
2550 SW HILLSBORO HWY Permit Fee - Additions, Alterations, 08/04/2010 $19,169.30
HILLSBORO, OR 97123 Demolition
PHONE: 503 - 547 -8177 12% State Surcharge - Building 08/04/2010 $2,300.32
Plan Review 06/22/2010 $14,061.99
Plan Review - Fire Life Safety 06/22/2010 $8,653.53
Contractor: CDC Building Review, COM 08/04/2010 $128.00
HARBOR PACIFIC CONTRACTORS INC CDC Planning Review, COM 08/04/2010 $128.00
19628 144TH AVE NE - STE A CDC Planning Review, COM - LRP 08/04/2010 $38.00
WOODINVILLE, WA 98072 Erosion Control 08/04/2010 $1,192.00
PHONE: 425 - 488 -7131 Erosion Plan Review CWS 08/04/2010 $387.40
FAX: Erosion Plan Review COT 08/04/2010 $387.40
Metro Const. Excise Tax - Commercial 08/04/2010 $5,836.84
Specifics: Use
Type of Use: COM Tig -Tual School CET - Non Residential 08/04/2010 $1,026.00
Class of Work: ADD
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $4,864,037
Floor Areas:
Total Area: 2052
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $53,308.78
Required: Required Items and Reports (Conditions)
1 BUP Ersn Cntrl 681 -4444
Fire Sprinkler: Parapet: 2 BUP Structural Observation
Fire Alarm: Protected Corridors: 3 BUP Special Inspection (see plans)
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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. ATTENTIO • • on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are et fort , in OAR
952 - 001 -00 through OA • 2 -001 -0 • You may obtain a copy of the rules or direct questions to OUNC by calling 503.20 "800.3 32.2344.
Issued y: • /i / � Permittee Signature C '
Call 503.639.4175 by 7:00 a.m. for an inspection that bus e
This permit card shall be kept in a conspicuous place on the job site until c • mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
13urildin Perm A licatio e t.A, 3
Commercial RECEIVED I:OR OFFICE IiSE ONLY
11,1 City of Tigard JUN 1 2010 Date /B : LK �� Permit No.: 4 , , �,�,l3
° 1312 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598. my OF TIGARD Date/I3 : T 50 -1 0 Other Permit:
r f
G\ It D
Inspection Line: 503.639 Date Ready ]uris: (9 ® See Page 2 for
•
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: (9 Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
X Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling X Commercial /industrial Valuation: 8
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFO TION AND LOCATION Total number of floors:
( 63
Job site address: ( Se LI/o 9 j tJ Ave. New dwelling area: square feet
City /State /ZIP: '7-'6. 4 rI 0 h Ci 7 a a y Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 Project name: f) / t gse 581 // e/i✓o r ks Covered porch area: square feet
Cross street/directions to job site: / IM t'b re/nen ti Deck area: square feet
So .-I t /
h o n /7q i / Sid C , Yo 55 )J:.t r by,• -I nj o / Other structure area: square feet
We F i i�l L O $ S 1 ."f / vC, REQUIRED DATA: COMMERCIAL -USE 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 the profit for the
DESCRIPTION OF WORK work indicated on this application.
' / ] p� , Valuation: /11 1/ $b g/ ) 0 37 $ 54 2i " y
.See VaLrne, 1 D'- 6 D1 vl - _I_ GCnfr l �e'
r i p t ii / Existing building area: square feet
60030 ! I)e -jam r �, o � w ord
New building area: square feet
Pt PROPERTY OWNER ❑ TENANT Number of stories:
Name: Clean W a, Le r- S e r v le e-5 Type of construction:
Address: / to D 60 5. t'I/., / S ti f j / ,, e _ Occupancy groups:
City /State /ZIP: 73 4 Pi/ ' / ey / ofvt y Existing:
Phone: (5 5-y7_ 4/ Fax: (3 a.3 ) 5417.- g/7‘ New:
❑ APPLICANT la CONTACT PERSON NOTICE
Business name: C /e4 h W'q. { r S'e r v , L. e.5 All contractors and subcontractors are required to be
Contact name: ` o I p 1 , 4 t r� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: ' 6 0 ( 0 .S, 4/. gs t-i 4 r jurisdiction in which work is being performed. If the
City/State/ZIP: 1 /State /ZIP: -7-T 9 ' " / 1 q Z 9 2 q applicant is exempt from licensing, the following reasons
,.J 7 /
b e apply:
Phone: ( 5 5 ii 7 .— 4 � 7 7 Fax: : (53 ) .S"/ / " t 1 � / 7 6
E -mail: 4 t r .S tp c let'/ A fe r- s r ry i "c. r_.1 ,° J
�c�+ CONTRACTOR
Business name: l4* L/X,L P4- C 1 re C... dons i ✓it C-17)65 5 f /.-) C.. BUILDING PERMIT FEES*
Address: l 9 62,9 / t f t A► f E. .)1_ - ca re_ /3 (Please refer la fee schedule)
City/State/ZIP: Structural plan review fee (or deposit):
Y Woo7jt '3AIL_t AA 9 & 7
Phone: 645 tin- 7 15 / Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: j ? 131 Total fees due upon application: *A 5 5 }
Amount received: ao 7 6 'SP-
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building \Permits\BUP -COM PermitApp.doc 10/01/09 440-4613T( 1 I /02/COM/WEB)
4
4 Building Division
Accessibility: Barrier Removal Improvement Plan
T1GARD.i
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \ Building \ Permits \BUP -COM PernutApp.doc 06 /25/08
RECE IVED f3 ACO -0013,
oc JAN 0 9 . 2012 P ERMIT NO.
S!Tao,0- voD1
CleanWater Services DU DI DIVISION I
I
Our commitment is clear. LOT S'1 i e.
EROSION CONTROL INSPECTION REPORT
DATE / — Q -1 a. INSPECTOR Si vc. R J SUBDIVISION S; e
OWNER/PERMITEE Cita.,,wozr cis iliatdw ad lux al hi I∎ 113MKYhQ.r►/s
SITE ADDRESS /( S. �,J $s& 4
APPROVED
•
FINAL INSPECTION
THIS SITE MEETS THE POST = CONSTRUCTION
EROSION CONTROL REQUIREMENTS SET
FORTH IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST - CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING
EMPLOYED ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION,
THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE
OR PERMANENT GROUND COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE
FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES
THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL.
OTHER
THANK YOU FOR YOUR COOPERATION!
INSPECTOR 5;"� PHONE 6_5 ) 68=1— V/C