Permit i y
CITY OF TIGARD BUILDING PERMIT
°. COMMUNITY DEVELOPMENT Permit #: BUP2009 -00059
T [ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/09/2009
Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Subdivision: SEWER TREATMENT PLANT Lot: 0
Project: Clean Water Services
Project Description: Rebuild sand filters.
Owner: FEES
CLEAN WATER SERVICES Description Date Amount
2550 SW HILLSBORO HWY Permit Fee - COM 04/09/2009 $3,935.52
HILLSBORO, OR 97123 Tax - 12% State Surcharge 04 /09/2009 $472.26
PHONE: Plan Review 04 /09/2009 $2,558.09
Metro Const. Excise Tax - Commercial 04 /09/2009 $1,593.30
Contractor: Use
STETTLER SUPPLY CO INC Additional Plan Review 04 /09/2009 $7.86
1810 LANA AVE NE
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SALEM, OR 97303 -3198
PHONE: 503 - 585 -5550
FAX: 503 - 581 -6799
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $1,327,754
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $8,567.03
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Protected Corridors:
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 . - • - 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 day - ATTENTION: Or =: o a equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 0 through OAR 9520'1-0 00 ou may obtain a copy of the rules or direct questions to OUNC by calling 50 ,-, •697•r 1.800.332. 344.
Issued By: 1 / 4J4 � 4_ I . Permittee Signature: Ai J� e arA r l
Call 503.639.4175 by 7:00 a.m. for an inspection that bushy' day.
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
Commercial FOR OFFICE USE ONLY �
City of Tigard Re eiv ll`r�t� Permit No.: t� -o/J�
• 13125 SW Hall Blvd., Tigard, OR 97 ��W — ��� Plan Revie .
' C B Phone: 503.639.4171 Fax: 503.5 1 E Date ! `�` A 1 11 Other Pe it:
T G n R p Inspection Line: 503.639.4175 Date Rea.'•': • Juris: SI See Page 2 for
Internet: www.tigard or.gov D - 9 2009 Notified/Method: 1 CI Supplemental Information
AP f� ,�,,n
TYPE OF W1 ' , vilG REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction I 0
3 � 1VIs Permit fees* are based on the value of the work performed.
a Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder 12 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 6 S g d 5 w ie ,S t 4 New dwelling area: square feet
City/State /ZIP: '�f^ ; r� D ? 7 2 2 5/ j Garage /carport area: square feet
Suite/bldg.lapt. no.: S Project name: r'• / f rs /- y {,04str.,t,00e^ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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.
,%� J / r $ , 3 r-) 7 7
/f "Lb�tr/ .T �,rt� t l r� s t� �tf -S Valuation:
/ 1 y
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: e 9 7 ki //r Sff v'ery' Type of construction:
Address: 1 6 0 6 6 5 t,.t/ g 544.. Occupancy groups:
City/State /ZIP: / • f 4; o ie q 7 2 2 '/ Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: 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. Vale
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR
Business name: St. t tiler S 00 / (0 7 pH BUILDING PERMIT FEES*
Address: 9 O V / / (Pkase refer to fee schedule) / , * Structural plan review fee (or deposit):
City /State /ZIP:
..pc--L€ OR_
_ c FLS plan review fee (if applicable):
Phone: ( 609 5£S 5 - 5S 5 Fax: ( 56) 5 ZS i 6 751
Total fees due upon application:
CCB lic.: J) 2. 10
C Amount received:
Authorized signature: This p ermit a pp lica tion expires if a permit is not obtained
Be ithin 180 days after it has been accepted as complete.
Print name: 1 G, ,p relics Date: {y /9 /0 * Fee methodology set by Tri -County Building Industry
/ / 9 Service Board.
1: \Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(I1/02 /COM/WEB)
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Building Division .
Accessibility: Barrier Removal Improvement Plan
TIGARD
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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): $
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I: \Building \Permits \BUP -COM PcrmitApp.doc 02 /23/07
1 (oE P). " :see s - 1nu� CST j / Gq.\
III ° Building Division
Over- The - Counter (OTC) Building Permit
T 1 c A It Check List
Description of Project: - 11
GENERAL INFORMATION
Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: — Total sq ft.: N: S:
Stories: Note: Combine total floor area for E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: M9j Handicap access:
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ / 2,277
INSPECTIONS FEES DUE
Footing /foundation Firewall $ �j- � 1-j ,OZ_Permit Fee
Post /beam structural Smoke detector $ 4-71 . q,(. State Surcharge
Shear wall Misc. inspection $ `j * � Plan Review Fee
Masonry Approach /sidewalk $ FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ JJ Other:
$ cpc (p(, ` AA - total Fees Due
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK. ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
l: \Building \Forms \OTC- BUP.doc 08/19/08
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