Permit •
IL' CITY OF TIGARD BUILDING PERMIT
If
`r COMMUNITY DEVELOPMENT Permit #: BUP2010 -00239
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2011
Parcel: 2S11313000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Aeration Basin 4 Subdivision: SEWER TREATMENT PLANT Lot: 0
Project Description: Modifying and installing concrete baffle walls; adding diffusers and a slide gate; repairing water system.
Contractor: NORTHSTAR GENERAL CONTRACTOR Owner: CLEAN WATER SERVICES
5401 RIDGE DRIVE NE 2550 SW HILLSBORO HWY
KEIZER, OR 97303 HILLSBORO, OR 97123
PHONE: 503 - 304 -0500 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 01/20/2011 $1,558.95
Class of Work: ALT Demolition
Dwelling Units: 0 Plan Review 11/04/2010 $1,013.32
Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 11/04/2010 $623.58
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 01/20/2011 $187.07
Value: $175,000 Metro Const. Excise Tax - Commercial 01/20/2011 $210.00
Use
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,592.92
Required: Required Items and Reports (Conditions)
1 Reinforced Concrete
Fire Sprinkler: Parapet: 2 Bolts in Concrete
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 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 c• • - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B S Perm rt ee Signature:' / 6 )
ll 9.4175 by 7:00 a.m. for the next available insp: date.
This permit cards all 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 C54 VD °FOR.or,,LC,EsF,,o�;
City of Ti ty and RcCe1id ^�
`J g ry 10 Dateiv . l A �fi11 Permit No -: j a /Its P
13125 SW Hall Blvd., Tigard, OR 97223 `3 L Q 1 Plan Review i ��
w ' Phone 503.639.4171 Fax: 503.598.1960 V _ • Other Permit:
� ' �� • p �� Date/13 a�rr 1 ■
Inspection Line: 503.639.4175 Ntl Date Ready /By:
I'PCiAK "G) g g (I O i & 14� / Notified/Method: J y 1/ Juris: See Page 2 for
,� 7 Supplemental Information
` Internet: mvww.ti and -or. av Pt
Ve CID �� SedI,U —ems
TYPE OF 1 REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit ices* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
is Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: S
❑ I - and 2- family dwelling ig Commercial /industrial
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION "Total number of floors:
Job site address: 16580 SW 85th Avenue New dwelling area: square feet
City /State /ZIP: Tigard /OR/97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: AB4 Misc Improvements Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Driving south on Hall Boulevard, cross Durham Road onto 85th Other structure area: square feet
avenue. Turn into the first driveway on the left side of the road. REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map/parcel no.: equipment, 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.
Modifying and installing concrete baffle walls in Aeration Basin 4. Filling Valuation: s 175,000
in unused channels. Adding diffusers and a slide gate. Repair of the water Existing building area: square feet
system. Dissolved oxygen monitoring and control improvements.
New building area: square feet
Q PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Clean Water Services Type of construction:
Address: 2550 SW Hillsboro Highway Occupancy groups:
City /State/ZIP: Hillsboro, OR 97123 Existing: >
Phone: (503 )547 -8177 Fax: ( ) New:
❑ APPLICANT Q CONTACT PERSON NOTICE
Business name: Clean Water Services All contractors and subcontractors are required to be
Contact name: Joel Borchers licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:16060 SW. 85th Avenue jurisdiction in which work is being performed. If the
City /State /LIP: Tigard, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 789 -3564 Fax:: ( )
E-mail: borchersj @cleanwaterservices.org
7 CONTRACTOR
Business name: �d7 ) 6-c40-6 / r ,- i ,( BUILDING PERMIT FEES*
1 // Ai A• (Please refer lo fee schedule)
Address: m
5��0 1 ier N t�/ /� ✓� Structural plan review fee (or deposit):
City /State /ZIP: , e, i UK— 47812
i FLS plan review fee (if applicable):
Phone: ( ) b-, Fax:( )
CCB lie.: rci Qq� /A Total fees due upon application: Amount received:
Authorized signature: 4. f • ' I This permit application expires if a permit is not obtained
� within 180 days after it has been accepted as complete.
Print name: v a P f Bore L. /"_.3 Date: l l— 3 ^ 7,, * Fee methodology set by Tri- County Building Industry
` Service Board. lb accon etit --
1:1Building\Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(I l /02 /COM /WEB)