Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00056
i, DEVELOPMENT SERVICES DATE ISSUED: 4/20/04
.411- I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16580 SW 85TH AVE PARCEL: 2S11360 -00600
SUBDIVISION: SEWER TREATMENT PLANT ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 150,000.00
Remarks: Fermenter /scum project.
Owner: Contractor:
UNIFIED SEWERAGE AGENCY STELLAR J CORPORATION
150 N 1ST AVE 1395 DOWN RIVER DR SUITE E
HILLSBORO, OR 97123 WOODLAND, WA 98674
Phone:
Phone: 360 - 225 -7996
Reg #: LIC 127903
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[BUILD] Permit Fee 4/20/04 $939.30 Bolts in concrete final repot
[TAX] 8% State Surchart 4/20/04 $75.14 Final Inspection
F
[BUPPLN] Pln 12.v 4/20/04 $610.55 Final Inspection
Total $1,624.99
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 than 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: '7
Signature:
Call 639-4 y 7 p.m. for an inspection the next business day
It'cgo s b 8S `n*•'
' n a Permit Applic RECEIVE N FOR OFFICE USE ONLY
Received C Pemrit No oc a S(j
F
City of Tigard EB 1 8 Date/By: -/ ' ti - / � ii? 'my/'
13125 SW Hall Blvd., Tigard, OR 97223 Z00 . Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 a LLi; Date/By: T 5 Other Pernut:e - OO70.2
Inspection Line: 503.639.4175 "� " "� L ' I I Date Rea 4/ � J a na. ® See Attached Checklist for
CITY
Internet: www.ci.tigard.or.us OF T!GA - p Notified/Method: /� t' _ Supplemental Information
l- C. BcoggiNaDivisiopp_ $ i5ti.k RT ,, ;_ _ / REQUIRED DATA: i ,, u . i / ;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
V4 Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
i /2 /�F ( 5 - T work indicated on this application.
a` �, , ''..e" f � R ,g A 1 ,,, } � ,,,,, ,, ?.E^,,,� i f ,1 : o A.L�
Valuation: $
❑ 1- and 2- family dwelling gi Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
:':*eft '0 JOB SITE INFORMATION AND LOCA 'IIQ j > Total number of floors:
. .. , /i.5. . ,, . .
Job site address: 3.4.4960•0 SI g. As./ New dwelling area: square feet
City/State /ZIP: - erA>LD , 0 g 4 -72.ay Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 1)t.,glH 0 , 1 ,,, ‘ T, Efaityrtsiz. 04 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: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
F M V+ r IOC �r a ` work indicated on this application.
Valuation: $ /50 a ae ..�
ADo Sc_vo.. AavAL- 852t,1PRAEA T "To ExtSTtX-Y.ir /
"r1A 5 AN!) '5cVlti MN "4.)t) Assaraea d Existing building area: square ieet
pfPt4.,G► . New building area: square feet
. . , , . ; ' ki TNT` - Number of stories:
Name: e_e..�tv W th-raa.. 5M42..V IC -MS Type of construction:
Address: /c 4,0 SCA) TM Ava Occupancy groups:
City/State/ZIP: 7; ovit i OR_ 1 7 Z 2y Existing:
Phone: ('5 6$ Zp Fax ( )
t ,A H, °� * �s ' o rxt NH � Q t t't''
. ` ,�fi v _ c.... ,... r� , . ,.n . <k NOTICE •
Business name: S Uj x i CoQPp� -r pN All contractors and subcontractors are required to be
��� !�T ` /, licensed with the Oregon Construction Contractors Board
Contact name: V 1..161- a / under ORS 701 and may be required to be licensed in the
Address: 13OS pot..A._! 2..1 ve TA_ . ' o i re . E jurisdiction in which work is being performed. If the
City/State /ZIP: , '_-At-.A1V � � e� -� L. applicant is exempt from licensing, the following reasons
id, 'J I apply: p �/// ' c,
Phone: (v3 ) 2p . i CO 2 Fax: : ( ) zs . gc 1 i 4
E-mail: 6sr dh. /l C,� t '. . A
�N4 r i, J { c V
Business name: x+• Z c, oN $1[111 DIfNG PERMIT FEES*
Address: t 3 c1s Dou..►N Rt rt.. )fZ. Sti (tE
Please refer to fee schedule.
City/State/ZIP: /4000L..MtvA WA 8(e+7y
Fees due upon application
Phone: (y,..o) -2,2,15 , '74 4, Fax: (% c o 22 5. goo
Amount received
CCB lic.: (2:-.7 9 a3
Date received:
Authorized signature: —. This permit application expires if a permit is not obtained
� ` , within 180 days after it has been accepted as complete.
'aQ
Print name: .,, 'JE I Date: t ' V_l I D y * Fee methodology set by Tri- County Building Industry
1 Service Board.
i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11/02/COM/WEB)
1
Building Division
' Plan Submittal Requirement Matrix
Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
All g jpw 17'1 �la at
M I t� 011 Ir y A,. , , l 9 A 1 9 1 ` tO 8 s 7r' '!
5 / 99
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 3**
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP o e/r-X/ -67 -
Received // Date Requested ° 2 l---04 AM PM BUP
Location / 2 5 8o 5 `-- Suite MEC
Contact Person $ I Ci Ph ( 5 ) 3 Z- - /O lU PLM
Contractor �? Ph ( ) SWR
BUILDING Tenant/Owner ( O4A -� � / /(� c2 - ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: / SIT
Post & Beam C 0A,1
Sh - -r Anchor
Ext S eath/Shear ,
Int h/Shear
Framing
Insulation • l r �w�e�r P T4 I cK laN It L ILLS
Drywall Nailing 6� t��1�/1
Firewall ,tio o /z.Wa SK13 � r= L! '?) 41 'Cy c', 1 �-r
•��
Fire Sprinkler 1
Fire Alarm 131.4 1 L4 it)G- Qa 4-610 PVCr 1T - 1 - SP�y 4L
Susp'd Ceiling
Roof r -4 ' Ts) S � 7 $ L. ,/ 5 m 472/
Other:
ASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower ' - n
���n,
Other: i ;!�t/�• 07.• 17 rpt ";;i
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: _ Unable to inspect - no access
Fire Supply Line r-
ADA / �
Approach/Sidewalk Date (� Inspector agte Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
Main Office Salem Office Bend Office
4c . 1) .____ P.O. Box 23814 4060 Hudson Ave., NE P.O. Box 7918
1igard, Oregon 97281 Salem, OR 97301 Bend, OR 97708
Carlson Testing Inc • Phone (503) 684 -3460 Phone (503) 589 -1252 Phone (541) 330 -9155
FAX (503) 684 -0954 FAX (503) 589 -1309 FAX (541) 330 -9163
Special Inspection
FINAL SUMMARY LETTER
May 25, 2004
T0404858
City of Tigard
13125 SW Hall Blvd.,
Tigard, OR 97223 -8199
Attn: Building Department
Re: Durham WWTP- Fermenter Scum System Upgrade
- 18060 - SW 85 - Tigard, OR
1 638 u Permit No.: BUP2004 -00056
Dear Sir or Madam:
This is to certify that in accordance with Section 1701 of the Uniform Building Code, Title 24, we have
performed special inspection of the following item(s) per our inspection reports only:
Adhesive Anchors
All inspections and tests were performed and reported according to the requirements of Project Documents
and, to the best of our knowledge, the work was in conformance with the approved plans and
specifications, approved change orders and applicable workmanship provisions of the State Building Code
and Standards, as well as the structural engineer's design changes, approvals and verbal instructions.
Our reports pertain to the material tested /inspected only. Information contained herein is not to be
reproduced, except in full, without prior authorization from this office.
If there are any further questions regarding this matter, please do not hesitate to contact this office.
Respectf ly submitted,
CARLS"N TESTING .
•� mes F. Hietpas
• perations Manager
JFH /ks
cc: Clean Water Services- Tim Rondeau
Carollo Engineers- Rob Norton
Stellar J Corporation- Brint Devilling