Permit CITY OF TIGARD BUILDING PERMIT
s • - COMMUNITY DEVELOPMENT Permit #: BUP2012 -00162
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2012
Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16060 SW 85TH AVE
Project: Clean Water Services Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Install a 35 foot flag pole
Contractor: ELMER'S FLAG & BANNER Owner: CLEAN WATER SERVICES
1332 NE BROADWAY ATTN: ACCOUNTS PAYABLE
PORTLAND, OR 97232 2550 SW HILLSBORO HWY
HILLSBORO, OR 97123
PHONE: 503 - 282 -1214 PHONE: 503 - 547 -8177
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: Permit Fee - Additions, Alterations, 08/16/2012 $134.54
Demolition
Occupancy Grp: U Occupancy Load: 12% State Surcharge - Building 08/16/2012 $16.14
Dwelling Units: 0 Plan Review 08/16/2012 $87.45
Stories: 0 Height: 35 ft Info Process /Archiving - Sm $0.50 (up to 08/16/2012 $0.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $3,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $238.63
Required: Required Items and Reports (Conditions)
Fire Sprinkler: 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 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. ATTENT • • •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0 r through OA' 952 -01 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 987 •r 1.800.332.2344.
Issue By: Permittee Signature: C
Call 603.639.4175 by 7:00 a.m. for the next available Ins . date.
This permit card shall be kept In a conspicuous place on the job site un I completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Building Permit Application
Commercial RECEIVE FOR OFFICE USE ONLY
City of Tigard AUG 15 201 Received v Q .�yRR
Date/B : O ( I . Permit No.: tee e « ,•• 001
o 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review � T+ � � • r Permit:
' Phone: 503.718.2439 Fax: 503.598.1960 DateB : �1�7 I ra
CITYE T IGAR �� ® See Page 2 for
Ins coon Line: 503.639.4175 • to Ready/By: i mri.'
T I G A Ii D B UILD I NG D 1 3 /, / f / 1) ( P S
Internet: www.tigard- or.gov t ifie ethod: 3 twv Supplemental Information
A' I0 t , / .
TYPE OF WORK • ` 't D DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit , are based on the value of the work performed.
Indicate t e 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:
E A ❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16060 SW 85 Avenue New dwelling area: square feet
" ) City /State/ZIP: Tigard, OR 97224 (2 � k ) �
W � 2 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: l+7a�kel®- festallatiou� ��► jL 5 Covered porch area: square feet
Cross street/directions to job site: 85 and D urham Road Deck area: square feet
Go south on Hall Blvd. Crossing Durham Road, Hall Blvd becomes 85 Avenue. Other structure area: square feet
Your first left after Durham Road is the plant entrance. REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
tN equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Install a 35 foot flag pole Valuation:
_ $ 3 SQL
Existing building area: square feet
( New building area: square feet ■ ® PROPERTY OWNER I 0 TENANT Number of stories:
Name: Clean Water Services Type of construction:
Address: 16060 SW 85 Avenue Occupancy groups:
City /State /ZIP: Tigard, OR 97224 Existing:
Phone: (503)547 -8177 Fax: ( ) New:
VN ❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: Clean Water Services (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: Joel Borchers
FLS plan review fee (if applicable):
Address: 16060 SW 85 Avenue
City /State/ZIP: Tigard, OR 97224 Total fees due upon application:
Phone: (503) 547 -8177 I Fax: : ( ) Amount received: , .,41--••
E -mail: borchersj @cleanwaterservices.org PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive insta n of
CONTRACTOR roof -top me ted Photovoltaic Solar Pa ystem.
Business name: Elmer's Flag and Banner Submit two (2 ets of roof plan wit onnection details
and fire departme • ccess, alo ith the 2010 Oregon
Address: 1332 NE Broadway Solar Installation Spe de checklist.
City /State/ZIP: Portland, OR 97232 Permit fee (incl - -s • . • eview
$180.00
and . • .nistrative fee .
Phone: (503) 282 -1214 Fax: (503) 282 -2481
State surcha :.- (I 2% of permit fee): $21.60
CCB lie.: 195605 1 , Total fee due upon application: $201.60
Authorized signature.
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Joel Borch I Date: 8 -15 -2012 * Fcc methodology set by Tri- County Building Industry
Service Board. 2
I:\BuildingWermits�BUP -COM PermitApp.doc 02/24/2011 440- 4613T(I I /02/COM/WEB) (L.1 M� = tPa� 4g