Permit IIIIICITY OF TIGARD BUILDING PERMIT
■"" ' COMMUNITY DEVELOPMENT Permit#: BUP201600001
T f i ,1R D13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2016
Parcel: 251060001801
Jurisdiction: Tigard
Site address: 17480 SW CLEMENTINE ST
Project: Clean Water Services River Terrace Pump Station Subdivision: 2002-032 PARTITION PLAT Lot: 3
Project Description: Construction of a new sanitary sewage pump station to serve River Terrace.
Contractor: ROTSCHY INC Owner: CLEAN WATER SERVICES
9210 NE 62ND AVE 16060 SW 85TH AVE
VANCOUVER,WA 98665 TIGARD, OR 97224
PHONE: 360-334-3100 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB 12%State Surcharge-Building 05/10/2016 $142.39
Occupancy Grp: U Occupancy Load: 2 Plan Review 01/14/2016 $771.28
Dwelling Units: 0 Plan Review-Fire Life Safety 01/14/2016 $474.63
Permit Fee-COM-New Construction 05/10/2016 $1,186.58
Stories: 0 Height: 19.5 ft DC Provision Review,COM New-Bldg 05/10/2016 $175.50
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM New-Ping 05/10/2016 $175.50
Value: $184,000 Info Process/Archiving-Lg$2.00(over 05/10/2016 $106.00
11x17)
Info Process/Archiving-Sm$0.50(up to 05/10/2016 $325.00
Floor Areas: 11x17)
Total Area: 459 Metro Const.Excise Tax 05/10/2016 $220.80
Beaverton School CET-Non Residential 05/10/2016 $275.40
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,853.08
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: No 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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.:00.332.23 •.
/ //
_
Issued By: Permittee Signature: / ..-
Call 503.639.' 75 by 7:00 a.m.for the next available inspection date.
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.
NM"-
Su/Mina
Bt ldina Permit Application LC Q 0 /5
Commercial rt)12()umI: I. 0\11City of Tigard BEC Received
�� ' Date/By: N j /air_
Permit No.: /.f/,D 0(/_—th 1
114 4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Re ( (f'^ YJ
a Phone: 503.718.2439 Fax: 503.598.1960 Ec 3 0 2015 Date/By'' 'i (C t t.L Other Permit:(JPao1 c�yj i
I i \h t Inspection Line: 503.639.4175 to Reay My: / Juris: ® See Page 2 for V�+.
Internet: www.tigard-or.gov C TIGf d/Me od: / �7//6, c Supplemental Information
SkroV416:01 1
TYPE OF WORIe 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
El Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1-and 2-family dwelling ®Commercial/industrial Valuation: $
'� El Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 17480 SW Clementine St New dwelling area: square feet
City/State/ZIP:Beaverton,OR 97007 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:River Terrace North PS Covered porch area: square feet
Cross street/directions to job site: 1100'West of SW Roy Rogers Rd., Deck area: square feet
1350'South of SW Scholls Ferry Rd. Other structure area: square feet
I. 1,6p> ..,4t)0 REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: il Lot no.:1801 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1S 1 06 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.
\1 Construction of a new sanitary sewage pump station and 12-inch diameter sewer Valuation: $184,000
v force main. Existing building area: square feet
New building area: 459 square feet
® PROPERTY OWNER 0 TENANT Number of stories: I
Name:Mike Kebbe,Clean Water Services Type of construction: VB
Address: 16060 SW 85"'Ave Occupancy groups:
i• City/State/ZIP:Tigard,OR 97224 Existing:
p Phone:(503)547-8187 Fax:(503)547-8196 New: U
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(� Business name:Murray,Smith&Associates,Inc. (Please refer to fee schedule/' Structural plan review fee(or deposit):
Contact name:Alex Bargmeyer
FLS plan review fee(if applicable):
Address: 121 SW Salmon,Suite 900
City/State/ZIP:Portland,OR 97204 Total fees due upon application. I,'A i eV
Amount received:
\>3 Phone:(503)224-9010 Fax::( )
E-mail:Alex.Bargmeyer@msa-ep.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
vnrl CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Q Business name:To be determined 'T 4, - Submit two(2)sets of roof plan with connection details
e / —id�/c and fire department access,along with the 2010 Oregon
Address:/-� 3Jxv2 10 Solar Installation Specialty Code checklist. _
J Permit fee(includes plan review
City/State/ZIP: (/� ' .f ��d €q -75, /0 fees): $180.00
/ J and administrative
Phone:(36,c) 33, teL. Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:q ,Agii'/7 Total fee due upon application: $201.60
Authorized signature: 4 I ` This permit application expires if a permit is not obtained
\\\\ within 180 days after it has been accepted as complete.
Print name:Alex Barg yer Date: 12/30/15 * Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building\Pennits\BUP-COM PennitApp.doc 02/24/2011 440-4613T(I I/02/COM/WEB)
City of Tigard
III II
COMMUNITY DEVELOPMENT DEPARTMENT
TIC;A k D Building Permit Review — Commercial - With Land Use
Building Permit #: I3I%4P‘1?0I b 0000 I
Site Address: /91-/SO 2f J C)/P vv,An� S7 Suite/Bldg#:
Project Name: ke/v,P- ,npce AJ,lc-,Lk Pj4 ...S7A) Lk
(Name of commercial business occupying the space. I f vacant,enter Spec Space.)
Planning Review
Proposal: Mcoiyi ,.. 5?4 /lisyl
rcierify site address/suite# exists and actio n permit system.
'ver Terrace Neighborhood:/'
Yes ❑ No
yyand Use Case #: f 2 9/:. ()D /
Id Plan Match Approved Land Use:
V".to Plan ISG/Landscape Plan ID Other:
Urban Forestry Plan Lid Elevation Plan
Building Height: Maximum Height Actual Height /6. 4
❑ conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance
(/Business Licen
-'sts: Yes ❑ No,applicant notified to obtain business license
Public Facilities mprovement(PFI) Permit:
Required: Yes, applicant was notified ❑ No Applied For: 11Ves DINo, stop intake
Notes: GT/011 7)0 "eh .Q' .� mit / r/c7br 217). 23-e17yi/7G ISS iczn Ge
Approved by Planning: e-----t i, A Date: + .W c
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: /o/3o//S—
Site Plans: #
Building Plans: #
Building Permit#: building permit# above.
Workflow Routing: [}Pia ring L— fi neering lig--Pei7i—nit Coordinator KI—lictrittirig
Workflow Sign-off: l- f for Planning(include notes from planning review)
Route Application Documents: wilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: C'� // /6 ,�f
,L GU,1'r e,z r ..
By Permit Technician: ,-.00"'_._ __ Date: /11-7/77
dna
I:\Building\Forms\Bldg PennitRvw_COM_W ithLandUse_0709I 5.docx
•Engineering Review
Slope at building pad:
,2 PFI Permit#:
❑ Conditions "Met"prior to issuance of building permit
Afr Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP)
,\Vater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes SCJ No
Assess Water Quantity Fee in-lieu: ❑ Yes ela No
LIDA Facility on lot: ❑ Yes ,E'No
❑ NOT Approved by Engineering: Date
Notes: C64 1770 *2-1(nt— T 7v1[3l/J4, 70 /SSMC.
1 r p/2.4 . 7t 731,jC 1
Approved by Engineering: , ktt- _fir) Date: 2 /3//ic,
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit /��
pproved,NOT Released: ,1' 14— Fate: 21/4/71.•
Notes: �/yypC o-y� 1-Ce. £24e
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
,SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes /A
Tigard Trans SDC: ❑ Yes ••N/A
Parks SDC: ❑ Yes ►-'' /A
❑ OK to Issue Permit
Approved by Permit Coordinator: ,' 1M
,V v/n2-% y '/1(�cka Date: 4/f/ )
I:\Building\Fonns\BldgPennitRvw_COM_WithLandUse_0709I 5.docx
MSA RECEIVED
DEC 3 0 2015
Murray CITE'OF TIGARD
Smith Inc. CITY
rki
Engineers/Planners 121 S.W.Salmon,Suite 900 0 Portland,Oregon 97204-2919 PHONE 503.225.9010 PFP5)Y2
LETTER OF TRANSMITTAL
To: City of Tigard, Building Division Date: December 30, 2015
13125 SW Hall Blvd. Job No. 14-1611
Tigard, OR 97223 Re: River Terrace Pump Station Design
Services, Building Permit
Attn.:
WE ARE SENDING YOU: 0 Attached ❑ Plans ❑
Copies Date Description
1 Dec - 2015 Building Permit Application—Commercial
1 Dec - 2015 Building Permit Application—Site Work Permit
1 Dec - 2015 Commercial Application Checklist
1 Dec - 2015 COMcheck Envelope Compliance Certificate
3 Dec - 2015 River Terrace North Pump Station Plans—Building Permit
3 Dec - 2015 River Terrace North Pump Station Plans— Site Work Permit
2 Dec - 2015 River Terrace North Pump Station&Force Main Project Specifications
2 Dec - 2015 River Terrace North Pump Station Structural Calculations
THESE ARE TRANSMITTED as checked below:
❑ For approval 0 For your use ❑ As requested ❑ For review/comment
REMARKS:
City of Tigard:
Please find enclosed the above listed documents required for the building permit review.
Let me know if you have any questions or require additional information.
Thank you.
COPY TO: SIGNED:
Alex M. Bargmeyer, P.E.
CI:PDX_Projects 14 1611-River Tertace North PS&FM 0205-Approvals&Permits Transmittals City of Tigard 12-30-15.docx
A
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17480 SW CLEMENTINE ST, BEAVERTON, OR,
97007
Record Type:
Commercial - Building
Inspection Type:
299 Final inspection
Result:
PASS -CofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
February 16, 2017 at 9:07:23
AM
Record ID:
B U P2016-00001
Inspector:
Chip Barnett
Contractor