Demolition Permit Application
City of Happy Valley
16000 SE Misty Drive
Happy Valley, OR 97086
Phone (503) 783-3800 Fax (503) 658-5214
IVR 24 Hour Inspection Request Line (888) 299-2821
Schedule Online: www.oregon-epermitting.info
(Same day inspections /cancellations must be in by 7:00am)
www.happyvalleyor.gov
DEMOLITION APPLICATION
Development (over 1 acre) Existing Commercial / Industrial Structure
Existing Residential Single
Lot
High Density Residential
DEMOLITION SITE INFORMATION AND LOCATION
Demolition Site Address:
City/State/ZIP:
Suite/Bldg./Apt. No.: Project Name:
Cross Street:
Subdivision: Lot No.:
Tax Map/Parcel No.:
DESCRIPTION OF WORK
Erosion Control Required: Yes No
Disposal Site:
PROPERTY OWNER
Name:
Address:
City/State/ZIP:
E-Mail Address:
Phone: Fax:
APPLICANT CONTACT PERSON
Business Name:
Contact Name (print):
Address:
City/State/ZIP:
Phone: Fax:
E-Mail:
DEMOLITION CONTRACTOR
Business Name:
Address:
City/State/ZIP:
Contact Persons Signature:
Contact Person (print name):
Contact Phone: Fax:
E-mail: CCB lic.:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete
Revised 6/7/16
DEMOLITION REQUIREMENTS
1. Submit a site plan indicating the location of all
structures to be removed. Scale 1:50
2. The owner of record is responsible for the
complete removal and completions of the
required sewer, water, electrical and gas
disconnects.
3. Private sewer line connections to the public
sewer must be disconnected and capped, with
a City inspection prior to the covering of the
trench.
4. Water meters must be removed by the water
district. (Provide documentation)
5. Private sewage disposal systems must be
decommissioned per County and State
requirements. (Pump receipt required)
6. Private well systems must decommission per
County and State requirements.
(Provide documentation)
7. Letter stating there are no hazardous
materials at the site or contained within the
structures.
8. Commercial / Industrial, and High Density
Residential (more than four residential units)
require an Asbestos site survey conducted by
an accredited inspector. In addition to the copy
of the inspection, to be kept on site per DEQ,
submit a copy to the City of Happy Valley.
9. Inspections: Initial full site inspection with the
owner or their representative. At least one
inspection during the course of the demolition.
A final inspection to verify that the demolition
was per the permit requirements, and no
deficient items remain to be done.
NOTICE
I HAVE READ & COMPLETED THE ABOVE LISTED
REQUIREMENTS. DOCUMENTATION IS ATTACHED
Authorized
Signature:
Print Name:
Contact Phone:
Date:
DEMOLITION PERMIT FEES*
Please refer to fee schedule
Fee For Demo Permit $110.00
Fee for Sewer/Septic Disconnect $30.00
State Surcharge (12%)
Total Fee
Date Received:
By:
click to sign
signature
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