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Permit
7//6//0 ad ' (3)&d c i ►vc-c- 17 ' : �, CITY OF TIGAR® MASTER PERMIT :! eq COMMUNITY DEVELOPMENT Permit #: MST2010 -00073 T t ARtJ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/01/2010 Parcel: 2S111 BD01600 Jurisdiction: Tigard Site address: 9862 SW MURDOCK ST Subdivision: Lot: 0 Project: Lusk Project Description: 666 sq ft 2 -story addition. 7/16/10 added (3) branch circuits B.T. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 0 First: 330 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 20 Bathrooms: 1 Second: 336 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $66,846.34 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 2 Catch Basins: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 0 20 1-400 amp: 0 201 -400 amp: 0 1st W/O SvclFdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) LUSK, JOHN D & GWEN E CRAWFORD CUSTOM 1 MST Ersn Cntrl 503 681 - 4444 9862 SW MURDOCK ST CONSTRUCTION INC TIGARD, OR 97224 4970 MEADOWOOD LN Tillamook, OR 97141 PHONE: 503 -467 -8387 PHONE: 503 -515 -7363 FAX: 503- 842 -7828 Total Fees: $2,544.75 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 Cent l. Those rules aro set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a • - • the rules or direct • • -stions to OUNC by calling 503 •61 or 1.800.33 .2344. . I AP PIIRW- Issued Br L��� i 4. Permittee Signature: ...it k I. .4 • ' � / r w' • r WASMIRM a CITY OF TIGARD MASTER PERMIT % ;, g' _ . - COMMUNITY DEVELOPMENT Permit #: MST2010 -00073 Add 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/01/2010 A • ,1.. C , l Parcel: 25111 BD01600 Jurisdiction: Tigard Site address: 9862 SW MURDOCK ST Subdivision: Lot: 0 Project: Lusk Project Description: 666 sq ft 2 -story addition. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 0 First: 330 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 20 Bathrooms: 1 Second: 336 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $66,846.34 Rear: 15 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 2 Catch Basins: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr 0 Ea add] 500 sf: 0 20 1 -400 amp: 0 . 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea addl Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL • RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) LUSK, JOHN D & GWEN E CRAWFORD CUSTOM 1 MST Ersn Cntrl 503 - 681 - 4444 9862 SW MURDOCK ST CONSTRUCTION INC TIGARD, OR 97224 4970 MEADOWOOD LN Tillamook, OR 97141 PHONE: 503 -467 -8387 PHONE: 503- 515 -7363 FAX: 503 - 842 -7828 Total Fees: $2,519.82 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. ENTIO : e egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 1 -0010 through OA' 95 ' 1 1 -01 0 e. You may obtain a.copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /, r Issu By: / .1glikt Permittee Signature: Electrical Permit Application \ \ic �„ , 1 of f1 I Ic l iJsi O�N1 Ci of TI and ` t� '+ Received u Perm No.: igrffluim Date/13 : i •` t ,, `7 g 1 � - ° 13125 SW Hall Blvd., Tigard, OR 9' -It ' `VI' ' '�Q Plan Review . r : I Phone: 503.639.4171 Fax: 503.598 • ''� 1 1p � Date/B : Other Permit: f I t; A I I T Inspection Line: 503.639.4175 \\ } 04 Date Ready/By: ® See Page 2 for Internet: www.tigard- or.gov J ^ ^C �t ; ;� 1 \Notified/Method: / Supplemental Information r At3 TYPE OF WORKC�� . _ PLAN REVIEW m ent Please check all that apply (submit 2 sets of plans w /items checked below): 0 New construction 0 Addition/alterationtiAcY ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. . ❑ Addition of new motor Toad of ❑ "A ", "E ", "1 - ", "1 - ", ( �1. + - /J 51--- 100HP or more. occupancy. Job no.: Job site address: 1' (0a S� i� Lttr ejOCC ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: LA s k ❑ Service or feeder 600 amps or more. . FEE SCHEDULE : Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 " New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family k (3 b rzvvCt) C / IJ h) residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation if - \ T 2 UXX j -73 200 amps or less 100.70 2 ❑ PROPERTY OWNER I • ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT . ❑ - .CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 3 7.42 �. `a6 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 ty dwelling, service and/or feeder Phone: ( ) Fax: : ( ) . Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: Investigation (1 hr min) . 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (%: hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): W TOTAL PERMIT FEE: 4 2...L1 " Authorized signature: This permit application expires if a permit is not obtained within 80 days after it has been accepted as complete. Print name: Date: * Number of inspections allowed per permit. I:\ Building 'Permits\ELC- PermitApp.doc 07/01/10 440 -4615T(i 1/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: . • Fee for each commercial $75.00 • system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n B oiler Controls n C • lock Systems ❑ Data Telecommunication Installation n F ire Alarm Installation n HVAC ' ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations IABuilding\Perrnits\ELC-PermitApp.cloc 07/01/10 e2'3 .Ja's~ : a R E C F VED :4 7� FOR ()NI01 •, � �r Residential :, ..- :_ •'�,. �i. - T '- ° may . � o OF 71 - Ir u n .. a.r "sn ^ ., ° .. Receive) 1 1ty I � r Ci of Ti and 7 Q 3 I Permit No.. tY Date g�: � 5 , � —�♦ 7 13 1 25 SW Hall B lvd., "Ti gard. OR 97223 APR ; 2 8 2010 Plan Review . 11 ''• Phone: 503.639.4171 Fax: 503.598.1960 Date /Bv: ARAI MI Other Permit: ggTI D Inspection Line: 503.639.4175 CITY OF TIGARD Date Readp /'v; Notified /Method: „1 %Jur 0 See Page 2 for YI K t � Internet: www.tigard- or.gov � < 0 ��� .IupplementalInformation BUILDING DIVISION �/ ' TYPE OF WORK E Q ' . ;I) DATA : 1- AND.2- FAMILY DWELLING ❑ NOV construction ❑ Demolition Permit Ices* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 153 Addition /alteration /replacement ❑ Other: equipment. materials. labor, overhead, and the profit for the CATEGORY OF.CONSTRUCTION'- work in tied on this application. 1- and 2- family dwelling Valuation: `e F (0. ❑ C ommercial /industrial 111 Accessory building 111 Multi-family Number of bedrooms: E] Master builder ED Other: Number of bathrooms: / J OB SITE INFORMATION AM) LOCATION Total number of floors: a Job site address: Sc 9 49‘ ,2 i 10,,..,/, k St New dwelling area: ‘‘ square feet City/State/ZIP: / % ar' OR 9 7:2254 Garage /carport area: 0 square feet Suite /bldg. /apt. no.: Project name: Covered porch area: f�/ square feet ; 3 Cross street /directions 10 job site: Deck area: Ito square feet x'365 Other structure area: square feet 20 REQUIR I)A"1A: COMMERCIAL CIIECKLIST Subdivision: Lot no.: — Permit Ices* are based on the value of the work performed. > Jl a D n6 / / DD Indicate the value (rounded to the nearest dollar) of all Tax map /parcel / arcel no 4 equipment, materials. labor. overhead, and the profit for the - DESCRIPTION OF .WORK - work indicated on this application. / / Valuation: S la .2 7 � "wo . 5f - al ir,6h Existing building area: square feet New building area: square feet - N.PROPERT.Y OWNER: . _ 0. TENANT •. .. . Numberofstories: Name: JG h, G,, sh- Type of construction: Address: 9 3'2 S'4( 70 ,1 C k 5-7' Occupancy groups: City /State /ZIP: / r 4 , 0 / e) R 9722 q Existing: Phone: (. 3) 5.4 6 7- g 3 g 7 Fax: ( 1 New: APPLICANT - . .❑. CONI'AC : PERSSON . • NOTICE Business name: w A / S , o em fl f./ e0/4 Z'hc All contractors and subcontractors are required to he / /! • licensed xvith the Oregon Construction Contractors Board Contact name: phi lc C� P tr7c:^ G ✓ under ORS 701 and may be required to be licensed in the Address: y y 70 me4A,..,o0Gi G7 jurisdiction in which work is being performed. If the applicant is exempt tirom licensing. the following reasons City /State /ZIP: TIL ...,, , /2 v ? /y/ apply: Phone: (. 3 ) s/S ^ - 7 3 6 3 Fax:: ( ) C mail: .stc/ef ` // ,, e44 ,S e , dL' ..mil r.' . c- e.041 CO u R ACTOR Business name: e I"Gtsv T o/ r f f a.s+ O:� e 5 . G •� pi BUILDING PERMIT FEES* o " .. Address: Q (Please refer to fee schedule) - 7 U ��4 �" _ �',„� 4, Structural plan review fee (or deposit): 1 - ' ✓ City/State/ZIP: 771 /V 6s f 0 /� ! - /4�.f 5-52,±i,_-7 ' �^ / s p FES plan review lee (if applicable): Phone: 1 $ 3 J ) 7 3 g3 Fax: ( S 5 O s . 73 . b CCl3 tic.: /16 /f Total Ices due upon application: ^ , g a ��� I L Amount received: t 55 p` • / Authorized signatu - This permit application expires if a permit is not obtained [ within 180 days after it has been accepted as complete. Print name: j / e d .. G , y . / Date' / � = 7 %/j * Fee methodology set by'fri- Pointy Building Industry x, 03-337 Electr Permit Application � k ', * *,- 0I2.:( ))14'1 iC - . . , () I \' 1 .. t a i ,, l , , Ii i i 1 rr ''t 4 < ik � lettos iag ; uusoilI r"'r KilaII w,rl' Its k ��ns9n� t' -1 li ,1Vii11,i ,4'. : I Re ceived C of Tigard DateB : iiff /p _ : Permit No.: I N ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C Phone: 503.639.4171 Fax: 503.598.1960 DateB : Other Permit: 1 1 t /\, 61 Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 for ':':.':(, Internet: www.tigard - or.gov Notified/Method: Supplemental Information . TYPE OF WORK • 'PLAN REVIEW" ❑ New construction p Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION - exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor Toad of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: .1,6 2 5 j / 100HP or more. occupancy. / ' yro� c " - ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: tird t0 /Z4 7_22 y ❑ Health -care facilities. ❑ Supply voltage for more than 7 ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no., Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add] 500 sq. 0. or portion 33.92 Tax map /parcel no.: Limited energy, residential (with above sq. ft.) 67.84 2 DESCRIPTION OF WORK • .,, ( q / Limited energy, multi - family 67.84 2 / �l s �� c / o c h r i,s, /2Y2 7 / 1 6,G► residential (with above sq. 0.) .'� Services or feeders installation, alteration, and/or relocation •VZ.o.- , 414.4 . 200 amps or less 100.70 b<iJ 2 _ FL PROPERTY OWNER ❑ TENANT . , 201 amps to 400 amps 133.56 2 / / 401 amps to 600 amps 200.34 2 Name: _i H LG, 5 601 amps to 1,000 amps 301.04 2 Address: 9 56,.../ .. .4- Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City/State /ZIP: ri .-ti. r 4%)/2 9,2 2 relocation Phone: (50 j) •! 67 13 S 7 Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease t, or exch.. ge, a srding to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 A Branch circuits- new, alteration, or extension, per panel Owner signature: , — Date: &D/O A. Fee for branch circuits with • — APPLICANT 1 fir CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: �/ �/ e„,74;,.,".7 Fee for branch circuits w ithout r ��P�` ` G' ° p4 g� <' service or feeder fee, first / Contact name: J � branch circuit l 56.18 , 2 c" e � r Each add'I branch circuit 1 7.42 '7, 4-2-2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 ty dwelling, service and/or feeder Phone: ( 5 5/5 -7 3 63 Fax: ( ) Reconnect only 67.84 2 //� Pump or irrigation circle 67.84 2 E- mail: j h G i % s e_ 4 400 .. - 8 ay, Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: panel, alteration, or extension. Page 2 2 0 e Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (%z hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: .ELECTRICAL PERMIT .FEES • - Suprv. Electrician signature, required: Subtotal: �' , Plan review (25% of permit fee): i Print name: Date: State surcharge (12% of permit fee): 7 , 7 ,9 TOTAL PERMIT FEE: f 1 * '� Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: + Number of inspections allowed per permit. 1:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11/05/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: . Fee for all residential systems combined .. $67.84 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: j COMMERCIAL WORK.ONLY: . " Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \Building\Permits\ELC- PermitApp.doc 10/01/09 c �i o ry 1" ''v � ., i l� n. �r Liwro ' '"' , ,,rn rl y � � i l � J M 1 :.� M i 71"'�+� 't' �C , r ti if y � � t� f)tll �1 Mechan Permit Application ` fr , , y .� 2 0.5, , al oR 1, ( : ) E UC ; 1 . I w � O � kv ! , .� t ip ! E'� ° 14a r=44 l ���� eir', Received III City of Tigard Date/By: No.: I ' . q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: Date/By: Inspection Line: 503.639.4175 Date Ready/By: furls: ® See Page 2 for ( Pa I I C � It 1;2: yBy: g - •-iii Internet: www.tigard- or.gov Notified/Method: Supplemental Information • • TYPE OF WORK • COMMERCIAL ,FEE* .SCHEDULE -:. USE.CHECKLIST ; ❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF. CONSTRUCON Value: $ TI RESIDENTIAL EQUIPMENT / SYSTEMS FEES* W 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist, ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling l /74-.4 Ai conditioning Job site address: 71‘,2, 5� (requires uires site plan showing placement) 46.75 City /State /ZIP: 7/5�rr,.! © y'- V Furnace 100,000 BTU (ducts /vents) 46.75 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: Duct work / 23.32 'Lj .."37--- Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no's //f/3/) 0 d.ea Other fuel appliances DESCRIPTION OF WORK . . • Water heater 23.32 / / Gas fireplace 33.39 e }°fe.. -,,/, , A„-,k f o��c74S 7 1,7 c ��(/ iv Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 g PROPERTY OWNER I ❑ 'TENANT Other: 23.32 _ Name: j N / Lis I( Environmental exhaust and ventilation ,- .6, S � /J4 / � Range hood/other kitchen Address: .� i - `..tv� -" o ` equipment 33.39 City /State /ZIP: '72_2 7� S,r�-o, ‘ 5,. J a_ Y Clothes dryer exhaust 33.39 / Single -duct exhaust (bathrooms, Phone: ($03) 54, 7 - 8.3 tT') Fax: ( ) toilet compartments, utility rooms) / 23.32 2-5%:34:,--"' . ❑ APPLICANT / . . ❑ 'CONTACT ' PERSON. Attic /crawlspace fans 23.32 /! ? Other: 23.32 Business name: G-v ,4....c� C6.,5 e3„.... s - ,,,7 / o „ .Ls, e • Fuel i in PP g Contact name: / e j e , e --- � S14.15 for first four; $4.03 for each additional ‘/ r � , � / Furnace, etc. Address: 'y'7 a /`/, LA Gas heat pump City /State /ZIP: 7774 v Q/Z 7/ t// Wall /suspended/unit heater ( Water heater Phone: ( S > 9 ) � f S/S -- 73 d 3 / Fax:: 3) $Y 791.8 Fireplace E-mail: ;�6C4„S 46 e4 Gh �1D r t 5 e "4 04, . G ,":4, Range .CO . Barbecue Business name: �j A44,/ / 7 h � Clothes dryer (gas) 1%lfvs,e -i { evv /r ti q - Address: /- 4 /3 „5, 0 3 3 / Other: MECHANICAL PERMIT FEES* - City / State /ZIP: .. ',,--,P S gry? 0/ "f7O3 jt Subtotal , C Minimum permit fee ($90.00) g .(c• Phone: ( 5O3) 4 A) - go 3 g Fax: ( _) Plan review (25% of permit fee) CCB lie.: 1 ‘ 7 3' Y // 1A5M State surcharge (12% of permit fee) a e© i! TOTAL PERMIT FEE (One - -- This permit application expires it a permit is not obtained within 180 Authorized signature: `/ �y��j�y days after it has been accepted as complete. Print name: � I, mo o , ,, , ti " Date: Y z 7 w * Fee methodology set by Tri- County Building Industry Service Board IA Building C- PermitApp.d°c 10/01/09 440- 4617T / (11I /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\ Building \Permits\MEC- PermitApp.doc 10/01/09 2 'Plumbing Permit Application Building Fixtures t' ' It:;: r, � ��,!.�.� a��w3Y d n�� "�}''r�4 k 1'� i I� ^.� ,� � r;- ;� ' 1 "k "1 OR, �l 1c r:°; u�1 0 ���1 � '�,�,: �`, ?.. s i �t C, q•.r i °aW ihi:u,i r Ma16.4d" 11 al ai a" 'tom?•" City of Tigard Receive Permit No.: 0 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Plan Review C __ Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No.: r It . A it l-ii Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for . . , 1 Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ,. , ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total 0-Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION • Site utilities: Job site address: jge ..„5../ /0f l G� ' 57L Catch basin or area drain 18.76 y rG d City /State /ZIP: 72; OW T Drywell, leach line, or trench drain 18.76 7 3Z Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 '37 Sanitary sewer (no. linear ft.: J Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: 2 x/// a,v A 00 Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 tale / ! �r 11 4 44 /‘ j <, 4� , Clothes washer 25.02 Cl Lis.- f..� r - 5 Dishwasher 25.02 A rm ''''1 Ad f yE9;q Drinking fountain 25.02 Ejectors /sump 25.02 PROPERTY OWNER • I ❑ TENANT ' • Expansion tank 12.51 L Fixture /sewer cap 25.02 Name: j A.5. , Floor drain/floor sink/hub 25.02 Address: 9 7 / vr t s G t4 S' Garbage disposal 25.02 City /State /ZIP: 7 L2,1' ' 7,22 V Hose bib 25.02 Phone: (S?3) 94 Irmo Fax: ( ) Ice maker 12.51 ❑ APPLICANT ' ❑ CONTACT. PERSON Interceptor /grease trap 25.02 Business name: Li if - S s � Medical gas (value: $ ) Page 2 N v .. ay-r � r Jrf �' Primer 12.51 Contact name: j � rq � x fria / Roof drain (commercial) 12.51 Address: y20 /pe'.i4 „�o, l Sink/basin/lavatory / 25.02 25 o i City /State /ZIP: T!/� i- drZ l` 7/ V/ Solar units (potable water) 62.54 Phone: ( ,SDI) 5/5- 7 3 / 6 3 Fax: // : ( ) Tub /showe shower pan / 12.51 12,..51 E -mail: ' ,ei e4.GLr ph e � .4' 4PD • G a� _renal. 25.02 �' Water closet 1 25.02 'jI5 0 CONTRAC R / Water heater 37.52 Business name: 4/ /% b m , H 5",,,,,,,,,/A es Water piping/DWV 56.29 Address: M9 w 5 5 . , _,f Other: 25.02 / City /State /ZIP: / �� Le ere t l e D4 97 0 � S ubtotal � � iS � Minimum permit fee: $72.50 Phone: ( s p3) 7 D Fax: ( ) 3 a Plan review (25% of permit fee) CCB Lic.: 7 .J 22 /D 13 I Plumbin g ;6^ Lic. no.: ,SZ l /` `ll State surcharge (12% of permit fee) �, D Authorized signature: 4a +r �� TOTAL, PERMIT FEE 1 1 t �,� This permit application expires if a permit is not obtained within 180 days ,!!f Print name: / /4Y NLi�► kti�, `. /$ a Date: y �� j p after it has been accepted as complete. J *Fee methodology set by Tri- County Building Industry Service Board. 1:\Building\ Permits \PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) . Total Square Footage: Permit Fee: Footing drain - I t 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm &Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total • each additional $100.00 or fraction thereof, to P and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", Plan. Review for Plumbing Installations please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that apply. Quantity by (Fixture) Work Performed. ❑ Any new commercial building with water service 2" and Fixture Type: Replace greater, except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure Jacuzzi /Whirlpool as defined in OAR918- 780 -0040. Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities. Drive tall ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric or Riser Diagram , Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. -4" Car Wash Drain Garbage - Domestic Disposal - Commercial - Industrial Comments regarding fixture work: Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial *Note: If the fixture work under this permit results in an - Service increase of sewer EDUs, a sewer permit will be issued and Swimming Pool Filter fees assessed for the sewer increase must be paid before the Washer - Clothes Water Extractor plumbing permit can be issued. Water Closet - Toilet Urinal Other Fixtures: 1:\ Building \Permits\PLMF - PermitApp.doc 2 May 13, 2010 RE: ADDITION Project Information Building Permit: MST2010 -00073 Class of Work: Add Address: 9862 SW Murdock St. Lot Number: NA Area: 666 Sq. Ft. Stories: 2 Builders Name: Crawford Const. Subdivision: NA The plan review was performed under the State of Oregon Residential Specialty Code (ORSC) 2008 edition. Please respond to conditions below. 1) Provide engineered truss details. 2) Provide engineered I -Joist details. 3) Provide header sizes. 4) Provide ledger details for joist attachment at existing house. 5) Provide readable plans. 6) Show all framing details for patio cover. 7) Location of 6x12 beam shown on beam calc. 8) Preliminary plan review. When responding, provide an itemized letter stating in what way each numbered issue has been addressed in the revision. When submitting revised drawings or additional information, please attach a copy of the enclosed City of Tigard, Letter of Transmittal. The letter of transmittal assists the City of Tigard in tracking and processing the documents. Respectfully, Dan Nelson Senior Plans Examiner (503) 718 -2436 dann @tigard - or.gov