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Permit ‘s}3/10 6,60e4 ,_,,,,,p putn e5 ' ° - A' MASTER PERMIT 4 ;° ;'' CITY OF TIGARD x q ` a =; COMMUNITY DEVELOPMENT Permit #: MST2010 -00062 r x Date Issued: 06/25/2010 .41 G AR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S134BD08000 Jurisdiction: Tigard Site address: 11652 SW PENN CT Subdivision: PENN LAWN ESTATES Lot: 8 Project: Held Project Description: Addition of 704 sq ft of habitable space, 384 sq ft of deck and 140 sq ft of covered porch area. 8/3/10 added (1) sump pump B.T. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 2 First: 354 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 21 Bathrooms: 1 Second: 350 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $81,484.00 Rear: 15 PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 1 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 2 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 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) HELD, ANDREW D & MOLLY D BREWER BROS CONSTRUCTION INC 11652 SW PENN CT 9011 SW BEAVERTON HILLSDALE HW TIGARD, OR 97223 PORTLAND, OR 97225 -2452 PHONE: 971 -506 -4019 PHONE: 503 - 292 -1640 FAX: Total Fees: $3,385.81 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 Notifica'•n Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of th r dir- • questions to OUNC by calling 584.246.6699 or 1.800.332.2344. Issued By ' . — – , _ _ _ —.../1 Permittee Signature: l A /111901' I , r " `_ CITY OF TIGARD MASTER PERMIT n I a COMMUNITY DEVELOPMENT Permit #: MST2010 -00062 ;; Date Issued: 06/25/2010 T f GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 : . , , Parcel: 1S134BD08000 Jurisdiction: Tigard Site address: 11652 SW PENN CT Subdivision: PENN LAWN ESTATES Lot: 8 Project: Held Project Description: Addition of 704 sq ft of habitable space, 384 sq ft of deck and 140 sq ft of covered porch area. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 2 First: 354 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 21 Bathrooms: 1 Second: 350 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $81,484.00 Rear: 15 PLUMBING Sinks. 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 1 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 2 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 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 add9 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) HELD, ANDREW D & MOLLY D BREWER BROS CONSTRUCTION INC 11652 SW PENN CT 9011 SW BEAVERTON HILLSDALE HW TIGARD, OR 97223 PORTLAND, OR 97225 -2452 PHONE: 971 - 506 -4019 PHONE: 503 - 292 -1640 FAX: Total Fees: $3,357.79 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Co s and all other applicable law. All work will be do • ccordance with approved plans. This permit will expire if work is not started within 180 days of issu ce or if work is sus ended f more the 180 da . ATTENTION: Oregon requires you to follow the rules adopted by the Oregon Utility Notificatio C t . Those r are et forth in OAR 9 - 001 -0010 through OAR 2- 001 -01 . You may obtain a copy of the rules or direct questions to OUNC by calling 50 .246.6 or 1 0.332 44. / Is ed By: �adi Permittee Signature: /C. wing Permit Applicat Ti i U ® cEiED ' � � 6 6 -,- , + / ga d ' p ,7 . ':. Residential City of Tigard APR � 3 2 010 x e , ,,:s,1-,..',',..'14;40-1,...1z,-.1. ed 0- t O l , l,(11 l l t 1,., l til O � l , i,,4;;;; , , , , � 5� ti n 1 , w ' _ . � ®'� ■ I M gyp rt 13125 SW Hall Blvd., Tigard, OR Y O ga DateB . ❑ vs �� r a i / // 1 r,' Plan Review '1 � .. .34 ' 6 TIGARD Date/Bv: 0 0 PAW i !u � fill i Other Permit: ❑ D ❑ a f C .:; Phone: 503.639.4171 Fax: 503. i s . Inspection Line: 503.639.4175 BUILDIN G DIVISIO s Date Ready /By: 0 ■ • Juris: El See Page 2 for • 10 ' Internet: www.tigard - or.gov Notified/Method: ■ r v 6/ i0 /37," E Supplemental Information L, Ilt u SAIN F- TYPE OF WORK Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ New construction ❑ Demolition equipment, materials, labor, overhead, and the profit for the 54 Addition/altcration/rcplaccmcnt ❑ Othcr: ❑ 0 ❑ ❑ 0 work indicated on this application. Valuation: S L ° 8 t l d CATEGORY OF CONSTRUCTION 6t p 1- and 2- family dwelling ❑ Commercial/industrial Number of bedrooms: ❑ ❑ ❑ ❑ Accessory building ❑ Multi- family Numb bathrooms: 0 ❑ ❑ ❑ Master builder ❑ Other: 0 0 0 ❑ ❑ Total number of floors: 0 ❑ ❑ JOB SITE INFORMATION AND LOCATION New dwelling area: Ct'� square feet Job site address: 0 0 ❑ ❑ ❑ i 1 ( 5 W �P.v► ✓1 e .T Garage /carport area: t � ! , ' ( 4 square feet City/State/ZIP: 00000 T taao t t 0g_ 2 _ 2 , Covered porch area: I J 0 square feet 3 U Suite/bldg. /apt. no.: 0 ❑ 0 0 ❑ Project name: ❑ 0 ❑ ❑ ❑ Deck area: 3e4 0 ❑ square feet -2 Cross street/directions to job site: 0 0 0 ❑ 0 514) SrAwl:lb fP.ft(I k) Other structure area: ❑ ❑ 0 0 0 square feet � ( 4 21 ST v J( 1) --,privItr1)61 Dr - 114.711 Ake . REQUIRED DATA COMMERCIAL -USE CHECKLIST 0 0 0 0 0 40 p 0 (X. Permit fees* are based on the value of the work performed. Subdivision: ❑ ❑ ❑ ❑ 0 I Lot no.: 00000 Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the Tax map /parcel no.: ❑ 0 ❑ 0 0 work indicated on this application. DESCRIPTION OF WORK Valuation: S ❑ 0 0 ❑ ❑ 00000 A J /1 0 ti :-,,f `` I eac I . - - f - r & be� Existing building area: ❑ ❑ 0 0 ❑ square feet 0 0 0 0 ❑ hix 4/9t/`s' . t 1 k1'OVi NI (,I1 Jd p Larger . ttw r New building area: ❑ ❑ 0 0 ❑ square feet 0 0 0 0 0 (t tll 1 1M DI KL(.l) ketif t9011N Number of stories: 0 0 0 0 ❑ S PROPERTY OWNER I ❑ TENANT Type of construction: 0 0 ❑ 0 0 Namc: ❑ 0 ❑ 0 0 A ,1 Ail Occupancy groups: Address: 0 ❑ 0 ❑ 0 1 14, S(A) PP.I �IYI Existing: 0 0 ❑ 0 0 City/State /ZIP: 0 0 0 0 0 - ririq)/A 11_. q 1 t New: 00000 Phone: (art 4'01 rl Fax: (0 00 00)0000 NOTICE El APPLICANT • ❑ CONTACT PERSON All contractors and subcontractors are required to be Business name: ❑ ❑ 0 ❑ ❑ I N e. V • Util I arc I vl I c.-tV % e- . licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Contact name: 00000 ,3,014 N Frovl L /l jurisdiction in which work is being performed. If the Address: ❑ ❑ ❑ 0 ❑ 57.1 7,5 itive_. applicant is exempt from licensing, the following reasons City/ State/ZIP: ❑ ❑ 0 ❑ ❑ Por - IcAA4 I t 7at1 ❑pao❑❑ Phone: (Sinn) O> 33x4 Fax:: (00000) 00000 00❑❑❑ E-mail: 00 000 • 6 reV -vd vYi 6.01/0 '1 CONTRACTOR 0 ❑ 0 ❑ ❑ BUILDING PERMIT FEES* Business name: 0 ❑ ❑ 0 ❑ Ere Wee . g r 0(4 -- tx --}- l o 0 (Please refer to fee schedule) Address: ❑ ❑ 0 0 ❑ q ®E t 13ea tlP.d` /1 ` ' t p [69 Sif. I Structural plan review fee (or deposit) :, 00000 City/State /ZIP: 0 fl ❑ f1 ❑ portiatil t Q .- 9 -. FLS plan review fee (if applicable): � ,, ❑ ❑ r - 1 ❑ L ❑ °hone: (❑Q 7 ErZno 1 (O 10 Fax: (0 ❑ ❑ ❑ ❑) 0 000 0 Total fees due upon application: 0 B lic.: ❑ 0 0 00 s D5 11 5/1 N i t Amount received: 00000 orized signature: 1 _ This permit application expires if a permit is not obtained tame: ❑ ❑ 0 ❑ ❑ Date: 0 0 0 0 0 within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry UIRED DATA: 1- AND 2- FAMILY DWELLING Service Board. ,ding Permit Application Checklist / 1/..10P-- *mits\BUP -RES PermitApp.doc 10 /01/09 440 -4613T(11 /02/COM/WEB) 04/13/2010 12.34 5035991960 j CITY OF TIGARD PAGE 02/02 E IectricaI Permit Apphcai clir CI V CU =I r a t "° ;ti li , [ " ' '''t v^ 1 n h ` , 4 ''' ;�' '' ' wR, I t I II I (� I1 r11r t : 'a f �,' �. 5450 i i ' City o f Tigard APR 1 3 2090 mind �/ Perm v *he- dC�dl ° 13125 SW 1.1011 Blvd „Tigard, OR M c w ' ah Revi pir � Pt RIM: 503.639.4171 Faa: 503. M1POF TIGARD °avere : ` Other Permit: z;, ;;i Inspection bins: 503 639.4175 Q(f(LD{NG DiVISIO9■I DateReadyfy; !uric la Sec Page 2fbr 7�-- .c✓I , eliek! '' interInternet WWW.Iigard -or gov ,� Nernfred/Merhoe may^ Supple= coal /era tomb am ."•9Vtit�pteika. >• - . Yf s::7 r y , .:' : 1N ^ 'irit A� { kr'i:y r, 3:.;' O NCW construction Ain Addition/Sltcrationhcp(aeemc;nt Please check all ehnt apply (volenit a tcls ofpinnit Wittmr chocked below ❑ Service et feeder 400 imge nr more ©Builetinp over new stone,. 0 Demolition Q Other: where Ile 'vat labk fault current ❑ Mee ale =dimly-joule, c4 cbk `Qp' : 01 "Ws M 130 volts m . exceeds 70,000 n ❑ T•7oe;in8 brnldialp, Ica. to wean& or mecccda l a,tasl ❑ Cmnr.ereia4 -use aerie „lrutal 1- and2darnilydwelling CCommercial/industrial ❑ Accessory building amps for di other ientalt.tirms. but Wi ❑ Multi- family �� ❑ Maser. builder 0 Other ❑ Fire vamp. 0 installation of 75 KVA or JVBt 1s� INRt)�ll t1f011t"1ti1Q]d. i ll ❑ Emergency system, larger aemmrrcly derived system, 0 Addition motor Df new IO nd of °A" - 'R' "I -2" "I ]•• Y Job no.: lob site address: to S y w - 4-?J �1 `fr 1 t 00611` or morn. occupoeay, 0 sh Or mote residential emirs. 0 Reczentional seine!e parts, City/State /ZIP: i y k l . _(fi,, c 'fall_ ❑ lienith.... Ad titicyl. D Seam voltage fir more than r 1 ❑ Heaardoue locations. 6050 vole 'terming,. Sitte/bIdgJapt. no.: TPmjectname: 0,,n ❑ Service Of feeder OK de r nrmore. Cross seat et // /direCgons to job site: DowiMls. - qa. 1 Pc. l roil 1 • • S PO �L �p J f ��r New residential single: - or multi- family dwelling tams jJ Includes snitched garage. Subdivjsion: Lot no -: 1 1.000 sq. R. or less 168.54 ' 4 Et add'1 S00 sq. ft a minion 33.92 I ' Tax map /parcel no.: Limited energy. residential (wldlabuves R.) 67.84 2 • if !lots y Limited ri s ldeatiial with above a •.. R f �err t ,u a - � ld:�lr /o1r 67.84 2 Servleea ar feeders instal r edon al teration, and/or relocation 20Daminnrless ' 00.70 2 - Q' rftriiiiiirivtrifitont - OI - TErvAr T • . 201 amps to 400 amps 133.56 2 IMpg 40 ri 1� y 401 amps to 600 amp 200.34 - s 601 tempo to 1,000 amps 3n1.04 2 • 1/I 1 •w g. l a ) Over i 552,26 2 - At V ■ / q7 Z2g Temporary services or focdert installation. alteration. and/or Mandan Phone: ( A t AMMO FAX: ( ) 20(1 amps or IcAA 69.36 1 Otnner installation: This install at on is being made on property 1 own which is not 201 temps to 400 amp 125.504 2 tr intended for sale.1em, rent or exchange, according to ORS 447, 449. 670. and 701. 401 amps to 549 amps 168.5 2 8 Branch circuits - new altenrdo or ascension • . and Owner signature: Date.. A. Fee for branch circuits wah • :0 ppLict r • - • •• Q doerrAC ' t ar above service of feeder fee, 7.42 each ch branch circuit Btzsinecg name: ; /PT e' �•- B . brwl • - B Fee for ch circuits without '" r r/t 1 /037 novice or feeder fcc, first Contact name: Au S4 of - ta / I S Wt branch Omen 56.18 • B 2 Faeh odds branch citcait 5 7.42 :57, j 2 Address: gaol/ e 4ve 0 s pSli�� 4lIi(--- Mieccllantoaa sarvlceor feeder not iadvded) City/Sta1eIZ1P; otr /rd•t • 0 / Eachmanufacture"dormodular . / dwelling, service inviter fonder 57.84 2 Phone: (7 o `/ Z - 011(1 Fax:: ( lrG3) 2 • . 5�' Reconnect only 67.84 2 E -mail: - V W w / /e'a.E✓ , w F r e, i a Rump or irrigation circle 67.84 2 Sign or owl ine lighting 67.84 ^ 2 -: • ' : tZe3n -5;'` ': '. Signal circuit®or limited-mew . r , Business nnme: E IQ.T I-G. g L / G er p0ncl, elter ic ttiolt or extension. Pose 2 2 r� Each additional Inspection over allowable In over of the above Address: - ()• 1L9!` J � Additional inspect/on I hr min 66.251 hr 1 • City/Slate/DP: ` , e r to�G✓'E 9'7//0 Industrial (1 hr min) - 66.251 hr P fndustridplant (I hr min) 78,18/hr Phone: (5:6) S f `.e ,V 5 r.8. (CO ) 16 Inspeetians for which no tee Is l CCe Lie.: / 3 ( Apatificapylialcd % train) 402 0 /hr Electric8I Lic.: ■ 9p 41, 10 ,s; ( Id&1&R' Suprv. Electrici 17_441u, uircd j � A r Subtotal: 3 - L$ MA Plan review (25 %of permit fee): ' ' t ' 44-- Data: 4.i _.. , /c State surcharge (12% of permit fee); , /1 _ L Ca A uthorized s, � TOTAL PERMIT FEE: / 8 Ills permit a eonealtars avoteee If a pursuit is sit obtained w.mi.■ ISO Print name: Dote: day. anomie ban bass accepted n compete Number of int m:Olioo. nllowad per peon . 1 11Suldleeronnitr , E.CJamii/toodoc 1Mn1/09 440461570 6 ' d Z999 011 O1 S,I1a1- dZ9:Z0 0• Cl. .Idy Mechanical Permit Application tiMr litt9 c)Il l � c!" ! S ,! 2. A .;, ° Cl of Tigard Tigard w a Received Re I Receved [/ /� /d / Permit No 1d,. IIIII 13125 SW Hall Blvd., Tigard, t`' . s " '_,.' Plan Review I I c A li i� . Phone: 503.639.4171 Fax: 503.59§.11,960 Ready/By: Jut ® See Date/By: Other Permit: In Line: 503.639.4175 e 7 r R 1 3 2010 Dat Read Page 2 for ' g - : Internet: www.tigard- or.gov Notified/Method: Supplemental Information CITY OF TIGARD TYPi3l6 f I ^ is IVIS ION • COMMERCIAL FEE* SCHEDULE - .U,SE'CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction dition /alteration replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • • CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* . and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total • JOB SITE INFORMATION AND LOCATION • Heating/cooling Job site address: //b 57.- `/ 'U). 6 N at�� • // Air conditioning ji (requires site plan showing placement) 46.75 City /State /ZIP: 1 ,ai 'pg 97 Z ' Furnace 100,000 BTU (ducts /vents) 46.75 61-42 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: (� Heat pump , 61 Cross street/directions to job site: Duct work ki 23.32 1 I6 , 0 X11n iil /1T 1/ 4-1/1 / 1W (( J 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 Flue /vent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK . Water heater 23.32 4d 1 { 1� 1-irru/A-- ,K nal — n j q Gas fireplace 1 33.39 -1 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 ❑ • ROPERTY .OWNER: r ❑ TENANT . Other: Name: �' l ( Environmental exhaust and ventilation 23.32 U Cr ge hood/other kitchen Address: 1lb FL 1 Je t'� • equipment 1 33.39 33, ' City /State /ZIP: e rd ek 'f72z3 Clothes dryer exhaust '> 33.39 ', ...t9-41 Single -duct exhaust (bathrooms, Phone: (lj 93) - 46; Fax: ( ) toilet compartments, utility rooms) 23.32 •. ;❑ APPLICANT . . ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: �jti'i c..4“- �3 f�f C rieliCrie J Other: 23.32 S/ Fuel piping Contact name: -tpk N p`' Z� A ` r cti vp % * $14.15 for first four; $4.03 for each additional !. ]/ // / k. / Gas h pump eat etc. Address: ge t/ 17,14, � l (`TELL ■ f //Wk. //j Gas heat pu City /State /ZIP: A, / �/' Wall /suspended/unit heater • Phone: (� / 3) a�9L /640 ' , ` Fax:: ( 3 )1h L .. `1 Water heater ` Fireplace E -mail: Range 1 C TRACTOR Barbecue _ • Business name: J /' 7 ,- p a f lyyy.freuGp(f Clothes dryer (gas) P ` 4. Other Address: To j, . >�CAde is � t� ' [[[ l 666 S C` / Q ' MECHANICAL PERMIT -FEES* City /State /ZIP: 1 Q/1 d Pk. g 2 i4" Subtotal 2 Phone: ( i 3) igZ.. y - 0, Fax: ( 1 - U3 )1/1,--#.3 /9 Minimum permit fee ($90.00) 1 Plan review (25% of permit fee) 4j Q pj CCB lic.: iel 9 . r t i /i / State su (12% of permit fee) Z-7 7 I TOTAL PERMIT FEE Z5& t:›3 This permit application expires if a permit is not obtained within 180 Authorized suture: days after it has been accepted as complete. Print name: . 0 14 It 11 r l Date: a -1d * Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (11/02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: -Total Valuation: -. • 'Permit $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 $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1: \ Building \Permits\MEC - PermitApp.doc 10 /01/09 2 04/13/2010 16:02 5036849015 WESTERN PLUMBING INC PAGE 01/01 04/13/2018 11 :44 5035981960 CITY OF TIGARD PAGE 02/02 VIM to bine Permit M olie ti 1: Building Fixtures �» ` a !M ,S� �Afh riu �:�t. � a I f ' �a� r 4 � g � e r , y � �► ��+h 4rA :���u. .,•.:� li,l�l .r• Sh' k` �ak,�a"�v:"�`,i�,L���l^T�"r«�elll city 0/w nail Tigard, OR V22,3 � fa iii I rk J% `� ! , a"', Phone: 503,639,4171 Part: 503 - F ` rlp�loh Line 503,4394179 b / a emi w� Igtl MO: www tigtad-or eov Q �' JNG r ' GARIJ > xaaeyniy. " 15ed1Mghai � 4 � a s r ,,'tir N !ll 0 New COtlSQllCtilfrl - ' �'?� i'!r'��w� 7:7'7'''7-1411;47a111 ...'. ❑ Demolition PO - .. ,. w, sae theeldkd Li hldditiotrlalcafelierihcplacernenr 4 (?dicer i eta' N. 1 - 2 -farm dwell , s includes 100 & for oast mitt} canaactl r. ;: ?v w tiah =•r±hna " .t eM SFx 1 bath ( 7 IIIM 312 -70 - and 24amily dwelling 0 Commerci&Vindmatria1 9171(2) bets► 0 Aeneas:4y' building 0 Multi-ihmily 3Fll; (3) ha$a 400 32 Raeh additional tmth/kitchan 0 Matter builder 0 Other ts,02 Fire sprinkler sq. tl,) Paget . a ... _ site ertii .r Mb site address: //A . : x=rk All d Uatah basin or area drain City/SW/ZIP: , r 1 Myrna leach Jim or trench drain 18.76 MUM Suitrlbtdg./apt n0 - ' a .. E.h Footing drain (no. linear ft.' -„ ) NM )I 50. 2 : Air Manuibanund bona utilities 50 03 Cr atrar 0/b ooNBireetk7rrs to job site; MmrhoIti3 MMIN 6[p et, , a , thin Grain =moor •11.....MEMIIEFefill iir Smbttey sewer (no. linear ft: _`J IMIIIIIIII Storm sewer (no. linear R.: ,___,.,) Pagel r Water Nero= ow hamar it : ,.,,,,,J sismammi Subdivision: Lot »o Rita . Tax rozpipansel 0/o,: 084 vat � °,0r, 1111111.1111.11 ,1111150. l Clothes washer a z3.oa:7 Distrvaelter t 1 25.02 &r lrt Drinkin 25 MIEN i MB a 25 r , _ fountain Name: h a,� r} , Extra/mariv 111.1 2161 MEE i j Floor drain/floor srnk/hub 25.02 Cit /StatelLTP� �r ,r Garbage disposal t Ma 25.02 IF/1123 Mil Phone: ( #27) Fax ( ) 25.02 UMW lac mel '. ` . s -� „: �'. �r`� y'- �.,r- •�^'r,;q - r-�c.. mr �� � .>„ ,r`' I q'I� ,+arr,pr . ej '(„µ ejlAi §u {i3 1 9.. ^ t• 1 hiteree�rtori; 'age IreP �. + x. . . 25.171 MEI : , te r : ' , , , , / - Oantaac uamf: . _ m 1� to dot' /fit Address: �b`I Rea/drain(eanmgoial) ') ei v / ' f r J / .. SinldbaaaiMav City /Stara 1p: r ) / .3 r story ,.. 25.02 . 1 U Solar units (patabla wete* 111.1 62.54 1 � • b `D ,,,; ` • rob/showedshowet pen iMM ,., iY .ae'�',.AL. v =a n7 "RWYar.. 1' 'rMt+^Cr^l pMt �, ! ` i � n. Urtl10� � 23.o2 s s 7 /� r , War closet EN 25.02 0 0 1 reIiGN Btralz� tame: � �•y •� pt,, , Am, Water hcetcr 111.11M111.1.1 „, ream ' 66 .. /G+1b .51 , /a " piping/DWV 25.02 .. Gty/Stat+e/Z1P�-f Ol. 9/74.-S., . �- - ! 5nbfee.nnl MOM: (. r ) 61' Bo trarx: ) e' - - . .,. / , Minimum permit ruiit lee: 872.50 M. Phionbing Lie. no.: 3 q r Plan r0/ w (2596 await !b0/) A uthoNzod .... '�” State surcharge (12% of permit fie) le. �r:ri!I,� . IT T10'l'ALPERMJt 7v2 . i ' `'ISJIIJ /, flip 'Wj pg. .- IP Thu Permit RpOkleion� eglOireia if a pannlNr dal °Wald ' la IN dip // Apr it has hem Wagged MB cgmpleLe• ePee a tattraology ,ea by m Build t rndnghy 33rviee Raped, Mhuamnyiparoib MU • ' , ,e1C4 10/01/09 440.461d1 (1Mry/pk1 Plumbing Permit Application Building Fixtures C15V° . i t)it ( 1 icl uSl ��No'` City of Tigard , 1 Date/By: g�! / Permit No.: f ill i I � S T�� C � -C q 13125 SW Hall Blvd., Tigard, OR 9722 1' Q 3 (. Received y: l) / 3/t CI /477 g Plan Review fff / C Phone: 503.639.4171 Fax: 503.598. ARP Date/By: Other Permit No.: i. I G It l Inspection Line: 503.639.4175 O �'S1G` I `S,C� Date Ready/By: Juris: ® See Page 2 for w Internet: ww.tigard or.gov Cl� vl _,r• D,�1 Notified/Method: - j' _ Supplemental Information TYPE' OF WOg1d1L FEE* SCHEDULE ' ❑ New construction ❑ Demolition For special information use check list Description 1 Qty. 1 Ea. 1 Total ❑ 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 building SFR (3) bath 500.32 ❑ Accessory g ❑ 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: 11 (.----c),„ J C-4, Catch basin c h li drain 18.76 Drywall, leach line, or trench drain 18.76 City /State /ZIP: C filp Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: ?roject name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) 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.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 pad . VQC) 6) a L,, `1( p A rp Dishwasher 25.02 J 1 Drinking fountain 25.02 Ejectors /sump 1 25.02 as dd, ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin/lavatory 25.02 City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet 25.02 CONTRACTOR t � � � n -_ L Water heater 37.52 W Business name: S V'n) Ptt„b r�� Water piping/DWV 56.29 Address: Other: 25.02 City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 > CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (12% of permit fee) 3. 0C) Authorized signature: TOTAL PERMIT FEE 9--r, OA Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02JCOM/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 - 1' 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. Quantitxby (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 as defined in OAR918- 780 -0040. - Jacuzzi/Whirlpool 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 3 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: I:\ Building \Permits\PLMF- PermitApp.doc 2 <---------_____ ,ubV v 1 1/4'0 / arrow ; AA ;C•eti e tope 04 e7ed.. // 65-,2 J'i AA)x-)Cr RECEIVD 5,-,),,,Act • " APR 13 2.01U z e% ?7.2._..3 CITY OF TIGARD BUILDING DIVISION i H- FT?c--- - , \ r • ,,„_•_ —. — • • • .... ■ • ge m. • 7 ... ....• • ■ so • ■•• • • ■.. • ,■.......• ,.,■. • ■ • • ■•., • • .. • .■. 10 ■. •■••• • ■ • • . •••■• • • .m... • ....■ • ■• - — .-- ID %- t 4) I < io I pb f ..- • / 10 s Ix " 36 < ,- ___ r u.i cc I / 25-0 1/2" - 10-11 1/2" z llll ... . _ ____ _______ z__ ........ . ________ . _ Pro-0 1, ...› , .. ._ ________ _ , ■ ,l I n . ... ________ .. .. . ......... .. .. _ .. ..._ .....R_ ....x_ .h. .. 46 P.' I • . I 11 _____ -- _______ ------ ____ 0 I • I I • 0 I ... ....... ..... .. ... mi LU 1 0 lit -■ CITY OF TIGARD - SITE PLAN REVIE I z I ..... , b 1 1 `-' 0 0 " .... ....... , BUILDING, PERMIT NO.: NrePoit eacV 2-- 74. : :- 7-1 PLANNING DIVISION . . - fz Approved 0 Not Approved . ii-ei.g t irecl Setbacks: I )‹. .iii 111 , .. :: 71- i ....... ___, ....... __ _________ ______ ______ . ___________ .: __ _.____5de: _ . I 1.1 imp .. In =I I= =1:;1. NE NE E. ; g : V - ow „Zo i ... .. ...ao . R ear: L.,5 a At ' :..,, ! Nor .A. pp rov ed _. M ;iM .•::M: ::::::::: $""'' .i PX '''':e g''''' 44 i i n- ' / • Vistred Om mice 9 - > c I . . . . ••••• , ,• . :,:. _ .... ....,.„ ... , , ,,,:, . Ni„,,,• 2,,::,1,,, ;•,,..: , ...„.....„.. ........ ..... , ,•••., .„ • ..,•.. .:„, .. _ ••, •...--- • •• , •• -..., i :,:: , .; rws st!r, .!..-., • • . - • ,: ,i,-,-;", t r: ,.„.:,-• .,....,, A No I ,,, : ... ... ,_, , _ - -- ,.•,., . . :::,: .s p _ ,_ ,_ l.:. I E;:: ::- — , - • ....._ • 4 .4 . ,• EN:Lik EERING EPAR'FNIF.,NT: • i .,...<(• Wag Slope: % n.Approved 0 Not Approved ,,:„,. :.i Site Pia . ' - Approved 01 p roved I ; ..„ ....... _ , g .. _...::_. ... .1. By • Date: 4 19- c. . • ; Notes: ____ -- ---- --- in ___ ......... _ _. -- - - - 0 \ i 1 - z • , ri) - ' X I w ., ,:::: • : 1: '-& 3 i ' /-.. ' • : . _ : 1 '. ' ' - .? ;I -4- 9 ,' • tf-. -4 4,4. %,,,,,,--,,,, wo: 4t4. 444..04.34m i i0.4 .. 44 0 0 0 0 0 I •:-.4 /9' , , / ,/ I g-: 1 - , L.. CITY Of TIGARjC1 - , SITE P,11 ......,....—........... • BUILDINO PERMIT NO: ' . I z 5 a I ti ,:i Street Trees: E‘pproy 0 Not Approved ..0 ' ....... I 1 A Protected T%.e / la Approved ''. --q -. 7;;t 1 r Ej Not Approved Date: --,,5 ,-/c) ' .0•' ''''... • N 7 / / / I 5 , 4) . 1 SIDE f .N1' . // / ETBACK / ,C) p ___, ■.4 i <e/ . / I / I , /. I /6 / 0 co E? Li . • . I b ci) / I Z 0 . • / . / / ® Cr I U- 1 0# • . .. . • — — • -- --1... ••••• • ...... 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