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Permit
?3 o8 . 4, 34—dvf,' : G sPW a-Se , /0 /. cwt., �� g„,/,6, I' ' f G MASTER PERMIT IN 1 ir !Ty OF ,A ` ° PERMIT #: MST2008 -00090 COMMUNITY DEVELOPMENT DATE ISSUED: 6/20/2008 , 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112CC SITE ADDRESS: 15740 SW HALL BLVD ZONING: R -12 SUBDIVISION: TANIA PARK LOT: 005 JURISDICTION: 'FIG PROJECT: BUTLER Project Description: Reinforcing structural framing for floor, garage ceiling. Mechanical- heat pump. 6/23/2008 ADDED (2) services, (10) branch circuits and ALL PLUMBING. BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 3,000.00 REAR: PLUMBING SINKS: 3 WATER CLOSETS: 1 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 0 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 0 SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: 1 GARBAGE DISP: 0 WATER HEATERS: 1 WATER LINES: 90 BCKFLW PREVNTR: 2 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: 1 HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: 1 GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 2 0 - 200 amp: W /SVC OR FOR: 10 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO it STEREO: VACUUM SYSTEM: AUDIO f1 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: DATA BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable BRUCE & RITA BUTLER OWNER laws. All work will be done in accordance with approved plans. This 15740 SW HALL BLVD permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97224 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: 503_570_511 1 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Reg #: TOTAL FEES: $ 821.39 REQUIRED ITEMS AND REPORTS /1 i Air ill' Issued By : � L � �✓ Permittee Signature ir Call 503.6 ,� 5 by 7:00 a.m. for an inspection that business day. 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. MASTER PERMIT 1 . - i pii n CITY OF ® PERMIT #: MST2008 -00090 • COMMUNITY DEV OPMENT 'ATE ISSUED: 6/20/2008 Tt9Altp 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 112CC - 13000 SITE ADDRESS: 15740 SW HALL BLVD ZONING: R - SUBDIVISION: TANIA PARK LOT: 005 JURISDICTION: TIG PROJECT: BUTLER Project Description: Reinforcing structural framing for floor, garage ceiling. Mechanical- heat pump BUILDING . REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT, PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD, sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: . BATH: TOTAL: 0 sf 3,000.00 REAR: PLUMBING SINKS: 0 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 0 DISHWASHERS: 0 FLOOR DRAINS: SEWER LINES: 0 SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 0 GARBAGE DISP: 0 WATER HEATERS: 0 WATER LINES: 0 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: - BOIUCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: 1 HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: 1 GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 • 200 amp: 0 0 - 200 amp: W /SVC OR FDR: 0 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: • 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601•amps- 1000v: MINOR LABEL: 1000• amplvob : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/8PC OCC: ELECTRICAL - RESTRICTED ENERGY 1 A. SF RESIDENTIAL 8. COMMERCIAL A 0 UDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: DATA BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: Ca GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: _0 HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS: 0 This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable BRUCE & RITA BUTLER OWNER laws. All work will be done in accordance with approved plans. This 15740 SW HALL BLVD permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97224 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or direct Phone: 503_570_5111 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344. • Reg #: TOTAL FEES: $ 294.99 REQUIRED ITEMS AND REPORTS • AMP/ Issued -y : ' „�,�� Permittee Signature : . -, , Call 503.639.4175 by 7:00 a.m. for an inspection that business day. f 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. r Piiumbing Permit Application \ Site Utilities ?‘C). %1 0 FOR OFFICE USE ONLY City of Tigard � �� �' A � Q Date/By: V V � , Permit Na `� � �.,. C XLJ � lig . MIT 13125 SW Hall Blvd., Tigard, OR 97223 `U' y 0 OG� V Sp► ' Ian Review Phone: 503.639.4171 Fax: 503.598.1960 ` ` Other Permit No.: J 0�� Date/By: T I G A R D Inspection Line: 503.639.4175 CO� ` U` Q` Date Ready /By: ®See Page 2 for Internet: www.tigard- or.gov aa�` Notified/Method: lur o Supplemental Info TYPE OF WO . FEE* SCHEDULE W "New construction ❑ Demolition For special information use checklist Description I 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 249.20 I- and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350.00 // ❑ building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: t i 7 l{ 0 5 tt (1 ?A 4 6i Catch basin or area drain 16.60 �4- City /State /ZIP: 11 0 , 1 ( '( q `l 1) - Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: _) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: _) Page 2 • Subdivision: Lot no.: Water service (no. linear ft.: qO) / Page 2 S5 ,. Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 5 j r ( ) (/� / j �{ c , Ci)- / S7 ) i y / ini // -c4 J 'd Backwater valve 16.60 Clothes washer I 16.60 j („Q 4p4 Dishwasher ( 16.60 ( P , (C, . T PROPERTY OWNER 1 ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: 12 r�t A, k) Expansion tank 16.60 Address: \ '1 4 0 St,-1 %ka (i Fixture /sewer cap 16.60 City /State /ZIP: "r l 6 P-- 4 1 )-)A Floor drain/floor sink/hub 16.60 j Garbage disposal 16.60 Phone: (q'i t) S �Q s l l Fax: ( ) Hose bib 16.60 ll ❑ APPLICANT ❑ CONTACT PERSON Ice maker 16.60 Business name: S a. t Q J (')\O L.i`_ Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) 1 Fax: : ( ) Sink/basin/lavatory `� 16.60 , Tub /shower /shower pan ` 16.60 j�, 6v E -mail: Urinal 16.60 6 CONTRACTOR Water closet / 16.60 46,6 0 Business name: 4(i j,r-- Water heater / 16.60 (6 . V Address: Other: City /State /ZIP: Subtotal ay), 7 0 Minimum permit fee: $72.50 1 Phone: ( ) ( F'd5E ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: ,' lumbi�_/ ic. n Plan review (25% of permit fee) State surcharge (12% of permit fee) . dct a 1 S Authorized signature: TOTAL PERMIT FEE d17)...... d17)...... 0 ,� (...4 Print name: 13ty 1 1, ,- k,"-- ' Date: 6 / 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 12/27/06 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard t . Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - Is` 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Commercial Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918 -780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. - 3" - 4" Car Wash Drain Garbage -Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: I :\ Building \Petmits\PLMU - PermitApp.doc 2 a` , 1 14 V l,9 C C r XXX) f U ` o ' . : 1Site Utilities — Plumbing Permit Application ,;_; Plan Submittal Requirements ''T1GAR A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. 1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn to scale) labeled with: A. ❑ map & tax lot # ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads with project location. 2. PLUMBING PLANS - Two (2) complete sets, civil only. All details listed below shall be incorporated into the plumbing plans: A. Storm drainage plan showing: 1) Finish elevations throughout the developed site. 2) Grade breaks determining area serving each catch basin. 3) Location of catch basins. 4) Pipe size. 5) Type of material. 6) Slope of piping. 7) Manholes and field drains. 8) Cleanouts provided for each 100 feet or fraction thereof. 9) Roof drain laterals specifying cleanouts at each upper terminal. 10) Location of existing or proposed connection to a public sewer line. B. Utilities plan showing: 1) Sanitary sewer line location, pipe size, type of material, slope of piping, manholes and cleanouts provided as required for storm. 2) Size and location of domestic water piping and drainage. 3) Proposed location of connection to a public water or sanitary sewer line. 1:\ Building \Permits \PLMF - PermitApp.doc 12/30/05 / ?&k �f G � C�� �r/U 1 "5 vL ��J ill C 1 T O F TIGARD MASTER PERMIT PERMIT #: MST2008 -00090 °' COMMUNITY DEVELOPMENT . DATE ISSUED: 6/20/2008 :TIGARD', 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112CC -13000 SITE ADDRESS: 15740 SW HALL BLVD ZONING: R -12 SUBDIVISION: TANIA PARK LOT: 005 JURISDICTION: TIG PROJECT: BUTLER Project Description: Reinforcing structural framing for floor, garage ceiling. Mechanical- heat pump. 6/23/2008 ADDED (2) services and (10) branch circuits. BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 3,000.00 REAR: PLUMBING SINKS: 0 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 0 DISHWASHERS: 0 FLOOR DRAINS: SEWER LINES: 0 SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: 0 GARBAGE DISP: 0 WATER HEATERS: 0 WATER LINES: 0 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: 1 HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: 1 GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 2 0 - 200 amp: W /SVC OR FDR: 10 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601•amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: DATA BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable BRUCE & RITA BUTLER OWNER laws. All work will be done in accordance with approved plans. This 15740 SW HALL BLVD permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97224 if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct Phone: 503_570_5111 Contact #: questions to OUNC by calling 503.246.6699 or 1.800,332.2344. Reg #: TOTAL FEES: $ 549.34 REQUIRED ITEMS AND REPORTS / ft Issued B L `7 _ /ll �� Permittee Signature : `a Call ' 5 by 7:00 a.m. for an inspection that business day. ' 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. Electrical Permit Application . , " F oR'oFFICE;;us E ONLY: j ' E e a Anil , � 9Y , City of Tigard Deceived rmit No.: 1111 ,. i • 13125 SW Hall Blvd., Tigard, OR 97223 OQ$ Plan Review t Phone: 503.639.4171 Fax: 503.598.1960 6� 3 Z Other Permit: �� Date/B I GAR R D Inspection Line: 503.639 A '1, Date Ready /By: 1 El See Page 2 for 1 , '.dotal Internet: www.tigard- or.gov ov '11G 1 ,k01,1t ified/Method: 0 Supplemental Information CI TYPE OF WORK_� S , PLAN REVIEW New construction ddition /alteration /repl r e ' acement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. a CATEGORY OF CONSTRUCTION - ' "" exceeds 10,000 amps at 150 volts o r Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural '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 load of ❑ "A" "E" "1 -2" "I -3" Job no.: Job site address: 100HP or more. occupancy. ❑ 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: ❑ Service or feeder 600 amps or more. .. • ' . FEE' SCHEDULE ,. .. . Cross street/directions to job site: Description 1 Qty. l ee. l Total j • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: ' Limited energy, residential . • WORK . DESCRIPTION OF W OK - (with above sq. ft.) 75.00 2 Limited energy, multi- family add ) .rr/ yvy ikery)/1.' �Si avve ( 0 9c) residential (with above sq. ft.) 75.00 2 / Services or feeders installation, alteration, and/or r locatlno 200 amps or less 2 80.30 0-Cob 2 : ❑ PRO PERTY; OWNER - . . 0 TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 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, r � each branch circuit 6.65 co,G �2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR . • : . ,; Sign o r outline lighting 53.40 2 Business name: Signal circuit(s) or limited - energy panel, alteration, or Address: extension. Describe: Page 2 2 City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ELECTRICAL PERMIT, FEES -_ -- . Suprv. Electrician signature, required: Subtotal: ? -�-7. ` () Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): �� Authorized signature: TOTAL PERMIT FEE: a_ This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 46t5T(tl/05 /COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information d - LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK;ONLY::. " , .! Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: `: COMMERCIAL WORK ONLY: v - , Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ 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 03/23/06 Building Permit Application , Residential FOR OFFICE USE ONLY City of Tigard Received Permit N ° 13125 SW Hall Blvd., Tigard, OR 97 243rkett:CCIS? Plan : _ i 'j erm No.: `/ �' d g Plan Review Phone: 503.639.4171 Fax: 503. qS�0 Date/B : T , ,Vii: w U e, Other Permit: T I G A R D Inspection Line: 503.639.4175 *.\ .k Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard- or.gov \ \\v ,�,�s` ` yi ' Notified/Method• G Supplemental Information _ . -. Y C ` Awl S - . WRR,� TYPE 'OF O \ , . .. a " ' REQUIRED D AND 2- FAMILY,DWELI.,{ ING ' ' ❑ New construction ❑ De tlno " it o Permit fees* are based on the value of the work performed. W-)' Indicate the value (rounded to the'nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the °i, '' ';:'' "',CATEGORY OF CONSTRUCTION..: e ' work indicated on this application. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 3 WO 111 Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: Total number of floors: ; .'. JO B" SITE ^11VFORMATION,ANDy Job site address: 1 7 4 n / i 8.e- New dwelling area: square feet City /State /ZIP: J ! 5 7 _ , (.4 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: ' `mod Covered porch area: square feet Cross street/directions to job site: 64.. //!! � Deck area: square feet / /j „r�' Other structure area: square feet ._ 'REQUIRED' DATA: COMMERCIALIUSECHECKLIST'• Subdivision: 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 equipment, materials, labor, overhead, and the profit for the - ' DESCRIPTION OF WORK, . ', , - . work indicated on this application. L Q p om- l n + . 1, Valuation: $ �w I p v sa ( r� -e-� 0461A-4.10i � t 'I -1 hO4 Existing building area: square feet New building area: square feet ROPERTY: ` ❑,TENANT Number of stories: Name: & - -fiAAZ� ``-" 04- Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: (7)3 S 7 L) -- 57 j ( Fax: ( ) New: ❑ °APPLICANT • '' ❑ CO T:` NTAC PERSON _ _ .NOTICE • .. • . Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: . CONTRACTOR' ";,„, : :,.. t. _ = . Business name: (5—r_A--)71 1ti , ^'_ =-, . . ` BUILDING PERMIT FEES *•.:' Address: . (Please r'efe fee 'schedule) - ... s Structural plan review fee (or deposit): ol 7 City /State /ZIP: FLS plan review fee (if applicable): Phone: ( ) Fax:( ) CCB lic.: Total fees due upon application: If 7• Gb Amount received: L 7- Authorized signature: This permit application expires if a permit is not obtained L within 180 days after it has been accepted as complete. S� Print name /� ffi Dater 0 ' .ZO * Fee methodology set by Tri- County Building Industry Service Board. 1: \Building \Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02/COM /WEB) Building Permit Application Checklist One- and Two-Family Dwelling . - FOR 'OFFICE USE ONLY ihi City of Tigard Received Permit No.. Date/By e 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: . Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical TIGARD Internet: www.tigard- or.gov ❑ Other THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN 'REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ El 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ El basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 1 1 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ . there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, El ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ U. El Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full - size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. • 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ El ❑ architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS . 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ El 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type-and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be. drawn to scale and accompanied by the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (oyer non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. . 1:\ Building \Permits\BUP- RES- PemtitApp.doc 03/21/06 440.4613T(11/02/COM /WEB) . 7. Meehankal Permit Application u ,'� r FOR OFFICE USE ONLY R ece i v ed A-15 race ~ cf-6-6 - 6 City of Ti and r '1` Permit No.' `J g 1j a r Date/By: j it, 1 • !7/• s, � _:7:. ......L- . - q 13125 SW Hall Blvd., Tigard, OR 97223 , p Plan Revi r Phone: 503.639.4171 Fax: 503.598.1960 J USN 0 D ther Permit: Inspection Line: 503.639.4175 Date/By: T G AR D p ��} Date Ready/By: Juris ® See Page 2 for Internet: www.tigard- or.gov 7 Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE. -. USE CHECKLIST ❑ New construction - Addition /alteratiorplacement 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. CAT EGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT SYSTEMS FEES* , 1- 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: Is-114o S(„3 \ k4 . '3 k oa Air p r conditioning or ea t pump /4,1,00 ( quires site plan show ``ffu K p la m p ement 14.00 City /State /ZIP: 'y ( 0. rc k 07� c o )j L Furnace 100,000 BTU (ducts /vents) 14.00 Suite/bldg. /apt. no.: Project name: i ` (., � Furnace 100,000+ BTU (ducts /vents) - 17.90 c Gas heat pump 14.00 _ Cross street/directions to job site: Si k_kk li •%kvJ c t- - Duct work Y) JetiK ( ) 10.00 6 ii Hydronic hot water system 14.00 SU..) ' Room 1 �- S t Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: _ % �a r y...._ Lot for any of above 6.80 Lot no.: - Other: 10.00 Tax map /parcel no.: al i1 xC- - i 300 c Lolon0 Other fuel appliances . DESCRIPTION OF WORK Water heater i 10.00 / 0.0 U 1 ,1 . Gas fireplace 10.00 e.:'t . N. r ckikalc r '1k-et tk 4._ WCA u \k-tt.0- f to v\4 Flue vent for water heater or gas ■ a #- ilA (M ? 4 L1Ll' N f�-x \ r Motu Log 10.00 t7 � g lighter (gas) 10.00 0 \ S. T ‘,,c-Ved.,k-\B IU I Sc4A L ) \ e Wood/pellet stove _ 10.00 Wood fireplace /insert 10.00 a PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: 11 A Environmental exhaust and ventilation ange ho ther kitchen Address: i S I 0 S (,� A a t, 3` v ci 10.00 City /State /ZIP: "t- \ o, r 0 ( CO ) 1,k-k Clothes dryer exhaust 10.00 r_ Single -duct exhaust athrooms Phone: ( ) q`l Si 0 S- (t Fax: ( ) toilet compartments, u rooms) , 6.80 ❑ APPLICANT . ❑ CONTACT PERSON' Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /Z1P: Wall /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Business name: Clothes dryer (gas) Other: Address: . :MECHANICAL PERMIT FEES* r,_ _ __' __ City /State /ZIP: Subtotal 3.Z .5 Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: State surcharge (12% of permit fee) S. .4 0 , TOTAL PERMIT FEE { Authorized si_ ature: This permit application expires if a permit is not obtained within 180 lr/' / / days after it has been accepted as complete. Print name:, ` , ., - t /Al Date: Date: l ! D /7. 0 * Fee methodology set by Tri -County Building Industry Service Board v P\Building\Permits\MEC- PermitApp doe 01/19/07 40 -4617T (11 /02 /COM /WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $.1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC- PermitApp.doc 01/19/07 2 / 1 - 1 5 T CV 8'- C 9 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Date/B , /El : 4 ' a d i Pennit No ,�... �A 1 q Il l M 13125 SW Hall Blvd., Tigard, OR 97223 Plan Ru ''ew ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: Inspection Line: 503.639.4175 Date Ready/By: Juris. la See Page 2 for T I G A R D N otified/Method: Supplemental www.tigard- or.gov PP lemental Information TYPE OF WORK." PLAN REVIEW eplacem Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction E Addition /alteration/ ❑ 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 • &f 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 load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", S n 5W � Six or or o more more. Recreational Job no.: Job site address: IS" �, „ ` v � ❑ Six or more residential units. ❑Rr vehicle parks. City/State /ZIP: -1- k crew A 0 Z I aa y 7 3 3 ❑ Health -care facilities. ❑ Supply voltage for more than r -` ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: II Project name: � kirk,- (.-k X ❑ Service or feeder 600 amps or more. FEE SCHEDULE • ' Cross street /directions to job site: L 4 It . � k v co 5 W wq yy( 1 1 - Description I Qty. I Fee. I Total New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: `S' q A+ % �a* Lot no.: 1,000 sq. ft. or less 145.1 4 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: 1 rJ tk( - 1 '3OCf6 C (. ei I 0 Q Limited energy, residential . ' D ESCRIPTION OF WORK - (with above sq. ft.) 75.00 2 Limited energy, multi - family R �.�d e e . \ c t. t- ■ 04-r" M (k A ?Gxi._ S &rV & Ct residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation 1 l.) 4�� k pk C„. tom{, " �'MA lAizt 1_0.r`t mjt... - 200 amps or less 80.30 /4640 2 ❑ PROPERTY OWNER I ❑ TENANT • 201 amps to 400 amps 106.85 2 Name: Bc.kL� `3 tA �.k,yr- 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: ; c 4 w W ` "B\ v 01 Over 1,000 amps or volts 454.65 2 City/State /ZIP: '1...- Q A rct 0 --k v i a's _ `1 "' Temporary services or feeders installation, alteration, and/or I relocation Phone: (411 i ) 0 s t k k Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, le. se, rent, or ch ;n.,..; ,according to ORS 447, 449, 670, o 1 ` O0(� and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel .�, Owner signature: ,1 ` ,r j i. � Date: I A. Fee for branch circuits with ' ❑ .APPLICANT` , ❑ .CONTACT' PERSON — above service or feeder fee, i each, branch,circuita).- 3 ` 6.65 �(� 35 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR • , , Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited - �A energy panel, alteration, or extension,.Describe: Page 2 ,is t o 2 Address: i a' %IMO City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 ' .' ELECTRICAL, TRICAL, PERMIT FEES : Suprv. Electrician signature, required: Subtotal: 3 (pI, qrj' Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): q 3 , `f 3 Authorized signature: TOTAL PERMIT FEE: 105 , 3 0 // A> This permit application expires if a permit is not obtained within 180 Print name: St&e2t7 Date %� r G Qmrr days after it has been accepted as complete. ""�( /�` " * Number of inspections allowed per permit. C\Building \Permits \ELC- PermitApp.doc 05/23/06 440- 4615T(1I/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: FUSIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* 11 Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* E Other: IA 4-cc CGS p- k COMMERCIAL WORK ONLY. Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ,- • ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations UBuildingPermits\ELC- PermitApp doc 03/23/06 1 luwJing Permit Application , - v t Building Fixtures ,,, .. ;N ,N - FOR OFFICE USE ONLY City of Tigard Date/By: Received • (y/�(0/1:21 og PennPermit N I q 13125 SW Hall Blvd., Tigard, OR 97223 II Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit No.: Inspection Line: 503.639.4175 Date Read /B Ju ris ®See Page 2 for Internet: www.ti T.IGARD and -or. ov Ready /By: g g g Nohfied/Method: Supplemental Information TYPE OF WORK , -- FEE* SCHEDULE - . ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea I Total .Addition/alteration/r of cement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) • , CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 lig 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 1:1 Accessory building ID Multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: j 57 110 Sup c k v \ \I 4 Catch basin or area drain ��qq 16.60 % , -n City /State /ZIP: • I ch c r t� 0Q_ 4 ), t,' _ Drywell, leach line, or trench�drain 16.60 Suite/bldg. /apt. no.: Project name: 81li -&r c,,,.\ X Footing drain (no. linear ft.. ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: tt `i S� lA Q �` \ vet a� Stx) Manholes 16.60 Tiq \Arl ` - 5 - Rain drain connector 7I " 16.60 Sanitary sewer (no. linear ft.: _ ) Page 2 Storm sewer (no. linear ft.: _) Page 2 Subdivision: 1-4 $A k % ? A r Lot no.: 5` 'Water service (no. linear ft.: '73 ) Page 2 St 60 Fixture or item Tax map/parcel no.: , `i \ \1, ,.t3OOU f CO(OOd Absorption valve 16.60 DESCRIPTION OF WORK IP 'a Backflow preventer I Page 2 3( 5 4 '1 e_ k k Lt_ wa \,,,, w, ..N )r-{ v, r 1 4 Jek \ Vt6 , i?-e- y t ,i. Backwater valve 16.60 Q 1, r k ''J _ \4u' � StkPpIv Clothes washer I 1 16.60 /( 16.60 l 4,. (� W R to 1 � �( - Dishwasher 1 0 4 - Vtkv(A17..t-ci l 1wwtb∎h vAm r- CteSSt % t, )4 i s"?r V�1tr PROPERTY OWNE I ❑ TENANT MCA- 1 rA Drinking fountain 16.60 Ejectors /sump 16.60 Name: '� r�_,L, 4.,i \- k. A I- Expansion tank 16.60 Address: \ -7 to W )ko 't,\ s d Fixture /sewer cap 16.60 City /State /ZIP: T ` Cl, ctr f4 0 & G '1 XI 'A Floor drain/floor sink/hub 16.60 ° Garbage disposal 1 16.60 (( (d) Phone: (tok ) -7 O F ( ) t t l Hose bib 16.60 3 od ❑ APPLICANT, ❑ CONTACT PERSON Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) r 16.60 Phone: ( ) Fax: : ( ) in asin/lavatory \��G a 16.60 >�q, ' o Tub /showe?hower pan i 16.60 j ( ( E -mail: Urinal 16.60 . ' ' . CONT RACTOR Water closet 16.60 Business name: Water heater ` 16 60 / (p, ( Address: Other: City/State /ZIP: Subtotal Minimum permit fee: $72.50 - Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 a - ] 3.73 Plan review (25% of permit fee) CCB Lic.: Plumbing Lic. no.: State surcharge (12% of permit fee) 3, , s ' Authorized si ature: 306,60 TOTAL PERMIT FEE Print name: »� / Date: r0 '� ( � This permit application expires if a permit is not obtained within f L(J� G b 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 46I6T(I0/02 /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 - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 1 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 ,.,50 Water Service - 1st 100' 55.00 Medical Gas Systems: - Water Service - each additional 100' 46.40 . Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each ,Fixture or Item Qty. Fee;(ea) Total additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. 1 - Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72 50 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. 0 Fixture Work: 'Rk° c< r ° � Plan_ Review for Plumbing Installati . Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added .Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower I ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. - Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. -3" -4" Car Wash Drain Garbage - Domestic 1 Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains I Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang - -Stall Sink - Bar /Lavatory I . I - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service • 3 fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes I Water Extractor Water Closet - Toilet Urinal Other Fixtures: i• \Building\Permits\PLM- PermiiApp doc 12/27/06 /^ �� SL `sL - - - - 1 ' ' 01 01M P. - - • - 410nroilcrt -- ;W71∎. 3 c7 0Slv. f� AAA olbv 14Vikvjvi _WCra-14k4;, )" � trg Et t! o1. !I\ C) 1 —,� E t3 ki - T.E - 1 (Nol _n.y) ,1i 14oloc\ yb S1� -\ \ + O - alb \ �� —av al v1-4 Avt is 1bq -�, ! v Q 1)p - - (7-1.\10 '.alb Mj SS- �� - a VIC), I): - -i't'L ai - S''1 i - -- WNW 1 * A1�P0' ou bJ �aM 1 8A Wt V OC 57�� 'C - ; 1 Sad -javl I oveZell 1oz1 oaf\ Q \ r1)orn e - _I - - 0S'0�Z. ! -} JS •- �rov,'l O ;1 -O �_A4 t , (51 if V���7c 71 ° e 1, 09 1 I 11 1 v 1 O W - 014 / 1 k • 1 wt R evX 0 :‘,/okaj As _Vti %_v1p), ■ r-p _ LC' 51_14.-■sh t1/4‘4's 41.x.. _ Vit.k\. Vsbckte— \ SP(''+ AK■4 S Wckc -0 *A V\J r A 6 AkeCt \z■ 0A k V q _ Ott ciArt_0(.. Vol the_ r iLtclktvicik rol - 4%.S - - 4-I• - - _ _ Information Notice to Property Owners About Construction Responsibilities Statement Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. [ORS 701.055 (4)] This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box and complete the following statement: I own, reside in, or will reside in the completed structure and my general contractor i s : Name CCB# Expiration Date I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or r i I will be performing work on property I own, a residence that I reside in or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a 7‘ contractor who is licensed with the CCB and will immediately notify the office i ssuing this building permit of the name of the contractor. I have read and understand the Information Notice to PropertyOwners about Construction Responsibilities contained on these two pages and I hereby certify tha' ' e information checked and completed above is correct and accurate. j 0 Print name of permit applicant igna ure f pe 4 it applic to zoo Date Permit #: / i7 Q' " (5 96 This form is supplied to building ; permit offices by the Oregon S. ,� Address: !S /5 e ICJUd1 Construction Contractors Board,46r.�' as required by ORS 701.055 (6) �' 7'^ oe Pd-tf Issued by: .1. Date: a(/at This copy to issuing permit office ,. .. . CITY OF TIGARD BUILDING DIVISION A VI) ,,__ -, PERMIT #: MST )3-00 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: &70/7000 ."‘ Phone: (503) 639-4171 .., 4 , 11;12 , c C Inspection Requests (24 Hrs.): (503) 639-4175 a______-- INSPECTION WORKSHEET FOR DATE: 103/2009 TIME: 7 PAGE: 20 SITE ADDRESS: 16740 SW HALL BLVD CLASS OF WORK: SUBDIVISION: TANIA PARK . LOT #: 005 TYPE OF USE: PROJECT NAME: Eit,IFLER DESCRIPTION: Reinforcing structural framing fur flooi, garage:: ceiling. Mechanical- heat pump. 6123/2000 ADDED (2) SOMCOS, (10) branch circuits and ALL PLUMBING. OWNER: BUTLER, BRUCE & RITA PHONE #: 971- 570-51 ti CONTRACTOR: OWNER PHONE #: ,,,."- ii Inspection Request Scheduled For: Date: 1/23/2009 er Pour Time: - Code # Inspection Description Confirm # Contact # Met Plumbing unclerclob 0799.401 971-670-5111 ¥ 0 (1151;c)21clit-' ( 56 •--) / e,le— Corrections/Comments/Instructions: • / - I 0..‘ 1 71> ' 11\ 1 4 5 1-7,A •Nlwt .LszZ \A)-1.c---r LQpr (-k . .. ,:// --7 i I/1 , &--)' ,X PARTIAL APPROVAL Ai CANCEL lj] NO ACCESS El FAIL D CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED VAVC__- Inspector: Date: I/ / a 1 Phone #: (503) 718-2)11V CITY OF TIGARD BUILDING DIVISION PERMIT #: M S T2008-00030 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: fd20/2000 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ' jilt INSPECTION WORKSHEET FOR DATE: - 1/3 1 /2008 TIME: 7:OOAM PAGE: 47 SITE ADDRESS: 15740 SW HALL BLVD CLASS OF WORK: SUBDIVISION: TRIVIA PARK LOT #: OW) TYPE OF USE: PROJECT NAME: BUTLER DESCRIPTION: Reinforcing structural framing for floor, garage ceiling. Mechanical- heat pump. 6/23/2008 ADDED (2) services, (10) branch circuits and ALL PLUMBING. OWNER: RIFLER, BRUCE & RITA PHONE #: 971 -670 -5111 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/31/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 073492 -01 971-570-5111 N Corrections /Comments/ Instructions: F ■'0 ■/( ? A.) O✓"J w A- 0 s' ,Q -1--.. t l..w( a— (0 ,,,,-c, . `t k PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CriSk'vnn.JSl"1 Date: —42 1 f is ict' Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION _. PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 MST200B-00090 A DATE ISSUED: 6120/2008 Phone: (503) 639-4171 dil Inspection Requests (24 Hrs.): (503) 639-4175 ...,--41. , 11.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 7/2812008 7:03AM 1 SITE ADDRESS: CLASS OF WORK: 15740 SW HALL BLVD SUBDIVISION: LOT #: TYPE OF USE: TANIA PARK 0O PROJECT NAME: BUTLER DESCRIPTION: Reinforcing structural framing for floor, garage ceiling. Mechanical- heat pump. 6/23/2008 ADDED (2) service, (10) branch circuits and ALL PLUIVIBING, OWNER: BUTLER, BRUCE & RITA PHONE #: 971-570-Mil CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/20/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 073312-01 971-570-5111 N Corrections /Comments / Instructions: ,1 " AEC Rao Li 0 v:- V.) ) i I (3_e_ TJ_Jev4.--., 1 k-r--.4. Fvo k--- eirbi-fro F Sin-44.4, R ask --• 0 Cc" a--'; a— sC.\—\--,,,—, - ro 14 9 t e c‘e I 4 1 " - A 4 4.., P t .T0_216,,W_k_4 . ( 4Z3 V \M- g -4-13 v ,-- Oval 1-# , A 1 \ bl e- ( laro 4.-)r arc 1 , le ■; fi R a...3 . 0 fo..jvir Init, 0 1-1 44 P LAA-..., Pe,,,,Afr, e al , ‘40,„„..,. 0 T 1 -d Pe tiv.! 1 7/ .2---io TO 0 PASS % PARTIAL APPROVAL 1 I CANCEL ri NO ACCESS fl FAIL 11] CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: (31 \-_._'Y' \\---- Date: 7 )2- Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: M �2"°°7= o0 0 cr° 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: W :zz t-„sr Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 F'I_.. C. /20 INSPECTION WORKSHEET FOR DATE: 7 / 2Si O7", TIME: PAGE: SITE ADDRESS: 1 5 7 0SW 1 t Et vA ' CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: aft^ LC 8 PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: _00 n pi _ • - �" e b , Cep vi P k, & 1j c_ M-aci_ "7)2c)o7 Re7...t., (N ■.^.. cc L., a (3,(__ ric-d critlr-A \•• ' (A Sal P i‘P b oL.' P re Pe./ C 3, 4.'7 0PSG �G�► ��l��! -� ch,r) B� 6 Th 4. 54,1 F ov-. t S - l o c ( LT4-J p v a ■h e - J P■ CI u► Pe/ Se ,13-too r! o3. H. 11 ESL atz."1 ' 0,., he, NaU Po-h k 11,67r IMF E U trt � a v fi v k o✓ P,Arptxto l•,c t t Pa r c dl -+ /1/4/4 p'a k w CAS . p - - t ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: CT?) 6111,.11 V1- (`T....... Date: 7/2'/ 671 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: M, 20 0 4 —a)c) 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: (,! 2 Phone: (503) 639 -4171 1 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: / /Z p 0 • • TIME: PAGE: SITE ADDRESS: /57 LOS.J 14 i g I v1. CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: e��t� Qc�'r1�✓: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 33 0 Corrections /Comments /Instructions: D o,a, k ( L c ta. � v e � .11 (,.� �. � -cam ,�' ✓� f' cc &- ,i r -1 5 Pro AL Co r j "re, 1 [4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /l )0 n4'. Phone #: (503) 718- CITY OF TIGARD BUILDING B ® d V T g ar O d OR 97223 � DATEESSUED: s � 'Clet541 0 Phone: (503) 639 -4171 f �' p Inspection Requests (24 Hrs.): (503) 639 -4175 " -- INSPECTION WORKSHEET FOR DATE: 1.7,'$. PTO TIME: PAGE: SITE ADDRESS: , 5' ) 1 D vial-Li CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: yiittSCAEI, PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: `). Z %• Ott Pour Time: Code # Inspection Description Confirm # Contact # Message IOS V00C q�1 ®VP� - rl I`15.10'5 Corrections /Comments/ Instructions: • PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1 1 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: / - NCES1_2 Date: 7 3 Z Cl Phone #: (503) 718 - Ad\-.. _ ES ESR -1766 ES REPORTTM Issued January 1, 2007 This report is subject to re- examination in one year. ICC Evaluation Service, Inc. Bin on I Office • 5360 Women Mill Road, Whither, California 90601 • (562) 699 -0543 Regional Office • 900 Montclair Road, Suite A Birmingham, Alabama 35213 • (205) 599 -9800 W W W . i cc -e s. orq Regional Office • 4051 West Flossmoor Road, Country Club Hills, Illinois 60478 • (708) 799 -2305 DIVISION: 05- METALS Tiger Brand columns are available with an H Plate or a Section: 05500 -Metal Fabrications Standard Plate welded at the top of the column. The H plate is a 0.20 - inch -thick (5.1 mm) ASTM A 1011 CS Type B steel REPORT HOLDER: plate which allows for a connection between the column and a wood or steel beam (see Figure 1). THE TIGER BRAND JACK POST COMPANY The Standard Plate is a rectangular 0.20- inch -thick or' / 10721 SOUTH WATER STREET inch - thick (5.1 mm or 6.4 mm) ASTM A 1011 CS Type B steel MEADVILLE, PENNSYLVANIA 16335 plate. See Figure 1 for dimensions. (814) 333 -4302 The adjustment mechanism for the adjustable columns is as www.tiqerbrandiackpost.com • follows: a 3 / -thick (19.1 mm) or a 1- inch -thick (25.4 mm) jmccue(a.tapcocompanies.com (for the 3540A Series) " "shoulder" nut; a 1' / (32 mm) O.D. or a 1 (38 mm) O.D. (for the 3540A Series) screw EVALUATION SUBJECT: to provide the adjustment; a 75 / inch- diameter -by -7- inch -long (11.9 mm by 191 mm) "handle" to adjust the screw; and a TIGER BRAND FIXED AND ADJUSTABLE COLUMNS 0.20 - inch -thick or' / -thick (5.1 mm or 6.4 mm) "swivel" plate attached to the screw in a fashion that allows the plate 1.0 EVALUATION SCOPE to rotate. Compliance with the following codes: 3.2 Fixed Columns: • 2006 International Building Code (IBC) Fixed columns (Series 3F, 35F, 3540F and 4F) are the same as the adjustable columns, except they are produced with a • 2006 International Residential Code (IRC) 0.20- inch -thick (5.1 mm) or' / -thick (6.4 mm) ASTM A Property evaluated: 1011 CS Type B steel plate welded to each end, or with one plate welded to one end and the other plate attached by Structural straps (to be welded to the column after sizing in the field; see Section 4.3). 2.0 USES The 3F, 35F and 4F Series have lengths ranging from 6 feet Tiger Brand Fixed and Adjustable Columns are steel 0 inches to 12 feet 3 inches (1.8 m to 3.7 m). The Heavy Wall prefabricated columns for use as structural members to 3540F Series has lengths ranging from 6 feet 3 inches to 12 transfer axial compressive loads from steel or wood beams to feet 1 inch (1.6 m to 3.6 m). concrete foundations. 4.0 INSTALLATION 3.0 DESCRIPTION 4.1 Design: 3.1 Adjustable Columns: The allowable concentric axial compressive loads for All Tiger Brand Adjustable Columns are constructed of ASTM adjustable and fixed columns are noted in Tables 1 and 2, A 500, Class A, carbon steel tubing with a design base -metal respectively, for allowable strength design. The axial design thickness of 0.114 inch (2.9 mm) or 0.198 inch (5.0 mm) compressive load applied to the adjustable or fixed columns (heavy wall), a minimum yield strength of 33 ksi (227 MPa) must be less than the allowable loads specified in this report. and a minimum ultimate tensile strength of 45 ksi (306 MPa). The capacity of the end plates must be calculated in The 0.114- inch -thick (2.9 mm) columns are available in three accordance with applicable code requirements for the steel, series (3A, 35A and 4A). The 0.198 inch - thick (5.0 mm) concrete or wood to determine whether the supplied end plate columns are available in one series (3540A). The 3A Series thickness is adequate for the applied load interface (wood uses 3 -inch (77 mm) outside diameter (O.D.) steel tubing. beams, steel beams or concrete). The 35A and 3540A Series use 3 (89 mm) O.D. steel 4.2 Installation: tubing. The 4A Series uses 4 -inch (102 mm) O.D. steel tubing. The 3A and 35A Series have lengths ranging from 6 Installation of the Tiger Brand Adjustable and Fixed Columns feet to 10 feet 4 inches (1.8 m to 3.1 m). The 4A Series has described in this report must comply with this report and the lengths ranging from 6 feet to 12 feet 7 inches (1.8 m to 3.8 manufacturer's published installation instructions. The m). The Heavy Wall Series (3540A Series) has lengths manufacturer's published installation instructions and ranging from 6 feet 1 inch to 12 feet 1 inch (1.8 m to 3.6 m). engineering drawings must be available at the jobsite at all Tiger Brand Adjustable Columns adjust up to 4 inches (102 times during installation. When the manufacturer's published mm) in height for the 3A, 35A and 4A Series, and 3 inches installation instructions differ from this report, this report (76 mm) in height for the 3540 Series (see load tables). governs. *Revised March 2007 REPORTS are not to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject of the report or a recommendation for its use. There is no warranty by ICC Evaluation Service, Inc., express or implied, as to any ;ANSI finding or other matter in this report, or as to any product covered by the report. ANSI um .a..mu+emme MOW aennoaia Copyright © 2007 Page 1 of 5 • Page 2 of 5 ESR -1766 Adjustable and fixed columns must be installed vertically 5.2 Where required by the code official or this report, with the bottom supported by a foundation capable of engineering calculations and construction documents supporting the imposed Toads. Adjustable columns must be consistent with this report must be submitted for adjusted to the desired length. The adjustable columns are approval. The documents must contain details of the installed with the adjustment screw at the base. After attachment to the structure consistent with the installation, the adjustment assembly must be encased in requirements of this report. The documents must be concrete to prevent movement after installation. Fixed prepared by a registered design professional where columns are sized by cutting the unplated end of the post. required by the statutes of the jurisdiction in which the The cut end of the post must be smooth and level in order to project is to be constructed. fit flush with the end plate. 5.3 Loading on adjustable and fixed columns must be 4.3 Special Inspection: limited to the maximum concentric axial compressive Field- welding of end plate to post requires special inspection loads indicated in Tables 1 and 2. Other loading in accordance with IBC Section 1704.3 and Table 1704.3. conditions, such as (but not limited to) eccentric loads, The weld material used must be E70)0( or E60)0:, with the tensile axial loads, bending loads, and lateral loads, are welds conforming with the procedures given in AWS D1.1 or beyond the scope of this report. AWS 01.3. Special inspection in accordance with Section 5.4 Connections of the post to the foundation and the 1704 of the IBC must be provided for field- welding under the supported construction are outside the scope of this IRC. The code official must receive a report, from an report and must be approved by the code official. approved special inspector, that includes the following details: 5.5 Maximum adjustment of the adjustable columns is 4 1. The post description, including the product name, series inches (102 mm) for 3A, 35A and 4A Series posts, and number, initial length, final length, plate size and 3 inches (76 mm) for 3540A Series post, and the overall thickness. column height must be limited to the maximum height. 2. Verification of visual inspection, welding material used, Adjustable columns must be limited to the maximum storage conditions for weld material, joint preparation, lengths given in Table 1. conformance of weld procedures with AWS D1.1 or D1.3 5.6 Tiger Brand Adjustable and Fixed Columns are (depending on thickness of material) and size and type of manufactured in Meadville, Pennsylvania, under a weld. quality control program with inspections by PSI Inc. (AA- 3. Installation description, including verification of full 660). bearing of post on plate and orientation of plate to post 6.0 EVIDENCE SUBMITTED (the plate is at a 90- degree angle to the axis of the post). Data and test reports in accordance with the ICC -ES 5.0 CONDITIONS OF USE Acceptance Criteria for Steel Jack Posts (AC335), dated The Tiger Brand Adjustable and Fixed Columns described in October 2005. this report comply with, or are suitable alternatives to what is 7.0 IDENTIFICATION specified in, those codes listed in Section 1.0 of this report, subject to the following conditions: All Tiger Brand Adjustable and Fixed Columns are marked at the plant with the manufacturer's name (The Tiger Brand Jack 5.1 Adjustable and fixed columns must be fabricated and Post Company), post diameter, thickness, allowable installed in accordance with this report, the concentric axial compressive load, model number, the name manufacturer's published installation instructions and of the inspection agency (PSI) and the evaluation report the applicable code. In the event of a conflict between number (ESR- 1766). the manufacturer's published installation instructions and this report, this report governs. Ot t , TABLE 1- ALLOWABLE CONCENTRIC AXIAL COMPRESSIVE LOADS: TIGER BRAND ADJUSTABLE POSTS /COLUMNS t Q CD ca 3 -INCH OUTSIDE DIAMETER 4 -INCH OUTSIDE DIAMETER 3540A SERIES 0, TIGER BRAND MAXIMUM ALLOWABLE TIGER BRAND MAXIMUM ALLOWABLE MODEL ADJUSTABLE MAXIMUM ALLOWABLE u' ADJUSTABLE ADJUSTABLE LENGTH LOAD ADJUSTABLE LENGTH LOAD ADJUSTABLE RANGE LENGTH LOAD NO. RANGE RANGE (inches)' (pounds) MODEL NO. (inches) (pounds) MODEL NO. (inches) (pounds) 3540A6164 6'-176'-4" 76 29,370 3A -6064 6'- 0 76' -4" 76 13,933 4A -6064 6'- 0 "/6' -4" 76 21,105 3540A6467 6'- 4 "/6' -7" 79 28,892 3A -6367 6'- 376' -7" 79 13,641 4A -6367 6'- 376' -7" 79 20,860 4A 66610 6' 6 "/6' -10" 82 20,608 3540A67610 6'- 7 "/6' -10" 82 28,404 3A -66610 6'- 6 "/6' -10" 82 13,345 4A -6971 6'- 977-1" 85 20,351 3540A61071 6'- 10 "/7' -1" 85 27,906 3A -6971 6'-9"/7'-1" 85 13,044 4A -7074 7'- 077' -4" 88 20,087 3540A7174 7'- 1 "/7' -4" 88 27,400 3A -7074 7'- 0 77' -4" 88 12,740 4A -7377 7'- 3 "/7' -7" 91 19,818 3A -7377 7'- 3 "/7' -7" 91 12,432 3540A7477 7'- 4 "/7' -7" 91 26,886 4A -76710 7'- 6 "/7' -10" 94 19,544 3540A77710 7'- 7 "/7' -10" 94 26,364 3A -76710 7' - 6 "/7' - 10" 94 12,122 4A -7981 7'- 9"/8' -1" 97 19,265 3A -7981 7'- 978' -1" 97 11,810 3540A71081 7'- 10 "/8' -1" 97 25,837 3A -8084 8'- 0"!8' -4" 100 11,497 4A -8084 8' 0 "!8'13" 100 18,981 3540A8184 8'- 1 "/8' -4" 100 25,304 3A -8387 8'- 378' -7" 103 11,183 4A -8387 6- 378' -7" 103 18,693 3A -86810 8'- 6 "/8' -10" 106 10,868 4A -86810 8'- 6 "/8' -10" 106 18,401 3540A8487 8' 4 "/8' -7" 103 24,766 3A -8991 8'- 9 "/9' -1" 109 10,554 4A -8991 8'- 9 "/9' -1" 109 18,105 3540A87810 8'- 778' -10" 106 24,224 3A -9094 9'- 0 "/9' -4" 112 10,240 4A -9094 9'- 079' -4" 112 17,806 3540A81091 8'- 10 "/9' -1" 109 23,679 3A -9397 9'- 379' -7" 115 9,928 4A-9397 9' 3 79' -7" 115 17,504 3540A9194 9'- 1 "/9' -4" 112 23,131 3A -96910 9'- 6 "/9' -10" 118 9,617 3540A9497 9'- 4 "/9' -7" 115 22,582 3A -99101 9'- 9710' -1" 121 9,309 4A -96910 9'- 6"/9' -10" 118 17,200 3A- 100104 10'- 0 "/10' -4" 124 9,003 4A -99101 9'- 9"/10' -1" 121 16,893 3540A97910 9 118 22,032 4A- 100104 10 124 16,584 3540A910101 9'- 10"/10' -1" 121 21,482 4A- 103107 10'- 3 "/10' -7" 127 16,273 3540A101104 10'- 1 "/10' -4" 124 20,932 3.5 -INCH OUTSIDE DIAMETER 4A- 1061010 10'- 6710' -10" 130 15,961 3540A104107 10'- 4 "/10' -7" 127 20,383 TIGER BRAND MAXIMUM ALLOWABLE 4A- 109111 10'-9711-1" 133 15,648 3540A1071010 10'- 7 "/10' -10" 130 19,836 ADJUSTABLE ADJUSTABLE LENGTH LOAD 4A- 110114 11' 0 "/11'4" 136 15,334 3540A1010111 10'- 10 "/11' -1" 133 19,292 RANGE (pounds) 4A- 113117 11'- 3 "/11' -7" 139 15,020 MODEL NO. (inches ) (p ) 4A- 1161110 11'- 6 "/11' -10" 142 14,705 3540A111114 11'- 1 "/11' 4" 136 18,750 35A -6064 6- 076' -4" 76 17,564 4A- 119121 11- 9712' -1" 145 14,391 3540A114117 11- 4711-7" 139 18,212 35A -6367 6'- 3 "/6' -7" 79 17,296 4A- 120124 12'- 0712' -4" 148 14,077 3540A1171110 11'- 7 "/11' -10" 142 17,678 35A -66610 6'- 6 "/6' -10" 82 17,022 4A- 123127 12'- 3 "/12' -7" _ 151 13,763 3540A1110121 11- 10 "/12 " -1" _ 145 17,150 35A -6971 6'-9"/7'-1" 85 16,742 35A -7074 7'- 0 "/7' -4" 88 16,457 35A -7377 7'- 3 "/7' -7" 91 16,167 35A -76710 7'- 6 17' -10" 94 15,873 35A -7981 7'- 9 "/8' -1" 97 15,576 35A -8084 8'- 0 "/8' -4" 100 15,274 35A -8387 8'- 3 "18' -7" 103 14,970 35A -86810 8'- 6 "/8' -10" 106 14,662 TABLE NOTES: 35A -8991 8'- 9 "/9' -1" 109 14,353 For SI: 1 inch (in.) = 25.4 mm; 1 pound (Ib.) = 0.454 kg. 35A -9094 9'- 0 "/9' -4" 112 14,042 'Total length includes adjustable component. 35A -9397 9'- 3 "/9' -7" 115 13,729 2 No increases of allowable loads are permitted. m 35A -96910 9'- 6 "/9' -10" 118 13,416 0 35A -99101 9'- 9"/10' -1" 121 13,101 35A- 100104 10'- 0 "/10' -4" 124 12,787 �I rn en TABLE 2- ALLOWABLE CONCENTRIC AXIAL COMPRESSIVE LOADS: TIGER BRAND FIXED POSTS /COLUMNS tG , ao A 3-INCH OUTSIDE DIAMETER 4 -INCH OUTSIDE DIAMETER 3540F SERIES 2, MAXIMUM ALLOWABLE to TIGER BRAND MAXIMUM ALLOWABLE TIGER BRAND MAXIMUM ALLOWABLE MODEL LENGTH LOAD FIXED LENGTH LOAD FIXED LENGTH LOAD MODEL NO. (inches) (pounds) MODEL NO. (inches) (pounds) NO. (inches) (pounds) 3540F64 76 29,370 3F60 72 14,313 4F60 72 21,421 3540F67 79 28,892 3F66 78 13,739 4F66 78 20,942 3540F610 82 28,404 3F70 84 13,145 4F70 84 20,437 4F76 90 19,908 3540F71 85 27,906 3F76 90 12,535 3540F74 88 27,400 3F80 96 11,914 4F80 96 19,358 3F86 102 11,288 4F86 102 18,789 3540F77 91 26,886 3F90 108 10,659 4F90 108 18,204 3540F710 94 26,364 3F96 114 10,032 4F96 114 17,605 3540F81 97 25,837 4F100 120 16,996 3F100 120 9,411 3540F84 100 25,304 3F120 144 7,054 4F120 144 14,496 3540F87 103 24,766 3540F810 106 24,224 3540F91 109 23,679 3.5 -INCH OUTSIDE DIAMETER 3540F94 112 23,131 TIGER BRAND MAXIMUM ALLOWABLE 3540F97 115 22,582 FIXED LENGTH LOAD 3540F910 118 22,032 MODEL NO. (inches) (pounds) 3540F101 121 21,482 35F60 72 17,911 3540F104 124 20,932 35F66 78 17,386 3540F107 127 20,383 35F70 84 16,836 3540F1010 130 19,836 35F76 90 16,264 3540F111 133 19,292 35F80 96 15,675 35F86 102 15,071 3540F114 136 18,750 35F90 108 14,456 3540F117 139 18,212 35F96 114 13,834 TABLE NOTES: 3540F1110 142 17,678 35F100 120 13,206 For SI: 1 inch (in.) = 25.4 mm; 1 pound (Ib.) = 0.454 kg. 3540F121 145 17,150 35F120 144 10,710 'No increases of allowable Toads are permitted. m T v o) 0) Page 5 of 5 ESR•1766 TIGER BRAND SPOT WELD SPOT WELD TOP PLATE 3 ", 3 -1/2" OR 4" DIA. TUBING SPOT WELD SPOT WELD SWIVEL PLATE ADJUSTABLE COLUMN FIXED COLUMN a ®_ - -E3 O+ e_ • • T � \ ® ' SWIVEL PLATE I 4y" 2g" 4y" 1 x STANDARD PLATE "H" PLATE /( I a Al 1 \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ NUT SCREW FIGURE 1