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Permit Pk c;/611b,7, A CITY OF TIGARD MASTER PERMIT PERMIT #: MST2001 -00077 . ,- >I+A DEVELOPMENT SERVICES DATE ISSUED: 2/28/01 �` - � ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: W 69TH AVE ?VP i PARCEL: 1 S125DA -07900 SUBDIVISION: KINGS VIEW ZONING: R-4.5 BLOCK: LOT: 074 JURISDICTION: TIG REMARKS: 2 -story unit: 3 -car garage with accessory dwelling unit above. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 27 FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 836 sf GARAGE: 836 sf FRONT: 57 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: VALUE: $ 92,612.00 OCCUPANCY GRP: R3 BDRM: 1 BATH: 1 TOTAL: 836.00 sf REAR: 93 PLUMBING SINKS: 1 WATER CLOSETS: 1 WASHING MACH: 11 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: 2 CLOTHES DRYER: 1 GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FOR: 1 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: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 1,776.35 PAINE, JEFFREY C OWNER This permit is subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and 9155 SW 69TH AVE all other applicable laws. All work will be done in TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg #: forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. 5-6,5- g 4' _g1I4/ ` ( REQUIRED INSPECTIONS Erosion Control Insp & Underfloor insulation Plumb Top Out Exterior Sheathing Insl Electrical Final Footing Insp Crawl Drain /Backwater Electrical Service Low Voltage Mechanical Final Foundation Insp Footing/Foundation Dr Electrical Rough In Gas Line Insp Plumb Final Post/Beam Structural PLM /Underfloor Framing Insp Insulation Insp Final inspection Post/Beam Mechanical Mechanical Insp Shear Wall Insp Rain drain Insp Building Final / 10" / r 9 Issue. B #,i Cg_. PermitteeSignature : Aili AI Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the ne b , ss day 77 /)ST ,2,-z—,- / g T ., Building Permit Application Date received: „2../.2..„1-/4 Permitno.: -- 79 '�Fa City of Tigard i no.://cli40 ' -- Project/appl. no.: Expire date: City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: Bf7[�I(/I Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment if �I Y type: i Land use approval: / 6l0 6 -DOO 1 &2 family: Simple Complex: 1 OF 1'FRiI 11• O 1 & 2 family dwelling or accessory U Commercial/industrial 0 Multi- family Cl New construction 0 Demolition Eilddition/alteration/replacement U Tenant improvement 0 Fire sprinkler /alarm U Other: .IOB SI'I I. :INFORr9ATION Job address: i l$ AS 'Ti a- 7 `b Bldg. no.: Suite no.: Lot: 4- Block: Subdivision: i .5 j ' W Tax map/tax lot/account no.: /• , 9 U - i,o Project name: e - i - . n /P + _ o21 Description and location of work on premises/special conditions: Ad / 4 ' ' WI 1 1 ' C •PSSSO!` y / e/ ' OWNER FOR SPECIAL INFORIIATION, USE (IIEC1K1.1S1 Name: ,J t? Q- t- /t2._ (Floodpla it, septiccapacit,, Mailing address: "' C 5 w . - 1 & 2 family dwelling: q �� ,� _ Y r Stater ZIP: - a- 1 y Valuation of work f 1 Z $' Phone: .4 E -mail: 'ems • •'. k ', of bedrooms/baths i 1 Owner's representative: ' Gt Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) 83 iptgg , APPLICANT Garage/carport area (sq. ft.) G' 3 G Name: ( 0-F, Covered porch area (sq. ft.) Mailing address: - G 5 Std Deck area (sq. ft.) 96 mT ZIP i Other structure area (sq. ft.) ,' Phone: Fax: E -mail: CommerciaUindustrlaUmulti- family: CON'TRACI.OR Valuation of work $ Business name: Existing bldg. area (sq. ft.) Address: New bldg. area (sq. ft.) City: State: ZIP: Number of stories Phone: Fax: E-mail: Type of construction Occupancy group(s): Existing: CCB no.: New: City/metro lic. no.: Notice: All contractors and subcontractors are required to be ARCIII 11:(71 /DI SIGNFR licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: I :MANI:I Name: Y 1 per on )n Contact person: opt f w('P/' Fees due upon application $ Address: ! lir 0 . Date received: . I]'• /a .A111111.111Statet R ZIP: Q 7 f /9 -sv/ _ , ount received $ Phone: _ +6-/ZSO E - mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard work will be complied ik wheth �pecif or n^o�t. Credit card number / / ' i Vas' 4 - Date: sf-I / 0 Expires / Authorized signature: . Na me of cardholder as shown on credit card Print name: J e- ff w - Pa:. A Cardholder signature $ Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6ro0wCOM) A One- and Two - Family Dwelling .-. ',_,yr Building Permit Application Checklist Reference no.: Associated permits: City of Tigard City of Tigard `J g ❑ Electrical ❑ Plumbing ❑ Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 O Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 - UHF FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A / 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. V 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. 3 Verification of approved plat/lot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 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 -basin protection, etc. 0 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 ite/plot plan drawn tosc$ie. The plan must show lot and building setback dimensions; property comer 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, 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. 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 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 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. 26 No rolled, reversed or mirrored building plans will be accepted. 27 • 28 • Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614 (6ro0/COM) .s. Mechanical Permit Application Date received: Permit no.: ; : li'' - i i ll ' City of Tigard Project/appl. no.: Expire date: CiryojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt Phone: (503) 639 -4171 Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: Building permit no.: l 1 P OF PE ;RM11 0 1 & 2 family dwelling or accessory 0 Co ercial/industrial 0 Multi- family 0 Tenant improvement 0 New construction ddition/alteration/replacement 0 Other. JOB SI "I E; INFORMATION COiI\IERCIAI. VALUATION SCIIEDULE Job address: 0 S,sS . fers Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ Lot: .l_ Block: Subdivision: ` ; , • le 'See checklist for important application information and Project name: ' w CL f , A. 51 • • Q APaZa jurisdiction's fee schedule for residential permit fee. City /county: '.5/' i MIUMMILl l & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of - ork on premises: AND CONIMI RIC:V. /INDUS1RIAL EQUIPMENTSCIIEDULE Fee(ea.) Total Est. date of completion/inspection: Desai , ' on Qty. Res. only Res. only Tenant improvement or change of use: H AC: . - � Is existing space heated or conditioned? 0 Yes 0 No Air c unit CFM Air conditioning (site plan required) ME Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system MI —® NI [(;IIANICAI, CONTRACTOR Boiler /compressors Business name: ! . , State boile permit no.: it � — 6 W - HP Tons BTU/H Address: Fire/smoke dampers/duct smoke detectors City: State: ZIP: Heat pump (site plan required) II rn Phone: Fax: E -mail: Instal replace fuacelburner BTU/H Including ductwork/vent liner 0 Yes 0 No CCB no.: Instal replace/relocate heaters - suspended, II City/metro lic. no.: wall, or floor mounted Name (please print): Vent for a . • liance other than furnace 'el bs ti CONTACT 1'1 ;RSON Absorption units BTU/H Chillers HP . Name: Compressors HP MI Address: , , nmen : I • ust an . v . lirn on: 1 State: ZIP: Appliance vent Phone: Fax: E Dryer exhaust OWNER Hoods, Type I res.kitche azmat . __ hood fire suppression system Name: Exhaust fan with single duct (bath fans) - Mailing address: - 4 t lutuju. .. y Ill or AC = _ City: State: ZIP: ' e p p _ an G on up to . ou ets II - Type: LPG NG Oil Phone: Fax: E-mail: Fuel . i . ing each additional over ' outlets 111111 _ ENGINEER ' ' p p (schematic required) - Number of outlets Name: r er t , app 1 , , or eq , t pment: ■ - Address: Decorative fireplace City: State: ZIP: Insert - type Phone: Fax E -mail: Woodstov pellet stove I Other. = �� Applicant's signature: Date: 0 er: MI Name (print): = �� Not all jurisdictions accept aedit cards, please call jurisdiction for more information. Permit fee $ ❑ Visa O MasterCard Notice: This permit application Minimum fee $ expires if a permit is not obtained Plan review (at Credit card number Expires within 180 days after it has been ( %) $ State surcharge (8%) .... $ Name of cardholder as shown on credit sad accepted as complete. $ TOTAL $ - Cardholder signature Amount 440 -4617 (600/COM) • MECHANICAL PERMIT FEES 4. COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total $1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code QV (Ea) Amt $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Fumace to 100,000 BTU $1.52 for each additional $100.00 or induding ducts & vents 14.00 fraction thereof, to and including 2) Fumace 100,000 BTU+ $10,000.00. induding ducts & vents 17.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Fumace $1.54 for each additional $100.00 or including vent 14.00 fraction thereof, to and including 4) Suspended heater, wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional $100.00 or 6.80 fraction thereof, to and including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond fraction thereof. footnotes below. Comp* ** 7) <3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00 8) 3 -15 HP; absorb Value Total unit 100k to 500k BTU 25.60 Description: Qty (Ea) Amount 9) 15-30 HP; absorb Fumace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00 ducts & vents 10) 30 -50 HP; absorb Fumace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20 ducts & vents 11) >50HP: absorb Floor fumace induding vent 955 unit >1.75 mil BTU 87.20 Suspended heater, wall heater or 955 l 12) Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance p 445 t- t'15 13) Air handling unit 10,000 CFM+ permit 1 17.20 Repair units 805 14) Non - portable evaporate cooler < 3 hp; absorb. unit, 955 10.00 to 100k BTU 15) Vent fan connected to a single duct 3-15 hp; absorb. unit, 1,700 6.80 101k to 500k BTU 16) Ventilation system not included in 15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00 mil. BTU 17) Hood served by mechanical exhaust 30-50 hp; absorb. unit, 3,400 10.00 1 -1.75 mil. BTU 18) Domestic incinerators >50 hp; absorb. unit, 5,725 17.40 >1.75 mil. BTU 19) Commercial or industrial type incinerator Air handling unit to 10,000 cfm 656 69.95 Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves Non - portable evaporate cooler 656 10.00 Vent fan connected to a single duct 446 21) Gas piping one to four outlets Vent system not included in 656 5.40 appliance permit 22) More than 4 -per outlet (each) Hood served by mechanical exhaust 656 1.00 Domestic incinerator 1,170 �` Minimum Permit Fee $72.50 SUBTOTAL: $ Commercial or industrial incinerator 4,590 Other unit induding wood stoves, t 656 � 8% State Surcharge $ ,inserts, etc. 1 Gas piping 1-4 outlets li 360 Ca,_ d 25% Plan Review Fee (of subtotal) $ Each additional outlet 63 Required for ALL commercial permits only TOTAL COMMERCIAL $(41 (9 v r, e 0 TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: � Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum charge -two hours) $72.50 per hour. 2. Inspections for which no fee is specifically indicated (minimum charge half hour) $72.50 per hour 3. Additional plan review required by changes, additions or revisions to plans (minimum charge-one-half hour) $72.50 per hour * State Contractor Boller Certification required for units >200k BTU. ** Residential A/C requires site plan showing placement of unit I:\dsts\formsVnech- fees.doc 10/11/00 . Electrical Permit Application Date received: Permit no.: > `'11 City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receiptno.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TIN:, Or ri :i i11 ❑ 1 & 2 family dwelling or accessory ❑ C�ommercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction Bl�►ddition/alteration/replacement ❑ Other. ❑ Partial Job address: 1,5 f• Q' Tay Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: 74 Block: Subdivision: K, r, p ( f / e (k) Project name, -Pat ix__ X:on I Description and location of work on premises: 3 cot - q er's�Je G!% i A / 1 .Q 0 Estimated date of completion/inspection: �/ CONTRAC I OR APPLICATION rl.r SCIIIDU.E Job no: Fee Max ,(6 1) Business name: (r) (,o A . .e Description Description Qty. (ea.) Total , no. insp New resideatial- single ormulti-family per Address: dwellingmttt . Includes attached garage. City: I State: I ZIP: Serviceincludet Phone: I Fax: I E -mail: 1000 sq. ft. or less 4 CCB no.: I Elec. bus. lic. no: Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro lic. no.: Limited energy, non - residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders InstaliatIon, alteration or relocation: r 200 amps or less 2 Name (print): J e_-c---f- ea_ l hQ_ 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: r S UL.) 6 - 601 amps to 1000 amps 2 City: (j Q r'' State ZIP: Q 7 a-a- 3 Over 1000 amps or volts 2 Phone: 41-3 Q 517 Reconnect Fax: E -mail: y 1 ,_— Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: ORS 447, 455, 479, 670, 7 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: C. Date: - w 401 to 600 am s 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State:. I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: PLAN R1•:V11 :N1' (Please check all that appI') Misc. (Service or feeder not included): ❑ Service over 225 amps-commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 18r2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or mote *Description: O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/Iightingplan ❑ Other Per inspection 1 1 l I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number 1 / within 180 days after it has been State surcharge (8%) .... $ E accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 4444615 (6100/COM) • Electrical Permit Fees: Limited Energy Fees: 4. TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Garage Door Opener* Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ Vacuum Systems* 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918-260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see "b" above. Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 2 ❑ Data Telecommunication Installation . b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline fighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Imgation Control* Minor Labels (10) $125.00 Each additional inspection over ❑ . Medical the allowable In any of the above Per inspection $62.50 El Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting* Fees: ❑ Protective Signaling Enter total of above fees $ E Other 8% State Surcharge $ Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ i:\dsts\fomu\elc- fees.doc 10/09/00 Plumbing Permit Application Date received: Permit no.: - •,.. -, City of Tigard o _ I I i Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: Payment type: 'TYPE 01: 1'ER11F1 O 1 & 2 family dwelling or accessory O (ommercial/industrial 0 Multi- family O Tenant improvement O New construction p'Addition/alteration/replacement O Food service 0 Other. JOB SI I'E INFORMATION 1 :1 SCI1I l)tiEE (for special information use checklist) Job address: Cr S 5 QJ 6 Q ' --7 4 Description Qty. Fee(ea.) Total New 1- and 2- family dwellings only: Bldg. no.: Suite no.: (includes 100 ft. for each utility connection) Tax map/tax lot/account no.: SFR (1) bath Lot: 4-Block: Subdivision: /C.'ngs (/% e w SFR (2) bath Project name: J e4-F- Pa , ktsidait - Ng ( 11/WoN SFR (3) bath City/county: Wagh I ZIP: 9 7 a--a- 3 Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Est. date of completion/inspection: Drywells/leach line/trench drain Footing drain (no. lin. ft.) Manufactured home utilities Business name: CO A Q r - Manholes Address: Rain drain connector City: I State: I ZIP: _ Sanitary sewer (no. lin. ft.) Phone: I Fax: I E -mail: Storm sewer (no. lin. ft.) CCB no.: I Plumb. bus. reg. no: Water service (no. lin. ft.) City/metro lic. no.: °! item: Contractor's representative signature: Absorption valve Back flow preventer Print name: Date: Backwater valve Basins/lavatory Name: Clothes washer • Dishwasher Address: Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: I Fax: E -mail: Expansion tank Fixture/sewer cap Floor drains/floor sinks/hub Name (print): Garbage disposal Mailing address: Hose bibb City: I State: I ZIP: Ice maker Phone: I Fax: 1E-mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump ENG 1 N EI.:R Tubs/shower /shower pan _ Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other. Phone: [Fax: I E -mail: Total Na all jurisdictions accept credit cards, please eau jorisdicnoo for more information Minimum fee $ No This permit application Plan review (at _ %) $ O Visa O Maste,Card expires if a permit is not obtained Credit card t / / within 180 days after it has been State surcharge (8 %) .... $ Expires TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440-4616 (6/00/COM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 24amily dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the firsH00 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection) One (1) bath $249.20 Tub or Tub/Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" 16.60 PLEASE COMPLETE: 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory Tub or Tub /Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet 16.60 Urinal Fixtures tures (Specify) Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain/Sink: 2" Sewer -1st 100' 55.00 3" Sewer - each additional 100' 46.40 4" Water Service - 1st 100' 55.00 Water Heater Water Service - each additional 200' 46.40 Other Fixtures (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device" 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram Is required if Quantity Total is > 9 *SUBTOTAL 8% STATE SURCHARGE **PLAN REVIEW 25% OF SUBTOTAL Required only If fixture qty. total Is > 9 TOTAL $ * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge. ** All New Commercial Buildings require plans with isometric or riser diagram and plan review. hdsts\fonns\plm- fees.doc 10/10/00 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 ` .._00 7' INSPECTION DIVISION • Business Line: (503) 639 -4171 BUP Received `—' ' 1 Date Requested (31 / AM PM BUP Location Z—/ Suite MEC Contact Person I • I ; Ph ( ���) q3 —�� 7 PLM 5 Contra Ph ( ) SWR ILDIN Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: Post & Beam �� �� Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation t Drywall Nailing d y L ° '� f �f-� Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: F j .)• PART FAIL 1:PCGMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains 91/ Catch Basin / Manhole Storm Drain Shower Pan Other: Final FAIL CRANK Post yam Rough -In Gas Line S • Dampers PART FAIL f - TRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: Unable to inspect — no access Fire Supply Line l // ADA Date J ? (o /' 6 if Inspector f Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639 -4175 Business Phone: 639 -4171 Footing Rain Drain Cover /Service FINAL: Foundation Water Line Ceiling - Plumb. Post/Beam Mech. Shear /Sheath Framing PIbg.Und /Flr /Slab Plbg. Top Out Insulation - ect. Post/Beam Struct. 41 Rough -in Gyp. Bd. -Bldg. San. Sewer as Lin Appr /Sdwlk Reins. Other: — , A /11 . Date: -- © A. P.M. Entry: Address: � /S 9V-it Tenant: Ste: MST: BUP: Con /Own: M EC: PLM: ELC: THE FOL OWING CORRECTIONS AR' G IRED ELR: )...19---3 Af'�� �� 1 S 5 1 Q StA -- 1lte 6 l ✓ ‘ 7 9 .. ' ‘■ be Inspector: R Date:2 APPROVED _ DISAPPROVED /CALL FOR REINSP. 0 GO