Permit •
•
•
111 p CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit #: MST2008 -00164
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/15/2009
Parcel: 1 S135ACLC006
Jurisdiction: TIG
Site address: 9428 SW MANDAMUS CT
Subdivision: Lot:
Project: LONGSTAFF CONDOMINIUMS
Project Description:. New MF. Building 1 (unit type B -1).
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 2 First: 1 0 7 3 sf Basement: sf Left: Parking Spaces:
Height: 23 Bathrooms: 2 Second: sf Garage: 229 sf Front: Smoke
Dwelling Units: 1 Third: sf Right: Detectors:
Yes
Total: sf Value: $0.00 Rear:
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: Rain Drain: 100 Catch Basins:
Lavatories: 3 Dishwashers: 1 Floor Drains: Sewer Lines: 100 SF Rain Drains: 2 Other Fixtures:
Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines:' 100
Bckflw Prevntr:
MECHANICAL
Fuel Types Air Conditioning: • Vent Fans: 3 Clothes Dryers: 1
ELE Heat Pump: Hoods: 1 Other Units:
Fum <100K: Vents: Woodstoves: Gas Outlets:
Fum > =100K:
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 -200 amp: W/ Svc or Fdr:
Ea add'I 500 sf: 1 20 1-400 amp: 201 -400 amp: 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 401 -600 amp: Ea add'I Br Cir:
601 -1000 amp: 601 +amp- 1000v: •
1000 +amp /volt:
•
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio 8 Stereo: N HVAC: Security Alarm: N Vaccuum System: Garage Opener: N All
Other: Other Description: Ecompasing:
' BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW Multi V B R - 2 1073
Owner: Contractor: Required Items and Reports (Conditions)
LONGSTAFF LLC RCM HOMES INC
7050 SW CLINTON 7050 SW CLINTON ST •
TIGARD, OR 97223 Tigard, OR 97223
PHONE: 503 -598 -7565 PHONE: 503 -598 -7565
FAX: 503 -620 -9965
Total Fees: $8,769.37
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of Issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 throu. h OAR 952 -001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. c-
Issued By: 1 !I I - ' >1 U I ! 1 h Permittee Signature: I \•, %tO l It v
•
Building Permit Applicatio ; _ ` k
'
ommercial 1....... �
City of Tigard DEC .g 2008 Da fed n . ( e .0: / . Permit No.: ryY %2 cog • 001
11
• 13125 SW Hall Blvd., Tigard, 5 OR 97223 .
0 Y OF TIGARD ;,i f1 a Milli Other Perntit �. - • . •
Phone: 503.639.4171 Fax: 03.598.
P lan DateB Revi : �`; V 6,. • ._
-1- Ci A It L) Inspection Line: 503.639.4175 11 !9 ne1461 DIVISION Date Ready By: % See Page 2 for
Internet: www.tigard or.gov 191 Notified/Method: IIIN Supplemental Information
TYPE OF WORK r REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ❑ Commercial/industrial
Valuation: $ I C r '
❑ Accessory building ® Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: Z
JOB SITE INFORMATION AND LOCATION Total number of floors: Z
Job site address: 9428 SW Mandamus Court New dwelling area: 1079 square feet
City /State/ZIP: Tigard, Oregon 97223 Garage/carport area: 2 square feet
Suit idg. pt. no.:10 i____ Project name: Longstaff Covered porch area: square feet
Cross street/directions to job site: SW 95 Avenue and SW Shady Lane Deck area: square feet
OM / l 73 fi / Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Longstaff I 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.
6 Plex Condominium Staked Flats Valuation: $
R -2 Existing building area: square feet
Sprnklered New building area: square feet
tEl PROPERTY -OWNER I 0 TENANT Number of stories:
Name: Longstaff LLC . Type of construction:
Address: 7050 SW Clinton Occupancy groups:
City/State/ZIP: Tigard, Oregon 97223 Existing:
Phone: (503)598 -7565 Fax: (503)620 -9965 New: R -2
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Longstaff LLC All contractors and subcontractors are required to be
Contact name: Ron Lightner licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7050 SW Clinton jurisdiction in which work is being performed. If the
City/ State/ZIP: Tigard, Oregon 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 598 -7565 Fax: : (503) 620-9965
E -mail: RLightner ®RCMHomes.net
CONTRACTOR
Business name: Longstaff LLC BUILDING PERMIT FEES*
Address: 7050 SW Clinton Street (Please refer to fee schedule)
City/State/ZIP: Tigard, Oregon 97223 Structural plan review fee (or deposit): 9314 ,32-
Phone: (503) 598 -7565 I Fax: (503) 620 -9965 FLS plan review fee (if applicable): It L_lCI • 514
CCB lic.: 158043 Total fees due upon application:
, Amount received: , ]a Q3 . g 6
Authorized signature: 12�� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Ron Lightner Date: 12 -19-08 • Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02 /COM/WEB)
• Plumbing Permit Application
g r ECE tJE! J Buildin Fixtures rolz ()rrlc •1: ust: 0,1.v
Received 2 I O �
• � City of Tigard . g Date/By: L CI. Permit No.:''yt Cg �a .00I4 (1. • 13125 SW Hall Blvd., Tigard, OR 97223 DEC 9 ZOQt) Plan Review i 1l) � `( i bc
I
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit N
CITY OF TIGAR® R
Inspection Li ne: 503 Date Ready/By: Juris: ®See P e 2 for
� dyBr ag
Internet: www.tigard- or.gov /g ¢� �p ®� Notified/Method: 1 e Supplemental Information
TYPE OF WO 'LC�INU VIVI�7l®ry
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I 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
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath ( 350.00 ' cr _,
❑ Accessory 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
lob site address: 9428 SW Mandamus Court Catch basin or area drain 16.60
City/State/ZIP: Tigard, Oregon 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: B1-6 I Project name: Longstaff Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW 95 Avenue and SW Shady Lane
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: _) Page 2
Subdivision: Longstaff I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIFITON OF 4'0RK Backflow preventer Page 2
Condominium Domestic Supply, Waste & Storm Drainage Backwater valve 16.60
Clothes washer I 16.60
Dishwasher ( 16.60
_< PROPERTY OWNER I ❑ TENANT _ Drinking fountain 16.60
Ejectors/sump 16.60
Name: Longstaff LLC Expansion tank 16.60
Address: 7050 SW Clinton Fixture/sewer cap 16.60
City/State/ZIP: Tigard, Oregon 97223 Floor drain/floor sink/hub 16.60
Phone: (503)598 -7565 Fax: (503)620 -9965 Garbage disposal / 16.60
I${ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Longstaff LLC
Interceptor /grease trap 16.60
Contact name: Ron Lightner Medical gas (value: $ ) Page 2
Address: 7050 SW Clinton Primer 16.60
City/State/ZIP: Tigard, Oregon 97223 Roof drain (commercial) 16.60
Phone: (503) 598 -7565 I Fax:: (503) 620 -9965 Sink/basin/lavatory /0/! 16.60
Tub /shower /shower pan �j 16.60
E -mail: RLightner @RCMHomes.net Urinal 16.60
CONTRACTOR Water closet ?j 16.60
Water heater 1 16.60
. Wolcott Plumbing Contractors
. 1075 W Historic Columbia River Hwy Subtotal
Troutdale OR 97060 Minimum permit fee: $72.50
503 -667 -9891 Residential backflow minimum permit fee: $36.25 f'�.00
CCB: 23847 PLM: 26-208PB Plan review (25% of permit fee)
State surcharge (12% of permit fee) At CO
Authorized signature: TOTAL PERMIT FEE '/ Cf w
Print name: I Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\ Building \Permas\PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /02/COM/WEB)
Mechanical Permit Application Fcl It o F F icy us l: o N L v
City of Tigard . — Received e rmit No.:
13125 SW Hall Blvd., Tigard, OR 972 •� • teBy` . 4 . r ? 11 - 2 00g 0o 1 .
��� Et/
." Plan Review
IN II Phone: 503.639.4171 Fax: 503.598.1' . I t La Other Permit. I- [ill, DateBy: • 1 1i ',li 10
T I c n It I:) Inspection Line: 503.639 Date Read /B ® See Page 2 for
Internet: www.tigard-or.gov DEC . 9 20C Noti6e Supplemental Information
TYPE OF WO QIN . OF TIGAR .COMi1tERC i � 'lgea SCHEDULE — Li:SE C ST
d[1 a NG DIVISION
® New construction ❑ Addition/alterafi acement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTOTLON Value: $
E Q U I P M E N T S Y S T E M S IE
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building - -
® For special information use check list.
Multi - family 0 builder 0
Description I Qt I Fa. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9428 SW Mandamus Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Suite/bldg. /apt. no.: B1-6 Project name: Longstaff Furnace 100,000+ BTU (ducts /vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: SW 95 Avenue and SW Shady Lane Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Longstaff Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION IO.N OF WORK Water heater 10.00
Condominium Mecanical Ventilation Gas fireplace 10.00
Flue vent for r water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
® PROPERTY OWNER I ❑ 'TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: Longstaff LLC Environmental exhaust and ventilation _
Address: 7050 SW Clinton Range hood /other kitchen
equipment 1 10.00
City/ State/ZIP: Tigard, Oregon 97223 Clothes dryer exhaust I 10.00
Single -duct exhaust (bathrooms,
Phone: (503)598 -7565 Fax: (503)620 -9965 toilet compartments, utility moms .J 6.80
i2 APPLICANT 0 CONTACT PERSON Attic /crawispace fans 10.00
Business name: Longstaff LLC' 10.00
Fuel piping
Contact name: Ron Lightgner $5.40 for first four; $1.00 for each additional
Address: 7050 SW Clinton Furnace, etc.
Gas heat pump
City/State/ZIP: Tigard, Oregon 97223 Wall/suspended/unit heater
Phone: (503) 598 -7565 Fax: : (503) 620 -9965 Water heater
Fireplace
E -mail: RLighter ®RCMHomes.net Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Oregon Comfort Heating
PO Box 190 MECHANICAL PERMIT FEES*
Eagle Creek OR 97022 Subtotal
Ph: 503 -655 -0221, F: 503 -650 -2933 Minimum permit fee ($72.50) 72,..
!GCB: 42519 Plan review (25% of permit fee)
State surcharge (12% of permit fee) 170
TOTAL PERMIT FEE 0( , 20
Authorized signature: This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: Date: • Fee methodology set by Tri - County Building Industry Service Board
1:\ Building \Permits\MEC-PenniiApp.doc 01/19/07 440-4617T(1I /02/COM/WEB)
Electrical Permit Application roll orrlcl; usl: ONI.,
�� i v . Received
City of Tig ard ; 'T= CEN f Date/B : - . ; , ► Permit No.: VZc : . 001 ,
• 13125 SW Hall Blvd., Tigard, O' 'r sz Plan Review
'� I Phone: 503.639.4171 Fax: 503.598.1960 - ,. 9 ZOOS Date/B : Other Permit• • r ••:.00 loS
lT I (; A I: D Inspection Line: 503.639.4175 L L Date Ready /By: NM 7. See Page 2 for
Internet: www.tigard or.gov ,, °°������// Notified/Method: . Supplemental Information
TYPE OF ``Il^let'O�lat®F 4 �1I1�G�AR{DA1 PLAN REVIEW
® New construction ❑ Addition/altei�ating I ccmcnt� Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
® Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addddition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: 9428 SW Mandamus Court 10011P or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, Oregon 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: B1-6 Project name: Longstaff ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: SW 95 Avenue & Shady Lane Description I Qty. I Fee. I Total I •
New residential single- or multi -family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less I 145.15 4
Subdivision: Longstaff Lot no.: Ea. add'I 500 sq. ft. or portion ' 33.40 1
Tax map /parcel no.: limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. R) 1
Limited energy, multi - family 75.00 2
Condominium Electrical, Low Voltage Phone & CATV residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Longstaff LLC 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 7050 SW Clinton Over 1,000 amps or volts 454.65 2
City/State/ZIP: Tigard, Oregon 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)598 -7565 Fax: (503)620 -9965 200 amps or less 66.85 I
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 I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Longstaff LLC B. Fee for branch circuits
Contact name: Ron Lightner without service or feeder fee, 46.85 2
g fast branch circuit
Address: 7050 SW Clinton Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Tigard, Oregon 97223 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 598 -7565 Fax: : (503) 620 -9965 Reconnect only 66.85 2
E -mail: RLightner @RCMHomes.net Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
LAMS Electric Signal circuit(s) or limited -
energy panel, alteration, or
8504 SE Stark extension. Describe: Page 2 2
Portland OR 97216 Each additional inspection over allowable in any of the above
' Portland
118073, ELC: 37 -742C, Sup: 4542S Per inspection 62.50
Investigation per hour (1 hr min) 62.50
" L7 I .���.r .. Industrial plant per hour 73.75 •
.. ..
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 253, F�
Plan review (25% of permit fee):
Print name: Date: State surcharge (12% of permit fee): , 4.3
Authorized signature: TOTAL PERMIT FEE: n-3. lei
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.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440-4615T( I I /05/COM/WEB
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems)
Description I Qty. I Fee(ea:) I Total Description I Qty I Fee(ea.) I Total
New 1- &2 dwellings Heating/Cooling
. (includes 100 ft. for each utility connection) • • Air conditioning or heat pump* 14.00
SFR (1) bath 249.20 Furnace 100,000 BTU (ducts /vents) _ 14.00
SFR (2) bath I 350.00 2 Furnace 100,000+ BTU (ducts /vents) 17.90
SFR (3) bath 399.00 Gas heat pump 14.00
Each additional bath/kitchen 45.00 Duct work 10.00
Rain Drain, single family dwelling 65.25 Hydronic hot water system 14.00
Fire sprinkler -sq. ft. 0 to 2,000 115.00 Residential boiler
Fire sprinkler - sq. ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00
Fire sprinkler - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric)
Fire sprinkler - sq. ft. 7,200 and greater 309.00 (in wall, in -duct, suspended, etc.) 14.00
. Site Utilities • • Flue /vent (for any of above) 6.80
Catch basin/area drain 16.60 Repair units 12.15
Drywell /leach line /trench drain 16.60 Other Fuel Appliances
Footing drain - 1 100' 55.00 Water heater 10.00
Footing drain - each additional 100' 46.40 Gas fireplace 10.00
Manufactured home utilities 1 10.00 Flue vent (water heater /gas fireplace) 10.00
Manholes 16.60 Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Rain drain connector 16.60 Wood fireplace /insert 10.00
Sanitary sewer - 1 100' 55.00 Chimney /liner /flue /vent 10.00
Sanitary sewer - each additional 100' 46.40 Other: 10.00
Storm sewer - 1 100' 55.00 Environmental Exhaust & Ventilation
Storm sewer - each additional 100' 46.40 Range hood /other kitchen equipment 1 10.00
Water service - 1 100' 55.00 Clothes dryer exhaust 10.00
Water service - each additional 100' 46.40 _
Fixture or Item Single duct exhaust
Absorption valve 16.60 (bathrooms, toilet compartments,
8
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve 16.60 Attic /crawl space fans 10.00
Clothes washer ( 16.60 Other: 10.00
Fuel Piping
Dishwasher j 16.60 * *($5.40 for first 4, $1.00 each additional)
Drinking fountain 16.60 Furnace, etc. **
Ejectors /sump 16.60 Gas heat pump **
Expansion tank 16.60 Wall /suspended /unit heater **
Fixture /sewer cap 16.60 Water heater **
Floor drain/floor sink/hub 16.60 Fireplace . **
Garbage disposal , 16.60 Range
Hose bib 16.60 BBQ **
Ice maker 16.60 Clothes dryer (gas) **
Interceptor /grease trap 16.60 Other: **
Primer 16.60 Total:
Roof drain (commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory IA)" t 16.60 Subtotal: $
Tub /shower /shower pan 16.60 Minimum Permit Fee $72.50 $ 72 ,5 )
Urinal • 16.60 Plan Review Fee (25% of Permit Fee) $
Water closet _. 16.60 State Surcharge (12% of Permit Fee) $ " j . 70
Water heater I 16.60 TOTAL PERMIT FEE $ l 1 , ?.
Other:
Other:
P lumbitil; Permit Fees ELECTRICAL FEES (residential single or multi - family)
Subtotal $ 1 ?- ) :), QC) Description Qty. Fee Total Insp
1,000 sq. ft. or F less I 145.15 SC 4
Minimum Permit Fee $72.50 $ 1
Ea. add'l 500 sq. ft. or portion 1
Plan Review (25% of Permit Fee) $ q p 33.40 ��
State Surcharge (12% of Permit Fee) $ 4 Limited energy, residential 75.00 2
TOTAL PERMIT FEE _ $ S Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Electrical Permit Fees
Subtotal: , $ l ,
Plan review (25% of permit fee) $
. State surcharge (12% of permit fee) $ 2
TOTAL PERMIT FEE $ 1 ,
L (14' 17ED - 7'.a.w
I: \Building \Forms \ResPlanCheckFees.doc 01/19/07 t2 ' 8i-.CD . D Page 2
I Building Division
One & Two - Family Dwelling
r i c n K Fees Checklist
ERMIT INFORMATION: :..
Permit #: Plan #: OM fl . I Date:
Site Address: . Parcel #:
Subdivision: j , 0 c 9 ' i o1 VMS Lot #: Zoning:
Jurisdiction: - n6 Setbacks: Front: Rear: Left: Right:
Class of Work: ORO Stories: Z First Floor:, I 073 t‘:.:
Type of Use: R E j Height: Z Third Floor: Second Floor: _ _
Construction: � F Floor Load: .
Occupancy Group: • R. a Dwelling Units: - 1 Bonus Room:
Valuation: i CA .2+ Bedrooms: Z Total Floors: 107.1'
Bathrooms: 2 Basement:
Decks: Garage: '7 24F=1' tS
Porches: -- Other:
FEES :. D ' Fee "Amount:`
. . � - . - Amount Paid ;. Balan :::
Plan Check: Building:
Extra Set:
Permit: Building: $ 8 32J
Tax: 1 68 . 7
Metro CET: 4 ( Zfi, - 3`1
School CET: 4 10
Mechanical 4. 72-
Tax: R.
Plumbing: .4; i ). CJc:3
Tax: 4 42,C0
Electrical: 1 "7ec►'37;
Tax: 4 21 , 43
Low Voltage: `T CO
Tax: / ,
CDC: CDC Ping. Rev.: 1 '1,6 . CO
CDC LRP Fee: 1 • , 0 M
SDC: Parks: ai Z„
TIF Res.: (7G
TIF MT: 1'4 0.. 7C
Erosion Permit: fit, Can
Erosion CWS: ,8
Erosion COT: 2Q. 80
Water Quality:
Water Quantity:
SUB - TOTAL:
Sewer: Permit:
Inspection:
SUB - TOTAL:
TOTAL MST & SWR:
I: \Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 1
. •
DATE: PLANS CHECK NO.:
/ od e5
PROJECT TITLE:
4 ,01A - 719FF - (1,,,,aPt/A601-t5
COUNTYWIDE
TRAFFIC IMPACT FEE
WORKSHEET MAADDRES, . Sh ea..
(FOR NON-SINGLE FAMILY USES) , X„a47 sc:7 i?
RATE PER TA gjg g i ik . ,— 0 oo 25 d1700
AND USE CATEGORY TRIP • SITUS NO. ADORE_
V RESIDENTIAL $339.00 , -44; 0 OW "7" 9 S#/» i
BUSINESS AND COMMERCIAL $85.00
OFFICE • $312.00 •
INDUSTRIAL $327.00
INSTITUTIONAL $141.00
PAYMENT METHOD: •
CASH/CHECK
CREDIT INSTITUTIONAL ONLY:
BANCROFT (PROMISSORY NOTE) LAND USE CATEGORY DES Ti I WEEKDAY AVG. TIP WEEKEND_AyG/RIP
DEFER TO OCCUPANCY 3 cr) US E eSUCIN1 / 0 RATE 5 (4 1 RATE
BASIS: • TT 00/Q>::) ( Arpip ""'
--- OgfrO DKE
CALCULATIONS:C '1 X 57.6 14:1• r- 2 7 /S
e AID
2- ,„.5S9.erDT-A2
2-442___
7
PROJEEX GENERATION:
76, V./C. FEsir
03 8
FOR ACCOUNTING PURPOSES
MDC-- • 4 ONLY
ADDITIONAL NOTES:
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CC: WASHINGTON COUNTY TIF NOTEBOOK
•
DATE PLANS CHECK NO.:
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PROJE TITL : 7=x. e_- / g
• COUNTYWIDE
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TRAFFIC IMPACT FEE
APPLIOAOL�f� /0f 0C /•4 S' •
F
W O R K S H E E T - ..... - - ...
DD • t e : 4 9 P e Sr re 2 - b
(FOR NON - SINGLE FAMILY USES) - -
CIP /PHONE:
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TAX MAP NO.:
RATE PER S te 5 -da11V 0..?�o o .r(dvod/Pe
LAND USE CATEGORY TRIP RESIDENTIAL 111800r
it/ . 93G S,5 is 63
BUSINESS AND COMMERCIAL
OFFICE S t :2 i 6.-)1rDD5
INDUSTRIAL * : _ _ ; / S �� DE-HO
INSTITUTIONAL
PAYMENT METHOD: 7°/•1 / / /�` •
• CASH /CHECK 6../6464E_ /02
CREDIT INSTITUTIONAL ONLY:
BANCROFT (PROMISSORY NOTE) LAND USE CATEGORY DESCRIPTION OF WEEKDAY AVG. TRIP WEEKEND AVG. TRIP
DEFER TO OCCUPANCY 2 "60 USE Rs5 j I RATE VI,. RATE
BASIS: ntitoh. a y • - cJ X d e = P
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CALCULATIONS:
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PROJECT TRIP ERATION:
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7 15 FOR ACCOUNTING PURPOSES
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