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Permit ' CITY OF TIGARD MASTER PERMIT PERMIT #: MST2003 -00475 711 DEVELOPMENT SERVICES DATE ISSUED: 11/14/03 A i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11500 SW 98TH AVE PARCEL: 1S135CD-08900 SUBDIVISION: PP1994 -029 ZONING: R -4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: New SF detached dwelling. BUILDING REISSUE: 1328R7 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 21 FIRST: 900 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,110 sf GARAGE: 440 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD. sf RIGHT: 5 VALUE: 198,009.60 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,010 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 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 FD R: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +am ps-1000 v: 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: $ 7,713.57 MIKE PARKER CONSTRUCTION MIKE PARKER CONSTRUCTION This permit is d C o to the regulations contained C o i the Tigard other h r ap applicable la c, State work OR. Specialty Codes and 16594 TIMBERLAND DR 16594 SW TIMBERLAND DRIVE all other applicable l ro v. All p work will be done i ALOHA, OR 97007 BEAVERTON, OR 97007 t accordance with approved plans. This permit expire 'If work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 680 - 0893 Phone: 503 642 - 5582 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Rey #: LIC 46999 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. .6 _ .846 -att-- 4q 4' REQUIRED INSPECTIONS Erosion Control Insp 8 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insr Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing lnsp Crawl Drain /Backwater Electrical Rough In Gas Line lnsp Water Line Insp Plumb Final Foundation lnsp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final PosUQe Mechanica nsp Shear Wall Insp Insulation Insp Appr /Sdwlk Ins. , /7) Issu Y : k ■ / � , ` ✓ �!� �_ Permittee Signature : . .,_ [ - Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day T o ?T- e - D ? 4200 - 6 Building Permit R W P FOR OFFICE USE ONLY Received Building [^� Date/By: yir/0,/ Pem�it No..Sr1Olp-i - ®O Y7. f C i of Ti and S E P 1 9 2003 Planning A Other `, g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 CITY OFTIB�ARL DatelBy: B1 IV• ( - U 3 Permit No.: Phone: 503 -639 -4171 Fax: VIF Post Review Land Use Date/By: Case No. Internet: www.ci.tigard.or.us -. a Contact J ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Method: 7 - 76 _ Supplemental Information /IL !° 7y QQQ po2-2 /°L 4'T /??V — T;9 — ,:; .'tu ? 1 K q. 0��' 1 .Tir .sir $.' ., F° r a fix« a d r 1q 1 1 ' , 14 New construction ❑ Demolition ` o E p l l i % t v 1 ■ Addition/alteration/re . lacement ❑ Other: ,. s : i_ ; w ;, T' :, _ ON':? r "` Note: Permit fees* are based on the total value of the work performed. Indicate n 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials or, ov erhead and profit for the work indicated on this application. R Accessory Building ❑ Multi- Family -,, Master Builder ❑ Other: Valuation /.?e � � i . �' t $ ilk'Di■ ,t; 3 " , I s ' - ; s , e s: _ No. of bedroom ¢ No. of baths: L Job site address: S0 • 5 q , .� Total number of Hoots New dwelling area (sq. ft.)...2A. . /3.5 2 I f Suite #: I Bldg. /Apt. #: Garage/carport area (sq. ft.) .. .( .41k Project Name: Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) /.S G (a. e eu∎ b ? & -1 Other structure area (sq ft.) Subdivision: I Lot #: Tax ma • / • arcel #: Note: Permit fees* are based on the total value of the work performed. Indicate i 1 1 f ° , �, the value (rounded to the nearest dollar) of all equipment, materials, labor, �� � overhead and profit for the work indicated on this application. Valuation $ Existing building area (sq. ft.) New building area (sq. ft.) Number of stories .. E . i t , t .4.. ii g '.: :_ Type of construction ... Name: I' i 1/ � '* ' ed(5,,Lc3 Occupancy group(s): Existing: i- New: Address: (lo SI + S v -± -t,14 ..... td� . City /State/Zip: &off Ott- 9 700'7 P • , ne: L Q O -0 s c i 3 Fax: (.fl ` l ; ' L - .53 Z . — NOTICE: d t All th contractors Co and subcontractors a are required to be n Contractors s licensed Board un in d the er Business Name: tI 0, - ee . , 1 jurisdiction where work is being performed. If the applicant is exempt Contact Name: . - leis .- from licensing, the following reason applies: Address: Ito SI 4 AA-t a ei Qia_ . City /State/Zip: A tMMn.q ©o& b07 ' Phone: (D ce0 -08X.3 1 Fax: (0 -5313-2- „.,,,; . . _. ” 6 * E -mail . ` , . 1' I '' it: � �� ,'1 � , -P� , . , - : 6. it ;' ;a te_ ` ' k ': ds.. a s, ,- _ Business Name: M, • 14,. '• - 5 . Fees due upon application $ o2SO , at Address: I la 5 54t) 4- .. A€ City /State /Zip: AtCL ?7,7 Amount received $ Phone: (Q BO -0 j cf3 1 Fax: O Cf'2...':SS92_ Date received: CCB Lic. #: , Authorized � Notice: This permit application expires if a permit is not obtained within Signature: j Date: / 180 days after it has been accepted as complete. 14 i L t Lie. *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms\BldgPemiitApp.doc 01/03 k One- and Two - Family Dwelling . � � . ' • ' • ' ' „ °kayo Building Permit Application Checklist Referenceno.: Associated permits: City of Tigard City f Tigard Y b ❑ Electrical U Plumbing ❑Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 LI Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 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. 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 LI permit required. Include drainage -way protection, silt fence design and location of basin protection, etc. 10 3 omplete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state • ing 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. x 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, 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 I 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. "Mirrored" building plans will be not 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 & location per approved project street tree plan (if applicable), and COT Street Tree List. 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 (6100 /COM) Mechanical Pe '1'r i Lion FOR OFFICE USE ONLY Received Mechanical ` Date/By: Permit No.: City of Tigard SEP 19 2003 Planning Approval Building Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 CITY OF TIGARD Date/By: Permit No.: Phone: 503- 639 -4171 Fay$( b1C9 IO A, Post- Review [.and Use ',f � � � �� Da teB Case No.: r � y: Internet: www.ci.tigard.or.us � ` _� Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 __" Name/Method: Supplemental Information. 4'' ® e , c 1: z `. r '' ' '' i :USECRECKi d � . '� � f � a .,..b � COMMERCIAL FEE* SCHEDU a New construction • Demolition Mechanical permit fees* are based on the total value of the work • Addition/alteration/re • lacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, overhead and profit. a 1 & 2- Family dwelling ❑ Commercial/Industrial 3. Value: $ See Page 2 for Fee Schedule El Accessory Building [=I Multi- Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE* SCHEDULE Description Qty Fee(ea.) Total ❑ Master Builder • Other: Heating/Cooling JOB SITE i. s I @ ,!. �.� : ., :- Furnace - add -on air conditioning ** 14.00 Job site address: 1150 � W ei it Gas heat pump 14.00 Suite #: I Bldg. /Apt. #: Duct work 14.00 Project Name: Hydronic hot water system 14.00 Residential boiler Cross street/Directions to job site: (for radiator or hydronic system) 14.00 {� v _ ,/a c_e_kt 10,e...<1 k, 9 914-A Unit heaters (fuel, not electric) / (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) 10.00 Subdivision: I Lot #: Repair units 12.15 Other Fuel Appliances Tax ma./ . arcel #: Water heater 10.00 T R . � ) L -A' , [ ,:t.;1 IiisIdAri Gas fireplace 10.00 Flue vent (water heater /gas fireplace) 10.00 N�.w Log lighter (gas) 10.00 Wood/Pellet stove 10.00 1 Wood fireplace /insert 10.00 Chimney/liner /flue /vent 10.00 a ' 1 h`'. , K ' g .d Other: 10.00 Name: �� Environmental Exhaust & Ventilation ��' " Zf� (, �� S � Range hood/other kitchen equipment 10.00 Address: t WS 5 W -1 .12G.c,�cx .L*l pre_ Clothes dryer exhaust 10.00 City /State /Zip: o l re_ -/ 7 �0 7 Single duct exhaust Ph•ne: ii3 -d VI Fax: (, Y Z- (bathrooms, toilet compartments, 111:;k' ,, i:1; b : f 4 ' 4 ',' \ utility rooms) 6.80 Name: I44 ' s .z_ CO., Attic /crawl space fans 10.00 Address: t4 S 9 Le of it) '4 i, Other: 10.00 Fuel Piping City /State /Zip: gat, ©e 9-2007 * *($5.40 for first 4, $1.00 each additional) Phone: (p160 -- O eel 3 I Fax: CO ‘t2., - 5-5-02.- Furnace, etc. ** Gas heat pump ** E-mail: Wall /suspended/unit heater ** . ,- , .`. .:V111.4:111':‘! ' , :x 4 Water heater ** Business Name: Fireplace ** Address: 1 l6000 s E Eli vl. Gtq cf< Range ** sBQ City /State /Zip: c q Q.V. 0 t 6 .-- Clothes dryer (gas) ** Phone: (r To - U. 02— Fax: 6 Zq cj 0 Other: ** CCB Lic. #: I g'7 (8 Total: Authorized Mechanical Permit Fees* Signature: Date: 9 If� Subtotal: $ Minimum Permit Fee $72.50 $ S fLvL N o o d& Plan Review Fee (25% of Permit Fee) $ (Please print name) State Surcharge (8% of Permit Fee) $ TOTAL PERMIT FEE $ Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: T(tafValuation; Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for each additional $100.00 or fraction thereof, to and including $25,000.00. $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Assatned Valuations Per Appliance: Value Total Description: Qty (Ea) Amount Furnace to 100,000 BTU, including 955 ducts & vents Furnace > 100,000 BTU including ducts 1,170 & vents Floor furnace including vent 955 Suspended heater, wall heater or floor 955 mounted heater Vent not included in appliance permit 445 Repair units 805 < 3 hp; absorb. unit, 955 to 100k BTU 3 -15 hp; absorb. unit, 1,700 101k to 500k BTU 15 -30 hp; absorb. unit, 501k to 1 mil. 2,310 BTU 30-50 hp; absorb. unit, 3,400 1 -1.75 mil. BTU >50 hp; absorb. unit, 5,725. >1.75 mil. BTU Air handling unit to 10,000 cfm 656 Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 Vent fan connected to a single duct 446 Vent system not included in appliance 656 permit Hood served by mechanical exhaust 656 Domestic incinerator 1,170 Commercial or industrial incinerator 4,590 Other unit, including wood stoves, 656 inserts, etc. Gas piping 1-4 outlets 360 Each additional outlet 63 TOTAL COMMERCIAL $ VALUATION: is \Dsts\Permit Forms\MecPermitAppPg2.doc 01/03 Plumbing PermI9 IY n FOR OFFICE USE ONLY g Received Plumbing � Date/By: Permit No.: ��F 1 7 �UU3 Planning Approval Sewer City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd CITY OF TIGARD Plan Review Other Tigard, Oregon 97223 BUILDING DIVISIO Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use ;; Internet: www.ci.tigard.or.us ■ J. i I I d Date/By: Case No.: Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 - "" -- Name/Method: Supplemental Information. ° k 17 _ 0 ..9 i 7 '"' `e1311, } .0 ta i ii rg iii 1 ':. w New construction • Demolition D n esc s tion Qty. Fee(ea.) Total I_ Addltion/alteration/r - .lacement ❑ " 4a" ' Other ' i . ii v 2 �{ b mil �< G � em .. bath 249.20 nk I I ;_ -- $*�i i z i 3 m. ' ' SFR 1 l in 1 & 2 -Famil dwellin_ ❑ Commercial/Industrial SFR 2 bath 350.00 rm Accesso Buildin: ❑ Multi -Famil SFR 3 bath 399.00 (_ Master Builder ❑ Other: Each additional bath/kitchen 45.00 G : t i IMMtlON a , O -1 " n Fire s•nkler - ft Pale 2 Job site address: 105'0 W, • I, 1N 'f' Suite #: Bld:. /A •t. #: Catch basin/area drain 16.60 Pro ect Name: D ell/leach line/trench drain 16.60 Footin: drain no. linear ft. Pa:e 2 Cross street/Directions to job site: Manufactured home utilities 110.00 LP ete-A4 6-(4,-.? k c o .. t ,� Manholes 16.60 v Ram dram connector 16.60 Sanit• sewer no. linear ft. Pa:e 2 Subdivision: Lot #: Storm sewer no. linear ft. Pa:e 2 Water service no linear ft. Pale 2 Tax ma • / 1 arcel #: , " " Abso •tion valve 16.60 L t Backflow .reverter Pa:e 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinkin: fountain 16.60 '':" q,',7h s> 41 E'ectors/sum. 16.60 Name: { / a ,, Ex • ansion tank 16.60 Address: S" ' ' 5 W + , t . • ,,a= Fixture/sewer c. s 16.60 IEMEETIMII Floor drain/floor sink/hub 16.60 `'A&.' l Garb :e di ..sal 16.60 - Ph. e: (990 ^0 O$ Fax: , Z -��6v Hose bib 16.60 i; '1,42Z.„4',.:, 4 A r ` . e1•. Ice maker 16.60 ' IRMINIFIZAPILIPPPIAMIIIIIIIMI Inter .tor /: ease tra. 16.60 Address: , Si iii, � - , 0 A Medical :as - value: $ Pare 2 Ci /State /Zi.: ® ' 78o Primer 16.60 Roof drain commercial 16.60 Phone: 060 - 0 I el IIMMEENTali Sink/basin/lavato 16.60 E-mail: Tub/shower /shower . • i 16.60 : :7; ,.A 'w Urinal 16.60 Business Name: 1l� �, / at Water closet 16.60 Water heater 16.60 Address: 2 - Other: -- er: • Other: _ -- Phone: (p : 1 7 Fax: - 7' -6(031 .. :71z . . . CCB Lic. #: 0921 Plumb. Lic. #: 2 6 , Subtotal $ Authorized Minimum Permit Fee $72.50 $ R es id en t ial Backflow Minimum Fee $36.25 Sign • + e: � / i�� i Date: lily Plan Review 25% of Permit Fee $ �, \ / State Surchar:e 8% of Permit Fee $ (Please print name) TOTAL PERMIT FEE $ Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri - County Building Industry Service Board. I: \Dsts \Permit Forms \P1mPermitApp.doc 01/03 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - I 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 additional $100.00 or fraction thereof, to and • Fixture or Item Qty. Fee (ea) Total 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees *. • Quantity, (Fixture) Work Performed Comments regarding fixture work: Fixture Type: Replace New Moved - Existing Capped Baptistry /Font Bath - Tub /Shower - Jacuzzi /Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" -3" -4 „ Car Wash Drain i *Note: If the fixture work under this permit results in an Garbage - Domestic increase of sewer EDUs, a sewer permit will be issued and Disposal -Commercial - Industrial fees assessed for the sewer increase must be paid before the Ice Mach. /Refrig. Drains plumbing permit can be issued. Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet - Urinal Other Fixtures: is \Dsts\Permit Forms\PlmPermitAppPg2.doc 01/03 Elect rical Permi FOR OFFICE USE ONLY Received Electrical Date/By: Permit No.: City of Tigard SEP 19 2003 DaPlanning teBy: Approval Sign Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: 'GAR r Post - Review Land Use Phone: 503-639-4171 Fax: o IVIS ' °,r ` DateBy: Case No.: Internet: www.ci.tigard.or.us a I ' Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 ''" Name/Method: Supplemental Information. ,, — : TYPE OF WORK _ . Ae,_ ._ PLAN REVIEW (Please ,check -; all that aPP1YI- V . I• New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location ■ Addition /alteration/re a lacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet, B4igleigAb-ciovqleroalltliztailf.PWUctitek -, :. , , I & 2 family dwellings four or more residential units in • 1 & 2 -Famil dwellin: El Commercial/Industrial ❑ System over 6 00 volts nominal one structure ❑ Building ove three stories ❑Fe eders, 400 amps or more ❑ Accesso Buildin: ❑ Multi - Famil ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other: )0.11--.. V la;I TIM /V M itr a r . li) Submit sets of plans with any of the above. The above are not applicable to temporary construction service. Job site address: 1 5b0 S W ` ; YEE *:SCRED E Suite #: Bld:. /A.t. #: Number of inspections per permit allowed Pro'ect Name: Description Qty Fee (ea.) Total Cross street/Directions to job site: New residential - single or multi - family per dwelling unit. Includes attached garage. `�... Service included: �p b 4--2 J 1000 sq. ft. or less 145.15 4 �—" / Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: Lot #: Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax ma.1 • arcel #: Each manufactured home or modular dwelling *1::::-;: service and/or feeder 90.90 2 Services or feeders - Installation, alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 i ''1 t'r J i a , . � 601 amps to 1000 amps 240.60 2 �" � ' Over 1000 amps or volts 454.65 2 �� /. " ' Reconnect only 66.85 2 Address: Temporary services or feeders - installation, alteration, or relocation: Cit /State /Zi.: 200 amps or less 66.85 1 Phone: Fax: 201 amps to 400 amps 100.30 2 _, t i 's ! , , 401 to 600 amps 133.75 2 � n - -• - - - � Branch circuits -new, alteration, or Name: extension per panel: Address: A. Fee for branch circuits with purchase of 6.65 2 service or feeder fee, each branch circuit Cit /State /Zi.: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit 46.85 2 Phone: Fax: Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): it t Each pump or irrigation circle 53.40 2 Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, alteration, or extension Page 2 2 Business Name: ° , -, — Gl Description: Address: " 0. ' 0 /L ° r r Each additional inspection over the allowable in any of the above: Cit /State /Zi.: , © r 7 ii 7 i / Per inspection per hour (min. 1 hour) 62.50 Phone: (o4 - i Z am Fax: Investigation fee: CCB Lic. #: 0 : i `i-- ' . oz othe ° 1 Supervising electrician Subtotal $ si: ature re' uired: Plan Review (25% of Permit Fee) $ Print Name: lEll State Surcharge (8% of Permit Fee) $ TOTAL PERMIT FEE $ Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) is \Dsts\Permit Forms\ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: n Audio and Stereo Systems n Burglar Alarm n Garage Door Opener Heating, Ventilation and Air Conditioning System Vacuum Systems O Other COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation • HVAC I - 1 Instrumentation O Intercom and Paging Systems • Landscape Irrigation Control El Medical El Nurse Calls • Outdoor Landscape Lighting n Protective Signaling n Other Number of Systems * No licenses are required. Licenses are required for all other installations i: \Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ROSE ELECTRIC PO BOX 128 NORTH PLAINS, OR 97133 Electrical Signature Form Permit #: MST2003 -00475 Date Issued: 11/14/03 Parcel: 1 S135CD -08900 Site Address: 11500 SW 98TH AVE Subdivision: PP1994 - 029 Block: Lot: 002 Jurisdiction: TIG Zoning: R Remarks: New SF detached dwelling. Your company has been indicated as the electrical contractor for the permit indicated above. I n order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MIKE PARKER CONSTRUCTION ROSE ELECTRIC 16594 TIMBERLAND DR PO BOX 128 ALOHA, OR 97007 NORTH PLAINS, OR 97133 Phone #: 503 - 680 -0893 Phone #: 503 - 648 -8254 Reg #: ELE 34 -130C LIC 43084 SUP 2767S AN INK SIGNATURE IS REQUIRED ON THIS FORM x ,�_ Si nature of upervising Electrician If you have any questions, please call 503.718.2433. i 9o.0 ' i i - EIVED _ — — — _ `3 '„ — — — — y5 I o � � EP ' 19 2003 744"0,1 C. 0riy,Q0 PATIO ` SUILDI,10 DIVISION . .. if , 4. N Ftooe- (PAO i f J,' a, }EL _ }� OD 1 4 M, ,3 (OLt5'. 4 .6"' . ; y5 j fi Z FN4/ZAF 6- " j„ , 7` , , ' A x �L d ,P Polg5 g'15 1416 0-2/ El- P 3 00 5 i v). 9' i51-k-1 al I d MI ‘ e cocci' 5 CoSO -0i3.1 ?j S o3 - tote?, - 5S2 - 1=A CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO /-/STad03— 60517 PLANNING DIVISION: R � •S Required Setbacks: Side: pApproved ❑ Not Approved Street Side: Front. Po Garage: Visual Clearance; '� A Rear: 15 Maximum Buildin Approved ❑ Not Approved CWS Service Provider Letter Requi ❑ Yes ,No B ❑ Received Date: 9 - R3-673 ENGINEERING DEPA{'TMENT: Actual Slope: Site PI Approved ❑ Not Approved B ❑ Approved of pproved Notes: Date: 2- 0 411 J-(2." .�, 4 L 1 T � �17s� t ticaL l ti �.�I,� �j I �l 3z� ?ifs s. rkti 6 CITY OF TIGARD 24 -Hour BUILDING 4111 Inspection Line: (503) 639 -4175 CP 3 -0r) <175 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received ‘I / '7- Date Requested Z - 0C/ AM PM BUP Location /50 Suite MEC Contact Person Ph ( ) 7 FO -0F7.S PLM Contractor 92I,( -P 1Pad 00 tJA- C!/YL - Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation g Access: Ft :,- & �-- ELR Drain Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing //'�� // ))- Firewall / �/1;/A- !2 • ,,� sA,), ef'L Fire Sprinkler Fire Alarm �;�o LC-tz /o? 0 e, Susp'd Ceiling Roof Other: Final PASS PART FAIL I�L�iMBING� PosrrSeam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Ot _ • 11 I �44, PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final FAIL RIC - ervice Rough -In UG /Slab Low Voltage PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE D Please call for reinspection RE: Unable to inspect — no access Fire Supply Line C A DAoach/Sidewalk Date /7 Inspector C` `' Ext PP Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL 1■411)11,AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA4 '''' • ■ N • ■ o • • 4 • STREET fi EE IFI R �E T1�TI�N R . - • ► ,.., .„ • ► . • ► G A • ti • • Oo • I, M t VCS AA 1 , ,fi caner/ A. gent f or A &e (L Co , ■ ► • (PLEAS. PRIN7J (PERMIT HOLDER) lb. • • • • • (/�� RECEI • • • ' ' - .! •,i It. 4 Do hereb .z ' 'r fE ! i ' �_. ,, ; ,� �_ 4 ;� • ' MAY 10 2004 �� : CITY OF TIGARD • n ► .5), • �� 1 , BUILDING DIVISION ■ tS ... A� . ' ^ . ��� ,∎ iliA c' • .` on , ounty bl' • • land u d development standards for street tree installation. ► ► • • / 1 • • ADDRESS: I l C S Cll q 01 �1 ms r c� �J �a �' ► ••• • • .. • LOT: SUBDIVISION: PP / C I 6 (2,q IS. It • Yi/'( , • ■ • BY DATE: l D D Or ■ • • / it • • RECEIVED BY: Jr DATE: 5/10/D9/ ► 4 vvvvvvvvvvvvvvvvvvvvvvyyyyyyyyyyyr,yyyjyyyyvyyyyyyyyyyy l