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Permit CITY OF TIGARD MASTER PERMIT ' 8., COMMUNITY DEVELOPMENT ' 1 Permit #: MST2009 -00194 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2009 Parcel: 2S 111 BCO2303 Jurisdiction: Tigard Site address: 14600 SW 103RD AVE Subdivision: TIGARDVILLE HEIGHTS Lot: 21 Project: Nokes Project Description: Add new bathroom in existing living room space; replace and relocate gas furnace; convert water heater from electric to gas. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors. Yes Total: sf Value: $14,600.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 0 Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 2 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 5 Ea addl 500 sf: 0 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea addl Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) NOKES, KATHY EVELYN MITCH GREGOIRE CONSTRUCTION 14600 SW 103RD 3606 NE 68TH AVE TIGARD, OR 97223 Portland, OR 97213 PHONE: 503 - 639 -1427 PHONE: 503- 318 -6156 FAX: Total Fees: $649.40 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 b ne 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: Ore qn law fires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 95 - 1 -010. Y may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.80* 332.2344. Ara Issued By: K s__ )2_e_ Permittee Signature: A. ,,,,A., 'Bui'lding Permit Appli ,i0 1 , l sidential .0 . ' FOR OFFICE USE ONLY City of Tigard S EP 29 2009 Recerv: . II q ea 9,29 19 PertnitNo. . . a7 OO / -DO /J Dat 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revien;7 _ Phone: 503.639.4171 Fax: 5(63. Vf TIGARD Dat �J `•1 �l ` Other Permit: lr, r . l3 OS T I G A R D Inspection Lane: 503.639.4175 Date Ready r�ais: 0 See Page 2 for Internet: www.tigard or.gov BUILDING DIVISION Notified/Method: / 6- Supplemental Information TYPE OF WORK 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 Addi alteratio eplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF .CONSTRUCTION work indicated on this application. dwellin Valuation: $ 14, 06 1- and 2-family g ❑ Commercial/industrial 1 o Accessory building ❑Multr family Number of bedrooms: 2 t , 6 ❑ Master builder ❑ Other. Number of bathrooms: ' � 0 , JOB SITE "INFORMATION AND LOCATION Total number of floors: I qV) Job site address: 4 (3t) - 5\44 ( 0 S rd Ave (7) a New dwelling area: i \A/ square feet City/State/ZIP: - r - 1 A Kt) 0 iZ 91 2.414\ Garage/carport area: 43 square feet Suite/bldg. /apt. no.: Project name: 1\ g a s A.-®p 1 " I p lj Covered porch area: 6 square feet Cross street/directions to job site: I.I\C 1)c) kJ A-L� 4 99 Deck area: '.:" 0 square feet Other structure area: Cp square feet REQUIRED DATA: COMMERCIAL CHECKLIST ,9 Subdivision: - rla.card ,I11•O (4et cm#s Lot no.: p-r Q / Permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: Is 50 2 3(07 equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Pt N'W laATIi a-0 60A Iu SID E )(isr FcarfRffifr Valuation: $ RE. Mk e 6 4- , moVE e,i c (& er 5 ) Existing building area: square feet ZO ,L Rzo A-0er New building area: square feet • '<PROPERTY OWNER ❑ TENANT Number of stories: Name: K A -Hy 1 4 0 1.<5 Type of construction: Address: k ‘„®o N 105 NI Ave Occupancy groups: City/State/ZIP: 1" 1 61 A (Z. t 6 I. 9 Z44.4 Existing: Phone: ( isos) (p 3, r .4„2-7 Fax: ( ) New: 1 (APPLICANT CONTACT PERSON NOTICE Business name: M \ r t -1, e_EGo 1 «._E Co as r 12V cm oN j All contractors and subcontractors are required to be Contact name: IAN - •C'CN 7 2 � G0 1R,E licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 3(0.00 (p Al E GA; .fi Ave- PD X 0 R jurisdiction in which work is being performed. If the City / State/ZIP: q--7 3 applicant is exempt from licensing, the following reasons apply. Phone: ( 1503) 31 • (p 1 S J(p Fax: : ( ) E -mail: -7 ox. c iw -) E N "I" E 6.' e W O E— . (.' 0 1M CONTRACTOR Business name: M 1 T C W G ( E e01 R, cowsrerd,cr Ow BUILDING PERMIT FEES* Address: 3(o6 ( N f E 6 Ave (Please refer to fee schedule City/ State/ZIP: 'PO tz�•LA,pf Oa q412.13 Structural plan review fee (or deposit): Phone: ( 1" Fax: ( ) FLS plan review fee (if applicable): CCB lic.: i 5 4/ a 3 7'/ Li ( ` Total fees due upon application: Amount received: /3 „Z i / � Authorized signature: \(Nh t t ` ` `S'�°4' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: OA cr. OR C Date: Stop 21 ZVI * Fee methodology set by Tri- County Building Industry • Service Board. ~'7 'Pliutmbing Permit ApplicationRE Cc . wilding Fixtures L ' "_,° - FOR OFFICE USE ONLY .m. , - . - City of Tigard SEP 2 9 2009 Received Permit No. /-07 0 2C709 . _. n 13125 S W Hall Bl, d, 2 Date/By: 0©/ �f' y Phone: 503.639.4171 vd. Tigar Fax: 50 3.598. 1 OR 972 Plan Review Other Permit No.: // 6:TY O F TIGARL DateBy: Inspection Line: 503.639.4175 BUILDING �+ TI GARD BUILDING DIVI I j Date ReadyBy: Ions: H See Page 2 for -- Internet: www.ttgard or.gov a Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. _ Description Qty. j Ea. 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 Eg1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi 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: 0(O00 Sw' 103' Aic Catch basin or area d i 16.60 City /State/ZIP: 'P c r LkPJ 0 G. q° 41 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: l Project name: NOW(' , go D T-000 Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: C iel Q 4. trf9 ,C, R�r 0 Man holes rzd home utilities 110.00 j °" " Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: `n E 4 c:mi p ,F we Q ,6 , 5. I Lot no.: pr a p Water service (no. linear fl.: ) Page 2 Tax map /parcel no.: R 50 2 3‘) D fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 Mi) tv e w z,,(4--r 0, a 0,8 14, 1 s s Sttuwe e -V p' le,∎ Tr Backwater valve 16.60 ge L o Get. -E- 6 A LI 60 2 g ,t,. 1 u s " tL o ""t.) Clothes washer 16.60 6 Pt S *2 0 I i- eA-re- -- Dishwasher 16.60 Q PROPERTY OWNER ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: 14,31---rtri Y Wo KES Expansion tank 16.60 Address: Y Ght/ 6 t 16 .3 A A(E Fixture /sewer cap 16.60 City/State/ZIP: o0...7- D 0 g11.1 Floor drain/floor sink/hub 16.60 Phone: ( 6171 ) (t 361 R Z.1 Fax: ( ) Garbage disposal 16.60 ('APPLICANT El CONTACT PERSON Hose bib 16.60 Ice maker + 16.60 y Business name: 1A 1 li �.; 60 p (&E CON 5,,7"4„tvlC1llo Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: 94 J e It..6 , A 4v 6.7 Primer 16.60 City/State /ZIP: f E -� a q 7 3 Roof drain (commercial) 16.60 (, Sink/basin/lavatory op/ 1 � 16.60 Phone: ( �$1�) 3 ( 61 S� Fax: : ( ) it Tub /shower /shower pan 9 16.60 E -mail: C4 * C r O °'014 ter € 01 4 4 1 11 c 01 ��pp Urinal 16.60 u CONTRACTOIt' Water closet 1 16.60 Business name: Ltw y v Q Lp iouj en Water heater 11 16.60 Address: ,0 • s cic 1 5% Other: City/State /ZIP: C9 a 1 l c Iry f A 910 ai 5 Subtota - Minimum permit fee: $72.50 Phone: (S03) 5-7 5 ... 4 (q Fax: (5'O3) 4 so 115 9 Residential backflow minimum permit fee: $36.25 CCB Lie.: / 5 5 4 ilo (' Plumbing Lic'S1A : ' 8 6 45 Plan review (25% of permit fee) State surcharge (12% of pennit fee) Authorized signature: s° �� -- l r!I 7 1" °"" � ""�� v_ ""°�e,..,� TOTAL PERMIT FEE Print name: ?kill t p 5 v e. /"' tit tin I Date: i 4 7 This permit application expires if a permit is not obtained within I 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. Electrical Permit Application ; ; FOR - OFFICE USE ONLY City of Tigard 2009 Dat ved PemutNo. /757 Z UO/ p — 00 /Y i ° 13125 SW Hall Blvd., Tigard, OR 97223 SEP 2 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit - T TGARD Inspection Line: 503.639.4175 CITY OFTIGARD DateReady/By: iuis: El See Page 2 for Internet: www.tigard - or.gov R1IILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK . PLAN REVIEW ❑ New construction' , Addition/alteration/replacement 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 A l- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations buildings ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KV A or JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", a O S ` - I 0' f' d A C 100HP or more. Up �cY- Job no.: Job site address: d I W I I cp ❑ Six or more residential units. ❑ Recreational vehicle parks. (.�� (44-2...D ❑ Health -care facilities. ❑ Supply voltage for more than City/State {Z,IP: ` �- a 1 ® 1� ❑ Hazardous l ocations 600 volts nominal Suite/bldg. /apt. no.: I Project name: N OK ES �T Y� D-1: v ' n 0,4 ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: '(t^ c- D 01.1 F1-Lt, 9'9 \A/ Description I Qty. I Fee. I Total New residential single- or multi - fancily dwelling unit. Includes attached garage. Subdivision: - L ot no.: 1,000 sq. ft, or less ' 145.15 4 (a 11 � I l._l_.E 14 � I C1 T S PTA 1 Ea. add'l 500 sq. IF or portion 33.40 1 Tax map /parcel no.: R 5o ,p 3 , I Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Pe? Limited energy, multi - family U 1_ e? (kik 17 E PP.tiJL L, 'l'0 Zoo 1 (Z C L(0CA}TE residential (with above sq ft.) 75.00 2 Services or feeders installation, alteration, and /or relocation 11-1) D N E Ina i3 4174- Cl Rcu rrS rj Ecvn11 '.SSJ yxi : bL 200 amps or less 9 80.30 2 I',, PROPERTY OWNER ❑ TENANT °' • 201 amps to 400 amps 106.85 2 Name: \I..., �71,—‘ \ i V n K S 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: ' 4 \ 00 S tiV L. 01 it tgl A✓ e Over 1,000 amps or volts 454.65 2 City /State/ZIP: ! vb 1 ; ; Of, 49,-7P-1.9 Temporary services or feeders installation, alteration, and/or relocation Phone: ( 503) Co 3c, 1 Z 7 I 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 i 133.75 -2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with APPLICANT • I El CONTACT PERSON above service or feeder fee, 6.65 2 Business name: �p S p �,� d� each branch circuit 1 " d l C}-A ` O �E 1 B . Fee for branch circuits �rt without service or feeder fee, Contact name: r li d (R .E �s ,� IRO first branch circuit 46.85 2 Address: - 3( e .,00, kJ' E ( , e t'U j Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: i2. eft 97 2.0 3 Each manufactured or modular 90.90 2 Phone: ( �b3) 3 D 8 e 4( 5 , Fax : : ( ) Reconnect t onl ye and/or feeder Reconnect only 66.85 2 E - mail: E'°" g,, cAlk pew" , 6 644,4,1 L r CO PA Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: G 12 f� `ki 12,e ELec TA ) G Signal circuit(s) or limited - energy panel, alteration, or extension. Describe: Page 2 2 Address: �, 0 , �GJ / � / 2 J City /State /ZIP: po/ 7- LA, i v D a4 fe7.2 93 Each additional inspection over allowable in any of the above �a/ Per inspection 62. 1 \ Phone: ('5 3) E '. f D f p I Fax: ( t13 ) 5) 2 t i' �� Investigation per hour (1 hr min) 62.50 k\ CCB Lie.: d 7'f c 7 9cy I Electrical Lie.: C 3 04 II Suprv. Lie.: 5 Z61 S Industrial plant per hour 73.75 �� C ELECTRICAL PERMIT FEES � Suprv. Electrician signature, required: �olt vi Subtotal: Print name: L A / LeoN 01G. Date: See za, zoo Plan review (25% of permit fee): `° State surcharge (12% of pennit fee): Authorized signature: _ TOTAL PERMIT FEE: _ This permit application expires if a permit is not obtained within 180 Print name' Date: days after it has been accepted as complete. Mechanical Permit Applic. 1 . FOR OFFICE USE ON ' - ! . City of Tigard SEP 2 9 2009 Date/B: Perini[ No.: q i 1 " 13125 SW Hall Blvd 639417 ., Fax: Tigard, 503OR 97223 ` D y S /°2�� / -- O � / ..1 .598 OF TIGARD Plan Review Other Permit: r • - Phone: 503 1 �+ DateBy: T 1 GA 503.639.4175 RD Ins Line: 503 DI Date Re /By luris: Internet: www.ti trd - or. ov BUILDING 0 See Page 2 for g` g Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction AAddition /alteration/replacernent 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 CONSTRUCTION Value: $ �1 and 2- family dwelling ❑ Commercial/industrial RESIDENTIAL EQUIPMENT !SYSTEMS FEES* ❑ 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: r q (rO t) S v' 1 d a r t E Air conditioning or heat pump (requires site plan showing placement) 14.00 City/State/ZIP: 1" 1 & R' > 0 k 91 2. e' Furnace 100,000 BTU (ducts/vents) 14.00 Suite/bldg. /apt. no.: Project name: No K e_s AbD . lI0 NJ Gas heat pump 14.00 Cross street/directions to job site: go vl 4 c- i I, Duct work { 10.00 Hydrotuc 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: -1-11.E7 M.. \ G L �,.eg bi¢.�` 5 Lot no.: P72 l Flue/vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: 'R so & 3 co Q Other fuel appliances DESCRIPTION OF WORK Water heater 1 10.00 .� doMI S58o F 4 X C Gas uevent 10.00 e. 6 Q...� �°$ A' � Flue vent for water heater or gas µ hk,1 5 IL, ;veto 6 / gin e FF. � IJ Ao �.E � NEW- fireplace P 10.00 Log lighter (gas) 10.00 titY1 EC hk . it 04 . Loc4_. -rio al r RE m C° U ECr UPPLy+- Wood/pellet stove 10.00 , (2-e-1-02-41 1-02 -1 4, 6 ag. Wood fireplace /insert 10.00 (PROPERTY OWNER El TENANT • Chimney /liner /flue /vent 10.00 Other: 10.00 Name: ILA-114 V WO � gS Environmental exhaust and ventilation Address: 9 . �f 00 r 10 3r4 A4AZ Range hood/other kitchen equipment 10.00 City /State /ZIP: T1 ( 1 0 9 " - • t 44 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) 2.7 Fax: ( ) toilet compartments, utility rooms) 6.80 g APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 � Other: 10.00 Business name: NI t ''" "p,el & n ( M57 ottiy Fue piping ` P g Contact name: M II. r 4 $5.40 for first four; $1.00 for each additional Address: aou k1 beivA ( Furnace, etc. I Gas heat pump City/State /ZIP: oil. )1 v 3 Wall /suspended/unit heater Phone: ( 3 a 415c,,, Fax : ( ) Water heater �t ,pp���p / ,�!m� g j Fireplace E -mail: A% eire it , erE 4044 AQ � .. �" Range " p a CONTRA4'OR Barbecue Business name: Row Eck A. F pop) ALE 4F 7 rw 6 Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: po k r *ts , a A 97 .9.7 Subtotal Phone: ( 53) 2.e 6 .2 SO(� Fax: ( ) Minimum pemut fee ($72.50) Plan review (25% of permit fee) CCB lic.: 5 . 61 554 S��l State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: ` � j - 4 This permit application expires if a permit is not obtained within 180 r days after it has been accepted as complete. I _ , - 1` , " �OM i _ I .. .. .. .. T - . . - _ . PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems) Description I Qty. l Fee(ea.) I Total Description I Qty Fee(ea.) I Total New 1- & 2- family 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 350.00 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 fo 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 5� Water heater 1 10.00 1. C $ ° Footing drain - 1 100' 55.00 Gas fireplace 10.00 Footing drain - each additional 100' 46.40 Flue vent (water heater /gas fireplace) 10.00 Manufactured home utilities 110.00 Log lighter (gas) 10.00 Manholes 16.60 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 10.00 Water service - I 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, 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 Dishwasher 16.60 Fuel Piping Drinking fountain 16.60 * *($5.40 for first 4, $1.00 each additional) Furnace, etc. I ** 5 .qt j Ejectors /sump 16.60 Gas heat pump ** Expansion tank 16.60 Wall /suspended/unit heater ** Fixture /sewer cap 16.60 Water heater t ** 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 001 1. 1 16.60 IL .LoC) Subtotal: $ Q 9.'Q (,q 3 . (o) Tub /shower /shower pan ( 16.60 I ( Minimum Permit Fee $72.50 $ 1 Q . JO Urinal 16.60 Plan Review Fee (25% of Permit Fee) $ Water closet 1 16.60 lip .60 State Surcharge (12% of Permit Fee) $ 6 � . 13 Water heater C:) 16.60 1( (on TOTAL PERMIT FEE $ t . 20 Other: Other: Plumbing Permit Fees ELECTRICAL FEES (residential single- or multi - family) Subtotal $ U t o (( AO Description Qty. Fee Total Insp Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less 145.15 3C) 4 Plan Review (25% of Permit Fee) $ �a Ea. add'l 500 sq. ft. or portion 33.40(-x/ .� J . :55 1 State Surcharge (12% of Permit Fee) $ 3 0 Limited energy, residential 75.00 2 TOTAL PERMIT FEE $ Br. ` Q Each manufactured or modular 2 dwelling, service and /or feeder 90.90 Electrical Permit Fees Subtotal: $ ] 1 ,:5 , SS Plan review (25% of permit fee) $ State surcharge (12% of permit fee) $ ( TOTAL PERMIT FEE $ 1 • 20 I: \Buil ding \Foams \ResPlanCheckFees.doc 01/19/07 Page 2 " Building Division One & Two - Family Dwelling TIGARD Fees Checklist PE I'T INFORMATION+ : Permit #: M 51 --OP k Plan #: Date: !OA /0 9 Site Address: 11( to d O y e Parcel #: 2- ` Subdivision: TI CI rc V t L le u Qt q511.1 Lot #: rs ' 21 Zoning: Jurisdiction: Setbacks: Front: Rear: Left Right: Class of Work: A LT Stories: First Floor:, Type of Use: (".eS . Height: Second Floor: Construction: Floor Load: Third Floor: Occupancy Group: Dwelling Units: Bonus Room: Valuation: , ( (Jo Bedrooms: Total Floors: Bathrooms: Basement: Decks: Garage: Porches: Other: FE = �escnp in. P A ount Am±i} t Paid . ` B cL� e Plan Check: Building: Extra Set: Permit: Building: Tax: Metro CET: School CET: Mechanical Tax: Plumbing: Tax: Electrical: Tax: Low Voltage: Tax: CDC: CDC Ping. Rev.: CDC LRP Fee: SDC: Parks: TIF Res.: TIF MT: - Erosion Permit: Erosion CWS: Erosion COT: Water Quality: Water Quantity: SUB - TOTAL: Sewer: Permit: Inspection: SUB- TOTAL: TOTAL MST & SWR: I:\ Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 1