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Permit C OF TIGARD PERMIT #: MST2002 -00207 MASTER PERMIT , � I� i DEVELOPMENT SERVICES DATE ISSUED: 4/29/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13615 SW 115TH AVE PARCEL: 2S103CD -00400 SUBDIVISION: ZONING: R -4.5 BLOCK: LOT: JURISDICTION: TIG REMARKS: 393 square foot addition Path 1 BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 393 sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: 5 VALUE: $ 35,605.80 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 393.00 sf REAR: 47 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: CLOTHES DRYER: GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 • 200 amp: 0 • 200 amp: W /SVC OR FDR: 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: $ 880.03 This permit is subject to the regulations contained in the BITHER, ANDREW D + KELLY A ROYAL REMODELING RESOURCES Tigard Municipal Code, State of OR. Specialty Codes and 13615 SW 115TH AVE PO BOX 230805 all other applicable laws. All work will be done in TIGARD, OR 97223 TIGARD, OR 97281 -0805 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 #: LIC 90746 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. REQUIRED INSPECTIONS Footing Insp Crawl Drain /Backwater Shear Wall Insp Electrical Final Foundation Insp Footing /Foundation Dn Exterior Sheathing Insr Mechanical Final Post/Beam Structural Mechanical Insp Low Voltage Plumb Final Post/Beam Mechanica Electrical Service Insulation Insp Final inspection Underfloor insulation Electrical Rough In Rain drain Insp Isskd By : t� ; • 4 l ( -� I Permittee Signature : � rG Call (503) G39 -4175 by 7:00 p.m. for an inspection needed the next business day 1013 -z3 Z q A - - Bu Permit Application Date received: y / 7 4 Permit no.)16 -" . . _ �t�.,y� City of Tigard : -.. Project/appl. no.: Expire date: 0. City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 �-- ? Phone: (503) 639 - 4171 Date issued: (B Receipt no.: J :�: (503) 598 6 u06 ..14.4y Case file no.: Payment type: , �, Land use approval: h-eLL2 1 &2 family: Simple Complex: 'N TYPE OF PERMIT 0 1 & 2 family dwelling or accessory U Commercial/industrial 0 Multi family ❑ New construction ❑ Demolition ii.Addition/alteration/replacement ❑ Tenant improvement 0 Fire sprinkler /alarm U Other: JOB SITE INFORMATION • Job address: 1'>G� 1'5 Sim I IS T!� Bldg. no.: Suite no.: `\ \ Lot: I Block: 'Subdivision: TE R42.a..G E TraA>, LS I Tax map /tax lot/account no.: 25103 LD 0 Project name: FT [ ►e Description and location of work on premises/special conditions: >1' to ti T'o 0r`1E- � / �( OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: A N17 - 1 -- I =1 IZ (Floodplain, septic capacity, solar, etc.) ` Mailing address: 134 I S .t k IS " 1 & 2 family dwelling: / � City: 1 lf, rz c� I State: c� - I ZIP: 9 71.23 Valuation of work 3.,5 s D ° • $ aG 1 .ein k Phone: S `Je - 8`I C Co 'Fax: 1E-mail: No. of bedrooms/baths Owner's representative: Eo '>¶ '..)CJC2 Total number of floors q Phone: - 40 - 9313 Fax: �(C.C•93 I E -mail: - t New dwelling area (sq. ft.) V R V APPLICANT Garage /carport area (sq. ft.) Name: 124=7›'Ti>. t___ re €..r--A, c3p.lrt r— Covered porch area (sq. ft.) Mailing address: Pe) 1.30 8�•a Deck area (sq. ft.) City:7 67,i.2 n I State:c> i • I ZIP: 9 g-• c Other structure area (sq. ft.) Phone: 4 7$ Fax:l '4- .4'Z(.• E -mail: Commercial/industrial /multi - family: CONTRACTOR Valuation of work $ Business name: w. 0 `AL, 12r rw 0 - -et-, t �)`5 Existing bldg. area (s4. ft.) New bldg. area (sq. ft.) Address: A �tC Number of stories . City: o I State: 'ZIP: Type of construction .. Phone: 4 ax: I E -mail: CCB no.: c:›9 c) 4e.,.. Occupancy gro • : Existing: New: City /metro lie. no.: Shp Notice: All contractors and subcontractors are required to be ARCIIITECI (DESIGNER licensed with the Oregon Construction Contractors Board under V Name: .N 1=z. P� Lt■n C) -- C_.‘-- t-•=i provisions of ORS 701 and may be required to be licensed in the Address: lc) 3e, ti E 4,,at.� 1:::$-T-- -lam ZOO jurisdiction where work is being performed. If the applicant is City: 'a /Z l • State: O,( I ZIP: c l_) . l Z exempt from licensing, the following reason applies: Contact person: - '1 Plan no.: r� Phone: •6.0 -93 Fax:4 DOi E -mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: City: (State: IZIP: Amount received $ Phone: I Fax: I 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 ❑ visa 0 MasterCard work will be complied with whetherein or not. Credit card number: / / Expires Authorized signatu . Date: Name of cardholder as shown on credit card ■ $ ± ,, l ,�/ Print name: ....4� ' J C \ Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days / days after it has been accepted as complete. 440.4613 (6I0O/COM) One- and Two - Family Dwelling e Building Permit Application Checklist Reference no.: Associated permits: City of Tigard City f Tigard Y b ❑ Electrical ❑ Plumbing ❑ Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ 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 platllot. 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. 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. 11 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 details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, [hernial 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 (6/00/COM) t , A - 1lectrical Permit Application D ate received: -* ; Permit no.: 1 ,.. -,%4*I J ; ' .l City of Tigard Proje ct/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction 2 Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 131 Sw 1 l C ` 4 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: Project name: P -t - re_ I Description and location of work on premises: i i'DAJ Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max Business name: 4� V_ Q ......e. £ 1_.cr� , Description Qty. (es) Total no. insp New residential - single or multi - family per Address: 4 Z' G gi.sr dwelling tmit. Includes attached garage. City: ---ne,j'A2, I State: b/l I ZIP: °j ) 't,Z.4 Service included: Phone: GZp ( c, I Fax: I E -mail: 1000 sq. ft. or less 4 CCB no.: 9 Z\ (2) S1 I Elec. bus. lic. no: 3q 94z - c Each additional reside ft. or portion thereof Limited energy, residential 2 City /metro lic. no.: ' Es 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 — installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): / 0, 1 14 - t.2 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 13 415 Sv✓ l 1S 601 amps to 1000 amps 2 City: j l! I State: r Z I ZIP: ° 1.7 ZZ3 Over 1000 amps or volts 2 Phone: 5 8& 4— I Fax: I E -mail: Reconnect only 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, or relocation: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER 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 REVIEW (Please check all that apply) 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 1 &2 ❑ 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 over 600 volts nominal more residential units in one structure alteration, or extension* - 2 ❑ Building over three stories LI Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ Other. Per inspection I I I 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 $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ _ Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ - Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6100/COM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: • 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 NI, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 n 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 n 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 2 201 amps to 400 amps $106.85 2 I I Vacuum Systems 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 n 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. n Audio and Stereo Systems Branch Circuits n New, alteration or extension per panel Boiler Controls a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit / $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous n Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting $53.40 n Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over n Medical the allowable in any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ n 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 $ All New Commercial Buildings require 2 sets of plans. i:\dsts\forms\elc- fees.doc 08/30/01 i Mechanical'Permit Application Date received: �-7, Permit no.: ,1Aja a,,; j2 '' City of Tigar Project/appl. no.: Expire date: CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 - 4171 Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction iii Addition/alteration /replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: 134 1 S ' '/v I. 1 S Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ . Lot: 4D0 Block: I Subdivision: TE.e.2A.c.z Ta.A.. u * See checklist for important application information and Project name: F3,- -C.-i-1... 2 jurisdiction's fee schedule for residential permit fee. City /county: 7'14 I ZIP: ° 1 "-? 7...Z 1 & 2 FAMILY DWELLING PERMIT FIE SCHEDULE Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE „6.....,,...-,-- 0ry Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM space insulated? LI Yes ❑ No Air conditioning (site HVAC s is Is existing P Alterati of existi HVAC system NIECHANICAL CONTRACTOR Boiler /compressors IA erg 1 YV State boiler permit no.: Business name: T � � HP Tons BTU /H Address: Po I "Z.. C. 6 Fire/smoke dampers/duct smoke detectors City: C„ iSsy I State: 02.1 ZIP: 4 - 2C2.13 Heat pump (site plan required) Install/replace furnace/burner BTU /H Phone: ► Z q 9 I Fax: E I Including ductwork/vent liner 1:1 Yes CI No CCB no.: l AcPo g Install/replace/relocate heaters - suspended, City /metro lic. no.: I I3 Z wall, or floor mounted Name (please print): 104.v.__,v 1C t d riA. Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: Kt .r■ 20 4 - Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER Hoods, Type U IUres. kitchen/hazmat hood fire suppression system Name: / .r. 7 ;:; - T" (f4..\'/Z. Exhaust fan with single duct (bath fans) Mailing address: t. 3 C. t S 4N-t..) 1 1c. i Exhaust system apart from heating or AC T T i State: ZIP: � - 1 Z23 ' Fuel piping and distribution (up to 4 outlets) Cit Y Gi*�z I I Type: LPG NG Oil Phone: S`] E S'5 (t. Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert - type Phone: 1 Fax: _ 1E-mail: Woodstove/pellet stove PP signature: Other: Applicant's si nature: Date: Other: Name (print): ..> I .JC, - e____ Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ ❑ Visa CI MasterCard Notice: This permit application Minimum fee $ Credit card number: / / expires if a permit is not obtained Plan review (at %) $ Expires within 180 days after it has been State surcharge (8%) .... $ Name of cardholder as shown on credit card accepted as complete. S TOTAL $ Cardholder signature Amount 440 -4617 (bW/COM) . - MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: • TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to $5,000.00 Minimum fee $72.50 , Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional $100.00 or including ducts & vents 14.00 fraction thereof, to and including 2) Furnace 100,000 BTU+ $10,000.00. including ducts & vents 17.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace $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 Pump Cond fraction thereof. footnotes below. , p .« C Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit _ to 100K BTU 14.00 8% State Surcharge $ 8) 3-15 HP; absorb 25.60 unit 100k to 500k BTU 25% Plan Review Fee (of subtotal) $ 9) 15 -30 HP; absorb 35.00 Required for ALL commercial permits only unit .5 1 mil BTU TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20 unit 1 -1.75 mil BTU 11) >50HP; absorb unit >1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APP LIANCE: 12) Air handling unit to 10,000 CFM 10.00 Value Total 13) Air handling unit 10,000 CFM+ Description: Qty (Ea) Amount 17.20 Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler ducts & vents _ 10.00 Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct ducts & vents 6.80 Floor furnace including vent 955 16) Ventilation system not included in I Suspended heater, wall heater or 955 appliance permit 10.00 floor mounted heater 17) Hood served by mechanical exhaust Vent not included in applicance 445 10.00 permit 18) Domestic incinerators Repair units 805 17.40 < 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator to 100k BTU 69.95 3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves 101 k to 500k BTU 10.00 15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets mil. BTU 5.40 30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each) 1 -1.75 mil. BTU 1.00 >50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $ >1.75 mil. BTU Air handling unit to 10,000 cfm 656 8% State Surcharge $ Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not included in 656 appliance permit Hood served by mechanical exhaust 656 Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum charge - two hours) Domestic incinerator 1,170 $62.50 per hour. Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge - half hour) Other unit, including wood stoves, 656 $62.50 per hour inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum Gas piping 1 - 4 outlets 360 charge- one -half hour) $62.50 per hour Each additional outlet 63 * State Contractor Boiler Certification required for units >200k BTU. TOTAL COMMERCIAL ,, ;`` ** Residential NC requires site plan showing placement of unit. - $ VALUATION: t.., . . or,,::'' All New Commercial Buildings require 2 sets of plans. i:\dsts \forms\mech- fees.doc 12/26/01 ENDPOINT DESIGN PHONE NO. : 503 +460 +9317 Mar. 21 2002 11:590M P2 F /5 73 ClearnWat Services Our c:u,,,n it „ur;,'t i elcar_ Sensitive Area Pre - Screening Site Assessment Jurisdiction .c7 a ,y cp Date 3 - Z t - c_ 'i: Map & Tax Lot a.5/ 0,3,C,0 00'100 ` Owner fa--)3:DT f±;t7.� Site Address I/ i 5 SW i i 5 •n►' ,`_ ii z1::, Contact . .E-v 4 ins c Proposed Activity 12E./ 1 i� 1 1 F S,. i4 ow, c Address 44D 3 ! N �_. 4.4.'0 a-- Zo h�r:›■ tom IA _PO(4 - (t.�� o 9')212 Phone > t 44,4›...9 _. .16.0 C a� Y N NA Y N NA 1 M I I Sensitive Area Composite Map U ❑ rg Stormwater Infrastructure maps Map# 25I WA . QS# _ t_i`4 1 s Y N NA Y N NA ❑ ❑ 17, Locally adopted studies or maps 7 i ri4 Other Specify Specify Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order No. 00 -7: f] Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural Resources Assessment Report may also be required. 0 1. Sensitive areas do not appear to exist on site or within 200' of the site. This pre- screen site assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered on your property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STORMWATER CONNECTION PERMIT. I j The proposed activity does not meet the definition of development. NO SITE . ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Comments: Reviewed By: Lv„.0( 4 0 Date: 3 - .Z 6- 0 . 2 \ Returned to Applicant • Mail X Fax Counter 155 N First Avenue, Suite 270 • Hillsboro, Oregon 97124 Date 5 - 2.7 - Ca BY C6- Phone: (503) 846 -8621 • Fax: (503) 846 -3525 www c1 anwaterserviccs.org CITYYOF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WEBER ELECTRIC INC PO BOX 231154 TIGARD, OR 97281 Electrical Signature Form Permit #: MST2002 -00207 Date Issued: 4/29/02 Parcel: 2S103CD -00400 Site Address: 13615 SW 115TH AVE Subdivision: Block: Lot: Jurisdiction: TIG Zoning: R Remarks: 393 square foot addition Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In 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 Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: BITHER, ANDREW D + KELLY A WEBER ELECTRIC INC 13615 SW 115TH AVE PO BOX 231154 TIGARD, OR 97223 TIGARD, OR 97281 Phone #: Phone #: Reg #: s =Fs ELE 34 -442c AN INK SIGNATURE IS REQUIRED ON THIS FORM X � rC/ z ■ Ai Signature of Supervising Electrician If you have any questions, please call (503) 639 -4171, ext. # 310 CITY OF TIGARD 24 -Hour BUILDING , . Inspection Line: (503) 639 -4175 MST -6 O , d 7 INSPECTION DIVISION Business Line: (503) 639- 1 BUP I Received Date Requested - 7 i q _ AM PM BUP Location 13( 15- z I I : "^-- 1 Suite MEC Contact Person h Ph ( ) a d — 3TX 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes A SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling / Roof Other: ` a 1 •A PART FAIL G Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: A PART FAIL M ECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers ma AS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final D Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: Ei Unable to inspect — no access Fire Supply Line /f ADA 7/` 4c� \.&, 2--Y4—`( Approach/Sidewalk Date Inspector ja-------- Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST a 6-207 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested 3 — / AM PM BUP Location 1 S / l �; lJ-�— Suite MEC Contact Person Ph ( ) 3.3c. 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain 6,4-4aat Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Catch Basin / Manhole Storm Drain Shower Pan Other: ;iv PART FAIL ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL 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 ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date C � — Inspector r ' I �v Q ' Ext Other: Final ina DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY D 24 -Hour BUIL Inspection Line: (503) 639 -4175 MST - INSPECTION I SION Business Line: (503) 639 -4171 / BUP Received Date Requested ' ! / AM PM BUP Location 34e/s' MEC Contact Person Ph ( ) / 9r 33 '3' PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam mCi\ Shear Anchors , . . . V Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm 1 ∎j 4 5 t Susp'd Ceiling 1 Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage _Fire Alarm SS ART FAIL El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SIT El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA � /� — Approach/Sidewalk Date / Inspecto ■..g_rdea•' Ext Other: Final DO NOT REMOVE this inspection record from the Jo site. PASS PART FAIL CITY OF TIGARD 24 -Hour BILILI NA,G Inspection Line: (503) 639 -4175 MST • INSPECTION DIVISION Business Line: (503) 639 -4171 Received Date Requested / / (1 AM _ � PM BUP Location / C > , s sit MEC Contact Person Ph ( ) 8 / J 7 a.P PLM Contractor LJh rl f/`i Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain 0 P R Slab Inspection Not s: SIT Post & Beam Shear Anchors Ext Sheath/Shear • 00Cc- • M e / 71/47r ri L P ear.***----V Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm - Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Se ice UG/Slab Low Voltage Fire Alarm Fin Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL ITE Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA L � y m Approach/Sidewalk Date 'J'iQ / I LJ "2, Inspector ` _ Ext Other: • Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 - INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP / Received Date Requested �! /`� AM PM BUP Location / 3 1.S //S A-u-e-- Suite MEC Contact Person Ph ( _) . � —3 3 G- PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear '6% 4 r S /s c2 Jac cr •tp OFrz 0 o,e_ ns•a •• rywall Na I g Firewall Sp rinkle � � Sp �/� Fire ° �� �'� �' ��"`� Fire Alarm - r • Susp'd Ceili g I - fah 41 .61L... 0 �, "l. ' I�� Roof Other: Fin AS .ART FAIL PL ' BIN Post & Beam Under Slab - Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL 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 ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA G ` S - ` � Approach/Sidewalk Date Inspector �• Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 �j — a 6 7 INSPECTION DIVISION fr Business Line: (503) 639 -4171 �i' BUP Received Date Requested // t AM PM / J ' - BUP Location / 3 'e I 5 / Suite MEC Contact Person Ph ( ) 02 d 9- 33 '3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: - q "2---- ELR Ftg Drain `7 Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear ` V(..4V _ t�� ' . Insulation Drywall Nailing �� Firewall ) , c �C Fire Sprinkler • r LA...- - Fire Alarm , • Susp'd Ceiling M Roof if ! / Other: - Final PASS PART ( g) PLUMBING Post & Beam Under Slab Rough -In Water Service r Sanitary \C-7 wer /� _ '��( � � , �-,r • 1 �� � Rain Drains / \ N Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam =oug Gas me Smoke Dampers F - PART FAIL EL - ICAL 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 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date �{' l 4 " v Inspector \ Ext 2 - 922/ Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour �7 BUILDING • Inspection Line: (503) 639 -4175 MST �` _ 7 INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received 1 Date Requested / P AM PM BUP Location / -3 (/5 < �.3 Suite MEC Contact Person ,12;4 Ph ( ) ,a-o7 3303 PLM Contractor ) Ph ( ) SWR DING Tenant/Owner ELC noting Fo ation ELC Ftg Drain Access: ' J /4-n.- � 'e >' - ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: PART FAIL 4101, PLUMBING Post & Beam Under Slab Rough -In \—/ Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date V 1 `' Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested s 7 AM PM BUP Location / 3 l .- 11 _ Suite MEC Contact Person Ph ( ) ZI7 5' 3 3 3 PLM Contr Ph ( ) SWR UILDI Tenant/Owner ELC Footing Foundation Access: ELC Ftg D -. ELR Inspection Notes: SIT • • J - - ors eath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: C 0'ART FAIL • -, ° =ING Post & Beam Under Slab i0 1.1 Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P ASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL 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 ❑ Please call for re'nspectio ► RE: Unable to inspect — no access Fire Supply Line ADA / Approach/Sidewalk Date Inspector r Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ° OZG INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM PM BUP Location / / /3 V 1 -� Suite MEC Contact Person s Ph ( ) g 2' 336-3 PLM Contractor Ph ( ) SWR BUILDING _ Tenant/Owner ELC „ ootin a io ELC Access: tg rain ELR Crawl Drain Slab Inspection Notes: ,,{{ SIT Post & Beam U - L��/ Shear Anchors V Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Date - �. Approach/Sidewalk Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING • - Inspection Line: (503) 639 -4175 MST r66 07 INSPECTION DIVISION Business Line: (503) 639 -4171 UP Received Date Requested f AM s /PM BUP Location _ �� Suite MEC Contact Person Ph ( ) r 9 .3 30 PLM Contractor Ph ( ) SWR BU LONG Tenant/Owner ELC Foottq Foundation ELC � 8,�,�,v Access: Ftg Drain � ELR Crawl Drain Slab Inspection Note- �'v SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear ) 4 /1 _ e)Ps ,• u , Y _ (> Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: • Fi PART FAIL • • BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL 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 LI Please call for reinspection RE: Unable to inspect — no ss Fire Supply Line r D Inspector Ext Approach /Sidewalk P Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST y d ° aC INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM PM BUP Location / .3(4 / S 1/ � �"- -U Suite MEC Contact Person v Ph ( ) n - d' -33( PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC ooti oundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing / /L 7 • Insulation r Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART e PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final I I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE I I Please call for reinspection RE: Unable to inspect – no access Fire Supply Line ADA Approach /Sidewalk Date / ©��� Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL