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Permit
CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit #: MST2009 -00184 „ Date Issued: 10/30/2009 Ci, kt 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S125DC07200 Jurisdiction: Tigard Site address: 7131 SW ASH CREEK CT Subdivision: ASH CREEK ESTATES Lot: 5 Project: Ash Creek Estates Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories 2 Bedrooms: 3 First: 1142 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height. 25 Bathrooms: 3 Second: 1463 sf Garage: 592 sf Front: 15 Smoke Dwelling Units' 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $290,416.00 Rear: 15 PLUMBING Sinks. 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Catch Basins: 0 Lavatories 5 Dishwashers 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures' 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 1 Vents' 0 Woodstoves' 0 Gas Outlets: 4 Furn > =100K. 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 5 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 add'I 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. Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) ASH CREEK PROPERTIES LLC WINDWOOD CONSTRUCTION INC 1 rrcl -En. N6 in 12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA C : - • . • -; • G • TIGARD, OR 97223 TIGARD, OR 97223 3 PIn-Ge _ -_: - 4: _ _ PHONE: PHONE: 503- 625 -6526 4 MST Ersn Cntrl 503- 681 -4444 FAX: 590 -7606 Total Fees: $16,962.85 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ELATION. gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 1 -0010 through OA' - -01 0 r0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332 2344. f s Is ued By: — - �L1 .J 1 4 Permittee Signature: - Building Permit Applicatio 1 ® " Fog oFF ICE - USC ONC -: . City of Tigard I I� R � y WO �� Permit No.: �Gjr' -,/ J. t3' g Dat e/B i" W� .r`'/� —D• ° li •l -'' — 3 t hi t 13125 SW Hall Blvd -, Tigard OC, Plan Revie Alf ®' Phone: 503. 639.4171 Fax: 503.;$:}96•!' 2p �,/ 10 36 OtherPermit6�Q� �r ���J= . Inspection Line: 503.639 Date /By. / Tl G A R ,4175 t Date ReadyB$i: H See Attached Checklist for - Internet: www.tigard or.gov I\ Gp,RD Notified/Method: MI Supplemental Information 0•�"S!iuJ;<ys�'i,j,;"`+; �, c,e: �L'�di.�.: .ar .;�C. t �',' -aT ?� ''_ o s'`: *. ai,._. s�,°t'.. ,Stiiil .`wr I, TYPE , , , ,,, K,: `.1�. ,... .; • 3 , ";.0 R DATA I- AND .2- FAMILY DWELL* J 1 ew construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the :;:,ri:.^ a _1'?° - �- w,. ::''ht:; ,,; A ,, _ M <V -,, . a,: ro * , f work indicated on this application- L / �` '.` <''ti i l y . . , `,,; CATEGORY O ' CONSTR ^ - : , N `P:.`. " t . - �Q�� / r� elo; I c 0 1- and 2 -family dwelling El Commercial /industrial Valuation: $ ` C � ❑ Accessory building ❑ Multi- family Number of bedrooms: 3 ❑ Master builder El Other: Number of bathrooms: ''' o r # "2 4 : •- i «Gw`- , ,; E ' ', : - .r.: 3w a ; ,F w n� > i a X ,' ;,, SITE ;INFORMAT - , , , AN D'I.oCATION , g'0 10, `( Total number of floors: ,' . Job site address: 7/ v �r ) h Cre-e. C New dwelling area: , square feet City /State /ZIP: 7" , E./""( 9' 7 23 Garage /carport area: 59-2, s feet Suite/bldg. /apt. no.: Project name: A C/Yy (l - �+4 Covered porch area: 70 square feet Cross street /directions to job site: 6 Deck area: square feet Other structure area: square feet fl: _ REQUERED'DATA COMMERCIAL ,CHECKLIST Subdivision: S e trek . LAr'S Lot no.: y' Permit fees* are based on the value of the work performed Tax map /parcel no.: /5 / -S ,Q� G'c.J3UC.) - Od y Qd �►"" equipment, Indicate the value (rounded to the nearest an d the profit of all equipment, materials, labor, overhead, and the profit f for the � .a ;gym -.. A�,�.�;:?+t" ":a�.ij, . ; �, r. ;v»,.i ,�_,�.. -;�„ � µ., m.;a�„ - �. { ,...��ri^ � ;: ; "+r,w ;'e,- u•;a'.. 3s t4, � n i 1,h t , , DESCRIP:TIOIV?eOF; „ WORK ,y ,� s �;?'. }, �work indicated on this application, Valuation: $ Existing building area: square feet New building area: square feet ,k''. , �, #r ®LL PROPERTY`. OWNER,, , 4, ,, t ".4 ” « , .`0 ; • 4 , _ “ Number of stories: Name: tud peri z 604/sr- ' • — / / Type of construction: Address: l 's- S S (,v 4f o . - ,(, fit Cd/L Occupancy groups: •City /State /ZIP: p,,,z( i q 7 y a3 Existing: Phone: ( ) 7 a - 7S-- Fax: ( ) 6 -9a- 7 GIG New: Kt s, °µ ❑`;APPLICANT,;' Ha'� n,t`,; ': y, „,5 ®CONTACPERSO *'� ' {',t �s,., ky ....: + °� ;. `.�: , ., -. F . _ - . , .:0',. , • . ;a, ":, , . � �t�,;,� t Ir NOTICE ° � . . , ; , Business name: 1 55 All contractors and subcontractors are required to be Contact name: /j licensed with the Oregon Construction Contractors Board w�� under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the • City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone:( ) Fax::( ) E -mail: ,�� § ; ;.. «. i�r.•• . - . , ` •.� ;; � tr, , .,i�.;,:� �•, c � z,,§� 1 ,,f, ; : ; ;,_q.1, CONTRACTOR • " : a q 'ck"� SF d",;.ia 1E-';fi'i',i a., Business name: <5v BUILDING PERMIT FEES* Address: , . ,,, • - (Please refer to fee schedule City/State/ZIP: Structural plan review fee (or deposit): Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lie.: 6.--cL 6, 4/R8 /1i Total fees due upon application: / Amount received: eye) Authorized signatur l(( This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Permits \BUP- RES- PermitApp doc 03/21/06 440- 46!3T(I1 /02 /COM/WEB) ® �12i 02:49 5036206124 GREENWAY ELECTRIC CO PAGE 01/01 lii ® ii III 1.!Ci III 0 ® :® ® Permit Ap I l Ii = . 1 1 . 01 0111(1 11I 0\1.1 ` City of Tigard -' ,��� Received 6 /y 0 A . . 13125 SW Hall Blvd.. Tigard, OR 97223 c o 1 1 S plan Review �,� r ` Phone: 503.639.4171 Fax: 503.598.1960 J�` i'r+1•rl(ii11 Date/B : OtherPrnmc ∎ - ,. 0 0 / 00 o f 7 Inspection Line: 503.639.4175 c 1` /r.;„ .3.- 11, . Ante Rendy/13y; E: ® See Page 2 for Internet: www.ci•tigard.or,us /■1 t I ' Notified/Method: • Supplemental Information yi' � , ro y� , a° �t !'fC iSS ,.` . k _ * t t ? t,,t r} 1 9 1� �0J tr� yr .. A!,. f #3. ,. r 1., s e '. Y`", ,T Ntit, r „ f . �,t iliF tmti,+st t5t . t�L, y ' , A7.; n' ,t14.[ 'd h •t A,. . ", , ,Kt7 1 ;t ,, ''?".45 1 .N � n, ( ei r' •, "3A '41 rIVI' � [ � Y � ' ^ � ° 1 7147 ; n.�:{ , rt 1 �> i •. • � � + •VO47 ; �i A � �r P�fPA1 r F'Y�,IA,N�i i�•N t,.. ,r.9r 1 1 ew construction ❑ Addition/alteration /replacement Please check all that apply: ❑ Demolition El Other ❑Service over 225 amps, comm DI larnrdow location v : " 1t -' ^F' :r� "a "t N h'r` a; " y �t�s/ �� :, 1 r ., 1 • L ❑Service over 320 ampc- rating ❑Buildngover 10,000 sq, ft„ i'd •.'a.',g <1 ,"�''_ a.. 0:#4, ?t,'"t'4"*C+r�y1M b Y. �: :, �t'N: ^d' ='tl., ' �' '' +`,r, '..v+r.. ..,. , � .+ ear., T^ �„�,{,,,,� -. �,;�,� e {i,f�,@ , . , � �1',,�� >. , y:;'?_ of 1 - and 2 - family dwellings 4 or more new residential and 2 - family dwelling ❑ Commeroial /industrial ❑ Accessory building nSystem over 600 volts nominal units in one structure ❑ Multi- family 0 Master builder ❑ Other ❑Building over three stories OFeeders, 400 amps or more t - rW ['Occupant load over 99 persons ❑Manufactured structures or i;'�t,'i'.y:;:_,e. 'iu'''7,:.in. „o'!?! ti'R1 o g aM Y r r []E ress/li htin plan RV park Job no.: Tob site address: /J ❑Health -care facility Dither. ' 7/30 1ta.. 45 ets�L dI Submit A sets of plans with any of the above. City/State/ZIP: -0 0 ) -3 The above are not applicable to temporary construction service, Suite/bldg. /apt. no I Project name: ;?5, NM \- i: Al ,`' , Qi „7 i,•46 4;- r a l 2.t.:p. • ; :'s: Deictipdon Qq, fee Total .- •,, Cross street/directions to job site: ai /'L New residential single -or multifamily dwelling unit. �✓ includes atrached garage. 1,000 sq, ft. or less I / j 145,15 0,00 4 - j�,i Subdivision: / I Lo t no.: , Ea. add'1 / '"' Zit P 0 sq. ft, or portion 33,40 0.00 1 �Q` Limited energy, residential 75 0 2 Tax map /parcel no.. 5 /mss► - 40� ,� �� Limited energy. non - residential 75,00 0.00 2 - �n ,�q' I [�,, ��+, Sy ,�{ #444.,W;....•;:".4;:±'' r; ','in'i: N �'� �� f P , ' F11.fi R :nn , "' , 0 " tl4a ', ;;,' + i�Fr(� (nt 51! k F "' :�'" •�i�1�1.•,n . : R x a"' ' •i' , ..rt't.d�.ir�a41,�'rl n:. r �, ' t ach manufacnrrcdormodular /// , , L� 1/ - owci nap, service and/or feeder 90.90 0.00 2 Services or ieeders installation, alteration, and /or relocatio 200 amps or less 80.30 0.00 2 ., r ' �t� 201 amps to 400 amps 106.85 .;•,.,•••,,...,..;;;.,. 5 .r ;� i . r n t "' . '. : • '. •-, ; :. W O , . IP' , 4ir i ll , P P 0,0 2 rQbn:u PM1 ,1 „� ,��'� a„4 • , �� RI .�. � ^�,'�� :aa: ;:� � 401 amps to 600 amps 160.60 0.00 2 Name: ( , U J ? , O p C Jit / <> T _fit C.- 601 amps to 1,000 amps 240,60 0.00 2 Address: t �7 5-- 5 "ii 0 i f %4 . myrGy Over 1,000 amps or volts 454.65 0.00 2 Reconnect only 66,85 0.00 2 City/State/ZIP: 74-6- 4/2 L� Cie e ' 7�.33, Temporary services or feeders installation, alteration, and /or C J relocation Phone: 53 5 7 c -' /3 25' J Fax: 5 s5-) - (° 200 amps or less 66.85 0.00 f I Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 0.00 2 intended for Dale, loose, rent, or exchange, according to ORS 1 147, 419, 670, and 701. 401 amps to 6W amps W,73 73 0.00 2 Owner signature: Date: Branch circuits - new, altcrnlion, or extension, per panel '�+' ,Fx}�� �iy"�F `t� a' 1�3fr'�j' ,�y�yy ! ' A. Fe for i w / a r ,......... 64+ i.;% Ma< S!Y4R:wfCk'v;;ii'•l {'f.','_{�! , scrve ttz ut branch fccJet circu fee ,exult Business name: S4N1L= branch circuit 6.65 0.00 2 Contact name: D4.4 i .,..-- )Z �- j, /Z / JS B. without for service circuits wrrhaut service or feeder fee_ each branch circuit 46 0.00 2 Address: Each add'I branch circuit 6,65 0.00 2 City /State/ZIP: Miscellaneous (service or fettle r not included) Pump or irrigation circle 53.40 0.00 2 Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 0.00 2 E - mail: Signal circuit(s) or limited- , .`..-. rr (;+.•h:. �Y•I i,:o��.7:;. J. ,`•i. sP � " �,,�'r 1 , :ji.,:•:,; ::'..'d 4;: •;:' i.F:. ;� 's t 4 ;1,' . '!1 � gt 1' ^. Aa, a.Sl'i-ldT?•f, 4 1 * t t > 26 energy panel, alteration, or Business name: I �v�Z.O r..t CrZ t G extension. Describe: Page 2 0.00 2 • Address' P p . PD O -75 I Ent h nddlllonal int pccliun u♦Cr' aIlo ial)1e in any Of the above Per inspection 62.50 0.00 City /Statc,ZIP: 14 ( L(. S e() 1 O q7f 2 3 Investigation perhour(1 hr min) 62.50 0.00 Phone: (503) (f 4I g - 5 t q e/ v i Fax: ■ (503) i0 t4 g 1 'Z,,_ industrial plant per noun 73.75 0.00 jj , t, s; M in W Ai t1 a 4�'' a i• 1 n F. h. ;il'tti 9�' ,'y'` F•+ ''�t iwi Ki a��,...,,; 7....., i.,. � ..E.1��1,r:.�.:u , �.,uvedvi�,.u:: CCB Lie.: Electrical Lic.: ( Suprv. Lie.: ,28775 - Subtotal $0.00 71�.�� Suprv. Electrician signature, required: Plan review (25% of permit fee) r State surcharge (8% of permit Ice) $0.00 'al , 4G Print name late: -- TOTAL PERMIT FEE $U.00 '"......s7"--- Authorized signature: This permit application expires if a permit is not obtained within 180 `" 419 days after it has been accepted at complete Print name: Date: • Fee .euthodology sot by Tri County Building Induotry So Rpn.d ' • • Number of inspections per permit allowed. l'\I5u ialag \Permlis1gt,C•Pom,hApp,doc 1 Ln3 44 0-4615T(10 /07JCOM/WE5 , p, YO-e---( "15 - „ '— - _ . ,,•:,_:,-...,.;:::,...._ . ,,„„„..,::,- ..,_-” ' (- ../' 11 :% i ,- -; ,. * / 6, ,,, - x.7 / — vgv 7E, ) ., c) \„vvy c.. , cl p „ 4 .1 .., ...--ov ,,,..„-,,,, my (crczistaj...iatiii liargapiDc - ,TincP-a , ) ' "AV 1 ( ) MI.ICIANT : I. 65 - if/ g :,,t: Mil ,''' 44.4f 41:31*5 kgt........__tVitV.'Flggk5gtttkt;);k4ThnWg*;42(''',6' ) Atg 17 2 -2 —el .-Atl . ; ----- . /- I/a 7/1 yory c .,S .. . , ?i-u_i- .4s f1,02 , .. ..... I■ -....— JOIll.rd .. .. ' ... i' ,400V:Iii / 5 1 :7,)ti ionmd.,dtly.,:76,, P4C12:- cvg ez, — . 7$( 9 7 •q t -' 4 1 'W .1, num ... li mil 110 ol, rogeni?prAnp; ..4:411;73 e r ...f,tutur. ,-0:1 --..— c t 1.6 ' :-arzialelspkra 2-- :warmly ag qar t 2 , s , V.i1:1-.41a. .17 ‘ q , c)19..C401.0'.. 1 ` 1.104 0 7.1 piing attzpi 0 SIctir=t) El Bitipung,Drgt=tt 0 Tupstpuigepos:rwoo, FT li,74,TR4:44,, Af!utts.-r pw W1 lunixt 0 uog OLSPAIraPn' F841FM-Vtf... ig:M-Vji:!_ f: ,,... -4;,..oA4....,,,c :4 - ,,-,.., , —7),(4:1'; ' c . , , , ,,, t , = 4 ' , 4" ,,,,,,, ? t'ILI=A: , , , , " , t...,::' ..,-.. I ■ .... .... 8 , C7- L :..:r:1 OW 7 - SO 9i (40' YtUalail ici 9 /-.:1 ,4- mkt (crczistaj...iatiii liargapiDc Twv.littti$ 65 „ . are..:AING , .. ..... I■ -....— JOIll.rd .. .. ' ... i' Wilif itiird i . -.....,....--4-oe t 7 •q t -' 4 1 'W .1, num — , t,, ..,, ' Am.- A xciai II 1",-.1. 43 za Jc) , 40-Es „Au% itt 9. zili (wiz .... rE _ Al f ■./e5t_ „ --- , ainoi 1 . f..nrf aoe speaLp„..:9- '3.4 ,, (..uktiormwo :, uctitvolsflos. • `igt1. MirKIP Prisrf — a) 00-61 f k:.01.,: 01 00•4-, , mytAt , 1 rr lislyrrp. timwil..gy.31. a oll'im • n I nairaiii •Ilt -,lo•t: 4. t 0 4 1 - , , :; 21 11 P 13, k 0 ;r1: 4 1Fm.1 . I-77W ATO '"?' J 3.014 „ ef pl ., aw,r,e5.4. i 1 v; :21.,. H - ' i ,,,,,.■ anrizi 4v N, t P i n e d i l w 1 i nlo - tyri :I.*tp..0 OOP tyLego lo ,Cim.y.j. ppoqbnt:4 'tq'a Wttgulgrielsor■fra ii lal=r 1 id.'0 zw7 PrI ., i� t-r, . .-- 1 IP ' I!51 ilittiPPIT _ i °alit 1 , , etriCatZi....port ..:Floctips* 1 • • c"t: • ( Call - WV , Ttlal amunl . 1 0:YtT .-. -i- C',..)' V I ,. : 0000 4; Avi0P) 0.11.i lleb"401 kitivlir.4171 al. 1 4. 11 1. 13 !. thliitg )14 if .,.a ftitmagnICO .1q IrittriWAriilii rcifil J 0.'71 mui.twit-tkillr 1 -0:4 tneab -."'-'' •-, ,.. 4„,-,:,, :•. -,44,- ,..,-;---,- • - . -, - .3k.turd Fau 131: . 1.0T4 ItrgUltict.r/ . 1.,11•Itut tocuvi.tau it.r4 crwrp n,cr:liri.ci:.p.z..plInot) ainv... fm-Prr,i,rtni 1101131V3d . :TION. '..■ Ittja miltili, 0q1. no ws c-ra ..s.;..j, lgit.txt pFenqzmw ...: '''"" privu avIrms110 .51L1 411/T1 griCO:A. 0■rta 1 "Ilat° = „-- .. , .. „ , ..... t ,w1-Sur. oral./N-HA 7vio.T., ZOO 30 ZOO :E9Nid tra.v.talocm:t)oo-tin, Tot azygg4zor„. :XEL.07.cot ax..1 ttEEM,T3 .ttz.Vett mkt 3 Q 909L :01 'ouI 'a;EuTTO q la L loa,nuollndiur 41:4Gy1.13,4% 1 , P( lifY6S9 IU . V 1 ‘ twir1/42A vo itC1210,f; ztt 010 KINO Pin 2 11_, JO 'OD mycjOkl 1.11)!3.11atIcicty :0 it/1rd, •3401:153a c\-S 0 31i 1Da.pea wa TUE 900Z/P/Z: • , , Plumbing Permit Application Building Fixtures FOR OFFICE -List; ONLI ` ' t :z,,: , City of Tigard Received /� ��.���,y� `J U �. Daze e /5 ' Permit No.: �S- rJV�i/ W / gst v 13125 SW Hall Blvd, Tigard, O ? "�� A EA/ Plan Review / d „ ? Phone: 503.639.4171 Fax: 50 \ 5' Other Permit No. %�� Date/By Inspection Line: 503.639.4175 1 2o Date Ready/By: to H See Pa e 2 for TIGARD p SEP 5 Y y. g Internet: www.tigard- or.gov Notified/Method: 7 ( Supplemental Information /�. �i ,fir t tion �+i' _ 'fA `.f ,�•y, � _ - _ _ - r -7. I;1'�RV,;,a.. ij6C'!..ks. .,,,,,, :K..._;,. t :{ ..TYPE_4 ?F' F �1 FE SCAEDULE • .- .�:, -., 7F?f. `�'�tn r..r., -4r ._ lUl�t �� �� � i ®C4 •5 'i�.'k= v��'a: ;i• - -' �.,, ._ .. .. w construction gite8l1Q V I��' - For special information use checklist. Description i Qty. 1 Ea. 1 Total ❑ Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) MV >.;tit:.: qt r' , *'.,r " r;� . .; < � ' r., - _ ac -r:,-� _ u^ .sf: ; • WAr `ti`•� .0 ,V ,ay 't .:v, CATEGORYx;OF GONSTRUC'fION j , , - , ,' SFR (I) bath 249.20 ja 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi -family SFR (3) bath 4,,,.. 399.00 'Jr ( - Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: x= ; h .. x "' " " '` `f , .;.,;. .F .. Fire sprinkler ( sq. ft.) Page 2 �': \, , ' ,'' , : JOB SITE' INFORMATION ANDirLOCATION' ' ' ,\ �u.k Site utilities • iii Job site address: 7f 0 / A .ere �� Catch basin or area drain 16.60 City /State /ZIP: TO cc ✓G( L/'2 (' 72 2-- Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: �/ I Project name:A G X6.3, Footing drain (no. linear ft.: ) Page 2 Cross street /directions to job site: ` ' �, / `0, Manufactured 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 j i '` Water service (no. linear ft.: _ ) Page 2 Subdivision: C � } � Lot no -_ �_ Fixture or item Tax map /parcel no.: agf� a. � • ;��°�� "°" 61,49a, +�-�* Absorption valve 16.60 : t r iqt -j'' . ;.,,i,, r <ti - - s X+ i ' :a ;� .. �( =yg �+;c.,`, ' }it` t':``S='i,,.'.ri s , : " ;r 4 ., ,i, > <MDESCRIPTI`ON4O WOR x m, _... y , . , ';:^''''' Backflow preventer Paget J/ 6.J ,57- ,. Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 _4 ..r - :. i i �;°.' ,.. _ ; Y ; l ., x ,,,:.. Drinking fountain 16.60 ;•M1 PROPE RTYFOWNER p , �e ryz �t ` „' ❑v TEN ; Eject /sump 16.60 Name: (Ai it 6,/t a e/ flf4 / - Expansion tank 16.60 Address: 4 s- , 3 ay / ..M f� 4„ S�„g Fixture /sewer cap 16.60 City /State /ZIP: I l ,.,, / �,_s Floor drain/floor sink/hub 16.60 �' Garbage disposal 1 60 " Phone: (��P�) , FsC1 "�.� Fax: ( CJ1) 3) -� 6. ,x , . ;, .1`,.‘d r ,. ;{;:.. ,t., ,, .a., ,,.w ,,�■ ..,> >,r�r<.. ,w Hose bib 16.60 , ` a,, a �. « . APPLICANT �. . 45y %r �" x a � _ 0' CONT ; PON " , "` Ice maker 16.60 Business name: M < Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: Sink/basin/lavatory 16.60 ( ) Fax::( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 je::= 'tea;: - :�., _ `. } y ( . 7.,*;.: CONTRACTOR'.: ' tMt.',z ,a , -, °; . , : .i'. .,�;_� � ; m -:, r - . ,,, �,�,. .. . ��,t�,� Water closet 16.60 Business name: ,/,/ 6in /f� d Water heater 16.60 Address: y B c 4p ; 6 / C/ . (� /13 / Other: City /State /ZIP: / <J� � 7 0 3 S � Subtotal . Minimum permit fee: $72.50 - Phone: ( ) r I Fax: ( ) Residential backflow minimum permit fee: $36.25 ..- CCB Lie.: / 5 6 5 (.r 9.1 4k 1 , 1''l l t Plumbing Lic. no.: 3 C � 7 _g4 Plan review (25% of permit fee) State surcharge (8% of permit fee) 4 7, ih Authorized signature: / .4 .4 . . ems. //4� /�� TOTAL PERMIT FEE . Print name: 3 - c l / tX 22 � Date: v,ve, 7 This permit application expires if a permit is not obtained within / 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I'\ Building \Permits\PLMF- Perm,tApp.doc 04/06/06 440-4616T( I 0 /02JCOM/WEB) 12/11/2006 10:17 FAX 5035981960 CITY OF TIGARD [e] 002 One- and Two - Family Dwelling Building Permit Application Checklist r -gi 01:1:1(1-1.1.•!;;I:. o\l 1114 City of Tigard Received PermirNo,: �e 13125 SW Hall Blvd., Tlaard, OR. 97223 ssosiy '' • Phone: 503.639.4171 Fax: 503.598.1960 Asaoaoted �u 1" i ' i A -R -1) 24- Hour Inspection Line. 503.639A175 ❑ El ❑ Plumbing ❑ Mechanical Internet: www.tigard- or.gov ❑ Other. 4:' "riir l Ul:a.:O\\ Ii G - IT1.17' ARE 12EQUiREI) FOR I'I..kN RI VIEW '. ` ::,.4 �, . 1 "i. *;t tk 1 Land use actions completed- See jurisdiction criteria for concurrent reviews. ∎` DI r - y 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ■ — 171 - 73 - 3 Verification of approved platllot, ,B' ❑ El 4 Fire district approval required. Name of district: . ,a 0 ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ El �0' 6 Sewer permit. ❑ ❑ 7 Water district approval. lr ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. U 0 ..PF 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 —❑ El 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 .Er ❑ ❑ 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 arca; 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 ,Id' 0 and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, T ❑ ❑ • 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 - ) 2" ❑ ❑ floor, wall construction, roof construction_ More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ...Er ❑ 0 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 - Aar ❑ ❑ 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 Z ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered U ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design valuc � for ill b ee. s and m joists .E( ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load- 20 Manufactured floor /roof truss design details. .2' ❑ ❑ 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 g ❑ ❑ architect licensed in Ore • on and shall be shown to be a. • licable to the . o'ect under review. .Il 1R d1)I('J 10 \2\ ( S1.1'.II l(�S f � r 1, - :. 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or I I" x IT'. ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ' ❑ El 25 Building plans shall not contain red lines or tape -ors. "Mirrored" building plans will not be accepted. 0 ❑ -Iff" 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. _ .2 a7— & —I T - 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard s1" ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ • ❑ -Er 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, 0 ❑ - E ' " including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. l: lBuilding \£annin■6UP- RE5- PernilWpp,6oc 03.1/06 City of Tigard, Oregon • 13125 SWHal1 Blvd. • Tigard, OR 97223 1, • u1 Wednesday, December 16, 2009 .a. , • ' �A RD Windwood Construction Inc 12655 SW North Dakota Tigard, OR 97223 RE Transportation Development Tax (TDT) Refund. Permit No. MST2009 -00184 for 7131 SW Ash Creek Ct., Ash Creek Estates At the time the above building permit was issued you paid a Transportation Development Tax (TDT) fee of $4,599.00. Effective December 1, 2009, Washington County approved a Temporary Discount on TDT charges and has made that discount retroactive to July 1, 2009. The enclosed check represents a refund to you of the difference between your original TDT payment for your project and the new Temporary Discount charge. The amount of the credit refund is $920.00. Please call at 503 - 718 -2426 if you have any questions. Albert Shields Permits /Projects Coordinator 503 - 718 -2426 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard or.gov • TTY Relay: 503.684.2772 71 q City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Accela System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Windwood Construction Inc. DATE: 12/10/09 12655 SW North Dakota Tigard, OR 97223 REQUESTED BY: Dianna Howse AMS TRANSACTION INFORMATION: Receipt #: 175896 Case #: MST2009 -00184 Date: 10/30/09 Address /Parcel: 7131 SW Ash Creek Ct. Pay Method: Check Project Name: Ash Creek Estates EXPLANATION: Refund amount discounted for TDT per Washington County. ; REFUND:IN-FORMATIONc'::: - ., . .. , ... -. . j .. _ ... .. . ... ;+: . , •• Revel' iue' Acc oiintN o:; , =V - :; • ;• . •: 'i;�' Refund `Eee. D_escri `• tion• F. iom; Receipt�� ` ,... = . ;• -;� .; 1' .; ..' - �' - - - '°Amount;:!::. 1✓xairiple:. [BU•ILD� ;Permit Fee;. • . . � . „ : � � �'�;..._ �'� =�' ' ` � -': ' - 'Example:. 245- 0000:'432000' ; '.::.`;� � .:.' ...... TDT - Transportation Development Tax 4050000 -43320 $920.00 TOTAL REFUND: $920.00 APPROVALS: If under $500; Professional Staff (k.,)0606-44Ar_ i If under $7,500 Division Manager If under $22,500 Department Manager If under $50,000 City Manager I f over $50,000 Local Contract Review Board .. . °' :' ' -' :;FOR ACCEI:A' SYSTEM.ADMINISTRATI USE ONLY,. :`: s;::: - ; < <:.` •� = : R efund Request Reviewed: Date: . 4; By: 3 : f / Case Refund Processed: Date: A J /�; �.' By: _ 4 %`r C6 —fit-- '#-/ yA 03 1:\ Building \ Refunds \RefundRequesi.doc 04/13/09 ! III OF TIGARD RECEIPT a . ,I 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD 7 f ... -& rA• ../: Receipt Number: 176356 - 12/18/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2009 -00184 $- 920.00 Total: $- 920.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 102203 DHOWSE 12/18/2009 $- 920.00 Payor: Windwood Homes Total Payments: $- 920.00 Balance Due: $920.00 • Page 1 of 1 .,,: 74 :: CITY OF TIGARD RECEIPT • 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 t`: X g<<` -� /ham . Receipt Number: 175869 - 10/30/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID MST2009 -00184 Building Permit 2300000 -43104 $1,615.31 MST2009 -00184 12% State Surcharge - Plumbing 1003100 -24001 $47.88 MST2009 -00184 12% State Surcharge - Building 1003100 -24001 $193.84 MST2009 -00184 CDC Plan Review, RES 1003100 -43112 $46.00 MST2009 -00184 CDC Plan Review, RES - LRP 1003100 -43117 $6.00 MST2009 -00184 Metro Const. Excise Tax - Residential 2300000 -24011 $348.50 Use MST2009 -00184 Tig -Tual School CET - Residential 2300000 -24102 $2,605.00 MST2009 -00184 Park - Single Family Unit 4250000 -43300 $5,370.00 MST2009 -00184 TDT - Transportation Development Tax 4050000 -43320 $4,599.00 . MST2009 -00184 Erosion Control 1003100 -22002 $88.00 MST2009 -00184 Erosion Plan Review CWS 1003100 -22003 $28.60 MST2009 -00184 Erosion Plan Review COT 2300000 -43102 $28.60 MST2009 -00184 Permit Fee - Elect (per dwelling unit) 2200000 -43103 $312.15 MST2009 -00184 Limited Energy 2200000 -43103 $75.00 MST2009 -00184 12% State Surcharge - Electrical 1003100 -24001 $46.46 MST2009 -00184 Furnaces >= 100K BTU 2300000 -43102 $17.90 MST2009 -00184 Water Heater 2300000 -43102 $10.00 MST2009 -00184 Gas Fireplace 2300000 -43102 $10.00 MST2009 -00184 Range Hood /Other Kitchen 2300000 -43102 $10.00 MST2009 -00184 Clothes Dryer Exhaust 2300000 -43102 $10.00 MST2009 -00184 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $34.00 Utility Rooms) MST2009 -00184 Fuel Piping 2300000 -43102 $5.40 MST2009 -00184 12% State Surcharge - Mechanical 1003100 -24001 $11.68 MST2009 -00184 SFR - Baths 2300000 -43101 $399.00 MST2009 -00184 Plan Review 2300000 -43106 $294.53 Total: $16,212.85 PAYMENT METHOD CHECK IS CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1342 DADAMSKI 10/30/2009 $16,212.85 Payor: Windwood Construction Inc Total Payments: $16,212.85 Balance Due: $0.00 • Page 1 of 1 a 1 iE r r `" ,� , ` ' ` e• 0 C T p g 200 G N � � ILISIN I ' .-c tad y! 5 1:r4 -v ,6'6...4s1/4C.6 , . • ,�.�..w _ _. r �Et�1G�. ; .i jam 1 . . .. _ ' .. 90 - antic_., Ctitlit 3/e) 44 �, / i l'eztA i 1 r r i floc i. -4 I 1 1 14 * **4 --‘ / ,1,-.?, ,-ti ;II ,„ -- ' f C i �i.h ry y I C TP % 0/5/0? lir • r +mL•.crw.wn»n..oxw..r CITY OF TIGARD • SITE PLAN REVIEW BUILDING PERMITNO:: h(1 200S 06t c PLANNING DIVISION: Required Setbacks: ® Approved ❑ Not Apr rcb ed Side: S Street Side: 15 From. — Garage: Rear: S_. Visual Clearance: ® Approved ❑ Not Appro d Maximum Building Height feet CWS Service Provider Letter Required: ❑ Yes No ❑ ec ivied Bti: Date: f c; t `�� ENGINEERING DEPARTMENT: Actual Iope•1_% 4S1 Approved ❑ Not Approved Site n: .Approved ❑ No Ai proved By: (� Date: eO gy 07 Notes; OP, TIGARD ...SITE PLAN REVIEW . BUILDINC,_PERMIT NO: nn tRilerjq • cf'l St4 Street tees 'a Approved ❑ Not Approved Protec • T - . / ,p a. Approved ❑ Not pproved te_• . �► Da pp 6 9 NdNet! �o �Gl n � y,r This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. •, BUILDING DIVISION TIGARD TRANSMITTAL LETTER a TO: DATE RECEIVED: DEPT: BUILDING DIVISION REC EI i.D FROM: I_ecl ► -rte' CITY 0V TIG?RD IO N COMPANY: WI A BUILDING DIV PHONE: -- 4/32 r— B y : RE: S r.- rGi / (Site Address) (Permit /Case Number) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and /or lateral analysis. f Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): -7 hs, REMARKS: :E;QNLY:- #';: ;, .,. � �- Routed to Permit Technician Date: '' (01 Initial f or -' _Fees Due: ❑ Yes ['No Fee Description: Amount P ue: Special Instructions: Reprint Permit (per PE): ❑ Yes I I No ❑ Done Applicant Notified: Date: Initials: 1.1Building\ Forms \TransmittalLetter- Revisions.doc 4/4/07 City of Tigard, Oreg!sn 13125 SW Hall Blvd. © Tigard, OR 97223 r r a a7 Monday, October 05, 2009 �. ` ;� L A4i.t Y F .' w ® d Ash Creek Properties, LLC ��r�e 12.655 SW No. Dakota Tigard, OR 97223 RE Land Use Approval SUB2003 -00010 and Building Permits MST2009- 00183, 7143 SW Ash Creek Ct., MST2009- 00184, 7131 SW Ash Creek Ct. Dear Sirs: As you proceed with construction under the above building permits please bear in mind that the Conditions of Approval of SUB2003 -00010 read in part as follows: "THE FOLLOWING CONDITIONS SHALL BE SATISFIED PRIOR TO ISSUANCE OF FINAL BUILDING INSPECTION: 50. The applicant shall install street trees and an evergreen hedge of Leyland Cypress spaced no greater than three feet on center along the northern property line of Lots 1 -10 and the eastern property line of Lots 10 -12." We have not yet received confirmation that the above Condition has been satisfied regarding Lots 2 (7169 SW Ash Creek Ct.), 3 (7157 SW Ash Creek Ct.), 7 (7069 SW Ash Creek Ct.), and 8 (7041 SW Ash Creek Ct.). No building final inspections will be scheduled and no Certificates of Occupancy will be issued on the two subject permits or on permits for any other lots subject to this Condition until Condition # 50 above has been satisfied for Lots 2, 3, 7, and 8 as well as for whatever lot final building inspection is requested. A chart is attached .showing the location o f the subject lots Please call at 50z 71 0 2426 lots. P l i�.ua�, �, u me aL J J -/ lU -L-TLV if you havp. any question . bout this requirement. beet Shields Permits /Projects Coordinator cc: SUB2003- 00010, MST2009- 00183, MST2009- 00184, Dick Bewersdorff, Mark VanDomelen, Gary Pagenstecher, Todd Prager. Phone: 503.639.4171 ® Fax: 503.684.7297 0 www.tigard- or.gov ® TTY Relay: 503.684.2772 J Cy ... na ©n ) n ., , , uz:\uE \ SUB2003 -0001 1 S125DC- 00300/00400 llaCT E TR F ■Noinawl: Imo SW SHADY PLACE F F I P P 1 T co 0, TRACT 'B' c ^ h h R ^ o p N cv in � I N S n N O n r r / , � • N o © OJ • ��/ S5 < ® - F S W ASH CR EEK C O o 0 o VI iC IR oN a 61'9 0 rn n m o F o 1 iq o \ TRACT 'A' a \--1; � _ - c''' 9852 O ./ 9868 LOT 1 - 7183 SW ASH CREEK COURT LOT 14 - 7056 SW ASH CREEK COURT LOT 27 - 7284 SW SHADY PLACE F LOT 2 - 7169 SW ASH CREEK COURT � LOT 15 - 7070 SW ASH CREEK COURT LOT 28 - 9852 SW 74TH AVENUE LOT 3 - 7157 SW ASH CREEK COURT • c LOT 16 - 7094 SW ASH CREEK COURT LOT 29 - 9868 SW 74TH AVENUE G�� V VIP -- LOT 4 - 7143 SW ASH CREEK COURT LOT 17 - 7120 SW ASH CREEK COURT },» s l �r ;p ti � �� p — LOT 5 - 7131 SW ASH CREEK COURT PLOT 18 - 7136 SW ASH CREEK COURT %'6;t��� 1.1144y', 9 � LOT 6 - 7105 SW ASH CREEK COURT LOT 19 - 7144 SW ASH CREEK COURT rA ?`_ i1.0100 i1::4 ' F LOT 7 - 7069 SW ASH CREEK COURT .� LOT 20 - 7158 SW ASH CREEK COURT � "' (LOT 8 - 7041 SW ASH CREEK COURT F LOT 21 - 7172 SW ASH CREEK COURT ; 's:� *v r '^{ B ETHANY STEWART LOT 9 - 7023 SW ASH CREEK COURT LOT 22 - 7194 SW ASH CREEK COURT ZIP CODE IS 97223 ;ri�ss w, 5: m�'d CITY OF 11GARD C "' . ? iz , r ENGINEERING DEPARTMENT LOT 10 — 7017 SW ASH CREEK COURT F LOT 23 — 7206 SW ASH CREEK COURT _ i ,` 13125 S.W. HALL BLVD. LOT 11 - 7009 SW ASH CREEK COURT Pte' LOT 24 - 7230 SW SHADY PLACE top , ;„ 1 TIGARD, OREGON 97223 LOT 12 - 7012 SW ASH CREEK COURT dC LOT 25 - 7258 SW SHADY PLACE u . ..- VOICE: 703{- ' I (503 639 -4171 OT 13 - 7134 SW ASH CREEK COURT LOT 26 - 7272 SW SHADY PLACE ` _ • -Ir FAX: (503; 624 -0752 -PG g to r- 774 , bi `3 /0 ; O7 , OLD F� G ��E r I Building Divisi ®n • One & Two-Family Dwelling JTIGAItD Fees Checklist Sk_ P . . E R l ■i I T INFORMATION.: :: : Permit #: ii CU -C)0 G y Plan #: Date: 1 DAsf-3 g Site Address: ( 1 S 4 ) Ash C eo k_ Cc it Parcel #: Subdivision: 1,-1 Cpeo1 - -.(05 Lot #: 5 Zoning: Jurisdiction: Setbacks: Front: Rear: Left: Right: Class of Work: (..0 5 f fl Stories: 2. First Floor:, 12.a (II (0,9 Z(,, 96) Type of Use: Height: "Zr Second Floor: ) `16 3 (19 91 32 .. S Construction: Floor Load: Third Floor: Occupancy Group: Q -3 Dwelling Units: I Bonus Room: Valuation: (� l 2 \ \Co Bedrooms: '3 Total Floors: Bathrooms: Basement: Decks: Garage: . 10t : 03,119. I Porches: ---in D (j 3o Other: F ES:, ' .. Description: CF.ee'Amount Amount .Pai4:; .' Balance D:ue Plan Check: Building: f/ Extra Set: • Permit: Building: c/ Tax: L.Z Metro CET: c/ School CET: r✓ Mechanical ✓ Tax: Plumbing: Tax: --- , Electrical: i Tax: i Low Voltage: Tax: / CDC: CDC Ping. Rev.:- CDC LRP Fee: SDC: Parks: TIF Res.: .1-pl TIF MT: Erosion Permit: Erosion CWS: — Erosion COT: - f Water Quality: Water Quantity: SUB - TOTAL: Sewer: Permit: Inspection: . SUB - TOTAL: TOTAL MST & SWR: I: \ Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 1 i PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems) Description I Qty. I Fee(ea.) I Total Description Qty Fee(ea.) Total . . . Nev 1= & 2- fam4 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) 1 14.00 II-1 -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 to 7,200 220.00 Unit heaters (fuel, not electric) Fire sprinkler - sq. ft. 7,200 and greater 309.00 (in wall, in -duct, suspended, etc.) 14.00 . Site Utilities Flue /vent (for any of above) 6.80 Catch basin/area drain 16.60 Repair units • 12.15 Drywel] /leach line /trench drain 16.60 Other Fuel Appliances Footing drain - 1 100' 55.00 Water heater V 10.00 ( Cj .GO Footing drain - each additional 100' 46.40 Gas fireplace 10.00 Manufactured home utilities 110.00 Flue vent (water heater /gas fireplace) 10.00 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 I 10.00 \ 6 . 05 Water service - 1s` 100' 55.00 Water service - each additional 100' . 46.40 Clothes dryer exhaust 10.00 G - Fixture or Item • • • • . Single duct exhaust Absorption valve 16.60 (bathrooms, toilet compartments, � n Backflow preventer 27.55 utility rooms) .1 6.80 �I �� . G Backwater valve 16.60 Attic /crawl space fans 10.00 Clothes washer 16.60 Other: 10.00 Fuel Piping Dishwasher 16.60 Drinking fountain 16.60 **($5.40 for first 4, $1.00 each additional) Furnace, etc. ** Ejectors /sump 16.60 Gas heat pump ** Expansion tank 16.60 Wall /suspended /unit heater ** Fixture /sewer cap 16.60 Water heater ** Floor drain /floor sink/hub 16.60 Fireplace ** Garbage disposal 16.60 Range ** Hose bib 16.60 • BBQ ** Ice maker 16.60 Clothes dryer (gas) ** Interceptor /grease trap 16.60 Other: ** Primer 16.60 Total: • Roof drain (commercial) 16.60 Mechanical Permit Fees Sink/basin/lavatory 16.60 Subtotal: $ (p L( . 4 1 0 Tub /shower /shower pan • 16.60 Minimum Permit Fee $72.50 $ 7 2 . O Urinal 16.60 Plan Review Fee (25%.of Permit Fee) $ Water closet 16.60 State Surcharge (12% of Permit Fee) $ C) Water heater 16.60 TOTAL PERMIT FEE $ ( , 1, Other: Other: Phtmbing Permit Fees ELECTRICAL FEES (residential single- or multi- family) Subtotal $ 3 9 9.6o . Description Qty. Fee Total Insp Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less f 145.15 LS. 4 Plan Review (25% of Permit Fee) $ Ea. add'l 500 sq. ft. or portion 33.40 �j.�0 1 - State Surcharge (12% of Permit Fee) $ Z-1-1.6 Limited energy, residential 75.00 2 TOTAL PERMIT FEE $ Each manufactured or modular dwelling, service and /or feeder 90.90 2 Electrical Permit Fees - - - - Subtotal: $ 2 7B .75 Plan review (25% of permit fee) $ (p 9 , Ca `) State surcharge (12% of permit fee) $ 57 .ys TOTAL PERMIT FEE $ I•\ Building \Forms \ResPlanCheckFees.doc 01/19/07 Page 2