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Permit CITY OF TIGARD MASTER PERMIT PERMIT #: MST2002 -00457 V0.1111'. DEVELOPMENT SERVICES DATE ISSUED: 1/6/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 SITE ADDRESS: 10495 SW JOHNSON CT PARCEL: 2S102BB - 00827 SUBDIVISION: BROOKSIDE PARK NO. 2 ZONING: R -4.5 BLOCK: LOT: 003 JURISDICTION: TIG REMARKS: Remodel family room into (3) bedrooms and convert half bath to full bath. BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT: VALUE: 10,000.00 OCCUPANCY GRP: SR2 BDRM: 6 BATH: 2 TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: I BOIUCMP < 3HP: 1 VENT FANS: 2 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 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 FD R: PUMP /IRRIGATION: PER INSPECTION: EAADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: 5.00 SIGNAUPANEL: 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 AREAISPC 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: PROTECTIVESIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 484.10 This permit is subject to the regulations contained in the WINDSOR PROPERTY LTA WINDSOR PROPERTIES LTD Tigard Municipal Code, State of OR. Specialty Codes and DEAN SAFFLEY PO BOX 647 all other applicable laws. All work will be done in 2245 NE CORNELL RD HILLSBORO, OR 97124 accordance with approved plans. This permit will expire if HILLSBORO, OR 97124 work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 283 - 0977 Phone: 640 - 1755 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 -001 -0080. You Reg #: LIC 00052014 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Mechanical Insp Electrical Final Plumb Top Out Mechanical Final Electrical Rough In Plumb Final Framing Insp Building Final Insulation Inp s ---- �. i',,, , .. ,_ , Issued !J Permittee Signature ({ . A Call (503) 63' -4175 by 7:00 p.m. for an inspection needed the next bus d y B Permit Application Date received: /'' ',g�p -- Permit no.: , 5 , V,5 ' � w �' i City of Tigard °: _...> Project/appl. no.: Expir- • City gfTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Phone: (503) 639 -4171 Date issued: By / Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: 1 &2 family: Simple Complex: - • TYPE OF PERMIT ❑ 1 & 2 famil dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition Additio•ralteratio t replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: . JOB SITE INFORMATION - S Job address: /f2$96-t54 t/peS zigi,cJ 7 -774, 0 " Bldg. no.: Suite no.: Lot: I Block:. , [Subdivision; I Tax map /tax lot/account no.: Project name: Description and location of work on premises /special conditions: ,�CLt✓G.�f�L i+/i7/ ,, �/fkele..etK 4/# -4.0 77 1 4.4 X66 / ' —. , s , ,,s , ! 3 , ; s ,;; ti §OWNER r : � r rr p : . FOR, SPECIAL INFORMATION, USE CHECKLIST ,, Name: /-2 _/ 4 ,,, /,./.0. /' ,,,,,_/4 __ . .,C' Y ,a t 1.1' t 1 {4 t t , y, t ) � ,; »+` Mailing address: 2.. s- 0 G-7 , _` 1 & 2 family dwelling: City: ZIP: Valuation of work ...t 4 $ 14 L Phone: �G29Z7 Far ,, l' ,v E -mail: No: of bedrooms/baths ....410..r. z ...... : 41... 6 Owner's representative: Xis. Total number of floors - Phone: Fax: E -mail: New dwelling area (sq. ft.) ,; t „ wf , , t ;:.: APPLICANT' .. Garage /carport area (sq. ft.) Name: .S�&n Covered porch area (sq. ft.) Mailing address: Deck area (sq. ft.) City: I State: I ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commerciallindustriallmulti- family: •`,_• ;t 14n < CONTRACTOR Valuation of work $ Existing bldg. area (sq. ft.) Business name: / _ e ,,( f v d, i-rd New bldg. area (sq. ft.) Address: �� s Cla��i LL Number of stories City: f a,,,4a,,ee I State: &4 ZIP:97 7 2-4( Type of construction Phone: -of77 I Fax4.40 3LE mail: Occupancy group(s): Existing: CCB no.: ,4 / //7 Qn New: City /metro lic. no.: r, / r 7 Notice: All contractors and subcontractors are required to be I H.,; ". ';',;:':Ai , ARCHITECTIDESIGNER ' ' '4 licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: � ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: • Fax: E -mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: City: State: ZIP: Amount received $ Phone: 'I Fax: I E -mail: Please refer to fee schedule. I hereby certify I have read • examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provi •, • ��', of laws and ordinances governing this ❑ visa ❑ MasterCard work will be complied with, , er specified herein or not. Credit card number: I / Expires uthorized signat 1��J, ate: - —� Name of cardholder as shown on credit card P rint name: _ I A r �� �� �� B : ' ,! - Cardholder signature $- Amount Notice: This permit application expires' a permi is of obtaivd within 180 i ays after it has been accepted as complete. 44o -4613 (6/00 /COM) One- and Two - Family Dwelling . j ' . �� B uilding Permit Application Checklist R eferenceno.: Tigard cit Of T I Associated permits: City of Tigard 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 plat/lot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of ca -basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state • ding codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size s .eet 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, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing locations. Show attic ventilation. _ • 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. . JURISDICTIONAL SPECIFICS • 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. . 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not accepted. 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. 27 "Drawn to scale" indicates standard architect or engineer scale. 28 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street Tree List. Checklist must be completed before plan review start date. Minor changes'or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440 -4614 (6 /00/COM) Nov 11 02 09:16a Hughes Plumbing (5031 324 -3315 p.1 t NOV - 10 - 02 SUN 3:08 P6{ ALLYN HOMES FAX N0. 5036403242 .... -..P 1 { Building Fixtures f Tigard Dale received; l /.3 or Plumbing Permit Application Permit no.:�j , t r City O l W Sewer permit no.; Building permit no.: _�__, ^2�' -'" Address: 13l2S SW Hall B Tigard, OR 97223 eiry pf7lSasd Phone: (S03) 639.4171 PcojccUappl, no Expire data: ------ Fax: (S03) 59a -1960 Date issued: By: J Receipt.ao.: Cabe 61a no,: ' Payment typo: Land use approval: . TY1g: OF • PERMIT ' CI I & 2 family dwelling or accessory D Commercial/i r . rial O Multifamily 0 Tenant improvement 0 New construction A Additi. •• , taxation eplacement 0 Food service D Other: 1o13 SITE INFORMATION Fl:: SCIII:DU1.E (fur special int'nrniotiot a >eehtrkliat) J � Desert . don Qt . Vac (co. Total Job address: / .0" V - ew 1- and 2- family dwellings on Bldg. no Suite do.: (Includes lad It for eaclasatllity coomeetioa) Tar maprtax lot/account no; SFR (1 bath Lot: Block: Subdivision: SFR (2) bath S - 3 both • /iuntY• r _ ' AF� lrA Each additional bath/kitchen De riptt. a.d locatio .f work o premises: .4fQ D, Siteutilities: ' • ••• a 1 n . / t , fl• �; - ac , Catch basin. /area drain --, - Drywalls/teach line/trench dram _ _� Est, date of completion/Inspection; Footin, drain (no, lin. R � - . — __ 1 PLUMBING CONI2ACfOlt anu soured home utilities Business name: _. (- t .- �� 1: , ■ _ Manholes — _ _ Address: 0 --- Rain drain connector - _ a C ' snits sewer (no. min, ft.) G .. _ •t ZIP: c- -1 • Phone:: E - mail S torm sewer (no. Ilia. .) +y ater service no. lin, R. OCB nn r A _ Plumb. bus. reg. no ; r Flxtrtreorltesm: C(tylmetro I re. no.: /- Abso .lion valve r Contractoa s representative signature: // , / „ t aek f low p teventcr — print name: r R • i tnrtr * '_ +' vLl �' � Bar-kwaiet seise _ ....__ .� CON'1'ACf PERSON $asmsRavato -- Name: Clotbea washer __ Address: W bcshwas or Drinktn2 foanteitt s) City ZIP: Ejectors sum. - �� Phone: Fax; E -mail: Expansion tank OWNER Fixture /aewcrca. _ — 7oor drains/floor sinks/hub _ _ 1 Name (print) :, /,,;.,` i:-�� „ .• Garbs e.ts.osat Nose Bibb 1:107 '.r. .s.- �tL ZIP; ice malidr r _ T Phone: ''-‘, ' y r E-mail: Inlcrceptor /grease trap —_— Owner installation/residential maintenance only: The actual installation Primers) _,,,,.,_ will be made by me or Ole maintenance and repair made by my regular Roof drain commercial _ employee on the property I own at per ORS Chapter 447. , lays(s) Owner's signature: _. -.,... _Date: -_.. Sump __— ENGINEER bs/sbower/shower pan renal�_ Name: Water closet Address Water healer ^- City: State: ZIP: Other:/ . Phone; Fax: E -mail: Total' IMO Minimum fee $ _.- ___ 'No .o ianeMMom MCP cretin cods, plea". toil judsdisuon (cm mom mforowiot Notice This permit epplieation _ O Visa O Mattc.C.rd Plaew (at �^ %) S expires If a patina IS ool obtained Sta te T surc (go/. ..,. S ~ _ C.edd esro rwmbcr; . .- _ . _ . . - - - . 1 within 180 day after it hat been �' e.rt TOTAL .- ..,... S NynicnrurdboN ,.r e. aa.hn. on usdir card accepted as complete- "' s cardhobcc 0 now. " -- Amour 440- .616 (45/0Q/CUnt) M Application Date received: // ' /-3 Oa- Permit no.g ..Qp 5, ' City of Ti and 1. I g Project/appl. no Expire date: CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Phone: (503) 639 -4171 Date issued: By: Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: Building permit no.: , - : TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory LI CommerciaUindustrial ❑ Multi- family ❑ Tenant improvement ❑ New construction XAdditi.:.:. - .. ion/replacement ❑ Other: JOB SITE INFORMATION .' COMMERCIAL VALUATION SCHEDULE _ Job address: ovys" S' , J,,,r,, 7,- Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ . Lot: 'Block: I Subdivision: *See checklist for important application information and Project name: d , Al jurisdiction's schedule for residential permit fee. City /county: „� ZIP: u 1S 2 FAMILY DWELLING- PERMIT FEE SCHEDULE Description and locati s • f work on mises: 4 - " 45I i AN D COMMERIC EQUIPMENT SCHEDULE iiZ. - i. dv /` Jam:►/ "! I_ � . Fee(ea.) Total Est. date of completion /inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air Is existing space heated or conditioned? ❑ Yes ❑ Air c No handling unit CFM conditioning onditioning (site plan required) i a, /AP' Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system , ressors Boiler/compressors MECHANICAL CONTRACTOR '- . - p Business name: , j i�i l/ T, " ., ,E477,t.�j State boiler permit no.: HP Tons BTU /H _ Address: bp, ,1,r x ,7—,1 State dampers /duct smoke detectors City: -A.0%%/Ail I Statea/,�' ZIP: f742."7/ Heat pump (site plan required) Phorie;�Q��2AFax: E-mail: InstalUreplacefurnace/burner BTU /H �, Including ductwork/vent liner ❑ Yes ❑ No CCB no.: �f,?� 1,..._/ Install /replace /relocate heaters- suspended, City /metro lie. no.: . 14j,�» 9te 447 -5 wall, or floor mounted Name (please print): . L Vent for appliance other than furnace 2:, CONTACT PERSON Refrigeration: ptio • Absorption units BTU /H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust , . .', OWN Hoods, Type I/ II /res. kitchen/hazmat e�r 0 � hood fire suppression system / Name ),4J/4/4O /7, � - iAti if.e Exhaust fan with single duct (bath fans) *4 P ir Mailing address: .2.-1_ if-7, j', Cp, �� , " y Exhaust system apart from heating or AC City State. I ZIP: .f7/0_4- Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: ` _ /' Fax; r , A E -mail: Fuel piping each additional over 4 outlets _ ENGINEER Process piping (schematic required) Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: 4 I State: I ZIP: Insert - type Phone: I Fax: I, E-mail: ` W oodstove/pellet stove Other: Applicant's sign re: I/ i I Date: / / /2-'j2...- Other: . Name (print): „ , i1,.t,A22 ,04 ��s s R Not all jurisdictions accept credit cards, please call jurisdiction for more information.' Permit fee $ if ❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $ T Or fi Credit card number: / expires if a permit is not obtained Pl re view (at _ %) $ .fir' Expires within 180 days after it has been v State surcharge (8 %) .... $ s , Name of cardholder as shown on credit card accepted as complete. TOTAL $ • :x $ ' ` Cardholder signature Amount , 44o -46i7 (6/00 /COM) r ` . MECHANICAL PERMIT FEES . • COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION PERMIT `FEE ,'. ' "`, ,,, Desc�iptt Pii & Total .5 e + Tali )�„1 ,a ,.<, - $1.00 to $5,000.00 Minimum fee $72.50 , (." =Qt - .- (Ea)p , ..Amt' $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU i �� $1.52 for each additional $100.00 or including ducts & vents g/ 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 kCheck all thatrapply A Boiler' Heeat'L Air' $1.20 for each additional $100.00 or Forgttems 7' see F o r , - , Pu Co n d , e fraction thereof. fo o tn ot e s b elo w Comp 7) <3HP; absorb unit Minimum Permit Fee $72.50 SUBTOTAL: $ 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 ,, `ASS,U_MEDVALU4TIONS'PER APPLIANCE =;`i 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 'V 10.00 lo - Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct ducts & vents . j i/ 6.80 / Floor furnace including vent 955 16) Ventilation system not included in Suspended heater, wall heater or 955 appliance permit 10.00 floor mounted heater . 17) Hood served by mechanical exhaust / Vent not included in appliance 445 V 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: ', s } - $ >1.75 mil. BTU _ „ 1:1 Air handling unit to 10,000 cfm 656 8% State Surcharge °, Ma i . :71 $ Air handling unit >10,000 cfm 1,170 =r.N `° Non - portable evaporate cooler 656 », ; ; s ,, . 7 Vent fan connected to a single duct 446 TOTAL RESIDENTIAL PERMIT FEE: s ± ` :.,, $ Vent system not included in 656 4 .. %- appliance permit 70, ; 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) $62.50 per hour Each additional outlet 63 "State Contractor Boiler Certification required for units >200k BTU. TOTAL COMMERCIAL ''`Residential A/C requires site plan showing placement of unit. VALUATION: :� ei All New Commercial Buildings require 2 sets of plans. is \dsts \forms\mech- fees.doc 02/11/02 d . AVY' ' RN.' ,i LJ rAt /:W.ilt avtrt: n r rtA nv, .:U_UKU�c r.c 1. , . ectrit� Permit Applictlon • . • jeols • Daterecelved: / /Mr/ Permit no.' / „ !�� ' y „,. •! h City of igara[ Projcect.'4p1. no.: Expire date:: cilyaf778ar1 Addreet: 13125 SW Hall Blvd. Tigard, OR 97223 Dare issued: By: Receipt no. J ~�_ Phone: (503) 639 -4171 _ ,- -....- Fox: (503) 598 -1960 Case tile no.: Payeneattypo Land use approval: . . t 1 i't: 01. •PI ulil hI 0 t & 2 family dwelling or accessory G] Comrnetcial/il •, ~,' •1 U Multi - family © TensAt. improvement CI New construction ;IrA,ddltto 't teration/r..laeetnent 0 Other: T _ r 0 partial • It It :tit : Li` (\FOliMATI N . • job addteas: 2j Bl , , Bldg. no.: Sulte no.: Tax map/tax lot/account no.: Lot Block: Subdivision: ' w ��„ / ..,. .__ ,"- f'rojecr mama: f Description and location of work on prCmis ¢s: _ . } .. , .. a. Estimated date of corn .tetiorJins • - ion: .,?.' e. •• CON t72i(°I'Illt.: ANTIC-VI ION. • . I :i.1• - ti(;IiiU%.1.f: ' Bob nos ps lYttes Business name: It, Ills, _ J_ / Lo Pearl ton r'� Total no. tests Address: a ✓ 'i• ! • / - / , Stazee)e ZIP: 7Z-) se D 6 udm cMd�.ra�. . Phone: 762 4G S T' S `. E.. mom tt4. & or less a W CCB no,; Elec. bus. lie. no Eachadditional5D0 rcor crsi0nthcrwf loud ancr: , resident; sl M f 2 Cit /metre lie. (t0.: Gv — / 0 ei —/ -C.... Limited energy, non-msideatl;l i 2 ,• ,17/1 Each manufuctwed bomcormorM4rdeal Iing " SI$namre of supervising electdci (malted /Ate Baehr Service end/orfeeder __ 1 M 2 _ Sup 01,41, na M (pdnl), 4a[i►:�041 ,� Stalker or feeders -Lama ation, J ! CltU1'1'Iti 1' MN NIA alteradonurelucedge: 200 ampt or tee: _ _ 2 �'' �• 1 /,- cot • to 600 amp i �MSili' .. address: •,_ . . _ / tw • - -' . ,, _.,1 ' 601 am.s to 1000 mot --"" " — r .. reffr/ ! • Z l: L;,t , s A Over 1000 s+0 • of votes ar a ' lsltone. _ .: r i . r 5 7 : Rwotumctoc 2,.._. Owner installation: The installation is being rr.Sde on property T own `Fempararyeervhre+t or recdertt - - V l widlde is not intended for sale. lease, rerlr. or exchange according W 62Ndhlrco ,alkar r ila n , orraloaets ORS 447. 455, 4'79, 670, 701. 20 a • -a t c 4 0a i 2 2Al amps tc 400 a,ftps lip 2 Owner's si : nature: Date: i to . , , amps . h: Gtti1'.F'13 Minch ilrsiits'aaa,alieratlon, or oxleawFaea psrpaee4 A. [>eeforbrsnet ef[cuisvrifhpurct•,sseof II Adages!: usrvica or feeder sae, each branasl c,rcv r • Clty: State: ZIP: A. Fs; forb roncDtireuite without purohnae Phone. Fax ] 1• id amice ar (teder;ea, firm Wend, circuit; Eill $aeh A. need tzar . ctrtal, t: I s 1 ; 1• A ' i i(F'.V11'Iv (Yk2'.e r tt'•,-1.:rit rh :,t' Mise .(SerKeeorleedereotIncluded): o service ova *2?9 empr•comme&NO! O AeettroattefMWry Erich .v Ito Or irri !ion wale 2 0 Sor.irs wsr 820 amps. :.tins of 1842 01iasvc'ouslocation form lydwclling• Q BUtldlns over lo,OQ) ovum root roof or Signet cheat (s) or a limited energy enael, a Sysiamo vet MQO volts nomlaal room reotdanAal unite inonasrntntura alteratian,orextension' all --i 1 1 is Buiung overihree atone; 4 1eldera, 400 amps or mom *Dated • _ mm __ O peoupect load over 99 persons CI Metoureetured suusturet or RV put Eat additional inapet44at roar the alltrwable in anyof llte et rdre e A cgrras(t;ettingplan Q Other, Penns• • . p 1111111111111.11110111111111111111 S biiIt __._ sets Of Ow mats gay of the above. rm'esariv!ion fee 'Mohave ire Dot .. Wytble rotate • eonstractioe stroke, Ottxr rlaa in pw it wiz*, rdIois p ewe( cr wiz*, plume ealt juriadiaeen JCR ems rfc ,,.,taco MAIM; This permit application i�Crxn , $ � _ iI �Visa QMasterCard expirie Ira pemltla ant obtained 1'lan rc ie ew (at - %) $ i credit oxaeambu: _ - / f with!n IBOdays altar it hag keel State surcharge (8%) .... $ s accepted as complete. TOTAL ........... . ....... S _ , adIa c r p own an b c_ Ca d6o!dat petun Ampdst sao.4sis 6906/COW Ed NUBS : 60 ZBaZ LO ' ^ °N 62176 E9E 20S : '0N 3N0Hd DN I 3 I a10912 Se1019tiel1NO : Wald CITY OF TIGARD 24 -Hour !/ BUILDING Inspection Line: (503) 639 -4175 MST Z ) c C7 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested S AM PM BUP Location Suite MEC Contact Person / P Ph ( ) go 7 " 2- g 'o PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access /li "_ '4`' eat-1.4k " •c.G Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fi rewal I Fire Sprinkler Fire Alarm 0,....-Lt2 t■A ( A CE T C Susp'd Ceiling Roof — �� l S Other: Final Pal P ASS PART FAIL PLUMBING Post & Beam Y7� l3 Under Slab ���° Water Se �Ji- 1 1� , L_.L - L�j►CY� Y t ry • Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain (n� Shower Pan Other: Final PASS ECH ANIC T FAIL M l P v � MECHANICAL � l �' Post & Beam Rough -In Gas Line e Dampers PASS ART 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 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA 2--- 5 - n 3 Approach /Sidewalk Date Inspector Est Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD . 24 -Hour , BUILDING Inspection Line: (50 ! 4175 1 MST — v 4.4S 7 INSPECTION DIVISION . Business Line: (5 3) • -4171 - BUP Received Date Requested — 7 AM PM, BUP • Location 0 ` �••• L Suite MEC / Contact Person ' ' ' Ph ( ) - a Lf PLM Contractor' Ph ( ) SWR BG Tenant/Owner ELC Footing ELC Foundation ACC s$: Ftg Drain Il / Crawl Drain Slab Ins P ectio Notes: ) SIT Post & Beam Shear Anchors / / Ext Sheath/Shear V Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Ot•-4' i , i • PART FAIL P• :ING�' Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P D /VRT FAIL ECH: ' AL ', -`,- Post & Beam Rough -In Gas Line Sm• e Dampers •AS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm _ Anal ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ,, Please call f•r reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date C..) I nspector 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 ' I 0 , 5 'J INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested — oZ AM PM BUP Location A Suite MEC Contact Person • Ph ( ) D 7 —.2 0'4 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Acce s: Ftg Drain ELR Crawl Drain ✓t ,� =�� SIT Slab Inspecti Notes: Post: & Beam • Shear Anchors / Ext Sheath /Shear o 1 (/ Int Sheath /Shear Framing _ I Insulation ^ ` ( , V ►. ,� S ��' Drywall Nailing 0 L1 0�f ) , Fire Sp * 1 Fire Sprinkler J Fire Alarm Susp'd Ceiling Roof C \()i 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 PART FAIL ELECTRI ough -In Fi larm Reinspection fee of $ required before next inspection: Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE' Please call for einspect'•n RE: El Unable to inspect – no access Fire Supply Line ADA Approach /Sidewalk Date, _ — _/ 6 Insp ctori , / o-' -~ Ext Other: Final DO NOT REMOVE this inspection record fr , m the ) s site. PASS PART FAIL CITY OF TIGARD 24 -Hour !L BUILDING • Inspection Line: (50 175 MST Z 0 T S INSPECTION DIVISION • Business Line: (5 -4171 . BUP Received Date Re uested AM/6PM BUP Location 6 0 t g Suite MEC Contact Person Ph ( ) O G 7 — 5 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing - ELC Foundation • �q�GeSS , Ftg Drain � 2 U 1 a _ ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear () Lam \ ; y� (��� t M-✓N Framing Insulation i` — `'V s vl�t9 �. ' <LC s - 5 UJ • Drywall Nailing �� ` Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof \, a r c Oth- 4 91, P P BING NSJ S - "-'z</()IL Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains • Catch Basin / Manhole • Storm Drain Shower Pan Ot i - 4 PART FAIL • CHANICAL 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: El Unable to inspect - no access Fire Supply Line ADA Date 42'4/6 3 Approach /Sidewalk Inspector Ext Other: Final DO NOT REMOVE this inspection record from. the job site. PASS PART FAIL