Permit 1 ..
CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2001 -00167
i� �l; DEVELOPMENT SERVICES DATE ISSUED: 10/30/01
'" '�' I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13078 SW RAPTOR PL PARCEL: 2S104DA -06900
SUBDIVISION: QUAIL HOLLOW - WEST . ZONING: R -4.5
BLOCK: LOT: 055 JURISDICTION: TIG
REMARKS: New SF detached rowhouse in Building #5. Setbacks as per sheet A10.10
Plan D -SB
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 173 sf BASEMENT: st LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 735 sf GARAGE: 547 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 567 at RIGHT:
VALUE: $ 140,209.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,475.00 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 2 CATCH BASINS:
TUB/SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 1
• MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIIJCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 W00DSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 • 200 amp: 0 • 200 amp: W /SVC OR FDR: 2 PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 • 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: 00 SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: 1 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 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: ALL ENCOMB BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,691.92
This permit is subject to the regulations contained in the
BROWNSTONE HOMES BROWNSTONE HOMES, LLC
12670 SW 68TH PKWY #200 12670 SW 68TH PKWY all other Municipal Code, laws. All work k will l b Specialty Codes and
all other applicable law All work will by done i
PORTLAND, OR 97223 PORTLAND, OR 97223 t
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 124627 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
Erosion Control Insp 8 Underfloor insulation Electrical Service Low Voltage Firewall lnsp Appr /Sdwlk Insp
Sewer Inspection PIm/undslab Insp Electrical Rough In Gas Line lnsp Rain drain lnsp Electrical Final
Footing Insp PLM /Underfloor Framing Insp Gas Fireplace Roof Nailing Mechanical Final
Foundation Insp Mechanical Insp Shear Wall lnsp Insulation Insp Water Line Insp Plumb Final
Slab lnsp Plumb Top Out Exterior. Sheathing Insi Gyp Board lnsp Water Service lnsp Final inspection
` / leAll V Issued By : -1i . .---: _ Permlttee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
mitox/r/ejp
aoo - /D 9
1 Building Permit Application
li
. Datereceived: 3 i a Permit no.. frz /d / 67
5. = X City of C Tigard O
... Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By:J>, Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: l&2 family: Simple Complex:
TYPE OF PER111T
(di & 2 family dwelling or accessory O Commercial/industrial 0 Multi- family r% New construction 0 Demolition
0 Addition/alteration/replacement O Tenant improvement 0 Fire sprinkler /alarm O Other.
JOB SITE INFORMATION o
Job address: /30 y 5 ,tirmigns2 Bldg. no.: 5 Suite no.:
Lot: Block: Subdivision: & p. L , % otr) u . T . Tax map/tax lot/account no.:
Project name: a A ' i_ _ + l to 3ira.=
Description and location of work on premises/special conditions: , ■ NCUSG. Ika-Pe 1
O WNER FOR SPECIAL INFORMATION, USE CIIECKLIST
Name: $(/.44SNu'P 1 % 14 .1w∎es ( Floodplain ,septiccapacity,solar,ctc.)
Mailing address: )24,7O <,w (o$t j. qua 1 : 1 . Zoo 1 & 2 family dwelling:
City: 'aim kt..sip State: er MEM= Valuation of work $ et::› dC.)
Phone: • $ 7_ _ Fax: y 8 9o8 t E -mail: No. of bedr'ooms/baths
Owner's representative: • M ' • • pa Total number of floors 3
Phone: it.35775 Fax: 57n1 E -mail: New dwelling area (sq. ft.) ! t
APPLICANT Garage/carport area (sq. ft.)
Name: -ik�F A N — . Covered porch (sq. ft.) —
Mailing address: Deck area (sq. ft.) 4C) 5sa FT
City: State: ZIP: Other structure area ( ' . ft.)
Phone: Fax: E- mail: Commercial/industriallmultli- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name:
' A-861/e-) ' New bldg. area (sq. ft.)
Address:
City: State: ZIP:
Number of stories
Phone: Fax: E -mail: Type of construction
Occupancy group(s): Existing:
CCB no.: • New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: 41 6/ A O provisions of ORS 701 and may be required to be licensed in the
Address: \V;\ \ — MOP iv
S!- 1,050 jurisdiction where work is being performed. If the applicant is
exempt from licensing, the following reason applies:
on �a t S :wQ I ,: •101
Contact person: i t Plan no.:
Phone:76i, - 4( - - ; Fax:'} & 4(,7 -, _ E -mail:
ENGINEER
Name: 3 Q._ , €15l(fr . Contact person: '; e) Will, Fees due upon application $
Address: • • ' • 'S 4� i1 i ot 44 oS Date received:
Ii !17,x. liCi.3 StateOr ZIP: 722.3 Amount received $
Phone;00 - q b 33 Fax: 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 la s and ordinances governing this o Visa Cl MasterCard
work will be complie ified herein or not. Credit card number: /
'I Expires
Authorized signature: Date: WOO1 Name of cardholder as shown on credit card
Print name: if) M • 40-6S cCardholder $ aer signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/03/COM)
Y f Y
•
Electrical Permit Application •
Data recenve
• ;t.i.:.1 City of Tigard Pro)atyhppthe.:
cy,,,m Address: 1312S 3w Hatt Blvd. Tigard OR 972x.3 Datelined: er: Receipt no.:
Phone: (SOS) 6394191
Pau: (S03)198.1960 . Can An no.: Payment type:
Lend use approval: .
11 vi rrl IIlt.Il1
-2 family dwellia8 or accessary 0 Commemlaltindustrial 0 Mull- bunity 0 Tenant improvement
New coaaauotioa 0 Addition/elteratiadtmptaceatent 0 Other: 0 Partial
toils' It I\Imo! Wi\
t ■I i- rll Bid no.: - Tall in • lot/account no.:
Let Mock: SuWIvlelaa :: u tart, t. Ho % wa w em
Project oject name: 04 1+! Ne I I ota Deecti . ion told location of wait oft , , tea: New foxywrivc nna
E.timatod due of • • • eboall ' - .
4 0\1It\1 wit %1'1,11 tIII)\ III .11IIn111
Jett so 1111111111MMIIIMPEUR
IL:=1=wrzel , ...h., - r . ps lux
iu=rarammicsaaw-TOMMINIMMINIIIMMI doellegult.lellehoeledeigents
• V - ncouv - r =Ian ZIP: 98661 ser.loduchioa
• ... • 9 • - ITV. n :
• • r mail: woo . n. or law „ . .
lariThrnarallillil Elea. but. nu. not 3 4 - 4 3 2C b Widens too ft. or ■ lIr MN �
111111MtEWA MEI
Lionisee.ers .,as- rrwenda 11111111111.111 2
tote RiEE 2
MT= 11.11111 t to =no: srr eden– -s• •
o eetielc mos
ru
lct'l It t i 1►1� \i 1< 203 '0e • • oriels ., mapq 2
C r.1 • , to • I♦ MIN MN MEM
1100T"'t"" 7is?'r7 .�. to „ MEM MS NU!
• , ,O _ T -ND Sitatle.•t . TI: - Z. JAM ["s = 1111MI 1111111111E11111
4 " z : - a - a :11 E-mail: Receeeeri r111111111111111tOE
Owtler . I • , • : iaetalladott • . , S made eat property own oa y " aidin • .
which is pat intended for vale. I . or exchange ace:Wiad to bb/Mlrserarlttfa 111111101 2
ORS 449, 413, 4'19. - • •1. �r 201 le t env. �MEM 2
Owes 111 1. 11.1.........a... Dlae Ql _ sotto NM NM MI WAN
I \1.1 \1 1 It • De • new.
ors *Maiw per bleb
NOM A. Fee for beseer Omits with perehmtor
Adams minim or fader .. earth eraeoh sheaf; 11111 2
Cl • ZIP fakeer* dm . withal! . ,. -
darn= or feeder he, Arm br ochMorale �� 2
t•1 ■ It1 % lI'\ (t•I...'. cis.,I, :.II II,.II :+I,I.IYI 11111111111111.1
0IMMeesrNmemO► • O lieldtcerehAllq
O Service rmer2213empe setl02 O Rarrvdowbetlka L •-s++ —
ewer dwellings or 1e11Bes ovw lekeeneglwe An tower =" '" 't(e)
- a I Ned atoll ' •
O Syria o 600r slhal O
otti mom MUln dteteelo4 or.. 6 ladet il ■S
m 2
O ar;tdinseserrr metes 0 f`lwe. 400 amps a more • ,; . _
O Omega lad me") pass 0 M+whetered sweetmeat av peril syes '! — • ever Y• fey el •
O Eew.►NSA'MMtpurl 0 Omer: - tsar . , . ,.. •••NM 1•■1•11
1101.1* -_._ cep of Om *di W oute obeys.
• „TM ibaremoot . , t+etem. Y • e •Avegioemnt!. '
Ma aE)hdel�raa haatvlae/tnra.1 canamaiowaerMae&ido._lea` Noloe:71tiapeneltuppliedim l�ttsic fee.w.w.M1w._.w.. Z —°
e its a not coolies PIW review (at 96) $
O Mar O NaetelC.rd i Rama t S tate surcharge (S%) .... $ "L td. `to
caew.Ir+ , � ' within 1 LO days alter it Ws beat
eeeepted es complete. TOTAL •.•...•..•_• • � 40 ..... $
e.
+Mutts (00etoeh4
10 /t0 39eid OI2110313 3JI1Wti3alS Z60S£6609£ 6Z :LI Z00Z /SO /£0
Meer -06 -01 03:05P Wolcott Plumbing 503 667 9891 P.01
03/06/01 TUJ: 14:41 FAX 503 508 1960 CITY OF TI CARD
QI002
• Plumbing Permit Application •
A Detetzoeived: t
ii i , . : ; ;� City of Tigard L�l �dLIL�S
•
Address: 13125 SW Hall Blvd, Tiger I, OR 97223 SCWe` permit n0' Building permit no.:
City ojTigard Phone: (5O) 639 -4171 Project/appl.no.: J aPp Expire date:
Fez: (5(13) 59R-1960 Date Issued: By: Receipt no.:
Land use approval: - Ceac file no.: Payment type:
•
,. 'I 1'PF OF I'tR\IUf . •
U I & 2 family dwelling or accessory • U Comrnt:rciaUindtutriul O Multifamily U Tenant improvement
O New construction O Addidc n//alteration/replacement U Food service O Other _
JOB..ITE li\1•UR \I,�1'10N . ' .& L ti('IlLt)I Our speci :N t111otliAliritl vcc cl)Ctkti >t) ,
Job adikesr, /3o 7 ' 5; (.,-) , p Description Qty. Feel.) Total
Bldg- no.: Suite no.: Bl I. and Wtmlily dwellings only:
Tax map/tax lot/accouut no.: ( a100H for estcbuliUrycttoseetloo)
Lot: 1.< Block: (Subdivision: SFR (I) bath
SFR (2) bath 1 5
Project name: . SFR (3) bath
City /county: I ZIP: Each addidon itehen -
Description and location of wink on premises: Site utlliliea: -
- -- Catch bssio/area drain
Est. date of conplecon/inspectinn: - Dtywells/leach Iine/(rench t r n
Footing drain (no. lin. ft.)
43 pl e p Manufactured hone utilities ` '
Business name:
ISM r r ` 5 _L� - Manholes
Address: P o, e) o)r '2.0 07 Rain drain connector —'
City: Ere yl.e. ...... Siatcfl ; IP: Sanitary sewer (no, Ho. R.)
Phone:503- 469- Il $i 1Fax: 6b'7 -'i a 1 [E-mail: 6 . t -0os(- o.ine Storm sewer no. lin. ft.) .
CCB no.: - g �, Plumb. bus. reg. no :24 . Lo Sj pp W service (no. tin. it)
•
Cityimetro lie. no.: • Fixture or items
Guotractor s rcpresenladvc sit aatttrc Ab rias valve
�"' r r r- ='' Back flow preveater I
Print name: a b-: • et D .. •
Backwater valve
CONTACT PI•;RsON Ba sins lavatory "� •
Name: Clothes washer
Address: - - �(chvmsher
City: i State: :UP: A Drinldng fountain(s) •
Ejectors/rump
Phone: Fax: E -mail. Expansion tank •
Fiz sewer cap .
Name (print ): now dralas/floor sinks/bub
Mailing address: Hose go disposal
City: State: 1,riP Hose bibb _ _ ;
Ice maker
Phone: IRA: E-mail 1 nc - lntaceptor4rease sap
• Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by meat the maintenance and repair ma d - der by my replat Roof drvn (commercial)
employee on the pnpcny 1 own as per ORS Chapter 147. Sink(s), basin(s), lays(s) .
Owner's signature; per; -
k :NGENI l u . Tu a/shnwcr /shower pan —
Name: Urinal
-----]
Water close)
Address:
- Water heater .
City: State: ZIP: _ Other. -
Phone: I'v x: E -mail: Total
t it j„u a ,,,sc l semi credit cccdr, please cal iwirurem to mac in caution.' Notice: This permit application Minimum foe........... $ 1 d�
U via 0 MastatCard Plan review (at _ Tv) S
expires if a permit is cut obtained
oval card Dumber: - -L -.I— within 180 days after it has been Slat° wr `
charge (8 %) .... $ �•• } � r
600.1r01 600.1r01 TOTAL $ Y''
More of ca daoldu 4 itMr' ep 4604 cod hcetpled us complete. -
`f
S
` . —. ZSrdboWe■ sipulvrs AW4°— MtWld((�OD�CIW.I
6
r�/al .
�/1l oo
Mechanical Permit Application ,
Date received: Permit no.://ff200 7
Al' ''')J1 City of Tigard Project/appl. no.: Expire date:
City ofTtgard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
m 2 family dwelling or accessory 0 Commercial/industrial O Multi- family 0 Tenant improvement
New construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: _ j (,) ;_ 1 ./ / Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ _ �� -
Lot: _5' Block: Subdivision: QOp, I • . t> . 'See checklist for important application information and
Project name: MAR lob • - rwi )VILA AO. jurisdiction's fee schedule for residential permit fee.
City/county: ►Cl/i' JD t 51..; IIEZIMIONII 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location o work on premises: • 'tr i AND COMMERICALIINDUSTRI:AL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est date of completion/inspection: D Qty. R R=
improvement or change of use:
1 VAC:
Tenant
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM �o
g P Air conditioning (site plan required) INI
Is existing space insulated? 0 Yes 0 No Alteration of existing VAC :
Air h IIIII
MECHANICAL CONTRACTOR St e rmit I ■■
Business name: all Lj b, 1U(4 t C'oDl 1 State boiler permit no.:
HP Tons BTU/H
Address: ',O (o (o i,‘o' Fire /smoke dampers/duct smoke detectors ME
City: 'c)(2 .A ■ Stateb, ZIP: c(7 2 Heat pump (site p an required) I=
Phone: t 5 -54/ • Fax: 775 1141 E -mail: — Install/replace furna .inner BT III
Including ductwork/vent liner O Yes I7 No
CCB no.: 4 : 'l t3 Instal repla relocate . eaters- suspend -• , Ill
C ' / ' . 1 . • •.. DODO 1 •'L' wall, or floor mounted
Name (please print): 14.4 t ` - ent fora ..liance other than furnace in
CONTACT PERSON s . ■ --
Absorption units BTU/H
Name: -i .,,, . Chillers HP M
Address: Co -;11,. f�E .�.ressors HP N
mn - tier an ven on: MI
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER '
,Type 7 Tres. kitchen/hazmat ■ __
hood fire suppression system
Name: l'1. e ;. Or Exhaust fan with single duct (bath fans) —
Mailing address: • aust s stem a . art • m heaun ._ or AC
. State: ZIP: . p p . = an . Ili on up to ' ou ets
City: Type: LPG NG X Oil -
Phone: Fax: E -mail: uel • i • ing eac • additional over 4 outlets l♦ _
ENGINEER p p (schematic required) - IM
Name: lIl �u t;7/ Number of outlets
er I , - . app I ■ , or ell . 1 portal: ■
Address: Decorative fireplace -
City: State: ZIP: nsert p = ��
Phone: Fax: E -mail: 1 " * • . tov pelletstove NI
I .er _
Applicant's signature: Date: • ., : , II
Name (print): — ��
Na all Juriadlctiom accept aedii cords. Please information. iation for mae. information. Permit fee $ ` i.• 515
Notice: This permit application Minimum fee $
O Visa Cl MasterCard expires if a p ermit is not obtained
Credit and number: / / Plan review (at _ %) $ . `
Expires within 180 days after it has been State surcharge (8%) $ i
Name of cardholder as shown on credit cord accepted as complete.
S TOTAL $ 7 7
- cerdbolder signature Amount 4404617 (6I0OlCOM)
MECHANICAL PERMIT FEES '
•
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: 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) Fumace to 100,000 BTU
$1.52 for each additional $100.00 or induding duds &vents 14.00
fraction thereof, to and induding 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 Fumace
$1.54 for each additional $100.00 or induding 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 induded 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. ` ;.a ::Boiler ;' = Heat-.: Air :�" " .,;'-,- c. ;
$1.20 for each additional $100.00 or .,For.Iterils;7 -11, see ;_' or;'. :`.; , . Pump C ond
_ fract thereof. footnotes,below.t- F , Comp *.: ,, _ " "''• .
7) <3HP;absorb unit
to ASSUMED VALUATIONS PER APPLIANCE: 8) 3 3-1 BTU 14.00
8) -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9) 15-30 HP; absorb
Furnace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00
ducts & vents 10) 30-50 HP; absorb
Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
duds & vents 11) >50HP: absorb
Floor furnace induding vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM I
floor mounted heater 10.00
Vent not induded in applicane 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct
3-15 hp; absorb. unit, 1,700 4 6.80
101k to 500k BTU 16) Ventilation system not included in
15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30-50 hp; absorb. unit, 3,400 I 10.00
1 -1.75 mil. BTU 18) Domestic incinerators
>50 hp; absorb. unit, 5,725 17.40
>1.75 mil. BTU 19) Commercial or industrial type Incinerator
Air handling unit to 10,000 dm 656 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, induding wood stoves
Non - portable evaporate cooler 656 10.00
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not induded in 656 t 5.40
appliance permit .
22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic Incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: ? ,., r ;,`, :,, $ J5:
Commercial or industrial incinerator 4,590 > „s �? .; ", ,2 -
Other unit, induding wood stoves, 656 8% State Surcharge . ;�',: $
inserts, etc.
Gas piping 1-4 outlets 360 . r,
25 /. Plan Review Fee (of subtotal) -- ".. = . ' $
Each additional outlet 63 Required for ALL commercial permits only • ".f.11:'': 111,36
TOTAL COMMERCIAL = $ TOTAL RESIDENTIAL PERMIT FEE: .,: " 4,x; _ $
VALUATION: •
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee Is specifically Indicated (minimum charge -half hour)
$72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimum
charge-one-half hour) $72.50 per hour
* State Contractor Boiler Certification required for units >200k BTU.
"Residential NC requires site plan showing placement of unit
I Adsts',fomtsVnech- fees.doc 10/11/00
.Mar -06 -01 03:05P Wolcott Plumbing 503 667 9891 P.01
03/06/01 Tun 14:41 PAX 503 598 1960 . ' CITY OF TI CARD •
<(Q {.002 :
Plumbing Permit A pplication .
'` , ' of �i Date ruxived: �/ �/ , /
..t I' gAl' Sewer permit no.: Buildingperrnit no.:
re
Addresses: 131. 5 SW Hall Blvd, Tiger 1, OR 97223
Ciry ofTirar d pity: (503) 630 -4171 Project/appl.ao.: expire date:
Fax: (5(11) 59f1 -1960 Date issued: By: Receiptno,:
•
Land use approval: _ Ccsc file no.: Payment type:
L1'PE Of I . -
.0 1 & 2 family dwelling or accessory Ci Comrnt;rcial/industrial O Multi•family U Tenant improvement
Q
•
New construction 0 Additic n/alteradoc/rcplacemeot U Food service C] Other
JO[I.CITEINI'OR\IA I'M \ . ..r•tti % iiit: Itt: LE h. r spec i:dturonuutirmu lice cltcstlki)
_Job address: / 3o ? ' 5. W , 1 • / / / ,‘--- Description Qty. peeks. Total
Bld :. no.: Suites no.:
New 11• and ?rinnllydwelWgsably:
Tax map/tax lot/accouut no.: (blades 100 8.for each milkyconneedos)
SFR 6) bath
Lot ,5"( 'Block: Subdivision: _ SFR(2) - bath ! 29
Project name: . SFR (3) bath
City /county: . Each addns at /kitchen
Description and location of work on premises: Site utilities:
- -- Catch buin/area drain
Est. date of completion/inspection: - Dtywclls/leacb tiae/trench drain
Footing drain am. fin. ft.)
Manufactured home utilities _ .
Business name: t1 sal eo1' )..w, ivvg _.��. TvTanbolca
AOdress: PO. G 01r 2 O O 7 • ate , • connector • •
City: t (,rc ..`. trt•. State° O :1P: atutary sewer (no, lin, RI
Phone SO 3 - 667-17 ii,il [tax: 66'-46 t 1 E•ma1: O i - caw Storm sewer (no. lin. R.)
CCB no.: 2 3 g yi 1 Plumb. bus. reg. no: ?..4.- to Si pp Water service (no. lin. C
City /metro lie. no.: 1Fllrture or leaner
Contractor's represenlative signature: _ ' Ab non valve
r p ,' : ack i ow preventer
Print name: . - L.; - e\ D r. - ;
• ater valve
. CONTACT PEItsoN Basins/lavatory —.
Name: Clothes washer
Addreca: - Dishwasher
ity: _ 1 State: l :JP: • Mil
•ri. • gtountain(s)
E'ectas/mm
Phone: Fax: E-mail; Expansion tank _
ix , sewer cap '
Name (print): Floor dra ns/floor sinks/bub M
- Mailing address: orb :e dos. al
Hose bibb
City: State: '!.lP lee molter j
Phone: Fax: 1E.-mail ntace •tor /; mese trap
Owner installetiuNresidential maintenance only: The actual installation Primer(:
will be made by the or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 147. Sink(s), basin(s), lays(s)
Owner's signature: Date: _- ump
&NG tINE /At . u•a/s nwcr/ . wet pan
•
Name: Urin '
Water closer
Address: ' ater heater '
City: State: ZIP; Otter. -
Pltunc: Iti,t: E -mail: Total
'' h.. 'Is iwi"ctim' eeeta'14 uwe' r4,5e car jw;rucsm to mac to prntewL Minimum foe... .... S _31 0 4 5 -
r
*intone: This permit application
U Visa C Mastarcard Plan review (at • 9e) S
expires if a permit is out obtained
Cmiii card camber - � was
within 180 days alter it has been Slate surcharge (89i) .... $
•
?term
at caumolecr ;N.% ea awe sera ncccpted w complete. 7'OTAIt, $
i
• -- �'Sn7balder ugacrvn Atrowa , r
v e ,� «t.+aoei(6
r .c i i
t/
r7)Sbt ®s
1 t,
...„ f63.„--
Mar-06-01 03:05P Wolcott Plumb ing 503 667 9891 P .. 02 •
03/06/01 I'VE 14 : 42 FAX 503 .598 1960
CITY OF TIGARD (t003
PLUMBING PERMIT FEES:
r. • • - - ..:. "•••.:•i ,........:-.:,,,..•.• ,•• . -• :.: is:_,:,.. r:-,PRI,.cp..:...h..!.r.s.,:rA_Li... ••hiet■ti, and 2+Iiimily Airily:. ci ..!: • . • ...; •-• 2 :;..".'. - • - 7 1
i, FIXTURES. -Ondliridiail) 1 '..' • •-• ...I ..' ' ' .:. ':4 ',' '. 2 (Gail, .!''• 'ARIOLINT:' ; . • : •:,': '•IIIG
I.#. . : •;
rStrir _ 1 15.61 I le 40 ::: Irititig ft i 1.,:! ' . •(?V! / • -: AMOUNT
Ut ::•;; • '.!T,l: .-....': -• :•'..: .,:..-:;:. ::';• : ',..... :
Lav atory // 16.8) 33 1.,g)
Ono (1) bath $249.20 -
6
[ ub or Tub/ShuWernb 16.6) . V Two (2) bath . . - $350.60
3 .-
1 Shower Only 16.6) Three (3) bath 5399.00
Ft u c cs i T IA G R TA G L E . :. .. : •: ,. :I . . . :,r . . ' ...: :::1___ . :
'mar Closet tv 16.6) _ ...... 3 it:: L -. __ Urinal 16.63 I 8% STA71 SU
_ , :7.....::
Dish...a:met I 18.53 1 ( (0 PLAN REVIEW 25% OF SUBTOTAL -: • . . • ..
Garbage Disposal • f 16.80 6 TOTAL : - _ . 1 I
_ - IC°
Laundry Tray 16.10
Washing Machine
1 ' 16.6 16
Flow Ontinif ioor Sink 2" 16.10
_..
3" 15.10 PLEASE COMPLETE:
4" 16.10 •
water lteeter or rivers on 0 like kind 15 (0 : .:...l:.... .• - ,• • irl.■••:• : ' : ; - Ouantig Peomied
Gas piping requires a separate rivxManicat
I 104° „
'..FLIIcUI, TIfOrl '. • ! . • • RaP,Iii ce0. • Removed!
permit. - : ::.:'• • *. - • :::: : ' ;'; ";':'•.:• 1 : 12 - : ": :',,, • ' :. - .. :
MFG Vi . --- rsr -------------- rno ew Water Service 4 'Sink I _
M1.0 Home New San/Storm Sewer 46.10 tavatwy
Hose B to.te Tub or Tutahower
/; 7-9 Combination • ,
Roof O'al tie- -f,. 16.1.0 Shower Omit •
--
DOWN Fountain 16.110 Water Closet
thin
Other Fixtures (Specify) 16.110 e! --
,-. • Dishwasher
GarbadiDisPasai ---,-
Laundry Room Tray ----1
..._
Washing Machine
Floor Drain/Sink
- -- ---
Sewer - 1st 100' ) 55. l0 lila
3'
i
tower- each additional too • " 46.10 4•
Water Same.° • 1st 100' l i - 55. )0 Is 5.," Wet r Heater .
Other Fixtures
Water Service - each ariditional 200 48.10
(SPoothr)
Storm & Rain Main • 151 100 f 55.)0
i
Storm L Rain Drain - each adoltlonal 100' 45.10
Commercial Back Flow Prevention Device 46. so i
, .
Residential bacicflow Prevention Cevice• 27.55 - -
i
Catch Basin 60 -
: , i
Inspection ot Existing or Specially • - 72 50
RequeSled1119ectiOnS pei Mr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 1 6525 (492.5- -
Grease Traps 16 50 -
.
QUANTITY TOTAL : .,. - 4 ...;., ..... -:•...:,.:'• . ' i :-
Isometric or tsar diagram Is r equi r ed it
Ouantity rotai is 9 ' • ., ••!•1: .. .•:,;.
'SUBTOTAL 7.7
..-- ...----,----. • ;?'.
LY, STATE SURCHARGE ' •••.; ' ':- . - : .4 • -
PLAN REVIEW 25% OF SUBTOTAL ''' :..
Requked ciniy if ruilii re bry tobtin :. c
-
TOTAL . :'.. . • ..••: •••. 5
• Mirshnum permit fee Is 572.50 • 8% state surthansw. sump+ Re sit! will BeC880+4
Prevertun Device. which 4 316.15 • 5% irate surcharge.
"AU Now COOloservial flu Helms requite giall with isamettie ce rla it Mavens 360
plan ,e•Aew.
lA1stslforrns1p1m-tees.doc 10/10/00 .
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
STREAMLINE ELECTRICAL
6025 EAST 18TH STREET •
VANCOUVER, WA 98661 •
Electrical Signature Form
Permit #: MST2001 -00167
Date.Issued:
Parcel: 2S104DA -06900
Site Address: 13078 SW RAPTOR PL
Subdivision: QUAIL HOLLOW - WEST
Block: Lot: 055
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached rowhouse in Building #5. Setbacks as per sheet A10.10
Plan D -SB
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:
BROWNSTONE HOMES STREAMLINE ELECTRICAL
12670 SW 68TH PKWY #200 6025 EAST 18TH STREET
PORTLAND; OR 97223 VANCOUVER, WA 98661
Phone #: 503 - 598 -7565 Phone #: 360- 993 -5080
Reg #: Lic 1514
ELE 34 16 -432C
SUP 4081S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x %�
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 7- d C 3 ' 7
INSPECTION DIVISION Business Line: (503) 639 -4171
UP
Received Date Request-d q / / G AM PM BUP
Location / 3 O 7 R Suite EC
Contact Person I - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
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
Oi =•
4 00 PART FAIL
'BING
0./ ..19-5—
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
4 ;�11
PART FAIL
RICAL
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 4/\ D, /� \ ' t
Approach/Sidewalk Date / U / Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL