Permit �_. �.
CITY OF T I G A'R D MASTER PERMIT
PERMIT #: MST2001 -00168
4 III , DEVE R9 I 639 -4171 DATE ISSUED: 10/30/01
SITE ADDRESS: 13066 SW RAPTOR PL PARCEL: 2S104DA -07000
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 056 JURISDICTION: TIG
REMARKS: New SF detached rowhouse in Building #5. Setbacks as per sheet A10.10
Plan A -N
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 173 sf BASEMENT: sf 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: 580 sf RIGHT:
VALUE: $ 141,590.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,488.00 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 BOIL/CMP < BHP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADDL INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 2 PUMP /IRRIGATION: PER INSPECTION:
EA ADM 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 SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 • 1000 amp: . 601 +amps- 1000v: MINOR LABEL:
1000+ amp/volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL - B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: 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: $ 5,696.13
This permit is subject to the regulations contained in the .
BROWNSTONE HOMES BROWNSTONE HOMES, LLC Tigard Municipal Code, State of OR. Specialty Codes and
12670 SW 68TH PKWY #200 12670 SW 68TH PKWY all other applicable laws. All work will be done in
PORTLAND, OR 97223 PORTLAND, OR 97223 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 Insp Appr /Sdwlk Insp
Sewer Inspection Plm/undslab lnsp Electrical Rough In Gas Line Insp Rain drain Insp 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 Insp Plumb Top Out Exterior Sheathing Ins[ Gyp Board Insp Water Service Insp . F' I inspection
Issued By : ∎� � . / 1_, _ . Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
a �^
--1 A)4 -200/ 00 /0
Building Permit Application
...3/20/0 / Permit no.://fgati.-00/4
' City of Tigard -
1 �+1 . . Date received: Projecdappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 6394171 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
eri & 2 family dwelling or accessory 0 Commercial/industrial Cl Multi - family r% New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB Sf1 E INFORM
Job address: g . - • 1 ;_ J TO 2 l L Bldg. no.: S Suite no.:
Lot: _ , Block: Subdivis 'on: " p. (, , t ay , vj. ST , Tax map/tax lot/account no.:
Project name: Q A L _ to
JP' ■
Description and location of work on premises/special conditions: r 4 � . . . K — • 0 1104.1 L1104.1
•
O11NElt FOR SPECIAL INFORMATION, USE CIIECKLIST
(lloodplain, septic capacity, solar, etc.)
Mailing address: 12(0 ?0 5*' (o$a %, (Gtuq✓ 11 20o 1 & 2 family dwelling:
City: - OCT A-K.10 State: Valuation of work $ ems, OC»
Phone: ' , 1. Fax: a 8 gat I E -mail: -- No. of bedr+'ooms/baths
Owner's representative: • M • • pa . Total number of floors 3
Phone: /13 5775 Fax: 57q 399'1- E -mail: New dwelling area (sq. ft.) I a?
APPLICANT Garage/carport area (sq. ft.) f 4
Name: -,AE A6 • _ ./ Covered porch area (sq. ft,) —
Mailing address: Deck area (sq. ft.) 40 Sa FT
City: State: ZIP: Other structure area ( ft.)
Phone: Fax: E -mail: Commercial/indostriallmulti- family:
CONTRACTOR Valuation of work $
�� f� • Existing bldg. area (sq. ft.)
Business name:
' i, New bldg. area (sq. ft.)
Address:
City: S �p Number of stories
Phone: Fax: E -mail: Type of construction
CCB no.: Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCM] licensed with the Oregon Construction Contractors Board under
Name: G, I a provisions of ORS 701 and may be required to be licensed in the
jurisdiction where work is being performed. If the applicant is
Address: WO \ C01..1Dt , t ii- 14510 t exempt from licensing, the following reason applies:
te a. 3 State:UA ZIP: to 101 = -
Contact person: s ,; Plan no.:
Phone:76 f, - 4( - ; Fax:1: 47 -, _. E -mail:
ENGINEER
Name: 1 Q - , €610.1, Contact person: ; EN 'Ali, Fees due upon application $
Address: • � Sri ki, h t90S Date received:
a ,' • 3 Stated` ZIP: 7223 Amount received $
Phone:* - 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 =Et cards, please call jurisdiction for more information.
attached checklist. All provisions of la s and ordinances governing this U Visa o MasterCard
work will be compli wh ified herein or not. Credit end number: /
Authorized signature: Date: 3!� ` 1 D 1 Name of cardholder as shown on credit card $
Print name: Th 1M • A OtS Cardholder 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 (66wtr:OM)
•
At, Electrical Permit Application MO g
o
r . . Data received: l�rfaat 110.: ' , / 1 G 6
• '..4.• .: _ :. irtY of Projed/appl. to.: Expire date:
c r i Addewe :1312$ SW HMI Blvd. tipird. OR.97223 pt►teseaed: By: �
Phone: 003) 639.4171
Mkt (303 398 196 Can fds no.: Payment Irpe:
Land use approval: •
1I1'I. (Di ' I•110111
14 hodti dwellies or memory O Coenmarcialj ndnstrlal 0 MOW-family a Tenant improvement
or New eonsanotioo o AdditWVetterationlreptaeement o Other: . o Partial
It111 \) II 1\11t101 11110\
r=flingraMing =Mil =Mil E
La: 4ffl1111111 Block: Subdivleloo: ■ uAn L He llwa wrT
P r o j e c t Hartle: dt MI Flt I I mo Deeeei • ion add location of wok Ott • , ism: 1.2€1,4 eonut1t.Beneea
Estimated date of •., • etiaali • -
, .lu\IIt\1Wit kI'l \III)\ III 'c III 111 II
• MtgOS NFIPIIR
t • .disaer -•.. . per
. 1 , drletl agenialasle a eamelsdpnga
• V - ncouv - r 11=117111 ZIP: 98661 tlenaoeaohan
Phone: 9 9 3— 0 = I Li IVIVICEIMT:lr mail: loop • . n. orleo
I+.
CCB no.:1 1 6 51 Flea but. Ha. nos 34-432C aaltiend 200 . R, or • • • • . • ■ it iz
IIIIIIftIIIIII _ __
CI imetrollc. no.: . ...• . , , Limited ems . am- ►t*Idestlai r MO r 2
■11� 2
uelateeno: . eeMe -. Mks, �.
stem** ar sders– :"*"
victII'I 1t I1 I► % \i It 200 .. erleq 2
�� !: l�C>lld _ :� ./. � 4 ep4e0 Mi =MN E3i• 111.11111111 2
•. lr�f:, �l 0 .'ll t Iii _an
' _ Stito*) 0 VP 'G ilr. -ac �' t1MN �l01
IOW-.
IL • Zj . [ - B- Reconnect • •M111.MMIIt11111
ow , : I • • , : imolJtaoon • g made on property own • wipes /2 or Mein • .
which Is not Intended for sale, t , or enchants aocordln3 to relrae le
ORS 447, 455, 479. I •1. 111 201 le leer 2
,4
VPe e1 i . AL -� . .. ■.. v� ' 1 401 to ' __I�
I v.1•11 It .'. ' . NS•MIN 7 .- " .. .
oreiaeedllla re MMeb
Maim A. Fee for bulk %Merits Milt pmo%sseet
Addles*: • ammo a owe Mono%euedm 1111 2
11E11111.1111111111111111.11111E=11111 ZIP: 1111111r 2
I.I t'. Ill t II tt Ill ....• (I ,I..:di II..H :111/.1.1 ■.�
lMa P
oomali aae nnandol ' 9 t•ea10�enestldllq� 2
O M
0 I Ionics ern'n°= Wei% ofiet2 O howdeoeloeealen J • or Wane !; ......• 11111111111111111It1111111
IMnd4 • 0 ttattdlas owr 10000 memo All team ,," .. - aq et e 1 Wd d eneIIy • . S. _
0Spamware° gotta : ewing reed ed
Iestdedontoinoremoose detrwoR crabwise.*
a ewndlosew.dreS $Il 01roaen. 400 helps a wow Vacs .... .
0 Oedpew laid o v e r 99 paws s 0 M & th E ,ad eaeaslao Rv part Ego 1 , , fear , . • •''•"+. say et ,
0 semousicosens 0 Ober: t►et NM MR NM Mini
e1ea& sea of plea with ary 'fat lama . ' • tdlea
ober
..The above arms • • I ate. . , , meets esoa w ■.1te. • -
I+aI ee grata allwelree. permit Pell* tea ................_... $ 3�L —°
ter me rdelflri� t�ior. This �0° Phu tevlew. (,u " %) !
0� ilselerV110 Miles if • Ilona is not obtained - ----'_
Calk wee stall . . i I wWdp tI0 dap abler it ha beat sore Surcharge (B%) .... $ 40
.>w.. „eeatltedleeila. TOTAL �.. ..... s
-Colmar damn .. 4 115
TO/TO 39t7d 0I610313 3JFWd32l1S Z60SE6 0606 9E 6Z :LT T00Z /901E0
Mar -06 -01 03:05P Wolcott Plumbing 503 667 9891 P.01
03/06/01 TUs 14:41 PAX 503 508 1960 CITY ()le T1 CARD
Q1002
A Plumbing Permit Application • .
A!! City Date received: Permit no.:
�,� Cty of Tigard Mao/ i,;�
'' Address: 13125 SW Hall Blvd, Tiger 1, OR 97223 Sewer penult no.: Building permit no.:
City of Tigard phone: (503)4539.417i ProjecVapFl.ao.: ta
pue date:
Fax: (5(11) 59P -1960 - Date Issued: By: Receipt
)rand use approval: Case file no.: Payment type:
' ll'PI 01 l'a:It111'1' .
U 1 & 2 family dwelling or accessory U Comm' rcia /industristl O Multi•amily Q Tenant improvement •
Q New construction O Additic a/altesatioo/replacemeat U Food service Q Other
_ s
JOB SITE INFORMA FEE ti('IILUIi (h r speci:11larlot1uai Ilse diet tait)
•
Job address: ,_ O 6 6 ScJ 1 ,. • .il Deacrlpdon
Bldg. no.: Suite no.: New 1• audUnsay dweWngs ody: Qty. Fee(es4) Total
Tout map/tax loUaccouut no.: (� a 1 �� for 6 h a ta)
SFR (l) bath
Lot: 5 to !Block: 'Subdivision: .� () bath
Ptojeet name: . SFR (3) bath fib
Citykounty: �: Each add 1a
Description and location of work on premises: Site utilities:
- -- Catch basin/area drain
Est. date of completion/inspection: - Dtywclls/leach line/trench drain
Footin: drain (no. Iin. R)
Btsincss name: IA) O i� ) ∎. i rq Manufactured home utilities
- Manholes
Address: P0. a, Oh 2.0 0 7 - _ a n rum connector III
City; _Cjre yl,G.e. StateiQS AP: atutary sewer (no. lie, R.)
' .
Phor)e:So 867 - ail 'Fax: 66 9tig mail :6..y►.lpox -maw Storm sewer (no. lin. ft.)
CCB no.: 2.3 g yl J Plumb. bus. leg. no:24- ao y Pp Water service (no. lin. IL)
Cityimetro lie. no.: Ebtture or hew
Contractors rcpresentadvc signature: p Ab tree valve
r' " " �' r sek i ow preveates IMMI
Print name: Z.: - et D . -. _
: a • also valve
... CONTACT PFRSI)N • Basins/lavatory p
Name: Clothes washer
Address: Dishwasher
City: ] State: I ::1P: or founlala(s) •
Ejectors/sump _
Phone: • Fax: E -mail. Expansion tank
Fix sewer cap . •
Name (print): Moor dram' affloor sinks/bub
Mailing address: Garbage disposal
• Hose high •
City: State: 'UP: Ice maker
Phone: Flue: E-mail Mlti:i1:71/: p • 11111111111
Owner instaUutitxt/residential maintenance only: The actual installation Prmer(:
will be made by me or the maintenance and repair shade by my regular Roof drain (commercial) _
employee on the property I own as per ORS Chapter 347. Sink(s), basin(y), lava(s) `-
Owner's signature: Date: __, ump
ENCGN►:F.R . u •s/s wet shower pan -
Name: Water M IIN
Water C oast
—
Address: ' afar heater
Croy: State: Other _
- ■
Phunc: I•;trt; E Total l
IWr► lid CUM 0cccp acdit tare. Nom call iurirUrOm(a mac is oemlthul Notice: This p it application application Minimum rim'''....... �( •
erm
u Asa o MasterCard expires if o permit is nut obtained Plan review (at _ 9b) S
lC.
Ca,Gt card teeter: _ � ..L within 180 days after it has been Slate surcharge (8%) .... $
1.-• a11,ira TOTAL S iti 6
Nara Pa of cardboldcr .1 cair:; ed aura led rtovoied as complete.
` Ta,ub.ltle urnrlur s ATOM , b - wow, .
r .c I oo
• 1 �
Ma r 06- 01 03 : 05P Wolcott Plumbing 503 667 9891 P . Cr2
03/06/01 TUE 14:42 FAX 503 598 1960 , • -
CITY OF TIC RI)
• . ., (t003 .
PLUMBING PERMIT FEES:
•
r.• . ..., .:.• :i:f.'-' . : • Y..;.: ... , -' . -: ....:. 4:: ''.',4: ::', PRIPP. ': 1.1;!.T.grA.,,11:. Netir.S. 'NI 2t1.0.TRII iiitAfilirigt isriff • ' • - ; ' ". ' ' ....--"'
i FIZ'rukts:iinal■qcgiii).::;1 -. 1 ' '': ':.0S : , toalt!:: 'AMOUNT:' ;(1p.eludete.all;PfUrebinjats(teFee In . . - .FNR .: . :. TOTAL .;
1 -
, Sink 1, 16.61 I I, 40 ,11#0:4 alidit!0:011.0Pli !,;!•!* ! . . • : AMOUNT
v 16.8) 33 v? :roe oich-iitigtioariniattoni ,"..; ....• ,-..,• • • •.. ...•.:: ....,•
Lavatory
. One (1) bath 5249.20 ,
Tub or Tub/Showemb ) P Two (2) bath $350.00
---
I Sijower Only 16.6) Threelaktth
1
' Closet I
1 1, 16.6) 1 ,11 , -...- -....- - .........- •---. ........•
tlnnai 16.63 I SUBTOTAL • .::: : .. ,.
' .
6% sure SuRCHARGE i..r.^: ... i i'
Dishwai.ner I 16.63
, _ I ff' (#0 kyLAN REVIEW 45% OF SUBTOTAL •• • .. '
G.a ci lc. 40 ,...._ TOTAL , L1_______I
Laundry Tray 16.e0
Washing Machine I 16.6
Floor Drain/Fiver sink r 16.10
16.(0 PLEASE COMPLETE:
-
V' 16( 0 • _
water Heater 0 converilon 0 Oka kind 16 (0 .•• t::;...' • • • • 4.- ..," •,‘' . '41.l! - OUentiVttr WorliferfOrared.
• . . ,. . ,
Gas piping requires e separate mechanical
10411 '.:Ffi* irjrrpe't 't •.: ! :Neviir , ! , :telenielf., tReplaeeft • RenvE6■00/
Perna. ... - ,:.:. , .. , • :::: : -......•:i., ,:i; • I !.:':. 11:: : ": ::,,, . : • • . :' t„Igiiled
MFG Horne NOW Water Service sa .0 Sink
----
MI • G Home New San' Storm Sewer 46 40 I Lavatory ......---... 1
Tub or Tub/Shower
Hose tits _ fie 16.14 / g ZR Combination .
I
Roof lI'atris 10,10 Shower Orilt •
I
OnnK!ng Fountain 16.u0 Water Closet '
Other Fixtures (Specify) 16. Utinel 1Z -
Dishwasher _
Garbadi Disposal
-
• ' Laundry Room T9r ---1
. , Washing Machine
Floor Drain/Sink: V
-- 1
-
Sewer 1st 100' - i 56. JO Ire-414LI 3' - i
Sower- each additional W • O'
4s. 10 MEM .
, 4'
.
Meer ScrvIce • 1 it 100 l i 55. )C Ma „:-. Water Heater •
Other Fixtures
Water Service - each aridttronak 200 46.10
(S city)
Storm 44 Rain Drain • 1st 100' i 55. )0
--w- '
Storm & Rain Drain - each additional 100' 46.40 ---
...
Commercial Back Flow Prevention Device 46.40
Residential bacaflow Prevention Cevice* 27.55 ..-- --.
Catch Basin 16 60
I . _....--
inspection of Existing Plumbing or Specially • - 12 50
Requested inepections -- pa dr COMMENTS REGARDING ABOVE:
Rein Drain, single lerray dwelling I 6525 ram
_ _______
Grease Traps 16 50 _
QUANTITY TOTAL : .,,:::: ..•• :,
leom re 4ser disown IS niquifed it Ill
03t.. .::,ii !I : : . ,:,,: ..,;•
'SUBTOTAL. ,. 7 ; 77.tilt•
..,
a% STATE SURCHARGE - , ; - ; . ; ,r . "-.•
.. PLAN REVIEW 25% OF SUBTOTAL. ' '
Pte 1r
ouirodot A :•S ;. • :
I- TOTAL ' ....• ••• • $
.:.: .
. ; :',• • ;•
•Minlinum potTriSIN Is $73.50 • 5% coo 5Undialt9r. face0 Re skl villa! 900047*
Preveecan Device. wilier+ if 531.:5 • 5% state surcharge.
"All New COMM•rcIal liulIQINIS meal/e pies with Isomelfie 0/4 V diagram and
plan frwifw.
lAdstslforms1p1m-tees.doc 10/10/00 .
- Mechanical Permit Application
Date received: Permit no.:/'/) ,2�2O / 49 /4 is
,,i 14 City of Tigard Project/appl. no.: Expire date:
of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223
City f 8 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 PERM! I
2 family dwelling or accessory ❑ Commercialindustrial O Multi- family 0 Tenant improvement
Oili New construction ❑ Addition/alteration/replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: i 6 6 .5 L.,_ j N. � L Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 5 Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $ 3-411)0 -
Lot: , Block: Subdivision: QOp„l •, ou - 'See checklist for important application information and
Project name: QUA \ Hp .0 TO I-lotu.O. jurisdiction's fee schedule for residential permit fee.
City/county: 1CI�� I & 2 FAMILY DIVELLING PERMIT EEL SCHEDULE
Description and location o work on premises:
eV � AND COMMERICALIINDUSTRIAL EQUIPMENTSCHEDULE
Fee(ea.) Total
Est. date of completion/inspection: Desai . Ion Qty. Res. only Res. only
Tenant improvement or change of use: 0 ' handling �
Is existing
space heated or conditioned? 0 Y es 0 No Air conditng unit CFM
P Air conditioning site plan required) =
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system =
1\ILCIIANICAL CONTRACTOR State boiler no.:
P ell/ Tons BTU/H
Address: i 3 O (a ( „t, ' Fire /smokedampers/duct smoke detectors ME
StatetZIP: � ZOO Heat pump (site plan required) : ==
Phone: 5 - 5`1 • Fax: 775 1141 E E - m m
Instal replacefua .tier BTU
Including ductwork/vent liner O Yes O No
CCB no.: 4 . 2ita Install/repla re ocateheaters- suspended, III
City/metro lic. no.: DO ()O 1 02.. wall, or floor mounted
Name (please print): OA Mil ti / - Vent or a. • liance other than furnace <7♦
CONTACT PERSON ■ --
Absorption units BTU/H
Name: i LA Chillers HP M
Couu .ressors HP ii.
Address: , : ►`L� r nm - , , ant . , yen It • on: ri
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: ) er exhaust IN
OWNER oods, I fres. kltche • azmat
.
hood fire suppression system
Name: 11 !, l✓ A t : / Exhaust fan with single duct (bath fans) f —_
Mailing address: Exhausts stem a. art from heating or AC M
p an ; on up to ou ets � --
City: State: ZIP: Type: : LP NG X Oil
Phone: Fax: E -mail: uel .1. mg eac i additional over 4 outlets =
ENGINEER ' . . -.A P P ,,. (schematic required) MI11111■11
• a Number of outlets IM
Name: �41'Vl : 1 C i i . er I , . app I : , , or eq ' pment: El -
Address: Decorative fireplace
Cit State: ZIP: nsert - j' NM
Phone: Fax: E -mail: IT .. tov pellet stove ME
r. er. = ��
Applicant's signature: Date: t err.
Name (print): - �—
Not all jurisdictions accept credit car. please call jurisdiction for more. inforcmtion. Mini fee $ Sb
earth.
O Yrsa D MasterCard Notice: This permit application Minimum fee $
e if a permit is not obtained
/ / Plan review (at _ %) $
Credit card number: w ithin 180 days after it has been �
Expires State surcharge (8%) .... $
Name of cardholder as shown on credit Card accepted as complete.
. $ TOTAL $ 7 7
- Cardholder signature Amount 440-0617 (6/001COM)
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) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or induding ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. Including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or Including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and induding 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check allthat apply:! ';, Boiler,; IL Heat • ." Air ::7 o-
.
$1.20 for each additional $100.00 or , ,For,items : 7 -11, ` r:. < +.'or''.: = Pump : - -Con ' ,`;:.;. .,'
fraction thereof. :footnotes•belo . x � . q,.- '.', r. : ;r . .. .
` -Comp*� , r
7) <3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14 . 0 0
Value Total 8) 3-15 HP; absorb 25.60
unit 100k to 500k BTU
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
ducts & 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
floor mounted heater I 10.00
Vent not included in applicance' 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 �1
3-15 hp; absorb. unit, 1,700 A- 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 1 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 dm 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 included in 656 ( 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: :^ °n r a s: n ;; $ g2
CCommercial or industrial incinerator 4,590 tx, 1 ,
Other unit, induding wood stoves, 656 8% State Surcharge X, r ; .;; fi'�z $
inserts, etc. , :v :':
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) - ':,:;',,::: . ...`;'-:'..,..:„ . .,_ $
Each additional outlet 63 Required for ALL commercial permits only `"`' 1136
eq Pe N i >a _ , ' , °``•_
TOTAL COMMERCIAL $ • TOTAL RESIDENTIAL PERMIT FEE: -` - ;', ,, '- $
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) $72.50 per hour
* State Contractor Boller Certification required for units >200k BTU.
** Resldendal NC requires site plan showing placement of unit.
-
I:.dstsVormsjrnech- fees.doc 10/11/00 .
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
STREAMLINE ELECTRICAL
6025 EAST 18TH STREET
VANCOUVER, WA 98661
Electrical Signature Form
Permit #: MST2001 -00168
Date Issued:
Parcel: 2S104DA -07000
Site Address: 13066 SW RAPTOR PL
Subdivision: QUAIL HOLLOW - WEST
Block: Lot: 056
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached rowhouse in Building #5. Setbacks as per sheet A10.10
Plan A -N
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE HOMES STREAMLINE ELECTRICAL
12670 SW 68TH PKWY #200 6025 EAST 18TH STREET
PORTLAND, OR 97223 VANCOUVER, WA 98661
Phone #: 503 -598 -7565 Phone #: 360 -993 -5080
Reg #: LUG 116514
ELE 34 -432c
SUP 4081S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
14 67 - oZ 06 f - c5o((0 se
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1 STREET
TREE
CERTIFICATION ►
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• • I, ,4 , Owner/Agent for Xe),1 aitel2-f •
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(PLEASE PRINT) (PERMIT HOLDER)
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• Do hereb _ , e following location ■ ►
® meets . City of igard /$i(as#ti on County ■ ■
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land use and development standards for street tree installation. ■ ► •
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• • ADDRESS: /306,4 S,6J, 4 p
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• LOT: 5 &. o ► SUB DIVI SION: a va 1 ocA ►
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• $Y: / > DATE: •
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RECEIVED BY: ial r DATE: q --- UOZ • •
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CITY OF TIGARD 24 -Hour
WILDING Inspection Line: (503) 639 -4175 MST 2,00/00/6
INSPECTION DIVISION Business Line: (503) 639 -4171
'/ BUP
Received Date Requested `�' _ a 9' AM PM BUP A �l0
Location /31 I. _ . Suite MEC
Contact Person Ph ( ) 7 9 3 s3YS 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 tA6C E� Drywall Nailing
Firewall i r(`lt\/,
Fire Sprinkler ``,,UU
Fire Alarm
Susp'd Ceiling ,� ,�II
Roof 13�J M (A1CG -NA FAN �NV16 / � Q) ND (tia
Other: 1 ,, l
Final \ eV Jr/ V ► •\ S A , {e 4 j 67 # ,c ioas
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 1=1 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line '
ADA
Approach/Sidewalk Dat /- Z Inspect s • ♦ • - - -iz Ext
Other:
Final DO NOT REMOVE this inspection record from he job site.
, PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175 MST 2 0
INSPECTION DIVISION I Business Line: (503) 639 -4171
BUP
Received Date Requested 71 —)--- AM PM BUP
Location / 3 ow., Suite MEC
Contact Person Ph ( ) � 'I 3 . 5 - 3 ( 1,.. 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 G d holipl--
e- 7-& 61.,,,,,, 10 e / '1,f7a G LIB
Insulation k
Drywall Nailing / f f
Firewall - /Q,.frp& - 2Y-0 Z - c. �� /4 �I. v Fire Sprinkler c'
Fire Alarm
Susp'd Ceiling
Roof
Other: ANYLN=M7 Final
e P PART FAIL
LUMBI
Pos -earn
Under Slab l
Rough -In /
Water Service AAA 1 Aka. • i • . .
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain �
Shower Pan J i ` ,- G/fit
t/ C J
Li /■c.�i 4,L
Other: %` L ^
ti 4` y
• . RT FAIL �� � G� �/ vLt�G
I EC . , AL
Post & Beam
Rough -In r
Gas Line flg. fe ve X . 5iy/ r --ex -- b Smoke Dampers �!
;�- P -3 FAIL Vj 1
Service - Rough -In - � UG/Slab / ,
Low Voltage t
Fire Alarm
.140 PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S ❑ Please call for reinspection RE: _ _ E Unable to inspect - no access
Fire Supply Line
ADA L f - /6— O'� al
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY' OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
1 0 . )r 7- 661 60(ke
INSPECTION DIVISION Business Line: (503) 639-41Z1
BUP
Received Date Requested 1-- -0- AM PM BUP
Location 13 0 (o(a Suite MEC
.Contact Person P�. 'er) 4_1 Ph ( ) 79 3 , c ,, 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR £�
Crawl Drain • -
Slab Inspection Notes: SIT A I •
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear . ` d C e s' �5 "
Framing v� Ci
Insulation S _ .(� , � c.-4:, `cM
Drywall Nailing
Firewall >< r �1 R
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - 1 l Cs/0 (1) ;� •
Roof �� V ► � , 4 / 2 L— i 55\4.i C
Ot• -r:
i ,Yt'
PART FAIL V' c 'rt )1-8---P—
• ING • • : Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS _PART FAIL
GAECHANM
Post & Beam 2P (�
Rough-In � I \. 9
Gas s Line
Smoke Dampers
in
S RT F
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line l
ADA
Approach/Sidewalk Date ` 11 0 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL