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Permit CITY OF TIGARD MASTER PERMIT I A . a COMMUNITY DEVELOPMENT ~ Permit #: MST2012 00110 T l Ci A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/18/2012 Parcel: 2S109AA00600 Jurisdiction: Tigard Site address: 14275 SW 125TH AVE Subdivision: STANHURST Lot: 4 Project: Gerhard Project Description: Remodel kitchen and interior stairway. 7/19/12, rep change sco of electrical w to (1) panel change and (9) branch circuits. • - BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 0 sf Value: $40,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs /Showers: 0 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker. 1 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell- Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add'I 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 9 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +ampNolt: 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R -3 0 Owner: Contractor: GERHARD, JOHN C & AMY TOTAL HANDYMAN SERVICES LLC Required Items and Reports (Conditions) 14275 SW 125TH AVE PO BOX 264 TIGARD, OR 97224 BANKS, OR 97106 PHONE: 503- 624 -1828 PHONE: 503 -403 -8790 FAX: Total Fees: $1,491.03 , 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 . • - - • - nce 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. • TTENTION: . egon law requires you to follow the rules adopted by the Oregon Utility Notificati Center. Those rules are set forth in OAR 952 -1 r 1 -0010 through OA" • ; - . ' 1 ; • 0. You may obtain a copy of the rules or direct questions to OUNC by ca . 503.232.1987 or 1.800.332.344. / Issued ' Permittee Signatur . Gtr 14.4A-0 Call 603.639.4175 by 7:00 a.m. for the next available I on da This permit card shall be kept in a conspicuous place on the Job site until completion of the project Approved plans are required on the Job site at the time of each Inspection. Jul 18 12 03:40p Leeann Greason 503 -359 -1981 p.2 Electrical Permit ApplicatioBE JC U FOR OFFICE. l SF ONI.1 City of Tigard JUL 18 2012 Received PermitNo.: p•�yragp /j— //0 _ Date/B : 13125 SW Hall Blvd., Tiga OR 9722 Plan Review • Phone: 503.639.4171 Fax: Dat • 503.598. Other Permit. " I V T % T1G :1RD inspection Line: 503.639.4175 + DateReady/By: Itvir' El See Page 2for Internet: www.tigard.or.gov BUILD1 G D,IVIS ON Notified/Method: Sepplemcntal loformati no x. St. a v � ..r ' '': r„ 1 . .s' .. , r. ,.a - �r �e G ' - ,,w5 R .. n oft' "3:.` 5'•:.i..:;,...' �a,: �. i a i t . s - .r t•.t=s = • �ht..4t- N�'�'��atr_t._. '�S 't � •,. , c^�' z -�-,r� vow.. .:. is sd�.''i'��,.. ..t �;t- .r > 3. �� , i , El New construction f l Addition /alteration /replacement Please check all that apply (submit 2 sets of plans W'/ttems chocked below): El Demolition CI Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories. _ curare the avaibbk fault current ID Marinas and boatyards. x - - T e f `'' J ' excee am p at 150 volts or d, 10 r �¢ ::' . � .� ,..hr.+. 3nl.,a.o:.• ... -m ❑ Corn r, butlJin ® I- and 2- family dwelling El Commercial/industrial Ac cessory buildin am amps foall ground, other Ingol dorm. 0 ❑ Commercial-use agricultural ❑ building amps (or all other insal laticru. buildings. ❑ Multi- fam.Iy 0 Master builder ❑ Other: ❑Fire primp. ❑ Installation of 75 KVA or r .r� t-s •-, : err F-,� ray �srx•� x - 'z -•a te-�- - ?-.. � :�q ❑Emergwcy',vstem. tar r h• .. r ;- a t x :. xc ge separately "1- system. -' :r. s -.. T :mow : fiat; .- .. errs s xa T: w... + ❑Addition of is w motor load o ❑ " ,... 1 2 "1 3 ". 100HP or Recreational Jobno.: Job site address: 14275 SW 125th Ave tio ❑ Six a more residential units. ❑ Recteaiianal rehicle panes City /St.le/ZIP: ❑ Health -rare facilities. ❑ Supply voltage for more titan Tiqard, OR 97223 ❑liazardous lotatione. 600 vls aominl. Suite/bldg./apt. no.: Project name: ❑ Service or feeder 600 amps or snore. Cross street direction =_ t '` "-1 '" :: : :,` t' ' cu` -::':•-;'• . 0 job s ite: Y . • _ � •- � Description QN. Fee. Tool • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot nn.: 1,000 sq. ft. or less 168.54 4 Ea add'1500 sq. ft. or portion 33.92 1 Tax map/parcel no.: µ Limited were, residential >rN e e x+aa ya.. rr z , rr: 67.84 2 . ' t . — :. ;.7 fS1 ti .'� ;: •.,. -AN .,. .,, (with above sq. R) Limited energy, multi family 67.84 2 Add to permit # MST2 012 -00110 for panel Chang: residential (with above sc. it.) Services or feeders installation, alteration, and/or relocatio Ind additional work _ _ 200 amps or less 1 100.70 100.702 • ._ - .. i i lr#sEfr, �s . . r _ a - s ? t h~ . � 201 amps to 400 l 33.56 2 -: k amP amps Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Ova 1,000 amp, or volts 552.26 2 City /Slntc/ IP: Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 Owner installation_ This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intcndcd for sale, lease, rent. or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date' Branch circuits— mew, alteration, or extension, per panel A. Fee for branch circuits with Wit' �, b? -li ,. a r• , M.e, __,. fir• . . T `` �` _ fie "mr'xar ' n: above service or feeder fee, 14.8 4 7.42 2 each branch circuit 2 Business name: B. Fee for branch circuits Contact name- without service or feeder fee, first branch circuit 56.1 B I 2 Address: Each add'l branch circuit 7.42 i 2 Miscellaneous (service or feeder not indnded) City /State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E- mail: Pump or irrigation circle 67.84 2 ry" ; 7.84 2 `r _ ., 7r # Si or outline utlineli� art Business name: Alt.! Electric, Inc Signal circuit(s) or limited- eaergy panel. alreration, or Address: PO Box 330 extension. Desenbe: Paget 2 City /Slate /ZIP: Forest Grove, OR 97116 Each additional Inspection over allowable in any of the above Per inspection 66.25 Phone: (503) 359 -5891 1 Fax (503) 359 -1981 Investigation per hour (l tar min) 66.25 CCI3 Lic.: 959 1 Electrical Lie.: 34 -1c Suprv. Lie.: 959 industrial plant per hour 78.18 -- i � - 4..,...2_,--/-C----- = '° _ c ' a a - ri Suprv. Electrician signature, required : Subtotal: Print name: Anthony Wilson Dare-.---\/ , Plan review ;2S%of permit fee): 1 State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: 74 _ 80 This name Dale' is permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. e Number of inspections al'ww+ed per permit. 1.41u ising +PL., mitsT1C- PermiIAp,.doe 10/ 01,119 440.4615'1(11/05/C NMVl4FIt CITY OF TIGARD MASTER PERMIT ti I COMMUNITY DEVELOPMENT Permit #: MST2012 -00110 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/18/2012 Parcel: 2S 109AA00600 Jurisdiction: Tigard Site address: 14275 SW 125TH AVE Subdivision: STANHURST Lot: 4 Project: Gerhard Project Description: Remodel kitchen and interior stairway BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 0 sf Value: $40,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs /Showers: 0 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 0 Backwater Value: 0 Drywell- Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL • Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea addl 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 7 Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio 8 Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R - 3 0 Owner: Contractor: GERHARD, JOHN C 8 AMY TOTAL HANDYMAN SERVICES LLC Required Items and Reports (Conditions) 14275 SW 125TH AVE PO BOX 264 TIGARD, OR 97224 BANKS, OR 97106 PHONE: 503- 624 -1828 PHONE: 503 -403 -8790 FAX: Total Fees: $1,416.23 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 ac . - ' 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. ATT• ' ION: Oregon =w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 •010 through OAR 95 • ' 00 • - You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 4 X N .... � Issue. By: a /ANTS O �� Permittee Signature: / Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept In a conspicuous place on the job site until completion of the project. Approved plans are required on the Job site at the time of each inspection. • Building Permit Application Residential RECEIVED FOIL (FDIC,•: tisi: ONI.1 City of Tigard Received Date/B : .,..c°92 4/ � � Permit No /o 2O /_ —// 0 • 13125 SW Hall Blvd., Tigard,OR 97 QY 2 4 2012 • an • evie ' ■ Phone: 503.718.2439 Fax: 503.598.1960 Date/B : � MIN Wil Other Permit: . GA RD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready : y: line ® See Page 2 for ardor. g g Internet: www.ti ov BUILDING DIVISION Notified/Methoa: /� � � Supplemental Information . /_. 4_ , /4w1 TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING • 1- and i ❑ New 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: 0 `_^ equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: 2-family y dwellin g ❑ CommerciaUindustrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder CI Other: Number of bathrooms: $ l' t �� JOB SITE INFORMATION AND LOCATION Total number of floors: LW? Job site address: , � S S� . ds� New dwelling area: square feet City/State /ZIP: , ;�„& Q f, °\) aay Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: ( p4 \w,rk f f o,,,�,J l Covered porch area square feet Cross street/directions to job site: �� \\ K -,,, \ p.. 77, s‘\4 � • a�� Deck area: square feet `�� Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Kest- * I SCcI1{Wa� 9 � Valuation: $ Existing building area square feet New building area: square feet Igk PROPERTY OWNER ❑ TENANT Number of stories: Name: S Om\ (, Type of construction: Address: 1�'a - �S S,\„) �a A� City /State /ZIP: Occupancy groups: ` b(2„ ��`�'�a Existing: Phone: (561) Z0k — \ O � 'd,li Fax:: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: (Please refer to fee schedule) Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): Address: City/State /ZIP: Total fees due upon application: Phone: ( ) I F :: ( ) Amount received: d,�.- E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof -top mounted Photovoltaic Solar Panel System. Business name: O 1 P� r � tv�A*, Sw\ t C Submit two (2) sets of roof plan with connection details te'` r • �F' LAS and fire department access, along with the 2010 Oregon I Address: P �, Solar Installation Specialty Code checklist. City /State /ZIP: 0 c\11116 Permit Fee (includes plan review $180.00 1 and administrative fees): Phone: (S 0-9 �O�— its -iv Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: 10 �1 (frill' Total fee due upon application: $201.60 Authorized signature: N( 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 Print name: i \Ara Date: v\ _ 1� Service Board 1: \Building\Permits\BUP- RESPermitApp.doc 02/24/2011 440- 613T(11/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling I OR OFFICE i st: °NI.1' Received IN City of Tigard Received Permit No.: n 1 3125 SW Hall Blvd., Tigard,OR 97223 C Phone: 503.718.2439 Fax: 503.598.1960 Associated permits: - I'IGARD 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard- or.gov ❑ Other: THE FOLLOWING I I Ei\'IS ARE REQUIRED FOR PLAN REVIEW 1 e No NI,- 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. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ in protection, etc. 1 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ b 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. 1 I Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ X 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 Ore:on and shall be shown to be a rlicable to the •ro'ect under review. . JURISDICTIONAL SPECIFICS 23 Three (3) 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 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be 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 and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ 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. I:\Building\Permits\BUP - RESPermitApp.doc 02/24/2011 440 4613T(I 1/02 /COM/WEB) .Plumbing Permit Application Building Fixtures RECEIVED Received City of Tigard Date/By: off /d a L Permit No.: f �T�►D�A_Cb/!C7 111 n 13125 SW Hall Blvd., Tigard, OR 972 Ill 2 4 Q Plan Review C Phone: 503.718.2439 Fa 50 3.598.1 �a Date/By: Other Permit No.: Inspection Line: 503.639.4175 D ate R ea /B tuns: ®S Pa ge 2 for 1 "� li ° Internet: www.ti ard -or. o v CITY OF TIGARD g g Notified/Method: ' Supplemental Information TYPE OF v Ri 'DING DIVISION FEE* SCHEDULE ❑ New construction ❑Demolition For special information use checklist Description I Qty. T Ea. I Total ❑ Addition/alteration/replacement RI Other: k New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 312.70 _ / t2{-1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler (_ sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: NW C S'S,..) \ 1I Catch basin or area drain 18.76 City/State /ZIP: �� dve� t,n SS1� Drywell, leach line, or trench drain 18.76 '\ ° \1�� Footing drain (no. linear ft.: __ j Page 2 Suite/bldg. /apt. no.: 1 Project name: G IA �q Manufactured home utilities 50.03 Cross street/directions to job site: 1iS\ 7 ION \O Ste, 1 -, Manholes 18.76 s � \ Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: _) Page 2 Subdivision: I Lot no.: Fixture or item: • Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 %WM( MA/4- 3 i , Vala 1 G2. tQf 1 diskLJ() 't Dishwasher ' 25.02 7 b� � p Drinking fountain 25.02 u Ejectors /sump 25.02 lak PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Jotin �sY�,y,k Fixture /sewer cap 25.02 Name: Floor drain/floor sink/hub 25.02 Address: IL,RIS S 1"Ds`5- coz.... Garbage disposal I 25.02 City /State /ZI 'N . O2 C A/I). Hose bib 25.02 Phone: GCS) (;),y_ N1, Fax: ( ) Ice maker I 12.51 El APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Medical gas (value: $ ) . Page 2 Business name: 7 p W440\1 1V\ikk SC a4,,i - :<, u_L Primer 12.51 Contact name: \ ON\ 4QNA2Im Roof drain (commercial) 12.51 Address: v iso, ',l0\ Sink/basin/lavatory I 25.02 City/State/ZIP: t py •s Q � t, ` \ )\t)L Solar units (potable water) 62.54 Phone: (,S•6 \cj\_. 1 0 Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: �n�y 0Aotity�'g Urinal 25.02 1 4 " Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: five_ VI v ' pia/1,41(1.0 Water piping/DWV 56.29 Address: 'rvr b Other: 25.02 City /State/ZIP: � ext,A),A 1 ©yL Ct 1 1 Q b Subtotal Minimum permit fee: $72.50 Phone: ( ) ?>.q, (3 1 I'1 Fax: (55 5 .1{- Oki0 CCB Lic.: f 691 Plumbing Lic. no.� el f ( Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signat Y� ��v Y v � �_ Q/) ,(n TOTAL PERMIT FEE Print name: j oule ) %�1�/ , Date: S -aV 1 � This permit application expires if a permit is not obtained within 180 days v after it has been accepted as complete. *Fee methodology set by Tri County Building Industry Service Board. 1:\Building\Permits\PLMU- PermitApp.doc 10/01/09 440 -4616T(I0 /02/COM/WEB) • Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1' 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 - 3,601 to 7,200 $233.20 • Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 • Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to p and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge - 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Plan Review for Plumbing Installations Quantity by Fixture Type • Plan review is required for any of the following. • Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate . Baptistry/Font ❑ Any new commercial building with wate service 2" and greater, except systems designed and stamped by licensed Bath: -Tub/Shower - Jacuzzi/Whirlpool engineer. • Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive Thru as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918 -780 -0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: - 2" • - 3" Isometric or Riser Diagram 4,. ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage - Domestic non -food Disposal: - Domestic food related - Commercial food related - Industrial food related • Ice Mach/Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang -Stall : . Sink: - Lav/Bar non -food related - Bradley - Com/Serv/Util food related . • : ' • - Service .. *Note: If the fixture work under this permit results in an Swimming Pool Filter • increase of sewer EDUs, a sewer permit, will be issued and Washer - Clothes fees assessed for the sewer increase must be'paid before the Water Extractor Water Closet Toilet plumbing permit can be issued. ' . Urinal Other Fixtures: I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2 J, Mechanical Permit Applicati C EI1E) FOR OF usl: O. City of Tigard Received Date/By: s #� Permit No.: t y 0iw....ex o 1:1 n 13125 SW Hall Blvd., Tigard, OR 97223 I I Date/By: Y 2 4 2012 Plan Review Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: I' I G n ti u Inspection Line: 503.639 �. Date Ready/By: luris: El See Page 2 for Internet: www.tigard CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heatinp/cooling: Air conditioning • Job site address: \V\'a'� s 5 Wl \as b.. NI (requires site plan showing placement) 46.75 City/State /ZIP: Furnace 100,000 BTU (ducts/vents) 46.75 TG ` �7� ° 1��y Furn 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: ( 4 ‘‘,,A‘ ‘‘,,A‘ \ c � k Heat pump (requires site plan showing placement) 61.06 Cross streetldiretxions to job site: Duct work % , 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: I Lot no.: Flue /vent for any of above 23.32 . Other: 23.32 Tax map /parcel no.: Other fuel appliances: • DESCRIPTION OF WORK Water heater 23.32 Gas fireplace/insert 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 _ Wood fireplace /insert 23.32 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 33.39 City /State /ZIP: Clothes dryer exhaust 33.39 Fax: Single -duct exhaust (bathrooms, Phone: ( ) ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: ;Sty ,11; 1 5. r` UV Other: 23.32 `t� n(� Fuel piping: Contact name: "1", \ 4 ' j.. _ $14.15 for first four; $4.03 for each additional Address: e ,e' , bpir‘ "...k.1\ Furnace, etc. Gas heat pump City/State /ZIP: tbq,,, Oa C \MO rr b Wall /suspended/unit heater Phone: (I 5 , ) "47 %- p I Fax: : ( ) Water heater Fireplace E- mail: Range CONTRACTOR Barbecue Business name: `, tof ( 4 Of, v AIe t� Clothes dryer (gas) (�",��¢,,../, Other: O Address: f MECHANICAL PERMIT FEES* City/State/ZIP: 4 �� Low-z, C 97/,9 -0 Subtotal Phone: ( Fax: ( ) Minimum permit fee ($90.00) � �l Plan review (25% of permit fee) CCB lic.: J j 1—Al'L / / /6 State surcharge (12% of permit fee) ���//7 TOTAL PERMIT FEE Authorized signature: W _ This permit application expires if a permit is not obtained within 180 ....AP days after it has been accepted as complete. Print name — y am` Date: • Fee methodology set by Tri -County Building Industry Service Board I:\Building\Permits\ [NEC- PermitApp.doe 03/07/12 440-4617T(II /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Building\Permits\MEC- PermitApp.doc 03/07/12 2 r MVI . Electrical Permit Application FUR OI FRT. I SP: 11N IN City of Tigard MAY 2 4 2O1 Received ff, y - Permit No.: pl g i 'fJ' 4 /le, II • 13125 SW Hall Blvd., Tigard, OR 97223 . Phone: 503.639.4171 Fax: 503.598.1960 CITY OP TKGAR E Other Permit: T I G A R D Inspection Line: 503.639 B UIL NG D » , Ready/By: tuns, ®See Page 2 for Internet: www.tigard- or.gov L. �tstified/Method: Supplemental Information a ... ._ ., .. . , �, � �- :�ta� � ..: =�ie� ;•^ s ... _.� r ,^�F3'ms ai e�� :- .azd + �. � ^ a ^ '� '�mY"�'=t'TMi�'� .� ❑ New construction © Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked b elo w ) : ❑ Service or feeder 400 amps or more ❑ Building over three stones. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. ra - - - 4 N. r n'''� �x ' P r ye" b 4�'"'' .w ^r, ' exceeds 10,000 amps at 150 volts or El Floating buildings. - -, ^ ' "- i- ^'" " t' .- ::-A`` . ` " " a at i '1 -' t. ' ,, less to ground, or exceeds 14,000 ❑ Commercial -use agricultural © I - and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ��:' , ; t _ a drr rzr�s , � Emergency system. larger separately derived system. .. .. _s t-�' � � ,;� ..�..�` ,ar�.;;"� - • , _ .:. x_;, 44 ..s_'..:.. ❑ Addition of new motor load of ❑ "A ", "E" "1 -2 ". "I -3 ", Job no.: Job site address: 14275 SW 125th Ave 100HPor more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. Cit y' /State /ZIP: Tigard, OR 97223 0 Health-care facilities. ❑ Supply voltage for more than ['Hazardous locations. 600 volts nominal. &lite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more. job site: � Qty. Fee. I Total I .r , _ __ Description Qt P • Cross street/directions to New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no Ea add'I 500 sq. IL or portion 33.92 1 { � Limited energy, residential 67.84 2 ~4' � ', '' -a i -_,," ' ,, "IF- _- :n:i:,, Y i b• r" i A k Limited energy, multi - family 67 84 2 (with above sq. R.) Kitchen remodel W residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 i.��ti l ,i' d sv u ,, PlMY` +e ,...... 201 amps to 400 amps 133.56 2 Name: . (9k60,1e, 401 amps to 600 amps 200.34 2 ` (�, 601 amps to 1,000 amps 301.04 2 Address: 1�a S.W v 1 1yV� I Over 1,000 amps or volts 552.26 - 2 City /State /ZIP: - j (& O C� Temporary services or feeders installation, alteration, and/or // __ o� 1 \ 2lops Phone: ('So'3) ro � �; ( ) 200 am 0 amps or less 59.36 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 I 2 Owner signature: Date: Branch circuits - new, alteration, or extension, r panel A. Fee for branch circuits with ._ . '.•:., 111 ` ,_14,-. •:`& s' A ` ,, ' above service or feeder fee, 7.42 2 ,\^,`^ each branch circuit Business name 1`Y',`n'y A\ r� � ��L 1`Y'�"I' Q��,V S T-0�V� 7 �L B. Fee for branch circuits Contact name: W without service or feeder fee, 1 56.18 56 . 18 2 c% `• first branch circuit (,) Address: i ao a6lk Each add'l branch circuit 6 7.42 44 .52 2 Miscellaneous (service or feeder not Included) City /State /ZIP: (tll,^^'' ,,,, bne s 1 11`� Each manufactured or modular 67.84 2 mi �` K7 dwelling, service and/or feeder Phone: (St,I 46- 0c\b Fax:: ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 -= 7 w:,c _� .a _ ` 1: }°l =°rte% , Sign or outline lighting 67.84 2 Business name: A&J Electric, Inc Signal circuit(s) or limited - energy panel, alteration, or Address: PO Box 330 extension. Describe: Page 2 2 City /State /ZIP: Forest Grove, OR 97116 Each additional inspection over allowable in any of the above Phone: (503) 3 -5891 Per inspection 66.25 ( ) Fax: _ Investigation per hour (I hr min) 66.25 CCB Lie.: 959 511 1 ti Electrical Lie.: 34 - 1111 Suprv. Lie.: Del 055 Industrial plant per hour 78.18 Suprv. Electrician signature, required: G �� ��, {0 t �l 3 - " . - Subtotal: 100.70 Print name: Anthony Wilson Date: Plan review (25% of permit fee): 5/2 2 / 12 State surcharge (12% of permit fee): Authorized signature: TOTAL PERMIT FEE: 112.78 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. 1 •U 3 uitdingPermits \ELC- PermitApp.doc 10/01/09 440- 4615T(11 /05 /COM/WEr