Permit ld/Z' 4'3 4 ✓ /s/ � C ITY O MASTER PERMIT
PERMIT #: MST2001 -00558
11 DEVELOPMENT SERVICES DATE ISSUED: 5/6/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13005 SW ST JAMES LN PARCEL: 2S109AB -07700
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
REMARKS: New SF detached Path 1 MUST HAVE FIRE SPRINKLER SYSTEM PLAN APPROVED BEFORE
FRAMING INSPECTION
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 30 FIRST: 1,821 sf BASEMENT: 208.00 sf LEFT: 11 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,577 sf GARAGE: 643 sf FRONT: 25 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: at RIGHT: 6
VALUE: 439,127.00
OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 3,398 at REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN <100K: BOIL/CMP < 3HP: VENT FANS: 6 CLOTHES DRYER: 1
GAS FURN > =10OK: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 3
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADDL INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 9 201 - 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: 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 8 STEREO: X VACUUM SYSTEM: X AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: X OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner Contractor: TOTAL FEES: $ 9,308.40
JAMES SHULTZ HAPPY HOMES PLUS INC This permit is subject to the regulations contained in the
Tigard Municipal e Code, State A of l OR. ok wil Specialty e
22723 WEST PLUSS CT 8948 SW BARBUR BLVD done in
WEST LINN, OR 97068 # 64 and all other applicable laws. All work will be done in
PORTLAND, OR 97219 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: Oregon law requires you to follow rules
Phone: Phone: 639 - 9839 adopted by the Oregon Utility Notification Center. Those
tie rules are set forth in OAR 952 - 001 -0010 through
Reg #: 952- 001 -0080. You may obtain copies of these rules or d
REQUIRED INSPECTIONS
Erosion Control Insp 8g Footing Insp Wtr Proofing Bsm't Wa Footing /Foundation Dn Electrical Rough In Gas Line Insp
Grading Inspection Footing Insp Post/Beam Structural PLM /Underfloor Framing Insp Gas Fireplace
Sewer Inspection Foundation Insp Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp
Footing Insp Foundation Insp Underfloor insulation Plumb Top Out Exterior Sheathing Ins Rain drain Insp
Footing Insp Foundation Insp Crawl Drain /Backwater Electrical Service Low Voltage Rain drain Insp
Issued = • • ' . < /. :_, ..da afgadniaz_ ,
Permiftee Signature : 4,/""e ��� 60_
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
...„ )r/-0,21- 0 0 -x-r
4
Building Permit Application '
l Date received: it iffiliM Permit no.:111 Sr ZUp, _0
4,1_,, City of Tigard r C�
= Project/appl. no.: Expire date:
City nj Tigard Address: 13125 SW Hall Blvd, Tig O R 9.7
Phone: (503) 639 - 4171 Date issued: By:` ; • Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
\
TYPE OF PERMIT
• 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family I ew construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: ?% +,jam 4 — • . ;' /01. ��;� jt v 1 SW — S 174 Bldg. no.: Suite no.:
Lot: co, . Block: Subdivision: (Q-Ay-em R \��,�t Tax map /tax lot/account no.:
Project name: --- ► 3( - (a 1 (." , b0
Description and location of work on premises /special conditions: ni-evu (L • C.,D>1 S"(12AACT( 0
, : •'`'. OWNER . FOR SPECIAL INFORMATION, USE CHECKLIST._ .
Name: TY.e L (Floodplain,septiccapacity,solar,etc.) "°(i
Mailing address: 2,Z. - -f tovisS 6, (• 1 & 2 family dwelling:
City: Vv- egtk - IState:d IZIP: a7OY • Valuation of work i ,,3. J r . 1Z , , $
.
Phone: IFax: I E -mail: No. of bedrooms/baths _ 3 t 2
Owner's representative: Total number of floors _
Phone: Fax: E -mail: New dwelling area (sq. ft.)
Garage/catport area (sq. ft.) to 4.3 •
Name: tt rx.' (tp — S 'L11, , INJ C Covered porch area (sq. ft.)
Mailing address: 6 — %q V- SU) .- Mcit-13■M bud Deck area (sq. ft.) 4CTO
City: V,;Dirr( State:p)(Z ZIP: q?a(o) Other structure area (sq. ft.)
■
Phone: , 3 • q(3 3 • Fax • 3q q $ 3' E - b , s ic" 4 . Commercial/industrial/multi- family:
. 1 ,CONTRACTOR . Valuation of work $
Business name: 4V� S ( Existing bldg. area (sq. ft.)
Address: -fr $� C . 9.\ - -21 k by New bld area (s ft _
�— 4 Number of stories
City: 0 R I ate: di t?.. ZIP: q 7 _
Phone: 1 q ax: 63F4f 9 E-mail: Type of construction
CCB no.: ic �� lv �� E Occupancy group(s): Existing:
' New:
City /metro lie. no.: 46 q Notice: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: .p 1„L1,01/4J MA'S co pr _ e sic,--tom . provisions of ORS 701 and may be required to be licensed in the
Address: 13dS' — N W _ 1 PAW jurisdiction where work is being performed. If the applicant is
City: 70 ET( ,,eti , State )1- I ZIP: 617 a exempt from licensing, the following reason applies:
Contact person: tRit et _ Site j • Plan no.: 236 3 A •
Phone: 22S I ( . Fax: 22S -mail:
Name: KAMA CnpRJT(M( Contact person: KA Fees due upon application $
Address: 3 c-74... e 6l)1Ztu Si De Date received:
City: VoK J _ IState: b1Z IZIP: £ 72,(L . Amount received $
Phone:2'2 06 33 I Fax:7' O j3I 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 laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied with, whether specified herein or not. Credit card number: / /
Expires
Authorized signature: • Date: Name of cardholder as shown on credit card
Print name: Ckt"1t • ,`/( Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44o -4613 (6d00/COM)
One- and Two - Family Dwelling
m k-.4-�,y;� Building Permit Application Checklist Reference no.: i
Associated permits:
City of Tigard
City of Tigard 0 Electrical ❑ Plumbing 0 Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 O Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot. /
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval. '/
8 Soils report. Must c original applicable stamp and signature on file or with application.
9 Erosion control plan CI permit required. Include drainage -way protection, silt fence design and location of /
catch -basin protection, etc. V
10) 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
. if copyright violations exist.
11 Si(e/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and V
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 V
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. 1/
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.
1 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 1/
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. V
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ".
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons. 1/
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document.
t 27 No "mirrored" building plans will be accepted.
28 "Drawn to scale" indicates standard architect or engineer scale.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (6/00 /COM)
A4 s -r-g,_00 — � s
• Plumbing Permit Application
a Date received: Permit no.:
' City of Tigard Se wer permit no.: Building `.� 1 p g permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERM IT
❑ & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi - family ❑ Tenant improvement
I New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other: _
•
JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist)
Job address: ' % ; ii��,`t� Descri , tion • . Fee(ea.) Total
g l 3OO — ••w; New 1- and 2- family dwellings only:
Bld no.: S ire .: (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: 6 IBlock: I Subdivision: ialV'tN R.&'b CAE SFR (2) bath
Project name: Nth) SFR • SFR (3) bath !
City /county: t 'TC CUcrtA), I ZIP: Cif 22.4 ' Each additional bath/kitchen Z •
Description and location of work on premises: Site utilities:
N-e o S Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line trench drain
Footing drain (no. lin. ft.)
• PLUMBING CONTRACTOR Manufactured home utilities
Business name: (ipc F 11 w tA-5 k1 &t Manholes
Address: 4 ' 3 2. - Se- Mown.. (oulZ . Rain drain connector 44
City: Ppq' - [a9 I State flR I ZIP: a 2._QZ, • Sanitary sewer (no. lin. ft.) .
Phone: '76 _ • l'1 Fax: Sc'vt6& I E -mail: r Storm sewer (no. lin. ft.) ' • .
CCB no.: 12 4_ pm Plumb. bus. reg. .: 2G6 ■ g. Water service (no. lin. ft.) 0.
City /metro lic. no.: O ; c _ L li/MYS 07 Fixture or item:
Absorption valve
Contractor's representative signature: �(� C 1 •
Back flow preventer
Print name: t , i ' 1, . , Date: MV a Backwater valve •
CONTACT PERSON Basins/lavatory
Name: ( KU {k,\) W) . Clothes washer
Dishwasher
Address: t.i- 3 % — — ((k'1kk- Drinking fountain(s)
City: ' OUR..-7. - I State:09- I ZIP: ( - 5 1 -7 2 r (j Ejectors/sump
Phone: , 01 Fax:-7„ f -g it • E-mail: Expansion tank
OWNER Fixture/sewer cap
Name (print): Mg. NkQS ' 'cw- SWi) L.:12. Floor drains /floor sinks/hub
Mailing address: 2 3 e ?lam S$ C l Garbage disposal 1
Z 'w - Hose bibb -2
City9 (_ LI / I State:O R I ZIP: C(7O , Ice maker i
Phone: I Fax: I E -mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) 7
Owner's signature: Date: Sump
ENGINEER Tubs/shower /shower pan
Urinal
Name: Water closet 41-
Address: Water heater Z
City: I State: I ZIP: Other:
Phone: I Fax: I E -mail: Total
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $
Notice: This permit application Plan review (at _ %) $
❑ Visa 0 MasterCard expires if a permit is not obtained
Credit card number: 1 1 within 180 days after it has been State surcharge (8 %) .... $
Expires TOTAL $
Name of cardholder as shown on credit card accepted as complete.
$
Cardholder signature Amount 440-4616 (6/00/COM)
., 1
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2- family dwellings only:
FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the fiirst100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection)
One (1) bath $249.20
Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 PLEASE COMPLETE:
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 Sink 1 _
MFG Home New San/Storm Sewer 46.40 Lavatory 6
Tub or Tub /Shower
Hose Bibs 16 Combination _
Roof Drains 16.60 Shower Only I
Drinking Fountain 16.60 Water Closet 4
Other Fixtures (Specify) 16.60 Dishwasher I
Garbage Disposal ' j
Laundry Room Tray I
Washing Machine I
Floor Drain /Sink: 2"
i Sewer - 1st 100' 55.00 3"
Sewer - each additional 100' 46.40 4"
f Water Service - L
1st 100' 5 5.00 Water Heater
Water Service - each additional 200' ' 4 6.40 Other Fixtures
(Specify)
r Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' ' 4 6.40
Commercial Back Flow Prevention Device 4 6.40
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL
Isometric or riser diagram is required if
Quantity Total is > 9
*SUBTOTAL
8% STATE SURCHARGE
**PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total is > 9
TOTAL . $
* Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow
Prevention Device, which is $36.25 + 8% state surcharge.
' New Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
is \dsts \forms\plm- fees.doc 08/29/01 .
,i sr 0 / - cr -6 5s �
Mechanical Permit Application
Date received: Permit no.:
ta.;tri�Y� 1 ra
�,, j :.� �� City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi- family 0 Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE •
Job address: .. ./ii..
/i:T9.•% - - .%%. ,777.0.e. "'• �- - ' Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: +3 d OS- s w - •' SirrogoSe1 L: L.A.) value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: IBlock: I Subdivision: QAV RA3OI "See checklist for important application information and
Project name: !J Q, S F12, jurisdiction's fee schedule for residential permit fee.
City /county: Ti. - (r)(. I ZIP: °1 2.2 4.- 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMEN'TSCIIEDULE
1A15i#0L1 OfNJ 4}VP•ce SyS1 -&. • Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: ✓ HVAC:
Is existing space heated or conditioned? 0 Yes 1No Air handling unit CFM
space insulated? 0 Yes �No Air Alteration (site plan required)
Is existing P Alteration of existing HVAC system
.. MECHANICAL CONTRACTOR Boiler compressors
Business name: St )L pc jo . A-[ N( 2 fie • State boil permit no.:
HP Tons BTU /H
Address: L234'7 — St P mil' Fire/smoke dampers/duct smoke detectors
City: 1 AJo State:t ZIP: q`7 DQt1 Heat pump (site plan required)
Phone: 1 2S I Fax: s 1301 E -mail: Instal /replace furnace/burner BTU /H
Including ductwork/vent liner O Yes O No
CCB no.: gg U..'+7 , lnstalUreplace/relocate heaters - suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): -, i j , 4 W .c.0 1 Vent for a. pliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: 3 OLitan,01 lNl L,S , Chillers HP
Com ressors HP
Address: 2,Z 3\ �-, — — 4(( Environmental exhaust and ventilation:
City: boPj tk/ I State: QR_IZIP: CC 00) Appliance vent
Phone: -11 . 'LW Fax: �S •tr3 E -mail: Dryer exhaust
OWNER Hoods, Type U IUres. kitchen/hazmat
hood fire suppression system
Name: - VW L' Exhaust fan with single duct (bath fans)
Mailing address: 2 Z — SW— - v W , Exhaust system a . art from heating or AC
City: w�( (1 N State: 0 R ZIP: a 7, 6� , Fuel p p g and G nbut on (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel i ing each additional over 4 outlets
recess piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace •
City: I State: I ZIP: Insert - type
Phone: Fax: I E -mail: Woodstove/pelletstove
Other:
Applicant's signature: u t,ti ._ I Date: &iQ'J (T Other:
Name (print): - 3 --. k.>4 442.A.--, vJ % Sc7",_J . •
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
. $ TOTAL $
Cardholder signature Amount 440 -4617 (6K)0/COM)
MECHANICAL PERMIT FEES ,
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT 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 including 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 induding 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond
fraction thereof. footnotes below. Comp **
7) <3HP;absorb unit
Minimum Permit Fee $72.50 SUBTOTAL: $ to 100K BTU 14.00
8) 3 -15 HP; absorb
8% State Surcharge $ unit 100k to 500k BTU 25.60
9) 15 -30 HP; absorb
25% Plan Review Fee (of subtotal) $ unit .5 -1 mil BTU 35.00
Required for ALL commercial permits only 10) 30 -50 HP; absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1 -1.75 mil BTU 52.20
11) >50HP: absorb
unit >1.75 mil BTU 87.20
12) Air handling unit to 10,000 CFM
ASSUMED VALUATIONS PER APPLIANCE: 10.00
Value Total 13) Air handling unit 10,000 CFM+
Description: Qty (Ea) Amount 17.20
Fumace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Fumace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct
_ ducts & vents 6.80
Floor furnace including vent 955 16) Ventilation system not included in
Suspended heater, wall heater or 955 appliance permit 10.00
floor mounted heater 17) Hood served by mechanical exhaust
Vent not included in applicance 445 10.00
permit 18) Domestic incinerators
Repair units 805 17.40
< 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator
to 100k BTU 69.95
3 -15 hp; absorb. unit, 1,700 20) Other units, including wood stoves
101k to 500k BTU 10.00
15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets
mil. BTU 5.40
30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each)
1 -1.75 mil. BTU 1.00
>50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656 8% State Surcharge $
Air handling unit >10,000 cfrn 1,170
Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446
Vent system not included in 656 -
appliance permit Other Inspections and Fees:
Hood served by mechanical exhaust 656 1. Inspections outside of normal business hours (minimum charge -two hours)
Domestic incinerator 1,170 $72.50 per hour.
Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge - half hour)
Other unit, including wood stoves, 656 $72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimun
inserts, etc. charge-one-half hour) $72.50 per hour
Gas piping 1 outlets 360
Each additional outlet 63 * State Contractor Boiler Certification required for units >200k BTU.
** Residential NC requires site plan showing placement of unit.
TOTAL COMMERCIAL $
VALUATION:
is \dsts \forms\mech- fees.doc 08/06/01
• .
•
Electrical Permit Application
Date received: Permit no.:
-�-ay. °:(Ii, City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: ,; "' . ;`j�ijT% a ' _� ✓�' Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I300 `1: 'c \N u 'Rodp4 cJ LA)
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: IMIlli►fBN /MITIIININE711 Fee Max
Business name. 5 j i_ V i I - ' - , Description Qty. (ea.) Total no. insp
J f ` New residential -fie or mulls- family per
Address: .. L./ 1 I : dwellingunit. Includes attached garage.
City: cliIJ p p State' 6 ZIP: V 2, Senvicelociuded:
Phone( ojJQ (7 4Op Fax:7 Q 4 E -mail: 1000 sq. ft. or less / 4
CCB no.: If O 0 I Ele .b us . ic no: Each additional 500 sq. ft. or portion thereof f'p
r Limited energy, residential ( 2
City /metro lic. no.: t 6 d Z c Limited energy, non- residential 2
- r / .I . /o -/ -0' Each manufactured home or modular dwelling
� f
Signature of supervising e ectrician (required) Date Service and/or feeder 1 2
Sup. elect. name (print) (7, i d •; License no: ® Services or feeders - installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): `I - �T2 , 201 amps to 400 amps 2
` Mailing address: 'Z L3j' e ( (w,( ss 401 amps to 600 amps 2
2 !
601 amps to 1000 amps 2
City: w -07 ),.l I State: Q e I ZIP: C 7 '6 S, Over 1000 amps or volts 2
Phone: 'Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENG INFER Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: - I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail:
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle - 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension' 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
O Occupant load over 99 persons Cl Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
O Egress/lightingplan ❑ Other. Per inspection I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
0 Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card '
Cardholder signature Amount 440-4615 (6/00/COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total `i'
Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 RI Burglar Alarm
Limited Energy $75.00 _
Each Manurd Home or Modular
Dwelling Service or Feeder $90.90 2 V Garage Door Opener'
Services or Feeders Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 Vacuum Systems
401 amps to 600 amps $160.60 2 •
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 , 2 •
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation . Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. n Audio and Stereo Systems
Branch Circuits ❑
New, alteration or extension per panel Boiler Controls
a) The fee for branch circuits
with purchase of service or ❑ - Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ - Data Telecommunication Installation
b) The fee for branch circuits •
without purchase of service
or feeder fee. ❑ Fire Alarm Installation • First branch circuit $46.85 ❑
Each additional branch circuit $6.65 HVAC
Miscellaneous El Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $. l l Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge- $
Total Balance Due $
•
i :\dstsVbrms\elc- fees.doc 06/07/01
CITY OF TIGARD 24 -Hour
BUILDING ' • Inspection Line: (503) 639 -4175 MST 2 66 ` ` 6°'�5
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requ ted LC- AM PM BUP
Location L. 3 D d S Suite MEC
•
Contact Person Ph ( ) 9 '' CY/ q PLM
Contractor Ph (. ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing { rr — (N
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
ma
ASS/ 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
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE U Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date — S - e 3 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 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received 4'D`S' Date Requested S ( AM PM BUP
Location /300 5 St \ Suite MEC
Contact Person akC. Ph ( Ste'/ '5 I PLM
•
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall \ G
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PAS RT FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
,F1
(0 )) P. 'T FAIL
L
• :eam
Rough -In
Gas Line
Smok= Dampers
ina
RT FAIL
L
Service
Rough -In
UG /Slab
Low Voltage
Fire _ larm
AO"
Aida 'ART FAIL ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ll Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA / 3
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL