Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2001 -00523
MP DEVELOPMENT SERVICES DATE ISSUED: 10/22/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11600 SW SHEFFIELD CIR PARCEL: 1S133DB -01100
SUBDIVISION: BRITTANY SQUARE.NO. 2 ZONING: R -12
BLOCK: LOT: 035 JURISDICTION: TIG
REMARKS: Finish existing room over garage.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 165 sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: S 9,500.00
. OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 165.00 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: .
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 • 200 amp: 0 • 200 amp: W /SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 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 AREAISPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
•
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 333.65
This permit is subject to the regulations contained in the
KAMINSKI, GREG W + MARIA E THE ANDREW J GROUP, INC. Tigard Municipal Code, State of OR. Specialty Codes and
11600 SW SHEFFIELD CIRCLE PO BOX 19033 all other applicable laws. All work will be done in
TIGARD, OR 97223 PORTLAND, OR 97280 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
Rep #: LIC 17001 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
Mechanical Insp Electrical Final
Electrical Service Mechanical Final
Electrical Rough In Final inspection
Framing Insp
Insulation • . �, /-
Issu : d By : ! ': � ,. � e� Permittee Signature : _liMVr% � _
t ,
Call (503) r 9-4175 by 7:00 p.m. for an inspection needed t e next business day
7 8Sk lb- l 6
... Building Permit Application
Date received: /o — /d - Permit no.: /y$rapp /,
4 11 1' . : ',1 1 11 ' 5>-
-- C ity of Tigard
Project/appl. no.: Expire date:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City ofTigard 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: V t
TYPE OF PERMIT
k I & 2 family dwelling or accessory 0 CommerciaUindustrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION - Job address: - AP <AP o /l./` Bldg. no.: Suite no.:
Lot: _ .. Block: Subdivision: zeilliffiMiLIMMA Tax map /tax lot/account no.: ! -- .
Project name: /- /a .
CA
Description and location of work on premises /special conditions: I .' j t Ai 00 < L 1 b'V
it A4./ - _
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
IMMINNZ Al ( Floodplain ,septiccapacity,solar,etc.) ---,,,
Mailing address: • 0'0 ,Aii (JO ii & 2 family dwelling: • -- 00 \
i State: p ZIP: 7, Valuation of work $ J 00 ✓
Phone: ,r+ S Fax: E -mail: No. of bedrooms/baths � -
Owner's representative: A IN 4, ", ,a, Total number of floors -
Phone;gJ - 7 ,,,.. WAY/ME -mail: New dwelling area (sq. ft.) I arts_
..- . APPLICANT Garage/carport area (sq. ft.) 44')C)
Wi ti .� Covered porch area (sq. ft.)
Mailing address: ,W i y 03 Deck area (sq. ft.)
IlEirra►. CiiiME}i/ O
Other structure area (sq. ft.)
Phone: . —, 6,,2 JN E -mail: Commercial /industriallmulti- family:
CONTRACTOR Valuation of work $
� Existing bldg. area (sq. ft.)
d if Business name: ��
Address: ' New bldg. area (sq. ft.)
it Number of stories
/ s��i Stated - ZIP•
Type of construction
Phone: _ , af1 ! E -mail:
CCB no.: Occupancy group(s): Existing:
�, New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examin -. thik application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All p o • ion of i aws and ordi ces governing thi 0 Visa 0 MasterCard
work will be complied • , ether sp 'fi ei' or not. Credit card number: / /
Expires
Authorized signatur �i ./: -:,/,/,,,,,, -:,/,/,,,,,, -:,/,/,,,,,, / la 6 0 a ' : Name of cardholder as shown on credit card
, ,�M5 , 4 i Al ' $
Print name: i C ar dh o ld er s Amount
Notice: This permit application expires if a p rmit is not obtai d within 180 days after it has been accepted as complete. 440-4613 (6/00/COM)
11 C o - P L C V lf
One- and Two - Family Dwelling • c, ti
• • • Application •
Building Permit Application Checklist Reference no.:
City of Tigard City of Tigard Associated permits:
b O Electrical ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Cl Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control O plan CI permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
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 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot
area; building coverage'art,a; percentage of coverage; impervious area; existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing - member sizes and spacing such as floor beams, headers, joists, sub - floor,
wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for
non - prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details.
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
•
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ".
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons.
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document.
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 (6100 /COM)
Mechanical Permit Application
Date received: /p--/ -e / Permit no.: lArgeOI-w - 42. 3
kNrt�� I '� • •
.� 1� City of Tigard Project/appl. no.: Expire date:
CitynfTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: 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
0 New construction 0 Addition/alteration /replacement ❑ Other:
• • JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: /42620 5G?) g f „ ~ Iry / `r, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: i 6{ — /5, gy7s profit. Value $ .
Lot: 3" IBlock: Subdivision:-', , A. 03 *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: .-- rt9hp -0,1A M ZIP: 9 7 ZZ 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE '
Description and loca ion of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air
Is existing space heated or conditioned? 0 Yes 0 No Air conditioni ng handling unit CFM
tioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: a t i 1l - 'i(� State boiler permit no.:
HP Tons BTU /H
Address: / /0 L.2L�i Dr- Fire /smoke dampers/duct smoke detectors
. City: WQQ,n I State: I ZIP: 9 7 7/ Heat pump (site plan required) '
Phoneme —g 6 9' ax: I E -mail: Install/replacefurnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: 3,6,, Install/replace/relocate heaters - suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type I/ II/res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: I Fax: I E -mail: Woodstove/pelletstove
Other:
2 / Applicant's signature: I Date: Other:
Name (print): 1 •
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 (6/00 /COM)
MECHANICAL PERMIT FEES
h
COMMERCIAL FEE SCHEDULE: I & 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) Furnace 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 including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and 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
Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler
ducts & vents 10.00
Furnace > 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 cfm 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 1-4 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
... 4
Date received:fp,/4,,O/ Permit no.: f f l / ..Op5
;' 1114.4II'it` City of Tigard Project/appl. no.: • Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
X 1 & 2 family dwelling or accessory O Commercial/industrial ❑ Multi- family O Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address I/ ,,, i.:5 .e a 4 4'. Bldg. no.: Suite no.: Tax map /tax lot/account no.: •
Lot: ,� Block: Subdivision: i'/ f' Sau c
Project name: I Description anfl location of work on premises: A D) re.6 elite`$
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee .Max
•
Business name: AA) Ay Goo .x----Z,6-67--f-,..6_,, Description Qty. (ea.) Total no. insp
Address: / N ew residential or multi-family per
�� 7 �f B � ij dwelling unit Includes attached garage.
City: ) Y7 -h,(� I State: (i I ZIP: 9 7?„), 3' Service included:
Phone: W 4/ 3? 7 I Fax: I E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: /„() /(./A I Elec. bus. lic. no: Limited energy, residential 2
City /metro lic. no.: 3 -[; -0 34.- 5s C Limited energy, non- residential 2
/— 0 / —p Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date /42. /0
Service and/or feeder 2
Sup. elect. name (print): License no: ,y ..515 Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I 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:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
•
or extension per panel:
Name: 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 RI:VIEIV (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ 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:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection
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 $
❑ 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 (6110 /COM)
ELECTRICAL PERMIT FEES: - LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee ' $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: ' . Items Cost Total 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 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 n 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, r -- 1
see "b" above: I I 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 2. $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 ❑ 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 $ r7 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 $
All New Commercial Buildings require 2 sets of plans.
i:\dsts \forms \elc- fees.doc 08/30/01
11/10/2004
Case Activity Listing 2:53:26PM
TIDEMARK Case #: MST2001-00523
COMPUTER SYSTEMS, INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
MSTA005 Application received 10/16/2001 None DONE DEB 10/16/2001
BLD
MSTA008 Permit Created 10/16/2001 None DONE DEB 10/16/2001
BLD
MSTA010 Check for prcl. 10/16/2001 None DONE BLD 10/16/2001 Interior work only
restrict. BLD
MSTA012 Plans routed to Plans 10/16/2001 None DONE DEB 10/16/2001
Examiner BLD
MSTA026 Plans approved by Pln 10/17/2001 None DONE BT2 10/17/2001
Examiner BT2
MSTA030 Reviewed plans 10/17/2001 None DONE BT2 10/17/2001
routed to PT BT2
MSTA723 Electrical Service None 10/17/2001
BT2
MSTA724 Electrical Rough In 11/13/2001 None PASS TLP 11/15/2001
TLP
MSTA725 Framing Insp 11/7/2001 None PASS KBS 11/14/2001 #-1- additional fl joist
KBS
MSTA740 Insulation Insp 11/7/2001 None PASS KBS 11/14/2001 #-1- under fl
KBS
MSTA720 Mechanical Insp 11/7/2001 None PASS KBS 11/14/2001 #4- heat ducts @ fl joist
KBS
Page 1 of 2 CaseActivity..rpt
Case Activity Listing 11/10/2004
3' g 2:53:26PM
TIDEMARK Case #: MST2001 -00523
COMPUTER SYSTEMS, INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
MSTA790 Electrical Final 12/3/2001 None PASS TLP 12/3/2001
TLP
MSTA795 Mechanical Final 12/3/2001 None PASS TLP 12/3/2001
TLP
MSTA798 Final inspection 12/3/2001 None PASS TLP 12/3/2001
TLP
MSTA032 Post - review 10/18/2001 None DONE BB 10/18/2001
completed BB
MSTA080 (F) Ready to issue 10/18/2001 None DONE BB 10/18/2001 Mec. application needs signature.
BB
Issue elec. sign form.
MSTA092 (F) Issue combination 10/22/2001 None DONE DEB 10/22/2001
permit BLD
MSTA110 Void Permit 10/25/2001 None DONE JMT 10/25/2001 per phone call from owner. they are
JMT not going to do the remodel. no
refund requested.
MSTA150 Return permit to 10/30/2001 None DONE JMT 10/30/2001 homeowner changed their mind, will
issued status JMT continue with project
MSTA770 Misc. Inspection 10/31/2001 None SITE RB 10/31/2001 Site visit to verify work. Noted that
RB a banded lumber package exists in
front along the curb- no activity this
date.
MSTA740 Insulation Insp 11/15/2001 None PASS RB 11/15/2001 Partial- walls, ceiling. Walls =R -21
RB (R -15 installed)..
MSTA970 Case Finaled 12/3/2001 None PASS TLP 12/3/2001
TLP
Page 2 of 2 CaseActivity..rpt
CITY OF TIGARD BUI :DING INSPECTION DIVISION • MST ZOOI 0 S2.3
24 -Hour Inspection Line: 639. 75 Business Line: 639-41
BUP
Date Requested / a - 3 AM PM BLD
Location I / 4' O _ " - .X Suite MEC
Contact Person _, A,`..Q 721. Ph 5._3 9 S?lo a- 7 PLM
Contractor Ph SWR
WILDING Tenant/Owner , -e- "Ze3 --, ELC
- etainm all ELR
Fooling / /.� M D
Foundation Access: C � / / J FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab )--0._J SIT
Post & Beam
Ext Sheath /Shear / Q/L.l 1 . i _/L) )2-4-'7 , aLC--(.-
Int Sheath /Shear _
Framing _ — `'____
Insulation
Drywall Nailing `- ^\
Firewall / /
Fire Sprinkler / /
\
Fire Alarm / ((( \�=
Susp'd Ceiling \
Roof J
40E /
ASS PART FAIL '
Post & Beam
Under Slab i C � - / AA (-
Top Out
Water Service
Sanitary Sewer A d v C o g
R_ Drains '"
_ - • RT FAIL
i CHANIC
Post & Beam
Rough In
Gas Line
Smoke Dampers
%try
- • '.:T FAIL f'
ELECTRICAL
Service
Rough In
UG /Slab
I Low Voltage
Fire Alarm
r _• > PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA r
Approach /Sidewalk / ? ) )
Other Date l Z / U Inspector O Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.