Permit 7
o CITY OF TIGARD
PERMIT #: MST2008 - 00110 MASTER PERMIT
t: , COMMUNITY DEVELOPMENT DATE ISSUED: 7/22/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 109AA - 02500
SITE ADDRESS: 12990 SW STARVIEW DR ZONING: R -7
SUBDIVISION: WOODFORD ESTATES LOT: 033 JURISDICTION: TIG
PROJECT: COOK
Project Description: Interior remodel and increasing window size. Other fixture: ice maker.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: s1 LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: s1 FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT:
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf
VALUE' — - - REAR:
�,5000)• CaD
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN >>100K: UNIT HEATERS: HOODS: 1 OTHER UNITS:
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: SIGNALIPANEL: 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 0 SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other applicable
LOU COOK DANIEL G REIMER laws. All work will be done in accordance with approved plans. This
12990 SW STARVIEW DR PO BOX 70006 permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97224 VANCOUVER, WA 98665 if the work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952- 001 -0010
through 952- 001 -0080. You may obtain copies of these rules or direct
Phone: Contact #: PRI 360 852 - 8512 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #: LIC 29767
TOTAL FEES: $ 330.53
REQUIRED ITEMS AND REPORTS
/111111 /
Issued B . Permittee Signature : ,e6
Call 5 . 39.4175 by 7:00 a.m. for an inspection t • .t • - ness day.
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 . .
Pr sidential FOR OFFICE USE ONLY
g
., n City of Tigard o R j P enn t No.
`J DateB : i i _ :�
{ q 13125 SW Hall Blvd., Tigard, OR 9 'S, ` Plan Re ie raj
' C. Phone: 503.639.4171 Fax: 50 :.l iv', OQ� Date/B : Other Permit:
T I G A K D Inspection Line: 503.639 ��, O Date Rea. :y: El See Page 2 for
Internet: www.tigard �� % o � Notified/Method: (S Supplemental Information
TYPE OF WOII;K REQUIRED DATA: 1 - AND 2- FAMILY DWELLING
❑ New construction Permit fees* are based on the value of the work performed.
`` ````vV'' Indicate the value (rounded to the nearest dollar) of all
'Addit ion /alteration/replacement ( Qther: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
p I- and 2- family dwelling ❑ CommerciaUindustrial Valuation: $ s; 00
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12gio 5 L 5 rt/ • - s Dr • New dwelling area: square feet
City /State /ZIP: f I , � • O q t 7 22_ Li Garage /carport area: square feet
Suite/bldg. /apt. no.: � Project name: Gp 4eAO ✓a"1l l -✓'_ Covered porch area: square feet
Cross street/directions to job site: 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.
f\ \ 5( {) , 1 l D d,(b T e r1 - et e Valuation: $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: LOU Q t (ice_ c k Type of construction:
Address: (2.`[qo j t'�l rt+lcf� 19 r Occupancy groups:
1
City /State /ZIP: 1 1 f e / ? 22y Existing:
Phone: ( ) $ / _ $g 35 Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR ff . l ed
Business name: a „t a ige.4, S
BUI E, LDING PERMIT FEc.
Address: O 76M, (Please refer to fee sehedu/e)i q r . - 'i
' , rA 9g 6 6 Structural plan review fee (or deposit): - / L�
City /State /ZIP:
7/1rR, / !iv � •plan review fee (if applicable): — ` - r
Phone: (360) 12/ - 2g 113 Fax: ( )
Total fees due upon application: l(0- /3
CCB lic.: 217c. 2 3(.)-s-4 V
� � _ Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 4 02n) j a. ge. Imo/ Date: 7 /g� 3 • Fee methodology set by Tri -County Building Industry
/ ` _ Service Board. 330 - 5)
I:\Building\Permits\BUP -RES PermitApp.doc 11/ 6/07 440- 4613T(I1/02/COM/WEB) .7
Building Permit Application Checklist , •
One- and Two - Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received permit No.:
Date/By: 13125 SW H all Blvd., T igard, OR 97223 Associated permits:
C Phone: 503.639.4171 Fax: 503.598.1960
T I G A R D 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical
Internet: www.tigard -or.gov ❑ Other:
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 a 1 . royal re ■ uired. 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- ❑ ❑ ❑
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 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 Oregon and shall be shown to be ap plicable 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 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 accompanied by 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.
1:\ Building \Permits\BUP- RES- PermitApp.doc 03/21 /06 440-4613T(II /02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received *5) e ceived r � �'- ifr'�
Perm No r/ � -
'.
4 13125 SW Hall Blvd., Tigard, OR 97223 `� � ' -
Phone: 503.639.4171 Fax: 503.59 l Plan Review ate Other Permit:
C .: Date/By:
T t G /\ R D Inspection Line: 503.639.4175 �� �u p Date Ready/By: y: See Page 2 for
Internet: www.tigard or.gov ��� Notified/Method: it � Supplemental Information
TYPE OF WORK ® G� ® COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Addition /alters a I 0 Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑Other: ON \\,, mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
_ 4 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 Heating/cooling
Job site address: Air conditioning or heat pump
1 ���o C J" W S'��✓ t f"'' a D (requires site plan showing placement) 14.00
City/State/ZIP: Cit 6 r 9 ? 2 Furnace 100,000 BTU (ducts/vents) 14.00
y �� '1. Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: c6k► Rtin..6 , 03,,,
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
_. _ -. . DESCRIPTION OF WORK Water heater 10.00
'/_ L �^ Gas fireplace 10.00
Y e "� 1es R 1 c.__ d Flue vent for water heater or gas
fireplace 10.00
„ .. Log lighter (gas) 10.00
Wood/pellet stove 10.00
_.__. Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 10.00
Other: 10.00
•
Name: Lot) ii M2t1.1e 6490 Environmental exhaust and ventilation •
Address: Range hood/other kitchen
90 6 c ✓)e,O D . - equipment 10.00 ki.oi
City /State /ZIP: / 493 � , 6 K 17Z2/ Clothes dryer exhaust 10.00
[ Single -duct exhaust (bathrooms,
Phone: ( 3) 6e. 7 _ _g ga s- Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: W i e' < gel. Clothes dryer (gas)
Other:
Address: 'P e) ceof)X ?co 6 MECHANICAL PERMIT FEES*
City /State /ZIP: V b , (Al Pt - ` .C. Subtotal Al .cJt'
Minimum permit fee ($72.50) :c0
Phone: (pa)) 1 L( al i 3 Fax: ( )
Plan review (25% of permit fee)
CCB lic.: 2R ?6'7 State surcharge (12% of permit fee) i,
• TOTAL PERMIT FEE W. Jt.)
Authorized signature: This permit application expires if a permit is not obtained within 180
_ / days after it has been accepted as complete.
Print name: D 1 el & 4cetI'he✓+ I Date: 2/2.24e • Fee methodology set by Tri -County Building Industry Service Board
I:\Building\Permiis C- PermitApp.doc 01/19/07 440-4617T (I 1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 2
Plumbing Permit Application
&Alding Fixtures FOR OFFICE USE ONLY
R e ceived 7A / Permit No. ( ` i)5 / ` U A 1 • 13125 SW Hall Blvd., gar City of Tigard Tid 1_„ ` ^Q0� Plan R y :
�` ' l n � 1. Plan Review
Phone: 503.639.4171 Fax: 1960 - A �Q _ \ Date/By: Other Permit No.:
T I G n R D Inspection Line: 503.639.4175 0" .#14113 Date Ready/By: runs: la See Page 2 for
Internet: www.tigard or.gov o `�� Notified/Method: Supplemental Information
TYPE OF WO ` _ `N , FEE* SCHEDULE
❑ New construction`n For special information use checklist.
Description I Qty. I Ea. I Total
R Addition/alteration /replacement ❑gther: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
i gj I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: / 2.q /o C y! o Catch basin or area drain 16.60
City/State /ZIP: 7 „vci t t) r'1 572.2-4 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: U I Project name: � � Footing drain (no. linear ft.: ) Page 2
&Kb Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
•Re y-�� 6 b k Backwater valve 16.60
I Clothes washer • 16.60
Dishwasher 16.60
•
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: I„oo 4 6(,,yr- Gb.K Expansion tank 16.60
Address: (2,5111 $(N g f Or-44 D Fixture /sewer cap 16.60
City /State /ZIP: T a R f 2 �Y Floor drain/floor sink/hub 16.60
Phone: (3-0 6Rv7' 88 3� � _ Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 1 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory 1 16.60
Phone: ( ) I Fax: ( ) Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACT Water closet 16.60
Business name: " $ /4 vlL v . 1 1 ( J /C !
�. �,yJ Water heater 16.60
Address: �� D,^ e ( Other:
City /State /ZIP: /cdJ '' 1. ! 7 , Subtotal
Mi nimum permit fee: $72.50
Phone: 'P3) ( //' Z Fax: ( ) i s" ....tom - Residential backflow minimum permit fee: $36.25 �
CCB Lic.: �/ ,�
2- r9g Plan review (25% of permit fee)
'
0 ��� PI n g Lic. no.: O State surcharge (12% of permit fee) g.....7
Authorized signature: - TOTAL PERMIT FEE Tr
Print name: et ✓y. c t444_ t�vo 4 I Date:- ' _Z 90-A1/ 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 Service Board.
11Buitding \Permits\PLMF- PermitApp.doc 12/27/06 440.4616T(10/02/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 - l a 100' • 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
•
Commercial Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3
-4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i:\Building\Permits\PLM- PermitApp.doc 12/27/06
CITY OF TIGARD ,
BUILDING DIVISION . PERMIT #: MST200B -00110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7122
Phone: (503) 639 -4171 Ptill
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/23/2008 TIME: 7 :02AM PAGE: 27
SITE ADDRESS: 12990 SW STAR VIEW DR CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 033 TYPE OF USE:
PROJECT NAME: COOK
DESCRIPTION: Interior remodel and increasing window size. Other fixture: ice maker.
OWNER: COOK, LOU PHONE #:
CONTRACTOR: DANIEL G REIMER PHONE #: 360 -852 -8612
Inspection Request Scheduled For: Date: 7/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 073075-01 360 921-2813 N
1 Corrections /Comments /Instructions:
4 1
" ga -_ . • - Xcu•- - eiOS -T Zit
❑ PASS PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ifeA Date: 7 -G a Phone #: (503) 718 - 'Z4!
CITY OF TIGARD - .
BUILDING DIVISION . ' PERMIT #: MST2008.00110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/22/2008
Phone: (503) 639 - 4171 ' •
Inspection Requests (24 Hrs.): (503) 639 -4175 I �..
INSPECTION WORKSHEET FOR DATE: 7/23/2008 TIME: 7:02AM PAGE: 26
SITE ADDRESS: 12990 SW STAR VI EW DR CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 033 TYPE OF USE:
PROJECT NAME: COOK
DESCRIPTION: Interior remodel and increasing window size. Other fixture: ice maker.
OWNER: COOK, LOU PHONE #:
CONTRACTOR: DANIEL G REIMER PHONE #: 360 -852 -8512
Inspection Request Scheduled For: Date: 7/23/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 073075 -02 360 921-2813 N
Corrections /Comments /Instructions:
\PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V.--2._ Date: / )2.3)o) Phone #: (503) 718-
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: MST2008-00110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/22/2008
Phone: (503) 639 -4171 r�c��,�,�1
Inspection Requests (24 Hrs.): (503) 639 -4175 P__
INSPECTION WORKSHEET FOR DATE: 11/12/2008 TIME: 7:00AM PAGE: in
SITE ADDRESS: 12990 SW STARVIEW DR CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: Q33 TYPE OF USE:
PROJECT NAME: COOK
DESCRIPTION: Interior remodel and increasing window size. Other fixture: ice maker.
OWNER: COOT, LOU PHONE #:
CONTRACTOR: DANIEL G REIMER PHONE #: 360 -852 -8512
Inspection Request Scheduled For: Date: 11/12)2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 077973-03 360-921-2813 Y
Corrections /Comments /In uctions:
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0 ,74 -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: � Date: It / ° hone #: (503) 718-
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MST200B 0(1110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/:22120011
Phone: (503) 639- 4171TI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/12/2008 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 12990 SW STAR VI EW DR CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 033 TYPE OF USE:
PROJECT NAME: COOK
DESCRIPTION: Interior remodel and increasing window size. Other fixture: ice maker.
OWNER: COOK, LOU PHONE #:
CONTRACTOR: DANIEL G REIMER PHONE #: 360-852 -8612
Inspection Request Scheduled For: Date: 11/12/20118 Pour Time:
Code # Inspection Description Confirm # Contact # Message
69 9 Mechanical final 077973 -02 360-921 -2813 Y
Corrections /Comments /Instructio •
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` %2 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
• I
Inspector: � Date: l� Of Phone #: (503) 718-
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MST2008-00 1 1 0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2.2/2000
Phone: (503) 639 -4171 A � ' •
Inspection Requests (24 Hrs.): (503) 639 -4175 . �' F
INSPECTION WORKSHEET FOR DATE: 11/12/2008 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 12990 SW STAR VIEW DR CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 033 TYPE OF USE:
PROJECT NAME: COOK
DESCRIPTION: Interior remodel and increasing window size. Other fixture: ice maker.
OWNER: COOK, LOU PHONE #:
CONTRACTOR: DANIEL G REIMER PHONE #: 360 - 852.8512
- 4
Inspection Request Scheduled For: Date: 11/12/2006 )P11 Pour Time: ....
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Code # Inspection Description Confirm # Contact # Mes•.. • - ; 6 0
299 Final inspection 07797301 360.921 -2813
Corrections /Comments In tructions:
h - 4 s ( /a - vv. , Lcf---6.--,i,.. - - )
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
►�' AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: P hone #: (503) 718-
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MST200B -00110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/22/2008
Phone: (503) 639 -4171 l u ll
Inspection Requests (24 Hrs.): (503) 639 -4175 W
INSPECTION WORKSHEET FOR DATE: 11/14/2008 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 12990 SW STARVIEW DR CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 033 TYPE OF USE:
PROJECT NAME: COOK
DESCRIPTION: Interior remodel and increasing window size. Other fixture: ice maker.
. OWNER: COOK, LOU PHONE #:
CONTRACTOR: DANIEL C REIMER PHONE #: 360-8518512
Inspection Request Scheduled For: Date: 11/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection ' 076077 -01 360 - 821 -2813 Y
Corrections /Comments / Instructions:
10 574,a, - - ??fix f/V30 1 - 4 -6 tom- t�(krr/L /oide.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ACALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . Date: // --ht--(/ FY Phone #: (503) 718- _tS3Z