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Permit From: 12/10/2012 14:28 #014 P.001 /001 Plumbing Permit Application r �� � M 5 T Z0/ - Do 2 F.1 Building Fixtures t 1 I,L 111 t Ic ,,, I t 11 City of Tigard DEC 1 0 2014 Received %. . • Permit No. 7w,,1 -00 „.P..2- :� ,- 13125 SW Hall Blvd., Tigard, OR 97223 at Review • Phone: 503.718.2439 Fax: 503.598.190Y' TY OF TIG a ' Da nee Other Permit No: i i i 1 , Inspection L 503.639.4175 UILDING DIVISI i Rik Ready/By: Mr El See Page i for Internet: www.tigardor.gov Notified/Method: - Supplemental Information TYPE OF WORK FEE' SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. 1 Total Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 R for each utility correction) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 0- and 2 -famil dwellin SFR (2) balk 437.78 y g ❑ CommerciaUndustrial 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: / yi 86 u.) . &mow $ Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City / State/ZIP: 1 ! Footing drain (no. linear ft: ) Page 2 Suite/bldgJapt. no.: Ai Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 k2 j Rain drain connector 18.76 Sanitary sewer (no. linear R: _) Page 2 Storm sewer (no. linear ft: ) Page 2 Water service (no. linear $.: ) Page 2 Subdivision: [Lot no.: Fixture or item: - Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 � Clothes washer 25.02 //'" "QRe JD ils e� H y iSi Dishwasher 25.02 0 6a11_ Drinking fountain 25.02 /9"14.6 a AfTiQy5 /e- Tv �S rc219 /) /f0 v2- Ejectors/sump 25.02 ❑ PROPERTY OWNER f ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/ State/ZIP: Hose bib • 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Contact name: Primer 12.51 Roof drain (commercial) 12.51 Address: Sink/basin/lavatory / 25.02 City/State/ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) ' Tub/shower /shower pan 12.51 E -mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: '•_ 5 Ls� -► - ___ Water piping/DWV 56.29 Address. TA ii 4„ 0)► f a et ¢ "4„ Other. 25.02 - - City/State/ZIP: 144 I IS 19604 ` lei 7 / z' L( Subtotal Phone: (9)) 4 166 2 Fax: (S3) 9 -LZei Minimum permit fee: $72.50 Plan review (25 %of permit fee) Af Lic.: Coo - ��:�� 3 ALL . bing Lic. no.: 3`Jf ../ 83 P8 State surcharge (12% of permit fee) Authorized signs - 7//// / ? TOTAL PERMIT FEE ��� Print name: Da te: A This permit application expires if a permit a sot obtained witbr days S. -__ c �' a+' after it has been accepted as complete. _ "Fee methodology set by Tri- County Building Industry Service B. 4 ■ 1 l Building \PermiIfPLMU- PemnApp.doc 10/0109 440.4616T(10102/COM/WF.B) DEC -12 -2012 WED 03:39 PM ROTH HEATING FAX NO, 5032663478 P. 02 Mecliinieal Permit Applicat CElVED FOR 01+11 'l: i s t: ° I.% City of Tigard - mix DEC 1 2 2012 _ itNottisr,v,Z - „'Oo2,' '. 13125 SW Ball Blvd., Tigard,OR 97223 Plant Review • I Phone: 503.718.2439 Fax: 503.598.1960 �/•± �� pp n� Dais/Ily: Other Permit I i t , ,\ l.' I t Inspection Line' 503.639 CITY TIGAIl1J p Raady/Iiy: Jude: El Sec Page 2 for Internet: www,tigard- or.gov DIVISION Bt It,DtNn Notified/Method. Supplemental] nformatini TYPE OF WORK U COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* arc based on the value of the work ❑ New construction 'Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) ol'all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. std profit. L Value: $ RESIDENTIAL EQUIPMENT OF CONSTRUCTION QUIPMENT / SYSTEMS FEES* ,XI and 2- family dwelling ❑ CommerciaUindustrial I:1 Accessory building For speciallnforrnatlon use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description j Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling: L 1` Air conditioning Job site address: kl�\- •\)...) b�,rc A�S `( /"1 (requires silo plan showing placement) 46,75 � A � c rua? -) 1 Furnace 100,000 BTU (du ets vin 46.75 City/State/ZIP:—.7 Fuapc 100,000+ BTU (duets/vents) _ 54.91 Suitc/bldb. /upl. no.: i Project name: Heat pump ' `l� � �> 5 1 (requires site plan allowing pincemnnl) 61.06 Cross street/directions to job site: Duct work 23.32 1- 1ydronic 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 I 1 Flue/vent for any of above 23,32 Subdivision: Jett : no. Other: 23.32 Tax map /parcel no.; Other fuel appliances: DESCRIPTION OF WORK Water heater 23,32 • ( CO( 1 Gas fireplace/insert 33.39 rnNee � At� CO L' Qx1 -\_ 1.0cl\ L'\1. F 1 Flue vent for water heater or gas Q ( v fireplace 23.32 x - ► QA �'� , 1 Z Logliehter( gas) 23.32 \ F\ t -3Sl 2D J - [X , Wond/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23 -32 ❑ PROPERTY OWNER ❑ TENANT - Other: 23,32 Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 33.39 City /Stale /Z1P: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT COIN - PACT PERSON Attic /crawlspace fans 2332 �E •�• C Other: , 23.32 Business name: Furl piping: _ Contact name $ k �� � $14.15 for first four: S4.03 fur each additional Address: (1 a • l • t S Furnace, etc D Gas heat pump City /State /Z.1P: C r - Q qr3 0 \ Wall /suspended/unit heater Phone: Fax:: ( ) (s oy 1CyLe 1 � e •9i (l Water heater Fireplace E -mail: A/ A. A .r C M- r' I_ • V Range _ . c___- • t NTRACTOR 'Z i • : Barbecue Business name; I P 7 v ` Clothes dryer (gas) _ �.+�� It s.► :i.• _ __A. Other: - _ 1 1 S MECHANICAL PERMIT FEES* City /State/ZIP: A o- b 9 Subtotal Minimum permit fee ($90,00)� octet '�) A- ( .. �: � Fax ( 9 4 am 0 a Plan review (25 %of permit fee) A � �\ 1 st ale surcharge (12% of permit tee) U CC13 t 1` •., - TOTAL PERMIT FEE This permi application expires if a permit is not dual ed within 180 Authorized sig •. • im Ilk . � a �, days after it has been accepted as complc r I Date: ' Fcc methodology set by Tri.County Building Industry Service Board Print name: �- L(� I �'�'�, '(� I:U1uildins \ramite1MEC -Parini ,doe u3/07/I2 440.4617T /COM/WEB) DEC -12 -2012 WED 03:39 PM ROTH HEATING FAX NO. 5032663478 P. 01 R° Fax Transmittal ROTH HEATING & COOLING TO: FROM: _ . !.� • •. Y t _AAA! �_ 'F�\ A�a.�► COMP V-CLOAnkCk FAX NUMBER , C PAGES (including cover): PHONE: DATE: 12-tal TIME: RE: CC: ❑ For Approval [] For Review ❑ Please Comment ❑ Please Reply ❑ As Requested ❑ For Your Use REMARKS: 1 or CO310,1 a_i .A6 , :mot • • ` s ,.►: .1 !! ,,,, \. '1 Roth Heating & Cooling , PO Box 1 265, Canby, OR 97013, Phone: 503.266.1249, Fax: 503.266.3478 I y n CITY OF TIGARD MASTER PERMIT N I: COMMUNITY DEVELOPMENT areirea4 Permit #: MST2012 -00282 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Date Issued: 11/13/2012 Parcel: 1 S133CC80071 Jurisdiction: Tigard Site address: 14186 SW BARROWS RD 5 Subdivision: SCHOLLS VILLAGE CONDO STAGE 2 Lot: 7 -1 Project: Wickerd Project Description: Storage space converted to living space 12/12/12, reprinted to change contractor from owner to Steel Curtain Construction Co LLC BUILDING Floor Areas Required Setbacks Required Stories 0 Bedrooms 0 First 254 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 $16,377 00 Rear 0 PLUMBING Sinks 1 Water Closets, 1 Washing Mach 0 Laundry Trays 0 Rain Drain 0 Urinals 0 Lavatories 1 Dishwashers 0 Floor Drains 0 Sewer Lines 0 SF Rain Storm Sewer 0 Tubs /Showers 1 Garbage Disp 0 Water Heaters 0 Water Lines' 0 Drains 0 Catch Basins 0 Bckflw Prevntr 0 Footing Drain 0 Ice Maker 0 Hose Bib 0 Backwater Value: 0 Drywell- Trench Drain 0 Other Fixtures 0 Other Fixture Units MECHANICAL Fuel Types Air Conditioning N Vent Fans 1 Clothes Dryers 0 Heat Pump N Hoods' 0 Other Units 1 Furn <100K 0 Vents' 0 Woodstoves 0 Gas Outlets 0 Furn > =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 add'I 500 sf 0 201 -400 amp 0 201 -400 amp 0 W/O Svc/Fdr 2 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 Secunty Alarm N Vaccuum System N Garage Opener N All Other N Other Descnption Ecompasing N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF VB R -3 0 Owner: Contractor: WICKERD, PATRICIA STEEL CURTAIN CONSTRUCTION CO LLC Required Items and Reports (Conditions) 14186 SW BARROWS RD #5 PO BOX 6445 TIGARD, OR 97223 ALOHA, OR 97007 PHONE. 503 -579 -3632 PHONE 503 -572 -7202 FAX 503- 579 -8272 Total Fees: $858 73 This permit is • ect to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will be done i • accordance with - •proved 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 • TENTION Oregon la , r =• ir- you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952 -0 -0010 th •ugh OAR 952 -0' 0090 Y•u obtain a copy of the rules or direct questions to OUNC by calling 503 232 19: or 1 800 33 2344, Issue. By: ` Permittee Signature: All . roan- Call 503.639.4175 by 7:00 a.m. for the next available inspection dat- This permit card shall be kept in a conspicuous place on the job site until completion of the project. I lik Approved plans are required on the Job site at the time of each inspection. Building Permit Application Residential RECEIVED FOR OFFICE USE ONLY City of Tigard 1 \11V j �/ j� DateBy /A ' �/p (j /?' /A Permit No a O I� 0�8,2, ° 13125 SW Hall Blvd., Tigard,OR R 2 01 2 Plan Review II Phone: 503.718.2439 Fax: 503.598 196 Date/By Other Permit. Ti G A I. D Inspection Line: 503.639.4175 Date Ready/By Juns ® See Page 2 for Internet: www tigard-or gov CITYOFTIGA Notified/Method Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ 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: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. dwelling Valuation: $ ❑ 1- and 2-family g ❑ Commercial/industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /40 9 rP �w itenum..0 q S' New dwelling area: square feet City/State /ZIP: Garage /carport area: square feet Suite/bldg./apt. no.: I Project name: 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 (rotnded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. /} �� Q �� A - /) _„ � Valuation: $ ��Y 1 ] 1��� Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Structural plan review fee (or deposit): Contact name: FLS plan review fee (if applicable): Address: City /State /ZIP: Total fees due upon application: Phone: ( ) Fax:: ( ) Amount received: E - mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted Photovoltaic Solar Panel System. Business name: 6 r e - ! Z a � c , &o 4 L L Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: O r Q , i3 0 x 6 ( 2 / 1� Solar Installation Specialty Code checklist. City/State /ZIP: a la ©R, `7007 Permit Fee (includes plan reees) $180.00 and administrative fees): (5b3 �z — 72o7.._ Fax: (�03) 9- 7Z z — State surcharge (12% of permit fee): $21.60 CCB lie.: 60 7 /4 _ Total fee due upon application: $201.60 Authorized signature: i • This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. to 6 �c '.4a ' Date: f 2 /z — z0 /Z * Fee methodology set by Tri- County Building Industry Print name: ' �Q Service Board I:\ Building \Perrnits\BUP- RESPermitApp.doc 02/24/2011 440 -4613T(11 /02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No li Date/B u 1 3125 SW Hall Blvd , Tigard, OR 97223 Associated permits C Phone 503.718.2439 Fax. 503.598.1960 TIGARD 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 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- ❑ ❑ ❑ 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 Ore. on and shall be shown to be applicable 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 I I" 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(11 /02 /COM/WEB) TYPE OF waK1MLDMIG DIVISION • New construction • Addition/alteration/replacement ❑ Demolition jo Other: CATEGORY OF CONSTRUCTION ■ 1- and 2 - family dwelling ❑ Commercial /industrial • Accessory building Multi- family 0 Master builder 168 54 • Other: JOB SITE INFORMATION AND LOCATION Job no.: 1 lob site address: f (_ / 54 S.lc 1, &m a, ' City/State/ZIP: 71 -) I a CL Suite/bldg./apt. no.: I'mject Warne: Cross street/directions to job site: I Subdivision: . 7 Lot no.. Tax map/pored no.: DESCRIPTION OF WORK F ' . u - _' &sppcinV4-' £a s .cr 2 2 0 PROPERTY OWNER ❑ TENANT Name: Address: City /State /ZIP: Phone: ( ) Fax: ( ) Owner installation: This installation is being made on property that I owl) which is not intended for sale. lease. rent, or exchange, lu:cording to ORS 447, 449, 670. and 701. Owner signature Date: • APPLICANT I CONTACT PERSON Business name: Contact name: Address: City /State/ZIP. Phone: (50' 3) 3---7d_ w- 0 -)- tax:: ( ) E-mail: CONTRACTOR 13ucines' mime; ( h .i`o r)e r -4 C— Address. (( LZ 0 5,4_,,./. ✓ f1G 1 �N . City/Statc/ZIP: S4 e .,..-„.,„. _ O R N D Phone: ( ) Fax.( ) ( hint r' CCB Lic..)56 -� Electrical l.ic.: — p.- C Supry 1.1c.: ),,b l 1 S Suprv. Electrician signature, required: Print name: 1�� 4)VNOr / Date: 41 //t / /� / ( !JJ J Authorized signature: Print name. Date: PLAN REVIEW Pious check all that apply (submit 2 sets of plans w/itcros checked below) 0 Service or feeder 400 amps or more ['Building over three stories where the available fault cutrenl 0 Marinas and boatyards exceeds 10,00)) ,imps at 150 volts or ❑ hlIwiting buildings less to ground, a exceeds 14.000 0 Conmtereial• use agricultural amps for all other installations. buildings 0 Fire pump 0 Inetillalson of 75 KVA or ❑ hmergeney system. larger separately derived system 0 Addition of new minor load of 1 : 1 " A" `I •" "1 -2" "1 -3 ". 100)w or more. Oeety/Jn(y D Sir or more residential ands ❑ Recreational vehicle parks ❑ Health-cars Health-cars raalmes 0 Supply voltage for more than ❑ hazardous locations. 600 volts nominal 0 Service or feeder 6011 min or more FEE SCHEDULE lrereri • lion I Qty. I Pee l Total New residential single- or multi- family dwelling unit. Includes attached garage. 1,000 sq. ft or less 168 54 4 Pa. add'! 500 sq. R. or portion 3192 I Limited energy, residential with above . ft� alteration, 75 00 2 2 I =Red energy, multi- family residential (with above so. ft.)� 75.00 Services or feeders installation, and/or relocation 200 amps or seas 100.70 2 2 2 2 2 201 amps to 400 amps 133.56 401 amps to 600 amps 200 34 601 amps to 1,000 amps 30104 Over 1,000 amps Of volts 552.26 Temporary services or feeders installaliou. alteration. and /o relocation 200 amps ur los 59 36 2 201 amps to 400 amps 125.08 401 amps to 599 amps 168.54 2 Branch circuits •• new, alteration, or extension, r panel A Fee for brunch circuits with above service or feeder fee. each branch circuit 7 42 2 If Fee for branch circuits wifhoru service or feeder fee. feat branch circuit 96.18 2 Each add'l blanch circuit 7 42 2 Miscellaneous (service or feeder not included) Each manufactured or modular dwelling, service and/or feeder 6784 2 Reconnect only 67 84 2 Pump or irrigation circle 67 84 2 Sign oruutlinelighong 6784 2 2 Signal circuit(s) or limited panel. alteration, or extension Page 2 Each additional inspection over allowable in any of the abov Additional inspection (1 hr mm) 66 25/ hr Investigation (1 hr min) 66 25/ hr lndustnul plant (1 hr min) 78.18/ hr Inspections for which no fee is specifically listed (V2 hr mm) 90.001 hr ELECTRICAL PERMIT FEES Subtotal; Plan review (25% of permit ice): State surcharge (12% of permit fig); TOTALPh:RMfl FEL•: V • \ , t. a.-- ' v v !/t t7 c-- Electrical Permit Application RE C City of Tigard 13125 Phone: 503.718 2439 , I Fax 503 5981960 DEC 1 1 2012 Inspection line; 503.639.4175 Internet www.tigard- or,gov '1 A 1.lamidmg\Peonns5PJ f - piing 7 1 /10 L/L d 0966865£05 CI coved .' ete/B Plan Review nate/By. I}dte Ready/By. Nola Ted/Method 440.4015T(t OWL ttnyw115 << L£5£ Other Permit 1 El Sec Page 2 for Supplemental Information This permit application expires ifs permit Is not obtained within 1110 days after it has been accepted as complete. * Number of inspeetiaus allowed per permit. L£5£*i29£OS WOO, :8 L O L -2 6 -2 602 ■ a CITY OF TIGARD MASTER PERMIT IN t; COMMUNITY DEVELOPMENT Permit #: MST2012 -00282 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/13/2012 Parcel: 1S133CC80071 Jurisdiction: Tigard Site address: 14186 SW BARROWS RD 5 Subdivision: SCHOLLS VILLAGE CONDO STAGE 2 Lot: 7 -1 Project: Wickerd Project Description: Storage space converted to living space. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 0 First: 254 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: $16,377.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0. Hose Bib: 0 Backwater Value: 0 Drywell -Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 1 Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn > =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 add'I 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 2 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 & 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: ADD SF VB R -3 0 • Owner: Contractor: WICKERD, PATRICIA OWNER Required Items and Reports (Conditions) 14186 SW BARROWS RD #5 TIGARD, OR 97223 PHONE: 503- 579 -3632 PHONE: FAX: Total Fees: $858.73 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 ' accordant= ith 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. TENTION: Oreg• • - equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set•rth in OAR 952-0 1-0010 t rough OAR : -001 -• • • r You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 2.1987 or 1.800.332.23.4. /� / l 1 / 1 . // , z � Issu By: Permittee Signature: Call 503.638.4175 by 7:00 a.m. for the next available Inspec , t 'date. p 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. . �. r j I Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing per mits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date • I will inform my general contractor that a II subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and . l hereby certify that the information on this hom eowner statement is true and accurate. • P -TR (cm-- 6, 11/(KE Print Name of Permit Applicant zd / s evi_j_ t Signature of Permit Applicant Date Permit #: M Al Address: 14 ( g10 WDGVS D. ��•,,,,i�i�`1 x • Issued b Date: ///3// Y • :1.11/ This Copy for Permit Offices rl __ Building Permit Appliea 'on Residential CEIUED I QR c)I 1 1C1: USE ONLY City of Tigard Received AIn Date/B : l r Permit No.:// , ,/ ,,.o p��. II q 13125 SW Hall Blvd., Tigard,OR NA 1 3 2012 Plan Review ► �' 0 Other Permit: Ph one: 503 F ax: 503 598.1960 Date/B : dha�� i . 6 `i , i ., Inspection Line: 503.639.4175 C OFTIGARD Date Ready y: Lurie: ® See Page 2 for Internet: www.tigard -or.gov BUILDING DIVI^J„ I^ Notified/Method: Supplemental Information TYPE OF WORK J REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ 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 in Other: I2e,, R.. equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 1- and 2-family dwelling Valuation: $ y g ❑ Commercial/industrial 16, 3 7? ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder 123 Other: dp,rpo Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /yl gG ' 5 5 u/ /jip..., ou./S /a Q. New dwelling area: square feet 2 ,Sy City /State /ZIP: f . A 9 L y 9 y7 �y� Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area square feet Cross street/directions to job site: Deck area: square feet 544° 77 v /7v t . 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. ,) / IF �� 5 , e__ Valuation: $ /� Existing building area square feet New building area: square feet iiir PROPERTY OWNER ❑ TENANT Number of stories: Name: Ci4-/A g Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: • 1g APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* Business name: ��/.— e,/,/ (7 W ,' p,�e ,p (Pleaserelerto(eesehtdul� Structural plan review fee (or deposit): ? ,s- Contact name: 5n/„t L As C{Arras/t Address: r-4 i ct / fjf e,(../ e,(../ c r z A FLS plan review fee (if applicable): ` l S/ /8G City/State/ZIP: L _ Total fees due upon application: y it--,' i r/ „7 �')rZ. 97...1,2-:23 Amount received: Phone: (.5e ) ,f7 G -�../.---- Fax:: ( ) E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted PhotoVoltaic Solar Panel System. Business name: 0 W N Submit two (2) sets of roof plan with connection details and fire department access, along with the 2010 Oregon Address: l cr./ f'C 5c-r A�yy -r" S (,.. p Solar Installation Specialty Code checklist. City /State /ZIP: A cl e .,--4/;? , L q7 � Permit Fee (includes plan review $180.00 and administrative fees): Phone: (.f-Cti) 57? - 3 3z- I Fax: ( ) State surcharge (12% of permit fee): $21.60 CCB lic.: / / Total fee due upon application: $201.60 Authorized signature: p ti'' �Q ) , (/(f tCil�.t/LrJli This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: PA-TR_ I CI f)- (. IV (c /<'erd Date: 1/ /0/. - /L * Fee methodology set by Tri -County Building Industry Service Board ?4arrrr 3 33. )7 I:\Building\Permits\BUP- RESPermitApp.doc 02/24/2011 440 -4613T(11 /02 /COM/WEB) 1244sb'.'J I S.c. 3;.5 5`61.la Building Permit Application Checklist - - One- and Two - Family Dwelling FOIL ohhlch: usl: ()NIA City of Tigard Received Permit No.: ilii • Da(eBy: V 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: 0 _ Phone: 503.718.2439 Fax: 503.598.1960 TIGARD 24- Hour Inspection Line: 503.639.4175 0 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 approval required. Name of district: . ❑ CI CI 5 Septic system permit or authorization for remodel. Existing system capacity CI ❑ ❑ 6 Sewer permit. Cl ❑ ❑ 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 Orelon and shall be shown to be a, •licable 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 cnginccr 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. 1:\Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 4613T(I 1/02 /COM/WEB) -' llumbin Permit A licatio Site Utilities H CE I VED • City of Tigard Received c1 Dat l,/ �� ' f Permit No.:) ? /A F q 13125 SW Hall Blvd., Tigard,OR 97110 1 3 2012 Plan Review C Phone: 503.718.2439 Fax: 503.598.1960 '/� A p n Date/By: Other Permit No.: r 1 C. n 1t D Inspection Line: 503.639 CITY OF TIGARD Date Ready/By: Juris: Iii See Page 2 for Internet: www.tigard or.gov �^ DIVISION Notified/Method: Supplemental Information TYPE OF *DING u J llfV FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total X Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 312.70 - and 2- family dwelling ❑ Comercial/industrial SFR (2) bath 437.78 m - 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: / y/ gG s / cic .t '-415....-- Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP: / t �,frea ' c 9. 7 2� 3 �� Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 5 C- a / / / /, A49. 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 P tj P/r6 Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 Er PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 ..54/ Z.- Floor drain/floor sink/hub 25.02 Address: / ./ o G $ (,,/ g e7r.✓S (24 . Z r � Garbage disposal 1 25.02 City/State /ZIP: / G� , ce,/t,_ V' 72Z� Hose bib 25.02 Phone: (,93) ,0'79 _. 31- Fax: ( ) Ice maker 12.51 lia APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: , /' Af W k �, , Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: cZ pen /c AS 0 u/A/* Roof drain (commercial) 12.51 Address: /�// t 996 r y e / /! (9LUS /2... ' Sink/basin/lavatory 2 25.02 City /State /ZIP: /,‘ _ e 7 d_ 972,2-3 Solar units (potable water) 62.54 Phone: (y?j) 6 9_ j� I Fax: : ( ) Tub /shower /shower pan Q 12.51 E -mail: Urinal / 25.02 CONTRACTOR Water closet J 25.02 Water heater 37.52 Business name: 6 k,,,, NLit_ Water piping/DWV 56.29 Address: / y/ gt < 5 4 / C - " /34.f S (20' 2te .s--- Other: 25.02 City /State /ZIP: f er2/7 O (Z .7 � Subtotal 4 Phone: ( ) ),57 9.- 3G 3 - Fax: ( ) Minimum permit fee: $72.50 -7 L C v` Plan review (25% of permit fee) 3 /F �<1 CCB Lic.: �/ Plumbing- Lic. no.: State surcharge (12% of permit fee) t Authorized sigulture: ( j! C.C.0 �E- , w (t %� / o TOTAL PERMIT FEE 7 t i Print name: : * i '( c, 4 6- Date: / / - /L- 12- This permit application expires if a permit is not obtained within days /) after i Q t has been accepted as complete. " 'Fee methodology set by Tri -County Building Industry Service Boar d!`l7 1 t - -4 Nl� 1:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440-46 I 6T( I0 /02/COM/WEB) U l , Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information =r4 tY !� „. • Fee Schedule: Residential Fi'r'e 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 'JVi I t 6 I E.k. $169.69 Sewer - 1st 100' 62.54 3,601 to 7,200 • - • $23320 • 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 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 62:54 $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 Q ty. Fee (ea) Total each additional $100.00 or fraction thereof, to Other Inspections or Fees 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 V 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 * . Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is requited for any of the following. Work Performed: Capped Added Relocate Please check all that apply. y Baptistry/Font - Bath - Tub /Shower ❑ Any new commercial building with water service 2" and Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918 -780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. 4 " Isometric or Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage - Domestic -non -food q g Disposal - Domestic -food related that meet the qualifications - Commercial -food related • • - Industrial-food related Ice MachiRefrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lay - Non -food related - Bradley - Commercial- food related - Service Swimming Pool Filter *Note: If the fixture work under this permit results in an • Washer - Clothes increase of sewer EDUs, a sewer permit will be issued and Water Extractor p Water Closet Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: • I: \Building\Permits\PLMU- PermitApp.doc 2 Mechanical Permit Applica 1 E CEIVEID ' FO1t r)FF1c1.. U SI ()NIA IN City of Tigard Date/By: /./ � Permit No.: 4 7;. / _,z,,,,20,_ ° 13125 SW Hall Blvd., Tigard,OR 97223 - � Phone: 503.718.2439 Fax: 503.598.196t�OV 1 3 2012 Plan Review Date/By: Other Permit: "I" 1 G A 1i D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard -or.gov CITY OF T Notified/Method: Supplemental Information TYPE OF 1h G I f�l,'1SIION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ❑ New construction 8 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* I- 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: Air conditioning Job site address: /e.://86 $ ii/ �,,� g f/ 7 • (requires site plan showing placement) 46.75 City /State /ZIP: r � S/ Fumace 100,000 BTU (ducts/vents) 46.75 [re� _ Cl 9 -7 _ _> Fumace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.:‘ Project name: Heat pump (requires site plan showing placement) 61.06 Cross street/diredions to job site: Duct work 1 23.32 -5C-40 // // ` / / *9 R d n t hot water (radiator 23.32 l Residential boiler raadiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: 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 /J Gas fireplace/insert 33.39 /` e--,44s /Z- ,9/,J e. 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 er PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: S AM Environmental exhaust and ventilation: Address: 7 91 eG s , .B w5 fa p t� z, Range hood/other kitchen �d equipment 33.39 City /State /ZIP: I Gr�...p d 9 7a-...2---3 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (±'3) 5-7 ' 3 6 , 92 -- Fax: ( ) toilet compartments, utility rooms) 1 23.32 a APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Pf /r/=/ ` e r 6' c t • e 4 G,z_ D Other: 23.32 _ Fuel piping: Contact name: S P� h- As a.A.) F .. $14.15 for first four; $4.03 for each additional Address: / 4f7.t '( S Gf/ ��,,..�O9as !` ,? . Furnace, etc. Gas heat pump City /State /ZIP: /--, Cs. ed� QGC 9 77-iy,3 Wall /suspended/unit heater . Phone: (2 .$) y- 3G 3 _ Fax: : ( ) Water heater E -mail: Fireplace Range CONTRACTOR Barbecue Business name: Q w Al h� Clothes dryer (gas) /�8G 5 �/ / Other: Address: 7 g //�'�UW S ( #' MECHANICAL PERMIT FEES* City /State /ZIP: '- /' c. ,r,r.t� dam- g 7 . , , . 1 - ' Subtotal Phone: (.7 7 .9- Fax: ( ) Minimum permit fee ($90.00) Co / U - 3 ..3 Plan review (25% of permit fee) CCB lic.: State surcharge (12% of permit fee) A.). '60 �.� , l �� �p ,� � TOTAL PERMIT FEE /00.50 Authorized signature: I 7 2L-C.. 4 eL. � � ' l.V `� ��� This permit application expines if a permit is not obtained within 180 days after it has been accepted as complete. Print name: PAT - g 16/ A- G-,. al c (.er(( Date: / f - /Z - • Fee methodology set by Tri- County Building Industry Service Board 1:\ Building \PermitsV4EC- PermitApp.doc 09/09/10 440- 4617T(t1 /02/COM/WEB) • Mechanical Permit Application City of Tigard —1. • Page 2 - Supplemental Information • • V I. 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\Perrnits MEC- PermitApp.doc 09/09/10 2 Electrical Permit ApplicatioiRECEIVED Foil OFFICE USE ONLY 2 City of Tigard q 13125 SW Hall lvd., Tigard,OR 97223 NOV 1 3 2012 ° �eB mew / Permit No.: ��', -fig ' Phone: 503.718.2439 Fax: 503.598.1 d of T'( p� Date/By: Rece ived Other Permit: T I G A R D Inspection Line: 503.639.41751 1 1 Vf 1 Il�f'Mf1L/ Date Ready/By: tuna: 621 See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW Please check all that apply (submit sets of plans w /items checked below): ❑ New construction ZrAddition /alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition 121 Other: /Ze,/.,/,' where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural n._ 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ,,� ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ", Job site address: /9/ � y (, f/ ,r r " Pap , 100HP or more. occupancy. ❑ 0 Six or more residential units. Recreational vehicle parks. City/State /ZIP: e.,� e , G p d� J.7 Zy- ❑ Health -care facilities. ❑ Supply voltage for more than ! / ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: F 6 Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • New residential single- or multi - family dwelling unit. . 6'4 Q /7S // (//'$2' C--- Includes attached garage. Subdivision: Lot no.: 1,000 sq. R. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi- family 75.00 2 g e_�/¢,./e-- 0 .i.7.7 9e- residential (with above sq. ft.) _ Y� Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 tgl PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: Az /52 ? i e t- O,'C`eiCdc„-- 601 amps to 1,000 amps 301.04 2 Address: Sp" q Over 1,000 amps or volts 552.26 2 City/State /ZIP: At. v. 62/e_ V 7 Temporary services or feeders installation, alteration, and/or �� 3 relocation Phone: (,./,.3) ..N.-- -34, — Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits – new, alteration, or ex tension, per panel Owner signature: Date: A. Fee for branch circuits with gi APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: /49 z r l -- . r i(/ r ' (4d7 B. Fee for branch circuits without service or feeder fee, first / 56.18 2 Contact name: branch circuit 1 SAM(: A 5 Gwtilc Each add'I branch circuit f 7.42 2 Address: /9/ e .- 5 c;," ,am xO(A/ = ta,/,, Miscellaneous (service or feeder not included) Ai /� �� r /� Each manufactured or modular City/State /ZIP: 67.84 2 jG G Q C/ g77y- dwelling, service and/or feeder Phone: j3) 5 ���- Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: Owl., k panel, alteration, or extension. Page 2 2 G Each additional inspection over allowable in any of the above Address: 7/..//)9, 5,A/, R „ed('i/S f P. r- Additional inspection (I hr min) 66.25/ hr L �G 3 • Investigation (I hr min) 66.25/ hr City/State /ZIP: , 7 �� - Q a > T yr Industrial plant (I hr min) 78.18/ hr Phone: (. 2 $) 7 9 - 3 6 L Fax: ( ) Inspections for which no fee is 90.00/ hr specifically listed (/z hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 3.60 Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): 7, / " J TOTAL PERMIT FEE: Authorized signature: 0 a C.i.. _ ILL/ • U This permit application expires if a permit is not obtained 180 !� A - 1 - 21 �� - �( lee") Date: • dap after it has d per ac prmit. as complete. Print name: I C e ^� 1/ /� � � � • Number of inspections allowed r rmit. I:\ Building \Permits\ELC- PennitApp.doc 07/01/10 440.4615T(I I /05 /COM/WEB 'B 9T u'•a rn h 1`t • Electrical Permit Application -'City of Tigard''..L �'.d' ,� %. 6: ,. h A Page 2 - Supplemental Information I: LIMITED ENERGY PERMIT FEES: '+ w'`'' '' r ~ ^ '� -i ► J eR..' ' RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: • ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: • Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems • ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \ Building \Perrnits\ELC- PermitApp.doc, 07101/10