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Permit
EXPIRED 4 /s /o7 , Building Permit Application FOR OFFICE USE ONLY City of Tigard ! EC E I V E Received Date/Bv. It I (O oL • II1 ,/ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax 503.598 1960 -.' • 1 Date/By Other Per .. D ook. Ca$' f Inspection Line: 503.639.4175 t�OV {V 1 Zoo �-t,�. e` II Date Read B t for Internet: www.ci.ti g ard.or.us iv'onfied/Metho d. ion: `4 f -� y Supplemental Information li CITY OF TIGARD 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. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 1O(p,0 ❑ Accessory building js1 Multi- family Number of bedrooms: 2 ❑ Master builder ❑ Other: Number of bathrooms: 2 c JOB SITE INFORMATION " "AND LOCATION Total number of floors: 3 Job site address: 1033q, 51A1 A dL.6 - ma c New dwelling area: i 2 ZS square feet City/State /ZIP: -n GAl2_ D c;1 91 223 Garage /carport area: 254 square feet Suit ld apt, no.: 44 Project name: ©Ak1C 5•nz —j-s&4 p14.A6S Covered porch area: I (p square feet Cross street/directions to job site: Deck area: clip square feet 5W 9Ot" Ave . Other structure area: square feet (« #r - rvpc • 1) I REQUIRED DATA: COAWRCIAL -LSE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: I 5 13 SAAO3 �Gb d- 039 p ( 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. :ow -jlet)C -'t10NJ ei L- IT 32- ' . Valuation: S — r;-I VZ4 UJ((�,_ P 4(p t- (TS Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stones: Name: OAK S'ri r - 1 t4 ,- -0/vmS , 1 t_ Type of construction: Address: t 2(.j70 SW (0$ -1- 1. A■ , 5 Occupancy groups: City/State /ZIP: (e'M'_t , lk c 7 `L�3 Existing: Phone: (5 c.3) & 1 • 3104 Fax: (503) 99 8.908 I New: • • g APPLICANT . Er CONTACT PERSON:: • NOTICE - Business name: I cON r ri TL tze /QLAN N 110 G • I NiG. All contractors and subcontractors are required to be Contact name: D4a C ]a¢(C -M C . MC CA S1l2Il . licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: q - 725 5.) ' . - tZ-7 I LLS'ItAt. e Hw STE.,21ee' jurisdiction in which work is being performed. If the City/State/ZIP: QjE;,A-yam -Off , OR 9-7cc applicant is exempt from licensing, the following reasons apply: Phone: (503) (p4 .1( exp I Fax: : (So3) (l4 .1( E -mail: pt 19gp I GC+• G fc.11 t te.C Business nam Oak Street Townhomes LLC - - . BUILDING PER_ tiIIT FEES* • Address: j2 12670 SW 68th Ave Ste 400 Please refer to fee schedule City/State /ZII Tigard OR 97223 Phone: (!,-p. P 503- 639 -3104 F: 503 -598 -9081 Fees due upon application B lie.: ((o•i CCB: 169524 Amount received i 1 Date received: Authorized signature: i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1. A t . 32 Date: (, .23 .O (/ * Fee methodology set by Tri-County Building industry Service Board. i:\BwldmgTermns\BUP- PertmWppdoe 12/03 440 -4613T(11 /02/COMM'EB) ' _Mechanical Permit application FOR OFFICE U S E ©env'; City of Tigard I Iteca. I .. Ii Ii5SW11,111HIkd.. Tigard, OR --' - • r,,n t� ;rw r - -• a , . i -T !1jjam� Phone: 503.63 41-1 Fa:: 30 , 1S 1960 I ' n.: o h 6 !L I f 1: I'c:,; Irs �` � 1 DA:: @_ recuon Line: Si)3.63G.41 .S - , (l,a :ltwd ;'pap: tau � Stt•!'a�c3 for •rn:et: ur. ;a.. i tiearf..r.us Notified Ate;;Iod. I 1 Supplemental Information TYPE OF WORT: • COMMERCIAL FEE SCHEDULE - USE CHECKLIST ' • ® Nell" construction ❑ :d iition:naerar��n r Place ;: ;cot 1 I Mechanical peanit fees` ar_ to .ed on the value of the noel; I perfilrnted. Indicate the t"aiuc (rounded to the nearest dollar) of ail j ❑ Demolition • ❑ Other. mechanical materials. equipment. labor, overhead, and profit_ i - CATEGOR]• "OF CO\STRUCTIO -_ :.•• -' '. ` :. Value: ❑ 1 -and 2-family dv; cllin� • ' :RT•.SJDE• I TJAL EQUlpItMEr TJ S)'STEM ' FF FS't :' '1 i tt ❑ Commercialiindust -ia' ❑ ,1ccessury bu ilding For special ,,ifornzaaon tae cheek: c!. 10 Multi- family ❑ Master builder ❑ Other. I Description I Qty. I Ea. Total I - - ' .SITE,INt OR\L%TIO\ ...A-ND - , _ Ifcatin,, /coolin_ J • Job site address: q �,� Air conditioning orheat pump 3 l.� SW n $1 �� I ( ::auims slle c s p t : -n:1 I ( I 14.00 I J j Cit /Stale/ZIP• � , 0 91223 1 Furnace 100.000 BJ V t lu :C5". n :51 i I 1 14.00 1 1 I mace 100.000 BTU (chic:::' eats) 17.90 1 Suite/bldg. /app. rto : Project name: {� S r - r ?D 1••) CiK: -aS heat :imp I 14.00 I Cross street/directions to job site: Duct work I 14.00 I SW 410-Pot hot water system I I 14.00 l 1 Residential boiler (radiator or I I hvdronic) ! 14.00 I Unit heaters (fuel -type, not electric). I 1 in -wall, in-duct, suspended. etc. 10.00 Subdivision I Lot no.: I Flue /vent for any of above I 1 I 10.00 I 10 - 1Other I I 10.00 I - Tax map'parcel no.: 15135 ti IS 135 , tA03901 Other fuel appliances . -- , -' iii.scitirrini`: or•.,‘Vori* - 1 Water heater 1 I 1 10.00 I I D - , "- . I Gas fireplace I I 1 10.00 I 10 -- C.C- s 31(.t:Cr1Dk, 01 url IT 32 Flue vent for water heater or gus - i Z - WILL 1 -1tP WI fiS I'Ti'iii}'L • I Log 2- 10.00 2a Lng lighter (gas) { I 10.00 t Wood /pellet stove I I 10.00 I I Wood fireplace /insert I I 10.00 I I t i Chimney/liner/flue/vent I I 10.00 I I : 171 EF2 1°-: ' :: :.D - TF:: \ &vr .c,,_•,. 1 Other. l I 10 00 I II Name: Ob 14 S-r1a tT -'r J 4H p;,R ✓, Environmental exhaust and ventilation I Range hoodiother kitchen Address: 154.(47-70 SW (�g•H t Atccr, , Sr 4!0 equipment 10.00 City /State/ZIP: ' G. AiZ'b , OR c 7223 I Clothes dryer exhaust I 1 I 10.00 I 10 - 1 Single -duet exhaust (bathrooms, Phone: ( ) 6 • J D" I Fax: (C�p,7 59g g .9 O g I toilet compamnents. utility rooms) 3 1 6.80 I W. 1 D _ '•. . _1PP.LIC.A T CO\°r,1(r Pert ON,. - .1":" - 7.._ :: I AttickmwIspace fans I I 10.00 I Other. 10.00 Business name: `!_C. kr4-{ ITfl. E /P(ANtJIAla ` ! C . I Fuel piping I i I Contact name: DA N 6acsmtc4.4 OJT M p w t 0. { - 55.40 for first four: S1.00 for each additional Address: �--175 SW �1/ 'itkJ - s i IUST)A -LG 1-I (DV 5 `i � - 2 g I I rJ40 5.� D. M I Cite /State/ZIP: (J�R;V Tan + gy pR ' c>O S G heat I P um p Wall /suspended /unit heater I Water heater 1 1 ` ' . 5.90 Phone: (G�p'3) ()�G .1t.442 ( I Fax:: (ij[y3) 7�0� Fireplace 1 I `1O 640 E-mail: t GI I g 01 Cal a-rC..►- I - ; - er. co r., _ Ranee - 1 ( 5 4O 540 I I T hermal Flo Inc Clothes dryer (gas) 1 Business t --- 7236 SW DUrhm a Rd St 100 Addres I oilier ! _ _ 11EC�13:KI.CAL I'S:FU�1 LS" T FT : " Portland OR 97224 city/State. Subtotal I P: 503- 670 -8343 F: 503-620-1953 Minitnutn permit fee (572.50) I mc: ( CC B: 151847 1 Plan review (25';a of permit fee) I I CC13 lie.: l I 1 I State surehar a (8% of permit fee) I (1 j L_ TOTAL PERMIT FEE Authorized SIB ^3:tt II If This permit application cxpirts if it permit is nut uhtaIned uitltin IN _ - daya after it has been accepted as completes I Print name: 7), � -D �! i� 1 Da :e: cx .. c, j ' Fe; meth. :xi:tloey se: by Tri- County Building in ;h anti• Scrvice 3oard c.,..,.. d.„,,,..- mia,,,E,- P„...A due t2.J? 4404637T (11 /0_ ;COMVF..tt) t Plumbing Permit Application FOR OFFICE USE ONLY Received City of Tigard _ . • � oo e Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Dan R Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Date /By: Es( 7 P t f Other Permit No.: 24 Hour Inspection Line: 503.639.4175 e.' ( , p c ti Date Ready /By • 0 See Page 2 for Internet: www.ci.tigard.or us Notified/Method: Supplemental Information TYPE OF WORK : - FEE* SCHEDULE New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connectio: - CATEGORY OF CONSTRUCTION_ -_, SFR(1)bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building 1 K Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION - Site utilities Job site address: 10 ( S(/r n '(L(L.EA4 'r i ,k .E Catch basin or area drain 16.60 City/State/ZIP: -1`(G jD CA crl Z23 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Q(►'K $(K[ -1"'rOw N (•- 1•(�I,I�ES Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 5W Ci A Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: IS I �J 5 AD► O38'C)O d- 151544-193901 Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK • . Backflow preventcr Page 2 Co 1,1 i UC100 C Ltp t T 3Z Backwater valve 16.60 11-16/2.. WILL 41p u h r r 5 r - ryt - . Clothes washer I 16.60 I (4). CDC Dishwasher I 16.60 110 (pC Drinking fountain 16.60 lg. PROPERTY OWNER . . • ❑' .TENANT . Ejectors/sump 16.60 Name: °Ae_ 51 - r TvW 1,1 1 DMES , L-L-C Expansion tank 16.60 Address: 1 2-(o - D SW (pQ�ti Al , 3u 5urrE 4DO Fixture/sewer cap 16.60 City/ State/ZIP: -11 G , OE 91Z2_3 Floor drain/floor sink/hub 16.60 Phone: ( e , 3 ) (039 ..b 1 Fax: ( p o 3) 59y .9 g I Garbage disposal I 16.60 1( (pQ Hose bib 2 16.60 33. 2.0 APPLICANT . " ❑ CONTACT PERSON Ice maker 16.60 Business name: 1 CO t 44 t i ikee, / PLA N tjimc, , l SIC . Interceptor /grease trap 16.60 Contact name: ¶, .M Gct)le 1 0.4 be, J`AON ICA 8JLUGH . Medical gas (value: $ ) Page 2 Address: q,y 5 SW 4e v121T* 4-i jU SD 4-ttily , SIE.21 t6 Primer 16.60 City/State /ZIP: •( �N 1 0(L 9100S Roof drain (commercial) 16.60 Phone: (5j03) log ,7(O(p1 Fax:: ( rig) (a44 rCdv9 Sink/basin/l /shows 16.60 (Q(o. Tub /shower /shower pan 2 16.60 33.2C E -mail: dI' @)coda chi I eC +.CL)IP) Urinal 16.60 J CONTRACTOR . Water closet 2, 5 16.60 zi /. SC) Busines: The Mullen Company Water heater I 16.60 i(o.( Address: 1601 SE River Rd Other City/slat Hillsboro OR 97123 Subtotal P: 503- 640 -0113 Minimum permit fee: S72.50 Phone: ( Residential baclflow minimum permit fee: £36.25 CCB: 92689 PLM: 34 -260PB Plan review (25% permit fee i25% of CCB Lic.. p fee) - State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: .AN G co 7a ( C-I Date: 07. 23 o c,, 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. i.\Buitdtng\Pumas\PLM- PermitApp doc 06/05 440- 4616T(10/02 /C014/WEB) • Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Racei�ti I t Permit No. • Tigard, OR 97223 13125 SW Hall Blvd , Tr Pla/By: _.� g Plan n Review c— ' . �-9 Other Permit.: Phone: 503.639.4171 Fax: 503.598.1960 1 Date/By : Inspection Line: 503.639.4175 •� i•' I Date-Ready /By: lads El See Page 2 for :ntemet: www.ci.tigard.or.us Notified/Method. SupplementalInfon TYPE OF WORK = -- _ PLAN REVIEW ®, New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: 0 Service over 225 amps, comm'l 0 Hazardous location ❑ Service over 320 amps — rating 1XIBuildng over 10,000 sq. ft., • • , CATEGORY OF CONSTRUCTION • -• of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building System over 600 volts nominal units in one structure 21, Multi- family ❑Master builder ❑Building over three stories ❑Feeders, 400 amps or more ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or • JOB SITE INFORMATION AND LOCATION - ❑ Egress/lighting plan RV park • El Health-care facility ❑Other. Job no.: Job site address: (,0,39 (0 5(/J �U LC AN T$12t2AGE Submit 2 sets of plans with any of the above. City/State/ZIP: —1'(6, PCI(LD i C5a. 9 223 The above are not applicable to temporary construction service. FEE * SCHEDULE Suite/bldg. /apt. no.: Project name: O A K . ST 2 -T '( 1/4J --{Q),M, Description I Qty. I Fee. Total I •• Cross street/directions to job site: New residential single- or multi - family dwelling unit. Q Includes attached garage. SvJ 1 Q-' A-t/S- • 1,000 sq. ft. or less I_ I 145.15 1.45. J� 4 Subdivision: Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: I S 135A*03 4- I S 135A>-A403CO Limited energy, residential I 1 75.00 - ]5,00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular CONS'f72 L. - 17CM C. (An ti- 32 dwelling, service and/or feeder 90.90 2 _ Services or feeders installation, alteration, and/or relocation VA ITS x1. 200 amps or less I I 80.30 go .30 2 R PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: OAK S11200 —rOu3 ^l H OM t:S , I.(-C- 601 amps to 1,000 amps 240.60 2_ tddress: I _ 7 0 5V.1 6,S m PNG t ST . 400 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 I 2 City/ State/ZIP: —f G D , OQ , 912...zz Temporary services or feeders installation, alteration, and/or � relocation Phone: ( 03 ) (039.3( D 4 Fax: ( O Q .J 1 ) & q pg ( 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel (21, APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service 'or feeder fee, each ( 6.65 ( ( 2 Business name: I s ,C;f.tl1'g -11-∎L E- / PLA t la G (NC . branch circuit B. Fee for branch circuits Contact name: M ON 1 C4 5-1 k YL c> K. Z •N � G 0 al CL( without service or feeder fee, 46.85 2 Address: C1 2 1 f VJ �jE�= 1 H 1LLSC kl }iLW • t ZIDG first add'1 branch branch circuit cif Each h circuit 6.65 2 City/State/ZIP: I2 43.,K 01(Z Cj' O5 Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (G2 (944 ,1 ,7 (p(p I Fax: : ( O3) (.044 .-1c c Sign or outline lighting 53.40 2 E -mail: MI9 @ j LaOQ rC�j f tfi r -O►'Y, Signal circuit(s) or limited- 1 _. • ; CONTRACTOR': , .. . . - energy panel, alteration, or extension. Describe: Page 2 2 Business nai Ross Electric Inc Address: 2870 SE 75th Ave #203 Each additional inspection over allowable in any of the above Hillsboro OR 97123 Per inspection 62.50 City/State/Z. Investigation per hour (I hr min) 62.50 P: 503 - 642 -2800 F: 503- 642 -5815 Industrial plant per hour 73.75 Phone: ( CCB: 157891 ELC: 34 -436C SUP: 4232S • ., , ELECTRICAL PERMIT FEES* • -, CCB Lie.: I Electrical Lie.: I Suprv. Lie.: Subtotal 'uprv. Electrician signature, re uired: Plan review (25% of permit fee) State surcharge (8% of permit fee) Print name: Date: TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: - )A N & G DieziO4 Date: (j, 23. o(p • Fee methodology set by Tri -County Building Industry Service Board °' Number of inspections per permit allowed. i \Building\Permits\ELC.PermitApp doe 12/03 440-46 15T(1 0/02/COM/WEB • Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL, WORK ONLY,: -: ` ? _ Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm NI Garage Door Opener* 14 Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: [ C0�1'I1►ERCIAL WQR;ONr;':` - .: Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ H VAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ L andscape Irrigation Control* ❑ M edical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations • isU3uildmg \PumialELC- PermitApp.doe 04/03 Plumbing Permit Application - City of Tigard • Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: SiteUtilities -_- _� __ Total = Square Footage: _ - - _ -; Fee:- permit = Fee (ea) .: Total - - • Footing drain - l' 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 _ - :=Permit 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 Flxtur'e_or =Item " "Q , •. Fee (en) 'i _Ti.tal additional $100.00 or fraction thereof, to and — - including 510,000.00. 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 Backffow 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: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: . ` ew_for_Complex Structures; - Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria. accurately report fixtures could result in increased sewer fees *. Please check all that apply. - • Quaiifity by (FixtuFe) "Vl'orkperfoiiited• ❑ Any new commercial building. Fixture Type:' ::: ' - ❑ Any new exterior plumbing site utilities. - 'Previous: Capped' , Added . Existing ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi/Whirlpool providing services to human beings. Car Wash -Each Stall ❑ Plumbing installations, alterations or additions to food service . -Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator are being installed for the food service area. Dishwasher - Commercial Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system. Eye Wash Floor Drain/sink 2" Submit 2 sets of plans with any of the above. -3" -4., _ . Car Wash Drain Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial Ice Mach./Refrig. Drains . Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. 1•113uildmg\Permits\PLM- PemutApp doc 07/06/05 . , :IN 2 Building Division One & Two-Family Dwelling TIGARD Fees Checklist Permit #: ri 57- ) o ()A - 0 0 2 4 5 Plan #: ()A k Sr "bi Date: I )_ -9A 0( Site Address: lo 39 (., 6.,4 At Ti_ A J Parcel #: Subdivision: OA k_- 5 6:1- - rocvki i-1-0"A k s Lot #: 3.2 Zoning: "0 k - 1 Jurisdiction: - 7 ---- .=-6 Setbacks: Front: Rear: Left Right Class of Work Alf/ k Stories: 3 First Floor Type of Use: S r 4 Height 3 I Second Floor: 5 itt Construction: S N Floor Load: 50 0 5 Third Floor .575o '75 Occupancy Group: R 3 Dwelling Units: / Bonus Room: Valuation: /021 , rli O. 6,0 Bedrooms: g. Total Floors: 1;:, ')1 $) Bathrooms: 3 Basement Decks: 'ilo r) Garage: s 13 Porches: 0 0 ri Other: iTliOgi . eacklittai- 77 -7 - Ifilt;'14 . W.iiiiiii"7 7 -7:74 - kairlaihill:773:57::: - Bilar;ZiTg7 , 7 Plan Check Building: 5 57/ - ,. ---)64) ?: r d50 - o( 1 I. -7, Extra Set: Permit: Building 500.10 5f 3c, 1(9 Tax: C4/ Metro CET: P/5 1 (- 157.21 MechanicaL Tax: 7.5 7 Sr) Plumbing: 2 )91 on 3 99 Tax: 3 1- 92 3/ - 9) Electrical: 17 Y s c / 99 gs Tax: N. 2 i PY.9Y Low Voltage: - 7.5 - - 00 75- 00 Tax: 6 . 00 C - 00 SDC: CDC LRP Fee: 4 ( '1 CDC Ping. Rev.: ( /_5 - 7 rx9 1 /.5 - . CX2 Parks: 1 /0)3 00 TIF Res.: 0 q0O,', /9 qa0 .r v7 TIF MT: Erosion Permit: C ci oc, 6 V.O0 Erosion CWS: ,7 0 ein 9, . Erosion COT: Water Quality: — — Water Quantity: _ _ SUB-TOTAL: ')3 oz . 9). c....0 9067, /(, Sewer: Permit: ,-,-)7r)r) r...,-, 'D 7( , cf cr Inspection: SUB-TOTAL: A 7 ? TOTAL MST & SWR: Lz , 0 / 7 , 16 ) 1 1: '767./4, I: \Building\Fonns\ResPlanChedcFees doc 06/29/06 Page 1 s PLUMBING FEES (for special information use checklist) MECHANICAL FEES ( residential ui ment/s ems) Description I Qty. I Fee(ea.) ] Total Descri ption Qty Fee(ea.) [Total • New 1- & 2- family dwellings . Heating/Cooling (Includes 100 ft for each utility eoasestba) ' -6 . • • Air conditioning or heat pump* ) 14.00 / y - SFR (1) bath 249.20 Furnace 100,000 BTU (ducts/vents) 14.00 )t SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts/vents) 17.90 SFR (3) bath / 399.00 ,S J 5 Gas heat pump 14.00 Each additional bath/kitchen • 45.00 Dud work 14.00 Rain Drain, single famil dwelling 65.25 Hydronic hot water system 14.00 Fire sprinkler - sq. ft. 0 to 2,000 115.00 Residential boiler Fire sprinkler - sq. ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00 Fire sprinkler - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric) Fire sprinkler - sq. It 7,200 and greater 309.00 (in wall, in-duct, suspended, etc.) 14.00 t . , Sibe tJtOitges Flue/vent (for any of above) 10.00 Catch basin/area drain 16.60 Repair units 12.15 Drywell/leach line/trench drain 16.60 Other F.d Appliances Footing drain - 1" 100' / 55.00 Water heater ) 10.00 j() Footing drain - each additional 100' 46.40 Gas fireplace / 10.00 ` /1- Manufactured home utilities 110.00 Flue vent (watt heater/gas fireplace) 10.00 Manholes 16.60 Log lighter (�) 10.00 Rain drain connector 16.60 Wood/Pellet stove 10.00 Sanitary sewer - I 100' 1 55.00 Wood fireplaoJnsert 10.00 Chimney/liner/flue/vent 10.00 Sanitary sewer - each additional 100' 46.40 Other 10.00 Storm sewer - I" 100' / 55.00 Esviroaamstal Exhaust & Veati ' Storm sewer - each additional 100' 46.40 Range hood/other kitchen equipment / 10.00 /0 Water service - 1 u 100' / 55.00 Water service - each additional 100' 46.40 Clothes dryer exhaust / 10.00 /0 j - � > Firdrire0, item „ � : t::- Single duct exhaust Absorption valve 16.60 (bathrooms, toilet compartments, Badcflow preventer 27.55 utility rooms) '3 6.80 0t' '.' Backwater valve 16.60 Attic/crawl space fans 10.00 Other: ' Clothes washer / 16.60 _ 10.00 Dishwasher / 16.60 Feel Plying ' ••(SS.40 for first 4, 51.00 each additional) Drinking fountain 16.60 Furnace, etc. - o .. Ejectors/sump 16.60 Gas heat pump • • Expansion tank 16.60 Wall/suspended/unit heater •• Fixture/sewer cap 16.60 Water heater 1 • • Floor drain/floor sink/hub 16.60 Fireplace / •• Garbage disposal I 16.60 Range ' • • Hose bib 1. 16.60 BBQ •• Ice maker I 16.60 Clothes dryer (gas) • • Interceptor /grease trap 16.60 Other: • • Primer 16.60 Total: `/ 5. e/d Roof drain (commercial) 16.60 Meehaaial Permit Fees Sink/basin/lavatory / /G /. 1 16.60 Subtotal: $ `I W Tub/shower/shower pan 16.60 Minimum Permit Fee $72.50 S Urinal 16.60 Plan Review Fee (25% of Permit Fee) $ Water closet 3 16.60 State Surcharge (8% of Permit Fee) S 2 - 0 Water heater / 16.60 TOTAL PERMIT FEE S Other: Other: ELECTRICAL FEES (residential single- or multi-family) Plumbing Permit Fees - - - .. - Subtotal S Description Qty. Fee Total lnsp Minimum Permit Fee $72.50 $ 1,000 s1• ft or less / 145.15 4 Plan Review (25% of Permit Fee) S Ea add'l 500 sq ft or portion / 33.40 l State Surcharge (8% of Permit Fee) S Limited energy, residential / 75.00 2 TOTAL PERMIT FEE $ Each manufactured or modular dwelling, service and/or feeder 90.90 2 EkYtrleal Permit Fees - Subtotal: - S / 7 S"• S Plan review (25% of permit fee) S State surcharge (8% of permit fee) $ / `/ •? TOTAL PERMIT FEE $ I \Bwldmg\Forms\ResPlanCheckFees doc 06/29/06 Page 2