Permit EXPIRED 3 /$ /k9
Buildin Permit A lication FOR OFFICE USE ONLY
City of Tigard , miVEDA Received /�
Da[e/B : I r7 Permit N. ,_I /, • I /oZI
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
°hone: 503.639.4171 Fax: 503.598.1960@@ • (�— + Date/B • Other Pe -•t _ el (
nspection Line: 503.639.4175 I V ! �oo e!' I I Date Ready/By. El See Attached Checklist for
Internet: www.ci.tigard onus CITY OF TIGARD Notified/Method. Supplemental Information
DIALING DIVISION . . _ . . .
. . - - TYPE OF WORK " - - . . .REQUIRED DATA: I -AND .2-FAMILY DWELLING'
IN 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: S Z2� Z4
❑ Accessory building 0 Multi- family Number of bedrooms: Z
❑ Master builder ❑ Other: Number of bathrooms: Z S
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address: 104 04 S A— ( -re?12-A- e- New dwelling area: ILI ) (p square feet
City/State /ZIP: Gae.D 9- 223 Garage/carport area: 27 S square feet
Suit ld /apt. no.rt # Project name: O/.k S - - FcLiN N p Covered porch area: I (p square feet
Cross street/directions to job site: Deck area: et (, square feet
5V4 90 Ave . Other structure area: square feet
IA N sr TYgg ' A I • REQUIRED • DATA:.CO:IDVIERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
I Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: 15 1 3SAAO3 FC > 4- 0390 equipment, materials, labor, overhead, and the profit for the
D ESCRIPTION OF WORK work indicated on this application.
ON157120C -TI 0 NI e'er t -&v IT 3-1 - - . Valuation: S V
— r'i - 162 - UJ((.L 4'(p L4Pt (TS Existing building area: square feet
T�1'[ -
New building area: square feet
' 14 PROPERTY OWNER ❑ .TENANT. Number of stories:
Name: OAK S'theer 'R .)1S{- }ON1s, , LLC_ Type of construction:
Address: 1 2(p7 0 SW (08' -11, Av , S . 4o Occupancy groups:
City/State /ZIP: &A-121), c/ Z23 Existing:
Phone: (5O3) C 59 • 3 Fax: (503) 698 • qO ' I New:
It APPLICANT ❑ CONTACT PERSON • N
Business name: i cold Aitc- -1 -rE gE /Q i\J N I G , 1 t∎IG • All contractors and subcontractors are required to be
Contact name: DA� C.�AQ(C.14k C. M�taq S-�, le.; licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 9 725 54 1 -TO. +-t I USDA-6 f-ttApy, 3r- 31-6.,21Ce jurisdiction in which work is being performed. If the
City/State/ZIP: '2260^/ , OR c7� apply:
appicant is exempt from licensing, the following reasons
Phone: (503) Co4'4 7Cexp I Fax: : (503) (0 .7 (e
E -mail: d f9@ I Gcv1 C rcEt ct .c C,E7VN
l
Business nar • • - ..
Oak Street Townhonies LLC
� � BUILDING PERMIT F E E S* - _ ...
Address: I; 12670 SW 68th Ave Ste 400 Please refer to fee schedule
City/State /Zl Tigard OR 97223
Phone: (6,9 P: 503 -639 -3104 F: 503-598-9081 l Fees due upon application
B lie : I(p CCB: 16952 Amount received
I t
i Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Pnnt name: 'p Lit\{ tv D� C"1 Date: Co .23 .0 C, * Fee methodology set by Tri- County Building Industry
Service Board.
, :\ Bu PermitAppdoe 12/03 4404613T(11/02/COM/WEB)
. ,
Nlechanical Per nut Application :• UWOlitir. .-.."i:';',. ..'•• .. : ..::,
City of Ti!,arci ftcc..ived
111:z.3 I 1 i ) I rlo 6 I P--' -oosaf
13125 SW Hall Blvd., Ti.zard. (.1R 9722::
Plan Review
Phone: 503 63'14171 Fa,: :.'z1 13 iuS 19ot: ..,•,- ,, i .. Inn _, tht,sy. I
, _.
Inspection Line: 503.539 4.175 '-' -• ' ".- ' 4 UU ;4 1 - Cut Read •-'13.y: :, -' ,. 1 inns 0 S CT 1 a g e 2 if I r
'MIL:. v •.• w.zi.tittard.or us Not.: Supplern(nul Information
TYPE OF WORK COMMERCIAL FEE* Sell F.DULF, - ESE CHECkLIST
Mepermit chanical pe fees' are hased on the %-alue of the work
0 New construc:ion
D Addition' alteration/replace:pnt e
performed, Indicate the value Cr ended to the nearest dollar) oral;
0 Dem oi i ti on 0 Other mechanical materials. :I.:Idiom:mt. labor. overhead, and profit
.,_ .: ..... . _. .., . . _ e: I
, - .. .• . ,, , ,. . -_- - s' - CATEGOR1' or CONSTRUCTION '.' -. . -- ' . • . -, , - Valu S
REST1)ENTIAt - E - EtrIP.M.E.NT I SYSTEN
0 1- and 2-family dwellin 0 Commercial/industrial 0 Accessory building
For special itformstion use checklist.
0 Multi-family 0 Master builder 0 Other:
- Descr 1 1 Q.1. Total
:JOB SITE L\TORN1ATION A.ND:LOCATION ". -'... : - -. ,;: li Nitin2/coolin2
I Air conditionine or heat puinp
Job site address: 10404 .514 Ark.,1 1 ...A. A 1 -reggA_cE 1 (..,...,thirs site alan pialternenn I ( 14.00 I -
cityfstmezrP: ..1-16,... (342 9-721:3 Furnace 100.000 BTU titueisivents) I I I 14.00 1 1 -
mace 100.000-t BTU (dactaivents) 37.90 I
Suite/bldg./apt. no,: Project name:C,AK 5-trai- -toiz,v-icivi, .
as neat pump 14.00 I
Cross street/directions to job site: 1 Duct work I 14.00 I
1 Ityclronic hot water system 14.00
I I I
5, 904., iocv. I Residential boiler (radiator or
I
hydmnie) 14.00 1 1
Unit heaters (fuel-type, not electric). I
in-wall, in-duct, suspended. etc. 10.00 I
I noevolii for any of above I I 10.00 I I 0 -
Subdivision: I Lot no.:
I Other 10.00 I
Tax mapiparcel no.: 1515 AA 03800 -i- 15135 AtA 0390( I other fuel appliances
. -•-':.:: 7 - DESCRIPTION- OF,.,NVORh: .., : • ' " - • Water 11 ealCr I 10.00 I 1 0
. -
. . .. .,, .
• .1 Gas fireplace I I 10.00 10 -
C■or 5172 keTR)K1 OC LArl l'r 34 Flue vent for water heater or gas
i fireplace 2- 10.00 20 - 10111 i)0114.- -1(4 bui (15 1Z7TA-L . , Log lighter (gas) I 10.00 - I
I I Wood-Pellet stove 10.00 I I
1 Wood fireplacelinscrt 10.00 I
1 - . . . . , . , _ Chimney/liner/flue/vent 10.00 I
P.RO_PERT1. 7.0W.tiER .; ' _ ... ....•:..'-,. i .-.0 TENANT ..
-- Other I 10.00 I I
Name: c7A s-rese-i- ITAM Ali-1 0 M S.- , 1.4...r--. Environmental exhaust and ventilation
Range hood/other kitchen
Address: i 2,.(570 5W (08' in Ad/, St <ICC) equipment 10.00
City/State/ZIP: 11 G A , OR 912Z3 Clothes dryer exhaust I I 10.00 lo -
Single-duct exhaust (bathmums,
Phone: (5,LS ) 6,".39 . 51 Cx4 I Fax: (Gp,S ) seig .41 OK f toilet compartments. utility moms) 5 6.80 I W. 4 40
. ...'..- -- .14.' MT I. - •-:::- ..0 .ccisrAci' PErtsciN:1-.: .::. 7 :. A uic/craw lspace fans [ 10.00 I
Other I , 10.00
Business name: C.-C A.1244-t t1gC..114AcE /PLAKIKlinla. , I ki C . Fuel piping
Contact name: DANs &ac:IDliZtc.f...1 OR /VO4 ICA S 55.40 for first four: 51.00 for each additional
Furnace. etc. I 5401 5.40
Address: t:31Z5 SW
r - Hiu.sOirtk". 1-ki.tby, ST . & OE- I
Gas heat pump
City/State/ZIP: (2,Stak C71=2, 4 1 - 7005 Walltusperuiedfunit heater I
Phone: ( !)3) (944 ../(44, f I Fax: : ()(4.1( Water hatter Fin I 1S4 I 5.40
rplace I 1.40I 6.4
E-mail: 4419 0 Ccv ( I Range 1 15.401 540
. . . - • : - ,- • -CONTRACTOR : --- r' ,-- -...! '
.. . . ,. . . Barbecue I I
• .. . ,
I I
Clothes dryer (ens) i I
Business . Thermal Flo Inc
- Odter. . .
Addrers: 7236 SW Durham Rd Ste 100 ,:-...,:-.-•::.:-• :IECIfAXICAL PERMIT- FEES* • ' . . ' ;
Portland OR 97224
Ci ty!S:n re . Subtotal I
P: 503-670-8343 F: 503-620-1953 Miniinwn permit fee (S72.50) I
me: (
CCB: 151847 I Plan review (25% of pcnni t fee) I
CCB lie.: i ) State surcharge (81, of permit fee) I
ii TOTAL PERMIT FEE I
This permit application cxpina if a permit is nut obtained % 180
Authorized sin:rare: 1
dao; after it has been a=epted as complete.
Print name: DAN &,--, 1 c3-4 I Date: 0( .2_,..3 cc j ° F...-:, tnethadatou i.74 hy Tri-Couaty Buing Industry Service Board
1. 1.1.1c 11.Z3 .1.11)-4171.111,112;CONINT.B)
Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard Received / f
° �' ' '
Date/By:
/�� ..001,98
13125 SW Hall Blvd., Tigard, OR 97223 3 , : 1 _ 2O1,0 Plan Review E!
Phone: 503.639.4171 Fax: 503.598.1960 �� � 4 � B N U 11 (mil Other Permit No.:
24- Hour Inspection Line: 503 639.4175Jll D ate /B rw,5
Date Ready /By. 0 See Page 2 for
Internet: www.ci.tigard.or us Notified/Method Supplemental Information
- TYPE OF, WORK - - . . FEE* SCHEDULE
lX 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 JAI Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ O ther:
Fire sprinkler (_ sq. ft.) Page 2
. • - JOB SITE •INFORMATION AND LOCATION Site utilities
Job site address: I C &A ( }/4 -t om A{.e. Catch basin or area drain 16.60
City/State /ZIP: --'( G/ j) C oS cil 2-23 Drywcll, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Q afteee - 1•t' N 140,AE_$ Footing drain (no. linear ft.: Page 2
r
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60 g
5w - IOC 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
Fixture or item
Tax map /parcel no.: 15 I 5A<10 C'O d- 1 315A4 - 0390 I Absorption valve 16.60
DESCRIPTION • OF WORK Backflow preventer Page 2
GO!\► �LYLUt:T1ON C) Lull T .34 - Backwater valve 16.60
EV-E- WILL 1 4(Q U h 11 -t-C)-TL . Clothes washer ( 16.60 I Co • (
Dishwasher I 16.60 1(4 (pC
Drinking fountain 16.60
. • Igt . PROPERTY OWNER - . . ❑ TENANT
Ejectors/sump 16.60
Name: OAye... 5'1 - r - LAJ NN OM ES , L-LC Expansion tank 16.60
Address: I 2_(p1 D SW (perti4 (per Arlie , 5 LA. rrE 4UD Fixture/sewer cap 16.60
City/State/ZIP: -11 GI 1ZD , pt'. C O 1.2-3 Floordrain/tloorsink/hub 16.60
Phone: (5p3) ( , 3 4 Fax: ( 5:)3) 5Iy .9 C)g I Garbage disposal 1 16.60 ((o. (p 0
Hose bib 2 16.60 33. Zt
14 APPLICANT ❑ CONTACT PERSON
' Ice maker 16.60
Business name: I G01\1 C F-{ (-(- R L.e E. / PIA N i) I)J G 1 04c C . Interceptor /grease trap 16.60
Contact name: OA4 6e;typF2 t 04 b (t MOM ICA S17 - 11Ge . Medical gas (value: $ ) Page 2
Address: 912.5 SW (' Aveg-rpJ 4.4tus D Hoy , a p Primer 16.60
City/State /ZIP: i ...AveY�TaN t (Az. g7OD5 Roof drain (commercial) 16.60
Phone: (503) (0414 .7(v(OI Fax: : ( ) (044 1(.4.9 u /shows ...i 16.60 33. 2.6
Tub /shower /sbowerpan 2 16.60 �
E -mail: c 1 @ - I co n a (c i1 r +e C.. +- c.c 1,) Urinal 16.60
CONTRACTOR " ' Water closet d4 f , 50
2.5 1 6.60
Business The Mullen Company Water heater I 16.60 10. (op
Address: 1601 SE River Rd Other.
City/Stat. Hillsboro OR 97123 Subtotal
P: 503- 640 -0113 Minimum permit fee: $72.50
Phone: ( Residential bacldlow minimum permit fee: 536.25
CCB: 92689 PLM: 34 -260PB Plan review (25% of permit fee)
CCB Lie.. o -
I
State surcharge (8% of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: 17AN G pp'pt2(C1-1 Date: C Z3 ,p(,,, 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 \Budding\Pumas\PLM- PermitApp doe 06/05 440- 4616T(1O/OJCOM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard I r • I� i Received �"_ Q
b �)r'i� t lOI DateBv: ,�,, , ,_ . ,� Permit1 f'700� °pc:2AO
13125 SW Hall Blvd , Tigard, OR 97223 t r
Phone: 503.639.4171 Fax. 503.598.1960 � ' i � * Date/Bevtew Other Permit -
Inspection Line: 503.639.4175 ^ c"• I' Date Ready /By inns 0 See Page 2 for
Internet: www.ci.tigard.or.us - . _ Notified/Method: Supplemental Information
- - . TYPE OF - WORK ' - -- __ • PLAN REVIEW . . _ _
E New construction ❑ Addition/alteration/replacement Please check all that apply.
❑ Demolition ❑ Other:
❑ Service over 225 amps, comm'l ❑Hazardous location
❑ Service over 320 amps - rating EKBuildn 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 0 System over 600 volts nominal units in one structure
( Multi family ❑ Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION . . 0 Egress/lighting plan RV park
•
Job no.: Job site address: 10 404 StAl A(G Lell-/4 lelel'eACE" ❑Health -care facility ❑Other.
Submit 2 sets of plans with any of the above.
City/ State/ZIP: -1-16,#.02D, o►2 9 The above are not applicable to temporary construction service.
FEE* SCHEDULE .
Suite/bldg. /apt. no.: Project name: OA, 5l1Z E r' PASilif- 'IO►Jtlifg Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
0 Includes attached garage.
SW ��
1,000 sq. ft. or less I 145.15 145.I 4
Subdivision: Lot no.: Ea. add'1500 sq. ft. or portion _ 33.40 1
Tax map /parcel no.: 1513 SA 4- I S 135��e290 Limited energy, residential l 75.00 "75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
C47/.6172 LX-T7CM OF W'( 1T dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
Vr ITS --DT-At.. 200 amps or less 1 80.30 80.30 2
PROPERTY OWNER ❑ TENANT • 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: OA'K S?P2> r Td (A) r, H 0M C - S , (,LC_- 601 amps to 1,000 amps 240.60 2
.ddress: 12_(p10 51,A1 C ivl: t S , 400 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: --( 6flaD , OR 91223 Temporary services or feeders installation, alteration, and/or
(5 ) ( 039 • 31 o (� 3) $ , 908 ( relocation
Phone: Fax: 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
APPLICANT . ❑ CONTACT PERSON A. Fee for branch circuits with
• service or feeder fee, each 6.65 ( ( 2
Business name: I Go r - A AW - it -tKE / PIA NINI (AG (NC . branch circuit
B. Fee for branch circuits
Contact name:
M c4N I CG4• 5 L'E1 O K . LAN 60z ;.-D Q1 C.1 without service or feeder fee, 46.85 2
Address: C 1 2 5 SW 1 / 1t i H ILLSiJkt -t✓ , i14[ 3 , .3tE 210E Each add'1 branch circuit 6.65 2
City/State/ZIP: &r , e5 9 Miscellaneous (service or feeder not included)
Phone: (rij3) ( e 4 ,`1(p(0 ( F ax: : (03) (044 • (dog
Pump or irrigation circle 53.40 2
I Sign or outline lighting 53.40 2
E - mail: c11 i) j c a. rcJ.-j t-f- ct 7vt�) Signal circuit(s) or limited-
1 CONTRACTOR .. energy panel, alteration, or
extension. Describe: Page 2 2
Business: 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 Investigation per hour (1 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: rla, Go Dizl M ' Date: Co, 23.0(0 • Fee methodology set by Tri -County Building Industry Service Board
0 * Number of inspections per permit allowed.
i \BuildinglPerrints \JELC.PermitApp doe 12103 440.4615T(tO /02/COM/pEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
. iESiDENTi .L CORK ONLY: - = T { =-
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
Garage Door Opener*
g Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COIb MERCIALWORK "ON'I;Y: :. ` . • .
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
❑ 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
IABuildingTermiLs\ELGPermiWpp.doc 04/03
Plumbing Permit Application - City of Tigard '
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
_
Site Utilities _ _ Q �, ,_ _ - e ( . Foot ;Permit Fee:..
,; = �- �-_::... - - - - -- - _ - - --
: ,�Fe -Total �SgUare a:
Footing drain - 1 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46 40 2,001 to 3,600 S160.00
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
Storm & Rain Drain - 1st 100' 55.00 Permit if ee. >= ='' __ ; " '
$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
Q ' tZ Fcc,(cij), ' 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 Bacldlow 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
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or
specially requested inspections - per hour 72.50 and including f 0.00.
first st
Subtotal: $50,001.00 and up $742.00 for the a fa $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: ... Plan Review_ 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.
'Quantity by (Fixture):Woik Peifoiimed• I ❑ Any new commercial building.
Fixture Type: ;Replace, ❑ Any new exterior plumbing site utilities.
- • - • • - Capped . Added ".Eiisting ❑ 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"
Car Wash Drain . - IsO]Yieir1C .Or Riser Dlagt'atn
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice MachiRefrig. 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
Water Extractor
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued as
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
t•\Buildieg\Pe mits\PLM- PermiLApp dot 07/06/05
2 ' Building Division
One & Two - Family Dwelling
TIGARD Fees Checklist
- 04.
PERMI'T INFItMATION: " , .. . . _ r
Permit - ##: - O
- - - - - • • - ,`, . ,, ._ :�._'- � � ",Y�.�.. = `�,;_l
l`I 5 — r2(, � — OD 2 9 le Plan # : . r, - . S r -- A I Date ... _' (, CMG
Site Address: fagot/ 6,,) A ICS 2 A a) T A 22 . Parcel #: I ) -
Subdivision: NI K S1 E 'Tu..... N Hum k S Lot #: 3y Zoning: - , A
Jurisdiction: G . Setbacks: Front Rear: Left Right
Class of Work Ai; k A, Stories: 3 First Floor. 2 q y 1
Type of Use: 5 F A Height 35 Second Floor: 5 tb
Construction: S t o Floor Load .S Third Floor: SS 1y,
Occupancy Group: R-2, Dwelling Units: / ' ' Bonus Room: / r
Valuation: /31$ i 6 fq . 07) Bedrooms: 2 Total Floors: 1 / J�
Bathrooms: 3 Basement J �
Decks: - 9 6 4, Garage: as J d
Porches: D 0 ry Other.
- DescnP031 . Fee oust_ _ :Am P .- 1 " ance Pile:-.:2; :
Plan Check:
_.r.:�..��,�_�;._ y�', Dual aid: ..
TEES: � _ - __. ._. :
Building: St�.2 4 /a - 29/ 33 - 2s rr I ' / /. 33
Extra Set:
Permit: Building: $4G • cl n 2r54 • 1 /a
•
Tax: 7/, , - 7 / - 7/. 7/
Metro CET: 144: !b(, 39
MechanicaL q 3 9 q 3 R
Tax: 7 S-v 2. f �
Plumbing: 3q 7 vV 319 vr)
Tax: 3 , . 9a 3I . q
Electrical: c 9 c an I . s-
Tax: /6. 9/. 16 , qn
Low Voltage: 75700 re)
Tax: 4 . or.) 6. ( ,)
SDC: CDC LRP Fee: 6 .00 6 . (R)
CDC Ping. Rev.: I!5 op c1. -cr)
•
Parks: LI ` , ? co i /0a r:o
TIF Res.: 27o c.- .Pc," .,,
TIF MT: a o , c , o ^D.. e..t)
Erosion Permit: 6 L! 0, ,01 06
Erosion CWS: fi 7o a(,. g0
Erosion COT: c ? a 0 $O
Water Quality: -
Water Quantity: — —
SUB-TOTAL: 5 if 6-7. S 6 P500 •r r) 9 7/7. SC,
Sewer: Permit: ?nn vr, ,) 700
Inspection: 3c o 0 ' -- c,,,
SUB - TOTAL: a 735.00 n• 5 r 0
TOTAL MST & SWR t) / 2 5-C 0 c,Cd //, 5Se? 5--
I \Bwlding\Forms\RcsPlanCheckFees doc 0629/06 Page
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential uipment/systems)
Description Qty. I Fee(ea.) 1 Total Description I Qty I Fee(ea.) I Total
New 1- & 2- family dwaelinp • . , ' . Heating/Cooling
(Includes 100 R . f o r each utility connection) . • • Air conditioning or heat pump* C ` 14.00 / N
SFR (1) bath 249.20 Furnace 100,000 BTU (ducts/vents) 1 14.00 /
SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts/vents) 17.90
SFR (3) bath 1 399.00 391.c�v Gas heat pump 14.00
Each additional bath/kitchen • 45.00 Duct 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. ft. 7,200 and greater 309.00 (in wall, in-duct, suspended, etc.) 14.00
-•,.-. • . :Site s -- ' • 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 Otter Feel fiances
Footing drain - I ° 100' 1 55.00 Water heater ! 10.00 /0
firep
Footing drain - each additional 100' 46.40 Gases i 10.00 t -
Manufactured home utilities 110.00 Flue vent (water heats /gas fireplace) 10.00
Manholes 16.60 Log lighter (gas) 10.00
Rain drain connector 16.60
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Sanitary sewer - I 100' / 55.00 Chimney/liner /flue/vent 10.00
Sanitary sewer - each additional 100' 46.40
Other: 1 0.00
Storm sewer - I" 100' 1 55.00
additional ditional 100' 46.40 Environmental Exhaust Ventilation
-
Storm sewer - each 1
Water service - c 100' Range hood /oiler Idtdten equipment / 10.00 iu -- 55.00
Water service - each additional 100' 46.40 Clothes dryer exhaust / 10.00 / U
Fiklaae or Item .. , - Single duct exhaust
Absorption valve 16.60 (batluooms, toilet compartments,
Backflow preventer 27.55 utility rooms) '5 6.80 ,70 . (--/
Backwater valve 16.60 Attic/crawl space fans 10.00
Clothes washer 16.60 Other 10.00
Dishwasher / 16.60 Fuel Piphm
Drinking fountain 16.60 "(S5.40 for fast 4, 51.00 each additional)
Furnace, etc. / • •
Ejectors/sump 16.60 Gras heat pump • •
Expansion tank 16.60 WalUsuspended/unit heater ••
Fixture/sewer cap 16.60 Water heater I • •
Floor drain/floor sink/hub 16.60 Fireplace / ••
Garbage disposal 16.60 Range • ge l •
Hose bib '� 16.60 BBQ • ••
Ice maker / 16.60 Clothes dryer (gas) • •
Interceptor /grease trap 16.60 Other: • •
Primer 16.60 Total: t-/ .)^• r /O
Roof drain (commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory ? / 0/3
11 16.60 Subtotal: $ 6 13 $p
Tub/shower/shower pan a 16.60 Minimum Permit Fee $72.50 $
Urinal 16.60 Plan Review Fee (25% of Permit Fee) S
Water closet 3 16.60 State Surcharge (8% of Permit Fee) $ 7 S 0
Water heater I 16.60
TOTAL PERMIT FEE $
Other:
Other:
Plumbing Permit Fees ELECTRICAL FEES (residential single- or multi-family)
Subtotal $ 39 1 co . Description Qty. Fee Total Insp
Minimum Permit Fee $72.50 $ 1,000 sq. ft or less I 145.15 4
Plan Review (25% of Permit Fee) $
add'1 500 sq. ft or portion a 33.40 i
State Surcharge (8% of Permit Fee) $ 31. y Limited energy, residential 1 75.00 2
TOTAL PERMIT FEE $ Each manufactured or modular
dwelling, service and/or feeder 90.90 _ 2
Electrical Permit Fees
Subtotal: - $ a /I 9 S
Plan review (25% of permit fee) $
State surcharge (8% of permit fee) $ 10 5 6
TOTAL PERMIT FEE - $
I.\ Building\Forms\ResPlanCheckFees doc 06/79/06 Page 2