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Permit EXPO RED 3/s /o eV - Building Permit Application FOR OFFICE USE ONLY City of Tigard R eceived i � Permit it ,c r a te , c 13125 SW Hall Blvd., Tigard, OR 9722 r Date/B : I 1 � 6 T 6 Plan Review Other Permit• a e i ,,, ��� n ' , hone: 503 639.4171 Fax: 503.598.1 I DateBv: /` inspection Line: 503 639.4175 e• Date Ready/By. NI RI See Attached Checklist for Internet: www.ci.tigard.orus ++ WOV i ` 2006 Noufied/Method Supplemental Information TV.Pii UY • K�' - : , ... REQUIRED DATA: 1- 'AND.2-FAMILY DWELLING jpL - aill_� DIVIST Permit fees* are based on the value of the work erformed. New construction emolition P Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replaccment ❑ Other: equipment, materials, labor, overhead, and the profit for the - - ' CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling ❑ Commercial /industrial Valuation: S tap 1)9 El Accessory building xl Multi- family Number of bedrooms: Z ❑ Master builder ❑Other. Number of bathrooms: 0..,S JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: [0.4 1 a SW Ar ,( ,/4(2/ - � .1Q,�E New dwelling area: 22$ square feet J City/State /ZIP: -ft (,,,,,(Z 91223 Garage /carport area: 2.64 square feet Suit ldg. apt. no.: 4 Project name: OAk Si - N 0 ,Acs Covered porch area: i , square feet Cross eet/directions to job site: Deck area: elk, square feet 5W cl d " Ave . Other structure area: square feet Vw.T r -Nee ' J' I REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: 1 1 35AA03 $C 0 d- 03901 equipment, materials, labor, overhead, and the profit for the - . DESCRIPTION OF WORK work indicated on this application. VN 1 r eocrt 0 ).J C (Ail IT 3(I - - Valuation: S r -I012c- U..)((,(_ (. 4(p l.lh (TS Existing building area: square feet - 'TD'j'79'1_ - New building area: square feet .14 PROPERTY OWNER ❑ TENANT Number of stories: Name: OAK STLi fir -1 ,11,3 i -JODMes , I ! c. Type of construction: Address: [ (p7 SW (08'-I'1t A'V , 516. 4oc Occupancy groups: City/State /ZIP: GAia..t. , cik cr 22` Existing: Phone: ( 503) 0.039 • 3104 Fax: (503) 99 •90$ I New: APPLICANT . ❑ CONTACT PERSON NOTICE Business name: ( co NI A.4c#41 I IQ G , ( N. All contractors and subcontractors are required to be Contact name: DA Gar, ),Q p� MAmtCA S-R2IK licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: q 725 S i) 'P. kve(2- --ti LLS11 AL.E Hwy, 5`is,2(ce- jurisdiction in which work is being performed. If the City/State/ZIP: 'J�jE l pNJ o(z �� applicant is exempt from licensing, the following reasons / apply: Phone: (503) Coo 1(o(o I Fax: : (503) (Oc14 .1(4(v E -mail: d 190 I Gp1 4rcEt i , G©yVb - = ,.- CONTRACTOR , -. • • • . • Business m - • _ , . .. _ Oc11C Street TOWf1IlOI11eS LLC - BUILDING PERMIT FEES*. - - , Address: I 12670 SW 68th Ave Ste 400 Please refer to fee schedule. City/State/: Tigard OR 97223 Phone: (6e P: 503 -639 -3104 F: 503 -598 -9081 Fees due upon application CCB: 169524 - Amount received 1 _B lie.: I4., I .i' I , 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. Print name: © LAN( C. I DZ .. tC&-.k Date: (_ .23 .0 ;, * Fee methodology set by Tri-County Building Industry Service Board. r \ Building \Pe- mits\BUP- PermnApp doc 12/03 440- 4613T(11 /02/COM/VEB) E - Mechanical Permit Application FOROFFICEUSEONLY. City of Ti! R....h.cd 1.1125 SW Hall Blvd.. Tvzard. c)i; ' l y:n• Review ieN Plea... ? {! =.63 4 l'a :: 1 ii:. ;, u: ) I?tj ji : 1 t Date B:.- 1 1.'°i;'- -) () :url'c:;t.+; lnspectiun Line: 503.639 41 75 •t 2. ' � }lr , D.: :: wdo Readj.t4 0 t L'e. Las I El See Va:•r2 for ';:ritut. u W;t•.cI ti_ard.ot'.US. Notified tits :;,o:i: / Supplemental Information TYPE OF 110)1:1: - COMMERCIAL FEE* SCFJEDULE - ESE CHECKLIST �- M.fccfutnieal onit fees' are based on the value of the work: ; tiNew co,utr;:.:ii,n ❑ .�dditian aiI.. atirtt?r. placement t per armed. Indicate the vaIlle (rounded to the n.arst dollar) oral; i ❑ Demolition 0 Other. mechanical materials. equipment. labor. overhead. and profit I Value: S I '•" ' -• - ` : C "EGORY Or CO\STIU CT O1 - . 7'. ' • ❑ 1 - and 2-family dwelling ❑ Commercial/industrial U J s building i - - :RESIDENTIAL EQt7.PMENT, 55 STEMS FEES *, :1ce s on' j Far special Worrrra :inn tae: checklist. Multi-family I Master builder 0 Other. Description I Qty. I Ea. I Total ,`:;- `JOB .SITE, L \FOR'110-tT1O .A. \D si.00.1TJO..■i; llcrtin_tcoolin Job site address: Z. 51,4 A-14..1 L_ kA 't0 I Air conditioning or ytcat pump I 1 j r �4 (n iquitcs site Alan shown:;• plat: itineint s i ] 4.00 I City /Stale/ZIP: -1•- 1GA;,Q�1 c,x ct�Z2,� I Furnace 100.000 EiTUuyu:rti:t•cxs) 1 I 14.00 I ^ - I �j iintac e 100.000+ .BTU (ttae ::'vents; I I 17.90 Suite 'bldg. ?apt. no.: I Project reamer( ST r---1" "IDIA -}t` I teas heat pump I I 14.00 I Cross stteetrdi :•ections to job site: I Duct work: I I 14.00 I I I Hydronic hot water system I 1 14.00 I I � 1 1 5 4 1O* 5 Av ' Residential toiler (radiator or I hvdrunic) I I 14.00 I Unit heaters (fuel -type, not electric), in -wall. in- duct, suspended. etc. I I 10.00 Subdivision I Lot no : I Flue'vetit for any of above I ( I 10.00 I I D - I Other. I_ I 10.00 I Tax map /parcel no.: 151 5 03300 15135 AA 0390( I Other fuel appliances DESCRIPTIO�N'Of ):Vo ,!)' Water hewer 1 I 1 10.00 )0 - • 1 : : Gas fireplace • I 1 10.00 10 - C- IS 51'Q k�°"- o '- -' IT 3)o Flue vent fur water heater or g-as y �1 G W11.t._ -1Ce untrS r;-L . ( I Lt ul I 2- 1 10.00 2c� ) Lou lighter (gas) I I 10.00 I 1 I I Wood :pellet stove I 1 10.00 Wood fireplacciinscrt I I 10.00 Chimnev/liner/ilue /vent -. ] �.., .. 10.00 t I . . ' 0,.PRpTP_EI.T".'OA:' CR ... - . ....0 TE -.•T . - - -._ .... I 1 I _`.. Other 1 1 10.00 1 1 I Name: C ' Al< S .Cel -1- 0 Ai AI' G N Lr Lt-r-. I Environmental exhaust and ventilation I 1 ���� + Ranee hood /other kitchen j Address: 3 (r>� hf�t -v r sr . % cy:rtnm 7tt I 10.00 Citv!State/ZIP: 7'"I &A-12.13, Oq 9-727.3 Clothes dryer exhaust I ( 1 10.00 I 10 - _ _ Sin'lc -duct eshaust (bathrooms, Phone: ( ) (., • 0 I Fax: 05).1) 598 •90sg'1 toilet compartments. utility moms) I 5 I 6.50 1 2&. 4D • 1�: C I A tticieraa•Is fans ., .7E3... :�I'P1,fC�`'r - I' _ ;: t r:: - :• •. ,...� .1�.'C'O�'7'ALT PERSON `� : -� _ =c •� : psca I I 10.00 1 I Other. I 1 10.00 I Business name: 'iC..0>J -114 tT s /PLA kAhl kid , I)S C . 1 Fuel pipin_ I Contact name: D: t N c i NZ{C4 -1 OR MOM 1 cq S- 1 12...l l~ ett2 I 55.40 for first four: 51.00 for each additional I I Address: q- SLV i V' - H 1LL /rt . R LMf! STS . 2f OE Gas Furnace, ptc. I I (5<1D1 5.�1 D1 i Gas heat pump 1 I I City /State/ZIP: C ;Vi ?p/\N f aR cI _70oa5 I 1'allisuspertlml/unitheater I 1 / etne I I n 5 Phone: (.�3) C� •�It�l (Fax:: ( 7 �)(�e� :7CGCo� Water h IS•9 .90 E -mail: cl 1,3 01 C GLrC�t . C O Vt Range 1 5 . 0 540 J • . - Barbecue I Clothes dryer (ens) 1 I I Business n: Thermal Flo Inc I Offer 1 I Address: 72 36 SW Durham Rd Ste 100 I :,'.'' ._;',: :7.litd NI AL rhks1[T.F1iES°....: r city;S:-te'e Portland OR 97224 •= Subtotal P: 503 -670 -8343 F: 503 -620 -1953 1 Minimum permit fee (572.50) I tree: CCB: 151847 I Plan review (25%ofpem :it fee) I I CC/3 lie.: I I l State surcharge (1"!i, ofpemtit fee) I ' J l TOTAL PERMIT FEE Authorized 51o^.atUCe: 1 �/ This permit application expires if a permit is nut obtained within 181) -- days after it has been accepted as complete. I Print name: ' a-N 1 ~ j)l? 1C3-4 3-4 I Date: Q(,.., . . 1 • y methodology cc: by - 1 ri -Co -1 • ur Building taJttaL'y Scrvtce Iicard i•:3I.i4i rnia`MEC- PrciA;, d e c J 2..3 ; 10-46 I IT( 11102/CO1711TII) r f , tJ . Plumbing Permit Application FOR OFFICE USE ONLY City of Tigard NOV 1 '; I •I Received Permit N 7/0? Date /By: J (/[i(! P ni,/_ .e0g� 13125 SW Hall Blvd., Tigard, OR 97223 1 " Phone: 503.639.4171 Fax: 503.598.1960 Plan Review > • t P- 1I1 Plan E, • . I OlherPermuNo. • 24- Hour Inspection Line: 503.639 4175 - -- eJ ( J u ^s Date Ready/By. 8 See Page 2 for Internet: www.ci.tigard.or.us • - - Noufied/Method. Supplemental Information . - - TYPE OF WORK - - - FEE *. SCHEDULE - • rX New construction ❑ Demolition For special information use checklist Descnption I Qty. I Ea I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connectior . ' CATEGORY Of CONSTRUCTION ONSTRUCTION - - . SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler (__ sq. ft) Page 2 JOB SITE INFORMATION AND LOCATION _ . - - Site utilities Job site address: (04 ( 2. 3, v.4 ( /J le1242,13r0E Catch basin or area drain 16.60 City/State/ZIP: --1-16/02D, Q is 9-7 Z23 Drywcll, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Q apteer1z N 1 -100E$ Footing drain (no. linear ft.: ) Page 2 4' ( Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 5 I C ' Ave. Rain drain connector 16.60 Sanitary sewer (no. linear ft.: Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: 15I 5AA( O31r00 d- I5I35A4-O390I Fixture oritem Absorption valve 16.60 DESCRIPTION OF WORK Bacldlow preventer Page 2 - GOIS C►'LUGT+oIJ cii lAKI T 3(0 Backwater valve 16.60 £ WIL 4 LP U ll 1'15 - L . Clothes washer I 16.60 I Co , ( Dishwasher I 16.60 /(p ( Drinking fountain 16.60 Igl PROPERTY OWNER ❑ TENANT - Ejectors/sump 16.60 Name: (>A1� 5112...1 ToW IJF-I OMES , LL-C_, Expansion tank 16.60 Address: 1 2.(01 D SW (Peet" A I r 5 t,t. t i 400 Fixture/sewer cap 16.60 City/ State/ZIP: -1 & / 1 -2D , 012 9'77-23 Floor drain /floor sink/hub 16.60 Garbage disposal 1 16.60 ((p. (p Q Phone: (503) (039.310 `I Fax: (� 59y .9 og I Hose bib 2.. 16.60 33. ZO Iii APPLICANT ❑ CONTACT PERSON Ice maker 16.60 Business name: I C01J ,6 Cf j-( USE / Pew N i 00,1G 1 (MJC . Interceptor /grease trap 16.60 Contact name: DA.nl ( t c) e ).ADM ICA Mile -e Z- Medical gas (value: $ ) Page 2 Address: 917.5 SW (31%Av tt2TClU f-1 tL S'D& +lu)y , s E.24 tz Primer 16.60 City/State /ZIP: I Roof drain (commercial) 16.60 D �ttvfY�T�N i DR. 9 Phone: ( 5 0 3 ) e.09 1(0(01 Fax: : ( ) (0{4 GI u b / s o / 16.60 .40 T /sho /shower pan 2.. 16.60 333.20 E -mail: d + @' co yl ar ;-I- 2G-+-.coyyl Urinal 16.60 J CONTRACTOR - , • . Water closet 2, 5 16.60 •/ . 50 Busir The Mullen Company Water heater ( 16.60 /O. Addr 1601 SE River Rd Other. _ Cit Hillsboro OR 97123 Subtotal P: 503-640-0113 Minimum permit fee: 572.50 Phone Residential back-flow minimum permit fee: 536.25 _ CCB CCB: 92689 PLM: 34 -260PB Plan review (25 %ofpennit fee) State surcharge (8% of permit fee) Authorized signature: 0 / TOTAL PERMIT FEE Print name: 'l7AN G 0ODaICI -1 Date: C7, Z3 .o(, 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. is' Building \Permus\PLM- PermiiApp.doc 06/05 440- 46I6T(t0 /02/COMfWEB) Electrical Permit Application FOR OFFICE USE ONLY City of Tigard 1, • - t 20 Received V]� 3 9 I t Date/Br Petnnit No !s Aen k � � 3 r 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review r' ....i Phone: 503.639.4171 Fax: 503 598 1960 I Date/By: t� c" I ` 7 f Other Permit: Inspection Line: 503.639.4175 e'/ Date Ready /By: Juns Iit See Page 2 for *ntemet: www.ci.tigard.or.us Notified/Method Supplemental Information TYPE OF WORK • - PLAN REVIEW - . El New construction ❑ Addition /alteration/replacement Please check all that apply: ❑ Demolition ❑Other: E Service over 225 amps, comm'l ❑ Hazardous location ['Service over 320 amps - rating I$IBuildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure El Multi- family ❑Master builder ❑Other: ❑ Building over three stories ❑ Feeders, 400 amps or more . ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION . 0 Egress/lighting plan RV park Job no.: Job site address: (0412 SW AK(1..6Pt1J'(2✓ IZAte ❑ Health -care facility ❑Other. Submit 2 sets of plans with any of the above. City/ State/ZIP: -f-I(, A - ), tin 9 The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg. /apt. no.: Project name: QA STYLE: iI 'r0(,t*1 - 1 QUA Description I Qty. I Fee. Total I •• Cross street/directions to job site: New residential single- or multi - family dwelling unit. SW Includes attached garage. (7 �� 1,000 sq. ft. or less I I 145.15 1..45.1 c5 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: 15135 .kAk-o38cO - 1 5 135A- AcYa9O ( Limited energy, residential ( 75.00 ']�j, 00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90.90 2 et:21.16172 d- 1CT101■1 OF K 3(p r _ Services or feeders installation, alteration, and/or relocation -4(p Um ITS - T b l .. 200 amps or less I 80.30 ga,30 2 Rt. PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: Qlk1L S1 k1 H pM es , L,LC.- 601 amps to 1,000 amps 240.60 2 ,ddress: I2_4p1 O 5W (4 A vG , STe • 400 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: —11 6nal) , QQ 912-23 Temporary services or feeders installation, alteration, and /or Phone: (503 ) (039. 310.4 Fax: ( 5j9$. 9c ( 200amion 200 amps or less 66.85 I 1 Owner installation: This installation is being made on property that 1 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 . - rst APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 ( ( 2 Business name: IC e, A_ 1 +L1Uft- / PLA �NI 1M , (NC . branch circuit B. Fee for branch circuits Contact name: /4101 I C4 rr 1C-(I V/_ t't( DAN 6 el C1-( without service or feeder fee, 46.85 2 Address: t j-2 S first branch circuit �l��ON FA 1l.LSl�1 - 1: +tl.Jy . �•21OG Each add'1 branch circuit 6.65 2 City/ State/ZIP: l 4vt�2 t,.j , 91:;05 Miscellaneous (service or feeder not included) ( 3) C � 1 (O3) � (o!A Q o Pump or lighting 53.40 2 Phone: '1 Fax:: I Sign or outline e lightghting ng 53.40 2 E -mail: dl Th c ala.rde t-f ct .0 Cryl Signal circuit(s) or limited- , 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 . - . PERMIT ELECTRICAL PERT FEES* -- CCB Lie.: I Electrical Lie.: I Suprv. Lie.: Subtotal •tprv. Electrician signature, re uircd: 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: - 0 A G Diz1 !� Date: (j. Z� . p� y • Fee methodology set by Tri -County Building Indus Service Board 1 "• Number of inspections per pennit allowed. t \ ButldmgU'emtts\ELC- PemttApp.doc 1 2 2/03 440- 46I5T(10 /02 /COMM'EB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LINIITED ENERGY PERMIT FEES: ,RESIDENTIAL WORK ONI;Yi . Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm [yr Garage Door Opener* 14 Heating, Ventilation and Air Conditioning System* • ❑ Vacuum Systems* ❑ Other: l COMl�'IER -CIAL i) tE• ONLY: - - -- — 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 is 18w1dmgTPemics \ELC- PermitApp.doc 04/03 • Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities=__ ; - - =_ _ - - Foo g = = - Fee. -_ _ . , - Qt ,. :Tee (ea) Tota] .S Clll - are a �e`. • Perini t Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7.200 $220.00 Sewer- 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46 40 Valuation 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 •- -- .- � - - - - Total additional $100.00 or faction thereof, to and • == "' , - Fee(ea) . ,..._ Qty. � _ including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to g p tun g and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $120 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: - Plan Review - for Comdex Structures - Are you capping, adding or replacing futures? 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 (Fix€urerWork'Performed ❑ Any new commercial building. Fixture Type - Replace. ❑ 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 54 Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any NFPA 13 -D multipurpose are sprinkler system. Eye Wash Floor Drain/sink 2" Submit 2 sets of plans with any of the above. - 3" Car Wash Drain . Isometric;or Riser Diagr-am - ;; _ • . 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 r Water Extractor Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued ai. Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. i 1 Bwldiag\Pamits\PLM- PermitApp.doc 07/06/05 1 111 B uilding Division One & Two-Family Dwelling F1GARD Fees Checklist Permit #: frl ST)./70 6 - 00 ti Plan #: (A k - Date: 12-. 0 C, Site Address: /0/4/1 .5...) A k xi.. o Ani 1" . Parcel #: Subdivision: OA fc' S7 k_ -7 004./A)H-Clio k S Lot #: 3t Zoning: / I I 1 „ v , _ 1 Jurisdiction: 7 Setbacks: Front Rear: Left Right Class of Work /047 t--0 Stories: 3 First Floor: . //e4 7) Type of Use: S r . Height 7A 4 Second Floor 3 Construction: S Ai Floor Load: 50 9 5 c Third Floor Occupancy Group: R 3 Dwelling Units: / Bonus Room: Valuation: /,) i oi 0 6 Bedrooms: .;. Total Floors: la91$7 • Bathrooms: 3 Basement Decks : cr ( 1 Garage: p Porches: 0 r-f Other: :. 117rg:Faie - ',Aiw Imt'Priar Plan Check Building: 5 '-•-)C9 7 ( d50 . on 1 /. • Extra Set Permit: Building 9'30. /0 5( 30. /0 Tax: Cc . qi 6-(4.11/ Metro CET: /e/s .7 / 1 ( 15721 Mechanical: ° 1 3 SSD 93 2r0 Tar 7. _S 7. 5r7 Plumbing 2 )91 Or) '3 9 9 Cx") Tax 1 I- 9 2 3/ - p Electrical: 175r. .s I 241. 5 Tax: Low Voltage: "7.5 00 75: Gr9 Tax: 6 - 00 6' • oc9 SDC: CDC LRP Fee: 4 .( .' ) CDC Ping. Rev.: Parks: TIF Res.: .';`, ce620,,-) A loo /Pi TIF MT: d,.)(') r r Erosion Permit 6 q r.x • 6 Von Erosion CWS: a% (7 'ir-) 9 e, .c(') Erosion COT: :0 Water Quality: — — Water Quantity: ___ — SUB-TOTAL 9 30 . o g DSO- c-o 906 7, /( Sewer: Permit: ,) 7r,r) r.r, ') 7r, r• ^1'7 Inspection: SUB-TOTAL ? 7 ?) , 5 . c -, ,:' 7 7:2" ev TOTAL MST & SWR: I: \Building\Forms\RcsPlanCheckFoes doc 06/29/06 Page 1 PLUMBING FEES (for special information use checklist) MECHANICAL FEES ( residentialequipment/systems) r Description I Qty. I Fee(ea.) I Total Description I Qty I Fee(ea.) Total _ New 1 -& 2- family daeIl1.p,',. ); „ Hentln /coons des 100 ft. for • .h" 1 ";' - '' , '. • • (I■d■ � ■tWt�r eo ■■eeiloi) • • ^ . . Air conditioning or heat pump* j 14.00 1 V' SFR (1) bath 249.20 Furnace 100,000 BTU (ducts/vents) 14.00 It,) SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts/vents) 17.90 SFR (3) bath / 399.00 J95 Gas heat pump I 14.00 I Each additional bathhitdhat • 45.00 Duct work 14.00 Rain Drain, single famil dwelling 65.25 Hydrortic hot water system 14.00 Fire sprinkler - sq. ft. 0 to 2,000 11 5.00 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 beaters (fuel, not electric) Fire sprinkler - sq. (1 7,200 and greater 309.00 (in wall, in -duct, suspended, etc.) 14.00 _ _ . ° r:�?s :N it,: t�■Sibe •-• r- • Flue/vent (for any of above) 10.00 Catch basin/area drain 16.60 Repair units 12.15 _ Drywell/leadt line/trench drain 16.60 ' ' '- . • - Other Fad Appliances . • - Footing drain - 1 100' / 55.00 Water Theater 1 10.00 i /) Gas Footing drain - each additional 100' 46.40 beater/gas fireplace) / 10.00 /ll-- Flue vent (water Manufactured home utilities 110.00 Manholes 16.60 Log lighter (gas) 10.00 Rain drain connector 16.60 Wood/Pellet stove 10.00 Wood fireplacermsert 10.00 Sanitary sewer- 1 100' I 55.00 Chimneyftinerifludvau 10.00 Sanitary sewer - each additional 100' 46.40 Ode. 10.00 Storm ewer - I" 100' / 55.00 .- . ifavi.es.esta1 must & tYtaill■tlw - Sturm sewer - each additional 100' 46.40 Range hood/other kiitdnah equipment / 10.00 / 0 Water so vice - I' 100' / 55.00 Water service - each additional 100' 46.40 Clothes dryer . exhaust / 10.00 y. ' °- - `i' Piave sr Item - -- +i4. . ogle duct exhaust Absorption valve - 16.60 - (mss toilet compartments, Baccfow preventer 27.55 qty rooms) 6.80 .90 ; Backwater valve 16.60 aawt fans 10.00 Clothes washer / 16.60 Other - 10.00 Dishwasher 16.60 "(S5.40 for first 4, 51.00 each edditio■al) • Drinking famtain 16.60 Furnace, etc. - / - • • - Eje tors/swunp 16.60 Gas heat pump • • Expansion tank 16.60 Wall/suspended/unit heater • • Fixture/sewer cap 16.60 Water heater I • • Floor drain/floor sink/hub 16.60 Fireplace / •. Garbage disposal I 16.60 Range I • • Hose bb a 16.60 BBQ •• Ice maker I 16.60 Clothes dryer (gas) . • Interceptor /grease trap 16.60 Other . • Primer 16.60 Total: `, - - 5 . t/v Roof drain (commercial) 16.60 Mechanical Perwit Fees Sink/basin/lavatory / /d /3 6l 16.60 Subtotal: S "IJ• W Tub/shower/shower pan .2 16.60 Minimum Permit Fee $72.50 S Urinal 16.60 Plan Review Fee (25% of Permit Fee) S Water closet 3 16.60 State Surcharge (8% of Permit Fee) S 7 5 O Water heater / 16.60 TOTAL PERMIT FEE S Other: . - .. - . � -. W■mbisg Peewit Fees - - -. ... .. - ELECTRICAL FEES (residential single- or multi - family) Subtotal S Description Qty. Fee Total I■sp Minimum Permit Fee 572.50 S 1,000 s9 ft or less / . 145.15 4 Plan Review (25% of Permit Fee) S add'I 500 sq ft- or portion j 33.40 I Limited e State Surcharge (8% of Permit Fee) S energy, residential / 75.00 2 TOTAL PERMIT FEE S Each manufactured or modular dwelling, service and/or feeder 90.90 2 Electrical Permit Fees - Subtotal: S / 7 r• S Plan review (25% of permit fee) S State surcharge (8% of permit fee) S 1 `/ • a c TOTAL PERMIT FEE - S I \Budding\Forms\ResPlanCheckFecs doc 06/29/06 Page 2