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Permit
EXPIRED 3/5/09 Building Permit Application_ FOR OFFICE USE ONLY City of Tigard H CE V 1 • �.i Received /- 1 / Penn itN 0. ° Date/B : I ( O& I I Mc) 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review c 'hone: 503 639.4171 Fax. 503.598 1960 NOV v '1 '7 44s"d 1 DateBv: Other Permit. au ► e, _o 98 .nspection Line 503 639.4175 1 a'/ I Date Ready/By. lens 0 See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified /Method: Supplemental Information .. 3UIH D JG nIVISION TYPE OF WORK . . REQUIRED DATA: 1- AND 2-FAMILY DWELLING . Permit fees* are based on the value of the work performed. E New construction ❑ Demolition 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. ❑ I- and 2- family dwelling ❑ Commercial /industrial Valuation: s I�, 29 2- Number of bedrooms: ❑ Accessory building X Multi- family 2 ❑ Master builder ❑Oth Number of bathrooms: 2 , : .. JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: 104 140 5 i j gEAN -twa New dwelling area: (262," square feet City/State /ZIP: -n GA,12D i o q 91123 Garage/carport area: ZlJet square feet Suite ldg. pt. no.: ! I Project name: O 1- —1-r 3 (. -I01A $ Covered porch area: L ( square feet Cross street/directions to job site: Deck area: ei /„ square feet SW 904 Ave . Other structure area: 1 � square feet (LI A) -- 1 ; b . REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 151 3SAAO $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. e7ni rt21�C."flONi e ,-- L-U1 ii 37 - - -- Valuation: $ �i'1 G WILL._ t' 4(a L�4J 1 (TS Existing building area: square feet New building area: square feet g PROPERTY OWNER ❑ TENANT Number of stories: Name: OAK Sii v - 1 111 -IO i , LIZ r Type of construction: Address: 1 2e7O 5W (o 1 i' A'Vre , S't6.. 4o Occupancy groups: City/State /ZIP: 'n C :13 , Ork 6 1'7 ZZ5 Existing: Phone: (5C3) Cojq . 3104 Fax: (503) 598 • G IOS I New: E: APPLICANT ❑ C ONTACT PERSON NOTICE Business name: (t:0kl + PI - Luzel1 2 A') M I m6, 1 NG. All contractors and subcontractors are required to be Contact name: DA1, Gex�D121ck MG�11 CA s ILA licensed with the Oregon Construction Contractors Board p under ORS 701 and may be required to be licensed in the Address: 9-725 5) r✓ck V Q .1-'(I LLST)f t.E titAxi, 5'I'E.,24ce jurisdiction in which work is being performed. If the City/State/ZIP: 'IZ - , O R C or. applicant is exempt from licensing, the following reasons apply: Phone: (503) (04 1 ( p ( e I I Fax:: (503) (044 •1 (4409 _ E- mail: d 1901 C-Cs 1 Afc1/t t 'te- E'+.Gav1n - CONTRACTOR - Business naml Oak Street Townhornes LLC . • -.• - ' - - - B PERMIT FEES* - Address: 12 12670 SW 68th Ave Ste 400 - Please refer to fee schedule City /State /ZIP Tigard OR 97223 Phone: ( P: 503- 639 -3104 F: 503 -598 -9081 Fees due upon application B lie.: [(oil CCB: 169524 Amount received .i r 1 I Date received: Authorized signature: I Th p a perm: s not wit hin ermit 180 days application after it expi has been res if a ccept a s complete. obtained Print name: ©An[ G,, Date: C .2 , e) (, *Fee methodology set by Tri- County Building Industry Service Board i.\ Building \Pcrmits\BUp- PennnApp.doc 12/03 440- 4613T(II /O2/COM/WEB) . • INlechanical Perniit Aulicatioil -::. • .,• :: .....: ..-::.:. ft)FtOFFIcEllSEVi071,Y: - ,i',..1•••.r..:' ; :,:',.-,',. : ... :: • aid it,cd,:d City of Ti! u,,..c3... n i57 - 4 00&... 0030 13125 SW ;loll Blvd.. Tvjard. OS 9722:: .• -• 1 20 Phone: Sir; 630 4171 Fau. 30 5": IltirM I ' I P ) 1: 1 1 ., 1 :- x P i R ,4 7 ,, Othor l',, , , , !tripe:lion Lune: 503.539.41 75 A. Date Read litns 1 -. see rage 2 For '.:rnct: WV: 'A' ci.tiugAu r.e N u, o.;:letil Supplemental Infortnation - • - ' _L TYPE OF WORK COMMERCIAL. FEE* SCHEDULE - USE CHECKLIST • Mechanical permit fees' are bzed on the value of ih: wort I CE New constmc: ion 0 Addition.aiterationircplacement es i ; pnrft Indicate the value ( own:led to the nearest dollar) of lt I 1 I 1 0 Demolition 0 other. mechanical materials, e::: labor overhead. and profit. I Value: S I ' CATEGORY OF, CONSTRUCTION ..: _ . ,.-'...', '., ...; 'RFS1DENTRL EMTIPAIENT t qN Fr E5* 0 1 and 2 dwelling 0 Commercial/industrial 0 Accessory building r I FGr special Gliormatinn we chccklisi. 0 Multi-family 0 Master builder 0 Other Description I Qty. I Ea. I Total , . ' r. -. ,...;.: . , , : ,.• JOB SITE INFORMATION AND LOC.‘T.10.1. 21 . ... . : r. : :_2-.. lIcatine/cooli tie I Job site address: 1 0 1(0 5(A) ,-L-A t..) -reeigievec I ( Air i concit , iont h . n2.. h o o r v it i en r, t p p i. urn . p n,,nt) I ( i 3 ,.00 1 ...._ City/State/ZIP: _- ) , otz 9 -7213 I Furnace 100.000 BTU tductsfveics) i 1 I 14.00 . i . I imnace 100.000- BTU Uticialventst I I 17.90 I I Su:le/bldg./apt. no.: I Project name:CAK SIT-_--r as TOLe.111-160 ... . • neat pump I 14.00 I Cross strzettdirections to job site: - 1 Duct work I 14.00 I 1 Hydronic hot water system I I 14.00 I s cto-p, A - v 5. I Residential boiler (radiator or I I I I hydronic) 14.00 -( Unit heaters (fuel-type, not cleerric), 11 in-wall, in-duct, suspended. etc. I I 10.00 I Flueivent for any of above I I 1 10.00 10 - I subdivision: I Lou no.: Other I 110.00 F I Tax map/parcel no.: 151 5 AA 05800 -4-- i 5135 A.-gt (2390( Other fuel appliances • . "".-- "." ' - - .-DLSCRIPTMN Of' WORIZ • .; .: . ' . ' ' ' I I I 10.00 ID - . -. ., . Gas fireplace I 1 I 10.00 10 - C...-h . -T . of- LAY! rr 37 Flue 'cm for WaleT htratcr or gus I I firealace I 2- I 10.00 20- -10 WILL_ - tot ITS 1 - i Log lighter (gas) I I 10.00 i 1 Wood/pellet stove I I 10.00 I i i I Wood fimplacefinsen I I 10.00 1 • • . .. _ • •• .. ..: • .. . .1 Chimney;liner/flue/vent I I 10.00 1 .. :. • . 4, :, ..!:j ...:-:-..:...:',.... JD TE;' _ .• : . :::._ : t ''.. ' Other I 10 00 F I I Name " QA-K s-r)eeeT - rDawHop,Ass Lt.- 1 Environmental exhaust and ventilation I ' I Rinee hood/other kitchen 1 I Address: 154.( 3W (08 Ai.#1. , St. •• eauirimen: I 10.00 City/State/ZIT': -- ri 6- A-12:p , 0 42 cin - 1 22.:3 F Clothes dryer e.xhaust F I I 10.00 F 10 - I Single-duct exhaust (bathrooms, Phone: (5M ) -5104 I Fax: ( 5 .9 toilet compartments. utility morns) 5 I 6.80 I 24 '40 '. ' ' ' • , •Akel.,[cv.\ - x . ' • : .:1•'... coNTACT'pr:ii64::,..1-e-;....-:...,,: Atticfcrawlspace fans 1 10.00 • • ,. ......,-.,... . _.....,.....•_. • Other: 1 10.00 Business name: ::EC..01,1 A.g.;.1.44 t-1-1..,,,,,, /RA jIma Kl iksc - I Fuel pinine I Contact name: D4,4 6ce bR ivioNi tog 5112-1.-eit_ S5.40 for first four: S1.00 for each additional Address: c:9-7z st.Ai r6eAv fel ILLST)."- R u5y , SR- - 2 - t IDE City/State/ZIP: (2v7aeTot , 17_, 9 R -70if:15 1,V Furnace, etc. Gas heat pump allisuspend=ltunit heater I I 5401 5..1 o I I Phone: ( r 3 (.214 . / I Fax: : (553)(44 IC(1,49' Water heater I i tS' e l0 1 . Fireolacue I 1 .••1101 640 I E - mail: cA i 9 01 c.cn ar6 . C 0 VI Range I 15.401 540 . - .:.. ,,, ,i, .•;. ,-,:..... .:,.'.:.::. ..,..,-• -F::::..- :..:L-L . ... . ... . ,.., ,. . Barbecue I Clothes dryer (ens) I I 1 Business na Thermal Flo Inc i Other I I Address: 7236 SW Durham Rd Ste 100 . _..._ . .., ••,. . . ..,,, P.E.W.11 :',„' r ci t ,Is tate ,2 Portland OR 97224 subtotal 1 P: 503-670-8343 F: 503-620-1953 Minimum perrnit fee (S72.50) CCB: 151847 I Plan review (23%, of pennit fez) i CCB lie.: • ) 1 j State SUM harge (V4, of permit fee) I /1 1 i L TOTAL PERMIT FEE I I / i Tilts permit applicatinn expires if a permit is nut ubtained within 180 Authorized sienm are: / i . days after it tuts been =unwed as complete. I Print name: DAN The i c ) ..1 I Date: . , ot • re: =Lind:dog:: set by Tn-Cocnr,.. Budding industry Sem= Board i tinc IVO: 446-16 17T ( I 1.72/COSINT13) Plumbing Permit Application FOR OFFICE USE ONLY CI of Tigard REEew 131 SW Hall Blvd., Tigard, OR 97223 � 2O D i P erniit t 15ra . 3„07 Pl �"`'' !! Phone: 503.639.4171 Fax: 503.598.1960 Other Permit No.: y. Date /B • l 24- Hour Inspection Line: 503.639 4175 „I Date Ready /By. dun p See Page 2 for Internet: www.ci tigard.or.us _ Notified/Method: Supplemental Information • . _ TYPE OF WORK . : - - - - FEE *. SCHEDULE For special information use checklist IX New construction ❑ Demolition Description 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 . SFR (1) bath 24920 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building xi 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: ( off ((p c Ale--11....6A-4 ' .4e.A- C Catch basin or area drain 16.60 City/State /ZIP: -"( &/2D , CA el? 2..23 Drywell, leach line, or trench drain 16.60 g p 1 j � ?.� Al ��MES Footing drain (no. linear ft.: ) Page 2 Suite/bld /a t. no.: I Project name: Q4{� Sile Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 5w i I /1/4t• 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.: ) I Page 2 Fixture or item Tax map /parcel no.: I S 13 S AA 038'00 d- l 5 13 Av4 I 0390 Absorption valve 16.60 - - • - . DESCRIPTION OF WORK - ' Backflow preventer Page 2 • t✓0I15[YLUC,TION > I.t1jI1' 3-7 Backwater valve 16.60 -Th ele-e- WILL e 41p u h I-r - r rAct- . Clothes washer ( 16.60 ( (p , 6o0 Dishwasher I 16.60 1(0 (pO r - Drinking fountain 16.60 a PROPERTY OWNER . D TENANT. - Ejectors/sump 16.60 Name: O 51'7 - M.4 DMES , LL-C, Expansion tank 16 60 Address: 1 2.(01 D 5V) (prt.1i Ali , 5u(1 5utrrE $o0 Fixture/sewer cap 16.60 City/State /ZIP: - n G AWD , pI 9 i Z23 Floor drain/floor sink/hub 16.60 Phone: (503) (039. 310 4 Fax: (L,D3) 59 , 9 Dg I Garbage disposal 1 16.60 1(p, 400 Hose bib 2.. 16.60 33. 2,0 a1 APPLICANT ❑ CONTACT PERSON Ice maker 16.60 Business name: I C0K1 I" re.0 1 Jj2.E / P(A N IJ I1J i 1W C. . Interceptor /grease trap 16.60 Contact name: D &d zDI21 c 4 5K µcM ICA 8T11 -1 _ez Medical gas (value: $ ) Page 2 Address: 01-125 S W e,e,,Avetaroj f- (ILLS Dietz. Hoy , S'iE, dE Primer 16.60 City/State /ZIP: f�.V� - rpN t D(_ 9 -700S Roof drain (commercial) 16.6 Phone: ( p3) �I 4 :how Fax: : (I St S) (,44 -j�Ci Sink/basin/lavatory howea .� 16.60 (p( S. Tub /shower /showerpan 2 16.60 �j3, W 2,O_ E -mail: al.5 @ covlare i4- ec..+ . cowl Urinal 16.60 . CONTRACTOR . Water closet .11, 50 . . . . . . 2 16.60 Busines: The Mullen Company Water heater 1 16.60 ((o. ( Address: 1601 SE River Rd Other. City /Star Hillsboro OR 97123 Subtotal P: 503- 640 -0113 Minimum permit fee: $72.50 Phone: ( Residential backilow minimum permit fee: $36.25 CCB Lie.. I CCB: 92689 PLM: 34 -260PB Plan review (25 %of permit fee) State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: -{,A1,4 , 001,12(0► -I Date: C9. 2.3 .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 \Buitdmg \Permits\PLM- PetmitApp doe 06/05 440-46I6T(10 /02/COM/WEB) , • Electrical Permit Application • FOR OFFICE USE ONLY Received City of Tigard -1.1...;'! _ a 20 Date/By. Permit No - 0030 ' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review II i Phone: 503.639.4171 Fax: 503 598.1960 + / " DateB • ,i V L ' - Other Permit- Inspection Line: 503.639.4175 „�- l t•' Date Ready /By Juns 0 See Page 2 for Internet: www.ci.tigard.or.us Nottfted/Method• Supplemental Information ' - , TYPE OF WORK . • - • . PLAN REVIEW . - El New construction ❑ Addition /alteration/replacement Please check all that apply: El Demolition ❑Other: 0 Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps - rating ® Buildng over 10,000 sq. ft., • CATEGORY OF CONSTRUCTION - of 1- and 2- family dwellings 4 or more new residential El 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure rs Multi- family ❑Master builder ❑ Other: ❑ Building over three stories ['Feeders, 400 amps or more . ❑Occupant load over 99 persons 0 Manufactured structures or . JOB SITE INFORMATION AND LOCATION • ❑Egress/lighting plan RV park Job no.: Job site address: f 041(9 keIl. 4 j[s✓ GE ❑Health -care facility ❑Other. Submit 2 sets of plans with any of the above. City/State/ZIP: -116 A 4 (), 1°512 9 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: OAt ? S r �3 'TOWN FEE* SCHEDULE Description I Qty. Fee. I Total •• Cross street/directions to job site: New residential single- or multi- family dwelling unit. Includes attached garage. SW 9 0' Avg . 1,000 sq. ft. or less I 145.15 145.1 c5 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion ' 33.40 1 Tax map /parcel no.: (S 135 - 038 4- I S i35 1 O I Limited energy, residential ( 75.00 75,00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular CcoNS?72I.X.T1c44 OF WTI t'r '3, dwelling, service and/or feeder 90.90 2 _ Services or feeders installation, alteration, and/or relocation um ITS 200 amps or less ( 80.30 $0.30 2 g PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: OA14. S1121e1 - 1Z)0 3k) + OM ES , LLC - 601 amps to 1,000 amps 240.60 2 .ddress: 12_(9'10 51 C98 P vt- , S . 4 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/ State/ZIP: --116AK D , OQ 4: 112-2.. Temporary services or feeders installation, alteration, and /or 1 relocation Phone: (r,�03 c 9 . 310 - ,1 Fax: ( 59 , clog I 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 , 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ($ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 ( ( 2 Business name: I Gou A rtr /r1- LLIZE. / P� t IA G WC . branch circuit B. Fee for branch circuits Contact name: M 0 5-re( I vZ.. c> K. DAN Ga lD el 04 without service or feeder fee, 46.85 2 Address: � 2 5 50 �1A2T H IL-LSl 1. +MAW first branch circuit cit �,ZIOG Each add'1 branch circuit ) 6.65 2 City /State/ZIP: (2 v O1..) , C5b2 9 5 Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (3) (044 ,'1(e(0 I Fax: : ( c'3) (pw=1 : Sign or outline lighting 53.40 2 E - mail: c. I g (D ) c..43, 1-eel- .corp-) 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 ltr min) 62.50 P: 503- 642 -2800 F: 503- 642 -5815 Phone: ( Industrial plant per hour 73.75 CCB: 157891 ELC: 34 -436C SUP: 4232S ELECTRICAL PERMIT FEES* . • CCB Lic.: I Electrical Lie.: I Suprv. Lic.: Subtotal - uprv. Electrician signt ed: 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: �rlk C 1 Date: Co. Z3. p(o • Fee methodology set by Tri -County Building Industry Service Board ** Number of inspections per permit allowed i \ButldmgVermits ELC- PcmitApp doe 1 440.4615T(1 0/02JCOM/WEB • Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm y Garage Door Opener* Vj Heating, Ventilation and Air Conditioning . System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK 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 • El 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 1:\Building\P min\ELC- PcmiLApp.doc 04/03 Plumbing Permit Application - City of Tigard ' • . Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities:; = Qty: Fe Tot (ea) '.: t al S Footage:` . . ":Permit Feef_ 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 s = =- Per nit Fee:. = ` . ` Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fiature,or I #erii - =Qa' Fee (ea)'. ' Total' . additional $100.00 or fraction thereof, to and _ - - including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Bacldlow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee S36.25) 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: Plan Re Complex 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 iiy.(F ❑ 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 Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any INNFPA 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 I sOmetrcor :Ri Diagram - Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial Ice MachlRefrig. 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 ai Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. i:\ Buildmg\Pcauts\PLM- PcmitApp.doc 07/06/05 . ... : _ ' PI B uilding Division One & Two-Family Dwelling ricAlw Fees Checklist iiiititti# tig 77.7.4„ Permit #: /15-r j_ _ or) . I Plan #: OA.. sT ,3) Date: /) -,2 6_ 0 4 Site Address: log i 6 s. , Ak -7-4,elz. • Parcel #: Subdivision: 0 A - r 5 tez.f._ 7-- TC Al 14 v/./ Lot #: 3 7 Zoning. / VILA I2 ,, Jurisdiction: -7 --r c Setbacks: Front Rear Left Right Class of Work A 1 f ‘. ) Stories: A. First Floor. l I 1 4 Type of Use: 5F Height 3 S— Second Floor: Construction: 5 Floor Load: SU fs-te Third Floor: 5 6 Ph Occupancy Group: R - 3 Dwelling Units: / Bonus Room: Valuation: ii V 9 7 7, ly) Bedrooms: .2. Total Floors: J9 Bathrooms: 3 Basement Decks: qG * Garage: Porches: (70 ri) Other: litekS: -1:7—=rDeilais. tioft=7-1122YietWcitiii—E77771rilinO"uitt—Piailr:÷=MBitiancle"'"Thaial= Plan Check Building S ,?13 ..7 cdo 1,5 q5s Extra Set Permit: Building ¶f'l. (-Jo 5)1 7- LIP) Tax: Metro CET: Ma :7 7 P/2•77 Mechanical: Tax: 7 -o 7 S Plumbing 399.0o 99 oc - Tax: Electrical: rn 5 S I - /f Tax: lti • 2S- /LI . ) 9 Low Voltage: 7570o 9.5": 00 Tax: 4 ,00 ( .c.)o SDC: CDC LRP Fee: 4.00 6 .00 CDC Ping. Rev.: 4 / 5 '-I5:oo Parks: C/O) 3, vo 1 10) 3 00 TIF Res.: p etroo - co P fat, ov TIF MT: Erosion Permit: 6V an ( ...■ . 00 Erosion CWS: Erosion COT: ,20 70 ? O. g0 Water Quality: — — ......, Water Quantity: SUB-TOTAL 5', q 5/ 7 )5o. c.io q Sewer: Permit: j 7oo - 76,T.,) - Inspection: _ SUB-TOTAL ? ,--) 73 !':: TOTAL MST & SWR: i 0 3 3. 'D./ d5r) c_)c- // 73.7 I:\8uIIdingmssPIanCheckF doc 06129/06 Page 1 • PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential e r a uipme ) Description I Qty. I Fee(ea.) I Total Description I Qty I Fee(ea.) I Total New 1 & 2 dwellltap' „cti4i. ;a' - HeadnaJCootia �• .• - - l aehides 100 R. for each atilib`"aintietla') ! "" Air conditioning or heat pump• j 14.00 1 y - SFR (I) bath 249.20 Furnace 100,000 BTU ( ducts/vents) / , 14.00 /1../ - , SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts/vents) 17.90 SFR (3) bath ) 399.00 39 / UU 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 sprinlda - 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 spinkla - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric) Fire sprinkle - sq. R 7,200 and greats _ 309.00 in wall, ire- d<rct snzspddod, a tc.) 14.00 "R-..- :; O , t r >:- She '70/r1-; : - ._ ^ - ,: . Fludvent (far any of above) 10.00 Catch basin/area drain 16.60 Repair units 12.15 Dtywell/leach lindtreYnch drain 16.60 Water heater :. - .Otter Fuel �� _ 10.00 / Footing drain - I 100' I 55.00 Gas / 10.00 IO Footing drain - each additional 100' 46.40 I Flue vent (water hater/gas fireplace) 10.00 Manufactured home utilities 110.00 Log lighter (gas) 10.00 Manholes 16.60 Wood/Pellet stove 10.00 Rain drain connector 16.60 Sanitary sewer - I` 100' I 55.00 Wood 5repiaodiosat 10.00 Sanitary sewer - each additional 100' 46.40 Ot ey/lithed8tdverut 10.00 Other Storm sewer - I 100' 1 55.00 dra 10.00 . Fasisioeadl Bttiaart & Ventilation Storm sewer - cad' trdfiticnal 100' 46.40 Raw hood /other kitchen equipment / 10.00 0 - Water service - I" 100' / 55.00 f Water service - each additional 100' 46.40 Clothes st / 10.00 /U - •:� 7 :. .- -i ww • ,...,•• :-.. 11 sbee er Item = • ,- :• .i -q - -z --01- Single duct exhaust Absorption valve 16.60 mss, toilet compartments, utility rooms) ?. 6.80 0 I -I n Bad�aw prevents 27.55 - J 10.00 Backwater valve 16.60 Attic/crawl Clothes washer / 16.60 Other _ 10.00 Dishwasher / 16.60 Fed rein - Drinking fountain 16.60 "(� for first 4, S1.N each additioul) Furnace, etc • • e Ej ctors/su mp 16.60 Gas head pump -"/ • • Expansion tank 16.60 Wall/suspe nded/unit heats • • Fixttne/sewa cap 16.60 Water heater ' / • • Floor drain/floor sink/hub 16.60 F'ueplaa ' / • • Garbage disposal / 16.60 Range / • • Hose bb ) 16.60 BBQ • • la maker / 16.60 Clothes dryer (gas) • - Interceptor/grease trap 16.60 Other • • Primer 16.60 Total: 4 ✓ ' �7 Roof drain (commercial) 16.60 Mechanical cal Permit Fees Sink/basin/lavatory 1 k2/ 3 1 4 16.60 Subtotal: S c) ? $o Tub/shower/shows pan a 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 0 Water heater ) 16.60 TOTAL PERMIT FEE S Other Other. Plumbing Permit Fees ELECTRICAL FEES (residential single- or multi-fatuity) Subtotal S 3 r 1 `/ G O Description Qty. Fee Total lasp 1,000 sq. ft. or less / 145.15 4 Minimum Permit Fee $72.50 S Ea. add'I 500 sq. ft. or portion 1 33.40 t Plan Review (25% of Permit Fee) S State Surcharge (8% of Permit Fee) S '5 I ° I 2 Limited energy, residential 1 75.00 2 TOTAL PERMIT FEE S Each manufactured or modular dwelling, service and/or feeder 90.90 2 • • Eketrind Permit Fees Subtotal: S ] 7S( S Plan review (25% of permit fee) S State surcharge (8% of permit fee) $ 1 1- 1 ? S TOTAL PERMIT FEE S I \Building \FormsVtaPlanCheckFees doc 06/29/06 Page 2