Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
EXPIRED 3 /s /o1 Building Permit Application FOR OFFICE USE ONLY City of Tigard DDatee/Bv I 1 1 tg f2/ dl i 1 Permit No OD6 • DO'00-5 /'1 13125 SW Hall Blvd., Tigard, OR _ �'t� * Plan Review d 'hone: 503.639.4171 Fax: 503 5 f C Q77 DateBv: Other Permit 4 � , O ins ection Line: 503 639.4175 �. • tt/ �I p � Date Ready/By: rtms� El See Attached Checklist for Internet: www.ci.tigard.or.us y . � 20U Notified/Method Supplemental Information 6 �0l� 1 Q1R - .REQUIRED DATA: I -AND 2- FAMILY DWELLING New construction 3U1L[?IN (' �L l vem�lia1n 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, matenals, labor, overhead, and the profit for the - ' - CATEGORY "OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 2-2, 24 ❑ Accessory building Multi- family Number of bedrooms: 2_. , ❑ Master builder 1:1 Other: Number of bathrooms: 2 C - , - _ --- JOB SITE INFORMATION AND LOCATION . , Total number of floors: 3 Job site address: _11:)X1-24:7 SIB A( rte - Tv -K1kP New dwelling area: I L.I ic square feet City/State /ZIP: - GAD cyl 91123 Garage/carport area: 215 square feet Suit g. pt. no.: 1 Project name: © — rov3M 401,,A6- Covered porch area: ( ( square feet Cross street/directions to job site: Deck area: 940 square feet 5W qa'" AvE • Other structure area: square feet V\ /kJ ,sr TY(tF,• • A ) REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: 15 I -J SAA03 Fc0 4- 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. 01.15 D I2/ c L ii IT 38 - Valuation: S ITS � G Mu_ Mu_ 4(p }'1 Existing building area: square feet "T�r�t t- . New building area: square feet 14 PROPERTY OWNER ❑ TENANT Number of stories: Name: OA K Srteer iZakj -}OMB , t r C Type of construction: Address: ( 2, 0 5W (4,8 1 -11, A , S't6. 4 O Occupancy groups: City/State /ZIP: -n D , 01' • cl7 - �I 3 Existing: Phone: (5�) CO59 • 310 f Fax: (503) 8 •908 I New: isi. APPLICANT,. ❑ CONTACT PERSON NOTICE Business name: I C.oki A'v-Ck•t lit rL&a. . /P 1,11 k ) 6 INC. All contractors and subcontractors are required to be Contact name: (DA1� C• ba(c oiz malt S.1'i2. 1e. licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 01-725 54 At- V612 --TO1/41 .(-t I LLSDAL.E Hw 31S,21cC jurisdiction in which work is being performed. If the City/State/ZIP: 'rJE Ory , OR o ''7 / applicant is exempt from licensing, the following reasons apply: Phone: (5o3) Co$ •1C0(42 I Fax: : ( ) (4;44 1 fi e, E -mail: d (9@ 1 c atroin 1 . C-Ovo .. CONTRACTOR Business n: Oak Street Townhomes LLC . ' ' BUILDING PERMIT., FEES* • Address: I 12670 SW 68th Ave Ste 400 - Please refer to fee schedule City/State /: Tigard OR 97223 Phone: (6i P: 503- 639 -3104 F: 503 -598 -9081 Fees due upon application . B lie.: ( CCB; 169524 - Amount received i Date received: Authorized signature: 1 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Q q I Date: Co 23 . o �, * Fee methodology set by Tri-County Building Industry Service Board. i•\BuildingWermus\BUP- PermnApp doe 12/03 440 -4613T( I 1/02/COM/WEB) :Mechanical Permit Application .: -.;:-;.-•..-- ' :-':.: 01FF10E 11St0i4Li ':: ••••••• ' .. .' .,".. Ci ty of Tigard R;:ct.ive.(1 1, : .• --., . -- , - .. , P N IPer c g)0& ••• 00 a fl' 13125 SW 11011 B1'. d . Ti:: ' OR '.; 1-i ln(lb Plan Rvviesv 1 - 1 -•:- , '"‘. 2 -; - ':'. . r .../ Phone: )113 63 4171 Fa:. : 1960 1,'"1`, 1 0.".' ar.e Br - Othoi l'ent.:: . Irv:peen:Ai Line: 503.6.1<::.4 i 75 - Datt Reath •Ity: :.ini -2 see l'aga: 2 for '•:mct: uP,i w.ci tic:ad...01.es Not:fie,' Niethixt: Supplemental Information • TYPE OF NN 0/ COADTERCIAl. FEE* SCHEDULE - USE cilEda..isT ; Nle.:hanical permit fees' are based on the value of the wori; i 0 New construe:ion 0 Addition alteration/replace:neat performed. Indicate the value (rounded to the nearest dollar) oral: 1 0 De:1million D Other mechanical materials. equipment. labor. overhead, and pmfit. Value: S I - , , ..-,..,,: :•:' ,. . i :,..,..-, CATEGORY OF coNsTRucrio ,-•:',...- .. .,:::•.-`- .2 . ' '.:. , -. - 1 -: .., :12,ES'IDENTIAll. I±QUI.PMENT / SYStEN:1 ' ' 01- and 2-family dwelling 0 Commercial/industrial 0 Accesson.,' building For spend l informadon use chccklist. 0 Multi-family 0 Master builder 0 Other: Description 1 Qty. Ea. 1 Total . . :. . ‘-. • .. --.' JOB SITE EN1f AND LCIOATION, '--:;: .:. _ ._:-..:'. : 2:; Heatingteooling Air conditioning or heat pump 1 , Job site address: ( 0.4 tO SIA) A-K.1 VrA-Al -- tC- - E-62A-e-e - (requires sia: alanshowiiT placement) 1 1 14.00 I I tl - City/State/ZIP: - pr2 9-72_2;3 Furnace 100.000 BTU tduetsivents) 1 I 14.00 I - 5urnace 100.000i- BTU (daetsvents) I I 17.90 I Suitelbldg.tapt. no.: I Project name:CAI.C. STD._ ..c"..::r - roi):::41-11w::8 h eal punr, I 14.00 I Cross street/directions to job site: Duct work 1 14.00 I I Hydronic hot water sv,stern 1 I 14.00 1 1 StAi 0 10-4 - 1 , 1 AN/5 • Residential boiler (radiator or i hydronic) I 14.00 1 Unit heaters (fuel-type. not elecrrie), in-wall, in-duct. suspended. me, 1 10.00 I I Flue/vent for any of above 1 I 10.00 I ID - Subdivision: Lot no.: I I Other 1 10.00 1 Tax map'parcel no.: 15 I 5 A A03800 -4--- i 5135 A Other fuel appliances 1 . - . .. .. . . . ' DESCRIIMON Cir, WORK' ., , , - -',-.' '. Water heater I I 10.00 1 10 - _ _ , . . Gas fireplace 1 f 10.00 ID - C- 5-Tqu.crrokl oc (Ail tr W 1 Flue vent for water heater or gas I firmlace 1 2- 10.00 7-b- le-g t.41(.4.- IAA tiS 1v771-f_ • , Log lighter (gas) 1 10.00 I 1 I Woodipefiet smve I 10.00 1 1 I Wood fireplace/insert 1 I 10.00 I I I 0 . , .: . 1 . , ..: ,......;,...... 0 TENANT . .. . Chimney/liner/flue/vent 10.00 ,.. . _ - -I Other: 1 1 1 10.00 1 li 1 Nam e: °Ai< STR-eeT - rOtAJ)41,-1 c WaS , L4-C-_ Environmental exhaust and ventilation 1 Range hood/other kitchen I i Address: 1 3tAi (08410, Ave:, sr. -- enuMment 10.00 I . City/State/ZIP: -7 &Aral), 012 9/2-Z-1 I Single-duct Phone: (503 ) ( . 5104 I Fax: (11 ) 5 .908-1 Clothes dryer exhaust exhaust (bathrooms, 1 ( 10.00 1 10 - toilet compartments. utility rooms) 1 5 I 6.80 I W. 4D . . . ..._._: i':.: - . -n.- coNT kcr pERIzo, -:.- .-. 7 - Attickrawlspacc fans I 1000 1 Other 1 I 10.00 1 Business n ame: - irr1e:44 rrec-Tus /PLAkwinla imc . _ Fuel piping I Contact name: DA N I 6ctroiztcH c)R ivioNitciel STIst .C4.z_ 55.40 for first four: 51.00 for each additional Furnace, etc. I I 5401 5.4(9 Address: 91/5 stAi rnE.A6r f-11LISDA-t.e. 14 Loy , S . 2(0E: I 1 Gas heat pump City/State/ZIP: r t 1 271R 4: 1 - 7CO5 Wall/suspentlediunit heater I 1 1 Phone: ( V3) (.0-I4 . f I Fax: : (6.3)(v44 ric.ct Water heater I I 1S' 1 . '10 Fir:place I 1 .401 6.40 E-mail: c.11Ct 0 COvi CarC- . C 0 11,1 Range I I I6:4Di 540 .,,, . . : . ... . •.- • .. ... "...;:. T .....', : . , co:NTRACTPR''':"- . ..j..".? "'.. r - - . - , • - Barbecue / 1 Clothes dryer (gas) i 1 Business na Thermal Flo Inc Other i 1 Address: 7236 SW Durham Rd Ste 100 kv.....;•- PERNIIT rtEs. . • • Portland OR 97224 Subtotal City/State.rZ I - P: 503-670-8343 F: 503-620-1953 Minimum permit fee (S72.50) I me: ( CC B: 151847 I Plan review (25% of pcnnit fee) 1 CCI3 lie,: i I 1 State surcharge (8% of permit fee.) 1 A ii TOTAL PERMIT FEE 1 Flub permit application expires if a permit is nut obtained ■■ilitin 130 Authorized signature: days after it has been accepted as complete. i • ncthodolory set by 1'6-Comity Betiding :a.th:_•vtr Service y Bo3n1 I Print name: DAN ci-1 , Date: C(,v . Z-3 . ck 1 Fee I i t.I....3: x4O-a6171 (11,0:-'.COMAVEri) Plumbing Permit Application FOR OFFICE USE ONLY City of Tigard Received � f10 � Date /By Permit No :06.0 13125 SW Hall Blvd., Tigard, OR 9724:. 1. I _ 11l Plan Reviltw. w� " '- t Phone: 503 639.4171 Fax: 503.598.1960' ti : t M ; Other PernrttNo.: � �,y Date /B 24- Hour Inspection Line: 503.639 4175 a ili l D y Internet: www.Ci.tigard.or us �°� = w Date Ready /By Juno 8 See Page 2 for Notified/Method. Supplemental Information - .• TYPE `OF'•WORK • , • FEE *, SCHEDULE. New construction ❑ Demolition For special information use checklist. Descnption I Qty. I Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connectioi - ' - CATEGORY OF C 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 g ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler P (_____ sq. ft ) Page 2 • JOB - SITE INFORMATION AND LOCATION Site utilities Job site address: 1 04 20 V (A1 kr. i L.1A 7EZ12tEf-S Catch basin or area drain 16.60 City/State/ZIP: - '1 &A/Z1D O'S q� � �3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: 04-K. S(xE - C - TI ZU N I- {•(MMES Footing dram (no. linear ft.: Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 Manholes 16.60 5W 67 k. Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) I Page 2 Storm sewer (no. linear ft.: ) I Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: 15 13SA 03r$D0 d- i 5155'M-03901 Fixture or item Absorption valve 16.60 . DESCRIPTION OF WORK Backflow preventer Page 2 GDm IT12UC-T1ON1 OF -uit T 38' Backwater valve 16.60 - 11 - 1 6 W I L!_ P- 4(p IJ h rr5 - rprtL - Clothes washer ( 16.60 I ( , (,(30 Dishwasher I 16.60 1(0 (00 Drinking fountain 16.60 PROPERTY OWNER ❑ TENANT Ejectors /sump 16.60 Name: 0A14, 5 -(^ TpW N 1 OMES , L-L-C, Expansion tank 16.60 Address: I 2491 SW Cverf1+ Arlie- r 5 (Arm 400 Fixture/sewer cap 16.60 City/State /ZIP: -n &A-KD , or ct 123 Floor drain/floor sink/hub 16.60 Phone: ( 5 9 3 3 ) (o39. 310.4 Fax: (r,-p3) 59 i • 9 ow I Garbage disposal I 16.60 1(0, (p C) 0 APPLICANT ❑ CONTACT PERSON Hose bib 2 16.60 33. Zp Ice maker 16.60 Business name: I CQIJ Al ZLM I l aE l RA N rJ IJJG lam- Interceptor/grease trap 16.60 Contact name: f) p4 60_,Dizicy4 b K MoM lCA s YL Medical gas (value: S ) Page 2 Address: 0 1125 SW aeAvelaTdJ 4- (1115DALE +.0.0y . 5iE.zie: Primer 16.60 City/State /ZIP: f 1WEYrTpN i t)2 9-7oDS Roof drain (commercial) 16.60 Phone: (503) (0,14 �ro(oI Fax:: ( ) (�4 �( C Sint /basin/lavatory ...1 16.60 ( 1 Tub /shower /shower pan Z 16.60 3s. 2.0 E -mail: d 9 01 c4, Urinal 16.60 CONTRACTOR Water closet 2,5 16.60 -4/.50 Business The Mullen Company Water heater 1 16.60 Po.( Address: 1601 SE River Rd Other City /Stat Hillsboro OR 97123 Subtotal M inimum P: 503-640-0113 permit fee: S72 50 Phone: ( Residential backflow minimum pennit fee: S36.25 CCB: 92689 PLM: 34 -260PB Plan review (25 %ofpermit fee) CCB Lic.. i J I State surcharge (8% of permit fec) Authorized signature: / TOTAL PERMIT FEE I Print name: - >L N I G o i,i2 (C{-I Date: C 13.0c, 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:\ nuildmg \Permns\J'LM- PermitAppdoc 06/05 440- 4616T(I0/02/COM/WEB) . ., Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received b : .r ;y. Pit 13125 SW Hall Blvd, Tigard, OR 97223 i, )p � Plan n Review i ; ' �? i Date/By. j` I erm ,c 'dp j (�3 v ev Phone: 503.639.4171 Fax: 503.598.1960 - t I Other Permit - Inspection Line. 503.639.4175 -.' D ■ 67 11, (( Date Ready /By. _tuns: El See Page 2 for Internet: www ci.tigard.or.us Notified/Method Supplemental Information TYPE OF WORK : -' _ . - . . _ PLAN REVIEW • I, ' IS, New construction ❑ Addition /alteration/replacement Please check all that apply: ❑ Demolition ❑Other: 0 Service over 225 amps, comm'l DHazardous location . amps r a - rating ['Service over 320 ratin Buildng 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 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 Job no.: Job site address: I al to $w 05444 Lem TazigAte ❑Health -care facility ❑Other. Submit 2 sets of plans with any of the above. City/State/ZIP: - r - (C, A Z- D i C1512.. 9 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: pA STYL.L[ [— �( J.H OLl FEES SCIiEDULE Description I Qty. Fee. I Total '" Cross street/directions to job site: New residential single- or multi- family dwelling unit. Includes attached garage. sW 9 0 A-vs. ' 1,000 sq. ft. or less 1 145.15 145. I 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion I 33.40 I Limited energy, residential 1 75.00 15.00 2 Tax map /parcel no.: I S 135 A ,E I S 135,444o A0 ( Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK - Each manufactured or modular CoNSTI2 UCr/C.M 01= (An K 3$' dwelling, service and/or feeder 90 90 2 _ Services or feeders installation, alteration, and/or relocation UPI ITS TaTA 200 amps or less I 80.30 3 ,30 2 PROPERTY OWNER ' - . . • - ....; ' . • - • 201 amps to 400 amps 106.85 2 . _ 401 amps to 600 amps 160.60 2 Name: OAK S1720er — FZWN1 H DM , L.LC. 601 amps to 1,000 amps 240.60 2 .ddress: 12-.-(1'1 SW Cor5+t" tMtC , S 400 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/ State/ZIP: 11 GA72.3) , OQ 9- Temporary services or feeders installation, alteration, and/or Phone: (03) Cv3ei • 310'1 Fax: ( O3) 5qM 90g ( . 2000 0 a 2 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 (a, APPLICANT. ❑ CONTACT PERSON ' A. Fee for branch circuits with service or feeder fee, each Business name: ICou 1 - 4 4 v r -> g. / PLA, Na (A G (NC . branch circuit ( 6.65 ( ( 5 2 B. Fee for branch circuits • • Contact name: M pN ICA 5-(l-(k - 2 c',e DA•N 6 21 0-4 without service or feeder fee, first branch circuit Address: -1 / 2 s 46.85 2 t?j&� W H Il- I"SDKLe i , .ZIOG Each add'l branch circuit 6.65 2 City /State/ZIP: ( 27 4 pk) t (51 9 5 Miscellaneous (service or feeder not included) ( G ) ( 44 ,,(O(D 1 (O3) 1044 v4 Pump or irrigation lighting 53.40 2 Phone: Fax: : Q f Sign or outline lighting 53.40 2 E -mail: o1I 1 cetla, r t-1-e cf-,LOrn 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 Hill OR 97123 . Per inspection 62.50 City/State Investigation per hour (1 hr min) 62.50 P: 503- 642 -2800 F: 503- 642 -5815 Industnal 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 - 'lprv. Electrician signature, re uired: Plan review (25% of pernut fee) Print name: State surcharge (8% of permit fee) Date: TOTAL PERMIT FEE Authorized signature: This permit a days pplication aftit expires has been if a permit accepted is as not obtained complete within 180 er Print name: -}� J GO DrZI Date: (9.Z3. gy by Building Industry Fee methodology set b Tn- County Buildtn Indus Service Board '• Number of inspections per permit allowed. r■Building\Pmnits\ELC- PermttApp.doc 12/03 440 46t5T(10 /02/COM'WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LINIITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm [f Garage Door Opener* gi Heating, Ventilation and Air Conditioning System* ❑ • Vacuum Systems* ❑ Other: fi CONAi RCIAL WORK ONLY: - - - -- : i 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 i•\ Building lPermits'ELC- PermitAppdoc 04/03 • Plumbing Permit Application - City of Tigard - Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site - Utilities':'; Q ":.. Fee. - Total , •'Square Footage:= Permit Fee:- _ Footing drain - I" 100' 55.00 0 to 2,000 5115.00 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 = _ _ =• - _ _ _ _ _ _ - 'Va 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 S1.52 for each F.ee!(ea): °" ='Total . additional $100.00 or fraction thereof, to and .- including $10,000.00. Commercial Back Flow Prevention Device 46.40 S10,001.00 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 536.25) 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 550,000.00. $50,001.00 and up $742.00 for the first $50,000.00 and $1. -' 0 for Subtotal: 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. - Qtianfitl•liyffixture)"Worklie`rformed ❑ Any new commercial building. Fixture Type: Replace ❑ Any new exterior plumbing site utilities. • - Precious. 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 Thnr 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 "_.. ISoritetr1e- orRiser • _,.. _• 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 a Water Extractor Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued an. Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. 1•1BuildingTermits\PLM- PermitApp doc 07/06/05 III • B uilding Division I - i `, 1 I, D One & Two-Family Dwelling Fees Checklist lPEitillt NFORMATION:' - - a; " • 7—FT7 : -:: , r v ._: ;F:7: 7- �. ;: - : - -... �_.. ,_� .,- ._.�... _ .,:_�.. =; .: -�•� __ Permit #: /1-716(,6 ,....� �. - o n I Z P lan #: l k s - A I Date: v /) - .24- or, Site Address: Intl 2,n s,,,, A k' I L CAN 7: Parcel #: Subdivision: 0d K ST24 E7 "Thw Nom E S Lot #: 3 9 Zoning: M N2 - / Jurisdiction: -/ 6 . Setbacks: Front: Rear: Left: Right Class of Work Al; , A , Stories: 3 First Floor. 2 q q 13 Type of Use 5 F A Height 3.5 Second Floor: s rb Construction: S'N Floor Load: .25F: Third Floor: ,sss- Occupancy Group: Rte, Dwelling Units: / ' Bonus Room: Valuation: /2-, 1 6 S c i _ (JD Bedrooms: 2 Total Floors: / 1 113 Bathrooms: 3 Basement Decks: 6 16 , 4, Garage: as 1/ f i l pp� � Porches: 0 p q Other F�: `� .:. �'_. i'R+p.vi�.�. L - +.- -•�-• -n!.... -.>-.r ►+. c �..o,..:....ar ..- .- ....._. . - „ a�„q ::ry. l " p4 -:.. .L '� FCt . _ o uIIt_: . 7:M' .AmOtmtpaid. i�ytr�sJ � DpC. Plan Check Building: St .64, a = 29, 33 ?Sr i ro 11133 Extra Set • Permit: Building: 'i3' 4 C • t/ n ?16.1/0 Tax: 7/ _ - 7 / " . 7/ Metro CET: / 4r - 9 /66 39 Mechanical: q 3 fro 63 ,rio Tax: 7 5v 7• St, Plumbing: 391 v,, -31/.00 T 3t. 9 z 31 - q �. Electrical: , ; 7 1/ 9<- a l!- q s- Tax: 14. 9( /(9 , q6 Low Voltage: 75 Tax: , . or.) 6. r vl SDC: CDC LRP Fee: 6..0 !:' 6 . r It) CDC Ping. Rev.: !f.S !f. 09 l'i or, Parks: L! , TIF Res.: o. f 0 I.r'l TIF MT: = o.''o - •)..r, Erosion Permit: 6 .r 0 .J 06 Erosion CWS: r',;- 19 a, TO Erosion COT: 9c.1 ? av go Water Quality: _ Water Quantity: — — SUB - TOTAL: ? L 1 7 . 5 C, a 50 .c r') 12 /7.5 Sewer: Permit: a 7r v, 7('c Inspection: ?, o - SUB - TOTAL: (9 73.S•.0U -; rJ TOTAL MST & SWR: t.2 , 2 n . 2 5 - v c , r //, 5 5a 1 I:\ Building\FormsVtesPlanCheckFees doc 06/29/06 Page I PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential nipment/systems) Qt Description I y. I F4440 � Total Description I Qty 1 Fee(ta.) I Total . . . , -• - • Newl- ...New - famt�dwe0iep '� {. �.'-' . - er • • • Heating/Cooling Heating/Cooling .•.'.: - : ' '.- ` .. .. (t "' .elides 100 R. for each .tiliWee..eeUo.j `. ? -- _ mil' Air conditioning or heat pump' t 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 .cu 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. R. 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 Foe sprinkles - sq. ft. 3,601 to 7,200 220.00 Unit heaters (Cud, not electric) Fun: sprinkler - sq. R. 7,200 and grate 309.00 (in wall, in-duct, suspended, etc.) 14.00 '--":•' * •ViRI; .. 7 "!' Site Utak' ' : . :,fib.. _ - f Flue/vent (for any of above) 10.00 Catch basin/area drain - 16.60 Repair units 12.15 Drywell/kadt lbw/tenth drain 16.60 " - • ' • - Other Fleet Applia.oea - - - . Footing drain - I 100' / 55.00 Water heater r 10.00 /U Footing drain - each additional 100' 46.40 Gas fireplace / 10.00 V - Manufactured home utilities 110.00 Rue vent (sue heater/pis fireptaae) 10.00 Manholes 16.60 Log lighter (gas) 10.00 Rain drain connector 16.60 WoodlPellet stove 10.00 Sanitary sewer - I 100' / 55.00 Wood fireplaoeltnsert 10.00 Sanitary sewer - each additional 100' 46.40 - Other: yAiner/flurJvent 10.00 O Storm sewer - I 100' 1 55.00 Other 10.00 Ba.iweael ttahamrt & Ventilates - Storm sewer - cad' additional 100' 46.40 Range hood/other kitchen equipment ' j 10.00 Id - Water service - I 100' 1 55.00 Water service - each ational 100' 46.40 Ckh� dryer exhaust / 10.00 / u ddi •: :'M : Mane err item _ , :-r :r� - :;;4;ctlifigim. Single duct exhaust Absorption valve 16.60 (mss, toilet compartments, Backfow preventer 27.55 utility rooms) 'S 6.80 ,70 , '-/ 0 Backwater valve 16.60 Attidaawl space fans 10.00 Clothes washer 16.60 Other 10.00 Dishwasher / 16.60 �t .. •• (SS 40 for lust 4, SI N each additional) Drinking formtain 16.60 Furnace, etc. Ejectors/gaup 16.60 Gas heat Pump .. Expansion tank 16.60 WalUsuspehded/unit heater •• Fixture/sewer cap 16.60 Water heater I • • Floor drain/floor sink/hub 16.60 Fireplace I • • Garbage disposal 16.60 a l a. Hose bb i 16.60 BBQ • • • Ice maker / 16.60 Clothes dryer (gas) • • Interceptor /grease trap 16.60 Other: a. Prima 16.60 Total: i j . Roof drain (cornmercial) 16.60 Meeha.ieal Permit Fees Sink/basin/lavatory i / 0/ 3 y 16.60 Subtotal: $ 6 / - 5 $0 Tub/showa /shower pan Z. 16.60 Minimum Permit Foe $72.50 S Urinal 16.60 Plan Review Fee (25% of Permit Fee) S Water doset 7■ 16.60 State Surcharge (8% of Permit Fee) S 7 S 0 Water heater T 16.60 TOTAL PERMIT FEE S Other: Other Pl.m6iat; Permit Bees - ELECTRICAL FEES (residential single- or multi-family) Subtotal S 39 1 Gl) Description Qty. Fee Total sup Minimum Permit Fee $72.50 $ 1,000 sq. ft or less I 145.15 4 Plan Review (25% of Permit Fee) $ Ea. add'l 500 sq ft. or portion a 33.40 l State Surcharge (8% of Permit Fee) S j1. t Limited energy, residential ) 75.00 2 TOTAL PERMIT FEE $ Each manufactured or modular dwelling, service and/or feeder 90.90 2 ' Eleeteteal Permit Fees Subtotal: $ a l l 5 S Plan review (25% of permit fee) $ State surcharge (8% of permit fee) S I : 5 E TOTAL PERMIT FEE S I \Buddingfoni RResPlanCheckFees doc 06/29/06 Page 2