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Permit • EXP i RED /S/D Buildi Permit Ap plication FOR OFFICE USE ONLY City of Tigard I _ ;I Received P n,, . _ � Date/Byd 1 1 7 Ob 6fi Pi t5'r , b - 09 3/ 4/ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie °hone: 503.639.4171 Fax 503.598.1960 I+ I Date/B). Other Permit.)e �30 4 inspection Line: 503.639.4175 NOV 1 . / , P_� e•.1 Date Ready/By: tun ' 0 See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method. Supplemental Information rP CITY OF TIGARD TY.P HI f� DIVISION R EQUIRED DATA_: 1- AND 2- FAMILY DWELLING Permit fees* are based on the value of the work performed. )g( 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. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: S ' 2.0 (pig ❑ Accessory building f$ Multi- family Number of bedrooms: Z ID builder ❑Other: Number of bathrooms: Z. 5 JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: _10404- •5 -( („EA-Al lea e.E New dwelling area: I -7 square feet City/State/ZIP: - c _, D c 91 223 Garage/carport area: Z75 square feet Sui ' .ldg. :pt. no.: 4 Project name: OAK 5112 [ - — rOv( - 101/(6'S Covered porch area: I square feet Cross street/directions to job site: Deck area: CI@ square feet 5W 9041- Ave • Other structure area: square feet l/IN J r T1 ?t!.' A REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: I 5 1 35AAD3 Fro •�- 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. -ONrsf}2 n 0 J LA.h IT 39 - Valuation: S —t.I�G W i. Lt._ 4(49 L- I (TS ' Existing building area: square feet TD'j74'(_ - New building area: square feet g PROPERTY OWNER - ❑ TENANT Number of stories: Name: OAK Sft 'r '(Z%1A.411 -10MsS , LL C - Type of construction: Address: 1 2-c 7 0 SW (0E-11.. A , .5-1-6.410c. Occupancy groups: City/State /ZIP: &A-11_1), c'k Q'] 22,3 Existing: Phone: ( 5 0'3) CO39 • 3104 Fax: (503) 698 • Rob 1 New: • X .APPLICANT ❑ CONTACT PERSON . NOTICE Business name: I COM A c_ -F I" _?1_& .E ptAiJ NA ( tJ G , ( 11C . All contractors and subcontractors are required to be Contact name: DA.1, C•�GnDIQ(C.t� mcmtC'A 5 - m _ [Km licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 9 5v1I 15 -VGA- 1 - 4 I LLSD tt. f-ILA y, S''1'E,ZIcc- jurisdiction in which work is being performed. If the City/ State/ZIP: �t%>At , O R C17� applicant is exempt from licensing, the following reasons apply: Phone: (5o3) Co441 7(v(v I Fax: : ( 50) (0ci 4 .1 (do°1 E -mail: d k9@ i Cap 4trot, t-f. cow, • • J - • yCONTR4CTOR . , Business nary, Oak Street Town homes LLC BUILDING PERMIT FEES - Address: 12 12670 SW 68th Ave Ste 400 Please refer to fee schedule. City/State /ZII Tigard OR 97223 Phone: (6,g: P 503- 639 -3104 F: 503 - 598 -9081 Fees due upon application �B lie.: ((o• , CCB: 169524 Amount received 1 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: © 6 �� Date: c .23 .D t�, * Fee methodology set by Tn- County Building Industry +` Service Board. t•\Buitdmg Tams \BUP- PermitApp doe 12/03 440.4613T(t I /02 /COM/WEE) , Mechanical Per niit Application = FOR OFFICE U S E °ONLY': ... City of l'i��arc1 Rec. :•ti Ni:;‘.! ! ; 21(� I n.,:c:a I ._.., 1a�_ . .•,.., tv3 /q ) 3 1 1 5 S`,1' Hull 1il ."d.. - ft::ard, O;: `•:' - r f'`It.): i.: 503 0:'' 41'1 Fat: ;t,; -:, .t:?t • ✓. t Nan Review '' .! 1 ; .,! E I r :) r i,t ■ �{ Da:e'tiy // l fit I'c ",;. t Ir.••puctinn Lute: 503.63(/.4 I7�• " �; ;�, L Um: I RcaJa; ;..•: J,:n. =� n� Page See � for _ '. -rnet: w.'ts. elli_aid.:)r.U} - \ - I -" Supplemental Information • TYPE OF WORN - ; COM1A1ERCIAI. FE-E° SC':I:ICDULE - ESE CHECKLIST New caustructi,�n ❑ , addition altcrata >nireplacgntcat j Mechanical permit fees• are based on the value of the work i pertbtmed. Indicate the value (rounded to the Hears i t dollar) of all : I ❑ Demolition ❑ Other-. I tnechantcat materials. equipment. labor, overhead, and profit. I value:$ 1 l -' ,.,.'. -= -.:- _CATCGORI''OF,CO'\STRCCT101- -. °`:',. ❑ 1- and 2- family dwelling ❑ Conrmcrciel5tudustritit ❑ :1ct:ssory building ( 1t,G5IDL�TJAI [QI:1.PdIE�F/ s1 aTCAlS FE£s* I ` For special iniorn:e ion use chccklat. 0 Multi- family ❑ Ivlaster ❑ Other: t Description � 1 Qty. I Ea. 1 Total :•, JOB SITE I \FORRL• \TIO\ AND LOCATIO \ Ile:ttine /cooline Job site address: I QA.Z4 � I �j jj ' � � I Air conditioning heat pump (::,sites sire plan Sho wit:!• placem ^u:l ( ( I 14,00 1 l I Ciry /State,7-lP: '1 16,Ort2D, O 9 _7213 I Furnace 100.000 BTIJiductsiventsi 1 I I 14.00 14- 1 Suite/bldg �apt.:to.: Project name: , l tntaee 100.000- BTU (da ;;s', ct;ts) 1 I 17.90 1 5"f� -CST - Tolt.111 rM` ,ts heat pump 1 14.00 1 I Cross str`eei'directions to job site: Duct work 1 14.00 1 I 1 1 5.:w q�,t, AV Residential eni hot water system I 14.00 1 I I Rsid boiler(radiator or I 1 hvdronic) 14.00 I ( Unit hctc s (fuel -type, not clect icj, 1 in -wall, in -duct, suspended. etc. I 10.00 I I Subdivision I Lot no.: Flue/vent for any of above 1 I I 10.00 1 (0 - Other. 1 I 10.00 I Tax mapiparcel no.: (51 35 AA 03E300 -- 1,5I 5Aao39O( I Other fuel appliances _ -' DESCRIPTION" OF WOO • Water heater 1 I I 10.00 I ) D - ' Gas fireplace I I I 10.00 ! 10 - Ci 0 A T7:IL.CT70►■1 C?c' Log IT 3 f Flue vent for water heater or gas I -plc, IAA rs -1 I frenLice 2- 10.00 2v- �� � Log lighter (;as) 1 1 10.00 I Wood /pellet stove I I 10.00 I 1. i Wood fireplace/insert 1 I 10.00 I I 1 -- { Cltimnev/liner/Ouevent 1 I 10.00 I 1 I I Imo .- I ROPER7'3 .0:!'ti,ER - .4 ,:,--•-,- . - ...0 'rE'�.A.\T - _ . .. . I Other: I I 10 00 I I I Name: QA-K STt't26 -r - i cvdi1.4._i o Ni s-5 �{„f✓ I Environmental exhaust and ventilation I Address: 1 � (p W r Ranee hood /other kitchen I S LG9B t !h'VIr , STc, tCC eauinn:cnt 10.00 I I city/slate/zip: - A-213 , OR 9 ��3 I Clothes dryer exhaust 1 I I 10.00 1 10 - _ Single-duct exhaust (bathrooms, Phone: (C�m C • =l0 I Fax: (GDS ) 59 .90g-( toilet compartments. utility morns) 1 3 I 6.50 1 2). 4) -.,: : -:u rn [CAN] 1 - : - 0 CO \T ACT PLR,O\ - - ... , I Anicic:awlspace farts 1 1 Moo I �cpN A cc a-{ I'j'• � Pr I Other: I 1 10.00 I Business name: r ..AIJtJ1n(G Rs . . I Fuel piping Contact name: LAN GG - 0121Q -I oR M0N t Cq S1 ..t :et 55.40 for first four: Si.00 fur each additional Address: Gj'lV 51,1 ti/Lia -T - 4 1- l use ' r Furnace, etc. I I 1 5401 5.401 s / , �t (-G t"� {�V , 5 . 2 ` DE Gas heat pump I 1 I City /Sta1JZIP: VbeivN prZ 970 Wallisuspended'unit heater I I I Phone: ( j (2 Fax: Water he tt r I I S• I 9n 1 590 G} •�Cdv I I : (563)0}4 :7Cdo9 E -mail: I 0{ C.cr1 Qrt�'1 r+. o M Fireplace I I 15 ` 1 5 4o � Range I ( 15. �v 1 �o . : - • . . C . .. , ._Co'-' 11uL --0A_- :'`_ - I Barbecue I 1 I Business 1 Thermal Flo Inc I Clothes dyer(Fns) _ I I 1 l 1 Other.. 1 I I • 1 Address: 7236 SW Durham Rd Ste 100 (,_,;-_ .. ' • ' - A1 F.Clft1 \'ICAL PI ;Itt \ l'1T FEES''' ' 1 - Cit.y :State Portland OR 97224 Subtotal me: P: 503- 670 -8343 F: 503 -620 -1953 • y Mtttimutn permit fee (572.50) 1 -- CCB: 151847 1 Plan review (25 %ofperit ;c)1 _ I CCE lie.: i t 1 rm I- State sutth3 ge (S% of permit fee) 1 I k i I I TOTAL PERMIT FEE 1 1 Authorized Sle^.atart,. This permit application cspirts if a permit is nut obtained oitbin 18U - __ _ days after it has brett accepted as complete. i t Print name: 'r N,1 i I Date: 0{.. . I • 1:ez methodolou: S: a -. ! 1 : by 7'ri- Cnt:at ;• Rait,l:n t :Em:try Service Board i• �Ik: ldinr!'rn:its %OtEi,- Pe:mi :Apadae 12 :acI -o, ;T (1Ud'- itO11'11'F13) • Plumbing Permit Application] ; , )� FOR OFFICE USE ONLY t _ 2 City of Tigard " ' Received 13125 SW Hall Blvd., Tigard, OR 97223 Date /B Permir j s (- QQ 3 / l j Plan Review u� Phone: 503 639.4171 Fax: 503.598.1960 Other Permit No.• ;441.11i1 Date /By: 24- Hour Inspection Line: 503.639 4175 . Date Ready /By • Juns' D See Page 2 for Internet: www.ci.tigard.or.us Notified /Method• Supplemental Information TYPE OF WORK - _ FEE* SCHEDULE .. ' . - For special use checklist fX New construction I=1 Demolition 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 SFR (1) bath 249.20 ❑ 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: I 041-14 SW Ak-t t (EA 1J iri2-12-01-e-E Catch basin or area drain 16.60 City/State /ZIP: -11 GAiZiD O• G7 27_3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: CM< 3O €e1 ki l..[.0MEC Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 5‘A/ gOi1. �. Manholes 16.60 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.: 151 ?j 5 AA 038'00 d- 1515 I Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 COM1(12_ UCf1 01.1 OF LAVE I 3/ Bacicwater valve 16.60 - 64.-E. WILL 4(p () h r r 5 - f L • Clothes washer ( 16.60 I Co . ( Dishwasher 1 16.60 I ( (pC r( PROPERTY OWNER ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: OqK 51-72...1- I ow NN OM , LLC_. Expansion tank 16.60 Address: 124 SW ( / , St lTE 400 Fixture/sewer cap 16.60 City/State/ZIP: -('1( /j) , p12 CI / Z23 Floor drain/floor sink/hub 16.60 Phone: (523) ( 0 3 9 , 310.4 Fax: ( 5D3) 59.8 .9 OW I Garbage disposal 1 16.60 1 G . ( 0 0 A PPLICANT Hose bib 2 16 0 ❑ CONTACT PERSON 33. ZD Ice maker 16.60 Business name: 1 C pPl Ai .C*41 - 6.0 - T Uti? E l PLA N tJ Imo! G l r IIC • Interceptor /grease trap 16.60 Contact name: f' G iQ- O K MomICA 871_114 62. Medical gas (value: $ ) Page 2 Address: C 1 �5 Sv4 ae. Avearmi 4- LLSDP Roy , SiE.216E Primer 16.60 City/State /ZIP: �v f l t I>(. 9-7005 Roof drain (commercial) 16.60 Sink/basin/lavatory .1 16.60 (,(2.40 Phone: (503) Col 4 •76,(.4.1 Fax: : ( Sts) &44 •Cdo 1 Tub /shower /shower pan Z 16.60 33.2.0 E -mail: d (1 0 'I GO via rCk i -i-e G+. C.QVV1 Urinal 16.60 . , CONTRACTO Water closet 2, 5 16.60 f. 50 • Busin The Mullen Company Water heater J 16.60 /(p. O Addre 1601 SE River Rd Other. City/5 Hillsboro OR 97123 Subtotal P: 503-640-0113 Minimum permit fee: $72.50 Ph one Residential back low minimum permit fee: $36.25 CCB: 92689 PLM: 34 -260PB CCB L. I _ _ _ -___ _ I Plan review (25% of permit fee) / State surcharge (8% of permit fee) Authorized signature: / TOTAL PERMIT FEE Print name: - r7ANI G 04.I)12(Cl -I Date: Cam. 2-3 ASo 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•\Buildmg\Permiis \PLM- PermiiApp.doc 06/05 4404616T(I 0/02 /COM/WEB) electrical Permit Application ., I ncif, FOR OFFICE USE ONLY ; I t 1 i.uu" City of Tigard Received Permit No Tigard, OR 97223 in, ra�oo(� _0034 13125 SW Hall Blvd., Ti g Plan Review - .. 11 Other Permit 503.639.4171 Fax: 503 598.1960 t' Date/By: Inspection Line: 503.639.4175 � Date Ready /By: Tuns a See Page 2 for ntemet: 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: E Service over 225 amps, comm'l ❑Hazardous location ❑Service over 320 amps — rating EBuildn over 10,000 sq ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure IZI, 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 ❑Egress/lightingplan RV park ❑Health -care facility ❑Other. Job no.: Job site address: 10424 SA/ Abell git4 TreleieACC Submit 2 sets of plans with any of the above. City/State/ZIP: —f-(,, , I& D ect2 9'1 22'3 The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg. /apt.no.: Project name: 0Ai .STJ2 1 r0(,tS/j1 -I0ij Description I Qty. I Fee. I Total I •• Cross street/directions to job site: New residential single- or multi - family dwelling unit. Q Includes attached garage. SW I Q� A-vS. • 1,000 sq. ft. or less I I 145.15 j45.1 5 4 Subdivision: Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: I S 135AA .. I S 135A - A03A0 I Limited energy, non-residential ( 75.00 - 75.00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular CAN6'rra -1 -ricm O* LAY1 t"( 9 dwelling, service and/or feeder 90.90 2 `-� 1 Services or feeders installation, alteration, and/or relocation UPI ITS -rterrit, 200 amps or less ( 80.30 go 30 2 • g PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: OAK. S-(neef -iyo I OM Gs , L-Lc- 601 amps to 1,000 amps 240.60 2 .ddress: 12 -(plO sW (pSS - H' Pv e. , S 4 c Over 1,000 amps or volts 454.65 2 Reconnect only I 66.85 2 City/State/ZIP: —1 , OP 912.1....S Temporary services or feeders installation, alteration, and/or Phone: ( 03 ) C • 31 D , I Fax: (,)2) 59 Ts. 90g ( relocation 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 (fil, APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 ( ( 2 Business name: I GO11 A- p— cri.ilI2iU.R-E / PI N/2/ ItA 6 (NC . branch circuit B. Fee for branch circuits Contact name: mom icA 5-pL -eg_ OK DAN GcpDal43 -{ without service or feeder fee, 46.85 2 Address: -1 ' 2 5 first branch circuit � EN H It [SI� -� 'K(.�y . �.ZIOG Each add'1 branch circuit 6.65 2 City/State/ZIP: ,e1,�i ovi r c52 9 5 Miscellaneous (service or feeder not included) Phone: (o3) ( -( (p(p I Fax: : 6.-,3) (v44 —<p9 Pump or irrigation t ne lighting t ine 53.40 2 L 1 Sign or outline lrghting 53.40 2 E -mail: o n t3 q 1 e ea,rc l- -e t •GDVy) Signal circuit(s) or limited - J . • CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business i 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.: l Electrical Lie.: I Suprv. Lie.: Subtotal tprv. 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 ' t days after it has been accepted as complete Print name: -() Al GD `mi Dt21 Date: (.0• Z3.1* • Fee methodology set by Tri -County Building Industry Service Board Y l •• Number of inspections per permit allowed rU3uilding\PermitsUtLC- PermiiApp doe 12/03 440.4615T(10/O2/COMPVEB ■ • Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL.WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: 0 Audio and Stereo Systems* El Burglar Alarm Er Garage Door Opener* 14 Heating, Ventilation and Air Conditioning System* • 0 Vacuum Systems* 0 Other: rOROPj(ONLY :. Fee for each commercial system $75.00 • (SEE OAR 918-260-260) Check Type of Work Involved: • 0 Audio and Stereo Systems El Boiler Controls 0 Clock Systems O Data Telecommunication Installation O Fire Alarm Installation El HVAC 0 Instrumentation 0 Intercom and Paging Systems El Landscape Irrigation Control* 0 Medical n Nurse Calls • 0 Outdoor Landscape Lighting* O Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\Buildwg1Permits \ELC-PermitApp.doe 04/03 Plumbing Permit Application - City of Tigard • Page 2 - Supplemental Information • Fee Schedule: Residential Fire Suppression Systems: Site, Utilities. • ; . _, :_ ; :Qty = _e (ea) Square Footage :Pernik mit Fee:: _ _ - __ - - - -, Fe Total Footing drain - I 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 5220.00 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:; = _' = _; Permit`F ee ` 5 = : :_..; =_� :_, j _ = _ Storm 84 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 Ql} Fee(ea) ' °Total additional $100.00 or fraction thereof, to and Fatllre O It em = . - _ .: 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 $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1._' 0 for each additional £100.00 or fraction thereof. Fixture Work: - Plan Review: for CQniplex • 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 futures could result in increased sewer fees*. Please check all that apply. • Quantity by (Fixture)'Work Perfoiined• • ❑ 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 ig 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 - - _ 1SOIf ethllc�OT'RLCC3 . Diagram • 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 Water Extractor *Note: If the fixture work under this permit results in r 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. i.\Bmldmg'Permns\PLM- Permivlpp doc 07/06/05 : - ' Building Division I . i \ R D One & Two-Family Dwelling • Fees Checklist PFitift INFORMATION:. '73.: -� �^+^. _ �va- : _ - -. a � �r.s..srd � ,.: ` , �.-. 73 '�. 7 _.. r rle i. r A :� ..� ���..._ • -. _ e..: --... ,-.::; �:�} °I <:'. '. �a Permit #: /15 - 00 3/11 - Plan #: 0 ft tr A Dace: / . a -= G -- 06, ' . _'�t .. w i • Site Address: Mint/ 5,J A Ica t.- t ,.) 1-4,2R. Parcel #: Subdivision: QA k s`r2 f f r - rov , ..bo 110 ME S Lot #: JI Zoning y jurisdiction: _ Setbacks: Front Rear: Left Right Class of Work IVI k i Stories: 3 First Floor: .1/ 1/ Type of Use: 5F Height: 3s ' Second Floor: Ss-5 91 • Construction: _CA) Floor Load: So Third Floor: Sy l Occupancy Group: g 3 Dwelling Units: / Bonus Room: Valuation: /i 7 q/ 13 7n Bedrooms: Total Floors: / 3 9 e/ , - _ Bathrooms: 3 Basement Decks: Q A Garage: .77 5 0 pp� ' Porches: ,,s0 Other: r� E .:,� Y " --'r te . Wca dmi. ��.:^ .� K _. r srw. � n- _ o ° - -+wryes t Plan Check Building: svo. l = a 90•07 � 7 ,. �+_= �st) r) c� �/ a • o Extra Set: Permit: Building: $ya . To 192 ,5 Tax: 7l -c-/c, 7/ 1 10 Metro CET: /a/ .90 I AL i .5 0 Mechanical: 9 3 to 9-90 Tam 756 ` 7.,so Plumbing oa ,3q7 vo Tax: 3 1 4 ) 3i . 9 2 Electrical: a 11.95" ?//.Q S Tax: IA •9 f'•9„ Low Voltage: 7S- 00 75 Tax: G . r00 6 -Cr) SDC: CDC LRP Fee: r .0c, 6 Co CDC Ping. Rev.: 1./ S. c o t i i. ,» Parks: `I013. 00 ! /;) � 3 - e: r) TIF Res.: ? Cccb rx, • co TIF MT: 2)o. 00 ) ?. 0 00 Erosion Permit Cy_ 00 C-/ cc, Erosion CWS: ao . 4 10 ..70.:c Erosion COT: ?v - 9/2 90. ctO Water Quality: – _ Water Quantity: — — SUB-TOTAL 9 4 / Gn 60 f'... r r, 9 .2 I0 K(') Sewer: Permit: )7c•n rr ) 7 00 – Inspection: 3s. co 2 ,5 - SUB- TOTAL: ' 7 35. 0 TOTAL MST & SWR: I.2 , ) 9 . /- : - r , i , te e Li,;' 4„ I.\Building\Fo ms\RcsPlanChedcFees.doc 06/29/06 Page 1 PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential a uipment/ ) Description I Qty. I Fee(ea.) I Total Description I Qty I Fee(ea.) I Toad �' ; • - . N e w I - '' :`- 3 " ` -" 2; Heating/Coast Heating/Cost ;_ ... - -. '(Includes tall R. itBfti `? " Air conditioning or heat pump / 14.00 Ii/ 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 I 399.00 3 99. G» Gas teat pump 14.00 Each additional badvkitchen - 45.00 . Duct work 14.00 Rain Drain, single Tamil 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 greats 309.00 (in wall, in- duct, suspended, etc.) 1 4.00 `." ► ! :" :• $ Site Ut ai ':"�`;�4." `: ;y. =*- 3- 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 Fed Apps Footing drain • I" 100' / 55.00 Gas fireplace / J 10.00 / v Footing drain -each additional 100' 46.40 Flue vent (wider beater/pas fireplace) 10.00 Manufactured home utilities 110.00 Log lighter (gas) 10.00 Mar>twles 16.60 Wood/Pellet stove 10.00 Rain drain connector 16.60 Wood 6replaoerase t 10.00 Sanitary sewer -1" 100' 1 55.00 ChimneyAinan trdvan 10.00 Sanitary sewer - each additional 100' 46.40 Other: 10.00 Storm sewer - c 100' / 55.00 g..frossamed Kalwast & veataausa • : Storm sewer - ears additional 100' 46.40 Range hood /other kitchen equipment 1 0.00 /('" Water service - 1" 100' I 55.00 Water service - each additional 100' 46.40 Clothes 10.00 d- - - ,, yam .�. :k. ,due orb= .z*rz . ;oc?.cr. - .. - .....44-1.4.4* Single duct exhaust Absorption valve 16.60 (mss, toilet compartments. Backflow prevents 27.55 utility rooms) 3 6.80 ./) . tic) Backwater valve 16.60 Attidaawl space Fens 10.00 Clothes washer I 16.60 Other 10.00 Fad Piping • " Dishwasher / 16.60 ••(WM for first 4, flab each additioul) Drinking fountain 16.60 Furnace, etc. 1 - • • Ejectors/sump 16.60 Gas heat pump • • Expansion tank 16.60 WalUsuspadcd/unit hcata • • Fixture/sewer cap 16.60 Water heater / • • Floor drain/floor sink/hub 16.60 Fireplace • • Garbage disposal I 16.60 Range • • Hose bib ,.,2 16.60 BBQ j • • toe maker 1 16.60 Clothes dryer (gas) • • Interceptor /grease trap 16.60 Other. • • Primer 16.60 Total: /-/ -3 `/ O Roof drain (commercial) 16.60 Meeka.kal Permit Fees - Sink/basin/Iavatory 1 70/3 3 L 16.60 , Subtotal: S ? j?O Tub/shower/shower pan 16.60 Minimum Permit Fee $72.50 S Urinal 16.60 Plan Review Fee (25% of Permit Fee) S Water closet 3 16.60 State Surcharge (8% of Permit Fee) S • Water heater / 16.60 TOTAL PERMIT FEE - S Other: Other: ELECTRICAL FEES (raideatiai single - or multi-family) Pleebing hermit Fees - • Description Qty. Fee Total lssp Subtotal S 399.00 1,000 sq. R or less / 145.15 4 Minimum Permit fee 572.50 S Ea add'$ 500 s4 ft. or portion 2 33.40 I Plan Review (25% of Permit Fee) S State Surcharge (8% of Permit Fee) S 31.5a Limited energy, residential / 75.00 2 TOTAL PERMIT FEE $ Each manufactured or modular dwelling. service and/or feeder 90.90 2 • FJeetrk J Pend* Fees Subtotal: S 11. C Plan review (25% of permit fee) S State surcharge (8% of permit fee) S /2 cj TOTAL PERMIT FEE S I.\ Building \Forms\ResPlanCheckFees.doc 06/29/06 Page 2