Permit Building Permit Application
E X\' I RED-
RECEIVED ti)ltt)iltt , , ,, ()\I 1
City of Tigard DEC 19 2008 Dated f►�L �:�! ' Permit No.: „ r�� 48
11114 i 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
b°21111
Phone: 503.639.4171 Fax: 503.598. Date/B : Other Permit: • t e 0,4;
Plumbing Permit Application
Building Fixtures RECEIVED I OR OI I I( I I ■I OBI 1
ed
City of Tigard Received Permit No.: �Q
1114
• 13125 SW Hall Blvd.,Tigard,OR 9722f C 1 9 2008
Date/By: ('Z ��. C1 �/]'$ 2Oo •Oo!W
: ■ Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Permit Noa'V' R,a01 Q+(f
Inspection Line: 503.639.4175 + Date By.
� CITY OF TIGARD Date Ready/By: luris: ii See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
®New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
SFR(1)bath 249.20
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath A 350.00 #f3,CO
❑Accessory building ®Multi-family SFR(3)bath 399.00
Each additional bath/kitchen 45.00
❑Master builder ❑Other:
Fire sprinkler(_sq.ft.) Page 2
Site utilities
Job site address:9304 SW Mandamus Court Catch basin or area drain 16.60
City/State/ZIP:Tigard,Oregon 97223 Drywell,leach line,or trench drain 16.60
Suite/bldg./apt.no.:B5-25 I Project name:Longstaff Footing drain(no.linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:SW 95`"Avenue and SW Shady Lane
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision:Longstaff f Lot no.: Water service(no.linear ft.:_) Page 2
Fixture or item
Tax map/parcel no.:
Absorption valve 16.60
Backflow preventer Page 2
Condominium Domestic Supply,Waste&Storm Drainage Backwater valve 16.60
Clothes washer 1 16.60
Dishwasher ' 16.60
Drinking fountain 16.60
Ejectors/sump 16.60
Name:Longstaff LLC Expansion tank 16.60
Address:7050 SW Clinton Fixture/sewer cap 16.60
City/State/Z1P:Tigard,Oregon 97223 Floor drain/floor sink/hub 16.60
Phone:(503)598-7565 Fax:(503)620-9965 Garbage disposal 1 16.60
Hose bib 16.60
Ice maker 16.60
Business name:Longstaff LLC
Interceptor/grease trap 16.60
Contact name:Ron Lightner Medical gas(value:$ ) Page 2
Address:7050 SW Clinton Primer 16.60
City/State/ZIP:Tigard,Oregon 97223 Roof drain(commercial) 16.60
Phone:(503)598-7565 I Fax::(503)620-9965 Sink/basin/lavatory I/O/- 4 16.60
Tub/shower/shower par 2 16.60
E-mail:RLightner @RCMHomes.net Urinal 16.60
Water closet 16.60
Water heater ) 16.60
_Wolcott Plumbing Contractors
1075 W Historic Columbia River Hwy ther:
Subtotal
Troutdale OR 97060 Minimum permit fee: $72.50
503-667-9891 Residential backflow minimum permit fee: $36.25 f
"CCB: 23847 PLM: 26-208PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) A2.00
Authorized signature:
TOTAL PERMIT FEE 3f'(2.Io
Print name: Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PI.MF•PermitApp.doc 12/27/06 440-4616T(10/02/COM/W£B)
RECEIV
Mechanical Permit Application O1/ 1)l I It I l ',l t l\l
DEC pr
20C C, Received
City of Tigard Date/13y: • - t _ Permit No.: I `
..11108' •O
111
13125 SW Hall Blvd.,Tigard,OR 97223 �:i
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGA 4.tr. Other Permit:' : •• 9
Inspection Line: 503.639.4175 luunING DIVI• 7`..
eady/By: see Page 2 for
Internet: www.tigard-or.gov otified/Method: Supplemental Information
®New construction ❑Addition/alteration/replacement Mechanical permit fees'are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
For special information use checklist.
0 Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
Heating/cooling
Air conditioning or heat pump
Job site address:9304 SW Mandamus
(requires site plan showing placement) 14.00
City/State/ZIP:Tigard,Oregon 97223 Furnace 100,000 BTU(ducts/vents) 14.00
Furnace 100,000+BTU(ducts/vents) 17.90
Suite/bldg./apt.no.:B5-25 I Project name:Longstaff
Gas heat pump 14.00
Cross street/directions to job site:SW 95`s Avenue and SW Shady Lane Duct work 10.00
Hydronic hot water system 14.00
Residential boiler(radiator or
hydronic) 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 14.00
Subdivision:Longstaff I Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map/parcel no.: Other fuel appliances
Water heater 10.00
Gas fireplace 10.00
Condominium Mecanical Ventilation Flue vent for water heater or gas
fireplace 10.00
Log lighter(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
Other: 10.00
Name:Longstaff LLC Environmental exhaust and ventilation
Range hood/other kitchen
Address:7050 SW Clinton 10.00
equipment
City/State/ZIP:Tigard,Oregon 97223 Clothes dryer exhaust t 10.00
Phone: 503 598-7565 Fax: 503 20-9965
Single-duct t compartments,ts(bathrooms,
( ) ( )6 mne utility rooms) � 6.80
Attic/crawlspace fans 10.00
Other: 10.00
Business name:Longstaff LLC Fuel piping
Contact name:Ron Lightgner $5.40 for first four;$1.00 for each additional
Address:7050 SW Clinton Furnace,etc.
Gas heat pump
City/State/ZIP:Tigard,Oregon 97223 Wall/suspended/unit heater
Phone:(503)598-7565 I Fax::(503)620-9965 Water heater
Fireplace
E-mail:RLighter @RCMHomes.net Range
Barbecue
Oregon Comtort Heating Clothes dryer(gas)
"PO Box 190 Other:
-Eagle Creek OR 97022 Subtotal
_Ph: 503-655-0221, F: 503-650-2933
CCB: 42519 Minimum permit fee($72.50) .-72
j-�
Plan review(25%of permit fee)
c.n uc.. - -- State surcharge(12%of permit fee)
TOTAL PERMIT FEE k •ZQ
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
1:13uilding Pennits\MEC-PmnitApp.doc 01/19/07 440-4617T(I1/02/COM/WEB)
1
Electrical Permit Applica CE \JED l ul, OI l 1( 1 1 .I 0\I 1
Reserved
City of Tigard _ i 4 • ` _ Permit No IL. 4r ro r_
IN
13125 SW Hall Blvd.,Tigard,OR 9722 1 - 71P• Plan Review �/ a
g Phone: 503.639.4171 Fax: 503.598.1960 pa�/g ; Other Permit: . _ .0... a • 1
I I c r.l Inspection Line: 503.639.4175 f�+f•TY OF T�GARE) Date Ready/By: 1 S: ® See Page 2 for
Internet: www.tigard-or.gov ' 'ON Notified/Method: I C Supplemental Information
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
['Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
®Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address:9304 SW Mandamus Court 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,Oregon 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:B5-25 I Project name:Longstaff ❑Service or feeder 600 amps or more.
Cross street/directions to job site:SW 95th Avenue&Shady Lane Description Qty. Fee. Total •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision:Longstaff 1 Lot no.: 1,000 sq.ft.or less [ 145.15 1f6,1 4
Ea.add'l 500 sq.ft.or portion ( 33.40 ' j, I
Tax map/parcel no.: Limited energy,residential
i (with above sq.it) ( 75.00 -pi; - 2
Condominium Electrical,Low Voltage Phone&CATV Limited energy,multi-family 75.00 2
g residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 80.30 2
TY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name:Longstaff LLC 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address:7050 SW Clinton Over 1,000 amps or volts 454.65 2
City/State/ZIP:Tigard,Oregon 97223 Temporary services or feeders installation,alteration,and/or
relocation
Phone:(503)598-7565 I Fax:(503)620-9965 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 599 amps 133.75 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
above service or feeder fee, 6.65 2
each branch circuit
Business name:Longstaff LLC B.Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name:Ron Lightner first branch circuit
Address:7050 SW Clinton Each add'I branch circuit 6.65 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Tigard,Oregon 97223 Each manufactured or modular 2
90.90 dwelling,service and/or feeder
Phone:(503)598-7565 I Fax: :(503)620-9965 Reconnect only 1 66.85 2
E-mail:RLightner @RCMHomes.net Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
UMS Electric Signal circuit(s)or limited-
8504 SE Stark energy panel,alteration,or
extension.Describe: Page 2 2
.Portland OR 97216
CCB: 118073, ELC: 37-742C, Sup: 4542S Each additional inspection over allowable in any of the above
Per inspection 62.50
Investigation per hour(1 hr min) 62.50
CCl3 Lrc.: I Electrical Lic.: I Suprv. Lic.: Industrial plant per hour 73.75
Suprv. Electrician signature,required: Subtotal: f,33,
Print name: Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee): ,4
Authorized signature: TOTAL PERMIT FEE: 3. I .
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doc 05/23/06 440-4615T(I l/05/COM/WEB
U , " Building Division
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: q
Permit #: �i�, eio - CO( ,.j Plan #: t9 IT I Date: /,,j id [
Site Address: . (� Parcel #:
Subdivision: Lej !- 0'O 10(0/14S Lot #: Zoning:
Jurisdiction: 'r6 Setbacks: Front: Rear: Left: Right:
Class of Work: o Stories: First Floor:, I fY7
Type of Use: RES Height: Z'J Second Floor: _ _
Construction: ,5 Floor Load: C,-.. Third Floor: -
Occupancy Group: Dwelling Units: 1 Bonus Room:
Valuation: 1 CAI% Bedrooms: 2 Total Floors: t ef7' d -
Bathrooms: 2- Basement:
Decks: Garage: ZZ� 1.
Porches: -- Other:
FEES: Description: Fee Amount: Amount Paid: Balance Due:
Plan Check: Building:
Extra Set:
Permit: Building: 3 a,,
Tax: 4, C-:�r 71
Metro CET: e ( Z-5, .7
School CET: 4 /0'7'3.00
Mechanical f; '7'Z,-?-fig
Tax: '$ e,.70
70
Plumbing: 4 ),0
Tax: 4 4Z,
Electrical: t ("7 ,-- -
Tax: 5 21 ,4c3
Low Voltage: '16 '7'5 c
Tax: l , '}
CDC: CDC Ping. Rev.: 'S •IL,. CO
CDC LRP Fee: :, , lb I
SDC: Parks: .5 Z,Z
TIF Res.: .. (7G i•-�r
TIF MT: •d6 (4C,`7&j
Erosion Permit: 4, &A
Erosion CWS: )�,80
Erosion COT: Aj 20, 8 C3
Water Quality:
Water Quantity:
SUB-TOTAL:
Sewer: Permit:
Inspection:
SUB-TOTAL:
TOTAL MST & SWR:
I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 1
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems)
Description 1 Qty. 1 Fee(ea:) 1 Total Description Qty 1 Fee(ea.) 1 Total
New 1-&2-family dwellings Heating/Cooling
(includes 100 ft.for each utility connection) Air conditioning or heat pump* 14.00
SFR(1)bath 249.20 Furnace 100,000 BTU(ducts/vents) 14.00
SFR(2)bath 1 350.00 '3),C) Furnace 100,000+BTU(ducts/vents) 17.90
SFR(3)bath 399.00 Gas heat pump 14.00 _
Each additional bath/kitchen 45.00 Duct work 10.00
Rain Drain,single family dwelling 65.25 Hydronic hot water system 14.00
Fire sprinkler-sq.ft. 0 to 2,000 115.00 Residential boiler
Fire sprinkler-sq.ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00
Fire sprinkler-sq.ft. 3,601 to 7,200 220.00 Unit heaters(fuel,not electric)
Fire sprinkler-sq.ft. _ 7,200 and greater 309.00 (in wall,in-duct,suspended,etc.) 14.00
Site Utilities Flue/vent(for any of above) 6.80
Catch basin/area drain 16.60 Repair units 12.15
Drywell/leach line/trench drain 16.60 Other Fuel Appliances _
Footing drain-1u 100' 55.00 Water heater 10.00
Footing drain-each additional 100' 46.40 Gas fireplace 10.00
Manufactured home utilities 110.00 Flue vent(water heater/gas fireplace) 10.00
Manholes 16.60 Log lighter(gas) 10.00
Wood/Pellet stove 10.00
Rain drain connector 16.60 Wood fireplace/insert 10.00
Sanitary sewer- 1" 100' 55.00 Chimney/liner/flue/vent 10.00
Sanitary sewer-each additional 100' 46.40 Other: 10.00
Storm sewer- In 100' 55.00 Environmental Exhaust&Ventilation
Storm sewer-each additional 100' 46.40 Range hood/other kitchen equipment 1 10.00
Water service- 1 100' 55.00 Clothes dryer exhaust 10.00
Water service-each additional 100' 46.40
Fixture or Item Single duct exhaust
Absorption valve 16.60 (bathrooms,toilet compartments,
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve 16.60 Attic/crawl space fans 10.00
Clothes washer / 16.60 Other: 10.00
Fuel Piping
Dishwasher 16.60 **($5.40 for first 4,$1.00 each additional)
Drinking fountain 16.60 Furnace,etc. **
Ejectors/sump 16.60 Gas heat pump **
Expansion tank 16.60 . Wall/suspended/unit heater **
Fixture/sewer cap 16.60 Water heater **
Floor drain/floor sink/hub 16.60 Fireplace **
Garbage disposal 16.60 Range **
Hose bib 16.60 BBQ **
Ice maker 16.60 Clothes dryer(gas) **
Interceptor/grease trap 16.60 Other: *4,
Primer 16.60 Total:
Roof drain(commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory 1/0/3 16.60 Subtotal: $
Tub/shower/shower pan 16.60 Minimum Permit Fee$72.50 $ 7Z,' ' )
Urinal 16.60 Plan Review Fee(25%of Permit Fee) $
Water closet - 16.60 State Surcharge(12%of Permit Fee) $ ,..70
Water heater 1 16.60 TOTAL PERMIT FEE $ I , 7r)
Other:
Other:
Plumbing Permit Fees ELECTRICAL FEES (residential single-or multi-family)
Subtotal $ S ,,Qtr') Description Qty. Fee Total Insp
Minimum Permit Fee$72.50 $ 1,000 sq.ft.or less 145.15 j5 4
Plan Review(25%of Permit Fee) $ Ea add'l 500 sq.ft.or portion 33.40 3j 1
State Surcharge(12%of Permit Fee) $ ; j� Limited energy,residential 75.00 2
TOTAL PERMIT FEE _ $ � :Cr)
Each manufactured or modular
dwelling,service and/or feeder 90.90 2
Electrical Permit Fees
Subtotal: $ k ,�}�
Plan review(25%of permit fee) $
• State surcharge(12%of permit fee) $ 2,
TOTAL PERMIT FEE _ $ I '�
• L (l4' i1 b '7SW
I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 l` 9 .00 Page 2
eADD
DATE: PLANS CHECK NO.:
ice- 3 10r--
v vod//
PROJECT TITLE:
1.40„7 0(2).,7-1 ePt/AGV HS
COUNTYWIDE
TRAFFIC IMPACT FEE Nw271 04- soc .
WORKSHEET MA,002 ADS Ss5:p - s-,_____ g,23 4.3
(FOR NON SINGLE FAMILY USES) .OQ= 1--' Q/C , 977 Z 2_
TAX MAP NO
RATE PER .•
AUSE CATEGORY TRIP /�r3S�G o/0o/2S c.)/1646 idif 7 OC]
SITUS NO.ADDRES 7� Vv.
V RESIDENTIAL $339.00 /cJ c w9S!/93GS silz r3
BUSINESS AND COMMERCIAL $85.00
OFFICE $312.00
INDUSTRIAL $327.00
INSTITUTIONAL $141.00
PAYMENT METHOD:
CASH/CHECK
CREDIT INSTITUTIONAL ONLY
BANCROFT(PROMISSORY NOTE) LAND USE CATEGORY I DES TI oircO�,F�1 WEEKDAY AVG/L)PJ 'P IP WEEKEND AYG tRIP
DEFER TO OCCUPANCY .Z 3 C� USE S?UN)O I RATE S�lp I RATE 0.4 1 --
BASIS: _-�/5 ) f %-CO J C) (3011-i PLE / 2 - G,y�/�
CALCULATIONS:C,Dk T>IC.E�: 113 X Jam. 8 et, = 2 �2�r5
242, c 39.60=,e2,C38:� — /O a�l2 �E��
/•og"teT 242? 2j°v-- l�,Oso . -5/ZTZi�S
-7--.E., thirr-, -/4'2,D3(1-T43 =,1 r/9 0 � PROJECT TRIP GENERATION:
G. O SC —6'3 =7r( ISO 40 "�2�
7 sit7 5r+---l3 =, 1, 76V./6 F Es: O 3 8
- . FOR ACCOUNTING PURPOSES
ONLY
t-',9" 105 DITIONAL NOTES:HPL I -`/3 x -5//3/=/7 ° 00 '7 od)v: / cry c-LLz5 5��EMO — 5;21 S •v c7 /tom R eS/9 5 9. o v2, 5�sr . do ,�- /4D •7v T*NSITII 050 .c o CA ir- '-73 - �- i 0/2 .�L //�—/r PREPARED BY:
June 30,2008 Worksheet OB-09.doc ',!d
CC: WASHINGTON COUNTY TIF NOTEBOOK
WOLCOTT R CE d En Street Address
7075 W Historic Columbia River Hwy
Troutdale,Oregon 97060
PLUMBING APR 2 9 2009 (503)667-1781
UMBING Fax(503}687-9891
CITY OF TIGARD GCB#23847
CONTRACTORS, INC. BUILDING DIVISION
April 29, 2009
City of Tigard
13125 SW flail Blvd.
Tigard, OR 97223
C/o Debbie
Re: LongstaiiCdndominiums.
To Whom It May Concern:
This letter confirms that Wolcott will be the Plumber of record for the Longstuff Condominiums,
Thank you,
?e y N. Pe04404
Terry M. Proud foot
Project Manager
503-667-1781 X102
tproudfoot�)wolcottplumbing.com
Td Wd60:IT 600E 6E '-idt3 1686L9920S: '0N Xtid : Wald