Case File I
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7517 SW Ashford St
�` a O� �.����D -- MASTER PE!'fAIT
1 PERMIT#: MST2002-00216
DEVELOPMENT SERVICES DATE ISSUED: 5/1/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 075.17 SW ASHFORD ST PARCEL: 2)112CA-10700
SUBDIVISION: RENAISSANCE WOODS ZONING: R-4.5
BLOCK: LOT:033 JURISDICTION: TIG
REMARKS: Garage finished to habitable space.
BUILDING
REISSJE: STORIES: FLOOR AREAS y REQUIRED SETBACKS REQUIRED
Ct ASS OF WORK: Al T HEIGHT. FIRST: of BASEMENT. 51 LEFT': SMOKE DETECTORS-
TYPE OF USE: SF FLOOR LOAD: SECOND. SI GARAGE: at FRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sl RIGHT
VALUE: S 21,00 n0
OCCUPANCY GRI': R7 BDRM: BATH. TOTAL: o U" at REAR:
PLUMBING
SINKS ' WATER CLOSETS: WASHING MAC4. LAUNDRY TRAYS RAIN DRAIN. TRAPS:
LAVATORIES. DISHWASHERS: FLOOR DRAINS. SEWER LINES: SF RAIN DRAINS: CATL 'BASINS.
TUSISHOWERS GARBAGE DISP' WATER HEAL ERS'. WATER LIVES: BCY.FLW PREVNTR: 1 GREASE TRAPS
OTHER FIXTURES
11EC14ANICAL _
FUEL TYPES FURN c 100KBOIL/CMP c]HP. VENT FANS: CLOTHES DRYER:
FURN '01K: UNIT HEATERS. HOOCS: G OTHER UNITS:
MAX INP. btu FLOOR FURNANC.-S: VFNTS: WOODSTOVES: GAS OUTLETS,
ELECTRICAL
�RESIDE N1IAL UNIT - SERVICE FEEDER-� 1 EMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS. 0 200 amp: 0 0 200 amp. W%SVC OR FUR. PUMPIIRRIGATION: PER INSPECTION.
EA ADD'I.SOOSF 201 - 400 amp: 201 400 amp. 1st WIO SVCIFDR. SIGN/OU'LIA LT PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp EA ADDL BR CIR SIGNAL/PAL -. IN PLANT
MANU HM1SVCIFDR 601 - 1000 amp: 6011-amps-1000v MINOR LABEL
1000+amplvolt
_ PLCN REVIEW SECTION
Reconnect I,Ny:
>.d RES UIiITS SVC/FDR>=225 A. >600 V NOMINAL: CLS AREAISPC UCC
ELECTRICAL•RESTRICTED ENcRGY
�- A.SF RESIDENTIAL _— _ 8.COMMERCIAL _—
AUDIO&STEREO VACUUM SYSTEM AUDIO&STEREO FIRE ALARM. INTERCOM'PAGING. OUTDOOR LNDSC LT.
BURGLAR ALARM. OTH. BOILER HVAC. I ANDSCAPFJIRRIG: PROTECTIVE 31GNL,
CARAGE OPENER CLOCK. INSTRLMENTATION. MEDICAL. OTHR.
HVAC DATA/TELE COMM #n1RSE CALLS. TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 574.54
K.CHRISTOPHER B/TRACY V OWNER This permit is subject to the regulations contained in the
WALI_UC
WAL UC ASHFORD ST Tigard Municipal Code.Stale of OR Specialty Codes and
all other applicable laws. All work will be done in
TIGARD,OR 97224 accordance with approved plans. This permit will expire d
work is nct started within 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION
Phone Phono Oregun law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg a forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)2.46-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8• Framing Insp Final inspection
Mechanical Insp Insulation Insp
Plumb Top Out Electrical Final
Electrical Service Mechanical Final
Electrical Rough In Plumb Final
IstiLed By . _-�; .�j�<.�JC.1- � Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business clay
i
Building Permit Application
City of Tigard ---- Date received:�f .` d �i Permit no.• �t 1 v -rJ LI (
%/C�
Address: 13125 SW Hall Blvd,Tt�ard, 7223 Project/appl.no.: Expire date:
h 1't �t
, . � rd ",
/ Phone: (503) 639-4171 �'� Hale issued: Byrt Receipt no.:
Fax: (503) 598-1960 T Case file no.: Payment type:
Land use approval: r 1&2 family:Simple Complex:
TYPE OF N
U I &2 fvnily dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
Addition/aIterat ion/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
t
Job address: /7 `i �' '2 `�71 z Bldg.no.: Suite no.:
Lot: Block: Subdivision: A',,/ , Tax map/tux lot/account no.:
Project name:
Description and location of work on premises/special conditions: Ct;A.�ed.—C- F-_Lb_jt 4j!ELU -T-tJit F�
OWNER FOR
' '
lain.--eplickapacity,solar,etc.)
Mailing address: _'� 7 set/ 'voj 1 &2 family dwelling: () ,
City T/�,.*, V! State: OJZIP: 7,t3� Valuation of worl ..................................... $ —
Phone:sS; 9 -t,?c, -.2 17 Fax: F:-mail: No.of bedrooms/baths.................................
Owner's mpt-vwntative: Total number of flans................................. ---
Phone: New dwelling area(sq.ft.)
Garage/carport area(sq.ft,).........................
Name: Covered porch area(sq. ft.) .........................
Mailing address: I)cck area(sq. ft.) ........................ ............... _
City: State: ZIP: ()(her structure area(sq. ft.).........................
Phone: — Fax. E-mail: ('ommercial/industrial/multi-family:
Valuation of work........................................ $
�, (, r —_�
Existing bldg.area(sq.ft.) ..........................
Business name:
Address: New bldg.area(sq.ft.) ................................ _
- -- — Number of stories........................................
City: _ _ State: LI{': _ -
Phone: Fax: E-mail: rYl of construction
— Occupancy group(s): Existing:
CC6 uo.^_ ---- -
-- — Nc w:
City/metro Gc.no" Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Nie; Uu,,n,.e provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: - State: 711,: exempt from licensing,the following reason applies:
Contact person: Plan no.: — - -
Phone: Fax E-mail: — -- -- -
Name: _ Contact person: Fees due upon application ........................... $
Address: -- Date received:
City: — — — State: 7_1P: _ Amount received ......................................... $
Phone:— Fax: E-mail: — — Please refer to fee schedule.
hereby certify I have read and examined this application and the Not all luriedietione reap credit cattle,please call)unedicaon ror nuxeintormnuon1
attached checklist.All pmvisions of laws and ordinances governing this U vias U Masterf arts
work will be complied whe er specifrfd here or 91. Credit cora number
/ I:tpYrn
Authorized signature:C r �* 7� — Naar d cardholder as shown on credit card
Print name: 1,61•,s // — - — S —
Cardholdet eipature Amount
Notice:This permit application expires if a permit is not obtained within ISO days alter it has bee accepted as complete. 44G-4613(6MOCOM)
One- and 7'wo-llanjily Dwelling
Building Permit Application Checklist Reference no.:
-- — Associated permits:
(lrrn/"/n;,nJ
City of Tigard U Electrical U Plumbing U Mechanical
Address: 13125 SVS' I lalI Blvd.Tieard,OR 97_'.'{ U Other:
Phone: (503) 639-4171 —
Fax: (503) 59R-1960
T HE ! 1 1 ! FOR PLAN REVIEW Yes No N/A
I Land use actions cornplcl, See jurisdicuun CI II(Alll lilt C011CUITC111 t'CVICWS.
2 toning.Flood plain,sol-ii balance points,seisnuc ,oils designation,historic district.o
3 Verification of approved plat/lot.
4 Fire district _approval required.
5 Septic system permit or authorization for remodel. Existing system a^nacity
6 Sewer permit. —
7 Water district approval.
fl Solis report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control U plan U permit required. Include drainage-way protection,silt fence design and location of
catch-basin protection,etc. _
1() 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable I al and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
il'copyright violations exist.
I I Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if
there is mon:than a 4-ft.elevation differential,plan must show contour lines at 2-11,intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot
arca:building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
12 Foundation plan. Snow dimensions,anchor bolas,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detector( vater heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor.
wall construction.roof construction.More than one cross section may be required to clearly portray construction.Show
details ol'all wall and roof sheathing,roofing,roof slope.ceiling height,tiding material,fernings and foundation,stairs,
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot it building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable. _
Ie Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for
non-prescriptive path analysis provide specifications and calculations to engineering standards. _
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing.spacing,and hearing
locations.Show attic ventilation. _
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems,see iteral 22,"Engineer's calculations."
19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple,joists
over 10 feet long and/or any fvaam/joist carrying a non-uniform load.
20 Manufactured_floor/roof truss design details.
21 Energy Code compliance.Identify the prescriptive path or provide calculations.A gas-plpinQ schematic IS required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e.,shear wall.roof truss)shall he stamped by i n engineer or
architect licensed in Oregon and shall he shown to be;1pplic;Ihle to the project under review.
23 Fivr(5)site plans are required for Iten1 I I above. Site plans must he 9-1/2"x I1"or 11"x 17".
24 ')wo(2)sets each are required for Items 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will b:not accepted.
26 "Reversed" building plans must meet criteria outlined in the Permit&System Development Fees document.
27 "Drawn to scale" indicates standard architect or engineer scale. _
79 Site plan to include tree site,type&location per approved project street tree plan(if applicable),and COT Street'free List.
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved for department use or'y. 440-4614(acWOM1
04/25/2002 15:09 5036283076 HEBERLE ELECTRIC PAGE 01
03/04/2002 09,39 FAX 50329A880 R-J-Platt-Const:- CV'
Iwlec deal I"'crinit A►ppllcatio
l)ttertxeived=`� U�- PeM*no.: 7
City 13f Tigard Project/appl.no,: IGAyiredue-.
C17,rrfnoa►d Addre9e: 13125 SW t ell Filed.Tigan1.OR 97223 Date isstled. Byfk.i- FRt Ptna.;
Mimic. (501) 639-4171
CMO Isle 110: ►.+aymenttypes'
Fnx- (501)598-1960
TAM use approval.
Ac 2 family dwelling or acc essory (]currlmerLiailindlirrrial O Maki-ramtly U Tenant Improvement
U Nrw construction ddthon/altornllurtlreptxt entr❑t J(A]rI- _ _ U partial
Job adON$' 775 l j1,.515�QR-p St"' _ Bidg.no..
quite no.: Tax ma tats lodeceouat no.:
Lok Block: Subdivision'
PrctJtxt naftu: __WI� c*4, DeAcription and Location of work on prtsrnlscs: �1� �
.-
ristlmated date of eom letiuribli prchor.. ys•,` G��'.
.lob elmK.>h Mart
� I� G�RI� r ,i,�;-� (cam) Taxi nm lM
BQlxillep tl9t11r: Irl ��auef_Road---- ..- Ive.�tes�+rntaal-.Itrete�ar nwm intaOy ptT
Addrr.>ia: _---I968tT 3.9445 4WMnrMk,;nritadwxttacfirdV"-F r.
•c1 tat
.' e: 2TP• _! :gnnkratia,trd:
• tOtM.^5�n, n lar 4
""Me: , 'r ` Fan: . 3'J mail — 6+ch
maeddcotenttawS0o
CCBno.: Eke,bus.lie.no: usynporoae ebaof
mtfnf 7
t rt e lie,no.: _ Llrtocedeneray,non nslEental
'�'- �� • Etteh manufstlurcd Items or mt>tlttler dwellln6
8nature of Vic) ian u_irod__-) [� Dater�LPi Service ae rh0@11r�^ -
$op,n1ecL tram tent)- ,�r ��' `( lcatn•rho; j'�'b-�j .rirnirev fr•elrry-tlstalla aa,
xherxtian '� � ��j 1 i
ZIw unpsarlcas
Nsllte(pr1 t)' ��57111 am Ie 4UU s... . �
401 adeps ro 6t10 unpl
Mailing nd as __ _ - 601 unps tDitxx)unpr
Cily. -�- gf'tC; : tMt r 11100 wps or vola -- - —
Phone; Fax: L.mail: Itmonnect onlyt
`Clwfler i atitm 'Ilra iustallauou is heinp,made on prccprity I nwn Teo �' a0v
whic817,t not intended for We,letre,rent,or exch:urgr arrtmting 14
200 imps or lest
ORS 447,455,479,670,701101 to stxl„r, , ._ - 2
(Anew sl t?atc: 401 tofiflo LM
-- S mebel"its-laefl.afterafi0%
a valnadnn per pnati:
Nome: _ A. Fee fnrhnrtch citcuitl wit tirchA"of
Addms: serv:.c e;feeder foe each bmeh cir>;ttit
City' State: 7fF: 9.
Fee for tripwAl lruitdwtt ,nprcc�rue
-- of aerviec at ftrrler fm fim Inaech dMWe
Ehrh additioonl hraoch cilerilt:
Mint(Bewke M federatN Ylalallefr
U Smlrr nvFf 2]S amptontmew ia1 Cl}f�ulrh cnebcilitr Wi pump or hrl ation circle t
M 9erviee over 320 arnpr-retina of I 2 U H1a»mbat IeeadM Each r orntNlloe ' R - —
rnmily dwellings 13 B911dlno nvy 10,0110 umpte►ext fbw a Sihnal a tae)or a limited erherlry para. Z
Ll Sy'"em over 600 vola nnrrtirul ntrrre residen0al unit in one Mc9're al ietttion,ar utrrwioa'
U 11ni)(UM ovef three non•• U Fa'elrse,4on amts of mora •h _
0 paretpant Inad nvn 99 t,Amim O Mana(Ktntld structure+rt Kv,,,ret r WtetMr)Mspeclltrn offer f11!xnoaxMe i a"sf f,in Wa'e -
O 4"Othting1101n U tither
ISub it,..- _Wo nt plans svhh my of the shove Irrvcf�ntloo fta
Tito above are ssal appOmMe to teapottry cowmcrion tfvicc. ahR
Nntap �M wSaneytstetcatdr.rk�eallJ �►� m Notiat 7ltiepremiea{�IiuUion Pemdtfee....------- .....s ,
U Visa atte aw c-xpltcs if x po:ntit i5 Leet nblelned Plin review(et
ch air a.bm..- ?ov-p__i to•370,7-_ �Z a>R`y within 110 Lays sRet it hav Lawn State SurchRrge
J E.Y ®—® accupt"I H romptete. TOTAL ..._.....
. ,...,..!
n4tnn 7 M ,M1Y w $t
. l y�
A -
Mechanical Permit Application
Date received: Permit no.:
City of Tigard ProjecUappl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.:
1ja 11
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction /Addition/alteralion/repl icemcnt U()thrr
Job address: 75-/? -j c77 S '/ MT si T7e f�'�! C)7 Indicate ealutpnlcnt quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: — profit. Value$
Lot: jBIock., Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fire.
City/county: / ora U y ZIP: 97,1 Yt 1
Description and 111cation of work on premises:_L,��f_ -!8�� 1 1 t 1 1
,f'v_,►► ��r t�usril.e s s. r7_ 1.ec(ea.) 'Total
Est.date of completion/inspection: ,ru lie / Uescri ion Qty. Res.ordv Flex.onh
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or con itioned! Yes U No it conditioning(site plan required)
-- -
Is existing space insulated7)dYes U No sting HVAC system -
oi er�essors -- -
Business name: �L;� t� State boiler permit no.:
-- HP Tons -BTU/1IAddress: it smo a-damper uct smo a ejectors ----
�.e-- - --
City: State: ZIP: Heat pump(site plan require ) —
Phone: Install/replace urnac urner
CCB no.: - Including ductwork/vent liner U Yes U No
nstal rep ac relocate eaters-suspen c , -
Cily/metro lic.no.: wall,or floor mounted
Name(pleaseprint): Vent for appliance other than furnace
Refrigeration:
Absutplion units Ii I l i/Il
Nam /e: ` 11 z is (ti/i1iL Ltt C Chillers --
Address: - - Compressors_
'ov momenta exhaust an vent ton:
City: T/��r State:[,i�^ ZIP:�J Appliancevent
I7 Fax: E-mail: Dryetexhaust
foo s. Type res. itc a aztnat T
hood fitz suppression system
Name: e f- Exhaust fan with single duct(bath fans)
Mailing address: -7 S&4 i~re 1-d' S r :x aust s stem a art from heating or AC --
(City: /G,¢r�� _ State: p_t ZIP: ,7 2 2 c� Fuelpiping an distribution(up to outlets)
- — Type. 1-1'C, _ NC Oil _
Phone: y ' L 10 ,+7f.- Fax: I` mail Fac i ping each additional over 4out ets
Process piping(schematicrequire )
Name: Number of owlets _
Other st aped pp lance or equipment:
Address: Decorative fireplace
City: State: ZIP: nsert-type
Phone: IF= E-mail oo stove et stove _
Ch er: --
Applicant's signature: �� Date: lj iq- �� �. ter:
Natne (print):
Not all Jurisdictions acce^t ctnlit cards,pleae call Jurisdiction for more infornutlm Permit fee.....................$ _
U Visa U Mas!c Card Notice:This permit application Minimum fee................$
Credit earl numbs // // expires if a permit is not obtained Plan review(at — %) $
---_ �- within 180 days after it has been State surcharge(8%)....$
--fie of c n r is shown on credit card $ accepted as complete. TOTAL . $
— Cardholder sisnattae 4 — Amount
461-4617((.ZxMCOMi
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2. FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional$100,00 or including ducts&vents 14.00
fraction thereof,to and Including 2) Furnace 100,000 BTU+
$10,000.00. Including ducts&vents 17.40
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or _includin vent 14.00
fraction thereof,to and Including 4) Suspended heater,wall heater
S25,000-00. or floor mounted heater 14.00
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or 6.80
fraction thereof,to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp ••
Minimum Permit Fee$72.50 SUBTOTAL: 7) absorb unit
s to 1100K00K BTU 14,00
8%State Surcharge $ 8) 15 absorb
unit 100kk to 500k BTU 25.60
t t
25%Plan Review Fee(of subtotal) 9)15-30 HP;absorb
Re uired for ALL commercial ermits onl a unit.5-1 mil BTU 35.00
- - 9- ---- -- -�--Y 10)30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU _ 52.20
11)>50HP;absorb
unit>1.75 mil BTU _ 87.20
ASSUMED_ VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM
_ _ 10.00 _
Value Total 13)Air handling unit 10,000 CFM+
Description: Q Ea Amount _ 17,20 _
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts&vents 10.00
Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a single duct _
ducts&vents 6.80
Floor furnace Including vent 955 _ 16)Ventilation system not Included in
Suspended heater,wall heater or 955 alip ance permit 10.00
floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included In appliance 445 10.00
permit --- - 18)Domestic incinerators
Repair units 805 17.40
<3 hp;absorb.unit, 955 --
to 100k BTU 19)Commercial or industrial type Incinerator
_ 89.95
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101k to 500k BTU 10,00
15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
m11.5TU 5.40 'f _
30-50 hp;absorh.unit, 3,400 22)More than 4-per outlet(each)
1-1.75 mil.BTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU __
Air handling unit to 10,000 dm_ _ 658 8%State Surcharge
Air handlin unit>10,000 dm ^ 1,170
Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: 5
Vent fan connected to a single dud 446 J
Vent system not included In 656
appliance permit
Hood served by mechanical exhaust 656 Other Ins me ions and F res:
Domestic Incinerator 1,170 1 Inspections outsidr:of normal business hours(minimum charge-two hours)
$62 50 per hour
Commercial or industrial incinerator 4,590 2 Inspections for which no fee is specifically indicated (minimum charge-half hour)
Other unit,Including wood stoves, 656 $62 50 per hour
Inserts,etc. 3 Additional plan review required by changes.additions or revisions to plans(minimum
Gas piping 1-4 outlets ^T ` 360 charge-one-half hour)$62.50 per hour
Each additional outlet _ 63 ► *State Contractor Boiler Certification required for units>200k BTU.
'Residential A/C requires site plan showing placement of unit.
TOTAL COMMERCIAL :
VALUATION: _ All New Commercial Buildings require 2 sets of plans.
I Wsts\formsvnech-fees.doc 02111/02
L
Permit#: M-jSr_Q( _CDO
o
Address: ) ,
Issued by: --Y� -- Date:
Statement; Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit..this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
Er1. 1 own, reside in, or will reside in the completed structure.
Ej2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is _—
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
313. I will be my own general contractor.
If I hire subcontractors, I wil! hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, 1 will contract w?th a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that 1 have read an(I(lo understand the Information
Notice to Prope wneers about Construction Responsibilities on the reverse side of this form.
(Signature of permit applicant) (Date)
(White cope to issuing agency permit file.
pink copy to applicant)
Information Notio a to Property Owners
Aboa.It Construction Respon3ibilitie y
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OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
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l.iuhitil - •,rnd properk}damage insurance. (.'o nkjJ t Im msuruue agcl)I to rlte if you limC adequate insurancr , .,,•'I l<<t, i,,,
JCt'Idcltt v find 111111Sti111iv, Such ab Iallln!', took, [)(itIit ;)1'I:rSlll'11Y, wa wr ki:trt+ilp. II Vllt p111t 1)Ilf1t Iltr�S, �rTC'''- t+1 �tl't• +},.�9 I,i
rrintle III)SUpP -ke empl?net'v: M.lkc ,mk, int; h,I\t• ••IIIIIt:IcIIt 111111.' It, 1�illll'1',1"., tt''UI I'illlllovices
i',Ap('1'ti,w: Makt`ti,i,ovrlllhm,c the oxpe1l.ltit,Ill act l,tiN,f1tlrCtt,l'r1gt"rlemlrontrilvitsr,it)c orrift),itetheivnirknfrtmph t!tondfini'+
Trades. nntI if Ill,tifv hllildiil�offirir)lq it thea ahprrilrime times to they rim I,,rform the rrquired inepections.
If eou have addillmn.11 (ll eslloll". tl lill- (It cal I111'Coll,I Contractors Board(N.) Box 1414(1.!�nlem,l.)K 1I 1.11'`1 `i I';.'
5n!/Us-4t,?I 1 I tit; Iinard k loc led at 700 Smim t'r St. NF Stnte 31X), in Saxlem.
1/94
CITY OF TIGARD 24-Hour
BUILDING Inspectior Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 539-4171
r SUP ------ - -_..
Received __ —___ Date Requested AM__ ____ PM _- -___. BLIP _—
Location _-.___-- S -_ Suite ___ AVEC _ - —-- -- _----_—.___
Contact Person ______ Ph (---) _ X0 PLM ---
- -
Ph( )
CptatrecMt; SWR
_ --- --- _-
BUILD lenant/Owner ------------- --- ELC -
-ooting -- ELC - ----- -----
Foundation Access:
Ftg Drain �� /', fr �� � ELF! ---- __.
Crawl Drain - �- / U ------
Slab inspection Notes: SIT _
Post&Beam
Shear.Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
---- —
Insulation
Drywall Nailing -._---- ------- -- ------- ----- -
Firewall /
Fire Sprinkler - -- -- --
Fire Alarm
Susp'd Ceiling - - -
Roof
X-,PART FAIL - _--. --- --- -
MBING - - ---_ - --_ -- - ---
os e-am
Under Slab --___-- -- - - -
Rough-In
Water Service -
Sanitary Sewer
Rain Drains - ------- ------- - ------
Catch Basin/Manhole
Storm Drain ---' -- —
Shower Pan
Ot - -
rnal
PAR _FAIL --- _ - - -- -- _--
lost& Beam
Rough-In --- -- -- - --- - -.
Gas Line 1
Smoke Dampers - - --- 7 - -�- - --
A .- _ PART FAIL -- ---' -
L ---- ---
Rough-In ------
UG/Slab
Low Voltage --_--- - _.- --------
�Fj[jLAlarm
ART FAIL
PF-] Reinspectionfee of$_._... ___-__ required before next inspautien Pay et City Hall, 13125 SW Hall Blvd
reinspection RE .
Please call for reinsp .-- .___-__-.___ ��
-�------ ---- - _ _-_- Unable to inspect-no access
Fire Supply Line
ADA Date / Inspector.---____\-> y \ Ext
I Approach/Sidewalk -
Other _
Final DCS NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL