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Case File NEWCAStLE HOMES$ INC,i'U nox 230459 1 IGARD 011 97 281 PLU I PLAN VEL; 503-664.1541 rAX: 50:1-684. 0F11 CCC: 5961;7 Address 0 SW AMANDA ("J 8 5cole 1W V Notes: bowm1muts and crawlspace draft to street. Sidewalks acid dilvpway approach to 010 code. w �r 33 60 27CAq) J mss-• * nrNC, F TV QC Pltd��'� �A o 1 F1 � ► , --- r r�4 3 �0o1' EL ct Fell q7,3qp � . 3 A.c,6 C Y;l v✓ G� J i0 ..y• ;.1 �.' �✓qty � A'�>; ,��,��• i r '"�� y � � // if J�iU r C cv\(ve P, f r IW 0'C)o 10 dl NOTICE: IF THE PRINT OR TYPE ON ANY TI I III i I III III III III III III III III 1 ( f 1 I I. I I l I I� T I1- l I 1 1 III I I ( 11 1 III III III III I I I I I I I � I iII III III III III f 11 III I I I I I I I I III i i I I I I I I i I I III I I I , 1 I I I I I 1 � I I I I I I I I I � IIIII � IIIIIIII � J IMAGE IS NOT AS _ EAR AS fF-IIS NOTICE, V� IT IS DUE TO THE QUALITY OF THEOj ,�.��. ��... 36 ORIGINAL_ DOCUMENT -T -- -_______ _-_----__— __- _-.--_- ------- - E 6Z gZ LZ 8Z � Z 'YZ I EZ ZZ i t OZ 6t 8T LI 8I 5i by Ei ZI I [ t IIlI i. 1111 .. 11 II I IIII II i IIII II ,I I i IIII I �I II I IIII I IIII IIII I II IIII IIII IIII IIII II I IIII�IIIIIIIII II I IIII II II ,1111 IIII IIII IIII III(►IIII IIII ,�II� IIII � ll.11lilll 111 llll IIII I-Ill- l.l.11 .11111111111111 111111C�1�k11 I c a c u m :J p C c c a 1 n480 SIM Amanda Cou-,,,, J :ITY OF TIOARD Residential Certificate of' Occupancy i I'ennit No.:Add�_ b U,C;o7 Address: le) Ya 00 T � Owner/Contractor: /L Date of Final Insivaion: �(yz_._ Inspectot: This structure has been found to he in substantial compliance with the provisions of the State of'Oregon One& Two Family Dwelling Aecia�Code and is hereby approved for occupants. CITY OF TIGARD 24-Hour BUILDING Inspection Line- 0 ua9-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST _ BUP __— Received ___ Date Requested__ AM PM BLIP ;_ocation l d `� —�IY ti �� 5:�_Suite MEC — Contact Person -�--_ _--�� ph ) t� _L '� PLM Contractor -- ----- -- (- ) _ SWRfi- - -- -UILDING_ TenanUQNmer -__ __—FoELC o rng — - -----._— Foundation Access: ELC Ftg Drains Crawl Drain _ L d`"1�- r f-� ELR --- - - Slab Inspection Notes: SIT Post&Beam Shear Anchors --- -- Fxt SheatiVShear Int Sheath/.Shear - -- - Framing ---- --- - Insulation Drywall Nailir,q Firewall -- - - Fire Sprinkler - " ---- -- --- -__--_ Fire Alarm Susp'd Ceiling -- ------- Hoof Other: -----.- -- SS PRT FAIL -------�—-""- — - a&R eam Under Slab _ __- Rough-In _ -- Water Ser.'ce --_.----._..---- - Sanitary Sewer Rain Drains —_______ ._ Catch Basin/Manhole Storm Drain -- -- -- - - - -- __ Shower Pan Oth;- - - --- ----- ASS PART FAIL_ - —VEtIVANICAL Post 8 Beam - ----- -- - -----._ ,. ------ -— Rough-In — -- -------- ----- Gas Line - Sr a Dampers ---.._...----_.-_--_-- naT __ PART FAlL - ---- -- ---._---------- -- --- L Rough-In LIG/Slab i- --- —" - ---- Low Voltage — Firo larm rr--�� --- --- --- — --- ASS PART_ FAIL lJ Reinspection fee of$ —_-_—required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _ - — [] Please call for reinspection HE:____ L� Unable to inspect-no access Fire Supply Line DateExt ADA ecorNpprcach/Sidewalk \ Other - F-111,11 -- -- DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITYOF TIGARD MASTER PERMIT PERMIT#: MSI 200,I 00521 DEVELOPMENT SERVICES DATE ISSUED: 10/26/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10480 SW AMANDA CT PARCEL: 2S111B8-BW002 SUBDIVISION: BRIE WOODS ZONING: R-3.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: S/P Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS_ REQUIRED _V CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,412 at BASEMENT: of LEFT: 19 SMOKE DE,ECTORS. Y TYPE OF USE. SF FLOOR LOAD: 40 SECOND: 1,330 of GARAGE: eeo of FRONT, 22 PARKING SPACES TYPE OF CONST. SN DWELLING'1NITS: 1 FINSSMENT: of RICH r: 8 : OCCUPANCY GRP: R3 BDRM: 3 BAVALUE $255.311e an BATH: 4 TOTAL: 2.742.00 sl REAR 21 PLUMBING SINKS: 1 WATER CLOSETS: .1 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN, 100 TRAPS: LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: Ino SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWF.RS: 4 GARBAGE DISE'. i WATER HEATERS: 1 WATER LINES' I';rl BCKFLW PREVNIR: I GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 5 CLOTHES DRYER: I ("AS FURN,-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FE_DERTEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 - 200 amp: WISVC OR FDR: 1 PUMPARRIGATION: PER INSPECTION: EA AOD'L 500SF: 5 201 400 arnp- 201 400 amp: 1st W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • $00 amp: 401 60L'amp: EA ADDL OR CIR: SIGN.AUPANEL: IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp 601-amps-1000v MINOR LABEL: 1000.arnplvolt Reconnect only: PLAN REVIEW SECTION —4 RES UNI1 S• SVCIFDR>=226 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL _ B.COMMERCIAL AUDIO B STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE.ALARM: INTERCOMVPAGING: OUTDOOR LNDSC LT. BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL: OTHR: HVAC: DATArTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 8,056.07 NEWCASTLE HOMES INC NEWCASTLE HOME i This permit is subject to the regulations contained in the FO BOX 230459 PO BOX 230459 Tigard Municipal Code,State of OR. Specialty Codes and TIGARD,OR 97281 IGARD,OR 97281 all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not startod within 180 days of issuana3,cr if the work Is suspended for more than 180 days. ATTENTION Phot»: Phone: Oregon law requires you to followrules adopted by the Oregon Utility Notification Center. Those rules are set Rea•: LIC 5;..1„- 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)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Grading Inspection PosUBeam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Snwer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing.IFoundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Issued By Permittee Signature Call(503)664175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWE R CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00283 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/26/01 SITE ADORE-`S; 10480 SW AMANDA CT PARCEI . 2S111 BB-BW002 SUBDIVISION: BRIE WOODS ZONING. R-3.5 BLOCK: LOT: 002 _ JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNIT S: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Owner: — -- -' __ FEES_ PO BOA 230459 NEWCASTLE HOMES INC Type By � Date Amount Receipt TIGARD, OR 97281 PRMT CTR 10/26/01 $2,300.00 27200100000 INSP CTR 10/26/01 $35.00 2.72.00100000 Phone: 503-684-7543 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in PII directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm Issued by: _<- 2�� Permittee Signature` (,` Call (5 3) 639.4175 by 7:00 N.M. for an Inspection needed the next business day 77)dot/DyZ—o( B S(,c� aao o; 3 _B►uilding Permit A °on City of Tigard T f'�7 Datereceived: � Ptrtnritruo.: - a g Project/appl.no.: Expire date: C%rynj7igurd `� � 13125 SW Hall Blvd, ard,OR,QZ2Z3 Phone: (503) 6394171 Date issued: By: I Receipt no.: Fax: (503) 598-1960 Case rile no.: Payment type: Land use approval: 137 , 1&2 family:Simple Complex: v ,�I di:2 family dwelling or accessory U Commercial/industrial U Mull! family XNcw const-action O Demolition LJ Addition/alteration/replacement U Tenant improvement U Fhr sprinkler/alarm C]Other: Job address: y$O Vn l A`yl u nCl u C/ Bldg.no.: Suite no.: Lot: 2-. 1 Block: Subdivision: r31j L V-10045 _ Tax map/tax lot/account no.: Project name: =e- Description e Description and location of work on premises/special conditions: Name: W C Gt 5 t I e, I O Q S rI (Flotidplain.septic capacity,solar etc.) Mailing address: }--1 C) /30/( 2.36 1 k 2 Wally dwelling: city: -1 , cL rel State:oR ZIP: q-72.91 Valuation of work........................................ $ OG Phone:624. -7-5 V 3 IFax:&,8Y o(e7t E-mail: No.of bedrooms/baths................................. 3 �_ Owner's representative: Nt i 1 lar Total number of floors................................. Z Phone: Fax: E-mail: New dwelling area(sq ft. 2- 4 Z Garage/carport area(sq.ft _ 6 Name: KCt t-h -&t I Covered porch area(sq.ft.) ......................... 7 L Deck area(sq.ft.) Mailing address: ........................................ Other structure area( ) -� City: State: Z1P: .ft. ......................... Phone: _ Fax: E-mail: CommercinUindustriaUmultl-family: Valuation of work........ .............................. $ Business name: /(%S U)CCt t L& 5 �0 u Existing bldg.area(sq.ft.) ............ ........... Address: New bldg.arra(sq.ft.)...................... ....... City: State: ZIP Number of stories...................... .......... .... Type of construction.................................... Phone: Fax: Email: Occupancy group(s): Existing: C(:B no.: '5 New: City/metro tic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under p. i1C. provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed.If the applicant is Ci _ State: ZIP: exempt from licensing,the following reason applies: Contact person: _ Plan no.: Phone: ik E-mail: - — lm Name: Cor tact person: _ Fees due upxm application...........................$ Address: Date received: City: tate: ZIP: Amount—ceived.........................................$ _ Phone: Tf+ax: E—maii: --- , Please refer to fee schedule. _ I hereby certify I have read and examined this application and the Not @11 JuWkfiam weep a*&ardr,ptrr call*Wk--Aw for mors Wbrmuuoo. ` attached checklist.All provisions of laws and ordinances governing thin 0 vin U MasterCud work will be complied ift whethar aPecitiodherein or not Cmdu and rramber_ / / Authorised signature.Z IC42 ,4-c Daws: /V Z& r✓/ Nmwof, 6otdar an and Print name: K-all); -ryjcj t-h"-✓ ray w S s� Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. •u04613(&MICOM) One-and Two-Family Dwelling B uffi ing Permit Application Checklist Reference...: ——` Associatedpermits: City of`'far City or Tigard ig11<rd U Electrical U Plumbing 1.1 Mechanicai Address: 13125 SW Hall Blvd,Tigard,OR 97223 ELI Other: Phone: (503) 639-4171 --- Fax: (503) 598-1960 I Land use actions completed.See jurisdiction criteria for concuriont reviews. — _- 2 Zoning.Flood plain,sc.lar balance points,seismic soils designation,historic district,etc.----------.— - 3 Verification of approved platflot. 4 Fire district _approval required. _ — 5 Septic system permit or authorization for remodel. Existing system capacity r—_ �- 6 SewcrpeayrrIt. 7 Water district approval. 8 Soils.report.Must carry original applicable staml i:sign:+ture on rle or with application. - 9 Erosion control U plan U permit requited. Include ftunas�e-way protection,silt.fence design and location of _catch-basin protection,etc. __ _ _—_• _ _ _ �10 J Complete sets of legible plans.Mast be dt:wn to scale,showing conformance to applicable local and st building codes.Lateral design details and connections must be,incorporated i-to ct a glans or on a separate ful' sheet attached to the plans with cross references bctwcen plan location and details. i 'an review cannot he corn, _,ed if copyright violations exist. 11 Sitelplot pian drawn to scale.Tltc plan must show lot and building setback dimensions;property comer elevations(if there is more than a 4-ft elevation differential,plan must show contour lines at 2-lt.intervals);location of easements and drveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage tf coverage;impervious area;existing snuctums on site;and surface:drainage. 12 Foundation plan.Show dimensi.rns,anchor bolts,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 detectors,water heater. furnace,ventilation fans,lsiumbing fixtures,balconies and decks 30 inches above grade,etc.. — 14 Cross section(s)and details.Show all..aming-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 of all wall and roof sheathing,roofing,roof slope,ceiling height,siding materiel,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;min,mum of two elevations for additions sand remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. _ 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non- rescririve path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all''nors/roof assemblies,indica. .g member sizing,spacing,and bearing _locations. Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered _ systems,see item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using currant code design values for all beams and multiple joists over 10 feet long and(or any beam/joist carrying!.non-uniform load. 20 Manufactured floonroof truss design details. 21 Energy Code compliance.Identify die prescriptive path or provide calculations. A gas-piping schematic is required for tour or more appliances. 22 Engineer's cAlculadon&Wlten required or provided.(i.e.,shear wall,roof truss)shall be stn nped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. 23 Five(5)site plans are required for Item I l above. - 24 25 26 _ - - — — --- ---- — -- 27 - ----_�— —— - - 28 -- Checklist must be comoleted before plan review start date. Minor changes or cotes on submittcxl plans may be in blue or black ink. Red ink i!, m5erved for department tree only. 140,4614 i600000t) Electrical Perinit Appl c2 ion A6, Uatereceived: Permit no.:/1157a60 City of Tigard Project/appl.no.: _ Expiredate: City of Tigard Adder+s: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued:- gy: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TWE OF PERMIT I ,4c 2 lamiiy dwelling or accessory U Commerwal/industrial U Multi-family 0 Ttnant improvement New construction U Addition/altemtion/replacement U Other. 0 Partial I SITE INFORMATION Job address: A oda Ct Hldg it,t.. Suite no.: Tax reap/tax lot/account no.: Lot: 2_ Block: Subdivision_ Yr'G M/00d 3 Project name: Description and location of work on premises: -�-- Estimated date of completion/inspection: _— — 1 APPLICATION 1 Job no: Business name: . . U Description Qty. (Fea�) tool no.hI.nxt Address: New residential tingle ormulti•famflvper —i X dwelling unit.Includes attached garage. City: sLA_ ;fate:o,e ZIP: q 7 n Service included Phone: 39 3 ,-.Z2 3 Fax: 1 E-mail: 1000 sq.ft.or less _ 1 CCB no.: 11-71-4 I EIeC.bus. lie.no: Each additional 500 sq.ft.or onion thereof Limited energy,residential Chy/metro lie.n0.: Limited energy,non-resrdemml Each manufactured home or modular dwelling Si store of supervising electrician(required) pate Service and/or feeder , Sup.elect.name(print): License no: Services or feeders-Installarlon, alteration or relocation: as 200 amps or less , Name(print): N I! W CQ 5-t-[A_ } yyus I 201 amps to 400 amps 7- Mailing uddress: C) Z 3045 401 amps to 600 an,ps 2 601 amps to 1000 amps 2 cry: , rd State:0 k_I ZIP: Z8 I Over 1000 amps or volts 2 Phone: o Fax: E-mail: Reconnect only _ I Owner installation:The installation is being made on property I own Tempomry services or feeders- whi"Ownees h it itended for sale,lease,rent,or exchange according to Installation,allerstlon,orreloation: 479,670,701. 200 amps or less 2 201 amps to 400 amps Z' ure: Date: _ 401 to 600 amps Branch circuits-new,alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State. ZIP: R. Fee for branch circuits without purchase Fax: E-mail of service or feeder fee,first branch circuit: 2 Phone: Each additional branch circuit: d Misc.(Service or seeder not Included): U Service over 225 amps-comr..ercial U Health-care facility Each pump ur irrigation circle U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 familydwellings U Building over 10,000 square feel four or Signal circuit(s)or a limited energy panel, U System over 600 volts nominal more iesidential units in one structure alteration,or extension* U Building over three stories U Feeders,400 amps or more *Description: _ U Occupant load over 99 perrons U Manufactured structures or RV park Each additional l: pec lon over the allowable in any of the alcove: U Egresc/lightir-;plan U Other -- I Perinspection _T Subsalt—sets of ph=with any of the alcove. I I nvesti potion fee The above are not applicable to temporary colostructlon service. F Other Not all)urisdicdona accept credit cards.please call Jurisdiction for more information. Notice:This permit application Permit fee.....................$ -- U Visa U MasterCard expires if a Plan review p permit is not obtained (at — r!h) $ _ Credit card number: ! within IRO days after it has been State surcharge($%) ....$ — Nimeof cardhola�r o c,ealt card Expires accepted as complete. TOTAL .......................$ f C_ older sirnarurc Anrotrm 440-161 S((VIWOM) Electrical Permit Fees: Limited Energy Fet=es: Complete Fee Schedule Below: _TYPE OF WORK INVOLVED -RESIDENTIAL ONLY pRestricted Energy Fee...................................................... $75.00 Number of inspections per permit allowed (FOR ALI.SYSTEMS) i i Service included: Items Cost Total y Check Type of Work Involved: Residential-per unit 1000 sq.It.or less $14515 ^ 4 ❑ Audio and Stereo Systems Each additional 500 sq fl.or portion thereof $3340 _ 1 ❑ Burglar Alarm Limited Energy ,.� $7500 Each Manul'd Home or Modular ❑ Dwelling Sorvice or Feeder _ $9090 2 Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration.or relocation 200 amps or less $80.30 2 ❑ 201 amps to 400 amps $106.85 2 Vacuum Systems 401 amp,.to 600 amps $160.60 2 601 amps to 1000 amps ,M $240.60 2 ❑ Other Ova,1000 amps Or volts $454.65 2 Reconnect only _ _ $66.85 2 Temporary Services-)r Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each syrtem......................................................... $75.00 200 amps or less $66.65 _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 401 amps to 600 amps $133.75_ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits ❑ Bailer Controls Now,alteration or extension per panel a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit _ $6.65 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ or feeder fee. Fire A18rtn Installation First branch circuit $46.85 Each additional branch circuit $6.65 _ ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or Irrigation circle $53.40 ❑ Each sign or outline lignting $53.40 Intercom and Paging Systems Signal circuits)or a limiter;energy panel,alteration or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 Each additional inspection over �� ❑ Medical the al owable in any of the above Per inspection $62.50 _ ❑ Nurse Cells Per hour $62.50 In Plant $73.75�— ❑ Outduor Landscape Lighting* ,Fees: ❑ Protective Sinnaling Enter total of above fees $ ❑ Other 80,6 State Surcharge $ Number of Systems 25%Plan Review Fee See"Plan P.eview'section on $ No licensee are required. Licensee are required for all other Installations ftrot of appticvion. Fees: Total Balance Due $ Enter total of above fees $--- Trust _Trust Account 0_ 8%State Surcharge $ -----�----y-`Y--�--�---�^-----_��- Total Balance Due $---- lets _ _lets do, W/0910) Plumbing Permit Application Datereccived: Permit noapt-&0;1 (.. City of Tigard Address. 1312 5 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: City of 77gard Phone: (.503) 639-4171 Project/aWl.no.: Expire due- Fax (503) 598-BS60 Dateisaued: By: Receipt no.: Land use approval: _ Cue filen.: Payment type: ,<a) t&2 family dwelling or accessory D Commercial/industrial ❑Multi-famil) U Tenant improvement Z New construction U Addition/.Jteradon/replacement ❑Ftx)d wmcc U Other: Job address: /DSU v l �1 Y11C�nd Q Lf oescriptton _ Fee ea.) Total Bldg.no.: I Suite no.: — Nen I.-And 2-family dwetllnrq only: Tax map/tax lot/account no.: - (include@ 100 R.for each uttlky connection) SFR(1)bath LOO 2. Block: Subdivision: ) 1/1/00 5 SFR(2)bath — Project name: SFR(3)bath City/county: Wo 5 h;nC{fin- ZIP: q-7 2-7- Each additional bath/kitchen Description and location of work on premises: SiteutWtlea: _ Catch basin/area drain Est.date of completinn/inspection: Drywellstleach line/trench drain FDoting drain(no.lin.ft.) _ Businessname: Manufactured home utilities —_- 'UUrj-hWe_.5.J i'ft111;e/ �t'VMIbi�� Manholes Address: 0 X -,- Rain drain connector _ City: d StatepR I'LIP: z 5' 1 Sanitary sewer(no.lin.f.) Phone: ?92 Fax: E-mail: Storni sewer(no. lin.ft.) — CCB no.: 13 5 07„2.. Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: Fixture or Item: Contractor's representative signature: Abse tion valve PBack flow mventtr Print name: Date: Backwater valve Basins/lavatory _ Name: KIn �L GL t Clothes washer Dishwasher Address: _ _ City- State:-- ZIP: - Drinking fountain(s) -- Electors/sum Pho;e:_ Fax: E-mail: Expansion tank xture/sewer ca Name(print): Floor drains/floor sinks/hub Mailing address: Garbage disposal Hose bibb _ City: State: ZIP: Ice maker Phone: Fax: E-mail: IInnterce torgrrase trA -- -- Owner installation/residential maintenance only: The *ctual installation Primers) will be made by me or the mOntenance and repair made by my regular Roof drain(commercial) employee on the pn,perty I own as pe, 'JRR Chapter 447. i (s),basinfs),lays(s) Owner's signaGras: Date: Sum • Tubs/st+ower/shower pan Nom: Urinal W ater c oset Addrtas: _ Water heater City: _ State: ZIP: _ Other. Phone: --- Fax: &mail: Total _ — Nae'b J.'di`u°°"°°go'aimend''pi we an)tfdetlm tQ'°''^Idaordm Notice:This rt licuion Minimum fre................s Mas 0 VFW Gl teWsm mpires if a pernit isnot obtained Plan review(at `%) S coo and sic--— — withirt 180 days after it has been State%4rcharge(8%)....S ------- ------- p accepted as complete. TOTAL ......................S g` -- CoMmkin uV__Wm AnKMA "G-4616(6AWOM) PLUMBING PERMIT FEES: , ndi2famliy:dwaIIInpromly:.t :+,V �+; °» biz • +� FIXTiIftESr�C_nfrr>x xQ IIMOUf7�: (1 alit pitunl�InpPxbtcnIr 1 Sink 16.60 tfi + ilunp+and°3ltaeratl6dit. or�• .,,(a uwr Lavatory 16.60 iif111 eonrieclton R l+r •+:`' One 1 bath $249.20 Tub or Tub/Sh.wiar Comb. 16.60 Two(2)bath -$350.00 I _Shower Only _^ �-_ 16.60 Throe(3)bath V S"y'1.00 Water Closet 16.80 SUBTOTAL_____,_ Urinal 16.60 80:STATE SURCHARGE _ Dishwasher _ 16.60 - PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL "?• � _ L.aundiy Tray 16.60 Washing Machine 16.60 FloorDreifllFkscx Sink 2" _ 16.60 3" _ 16.60 PLEASE COMPLETE: 4" 16.60 _ Wirer Heater O conversion O like kind 1660 uanti b Work Performed bas pfoing requires a separate mechanical Fixture Type: New Moved .;Replaced,, Removed! permit. _ - Capped MFG Home New Water Service 46.40 Sink _ MFG Home New San/Storm Sewer 46.40 Lavato: Hose Buss - 1660 Tub or'rub/Shower Cem_bination _ Roof Grains 16,60 Shower Only Drinking Fountain �- 16.60 Water Closet Other Fixtures(Specify) 16 r-,p �- Urinal -�- �_ Dishwasher Garbage Disposal Laund Room Tra ---�- --- - Washing Machine _ _- Floor Drain/Sink: 2" Sewer-1 at 100' - -- 55.00 W ( Sewer-each additional 100' 4640 _4" Water Se,4ce-1st 100' 55.Dt) Water Heater Water Sanice-each additional 200' 46.40 Other Fixtures _ S d Storm 6 RamiDrain-1st 100' 55.00 Slone 3 Rain Drain•each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 - - - Residential Backflow Prevention Device* 27.55 - - - Catch Basin 16.60 - -- -- Inspection of Existing Plumbing or Speclalt j 72.50 Requested Ins ora___ _ _ erlhr _ COMMENTS REGARDING ABOVE: "a Rain Dhs.singh_fa:irily dvieliing7__ 65.2.5 Crease Traps 16.60 - -- i- QUANTITY TOTAL -�--- -" lsoruW,;oe riser diagram Is required K _ Quantity_TetalIs >0 �';'4._,!: ,' r•-. 'SUBTOTAL ::�°;�`'.'�' - _ 8'Y.1lTATE SURCHARGE �'w "PLAN REVIEW 25%OF SUBTOTAL ;`': :`4s Reyutrwe only If blure qty_total is>0 il ' t TOTAL `• ',A, $ '11Inirr,um permit reals$72.50.11%state surcharge.except RosldeMiai Pw*flow rheventim Devbw,which Is$.'x6.25«R%state surchorW. .. , -All Now Commercial Buildings require plans with Isometric or riser diagram vd _+ plan mviswx i:4lstsVarmsbkrifnr .riot 10/10i.70 r I Mechanical Permit Application City of Tigard Datereceived: Permit no.,2061-00 p-i Address: 13125 SW Hall Blvd,Ti ard,OR 9",223 Prolect/appl.no.: Expire date: Ciry ofTigar�d g Phone: (503) 639-4171 Date iuued: By: Receipt nt,.: Fax: (503) 598-1960 Caw file no: Payment type: Land use approval: _ Building permit no.: r igl I &2 family dwelling or accessory Ll Commercial/industrial ❑Multi-family 0 Tenant improvement A New constniction 0 A(ldition/alteratio►>/replacement U Other: Job address: I p 4 $0 51A1 Ayyl"Ada c- Indicate equipment quantities in boxes()clow. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax iot/account no.: profit.Value W _. Lot: 2- Block: Subdivision: /,'e WOO C1 g 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: 9-722-4 111P.5 UNMIlkt Description and location of work on p.-emises: __ slei Est.date of completion/inspection: Tee(ea.) ToW Tenant improvement or change of use: Uescrion er.col Ree.r al Is existing space heated or conditioned?0 Yes 0 No Air handling unit CFM Is existing space insulated?O Yes ❑No r conditioning(site plan requir ) Alteration of ex►stinit A system of e-compressors Business name:—CM)( S Q-a 5 a. f if -& State moiler permit no.: Address: Pa B x Cr, HP Tons BTU/H r"irdsmo a amt uct smo a detectors City: r State:p LIP: 9 72- u cat pump(site plan require ) Phone: Fax; E-mail: este rep ace urnac um CCB no.: tf$ 2.8 3 Including ductwork/vent liner O Yes O No City/metro lic.no.: este rep ac re ovate eed. aters-suspendwall,or floor mounted Name(p;ease print): �- eat fora liance o ter than furnace 10111011"111 WTIVII e` eat on: Absorption units BTIJ/H Nam c Chillers HP Addtesa: Compressors Hp C'it s ement• a uet an rent ton: Y: Slate: ZIP: Appliancevent Phone: I Fax: E-mail: era ausTi t s,Type res. uc a azmat hoexf fire suppression system Name: E thaust fan with single duct(bath fans) Mailing address: _ xTiaust system a arty M teau of -- City: State: ZIP: re PIPIng PIPand oo up to 4 outlets► Phone: T)oe: LPG NO Oil Fax: E-mail uapptn each a tnon over out ets vPiping((schematicrequired) Name: Number of outlets Address: (NWe-1 sipplinu—m or eq parent: Decorative furplace City: State ZIP --tvne Phone: IFax: E-mail. Wood.tov pe ei stove Applicant's signature: Date1eT Name(print): — ".` NM all jurirdkd"rtep Hera)rmy.plers caa iurivartion for nova WWMW XLPermit fee..................... This ► application a U Visa L3 MartaCenjNotice:Th �.t aPP Minimum fee................S Gest►c.a mob": _ _ _ / [_ expires if a permit is not obtained Plan review(at ___%) $ _ y E*— within 180 days after it has been State surcharge accepted as complete. ergo(11%)...$ Cardb'r:k1n�iRnanar- __ s A TOTAL.......................S mo.m 4404617(iWMM) MECHANICAL PERMIT FESS COMMERCIAL FEE SCt I & 2 FAMILY DWELLING FEE SCHEDULE: Description: Price Total TOTAL-VALUATION:---F FEE: City (Ea)_ Amt Table 1A Mechanical Code $1.00 to$5,000.00N�nnnu:n 1) Furnace to 100,000 BTU $5,001.00 to$10,000.03 � 2.F.)for t: o• -,J0.00 and inrluding ducts I�e_nt, 14.00 �2 for ea.�ddditional$100.00 or `) Fumaue 100,Otl0 B('J�- hac on thereof,to and induding Fumaincludingducts&vents 1740 __ $10 00.00. 3) Floor Fa-nace 510,001.00 to$25,000.00 5146.50 for the first 510,000.00 and Including vent 1x.00 41.54 for each additional$100.00 or -'4-) Suspendedheater,wall healer - - �$25,000-00. ction thereof,to and including1400 _ _or floor rnountad heater -_ $25,001.00 to$.r,):000.00 79.5C for the first$25,000.00 and 51 Vent not included in appliance permit $1.45 for each additional$100.00 or 6.90 fraction thereof,to and including o) Repair units 12.15 $50,000.00. $50,001.00 and up-- $742.00 for the first$50,000.00 and Check all Lhat apply: Boiler Heat Air $1.20 for oach additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. J -^_ footnotes below. Comp" 7)<3HP;absorb unit to 100K BTU 14.00 ASSUMED VALUATIONS PER APPLIANCE: g)3-15HP:absorb Value Total unit 100k to 500k BTU 25.60 Descri tion: 0 Eat -Amount...... 9)15-30 HP;absorb Fumace to 100,000 BTIJ,including 955 unit.5-1 nil BTU 35_00 ducts&vents 10)30-50 HP;absorb Fumace>100,000 BTU including 1.170 unit 1-1.75 mil BTU _ 52.20 _ ducts&vents 11)>50HP:absorb- Floor fumaoe including vent _ 955 _- unit>1.75 mil BTU 20 Suspended healer,wall heater or 955 12)Air windlinq unit to 10,000 CFM floor mounted heater _ 10.00 - Vent not Included in appllcance 13)Air handling unit 10,000 CFM+ - ermit _ �_ -- - 17.20 Repair units-_ __. 805 14)Non-portable evaporate cooler ---- <3 hp;absorb.unit, =b'� _ 10.00 _ to 160k BTU �� --- 15)Vent fan connected to a single duct 3-15 hp;absorb.unit, -- .1,700 680 101k to 500k BTU ----- 16)Ventilation system not included in 15-30 hp;absorb.uric,501k to 1- 2,310 appliance permit _ 10.00 trill.BTU _ - ------ 17)Ho,:; served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 _ 10.00 1-1.75 mil.BTU -- -- IH)Domestic Incinerators >50 hp;absorb.unit, 5,725 v 17.40 `-- >1.75 mil.BTU 19)Commercial or industrial type incinerator 69 95 Air handlimr_q to 10,000 cfrl 656 _ - _ Air handling unit>10,000 c�tn _ 1 170 20)Other units,inclucing wood stoves -Non-portable evaporate cooler - 656 _ -_-�_ _ 10.00 FVent fan<bnneded to a sin le duct __ 446 _ 21)Cas piping one to four outlets Vent system not Included in 656 5.40 �- appliancepw nit _ - 22)More than 4-per outlet(each) _ Rood served-y mechanical exhaust 656 _ --- - 1.00 Domestic inrineratur _ 1 170 _. Minimum Permit Fee$72.50 SUBTOTAL: $ ---- - ;om_merdai or industrial incinerator 4 590_ C:"ter unit inrtuding wood stoves 656 - 8%State Surcharge $ �_tnserts,etc. - Vas I In 1 4 outlets- 360 25%Plot,Review Fee(of subtotal) $ Each additional outlet �. 83 Required for ALL commercial permits only , TOTAL.COMMERCIAL $ TOTAL RESIDENTIAL. PERMIT FEE: $ VALUATION: ». - --- -------- -- -- --- Other InsMtIgfts and Fees: 1 Inspections oulskte of normal business hours(minimum dmrge-Iwo hours) $72 50 per hour. 2 Inspections for wMch no fee is specifically indleated (minimum r,harpe-half Dour) $72.50 per hour 3 Ad titional plan reNew required by changes,30itions or revisions to plans(rninimum charge-one-half hour)$72.50 per ttirui 'state Contractor Boller Certification required for wilts>200k BTU. "ResldenWI A1C requires site plan showing placsrment of un!:. i:ldsts\f01lI «rh-fees.doC 10/11/x)0 SEE 35MM. ROLL # 20 I FOR 0.VERSIZED DOCUM-ENT "}I , i