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Case File N N O W N E b qj z I H b 1 hrJ ;o i H C CTJ 1 4 �r l t 12012 SW. Aspen Ridge Dr . 1 I I O W n o a � n � a 0. w -y n R, n cy, r T' a A h a �a O S .y v S 'C K GiTY OF TIGARD BUILDING INSPECTION h:VISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ------ �— BUP -_-_ Date Requested ��_—_-- >M_ —PM 4"" BLD .-- Location t'2-U / Z Suite _-- — — MEC Contact Person —_ Ph S3} -G y _ PLM Contractor — __ _ Ph SWR _— FIL I Tenant/Owner 3 y `h^ '-� � "_`Z ELC nTa,ining Wall ELRng Access Foundation FPS Ftg Drain � SGN --------_--------_ Crawl Drain Inspection Notes — — Slab ---- SIT Post&Beam - - -- —-� Ext Sheath/Shear Int Sheath/Shear - Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm 1AJ �. Susp'd Ceiling - -._- ---- -- -- Roof t Misc ----- -- - - ------ - - -1(, Final PAS' PART FAIL --- - -- ---- -- -- ' Post& Beam - _._..---- ----- ----- - -- - -- -- --------------------_----_ _- Under Slab Top Out Water Service Sanitary Sewer _ --- -- _ _------- ------- ----__...----- Rain Drains q-) PART FAIL MECHANICAL -- -- - - ----_----- -- -- i Post& Beam ----- - Rough In Gas Line -- ----- Smoke Dampers Final -- PASS PART FAIL ELECTRICAL - - - -- - - - - - Service Rough In --.__.----- -- - --- UG/Slab Low Voltage -- FireAlarm - - ------- ---- ----- ---- -------------- -- Final PASS PART FAIL - ---- - --- - - - ----- - -------- ------- -_ _ -- --- SITE Backfill/Grading -----_ - _----_�-----___--- -� -- Sanitary Sewer Storm Drain ( )Reinspection fee of$ -_-__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Bssin Fire Supply Line [ J Please call For reinspection RE _ ( )Unable to inspect- no access ADA Approach/Sidewalk Other Date ,�� Inspector Ext- - --„- Fina' PASS PART FAIL_ DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION As"'T' ,d y�( 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 a BLIP _ -- _Date RequectecJ /7-11 AM PM BLU Location G Z 5`v 'tee Su to MEC _ Contact Person —_ Ph PLM Contractor _ — Ph _— SWR — BUILDING Tenant/Owner — tl_C — — e arnrng a I ELR Footing Access Foundation FPS Fig Drain - SGN Crawl Drain Inspection Notes: -------.___�_ Slab SIT Post& Beam — Ext Sheath/Sheaf Int Sheath/Shear \ ( '`— Framing Insulation ' Drywall Nailing -- Firewall Fire Sprinkler --- --- Fire Alarm Susp'd Ceiling `�•''l,� - -----� � �—,• - _--- Roof (� PASS PART FAIL --- --- — — Post & Beare N — Under Slab —_.--- Top Out Water Service S,:nitary Sewer --L�— -- Rain Drains PASS_ AIL ' ECHANICAL. Rough In Gas Line — -- —--- _ - — - Smoke Dampers fin � ------ ----- --- ---- S3 ' PAR( FAIL _ EI-ECTRICAL — — Service —� —�-- -- Rough In UG/Slab Low Voltage Fire Alarm -- _ _-.-- —.- — Final PASS PART FAILSITE Backfill/Grading — — — — Sanitary Sewer Storm Drain [ ]Reinspection fee of$ __ .required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE: _--T — [ J Unable to inspect - no access ADA "> Approach/Sidewalk I Date \ t �� Other Inspector Ext __ _ F inal PASS PART —FAL I DO NO f REMOVE this inspection record from the job site. CITY OF TIGARD BUILU'NG INSPECTION DIVISION MST 24-Hour Inspection Line: 639 1175 Business Line: 639-4171 - ----- ---- —Date Requested /_ Z- —AM-- PM BLID Location `Z-U / �- J�� /�`S - r �� - - Suite - MEC Contact Person _ Ph 5�� Z- PLM Contractor Ph SWR �13UIUD ING Tenant/OwnerELC Retaining Wall - ELR Footing Access: -- Foundation FPS Fig Drain Crawl Drain Inspection Notes- Slab otes SIGN Slab - ----- - ----..-..------- SIT Post& Beam - ------- Ext Sheath/Shear Int Sheath/Shear - Framing --- --- - -- Insulation - ----- -' Drywall Nailing Firewall - Fire Sprinkler - Fire Alarm Susp'd Ceiling � L-1Lr--.,___ Roof Misc ___ ✓ i �� ---� C � -'— - ----- Final PASS PART FAIL ----------- _ _ ---- -- — PLUMBING Post& Beam - -------- -- --- - - Under Slab Top Out ---- -- ------ - — Water Service --------------..----- - - Sanitary Sower ---- -- -- --- - Rain Drains Final _— PASS PART FAIL MECHANICAL ------ �—----- Post& Beam -- - - ---- - ----- Rough -Rough In Gas Line - - -- Smoke Damper, — — Final --- - PASS PART FAIL - - Iry ice Rough In ----- - UG/Slab Low Voltage Fire Alarm PASS PART FAIL Backfill/Grading ---- - --- ----- — —-- --- Sanitary Sewer Storm Drain [ J Reinspection fee of$- _ _ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin i ll f Please call reinspection RE. Fire Supply Line Pl [ J p �( J linable to inspect- no access ADA _ / Approach/Sinewalk �+ / Cther Date - �� _ Inspector _ — Ext Final —v _ PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF T'IGA►RD __�._ MASTER PERMIT 1 1 PERMIT #: MST2001-00411 DEVELOPMENT SERVICES DATE ISSUED: 7/10/01 13'.25 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12.012 SW ASPEN RIDGE DR PARCEL: 2S110BC-02200 SUB[11VISION: ASPEN RIDGE ZONING: R-4.5 BLOCK: LOT:034 JURISDICTION: TIG REMARKS: This permit is for owner requested inspections of work done previously without a permit. This permit is for inspections for as-built conditions for Fire/Life & Health Safety issues as apparent at this time. BUILDING REISSUE: STORIES: FLOOR AREAS _ REQUIRED SETBACKS _ REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sl BASFME14T at LEFT. SMOKE DETECTORS. TYPE OF USE: SF FLOOR LOAD SECOND: SI GARAGE. et FRONT: PARKING SPACES TYPE OF CONST: UNK DWELLING UNITS: FIN3SMENT: at RIGHT: VALUE: OCCUPANCY GRP: R3 BORM: BATH: TOTAL: o uo st REAR: PI..UMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS, SEWER LINES: SF RAIN DRAINS: CATC14 bASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES. BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K, BOILICMP c 3HP: VENT FANS: CLOTHES DRYER. FURN 1=100K: UNIT Y.FATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES, VENTS: WOOOSTOVES: GAS OUTLETS. ELECTRICAL _RESIDENTIAL UNIT SERVICE-E DER TEMP SkVC:FI EDERS BRANCH CIRCUITS MISCELLANEOUS _ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp. WISVC OR FOR, PUMP/IRRIGATION PER INSPECTION. EA ADD'L 500SF: 201 400 amp: 201 400 amp: 1st W/O SVCIFDR. SIGNIOUT LIN LT: PER HOUR: I LIMITED ENERGY: 401 600 amp: 401 600 amp FA ADDL BR CIR SIGNAL/PANEL: IN PLANT MANU HM/SVC/FDR: 001 • 1000 amp: 601 ramps-1000v: MINOR LABEL: 1000.amplvolt: Reconnect only: PLAN REVIEW SECTION --- -- `^4 REG UNITS: svc,rDR,X225 A. .000 V NOMINAL. LLS AHtA/SPI.UCL:: ELECTRICAL•REST_RICT_ED ENERGY _ A.SF RESIDENTIAL � � B.COMMERCIAL_ _ AUDIO R STEREO: VACUUM SYSTEM: AUDIO it STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT +� BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG. PROTECTIVE SIGNL- GARAGEOPENER CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC, DATA/TELE COMM: NURSE CALLS TOTAL 0 SYSTEMS Owner: Contra,-tor: TOTAL FEES: $ 375.00 PAMELA PAYNE OWNER This permit is subject to the regulations contained Ti the 12012 SW ASPEN RIDGE DR Tigard Municipal Code, State of OR Specialty Codes and TIGARD,OR 97224 all other applicable laws All work will be done in accordance with approved plans. This permit will expire If work is not started within 180 days of issuance,Or if the work is suspended for more than i80 days. ATTENTION Phone Phone: Oregon law requires you I-I follow rules adopted by the Oregon Utility Notification Genter Those rules are set Rep 0 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 Electrical Final Mechanical Final Plumb Final Final inspection Building FipeY Issued By : J j � _� Permittee Signature : �_drl _L'U! e Lc (t Call (503) 639-4175 by 7:00 p.rn for an inspection needed the next business day Building.Permit Application City of Tigard FrDauercccived: ?, 9 Permit no.:/vsw��-Lk7f/i� City ojTignrd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: Phone: (503) 639-4171 Date issued: By: Receipt no.: Fit: (503)598-1960 Case file no.: Payment type: Land use approval: _ 1&2 family.Simple Complex: U 1 &" �Emily dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition UA(lditn.n/alleration/rcplacement U Tenant improvement U Fire sprinkler/alarm U Other: —_ Job address: 1A Ildg.no.: Suite no.: -L Lot: Block_ Subdivision: Tax map/tnx lot/account no..- Project o.:Project name: Description and location of work on premises/special conditions:— Name: Yti kn ' , Mailing address: Nil I &2 famia dwelling: City: . Sla c: ZIP: Valuation of work........................................ $ - - Phone: � j I Fax: E-mail: No.of bedrooms/baths................................. Owner's sentative: Total number of floors................................. Phone: Fax: E-mail: New dwelling arca(sq.ft.) .......................... - Garage/carport area(sq.ft.)......................... Name: Covered porch area(sq.ft.) ......................... -- Mailing address: --- --- Deck area(sq. ........................................ - -.. City: _ _ State: ZIP: Other structure area(sq.ft.)......................... Phone: I ,�. - n ;,il ('ommerci,Ulndustri,Umultl-family: Valuation of work........................................ $-- ----- - Existing bldg.area(sq.ft.) .......................... Business name: Address: - - New bldg.area(sq.ft.) ................................ City: State: ZIP: Number of stories........................................ Phone: Fax: E-mail: Type(A(construction.................................... CCB no.: _ — Occupancy grvup(s): Existing: -- - — New: City/metro lie.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Natne: 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 ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: Phone: Fax: F:-mail: -- - - -- Name: Contact person: Fees due upon application ......... ................. $ Address: Date received: City: StateAmount received ............................. ......... $_ -- Phone: _ Fax: I E-mail: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Not all furiadkUoru accept credo cords,pteame call)uds<actlon ror more inrorrnatlon. attached checklist. All pv visions of laws d ordinances governing this U Visa U Mastercard work will be complied whe r spe led herein or not. credut cab numtws Expires Authorized sign re g: �_ � Nene or cardholder u shown on creat card Print name: 1 ' — mr -- S - Cardholder siprae Amami Notice:This permit application expires ill a permit is not obtained within 190 days after it has been accepted as complete. 4404613(daac'o►d) One-and Two-family Dwelling Bidlding Permit Application Checklist 7R2e�feceno.: , ted permits: City of Tigard O Electrical O PlumbingU Mechan,c,l Address: 13125 SW Hall Blvd,Tigard,OR 97223 ❑Other: Phone: (503) 639-4171 —_ -- - - -- Fax: (503) 5913-1960 1WING lTJ-,MS ARE REQUIRED40R. PLAN REVkVW Ves No NIA (Land use actions completed.Se,.-jurisdiction criteria lot concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved platllot. 4 Hire district__ _approval required. 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewer permit. —TWater district approval. R Soils report. Must cavy original applicable stamp and signature on file or with application. 9 Erosion control U plan U pennit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. _ 10 3 Complete seta of legible plans.Must be drawn to scale,showing conformance to applicable local 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 refecences between plan location and details.Plan review cannot be;completed if copyright violations exist. I 1 Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if tier:is more than a 4-11.elevation differential,plan must show contour lines at 2-11.intervals);location of casements and driveway;footprint of structure(including decks);location of wells/Feptic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor plans.Show all dimensions,rotn identification,window sire,location of smoke detectors,water heater, furnace,ventilation fans. plumbing fixtures,balconic� rid decks 30 inches above grade,etc. _ 14 Cross section(s)and details.Show all framing-mem, es a^d spacing such as floor hcams,headers,joists,sub-floc r, wall construction,roof construction.More than one cross sectior, •+ay he required to clearly portray construction.Show details of all wall and roof sheathing,ro oling,roof slope,ceiling height,siding material,footings and foundation,stairs. fireplace constmction, thermal insulation,etc. I Elevation vier i.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reBect 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 accopinhie. 10 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for -non-prescriptive bath 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 rehar. For engineered systems,see item 22,"Engineer's calculations." _ 19 Beam calculations. Provide two sets of calculations v.mg current code design values for all heams and multiple joists over 10 feel long and/or any beam/joist carrying a non-unifomi load. 20 Manufactured floor/roof truss design details. _ 21 Energy Code compliance.Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. _ 22 1,nglneer't calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or .trchaect licensed in Oregon and shall be shown t„he applieahle to the project under whew 23 Five(5)site plans are required for Item I I above. Site plans must be R-1/2" x 11"or I I"x 17". _ ^_ 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. 26 No rolled,reversed or mirrored building plans will be accepted. _ 27 28 Checklist must he completed before plan review star date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 140-4614(WWOM) Electrical Permit Application pDatereceived: 7 D/ Permi:no.:h�51, Ciiy of Tigard Project/appl.no.: _ Expiredate: City ttjTigard Address: 13125 SW Hall b!",d,Tigard,OR 97223 Date issued: By: _ Receipt no.: Phone: (503) 639-0171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: U I &2 family dwelling or accessory U Commcrciaihudustnai j N1::iu t,unily U Tenant improvement U New construction U Addition/alteration/replacement ._I 011rri U Partial Juh address: ` Bldg.no.: ITax map/tax lovaccount no.: Lot: Block: Subdi J 41 Project name: Description Ad location of work on premises: Estimated date of completion/inspection: Job tuns !/ ) Ftr ntnx G— — Description Ipy. (en.) total 11w insp Business name: rr Nen sidrvrlial-single or multi-fnmlly per Address: _–_ d»ellinpunit.lochokrallachedgnraee. City: State: ZIP: Service included: Phone: I E-mail: 1000 sq.ft.or less - -- ,t Each additional 500 sq.It,or portion ilw:cof CCB no.: i W.hos.IIC.no: Limited energy,residential 2 City/metro lic.no.: Limited energy,non-residential 2 Each manufactured home or modular dwelling Si nature of sit rvisin electrician(t uirui) Date Service and/or feeder 2 _ Sup.elect name(Print): License no: Services or feeders–r tstallatlon, alteration or relocation: 91LUAWAM 200 amps or less 2 Name(prinq: 201 amps to 400 amps _ _ 2 401 amps to 600 amps Mailing address: 601 amps to 1000 amps 2 City: / St e: ZI Over 1000 amps or volts 2 Phone: Far: E-mail: Reconnect only I Owner ins I on:The installation is being made on property I own Tessporary,wrvksaorfeeden- which is not intended sale,lease,re ,or exchange according to Installation.siteration,or relocation: 200 amps or less _ 2 ORS 447,455,479,6 /�f 701. 201 amps to 400 amps 2 Owner. sl nature` L'` ate: 4011n600ams Z Branch circuits-new,alteration, or extension per panel: Name: _ A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 _ City: State; ZIP; B Fee for branch circuits without purchase of service or feeder fee,first branch circuit _ 2 Phone; rax F, mall: Each additional branch circuit . misc.(Service or feeder not Incladed): rSermce r 225 amps-commercial U Health-carefacility Each pun or irrigation circle 2 r 320 amps rating of 1 Art U Hatardous location Each sign or outline lighting2 lings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel.ysr 600 volts nominal more residential units in Ane structure alteration,or extension* U Building over three stories U Feeders.400 amps or more *Descriptio . — U Occupant load over 99 persons U Manufactured structures or RV park: Each additional Inspection over the allowable in any of the above: U Fgressrtightingplan J Other: Per inspection I Submit—_ sets of pians with any of the above. Investj stion tee The above are not applicable to tenrpomry construction service. Other U t all jurisdictions MasterCard credit earls.please call jurisdiction fro more mGxmation. Notice:This permit application Permit fee..................... expires if a permit is not obtained Plan review(at _ %) $ _ Credit card number, within 180 days after it has been State surcharge(8%)....$ expires accepted as complete. TOTAL S ....................... Named o r u shown on credit card Catdroldet sip alure Amaral 440-41613(fifflOCoM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule ^glow: - - Restricted Energy Fee...................................................... $75.00 Number or Inspect+ons per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total l Check type of Work Involved: Residential-per unit 1000 sq it or less _ $145.15 _ 4 ❑ Audio and Stereo Systems' Each additional 500 sq it or portion thereof $33.40 1 Limited Encrgy $75.00 ❑ burglar Alarm Each Manurd Home or Modular Dwelling Service 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 arnps to 400 amps $10685 2 ❑ Vacuum Systems' 401 amps to 600 amps _ $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $6685 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 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 New,alteration or extension per panel ❑ Boiler Controls a)The fee for branch circuits wlfh purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 _ _ �� Oata Telecommunication Installation b)The lee for branch circuits wfthord purchase of!;ervke or feeder fee. ❑ F're Alarm Installation First branch circuit $46.85 _ Each additional branch circuit —� $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation i (Ser.;r;e or leader not included) Each F�imp or irrigation dre's $53.40_ Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension _ $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) $12500 Each additional Inspection ovor ❑ Medical the allowable in any of the above Per inspection $6250 _ ❑ Nurse Calls Per hour _ $6250 _ In Plant $73 75 _ ❑ Outdoor:andscape Lighting' Fees: ❑ Protective Signa'ing Enter total of above fees $ I ❑ ui— -- -- Other 8%State Surcharge $ �------- __i Number of Systems 25%Plan Review Fee See`Plan Review"section c $ No licenses a-e required Licenses are required for all other Installations front of application Fees: Total Balance Due El Enter total of above tees Ll Trust Account# _ 8%State Surcharge Total Balance Due 5_ _ r'fists\fbrms\eIc-fces.doc 06/07/01 Mechanical Permit Application ITatereceived:: Permit no.: City of Tigard Project/appl.no.: Expire date: CityafTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Datcissued: By. Receipt no.: Phone: (503) 639-4171 -— Fax: (503) 598-1960 Case file no.: Payment type: i.rina use approval: Building permit no.: U I &2 family dwelling or acce:,sory U Commercial/industrial U Multi-family U Tenant improvement U New construction U AdJilion/alteration/replacement U Other: JOB SITIF 1 ' Job address: Indican,equipment quantities;in boxes below. Indicate the dolLu Bldg.no.: site no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ . Lot: Block: I Subdivision: *See checklist for important application information and Project name: jurisdiction's Ice schedule for residential permit tic. City/county: Ociail a ZIP: f Description and lt!�if of wb k on ply es• ) 1 l 1 ) Fee(ea.) Total Est.date of completio inspection: [ewfilrlion (jly. Res.only Res.ooh Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air e.,hanung unit _CI M Is existing space insulabe,l'''_1 Yes U No Airrnn iuonexistng i g V C syse ) b•p Alteration of existing C system Boiler/compressors Business name: State boiler permit no.: HP Tons BTU/H Address: it smo a amper uc�s d t smuTccaelectors City: — Stale: Z_1P Heat pump(site plan required)_ Phone: I Fax: E-mail: nsta /rep ace urnac umer CCB no.: Inclut ging ductwork/vent liner U Yes U No nsta 1/rep acc rc locate heaters-swpen e , City/metro lic.no.: wall,or floor mounted Name(please tint). Vent fora Mance other than furnace 1Refrigeration: Absorption unitsl Name: Chillers -----_--_-- HP — --- -- Address: Compressors HP - Environmental exhaust and ventilation: City: State: ZIP: Appliance vent _ Phone: Fax: 1; mail ryerex aust - Mods,Type res. il�c ten/hazmat hood Iire suppression system Name: Exhaust fan with single duct(bath fans) Mailing address: Exhaust system apart fiont heating or AC — - City: _ _ State: ZIP Fuel piping an st ut on(up to 4 outlets) Type: _ LPG _ NG (til _ Phone uel ii in eac additional over outlets roeess piping(schematic required) Name: Number of outlets - -. 1 er appliance or equuIpmenl: Address: l)ecorative fireplace City: State: ZIP: nsert-type _ Phone: J I Fax: r I Vinail: Woodstov pe et stove Applicant's sign t «. Name(print): Not all junsdicaons am-elm credit cards,please call juri etia,i for mac informotlon Notice:This permit application Permit fee.....................$ Minimum fee................$ _ U Visa U MasterCard expires if a permit is not obtained Credit card number:------_--,-.-----_--... �1_�_ Plan review(at _ %) $ Expires within I80 days after it has been State surcharge(8%)....$ Nanx of c ardhohler as shown on credit cud accepted as complete. TOTAL -- -- Cardholder signature---- —Amount 4"17(6110LUM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: I FEE: _ Description: - - - _ Prioe Total $1.00 to$500.00_ 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 Includin 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 including vent 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $25 OOO.00. or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 -id 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: Boller Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. footnotes bellow. Com * ** ------ - _ - 7)<3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00 Value 1 otal 8)3-15 HP;absorb unit 100n to 500k BTU 25.60 Description: Cit Ea Amount 9)15-30 HP;absorb Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU 35.00 _ ducts&vents 10)30-50 HP;absorb Furnace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU 52.20 ducts&vents 11)>50HP:absorb Floor Fumace including vent 955 _ unit>1.75 mil BTU 87.20 Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM floor mou ited heater - 10.00 _ Vent not Included in applicance 445 13)Air handling unit 10,000 CFM+ unit _ 17.20 Repair units 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 1000 to 100k BTU ------ 15)Vent fan connected to a single duct 3-15 hp;absorb.unit,- 1,700 6.80 101k to 500k BTU 15-30 hp;absorb.unit,501k to 1 2,310 16)Ventilation system not Included In mil.BTU appliance permit 10.00 30-50 hp;absorb.unit, 3,400 17)Hood served by mechanical exhaust 10.00 1-1.75 mil.BTU >50 hp;absorb.unit, 5,725 18)Domestic incinerators 17.40 _ >1.75 mil.BTU 19)Commercial or Industrial type Incinerator Air handlingunit to 10,000 cfm 656 69.95 Air handling unit>10,000 cfm 1,170 20)Other units,including wood stoves Non-portable evaporate cooler 656 __ _ 10.00 Vent fan connected to a single duct 446 21)Gas piping one to four outlets Vent system not Included In 656 5.40 appliance permit 22)More than 4-per outlet(each) Hood served b mechanical exhaust 656 100 Domestic incinerator 1.170 _ Minimum Permit Fee$72.50 SUBTOT%L: $ Commercial or Industrial Incineratnr 41590 Otter unit,Including wood stoves, 656 8%State Surcharge $ inserts,etc. _ Gas piping 14 oWets 360 - 25%Pian Review Fee(of subtotal) $ Each additionaloutlet 63 -- --- - ---- Required for ALL commercial permits only TOTAL COMMERCIAL $_ TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: Other Inspections and Fees: 1 Inspections outside of normal business hours(minimum charge-two nours) $72 50 per hour 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) $72 50 per hour 3. Additional plan review required by changes,additions or revisions to plans(minimum charge-one-haft hour)S 72 50 per hour State Contractor Boller Certification requited for units>200k BTU. **Residential A/C requires site plan showing placement of unit. i\dsts\forms\mech-fees doc 10/11/00 l -- Plumbing Permit Application Datereceived: 71/ 0/ Permit no.: C y of Tigard Sewer permit no.: Building Address: 13125 SW Hal;Blvd,Tigard.OR 97223 -_ Bpermitno.: City of erg°r� Phone: (503) 639-4171 Project/appl.no.: Expiredate: Fax: (503) 598-1960 Date issued: By: Receipt no.: 1 ind use approval: Case file no.: Payment type: o t U I &2!'amity dwelling or accessory U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: l i Joh address: Q ' i �� . Description (1ty. hre(ra.) Total Bldg.no.: itc no.: --- New 1•and 2-family dwellings only: Ta):map/lax lot/account no.: -- (Includes 100 ft.for each utility connection) _ SFR(1)bath Lot: Block: Subdivision: SFR(2)bath--- - __ -- - -- --- Project name: _ SFR(3)bath - City/county: Z1P: Each additional bath/kitchen - Description ynd loc tion of wo on mise : Sheutilitles. -�� _ Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain -- RUL21 11 Igm it I Footing drain(no.lin. ft.) Business name: --- Manufactured home utilities /ri� � r I�/, - Manholes - Address: - Rain drain connector Cit : Y State: ZIP: _ _ Sanitary sewer(no.lin. ft.) --�- Phone: Fax: I E-mail: Storm sewer(no.lin.ft.) _ ---�- CCB no.: Plumb.bus.reg.no: Water service(no.lin.ft.) — ---- City/metro lic.no.: - iv Fixture or Item: Contractor's representative signature: Absorption valve Back flow reventer Print name: Dat Backwater valve_ - Basins/lavatory — -- Name: Clothes washer Address: -- Dishwasher - -- W- "- City: - State; ZIP. - Drinking fountains) - a Ejectors/sum Phone: I ;i E-mail: Expansion tank -� - Fixture/sewer cap _ - — Name(print): Floor dmins/floor sinks/hub -- - Mailing address: Garbage disposal --- --- City: ate ZIP: Hose hibb `— Ice maker — Phone: - Fax: E-mail Inter plot/grease trap Owner installalio residential maintenance only: The actual installation Primer(s) will be made by me or rnauntenancr repair made by my regular Roof drain(commercial) employee on the propc I own as per O Chapter 4 t7. �_1 j Sink(s),basin(s),lays(s) Owner's signature. { (L"'�1 Ute. Sump ---- Tubsishower/shower oan 7city: - Water closet _Water heater-- - _ State: ZIP: Other. - Phone. rFax: _ E-mail: Total Na ar1)urirdictim accept credit cards,please call Juriadictian for mare inronmion. Notice:This permit application Minimum fee................$ - UVisa U Mastercard expires if a Plan review(at _ %) $ Credit card number. / P permit Is not obtained - - r.p — within 180 days after it has been State surcharge(8%)....$ _ Name of car`dnoidei u shown on ctedi(card__ accepted as complete. TOTAL .......................$ -- Cxdhr'.ler sisautue --- S Amount 4441616(&%rOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-famlly dwellings only: FIXTURES (individual) QTY_ ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 1660 the dwelling and the tirst100 ft. QTY (ea) AMOUNT 16 60 for each utllity connection) _- Lavatory One 1 bath $24^.. Tub or Tub/Shower Comb 16.60 Two 2Lbath _ $350.00 Shower Only -- 16.60 — Three�3�bath_ ___ __.—____ _ $399.00 Water Closet 16.60 _--- _ SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher _ 16.60 PLAN REVIEW 25'/.OF SUBTOTAL —_ TOTAL Garbage Disposal Laundry Tray 16.60 — Washing Machine 16,60 Floor Drain/Floor Sink 2" _ _ 16 60---j, _ PLEASE COMPLETE: 3•' � 60 q" 16,60 ---- Quantityb Work Performed Vvater ter HeaO conversion O like kind 16 60 Fixture Type: New Moved Replaced Removed/ Gas piping requires a separate mechanical Capped ermit _ --- MFG Home New Water Service 46.40 Sink — MFG Home New SaniS orm Sewer 46.40 Lavatory_--- _ —.-- Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains I 16.60 Shower Only _ Drinking Fountain 16.60 Water Closet _-- 16.60 Urinal Other Fixtures(Specify) Dishwasher _ —— — garbage Disposal —" —Laundry Room Tray _ 14 — -- — _Washing Machine _- Floor Drain/Sink: 2" _ Sewer-1st 100' -- 5500 — — 3" Sewer-each additional 100' 46.40 _ 4 -- -- Water Service-1st 100' 55.00 Vvater Heater _ Other Fixtures Water Service-each additional 200' 46.40 S er:if Storm 8 Rain Drain-1st 100' 5.00 ^loan&Rain Drain-each additional 100' 46.40 _. Commercial Back Flow Prevention Device 4640 P.esidehtial Backflow Prevention Device27.55 — Catrh Basin 1660 -- — —V Inspection of Existing Plumbing or Specially 72.50 Re u� ested Inspectionsep r/hr COMMENTS REGARDING ABOVE: Rain Drain,single farnity dwelling 65.25 -- Grease Traps 1660 ---- QUANTITY TOTAL — — _-- Isometric or riser diagram is required It Ouant�Total is >9 _ 'SUBTOTAL --- 8%STATE SURCH"^C. -- -- "PLAN REVIEW 25%OF SUBTOTAL Re9_uired only if fixture qty total is>9 TOTAL $ Minimum permit fee is$7250-8%state surcharge,except Resider..al Backilow Prevention Device which Is$36 25+8'i state surcharge "Sil New Commercial Buildings regwre Wans with isometric or riser diagram and plan review i:klsts\forms\plm4eer..doc 10/10/00