8001 SW CAROL ANN COURT SITE LAN .
LOT: 17 BLOCK; N/A SU13DIVISION: DURHAM SCHOOL PARK
CITY: TIGARD
SECTION: s
SW 1 4 12 T-2S R- 1 VII W.M. -�
COUNTY: WASHINGTON STATE: OREGON SCALE: 1 8
TAX MAP AND TAX LOT No.: TAX MAP 2S 1 -12CD _
SITE ADDRESS: 8089 SW CAROL ANN CT.
ZONING: R — 12 OWNER: HERB HOFFART & Co. �
4632 S.W. VERMONT
PORTLAND, OREGON 97219
T`LEPHONE: 244--08"17F
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8001 SW Cara! ",nn Court
CITY OF T I CCA R D MASTER PERMIT
PERMIT#: MST2001-00045
DEVELOPMENT SERVICES DATE ISSUED: 2/21/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171
SITE ADDRESS: 08001 SW CAROL ANN CT PARCEL: 2S112CC-15500
SUBDIVISION: DURHAM SCHOOL PARK ZONING: R-12
BLOCK: LOT: 017 JURISDICTION: TIG
REMARKS: Construction of new single family detached residence, Path 1.
BUILDING
REISSUE STORIES: _ FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: „ FIRST: 63e, of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 4G SECOND: 9.5 or GARAGE: 400 or FRONT: 70 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: of RIGHT: 5
VALUE: S 144.140 00
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 1.ti6500 or RFAR: 19
_ PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS:
TUB/SHOWERS: GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN a 10OK: I BOIL/CMP<3HP: VENT FANS: 4 CLOTHES DRYER: 1
(,AS FURN—100K. UNIT HEATERS: HOODS, I OTHER UNITS: 1
MAX INP btu FLOOR FURNANCES. VENTS: I WOOOSTOVES: GAS OUTLETS. 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPARRIGATION: PER INSPECTION:
EA AOD'L 5003F: 201 400 amp: 201 400 amp: lel WIO SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY 401 - 600 amp 401 600 amp: EA ADDL BA CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVCIFDR'. 601 - 1000 amp: 601-amps-1000v: MINOR LABEL:
1000♦amplvr It
PLAN REVIEW SECTION
Reconnect only,
—4 RES UNITS: SVCIFDR-225 A. 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 8 STEREO VACUUM SYSTEM: AUDIO R STEREO. FIRE ALARM- INTERCOM/PACING: OUTDOOR LNDSC LT
BURGLAR ALARM. OTH: BOILER. HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNI-
GARAGE OPENER. CLOCK- INSTRUMENTATION: MEDICAL: OTHR,
HVAC: DATA/TELE COMM: NURSE CALLS TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,178.75
HERB HOFFART& CO HERB HOFFART This permit Is subject to the regulations contained in the
4632 SW VERMONT ST 4632 SW VERMONT Tigard Municipal Code. State of OR Specialty Codes and
PORTLAND OR 97219 PORTLAND.OR 97219 all other applicable laws All work will be done 1n
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 180 days ATTENTION
Phone Phono. Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those pules are set
Reg 0: LIC 34247 forth in OAR 952-001-0010 through 952-001-0080 YOU
may obtain copies of these rules or direct questwns to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer 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/Foundation Dr Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Building Final
Post/Beam StWr-t-Yral PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Issued By : � ,�( ,� Permittee Signature __-
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next busin4s day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-00031
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/21/01
SITE ADDRESS; 08001 SW CAP.nI ANN CT
PARCEL: 2S112CC-15500
SUBDIVISION: DURHAM SCHOOL PARK ZONING: R-12
BLOCK: LOT: 017 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new single family residence.
Owner: -
- FEES _
HERB HOFFART & CO
4632 SW VERMONT ST Type By Date Arrrount Receipt
_
PORTLAND, OR 97219 PRMT CTR 2/21/01 $2,300.00 27200100000
INSP CTR 2/21/01 $35.00 27200100000
Phone: 503-244-0876 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 measuremen! given, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral ATTENTION Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987
Issued by: (��( 'CL.11 t 61�� Permittee Signature:
Call (503) 639-4175 by 7.00 P.M. for an inspection needed the next busines play
Building Permit Application
City of Tigard Datereceived: it-P• r'/ Permit no.: P! r,4ee e_ e0lf
Address: 13125 SW Nall Blvd,Tigard,OR 97223 Project/appl,no.: Expire date:
City of Tigard --
Phone: (503) 639-4.'71 Date issued: By; Receipt no.:
Fax: (503) 598-1960 (ase filen.: Payment type:
Land use approval: _ 1&2 family:Simple Complex:
U 1&2 family dwelling or accessory ❑Commercial/industrial U Multi-fa nily New construction U Demolition
ilAddidan/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
!o')address: C"tre ggtq (7r Bldg.no.: /" Suite no.:
Block: Subdivision: [) ( Tax map/tax lot/account n��'
Projectname: 1t `Y het t E.7R�
Description and location of work on premises/special conditions: ;t t a� /�cr716
1
Name: C_�E, W !W j c (D. =Raw
Mailing addtnsa: 1 &t f:.mily dwelling:
City: jStatwk' ZIP: i7Ziy \,aluation of work................ f G
Phone: D't Fax: /vu C J'' E-mail: No.of bedrooms/baths................................
Owner's representative: 'a -1 is Total number of floors............... ............... . -
77f
Phone: 4 E-mail: New dwelling area(sq. ft.) ..........................on _ S Garage/carport area(sq.ft. '41' 0
Name: `=,��/�'C /; �� .�L�'i Covered porch area(sq. ft.) .........................
Mailing address: heck area(sq.ft.)........................................
—`--`—
City: Other structure arras , ft.).........................
_ S1ate: ZIP:
Phone: Fax: I E'-mail: f'ontmercial/Industrial/multi-family:
align 111111111,10 Uj�� Valuation of work........................................ $
Business name: �.q�/�r �z• �,(� r
Existing bldg.area(sq.ft /............
New bldg.area(sq. ft.) ..........
rrss: ---
-� Number of stories.............. .....�.\.........
City: State: 7.IP:
--_ Type of construction.......:...................s.....,..
Phone: Fax: L'-mail:
CCP no.: 7 ---- Occupancy group(s): Existing:
6""M
Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: �t{�� e. provisions of ORS 701 and may be required to be licensed in the
Address: ' 0 jurisdiction where work is being performed.If the applicant is
City: ;c State~, ZIP: exempt from licensing,the following reason applies:
Contact person: _ y� plan no.: - L` _.
Phone: Fax: E-mail: ---
Name: Contact person Fees due upon applicai ion ........................... S
Address: ,��, - -"� % Date received: . _
City: date: 7_IP: Amount received ......................................... $—
Phone: Fax: ^ - E-mail Please refer to fee schedule. _
1 hereby 7ertify I have read and examined this application and the Not all jurirdictionr"'crit cmdil cants,ptew caul jurisdiction for more inh—,%;-. .
attached checklist. All provisions of laws and ordinances govrming this a visa U SlastrrCard
work will be complied withi w ethers cifie rein or not. Credit card number:
''' Expires
Authorized signatu t� / Date: —
' — Name of cardholder u shown on credit card
Print name:_ f5.(& 4 f r'r` S
— _ Cardholder signature _ -� Amount
has b
Notice:This permit application expires if a permit is not obtained within I8i days atter it een accepted as complete. 440-4611(bMCOM)
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
AssoCity of Tigard City of Tit►ard UElctricalted ermits:
y �, O Electrical ❑plumbing U Mechanical
Address: 13125 SW Hall Blvd,'Tigard,OR 97223 U Other:
Phone: (503) 639-4171
Fax: (503) 598-1960
I IIF' 11-011.11,01VING UI FNIS ARF, 1111'QUIR11-:1) FOR PLAN IUIA'1111% Yes No N/A
I Land use actions completed.See jurisdiction criteria for concurrent reviews.
2 'Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 _Verification of approved plat/lot.
4 Fire district___approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report.Must carry original applicable stamp and signature on file or with applic•:Lion.
9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of
catch-basin protection,etc.
10 _ Complete sets 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 references between plan location and details. Plan review cannot be completed
if copyright violations exist.
I I Site/plot plan drawn to scale.The plan must show lot mid building setback dimensions;r,uperty comer elevations(if
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.in(ervals);location c f easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;directiun indicator;lot
area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and location._ _
I A Floor pians.Show all dimensions,room identification,window size,location of smoke detectors,water heater,
turnace,ventilatifm fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
'
i_(ross section(@)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor,
wall constriction,roof construction.More than one cross section may be required to t 1";1 ly portray construction.Show
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,
fireplace construction. thenal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimum of two elevations tut additions and remodels.
Exteror elevations mint reflect the actual grade if the change in grade is greater than -our foot at building envelope.
fulksirc sheet addendums showing foundation elevations with cross references are acCeptable.
1'. Wall bracing(prescriptive path)andior lateral analysis plans.Must indicate details m,.d locations;for
non-prescriptive path analysis provide specifications and calculations to engineering simidards.
17 I'loorlroof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing
locations.Show auic ventilation.
1,11, Its-wement and refntning walls. Provide cross sections and details showing placement of rebar.For engineere.I
_systems,see item 22,"Friginver's calculations."
19 Ream calculations.Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/Or any beam/joist carrying a non-uniform load.
'0 Manufactured floor/roof truss design details.
21 Encrgy Code compliance. Identify die prescriptive path or provide calculations.A gas-piping schematic is required
for four or more V11111 ,inces.
Uigineer's calculalinns.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in 0,rgon and shall be shown to be applicable to the project under review.
23 Five(5)site plans are required for Iran 11 above.
24
25
26
27
28 _
Checklist must be completed before plan review start date. Mirror changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved f'or department use only. 4404614 t15MOCOW
Plumbing Permit Application
Cit
Date received: ;i 01 Permit no.:
City of Tigard
Sewer permit r: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 972.23 – —
Cit yofTigard Phone: (503) 639-4171 Project/appl.no.: Expire date: –
Fax: (503) 598-1960 Date issued: By: I Receipt no.:
Ladd use approval: Casc file no.: - Payment type:
U 1�c 2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement
ew construction U Addition/alteration/replacement U Food service U Other:
JORSITEINFOHNIIATION
Joh address: y C&i L! (' !n r! / ICI (7' Description Fee ea. Total
Bldg. no.: /Z _ Suite no.: NO New 1-and 2-family dwellings only:
Tax map/tax IoUnecount no,: /a (includes 100 f.for each utilityconnedlon)
SFR(1)bath
Lot:_/' __ BIock_ ,,d Subdivision: 0S. SFR(2)bath -- ----�– -- – --
Projcct name: S ( 49 SFR(3)bath
City/county: , ,l i ZIP: e 5` Each additional bath/kitchen
Description and Ilication of work on premises: Siteutilltles:
dreG/ rInc-- Catch basirdarea drain _
Est,date of completion/inspection: Drywells/leach line/trench drain _ –
Footing drain no.'in. ft.)
PLUMBING CON�LIIAC*Uollt Manufactured hom,�utilities
Business name: C�k'/I�I w'c'y�( f l(t��), 'tt _ Manholes
Address: �7736, 6 a' ;016,1-4 5 � _ Rain drain connector
City: State: ZIP: ti-,&V 7 Sanitary sewer(no. lin. R.)
Phone: 4- Fax: I E-mail: Storm sewer(no. lin.ft.)
CCB no.: Plumb.bus.reg.no: 70iy
Water service(no. lin. fl.)
City/metro lie.no.: 3O Fixture or Item:
Absorption valve
Contractor's representative sf nature: Vie! – –– --
–�- Back flow prevcntcr
Print name: Date: " C/ Backwater valve —
Basins/lavatory _
Name: r/rJq't /.�� A�Y'c'C Clothes washer
Address: Dishwasher
City: State: "LIP: Drinking fountain(s)
i:jeclors/sump
Phone: Fax: E-mail: Expansion tank
Fixture/sewer cap _
7 t0
Floor drains/floor sinks/10i(print): 4A?,6 4'AAWf
Mailing address: < 11 Garbage disposal
-- Hosc bibb
City: State: ? ZIP: .7/y Ice maker _—
Phone: " Fax:.,1W-,,46 ,,' E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s) _
will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _
employee on the.property 1 own as per ORS Chapter 447. Sink(s),basin(s), lays(s)
Owner's signature: Date: Sump — _ _
Tuhs/shower/shower span _
Name:
Urinal _
Water closet _
Address: /%LAL`. 'li-i.-,, -- WIatcr heater
City: State: ZIP: (hher. --
Phone: Fax: I E-mail: 7 oral
Not all jurisdictions accept credit cards,please call jurisdiction rot snore Notice:This permit application
information. Minimum fee.................$ —
-
Uvisa U Mastercard expires if a permit is not obtained Plan review(at ___ %) $ _
Credit cad numbs: -- / / within ISO days after it has been State surcharge(8%) ....$
Expiresecce ted as complete. TOTAL .......................$
Name of cardholder u Chown on credit cad Ea
� p P
S
Cardholder sijrWure Amount
440.-A!I G(tilxK'(tM i
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES Individual_ QTY ea AM01INT (includes all plumbing flxtures9n PRICE TOTAL
s nk 16,60 the dwelling and the flrst100 ft. "ITY (ea) AMOUNT
1,wator 16.60 for each t:tll�connection
' _ One 1 bath
17,7 1 ub/Shower Comb. 16.60 Two(2)bath _— S350.Oti
r,v1,r Only 16.60 Three(3)bath v- $39F.00 __-
Itar Closet - - 16.60 -_ - -- SUBTOTAL _
t. ,iI- 16.60 8%STATE SURCHARGE
J wo-for 16.60 PLAN REVIEW 25%OF SUBTOTAL
_ __ -- TOTAL
rt: � 16 60
tge Dis,-osal --- ---
Laundry Tray - 1650
Washing Mnrhlne -'----- 16 GO
I loor DralrrF'loor Sink �" 16.60
3" 16.60 PLEASE COMPLETE:
4 _ 1660
alar Neater O conversion O like kind 1660 Quanli b Work Performed
G.,s piping requires a separate mechanical Fixture Type: Now Moved Replaced Removed/
ernit. _.___ Capped
MFG Home New Water Service 4640 Sink -
MFG t-Inme New SarVStorm Sewer 46.40 1 avat�— — _--.—-
--� 1 ub or TLib/Sh, nr
Pose Bibs 16.60 Combination _
12uuf Drains — 1660 Shower Only_— -
nrinking Fountain 16.60 — _Water Closet
ther Firlures(SpecHy) 16 B0 Urinal --_
Dishwasher_ _
-• ---- --�- - Garbage Disposal,-- -- - _--
----- -- - — - -- Laundry Room 1 y
— -- - --- Washing h,.Jchine
f T - Ist 100' _ 55Floor Drain/Sh,k 2"
.00
_ 3"
e,er-each additional 100' 46.40 _ 4"
IWater Heater _
r. r,i,o-1st 100' 55.00 —
onr Service-each additional 2.00' 46,40 - Other Fixtures
••I 8 Rain Drain-tsl 100' 55.00
• -I d Rain Drain-each. .Idiu,.•nal 100' 46.40
'-rlunlmerclal Rack Flow Pre ention Devine 4640 ----- --- -
nsidential Sackflow Prevention Device' 27.55 — ---`—'
Catch Basin — 16.6U ---- -'
IrIve^.11- Existing Plum' ng or Specially 72.50 --- -� — ---
f7nr ,.IJ.' .Insep rmr _ COMMENTS REr4RDING ABOVE:
F..hn Dr nn,single family dw-Aing 65 75 _—,-
Grenlcr� 16.60
-- - QUANT17•r TOTAL `------` --- --
1-trimetric or riser d6yam Is required If -
Quantj Total IssB—
*SUBTOTAL -- -----
- '- -- 8% STAT: 'HARGE ---
14 REVIEW 2S OF SUtJTO1AL
_--.-- Re aired only it fidrun rlt�total is�B _- _
OTAL - S
.Mlnlmum permit fee Is$72 50-8%state surcharge,except Residential BackBow
r'revontion Devine,which Is$36 25•8%state surcharge
..All New Commercial Buildings require plans with Isometric or riser diagram and
plan,evlew .
i\dsts\forms\plm-fees.doc 10/10/00
Electrical Permit Application
Dalc received: A-a.of Permit no.:Mgrb,/
City of Tigard Project/appl.no.: Expire date:
C'ityn(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _
01r&2 family dwelling or accessory O Commercial/industrial U Multi-family U'tenant improvement
New construction U Addition/alteration/replacement U Other: U Penial
JOB SI-I I-,'INFORMATION
Job address: WX) S.w, (,q7 / a/7-7 Bldg.no.: Suite no.Xl Tax map/tax Int/account no.: /.'
Lot: Block: i Subdivision; �—
Project name: Desch tion and location of work on remises
p —_p Itn m 5ctcr R�—
Estimated date of completion/inspection:
CONTRAC11-011 APPLICA]ION 'I-'I-'E SCHEDULE
Job no: _ Pee —M-77 1
Business name: _ ,C. Description Qty. (ea) Total no.insp
New residential-singre or multi-family per
Address: </ UL C- n ��s dweliingmill.Includes attaciadgarage.
City: !, ilate�l,tQ ZIP: QO Serviceincluded:
_('hone: - / Fax: E-mail: I WO sq.ft.or less 4
CCB no.: FICC.bus.tic.no: _ (y C� Fath additional 500 sq.ft.or portion lhe.:of
Limited energy,residential 2
City/metro lic. no.: Limited energy,non-residential 2
1. 1 Each manufactured home or moeular dwelling
Signature ol'supervising electrician wired) Date Service and/or feeder 2
Sup.elect.name(print): -fie-lye License no: 612 5 Services or feeders-Installation,
alteration or relocation:
200 amps or less 2
Name(Print): eWe 6 1V—/? t1 201 amps to 400 amps 2
Mailing address: �! �, 401 amps to 600 amps 2
l 601 amps to IOfxl amps 7
City: 7,;t .0 Stale' ZIP: 9) / Over I WO amps or volts -
Phone: -jlf7k I Fax i E-mail: Reconnectonl 1
Owner installation:The installation is being made on property 1 own Temporary services orfeeders-
which is not intended for sale,lease,rent,or exchange according to installation.alteration,or relocation!
ORS 447,455,479,670,701. 2tx1 amps or less 2
201 amps to 4(x1 amps - -- i�
Owner's si nature: Date: 401 to 600 ams - 2
Branch circuits-new,alteration,
Name:
or exter.-Ion per panel:
A Fee for branch circuits with purchase tit
Address: ? t t C service or feeder fee,each branch circuit
City: _ State; ZIP; n. Fee for branch circuits without purchase
Phone: r. E-mail: of service or feeder fee,first branch circuit:
lu Each additional hrsnch circuit:
Mlsc.(Service or feedernot Included):
U Service over 225 amps-conunetciad U Health-care facility Each pump or irrigation circle 2 i
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 1
family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel.
U System over 600 volts nominal mote residential units in one structure alteration,or extension* 2
O Building over three stories U Feeders,400 amps or more •rkscri tion: _
U fkcupant load over 99 persons U Manufactured structures or R V park Fitch additional Inspection over the allowable in any of the above:
U t:gress/Iightingplan U nther: _ pection
Submit_sell,of plant with any of the abovr• Investigation fee
The above are not applicable to temporary cottstruclion service. Other
Not all jurisdictions accept credit cants,please can jurisdiction for move intnmution. Notice'This pemlil application Permit fee....................$ _
U Visa U MasterCard expires if a permit is not obtained Plan review(at _, %) $
Credit cud number within 190 days after it has hecn State surcharge(8%) ....$ _
spire' - accepted as complete. TOTAL $
Name o cudho r as shown on credit card - ' """""""••'•••^
$ —!
C rdA+lder sl`rrattae Amount 4u1.It;IS ftiRXUCOAl1
t
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
pRestricted Energy Fee...................................................... $75.0C,
Number of Inspections par permit allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total
Check Type of Work Involved:
Residentlgl-per unit
1000 sq ft.or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq.ft or
porior,thereof $33.40 1 ❑ Burglar Alarm
I imlled Energy $75.00
Hach Manufd Home or Modular F-] Garage Door Opener'
CINolling Service or Feeder $90.90 2
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 ❑ Vacuum Systems"'
201 amps to 400 amps $106.85 2
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 $66.85 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 916-260-260)
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 ❑ Boller Controls
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
fender fee,
Each branch circuit a $6.65_ 2 ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder lee.
First branch circuit $46.85_
Each additional bran, d _ __ $6.65 ❑ HVAC
Miscellaneous L 1 Instrumentation
(Service or feeder not Included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 _ E] Intercom and Paging Systems
Signal circuit(s)or a limited energy
pnooi all„ration or extension $75.00 ❑ Landscape Irrigation Contril'
Minor Labels(10) $125.00 _
Enrh-idifional Inspection over ❑ Medical
the +: r••n,any of the above
I'cr ut,I ocluut $62.50 ❑ Nurse Cells
hro,r $62.50
11,,111 $7375 Outdoor Landscape Lighting'
jr-4,
[� Protective Signaling
rr!nr total of above fees $ ❑ Other
8%State Surcharge $
_ ___Number of Systems
25`A.Plan Review Fee
See"Plan Review"section on $ No licenses are required. Licenses are required for all ocher Installations
front of application. _
Fees:
Total Balance Due $
-� Enter total of above fees
U Trust Account M 8%State Surcharge $
Total Balance Due $
i:\dsts1forms\cic4ees.doc 10/09/00
Mechanical Permit Application
Date received:/t-,? d/ Permit nor.:hA,7;;.-n1
City of Tigard I'roject/appl.no: Expire date
Citynf"rigard 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.:
A&2 family dwelling or accessory ❑Commercial/industrial CI Muld-family ❑Tenant improvement
ew construction U Addition/alteration/replacement U Other:
Job address: )o la: t'rt i,'G ;Il'I r jJ, Indicate equipment quanudes in boxes below.Indicate the dollar
Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/account no.: /L',4 profit. Value$
Lot: Block: ILO I Subdivision: / `� j 'Scc checklist for Important application information and
Project name: 1 U r� ,�� / ,/ - jurisdiction's fee scheduic for residenti l permit fee.
City/county: a`�f� h'�r✓h ZIP: i7 ;
Description and location of work on premises: _
Fee(ea.) ToW
Est.date of coripletion/impection: G ,)j ,� De" lon Reis
.anl Res.onl
Tenant impio-:vent or change of use:
Is existing space heated or conditioned'?U Yes U No Air handling unit _ -CFM
Is existingspice insulated?Ll YU No it conditioning(site plan required)
'p`ce nsuAlteration of existing HVAC system
oiler/compressors
State boiler permit no.:
Business name: ,f ' - l o^ m lip Tons BTU/H
Address: <� - .,.1 (�O�,Gn r L'(-0 cHic/smokedampers/ductsmoa electors
City: ( —k u, /t S!aire ? ZIP; G/'J� ��) tical pump(site plan require
Phone: - Fax;r mill: Install/replace urnac wear
� �� i. �J
CCB no. -including duclwork/vcntliner UYcsUNo
limall/rep acOrelocate heaters-suspen ,
Cit /metro lic.no.:
City/metro „� � will,or floor mounted
Name(please print): ani for a�}t lance other than furnace1101 -
c girl errlfon: i
Absorption units.-- BTU/II
Name: ;!I'l < J/k , { Chillers _ lip
Address: Compressors HP
nv.ronmenta eemust ao�Teot
City: State: ZIP: -�-- Appliance vent
Phone: Fax: I E-mail: )ryerexhaust
Hoods,Type I/IVr_c7.T1tcTJn7Fazmat
hood foe suppression system
Name: / - t ilC EXhaust fan with single duct(bath fans)
Mailing address: �/t 34 1{ ; lyi h1 aunt system a hartrem h�eatin or-
City: ,";:/ 1"-:,A State:/,K ZIP: `/J�,i
-uc piping an distribution ,up to outlets)
Type: —_U1(3 NG Oil
14"
7 E-mThune: � v Fax: !F, ail: Fuc piping each additional over outlets
Process piping(schematic required)
Narne: Number of outlets
O
1 er steii appliance er equipment:
Address: Decointivefireplace
City: Slate: ZIP: nsert-type
Phone: I Fax: E mail: Woods tove/pellet strive
Ott cr:
Applicant's signature. �� �_` �..' Uale: .-,Z3 �/
N6me(print): OL ,4
Wit all jurisdictions accept credit tardy,please eW jurisdiction for mere information Permit fee...... ..............
U visa U MasterCard Notice:This permit application Minimum fee................$
expires if a permit is not obtained --
Credit card numMi: _� Plan review(at _ 96) $
Expires within 180 days after it has been State surcharge(8%)....$
Name cardholder as shown on credit card accepted as complete. —---"
_ $ TOTAL ................ ......$
Cardholder signature 'Amount -!
'— --- 440-4617(~)W,
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 3 2 FAMILY DWELLING FEE SCHEDULE:
_TOTAL VALUATION'.- FEES _ Description: Price Tot:.
$1.00 to$5,000.00 - m �imum fee$72.50 Table 1A Mechanical Code ob (Ea) Am,
$5,001.00 to$ 0,000.00 $72.50 for the first$5,000.00 and 1) Fu to 100,000 BTU
$1 52 for each additional$100.00 cr Incluudindin g ducts&vents 14.00
fraction thereof,to and Including 2) Furnace 100,000 BTU+
_ _$10.000.00. _Including ducts&vents 17.40
$10.001-CO 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 1400
fraction thereof,to and Including 4) Suspended heater,wall heater
_ $25.000.00. or floor mounted heater 14.00 --
$25,(j01.00 t $$50,000.(:J $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: k1r`:.011e eat Air
$1.20 for each additional$100.00 or For Items 7.11,_.d +x,'t o[i: Ump' Cc,nd
fraction thereof. -footnotes below.•'r':: 'COm kr
'
1)<31-11P;� sorb unit
ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00
- Value Total 8)3-15 HP;absorb 2�60
Unit IOCK to 500k BTU
Description:- __.qty Ea Amount g)15-30 HP;absorb
Furnace to 100,000 BTU,Including 955 unit.5.1 mil BTU 35.00
ducts✓i vents 10)30-50 HP;absorb -
Furnace> 100,000 BTU Including 1,170 _unit 1-1.75 mil BTU 5220
ducts&vents 11)>50HP:absorb
Floor furnace including vent 955 unit>1.75 mil BTU
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM T
n hunted heater
„ut Included In applicance 445 13)Air handling unit 10,000 CFM+
trent _ 17.20
Rr 'ir units _ _ 805 _
-- 14)Ncn-portable evaporate cooler
3 tip;absorb.unit, _ - 955 - 10.00
to 100k BTU 15)Vent tan conno:lad to a single duct
3-15-15 hp,absorb.unit, �- 1,700 _ 6.80
1C tk to 500k BTU - - 16)Ventilation system not Included In
1!, .x,hp,absorb.unit, 0115
1 _ 2,310
_PTU _ appliance permit _- 10.00
30-rif.,hp;at surb.t reit, -� 3,400 17)I food served by mechanical exhaust 10.00
1•'.7;, mil.dTU _ _ _ -- -- --
5U hp;absorb.unit, 5,725 1E)Uornestic Incinerators
17.4.1
1.7' trill.BTU -
�Air ha1dlutg unit to 10,000 On658 19)Commercial at Industrial type Inr,neralor
I Air handlinQunit>10,000cim� 1,170 - -- 69.95 -
r ible evaporate cooler 20)_658 _ 20)Other units,including wood sto es _ 10.00
,:It tan connected M m,Ingle duct 446 21)Gas piping one to four outlets -
vent system not inciuucrl In 656 p p g _ 540
appliance permit - - - 22)More than 4-ner outlet(each)
H�• :x!"IUSt ;,56 1.00
l)ol"' ", _ 1.170 Mlnimt.m Pormlt Fee$72.50 SUBTOTAL: $
tn
Comerciat of Industrial int neldlor 4,591)
Othr,r unit,Including wird stoves, 056 8°/.State Surcharge $
IIlSHrtJ,elG. _
Gas piping 1-4 oullets 360 - 25%Plan Review Fee(of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL----r $� TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:
Other In>lpectlons and Fee.:
I Inspections outside of normal business hour(minimum charge-two hours)
$72 50 per hour.
2 Inspections for which no fee is specifically indicated (minimum charge-half how 1
R72 50 per hour
3 Additional plan review required by changes,additions or�revislons to plans(minor
charge ec^-hall hour)$72 50 per hour
"State Contractor Boller Certification required for unite>200k BTU.
**Residential A/C requires site plan showing placement of unit.
I:\dsts\forms\moch-fees.doc 10/11/00
SEE 35MM
ROLL# 22
FOS
LARGE
DOCUMENT
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
I
IMPORTANT PERMIT NOTICE
EASTGATE ELECTRICAL INC
1410 NE 106TH
SUITE 206
PORTLAND, OR 97220
Electrical Signature Form
Permit #: MST2001-00045
Date Issued: 0212112001
Parcel. 2S112CC-15500
Site Address: 08001 SW CAROL ANN CT
Subdivision: DURHAM SCHOOL PARK
Block: Lot: 017
Jurisdiction: TIG
Zoning: R-12
Remarks: Construction of new single family detached residence, Path 1.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
HERB HOFFART & CO EASTGATE ELECTRICAL INC
4632 SW VERMONT ST 1410 NE 106TH
PORTLAND, OR 97219 SUITE 206
PORIkAND, OR 97220
Phone #: 503-244-0876 Phone
Req #: LIC 43701
ELE 26-340C
SUP 1512S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
S' nater of Supe ising�Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CRAFTWORK PLUMBING INC
7736 SW NIMBUS AVE
BEAVERTON, OR 97008
Plumbing Signature Form
Permit #: MST2001-00045
Date Issued: 02121/2001
Parcel: 2S1 12CC-1 5500
Site Address: 08001 SW CAROL ANN CT
Subdivision: DURHAM SCHOOL PARK
Block: Lot: 017
Jurisdiction: TIG
Zoning: R-12
Remarks: Construction of new single {amity detached residence, Path 1.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN-. Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
HERB HOFFART & CO CRAFTWORK PLUMBING INC
4632 SW VERMONT ST 7736 SW NIMBUS AVE
PORTLAND. OP 97219 BEAVERTON, OR 97008
Phone #: 503-244-0876 Phone #: 644-8698
Reg #: I Ir: 79666
PI M 20-148PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signature of Authorized Plumber
It you have any questions, please call (503) 639-4171, ext. # 310
T (��
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CITY , t= 7GARD BUILDING INSPECTION DIVISION MSTel G y�
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- -
q � BUP —
—_J-- Date Rdquasted /-' 1 AM PM BLD
Location C'q �12 -I coe Suite _ MEC
Contact Person _ Ph 2Ze., - 77 V FLM _
Contractor Ph SWR
RUILD ---- — Tenant/Owner ELC
retaining Wall ELR
Footing Access:
Foundation FPS -
Fig Drain SGN
Crawl Drain Inspection Notes: ---
Slab _ — — --- SIT
Post& Beam -^ --
Ext Sheath/Shear -
Int Sheath/Shear
Framing -------_-.--- - --
Insu'ation
Drywall Nailing --
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof
Mise - -------- - ---- ---
Fi _
ASS PART FAIL --- ----- --- -
MBING
Post 8 Beam - _------------ ----------
Under Slab
1 op Out ---- ---_ --
Water Service
Sanitary Sewer
Rain Drains
F inal
PASS PART FAIL
MECHANICAL
Post& Bearn ----- -------- -- -- -
Pjugh In
Gas Line --- - -
Smoke Dampers
Final ------ -------- - -
PASS PART FAIL
ELECTRICAL - - - - — —
Service -- -- ---- - --- --- - -
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL _ ----_ __----- --___-. ---- _ --
SITE
Bacl,fill/Grading `_----- -
Sanitary Sewer
Storm Drain [ J Reinspection fee of$_ -_required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( 1 Please call for reinspection RE: ( ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date %- �j- C/ _Inspector Ext
- --- -------- -
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST -
24-Hour Inspection Line: 639-4175 Business Linc: 639-4171
c/ BUP
Date Requested
���� �� C�-- � -AM PM _ BLD
Location_ ���� ( Cr.-1,64� Anaai LL4,- Suite / / MEC
Contact Person �.{� Ph 72 L 7 r' q y PLM
IF
Contractor Ph SWR _
BUILDING Tenant/Owner ELC
Retaining Wall ELR
F oozing Access
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab — SIT
Post A ream
Ext Sheaih/Shear
Int Sheath/Shear �-
Framing
Insulation _
Drywall Nailing /"; � � �'� /�f/�,<.' -^GYjia: a/ id�/s`�� G'` 'C''�i" L-
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: —
rna ^-�
.PASS PART rFAIL --- -- —
PLUMBING
Bost& Beam —___—
Under Slab
Top Out ---- ------------- --- - —
Water Service
Sanitary Sewer ----- --- ----------------- — --- —
Pain Drains
aminal
PASS PART FAIL
' MECHANICA ' ------- -- --- — — — .^
Post& Bearn ----- _-- _----- __—_-- — —
Rough In
Gas Line -- -- ----- - --
SmQke Dampers
SS PART FAIL
Service
Rough In ------��._------------- ----
UG/Slab
LOW Volta_ae
Fire Alarm
Final
PASS PART FAIL_ --_SITE
Backfill/Grading ---- -- - - --
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ —required before next inspection. Pay sat City Hall. 13125 SW Hall Blvd
Catch Basin
F";•e Supply Li ie [ J Please call for reinspection RE:--_ [ ]Unable to inspect nc access
ALIQ
Approach/Sidewalk
Other Date C' _Inspector 1 , ,_— Ext
Final
PASS PART FAIL DO NOT REMOTE this inspection record from th:� job site.
CITY OF TIGARD Bl"I-DING INSPECTION DIVISION
24-Hour Inspection Line: 6..- 4176 Business Line: 639, 1 MST f4 7'j
BUP
—_— Date Requested f.�-tel' AM PM BLD
Location �?��1 � �[tee�' 4""L, Suite MEC
Contact Person �,C. G�i Ph
_2Z e -7 7 —
PLM
Contractor Ph SWR
BUILDING Tenant/Owner _ ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS _
Fig Drain 5GN
Crawl Drain Inspection Notes -- --
Slab --. SIT
Post& Beam —
Ext Sheath/Shear
In!Sheath/Shear
Frarning ----
Insulation
Drywall Nailing
Firewall
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling
Roof
— L?�' _ � 14 y0f -----
Final
PASS PART FAIL
PLUMBING
Post& Ream
Under Slab
Top Out ----- — �—_---- --_._ .--
Water Service
`sanitary Sewer —� --- --' `--- -----
Rain Drains
Final '— ---- — — - -- — ----
PASS PART FAIL
MECHANICAL �� \
Post& Beam —
Rough In \
Gas Line ------ — --- — -- — —
Smoke Dampers
Final —.,_--
-PART� FAIL
Sf'rVrC
Rough In
UG/Slab _
Low Voltage
bSS PART FAIL
STrr—
Backfill/Grading -- - - -- —
Sanitary Sewer
Storm Drain ( )Reinspection fee of$ required before ne nspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE:�� — ( ]Unable to inspect no access
ADA
Approach/Sidewalk
Other Date _ - Inspector Ext
Final
PASS PART_FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTIC?,. DIVISIONoYs-
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
—_Date Requested_ ��']-/ ��__AM PM BLD
Location ROc� l C-C /1t �'—� w/�� Suite MEC
Contact PersonPh -7'y PLM �✓�`� LfQ
Contractor _ _ Ph _ Y SWR
BUILDING'- Tenant/Owner _ ELC
Retaining Wall IELR
Footing Access-. FPS
Foundation
Fig Drain SIGN
Crawl Drai i Inspection Notes:
Slab SIT
Post& Beam
Ext Sheath,!Ghear
Int Sheath/Shear 1J �� �� � �_
Framing
\\ --- --
Insulation �/C C ��S L-` �� ' f- L. R CJZ-
Drywall Nailing - - --
Firewall C
Fire Sprinkler G
Fire Alarm _
Susp'd Ceiling `
Root � � �'� �L� lV ��z-�--V
Misc: _ --
Final
PASS PART FAIL -- ----
LUMB ___ ___---_----_—_--- -
Post& Beam
Under Slab - -_- _--- --
Top Out
Water Service -------
Sanitary Sewer
IRain Drains ----,_ _-__- - -- --
9 PART FAIL -� -----_----- _ _- -__ _--- -
ANICAL
Post 8 Beam -- _- -----_--------- ---- ------
Rough In ---
Gas Line _ ---
Sr!oke Dampers - -_
Final - -- ----- ---�
PASS PART FAIL
ELECTRICAL
Service _- ----- - -- --- -- ----------
Rough In
UC!';lah - _- --- ---- - --- --
Low Voltage.
Fire Alarm - -- ---- - - --- - -- --
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 BasinUnable to inspect-no access
Fire Supply Line I 1 Please call for reinspection RE --_--_ -_ [ 1 p
ADA CI
Approach/SidewalkDate Inspector I C� �_� Ext
Other -
Final
PASS PART FAIL. DO NOT REMOVE this Inspection record from the job site.