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12725 SW BUGLE COURT ..a N 'V N c� C W G �D h O C .f I i 12725 SW Bugle Court F ; CI14Y OF •TIGARD —_ MAS- PERMIT PERMIT#: MST2002-00202 DEVELOPMENT SERVICES DATE ISSUED: 4/26/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 339-4171 SITE ADDRESS: 12725 SW BU'GLE CT PARCEL. 2S109AD-08800 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: ^32 JURISDICTION: TIG REMARKS: New SF detached, Path 1. BUILDING REISSUE: STORIES: el FLOOR AREAS REQUIRED SETBACKS REQUIRED_ CLASS OF WORK: NEW HEIGHT: ^7 FIRST: I n94 of BASEMENT: 070 00 of LEFT: 6 SMOKE DETECTORSY TYPE Or USE: SF FLOOR LOAD: 4r, SECOND. r,;0 sf GARAGE: 420 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: FINSSMENT: sf RIGHT: 8 VALUE: 5 209,720 80 OCCUPANCY GRP: R3 BDRM. .1 BATH: 3 TOTAL: 1]64 00 of REAR: 23 PLUMBING SINKS: 1 WATER CLOSET'S 3 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVAL DRIES: 5 DISHWASHERS. FLOOR DRAINS: SEWER LINES- 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 3 GARBAGE.DISP: I WATER HEATERS.- 1 WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: �iBOILICMP<311P: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>•100K: I UNIT HEATERS: HOODS: I OTHER UNITS I MAX INP blit FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL PESIDENTIAL UNIT SERVICE FEEDER_ TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS_ ADO'L INSPECTIONS 1000 SF OR LESS. 1 U 200 amp: 0 200 amp: WISVC OR FDR: I PUMPIIRRIGATIJN: PER INSPECTION: EA ADD'L 500SF: 5 201 400 amp: 201 400 amp: 1e1 WIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY 401 600 amp. 401 600 amp: FA ADDL BR CIR: SIGNAL/PANEL: IN PLANT' MANU HMISVCIFDR: 601 • 1000 amp: 601-amps-1000v: MINOR LABEL: 1000♦amp/volt: PLAN REVIEW SECTION Reconnect only: - - -- >-4 RES UNITS. SVC/FIR,-225 A >600 V NOMINAL. CLS AREAISPC OCC' ELECTRICAL•RE.STR CTED ENERGY _ A.SF RESIDENTIAL B.COMMERCIAL AUDIO R STEREO. VACUUM SYSTEM: AUDIO h STEREO. FIRE ALARM. INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM. OTH BOILER: HVAC: LANDSCAPE/IRRIG. PROTECTIVE SIGNL: GARAGE OPENER. CLOCK INSTRUMENTATION: MEDICAL. OTHR: HVAC DATA7TELE COMM. NURSE CALLS: TOTAL 1 SYSTEMS Owner: Contractor: TOTAL FEES: $ 7,701.23 PAUThis permit is subject to the regulations contained in the 1480 NW 102ND AVE 1480 NW 102ND AVENUE R CARNEY INC PAUL R WARNED INC Tigard Municipal Code,State of OR Specialty Codes and 1480 PORTLAND,OR 97229 PORTLAND,OR 97,e29 all other applicable laws All work will be done i accordance with approved plans, This nprmlt 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: Phone. Oregon law requires you to followru'es adopted by the Oregon Utility Notification Center Those rules are set Rep M: I.Ir; 56852 forth in OAR 952-001-0010 throu;h X52-001-0080. You may obtain c opies of these rules cr direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Slab Insp Footing;Fourldalion Dr Plumb Top Out Exterior Sheathing Insl Rain drain Insp Grading Inspection Post/Beam Structural Plmiundslab Insp Electrical Service Low Voltage Water Line Insp Sewer Inspection Post/Beam Mechanica PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Footing Insp Underfloor insulation Ftng Drain Bsm'1 Walls Framing Insp Gas Fireplace Electrical Final Foundation Insp Crawl Drain'Backwaler Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final lssu�d By Permittee Signature : —i Call (503) 639-4175 by 7.00 p.m. for an inspection needed the next business day CITYOF TI GA R D SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00141 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/26/02 SITE ADDRESS; 52725 SW BUGLE CT PARCEL: 2S109AD-08800 SUEDWISION: ELK HORN RIDGE ESTATES ZONING: R _ BLOCK: LOT: 032 -- JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: 1 CLASS OF WORK: NEW 11WELLING UNITS: 1 T%'PE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWq IMPERV SURFACE: Remarks: Sewer connection for new SF Owner - — FEES PAUL R CARNEY INC — -- — 1480 NW 102ND AVE _Type P., Date ` Amount Receipt PORTLAND, OR 97229 PRMT CTR 4/26/02 $2,300.00 27200'•'00000 INSP CTR 4/26/02 $35.00 27200200000 Phone: -- _ 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 rneaFurement 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" Perm Issue by: c , _ Permittee Signature: ? Call (503) 33 -4175 by 7:00 P.M. for an inspection needed the next business day a r Build4ng Permit Application - —_ Datcm-rived: �/ /� p'� Permit no.:!-IyT sad-0 �2 (�!ly of Tigardt'. ��6 fly Projecttappl.no.: Expire date: City of Tigard ilddies§:13125 SW Hall Blvd, 91t 3t► �� Phone: (503) 639-4171 Date issued: CA Receipt no.: V Fax: (503) 598-1960 Case file no.: Payment type: Land r; .t, approval' _ ___._.. _ _.- 1&2 family:Simple Complex: U JasK &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Addilio:ua!'^ration/replacemrnt U Tenant improventent U Fire sprinkler/alamt U Other: JOB SUTE INFORMATION. Inh rudrCSS: /,%� j (. (�i Bldg.no.: Suite no.: Block: Subdivision: f /le ff, Tax map/tax lot/account no.: Project name: Description and location of work on premises/special condition, 01%NI It FORSPFCIAILIr t ' Name: _ C .l., wc Mailing address: w``/ solo I, o0V i, 1 &2 family dwelling: r Stu!e: 'LIP: Valuation of work........................................ Phone: ZYqOGr Fax: Y6 E-mail: -� No.of be ................................. Z Owner's representative: . , Total number of floors Phone: Fax: A E-mail• New dwelling area(sq.ft.) �.................. Z _ Garage/carport area(sq. ft.)......................... --- - Name: -L--, S Covered porch area(sq.ft.) ......................... 0 -- k ecarea(sq. ft. Mailing address: D ) ........................................ �— City: State: ZIP: Other structure arca(sq, ft.)......................... Phone: Fax: E-mail: Commercial/indr►striallmulti-family: ` Valuation of work........................................ $ -- Business name: Existing bldg.area(sq,ft.) ...................... .. Address: �,'f-`-• rew bldg.area(sq. It.) .......�............. ....... City: State: ZIP: — Number of stories..................... ............ l Phone: Fax: F.-mail: Type of construction............... ................... ni Occupancy group(s): Existing; CCB no.: r6 J?S-Z _ _ New: City/metro lie.no.: Notice:All contractors and subcontractors are required to he 'Iflicensed with the Oregon Construction Contractors Board under Name: % - provisions of ORS 701 and may he required to he licensed in die Address: S ` • ,� tt^>! jurisdiction where work is bring performed. If the applicant is City: 0. 7,.. Staten k 'LIP: O Z exempt from licensing,the following reason al,nlies: nn Contact person: ) Plan no.: E-mail: i�! r Name: r o Contact person:)) g nr-61 4-ees due upon application ........................... $ Address zIf h,7 Date received: _ City: Stair: ZIP: Amount received ......................................... Phone: I Fax: E-mail: I Please refer to fee schedule.- hereby certify I have read and examined this application and die Not dl Jurisdictions rccerit credit cud%,please call pudsdict;onro.mrne information attached checklist. All provisions 011T,ws and ordinances governing this U visa ❑Maatereard work will be complicO with,' s ified not. ctedii cad number: __/ I— /, Authorized signatu ' W Date:? d Nune of cardholder as shown on credit cordExpires Print name:- -� - _�'t,r ^ / — s— — �.rdh�lder N`naiuue Ar.oum Notice:This permit application expires if a permit is not obtained within 190 days atler it has been ac,epted as complete. 440 4613(6txWOMI _ I i Commercial Plan Submittal lZequirement Matrix Cit.),of'TY4a►-d TYPE OF SUBMITTAL # of Plans (includes New, Additions or Alterations) Required at Submittal Site Work `t (must include location of all accessible parking) Plumbing - Site Utilities 2 Building 1* Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets r.f plans for distribution purposes (for Contractor, City of -Tigard, Washington County, and 'Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i\dsts\fortes\COM-matrix doc 9'24/01 Plumbing Permit Application City of Tigard "Dateeived: t4 a 69— Permitno.: N,,r � Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 CirynJTigard phone: (503) 639-4171 1'rojccUappl.no.: Trxpiredate: Fax: (503) 598-1960 Date issued: By: Receipt no.: t Land use approval: Case file no.: payment type: 'W &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant inlpro,;ment U New construction U Addition/alteration/replacement U Food service U()tiler: JOB SITE INFOkMATION FEE SCHEDULE(for,sp�clal Infor.-, Joh address: t�u, `� t.1 r Description -_ QtY. Fee(ea.) Total Bldg.no.: I Suite no.: —� Ne" 1 and 2-family dwellings only. Tax map/tax lot/account no,: _ -- --- (includes 100 A.foreacbz;tilityconnection) __.....— till. (i)bath Lot: Block: Subdivision: F//(� �{ys, /, SFR(2)bath -- - - Project name: SFR(3)bath -- City/county: ZIP: Each additional bath/kitchen _ Description and I cation of work on premises: teutilities: _ Catch basin/area drain Est.date ol'cumpletion/inspection: Drywells/leach line/trench drain _ Footing drain(no.lin. ft.) _ Manufactured home utilities Business name! )f\L-11 i l SDA L— Laz C , Manholes Address: Rain drain connector City: State: Zip: Sanitary sewer(no.lin, ft.) f Phone: Fax: E-mail: Storm sewer(no.lin.ft.) CCB no.: I Plumb.bus.reg.no: jjq -Z 12A? Water service(no.lin.ft.) City/metro lic.no.: (� � Fixture or item: Contractor's representative signature: Absorption valve Back flow pt>eventer Print name: Date: Backwater valve _ -7� Basins/lavatory Name: /�. �A� " Clothes washer Dishwasher --- — Address: /!� t' JZ ,�4 �l City: .+y ,r,� Stale: ZIP: Drinking fountain(s) Ejectors/sump Phone:j q — Fax:Z 6— 68 L-mail: I Expansion tank Fixture/sewer cap Name(print): Floor drains/floor sinks/hub i ---- Mailing address: Garbage disposalHose hibb _ Z City: State: ZIP: _ Ice maker Phone: Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primei(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on die property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Stt AGwt Owner's si mature: Date: _ Sum Tubs/shower/shower pan Urinal Name: Address: Water closet Water heater r City: State: ZIP: — Other: _ Phone: Fax: E-mail: Total Not all jurisdictions accept cmd+t cards,please cd:!udRdiction rat more lnf�w ion. Minimum fee................$ e 6// / Notice:This permit application )(Visa O MasterCard yv Plan review(at _ %) $ �,� ( expires if a permit is not obtained Credit card num y�S-� Z __ QG 1 a3 within 180 days atter it has been State surcharge(8%)....$ _�. -`„�-/�-A.. Expires �q accepted rs complete. TOTAL .......................$ _ Nem:of - r y sqm y on credit e P P n yr tiros ae Amount 4411-4616(MUT-0M) a� 1 PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES individual r QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 1660 the dwelling and the first100 ft. QTY (ea) t. 40UNT Lavatory 16.60 for each utility connection) One(1 bath - _ $249.20 Tub or Tutt/Shower Comb 16.60 Two 2 bath _ _ $350.00 - Shower Only 16.60 Three(3)bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.608/a a -- STATE SURCHARGE Dishwasher - 16.60 PLAN REVIEW 25%OF SUBTOTAL ------ --- - Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine -T 16.60 Floor Drain/Floor Sink 2" 16.60 3" 16.60 PLEASE COMPLETE: 4" 16.60 Water Heater 0 conversion O like kind 16.60 - _ Quantity b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. _- _ Capped MFG Home New Water Servicc E 40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory Hose Bibs 16.60 Tub or Tub/Shower Combination Roof Drains 16.60 Shower Only Drinking Fuuntain 16.60 Water Closet Other Fixwr?a(Specify) 16.60 _- Dishwasher Garbage Disposal Laundry Room Tray - Washing Machine Floor Drain/Sink: 2" Sewer-1st 100' 55.00 3„ Sewer-each additi,mal 100' 46.40 4" Water Service-1sr 100' 55.00 Water Heater Water Service-:sach additional 200' 46.40 Other Fixtures S eci Storer!k Rain Drain-1st 100' 55.00 _ Storm 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 -- Residentia:Backflow Prevention Device' 27.55 Catch Basin 1660 - - Inspection of Existing Plumbinq or Specially 62.50 Requested inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease`-aps 16.60 - _---___.-- -- _---- QIUANTITY TOTAL Isometric or riser diagram Is required 0 - - Quantity Total Is >9 'SUBTOTAL ---- - -- 8%STATE SURCHARGE ------- - - --- "PLAN REVIEW 25%OF SUBTOTAL Required onlyif f fixture qty total is>a _ TOTAL E "Minimum permit fee is$72 50+8%slate surcharge,except Residential Backflow Prevention Device,which Is$36 25+8%state surcharge "All New Commercial Buildings requlre 2 sets or plans with Isometric or riser diagram for plan review. 1:\dsts\forms\plm-fees doc 12/26101 Mechanical Permit Applicanon Date received: 19- l'crmit no.:N s►� ;- ;'0s City of Tigard Projectlappl.no.: Expire date: Ciryuf"/'iburcl Address: 13125 SW hall Illvd,'1'igard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: c Land use approval: _ Building permit no.: TYPE OF U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New constniction U Atldition/alteration/,eplicement U Other: I Job address: /Z 'LU Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment.labor,overhead, Tax map/tax lot/account no.: profit. Value$ _ Lot: Block: Subdivision: .. *See checklist for important application information and Project name: jurisdiction's fee schedul fur rt siaential permit Foe. City/county: ZIP: t Description and loonficin of work on premises: -pillIfiLl t hecl,c�t.) Total Est.date of completion/inspection: Description Qty. Rcs.only Res.onh Tenant improvement or change of use: IAi,rhan li!n g unit CFM Is existing space heated or conditioned?U Yes U No it conditioning(site plan required) Is existing space insulated?U Yes U No A teration of existing HVACsystem o er compressors Business name: State boiler permit no.: HP Tons BTU/H Address: Pir smoke dampeRlduct smoke detectors _ City: State: ZIP: Heat pump(site p an require ) Phone: Fax E-mail: nsta rep ace unit,- umer T � � - -- —�- - Including ductwork vent liner U Yes U No CCB no.: (.) nstalUre— p a/reTccateheaters-suspen c . city/metre lic,no.: _ wall,or floor mounted Name(please print): Vent fora iance other than urnace t e erat on: Absorption units BTUM _ Name: Chillers_ _ HP --- Com ressors HP Address: M ronmenta exhaust and vent at on: City. _ Mate: ZIP: Appliance vent Phone: rax: E-mail: Dryer exhaust Hoods,Type /res. tc e-Whazmat hood fire suppression system Name: Exhaust fan with single duct(hath fans) Mailing address: _x aunt systema art from heatingor C State: ZIP: uelpiping and silt uilon(up to outlets) City: 1 Type: LPG ___ NG -- Oil Phone: tar E-mail: vel ,i in cac a itiona over outlets Process piping(sc ematic require ) Number of outlets _ Name: ter listed appliance or equipment: Address: _ Decorative fireplace City: State: ZIP: nsert-type Phone: Fax: I E-mail' WoodstovRpel let stove Other: Applicant's signature: Date: 71 other. Name(print): Not*jurtulictione accept credit cards,please call jurisdiction for mrxe lnf lion. Permit fee..................... tea U Mash a(/0 41le Notice:This permit application Minimum fee................$ 7 expires if a permit is not obtained Credit d nun Ofa/O s Plan review(at 96) $ �V? -4/ — Expires within IBO days after it has been State surcharge(8%)....$ None of c o r n on credit c accepted as complete' TOTAL ....................... S i9r of at lure Amount 4401617(NONCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION_: PERMIT FEE: Descripbon�.__ price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code __ Oty -(Ea) Am', $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace it. 100,00 dTU $1.52 for each additional$100.00 or including ducts&vents _ 14 00 - fraction thereof,to and inr'uding 2) Furnace 100,0;.;,BTU+ $10,000.0c. including ducts&vents 1 7•t0 $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 $25,000.00. _ _ or floor mounted heater 14 00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction therdof,to and including 6) Repair units $50,000.00. 1 _ 12.15 $50,001.00 and up $742.00 for llle first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each i litional$100.00 or For items 7-11,see or Pump Cond fraction thereof, footnotes below. Comp •• Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K 7)100K absorb unit BTU _ 14.00 8%State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb 35.00 Required for ALL commercial permits crit unit.5-1 mil BTU TOTAL COMMERCIAL PERMIT FEE: $ 10).30-50 HP;absorb uni'1-1.75 mil BTU 52.20 11)>50HP;absorb unit=1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM -- Value Total t0.0U Descri tion: O Ea Amount t 3)Air handling unit 10,000 CFM+ 17.20 Furnace to 100,000 BTU,including 955 14)/Jan-portable evaporate cooler ducts&vents t0.00 Furnace>100,000 BTU Including 1,170 - _ ducts&vents, Vsnt fan connected to a single duct 6.80 _ Floor furnace including vent 955 16)Ventilation system not Included In Suspended heater,wall heater or 955 floor mounted heetar appliance permit 10.00 Vent not Included In appliance 445 17)Hood served by mechanical exhaust pe It _ 10.00 Repair units 805 18)Domestic incinerators 17.40 <3 hp;absorb,unit, 955 to 100k BTU 19)Commercial or Industrial tyt a Incinerator 69.95 3-15 hp;absorb.unit, - 1,700 20)Otherincluding 101k to 500k BTU units, ug wood stoves 15-30 hp;absorb.unit,501k to 1 2,310 t0.00 mil.BTU 21)Gas piping one to four outlets 5.40 30-50 hp;absorb.unit, 3,400 1-1.75 mil.BTU 22)More than 4-per outlet(each) - t 00 >50 hp;ab@orb.unit, 5,725 Minimum Permit Fee$72.80 SUBTOTAL: >1.75 mill.BTU _ Air handling unit to 10,000 cfm 656 - Air handlingunit>10,000 cfm 1.170 8°/.State Surcharge $ Non-portable evaporate cooler 658 -- - - ----- Vent fan connected to a single duct 446 - TOTAL. RESIDENTIAL PERMIT FEE: $ Vent system not Included in 658 appliance permit _ Hood served by mechanical exhaust 656 Other Inspections and Fees: Domestic incinerator 1,170 1 Inspections outside or normal business tours(minimum charge-two hours) $02 per hour Commercial or Industrial Incinerator 4,590 2 Inspections tions for which no fee is specifically indicated (minimum charge-half hour) Other unit,including wood stoves, 656 $62.50 pet hour Inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas piping 1-4 outlets 360 charge-one-half hour)$62 50 per hour Each additional outlet63 _ -- 'State Contractor Boller Certification required for units>200k BTU. .*Residential AIC requires site plan showing placement nt unit. TOTAL COMMERCIAL $ VALUATION: -_ All Now Commercial Bulldings require 2 sets of plans. iAdsta\forms\mech-fees.doc 02/11/02 Electrical Permit Application Date received: f GsrS- �=itnci City Of Ti and Project/appl.no.: Expire date: Ciry gn8ard Addres-: 13125 SW Ila[l 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: &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Olher: U Partial 1 : 1 ' ON Bldg.no.: Suite no.: Tax map/tax lot/account no.: Joh address: ' 7�5 duJ GL dr ----- Lot: Block: Subdivision: / '5 Project name: I Descrie,iion and l&7-or work on pre i, - Estimated date of completion/inspection: Q J. CONTRAUI OR 1 1 Job no: Fre Max Ihsrriprinu (►h. (va.) Total no.brsp Business name: . F� _ New residerdial�single or multi famHS per Address: dwelling unit.Includes attached garage. City: lateZIP: Service Included: Phone:' IWO sq.rt.or less — _ 4 CCB no'• Elec.bus.tic.no: Each additional 506 sg.ii.or onion dienol -- Limited energy,residential 2 _ City/metro Inc.no,: 1-i-i ted energy,non-residential 2 each manufactured home or modular dwelling Signature of supervising electrician(required) I to Svrvlce anTor feeder Sup.elect.name((print): Services or feeders-Installation, p. p ) (tLicense ,_1 . alteration or relocation: 200 amps or less 2 Name(print): 201 amps to 400 amps 2Mailing address: —_— -- 401 amps to 600 amps 2 601 amps to 1000 amps City: State: ZIP: Over 1006 amps or volts �--- 2 - Phone: I E-mail: Reconnectonly I Owner installation:The installation is heing made on property I own Temporary services or feeders which is not intended for sale,lease,rent,or exchange according to (nrhllallon,alteration,orrelocation: ORS 447,455,479,670,701. 200 amps or less _ 2 201 amps to 400 amps 2 O11'nel'5 SI naluft': l�alC: 401 to 600 am s - 2 Branch cirrults-new,alteration, or extension per panel: Z Name: _ Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 Clly: State: ZIP: B. Fee for branch circuits without purchase - Phone: Fax. E-mail: of service or feeder fee,first branch circuit: 2 - — Fach additional branch circuit: Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Health-carr facility Each pump or irrigation circle 2 U Service over 120 amps-rating of I&2 U Hazardous location Each sign or outline lighting 2 fmnilydwellings U Building over 10,000 square..feet four or Signal circuit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,orextension• J Building over three stories U Feeders,400 amps or more •I k seri Linn: _ U Occupant load over 99 persons U Manufactured structures or RV park Foch additional btspecilon over the allowable In any of the above: U Egres0ightingplan U Other: - Porinspection Submit__sets of plant with any of the above. Investigation fee Thr above are not applicable to temporary construction service. Other - Ni"all Jurisdictions accepa ctedn cants,please call JUrr 11c111N1 r miny�i;ryanal Notice:This permit application Permit fee.....................$ U Visa Ube S-/ 6013 C7 Y V I .pires ifit permit is not obtained Plan review(al _ %) $ _ Credit number. J _t L_/Q� within 180 days after it has been State surcharge(8%) ....$ v Expires accepted es complete. TOT U .......................$ Name sol r as shown on credit card y-S h der sivailite --- Amount gg0.4615(61004'01VII ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: ---------- -- ------------ Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Restricted Energy Foe................ $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service `ncluded: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.ft.or IP56 $145.15 _ 4 LI Audio and Stereo Systems' Each additionai 500 sq.ft.or portion thereof _ $33.40 1 C Burglar Alarrn Limited Energy $75.00 _ Each Manufd Home or Modular Dwelling Service or Feeder $90.90 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 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 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $6685 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 with purchase at service or Clock Systems feeder foe. Each branch circuit _ $6.65 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 ❑ Each additional branch circuit $6.65 — HVAC Miscellaneous Instrumentation (Service or feeder not included) Each pump or Irrigation circle $5340 ❑ Each sign or outline linhting $53.40 —_ Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension $7500 Landscape Irrigation Control' Minor Labels(10) $125.00 Each additional Inspection over ❑ Medical the allowable In any of the above ❑ I'er inspection __ $62 5G _ — Nurse Calls Per hour _ $62.50 _ In Plant -_ _w $73.75 ❑ Outdoor Landscape Lightirg' Fees: ❑ Prolective Signaling Enter total of above fees $ Other 8%State Surcharge $ —Number of Systems 25%Plan Review Fee See"Plan Review" ;� linn ni i g No licenses are required Licenses aia required for all other installations front of application — Fees: Total Balance Due $ Enter total of above fees $ �.— ❑ Trust Account# - I 8;.State Surcharge f All New Commercial Buildings require 2 sets of plans. Total Balance Due $ i\dsts\fomuklc-fces.doc 08/30/01 Z T sw P CE _._rpt II 5. 103 sq.ft. r\I Zc r-�i a - LOT 30 ,, ' moi' L F . 62 FF: S F S) F F-- 485 . I N F�= Fdl SFF- 473 . 81 451( 5, 040--_ q.ft. 4,?o Ff CONSTRUCT RY I PER ARC AN[ RD, -/ r c REI (r2 Fl% 480 s(I..ft T ,-32, FF- 2 Fr= Cl --- 71 D o .�- - �.._.��: _��._ _ .....: : �.�._.. ... -.._ 40 5, 1 C3 sq.ft. 1 LOT 30 L 4�- FF- . 62 SFF-- 4-85 . SF Q) F�- vq w �' , SFF- 473 . 81 � s c ' '3`� a � 5 � 5., 040 sq.ft. /7 490 V F s - A; L --C.ONSTRUCT RY WALL PER AR - AN LRD. TER 2T—MR Dr lop G 6 59 -f-F-- 4 6 . ' 2 IL TL L 0010' C.) owl CITY OF T I GA R D ELECTRICAL PERMIT- RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-0 129 13125 SW Pill Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/22/02 SITE ADDRESS: 12725 SW BUCLE CT PARCEL: 2S109AD-08800 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 032 JURISDICTION: TIG Proiect Description: Low voltage for burglar alarm system. A. RESIDENTIAL _ B.COMMERCIAL AUDIO & STEREO: AUDIO&STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS: Owner: Contractor: PAUL R CARNEY INC BRINKS HOME SECURITY 1480 M.V 102ND AVE 8080 SW CIRRUS DR PORTLAND OR 97229 BEAVERTON, OR 97008 Phone: Phone: 641-0574 Reg #: SUP 2650JLE LIC 44421 ELE 34166CLE FEES Required Inspections Type By Date _ Amount Receipt Low Voltage Inspection PRMT GTR Y122102 $75.00 2720020000 Elect'I Final 5PCT CTR 7/22'02 $6.00 2720020000 Total $81.00 1-his Permit is issued sub;ec, to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if wort[ is riot started within 180 days of issuance, or if work is sr,spended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95c-001-0010 through,OAR 95; -Q-Q1-0080. You may obtain copies of these rules or direct questions to OUNC at (503) 2 1987 �� t Permittee Si nature - I sued ay �. Yy g , OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'NDATE: LICENSE NO: - 4 Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 10/18/00 WED t1:22 FAX .598 1960 '.:Iry OF I'lGAUD Ffboo: Electrical Permit Application Date received: Permitno.: City of Tigard Project/appl.no P.xpiredue: Gryo)Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 - I'lu)nc: (503) 039-4171 Uate issued_ By: Receipt no.. Fax: (503) 59g-19110 Case file no.: Payment type: Land use approval: 1 &2 family dwelling or accessory O commerciat!tndustrial O Multi-family :]Tenant improvement New construction U Addition/alteration/rr_plac:ernent U Other:_ U Paatial JOR INESITE1 1 Joh address: no.: Suite no.: Tax rn*tax lot/accrwnt no.: -l.ot Block: Subdivision. - 0 - - Project mune: _ Description;end location work on premises: - ff Estimated date of Com letionrns on: CON-111%C1 Oil A11111AA I ION YFF. SCHEDULE Fra 11ct Business name: = z- (ea) Total no.lrtsp Address! I � t ,L New residential--40atdd-fatiewper dwenhalt alit.tnchrdes atraehed gavage. City: ��( State drL 7IP: �Ljj Serricekniuded: Phone:6-cV_6666 1 Fax:6 y/-d 160 I E-mail: IWO sq.ft.or les% 4 CCB no.: Q VyDec.btu, tic.no: L E Pesch additional 500 sq,k or portion thereof Limited energy,residential 2 City/metro tic.no.: Unlitedann ,tum-residential �_ Perch manufactured home or modular dwelling Signautte of nmMistng ciit 1�a Service amVor feeder Su clam name(print). set.kesorrtrdm-ItutulWtloss - p (pr+ P•.� r+,eirurr.D licensem:�27Y1LC dt«stloaarreleirs-fo MINIMUM' 200 inti tx less 2 Name(print): (3 c 201 amp.to 4011 amEa--_� 2 --.----- 401 am to 600 amps Mailing adcltess: -_ _-- 601 amtn to 1000 amps_ _ City: — State: JJP' Over 1000 ampg car volts — 2 Phone: Fax:- -- E-mail. r — Rcwnnectonty - l Owner Imtallation:The installation is being merle on property I own 1casponryservices orfeedety- which is not intended for We.lease,rent.or exchange according to InOARAdou,alteMdon,orrelomttaesi ORS 447,455,479,670,701. 211(1 amps or less 2 201 amps to 400 amps 2 f lwncl's signature: Date: 401 tof00am Branch circtllta-nen,atteratlne, Name: Or extension per panel: AL Cee for branch cunt ra with purchase of Address: _ service or feeder fee.each hriuic t circuit City - Ltate �— B. Fee for bench dreviu without putdrue Photo: Fax: Mail: of cervico cr feeder tee,tint bench atnir 2 Pasch sxldiborud branch circurt Hist.(Smice or feeder net Included): "OT.over 215 ampa-Conutrrad l-] ft.alth-.are facilitN Pxh pump onmsanun circle I O Service over 320 amps-%stiftS4I4. U ItaLwdou%Lmauon Each signor outline lighting farruly dwellings U Building over 10.000 square feet four nr S:gnal orcuit(s)or At limited energy npanel. .t O System over 6W wolu trounal arra residential uruta to une uructure altuatiom or extension' _-� 5 15 2 U Huddmg over three anon IJ reedem 400 amps nr more 0 Ckcupant load over 99 persons U Manufactured stru turev m RV perk +Desai tion �T 1 Cate%sJlighdnRplan J 1>rber Fick additional teir}actiou over the allowable is easy at tist.bove: -- Pernupection f_-1— Subak- __ 'tads of plana with any of the above. Inveauxnuon tee — -- 11ae above are not appUcable to lemPorary cotarructloo++nitre, t nher - - --- - -- -- �or AN pns,k,wn acoep uwdlt COMA.please csa tunsdirnao ria enc u,urrood a Notice:Ttsis Permit application Permit fee.....................S 17 lY) ❑Vita U Muieriatd expires if a permit is not obtained Plan review(at _ %) $ avr,t Lia nom' --•- --.— -_ ---�_/ _ . within 180 days after t has been State Surcharge t,8%) ...$ __ — "3t•1e' accepted:u cnmpiete. TOTAL ................. ....S _ 1.00 ^lam d cn1VA110f u abmaa.m eMWtl earl --- __ _ S 44PA615(6AdC0M) CITY OF TIIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DWISION Business Line: (503)639-4171 MST BUP —_-- Received A Date Request, __- oZ _— AM PM______— BUP Location _ _!O`Za_s _ Suite _ MEC Contact Person -- — _ Ph 910O 17 PLM -- ----- —___-- Contractor _ Ph(__ _) _ SWR _DIN — Tenant/Owner --_._ _ _ ELC rrobv Fou ion ELC -_ Ar;cess: Ft g Drain ELR Crawl Drain _ Slab Inspection Notes: SIT Post&Beam -- - - ---- - --- -- - - ---- ---- Shear An ------ --- Ext Sh h/Shur A h/ShearNailingallprink) --- ------- - — - - - Fire A Susp'd Ceiling -- -- -- --- Poof Final PAS PART FAIL -- _BING Post 8 Beam__.__--- - --- -----.-�- — Under Slab Rough-In Water Service ---- -- _ Sanitary Sewer Rain Drains - - - ---- Catch Basin/Manhole Storm Drain ---- -- --- ---�� - - Shower Pan Other: -- -- - ------ - -- -- Final _PASS PART FAIL — — - - MECHANICAL Post&Beam -------------- - -- - Rough-In Gas Line Smoke pKiin ei_� ---- Fina c Service -- _— - -- - Rough-In G F ve)V6rm -----� F [_1 Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PART FAIL SITE Please call for reinspection RE ,.- [A Unable to inspect-no access Fire Supply Line ADA IApproach/Sidewalk Date �nePeatar ��'�_"'�- Ext — Other �P Final DO NOT REMOVE this Inspection record from the job site. A.SS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST q BUP Received ___ Date Requested / AM PM _—_—______ BUP Location __ i • - -7 J f C� C� -s Suite MEC Contact Person �� * - _ Ph(-) G l-y ,`'7 PLM Contractor&' Ph( ) SWR BUILDING Tenant/Owner _- ELC Footing ELC Foundation Access: Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Beam Shear Anchors -- -—— Ext Sheath/Shear _ Int Sheath/Shear Framing - -- Insulation Drywall Nailing ---------- Firewall Fire Sprinkler ------ ---- - -- — Fire Alarm Susp'd Ceiling -- Root `r Other: - ----- -- --- Final PASS PART FAIL - ------------------------ PLUMBING Post& Beam Under --- Under Slab Rough-In ----- Water Service _-- - --- Sanitary Sewer Rain Drains - - - - Catch Basin/Manholu- Storm Drain - Shower Pan Other: Final PASS RT FAIL MECHANICAL Post&Beam Rough-In -- Gas Line Smoke Dampers Final PASS PART FAIL - - -_ ---------- --- — -------- - ELECTRICAL Service - - Hough-In UG/Slab - -__ -- - ---- ---- ----- .-------------- Low Voltage — -- - ------------------- Fire Alarm PART FAIL Reinspection fee of$. required before next inspection. Pay at City Hall, 13125 SW Hall Blvdprs� . F] Please call for reinspection RE: - - [] Unable to inspect-no access Fire Supply Line ADA _✓ Approach/Sidewalk Dab�#9 _- Ins odor -__ vr� Ext -- Other: Final -u DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL h a ti w' •v, c � Er* h � O 1'J p n -4 H \ 'O^f l O IQ. x '1 o 'E �o CITY 4F TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST �a INSPECTION DIVISION Busines'.s Line: (503)639-4171 BLIP Received __-__ Date Requested --- 1�1'/ AM PM BUP Location / ��_ L:�—Suite — MEC Contact Person ------ _- --- Ph(—) 3 q—, a,Z_PLM Contractor ___-__-- _ Ph(_—_) SWR r_BUILDI Tenant/Owner Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain _ F --- Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing —__-- Firewall Fire Sprinkler - ----- ----- Fire Alarm Susp'd Ceiling - - - Roof Other: Final ------ _ _ PART FAIL ----- - - - P_ UMBIPf_i3T—A- Post& Beam Under Slab _..- ----- - Rough-in — —_------- - - — — Water Service -- Sanitary Sewer ` Rain Drains -- ----- Catch Basin/Manhole Stcrm Drain - - - - - Shower Pan -- Final "PASS PART FAIL - -_ - - - - - --- -- -- ANIC - Post& Beam nounh-In - Gas Line Smoke Dampers -- - -- - Final SS PART FAIL - --- RICAL Service - Rough-In UG/Slab Low Voltage Fire Alarm m El Reins required Reinspection fee of$_ re before next ins S PART FAIL — Q pection. Pay at City Hall, 13125 SW Hall Blvd. — n Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA 1 Approach/Sidewalk Date —__- inspector � —Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL