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12744 SW BUGLE COURT r� 1. PROVIDE A MINIMUM a' DEEP CaRAVEL BASE FOR ALL DRIVEWAY AREAS. MAXIMLIN DRIVELIJA-T- SLOPE SHOULD BE VERIFIED IUITH THE EUILDING DEPARTMENT PRIOR TO CON5TF2UCTION, 3- PROVIDE A MINIMUM 4' DEEP GRAVEL BAST= FOR ALL IDEWALK AND PATIO AREAS. d- .. FIFE ALL 570R11-1 ✓RAINAGE FROM Z a'THE E'�U!I_pING TO DISPOSAL F`OINT APPROVED BY 7 HE BUILPING R-I- DEPAF TI'1ENT. 5. PROVIDE ANn MAINTAIN P051TIVE DRAINAGE AWAY FRCM BUILDING ON ALL SIDES. ••,,,,♦ W x Q a. THE BC'UNDARY AND TCPOGR.=aPHY INFORMATION � U) � HA5 BEEN PROVIDED TO POLLARD - H05MAR 40. DEE 1I -sNERS, INC. BY THL CONTRACTOR, OWNER OR ENGINEERING CONSULTANT. POLLARD - ►-IOSMAR LlC Lr, 488' 4c�0, ' (NDESIGNERS, INC. UJILL NOT 5FHELD LIAE�LE FOR THE 492' cN ACCURACY OF TH15 INFORMATION. IT IS THE SOLE W RESPONSIE,ILITY OF THE CONTRACTOR TO VERIFY N 00.15'23' E cv =— �„ co ALL SITE CONDITIONS INCLUDING ANY FILL PLACED gq.,)3' `�. —' :z ON THE SITE. THE COI•ITRACTOR. MUST INFORM THrlIS � '- � --_.._ �� �, \ ♦ o OFFICE OF ANY POTENTIAL FIELD, MODIFICATIONS ,n i ----- ---------- — -____- - NO ON THE OTHE PLANS_ — _ L. ►� 7. NON-STABILIZED FILL MUST NOT EXCEED 2.I SLOPE I + 1 ................. ............ 1..... I . . . -- �. EXCAVATION h'i,4TERIAL F:EMAIN(NCz ON SITE fS TG �.. I'...'.:. I _0� . ::... ... . . r ::r,'.'. . I ...'.• r /N ` O +� BE CONTAINED BY AN APPROVED SEDIMENT BARRIER, f I �;:•:•'; ; r.'.�'.' I . .. .. . .. � FABRIC , ENSILE, 5TRALU BALE SECIMENT BARRIER i r :..... -�: GAR I8'-0' WIDE W a OR ER0!5i0N BLANKET WITH ANC;-IOR5) THE CON T eAG70 � + :. � :'::::::::::: ' 1488. 0' I t 4' THICK W r ..... ... ...... . . . .. I" .. GONG. DRIVE ..,r MUST vER1FY 1_L�:ATION WITH APPROPRIATE BUILfDING I :::::::.:: ..::.......:.•.•....: �. I ... ....... .... E CJ') 0 OFFICIAL. ! �} :i'. :: :..'.:::.:::::: :: ` I.•.. �... . ...'.... . �u (318 5Q. FT.} PROTECT 570C< PILES FROM OCTO-ER 15t THRU APRIL 30•tn PER THE ERG510N CONTROL HANDBOOK. F LAN/ � Z I.. . CD � I. �..... •� .. 8850 . .. . ..�. . .�. � m ul 10. d�lO CUTTING OR FILLING SHALL TAKE PLACE WITHIN �...... ... .. .. I... I Q N THE DF--IP LINE OF AN EXISTING TREE UNLE55 THE ::•;);; :::: I: { •:� w EXCEFTION IS A PF'ROVED BY THE BUILDING DEPT_ I .. . . .'1•.•.•.:.•:.•:.•.. •.•i•.•.�. .•.�.•.�. ... .•.i•.�:�•'• .. ,.. I � �"" �. ,..:...... WIDE ----✓✓� Ln li. AFTER COMPLETIO d OF rON5TRUCT!ON; THE CONTFACTOR DEPk ::::".:, t.'.....'...... .. I .:::::.:....:.t......::.,.,....�. . J I 'NC. WALK MUST EITHER LAN ��;� i ( ...L:..:.:.. I t.:... ....... I 1 �) C a0 SQ. FTJ d► Z I • L . ..APE THE SOIL.., h'IU.-CH TNc SOIL OR I I �_. L ,_._ U ::::... �� ci SEED THE EXPO --------- -_ _ BLDaED SC(L5_ ... . .... \ COVERED PURCPI.� O G RIDGE-: HT. 24'- 10" .4.F.1-. — - _ --- --- LOT COVERAGEAREA �- - 84.3E (INCL. ROOF 4 DECKS) 2,444 SQ. FT. -- -- -- --- ---------- -- -- N 00I5'2:3' E � Lar AREA: 5,055 s.F. U1 ©T COVERAGE_ 2,444 6.F. LA PERCENTAGE: 48% � LOT 34 T E\ N50-3-5 SQ. FT. 1 L A LOT 34 ELK HORN RIDGE ESTATES CITY OF TIGARD OREGON GON TRACTOR O1� 34444 S.W. LADD HILL RD. WILSONVILLE, OREGON S1070 (503) 625-4400 20-051 11/21/00 KAK NOTICE: I1= THE PRINT OR TYPE ON ANY I I I-( ► 1 rI I I I ( III I I I I I 1 1 III + III AS Ili 11 1 I f f IT rT , I I IMAGE IS NOT AS CLEAR -11774-71-17 , CLEAR � �HIS NOTICE, 1 2 91 12 �-� �,2 ITIS DUE TO THE QUALITY OF THE iL ORIGINAL DOCUMENT �-- ---- --- ---- --- No.36 6Z 8Z LZ 9Z SZ � Z EZ ZZ TZ U7,1111161111 SI LT- 9T'- � T � T� ETI _ Zi _ TT OT ---- g g_�- L 9 �----- � —_ _ I , S Z IIit, II Illl ILII 1111 III, !II! IIIIIIIII III! ILL -11.1.11 1111. IIII III►. , � I T �iai3w IIII�JIIL Iill IIII 1111 IIIII111111 IIII IIII IIII 1111!1111 IIII IIII IIII illi Ililillll IIII IIII Illi l� IIII IIII _IIII ilfl Illi IIII 11.11 X111.1 11.11 l 1� IIII�NiI iMiw .ua�.arw+i nN.wwW.uw+�.w..rw.• —r+...w.Mt+YYrM i1Wn01rWrwrYMLJWwiYt4.lw��w'onwWVfMWwMwrrw'wrr .:AffWW 12744 SW Bugle Court CITY OF TIGARD BUILDING INSPECTION DIVISION .24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST �IYJ-dss�Z Date Requested_--I -��� AM I'M BUP Location� BLD - Suite MEC Contact Person X11"- -- Ph —1 ` 7Jr PLM Contractor --4� - Ph SWR _ UILDlN -I Tenant/Owner ELC Retaining Wall ----____-___- Footing ELR Foundation Access: Fig Drain FPS _ Crawl nrain Inspection Notes: SGN Slab Post&Beam -- —--------- SIT Ext Sheath/Shear '- - Int Sheath/Shear Framing Insulation ____ - ----- --------- _.-- -- _- Drywall Nailing - Firewall - — ---- --------------—_ Fire Sprinkler -----------_---.__-.-_--- Fire Alarm -.--. __ __ -------------- -- -------- - --- - Susp'd Ceiling ------------ Roof ----- Misc: J -PART FAIL - Post& Beam rM -- ---_- - Under Slab - Top Out - --- ----- __ _ Water Service ----- Sanitary Sewer --- - --— ------- ---� -- Rain Drains -------- ina > P T FAIL - ANIC -_—_�------- -- - earn ------ — - Rough In -- Gas Line Smoke Dampers / Final ------ --- _____ PASS PART FAIL - _ - LECT ---- ---- Service --- - - Rough In UG/Slab ---- Low Voltage - Fire Alarm S PART FAIL n iluGradrrg - ------ -- Sanitary Sewer - -- - - Storm Drain ( )Reinspection fee of$ required before next ins ection. Pa at City Hall, 13125 SW Hall Blvd Catch Basin p Y Fire Supply Line ( )Please call for reinspection RE: ADA 1 ( J Unable to inspect-no access Approach/Sidewalk Other Date Inspector i Final -- -- --------4_---------- -- .��1. � _Ext PASS PART -FAIL DO NOT REMOVE this inspection record from theob j site. � N fD `.7 •� p' N C w 0 t a f ro Y, r NQ �+ s � v c o , J 0 3 00 wa a S�� CITE( OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001 00328 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/31/01 PARCEL: 2S 109AD-09000 SITE ADDRESS: 12744 SW BUGLE CT SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 034 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of backflow prevention device foi irrigation, system. FEES Owner: Type By Date Amount Receipt O'BRIEN HOMES INC PRMT „TR 7/31/01 $36.25 27200100000 34444 SW LADD HILL RD 5PCT CTR 7/31/01 $2.90 27200100000 WILSONVILLE, OR 97070 Total $39.15 Phone 1: 503-625-4400 Contractor: _ CLASSIC GARDEN CREATION. INC 16080 NW PARSON RD. FOREST GROVE, OR 97116 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 503-359-1823 Final Inspection Reg#: PLM 7204 This permit is issued subject 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 work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by thy- Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001.0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 = — Issued By 't '" l (���l�(d � Permittee Signature: Call (503) 6394175 by 7:00 P.M. for ars Inspection needed the n x business day Plumbing Permit Application Pate-received: 7/3/ O l Permitno.: LNa�I"AO'� City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 — Ciry of Tigard Phone: (503) 639-417' Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ Case file no.: Payment type: L)l&2 family dwelling or accessory U Commercial/industrial 0 Multi-family U Tenant improvement — New construction U Addition/alteration/replacement U Food service. U Other:Im mm, y,t 1oh address: 1 Description . Fee(ea. Total --1 - New 1-and 2-family dwellings only: Bldg.no.: lune no.: (Includes 100 ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath _ Lot Stock: Sutrctivision: SFR(2)bath — Project name: SFR(3)bath City/county: —�— LIP: Each additional bath/kitchen M rition d I tcation of work nn rises ,� tc SlteutlllNes: P ' �� c Catch basin/area drain Drywells/leach line/trench drain Est.date of completion/inspection: rooting drain(no.lin.ft.) MKIA"MMIN K11 _ Manufactured home utilities — Business name: S ; —1�. Manholes Address: fi66.4,0 H. 0. Harker,_dip, Rain drain connector — C;h,; L tate: Sanitary sewer(no.lin. ft.) Phone:5-0 1 E-mail: Stonn sewer(no.lin.ft.) CCB no.: p Plumb.bus.reg.no: _— Water service(no.lin.ft.) -- -- Fixture or item: City/metro lie.no.: A Absorption valve Contractor's representative signature: _ .M-- pack flow preventer / Print name.: � � Date: � G — Backwater valve _ 3asin.0avatory Name: — Clothes washer _ ', A� Dishwasher Drinking fountain(s) rrzip:--Ti City' State: . 7.IP_ � Ejectors/sump — pno Fax: F-mail: Expansion tank Fixture/sewer cap Name.( rint): Floor drains/floor sinks/hub P —_ ]L�� Garbage disposal Mailing address: _ Hose bibb _ City: — State: ZIP: Ice maker Phone: Fax: E-mail:— Interceptor/grease trap Owner instal lation/residential maintenance only: rhe actual installation Primer(%) will be made by me or the maintenance and repair made by my regular F.00f drain(commercial) — employee on the prope y l ow ns per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's si nature: . t.�-- - Date: ump Tubs/shower/shower pan _ Urinal Name: — -- —.— _ —-— Water closet Address: _ Water heater City: -- TState: -�L1P: _ Other: Phone: -_ Fax: — &nmaiL fotal Minimum fee.. I. _ 'S Nd nr ell JmisdlctinKcepl credit c",ptew cell Jurisdiction for m xr infextrmtlon. Notice:This permit application U Visa U MasterCard expires if a permit is not obtained Stan review(at _ %) $ .— State surcharge(87f) ....$ Credit card number —_— _L ., within 160 days after it has been c-� accepted as complete. TOTAL .......... . ..........$ Name of can9to—I rr a shown on creditrard— s - Cardholder aiputtve Mn�unl 440-4616(6A01MMl PLUMBING PERMIT FEES: PRICE TOTAL F"e v 1 and 24amliy dwellings only: FIXTURES (individual) QTY ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory — 16.60 for each utility connection) _— One 1 bath-- $249.20 Tub or Tub/Shower Comb 7-- 16.60 Two 2 bath _ $350.00 Shower Only 16.60 Three B)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 16.60 ------------- — -- - - — Laundry Tray — 16.60 Washing Machine — 16.60 Floor Drain/Floor Sink 2° - 16.60 PLEASE COMPLETE: 3^ 16.60 4^ 16.60 Water Heater O conversion O like kind 16.60 _— Quante b I Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ ermit. _ — Capped MFG Home New Water Service 46.40 Sink _-- _ MFG Home New San/Storm Sewer 46.40 Lavatory._ — __ Tub or Tub/Shower Hose Bibs — 16.60 ___ Combination Roof Drains 16.60 Shower Only — Drinking Fountain 16.60 Water Closet — 16.60 Urinal — Other Fixtures(Specify) _ Dishwasher _ Garbage Disposal Laundry Room Tray__ —_ -- --- — -- Washing Machine _ Floor Drain/Sink: 2" — Sewer-1st 100' 55.00 3„ -- -- Sewer-each additional 100' 46A0 v 4" Water Service--1 st 100' 55.00 Water Heater — — Other Fixtures Water Service-each additional 200' 46;.40 (Specify)_ _— Storm&Rain Drain-list 100' 55.00 Storm R Rain Drain-each additiona1-10 0' 46.40 _ _Commercial Rack Flow Prevention Device 46.40 -- Residential Backflow Prevention Device' 2755 — — Catch Basin 16.60 — ---- — — — -- Inspection of Existing Plumbing or Specially 7250 Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65,25 Grease Traps 1660 J --- -- — — �_ QUANTITY TOTAL -- Isometric or riser diagram Is required If _ Quantity Total Is >9 �- *SUBTOTAL -- --- — --— $%STATE SURCHARGE - --- -- "PLAN REVIEW 25%OF SUBTOTAL Required only It Hxture city total Is>9 TOTAL 5 "Mlnlmum pennlf fee is$72 50-8%state surcharge.except Residential Backflow Prevention Device,which Is$36 25+8%state surcharge. ""All Naw Commercial Fulldinpe require plans wflh Isometric or riser diagram and plan review i:'rdst9\forms\plm fees.doc 10/10100 ELECTRICAL RMIT - CITYOF TIGARD RESTRICTED ENERGY RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2001-00115 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/17/01 PARCEL: 2S109AD-09000 SITE ADDRESS: 12744 SW BUGLE CT SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 034 JURISDICTION: TIG Proiect Description: All encompassing. A.RESIDENTIAL B.COMMERCIAL AUDIO &STEREO: AUDIO &STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK. MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL EMCOMF : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS:^ _J Owner: ----------Contractor: O'BRIEN HOMES INC CANBY EL-ECTRIC INC 34444 SW LADD HILL RD 790 S IVY WILSONVILLE, OR 97070 CANBY, OR 97013 Phone: 503-625-4400 Phone: 266-7878 Reg#: LIC 26071 SUP 2123S ELE 3-112C _ FEES Required Inspections _Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 4/17/01 $75.00 2720010000 Elect'I Final 5PCT CTR 4/17/01 $6.00 2720010000 ^Total $81.00 This Permit is issued subject to the r agulations 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 work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set fortis in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules ordiroct questions to OUNC at (503) 246-1987. \ Issued by - ; L _ Permittee Signatures OWNER INSTALLATION ONLY The installation Is being made on property I own which is ncf intended for sale. lease, or rent. OWNER'S SIGNATURE: _ _ — _ DATE: CONTRACTOR INSTALLATION ONLY SIG14ATURE OF SUPR. ELEC'N _ ____-__ DATE: LICENSE NO: -- ----- -- ---- -- - Call 639-4175 by 7:00 P M. for an inspection needed the next business day Electrical Permit Application Datereceived: II-17-al Permit no.: City of Tigard `, --- -- Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd:Tqg-aia,-W-97223 pate issued: By: Receipt no.: Phone: (503) 639-41 . Fax: (503)598-196 H'<- l?GfJ -�5 3 ase file no.: Payment type: Land use approval: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improventenf U New construction U Addi(ion/alteration/replacement U Other U Partial Job address_: /a yy d[v 4, T` Bldg.no.: Suite no.: ITax map/tax lot/account no.: Lot: Block: Suhdivision: Project name: _ _ Description and location of work on premises: Estimated date of cog Iction/inspertion: 7. 140&70�6y no- Description fee Mai f e ti) Description Qty. I—) Total no.insp New residential-single or m hl-sadly per vdwellingunit.Incluflesattachedgarwge. $lele:0 ZIP: /]0/%' Serviteincluded: Phone: Fax: I E-mail: la)u sq.ft.or less t CCB no.: 01P G 71 1 Elec.bus.11C.no: / A Each additional 500 N.R.or portion thereof _ �j Limited energy,residential " / 2 City/metro Ilc.no.: Limited energy,non-residential 2 4-3, L1rtn Each manufactured home or modular dwelling Signature of supervising ectrician(required) Date Service and/or feeder 2 Sup.elect.name(print): License no: Services orfeeders-Installation, alteration or relocation: 1101 W Jul ROVER 0 to 200 amps or less 2 Name(print): 201 amps to 400 amps 2 - -- - 401 amps to 600 amps 2 Mailing address: _ 601 amps to 1010 amps _ City: Slate: ZIP: Over 1000 amps or volts 2 Phone F'ax: E-mail: Reconnect onlyl Owner installation:The installation is being made on property 1 own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to kuriallatioe,allendlon,orrelocalion- 201 amps or less ORS 447,455,479,670,701. 2 201 amps to 400 amps owner's A fC: _ Date: 401 to 600 ams - Branch circ-tits-new,alteration, or extension per panel: Name: _-- A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 __ statt� _ QIP: B. Fee for branch circuits without purchase City: of service or feeder fee,first branch circuit: 2 Phone: Fax: - 1 mail: - Each additional branch circuit Mbe.(Service or feeder not Included): O Servicc ovu amps commercial U Health-care facility Each pump or inri ation circle 2 U Service over 320 amps-rating of 1 R2 U Harmdous location Each si n or outline lighting 2 farni ly dwell ings 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,or extension* 2 U Building over three stories U Feeders.41)0 amps or more *Description: U(kcupant load over 99 persons U Manufactured structures or RV park FAch addhitmal Inspection over the allowable In any of the above: D P4irs nightingplan U Other: --- Per inspection Submit__sets of plans with anv of the above. Investigation fee lire shove are not applicable to temporary construction service. Other -- � - ' Nrw all)urisdkrlons rcept cfedir can-ts,please call)trisdlellon for more lnfomwlan. Notice:This permit application Permit fee.....................$ U Visa U MasterCard expires if a permit is not obtained Plan review(at — %) $ credit cant number: _ _ -�__ within ISO days eller it has been State surcharge(896)....$ r3 Pxpires accepted as complete. TOTAL ................ ......$ Name of canarohkr u drown on credit c l --- C'anlholdef aiignature Anaunl 446-4615(&&ICOM) Electrical Pei-mit Fees: Limited Energy Fees: ------ — ---- --- T(PE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: — — - Restricted Energy Foe...................................................... $75.00 Number of Inspections per peryinit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft.or less $145.15 4 Audio and Stereo Systems Each additional 500 sq,ft.or portion thereof _ $33.40 _ 1 [� Burglar Alarm Limited Energy $75.00 Each M inufd Home or Modular Dwelling Service or Feeder $90Garage.90 2 ❑ g Door Opener* Services or Feeders [] Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps o.less $80.30 _ 1 201 amps to 400 amps $106.85 _ 2 ElVacuumSystems* 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 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 $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)1 he fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit - $665 _ ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service or feeder lee. ❑ Fire AlanTr Installation Fiist branch circuit $46 85 _ r Each additional branch circuit _ $665 l HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $5340 Each sign or outline lighting $53 40 ❑ Intercom arid Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension $15.00 _ [� Landscape Irrigation Control' Minor labels(10) $125.00_ Each additional inspection over — Medical the allowable in any of the above ❑ Per Inspection ___ $62.50 Nurse calls Per hour _ ___ $62..50_ In Plant __ $73.75 ❑ Outdoor Landscape Lighting' Fees: [_) Protective Signaling Enter total of above fees $ ❑ Other 8%State Smcharflo $ ----- _, Number of Systems 25%Plan Review Fee See,"Plan Review"section on $ ' No licenses are required Licenses are required for all other installations front of applk;atton ____.... - Fees: Total Balance Due $ - Enter total of above fees $ __ 1rust Account#--_.__.— 8%State Surcharge $ -- — -- -------- I Total Balance Due $ i:`dsts',farmsklc-fees.doc lOmq.Yxt CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE JIM'S PLUMBING PO BOX 7160 ALOHA, OR 97007 Plumbing Signature Form Permit #: MST2000-00532 Date Issued: 1/31/01 Parcel: 2S109AD-09000 Site Address: 12744 SW BUGLE CT Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 034 Jurisdiction: TIG Zoning: R-7 Remarks: Single family detached, Path 1. Your company has been indic�ited as th3 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 s!art of the work to the address above, ATTN: Building Dept. No plumbing inspection; will be authorized until this completed form is received OWNER: PLUMBING (:,ONIRACTOR: O'BRIEN HOMES INC JIM'S PLUMBING 34444 SW II HILL RD PO BOX 7160 WILSONVIL LE, OR 97070 ALOHA, OR 97007 Phone #: 503-625-4400 Phone ##. 649-4034 Reg #: I it 71860 PI M 34-186t)b AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of At#Aorized jAumber 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 CANBY ELECTRIC INC 790 S IVY CANBY, OR 97013 Electrical Signature Form Permit#: MST2030-00532 Date Issued: 1131101 Parcel: 2S109AD-09000 Site Address: 12744 SW BUGLE CT Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 034 Jurisdiction: TIG Zoning: R-7 Remarks: Single family detached, 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 t�e 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, A1TN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: O'BRIEN HOMES INC CANBY ELECTRIC INC 3#444_SW LADD HILL RD 790 S.IVY WILSONVILLE, OR 97070 CANBY, OR 97013 Phone #: 503-625-4400 Phone #: 266-7878 Req #- LIC 26071 SUP 2123S ELE 3-112C AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITYOF T G A R D MASTER PERMIT PERMIT#: MST2000-00532 ,... DEVELOPMENT SERVICES DATE ISSUED: 1/31/01 13125 SVV Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12744 SW BUGLE CT PARCEL: 2S109AD-09000 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT-034 JURISDICTIOI4: TIG REMARKS: Single Family detached, Path 1. BUILDING REISSUE: STORIES: 2 FLOOR AREAS _ REQUIRED SETBACKS _ RcUUIRED CLASS OF WORK: NF W HEIGHT: 73 FIRST: 1,576 of BASEMENT: sf LEFT. I SMOKE DETECTORS. v TYPE OF USE. SF FLOOR LOAD: 4o SECOND: 911 sf GARAGE 440 sf FRONT: Z1 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: at RIGHT: 5 VALUE: 8 71y.7u5 00 OCCUPANCY GRP: R3 BDRM: 1 BATH: 3 TO i,L, 1387 05 of REAR 19 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS. I RAIN DRAIN: 1M TRAPS: LAVATORIES: •1 DISHWASHERS: I FLOOR DRAINS. SEWER LINES: inn SF RAIN DRAINS. I CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP I WATER HEATERS I WATER LINES, 1,n' BCKFLW PREVN"rR i GREASE Tr'APS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN<100K: BOIL/CMP<7HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN—100K: 1 UNIT HEATERS: HOODS: i OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES. GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS _BRANCH CIRCUITS _ MISCELLANFOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 .00 amp: 0 200 amp: WISVC OR FOR: I PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 400 amp: 201 - 400 amp' 1st wl0 svclrnR. 10 SIGNIOUT L!N LT: PER HOUR LIMITED ENERGY: 401 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT MANU HMISVCIFDR: 601 • 1000 amu'. 601-amps-1000V MINOR LABi L, 1000.amplvolt Reconnactonly: " PLAN REVIEW SECTION —4 RES UNITS SVCIFDR>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCC. --__ ELECTRICAL•RESTRICTED ENERGY -_ A.S.'-RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO R STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC: nATA/T'ELF-COMM- NURSE CALLS. TOTAL-a SYSTEMS: Owner: Contractor: TOTAL- FEES: $ 6,795.54 This permit is subject to the regulations contained In the U'BRIEN HOMES INC O'BRIFN HOMES INC Tigard Municipal Code, State of OR Specialty Codes and 34444 SW LADD HILL RD 34444 SW LADD HILL RD all other applicable laws All work will be done in VVI-SONVILL E,OR 97070 WILSONVILLE,OR 97070 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 Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set R*g#: LIC 69361 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 j 10✓��`(I`- ��4u � REQUIRED INSPECTIONS ' Erosion Control Insp 8, Pc3t/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Grading Inspection Post/Beam Mechanica Mechanical Insp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Undertloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr; Electrical Service Low Voltage Water L' Insp Final inspection laaued _ Permittee Signature :_ �--- Call (F03) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00364 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/31/01 SITE ADDRESS; 12744 SW Bt GLE CT PARCEL: 2S109AD-09000 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 034 _ 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: Single family detached. _Owner: -- _ --- FEES O'BRIEN HOMES INC --- — 34444 SW LADD HILL RD Type By Date Amount Receipt WILSONVILLE, OR 97070 PRMT CTR 1/31/01 $2,30000 27200100000 INSP CTR 1/31/01 $35.00 27200100000 Phone: 503-625-4400 -- — Tots,1 $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 frorn 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 nct located at the measurement 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 insi.+il a lateral. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-031-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by cailing(503) 246-19 7. Permittee Signature: — Call (503) 639-4175 by 7.00 P.M. for an inspection needed the next business day I E_ _ - - E One-and Two-Family Dwelling Building Permit Application Checklist Reference no.. -- Associated permits: City of figard City of Tigard U Electrical ❑Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Other: __ - Phone: (503) 639-4171 Fax: (503)598-1960 1 Land use actions completed.See jurisdiction crit ria for concurrent reviews. 2 'I,oning.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 application. 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 he 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 he completed if'copyright viol­tions exist. - 11 Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 4-11.elevation diff--rential,plan must show contour lines at 24 intervals);location of easements and driveway;footprint of structure(including decks);location of wells/sepfic systems;utility fixations;direction indicator;lot arra;building coverage arra;percentage of coverage;impervious arra;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 plains.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans, Ip umbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers.joists,sub-floor, wall construction,roof construction.More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 "elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterioi elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are ace, Mable. _ If Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. _ 17 Fhoorlroof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. _ 18 Bas�Mrreut and retaining walls.Provide cross sections and details showing placement of reba, For engineered systems,see item 22,"Engineer's calculations." _ 19 Beam calculations.Provide two sets of calculations using current code design values for all bear..• -id multiple join' over 10 feet long and/or any bearn/joir'carrying a non-uniforn load. 20 Manufactured floorlroof fetus design detaUa. 21 Energy Code compliance.Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. 22 Engineer"s calculations.When required or provided,(i.e..shear wall,roof truss)shall he stamped by an engineer or architect licensed in Oregoi:and shall be shown to be applicable to the project under review. 23 Five(5)site plans ate required for Item I I ahove• 24 v — 25 — 26 _. _—__— -- -- -- --- — 27 28 — -- -- -- Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may be in blue �-r black ink. Red ink is reserved for &partment use only. 441)4614OV'Co^t) Mechanical Permit Application o _ Date received: Permit no.: City of 'Tigard Prolect/appl.no.: � Expirc date: City nfTigard Address: 13125 SW {all Blvd,Tigard,OR 97223 Date issued: By: Itecciptno.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: ____ Building permit no.: rgI &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addiiiou/alteration/replacemen! U c)thrr. _____ 1 � 1 Job address: / r Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: — value of all mechanical materials,equipment,labor,overhead, profit.Value$ Tax map/tax lot/account no.: .— "See checklist for important application information and Lot: Block: Subdivision: Project name: J _ jurisdiction's fee schedule for residential permit fee. City/county: ZIP: l �IMNIODIIM= t Description and location of work on premises:_ __ __ Pec(ca.) Total inspection: Description (py. Iles.only Res.only Fst.date of completion Tenant improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?U Yes U No Air conditioning(site p an require ) Is existing space insulated?U Yes U No Alteration of existing It AC system of er/compressors State boiler permit no.: Business name: G9!/.Q rS'G;�S�XS � _r�'�� HP Tons BTUIH Address: U01 �C 9 FireTno a amper uct smoke electors City: Q rL�Xd Slateae Zi�OV'a eat pump(site p nn require ) nsta rep ace urnace/hsumer Fax: TE-mail' — Including ductwork/vent liner U Yes U No Phone:77s�f/ CCB no.: SC Z 3 —_ —_ nst-Tree acelre ocateTeaters-suspende • City/metro lie.no.: 0000 /OZ,4 wall,or floor mounted _ Vencor apV lance of er than furnace Name(please print): — (—KA_ M A-10 Refrigeration: Ahsotption units BTU/H Nantc: —_ /j1N / HP Chillersl/U�a Com rccssors Address: ary ronmental exhaust and ventilation: City: State: ZIP: Appliance vent Phone: ryer exhaust ---� �'� E-mail: .� o ;, ypc / 1/res. etc a azmat hood fire suppression system — Name D'j6641 ��ltK. _ Exhaust fan with single duct(bath fans) Mailingaddress: /y/(, x oust s stem a art from eating or AC �4N y� W- �' tie p p ng ant str tit on(up tett els) city Gsox�i_�!� 15tateo� zlP: O'7e) T LIk; NG _ oil _ ype — Phone: yt/OD Fax:: ZG" -mail: ue piping eac.a itional over out ets tocess p p nR(rchematIc required) _ Number of outlets __. Name: t er . app auce oror equipment: Address: _ _ i)ecorativefireplace Slate: IP_ _ nsert--type _ — ✓o stovupe et stove Phone: Fix I E-mail: (Aher Applicant's signature: Date: Other. _— Name(print): I-- — - - -- — — Permit fee............ ........$ ---- Not ali iudedictions accept cmtit cords.pierce call Jurisdiction few mire infnmration. Notice:This permit application N!intmum fee................$ U Viso U hAnsdcK and expires if a permit is not obtained plan review(at __ %) $ Ordit card number within ISO days after it has been rspiree y State surcharge(8%, ....$ accepted as complete. Name of canlholdet es shown on reedit crd s TOTAL .......................$ -- Cardholder ai�itutne Amount 4404617(611)(11CO!,1) Commercial Schedule 1&2 Family Dwelling Sc`-- ASSUMED VALUATIONS PER APPLIANCE Das«Ipllnn - �� F,Fw-narAA_,to 100,000 BTU Table 1A Mechanical Code Price Total dingduras&vents g55 1) Furnace to 100,000 BTU -- -� inc(TLngq duds 8 vents 1400 Furnace> 100,000 BTU 2) Furnace 1oo,0oo BTU:- Including duds&vents 17.40 including ducts&vents_ 1,170 3) Floor Furnace - floor fumaCf' Including vent _ _ 14.00 4) Suspended heater,wall heater including vent 955 or Door mounted healer 1400 suspended heater,wall heater 5) Vent not Included in affliance ennR-_ _ 8.80 or noor mounted heater _ 955 6 Rc as unds 1215 Vent not included In appliance permit_ 445 Check all that apply 'Boller Heal Air - For Nems 7-10,see or Pump Cond City Price Total Repair units 805 footnotes 1,2 Com •• 7)4HP,absorb unit to -- - <3 hp,abs-)tb unit 1001K BTU 14.00 to took BTU 955 8)3.15 HP,absorb ung - -- _ 100k to 500k BTU 25.00 3-15 hp,ab;orb.unil 9)15-30 HP;absorb unit.5.1 mill BTU 35.00 101k to 500k BTU 1700 10)30.50 HP,abiorb - --- 15-30 hp; �bsorb.un+t1_.Hni 1-1.75 m0 BTU .12.20 - 11)>"rl,absorb unit>1.75 mil BTU 501k to 1 mil. BTIJ 2310 07.20 -- IZ)Ab handling unit to 10,000 CFM 30-50 hp;absorb.Unit 10.00 13)Air handling unit 10,000 CFM• 1-1.75 mll,BTU _ _ 3400 1720 >50 hp;absorb.unit 14)Non-portable evaporate coolm > 1.75 mil.13 TU 5725 15)Vent fan connedM ld a 1000 single dud 8.50 Air handling unit to 10,000 cfm 656 18)Ventilation system not Included in Air handling unit> 10,000 cfm i I70 ■ lian`e pemlr. 10,00 17)f food served by mechanical exhaust Non-portable evaporate Collor 656 vent tan connected o a single duct 446 18)Domestic Ineblerators 17.40 Vent syst.not included In appliance permit 656 19)Commercial or h;J4 rlal type Incinerator -•- 89.95 Hood served by mechanical exhaust 656 20)Other units,k,ciudlog%w moves- --.-- 10.00 Domestic incinerator 1170 21)Gas piping one to lour outlets -- s_4o Commercial or industral Incinerator 4590 zz)More than 413er oulhl teach) - 'Other unit,Including wood stoves,inserts,etc. 656 1.00 Minimum Permit Fora(12.50 SUBTOTAL . Gas piping 14 outlets - 360 s%SURCHARGE Each additional outlet G3 PLAN REVIEW 25%OF SUBTOTAL --- --- Required for ALL commercial pefmlts only TOTAL Me,tnatfeceene and Fen: 1 Inspections oW>1de of normal Wslness h-%(mnrmum drarae-Ma t-) 172 ore pit Ixvx 2 Inspections lar sNd h-fee n.I-g A"y xA_jed(-.,-Maree hall Ixxnl 172.So per hour Total Valuation _ _. 3 Addax-1 plan evfew e4u of by dunces oddlm cit emwnsb pans hwnimim _-- -- --.._-- ----- dwae-4,olr h-)172 to pe.hour _ 'Stale C-In0clor Baser CA W"I-rrpuued S 1.00 to$5,000.00 Minimum$72.50 nesMenuat ASC revuves*ore plan aMMnq p acenrnl nl Unit S5,001.110 to 510.000,00 572.50 for the first$5,000.00 and S1.52 for each additional$100.00 or fmcdon thereof, to and including$10,000.00 S 10,001.00 to$25,000.00 S 148.50 for the first S 10,000.00 and S 1.54 for each additional$100.00 or fraction thereof,to and including$25,000.00 S25,001.001n 550,000.00 $374.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction dlereof,to and including$50,000.00 S50,000.00 and up $742.00 ror the first$5o,1)- and$1.20 for each additional$100.00 or fraction -- -------._..__ thereof - -- Plumbing Permit Application City of Tigard Date received:/.12_/_e40 Pcrmitno.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: Ciryoj'figard phone: (503)6394171 Project/appl.no.: Expiredate: Fax: (503) 598.1960 Date issued: By: Receipt no.: Land use approval: _ Case file no.: Payment type: 1 U 1 &4 family dwelling or accessory U Commercial/industrial U Multi l;unily U Tenant improvement U New co tsiruction U Addition/alteration/replacement U Food.Service U()the[: Job address: /,�A��/!/ y �� � C1� Description Qty. Fee(ea.) 'total Bldg.no.: __ FS_Uitte no.: New 1-and 2-family dnellings only: Tax map/tax lot/account no.. — (includes 100 fl.for each utility connection) SFR(1)bath Lot: jBiock, I Subdivision: SFR(2)bath -- — - Project name: — _ SFR(3)bath —^- - City/county: _ Z.IP: Each additional bath/kitchen Description and location of work on premises: ;Iteutilities: Catch basin/area drain Est.date of completion/inspcction: Drywells/leach line/trench drain Footing drain(no.lin.ft.) Manufactured home utilities — - Business name:_ (.(.t Manholes Address: UO T30)! Rain drain connector City: J 1.4 A- Stater � Z[P�Q-d ' ; S,tratary sewer(no.lin.ft.) -- — — Phone:6, 9- D3 Fa&J2,-4WE-mail: St arm sewer(no.lin.ft.) CCB n (gyp Plumb. bus.reg.no-�q_ O'-_ ater service(no.lin.ft.) City/metro lic.no.: r3 p /(V a Fixture or Item: Contractor's representative signature: Absorption valve Back flow reventer Print name: �rYyl?'j� Da e:/< k� Backwater valve -- Basins/lavatory Name: �Q $ 0�Q,l C-e)> Clothes washer Address: �ye/�,�jw�.p�,�179iel Dishwasher City:: Llli7U�! (JlCG6� State6jr ZIP: 7a Drinking fountain(s) Ejectors/sump Phone: 25q"_0 Fax: E-mail: Ernansion tank _ e Fixture/sewer cap Name(print): Floor drains/floor sinks/hub —— -- Mailing address --� - Garbage di s sal - Hose bibb — -- City:_ State: ZIP: Ice maker Phone: Fax: Email: lnterceptor/grease trap Owner instal lation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) -� employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),Ia-s(s) Owner's si nature: Date: Sump -- kX"101 It Tubs/shower/shower.pan Name: Urinal - ------ Water closet Address: Water heater' City: State: zip: A` Other: Phone: Fax: --Lmail: 'Total Na all Judseictlonc rcer>f credit cods,please call Jurisdiction for more information Minimum fee................$ Notice:This pert application — - Uvisa U MasterCard expires if a permit is not obtained Plan review(al _ %) $ Cirdit card numl v. L�__ State surcharge 8% Fsplies within 180 da- after it has been g ( ) $ ---- —� —� accepted as cvm le TOTAL ...................... None of cardholder u shown nn coedit card � P p tC. $ _ --- iudtmlder s ilp_mtum Amount — -- _. —---—-- 440J616(tiA(tQ'OM) r' F�g$E COMPLETE: • FIXTURES (Individual) Oty ;Price, Total - Fixture Type-�- --T Quantity Work Performed Sink 16.60 —_-^_ -Now Moved ?aplaced Removed/Capprrd Lavatory 16.60 Sink rte___ 'rub or Tub/Shower Comb. 16.60 - Levator Tub or Tub/Shower Combination Shower Only 16.60 -Shower Only _ Water Closet --- - -- 16.60 Water Cioset - _ _ ----- _ Urinal Unci_al - 16.60 Dishwasher Dishwasher 16.66 Garbage Disposal Laundry Room Tray _ Garbage Disposal �- 16.60 Washing Machine - FloDrain/Floor Sink 2' --` Laundry'fray — 16.60 .or_. _. -_� 3" Washing Machine 1660 '- 4" Fioor Drairt/Floor Sink 2." 16.60 Water Heater - --- 3" 16.60 - Other Fixtures(Specify) ---- 4' - 16.60 -- _ Waley Heater 0 convec ion O like kind 16.60- -- - -- — Gaspiping requires a s,,)arate mechanical permit. - --- - -- MFG Home New Watt, Service 46.40 J ----- — MFG Home New San/Storm Sewer 46.40 --- - COMMENTS REGARDING ABOVE: Hose Bibs 16.60 Roof Drains 16.60 Drinking Fountain - 16.60 -- --- - - Other Fixtures(Specify) Sewer-1st 100' 55.00 Sewer-each additional 100' 46.40 Water Service-1 st 100' 55.00 Water Service-each additional 200' 46.40 Storm 6 Rain Drain-tsl 100' 55.00 Stomt 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow P evention Device 46.40 Residential Backflow Prevention Device' 27.55 Cntch Basin 16.60 iInsp.of Existing Plumbing or Specially Requested 72.50v Inspections -_ erthr Rain Drain•single family dwelling 65.25 Grease Traps - 16.60 (.QUANTITY TOTAL. -- r -Isometric or riser dingrarr Is required N Quantity Total Is >9 -- "SUBTO-AL --- --0%SURCHARGE **PLAN REVIEW 25%OF SUBTOTAL Required only N nxlure qt .ylotal Is>9 '.:"uric a - TOTAL ;. . 'Minimum perrnn fee is$72 50•8%surcharge,except Residential©acktlow I reven0on Nice,which Is$36 25+8%surcharge. All New Commercial Bulldtngs require plans with Ko4rwirlc or riser diagram and plan review Electrical Permit Application -- Date received:/�/-GL Pennit no.: j�` y�• 5 City of Tigard Project/appl.no.: Expiredate: Ciry of Tigard Address: 13125 SW Ball Blvd,Tigard,OR 9722 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: F_ — TY PE 0 U I &2 family dwelling or accessory U Commercial/indust,fal U Multi-family U'I cnanl imhn,vrmrlu U New construction U Addition/alterationheplacement U Other:_ U Parlial 1 Job address: Bldg.no.: Suite no.: 17ax map/tax lot/account no.: Lot: I Block: Subdivision: _ Project name: I Description and location of work on premises: Estimated date of com lotion/inspection: Job no: Cee oras �' Description Qty. (ea.) Total no.incl) Business name: r s k New residential-single or multi-farnily per Address: x U sr Includrsattachedt:arage. City: A7taStatZIP: j Sersiccincluded: Phone ` g Fax: E-mail 1000 sq.ft.or less _ r Each additional 500 sq.ft.or portion thereof _ CCB Elec.bus.lic.no: 1 e— Limited energy,residential 2 City/metro lie.no.: p?- �d 0i 6/ Limited energy,non-n.aidenlial _ Each manufactured[ionic or modular dwelling —� ✓ Service and/or feeder -' Signature of supervising electrician(required) _ Dat — — Services orfeeden-Installation, Sup.elect.name(print) (' (OtitJ License no' 3 alteration or relocation: 200 amps or Ices _ 2 Name(print): e/CEJ �S /�C-'G 201 amps to 4W amps_ 2 �� S�a� Gtr /d�►GL- 40!amps to 600 amps _ 2 Mallin address: 601 amps to 1000 amps 2 City: —�- e Stolt Q Z1P, 7"o quer IOW amps or volts _ 2 Phone: I Fax ed I E-mail: Reconnectonly I Owner installation:The installation is being made on property town Temporary services or feeders- whic.h is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: 200 amps or less _ ORS 447,455,479, 701. - 201 amps to 400 amps _ _ 2 Owner's signature: Date:�� 7J 401 to 600 ams 2 Branch circuits-new,alteration, or extension per panel: Name: _ _ _ A. Fee fer branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 ZIP_ B. Fee for branch circuits without purchase -- of service or feeder fee,first branch circuit: Phone: Fax: E-mail: Each additional branch circuit: Misc.(Service or feeder not Included): O Service over 225 amps-commercial U licalth-carr facility Ench pump or ircigation circle _ U Service over 320 amps-rating of 1&2 U Hazardous hlealinn Each sign or outline lighting family dwellings UBuilding over lQO(x)square feet four or Signal cirruit(s)oralimited energy panel, U System over 6W volts nominal more residential units in one structure alteration,or extension' 2 O Building over three stories U Feeders,400 amps or more 'I)escrirtion: U Occupant load over 99 persons U Manufactured structures or RV park Each additional inspection over the allowable In any of the above: U F.gress/lightingpion U Other __��_ Perinspection Submit—sets of plans with any of the above. Investigation fee _ The above are not applicable to temporary construction serve)_e. Other No1 all jurisdictions accept cmat cants,plena call jurisdiction for moir inforrnrttion. Notice: fIrIS permit application Permit fee.....................$ _ U Visa U MastetCnrd expires if a permit is not obtained Plan review(at _ 96) $ Credit card number:____ __--_ L/-_ within 190 days after it has been State surcharge(8%)....$ ispirr. accepted as complete. TOTAL ....................... Name of eta 1 ;-a sshnwn on creit card - _S_ Csrdh0der signature Amount 4404615(6t WOM) Electrical Permit Fees: Limited Energy Fees: ----------------- Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Number of Inspections per permit allowed Rest Energy Fee..................................................... $75.00 „� (FOROR ALL SYSTEMS) Service included: Items Cost Total I Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less $145.15_ 4 Audio and Stereo Systems Each additional 500 sq.ft.or portion thereof _ $33.40 1 Burglar Alarm Limited Energy _`— $75.00 Fach Manufd Home or Modular ElDwelling Service or Feeder $9090 2 Garage Door Opener' Servicus or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relaxation 2.00 amps or loss $80.30 2 r 201 amps to 400 amps _ $106.85 2 l Vacuum Systems' 401 amps to 6^0 amps $160.60 2 601 amps to 1000 amps $240.60 2 Fi Other Over 1000 amps or volts _— $45465 2 Reconner-!only $6685 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation 200 amps or less $66.85 2 Fee for each system.......................................................... $75.00 201 amps to 400 amps _ $100.30 2 (SEE OAR 918-260-260) 401 anips to 600 amps $133,75 _ 2 Over 600 amps to 1000 volts, Check Type of Work Involved: see"b"above. ❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel ❑ a)The fee for blanch circuits Boiler Controls with purchase of service or feeder fee. Clock Systems Each branch circuit _ $6.65 2 b)The fee for branch circuits Data 1 elecommunicabon Installation withouf purchase of service or feeder fee. Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit _ $6.65 HVAC Miscellaneous (Service or feeder not included) Instrumentation Each pump or irrigation circle $5340 __— Each Sign or outline lighting $53 40 Siqnal circuit(s)or a limited energy Intercom and Paging Systems panel,alteration or extension _ _ $7500 _ Minor Labels(10) _ $125.00 _ El Landscape Irrigation Control' Each additional inspection over I—1 the allowable In any of the above l—J Medical Per inspection _ _ $62.50 Per hour $62.50 LJ Nurse Calls In Plant $73.75 _ Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ 8%Slate Surcharge $ F] 25%Plan Review Fee __—____._.._. —_Number of Systems See"Plan Review"section on front of application _ No licenses are required Licenses are required for all other installations Total Balance Due $ Fees: ❑ Trust Account# Enter total of above fees S. ------ —--- - - i 8%State Surcharge $ -- -- Total Balance Due $__—_ is 1(lslsJonns'\cic-il'cs.doc IC/09100 lig .l. TY CITY OF TIGAR® OREGON ------ INTENT TO HAUL EXCAVATION (LOT'S STEEPER THAN 20%) (print name), hereby certify that ALL excavation material on the subject property will be removed from the site and not be placed as fill, except :or that amount necessary to back-fill the foundation ONLY. I understand that failure to remove the excavation material will result in the requirement to remove the mate;ial or obtain a grading permit by submitting gradin plans y a licensed engineer accompanied by a geo-technical report regarding the placement of the excavation material as fill. further understand that my footing inspection will be denied if that inspection reveals that excavated material has not been hauled, and that work will be stopped and no further inspections conducted until the City has received and approved a plan and report from a geo-technical engineer regarding placement of the fill material. i Signature Date , Permit #: f Job Address: lc;�7�� Subdivision: 4� VLot:_�� - I.haul doc(DST)MR 13125 SW Hall Blvd., Tigard, OR 97223 (.503)639-4171 TDD(503)684-2772 -- —_- a �KayYlY.'+due.::wJ1•- dip d-, '�t; `y'_.,a.e :W�..,-ice .duiL'1,:-L i