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10965 SW ERROL STREET V• m 0 0 c� 10965 SW Errol Street CITYOF T I GA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00246 1',125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/5/03 SITE ADDRESS; 10965 SW ERROL ST PARCEL: 2S 103AA-01000 SUBDIVISION: ECHO HEIGHTS ZONING: R-4.5 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: ALT CARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: u;''KFLO ': PREVNTRS: 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: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install 10UfUless sewer line to connect to sewer lateral. Septic tank is to be pumped, filled and inspected. Reimbursement District#21 fee paid. Owner: — FEES - -- --- Description Date Amount t-EHMAN, DONALD A + KATHLEEN M -- ---- 10965 SW ARR;)L ST I I AXJ 8° State Tax 6/5/03 $5.80 TIGARD. OR 97223 1I'LlIMHI Permit Fee 6/5/03 $72 50 Total $78.30 Phone Contractor: TERRY RINKES TRACTOR WORK PO BOX 546 BEAVERCREEK, OR 97004 REQUIRED INSPECTIONS Phone : 503-632.6227 Sewer InspectionFinal Inspection Reg#: I'LM 5550 LIC 48563 This permit is issued subject to the regulations contained in the Tigard Municipal Code, Slate 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 ',c not started vv, t 'n 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION- Oregor, law ,„�Juires you to follow rules adopted by the Oregon Issued By: �'_ Permittee Signature: Call (503) 63941'75 by 7:00 P.M. for an inspection needed the next business day bulluing lr txtures Plumbin�+ : -_,,nnit Ap-plication ' Received I'I i n nF"n g Date/B 1u�'ti. I'enmt No.:�LVi of Tigard Planning Approval I Sewer City g Date/By- Permit 13125 SW Hall Blvd. Plan Review Other —` Tigard,Oregon 97223 Da Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Internet: www.ci.tigard.or.us Contac : Case No. _— g Contact j)tris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: / �� _ Supplemental Information. TYPE OF WORK FEE*SCHEDULE forspecial Information use checklist constructionDemolition Description lty. F19%tion/alteration/replacement _ Other: New,i-&2-famliy dwellings _ CATEGORY OF CONSTRUCTION includes 100 fl.for each utilitv .-onnection 1 & 2-Family dwelling Commercial/Industrial SFR I bath 249.20 SFR 2 bath 350.00 Accessory Building _Multi-Familly SFR 3)bath 399.00 Master Builder _ Other: Each additional bath/kitclten 45.00 JOB SiTE INFORMATION and LOCATIONFiresprinkler-sq. fl _ Pa c ? Job site address: ) 69 657LA5 Z V W.6L_ — Site Utilities _ Suite#: Bld ./A t.#: Catch basin/area drain _16,60 Suit Sed Name: Dr ell/leach line/trench drain 16.60 ProjFooting drain no.linear R. Pae 2 Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer no. linear fl.) _Z �Pagc 2 Subdivision: _ Lot#: Storm sewer no, linear fl.) ae 2Tax ma / areal #: Water service no.linear it a e 2 _.�Fixture or Item -- DESCRIPTION OF WORK - Abso tion valve _ _ 16.60 Backflow preventer _ —� _ Page 2 _ _ Backwater valve _ _ 16.60 Clothes washer 16.60 - -- - -------- ------ Dishwasher 16.60 -- Drinkingfountain _ _ 16.60 PROPERTY OWNER TENANT Ejectors/sum 16.60 Name: DON LFL mcwJ KrTPY if-N/'W+' -- - -- — Ex ansion tank 16,60 Address: 10 9 6' $W FIM dL 'ST Fixture/sewer cap 16.60 Cid/State/Zip: (7 Iq RD 112 Z Z Floor drain/floor sink/hub 16.60 Garbage disposal _ 16.60 Phone: 7,6 ' 6Z -q-'11-13 Fax:i-6-3 "S IF, l i�'-F^ Hoebib 16.60 _APPLICANT _ _ I U CONTACT PERSON Ice maker 16.60 — Nanie: Interceptor/grease trap 16.60 Address: ---- _-- -_--- -- Medical gas-value: S Pae 2 City/State/Zip: Primer _ 16.60 _ — Roof drain(commercial) 16.60 Phone: Fax: _ Sink/basin/lavatory 16.60_ E-mail: fub!shower/showerpan 16.60 CONTRACTOR Urinal 16.60 Business Name: �fk> ,aJ tr TJWM 4,,Pc.-1(xcn#�JAX' Water closet 16.60 —�— -- Water heater 16.60 Address: Po t3cx S G Other- _ Cit /State/Zip: l 61_ft 69- , 1:14 tf1-7 001 _ Other: _ Phone:5-03 6 31 6 -t't"1 Fax: - "J$(,'3 Plumbing Fees* CCA Lic. #-._q 8 5 3 Plumb. Lic.#: Subtotal $ — — Minimum Permit Fee$S72-72.50 $ Authorized ` S Residential Backflow Minimum Fee$36.25 - __ Signature: bate: Plan Review 25%of Permit Fee S AJ (, �n`4`1 State Surcharge 8%of Permit Fee $ LL arr (Please t, Int name) TOTAL PERMIT FEE S Notice: This permit application expires If a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or Igo days after It has been accepted as complete. riser diagram for plan review. 'Fec methodology set by Tri-Counts noilding Industry Service Board. i.\Dsts\Permit Forms\PlmPcrtnitApp.doc 01!01 Plumbing Permit Application-City of Tigard Page 2-Supplemental Inforination Fee Schedule: _ Residential Fire Sill cession Systems_: Site Utilitic, Qty_ Fee(ea) Total S ua:a Footage: Permit Fee: Footing drain-I"IPO' - 1; lm 0 to'MT $115.00 Footing drain each additional 100' 46.40 2,001 to 3,600 — 5160,00 3,601 to 7,200 _ $220.00 Sewer- Ist 100' / 55.00 7,201 and greater $309.00 Sewer-each additional 100' 46.40 Water Service- Ist 100' 55.00 Medical Gas S stems• _ Water Service-each additional 100' 46.40 Valuation: Permit Fees Storm&Rain Drain-I st 100' 55.01' $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 4!40 $5,001.00 to$101000.00 $72.50 for the Bret$5,000.00 and si.52 for each Fixture or Item Qty. Fee 10sa additional$100.00 or fraction thereof,to and ) Total including$10,000,00. Commercial Lack Flow Prevention Device 46 4(I $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee$36.25 27.55 and including$25,000,00. Rain Drain,single family dwelling 05.25 $25,001.00 to$50,000.00 $379.50 for the first$15,000.00 and$1.45 for Inspecti_n of existing plumbing or each additional$100.00 or fraction thereof,to specially requested inspections-per hour _ 72.50 and including$50,000.00. _ Subtotal: each and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures? If "Yes",please Indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. uanllt b Fixture "'mk Performed Vomments regarding fixture work: Flxtur•r Type: Replace New Moved Reptaa Capped ------ -------_--- - _ 11;1 11 i.l!t l aril T_ Bath ILb/Shower _ - - -Jacuzzi/Whirl rot Car Wash -Each Stall -Drive Thry - — - Cuspidor/Water Aspirator - -- - --- --- Dishwasher -Commercial -Domestic — — ^- - Drinking Fountain —Eye Wash Floor Drain/sink .2" - 3" - — 4" Car Wash Drain Garbage -Domestic *Note: If the fixture work under this permit results in an Disposal -Commercial increase of sewer F Dtls,a sewer permit will be issued and -Industrial fees assessed for the sewer increase must be paid before the Ice Mach./Refri .Drains _ _ plumbing permit can be Issued. Oil Separator Gas Station _ Rec.Vehicle Dump Station Shower -Gang _ -Stall Sink -Bar/Lavatory -Bradley -Commercial _ -Service Swimming Pool Filter _ Washer-Clothes _ Water Extractor Water Closet-Toilet Urinal Utlror Fixtures. i:tDstslPermit FormslPlmPerm!tAppPg2.doc 01103 CITYOF IGARD y SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00181 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/5/03 SITE ADDRESS; 10965 S1A cRROL ST PARCEL: 2S 103AA-01000 SUBDIVISION: ECHO HE►GHTS ZONING: It-1.5 BLOCK: LOT: 005 JURISDICTION: 11c TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYFE OF USE: SF NO, OF BUILDINGS: INSTALL. TYPE: LTPSWR IMPERV SURFACE: Remarks: Connect existing house to sewer lateral. Owner: FEES LEHMAN, DONALD A +KATHLEEN M -�-- 10965 SW ARROL ST Description Date Amount TIGARD, CR 97223 [SWUSA] Swr Connect 6/5/03 $2,300.00 [SWUSA] Swr Connect 6/5/03 $0.00 ,-hone: [SWINSP] Swr Inspect 6/5/03 $35.00 [SWINS111 Swr Inspect 6/5/03 $0.00 Contractor: h — Total $2,335.00 Phone: Reg#: Required Inspections Sewer Inspection Septic Tank Filled This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the instailer shall prospect 3 feet in all directinns from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer' Perm r 1� Issued by: Permittee Signature: - Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP ------- - Received _L 'Z Date Requested -" '�' AM- r�4_- - _ BIJP Location �t LqSuite MEC Contact Person _ _ __ __ Ph( ) S �'I�' S�L _ PLM 0r�a Contractor Ph( ) :AWP. BUILDING Tenant/Owner -_ - ELC Footing ELC Foundatiun Access: Ftg Drain ELR Crawl Drain Slab Inspecti-n Notes: SIT Post&Beam Shear Anchors - - --- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Pr;waln Nailing -- -- Firewai! Fire Sprinkler --- Fire Alarm Susp'd Ceiling - - - Roof Other:-- - Final 01 - PASS PART FAIL - J- Post&Beam - Under Slab - Rough-In /J Water Service / -------_.--------- Rain Drains --- - - - -- -- Catch Basin/Manhole Storm Drain - Shower Pen Other: Final _ VV S PART FAIL -- _ ..HANICAL Post&Beam Rough 's - Gas Line Smoke Dampers Final PASS PART FAIL ---- - — ELECTRICAL Service - Rough-In - UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$ required byefore next Ina _PASS PART FAIL pection. Pay at City Hall, 13125 SW Hall Blvd. SITE L-] Please call for reinspection RE:___ _ _ Unable to inspect-no access Fire Supply Line -, ASA � Approach/Sidewalk 011b— - - Inspector_I'U _ ___ Ext.- Other: xt._Other. Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL l 0: I� CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639•4175 Business Line: 639-4171 MST —` BLIP Date Requested - __AM�iPM _ �- �l BLD Location / U � --� c✓ �rr4-( Suite MEC Contact Person 1Q26,C Ph _kL6- PLM -GVI-- -V / 71 Contractor Ph SWR BUILDING Tenant/Owner _ �� C e--Ci ELC _ Retaining Wall - Footing Access: �,-,a W � ELR FoundationPrr FPS Fig Drain Sr�''c V- - Crawl Drain InFpection Note SGN Slab - -----� LS. �- -- ---- Post& Beam 1� SIT Ext Sheath/Shear Int Sheath/Shear - ----- --- Framing insulation _ ---- -- Drywall Nailing Firewall -- --- - ---- - _ -_� Fire Sprinkler - Fire Alarm — Susp'd Ceiling Root -` ------ Misc: --_---- Final - --------_ - PASS PART FAIL_ Post&Beam -- ------ ------ - ---- ----------- _ Under Slab TopOut -- -- -- ----- - ----- -- ----- ---- _ Water Service Sanitary Sewer _- in Drains Fin AS PART FAIL. ANICAL -- -_ - - -- - Post& Beam ------------------ Rough In Gas Line ----- -- -- Smoke Dampers �'-------_ ...._- -- --- ------- Final ------- - - - --- --- — PASS PART FAIL ELECTRICAL ___-----_-------- ---------_ - Service Rough In - ------ ---- -- ---- UG/Slab Low Voltage ----- ------- ----- -- Fire Alarm Final _-- PASS PART FAIL SITE Backfill/Grading ----- --- __- Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: Fire Supply Line [ I Unable to inspect-no access ADA Approach/Sidewalk Other Date q - 4/ Inspector_4,,,L�� Ce�a�/� . Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST , _00 2 vo 24-Hoer Inspection Line: 639-4175 Business Line: 639-4171 — BUP _ — bate Requested_ AM � PM BLD Location�`U ��S �� C!E7 rra _ Suite MEC Contact Person Ph Z y PLM Contractor Ph SWI, BUILDING TenantlOwner ELC Retaining Wall ELR Fouting Access: Foundation �,�OW P '-J�" �[�.. /dam. S ---- —.._ ,� FPS rtg Drain �- �"""� '�'` "' c�lS a. �/ SGN Crawl Drain Inspection Notes: -- ------- — - Slab SIT Post&Beam —— -- ----- — Ext Sheath/Shear Int Sheath/Shear �+ — Fram'ng — —- - - —- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof Misc: -- Final PASS PART FAIL - PLUMBING Post& Beam `- Under Slab _ Top Out Water Service _ Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam -- ----- -------- Rough In Gas Line - -- - ------ -- -------- ---- Srnoke Dampers Final — PASS PART FAIL ,, ECTQ AL — Service Rough In UGISiab Low Voltage Fire Alarm S PART FAIL Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$i required before inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Linc [ J Please call for reinspection RE: J Unable to Inspect-no acc,+ss ADA Approach/Sidewalk Date Inspectors Ext Other - Final PASS PART,FAIL DO NOT REMOVE this Inspection recond from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION ;`, � � _ 00 24-Hou: Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requesteci �P J Zb/G —AM-A PM — BLD Location, Ot cr d 1 —_� Suite _ —_ MEC Conte Person Ph PLM Contractor Ph SWR Tenant/Owner _ ELC Retaining Wail ELR Footing Foundation Access: FPS Ftg Drain -"� ,----- Grawt Drain Inspection Notes: SGN ---- — -- Slab Post& Beam - - 'IT Ext Sheath/Shear Int Sheeth/Shear �— Framing Insulation --- --��_----�- -�- Drywall Nailing Firewall -- Fire Sprinkler Fire Alarm Susp'd Ceiling _ Root ---- .---- - Misc: _— —- -- - - - --_...... _.. ---- - AS PART FAIL PLUMBING Post&Beam - - Under Slab Top Out — — Water Service Sanitary Sewer Rain Drains Final — PASS PART FAIL MECHANICAL Post& Beam -- -- Rough In Gas Line -- -- - - — Smoke Dampers Final -- PASS PART FAIL ELECTRICAL -- --- — ---- ----- ---- — Service Rough In — - UG/Slab _ Low Voltage Fire Alarm Final --- PASS PART FAIL _— sl Backfill/Grading - - Sanitary Sewer Storm Drain ( ]Reinspection fee of$` —required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE ( ]Unable to inspect-no access ADA Approach/Sidewalk Other Date ?-4,r - Inspector U� _ .- Ex' Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGAP!) I3UILDIR'G INSPECTION DIVISION -TMST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — -- LL G BUP —,Date Requestteed- J"" d -'� • AM PM _— BLD Location { �,a S G�T r U 1 �S Suite C_ME ,e 00/ — Q(/ S I Contact Person IPhZ-�,� ^) /�L Q� OC4 1 Contractor _- Ph SWR BUILDINGTenant/Owner EL C Retaining Wall - ELR _ Footing Access: Foundation FP^ Ftg Drain _ W - Crawl Drain Inspection Notes: SIGN Slab Post& Beam - -- SIT Ext Sheath/Shear Int Sheath/Shear Framing Insulation - Drywall Nailing _^ - Firewall - — - F're Sprinkler Fire Alarm —� Susp'd CeilingT- RoofMisc:_ .��, ✓\�-�-� i . Final P..� PART FAIL � M D [lost& Beam,- 4-1-- - a► Under Slat( Ord V Top Out Water Ser SanitarySe r --� Rain Drains Ir�/^ ��,_\��,1,�. - `'� ✓� �--s �--yv� _ in PAS PAR r FAIT_ _A41 o� ANIe-L ?Mt& Beam Rough In ��` \ , r Gas Line Smoke Dampers rr /. G�(i _U_W�- C U L .--vim ov r i A% PART FAIL �l ELECTRICAL c� - - G�•` Service Rough In `/� -' UG/Slab A— \►0 <N Low Voltage "--"' Fire '1larrn �� I 1 Final - PASS PART FAIL -_. ------ �- SITE Backfill/Gra.iing — -- -------- _.^__ Saniiary Sewer Storm Drain I ;Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ] Please call for reinspection RE [ ] Unable to inspect- no access ADA Approach/Sidewalk L:-- (/ Other - Date _7 b/C) Inspector ��J' - — Ext t Final PASS PART _FAIT_ 00 NOT REMOVE this inspection record from ine joh site, CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2001-00125 PATE ISSUED: 04/20/21501 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AA-01000 SITE ADDRESS: 10965 SO! ERROL ST SUBDIVISION: ECHO HEIGHTS ZONING: R-4.5 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/"OMPRESS ORS HOODS: FUEL TYPES0 3 HP: DOMES. INCIN: GAS 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HN: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 504- HP: CLO DRYERS: FURN < 100K BTU: 0 AIR_ HANDLING UNITS OTHER UNITS: FURN >=10GK BTU: 1 <= 10000 cfm: _ GAS OUTLETS: 2 > 10000 cfm: Remarks: Installation of gas line to range and furnace. Owner: ---- FEES LEHMAN, DONALD A + KATHLEEN M Type By Date Amount Receipt 10965 SW ARROL ST PRMT CTR 04/20/20( $72.50 272001000C TIGARD, OR 97223 5PCT CTR 04/20/20( $5.80 272001000C Total $78.30 Phone: -- Contractor: SUN GLOW INC 2428 SE 1051H AVE PORTLAND, OR 97216 REQUIRED INSPECTIONS Gas Line Insp Phone:253-7789 Final Inspection Reg #:LIC 48131 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-0151-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9,189. Issue By: (� _ Permittee Signature: _ )L j,L,i Call (503) 639-4175 by 7:00 P.M. for inspect ins needed the next business day 04%19/2001 09:23 FAX 5018847297 City of Tigard Z002 Mechanical Peradt AppUication :talc received: p I Neeetit eo.:: ;/' ,I. City of Tigard r(F(`Flt/Fr, Pmjb.c!/■ppi.no.: Bxpuodate. ClryofT:aard Address: 13125 SW flail Blvd,Tigard OR 97223 Detciswed: By: Rsceiptno.: I'lronc: (503) 639-4171 - -- - Fax: (503) 598-1960 p Ply 200) Cue File no.: Payment type Lant! use-approval- Building permttno.: _ 41 1 &2 family dwelling or accessory U Commcxcial/industrial Q Multi-family U Tenant improvement U New construction J Addi'on/altcm ion/replacemcnt U off)m Job address:_ e.r r a Indicate equipment quantities in boxes below.Indicate the dollar BWA.no. iritc no.: _ value of all mechanical materials,cqurpmeni,labor,overttead, Tax mapittax lot/ac c wet no,: profit.Value$ _ _ Lot Blotsk: Subdivision: "Sep,checklist for important application information and proms ntmte• h rye,._ juxMi.,.wn's fee schedule fbr residential permit fee- Ck /county: - ZIP. q-7 -- lNwApdon and I tion of work on ptemiaes: c,/ - (-,-v_ « r r t 1 ,; In " C , - ��, cd Lf Fee(ci.) Tntal ISL date of complerfon/irtapcct Cln lkxtaipt" _ (Xy. Ret.oaly Rey.(4d Tenant improvement or change of use: HVAU Is existing space heated or conditioned?U Yes 0 No Air handling unit -_red Air conditioning(site p an tegnit ) i _ Ia extsting space insulated?0 Yes U No Alterationo existing HVAC system Bolledcotnpressots Business name: - State boil"permit no.: _ S -_ 1 a�__ i �`- -_---- HP _Tons BTU/H Address: 1'- sire/atrtokedampers/ductwtokedetectots I _ oty: Stam:n rZ ZIP. city pump ate p an i ow Phrrne: , S . Fu: E-mail; --' instalVreplace fern titre? - - 1�)3 no; t_i ( Z I _.- -- Inch,diop ductwtxk/vent flea a U No - _ nsT- telUreplac rcaateheaters-susp Clt`1/tlfetro tic.1a0.: wail,or floor Mounted -_ for t - - Mattie(plan Print): II' r _ C�� (A% cel PPliancxo than furnace tlea Absorption units _ BTUIH Name: c'. , , 1!L_ Chillers —------ HP - - Addmu: Co tessortt HP - r • hrietn: City: tate: _ -- -- Appliance-w? Photic: Fax &mail' esexhaust - Fi�wxls, yTe res_IJ`tcG-en/11aZ7net - hrxul fire sur4wmion system __- IVtllne: I"Exhaust fan with siuSle duct(bath fans) Mallin addmu: ( C �" S ,v [.^f aust systema alt um ton ni,or AC 3bste:(� 7dP: ae a# d btrtwa(up to out els) City / oL 1 l Yrc 1 j Type: _._LPG -_ NG _. Oil Phone: - Fix: Is teat?: el /ping aich Rditioriat oven pW'g sC itn1 regnlre(1) Nme: - Number nt outlets _-- %W mice e�egr ieoh - Addrw* Decorative fireplace_- ply: --�Stare� 7.� exit-type _ _.__-- stovypellet sour Pttc+no: I Fax: I r Wood Applicant's signature: nate: -- Nance(ptlut). Perrnit fee Nd.n rrualoaeor.00rpt audit CW*.pe.co}.tnacaa for mac tabttoana. .....................$ l]Ynce OMamereatd Notice This Permit application Minimum fee................f 7.1.5-6) res expiit a permit is not obttinexi within 180 days after it has horn Plan review t at d%) $ �3� State surrftarge(R%)....S aur d 6046OWW r Iowa ai ae�i ea�d - j accreted w complete TOTAL __.................$ 41+117 Rit00ttg" 7S. JU Plan Ck'TY OF TIGARD / Mechanical Permit Application Recd Beck# Y 13125 SW HALL BLV � �YV Commercial and Residential +w Date Recd 7223 UGARD, OR 9Date to P E. (503) 639-4171, x30 '� 4 ( r`; h) Date to DST__ '' l Print or Type i l �, Permit# _ Incomp:ete or illegible a plicptions will Ib `�ti i ed called Name of Development/Projed Description - ) L L eh Table to Mechanical Code _ Out Price _Amt Job Street Address Suits# A Permit Fee � 16.00 G' ( 5 l.v L rr� 1) curnace to 100,000 BTU Address _ In:luding ducts&vents see footnote 1,2 9.65 ardga I city/state Zip 2) Furnace 100,000 BTUf, _includinn ducts&vents see footnote 1,2 12 00 %. Name(or name of business) 3) Floor Furnace — Owner Yj a ,i C )t �,� including vent see footnote 1,2 9 65 A;allinp Addreu 4) Suspended heater,wall heater _ or floor mounted heater see footnote_1_2 9.65 L' C S L"_) el r U( 5 Vent not included in a ppliance permit 4.75 Citylststs Zip I Phare Check all that apply 'Boiler Heat Air 7 23 y- ;, For Items 6-10,see or Pump Cownd City Price Amt Name(ofr/4iatne of business) footnotes 1,2 COTY • 6)<3HP;absorb unit to 100K BTU 9_65 Occupant Mailing Adre3s 7)3-15 HP;absorb unit 100k to 500k BTLI _ _ 17.65 Cnylstate zip one 8)15-30 HP;absorb unit.5-1 mil BTU 24.15 -50 HP;absorb Contractor deme I I unit 01-1.75 mil BTU 3600 _ 10)>50HP;absorb unit Prior to per-nit Meiling Address �r >1.75 mil BTU 1 60.15 _ issuance,a copy �;2`/ L' CS` 11 Air handling unit to 10,000 CFM of all licenses cytl34tate Zip Phone are required 9 - 72, 7. 12)Air handling unit 10,000 CFM+ expired in COT Oregon Const.Cont.Board Llo.rr Exp.Pate 11.75 database J.rr.3 S oo 13)Non-portable evaporate cooler Architect Name 7.00 14)Vent fan connected to a single dud Or Melling Address 4.75 15)Ventilation system n,,i incfuaed in a liance permii 7.00 Engineer Cayrstate Zip I Phone 16)Hood served by mechanical exhaust 7.00 Describe work to be done 17)Domestic Incinerators _ 12_n0 _ New O Repair O Replace with like kind Yes)(No O 18)Commercial or industrial type incinerator ResjdPntiaK commercial 4840 19)Repair units Additional infoetion or descri ..uu of work: 11 ,! 8_40 p �'' f _ � 4t ��- 20) �.- - Wood stove/gas Pother units/clothe dryer/etc.Lu t� 4-4.J lrn or 7.00+1J - NOT or Commercial projetts only;Units over 400 lbs require 21)Gas piping one to four outlets structural gas calcs. See footnote 1 3.75 3 — -- __ Type of fuel. oil O natural ga L.PG O electric O 27_)More than 4-per Feu$et.each) 75 _ Minimum Permit Fee 550.00 SUBTOTAL I hereby acknowledge that I have read this application,that ' ^information c �e TOo SURCHARGE given is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL the owner,that plans submitted are In compliance with Oregon State laws Required for ALL commercial permits onl TOTAL Signature of Owner/Agent Date -y. j,F, C/' le-0/ Other Inspections and Fees: lr 7- c, / K 1. Inspections outside of normal business hours(mininum charge-two "J� Sv Contact Persen me Phone hour-,) $50.00 per hour J �� 2. Inspections for which no fee Is specifically Indicated (minimum �` CJ charge-half hour) $50.00 per hour Foonotes for com ictal projects only: 3. Additional plan review required by changes,additions or revisions to 1. Provide full.schematic of existing and proposed gas line and pressure. plans(minimum charge-one-half hour)$50.00 per hour ;,W'30 2. Provide drawings to scale showing existing and proposed mechanical units. 'State Contractor Boiler Certification required — "Residential A/C requires site plan showing placement of unit 1:lmechperm.doc rev 02/4/99 t t r _ + iT41 W / y� / I1t1 1-1 . , h144) CITY OF I'C A R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2001-00171 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/25/01 SITE ADDRESS: 10965 SW ERROL. ST PARCEL: 2S103AA-01000 SUBDtVISIVN: LCHO HEIGHTS ZONING: R-4.5 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE UISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Install one sink, one dishwasher, one ice maker/water line Owner: FEES-- — Type By Date Amount Receipt I_EHMAN, DONALD A + KATHLEEN M pRMT CTR 4/25/01 $49.80 27200100000 TIGARU, ORR 9 972 10965 SW 72233OL 5PCT CTR 4/25/01 $3.99 27200100000 Total $53.79 Phone 1: Contractor: iWNER REQUIRED INSPECTIONS Phone 1: Water Line Insp Rough-in Insp Reg #: Top-out Insp Final Inspection This permit is issued subject to the regulations contained in the Tigard MLW.icipal 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 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: Permittee Signature: L�y i Calf (50 1) 639-4175 by 7:00 P.M. for an inspection needed the ne "mess day Plumbing Permit Application Date received: .. D Permit no.: 60/ City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Hlvd,'I i}tad,OR 97223 — City of Tigard Phone: (503) 6394171 Projecl/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: case file nu.: Payment type: t 41 &2 family dwelling or accessary U('ununcrcrll/indutiuial U Multi-fanuly U'lenant iniprovenu'nt U New construction U Add iIiotdalteratiin/re place men t U Foal service U()Iher: _ t ' (for special Information use checklist) - Description (tt hee(ea-) 'Total Job address: it? S,y6S (.(/ G/ — Nety 1-and 2-family dwellings only: Bldg.no.: Suite no.: (Includes 100 ft.for each Wilily connection) 'fax map/tax lot/account no.: SFR(1)bath Lot: Block: Subdivision: SFR(2)bath ---- - - --- Project name: �N/Yi?� L _ SFR(3)bath City/county: ZIP: _ Each additional hath/kitchen Description and location of work on premises: Site utilities: ZLV LLL /C.7TCP6 (/ S21V1(' 4 UZSIjW/ENFI�_ Catch basin/area drain Est.date of completion/inspection: ,7 tm"T U( Drywells/leach line/trench drain Footing drain(no.lin. ft.) PLUMBING t Manufactured home utilities Business name: Manholes Address: Rain drain connector City: State: ZIP: Sanitary sewer(no.lin.ft.) ` Phone: Fax: E-mail: Storm sewer(no.lin.ft.) CCB no,: Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: Fixture or them: Contractor's representative signature: Absorption valve _— --7D;11(, —_— !Jack flow reventcr _ Print name: n tt+' Backwater valve Basinstlavato Name Clothes washer _ -- - - - Dishwasher Address: Drinking fountain(s) City: -( /lp: _ Ejectomisump Phone: Fay: 1{ m;iiL Expansion tank Fixture/sewer cap _ Narne(print): Dv,, L N hAl Moor drains/floor sinks/hub Mailing address: 65'S �� - �� Garbage disposal Hose hibb City: zG/jr b Slate:Pf2 ZIP: r Ice maker - Phone: I 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 )rope y ow Ixr ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's si nalt:r ( -� Date: Sump Tubs/shower/shower pan Urinal _ Name_ Water closet Address: _ _— Water heater City: _ State ZIP__ _ Other- Phone: — Phone: Fax: E-mail: Tota Nd dl jus"cti_w.cept crettir cards,rdewre calf jutirdicNae rex mac ird+xmarionMinimum fee................ Notice:This permit application Plan review(al 96) � U Visa _U MasterCard expires if a permit is not obtained — ('"(card number within I80 days after it has been State surcharge(8%)....$ E.cpiret der u dawn qt t cud _.— accepted as complete. TOTAL .......................$ Nrtme e>< _ S _ CtrdbeAdet signature Amount 1141616(MOCOM) Plumbing Permit Application Date received: Permit no.: City of Tigard -- —Address: 13125 SW Hall Blvd,'1'tgard,OR 97223 Sewer permit no.: Building permit no.: -- City ojTigard phone: (503)639-4171 Project/appl no.: Expire date: Fax: (503) 598-1960 Date issued: By: I Receipt no.: Land use approval: Case file.no.: Paymenttype: U I &2 family dwelling or accessory U Contmercial/industrial U Multi-family U Tenant improvement U New constriction U Addilion/alteration/replacemenl U Food service U OthcI: .1011 SUIT INFORM.%][ON 114,11. S( I I IA)l J,l�(1,4;r%peelal inforiomion ti%e checklim) Job address:%!` ( a Description Qt Fee(ea.) Total Bldg.no.: Suite no.: Ness I-and 2-family dwellings only: Tax n /tax lot/accounl no.: (includes 100 .for each utility connection) P _ SFR(1)bath _ Lot: Block: I Subdivision: SFR(2)bath Project name: f SFR(3)bath _ C4yii,ounty: I ZIP: Each additional hath/kitchen Description and location of work on premises: Siteutilities: 6 11 _ Catch basin/area drain - Est.date of completion/inspection: Drywells/leach line/bench drain Footing drain(no. lin. ft.) _ Manufactured home utilities Business name: _ �� ' /?l 1 / -__ Manholes Address: Rain drain connector City: State: ZIP: Sanitary sewer(no.lin.ft.) _ Phone: E-mail: Storm sewer(no.lin.ft.) _ CCB no.: Plumb.bus.reg,no: Water service(no.lin.ft.) Fax: City/metro lie..no.: --' Fixture or kern: Contractor's representative signature: �- Absorption valve ---_ Back flow preventer Print name: Backwater valve - - --— Basins/lavatory _Name: Clothes washer - ---- - - - -- Dishwasher Address: Drinking fountain(s) City: —~ � State: -7_IP: _-- -_ - -_ Ejectors/sump Phone: Fax: Email: Expansion tank Fixturelsewer cap_ Name(print): Floor drains/hc:.. aitrks/hub - Mailing address: Garbage disposal 1 -- Hose bibb City: - _ State: 'LIP: - Ice maker Phone; Fa;.: TE-mail Interceptor/grease trap_ _ ^...ner installation/residential maintenance only: The actual installation Primer(s) _ .ill 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),lays(s) _ Owner's signature: Date: Sump _ Tubs/shower/shower pan _ Urinal Name: -p�_-- Water closet Address: ate- heater _ City: State: ZIP: Other: Phone: Fax: E-mail: o Nat all juris&cn at accept credit c.r&,please call jurisdiction for morr inform'timNotice:This permit application Minimum fee................$ U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit card nurntm: LL within Igo days after it has been State surcharge(8%)....$ Name d cardholder u shown on credit card --- accepted as complete. TOTAL. .......................$ -- -- S Cardholder sigwure Annxtnt-- 4144616(60"M) PLUMBING PERMIT FEES: PRICE TOTAL Now 1 and 2-family 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 rrtillty connection - _ ry _ One 1 bath _ 3249.2 0 _ 1 ub or Tuh/Shower Comb 16.60 Two 2'bath $350.00 Shower Only - 1660 Three3 bath _- $399.00 Water Closet 1660 vSUBTOTAL _ ^ Urinal _� 16.60 _ 8%STATE SURCHARGE Dishwasher^- 16.60 ,(` PLAN REVIEW 25%OF SUBTOTAL_ Garbage Disposal 1660 _. TOTAL Laundry Tray _ 16.60- Washing Machine y 16.60 Floor Drain/Floor Sink 2" i 16.60 3:--- - 1660 -- PLEASE COMPLETE: 4" — 16.60 Water Healer O conversion O like kind 16.60 uantl',y by Work Performed Gas piping requires a separate mechaniczl Fixture Type: New Moved Replaced Removed/ ermit. _ Capped MFG Home New Water Service - 46.40 Sink MFG Home New San/Storm Sewer 46.40 — Lavata-_i _ Tub or Tub/Shower Hose Bibs ?6.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16-60-- Water Closet Urinal - Other Fixtures(Specify) 16.60 Dishwasher Garbage Disposal - - — Laundry Room Tray -- - Washing Machine Floor Drain/Sink: 2" Se ver-1 sl 00' 55.00 - 3" -- Sewer-each additional 100' 46.40 4" Water—Service. 1st 100' -^ 5500 Water Healer Water Service• each additional 200' 46.40 1,ther Fixtures (Specify) Storm&Rain Drain-1st 100' `5.00 Storm&Rain Drain-each additional 100' 4640 — - Commercial Back Flow Prevention Device 46.40 - -- - -- Rosidential Backflow Prevention Device' 27.55 -- Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72,50 Re uested Inspectionse' r/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Greasr�Traps - 16.60 -- --------- QUANTITY TOTAL - I'ometdc or riser diagram is required If — Ouanlity Tnlal is -9 _ —— -- 'SUBTOTAL ------ / 8%STATE SURCHARGE - -- "PLAN REVIEW 25%OF SUBTOTAL Required only it fixture gly total is>9 TOTAL Minimum permit fee is 172 50-8%stole surcharge,except Residential Backilow Prevention Device,which is$ae 25•8%stale surcharge "All New Commercial Buildings require plans with Isometric nr riser diagram and plan review i:Wsts\fomis\plm-fees.doc 10/10/00 CITY OF TIGARD MASTER PERMIT PERMIT! : MST2001-00240 DEVELOPMENT SERVICES DATE ISSUED: 1/25/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10965 SW ERR ST PARCEL: 2S103,6A-01000 SUBDIVISION: ECHO HEIGHTS ZONING: R-4.5 BLOCK: LOT: 005 JURISDICTION: TIG REMARKS: 96 s.f. Deck BUILDING REISSUE: STORIES _ FLOOR AREAS _ REQUIRED SETBACKS REQUIRED CLASS OF WORK: OTR HEIGHT: FIRST of BASEMENT: �of` LEFT: SMOKE DETECTORS, TYPE OF USE: SF FLOOR LOAD: SECOND: 96 of GARAGE: of FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: FINBSMF-NT: of RIGHT VALUE: $4,000 00 OCCUPANCY GRP: U2 BDRM: BATH: TOTAL: 96 00 of REAR: PLUMBING SINKS: 0 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 0 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: 1 USISHOWERS: GARBAGE DISP: WATER HEATERS. WATER LINES: BCKFLW PREVNTR: GREASE TRAPS. OTHER FIXTURES: MECHANICAL _ FUEL TYPES FURN<100K: BOIL/CMP<THP: VENT FANS- CLOTHES DRYER: FURN>000K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: blu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS. _ ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRvctrEFOERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 200 amp: 0 20n arnp: WIFVC OR FDR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 400 amp: 201 400 sing): 1st W/O SVCIFDR: SIGNIOUT LIN LT: PER HOUR. LIMITED ENERGY: 401 - 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT. MANII HM/SVC/FDR: 601 - 1000 amp. 601+amps-1000v: MINOR LABEL: 1000*amplvolt PLAN REV.EW SECTION _ Rocomrect only: —4 RES UNITS'. SVCIFDR>-225 A. >600 V NOMINAL: CLS AREA/SPC OCC: _ ELECrRICAL-RESTRICTED ENERGY _ A.SF RESIDENTIAL _ _ B.COMMERCIAL AUDIO 4 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: SURGI.AR ALARM: OTH: BOILER: HVAC. LANDSCAPEARRIG: PROTECTIVE SIGNL GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 199.1:. I_EHMAN,DONALD A +KATHLEEN M LH REMODELING This permit is subject to the regulations contained in the 10965 N, ARNOL ST LHR?442 MODELOUTHS LOPE INCI WAY Tigard Municipal Code.State of OR Specialty Codes and TIGARD,S OR OL WEST LINN,OR 97068 all other applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of Issuance,or if the work is suspended for more than 180 days ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utiliy Notification Center Those rules are set Req 0: LIC 110266 forth in OAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Footing Insp Framing Insp Final inspection Issued By : --1 =— -_ Permittee Signature Call (50f) 639-4175 by 7:00 p.m. for an inspection needed the next slness day Building Permit Application City of Tigard "Dateceived: /J Permitr� ' qg Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl,no.: Expire date: (� City of Tigard Phone: (503) 639.4171 Date issued: Bv: Receipt no.: Fax: (503) 598-1960 \ Case file no.: Payment type: � Land use approval: _ 1&2 family:Simple. Complex: FRM UI &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition ❑Addition/alteration/replacement U Tenant improvement U File sprinkler/alarm U Other: Job address: fQ1G":LSJV, E KuLJ a Lk Bldg.no.: suite no.: _ Lot: I Block: Subdivision: Tax map/tax lol/account no.: Project name: �,`Nl y9n," 13 MVDi L _ --- / 1 Description and location of work on premises/special cong iti9ns:��y l��i�x,. Ct;77t'�.�i.[�.+.� ,26rL � 14d l S ff J I«T/l MA WHI`l?N Mailing address: I Cc e;S:_S,W�ff a(/-(_ s 1, 1 &2 family dwelling: City G '1"'b Statc:C? 'ill' Valuation of work........................................ R Phone:,,sUu J41 IF= E-mail: No.of bedrooms/haths................................. Owner's representative:,L l r IY. NNYL Total number of floors................................. a !Gv-; "::.0 r i- v Fax: Email: New dwelling area(sq.ft) .......................... Garage/carport arca(sq.It.)......................... Name:/Ji. JfFl`1DlaE6ZA�G- i r covered porch area(sq.ft.) ......................... Mailing address: SLG'i'E l-T/7 Deck area(sq. ft.) ........................................ -- City:l&t-sr [Tt, (. state: JZIP: „ Other structure.area(sq. ft.)......................... Phone: :S`C% I ax: — I nulil --- - Commercla[/Indwit rial/multI-family: Valuation of work...................................... . $CON URAVFOR - --- T. Existing bldg.area(sq. fl.) .......................... Business naine: Li /��;' i, . , - K -- — -� New bldg.arca(sq.ft.)................................ Address: . f s, S 't {� — - i cT ti State: C'' ZIP: y 6� Number of stories........................................ City: 1-YPe of construction.................................... __------- Phone:(� i• S`{, Fax:fo U /(f E-mail: Occupancy group(s): Existing: CCBno.: C2.6( New: ------ City/metro lie.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address:— jurisdiction where work is being performed.if tLe applicant is Cit State: ZII': exempt from licensing,the following reason applies: Contact person: Plan no.: --- Phone: I F-mail -- Name: ('lmlact 1>Lrsun: tees duc upon application ........................... $ _ Address: Date received: City: _ State: ZIP: Amount received ......................................... $ Phone: Fax: — E-mail: _ Please refer to fce schedule. hereby certify I have read and examined this application and die Not all Juriodlctiom accept credit ends,please call Jurie6ction for nincr informati"a. attached checklist.All provisions of laws and ordinances governing this Oviaa OMmterCard work will be complied lith,whethe sinified herein or not. Credit cord nnmher E _�— xp m� Authorized signature:-G C l ' t ' Date: Name nt cudholder u shown on credit card l S Print name: �-// q U - — Y Crdholder sipwlre ---- - Arxwo Notice:This permit application expires if a permit is not obtained within 180 days after it hes been accepted as complete. 44DA13(60DC OM) One-and'fwo-Family Dwelling o.:ONMINJ Building Permit Application Checklist Associate pe --'� -- '— Associated permits: City of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW hall Blvd,Tigard,OI? '17.'.2{ U Other: Phone: (503) 639-4171 Fax: (503) 598-1960 1 Land use actions completed.See jurisdiction critetta Ian concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic disrrict,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 Solis 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 3 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 fo scale.The plan must show lot and building setback dimensions;properly corner elevations(if there is more than a 44 clevatit ,differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;fo otprint of structure(' eluding decks);location of wells/septic systems;utility locations;direction indicator;lot _area;building coverage area;per -ntage of coverage;impervious arca;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 Iutation. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,pl mbing fixtures,balconies and decks 30 inches above grade,etc. _ 14 Cross sedion(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 n of sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. I T Elevation views.Provide elevations for new construction-,minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references an:acceptable. _ 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriplive path analysis provide specifications and calculations to engineering standards. _ 17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered systems,see item 2.2,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any bcam/joist carrying a non-uniform load. 20 Manufactured floortro_of truss design details. 21 Enemy 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 licenseo.,,Oregon and shall be shown to be applicable to the project under review. 23 hive(5)site plans are required for Item I I above. Site plans must be 8-1/2"x 11"or I I" x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. _ 26 No rolled,reversed or mirrored building plans will be accepted. 27 — --- - - 28 _ Checklist must be completed before plan review start date. Minor changes or notes on submitted plans ma} he in blue or black ink. Red ink is reserved for department use only. 440-4614(6AQR'OM) Electrical Permit Application rl)ater�eceivixl: Permit no.: City of Tigard Project/app1.no.: Expire date: CII v,,t f,,!,,,,/ Address: 13125 SW Nall 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: t�l &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteratiott/rcplacement U Other: U Partial Joh address: C 96 S, S, W ti Bldg.no.: I Suite no. ITax map/tax lot/account no.: Lot: Block: Subdivision: Project name: L ,4k' Description and location of work on premises: Estimated date of cora letion/inspection: �Iwat Job no: Fee Mat — Business name:�0�9 --— Description Qty. (ea.) Total no.insp L L SS C FC Td>'� Ne"residential-singe orm+dti-family per Address: d++cIli ngunit.Includes anachedgarage. City; 7' 'C' State: I ZIP: Scntceinclude4l: Phone: Pax: E-mail: lax)sq.ft.or less CCB no.: (' r Elec.bus.lic.no: 11 Each additional 500 sq.ft.or portion thereof' Limited energy,residential 2 City/metro lic.no.: Limited energy,non-residential 2 Each manufactured home or modular dwelling Signature of supervising electrician i n yul ) Date Service and/or feeder _ 2 Sup.elect.name(print): „,silt.,,,, Services or feeders-installation, alteration or relocation: PROPERIN OWNER 201 amps or less 2 Name(print): C�( L- ti 201 amps to 400 amps — 2 401 amps to Mailing address: K" IO - Wam00 s 2 — _ � — 601 amps to (11)U amps _ 2 City: Ti(;, Slate: ZIP: Over IW)amps or volts 2 Phone: 1 1 Fax: I E-mail: Reccamc�t only I Owner Installation:The installation is being made on property 1 own Ternponryservices orfeeders- which is not intended for sale. lease,rent,or exchange according to Installation,alteration,or relocation: 201 amps or less ORS 447,455,479,670,701. _ 2 20!amps to 400 amps 2 Owner's signature: _ _ Date: _ toii,�wx)am s 2 Branch circuits-new,alteration, .'r extension per panel: Na A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: Y State: ZIP: B. Fee for branch circuits without purchase —— of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: 2 Misc.(Service or feeder not Included): U Service over 225 amps-conmrerciat U Health-care facility Each pump or nrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous location Fach sign or outline lighting 2 familydwellinga U Building over 10.000 square acct kmrar Signal circuitls)or a limited energy panel, U System over 6110 volts rwntlnal nmre residential wits in one structure alteration,or extension* _ 2 O Building over three stories U Feeders,400 argq or more *Description: U Occupant load over 99 persons U Manufactured structures or RV park Each additional Napectlon over the allowable In any of the above: U Egresa/lighungplan U Other' — Per inspection F Submit_i sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Nat all jurisdictimm accept credit cardsm ,please call ludsdiction fm more infarui„n. Notice:This permit application Permit fee.... ............$ Na U visa U MasterCard expires if a permit is not obtained Plan review(al _ %) 1± c•rerht card numb", ______ —__ _. / _._.1 within 180 days after it has be^.n State surcharge(8%)....$ Fxpires accepted as complete. TOTAL ....................... Name of cardholder n shown an credit cod S - --- Cardholder signature - --- Amount 440.461516MUCOMt Electrical Permit Fees: Limited Energy Fees: - _ TYPE OF WORK INVOLVED •RESIDENTIAL ONLY Complete Fee Schedule Below: —Restricted Ener---- �- —--� gy Fee................................. ........... ........ $75.00 Number of Inspections per permit allowed (FOR 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 fl.or portion thereof —_ _ $33.40 —_ 1 Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ( Garage Door Opener" Dwell; ,1 Service or Feeder $90.90 Services or Feeders Heatin(j,Ven4lation and Ar Conditionmy System' Installation,alteration,or relocation 200 amps or less $8030 — 2 I l Vacurnn Systems" 201 amps to 400 amps _ $106.85 —� 2 r -! 401 amps to 600 amps $16060 2 1 --- (Ther 601 amps to 1000 amps $240.60 2 Over 1000 amps or volts —__— $45465 2 Reconnect only _ $66.85 — 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system................ ........................................ $75.00 Installation,alteration,or relocation 200 amps or less _ $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps __ $1U0.30_ 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 ❑ Boilor Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of serv/cr or Clock Systems feeder fee. Each branch circuit $6 55 2 Data Telecommunication Installation b)The fee for brae 1h circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46 85 ❑ HVAC Each additional branch circuit $665 Miscellaneous Instrumentation (Service or feeder nor included) Each pump or irrigation circle _ $534, _ Intercom and Paging Systems Each sign or outline lighting $5340 Signal cirouit(s)or a limited energy panel,al!eralion or extension _ $7500 Landscape Irrigation Control' Minor Labels(10) — $12500 r� Medical additional Inspection over LJ the allowable In any of the above �] Nurse Calls Per inspection _ _T $6250 Por hour _ _ _ $6250 _ ❑ In Plant _ f $73 75 _ _ ^_ Outdoor Landscape Lighting' Fees: n Protective Signaling Enter total of above fees $ CJ Other 8°i state Surcharge $ ---- _-Number of Systems 25%Plan Review Fee No licenses are required Licenses are required for all other installations Sea"Plan Review"section on $ front of application _ .__ — - Fees: Total Balance nue ------- - Enter total of above fees $—_ E] 1rust Account ft 8%Stale Surcharge s Total Balance Due $`-- -- 0dsts\1[orms\elc-fees.dcc 10/09/00 R P. 02 Gc)�. C7 Ij.H.. REMODELING, INC. 2442 Southsiope Way LARRY G. HAROUN WesL Linn, Or. 97069 GENERAL CONTRACTOR (503) 650 -9568 CUSTOM REMODELS (503) 323--5145 Dig. Pgr. OR. LIC. #110266 (503) 650-1066 Fax DATE : :S� J) mo��i -.7 -0 < m zs � � T8 x rl v Q I M a1 a , � M b All i M Y3 j ± it -IYK- 177-b 1 1 Hu W r :t) r AM _ P. 03 L.FI. REMODELING, INC. 2442 southslope Way LARRY G. HAROUN West Linn., Or. 97068 GENERAL CONTRACTOR (503) 650-9568 CUSTOM REMODELS (503) 323-5145 Dig_ Pgr. OR. LIC. #110266 (503) 650-1066 Fax DATE . ��I7'a� 'SIS.�sXr iM I X �v � S oq ,, ._- ---- --of N d 7)aI $ n n, n V ��3 APR--19--01 THU 07 :57 AM P. 04 �� vD/ � fl�i�9•a L.H. REMODELING, l-- 2442 Southalope Way LARRY G. RAROUN West Linn, Or. 97068 GENERAL CONTRACTOR (503) 650-9566 CUSTOM REMODELS (503) 323-5145 Dig , Pgr. � OR. LIC. #110266 (503) 650-1066 Fax I DATE : II Q t-lv -� -r s x k 71g i I k QQ11 z I - I �C X n I� - o t �v a 19 b v ti