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11075 SW ERROL STREET Q 4 0 m X O cn r i m 1107 SW ERROL ST. -- CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)630-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP Received Date Requested----,---/ AM--- PM_ _ __ BUP Location __ 1 D :7 Suite _ MEG Contact Pe,son 17 � — Ph(--) _3 L/ g �_-� �PLM Contractor rl�' ' E;[" ,(£L .. Ph(_Z3) � --L� SWR BUILDING Tenam'Owner ELC _ Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain - - Slab Inspection Notes: 74'���� d. SIT _ Post&Beam T, Shear A,ichurs -- Ext Sheath/Shear Int Sheath/Shoar - Framing Insulation Drywall Nailing ---- - -- -- Firewall Fire Sprinkler - - - -- Fire Alarm Susp'd Ceiling n-�- -- - -- Roof Other: Final - PASS PART FAIL - -- -- --� PLUMBING Post 8.Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains --- - --- Catch Basin/Manhole Storm Drain - -- - Shower Pan Other: - ----- ------ Final -..----_------------ PASS PART__FAIL --- ^ - -- -- MECHANICAL _ Post&Ream Rough-In --- -- ------____-- ---.-- - Gas Line Smoke Dampers -- ------ -- Final PASS PART FAIL. -- --- - - - ELECTWCAL Service � __ --- ---- ----- ---- ----- --- Rough-In UG/Slab Low Voltage - Fire Alarm final > PART FAIL Reinspection fee of$ required before next InspPcction. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinspection RE: Unable to it_ -no access Fire Supply Line _ ADA \ + Approach/Sidewalk Daft inspoetor l -Ext---- Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-"171 BUP Received Date Requested U _ AN1 PM BUP Location A t;Z Suite— MEC — Contact Person -�A'Yl� Ph( ) _LQ_�O�5 PLM Contractor — Ph( ) SWR BUILDING _ Tenant/Owner ELC — Footirg ELC _ Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT _ Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler --- Fire Alarm Susp'd Ceiling - -- - - Roof Other: -- Final � �- PASS PART_ FAIL -"- - --`- PLUMDING — Post&Beam - — --_-—� -� - - — Under Slab Rough-In Water Service ----- - _ Sanitary Sewer Rain Drains - - ---- - - Catch Basin/Manhold Storm Drain -- - -- --- Shower Pan Other: __- --_-- -- PART FAIL ---- -"- _—`- — _MECHANICAL Post&Beam �- Rough-In Gas Line Smoke Dampers - ---- ---- —�-. Final PASS PART FAIL ELECTRICAL Service - --- -- — - Rough-In Low Voltage - Fire Alarm Final El Reins on fee of$ required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd. PASS PART FAIL Sh-E -- [] Please call for reinspection RE:_ I Inable to Inspect no access Fire Supply Line A ADA Approach/Sidewalk Dab- _ lntita�ctor - Ext Other: Final DO NOT REMOVE this Inspoal record holm this fob oto. PASS PART FAIL CITY OF TIGAIRD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Requested �� U AM PM P BU 7 — Loczwon _ r 5– C Suite MEC p Contact Person — � _ Ph(__._} b 5 PLM Contractor—� _ Ph( _) SWR BUILCIN_G Tenant/Owner _ _ ELC Footing - ELC Foundation Access: - Ftg Drain I_LR Crawl Drain Slab Inspection Notes: IT _ Post&Beam _ Shear Anchors Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywall Nailing - - Firewall Fire Sprinkler - -- -- Fire Alarm Susp'd Ceiling - - --- Roof Other: Final PASS PART FAIL -�- PLIIMBING Pust& Beam - -- -- - -- --_ -__.- Under Slab Rough-In Water Service - Sanitary Sewer Rain Drains - -- ------- -- Catch Basin/Manhole Storm Drain -- -- --- - - Shower Pan Other: _ --- - - - 499 PART FAIL - MEC%IANICAL Past&Beam T. - - ----Rough-In Gas Line Smoke Dampers -- - - Finnl PASS PART FAIL - - - -------- ELECTRICAL _ Service -" - Rough-In UG/Slab - ---` Low Voltage Fire Alarm Final L] Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hail Blvd. PASS PART FAIL SITZ: ❑ Pl,ase call for reinspection RE: E1 Unable to inspect-no access Fire Supply Line ADA n Approach/Sidewalk Other: Final v -- I NOT REMOVE this inspo i lon r000rd freer tho JO aft, PASS PART -AIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST " INSPECTION DIVISION Business Line: (503)639-4M-7 BUP Received [)ate Requested. l f _AM PM BUP Location Suite_ F _— MEC Contact Person Ph(—) PLM Contractor__ _ Ph( ) SWR _ BUILDING Tenant/Owner ELC _ Footing ELC _ Foundation Access: Drain ft'6j--" c� �;; !� ELR C;awl Drain Slab Inspection Notes: JkLa �. SIT Oost&Beam — Shear Anchors Lt 'S 4-- Ext . Ext Sheath/Shear Int Sheath/Shear �) Framing l.7 InsulationZ- f_e ! ' Drywall Nailing Firewall �� r /�/e� &l Fire Sprinkler Fire Alarm �d� T��✓ r Susp'd Ceiling Roof Ot er:PASS >c a PART AI PLUMBING Post&Beam Under Slab Rough-In Water Service - -- — Sanitary Sewer Rain Drains --- -- Catch Basio/Manhole Storm Drain --- - -- -- - Shower Pan Final ---�---�---- PASS PART FAIL — -- MECHANICAL Post&Beam Rough-In Gas Line Smoke Dampers - ----- S PART_ FAIL -- --- --- -- EL CTRICA_i Service Rough-In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$. required before next inspection. Pay at City Hall, 13125 SN!Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: _ Q Unable to Inspect-no access Fire Supply Line ADA 1 m Approach/Sidewalk Date— Inspector Ext Other: Final --— DO NOT RKMOVE this Inspection record from the job alto. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST 0 a 3 ! r INSPECT;CN DIVISION-TIytA; Business Line: (503)630-4171 — m / BUP Received — 3 ( P� Date Requested AM _ PM_ BUP Location ._ _ 7 S Suite — MEC Contact Person — Ph(_ ) _ PLM Contractor _ — Ph(--_) _ SWR BUILDING Tenant/Owner ELC _ FootingIQ - O ".LC Foundation Access: -- Fog Drl.In ELR __— Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing _LrSLV ^o l ✓Zi1.�p s✓�5, <'en�S< <:'1�r Insulation Drywall r- DrywallNailing Firewall Fire Sprinkler -- -- Fire Alarm Susp'd Ceiling �— Root Other: - i _ ASS) PART FAIL_ FIMBING _ D,L - .- fir' lid'7'-- Post Post&Beam Under Slab -- -------------- -- Rough-In Water Service ------- Sanitary Sewer Rain Drains -------- — — - --- — Catch Basin/Manhole Storm Drain -- ------ — Shower Pan Other- Final therFinal — PASS PART FAIL -- - -�---- - -- - - MECHANICAL — Post& Beam Rough-In ------ -------- - Gas Line Smoke Dampers --- -- Final PASS PART FAIL — - — ELECTRtC,ZL Service - _— ----------- -- - - - Rough-In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspectbn fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ ❑ Please call for reinspection RE: _ ❑ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Dab ' G 4-� ____ Inapaetor — Ext_ Other: Final _ 00 NOT REMOVE this Inspoction mord Froin tho fob eke. PASS PART FAIL CITY OF TIGARD TEMPORARY CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PERMIT ISSUED: ?!!,�-eZ PARCEL: ag/0:3/K-0 21602) ZONING: R. ' 5 JURISDICTION: -n61/41L/) SITE ADDRESS: �Q����`114 16;r,-D I`�-T SUBDIVISION: BLOCK: LOT: CLASS OF WORK:`! � ' TYPE OF USE: OCCUPANCY GRP. tQ '7j OCCUPANCY LOAD: TENANT NAME: REMARKS: TEMPORARY OCCUPANCY FOR DAYS FROM /" 3 Owner: 5af.yz- Phone: .07 - 310 - 7 7lj Contractor: lntyIlli'kl `Any 600 Phone: Reg #: lj7g 7j i It is understood by the owner/tenant that the issuance of this Temporary Occupancy Permit by the City of Tigard for the use and/or occupancy of the structure located at the site address listed above(hereinafter"structure"),does not grant orconvey to the owner or tenant any property right or other protectible property Interest in the use and/or occupancy of the structure forany purpose. It is further understood that this Temporary Occupancy Permit shall only be valid for the number of days frem date of issuance listed above and that the owner/tenant will no longer be authorized to occupy the structure after the period sperified,unless and until all the conditions of approval Imposed under the City's or County's Notice of Decision for the project's land use case(s)Issued by the City's Development Services Department or the County's Department of Land Use and Transportation and/or the Clean Water Services and all building and related code requirements and any other applicable requirements h e been com letely fulflllea and complied with to the Citv's or C�'s satisfactlo 1 7 BUILDING INSPEC OR BUILDIRd OFFICIAL a POST IN CONSPICUOUS PLACE DEC-19-2072 04 : 14 PM JAMESGRIFFITHSEXC 503 263 174" James Griffiths Excavating, Inc. Invoice dAa. Griff'a Sepur S> Mce ---- PU Box 1136 OATS —� INVOICE 0 Canby, OR 97013 I2118n002 — lgoe`^ 503-263-9038 503-263-1743 Fax BILL TO JOB NAME I ADORE 88 R J. STEVENSON CONSTRUCTION 11073 SW ERROL ST 1297)SW 22ND 713ARD,OR LAKE OSWEGO,OR 971 034 I P,O,NUMBER TERMS TOLEPHONE A CCM DECK Dere Upon CompletionISOUEDIATE 02 2434694 104320 37164 ---- - --— - - - DESCRIPTION AMOUNT —� i PUMPEA SEPTIC TANK FOR ABANDONMENT 200.00 PAID IN FULL BY CHECK 02266 i I t,�cl t , I �ii,i Ni YOC FOR YOUR BUSINESS. Total :wo "A service charp of 1 1%will be laviad on all put dun+invoices •Reumned chock tee to Stn 00 "to case suit,Action or arbitnition is inatintted by either part fcrr breach or to enfbrce any provision heroin,the ooun shell award reasonable attorney fees and actual costs to the r vailrng party at trial or arbibrabon,or upon any appeal takan chert fbm. CITY OF TIGA,RD 24-Hour BUiLDING Inspection Line: (503)639-4175 MST INSPECTION UIVISION Business Jne: (503)639-4171 BLIP — Received --Date Requested AM—_. ----- 3UP Location / 7_ r'Zt::7 Suite MEC Contact Person �- r -- Ph( --) ? PLM .,22 d� o Contractor _ — __-- Ph(_--) — SWR ---- _ BUILDING TPnanVOwner .___ — ELC Footing ELC -- Foundation Access: Ftg Drain ELR Crawl Drain SIT Slab Inspection Notes: Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- -- -- Insulation , Drywall Nailing - Firewall Fire Sprinkler -- -- - Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL — — _PLUMBING —_--_ — Post&Beam Under Slab — -- Rough-In Water Service -- — Sanitary Sewer Rain Drains — ----�— Catch Basin/Manhole Storm Drain Shower Pan (ow_hF ii - — - -- -- PAS PART FAIL _ _ANI CAL Post&Beam --__ Rough-In Gas Line Sm(ke Dampers ------ Final PASS PART FAIL ELECTRICAI.– Service Rough-In UG/Slab Low Voltage — — Fire Alarm Final LJ Reinspection fee of$ requirad before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SITE _ r] Please call for reinspec'on RE: Unable to inspect-no access Fire Supply—Lin-13-- ADA ino n /` � ) ADA Deft j I �!J /i-- Inspector � �t— Approach/Sidewalk -- Other:----.--_--_ Final ID NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY of T IGARDDL:JMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00483 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1216/02 PARCEL.: 2 S 103AC-02800 SITEADDRESS: 11075 SW ERROL :iT SUBDIVISION: ECHO HEIGHTS ZONING: R-4.5 BLOCK: LOT: PT .JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW 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: TUBISHOWERS: SEWER LINE: 80 ft WATER CLOSE i S: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of approximanely 80 feet of sewer line tc connect to sewer lateral Septic tank is to be pumped, filled and inspected. Reimbursement district fee previously paid. FEES � Owner: -`---' Description Date Amount PIERCE, DARE<FN F +AMY J 11075 SW ERROL ST II'LUMBI I'ernit Fee 12/16/02 $72.50 TIGARD, OR 97223 (TAXI8%State Tax_ 12/16/02 _ $5.80 Total $78.30 Phone Contractor: R.J. STEVENSON CONST. 12820 SW 22 LAKE OSWEGO, OR 97034 REQUIRED INSPECTIONS Phone : 503-245-8694 Sewer Inspection Misc. Inspection Reg#: LIQ' 56228 Final Inspection This permit is issued subject to the regulations contained in the Tigard Wnicipal 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 Issued By: LA -�c�7r Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next businAss day Plumhini! Permit Aim>lication ' -�� Received Plumbing Date/By: Permit No.?!-en,iJOa Planning Approval Sewer City of Figatrd Test Form Date/By: Permit No.:SL0�a 00 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date!D : Permit No.: Phone: 503-639AI71 Fax: 503-598-1960 Post-Revicw Land Use Date,D . Case No.: Internet: Llk Contact Juris.: ID See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: I Supplemental Information. TYPE OF WORK _ FEE*SCHEDULE(forspecial Information use checklist) New constructionDemolition Description Qty. Fee(ea.) Total Addition/alteration/re lacement Other New 1-&2-family dwellings CATEGORY OF CONS-- N (Includes 11111 ft.for each unlit connection) SFR I bath 249.20 1 &2-Family dwelling- Commercial/Industrial SFR 2 bath 350.00 Accessory BuildingMulti-Family SFR 3 bath 399.00 Master Builder Other: Each additional bath/kitchen 45.00 JOD SITE.I FORMATION and LOCATION Firesprinkler-sq. fl.: Pape 2 Job site address: J o'SVS L Site Utilities Suite#: Bldg./Apt.#: Catch basin/area drain 16.60 D wrell/lench line/trench drain 16.60 Project Name: Footing drain no.linear ft. 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 R. r7 Page 2 Subdivisic n: _ Lot#: Storm sewer no.linear ft. Page 2 Tax map/] .reel#: Water service no.linear ft. Page 2 Fixture or Item _ DESCRIPTION OF J ORK Absorption valve 16.60 _ &&o ate �C (9+ti Backflow prevcntcr Page 2 Backwater valve _ 16.60 - Clothes washer 16.60 -- Dishwasher _ 16.60 _ Drinking fountain 16.60 PROPERTY O NER ENANT Ejectors/sump I6.60 Name: t Expansion tank 16.60 Address: Fixture/sewer cap 16.60 City/State/Zip: Floor drain/floor sinkihub 16.60 Garbage disposal 16.60 Phone: Fax: Flose bib 16.60 APPLICANT Y CONTACT PERSON Ice maker 16.60 Name- _ Interco tor/ rcase trap 16.60 Addn;ss: Medical gas-value: $ _ P .2 _ Cit /State/Zi Primer 16.60 �_ --------- Roof drain commercia; 16.60 Phone: FaX: _ Sink/basin/lavato _ 16.60 E-mail: Tub/shower/shower an _ 16.60 _ CONTRACTOR Urinal 16..,J Business Name: -(k)-4%1L V-VA t Water closet 16.60 v- Water heater 16.60 Address: tW_ 3 Other: Cit /State/Zi .L Other: Phone: S= Fax: 3 U -y0 4.3 Plumbing Permit Fees* CCB Lic. #: ST1'd Plumb. Lic.#: subtotal 5 Minimum Permit Fee$72.50 5 D Authorized �-I Residential Backflow Minimum Fee 536.25 2 �;V Signature: / ' �� Plan Review 25"6 of Permit Fee) 5 B ate: State Surcharge 8%of Permit Fec 5 47- TOTAL TOTAL PERMIT FEE 5 _ (Please print name) Notice: This permit application expires If a permit Is not obtained within All new Commercial building require 2 sets of plans with Isometric or 180 days after It has been accepted as complete.•Fee methodology set by Tri-County Building Industry Service aoard. riser diagram for plan review. Plumbine Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule. Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing dram-1"100' 55.00 0 to 2,000___ $115.00 2.001 to 3,600 $1%00 Footing drain-each additional 100' 46.40 3,601 to 7,200 $220.00 Sewer-1 st 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 Fee: Stnmi&Rain Drain-Ist 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Ram Drain-each additional 100' 46.40 $5,001.00 to$10.p00.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and Fixture or Item Qty. Fee(ea) Total including$10,(M.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to$25,000.00 $148,50 for the first$10,000.00 and$1.54 for each additional$100.00 or fraction thereof,to Residential Backflow Prevention Dev'^c and including000.00. minimum permit fee$36.25 27.55 _ $25 Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or —� and including$50,000.00. specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping,mav'^n or replacing existing fixtures? If "yes",please indicate • k performed by fixture. iiallure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Work Performed Comments regarding fixture work: Fixture Type: Replace - Ncw Moved Exbtin C cd Baptistry/Font _ -- Bath -1 uh/Shower -Jacuzzi/Whirl ool ,at Wash -Each Stall -- -Drive Thru _ Cuspidor/Water Aspirator Dishwasher -Commercial - -Domestic Drinking Fountain _Eye Wash Floor Drain/sink -2" 3.. .4" Car Wash Drain *Note: If lite fixture work under this permit results in an Garbage -Romestic increase of sewer EUUs,a sewer permit will be issued and Disposal -Commercial -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 -Gi'ng -Stall Sink -Bar/lavatory -Bradley -Commercial -Service Swimming Pool Filter _ Washer-Clothes Water Extractor Water Closet_Toilet Urinal Other Fixtures: / CITY OF TI GAR D SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002..00266 13125 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/18/02 SITE ADDRESS; 11075 SW ERROL ST PARCEL: 2S 103AC-02800 SUBDIVISION: ECHO HEIGHTS ZONING: R-4.5 BLOCK: LOT: PT JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF Bf.,ILDINGS: INSTALL TYPE: LTPSWR IMPERV bURFACE: Remarks: Connect existing house to newly installed sewer lateral. Septic tank is to be pumped,filled and inspected. Owner: � FEES PIERCE, DARREN F +AMY J Type By Date Amount Receipt 11075 SW ERROL ST — -. -- --- TIGARD, OR 97223 r 'I.MT CTR C-,18/02 $2,300.00 272.00200000 INSP CTR 9/18;;;2 $35.00 27200200000 Phone: Total $2,335.00 Contractor: Phone: Y #. Required Inspections Sewer Inspection Septic Tank Filled This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions froin the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm i J Jssued b �-' Permittee Signature: C Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day I� 1 CITY OF TIGARD MASTER PERMIT PERMIT#: MS'T2002-00311 DEVELOPMENT SERVICES DATE ISSUED: 7/19/02 13125 SW Hail Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11 X75 SW ERROL ST PARCEL: 2S103AC-02800 SU 'DDI V IOION CCI IO I IF-IG! ITC ZONING: R-4.,; BLOCK: LOT: PT JURISDICTION: TIG REMARKS: Add itioWremodel 350s.f. plus garage arid covered porch. `_W !UILDINc REISSUE: •� ,••� STORIES: I FLOOR AHEA5 - — —REQUIRED SETBACKS _ RFOUIRED __ CLASS OF WORK: Or HEIGHT: FIRST: 350 of BASEMENT: of LEFT: SMOKE DETECTORS TYPE OF USE: Sr FLOOP LOAD: 40 SECOND: e. GARAGE: 154 of FRONT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS FINSSMENT: of RIGHT OCCUPANCY GRP: n3 BDNM: BATH P i TOTAL: 350 DO of VALUE: $70 oaa ro HEAR PLUMBING — SINKS: I WATEF:CLOSETS: 1 WASHING MACH: I LAUNL .4AYS RAIN DRAIN' TRAPS: LAVATORIES: DISHWASHERS: FLOOR L'RAINS: SEWER LINES: SF RAIN DRAINS: I CATCH BASINF.: TUB1SHOWERS. I GARBAGE DISP: 1 WATER HEATERS: I WATER LINES: BCKFLW PREVNTR. GREASE TRAPS MECHANICAL OTHER FIXTUCES. FI IEL TYPES FURN�100K BOIUCMP<3HP: VENT FANS: i CLO HEf.DRYER. I FURN -10001: UNIT HEATERS: HOODS: I OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: I WL'OOSTOVES: GAS OUTLETS: •1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TE19P SRVC/FECnERS BRANCH CfRCU1TS MISCELLANEOUS _ ADO'L INSPECTIONS_ 1000 SF OR LESS. 0 200 amp: 1 U 200 amp: WISVC OR FDR: 1 PUMPIIRRU-01ON: PER INSPECTION, EA ADD'L 500SF: 201 - 400 amp: 201 40h amp 1st WIO SVCIFDR: SIGN/OUT LIN LT: PER HOUR, 1 RdITcD LNERGY. 401 - 600 amp: 401 600 amp: EA ADDL 7R CIR: SIGNAI_IPANEL: IN PLANT MANII HMISVCIFDR: 601 • 1000 amp: 601+8n105•1000V MINOR LABEL. 101)0+amp/volt PLAN REVIEW SECTION Reconnucl only: �• — — -- -- -4 RES UNITS: SVCIFDR-=225 A.: -600 V NOMINAL CLS AREAISPC OCC, _.,• ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL__ AUDIO a STEREO. VACUUM SYSTEM AUDIO 6 STEREO: FIRE ALARM: INTEKCOMIPAGINGOUTDOOR LNDSC LT. BURGLAR ALARM: OTH. BOILER HVAC: LAND.SCAPE9RRIG: PROTECTIVE SIGNLI GAVAGE OPENER: CLOCK INSTRUMFNTATIOW MEDICAL, OTHR: HVAC: DATA7TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL_ FEES: $ 1,520.02 PIERCE, DARREN F +AMY J MORNING STAR CONSTRt1CTION INThis permit is subbed to the regulations contained in the 11075 SW ERROL ST' 11180 SW ERROL ST igard Municipal Code, State of OR. Specialty Codes and TIGARD.OR 97223 TIGARD,OR 97223 all other applicable laws All work will be done in accordance with approved plans This perm it will expire if work is not started within 180 days of issuance,or if the work is suspen led for more than 180 days ATTENTION Phone: Fhone: Oregon law requires you to follow rules adopted by the Oregon Utility Noti:ication Center Those rul_r are set Rep M: I Ic oort forth in OAR 952.001-00101hrough 952-001-0080 You may obt::in copses of these -files or direct questions to CUNC by calling(503)246-1987. RFQUIRED 114SPECTIONS Erosion Control Insp 8, Underfloor insulation Electrical Servicc Low Voltage Appr/Sdwlk Insp Fooling Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Electrical Final FOUndation Insp PLM/Underfloor Framing Insp Cas Fireplace Mechanical Final POSUBean,Structural Mechanical Insp Shear Wall Insp Insulation Insp Plumb Final Post/Hearn Mechanics plumb Top Out Exterior Sheathing Inst Rain drain Insp Final inspection Issued By :r -!�_- may Permittee Signature : Call ('503) 639-4175 by 7:00 p m. for an inspection needed the next business day Building Piermit Application , FDreceived: p y Permit no.:M jo. o City of 'Tigard . -- Address: 13125 SW Hall Bl h VED Project/appl.no.: Expire date: City nfTigard Phune. (503) 639-41 71 nntriexned By: fteceiptno.: . r Fax: (503) 598-1960 -ase fiileno.: Payment type: J fr Simple Complex: r U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-tamily U New construction U Demolition Addition/:Iteration/replacement U Tcnant improvement 0 Fire sprinklvdalarm U Other:IoR SUIT INFORMATION t Joh address: ( s7 7 S.IJ. Fv r�� �� 131t1�. n Suite no.: �— l — Tax ma /tax lot/account no.: '2 5103CO Lot: Bhxrk: Subdivision: p 2 SL�6 _ Project name: Description and location of work on premises/special conditions:_ on - e14 G rK (Floodplain.septic capacity, lar.eft.) Name: !:h rC� _ r Mailing address: 11075 SQ. E rwO 1 3� 1 &2 family diAePing: oW City: —�, 5tdle: dr "LIP: T77-Z3Valuationof work........................................ ��, Phone: 'jn Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: l i u,v eex er Total number of floors............. ^_Z __— Phone: ,CD3 37 Y(0yS f:ax: 96 ?_V E-mail: New dwelling area(sq.ft.) .......................... U Garage/carport area(sq.ft.) ........................ Name: -� C.overed,porch area(s(t.ft.) ......................... L7__ —" Mailing address: I l g0 S.w. Erqd 5f-, Deck area(sq. ft.) ....................................... ---- City: Slate:o ZIP: Q77Z3 Other structure area(sq.ft.)........... ............. Phone: 3 yf(�ySS" Fix; Email: ('ommerciallindustrisllmulti-family: Valuation of work........................................ $ -- Exishng bldg.arca(sq. ft.) .......................... Business name: rWl41 5 ►� ►'�+� ""� New bldg,area(sq. ft.) Address: C) 5-L.J.. E trvfl _ S Number of stories City: `Tt � Stale: Qr- ZIP: 2L ........................................ -------- i yle of construction.................................... Phone: 1 '63 (D Occupancy group(s): Existing: CCB no.: S6 (v$3 New: City/metro lie.no. I"''>/' Notice:All contractor-,and subcontractors arc required to be t licensed with the Oregon Construction Contractors Board under Name: `pry�'It1� 1�cty �av1S� ('iw� �1�}2r provisions of ORS 701 and may be required to be licensed in the Address: ��� � ,;� ,�. �y,.,�. e� jurisdiction where work is being performed. If the applicant is ZIP: exempt from licensing,the following reason applies: City: Slate; Contact person: 7-jt� _ked Plan no. 34 — —� phone: 8 l�y5 ' Fax:4 gZz7 E-mail: T rh ar ewit9 Name: lConlact person: - — I-ces due upon application ........................... ___-- Address- Date received: — City: — State: ZIP: _ Amount received ................ ........................ _ Phone: Fax: E-mail: Please refer to fee schedule_ 1 hereby certify I have read and examined this application and the Nut all juriKlictions accept credit cods,please call jurisdiction lot mote intonnati,xt attached checkh '_:' nrovisions of laws and ordinances governing this U Visa U MasterCard work will be complied% ith,whether speclfi d herein or nM, credit carni number. Authorized signature: �.,._�1� Dale: _ Name of cardholder as dm-Nn on credit card Print:tame: -Tj►"'k l eje)eGr -- Cardholder sipapur Notice:This permit application expires if a pcmil is not obtained within 180 days after it has I�cn accepted as complete. +w461.1(6MCOM) �tv _ , i3 t' One- and"Two-Family Dwelling Building Permit Application Checklist 7Relerencen- MRno-Wedpermits Citygfhgurd City of Tigard O Electrical J Plumping U Mechanical Addw,, 11125 SW Hall lilvd,'Tigard,OR 9722 U t ichor Phone: (503) 639-4171 _ - ---- f-ax: (501) 598-1960 THE t w t I band use actions completed.See jurisdiction criteria for concurrent reviews. 2 ; ning.Mood plain,solar balance points,seismic soils designation,historic di•u rct,etc. 3 Verincation of approved plat/lot. 4 hire district__approval required. 5 Septic system permit or authorization for remodel. Existing system capacity _- 6 Server permit. — _ -- 7 Water district approval. 8 Soils report.Must carry original applicable stamp and signature or.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 he 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 it copyright violations exist. I I Silt/plot plan drawn to scale.The plan must show lot and building setback dimensions:property corner elevations(it' rheic is purr.:than a 4-11.elevation differential,plan must show contour lines at 241.intervals);location of easements and th n c%k;iv:10 K)tprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot arra;budding coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. I' Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent we and location. _ I t Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater. -- lurnace, ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _ 1.1 Cross section(s)and detaiM.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 he required to clearly portray construction.Show details of all wall and rool sheathing,rooAling,roof slope,ceiling height,siding material,f(x)tings and foundation,stain, fireplace construction, thermal insulation,etc. Is 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 tour foot at building envelope. Dull-size sheet addendums showing foundan,m elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)andlor lateral nnalis;s plans.Must indicate details and locations;for non-prescriptive path analysis provide sl_, rtrcatrons and calculations to engineering standards. _ 17 )Floor/roof framing. Provide plans torr all noors/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 rehar. For engineered systems,see item 22,"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 beam/ioist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more appliances. 22 Engineer's calculations.When required or provided,O.e.,shear wall,roof truss)shall he slanrped by an engineer or architect licensed in Oregon and shall he Shown to br;y,plicahle ro rhe project under wN ic%%. JURISDII01ONAL SPECIFICS 23 Five(5)site plans are required for Item 1 I abcwe. Site plans must be 8-U2" x I I''or 11" 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. "Mirrored"building phun will he not accepted. 36 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. _ 23 Site plan must include street tree size,type&location per City of Tigard Street Tree List box+klet. Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614(r,VICOW El lectrical Permit Application • Daterecciyed: Permit no.! rT.IXXV _0631 City of Tigard Project/appl.no.: Expire date: —_ City of Tigard Address: 13125 SW H:di Blvd,Tigard,OR 9722.3 Date issued: HV:—_ Receiptno.:_ Phone: (503) 639-4171 -- I Fax: (503) 598-1960 Case file no.: Payment type Land use approval: U I &2 family dwelling or accessory Cummerc:iavrndustrial U Multi-family U Tenant improvement U New construction Addition/aheration/replaccrnenl U(ether: U Pattial Joh address I ID _I Elrro I 5-t Itldg. nc. _ tiuilr no. — Tax map/tax lot/account no.:2S103[p Lot: Block: Subdivision: Project name: Description and location of work on premises: li� Estimated(late of completion/impection: Job no: Fee Max Business name: - Description cry (ryr> 7brsl n0.insp P L - 9 Y'1 L —___ New residential-single or multi-family per Address: 4AgQ 5.W• dwellingunit.Inchafesattached&rdrage. City: ' State: ZIP: Serviceincluded Phone: �YY 7 Fax: ;Z n E-mail: 1000 sq. .or less00 __^— - - 4 Each additional 5s .ft,or rtion thereof _ CCB no.: Elec.bus.lie.no:...'211. 10 7 G Limited energy,residential _ _2 City/metro lic.no.: p 3 Al Limited energy,non-residential 2 Fach manufactured home or modular dwelling signature ms'jri electrician(required) »_ pate Service andfor feeder — 2 License a no: Services or feeden-Installation, Sup.elect.name(print): ,T , alteration or relocation: III Itelill 200 amps or less _ 2 _ :1.-p.-�'to 400 amps 2 Name(print): C f �I ey C.� -- -- — to W)amps z Mailing address: 07S S•GJ r/t�T S to 1000 amps 2 Pity; State: ZIP: 0 amps or volts _ _ 2 Phone: Fa I E-mail: Re-nnne t only I Owner installation:The installation is being made on property I own Temporary services U.feeders- which is not intended for sale,lease,rent,or exchange according to Instanation,aiteratlop d relocation: 'is-:amps nr less _ __ 2 e ORS 447,455,479,670,701. 201 amps to 4M amps 2 Owner's si nature: Date: 1401 to 600 ams 2 Branch circalts-new,al::ntke. or extension per panel: Name: A l�ce for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: ZIP:. f B. Fee for branch circuits without purchase of service or feeder fee,first branch circsit: 2 Phone: Fax: F.-mall: Fach additional branch circuit P::: 'r"Iceorfeedernot included): U Service over 225 amps-commercial U 11calth carc:aciliry l a,. ump or irrigation circle 2 U Service over 320 amps rating of 1&2 U Hazaidous locationEach signor outline lighting J_� 2 family dwellings U Building over 10,0(x)square feet four or Signal circuits)or a limited energy panel, U System over 600 volts nominal none residential units in one structure alteration,or extension' _ _ 2 — O Building over three stories U Feeders.4(x)amm or mom *Description: U Occupant load over 99 persons U Manufactured structures or RV park Fich addNtottal inspection over the allowahle M any of the above: _ U Egteas/lightingplan U tllher -- Perinspection _ --� Sabwit sets of plan+with any of the above. Investigation fee The above are not applicable to temporary construction service. Other -- Nd all jurisdiction Lm fit dr cards,pleae call jurisdiction tar.ower Wornueioa Notice:this permit applicatic i Per nit fee................ ) $ -- UVisa U MasterCard expires if a permit is not obtained Plan�e view(at — 96) $ Credit cad rumbm - __—_ ____ _ — within 190 days ager it has been Stare surcharge(8%)....$ accepted as complete. TOTAL.......................$ - - Near did u drovro on credit rand - S Aman 4"15(&"'Mi ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIgI_PNLY Complete l=ee Schedule Below: ------ - - p Reatriclod Energy Feo..................................................... $75.00 'Number of Inspections per permit allowed) (FOR ALL.SYSTEMS) Service included: Items Cost Total + Check Tvne of Work Involved Residential-par unit 1000 sq.ft or less — $145 15 4 Audio and Stereo Systems' Lach additional 500 sq ft.or portion thereof _ $33.40_--_� 1 �� Burglar Alarm I Imited Energy $75.00 I:ach Manufd Home or Modular Dwelling Service or Feeder $90.90 —_—�— 2 Garage Door Opener' Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 toms�S � 201 amps to 400 amps $106.85 2 ❑ Vacuum y 401 amps to 600 amps $160.60 2 601 amps to 1000 amps �— $240.60 ��— 2 ❑ Other Over 1000 amps of volts _ $454 65_ 2 Reconnect only $66,85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL.ONLY Installation,alteration,or relocation Fee for each system.................................. ...................... $75.00 200 snips or less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps _ $133.75 _ 2 Cheek T ype of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits New,alteration or extension per panel Moiler Controls a)The fee for branch circuits with purchase of service or I j clock:;y tems feeder fee. Each branch rircuil _ $5 65 2 1).ita 1 etprommunication Installation b)The fee for branch dicuits without purchase of service or leader fee. Fire Alarm Installation First branch circuit _ $46.85 Fach additional branch circuit Y� $6.65 HVAC Miscellaneousr (Service or feeder not included) Lam) Instrumentation I ach pump or irrigation circle $53.40 I ach sigr x outline lighting v _ $53,40 ❑ intercom and Paging g g Systems agnal circult(s)or a limited energy panel,alteration or extension $75.GJ_ ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 Each additional inspection over Medical the allowable In any of the above :'er inspection $6250 _ Q Nurse Calls Per hour $62.50_ In Plant _— $73.75 — ❑ Outdoor Landscape Lighting' Fees: (� Protective Signaling Fntertotal ofabove fees $ JJ• �� Other---- __.--_—_-------____ --- R%State Surcharge $ /Z•3 U _Number of Systems 25%Plan Review Fee See-Plan Review"section on s No licenses are rewired Licenses are required for all other installations frond of application Fees: Total Balance Dote $ -- Enter total of above feesFJ Trust Account>K - ------ --- 8•/.State Surcharge : — __.-- -----------.--------- — =_A All New Commercial Buildings require 2 sets of plans. Total Balance Due — i dxtsV'orms4lc-fees.doc 08/30/01 Mechanical Permit Application 0 7ID),tjc recehvei: Permit no.art;1 City of Tigard ct/appl.no.: Expire date: Cityoffigard Addref(8: 13125 SW Hall Blvd,Tigard,OR 97223 --- Phone: (503) 639-4171 issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: U I & 2 Ianily dwell ,c.or accessory U('nnuncn ial/industrial U Multi-family U Tenant improvement U New construction Addition/alteration/:eplaccntent U Other: _ i Job address: C)Z j $,(,t). ,w - - T" qy Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Sujtc no_: _J _ value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: 2 51 C)3 C 'ZWD Q profit. Value.$ -- Trot: Block: — Subdivision: *See checklist for important application information and Project name: jutisdiclion's fee schedule for residential l.crinit fee. City/county: 1 g i.,rcl Z.IP: Descriptionand�n of work on premises: M_ i Fee(ea.) Total Est.date of completion/inspection: �j -- lk�scri ion Qly. Res.orrly Res.only Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U Nu Air handling unit .—CFM is existingspace insulated?U Yes U No Alt conditioningrxi ting pan C sysi 1 _ �P _Alteration of existing AC system: of er compressors Business name: State hoilcr permit no.: 7- 1"0 �C_ HP _,tons_ HTUM Address: e 33 Fir smo a amper, act smo a defectors _ City: 1 State: ZIP: eat pump(s--- ite pian required Phone:rI'M I-ax:1-� E-mail: Instal replacefurnace/burner B U/Il CCB no: Including ductwork/vent liner U Yes U No - n_to rep aTL/re ocatTiers-suspen ec. City/metro lic.no.: ro : qz VS _ wall,or floor mounted _ tName: ase print): Ch Le ent fora iance other than furnace e emit on: Absorption units _ BTU/Fi I VA Keele Chillers H!'s: S.LtJ -rep S Compressors Cil -Titate: :nv rorrmenta exhaust an vent at on: City. r Qtr ZIP: 4722.3 Appliance vent Phone: ,SS I Fax: ZL E-mail: Dryerexhaust foods,TypeT111/res�n/hhazmat — — hood fire suppression system Name: r e rC e— Exhaust fu..with single duct(bath fans) —_ Mailing address: I I D 7S 9.w. E rro, — Exhaust- s stem a an from heatingor A C ue p p ng an sl ut o o 0vt ets) City: -- 1_ State: Qac ZIP: e172LU Type: —LPG G Oil Phone: Q (p Fax: E-mail' I-uei hi rim�e�ac hTd id t�Ona outlets — -- rocP etspiping(scheematicrc(Iuired) Name: Number of outlets -_ _ terTlsle�i appliance or pmenl: equ Address: Decorative fireplace --- — City: --- - state: zIP: _ inst•rt-type Phone I ax: - E-mail: 1VrooTtove/pe let stove Other: Applicant's signature: Dat:: Name (print): Not an jurisdictions accept credit cards.plena call juriulirtirn fen mrw infarmatirn Permit fee.....................$ U Visa U MasterCard Notice:This permit application Minimum fee................$ trait sand nnnrner -_ 1 expires if a permit is not obtained Plan review(at _ 96) $ _ - -- within 180 days after it has been State surcharge(8%) ....$ ------ ------ Name or cardholder u s-gown an credit cm1 accepted as complete. S TOTAL .......................$ _— Cardholder sipature _ __ _ Amount 441-4617(6Mi NO MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Des,,�intlon: Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mdehanical Code Oly (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or including ducts A vents 14.00 fraction thereof,to and including 2) Furnace 100,000 BTU+ -` $10,000.00. including ducts 3 vents _ 17 40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace - $1.54 for each additional$100.00 or including vent _ _ _ 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater --- $25,000.00. or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit ~-- $1.45 for each additional$100.00 or fraction thereof,to and including 6) Repair units - - -- $r'0O013.00. 12.15 $50,001.00 and up 2,0 for the first$50,000.00 and Check all that apply: Boiler Heat Air --- $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. footnotes below. Comp Minimum Permit Fee$72.60 SUBTOTAL: a 7)<3HP;absorb unit - --- to 100K BTU 14.00 8`/.State Surchargea 8)3-15 HP;absorb unit 100k to 500k BTU _ 25.60 25%Plart Review Fee(of subtotal) S 9)15-30 HP;absorb Required for ALL commercial�ermits onl unit.5-1 mil BTU _ 35.00 TOTAL COMMERCIAL. PERMIT FEE: $ 10)30 unit 1-11.7.7 5 mil BTU 52.20 _.._. 11)>50HP;absorb __ unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM -- - --- __ Value Total 10,0013)Air handling unit 10,000 CFM+ Description: _ _ _ C]t Ea Amount _ 17,20 Furnace to 100,000 BTU,Including 955 ducts&vents 14)Non-portable evaporate cooler _ _ -- .1000 Furnace>100,000 BTU including 1,170 ducts&vents 15)Vent tan connected to a single duct Floor furnace Including vent 955 6.80 Suspended heater,wall heater cr 955 16)Ventilation system not Included in floor mounted heater appliance permit 10.00 Vent not included In applicant e 445 17)Hood served by mechanical exhaust permit 1000 Repair units 805 - 1 B)Domestic incinerators <3 hp;absorb.unit, 955 - _` 1740 to 100k BTU 19)Commercial or industrial type Incinerator 3-15 hp;absorb.unit, 1,700 6E 95 _- 101'(to 500k BTU 20)Other units,Including wood stoves 15-30 hp;absorb.unit,501k to 1 2,310 1000 mil.BTU 21)Gas piping one to four outlets 30-50 _ 1-1.75 mil.BTU s 40 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.7 I P >50 hp;absorb.unit, 5,725 1 1 00 >1.75 mil.BTU Minimum Permit Fee:72.60 SUBTOTAL: $ Air handling unit to 10,000 cffn 656 ----- Alr handlingunit>10,000 cfm 1,170 8%State Surcharge $ Non-portable evaporate cooler _ 656 Vent fan connected to a single duct 446 - TOTAL RESIDENTIAL PERMIT FEE: S Vent system not Included in 658 a Iiancepermil - Hood seryed by mechanical exhaust 656 Other Inspections and Fees: Domestic incinerator 1.170 1 Inspections outside of normal business hours(minimum chargeJwo hours) Commercial or industrial Incinerator 4,590 $62 50 per hour 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 $62.50 per hour Inserts,Rtc. 3 Additional plan review required by changes,additions or revisions to plans(minimum GaspIping 1-4 outlets S60 charge-one-half hour);62.50 per hour Each addlUonal outlet 83 - *State Contractor Boiler Certification required for unite>200k BTU. TOTAL COMMERCIAL $ *"Residential A/C requires site plan showing placement of unit. VALUATION: -__ All New Commercial Buildings require 2 sets of plans I\dsts\forms\mech-fees.doc 12/26/01 Plumbing Permit Application City of Tigard Datereceived: Permit no.:r Sewer permit no.: Building perinit no Addre.%:13125 SW Hall Blvd,Tigard,OP. 97221 --- CiryofTigard phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: �Reccipt no.: Land use approval: Case rile no.: Payment type. TYPE 1 U 1 & 2 family dwelling or accessory U('unnncrcial/industrial U Multi-family U Tenant inipitnendent U New construction nddititm/;dterntiun/rclrlacenlcnt U Food service U Other: 7 �-- .1011 SITE 1 Job address: )S.W. Errol $ I/escri tion Qt Y.f Fee(ea.) Total Bldg.no.: Suite no.: 4SFR New1-and 2-family dwellings only: Tax map/laxlot/accountno.: Includes 1000.for each utility connection) c> O SFR(I)bathLot: Block: SFR(2)bathProject name: (3)bath City/county: ZIP: Q u'3 Each additional bath/kitchen Description and location of work on premises: _ Siteutilitles: Catch basin/arca drain Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no. lin.ft.) v —v Manufactured home utilities _Business name: Q 1 hyl ty s / �� jtL, Manholes Address: U(c2 _ q g Rain drain connector — City: _C)yeciovN State: orl ZIP: � Sanitary sewer(no.lin.ft.) - -- Phone:(iL yp a Fax: (off 0 Email: Storm sewer(no.lin.ft.) _ ---- CCB no.:(OS 3L S Plumb.bus.reg.no •«3� Water service(nu. lin. ft.) City/metro lic.no.: A Fixture or Item: Contractor's representative signal ,� Absorption valve — Print name: �- ,tT., �,r,, pate: Back flow preventer -Backwater valve Basins/lavatory IN me: lu+r. �E'E'�Ce+• Clothes washer Address: - Dishwasher - — _ s j��$G S.w. t rro Drinking fountains) �— -- -- City: �; at . State: ZIP: 2Z3 Ejectors/sum Phone: 3 Fax:94( E-mail: Expansion tank _ Fixture-sewer cap Name(print): r Fla)r drainstfloor sinks/huh -- .�t.rret� �— Garbage disposal --- Mailing address�1 67 3.L j fs►-ro l GarbHose aged _ -- bibb City: -j 9 Q; _ State: Or ZIP: e172Z-3 Ice maker — Phone: (�2Q- �� (� Fax: E-mail: Interceptor/grease trap — Owner ir.stalletion/residential maintenance oily: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial)— employee on the property I own as per OR;N Chapter 447. Sink(s),basin(s),lays(s) Owner's signature:_ Date: Sump - Tubs/shower/shower pan - — Urinal -- —� Name: -_---- -- Water closet —v Address: Water heater City: —�--- State: _ 7,(P: Other. Phone: _ - Fax F-mail: Total Na all jurisdictiotn accert credit earls,please cell jurisdiction for mom informatimMinimum fee................$ Notice:•fhia permit application — U Visa U Mastr;C•ard expires if a permit is not obtained Plan review(at — %) $ Credit card number _____ -_- surcharge — _ _ _�^,L State surchar a(8% within 180 days after it hes been g ) •�••$ Expires TOTAL . .$ ---Nnnx td cardholder u shown on credit cart---- aCCCpled as complete. •.•••••••••••••••••.. �--- S Cardholder siguave — Anaum 40416(b00R OM) .'a PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individualr QTY ez AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink �, 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavato 16 60 for each utility connection____— ry _ One 1)bath $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath $350.00 _ Shower Only 16.60 Three 3 bath — __ $399.00 _ Water Closet �— 16.60 —� SUBTOTAL _ __— Urinal — 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 — —__TOTAL — Laundry Tray 16.60 Washing Machine 16 c0 FloorDrain/Floor Sir:, - 2— 16.60 _ PLEASE COMPLETE: 3" 16.60 4" 16.60 _ ---� Water Heater O conversion O like kind 16.60 — Quantic b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ Capped MF(3 dome Now Water Service _ 4640 Sink MFG Home New San/Storni 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 _ v - ---- — — Laundry Room Tra _ -- Wash±Machine Floor Drain/Sink: 2" Sewer-1s1100' ---- 55.00 — Sewer-each additional 100' 46.40 4" —_ Water Service-1st 100' 5'5 0 Watnr Heater — — Other Fixtures Water Service-each additional 200' 46.40 S eu�f�-- — -- - — Storm 8 Rain Drain- 1st 100' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 -- Commercial Back Flow Prevention Device 46.40 -- — Residential Backflow Prevention Device' r65. — Catch Basin —inspection of of Existing Plumbing or Specialty requested Inspections _ __ COMMENTS II.EGARDING ABOVE: Rain Drain,single family dwelling Grease Traps 16.c0 -"--- QUANTI'TY TOTAL Isometric or riser diagram is required if quant LTolal is g "SUBTOTAL — 8%STATE SURCHARGE -- -- -- — -- "PLAN REVIEW 25%OF SUBTOTAL _ Required o If rxture qty total is> — TOI AL. S "Minimum permit fee Is$72 50+8%state surcharge,except Residential Backflow Prevention Device,which Is$36.25+8%state surcharge. "All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. i:\dsts\forms\pim-fees.doc 12/26/01 294M I 21'-0"- X12'-0"-- -- -26-0"- OM 28'-0"- -- I( � II I � m II J (I � I � I N IIS ( II RECEIVED VED 0 JUN Ul SITE PLAN �rinst��r CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC1999-00490 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/16/1999 PARCEL: 2S103AC-02800 SITE ADDRESS: 11075 SW ERROL ST SUBDIVISION: ECHO HEIGHTS ZONING: R-4.5 BLOCK: LOT: PT JURISDICTION: URB CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL TYPES0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS _ OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 2 > 10000 cfm: Remarks: Furnace, gas ir3t.rt and gas piping to both units. Owner: _ FEES PIERCE, DARREN F + AMY J Type By Date Amount Receipt 11075 SW ERROL ST PRM4 BON 11/16/19 $50.00 99-319798 TIGARD, OR 97223 5PC2 BON 11/16/19f $4.00 99-319798 Total $54.00 Phone: -- 77 Contractor: SCOTT A SHAMBURG HEATING LLC 17913 SW PACIFiC HWY TUALATIN, OR 97062 _ REQUIRED INSPECTIONS Gas Line Insp Phone:503-692-5563 Misc. Inspection Reg #:LIC 126881 Final Inspection ORIGINAL 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 952-001-0080. You may obtain co)pies,of these rules or direct questions to OUNC by calling (503)246--9189. Issue By: � r lel- ! l"i�?(,� c --- Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day 1_ CITY OF TIGARD Mechanical Permit Application Plan Check p� Rec'd By 1312.5 SW HALL BLVD. Commercial and Residential Date Recd t- TIGARD, OR 97223 Date to P.E. (503) 639-4171, x304 Date to DST Print or Type Permit# r--:c_I Incomplete or illegible applications will not be accepted_ Called Name of Development/Project Description Table 1A Mechanical Code _ Qt P►ICe Amt Job Street Address (� 1 TSuneN A) Perini!Fee 16.00 Address /C/5� �j�C//D� -S C 1) Fumn;e to 100,000 BTU Bldg# CRY/State zip inr uding ducts&vents _ 9.65 1 V) Furnace 100,000 BTU+ 1 Cl/Ole� �_a3 including ducts&vents _ _ 1200 Name(or name of bt inose! 10(� 3) Floor Furnace Owner Z�I /Cil 'f ,+I9 �e including vent_ _ —_ 9.65 Melling Address 4) Suspended heater,wall heater 1 or floor mounted heater _ 9.65 5) Vent not included in appliance permit _ 4.75 City/State Zip Phone Check all that apply 'Boiler Heat Air �3_ y.3�5/� For Items 6-10,see or Pump Cond Qty Price Amt e(or name of business) footnotes 1,2 Comte 11� 6)Repair units 8.40 J C( �, �L�U✓(� Occupant Mailing Address 7)<3HP;absorb unit to 100K BTU _ 9 65 CRyrSta!e zip Pnone 8)3.15 HP;absorb unit t 00k to 500k BTU _ _ 17.65 Contractor Name 9) 15-30 HP;absorb '` / unit.5-1 mil BTU _ _ 24.15 _ �.. 41/Y)"((�� /7 u( – 10)30-50 HP;absorb Prior to permit Mailing Address unit 1-1.75 mil BTU I 1 _36.00 issuance,a copy 1 ri I � 11)>50HP,absorb unit>1.75 mil BTU of all licenses CHy/State ,,/� Zip Phone _ _ 60.15 are required if �G (a�/L(/�— (��7i''SS-&3 12)Air handling unit to 10,000 CFM expired in COT Oregon Const Cont.Board LIc.0 Exp,Date 7.00 _ database /" G> 13)Aii handling unit 10,000 CFM+ Architect Name 11.85 14)Non-portable evaporate cooler or Meiling Address _ _ �'p� -- 15)Vent fan connected to a single duct _ _ 4.75 CRY/State Zip Phone Engineer 16)Ventilation system not included in _appliance permit— 700 Describe work to he done 17)Hood served by mechanical exhaust _ 7.00_ New O Repair O Replace with like kind Yes O No O 18)Domestic incinerators Residential la— Commercial O Modification O __ 12 00 19)Commercial or industri_ ,,e incinerator Additional information or description of work. _ _ 48.25 nos-ea LC F0 lo f,&,Ili rwe �r9a S' InSP/� -P .5 444 20) Other units, including wood stoves` r e bov-A Griltie-y 700 NOTE: For Commercial projects only;Units over 400 lbs.located on the 21)Gas,piping one to four outlets roof,require structural talcs.prepared by licensed engineer �1375 Type of fuel oil O natural gas(DLPG O electric O 22)More than Tper outlet(each) 75 I hereby acknowledge that I have read this application,that the information MI um Permit Fee$60.00 U SUBTOTAL . Nen is correct,that I am the owner or authorized agent of 8%SURCHARGE g g PLAN REVIEW 25%OF SUBTOTAL the owner,that plans submitted are in compliance with Oregon State laws Required for ALL commercial permits only SlgnaJ�tr�of OwrterlA inth/ Date/ — TOTAL CA/1l Other Inspections and Fees Contact Person Name Phone I Inspections outside of normal business hours(minimum charge-two hours) $50 00 per hour /'� 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) s50 00pertintir Foonotes for commercial projects or:?: i 3 Additional plan review required by changes,additions or revisions to plans(minimum 1. Provide full schematic of existing and proposed gas line and pressure charge-one-half hour)$50 00 per hour 2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required units. "Residential A/C requires site plan showing placement of unit 1:lmechperrill rev 1111/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 _ BUP Date Requested ;;_!�M PM _ BLD Location_ / 6,7 { %� Suite MEC /!%" - GpG�t!G Contact Person Ph PLM Contractor Ph SWR BUILvING Tenant/Owner ELC Retaining Wall ELR Footing Access.- Y~ Foundation FPS Fig Drain SIGN Crawl Drain Inspection Nates: Slab _ _ ---____—. --- SIT Post& Beam --` Ext Sheath/Shear Int Sheath/Shear �— Framing -- — --- --- — --- ----- — -- -----..--_.-. Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- Roof Misc: --- i 4r -� - - - - ---- - -- -- Final - - PASS PART FAIL — — — --- --- - - ----- PLUMBING _ Post& Beam --- - -- -- --- - - Under Stab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Post$BeamRough In =IN- Smoke Dampers - - -- - S PART FAIL rRICAI_ - Service Rough In UG/Slab Low Voltage Fire Alarm Final PASS_ PART FAIL SITE backfih/Grading - Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I ]Please call for reinspection RE: [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewplk Other Date Inspector Exv, Final PASS PART FAIL DC I NOT REMOVE this inspection record from the job site.