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9543 SW ELROSE STREET o — - - - - -- t-- 20.00 127.30' o ` R1 _ 1.55' 205' -- - - - - - - - - — T -- - - -- -- - — 5S -- �._� 0 , •~ ^ S 70' WIDE SEWER EASEMENT C y0� ` _ L PER DOC. NO. 81-40723 26.57' 15.11 4k ton BID r� � Z LOT 2 ,� ' N 8F rl30E 127.34' 8,808 sq.ft. � C '� R a SP •✓✓F r 4$' 89'5_13_W 87_50' LOT 7 10.51 - - - - -- --�– g 7,504 s4.ft. r PRIVATE STORM .W !� In EASEMENT �-� ° f >~ � BENEFITS LOT 1 � ao v \ ! f o t M LOT 3 z , " ) - — - _. _ cb 7,662 sq-ft. , n rr r (lam\ o - V-A J ----- ` 67• .,,_ l C ^ ��., v lam' Q ""'�,` �`e�Z• a e' PU9UC UTILITY EASEMENT r C ^� "y 216 :) ! � ? 1 t L. . 1 : t— _ -771-`�, . L'3.84• S ? C6 �,� .� l •r - 0.00' %, ^� , - ` ` r .1Ov CAW Z 1{ Oak — r _• . _. vv vv Cn Y 4 ob W1. v - E _ lei6o I t C ` VIN. LA Ul r w vp •a C to / S 1%o r r"1 F " - f / t r • ... •- � �' ( G J� 1"11 !' t'• LST 1 ee,y� `� v Y lis av — 300 f7 L- NOTICE: IFTHEPRINTORTYPEONANY � Ir � 11 � 11 � � 11 � III � 111IIIi II � .JIII 11 � i , T- � LTLl1.�_..�� t.1 �� 1.r. ..�.�..� _r � fI I ( I LIL IIS .rf � X11 IIS I I SII Ifs I_I1. ..fII SII. T-I I11.. .I. I I I _Ij11 , 11101 111I � I . I�� I ) � I.ILI III 1It tII I I I I 1 I I I � I I 1 I I � r--- IMAGE IS NOT AS CLEAR AS THIS NOTICE 1 2 _ 4 6 �'�L cz C2 6�Q6 s l0 11 � � I•f IS DUE TO THE QUALITY OF THE No.38 ° ' '"• _ -- ; ORIGINAL DOCUMENT _ E 6Z 8Z LZ 9Z 9Z fiZ £Z Z TZ OZ 6I 8I LT 9T QT fiT ET ZT IT T 6 8 L 8 L�i fiEIIII 11.11 JJ1l1111 ff ll I I[ llll III Illi1111 ill 1111 IIII � ll11� 11 cc N m 0 N CD Cl) m m ro f 1 i 9543 SW Elrose Street CITY OF TIG,ARD BUILDING INSPECTION DIVISION MsT qtat-' -00V? 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP —Date Requested �l a�� Afvi —PM _, BLD Location ��, ✓,(� ..6 Suite MEC Contact Person _ — -Ph PLM Contractor Ph SWR — BUILDING 1-enant/Owner _ ELD Retaining Wall ELR Foot,ig Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes. -- - Slab _ — _ SIT Post&Beam Ext Sheath/Shear _ Int Sheath/Shear Framing -- Insulation Drywall Nailing Firewall // /' Fire Sprinkler —� At/� //t./ �h ✓ ��_ `� � t?-,a irz Aa Fire Alarm Susp'd Ceiling Roof Misc: __ _ -- -- ----- — - Final 0ost 8S PA T FAIL&Beam — - -- -- - - Under Slab Top Out - ------- --- ------- Water Service Sanitary Sewer aiMP(ains PART FAIL CHANICAL Post&Beam -- -- --- —-- Rough In Gas Line --- --- Smoke Dampers Final --- ----- FAIL Service Rough In - - - -- -- - - - UG/Slab Low Voltage Fire-Alarm - ---------------- - -- - -— -- i ASS PART FAIL 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 [ ]PleXcallreinscoon RE: [ ]Unable to inspect no access ADA Approach/Sidewalk Other Date Inspector ---�--- Ext _ Final PASS PART FAIL UO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 — — // BUP _ Date Requested `+' ' Z3 _—�AM —PM _ BSD — Location ��c✓ C,�C�- �–t- Suite _ MEC Contact Person _ _ Ph 7�� /�� PLM Contractor _ Ph — SWR gefft Tenant/Owner ELC —_ e aining Wall ELR Footing Access: Foundation FPS `-- Ftg Drain SGN Crawl Drain Inspection Notes --- Slab _—__-- — __ _--- SIT Post&Beam Ext Sheath/Shear __-- Int Sheath/Shear Framing Insulationc- -- DrywallNailing -- Firewall Fire Sprinkler ___--- Fire Alarm Susp'd Ceiling -- Roof �- in ASS PART ` IL -- -----_-_—_-- — -- -- PLUMBING Post&Beam --- Under Slab ------------ -- —-- --- -- Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Post R Plemn ------------ --- — --- Rough In GasLine ------ --- -- -- - ... _ ._.-_ --- ------_ -- - Smoke harnpers ASS PART FAIL ELECTRICAL ----------------- Service - - - -------- - -- --- Rough In Ur/Slab ----____-- _---_-�.__- Low Voltage Fire Alarm Final PASS PART FAIL_ — SI TE 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 Date Inspector Ext Other - --- - Final PASS PART FAIL 00 NOT REMOVE this inspection record from the Job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST - CC y 5- 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BVP Date Requested AM _—PM --_, BLD Location �/ `� `/ r �_ �- l: { _ Suite —_ MEC Contact Person Ph —_ PLM Contractor C'c< <, (r N c Ph _ SWR _— BUILDING Tenant/Owner — _— _ ELC _-- Retaining Wall ELR _- Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Noes: —� ---�' Slab _-- ----- - ---..___.-- - SIT Post&Beam I -�-- Ext Sheath/Shear I -. --^ Int Sheath/Shear Framing Insulation Drywall Nailing ---------- — - - _ ------- - Firewall Fire Sprinkler - --�T----- -- ------ - -- ___ -_ - Fire Alarm Susp'd Ceiling - ----% -j ---- -- -- --- ---- Roof Final PASS PART FAILPLUMBING 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 - -- - -- — Sorvice Rough In UG/Slab Low Voltage Fire Alarm - - - -- - Final PASS PART FAIL --- -_ _ ------ _ __-- -- SITE Backfill/Grading --_-- ---- - Sanitary Sewer Storm Drain ] ] Reinspection fee of g - - required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I ]Please call I&Wirispection RF [ ]Unable to inspect-no access Fire Supply Line - ADA / Approach/Sidewalk Date � Inspector l I ` L k f/e- Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job .site. ny ff 0 ; . Con io 0 cv � � r er d � a H of tN � � n o � Q a r CITY O F TIGARD IGARD _ MASTER PERMIT PERMIT#: MST2000-00495 DEVELOPMENT SERVICES DATE ISSUED: 11/29/00 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 09543 SW ELROSE ST PARCEL: 2S111BA-10800 SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: S/F PATH 1 PUILDING REISSUE: STORIES: 2 F-OOR AREAS v REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1 114 at BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,408 of GARAGE: 297 of FRONT: 27 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 12 VALUE: $225,383.00 OCCUPANCY GRP: R3 BDRM: 4 BATH 3 TOTAL: 2,522.00 at REAR: 16 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOILICMP<3h6: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN a.t00K: 1 UNIT HEATERS HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 -200 amp: WISVC OR FDR: I PUMPARRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 400 amp: 201 •400 amp: let WIO SVCIFDR: 00 SIGNIOUI LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 •600 amp: EA ADDL SR CIR: SIGNALIPANEL IN PLANT: MANU HMISVCIFDR: 501 • 1000 amp: 5014ampo.1000v: MINOR LABEL:. 1000+amplvoll PLAN REVIEW SECTION Reconnect only: >•4 RES UNITS: 9VCIFDRa.225 A.: >600 V NOMINAL: CLS AREA'3PC UCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATArrELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,836.03 HOMES This permit is subject to the regulations contained in the NEWCASTLE HOMES,INC. NEWCASTLE PO BOX H Tigard Municipal Code,State of OR. Specialty Codes and P O BOX 230459 TIGARD, 23 59 all other applicable laws. All work will be done in 959 TIGARD,OR accordance with approved plans. This permit will expired work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION: Phone: qqq Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set 1' Reg N: LIC 5966: forth in OAR 952-001-0010 through 952-n41-0080. You 'I may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp Post/Beam Mechanica Mechanical Insp Framing Insp Gas Fireplacs Electrical Final Sewer Inspection Underfloor Insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr Electrical Service Low Voltage Water Line Insp Final inspection Post/Beam Structural PLM/Underfloor Elect,ical Rough In Gas Line Insp Appr/Sdwlk Insp Building Final Issued By :4yl '1_�:� Permittee Signature Call (503) 6394175 by 7:00 p.m.for an Inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPME14T SL-RVICES PERMIT#: SWR200000344 13125 SW Hall Blvd.,T n%j, OR 97223 (503) 639-4171 DATE ISSUED: 11/29/00 PARCEL: 25111 BA-10800 SITE ADDRESS; 09543 SW ELROSE ST SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCK: LOT: 002 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEIN DWELLING UNITS: 1 'TYPE OF USE: SF NO. OF BUILDINGo: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached. Owner: -- FEES NEWCASTLE HOMES, INC. Type By Date Amount Receipt P.O BOX 230459 ----- TIGARD, OR 97281 PRMT CTR 11/29/00 $2,300.00 27200000000 INSP CTR 11/29/00 $35.00 27200000000 Phone: 503-684-7543 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does riot guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 ,-1 Issued by: 'i '`t't`G4_ 1 t'-. Permittee Signature: ' Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day cv rc 2 Building Permit Application Date received:// i re) Permit no.:/y�rZW-W y95 _ City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 �� Project/appl.no.: Expiredatc: Cit y of l igard Phone: (503) 6394171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ 1&2family:Simple Cnmplex: 1 I &2 family dwelling or accessory U Commercial/industrial U Multi-family �d New construction U Demolition Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:A1,111110111 _' M 1 Job address: 5 5 v✓ e l ros L.) �� _ Bldg.no.: Suite no.: Lot: I Block Subdivision: ",tM Tax map/tax lot/account no.: Project namt.-: . S Description and location of work on premi es/special conditions: 5 P19 It�7� d wil U q Name: �i�IAIGAS?1p f��L0.5 Ln� __ Mailing address: d X 23a .r$ I &2 family dwelling: 7 City: State:OR ZIP: q7 Z8/ Valuation of work $ ,'3OG, ........................................ _ Phone: Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: :�rq, M i I/PX Total number of floors................................. Phone: r I"ax: 1F.-mail: New dwelling arca(sq.ft.) .......................... 2-5 z 2— iiiiiiiiiiiiiil&j 11 Wool Garage/carport area(sq.ft.) Z ......................... Name: �t d c{>_o Covered porch area(sq.ft.) ......................... Mailing address: (.544nL J Deck area(sq. R.) City: — - State: LIP: - Other structure area(sq It.I......................... _ CommercluUindustrial/multi-family: Phone: f'a� I?-mail. Y: Valuation of work........................................ $ Business name: Altwca5tLQ.. Amts Iris. Existing bldg.area(sq.ft.) .......................... Address: New bldg.area(sq. L.)................................ Number of stories........................................ City: State: ZIP: Phone: Fax: E-mail: Type of construction.................................... CCB no.: -� — Occupancy group(s): Existing: _ New: City/metro lic.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 the applicant is --- - - exempt from licensing,the following reason applies: City: Siatc: �1P: V Contact arson: I Plan no.: tNanie: (t1,-1L4( I ; t E-mail: -- — l' Contact person: i) Fees due upon application ............. ............. $ln/ bttr v Date received:yState:OR ZIP: 2/ Amount received ......................................... $ Phone: p Fax: I E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction For more information. attached checklist. All provisions of laws and ordinances governing this U Visa U Mastercard work will he complied with whc4her specified herein or not. credit card number --L-1— J Expires Authori i signat _ Date: / / 00 None of cardholder as shown an credit cud Print name: I<CL*hi -4101 LI I -�- Cardholder signature s Amoant Notice:This permit application expires if a permit is not obtained within 180 days alter it has been accepted as complete. 4404613(t^COM) One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: -- — Associated permits: Ciryq(Tigard City of Tigard U Electrical U Plumbing U Mechanical Address; 13125 SW I fall Blvd,Tigard,()R 9722-1 U Other: Phone: (503) 639-4171 Fax: (503) 598-1960 1 Land use actions completed.Sec jurisdiction crno: a lire Concurrent reviews. 2 Zoning.Mood plain,solar balance,points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel.Existing system capacity 6 Scwerpermit. 7 Water district approval. h Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. _ 1() Complete sets of legible plans.Must be drawn to scale,showing con ormance to applicable local and state building codes.Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. I I Sitelplot plan drawn to scale.The plan must show lot raid building setback dimensions;property corner elevations(if there is more than a 4-fl.elevation differential,plan must show contour lines at 24 intervals);location of casements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot _ area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor plasm.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,w;ntilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and sparing 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 roof sheathing,muting,roof slope,ceiling height,siding material,footings and foundation,stairs, _--fireplace construction, thermal insulation,etc. _ 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at Wilding envelope. Full-size sheet addendurns showing foundation elevations with cross references are acceptable. 16 Well bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. I H Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered Ti- stems,see item 22,"Engineer's calculations." I` 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 beant/joist 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,(i.e.,shear wall,rx)f truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the project under review. 23 Five(5)site plans are required ibr Item 1 I above 24 25 v 26 27 28 Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink. Red ink is reserved :it department use only. 440-4614(6AXN'OM) 4 Mechanical Permit Application Date received: Permit no.: City of Tigard Projec:/appl.no.: Expiredate: City(Vigurd Address: 13125 SW Ifall Blvd,Tigard,OR 97223 Date issued: Ey: Receiptno.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: __ Buuding permit no.: X l &2 family dwelling or accessory U Conuuercial/industrial U Multi-family U Tenant improvement A New construction U Addition/alteration/replacement U(Wier: _- IOU SITUIN FOR N71ATION sVALUATION Job `1/l13 S Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead. Tax map/tax lot/account no.: profit.Value$ Lot: a, Block: Subdivision: L.a4jtj3 Te Kira *See checklist for important application information and Project name: jurisdiction's fee schedule for residential pe,mit fee. City/county: -Ti-I and ZIP: q 7.Z,2 Description and ideation of work on premises t Fee(ea.) '10181 Est.date of completion/inspection: D wcri ion _ "y. Res.only Res.only Tenant improvement or change of use: Is existing space heated or conditioned?U Yes ❑No 7Arhandling unit CRM - Air conditioning(site plan require ) Is existing space insulated?U Yes U No teration of exist' ing HVAC system Boiler/compressors State boiler permit no.: Business name: FO-U/ �PQ.Sy�I �{� t J y _ _ HP Tons i_BTU/II Address: D BOX ev 0 T it smo c ampers/duct smoke detectors _ City: d State:09 1 ZIP:9 7 Z94 Flea(pump(site pl_an require ij— Phone: 7g • $ / Fax: -77_5. 11 E-mail: nsta rep ace urnac urner B1 U/11 Including ductwork/vent liner U Yes U No CCB no.: nst-aii/rep aace/rclocate heaters-suspen ed, City/metro lic.no.: wall,or floor mounted _ Name(please print): Vent for app,iance other t anurns Refrigeration: Absorption units BTU/H Name: L5,m AA&h;o Chillers HP Address: �� 1 _ Com�ressors HP nv ronmenl>i ex aunt and ventilation, City: State: ZIP: Appliance vent Phone: Fax: E-mail: ryerex gust _ t Hoods,Type res, itc en/hazmat hood fire suppression system Name: Exhaust fan with single duct(bath tans) Mailing address: :x aust system a art from heating or AC Citv: - -- State: ZII' _ Fuel piping run ser rut on(up to 4 outlets) Type: LPG NG Oil Phone: Fax: 1: -mail: Fueli in eachadditionafover outets 17"10JAMM rocets p p ng(schematic requirr ) _ Number of outlets Name: --____— Outer orequipment: --- Address: _ Decorative fireplace City: Stat.': ZIP: nsert-type Phone: Fax: I:-mail: oo stov pe let stove Oth Cf: Applicant's signature: Irttc: Name (print): Not all jurisdictions accept credit cards,please call Jurisdiction ror more infomtatlon Permit fee.....................$ _— U Visa U MasterCard Notice:This permit application Minimum fee...... .........$ Credit card number: ____ _(_L expires if a permit is not obtained Plan review(at — 46) $ Expires within 180 days after it has been State surcharge(8%)....$ Name of cardholder ass own on credit card S accepted as complete. TOTAL .......................$ -- Cardholder signature —Amount 4104617,6011COM1 MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: DescTOTAL VALUA i ION: FEE: _ Table 1A M Price Total $1.00 to$5 000.00 Minimum fee$72.50 Table 1A Mealanical Code � Qty (Ea) Amt _ -_- 1) Furnace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vents 14.00 $1.52 for each additional$100.J0 or 2) Furnace 100,000 BTU+ fraction thereof,to and Including includino ducts&vents 17.40 _ $10,0_00.00. -- - $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and ?1 Flonr 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$2.5,000.00 and 5) Vent not Included in appliance permit $1.45 for each additional$100 AO or _ 6.80 fraction thereof,to and Including 6) Repair units _ 12.15 $50,000.00. $50,001.00 and up $742.00 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 f umo Cond fraction thereof, footnotes below. Comp' "_ ___ - -_ 7)<31!P;absorb unit _ to'TOOK BTU 14.00 T_ ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb Value Total unit 100k to 500k BTU It 25.60 Description: (Ea) Amount 9)15-30 HP;absorb Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU 35.00 _ ducts&vents _ 10)30-50 HP;absorb Furnace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU 52.220 _- ducts&vents 11)>50HP:absorb Floor furnace including vent 955 unit>1.75 mil BTU I I 87.20 Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM floor mounted heater 1000 ` Vent not included in applicance 445 13)Air handling unit 10,000 CFM+ 17.20 Repair units _ 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 10.00 to 100k BTU -- - 15)Vent fan connected to a single duct 3-15 hp;absorb.unit, 1,700 680 101k to 500k BTU - -- -- 16)Ventilation system not Included In 15-30 hp;absorb.unit,501k to 1 2,310 a liance permit 1000 mil.BTU -- 17)Hood served by mechanical exhaust 30.50 hp;absorb.unit, 3,400 10.00 _ 1-1.75 mil.BTU 5 725 18)Domestic incinerators 17 40 >50 hp;absorb.unit, _ >1.75 mil.BTU 19)Commercial or industrial type Incinerator Air handling unit to 10 000 cfm 656 -_ 69_95 Air handling unit>10,000 cfm 1 170 20)Other units,including wood stoves Non-portable evaporate cooler _ 656 10.00 -_- Vent fan connected to a_single duct 446 21)Gas piping one to four outlets Vent system not Included In 656 5.40 a (lance ermil 22)More than 4-per outlet(each) Hood served by mechanical exhaust 658 1 00 Domestic Incinerator_--- 1,170 __ Minimum Permit Fee$72.50 SUBTOTALS $ Commercial or industrial Incinerator 4,590 __- Other unit,including wood stoves, 856 8%'-tate Surcharge $ Inserts,etc. - Gas 1�l Ing 1-4 outlets ___ 380 25•/.Plan Review Fee(of subtotal) $ Each additional outlet 63 Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: E VALUATION: - Citherin tions and Fees: 1 Inspections outside of normal business hours(minimum charge two hours) $72 50 per hour 2 Inspections for which no fee Is specifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum chargeone-half hour)$72 50 per hour "State Contractor Boller Certification required for units 400k BTU. 'Residential AIC requires site plan showing placement of unit 1:\dstslformslmech-feeo.doc 10/11 rOO Plumbing Permit Application Date received: Permit no.: City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Ilall Hlvd,'I'igard,OR 97223 — CiryofTigard phone: (503) 639-4171 ProJect/appl.no.: Expircdatc: Fax: (503)598-1960 Date issued: By: Rccciptno.. Land use approval: — Case file no.: Payment type: cK 2 family dwelling or accessory U Commercial/industrial U Mulu-family U Tenant improvement 'yA New construction U Addition/alterition/repliiccrticnt U Food scivirr U Other: INFORMATION.1011 SITIF Job address: _,4yl/ 05¢_ S Deseri tion "Y. Fee(ea.) 'Total Bldg. no.: I Suite no.: Nen I• and 2-family dwellings only: Tax map/lax lot/account no.: (includes 10011.for each utility connection) SFR(1)bath l.ot: a Blcrk: Subdivision:LCW-&' ¢ CA_ SFR(2)bath — — -- Project name: SFR(3)bath City/county'i a,rd ox__ ZIP: CJ 7.2;l Each additional bath/kitchen Description and ovation of work on premises: Siteutillties: Catch basin/area drain _ Est.date of compNtion/inspcction: Drywells/leach line/trench drain Footing drain(no.lin.ft.) PLUMBING CONTRAUll Oil Manufactured home utilities Business name: A&IM b/Y3 f- 7°re m i c L'lUM n Manholes Address: Y0,0 Rain drain connector City: Stalc: ZIP: r-r 7a$ Sanitary sewer(no.lin.ft.) Phone: I Fax: -mail: Storm sewer(no.lin.ft.) CCB no.: / Plumb.bus.reg.no: Wcter service no.lin.R.) City/metro lie.no.: -- FIx►tire or hem: Contractor's representative signature: Ab:n, _; valve Back tloa pmvcntcr Print name: Date: Backwater valveRN III I _ Basins/lavatoLy _ Name: /t In16Uf-.5 Clothes washer Dishwasher Address: Drinkingfountain(s) _ City: State: ZIP: _ Ejectors/sump Phone: Fax E-mail: Expansion tank Fixture/sewer cap ^� _ Name(print): Floor drains/tloorsinks%hub Mailing address: -- Garbage disposal City: State: ZIP: Hose bibb —.___ Ice maker Phone.: Fax: E-mail: Interceptor/grease trap _ Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's si nature: Date: _ Sum Tubs/shower/shower pa Name: Urinal — Water closet _ Address: Water heater _ City: State: LIP: Other: Phone: Fax: E mail: _ Total Not all jurisdictions accept credit earls,please call jurisdiction fix rnme inkxmationNotice:This permit Minimum fee................$ application plan review(at ._ 96) $ _ 0 Visa U MasterCard _ expires if a permit is not obtained Credit card number, _ L�I within 180 days after it has been State surcharge(876)....$ l:api"s Name or cart1holder as shown on credit card -- accepted as complete. TOTAL .......................$ _ _ S Cardholder sipature Amount _ 4141616(6AarC\.'M) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) QTY —(ems AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 1660 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavator -16 6Q for each utility connection) y One 1 bath _ $249.20 Tub or Tub/Shower Comb. 1660 Two 2 bath _ $350.00 Shower Only 16.60 Three(3)bath _ $399.00 Water Closet 1660 SUBTOTAL _ Urinal 1660 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL_ Garbage Disposal 16.60 _ — TOTAL Laundry Tray _ 16.60 Washing Machine �— 16.60 FloorDrain/Floor Sink 2' _-- 16.60 PLEASE COMPLETE: 3^ 16.60 q" 16.60 Water Heater O conversion O like kind 16.60 Quantity b I Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ ermiL Capped MFG Home New Water Service 46.40 Sink _— ^-- MFG Home New San/Storm Sewer — 46.40 Lavato Tub or Tub/Shower Hose Bibs 16.60 (o_mbination _ Roof Drains 1660 Shower Only Drinking Fountain 16.60 Water Closet . Urinal Other Fixtures(Specify) 16 60 Dishwasher Garbage Disposal --- -" Laundry Room Tray Washing Machine _ Floor Dmin/Sink: 2" Sewer.-1 sl 100' 55.00 -- 3" Sewer-each additional 100' 46.40 V 4" Water Service 1st 100' 5500 — Water Healer Other Fixtures Water Service-each additional 200' - 4649 Storm 8 Rain Drain-1st 100' 55.00 _ Storm 8 Rain Drain-each additional 100' 46.40 - Commercial Back Flow Prwention Device 46.40 - Residential backflow Pre%e-ntion Device' 2755 -- Catch Basin 16,60 — Ins;,ection of Existing Pvmbing or Specially 72.50 Re bested Inspections __ er!ht COMMENTS REGARDING ABOVE: Rain Chain,single family dwelling 65.25 Grease 1 raps 16.60 —— --------- QUANTITY TOTAL Isometric or riser diagram is required If 'SUBTOTAL -- ---- -- 8%STATE SURCHARGE -- — — --- -- "PLAN REVIEW 25%OF SUBTOTAL — Required only if fixture qty total is>9 _ _ -- -- — TOTAL E *Minimum permit fee is$7,15o-8%skate surcharge,except Residential Backflow Prevention Device,which is$36 25•6%state surcharge *"All New Commercial Buildings require plans with isometric or riser diagram and pian review i\dsts\forms\plm-fees.doc 10/10/00 Electrical Permit Application -- -- FDatereceived: Pcrmil no.: City of Tigard Project/appl.no.: Expire date: City(if Tigard Address: 13125 SW Ilall Blvd,Tigard,OR 97223 Date issued: By: I Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ 1 >6 I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement )id New construction U Addition/alteration/replacemenl _I Olh l U Partial t Job address: rj S Bldg.no.: Suite no.: jTrx map/tax lot/account no.: Lot: 01 1 Block: Subdivision: �} Piojet-t name: I Description and location of work on premisee' Estimated date of completion/inspection: Job no: lee Ma. Business name: -J- - CL -ry;C, Ikserjpl-- Qty. (ea.) total no.lns asaNewresidential-single or mtdWramily per Address: 42., _ dwellineunit.Inclurksaltachedgarage. Lily: SIaICQ� ZIP: g73o3_ Senicelurluded: Phone: Fax: I E-mail: I(xxl sq.ft.or less 4 CCB no.: Elec.bus.lie.no: 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(requited) Date Service and/or feeder 2 Sup.elect.name(prim i License no: Services orfeeders–Installation, alteration or relocation: 200 amps or less 2 Name(print): 1V C tt/(-a6'r1A ttffLA3 Inv 201 empato4Wamps _ -- 2 401 amps to 600 amps _ 2_ Mailing address: f ,Qn�-4044.99 601 amps l0 1000 amps _ z City: I Statep ZIP:97,Z IrOver 1000 amps or volts � -- 2 Phone: E-mail: Reconnectonly I Owner installation:The installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: 200 amps or less__ 2 ORS 447,455,479,670,701. 201 amps to 40n amps 2 Owner's signature: Date: 1 401 to 600 amps 2 Branch circuits-new,alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: Slate: ZIP: I . Fee for branch circuits without purchase — of service or feeder fee,first branch circuit: 2 Phone: I ,t E-mail: Each additional branch circuit: misc.(Service or feeder not included): 7Lu'Sy.'iem anver225atnpsrnmmercial UHcal4:-cwetacility Finch pump or irrigation circle 2 ceover320 amps-rating of 1&2 U Hazardous Icxation Each sign or outline lighting2 dwellings U Building over 10,0W square feet four or Signal circuit(s)or a limited energy panel, over 6W volts nominal more residential units in one structure alteration,or extension• _ 2 U Building over three stories U Feeders.400 amps or more s[kscrition: U(kcupam load over 99 persons U Manufactured structures or RV park Each additional inspection over Ibe allowable In any of the above: U Fgress/lighlingplan U Other: – Perinspection T— _ Submit_sets of plans with any of the above. Invests ation fee 71re above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards.please calf jurisdiction for more information. Notice:This permit application Permit fee.....................$ U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ credit card number:_ _ _— 1—_ within 180 days after it has been State surcharge(8%)....$ �. xpfr" accepted as complete. Name c elder u shown on ercdlt cum _ S — Crudholu,.signature Amount 440-4615(MMCOM) Electrical Permit Fees: Limited Energy Fees: -- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft or less $145 15 4 Audio and Stereo Systems Each additional 500 sq,it or r, portion thereof $33.40 1 L__I Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Garage Door Opener' Dwelling Service or Feeder _—_— $90.90 __ 2 Services or Feeders Heating,Ventilation and Air Conditioning Systern' Installation,alteration,or relocation 200 amps or less $80.30 2 Vacuum Systems' 201 amps to 400 amps $1(6.85 2 401 amps to 600 amps _ $160.60 2 f Other 601 amps to 1000 amps $240.60 2 uver tuuu amps or vuiia _— Reconnect only $66.65�—_ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or Tela ion Fee for each system........................................................ . $75.00 200 amps or less —__ $66 85_ _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 Check Type of Work Involved: 401 amps to 600 amps _ $133.15 2 Over 600 amps to 1000 volts, U Audio and Stereo Systems see"b"above. Branch Circuits E] Boiler Controls New,alteration or extension per panel a)The fee for branch circuits ❑ with purchase of service or l— Clock Systems feeder fee. Each branch circuit $665 Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder lee. First branch circuit __ $46,85 _ HVAC Each additional branch circuit $665 �— Miscellaneous Instrumentation (Service a feeder not included) Fach pump or Irrigation circle $5340 _ Intercom and Paging Systems F ach sign at outline lighting ��- $5340 _ Signal circutt(s)or a limited energy La,tdsc ape Irrigation Control` panel,alteration or extension $75.00 Minor Labels(10) A_ $125.00 Medical Each additional Inspection over C 1 the allowable in any of the above Nurse Call:; Per inspection $62.50 r I ler hour -- — $62.50 C] In Plant $73.75 Outdoor Landscape Lighting' Fees: [] P otective signaling Enter total of abol,a fees $ ___ __ _ n Other 8%State Surcharge $ Number of Systems 25%Plan Review Fee No licenses are required Licenses are required for all other installations Soo"Plan Review'section.on $ front of application — Fees: Total Balance Due $ -- Enter total of above fees El Trust Account# __ -_ 8%State Surcharge $ _ __ ---- -- ---- Total Balance C •e $ i\dsts\forms\ole-fees,doc 10/09/00 l• SEE 35M--.. m-- ROLL# 22 FOR LARGE DOCUMENT CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE NORTHWEST PREMIER PLUMBING P.O. BOX 23338 TIGARD, OR 97281 Plumbing Signature Form Permit #: MST2000-00495 Date Issued: 11/29/00 PlArrpl SRI 11 Ella-16800 Site Address: 09543 SW ELROSE ST Subdivision: LA.!ITT'S TERRACE Block: Lot: 002 Jurisdiction: TIG Zoning: R-4.5 Remarks: S/F PATH 1 Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dep,. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: NEWCASTLE HOMES, INC. NORTHWEST PREMIER PLUMBING P.O. BOX 230459 P.O. BOX 23338 TIGARD. OR 97281 TIGARD, OR 97281 Phone 9: 5U3-b84-7543 Phone #: 503-624-0582 Reg #: I Ir 135022 PI M 34-348PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE INTERSTATE ELECTRIC INC PO BOX 7342 SALEM, OR 97303-0068 Electrical Signature Form Permit #: MST2000-00495 Date Issued: 11/29/00 Parcel: 2S11 B A-10800 Site Address: 09543 SW ELROSE ST Subdivision: LAUTT'S TERRACE Block: Lot: 002 Jurisdiction: TIG Zoning: R-4.5 Remarks: SIF PATH 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appro)riate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNFR: ELECTRICAL CONTRACTOR: NEWCASTLE HOMES, INC. INTERSTATE ELECTRIC INC P.O. BOX 230459 PO SOX 7342 TIGARD, OR 97281 SALEM, OR 97303-0068 Phone #: 503-684-7543 Phone #: MBL 393-2223 Req #: uc 117121 SUP 1479S ELF 24.35AC AN INK SIGNATURE IS REQUIRED THIS F� Signature of Supervising Electrician It you have any questions, please call (503) 039-4171, ext. # 310