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9547 SW ELROSE STREET % 7. 5d - �--� I V. - nSTur,.r, � ra , ,� — _ p- GS t evi T- �— ' 17 yd h (!1 clh ,v�, n c CD .� t.' cn W LOT °° coCj m I _ Cr „ z ; C G� W o o x 1 �� ,6 ,. O �' ► S To SE ,'� '''�cnJ' ifl. I N . ; 00 cn - N as N11 ' f fl.. t / -2o - --�_. 10 - -� cn F 17 CID r a 103 rt . / A lo3. o0dip A 72.1.4 NOTICE: IF THEPRINTORTYPEONANY Tll-� � l � Ill � lll Ill � tll Ill � lil ' ill � llllill III Ili IllilTT��f� T � I � 111 III �. T III IIl111 Ilf ill ' ill 11f I � i III f � i ' � I 111 II1 r1 1 � � 1 � 1 f11 I � I I � 11111 III 111 1111111 i11 � II � IIIIIII IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 _ _ _ 2 I 3 4 (7 '7 g 1Q 11 12 ��G�� oZ c IT IS DUE TO THE QUALITY OF THE _ _ - _ » -- - __ ORIGINAL DOCUMENT E 6Z 8 Z L Z 9 Z 9 Z 1 Z E Z Z T Z O Z �6 i�v8 I L T 91 w E Z [ ��tl13w II�� I1►I ��iIII��LI►1► �I1� 1111 �1�1 ��► 11►� 1�� 1 l ill X1111 Illllliilllllllllllllllllililllllllliliilll! III � . 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IIIiI1�1I Ln A v m_ "1 O N W lD �D 1 t 9547 SW Elrose Street CITY OF TIGARD EWILDING INSPECTION DIVISION MST /-Gv G ZU 24-Hour Inspection Line: 639-4175 Business Line: 6394*171L�4u P __Date Requested_ 51 Z z AM �M — BLD Location t/ 2 S 4�,�'/j-�-s-c Suite MEC Contact Person Ph V_ PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELI _ Footing Access: Foundation FPS F.tg..Dwia SGN w��l Drai Inspection Notes - --- Slav __.--.—_--- ----------____-------_____�_�_ SIT Post&Beam -��------- Ext Sheath/Shear Int Sheath/Shear Framing - -- ------- -- --—-- ----- _ _—._- -- - Insulation Drywall Nailing Firewall ____._—.��------ ----------------- Fire Sprinkler - -------------- -- Fire Alarm Susp'd Ceiling --- - - --- - ---- ---------- Roof --- Misc: _-------.-.-- Fi ASS PART FAIL - --- ------ ------ -- ---------^_ - ------_-�_— - --- s & Beam -------_ -.---- -- - -- -- ---- - - -- Under Slab Top Out Water Service SanitarySewer - --- - -------------_.�.--------------------------- -------------- Rain Drains rna S PART FAIL E .HANICAL _ Post&Beam Rough In Gas Line - - - -- -------------- -- Smoke Dampers Final - - ... ---- ------ --- PASS PART FAIL ELECTRICAL Seivice Rough to - ------- -- UG/Slab Low Voltage - Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE: [ J Unable to inspect-no access ADA Approach/Sidewalk Date d ` Inspector Other _ - .-- -� Final PASS PART FAIL DO NOT REMOVE this inspection record from the Job sAte. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 539-4171 �— BLIP ^Date Requested 2�3_ __ AM PM BLp Location ? .� w C�r�S-� _ Suite — MEC _ Contact Person Ph y Z PLM Contractor Ph SWR UILDI Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Fig Drain Crawl Drain Inspection Notes' SGN W Slab _ __. ._. SIT Post& Beam Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: -- _ n �S PART FAIT_ — 1-UMBINQQ Post&Beam Under Slab TopOut --__-------..-.... .-_-- ---------- Water Service Sanitary Sewer __ ^------_-_-_ Rain Drains Fina! — __ -------- -- ----.�._ PASS PART FAIL — L Post 6 Beam — - -- --- - Rough In Gas Line --- -- -- Smoke Dampers ina ---- �_ P SS )PART FAIL TRICAL Service _ Rough In UG/Slab Low Voltage --- _- _-_.-- _.-- -- Fire Alarm Final PASS PART FAIL —�— --_ ---.__-----._.- —� —. --- SITE Backfill/Grading -- --- -- ` Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( J Please call for reinspection RE:__ [ J Unable to Inspect-no access ADA Approach/Sidewalk Date S- Z `3 — f�/ Inspector Ext Other p --- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD 13125 S.W. HALL. BLVD. TIGARD, OR 97223 IMPORTANT PERMIT Nn"NCE NORTHWEST PREMIER PLUMBING P.O. BOX 23338 TIGARD, OR 97281 Plumbing Signature Form Permit #: MST2001-00020 Date Issued: 011231'zuu ; Parcel: 2S111 BA-10900 Site Address: 09547 SW ELROSE ST Subdivision: LAUTT'S TERRACE Block: Lot: 003 Jurisdiction: TIG Zoning: R-4.5 Remarks: SIF Path 1 With walls advance framing R-19 Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing per iit to be valid, please have the appropriate individual from your company si;� below and return this Plumbing Signature Form prior to the start o� the work to the address above, ATT"v: Building Dept. No plumbing inspections will be authorized until this completes, form is received OWNER: PLUMBING CONTRACTOR- NEWCASTLE ONTRACTORNEWCASTLE HOMES INC NORTHWEST PREMIER PLUMBING PO BOX 23049 P.O. BOX 23338 TIGARD, OR 97201 TIGARD, OR 97281 Phone #: 503-684-7543 Phone #: 503-624-0582 Reg it. 1 Ir 135022 P! M 34-348PB AN INK SIGNATURE IS REQUIRED ON THIS FORM 1 S� nature of Authorized Plumber 9 If you have any questions, please call (503) 639-4171, ext. # 310 n ton J r,, w o S o v' N e�• • b a ^ f�9 r7 y o O �� co g � O s � O �O I �e E 0 a C I s �e 9' x CITY OF TIGARD -- —_MASTER PERMIT PERMIT#: MST2001-00020 DEVELOPMENT SERVICES DATE ISSUED: 01/29/2001 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 09547 SW ELROSE ST PARCEL: 2S111BA-10900 SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCK: LOT:003 JURISDICTION: TIG REMARKS: S/F Path 1 With wells advance framing R-19 BUILDING REISSUE: S'rORIF.3 1 FLOOD AREAS REQUIRED SETBACKS REQUIRED _ CLASS OF WORK: NEW HEIG!IT: 15 FIRST: 2,054 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SE FLOOR LOAD: 40 SECOND: of GARAGE: 441 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 12 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 2.05400 at VALUE: S 180,356.00 REAR: 17 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 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: MECHANICAL OTHER FIXTURES: - FUEL TYPES FURN<1100K: BOIUCMP<AHP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN>-100K: 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 FOR: 1 PUMPIIRRIGATION: PER INSPECTION: FA ADD't.500SF: 3 201 400 amp: 201 400 amp: tat W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 - 600 amp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp: 6014amps•1000v: MINOR LABEL: 10004 amp/volt: Reconnect only: PLAN REVIEW SECTION ---- >-4 RES UNITS: SVCIFDR)-=225 A.: >800 V NOMINAL: C.LS AREA/sPC C„C ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: X VACUUM SYSTEM: X AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING OUTDOOR LNDSC 1 7 BURGLAR ALARM: X OTH: BOILER: HVAC: LANDSCAPEARRIG PRO7rClIVESIGNI GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL O'fHR HVAC: X DATAITELE COMM: NURSE CALLS TOTAL a SYSTEMS. Owner: Contractor: TOTAL. FEES: $ 6,543.44 This permit is subject to the regulations contained in the NEWCASTLE HOMES INC NEWCASTLE HOMES PO BOX 23049 PO BOX 230459 Tigard Municipal Code,State of OR. Specialty Codes and TIGARD,OR 97281 TIGARD,OR 97281 all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of Issuance,or if the work is suspended for more than 180 days. ATTENTION. Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rag e: LIC 59667 forth in OAR 952-001-0010 through 952-001-0-030. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanical Mechanical Insp Framing Insp Gas Fireplace 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 Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Building Final Issued By : _ S-0 Permittee Signatur*OC 1-[' !—��— Call 503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT _ DEVELOPMENT Sk.RV.CES PERMIT#: SWR2001-00016 DATE ISSUED: 01/29/2001 13125 SW Hall Blvd.,Tigard, 'R ^i223 (503) 639-4171 , SITE ADDRESS; 09547 SW ELROSE ST PARCEL: 25111 BA-10900 SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCK: LOT: 003 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: I INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: S/F Path 1- Owner: - --- --------- FEES - — -- NEWCASTLE HOMES INC Type By Date Amount Receipt — PO BOX 23049 - -- — ----- TIGARD, OR 97281 PRMT CTR 01/29/2001 $2,309.00 27200100000 INSP CTR 01/29/2001 $35.00 27200100000 Phone: 503-684-7543 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections 1 his 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 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. Issued by: Permittee Signature: Call ( 03) 639-4175 by 7:00 P.M. for an Inspection needed the next business day ! , W��, -[ Building Permit Application `` Date received: , Pel.n .:„Zlj(I/-000 w City of Tigard Address: 13125 SW Ball Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: City of Ti)and Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 p Case file no.: Payment type: Land use approval: -e,6C C,5 _ _ 1&2 family:Simple Complex: ✓ -- &2 family dwelling or accessory U Commercial/industrial U Multi-family W New constuctitrtt U Demolition 0 Addition/alteration/replacement U Tenant improvement U Fin. ',III inHellalnrtn U e lthcr: INFORMATION Job address: 5 W 6 f 51- Flildg. no.: Suite no.: Lot: Block: S_uttdivision: Lej.,o-H'.5 I Tax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions:.51 AC�(� Name: /1/t.tNC0..5 (¢� �d Ste• (Floodplain.septic capacity,War,etc.) Mailing address: p p 0 I &2 family dwelling: City: Statc: dR ZIP:97 Z 9rl Valuation of work........................................ $ i8�1� Phone:&, -7,5y-_3Fax:k,?Y.U671 I E-mail: No.ol'bedrooms/baths................................. _ Z Owner's representative: c{t jVi i)Lo ✓ Total number of floors................................. / Phone T I'.-mail: New dwelling area(sq.ft. 2 o_6+ Garage/carport area(sq.ft.) _ O Name: / Covered porch area(sq. ft.) ......................... ^ 7 0 Mailing address: „S Deck area(sq. ft.) ........................................ City: State: 7.1P: Other structure area(sq. ft.)......................... Phon:: Fax: �I tn,il Commerciallindustrinl/multi-family: Valuation of work..................... ................. $ Business name: /VeWccLstL� Otn�S 1./1 CJ Existing bldg.area(sq.R►� ........................ Address: New bldg.area(sq.ft.) ... ..................... -- City: State: ZIP: Number of stories............ .... .................... Phone: Fax C-mail: Type of construction.... ............. ............... CCB no.: 7 Occupancy group(s): Existing: _. New: City/metro lie.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Addresse jurisdiction where work is being performed.If the applicant is City. Stal:�. II' -- exempt from licensing,the following reason applies: Contact person tPlan no.: — f'ltonc: Nance: /tii r LLQ, Cn illCC✓i Contact person: Fees due upon application ........................... $ Address: _ Date received: City: State: ZIP: _ Amount received ......................................... $ Phone: _ Fax: E-mail: Please refer to fee schedule. hereby certify I have read and examined this application and the Not all iurisfictions accept credit cards,please call jurisdiction t«more information. attached checklist.All provisions of laws and ordinances governing this Uvisa UMasterCard work will he complied with,whether specified herein or not. credit card number.— _ / —I— Authorized ��, ) raphe: Authorized sib,; luta-T .C�[G e�i� Dale:O/• /X'0/ Name of cardholder as shown on credit card s Print name: K. ldcW — Carditdder atsnuare _Amount Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-41,11(60WOM) One-and'I'wo-Family Dwelling Building Permit Application Checklist Reference no. Associated permits: cityojTigord Cid of Tigard City � U Electrical l:r Plumbing C]Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Other: Phone: (503) 639-4.71 — —� Fax: (503) 598-1960 FOLLOWINGTHE I ,and use actions completed.tics junsLlicuun cfitcna Iof L,mcurfcnt fcv icws. 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plot/lot. 4 Fire district_ _approval required. 5 Septic system permit or authorization for remodel.Existing systrm capacity 6 Sewer permit. _ 7 Water district approval. 8 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and kx ation of catch-basin protection,etc. 10 % Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable Ircal 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 tilts/plot plan drawn to scale.The plan must show lot and building setback dimensions;property corner ele-vations(if there is more tlian;.44t.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements 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 an a;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent sire and location. 13 Floor plans.Shmv all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inch--s above grade,etc. 14 Cross section(it)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. _ 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for tion-prescriptive path analysis provide specifications and calculations to engineering standards. _ 17 Floortroof framing.Provide plans for all floors/roof assemblies,indicating member siring,spacing,and tearing locations.Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar.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/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,roof 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 hive(5)site pians are required for Item 1 I above. 24 25 LL - 26 27 28 1- +-H Checklist must be 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. 4404614 c6^coMi Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl. Expire date: City,,fTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: ;Jobaddress: 11 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U Addilion/alteration/replacement ❑Other: U Partial RMSHYINFOkMATION JW el f at- Bldg.no.: Suite no.: ITax map/tax lot/account no.: Lot: 1 Block: Subdivision: Lau-lt :5 TQ//4CL, Project name: I Description and location of work on premises: Estfmated date of completion/inspection: Job no: Fee Max Business name: 1 n >LG✓Sfatt - �t✓7e, Descrl ion Qty- (es.) Total no.las Address: P D 6On 7 7_ _ dwellingNew its�� tamlly per attached prW. City: ,5 a, Slate:0k 'LIP: q-7 Q Serviceinclu". Phone:3 9 2.3 1 Fax E-mail 1000 s ,n.or leas 4 CCB no.: / Z, Elec.bus.lic.no: Each additional 500 sq.ft.or portion thereof Limited energy,residential 2 City/(petro lic.no.: Limited energy,non-residential _ 2 Each manufactured home or modular dwelling Signature of supervising electrician(requn ,l) Date Service and/or feeder 2 Sup.elect.name(print): License no: Services or feeders–Installation, alteration or relocation: 200 amps or less 2 Name(print): N.L LA/Ca J t-LA_ /Ia/►'LQ 5 Z/7 v 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: P p 8 Gx Z 0 601 amps to 1000 amps 2 City: qlci Stale:p►( I'LIP: q 72 11 Over 1000 amps or volts 2 Phone: 9J- 753 1 Fax (J.Ofo7/ I E-mail: Reconnectonly I Owner installation:The installation is being made on property 1 own Temporary services orfeeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,670,701. 200 amps or less 2 201 amps to 400 amps 2 Owners si nature: Date, 401 to 600 ams 2 Branch circuits-new,alteration, or extension per panel: Name: /VI i I l 1./ En /%/1 _ A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: o rt I a A d Slate:ale ZIP: B. Fee for branch circuits without purchase __-- – of service or feeder fee,first branch circuit: 2_ Phone: Fax: v E-mail: Each additional branch circuit: PLAN Rl N 11 11 (I'lease check all that upply) Mlw.(Service or feeder not Included): U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 18x2 U Hazardous ovation Each sign or outline lighting 2 familydwellings U Building over I(1,000 square feet four or Signal circuit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension' 2 U Building over three stories U Feeders,400 amps or more 'Ikscri tion: U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection,)ver the allowable In any of the above: U Egressniphtingplan U Other. _—_ Per inspection E _ Submit_sets of ph►ta with any of the above. Investigation fee _ The above are not applicable to(emporairy coastruction servl:e. Other Not all Jutirdirlions oceep credit caaLr,pleas call junsdictim lex trnxe inGmnatino Notice:This permit application Permit fee.....................$ _ U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit card number. __ L_L within 190 days alter it has been State surcharge(F..%)....$ Eapirex accepted as complete. TOTAL . $ Name of cardholder u shown nn c U c� _ S Cardholder signaium ---------Anu,um _ 44&4615(&WCOP4) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Foe...................................................... $75.00 Number of Inspections per permit allowed 1 (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Vbork Involved: Residential-per unit 1000 sq R or less _ __ $145 15 —^_ _ 4 ❑ Audio and Stereo Systems Each additional 500 sq.ft.or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy _V $75.00 Each Manufd Home or Modular —1 Dwelling Service or Feeder $9090 _ 2 LJ Garage Docs(pener' Services or Feeders ❑ Healing,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 _ 2 Vacuum Systems' ❑ 201 amps to 400 amps __ $106.85 2 401 amps to 600 amps $160.60_ _ 2 601 amps to 1000 amps $240.60__ 2 ❑ Other Over 1000 amps or volts _ $454.65 _ — 2 Reconnect only $66.85—_ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less _ $66.85__ _ 2 (SEE OAR 918-260-7.60) 201 amps to 400 amps $100.30_ 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit _ — $6.65_ ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of servfce ❑ Fire Alarm Installation or feeder fee. First branch circuit $4685 _ ❑ Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or Irrigation circle $5340 Each sign or outline lighting $5340 Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extensicn $75 00_ ❑ Landscape Irrigation Control' M nor Labels(10) $12500 Each additional Inspection over ❑ Medical the allowable In any of the above Per inspection _ $62 50_ ❑ Nurse Calls Per hour ____ $62.50 _ In Plant $73.75 ❑ Outdoor Landscape Lighting' Fees; ❑ Protective Signaling Enter total of above fees $ _ ❑ Other 8%State Surcharge $ — —_Number of Systems 25%Plan Review Fee See"Plan Review"section on g No licenses are required licenses are required for all other Installations front of application Fees: Total Balance Due $ Enter total of above teas $ Trust Account N _ 8%State Surcharge $___`-_ Total Balance Due $ —_ i:\dsts\forms\elc-fees.doc 10/09/00 Mechanical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expire date: Ciryu/Ttgurd Address: 131215 SW Hall Illvd,Tigard,'`^. "'"' -- - Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ Building permit no.: 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement 'New construction �_I Addition/alteration/replacentenl J()ther VALUATION SCI Job address: .5 Y�/ fim Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: id010Wq Suite no.: value of all. echanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: L3 jBlock: Subdivision: Z.ZW& T�yrca` *See checklist for important application information and Project name: —� jurisdi0i0n•s fee Schedule for reNidential lurmit tic. City/county: Washes .Q._I ZIP: 97;-2.q __-- Descripi;ot, and location of work on premises: —_ imum imi Fee(ea.) 'Total Est.nate of completion/inspection: Deerription Qty. Res.only Res.only Tenant improvement or change of use: A handling Is existing space heated or conditioned?U Yes U No Air handling unit CFM Air conditioning(site plan required) _ Is existing space insulated?0 Yes U No Alteration of existing FIVAC system _ of er compr Business name: O-Ly �p 5 n s i}{ rlState boiler permit no.: HP ---Tons BTU/H _ Address: P t7 L3 D Xaf^4 0 it smo c dampers/duct smoke detectors _ City: Slate:0/t:I ZIP: 9 7a.+D Heat pump(site p un require ) - Fax: E-mail nsta d p ace urnac turner Phone -7-75-59 Includint ductwork/vent liner U Yes U No _ CCB no.: q 6 2-$ -Tns i%cp ,-e/relocate heaters-suspen e , City/metro lic.no.: wail,or Fla::-.-,_unted Name(please print): Vent fora ance other than furnace e etwt n: CONTAff PERSON Absorption units — BTC!Il Name: +r, Chillers J I./�l ) �J_- - _ Compressors HP Address: —�5 Q l Environmental exhaust and ventilation: City: _ State: ZIP: Appliance vent Phone: I'.dx: E-mail: Dryetexhaust _ Hoods,Type I Fres. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct(bath fans) _ Mailing address: —� u - sx nulls stem apart from heating or AC City: — State: ZIP: Ue P P ng and di4ribution(up to 4 outlets) —{ Type --LPG ___ NG _— Oil -- Phone: Fax: E-mail: i pin each additional over 4 outlets rocesspiping(sc ematicrequire ) Name: Number of outlets t er aped fiance or equipment: Address: Decorative fireplace City: _ — State__ 7,IP: nsert-type Phone: Fax: Email: 71*7 et stove — Applicant's signature: Date: Name(print): _ — Not all jurisdictions accept credit carrtt,please call jurisdiction for mote information Permit fee.....................$ U visa U MasterCard Notice:This permit application Minimum fee................$ expires if a permit is not obtained plan review(at -_ %) $ _ t•tedit card number: —_ -- -- - within 180 days after it has been Name of cnrd fodder as shown on credit card - - accepted as complete. State surcharge(8%)) ....$ s TOTALL .....g..................$ —Cardholder signature Amoum W-4617(NW170M) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEES - Description: Price Total TOT to$5,ALU Minimum fee 272.50 Table 1A Mechanical Code � Qty (Ea) Amt- $1.00 1) Furnace t $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and $1.52 for each addl,,,)nal$100.00 or including ducts 0 BTU &vents 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ $10,000.00. including drets R vents __--_ 17.40 $10,001.00 to$25,000.00^ $148.50 for the first$10,000.00 and 3) Floor Furnace 14.00 - $1.54 for each additional$100.00 or _ including vent -`- fraction thereof,to and including 4) Suspended healer,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 -_- 8.80 fracflon thereof,to and Including 6) Repair units $50000.00. 12.15 `-- $50,001,00 and up $742.00 for the first$50,000.00 and Check all that apply Boiler feat Air $1.20 for each additional$100.00 or For Items 7-11,see or f'ump Cond fraction thereof. rootnotes below. Comr,` `- 7) c3HP;absorb unit to 100K BTU 1400 _ ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb Value Total unit 100k to 500k BTU 25.60 Descri Uon: Qt Ea Amount 9)15-30 HP;absorb Furnace to 100,000 BTU,Including 955 unit.5-1 mil BTU -- 35.0^ ducts&vents _ -- 1U)3 Floor furnace Including vent HP;absorb Fwnace>100,000 BTU Including - 1.170 unit 1-1.75 mil BTU 52.20 ducts&vents -- 11)>50HP:absorb 955 __ unit-1 75 mil BTU 87.20 Suspended heater,wall heater or 955 12`Air handling unit to 10,000 CFM floor mounted heater _ 10.00 Vent not Included In applicance 445 13)Air hanc' :ig unit 10,000 CFM+ permit _- - 17.20 Repalr 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 6 80 101k to 500k BTU 16)Ventilation syste�o not Included in 15-30 hp;absorb.unit,501k to 1 2,310 applianre permit 10.00_____ mil.BTU 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 10.00 1-1.75 mll.BTU 18)Domestic incinerators >50 hp;absorb,unit, 5,725 1740 `^ >1.75 mil.BTU 19)Commercial or Industrial typeincinerator Air hR ndling unit to 10 000 cfrn 656 _ 69.95 _ Air handlinn unit>10,0110 cfm 1,1 0 - 20)Other units,Including wood stoves Non-portable eyeporatrr cooler 658 _- 10.00--- Vent 0.00 -____Vent fan connected to a single duct 446 21)Gas piping one to four outlets _ Vent system not Included In 656 _ _ 540 _ a iandce ermlt -.-. 22)More than 4-per outlet(each) Hoed served by mechanical exhaust 656 _ 1.00 Domestic Incinerator I'm Minimum permit Fee$72.50 SUBTOTAL: $ Commercial or industrial Incinerator 4,590 Other unit,including wood stoves, 656 8%State Surcharge $ Inserts,etc. _ Gas piping 14 outlets_ _ 360 - 2514 Plan Review Fee(of subtotal) $ Each additional outlet - 63 Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIA1. PERMIT FEE: $ VALUATION: �_-- Other InspActlons and Fees 1 Inspections outside of normal business hours(minimum chart-two h, rrs) $72 50 per hoer 2 Inspections for which no lee is specifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions t�plans(minimum charpe-one-half hour)$72 50 per hour "State Contractor Boller Certlf atlon required for wilts>20nk BTU. -Residential AIC requires site plan showing placement o' :ldstsVorrnsVnech-fees.doc 10/11/00 Plumbing Permit Application Mrae re City Permit no.: y of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hell Blvd,Tigard,OR 97223 City of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503)598-1960 Date issued: By: Receipt no.: Land use approval: _ _ Case file no.: Payment type: t� 'U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement X New construction U Addition/alteration/replacement U Food service U Other: INFORMATIONJOHAITE Job a es,: N/ E;/ die.- �(- -- I)escrlption Qty, Fee(ea.) Total Bldg.no.: — Suite no.: Nevi 1-and 2-family dwellings only: (Includes 100 It.for each utility connection) Tax map/tax lot/account no.: T_ SFR(1)bath Lot: 3 Block: SubdivisionSFR(2)bath -_-- Project name: SFR(3)bath _ City/county: WCL3 h s it tzZIP: 1172-24 Each additional ba-dWi-tc en Description and location of work on premises: Site utilities: Catch basin/arca drain _ Est,date of completion/inspection: Urywells/leach line/trench drain 1 Footing drain(no.lin.ft.) Manufactured home utilities Business name: ND 1-rh Wez-i- Prf_-Y)i,/ P/CJrn6lA- Manholes — -- Address:P6 BOX 7-3 3 3 8 Rain drain connector _ City: 7)'r 0-rd Stat.ezA, I ZIP: 2.8/ Sanitary sewer(no.lin,ft.) Phone: 3, '7 9 2 3 1 Fax: _ E-mail: Storm sewer(no.lin.ft.) CCB no.: 13 5 p z 2 Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: Fixture or Item: Contractor's representative signature: Abso, on valve: Back Flow preventer Print name: Date: Backwater valve 1 Basins/lavatory Name: rl W c�tf_s Clothes washer — — Dishwasher Addres1q: - _ Drinking fountain(s) _ City: -� State: LIP: Ejectors/sump Phone: Fax: E-mail: expansion tank Fixture/sewer cap Name(print): Floor drains/floor sinks/hub Mailing address: — Garbage disposal - -- Hose bihb City: —_ State: ZIP: Ice maker Phone: Fax: I E-mail Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on die property I own as per ORS Chapter 447. Sink(s),basin(s),lav_s(s) owner's signature: _ Date: Sump Tubs/shower/shower pan _ _Name: Urinal - -- Water closet Address: Water heater City: State: ZIP: __ Othcr: - Phone: Fax: Email• —•�i -- -- --- Not all jurisdictions accept credit cords,please cell jurisdiction for molt infomtmion. Notice:this permit application Minimum fee................ ❑Ville U MasterCard expires if a pencil is not obtained Plan review(al _( %) $ Credit card number: _ -_ � within 180 days alter it has been State surcharge(8N,, ....$ Expires -- accepted as complete. TOTAI. ....... ...............$ _ Name of cardholder as shown on credit card _ _ S `- --- Cardholder signature Amount 440.4616(6MC'OM) PLUMBING PERMIT FEES: PRICE TOTAL —we—w-1 and 2-family dwellings only: _FIXTURES (Individual) QTY _(ea AMOUNT (Includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection One Tub or tub/Shower Comb 16.60 i bath — -249.20 _ Wo ba) th — -350.00 Shower On!;, — 16.60 �— Three 3 bath $399 —' ___�" _ .00 Water Closet 16 60 _ SUBTOTAL Urinal 16.60 8%SPATE SURCHARGE Dishwasher — 16.60 _ PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 _ _.-_ __� TOTAL Laundry Tray — 16.60 Washing Machine—� 16.60 _ Floor Drain/Floor Sink 2" 16.60 3" - 1660 PLEASE COMPLETE: 4" 16.60 _ Water Heater O conversion O like kind 16.60 _ Quantit b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ _permit. MFG Home New Water Service 46.40 Sink _ MFG Home New Sen/Storm Sewer 46.40 Lavatory Hose Bibs 16.60 T ub or Tub/Shower Combination _ Roof Drains 16.60 Shower Only _ Drinking Fountain 16.60 Water Closet Other Fixtures(Specify) 1660 titin-!—_� Dishwasher _ Garbage Disposal _ Laundry Room Tray Washing Machine _—_ --_ Floor Drain/Sink: 2." Sewer-1st 100' 55.00 3" Sewer — Sewer-each additional 100' 46.40 4" Water Service-1st 100' 5500 Water Heater Water Service-each additional 200' 46,40 Other Fixtures Storm$Rain Drain-1st 100' 5500 LSe — Storm R Rain Drain-each additional 100' 4640 Commercial Back Flow Prevention Device 46.40 --- , — Residential Backflow Prevention Device' 7,55 --- -- Catch Basin — 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 85.25 Grease Traps 1660 --_--_ QUANTITY TOTAL --- "— Isometric or riser diagram is required if -- _ Quantity Total Is >9 _ -- ------- --- 'SUBTOTAL -- -- -- 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only if fixture qty total is>9 TOTAL .Minimum permit fee is$72 50+8%state surcharge,except Residential BacFBow Prevention Device,which Is$36 25-8%state sulchatge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review !Adsts\forrns\plm"fees.doc 10/10/00 SEE 35MM, ROLL# 22 FOR LARGE DOCUMENT 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 #: MST2001-00020 Daie 15tiued: 01/29/2001 Parcel: 2S111 BA-10900 Site Address: 09547 SW ELROSE ST Subdivision: LAUTT'S TERRACE Block: Lot: 003 Jurisdiction: TIG Zoning: R-4.5 Remarks- S1F Path 1 With walls advance framing R-19 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 requi-ed. Please have the appropriate individual frorn your company sign below arid return this Electrical Signature Form prior to the start of the work to the address above, ATTN- Building Dept. No electrical inspections will be ai.ithorized until this completed form is received OWNER: ELECTRICAL CONI RACTOR: NEWCASTLE HOMES INC INTERSTATE ELECTRIC INC PO BOX 23049 PO BOX 7342 TIGARD, Ot? 972°1 SALEM, OR 97393-10068 Phone #: 503-684-7543 Phone #: MBL 393-2223 Ren #: L.IC 11.7121 SUP 1479S ELE 24-354C AN INK SIGNATURE IS REQUIRED THIS FCR i Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310