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8811 SW GREENING LANE Oo to J sU) ^G Y/ 1 CD r 03i t, i j 1 I 8911 SW Greening Lane CITY OF TIGARD 13125 S.W. HALL BLVD. T IGARD, OR 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VALLEY HWY S ALOHA, OR 97006-1248 Elect ical Signature Form Permit #: MST2000-00542 Date Issued: 115101 Parcel: 2 S111 DA-17700 Site Address: 08911 SW GREENING LN Subdivision: APPLEWOOD PARK NO. 3 Block: l-ot: 171) Jurisdiction: 7'IG Zoning. R-7 Remarks: SIF PATH 1 Your cc^,pany has been indicated as the electrical contractor for the permit indicated above In order for the e!ecirncal permit to be valid, the signature of the supervising electrician is required. Please t ave the appropriate individ,-al from your company sign below and return this Electrical Signature Farm prior to the start of the wok to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWN!=P: ELECTRICAL CONTRACTOR. MATRIX D►.=VELOPMENT CORP GARNER ELECTRIC 6900 SW HAINES ST STE 200 21785 SW TUALATIN VALLEY HWY S TIOARD. OR 97224 ALOHA, OR 57006-1248 Phone #- Phone #: 591-1320 Req #: LAC 121159 .SUP 3707s ELI 34-305C AN INV %'-:I NATURE IS REQUIRED O TH)S F�M X - - Signature of SLi pervising Flectrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD BUILDING INSPECTION DIVISION MST �� 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - - ---- BUP --- Date Requested -I� -`- AM PM _4 BLD Location__ � 1� ��✓ CJ�.o �� _Gy,�-- Suite _ MEC Contact Person --- -- -- Ph 'S1� `� '1 Z -- PLM ------ --_-- / Contractor - _ -_, Ph 33 7v SWR _-_----- �_ �) Tenant/Owner -------- ELS- - Retaining Wall Footing ► ELR Access Foundation FPS Ftg Drain Craw' Drain Inspection Nodes: SGN Slab -__ ---_------ -_ -- SIT Post& Beam -_-- -- - Ext Sheathi Shear Int Sheath/Shear - Framing ! f �s) i Z-r ^-t i:- � PLLEl7y - 'nsulation �}� Drywall Nailing Firewall ------_----------_-_ _ Fire Sprinkler _- Fire Alarm �- Susp'd Ceiling -— - ----,� - --- Roof ic' ------ ---.... - ---- - --- --- ASS PART FAIL --- ----_-----�---_ _----_--- _ PLUMBING -- ost fs, [ yam Under Slab Too Out - -----...------- ------- ------ -__ - - Water Service Sanitary Sewer Rain Drains Final -------...----- -____---- --_._-�- ---__--------- PASS PART FAIL Rough In Gas Line Smo Dampers L ------- -- --- --- ASSPART FAIL LECTRICAL - - ---- ------ -- ---- ----____ __-�-_ _ -------_--_-- ServiC.e. Rough In -- -- ---------------- --------- UG/Slab ------------------- I..ow Voltage ----..._..---- F ire Alarm I-incl -_----- - - ------ ---- ._-_ ---------------------- PASS PART FAIL ---------.----..--o__---__-_-- SITE � ------ - — Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$-_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ] Please call for reinspection RE:.-_- _ - [ J Unable to inspect-no access ADA Approach!Sidewalk Other Datej 1�!�� i Inspector Ext Final ._.__ ----------------- ----- PASS PART FAIL , 00 NOT REMOVE this inspection record from the job site. CIT`.! OF TIGARD BUILDING INSPECTION DIVISION ��.�dG�U- 64371/2- 24-Hour Inspection Line: 639-4175 BU3iness Line: 639-4171 B iJ P _Date Requested _ cw PM BLU Location I�L � s•-�� '-. l c -- - Suite _ MEG ---- -- -3 u Contact Person Ph ��L'� i° PLM Contractor Ph SWR BUILDING Tenant/Owner _ Ek _ _ .� Retaining Wall I FLR Footing Access: Foundation FPS _ Fig Drain _ Crawl Drain Inspection Notes SGN Slab _.-- -------_.__-. �------._- SIT Post& Beam - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprir :,�r Fire Alam -- Strsp'd Ceiling - -- - ----- ------.. ------- — -_ ... ---- ----- -.-._. ----- - -- Roof Mise --__---- Final PA -. PART FAIL -- - -- ---___ .__ - ----- ..�---- ---- -- -- ---- �_ UM d I i Post& Beam Under - Under Slab Top Out --- --- ---� - - Water Service Sanitary Sewer Rain Drains AS^ PART FAIL MECHANICAL Post& Bearn Rough In Gas Line --- ------ —_ -- - -�____. ✓ Smoke Dampers Final �— —�.------ - ----- — -- - --�-_� --- ---. - PASS PART FAIL ELECTRICAL Service Rough In -- UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL _-- SITE Backfill/Grading Sanitary Sewer Storm Drain [ Reirspection fee of$ _required before next inspection Pay at City Hell, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ I Please call for reinspection RE _ __ _- — I 1 Unable to inspect-no access ADA on z SiL. ApproachiSidewalHL1 _ �� . Other Date � ` Inspector J f —` Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST , _ G.0 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 --T-/ BUP' Date Requesied 5_ _4 RAM— `' PM _ BLID .-.----- Location _ Suite MFC Contact Person Ph — IG PLM Contractor Ph SWR _— — BUILMING �— Tenant/OwnerELC _-- --- -_- Retaining Wall -- — ELI Footing Access. (�S, ----- --- Foundation F Ftg Drain --- -- SGh Crawl Drain Inspection Notes - ---------_---- Slab --- - - - -- -- _ -_-- ---- ----- _ -- SIT Post& Beam ---i-�-- - Ext Sheath/Shear Int Sheath/Shear � � ------'--^---.�_-- Framing Insulation Drywall Nailing - ------ ----- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- -------- - - -- — ------ Roof Misc: Final EA5Z P RT FAIL U�B111 Unkab VN �C/)' - -- -- - - - -- - -- rvice Sewerins PASS PART FAIL _ MECHANICAL Post& Beam - - -- - ---- --- - - --------------- Rough In Gas Line Smoke Dampers Final --- ---- - -- --- ------ -- -_—� __ - RT FAIL ELECTL, _- _ - ------ - -- ___- _------..----_.------ ------------___,.-...� Service Rough In UG/Slab Low Voltage F. rm }SAS PART FAIL _ - -----.-. ----- ------- -- ---- ----- Backfill/Cradir; —. —.� -- --------- ---- ------------- --- Sanitary Sewer Strnm Drain ( ]Reinspection fee of$ —required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ]Please call for reinspection RE:______ [ (Unable to inspect-no access Fire Supply Line ADA .` Approach/Sidewalk Date L%= Inspectorx C � Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. � o � a 0 o v' �1 1 'cam ti. � a N 7 , C 0 x a' 1 Ii1 1 CITY OF T I GA R D MASTER PERMIT PERMIT#: MST2000-00542 DEVELOPMENT SERVICES DATE ISSUED: 1/5/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 08911 SW GREENING LN PARCEL: 2S111DA-17700 SUBDIVISION: APPLEWOOD PARK NO 3 ZONING: R-7 BLOCK: LOT: 170 ,JURISDICTION: TIG REMARKS: S/F PATH 1 BUILDING REISSUE. STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK, NEW HEIGHT: 24 FIRST: 1.034 st BASEMENT st LEFT. 4 `SMOKE DETECTORS. r TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,286 at GARAGE: sf FRONT: "ro PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: sf RIGHT: 4 VALUE. 5 3.1''7 OCCUPANCY GRP: R3 BERM: 3 BATH: 3 TOTAL: 2,320.00 sf REAR: 22 PLUMBING _ SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS. LAVATORIES: 4 DISHWASHERS. I FLOOR DRAINS: SEWER LINES 1-1 SF RAIN FRAINS: 1 CATCH BASINS- TUWSHOWERS. i GARBAGE DlSP: I WATER HEATERS: I WATER LINES: 'nn BCKFLW PREVN7R: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL r- FUEL TYPES FL'RN<TOOK bOILICMP c 3HP: VENT FANS: 5 CLOTHES DRYER: I GAS FURN>-100K: I UNIT HEATERS HOODS. i OTHER UNITS: I MAX INP: btu FLOOR FURNANCES: VENTS. I WOODSTOVES GAS OUTLETS: I ` ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SPVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS _ 1000 SF OR LESS: I 0 - 200 amp: 0 200 amp: WISVC OR FOR I PUMP/IRRIGATION. PER INSPECTION: EA ADO'L 5005F. 4 201 400 amp201 - 400 amp. 1st WIO SVCIFDR: gill SIGNIOUT LIN LT' PER HOUR. LIMITED ENERGY: A01 600 amp: 401 - 600 amp' EA ADDL BR CIR. SIGNAL/PANEL: IN PLANT. MANU HMISVCIFDR: 001 1000 amp: 601-01711)5-1000v. MINOR LABEL: 1000+amplvolt PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS. SVC/FDR> 225 A.. >600 V NOMINAL- CLS AREAISPC OCC - ELECTRICAL-RESTRICTED ENERGY _ A.SF RESIDENTIAL B.COMMERCIAL _ AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO B STEREO, FIRE ALARM: IN7ERCOMIPAGING: OUTDOOR LNOSC LT BURGLAR ALARM: OTH: BOILER-. HVAC. LANDSCAPEIIRRIG: PROTECTIVE SIGNL. GARAGE OPENER CLOCK: INSTRUMENTATION MEDICAL- OTUR. HVAC DATArrrLE COMM: NURSE CALLS: TOTAL 0 SYSTEMS. TOTAL FEES: $ 4,097.45 Owner: Contractor: This permit Is subject to the regulations contained In the MATRIX DEVELOPMENT CORP LEGEND HOMES CORP Turd Municipal Code. State of OR Specialty Codes and 6900 SW HAINES ST STE 200 12755 SW 69TH AVE#100 all other applicable laws All work will be done In TIGARD,OR 97224 TIGARD,OR 97223 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 1^,W requires you to follow rules adopted by the Orego 1 Utility Notification Center Those mles are set Reg# LIC 60563 forth In OAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED I14SPECTIONS Erosion Control Insp 8, Post/Beam Muchanica Mechanical hasp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Mechanical Insp Shear Wait Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plurnb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr; Elerluc.al Service Low Voltage Water Line Insp Final inspection Post/Beam Structural PLM/Underfloor Eleculcal Rough In Gas Line Insp Appr/Sdwlk Insp Building Final Issued By : L-e Permittee Signature Call (50 1) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00369 i 1125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1!5101 PARCEL: 2S111 DA-17700 SITE ADDRESS; 08911 SW GREENING LN SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 170 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 114STALL TYPE: L.TPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF dwelling. Owner:_ - _ FEES MATRIX DEVELOPMENT CORP Type By Date Amount Recc;pt 6900 SW HAINES ST STE 200 — — - TIGARD, OR 97224 PRMT CTR 1/5/01 $2,300.00 27200100000 ' INSP CTR 115/01 $35.00 27200100000 Phone: ^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 Jays 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 lat.,rals If the sewer is not located at the measurement given,the installer shall F -ospect 3 feet in all directions from the distance given. If riot 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 ZIssu �/ ed by: � -- ___` Permittee Signature �� Call ( 03) 639-4175 by 7:00 P.M. for an Inspection needed the next business day I :JW (v l Building Permit:Application Date received: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Prolect/appl.no.: Expiredale: City nJ'I igard Y�Date issued: B Recei t no.: Phone: (SU3) 639-4171 p Fax: (503) 598.1960 Case file no.: Payment type: q Land use approval: 1 t&2 family:Simple Complex: ' all W Kilo lam tic I I &.2 family dwelling or accessory U Commerc aUindustrial O Multi-family eNew construction ❑Demolition U Addition/alteration/replacement U Tenant improvement 0 Fire sprinkler/alarm ❑Other. — JQH SIYE IWOON Job address:_ ( Ol� (532,t,' �/n)�1 LA-6j tBldg,no.: Suite no.: Lot: U Block: — Subdivision: V&P(3CGe.. X1 ,Q .PPvt fes- 1– Tax map/tax lot/account no.: Project name: _ Description and location of work on premises/special conditions: La .3 2- c/ _3L -31 011 N Lit FOR SPECIAL INFO.FNIATION, Name: t railing add ss: /,a � ��_ - �� 1 &2 family dwelling: ��E� y� Slate:p 7_IP: j7 Valuation of work........................................ $ne: G (� o Fax• - GYM E-mail: No.of bedrooms/baths................................. � _ �wner's representative: Total cumber of floors................................. 2— P - -- --- -- ------- Phone: Fax: Email New dwelling area(sq. ft.) .......................... ZC Garage/carport area(sq. ft.)......................... 7me: Covered porch area(sq,ft.) add ss: Q — Deck area(sq. ft.) ........................................ City: , Stateo ZIP: Other structure area(sq. ft.)......................... _ P ,one: (�- Faxl> Email:— Comrnerelallindustria!!multi-family. Valuation of work........................................ $ Business name: Q ems' 6zS Existinp bldg.area(sq.ft.) .... ..... ............. y Address: �c�t New bldg.area(sq. ft.) Cityly State��ZIP:`7'7a� Number of stories. _ -- Phone: o ca ) Fax:�� - - E-mail: Type of construction.................................... t'cCCB no.: Occupancy group(s): Existing: 3 �' New: City/metto lic.no.: G 7 Notice:All contractors and subcontractors air.required to be licensed with the Oregon Construction Contractors Board under Name: O f- provisions of ORS 701 and may N required to be.licensed in the. Address:/ 3 j Y— jurisdiction where work is being performed. If the applicant is City: P"'o StateCv IP: 9J exempt from licensing,the following reason applies: Contact person: �_ _fit j!? Plan no.: J —" --- Phone:4,do - o v Fax-. - E-mail: ENGINEER _Name: r l Contact person: Fees due upon application .................... ...... $_ Address: earl Date received: City: ai StateeNr 'LIP: 11 7,? J� Amount received ......................................... 5 Phone: p Fax E-mail: — Please refer to Cee schedt le. hereby certify I have read and examined this application and the Na all jurisdicdoos socerx credh ceras,please call jurisdi,non for more inforrrtstion attached chec'dist. All provisions of laws and ordinances go verning this U visa U MasterCard work will be complied with,whether s cifiod I in or not Credit crud"amber'— -- _ Exp:ms Authorized nature:._ o a1 (0 Co Nm a of cud oldu es shown on credit cud Print name: ! —_ Gadholder signature Amount J Notice:This permit applicali n expires if a permit is not obtained within 180 days after it has been accepted as complete. VG-4613(MnICOM) Mechanical Permit Application rDatercce�iyed: Permit no.: City of Tigard Project/appl.no.: Expire date: — CiryoJTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: 1 Receiptno.:_ Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: 1 Building permit no.: Land use approval: Aff I&2 family dwelling or accessory U Commercial/industrial U Multi-family D Tenant improvement dNew construct inn U Addition/alteration/replacement U Other: _- Job address: _ ((( �(,J �_` ruff C C�`/E__ Indicate equipment quantities in boxes below. Indicate the dollar Bldg—•no.: — Suite no.: -- value of all mechanical materials,equipment,labor,overhead, profit.Value$ Tax map/tax lot/account no.: _ Lot >� Block: Subdivision: l d *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP _L Description and 1 etion of work on premises: t t _ Fee(ea.) Total Est.date of completion/inspection: - - Dpi Qty. Res.only Rea.only C: Tenant improveme r change of use: Air handling unit CFM Is exjsti space heated or conditioned?U Yes U No Air cont3ioonjng(sue plan required) _ Ise ' ,ing space insulated?U Yes U No A reran ^o o existing I system To'iler compressors State boiler pMrmit no.: Business name: _! HP Tons BTU/H Add a s: I O 3 ' tr smo a amper! Tuct snI5keaetecto_rs Cit �tatg� ZIP: 9� -ileac pump sue plan required City nstal replace furnace/burner Phone: - 7 7 Fax: 5" 7GG Email: _,�_ �_'� Including ductwork vent liner ❑Yes U No _ CCB no.: _ Instalplac re ocate eaters-suspen e , City/metro lic.no.: a wall,or Floor mounted Name(please print): �pl/ a enc ora ianceocider anurnace Refrigeration: Absorptio-tunils __ BTU/H _ Chillers FIP Name: �pr/�)Ct _ _—� HP Com lressors__.� Address: J S — v ronmenta exhaustan gent ton: Cit State:n� ZIP: 9?,2 3 A 'iancevcnt — y: �v Z`: c�- PP� E-mail: erex exhaust _ _ Phone' 7) FaxiAj-, 7L tx,3s.I ypc�Tl7res.�hetJhazmat • hood fire suppression system - Name: p ,p fJ/1 Exhaust fan with single duct(bath fans) — ��@ 1--'� — CxTaus:s stem Apart,roam eaun ori- Mailing address: .1 _ '4� Fuelpiping and dtstrtbut on up to out ets City 1�_ Stal�"j,Q zrn:91 Type: --I.Pc NG _Oil Phone:/--V J G� Fax' E-mail: vel tin eacji a d.ti6n.(uvcr out ets cess piping(schetmaw:required) Number of outlets _. Name' /mac �r terst acs ppllanie or equ pmment:— Address: l Decorative fireplace ZIP: -type State: nsert-type --- Y - ---f— --r � Phone: foal- Gb pe et stove Fax: E-mail: G1.- Applicant',. signature:�� ate. er. 7TEH — Name (Print): Permit,.ee.....................$ Nu dl jurtsdirtiarr accept credit cards,pleale call jurisdrnt iction for more infoatioo. Nuke:This permit application p tinir um fee................$ U Visa U MdsterCard expires if a permit is not obtained plan review(at —_ %) S Credit cod numher - Expires - within Igo days after it has been State surcharge(896) ••••$ - �-- - accepted as complete. Name of cudholder u shown on credit card $ TOTAL ...... ................$ _ {_ Cudhoider signature— Amount 4404617(tiltlfY(:ON) Commercial Schedule 1&2 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE - - -. Desaptbn Furnace to 100,000 BTII Table IA Mechanical Code oly Price Total including8 vent, 955 Q Furnace to 100,000 BTU ducts _-- r,aua;nA rinse a venra 14.00 Furnace>100,000 ET J 2)Fuoaue 100,000 eTU. Inanding ducts 5 vents 17.40 Including ducts&vents 1,170 3) Floor Furnace Indudiri vent 14.00 floor furnace 4) sueperded heater,wait healer Including vent 955 or floor mounted heater 14.00 suspended heater,wall heater 5) vent not induo:d in appliance permil _ 6.60 or floor mounted hea`sr 955 61 R k unas 12.15 Check so Ihsl apply 'Boiler Heal Alf Vent not included in appliance permit 445 For nems 7-10,see of Pump Gond oty Pike Total - 805 footnotes 1,:uCom Repair units 7)SHF; bna to <a hp;absorb unit 100K BTU - 14.00 6)3-13-15 HP;absorb una to 100k Bl U 955 took to 500k eTU 25.60 3-15 hp;abSOfb.Uul( -_~ 9)15.30 HP;absorb una.5.1 mil BTU 35,00 101k to 500k BTU 1700 10)30.5011P;absorb - - - - unit 1.1.75 ma eTU 52.20 15-30 hp;absorb.unit 11)�WHP;absorb unit a,1.75 mu BTU 501k to 1 mil.BTU 2310 12)Air handling una_ l0 10,000 CFM 00,0 _ __ 30-50 hp;absorb.unit 10'00 131 Ale handling unit`10.000 CFM. 1-1.75 mil.BTU 3400 _ 17.20 14)NNor-portable evaporate 00oler >50 hp,absorb.unit 10.00 > 1.75 rail.BTU 5725 15)Vent fan connected to a single dud 8.60 Air handling unit to 10,000 cfm _ 656 16)VenWs(Wnaystem not InckKW M Air handling unit> 10,000 cfrn 1170 11)I�tood�i a a mechankal esnauut - 1000 • --- _ 10.00 Non-portable evaporate roller 656 is)Domevic ktanersfors vent fan connected to a single duct 446 mmne - 1T40 19)coerdal or Wultdal type Indtelor Vent syst.not Included In appliance permit 656 09.95 Hood served by mechanical exhaust 656 70)Other units,Inc ding wod oatovea �- 10.00 Domestic Incinerator 1170 21j GGi Poing one to your outlets 5.40 (Jommerclal or Industral Inclneralor 4590 22)More than 4-per outlet(each) 1.00 Other unit,Including word stoves,inserts,etc. 655 Minimum Pennil Fee$12.50 SUBTOTAL Gas piping tit outlets 360 ex SURciARGE Each additional outlet 6.3 PLAN REVIEW:5%OF SUBTOTAL Y, Required for AU commercial permits ovly T07AL War 1,aparlbnt end seer: r 'mpeoUorw ouBNr d n0rrral hutrnalt htLLn(rrYrYnrm d11100 Fo Mal $72 50 per h- 2 in padMru for nN 11 M ka b WedMiM MlcOMe:nv1M.a'0 cf "Il h0u1 $72 50 par parr Total luation F _ s A4dkk,,W 0-"e N'o'r *Id"danger.$"-Ia revhMm b pent It"-- duvpe4rehas Inv}$77 50 Per Mir 'SMI.Conaadar Boa.Cerlafrsbon requked S 1.00 to 55,000.00 Minimum$72.SO -".WdM"'r Nc".rarer tae pian at'.."r1sotinne of,." S1001.00 to S10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional 5100.00 or fraction thereof, to and including$10,000.00 S 10,OC 1.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for each additional$100.00 or fraction thereof,to and including S25 000.00 $25,001.00 to 550,000.00 5179.50 for the first$25,(1)0.00 and$1.45 for each additional$100.00 or fraction thereof,to and including 550,000.00 5n 1xtn.[x)arc!up S742.00 for the first 550,000.00 end 51.20 for each additional$100.00 or fraction - - _- thereof_ Plumbing Permit Application Date received: Permit no.: City of Tigard Sewer permit no.: Building permit no.; Address: 13125 SW[fall Blvd,Tigard,OR 9722.3 City of Tigard phone: (503) 639-4171 ProjecVappl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Ladd use approval: Case tile no.: Payment type: 1 &2 family dwelling or accessory ❑Commercial/irrdustrial U Multi-family O Tenant improvement U'New cet►struction U Addition/al teratiotdrgl ace men ❑Food service O Other: ffmJob address: s_(nl &AZt V/iyb Clig^Jt-- Description (lty. Fee(ea.) Total Bldg.no.: Suite no.: New 1-and 2-family dwellings only: (includes 100 fl.for each utility connection) _Fax map/tax lot/accouat no.: SFR(1)batt Lot: -r Block: - Subdivision: - �' � G SFR(2)bath_ - --- — Project name: __ SFR(3)bath _ City/county:� ,�� L 2 - . Each additionaT FRthlkitchcn Description and 14ation of work on premises: Site utilities: _ Catch basin/area drain Est.date of completion/inspection _ Drywells/leach linUtrench drain .11 t INro ! Footing drain(no.lin.ft.) Manufactured home utilities Business name: ��1� ��y, Manholes -- Address C9 3 o DORain drain connector --�-- City� g {�gfiY State:p Z1Y: /p'd Sanitary sewer(no.lin.ft.) _� 22__.._. jC(C:13 one: (,7- / Fax:G/.7-y E-mail: Storm sewer(no.lin.ft.) no.: Plumb.bus.reg.no �ZD Water service(no.lin.ft.) City/metro lic.no.: Fixture or Item: Contractor's representative signature: f Absorption valva: Back flow pn;vcn,er Pint name: P �d 0,,1 Date: (1D Backwater valve ! ! �asins/lavatory �^ Name: Clothes washer /ate �'a. _- _ Dishwasher _ ---- Address: pre B e fi p0 % -Drinking fountain(s) City�_�1��� I Stated ZIP: 1 lJ Ejectors/sump - Phone: Fax: E-mail: Expansion tank — 1 Fixture/sewer cap Nainerint : d Floor dtains/floor sinks/hub (p ) LG �� -- Garbage disposal - Mailing address: ��- - G -- - _ Hose bibb City: vtf off/ Statc:a"PIZIP: 9Z';2` — Ice maker `- Phone; -,Vo ) I Fax:d - Gmail: TE[nterce�rtodgrease bra_►�- ` Owner instal lation/residential maintenance only: The actual installation Primet�s) _ will be made by me or the maintenance and repair made by my regular Roof Fdrain(commercial) - employee on the property 1 own P prr ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Sump - - Tnbs/shower/shower pan Name: Urinal Address: --- WatCr Clcloset _ _ 96 _ ' � b��. Water heater City: State'1 ZIP: Phone: G _Lp�� Fax: — E-mail: Total Na vl JuriedicNont accept credit cud+,please call Iurirdkilon roe more inr<rmation. Minimum fee............ .$ _ Notice;71tis permit application �— U Visa U MulerCud Plan rrview(at — %) $ expires if a permit is not obtained -- Credit card number: _— _—� L_ State surcharge(8%) ....$ Expires within 180 days after it Lias been gcce ted as com TOTAL .......................S Nuet of caudM�J as shown on credit cud — P plele. ,��Cudholder dRnsture -�- _ .Atrumni 410-4616 OAXICOM) PLEASE COMP-LEET.E FIXTURES•(individutil Qty :Rhee Total -- Fix Sink quinti b Work Nerfomhed $Ink _ 18.60 Now Moved Replaced RanovediGappM Lavatory 16.60 Sink _ Lavatory - Tub or Tub/Shower Comb. 16.60 Tub or TutdStower Combination Shower Only 16.60 Shower Only -- Water Closet - 18.60 Water Close( _ Urinal _ -"'- Urinal -� 10.60 Dishwasher - Garbage Disposal ---- Dishwasher - 16.60 .-_ Laundry Room Tray Garbage Disposal 16.60 Washin Machine - --- Laundry Tray 16.60 Floor Drain/Floor Sink 2' -+ 3' --- Washing Machine 16.60 4• ---- Floor Drain/Floor Sink 2 16.60 Water Healer --- Other Fixtures(Specs - 3' 16.60 4" -- 16.60 Water Healer O conversion O like kind 16.60 - - - Gas piping requires a separate mechanical eimil. MFG Home New Water Service 46.40 ---- MFG Nome New San/Slonn Sewer 46.40 Hose Bibs 16.60 COMMENTS REGARDING ABOVE: Roof Drains 16.60 Drinking Fountain 16.60 -- - - Other Fixtures(Specify) 21.75 -- Sewer-1st 100' 55.00 Sewer-each additional 100' 46.40 ' Water Service-Is(100' 5 .00 Walei Service each additional 200' 46.40 Storm 3 Rain Drain-1st 190' 55.00 Storm 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin - ---^� 16.60 Insp.of Existheg Plun•bing or Specially Requested 72.50 Inspections rt Rain Drain,single family dwelling 65.25 Grease Traps ------ -- 16.60 QUANTITY TOTAL Isametic or riser diagram Is required it Quantity Total Is >9 `! 'SUBTOTAL -r 8%SURCHARGE Vin• ­PLAN REVIEW 25%OF SUBTOTAL i f Requred?2tif ruAure g1Y.Idai Is>9 Ah TOTAL_ fi •Minimum permit fee Is$72 5e♦e%surcharge,excer4 Reskhenlial Baddlaw PrevenWn De.,lm,which Is 136.25•a%surdurpe. "AII New Commerelal Fhulldings requin plans with IsanetAc d riser diagram aril plan revkw i Electrical Permit Application Date received: Permit no.: City of Tigard Project/appl.no.: Expire date: City of•fignrd Address: 131:5 SW Hall Blvd,Tir_nrd,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 --- Fax: (503)598-1960 Case file no.: Payment type: Land use approval: 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement ✓ New construction U Addi6ori/altemtion/replacement U Other. __ U Partial Job address: 1 ( �1` P!dg• no.: Suite no.: Tax snap/tax lot/account no.: [.c!tl� Block: Subdivision: Gt-,0 Project name: — - Descripuon and location of work on prettuses: i - Estimated date of completion/inspec6on: — Job no: f'a IMax BuRincas name: t?/ � lDescription Q(y. (ea) Total no.Ina Adtlresi: i y New reMentiai-cingle or ural((-family per � y-���� �/ ) 'S drrellSrrgrnft.Lrchadesattacltedgarage. City: stateQ ZIP_ 9';b-P %ervicewtided: Phone* "2/- •0 Fax:G _-79.11 -mail: 1000 sq.ft.or less 4 ftjEach additional 500 aq .or portion thereof -- C o.: S EIeC,hus.lic.no: S= - c energy,residential _ 2 _ _ Limited energy, 2 .h4tu .'A • . 3 (' �s, � rgy,non-residential _ Hach manufactured home or modular dwelling s gel tricisn(required) Date' - - Serviceand/orfeeder 2 Sup.elect.name(print): I.ti Licrnsc no U� enices orfeedera-inatallatlon, alteration or relocaliop.: _200 amps or less 2 Name(print): 20'amp!to 400 amps _- 2 401 amps to 600 amps 2 Mailing address 7J` 6tJ Q 601 amps m 1000 amps 2 City: r p t StatCYj Z: Over 1000 amp-ar volts _ 2 Phone:L�` !� d Fax:S 9 - E-mtil: Reconnect onl Ow;,er in.9Wlation:The installation is being made on property I own Temponrymrvicesorfeeders- whn,h is not intended for sale,lease,rent,or exchange according to lmotnllatlon,alteration,orrelocstfon: ORS 447,455,479,670, 701. 200 amps or less_- — 2 i� 201 amps to 400 amps 2 Owner's signature: /� ,- Date: Z C U 401 to 600 wn a 2 Branch cimults-nen,Aeration, ` or extension per panel: Name: ,C L_L _ A. Fee for branch circuits with purchase of Address: service or fader fee,each branch circuit 2 City:°,. State/) ZIPS 7 R. Fee for branch circuits without purchas- of service or fader fee,first branch circuit: 2 Phone Fax: E-mail: Each additiorul brunch circuit: Mlse.(Service or feeder not included): U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2 U;,rrvicr over 320 amps-rating of 1,Se2 U Hazardous location Each sign or Ondine lighting —__ 2 family dwrilings U Building over 10,000 square feet fcuror 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 FeeJers,400 amps or mote •perition U Occupant load over 99 persons U f;anufactureo structures or RV park Fich additional Irapretlon over the dlowable In any of the abuve U ligress/lightingplan U Other. _- _ Per inspection Submit-feta of plant with any of the above. Investigation tee _ The above are not applicable to temporary coti0ruction service. Other No,an j-oisdictiarn accept etodit cards,please call jurisdiction for nate irdo-Cation. Notice: I•his permit application Ctttt fee..................... U Visa U MasterCard expires if a permit is not obtained Plan inview(at -_ %) $ Credit card number: _ _—�_.._ within 180 days after it has been State surcharge(8%)....$ F'pires accepted as complete. 'I OTAL . $ Name o!cardhol�r as eM>wr on credit tad '- �-- Cardholder sigr'.1ul! .- -� Amount 440J613(tMg(WOM) TYPE OF WORK INVOLVED-RESIDENTIAL ONLY 4. Complete Fee Schedule Below: Number of Inspections per permit allowed Restricted Energy Fee........................................ $76.00 Service Included: Items Cost Total (FOR ALL SYSTEMS) 4a. Residential-per unit Check Type of Work Involved: 1000 sq.R or less _ _ $147.15 4 Eadr additional 500 sq.ft,or 0 Audio and Stereo Systems portion thereof $33.40 _ 1 L imiled Energy S75.00 Ej Burglar Alarm F'arh Manufd Home or Modular owelling Service or Feeder $90.90 2 -- E] Garage Door Opener' 4b.Sarvices or Feeders Inst.dation,alteration,or relocation Ej Heating,Ventilation and Air Conditioning System' 200 snips or less $8030 2 201 amps to 400 amps _ _ $106.85 2 EJ Vacuum Systems' 401 amps to 600 amps $160.60 2 60'amps to 1000 amps $240.60 2 Other laver 1000 amps or volts $454.65 2 Reconnect only _ $66.85 2 TYPE OF WORK INVOLVED -COMMERCIAL ONLY 4c,Temporary Services or Feeders Installation,alteration,or relocation Fee for each syst�om.............................................. 576.00 290 amps or less $66.65 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 401 amps to foo amps $133.75 2 Check Type of Work Involved: (ours 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems 4d.Branch Circuits New,alteration or extension per pal.el Boiler Controls s)'The fee for branch circuits with purchase of service or Clock Systerns feeder fee. Each branch circuit _ Y� $6.65 2 b)The fee for branch circuits Data Telecc,mmunicatlon Installation without pun;hase of service r-1 or feeder fee. LJ Fire Alarm Installation First brandy circr ! $46.85 Each addi!lonal branch circuit _ $6.65 ` HVAC 4e.MiSCOIN sous (Service or keder not Included) Instrumentation E.adi pump or Irrtga7ion circle _ $53.40 r, Each sign or outlin a fighting ��- $53.40 u Intercom and Paging Systems Signal circull(s)or it IimNed energy panel,alteration kx extension $75.00 _ Landscape Irrigation Control' Minor Labels(10) $125.00 4f.Foch additional Inspection over Medical tiie allowable In any of the above f--1 Per Inspection _ _ $62.50 lJ Nurse Calls Per lour $62.50- In Plant $73.75 E] Outdoor Landscape Lighting" 5. IFe('S: u Protective Signaling 5a.Enter total of above fees $ _ 8%Skxchargr(.08 X total ffres) $ Other Subtotal $T ab.Enter 25%of line 6a for , Number of Systems I lan Review H required(Sec.3) $ ,- Subtotal $ No lioenses are required. Licenses are required for all other Installations I r �- rl Trust Account 0 _ FEES: Total balance Due $ ENTER FEES s_ ---- "---- 8%SURCEARGE(.08 X TOTAL ABOVE) $ TOTAL $ FL OT FLAN LOT #110, A1"-'FL E WOOD 'ARK Rl 1=D 251 11 DA TAX LOT 011100 8911 5W GREENING LANE S.E. 1/4 OF SECTION il, T.2, R.IW, W.M. CITY OF TIGARD UJA5I-11NGTON COUNTY, OREGON LEGEND oil I-� � MES12755 SW 89th AVENUE SUITE 100 OFFICE (503) 820-8080 PORTLAND, OR. 97223 FAX (503) 598-8900 CCH/ 80583 I 162 +- N L�T 161 N59'5475"E I Lr 62.mD' I - - I" 2058' 4.0' 4.©' Q1 .� in 9 " 4311 SQ. FT.' 1� e :RFCsENT WATER METER Q r •`PIN. FLR. ■ 2m6I' .� Q W----- - J ' GARAGE FLR. 204.7' WATER LINE -� �/ / / 4.m' SS—--- SANITAR" SEWER - SD— - - - STORM DRAIN / / 2O4z, ' �- - - 4 CIF STREET d.O // / 204$' • MANHOLE ! ICA ® CATCH BASIN -��`} " PROPOSED 8 UTILITY I arREErTREES EASEMENT STREET LIGHT SIDEWALK S 89' 54' 25" FIRE W-DRANt 62.9 :? CURB -- N I PROVIDE EROSION CONTROL FENCE -- --- - G-- - --�- - --- -- �C- -� - -- -- f'ER COMMUNITY SD- - - - - ---- - - --9D- - - -SD-- - - - ERC CION PLAN ' 5W GREENING LANE