8600 SW INEZ STREET ao
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CITY I OF- (�-'+TIAARD PEPERMIT
PERR 1ERMIT #. NIST2002-(`')249
DEVELOPMENT SERVICES DATE ISSUED: 5/31/02
15125 SW Nall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS- 08600 SW INEZ ST PARCEL: 2S111AA-04600
SUBDIVISION: GREENSWARD PARK ZONING: R-4.5
BLOCK: LOT: 028 JURISDICTION: TIG
REMARKS: Kitchen alteration. 253 sT
BUILDING _
REISSUE. STORIES: FLOOR AREAS _ REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT. FIRST: at BASEMENT: of LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD SECOND: of GARAGE at FRONT: PARKING SPACES
TYPE OF CONST: DWELLING UNITE: FINBSMENT: at VALUE: S 40 000 00 RIGHT:
OCCUPANCY GRP BDRM: BATH: TOTAL: 000 of REAR
PLUMBING
a,NKS WATER CLOSETS: WASHING MACH: LAUND7Y TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS-
TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCI'.FLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: SOIL/CMP<3010: VENT FANS: CLOTHES DRYER:
FURN>■100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER_ TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 OF OR LESS: 0 200 amp: 0 200 amu: WISVC OR FOR: PUMP/IRRIGATION: PER INSPECTION:
FA ADD'L 500SF: 201 400 amp: 201 400 amu: tat W/O SVC/FDR: SIGN/OUT LIN LT: VrR HOUR:
LIMITED ENERGY401 600 amp: 401 600 amu: EA ADDL OR CIR: SIGNAL/PANEL: IN PLANT
MANU HMISVCIFDR: 501 • 1000 amp: 001-ampa•1000v: MINOR LABEL:
10004 amplvolt: PLAN REVIEW SECTION
Reconnect only: >•4 RES UNITS SVCIFDR>-225 A.: >E00 V NOMINAL: CLS AP'•AISPC OCC:
ELE(;TRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL _ B.COMMERCIAL _
AUUIO 6 STEREO VACUUM SYSTEM: AUDIO A STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEt1RRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR
HVAC: DATAJTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Contractor: TOTAL FEES: $ 1,042.49
Owner: VLADAN JOVANOVIC This permit Is subject to the regul,tions containeu In the
RASOR,MARK A/LURID Tigard M. nicipal Code,State of ON. Specialty Codes and
8600 SW INEZ ST 13405 SW WHISTLING WAY all ether applicable laws. All work will be done in
TIGARD,OR 97224 BEAVERTON.OR 97008 armrdance with approved plans. This permit will expire N
work is riot started within 180 days of Issuance,or If the
' ork 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
Reg 0: LIC 100905 forth In OAR 952.001-0010 through 952-001-0080. Yuu
may obtain cupies of these rules or direct c estions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
eI05,o1,EtlrttR trinp 81 Underfloor insulation Plumb,'op Out Insulation Insp Final inspection
Footing Insp Crawl DfaiNBackwater Electrical Service Rain drain Insp
Foundation Insp Footing/Foundation Dr; Electrical Rough In Electrical Final
Post/Beam Structural PLM/Underfloor Framing Insp Mechanical Final
Ftost/Beam Mechani%, Mechanical Insp Gas Lira Insp Plumb Final
Issued By : to - Permittee Signattl a
CaII4503) 9-4175 by 7:00 p.m for an inspection needed the next business day
Ruildi"g Permit Application_
City Of Tigard Date received: / ',._ Permit no,
Projecl/appl.no,• Expiredate: V�
City afTigard Address: 13125 SW Hall Bl%d, I it it,].()R 97223,; --
Phone: (503) 639-4171 i/�1 Date issued: B Heccipt no.:
Fax: (503) 598-1960 Case file no.: Paymcw;ype:
Land use approval: .._.___
`J I&?family: 'imply Complex:
all W 11a
) &2 family dwelling or accessory U rbmmercialhndustrial U Multi-fanuly U New construction LI Demolition
( Addition/alteration/replacement LI Tenant improvement U Fire Sprinkler/alarm U Other: _
j6n sorEilliIII76114MATION'
Job address: t•.3 J7 pie i 11 . s r .,j ;11 c ldg.nu.: Suite no.'_
Lot: �►� Bltck�— Sut.,livision: L_+er�LSt��+r �.�- _�ax map/tax lot/account nct`_�
Project name:
Description and location of work on premises/special conditions:
01%NI 14 FOR SPIIJ IAL 1NI,ORNIAjJON9,USF EUKIJS1'
41 1 It
Narne: F'11, L- lrvicl L c7 , IZ /lfor __ (Floodphilln,septic capacity,solar,etc.):
Mailing address: �k.(irc _ I &2 family dwelling:
City: 1 State. CrR ZIP: `I-1 1 z Valuation of work........................................ $�te"Q0 .—
I'Inmr: Zp " 5'!. Fax: r mail: YitScr iv y+ i,rr� No.of bedrooms/haths.................................
(r).act's representative: 'Total number of Vectra.......................
Phone: ___F1_-'ax- F-nen! New dwelling area(su.ft.) ...I...%,.:.r:..:......
AOPIIICANT Garage/carport arca(sq.ft.).........................
Name: jn rtic r..4u►, _ Covered porch area(sq.ft.) ........... ..... ......
Mailing address: 13 it arca(sq.fl.) ........................... ............ --
City; Slate: ZIP: Other structure area(sq. ft.). ....................... _
Phone: _ Fax: F: m;ul: ('ommerciallbldustriallmulti-famlly:
Valuation of work............. ..................... .... 9 --- ---
�� 1 ` ��PIJ C T/t►� Existing bldg.arca(sq. I'l.) ........;,::............. ----- - -—
Business azure: a New bldg.area(sq. ft.) .........,.:::.................
�-__— — _
Address: /3 yaS S w uiNf uN6 WA's
Number of stories............
�:. ................. ___ —
City: F Tp11/ stateV 7.IF': ; d 3' pe of construction.......... ................... .... _
Phone: / I'a_x: /
--mail: V..LO�l.2fZ-o Occupancy group(s): l:xisffs�:
CCB no.:�0,� Q — Nc%L:
City/metro lir. no Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Name: 1 - ✓„ rC b, i e� v . provisions of ORS 7111 and may be required to be licensed in the
Address: ;r E �L Jui7i diction where work is tieing performed. If the applicant i.
Cit } Rr ki
State: cul 7_IP: i exert pt from licensing,the following reason applies:
Contact person: 7 i 1i rnr Plan no.: ^—
iiii6i
Phone: k't- Fax: 1ss- o,, � --
Name ►i, l; a, Contact person: K,,L, fill. Fees due upon application ........................... $
Address: - M Q a Date received:
City:
' , + . ,
y Stale: oma. 7.IP: r- '1 Amount received ......................................... $_
Phone: 2 4 ,,. Fax: j,4,,-. .,,a 1 E-mail: Please refer to fee schedule.
hereby certify 1 have read and examined this application and the Na sit jim-Acriom accent credit cards,please call jurMiction fm nuxe infm,nation
attached checklist. All provisions of laws and ordinances governing this J visa U MasterCard
work will be complied with,whether specified herein or not. 00-1 card number —
_ xplreL
Authorized signature: 4.444-1-41-71--_ Date: S -1-1 V 7 - Nuns of cardholder as shown on otdit card
$
Print name: m�a k A.S a r' -- Cardholder NEnature Amount
Notice:11iis permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4101613(6WICOM)
-'� tine- and'1'w'o-Fantily Dwellhig
Building Permit Application Checklist f2cfercnce _
Cify(?f Tigard City of Tigard �«nciatedperinfts
J l.lecM rc;,l J Plun)11ufP J t`trchanicul
Address: 13125 SW Fall Blvd,Tigard,OR 9722� J�nhcr
Phone: (,503)639-4171 - -- ----_--—
Fax: (5(13) 598 I'",if
THE FOLLOWING I
I_Land use actions completed.Sce juii�di,,l 6n(ot(•rr,,for conc11nr11l n•\fcs�
2 '/.doing.Blood plain,sularhalance points,sc1s1111C soils design nfon.Iu,,I uf( df un t.eI6.
l Verification of approved plat/lot,
4 Fire district approval required.
5 Septic system permit or authorvaonn fin fcnl(nlrl. I:xisln,g systrnf(apucity _ ___
e Sewer permit.
7 Water district approval _-
8 Soils report. Must carry oripin;o :ipl,ficahfe stamp and signature out file or will,fipplicatioll -
9 Erosion control U plan J point n,! n:cd. Include drainage-sway protection,sill fence design and hx;ation of
catch-hasinprotection,etc.
10 _3 Complete sets of legible plant. Must fit-drawn to sc„Ie. sh(nwng Coll Iorrnawv to applicahir lural and state
hit ding codes. Lateral design details Mid rn11neclums,must be incorporated into the plan~or on a separate lull-si/e
sheet attached to the plan~ �s fill c t„`•,tvlcivi cc•.be tween plan I,,, ,,iwn and detach flan re1,1e i, c;mn(lt hr confpletecl
il'copyri ght violations exist.
I I Site/plot plan drawn to scale. Ili•plan nn,tit 1h11sv Int and huddn)y`cthact dnnrnsu nus.property corner cicvarons of
there is more than a 441.el6•%,1n m dlth•11-nfcd.plea 11111,(show t()w( r hnc-, i(' It 1111erval of I(,cation of eascmcnts and
driveway:Iftolpamt of'stlmcfIII c(1111 (hat drrl,�r loiauon Ill frrlkAl-I),It syslrn6s:Wilily hK•auons:dnec'llnII IIRllrv„r,lot
arca:building coverage ateaApercentage of(l 1\ 11nl,ets t areae•cxlsting structures on site;and surface draruuer.
12 Foundation plan.Show dimensions,an(h n holi., ,nn hold downs and reinforcing pads,connection detail~, vent
size find location.
13 Floor plans.Show all dimensions,room Idcntllfcauon,windrnv tis(. (oration of sntuke detectors, water he;urr,
flllnaCe,ventilation fans,plumbing fixtures,balconies find dCck, Ili inches above grade,etc.
14 Cross secaon(s)and details.Show all Iratning-nicniher sizes and spay tit ii sr(If as floor heams.Iuaders,joists.mull-flAflour,
wall amstrruciion,rool'consinfcUoi.. More than one cross section may 111 11.41011•11 fo clearly purrs ro usuucuur,.show
details ol'all wall anti roof sheathing,rooting,root slope,ceiling height,sldfng normal,fouling',and loundauon,stairs,
fireplace construction, thermal insulation,etc.
1-5 Elevation views. Provide elevations fur new construction;rluinn11ant of Iwo elevations For additions and ren,ndcls.
Exterior elevations must reflect the actual grade if the change 111 giadc 1ti greater(loaf Iour font at 111111( 6Ig envelope.
Full-size sheet addenduns showing hrundation elevations with cross refererte•e•s are acceptable.
lb Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate drlails and I(xalions; for
nun-prescriptive ath analysis provide specifications and calculations to engincet11ug sland:uds. _
17 Floor/ror,f framing. Pit,vide plans for all flours/roof assemblies.indicating nteniber sizing,spacing,:11111 hearing
localro•.s. Show attic velyilatiun.
18 Basputlent and retaining walls. Pro,ide cross sections and d units showing placement of rebar. I'ur engineered —
!,ysterns,see item 22,W:ngineer s calculations•”
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and muftiple joi>(x
over 10 feet long and/fir any heath/joist carrying it nun-uniform load. _
20 Manufactured floorlroof truss design details.
21 h:nergy Code compliance.Idewily the prescriptive path or provide calculations. A gas-piping schematic k required
for four or more appliances. — -
211 Foglnerr's calculations.When requited or provided,(i.e..shear wall,roof tnusx)shall he stamped by an engirerr nr
architect hccnsed in(hrgor;and shall hr shown In hr i1pphc1111c to IIIc pr,,ccl un;Icr revic,•
21 Five(5)site plans are required fur Itch, I I above. Site plan. nnf`t he," fi''• x I I'•or I I" x IT'.
24 'I'wu(2)sets each are required for Items 16, 19,20 k 2 2 above.
25 Building plans;hall not contain red lines or tape-ons. 'Mirrxrrcd_boilding plans will he no'accepted.
20 "Reversed"building plans must Hurl criteria outlined in the Pennit&_system Development gees docafmcnr _
27 "Drawn to scale"indio.ates standard architect or engineer scala _
28 Site plan to include free size type& location per approved pf,,,ecl street tree plan(if applicable),an„"AM'Strect 1 ee List
Checklist nust he completed before plan review start dote. Minor changes or notes on submitted plats may t.,r in blue or black ink.
Red ink is reserved for department use only. ern 46141nnx,n•osr)
Plumbing Permit Application
7Dateissued:
d: 7Building
mit no.:
-7
City of Tigard t no.: permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 .no.: ire date:
City of Tigard Phone: (503) 639-4171
Fax: (503),598-1960 Receipt no.:
Case file no.: Payment type:
Land use approval ` —
U 1 &.2 family dwelling or accessory UCommercial/industrial U Multi-family U Tenant improvement —
U New construction A(I(Iition/alteration/replaccnu ni U food service U Other:
I t
Description try. Fee(ea. Total
Job address: 9 C 5� rhe Z St i 9 aid d q�`}��_—.. Ncw I-and 2-family dwellings only:
Bldg.no.: buite 00.: — _ (include~too n.for each utility connection)
Tax map/tax lot/account no.: SFR(I)bath
Lot; Z Block: Subdivision: vetzwecld) PaAjL SFR(3)bath
Project name:
71P: �1aZ Each additional bkitchen
City/county.'fd' an A ath/Site utilities:
Description an ovation of wor m pdemises:_ Gatch basin/area drain
k i e r` G�`t— �� —_——— Drywells/leach lineArenc drain
Est.dote of completion/inspection: Footing drain(no.lin.ft.)
ma 11 QaKKV�=ft it]fa M Manufactured home utilities _
Business name: CoLUM(3/� ),7f 4L inhales -
Address: 6626 S Nft�NEY St.• _ Rain drain connector _.-
City: 11ORT&A7VID State:�je ZIP: 7Z>xa Sanitary sewer(no.lin.ft.)
Storm sewer(no.lin.ft.) _
Phone: Oj 7 Fax: ] J Email: Water service(no.lin.ft.)
CCB no.: // �Q Plumb,bus.reg.no: 7-6 6a P Fixture or item:
City/metro lic.no.. .33 62 Absorption valve
Contractor's representative signature: Back now preventer
Prim name: SCO ? > Date.t2s D AM Backwater valve
Basin%/lavatory
Clothes washer
Name: a r /� -- Dishwasher /
Address. tai TO Z S Drinkin fountain(s)
City: ► M(A State: p ZIP: l-,) 'ectors/sum
Phone: t,j 0 1 (,-1 Fax' I' r.,,tiL Expans tank
Fixture/sewer cap _
Moor drainslfloar sinks/hub
N_ar, (print) mUr �.J�'t hose t" ------ Garbage dis oral
Mttlling address Q( QQ S►n) rt1C Z _ _ Hose bibb —
City: 'rt ((v • - State:C) ZIP:c 4 Ice maker —
Phone: 1 Fax: E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will he made by me or the maintenance and repair made by my regular Rexdf drain(commercial)
employee on he property I own as per ORS Chapter 447. Sink(s), asin(s),lovs(s)
1 i� — Date: -- —
Owner's signature: `1 1�- �_ Sump Tubs/shower/shower pan
Urinal —
Name: dee Oat Water closet
Address: 0- 5vJ ACAAi'VN
Water heater
City: e.,rt State: ok 'ZIP: q'1�3_1( Other _
Phone: L — pE:t I Fax:,ly o6 E-mail: Total ._
Minimum fee.................$ ___--•—
Not all jurisdictions accept credit rude,please call Jurisdiction for more Infornuti.n. Noticc:7 his permit application Plan review(at •— %)
U Visa U Man.terCard expires if a permit is not obtained State sumhrrge(8%)....$
--- --L-1-- within 180 days tits•it has been
credit cod number:
------- Expires accepted as complete. TOTAL ....................•.$
Norm of cardhol r u shown nn credit c s
— 440J616(tSAdCOM)
Cardholder dputtue Atnouni
PLUMBING PERMIT FEES:
PRICE TOTA: New 1 and 2-family dwellings only:
FIXTURES individual) QTY ee AMOUNT (includes SII plumbing fixtures in PRICE TOTAL
Sink • 16.60 the dwelling and the firstlGO ft. QTt' (ea) AMOUNT
Lavatory 16.60 for each utilityconnection i _
_ One 1 bath $249.20
Tub or Tub/Shower Comb. 16.60 Two 2 bath _ _ $350.00
Shower Only 16.60 Three(3)bath _ $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8%STATE SURCHARGE
Dishwasher 16.60 _PLAN REVIEW 25%OF SUBTOTAL _ -
Garbage Disposal 16,60 _- TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.8C
PLEASE COMPLETE:
3" 16.60
4" 16.60
Water Heater O conversion O like kind 16.60 Quantity b f Work Performed�
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit, Capped
MFG Home New Water Service 46A0 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory _
Tub or Tub/Shower
Hose Bibs 16.60 _ Combination _
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Other Fixtures(Specify) 16.60 Urinal
_ Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine _
Floor Drain/Sink. 2"
Sewer-1 at 1 UQ' 55.00 3« �-
Sewer-each addiUnnal 100' 46.40 4"
We ter Service-1 at 100- 55.00 Water Heater
Other Fixtures
Water Service-each additional 200' 46.40
_ (specify)
Worm&Rain Drain-1st 100' 55.00
S orm&Rain Drain-each additional 100' 4640 - --
kommercial Back Flow Prevention Device 46.40 -
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60 _
Inspection of Existing Plumbing or Specially 62.50
Requested Inspections er/hr COMMENTS REGARDING ABOVE:
Rein Drain,single family dwelling 65.25
Grease Traps 16.60 - - ---- - --
QUANTITY TOTAL
IsometrIc or riser diagram Is required It
_
Quantity Total Is ?9 _
'SUBTOTAL ---
8%STATE SURCHARGE -
*.PLAN REVIEW 25%OF SUBTOTAL
_Required only I1 fixture 2ty total Is>9 _
TOTAL
Minimum permit fee is$72 50.8%,state surcharge,except Residential Backflow
Prevention Device,which Is$39 25•B%state surcharge.
~All New Commercial Buildings rvqulre 2 sets of plans with Isometric or riser
diagram for plan review.
I:tdsts\forms\plm-fees doc 12/26/01
Electrical Permit Application
-- rDatcm-creived: "TPernrn!itno.:
City df Tigard Prnject/appl.no.: pire date:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: �— By: Receipt n).:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
, t
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction leg Addition/alteration/replacement U Other:� _ U Partial
MM
Joh address: S600 5vi 1"f-L- 'r 71 ii r Bldg.no.: Suite no.: Tax map/tax lot/account no.:
Lot: QZ Block: Suhtlivision: oral ekVK _ — --.-
Project name: Description and location of work on premises: K.i'&A'QM yo'revue f o
Estimated date of completion/inspection:
1
Fee Mat
Job no:
--- Description _ t1(v. (ea) 'total no.his
Business name: t:ljViEW X[.E c?l«/' Newresidr sial-singkormulU-famllvper
Address: ev Al f=p..v«x dwelling unit.Includes attarl-I garage.
City: j-16;'.' r1 N l� State: 7.1 P: Q f,Z! J Service Included:
1(100 sy,It.or less _ 4
Phonc:�, -' L -7 5 Fax: Email: ---- —
� F:ach additional SW sq fr or portion thereof
CCH no.: ;// mil Z- Elec.bus.lic.no: 11,, p� �� Limitedcnorgy,resldcnllnl_ 2
City/metro lic.no.: 61 57 �L l } t Limited energy,non•residcntial 2
�r - r- Each manufactured home or modular dwelling
L—,�c � J �,v'Z 2
Signature of!u rvisin a ectrician it uirEd pate Service anti/or feeder
I.icenseno:Z J Servicesorfeeden••Inoallation,
Sup.elect.name(print): 1 ,/tel i� i/�t- �6/' alteration or relocation:
200 amps or less - 2
7 G 201 amps l0 400 amps 2
Name(print): :N r K �ox I 57. 401 amps to 600 amps 2
Mailing ad Jress: d o o .Sun r'l a z- 601 amps to 10(X1 amps 2
_. A 1G� stale: Zi P:L7,(/ Over 1000 amps or tolls _ 2
Phone:(v 1 56cI F'ax: .(, 9,,(5 1 E-mail: rrtsor' Sn 'plcsk Reconncctonl
Owncr installation:The installation is being made on property I own 'I Temporary services or feeders-
which is not intended for sale,ICa9C,rent,or exchange according to Installation,alteration,or relocation:
2(x1 amps or Icss 2
(IRS 447,455,479,67O,,y7,01. 201 amps to 4(x1 amps 2
Owner's signature: --/�r�'�r �_ F1atC: 1 2 ��Z 4111 to G(A)amps 2
Branch circuits-new,alteration,
or extension per panel:
A. pee for branch circuits with purchase of
service or feeder fee,each brunch circuit 2
Address: - n uY✓t ,
Slate:(� ZI / B. Fee for branch circuits without purchase
Clly: 6r a n! — of service of feeder fee,first branch circuit: _ 2
Phone; ,) � ( ( 1 Fax:,�yb -UES E-mail' iiachadditionalbranchcircuit:
Misc.(Service or feeder not Included):
Each pump or irrigation circle _ 2
U Service.over 225 amps conultercial U Henith-carr facility Each sign or outline lighting _ _ _2
U Service over 320 amps-rating of 1 Art U Hazardous location signal circuits)or n limited energy panel.
family dwellings U Building over 10S W square feet four or g
•System over600 volts nominal more residential units in one structure alteration,or extension" 2
❑Building over three stories U Feelers,400 amps or more "I kscri tion:
U Occupant load over 99 persons U Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
U Egressllightingplan U Other: -_-__ Per inspection
Submit_seta of plans"Ith any of the above. Investigation
The above are not applicable to temporary construction service. other
Permit fee.....................S
Not all JunOctions accept crrnlit cards,please call Junutictirm for more Int(waWinn. Notice:This permit application Plan review(al )
U 1,130 U MasterCard expires if a permit is not obtained
credit card number: -__._ ----- —-- —
�L—. within 180 days ager it has been State surcharge(911 ....$
xIM es accepted as complete. i OTAI, .......................1; —
Name of c older na s own on credit c $
--Cardholder allualure Amount— Out 4611 Ihl[a)tt'OM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED-RESIDENTIAL GNLY
N ember of Inspections per permit allowed Restricted Energy Fee................................ $75 0�-
............
(FOR ALL SYSTEMS) ...
Service included. Items Cost Total
Residential-per unit Check Type of Work Involved:
1000 sq fl.or less $145.15 4 ❑
Each a'.dtlional 500 sq,fl.or - Audio and Stereo Systems'
portion thereof $33.40 1
Limited Energy $75.00 ❑ Burglar Alarm
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 ❑ Garage Door Opener'
Services or Feeders
Installation,alteration,or relocation ❑ Heating,Ventilation and Air Conditioning System'
200 amps or less __ $80.30
201 amps to 400 amps _ $106.85 ❑ Vacuum Systems'
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
If stallation,alteration,or relocation Fee for each system...............................................
200 amps or lase $75.00
201 amps to 400 amps $$00.30 (SEE OAR 018-280-280)
401 amps to 600 amps Y $133.75 7 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
feeder fee. ❑ Clock Systems
Each branch circuit __ $6.65 2 ❑
b)The fee for branch circuits - Data Telecommunication installation
without purchase of service
or feeder lee. ❑ Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit S6.65 ❑ HVAC
Miscellaneous
(Service or feeder not Included, ❑ Instrumentation
Each pump or Irrigation circle $53.40
Each sign or outline lighting _ $53.40 ❑ Intercom and Paging Systems
Signal cirruit(s)or a limited energy
panel,alteration or extension $75.00 ❑ Landscape Irrigation Control"
Minor Labels(10) _ $125.00
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 $ 106. 70 ❑
Other_
8%State Surcharpe $ Number of Systems
25°h Plan Review Fee -.-----_Number
-_----
See"Plan Reviaw"section,,a $ ' No licenses are required Licenses are required for all other installations
front of applk at in.
Total Balance Vue
Fees:
El Trust Account
Enter total of above fees $
# _ -
--- -----_-.__, --.---- --_--- 8%State Surcharge $All New Comr,.jrcial Buildings require 2 sots of plans. Total Balance Due $
i:\dsts\fomu\cic-fees.doc 08/30/01
PROPrR-,Y UNE
of.
PA14D DRIIIEWAY
71
(rxsmc)
CONCRETE
PATIO I?
ARIA 17 VKPX
M'-101/7
FrmcE
SITE PLAN
SCALE: 1/15"=l'--O"
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 ; r,� •, ,�r'
INSPECTION DIVISION Business Line: (503) 639-4171
MST --- - - - ' ( _
BLIP
Received -_ Date Requested _ / 7- _ AM PM BUP
Location _ ��O C� ��'7� -.—Suite--- MEC
Contact Personr h( ) ^� c < <�
—_ _.. — � _.__�_.��_� ._-- PLM
Contractor Ph( _ SWR
Ult_DI Tenant/Owner ELC
'noting ELC
Fuundation Access:
Ftg Drain
Crawl Drain k'_�Apr, I�(C. -_ ELR
Cr _
Slub Inspection Notes: — SIT
Post&Beam -- -
Shear Anchors - -
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - —
Roof
Queer:------
PART
--PART FAIL_ `
Post&Beam
Under Slab
Rough-In
Water Service �_—
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain - -
Shower Pan
Other: ----
------_._-.-_.-------
Final
PASS PART FAIL -
MECHANICAL
Post&Beam - ----
Rough-In
Gas Line
Smoke Dampers _
Final
PASS PART FAIL — -- -- - -
ELECTRICAL
L _
Service_ — -- '�
Rough-In
UG/Slab --
Low Voltage _
Fire Alarm - - -
Final LJ Relnepectlon fee of$_ _required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PAkT FAIL
SITE El Meese call for reinspection RE: —_ Unable to inspect-no access
Fire Supply Line n
ADA
Approach!Sidewalk D -- f -�J I ., ----- Inspector —-- 4 _----------_._EXt
Other:_
Final DO NOT REMOVE this Inspection record from the job Ate.
L PASS PART FAIL.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (:03)639-4175 MST d a
INSPEC- ON DIVISION Business Line: (503) 639-4171
/ BLIP
Received _.________ Date Requested._` Q 2 �M BLIP _
Locations Suite _ - MEC
Contact Person — — Ph(---) PLM
����—�'-'-
Contractor. Ph SWR
BUILDING Tenant/Owner —__ ELC
Footing �w_� E LC
Foundation Access:
Ftg Drain ELF! -
Crawl Drain SIT
Slab Inspection Notes:
Post&Beam ----- ----
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing -----____--------_-- — -.--
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling
Root
Other:
Final
PASS PART FAIL_
PLUMBING _
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
CPHW
- - ----
PART FAIL_i
_ IC_AL
Post&Beam
Rough-In - --- -- - -
Gas Line
Smoke Dampers
Final
PASS PART FAIL
_ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage _—._ ___— - ---- - - ---- ----
Fire Alarm
Final Reinspection fee of$_ req: 1 before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_ PAS3 PART FAIL
SITE — — Please call for reinspection RE: - [� Unable to inspect-no access
Fire Supply Line / J,
ADA
Approach/Sidewalk D#ts
Other:------____ _
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIrGARD 24-Hour
BUILDING Inspection Line: (503)635-4175 MST
INSPECTION DIVISION Business Llne: (503)639-4171
BLIP
Received _ Date Requested__.d 22 AM------ PM_--__ BUP _--
Location ---Com-- Suite MEC --
Contact Person — ---- — Ph �0 PLM
Contractor Ph(_ ) SWR
BUILDING Tenant/Owner _-___- _ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors --
Ext Sheath/Shear -...-_-
In:Sheath/Shear
Framing - — - - ---- - -�"—
Insulation
Drywall Nailing - -------" -
Firewall
Fire Sprinkler -- -------
:ire Alarm
tiusp'd Ceiling - - —
Roof
Other:
Final
PASS PART FAIL -�
P_LUMBINCI ----__.--_-- — -- -- ----
Post& Beam
Under Slab ----- ------ _ _ --- -
Rough-In
Water Service ---- --- -
Sanitary Sewer
Rain Drains — -------- -- — --
Catch Basin/Manhole -� -
Storm Drain -�- - --ShowerPan -
Other. - --- —
Final ----_---------- ----
PASS PART FAIL
--- - -
MECHANICAL -
Post& Beam -
Rough-In ---------- -- . ._.... - — - --_- -
Gas Line
Smoke Dampers --
Final
PASS PART FAIL ---- -- — ------ —
ELECTRICAL -
Service --
Rough-In -- --- -- --_ _---._.
UG/Slab
Low Voltage --
Fire Alarm
i�hta
SS PART FAIL n Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
—_ [-] Please call for reinspection RE: —__—._- ❑ Unable to inspect-no access
Fire;supply Line
ADA Dais J _;2;Z Q Inspector:—� `.?tea Ut
Approach/Sidewalk -t J
Other: �---
Final DO NOT REMOVE this Inspection r000rd from the fob site.
PASS PART FAIL