9733 SW OAKS LANE c
9733 SW Oaks lane
RMIT
C' Y OF F TIGARD — MASTER PE PERMIT#: MSTTST2002-00198
DEVELOPMENT SERVICES DATE ISSUED: 4/19/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 09733 SW OAKS LN PARCEL: 2S i 11 CA-12100
SUBDIVISION. SATTLER PARK ZONING: R-7
BLOCK: LOT: 006 JURISDICTION: TIG
REMARKS: Kitchen extension 32 s.f.
BUILDING
REISSUE: STORIES I FLOOR AREAS REQUIRED SETBACKS _REQUIRED
CLASS OF WCRK: ADD HEIGHT: 0 FIRST: 32 of BASEMENT: of LEFT- SMOKE DETECTORS:
TYPE OF USE, SF FLOOR LOAD: 40 SECOND: sf GARAGE: of FRONT. PARKING SPACES
TYPE OF CONST SN DWELLING UNITS: FINBSMENT: of RIGHT
VALUE: 5 12,000.00
OCCUPANCY GRP: R3 BDRM: BATH TOTAL: 371!i of REAR
PLUMBING
�-
SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUBISHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS,
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN t 100K: IBOILICMP<3HP: VENT FANS: CLOTHES DRYER:
FURN>000K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOOD0OVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 200 snip: 0 200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 400 amp: 201 400 amp: 1st W/O SVCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 4`11 -600 amp: 401 600 amp: EA ADDL BR CIR: I SIGNAL/PANEL: IN PLANT:
MANU HWSVCIFDR: 601 - 1000 amp: 601•ampa•1000v: MINOR LABEL:
1000+amplvalt
PLAN REVIEW SECTION
Reconnect only:
a.q RES UNITS: SVCIFDR>o225 A.: >800 V NOMINAL: CLS AREA19PC OCC.
_ ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO S STEREO: VACUUM SYSTEM: AUDIO A STEREO: FIRE ALARM: INTER(OWPAGING: OUTDOOR LNDSC L1:
BURGLAR ALARM: O'tH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSr CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOT,*,L FEES: $ 443.11
GRABOW,JOHN K+VIRGINIA L MORNING STAR CONSTRUCTION INThis permit is subjecttthe regulations contained In the
9733 3W OAKS LANE 11180 SW ERROL ST igerd Municipal Code,
e,,State of OR. Specialty Codes and
TIGARD,OR 97224 TIGARD,OR 97223 all other applicable laws. All work will be done In
accordance with approved plans This permit will expired
work.f;I ct started within 180 days Of Issuance,or if the
work is susFerded 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 00050663 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 INSPECTIONS
Erosion Control In3p 8& Crawl Drain/Backwater Electrical Rough In Plumb Final
Footing Insp Footing/Foiindation Drl Framing Insp Final inspection
Foundation Insp PLM/Underfloor Insulation Insp
Post/Beam Structural Plumb Top Out Ri;n drain In;p
Underfloor Insulation Electrical Service Electrical Fin:1
j / Permittee Signature : �.+�J� /�t '
Issued By : ---- `x' �- __._._ 9 —
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
6•
Building Permit Application
City Of Tigard ... •�� � �'� 7 -
Fax:
�0 p z Permit no.:7R,,,,ptno..7-�
Address: 13125 SW Hall Blvd,Ti�rlt (3it 97223 : ExpiredatcCity nfTigard Phone: (503) 639-4171 By'
(503) 598-1960 I Case file no.: Payment type:
✓� 1 1`1ft * I&2 family:Simple Complex: per,
Land use approval _ A 1
t �
U I &2 family dwelling or accessory U Conunerciol/Industrial U Multi-family U New construction U Demolition
>(A(ldition/alteratcon/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
Joh address: L _Bldg.no.: Suite no.:
Lot: Block: Subdivision: Tax map/tax lot/account no.:,ZS�I L�tA,�100
Project alms.:
Description and location of work on premises/special conditions: ? v) 1_L._ G air 0 U,Se,
OWNER I FOR SPECIAL INIFOIIAATIJO N9 US JE('11IF(KILIST N
(Floodplain,septic clipalilty"plar,etc.)
Mailing address: 9_7 11 .S (J L 1 lac 2 htaily we ng:
City_ -li Statc:Qr ZIP: Valuation of work................................. ......
I'Itone: � Fax: F-mail: — No.of hedrooms/baths.................................
Owner's representative: Total number of floos.................................haS _�
Phone: - N r ilxb -QZL7 E-mai
imCv N s+cwho JIs1%,&g-, ,ing area(sq.ft.) ..........................
Garage/carport area(sq.ft.).........................
Name: S g,� �ntr "rtie. th Covered porch area(sq.f1.) ......................... --
Mailing address: -� (J. E r fi• Deck area(sq. ft.) ........................................
State:p 'LIP:4`TZ?3� Other structure arca(sq.fl.)... .....................
City:
Phone F'ax�. S E-mail Commercial/Industrial/multi-family:
Valuation of work........................................ $
Existing bldg.area(sq.ft.r ..........................
Business name: CNew bldg.area(sq.ft.)......I......................... ^—
Address: ffl (,J.
Number of stories..................... .................. .......... —._�--
City: stale: ZIP:
Type of construction....................................
Phone („ SSJ Fax: sJ E-mail: Occupancy group(s): Existing:
CCB no.: .�$3_ - New:
('iiy/me1mIic.no.: Ticilard 17-(C-9Nodes:All contractors and subcontractors are required to be-
Itsill t
with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may he required to he licensed in tic
Address: Nr d ,(�• Eiryp jurisdiction where work is being performed. If the applicant is
Cit ' State: "LIP: Q exempt front licensing,the following reasod applies:
Contact pers n: r flan no.:
Phone: 'trot/- I-Far.: fob Ei-ma,l:
Name: Contact person: Fees due upon application ........................... S
Address: V ' Date received:
City: —tate: ZIP: Amount received ......................................... —
phone: FaxesI E-mail: Pi refer to fee schedule.
heir.by certify I have read and examined this application and the Nor all jurisdictiomr accepi credit cards.please call Jurisdiction far more inforrnaiion
attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard
work will he compiled with,whether s ci ed herein or not.
Credit card number
p pe Expires
Authorized signature:__'Cal _ Date: - Name of cardholder as shown on credii card
s
Ptinl name:_, I't%-1 M mWe—r ___ Cardholder siEnalure e_ _ � Amount
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 4404613 tb WOM)
One- and Two-Family Dwelling
f- Building Perinit Application Checklist Reference no.:
—� V.sociatedpernuts
in.l ire n l City of Tigard J Electrical J I'lumhiny J Mechanical
nddmss I +I.'S SW hull Blvd,'I tpaid,OR 97223
I'b�nar i�n�aot') 4171
Ii r,usi ��a� 1O/•n
1
1 Land use aetfoi s completed.See,luii,di,ti,m,111i 11,1 hn ,uncuan Will rc%W%kti -- — —
-i-Zoning.Flood plata,solar balance point'.,tict.tri: Mull,drstgnatiuu.htsturtr lis t,etc.
i Verification ofapprove( plat/lot. _..-
4 hire district.---- :approval required. _
5 Septic system permit �t alit horililt loll for remodel.lixisting systeli,cal,icft)
6 Sevier perp 1.
7 1'li Aer district approval.
8 ,Sofa%report. %tu•.t r:ury original applicable stamp and signature on file or with alpplication. _
9 I roslon control U plan U permit required. Include drainage-way protection,sill fence design and loc•abun ul
it,li basin protection.etc. —
ti) ; Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable l cal and state
building codes. I iteral design details find connections mull be incorporated into the plans or un a separate full-size
sheet attached Io the plans",fill cross references h0ween plan lotabon and del:uls. ('Ian m%Wkt cannot he completed
it copyright cndattions v\rt —
I I Site/plot plan dravin to Scale 1111 plan must Show lot and building setback durcnstorm pn,lx ny corner elevations hl
there is nu ac Ib,ui a 1 It ,h c,auun(1illt,rentaal"plan must sbrn+ contour Imes at 2-11.inter\als)•laK•anon of casement,:cid
driveway:loolprmt of suurlutr i 111L 110111L dccks):laxation o1 wells/seplir systems:uttln) h x aauats:direction frnlk;llot:lot
_arra;building coverape arca;percentage of cuvvrapt%inipen ious area;existing strictures on sae:and sutiace drainage.
12 ronndation pl:w. Shops dimensions,anchor holt.anv hold-downs find reinforcing pads.connrruon details.vent
,;i/i-and location.
t Floor plans.Sh))", all duns- saran,,. runnl fdrut11IL MI,Ill. semi))\% ,I Iucau ria of smoke delecturs. %%AICI heatel.
luta a� cliff Lot fans,plumb lit Itxlun s,hak')aneM and dt,,i.•, If inches ahose grade,etc. -
1.1 Cross section(s)and details.Shu m Al flaming metnbc, ,1- ,and.pat top such as floor beauns.headers. Iunt•,solo Moor,
wall consttvction,roof cunstrucu m s1urc Than one to .Mr con m„ INtiu•d to clearly portray tonstruclion Siww
details of all wall ata roof sbeadung,rcorl'ing,raid dopr,cethnp ociphl,siding material.footings and houulalion,stairs.
tinplate c.)psi uctien, thernial insulation.etc.
15 1?levatlon views.Provide elevations for new construction;minunum of two elevations for addition%and remodels.
Exterior elevations roust reflect the actual grace il'the change in grade is greater than four foo building envelope.
Full-silt sheet adderldulus showing foundation elevations with cross references are acceptable.
16 Wall bracing(prewcriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescriptive path analysis provide specifications and calculations to enitineering standards.
17 Floor/roof framing.Provide plans for all floors/rroif assetublies,indicating.member sizing,spacing,and hearing
Irxalitnts.Show ante ventilation.
18 Basement and retandng walls.Provide cross sections and details showing placement of rehar. For engineered
systems,see item 22,-Engineer's calculations." _
It) Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple"joists
over IO feet long and/or any beam/joist carrying it non-unffonn load.
20 Manufactured flonrlroof truss design details. _ �_.
21 1?nergy Code compllance. Identity(he prescriptive path or provide calculations. A gas-piping schematic is required
for lour ur more appliances.
22 rngineer'• calculations. When requited(11 Irtos raft,a.Ox.,shear wall.roof truss)dull he stamped by an engineer or
architect licensed in Oregon end shall toe sbu",n In hr applicable to the paolect undt,r review.
21 Fee(5)sae plans are requited lot Item I I ahu:t,. Stat, plans must he 8-1/2" 11"of
21 'I'svu(2)sets each are required for Items 16. 19,20& 22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will Ix not accepted. —
26 "Reversed"building plans must meet criteria outlined in life Permit& System Development Fees document.
27 "Drawn to scale"indicates standard architect or engineer scale.
t3 Site plan must include street tree size,type&location per City of Tigard Street Tree List booklet.
Checklist m►at he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved for department use only. W-4614(ntx,rc•ost,
Electrical PernutApplication
--'� -- rDateceived: Permit no.::::::::
City of Tigard ProjecUappl.no.: Expire date:
CitvofTigard Address: 13125 SW Hall Blvd,Tigard,OR 77223 pate issued: By:^ Receiptno.: _
Phone: (503) 6394171
Fax: (503)598-1960 Case file no.: Payment type:
Land use approval: _
❑ I &2 family dwelling or accessory U Commercial/industrial U Multi-lamik U Tenant improvement
U New construction Addition/alteration/replacement U Other: U Partial
t
Joh tddfcs." Bldg.no: uu. no.: Tax ma /tax lot/account no.: _
[.ot: -- Blo k: - -- Subdivision: 5
Project name: IDewnpoon and location of work on premises:
Estimated date of completion/ins ction: ,S /5- o Z
Job no: Pee Max
Business ntrtne�gpr• Elee. YIT f-L - _ k- ri uhl -� [11y. lea) total no.lncp
-� Nets rralrkntfal sirtCF•or muhf family per
Address: Sr dwellingJudi.Inilwkeatiadrdg"r.
City: n Or Statl: ZIP: 2 j,3 Service Included:
Phonc: q-9 Fax: 2 E-mail: 1000 sq.ft.or less – 4
Fitch additional 500 .ft.or portion thereof
CCB no.: Elec.bus.tic.no: C. Limited energy,residential 2
City/metro lic.no.: p 3 Limited energy,non-residential 2
�j Fach manufactured home or modular dwelling
~ 4;201
Service and/or feeder 2
Signature of sur ervtsmg electrician(re uired) bateSup,elect.nanu(print): License noServices or feeders-Installation,
alteration or relocation:
200 amps or less 2
7Name(p.nint): u amps to 400 amps 2
s: W 401 amps to 600 ampa2
601 amps to 1000 amps 2
q Slate:0 ZIP: Z,Z Over 1000 strips or voltt: 2
Phone:!b Q G// Fax: I E-mail: -- Reconnect only I
Owner installation:The installation is being made on property I own Temporary set Acre or feeders-
which is not intended for sale,Iease,rent,or exchange according to �'n'llation•afferatlon,orrelocation:
ORS 447, 155,479,670,701. 200 amps or less 2
201 amps to 41x)amps 2
Owners signature: Date: 401 to 6(x)ams 2
Branch circuits-new,alteration,
or extemlon per panel:
Name; -- - A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2_
City: Slate: ZIP. R. Fee for branch circuits without purchase
- of service or feeder fee,first branch circuit: 2
Phone: Fax: E-mail –
Lich additional branch circuit:
hila:.(Service or feeder not Included):
U Service over 225 amps-commercial U Heath-care facility Each pump or irrigation circle 2
U Servide over 320 amps-rs ing of I eel U Harardous hxednn Each sign or outline lightingT 2
famtlydweIIings U Building over MOW square fed four or Signal circuit(s)or a limited energy panel,
U System over 600 volts terminal more re+idential units in one structure alteration,or extension' 2
U Building over three stories LI Feeder,'u,snips or more •bescrition: — --
l.l Occupant load over 99 persona U Manufactured structures or R4 parr Each additional ItspK41on over the allowable In any of the above-
*
boveU Egress/lightlngplan U Other. -_-- __..--_-_-__-- Per inspection
Submit._--seta of plafaa whit,my of the above. Investigation fee _
The above are not applkable to te•prrary construction oerdce. (cher
Not all}uridictiau atcceN Haat carcl.please cell)ue:sdletion fir aarrc inrnrmana, Notice:Thpermit application peapplication Permit fee.....................$
U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ .
Crust cold number: __L within 180 days afte,it has been State surcharge(8%)....$ —
f:tpiret accepted as complete. TOTAL.......................$
Name a n as cwt it card --
S
�— t..atdM!Jailipnnre ----- — Amami
140161'(6AXYCOM1
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee...................................................... $75.00
'Number of Inspections per permit allowed 1 (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per unit
1000 sq 0.or less _ $ -t' I ❑ Audio and Stereo Systems'
Each additional 500 sq.ft.or
portion thereof $334o 1
Limited Energy - $7500
- ❑ Burglar Alarm
Each Nianuf d Home or Modular
Dwelling Service or Feed L9n(lc,. 2 ❑ Garage Door Opener'
Services or Feeders ❑
fistallatlon,alteration,or relocation Heating,Ventilation and Air Conditioning System'
200 amps or less $80.30_ 2
201 amps to 400 amps _ $108.85 2 ❑ Vacuum Systems"
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $45465 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..260)
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 $665 _— 2 ❑
h) Lire lea for branch circuits Data Telecommunication Installation
without purchase of service
or feeder fee. ❑ Fire Alarm Installation
Firet branch circuit $46.85
Each additional branch circuit $665 ❑ HVAC
Miscellaneous
(Service or feeder trot Includod) instrumentation❑
Each pump or Irrigation circle $53.40
Each sign or outline lighting $5340 _ ❑ Intercom and Paging Systems
Signal circuit(s)or a limited energy ❑
panel,alteration or extension $1500 _ 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 Lightlng'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other
8%State Surcharge $
_ Number of Systems
25%Plan Review Fee
Sne'Plan Review"section on $ ' No licenses are required Licenses are ronuired for all uther risiallatow.
front of application
Fees:
Total Balance Due $ _
- Enter total of above fees $
ElTrust Account M
-_ 8%State Surchnrge $
S
All New Commercial Buildings require 2 sate of plans. Total Rafance flue --
i4lsts\formskic-4es.doc ORl10,p1
Plumbing Permit Application
Datereceived: Permit no.:
City of Tigard Sewer permit no.: Build!-g permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of Tigard phone: (503) 639-4171 ProjecUappl.no.: Expire daft:
Fax: (503) 598-1960 Date issued: By- Receipt no.:
Land use approval: Case file no.: Payment type:
U I & 2 I;imily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New comuucutm Addition/alteration/repl icenuent U Food wivice.100
1 t
Job address: S a Ic— _ 1)adiv d"elhee(ea.) "Total
Bldg.no.; Suite no,: New 1-and 2�inmily rellints only:
Tax map/taxloUaccountno.: Z$ I G 00 (locludetit110n.forr•arhmtllitvconncctfon)
—.-- SFR(1)Fath
Lot: Blnck: Subdivision: SFR(25 bath
Project name: SFR(3)hath
City/county: '-[• ZIP: 9 7 ZU Each additional bath/kitchen
Desc prion and Inc tion oof,work on remises: —�--___— Sileutilities:
k e er.-L0wgd r�ltlr p_ NOLtSe�_ Catch basin/area drain _
Cast.date of completion/inspection: p Dr;Foottinging drain
(each line/trench drain
drain(nn.lin. ft.)
` 11 fAlsManufactured home utilities
Business name: Manhor^s
Address- Rain drain connector
City: T1St1!t1ei: n_,r7zIP: 97pg5 Sanitary sewer(no.lin. ft.)
Phone:,pj �0 a ax: __+ E-mail: Storm sewer(no. lin. ft.)
CCB no.:_: J�.S — Plumb.bus.reg.no:,26»32 y P5 _ water service(no, lin. fl.)
City/metro lic.no.: _3f-0 Fixture or item:
— Absorption valve
Contractor's representative signature:---_._ Back flow preventer _
Print name: Date; Backwater valve ~
EmBasins/lavatorx
tr Clothes washer
Name:
Address: j gf7 S,Ill, E S _ Dishwasher
' Drinkingfountain(s)
City: State:C),r ZIP: azo Ejector. sum
Phone: 3 3 'ax: Vg E-mail: E tank —_—_
Fixt ire/sewer cap
Name(print): Floor drains/floor sinks/hub _ _ -
-- ? - -- Garbage disposal
Mailing address: CJC Nose bihb
City; State: Or ZIP: Ice maker _
Phone: Fax: E-mail Interceptor/grease trap
()caner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property 1 own as per ORS Chapter 447. Sink(s,,basin(s), ays(s) —
Ownet's signature: Date: Sum —
Tubs/showei/shower pan
Urinal _
Name: WLter closet
Address: ater eater
City: —_ _ State: ZIP: Other:
None: Total
Fax: E-mail: ota
Not all)uriadkaatu atxcq redit caulA,pleau call tut udiction frit more infrrWnwhon. Minimum fee................
Notice:This permit application Plan review(at ,_ 96) $
U Vies U MasterCard expires if a permit is not obtained
Credo card number:_ — _ —L 1-- within ISO days after it has been State surcharge(8%)....$
TOTAL
Named 1 as drown on credit card
accepted as complete.
S
alprartte- Amautt 446-4616(&OWOM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only: -
FIXTURES (individual) QTY (Na) AMOUNT (Includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the first100 It. QTY .(ea) AMOUNT
Lavatory 16.60 for each utllity connection
One 1'bath' _ ___ _ $249.20 _
Tub or Tub/Shower Comb. 16.60 Two 2 bath �__ $350.OU
Shower Only 16.60 Three 3 bath � - $399.00
Water Closet _ 16.60 SUBTOTAL
Urinal 16.60 6%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _ �_-
Garbage Disposal 16.60 TOTAL
Laundry Tray i 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 PLEASE COMPLETE:
4" 16.60
Water Heater O conversion O like kind 16.60 Quant�___byyy_Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped___
MFG Home New Water Service 46.40 Sink _
MFG Home New San/Storm Sewer 46.40 r Lavatory
Hose Bibs 16.60 Tub or Tub/Shower
Combination _
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Other Fixture- (Specify) - 16 60 Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine _
Sewer-1st 100' 55.00 Floor Drain/Sink: 2"3"
Sewer-each additional 100' 46.40 4"
Water Service-1st 100' 55.00 Water Heater
Water Service-each additional 2013' 46.40 Other Fixtures
(specify)
Storm&Rain Drain-1st 100' 55.00
Storm b Rain Drain•each additional 100' 46.40
Commercial 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 Inspectionsper/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25
Grease?raps 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 qly total is r 9 _
TOTAL �-
"Minimum permit fee is$72 50•B%state surcharge,except Residential Backflow
Prevention Device,which Is$36 25*B%state surcharge
~All New commercial Buildings require 2 sets of plans with Isometric or,Isar
diagram for pian review.
l Adsts\tormsWm-fees.dor. 12/26/01
Ll
Ul
In
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP - --
Received _ _Date Requeste -- AM,__—_ PM BLIP --
C� -1
Location - 1 .3 -__-suite MEC
Contact Person r-l-���� -__- Ph(-.______) __''_'L S3_PLM
Contractor __._____ ____.-___ _.__ . �____ __- Ph(-. ) __-__ __ SWR
BUILDING i Tenant/Owner --�_ __- ELC
FoundationE L C
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Bearn r
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shea,
Framing ------ ----
Insulation
Drywall Nailing _--
Firewall
Fire Sprinkler - - ---.-..___..-.---_...-.-_-_-��-- -
Fire Alarm
Susp'd Ceiling --------- -
Roof
Other:
ASS PART FAIL -----....----_._.-�s____-..--- --------- -------------
__ ING
Post&Beam - -------- --_-__----_
Under Slab --
Rough-In
Water Service ---- ---------- --- --^---- - __-_
Sanitary Sewer
Rain Drains -- _ ----- ----- - - --- - --_-----_W_--
Catch Basin/Manhole
Stcrm Drain
Shower Pan
Other:
Final
_ FAIL �-- ------ - -- -- ------- _- -.�----- -
ECHANICAL
Rough-In --- -------- --- -- - --_- -
,jas Line
Smoke Dampers - -- -- - -- ------ --
a
PART FAILICA--.__-
Service
Rough-In ---- - -
UG/Slab
Low Voltage
-._----..____--
Fire Alarm
Final Reinspection tee of$ required before next inspection. Pay at City Hall, 13125 SW NaA Blvd.
_ PASS PART_ F'All...
SITE _-_ �� Please call for reinspection RE _ _ _—- Unable to inspect no access
Fire Supply Line
ADA C'
Approach/Sidewalk Date _ �jgspector h _� '�.'� Ext -�-
Other-
Final DO 40T REMOVE this Inspection record from the job site.
PASS PARI FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175MST 4'
INSPECTION DIVISION Business Line: (503)639-4171
/ BUP
Received ____- _ __.__. Date Re fisted�__ .. '! �� __ AM _ -_ PM BUP
location Suite_--
------ MEC _--
Contact Person -
Contractor ___ Ph( ) _--. SWR
BUIWING _ Tenant/Owner —_ __ _ _
ELC
Footing _ ELC
Ft
Foundation
Access:
g ELR _
r.,
Crawl Drain
Slab Inspection Notes 'I SIT ----
Post&Beam
Shear Anchors - ---�
Ext Sheath/Shear
Int Sheath/Shear
Framing — --- -_
Insulation
Drywall Nailing
- - _- --
Firewall
Fire Sprinkler - -
Fire Alarm
Susp'd Ceiling - - -- - -
Roof
Other. _.
Final Jv--
PASS T FAIL --
BIN _ __ _ ------- --- --- - -—
Post&Beam
Under ilAb - _ ----
---
Rough-In
Water Service -
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: — ------- --
--
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
Final Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_PASS _PANT FAIL
SITE T Please cell for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date_ ---
---- Inspector _ --_ Ext
Other:
Final -�� � DO NOT REMOVE this Inspection r(scord from the job site,
PASS PART FAIL
CIT`'tf' OF TIGARD 24.Hour
BUii_DIN,i Inspection Line: (503) 639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received Date Requested -.5 - AM __ PM t•3UP
Location iq K G _Suite _ _ MEC —_
Contact Person n `" Ph (._- _) Sue_ 4� LS2 _ PLM
Contractor_-r I r % – _'.- c^ Ph(_ - --) SWR
_BUILDING �nt/Owner - -- - ELC
Footing
ELC
Foundation Access:
Ftg Drain G` 4�//14c ) � ELR
Crawl Drain
Slab Inspection Notes: SIT _ ---
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear !-
Framing
Insulation
Drywall Nailing ----
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --— --- - -
-� _
Roof �._�----
Other:
Final - -_-�
PASS PART FAIL _-.-__�-�---
PLUM_BING -
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
PA" PART FAIL - ___------ -- ---- --.- --
ELEC-------�-.eM -------
Service r�
ough-In -
UG/Slab ----�_•-- .--- -- ----- --- -
Low Voltage
Fire Alarm
iris Reins __-__ required before nex;tips
PART FAIL � Reinspection fee of Sre 4 pection. Pay at City Hall, 13125 SW Hall Blvd.
Lj Please call for reinspection RE:_ —_ -- Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Drttr. l �C Inspector "� 3rs _- taut-----
Other:
Final - - DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL