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10502 SW NAEVE STREET /,� 5... S. W. LADY MARION DRIVE -- NEW HOUSE PER C 3/15/02 MSG. NEW SCALE 3/27/027/02 MPW h r G� f�-- '`'`'�� W 100.00' -71N �--- 0 O ui Cj cv I O W v - � O 0 •'� 0 ' c � -- --------� ,�_ �? ��.oQ 35 In M7� "4 , �_ N LO 6.00' P O M J 36.33' --'. ` N 89057'060 W 103.16' v SCALE DRA WING Loi' 1 e, BRIMSON S.E. 1/4 SEC. 10, T.2S., R.1 W., W.M. CITY OF TIGARD -- A, 2, 3 FOOT LANDSCAPE EASEMENT ...........WASHINGTON COUNTY SHALL .-XIST ALONG ALL STREET FRONTAGE. OREGON :u --A 7.5 FOOT PUBLIC UTILITY EASEMENT MARCH 15, 2002 Centerline. Concepts Inc . SHALL EXIST ALONG THE LANQ5CAPE EASEMENT DRAWN 8Y: YAG CHECKED 8Y: WG0111 SCALE 1'=20' ACCOUN1 115 EMAIL C:CIEMAILOPAOL. COM 640 82nd Drive Gladstone, Oregon 97027 M: MLI L16ERICK 503 650-0188 fax 503 650--0189 NOTICE: IF THE PRINT OR TYPE ON ANY r� il � � � III � ' � � � � � � � � � � � � � � � III � � � � � r .i.li iIj ILI � � � + ' � �—� �� . .1� � � � � lel � � 1 � � f i i �< < � I < < < < < < �. �_ ,r: . i i i � �. . . I ,., 1 f If i I I 1 � 1 I ! ► �T � r1 � pp-1-fTniTIil � I1i � � � � l IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 I C I I I I IT IS DUE TO - - _ _________ _____�__._----.__-- _-- ______�_ �_---- � 7 _ _ g 9 - Q-L THE QUALITY OF THE11l 12 II I II IllR tllli Iillll8ZI � Z fiZ EZ ZZ TZ 0�b� T 9T � T EI Zi 1111�I1ll 111� 111ILIflIL—I( �!�I( -11.11 9 Q--- No.36ORIGINAL DOCUMENT 1110 EII II6Zlill gZ Z LullmI E r Z Ix � w # . 0 CD Z D m m cn m M, 10502 SW NAEVE STREET CITY CF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639-4171 �i BDP Received ___-___ . --- Date Requested__ if -- AM----- PM __ _-_-__ BUP Location --l�1 5� �- &J,2 r' U` - �— Suite--- --- MEC - -- - --- Contact Person --__ —__- -.- Ph PLM _ -- Contractor --- -- - .--_— PhSW _ - - _ --- BUILDING Tenant/Owner -- - —_---_._ - --- ------ --- ELC -- -- Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - -- — --- Firewall 1�5� Fire Sprinkler - - ----- - Fire Alarm Susp'd Ceiling - --" Roof Other: -- --- Final - - - -- PASS_ PAR_T FAIr- PLUMBING - 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 RT FAIL �-- --- - ---- -- -- Service Rough-In - — UG/Slab Low Voltage _— - - -- - - - --- - - Fire arm eA Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. � PAi'T FAIL - — SITE [ ] Please call for rr3ins action RE:- Unable to inspect-no access Fire Supply Line l ADA Dot* � ,�- �H` Inspector- - Approach/Sidewalk Other:----._—_—_ Final DO NOT REMOVE this Inspection record from the Job site. PASS PAP.T FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST `1��j INSPECTION DIVISION Business Line: (503)639-4171 BUP - -- Received — - Date Requested ___��—_._ AM_. ' PM ____- BUP � :� SZ - Location � G .� �✓� -�__-___ _Suite— MEC _ Contact Person - ___. Ph(_ ) t'9' �D L_ PLM Contractor Ph( ) SWR -- BUILDING Tenant/Owner - ELC - Footing ELC Foundat`.,in Access: Fig Drain ELR -- - Crawl Drain ' Slab Inspection Notes: V Z_ SIT - Post&Beam - ✓`'S �' f Shear Anchors Ext Sheath/Shear 11 INN _j Int Sheath!Shear Framing ' - Insulation d1 Atvc Drywafi Nailing - ---- Firewall Fire Sprinkler _%A -= -- _- - _-/— — Fire Alarm -1�i c� b l0 • 3 + Susp'd Ceiling ---- - . Root Other: - - - - Final PASS PART FAIL Post&Beam - Under Slab ---- Rough-In Water Service ----- - Sanitary Sewer Rain Drains — - Catch Basin/Manhole Storm Drain - Shower Pan Other: — - Sr PART FAIL --- _ HANICAL_ _- Post&Beam Rough-In - -- Gas Line Smoke Dampers — ---- -- — -- - - - - Final ASS ART FAIL —�- -----^ '- --- - E E ' A e vice- RoUg In UG/tab ab Love Voltage Fi A rima' Reinspection fee of$_ --_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _ SS PART FAIL SITE [� Please call for reinspection RE: _ _ �-] Unable to inspect--no access Fire Supply Line ADA Approach/Sidewalk Date Inspector _- -_ _ -_ E7It —_— Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 _ MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP ----- _ _ -- ---.. W 2,0 AM_-- -.-___. PM BLIP Received -----Date Requested --- Location _— / _��-J Suite MEC Contact Person _„ - Ph( ) —�� 3�0.Z PLM Contractor---. ------ Ph( _) SWR Tenant/Owner -_ ELC -_- - F hng ELC Foundation Access: Ftg Drain 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: - - _ iTT na PART FAIL - ___ PEMBING__ Post& Beam Under Slab Rough.-In Water Service Sanitary Sewer Rain Drains — -- ---- Catch Basin/Manhole Storm Drain — - -- - — - - Shower Pan Final --^.------- - PA__ T _FAIL _ --- -- --- --...--- -_ _ - -----_.._ -- _ .. _ ---- --_ CHANIC L Rough- --- Gas Line Smoke Dampers - S PART FAIL ------- -- - -- -- — —._ .�_ ELECTRICAL _ Service � - �- ----� Rough-In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$� required before next inspection. Pay at C4 Hell, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ble to inspect-no access Fire Supply Line abIfADA Duets IetApproach/Sidewalk Other:_ Final DO NOT REMOVE titis Inspection record from the job site. PASS PART FAIL CITY o F T'G A R D --_ MASTER PERMIT PERMIT#: MST2002-00195 DEVELOPMENT SERVICES DATE ISSUED: 4122/02 13125 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10502 SW NAE`%E ST PARCEL: 2S110DA-05500 SUBDIVISION: ERIC;KSON HEIGHTS ZONING: R-3 5 BLOCK: LOT: 016 JURIS[',ICTION: TIG REMARKS: New SF detached residence. BUILDING IILISSUE: STORIES. FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT. rIRST: 1,;91 at BASEMENT; a1 LEFT: 7 SMOKE DETECTORS TYPE OF USE: SF FLOOR LOAD: .I SECOND: 1 Qtr ai GARAGE: 550 51 FRONT: PARKING SPACES TYPE OF CONST: SN DWELLING UNITS, I FINBSMENT. at RIGHT- 7 VALUE. $294.58420 OCCUPANCY GRP: R3 BDRMr 4 BATH: 3 TOTAL: 3,10700 of REAR 3S PLUMBING SINKS: 1 WATER CLOSET S: f WASHING MACH: 1 LAUNDRY TRAYS: U RAIN DRAIN: 100 TRAPS. LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS, I CATCH BASINS. I LIBISHOWERS. 9 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 13CKFLW PREVNTW I GREASE TRAPS. OTHER FIXTURES: MECHANICAL _ FUEL TYPES TURN c 100K: SOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER. 1 nns FURN>•100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS, 1 MAX INP: btu FLOOR FURNANCES: VENTS, 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp; 0 200 amp WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: a 201 400 amp: 201 400 amp. tat WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp, EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANO HMISVCIFDR: 601 1000 amp: 601-ampa•1000V MINOR LABEL: 1000.amplV011 PLAN REVIEW SECTION Reconnect onIV: >•4 RES UNITS: SVC/FDR>•225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO d STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MECICAL: OTHR: HVAC: DATA(TELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,898.47 This permit,s subject to the regulations conlain3d in the RENAISSANCE CUSTOM HOMES RENAISSANCE C 'STOM HOMES Tigard Municipal Code,State of OR. Specialty Codes and 1672 SW WILLAMETTE FALLS OR 1672 WILLAMETTE FALLS DR all other applicable laws. All work will be done in WEST LINN,OR 97068 WEST LINN,OR 97068 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: Pnolta; Phone: Oregon law requires you to fallow rules adopted by the Oregon Utility Notification Center. Those rules are set Rap N: LIC 130449 forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by call Itig(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Craw:Z)'aln/Backwalef Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing/Foundation On Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Post/Beam Structural PLM/UndelAcir Framing Lisp Gas Fireplace Electrical Final Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Underfloor InsulationPlumb Top OUt Exterior Sheathing Inst Rain drain Insp Plumb Final issued By : i.t`� f /, �� °nrmittee Signature `.._. Call (503) 639-4175 by 7:00 p.rn for an inspection needed the next business day CITE' OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: S22/02 00137 DATE ISSUED: 4/22102 13125 SW hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S 110DA-05500 SITE ADDRESS; 10502 SW NAEVE ST SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: Lor: 016 JURISDICTION: TIG _ TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL. TYPE: L.TPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new SF detached residence Owner: FEES RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt 1672 SW WILLAMETTE FALLS DR WEST LINK, OR 07068 PRMT CTR 4122/02 $2,300.00 27200200000 INSP CTR 4/22/02 $35.00 27200200000 Phone: 557-8000 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The agency does 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' Perm Issued b LIJJI� Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business y 77.4,f ,I/-la-o2 All �V)P—. x -nal/3? Building Permit Application ('sty of Tigard Date icceived 7, Permit no.: City of Tigard Address: 13125 SW A dFWutl Yigai,t,OR 9721.3 Project/appl.no.; Expiredate: Phone: (503) 639-4171 A Date issued: B Receipt no.: i ' Fax: (503) 598-1960 � Case file no.: Payment type.: Land use approval:v-, : ,. ,. 1&2 family:Simple Complex: } 1 &2 family Dwelling or accessory ❑Commercial/industrial Mulls f,un,l� rNew construction ❑Demolition 1.1 Addition/alterition/replacement LITenant improvement J I ur ,prinkI;ih,larm Ll Other: _ JOB SI 11'.IN FORMATION Job address: 0 p 1,L_ $tW Bldg.no.: Suite no.: Lot: Hlock: Subdivision: ETax map/tax lot/account no.: Project name: Cnc Asn, He1#67's `�3 •5 ---- - 25//0 D/j - 06-5-0 Description and location of work on premises/special conditions: rim _�ri.�`/v /rJirYr�i rx/ 130 "3Jv_3 ' OWNER 1:011 SPLUAL INFORMATION, I %L CIIECKLIS] Name: ReN alfsa.rce 77 e (I'lloodillain,seolic capacity,solar,etc.) Mailing address: 1672 S(✓ 1 &2 family dwelling;: City: WeXIL 6 1,4 IIX I State: ZIP- Valuation of work........................................ $ Sb 7 Phone:.fffJ 791900 I Fax:So-V-CCIC VA E-mail: - No.of bedrooms/baths................................. Owner's representative: 7';O„,,,k oV ,Q io o It Total number of floors................................. Phone: spi»e Fax: E-mail: New dwelling area(sq. ft. .. Garage/carport area(q.ft.) ........................ Name: Ja,•1t Covered porch area(sq.ft.) ......................... Mailing address: Deck area(sq. ft.) ........................................ City: State: ZIP: Other structure area(sq. ft.)......................... Phone: Fax: E-mail: 7Existing rnercial/industrial/multi-family: ation of work........................................ $bldg.area(sq. ft.) ..........................Business name:Address: bldg.area(sq.ft.l............................. City: _ State: ?_IP: —� Number of storie;t............................. ........ Phone: Fax: E-mail: Type of construction.................. ....... .. .... CCB no.: Occupancy group(s): Existing. 97699 .. -�YJ° - T New: City/metro lic.no.: Notice:All contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under Name: provisions of URS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: ZIP: -^ exempt from licensing,the following reason applies: Contact person: Plan no.: -- Phone Fax: .L f11,111 -- -- — ---- -- Name: Contact person: Fees due upon application ........................... $ Address: Date received: _ City: Slate: ZIP: Amount received ......................................... $ Phone: Fax: E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdiction accept credit cards,please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this 0 Visa O Mastercard work will be complied with,whether specified herein or not. credit card number--- __ Expires Authorized signature: _ ��ate: _--..- -- Name of cudlwlder as shown on credit card � S Print name:—� 13,--yn <r --_-- Cardholder Op ature _ Amount Notice.This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404611(&MCOM) One-and Two-Family Dwelling ist Reference Building Permit Associated pe rmits City of Tigard U Electrical O Plumbing O Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 0Other: Phone: (503) 639-4171 Fax: (503) 598-1960 111111�11fii�ii 11 1 1toles 1 1 band use actions completed.See jurisdiction criteria for concurrent reviews_— 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. _ 4 Fire dlstric_ t 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewur permit. _ ---- - 7 Water district approval. — - 8 Solis report.Must carry original applicable stamp and signature on file or with application. _ e drainage-way protection,silt fence design and location of 9 Erosion control U plan ❑permit required.Includ catch-basin protection,etc. -- 10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. II I 1 Sltelplot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if there is more than a 4 fL elevation differential,plan must show contour lines at 2-ft.intervals);location of casements and driveway;footprint of structure(including decks);location of wells/Se ptic systems utility locations;direction indicator,lot area;building coverage aren;percentage of coverage;impervious area;existing sb secures on site;and surface drainage. 12 Foundation plan.Shoff'dimensions,anchor bolts,any hold downs and reinfc rcing pads,connection details,vent size and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show a�cfcrea than onemro sssecctiondmay be required to clearly portrayhead consjoists, truction.Show wall construction,roof construction roroof slope,ceiling height,siding material,footings and foundation,status, details of all wall and roof sheathing, oting, fire lace construction, thermal insulation,etc. I S Elevation vlews.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, h)slid/or lateral analysis plans.Must indicate details and locations;for 16 Wall bracing(prescriptive pat non- rescriptive path analysis rovide s ecifications and calculations to engineering standards. 17 Floor/roof(ranting.Provide plans for all floor! roof assemblies,indicating member sizing,spacing,and beating locations.Show attic ventilation. I OF 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 fcr all beams and multiple joists over 10 feet long and/or any beam/joist carrying;t nun-uniform load. _ 20 Manufactured floor/roof truss design details. __ 21 Energy('ode compliance.identify the prescriptive path or provide calculations. A gas-piling schematic is required for four ur more appliances. 22 Fug ineer's calculations.When required or provided,(i.e.,shear all,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. 23 Five(5)site plans arc required for hero I 1 above. Site plans must be 8.112"x It"or 11"x 17 24 Two(2)sets each are required for items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. 26 "Reversed"building plans must meet criteria outlined in the Permit& System Development Fees document. 27 No"mirrored"building plans will be accepted. — — 28 "Drawn to scale"indicates standard architect or engineer scale. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may he in blue 4Q4black� t�nko. , ment use only. Red ink is reserved for depart Plumbing Permit Application - date received: Permit no. ) i0o _00 115 City Of Tigard Address: 13125 SW I lall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: Cityq/Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 date issued. By: I Receipt no.: Land use approval: _ Case file no.: Payment type: TVPE OF PERMIT MEN I &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family ❑Tenant improvement New cowtru,Imo ❑Addition/alteration/replacement ❑Food service U Other: .` JOB SITE INFORMATION 1 (for special Information use check i%l Joh address: jn/ \\ X' Dc.cri lion Qtv.IFee(ca.) Total Bldg.no.: Suite no.: New I-and 2-farnily dnellings onl}: -- (includes 100 ft.for each utility connection) Tax map/lax lot/account no.: SFR (1)bath Lot: Block: Subdivision: /� ,� �, SFR (2)bath - - — — - --^_ - --_ Project name: / , , /-A-, s/,>, SFR(3)bath City/county: Vq0�,4, •• , LIP: Each additional hatlt/kitchcn—� Description and location of work on premises:_ .M Site utilities: Catch basin/area drain Est.date of completion/inspection Drywells/leach line/trench drain11 _ 1 Footing drain(no. lin. ft.) Manufactured home utilities _ Business name: Cv,;,<'f,r,�/� GH -_ _ Manholes Address: 7 -Y &1107 41,r Ruin drain connector _ City: /sr...rrt.., State: cn,< JZIP: 700. Sanitary sewer(no. lin. ft.) Phone:s j-b -1116 9 3A Fax: I E-mail: Storm sewer(no. lin. ft.) _ CCB no.: 79 '`6 _ I'lurnh.bus. reg.no: 'tT I�o(, Water service(no.lin. It.) City/metro lic.no.: 75,f/ Fixture or item: Absorption valve: Contractor's representative signature: �' ---- Back flow preventer Print name: r11e /'•//,.I,. I);tte. Backwater valve _ CONTACT1 Basins/lavatory _ Name: a Clothes washer Address: Dishwasher --- - -. - Drinking fountain(s) Cit 1a�c 711' - y ' -. _. - -- -- Ejectors/sump_ Phone: I: uuul Ex ansion tank Fixture/sewer cap Name(print): Floor drains/floor sinks/hub ��-�--�--� Garbage dis sal Mailing address: 6 7 S r/�ar�. N //s Hose bibb _ City: IState: -yC ZIP: 97A-*$' Ice maker _ Phone: 5,,ev3 SS77r'"C Fax: I E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),hasin(s),lays(s) Owner's signature: Date: Sump _ Tubs/shower/shower pan Urinal Name: Water closet Address: _ _ Water heater City: Stnte: ZIP:_ Other: Phone JFax: E-mail: Y Total Not all jurisdictions accept credit cards,please call jurisdiction for mtxe informationNotice:This permit application Minimum fee................$ Plan review(al , %) S Cl Visa ❑MasterCard expires if a permit is not obtained Credit card number_ . -_L_! within ISO days after it has been Slate surcharge(8%)....s E p Name of cardholder u shown on credit card cues accepted as complete. TOTAL Cardholder signature JAmount 440.4616 tfiWCOMt PLUMBING PERMIT FEES: --- — PRICE TO'.4L New 1 and 2-family dwellings only: FIXTURES (individual) -- QTY ea AMf 11NT (includes all plumbing fixtures In PRICE TOTAL Sink 1660 the dwelling and the ffrstirl ft. QTY (ea) AMOUNT for each utility connection) _ i6 60 — Lavatory One 1 bath $249.20 _ Tub or Tub/Shower Comb J 16.60 Two 2 bath $350.00 1660 ThreeL3Lbalh $399.00 S . ower Only _ Water Closet 16.60 SUBTOTAL Urinal — 16608%_ STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW'<5'/.OF SUBTOTAL —� — 16.60 TOTAL Garbage Disposal -_ Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 27 - - 16°0 PLEASE COMPLETE: 3- 16,60 4^ —16-60 Quantity b Work Performed Water Beater O conversion O like kind 16.60 Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed p p' g _ Capped ermit. — Sink MFG Home New Water Service 46.40 -- —`-- Lavatory _—_— MFG Horne New SaN5lorm Sewer 46.40 _ Tub or Tub/Shower Hose Bibs — 16 60 Combination Roof Drains — 16.60 Shower Only 16.60 Water Closet Drinking Fountain Urinal ----- Other Fixtures(Specify) —16.6° Dishwasher — _Garbage Disposal --- -- Laundry Room jLa.L_ — - - Washin Machine Floor Drain/Sink: 2" Sewer-1st 100' -- 55.00 _ — 3" Sewer-each itir addna1 100 46.40 4.. — _ - --- 5500 — Water Heater Wa.er Service- 1st 100' _ Other Fixtures — Water Service each additional 200' 46.40 _f (Specify) — — Storm 8 Raln Drain- Ist 100' — 55.00 — — -- Sloan 8 Rain Drain-each additional 100' 46 40 ------- Commercial Back Flow Prevention Device _ 46 40 -- Residential Backnow Prevention Device'v 27 55 Catch Basin 16.60 Inspection of Existing Plumbinq or Specially 72.50 — �erRu COMMENTS REGARDING ABOVE: Requested Inspections F2ain Drain,single family dwelling 6525 --- Grease Traps 1660 -- — QUANTITY TOTAL -- Isometric or riser diagram is required it —�---- ]uantlly Total Is I.9-- __ ---- _—___ 'Sl1BTOTAL _- ---- 8'/e STATE SURGNARGE "'PLAN REVIEW 25%OF SUBTOTAL Required only if fixture lity total is`9 — TOTAL S *Mlnlrnum pemdl fes is$72 50.6%state surcharge,except Residential Backflow Prevention Device,which Is$36 25 4 a%state surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review I:\dsts\forms\plm-fees doc 10/10/00 Mechanical Permit Application Date received: Permit no.yhc. City of Tigard Project/appl.no.: Expire date: � City nf Ti Address: 13125 SW Hall Blvd,Tigard,OR 97223 Tigard Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Paymenttype: Land use approval: _ Building permit no.: OF PERMIT 1 &2 family dwelling or accessory U Commercial/industrial ❑Multi-family U Tenant improvement �Ncw ctmstluction U Addition/alteration/replacement U Other: It SITE INFORMATION COMME.RCIAL VALUATION SCIIEDULE .10)address: 6--0 1-- V V./ %� rl Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Sui►e no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: Subdivision: �/ . �, *See checklist for important application information and Project name: j>;r�/� // , jurisdiction's fee schedule for residential permit fee. Z.I P: t t City/county:T2 � � ,� * " �, r Description and location of work on premises: "1•'A0A Le, rrlic/n rf7n/ F'ee(ea.) fotal Est.date of completion/inspection: _ Description (py. Rmi.only Rm.unh Tenant improvement or change of use: Au handling unit CFM Is existing space heated or conditioned?U Yes U No Is existing space insulalcAir conditioning(site plan require ) -- - d'�O Yes ❑No Alteration of existing system LMIMAcompressors Business name: ', Slate boiler permit no.: •' ^'r• HP Tons_ BTU/II Address: 2 7 Iv -S E 3, ire smo eampe-rrTuefsmo a—detTectors City: State: CW ZIP: 7/7eat—pump(iie Pan required) nsta replace urnace/ umerPhone:f.'3 .'/�Z/2 Cx: E-mail: - - Including ductwork/vent liner O Yes U No CCB no.: /'Z.,_1y�ff °jie y1t')lnt/ nsta rep ac re locate testers-suspen e City/metro lic.no.: wall,or floor mounted _ Name Vent for a lance other than furnace PERSON'CONTACT; Refrigeration: Absorption units_ BTU/H —_ Name: Chillers HP _ Address: Compressors HP - - - -- ------ nv ronmenta exhaust an vent at on: "Phone: State: ZIPApplianceventfax: mail: )ryerexhaust _ oo s,Type 111 Ures. itc en/ azmat � hood fire suppression system _ Name: /<s•.t�t,lsa.PC C.ff�.t _ -/A�•tl Exhaust fan with single duct(bath fans) Mailing add.;ss: /(; Z S'H/ /✓./c r' F L'x aust system a art rom heatin or AC , , Fuelpiping andistribution(up to outlets) City: ,00 St ilc: ZIP: Type: LPt3 NG Oil Phone:j9?SS,'$0 cc, Fax: 65 .iL mail: Fuel plinog each additional river 4 outlets rocess piping(sc sematic required) _ Number of outlets _Nat,le: terst appliance —*- -- - — or egmpmcnt: Address: _ Decorative fireplace City: State: 7.IP: nscrt-type — Phone: Fax: I E-snail: ooc stov pellet stove (.)t er" Applicant's signature: � �� .�„� Date: t �; Name (print): -�y✓1" y /!J — - --Not all jurisdictions accept credit cards.please call jurisdiction for more Information Permit fee.....................$ U Visa U MasterCard Notice:This permit application Minimum fee................$ expires if n permit is not obtained plan review(at — %) $ Credit card"""'rte" -- - it- s within I go days after it een has b -- --- -- - p State surcharge(896) ....$ Nwne of cardhoLkr m shown on credit card accepts as complete. s TOTAL .......................$ -- Cardh rider signature AMOUR 00.4617(WWCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.50Table 1A Mechanical Code Oty (Ea) Amt $5,001.00 to$10,000.00 $72,50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or including ducts&vents 1400 fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000.00. Including ducts&vents 1740 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Fumace $1.54 for each additional$100.00 or Including vent 14.00 fraction th�rnof,to and including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater 14.00 ` $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units _ $50,OU_O.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof, footnotes below. Comp 7)<;,HP;absorb unit Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14.00 8'/.State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU_ _ 2560 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb 35.00 Required for ALL commercial permits onl unit.5-1 mil BTU _._ TOTAL. COMMuni ERCIAL PERMIT FEE: $ 30absorb unit 1-11.7.7 5 mmil BTU 52.20 11)>50HP;absorb - unit>1.75 mil BTU 87.20 _ ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00 Value Total Description: _ Ot al Amount 13)Air handling unit 10,000 CFM+ 17.20 Fumace to 100,000 BTU,Including 955 14)Non-portable ev-porate cooler ducts&vents 10.00 Furnace> 100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&vents ___ 6.80 Floor fumace including vent 955 _ 16)Ventilation system not included In Suspended heater,wall heater or 955 yt0.00 floor mounted heater appliancepermit Vent not Included In applicance 445 17)Hood served bby mechanical exhaust 10.00 _ e�-- 18)Domestic incinerators Repair units 805 _ 17.40 <3 hp;absorb.unit, 955 19)Commercial or Industrial type incinerator to 100k BTU 1 W95 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 500k BTU 1000 15-30 hp;absorb.unit,501k to 1 2,310 mil.BTU21)Gas piping one to four outlets 5.40 30-50 hp;absorb.unit, 3,400 1-1.75 mil.BTU 22)More than 4-per outlet(each) >50 hp;absorb.unit, 5,725 1.00 _ Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU Air handling unit to 10 000 cfm 658 _ _ Air handling unit>10,000 cfm 1,170 8'/.State Surcharge $ Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 _ Vent system not Included in 656 appliance permit Hood served by mechanical exhaust 656 Ot er Inspections and Fees: Domestic incinerator 1,170 1 Inspections outside of normal business hours(minimum charge-two hours) --- $72 50 per hour Commercial or Industrial incinerator 4,590 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 $72.50 per hour Inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas piping 1-4 outlets 360 charge-one-half hour)$72.50 per hour Each additional outlet 63 _ 'Slate Contractor Boller Cerrlficstlon required for units 3,200k BTU. TOTAL COMMERCIAL "Residential A/C requires site plan showing placement of unit. VALUATION: � All New Commercial Buildings require 2 sets of plans. IAds40orms\mech-fees c oc 08/29/01 • Electrical Permit Application ---- - - I t tic received: Permit no.: /w _00/City of "Tigard 11rulect/appl•no.: Expiredate: Cir,(if Tigafd Address: 13125 SW Hall Blvd,Tigard,OR 9.1'' bale issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 1;i e Dile no.: Payment type: Land use approval: TYPE OFPERMIT &2 family dwelling or accessory U Commercial/industrial U Mulli-family J 1 enant improvement New construction U Addition/alteration/replacement J Othcr: U Partial INFORMATIONJOB SITE 1oh address: Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: E..c/c 1,19 Project Project name: ��pescription and Illation til•work on premises: Estimated date of completion/inspection: CONTRACTOR APPLICAT1SCHEDULE .lob no: p� O'�.- �r,� /��_9r� Fre tax Business name: IlMscription _ Qh. lea.) 'Intal no.in%p "'rw vL /(+c �i,G New residential-single or oodtl-(amts per Address: At., 2 7 dwellingunit.hicludmallacheds, Age. City: els /cu State:CW ZIP: )7 J 5' Sen iteIncluded: Phone:S n" , ti 0,,y 7- Fax: I E-mail: I(xM sq It.or less 4 .� Each additional 500 sq.It.of portion thereof ('CB no.: 3 Syy FICC. hUS,tic, f10: , /<w r Limited energy,residential 2 City/metro hc.no.: I Zil-I Linuiedenergy,non-residential 2 Bach manufactured home or modular dwelling Signature of supervising electtit i:m(required) Dote Seryice and/or feeder 2 Sup elect.name(print): L�� , r License no: Cj!�f Services or feeders-installation. ahcralion or relocation: 2(x1 amps nr less _ 2 Name(print): an / 201 amps to 400 amps 2 (p ) C r.�c1c1�5 c+n=a Us.i rss., rn.�p� -Mailingaddress: ( + ---� f p ` �. 601 amps to 600 amps 2 f. i1M� u s ✓r +' 601 amps to 1000 amps 2 City: �; �,c,� Slate: 79 ZIP: .j Cy Over 1000 amps or volts - 2 Phone: s., 5s7 fict21I Fax:Sncs i ® F-mail: Reconnecionly I Owner installation:The installation is being made on property I own Tempornryservlce+orfeeden- which is not intended for sale,lease,rent,or exchange according to Instal lallon,allerallon,orrelocalion: ORS 447.455,479,670,701. 200 amps or less 2 201 amps to 400 amps 2 Owner's SI unature: Dale: _ 401 to 600 an s _ 2 ENC�INEERBrunch circuits-rtew•alteration. Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch ciront City: State: ZIP B t'ee for branch circuits without purchase of service or feed;r fee,first branch circuit: _2 Phone: l plait Each additional branch circuit M isc.(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 1&2 U Hazardous location Each sign or outline lighting 2 familydwellings U Building over 10M square feel four or Signal circuit(s)or a limited energy panel, USystemover600volts nominal more residential units in one structure alteration,or extension' 2 U Building over three stories U Feeders,400 amps or more *Description: U("kcupant load over 99 persons U Manufactured structures or RV park FAch additional Inspection over the allowable in any of the alcove: U Egress/lightingpltut U Other. ----_� perIns,Noon _ r Submit_sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Omer Not all jurisdictions accept credit cud%,please call jurisdiction for mom informsumn. Notice.This permit application Permit fee.....................$ U Visa U MasterCard expires if a permit is not obtained Plan review(at _•,_• r%) $ Credit card number -_ --- / J within 180 days after it has been State surcharge(8%) ....$ expire' accepted as complete. TOTAL ........ $ Name of cardholder as shown on credit card _ Cardholder signature Amount 440-1615(6=/CUM) A M � PO�1yy1) Imo. a y a M f T r9 1 H O x o a 3 C 5