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9710 SW NACIRA LANE NI VHIOVN MS OW.6 s CL z QJ R OG d! � Z m N � O ti 9710 SW NACIRA LN it I � I � r Lt, O U e� C O CIO V O Q O O 'Ali t � o m O Z a oU CITY CJS TiGARD -- M4STERPERMIT PERMIT DEVELOPMENT SERVICES DATEISSUED: 0/1 .5/03 00449 13125 SW Hall Blvd., Tigard,CR 97223 (503)639-4171 SITE ADDRES ': 09710 MVV NACIRA LN PARCEL: 1S135CD-GP007 SUBDIVISION: GREE NBURG PINES ZONING: R-4.5 BLOCK: LOT: 007 JURISDICTION: 'I IG REMARKS: BUILDING REISSUE. MAS2152C STOfUES: 7 FLDOR AREAS _ REQUIRED SETBACKS REQUIRED CI ASS OF WORK: NEW HEKk;T: 24 FIRST: 1,000 of BASEMENT: $I LEFT: 5 SMOKE DETECTORS: v Tv- SF FLOOR LOAD: 40 SECOND: 1 u46 of GARAGE: 444 of FRONT: 20 PARKING SPACES: TYPE CONST: 5N DWELLING UNITS: I THIO of RIGHT: 5 OCCUPANCY GRP: R9 BDRM: 4 BATH: 3 TOTAL: ?,105 of VALUE: 207,624.60 REAR: 16 PLUMBING _ SINKS: 1 WATER CLOSETS: 3 WAJHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCII BASINS TUBISHOWERS GARBAGE DI5P• i WATER HEATERS 1 WOTER LINES: 100 BCKFLW PREVNT4: GREASE TRAPS: OTHER 171XTURES: MECHANICAL FUEL TYPES FURN c 100K: BOILICMP<3HP: VENT FABS: 3 CLOTHES DRYER: I GAS FURN s=1GOK: I UNIT HEATERS: HMOs: 1 OTHER UNITS: I MAX INP: btu FLOOR FURNANCES: VENTS I WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL _- RESIDENTIAL UNIT SERVICE FEEDER TEMP ERVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS _ ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 -200 anw: 0 -200 arty: WISVC OR FOR: PUMPARWCA',ION: PER INSPECTION: EA ADD'L 500SF: 4 201 - 400 amp: 101 - 400 amp: fot W/O 9V1..�OR: SIGNIOUT LIN LT: PEP.HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: FAADDL RR C,R: SIGNALMANEL: IN PLANT MANU HMISVCIFDR: 601 - 1000 amp: 601+amps-1000V: MINOR LABEL: 1000.amolvoll PL/NI REVIEW SECTION Recnnnsct nnly: - -- -- -4 RES UNITS: 3VCIFDR>-225 A.: >600 V NOMINAL: CLS AREAISPC OCC- ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL. AUDIO&STEREO: VACUUM SfSTEM: AUDIO 6 STEREO: FIRE ALARM: INTE,ICOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRK3: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE C46LLS: TOTAL f SYSTEMS: TOTAL FEES: $ 7,300.89 Owner: Contractor: This permit Is subject to the regulations contained In the VISTA NORTHWEST INC Tigard Municipal Code,State of OR. Specialty Codes and PO BOX 91459 all other applicable laws. All work will be done in PORTLAND.OR 97291 accordance with approved plans. This permit will expire lf work Is not started within 180 days of issuance,or If the d work is suspended for more than 180 days. ATTENTION: Oregon law requires you to followrules adapted by the �1O"" 503-531-0505 Phone: Oregon.Utility Notification Center. Those nit"are set forth In OAR 952-001-0010 throug'I 952-001-0080. You Reg 0: may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. m REQUIRED INSPECTIONS WErosion Control Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Inst Rain drain Insp Electrical Final -J Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp Water Une Insp Plumb Final Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Ins Issued By : ,' Permittee Signature _— Call (503) 639-4175 by 7:00 p.m.for an inspection needed the next business day -� SEWER CONNECTION PERMf1' CITY OF TIGARD ,- DEVELOPMENT SERVICES PERMIT#: SWR2003-00337 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 10/15003 SITE ADDRESS; 09710 SW NACIRA LN PARCEL: 1S135CD-GP007 SUBDIVISION: GREENBURG PINES ZONING: R-4.5 BLOCK: LOT: 007 JURISDICTION. TiL TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPEtRV SURFACE: Remarks: Owner: - __ _FEES VISTA NORTHWEST INC Description Date Amount PO BOX 91459 PORTLAND,OR 97291 [SWUSA]Swr Connect 10/15/03 $2,400.00 [SWUSA]Swr Connect 10/15/03 $0.00 Phone: 503-531-0505 [SWINSP]Swr Inspect 10/15/03 $35.00 Contractor: [SWINSP]Sw;Inspect 10/19/03 $0.00 -- Total $2,435.00 Phone: Reg#: Required Inspections +� a oc rn This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 1130 J days from the date issued. The total amount paid will be forfeited If the permit expires. The Agency does not guars^+.;.,e 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 ` rap and Side Sewer" Perm Issued by: Permittee Signature: — Call f,503(639-4175 by 7:00 P.M.for an Inspection needed the next business day I-T) �rT ��� ° ��^'� 5w2 ;L ova- 4),)33 Build i Permit Ayilieation 1RcccivTed,,J Building Date/ 6 3 _ Permit No.ms1r'203-0D proval Other City of Tigard Planning Ap _� Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oreton 97223 Date/By: 0 10-2-03 Permit No.: -- Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date/By: Case No. Internet: www.ci.tigard.or.us Contact Juris.: See Page x for 24-hour Inspection Request: 503-639-4175 Name/Method: — Supplemental Information TYPE OF WORK REQUIRED DATA- Caf4 ew construction Demolition 1&2 FAMILY DWELLING Addition/alteration/replacement Other: - � ' CATEGORY OF CONSTRUCTION Note: Permit fees"are based on the total value of!he work performed. Indicate 1 &2-Family dwelling CommercialAndustrial the value(roup led to the nearest dollar)of all equipment,materials,labor, overhead an?prufil for the work it on this application. Accessory Building Multi-Family — Valuation......................................................... $407(o z 4I,L,v Master Builder Other: __JOB SITE FORMATION and LOCATION No.of bedrooms:_ No.of bathe: p Total number of floors..................................... Job site address: _ Nr­dwelling area(sq.ft.).............................. �— Suite #: Bld ./A t.#: Garage/carport area(sq.ft.)............................ yet ec ProIt Name: -- Covered porch area(sq.ft.)............................. — --_— ( Deck arca R.) ............................................ ross strect/iNrections to job site: Other structure a-^a(sq.R.)............................ -' UIRED DATA:--_f _— _ COMMERCIAL a USE CHECKLIST Subdivisio � 1 Tax map/parcel#: Note: Permit fees'are baFed on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this lication. Valuation................................................. ...... S Existing building area(sq.R.).. ....... ...... -- -- New building area(sq.ft.)............. ............... Number of stories....................... .... ........... ROPERTY OWNER • T _ _ Type of construction............... .........N�:.... Name: Occupancy grou{i(s): Bx _ Address: _ Cit /State/Zi T� / NOTICE: All contractors and subcontractors are required to he Phone: '? licensed with the Oregon Construction Contractors Board under APPLICANT CO PACT ERSU _ provisions of ORS 701 and may be required to be licensed in the Business Name: _ jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing,the following reason applies: L Address: _ -- --- --- RCity/State/Zip: --- -- -- - - - � Phone: Fax: - -� _-- — 7ONTRACTOR — �BUILDING PERMIT FEES* E-mail:-m - Business Name. Fees due upon application....................... Address: Cit /State/Zl� - Amount received....................................... ..... S`--- -- Phone: Fax: Date received:_ CCB Lic. #: — Authorized Notice: This permit application expires If a permit is nor•potalned within Signature: — Date: 7 7 IRO days after It has bten accepted as eomplMe. 'Fee methodology set by Trl-County Building Industry Service Board. (Please pant name) is\Dsts\Permit Fmms\B1dgPermitApp.doc 01/03 One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: Ci1vofTi,gard Cit of Tigard City b U Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tiytard.OR 97221 UOther: Phone: (503) 639-4171 _• Fax: (503) 598-1960 IIIE F0]10%VI NG ITVNIS ARE REOVIRED.F011 1'1,%N REVIEW I Land 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 platflot. 4 Fire district approval required. _ 5 Septic sysfem ermlt or authorization for remodel. Existing system capacity _ 6 Sewer permit. 7 Water district appy vat. 8 Soils report.Must ca original applicable stamp and signature on file or with application. Z _ 9 Erosion control U plan\U permit required.Include drainage-way protection,silt fence desi and location of catch-basin protection,etc. 10 3 Complete sets of IegI a plans.Must be drawn to scale,showing conformance t pplicable local and state building codes. Lateral design snails and connections must be incorporated into the ans or on a separate full-size sheet attached to the plans withss references between plan location and detail Ian review cannot be completed if copyright violations exist. _ I I Site/plot plan drawn to scale,The p must show lot and building setback di nsions;property comer elevations(if there is more than a Oft.elevation diffe ntial,plan must show contour lines -ft.intervals);location of easements and driveway;footprint of structure(includin ecks);location of wells/septic. .tems;utility iocations;direction indicator,lot area;building coverage area,percentage of verage;impervious area;a sting structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor Its,any hold-down nd reinforcing pads,connection details,vent size and location. 13 Floor plata.Show all dimensions,room identific ion,windo)f size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconilb,and dgfks 30 inches above grade,etc. _ 14 Cross sections)and details.Show all framing-mc he i s and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than one cross tion may he required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slo ,cci g height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new cons ction;mini4m of two elevations for additions and remodels. Exterior elevations must reflect the actual grade the changb in g e is greater than four foot at building envelope. Full-size sheet addendums showing foundatio elevations with cross ferences are acceptable. 16 Wali bracing(prescriptive path)and/or 1 eral analysis plans.Must. dicate details and locations;for non-prescriptive path analysis provide speyffications and calculations to a ineering standards. 17 Floor/roof framing.Provide plans for floors/roof assemblies,indicating ember sizing,spacing,and bearing locations.Show attic ventilation. 18 Basement and retaining wails.Pm de cross sections and details showing place ent of rebar.For engineered systems,see item 22,"Engineer's lculations." 19 Beam calculations.Provide two ets of calculations using current code design values or all beams and multiple joists IL over 10 feet long and/or any m/joist carrying a non-uniform load. 20 Manufactured floor/roof t design details. N21 Energy Code compliancedentify the prescriptive path or provide calculations.A gas-pipi schematic is required for four or more a pli ng6s. 22 Engineer's calculatio .When required or provided,(i.e.,shear wall,roof truss)shall be star d by an engineer or J architect licenssd in regon and shall be shown to be applicable to the project under revi QD HILL C7 J23 Five(5)site pi s are required for Item 1 I above. Site plans must be 8-112"x 11"or I I"x 17". 24 Two(2)sets ach are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted. 26 "Reversed"building plans must me,:t criteria outlin d in the Permit&System Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 4404614(&MCOM) Electrical Permit_Application Received Electrical Da"y: Permit No.: City Of Tigard Planning Approval Sign y g Date/By: Permit No.: 4 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 _Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post.Review � Land Use Dale/By: _ Case No.: Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for 74-hour Inspection Request: 503-639-4175 Name/Method Su lamental Information. TYME OF WORD PLAN REVIEW(Pie se checktiu thattl _ _ FINew construction Demolition Service over 225 amps- Health-care facility commercial ❑Harardom location Addition/alteration/rep Other: ❑Service over 320 amps-rating of ❑9uilding over 10,000 square fc:.t, CATEGORY OF CONSTRUCTION i&2 family dwellings four or more residential unite in 1 & 2-Family dwelling F I Coinmercial/Industrial ❑System over 600 volts nominal onr stricture ❑Building over three stories ❑F-ecders,400 amps or more ACCCSSO B iildin Multi-Family C1 Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder Other: ❑Egress/lighting plan p Other:________ JOB SITE INFORMATION ft6d LOC Submit__sets of plans with any of the shove. The above are not applicable to lem orar construction service. Job site address: - Suite#: B'.dg./Aut* Number of ins ections er mitallowed Project Name: Description Qty Fee(ea.) _ Total Cross Sti Cet/DirCCtlOnS t0 OG site: New residenllat-single or multi-family per } dwelling unit.Includes allsched garage. Srn•ke Included: 1000 s .fl.or less 145.15 _ 4 Each additional 500 sq.it or portion thereof _ 33.40 1 SUbd1VlSiO Ot#: Limited energy,residential 75.0 2 _ Limited energy,non residential 75.0 _____2 Tax map/parcel#: Each manufactured lame or modular dwelling DESC ION OF WORK service and/or feeder 90.90 2 - -� -- _--�- -� Services or ferders-installation, alteration or relocation: 20 amps or less _ _ 80.30 1 - ---- -- -— .,— 201 amps to 40 — _ 106.85 _ 2 401 amps to 600 amp 160.60 2 TENANT601 amps to 1000 amps 240.60 2 Over 100 amps or volts 454.65 2 NaJ7ip: _ Reconnect ons 66.85 2 Address: U Temporary services or freders-Installation, r alteration.or relocation: �.1 ►Stat 1 20 amps or less 66.85 1 Phone: b Fax: 201 amps to 400 am . — _ 100.30 2 401 to 60 amps 133.75 2 r' Branch circuits-new,alteration,or I Name: extension per panel: A.Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit _ 6.65 2 City/State/Zip: B.Fee for branch circuits without purchase of service or facer feefust branch circuit 46.BS _ 2 Phone: Fax: Each additional branch circuit 6.63 1 a E-mail: Misc.(Smice or feeder not included): i Each pumpor irrigation circle 33.40 2 Each sign or outline lighting 53.40 2 Job No: --- Signal circuit(,)or a limited energy panel, N alteration,or extension Pae 2 2 Business Name: ,2Description: - .,1 Address: xza m City/State/Zi i 7 Each additional I!Veeetion over the allowable In as of the above: per�ctit.n per hour(min. 1 hour) 6x'.30 W Phone: z > Fax: Investigation rax CCB Lic.#: - Lic. - � �°di� , , Supervising electrician Subtotal S_ signature reqwired: Plan Review 25%of Permit Fee $ Print Narne: Lic.#: �j __ State Sur_har a 8%of Permit Fce S _ TOTAL PERMIT FEE S _ AuthorizedNotice: This permit applleallon expires If a permit Is not ehtolned wkhlet Signature: Date Date' 180 dsys after It Iras been accepted as complete. *Fee methodology met by Trl(aunty Bnllding Industry Service Board. (Please print name) i:lDstslPermit FormslElcPermitApp.doc 01/03 Electrical Permit AGQlicscion -City of Tigard Page 2 -Supplemental information LIMITED ENERGY PERMIT FEES: RESIDENTIAL,WORK ONLY: _ Feefor al systems.....................................................`.. $75.00 Check Type of Work Insslved: Audio a d Stereo systems* Burglar A arm ElGarage I) Opener* Heating,Ven 'lation and Air Conditioning System* EJ Vacuum Sysie Ej Other -- -- -- — COMMERCIAL WORK NLY: _ Vetfor tK4 system.................. ............. ....................... S75.00 (.SEE OAR 918-200-260) Check Type of Work Involved: F] Audio and Stereo Systems El Boiler Controls 0 Clock System, ElData Telecommu cation Installation Fire Alarm In Ilation IIVAC In0ru txtion F1 Int om and Paging Systems EJndscape Irrigation Control* 0 Medical (L Nurse Calls r Outdoor Landscape Lighting* Protective Signaling + J E] Other _ Number of Systems ..J * No licenses are required. Licenses are required for all other installations i 13stffermit FotTnsTIcPerrnitAppPg2.doc 01/'03 ;t3maing r fixtures Plumbing Permit Application Received Plumbing Date/By: Permit No.: Planning Approval Sewer -�- -----� City of Tigard Date/Hy: Permit No.: 13125 SW Hall Wild. Plan Review Other Tigard,Oregon 97223 Da 3 Permit No.. — Phone: 503-6394171 Fax: 503-598-1960 Post-Review land Use Date/fly: CasmuNo.: Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Narne/Method: _ Supplemental Information. TYPI OF WORK _ FEE*SCIIE ULE toi' tialtnCorltllitlU /. New construction Demolition nescrlptton Qty. Fee(ea-) Total Addition/alteration/re la�ement Other: New A-&2-fxmlly dtrellingl CATEGORY OF UCTIO _ Jlnclatta OQ R.jor,ach utW 1 &2-Family dwelling ComSFR1 bath 249.20mercial/Industrial SFS bath 350.00 _ Accessory Buildingmil Multi-FaZ_ SFR 3 bath 399.00 Master Builder Other: Each additional bath/kitchen 45.00 JOB SITE INF ORMA I An Fire sprinkler- ft.: P 2 Job site address: L�> ��.._�-s�� ' ' t" Suitt#: Bldg./Apt.#: Catch basin/tlreadrain 16.60 Project Name: - I D ell/leach linettrench drain 16.60 Footin drain no.linear R. Pae 2 Cross street/Uirectiotis to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector _ 16.60 _ Sanitary sewer no. linear ft. Fa e 2 Subdiyisio &jF„t/ _e ,eeSI Lot#: Storm sewer no.linear fi. Page 2 Tax map/parcel #: Water service no.linear ft. Pose 2 `' DLfiCRI ION; " O Absorption valve Backflov!preventcr Pee 2 Backwater valve 16.60 - —f'—- - Clothes washer 16.60 -- �- Dishwasher 16.60 OPSRTY OWNER -�y-T Drinkinsfountain 16.60 u Ejectors/sum 16.60 Expansion tank -_ -_ 16.60 Address: ���/ � _ Fixture/sewer cap 16.60 Cit /State/Zi Floor drain/fluor sink/hub 16.60 --- Garbage disposal 16.60 Phone: �,a't7 Fax: Hose bib 16.60 1 # '. r" Ice maker_ 16.60 Name: Interceptor/grease UW 16.60 Address: _ Medical gas-value: S Pae 2 City/State/Zip: `^ Primer 16.60 iiia _---- Roof drain commercial 16.60 & Phone: Fax: Sink/basut/lavraory 16.60 F- E-mail: Tub/shower/showcr pan 16.60 _ _CONTRA OR Urinal _ 16.60 `e � � � - Water closet - 16.60 Business Name: Water heater 16.60 DO Address: S` / / other: — - -- _ Cit /State/.,i �� ex'�,�.. Other: W Phone:S-3l -cam e:,' Fax: — — u CCB Lie. #:J, i Plumb. Lica#: _ Subtotal $ Minimum Permit Fee$72.50 S Authorized Residential Backflow Minimum Fee$36.25 Signature: �J ; Date:, Plan Review(25%of Permit Fee) $ _ State Surchar a 8%of Permit Fee S J- - (Please print name) TOTAL PERMIT FEE S Notice: This permit application expires it a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or 180 days after It has been accepted as complete. riser diagram for plan review. *Fee methoemogy set by Tri-County RulldlnR Industry Servire Board. i-\Dsts\Permit Fotms\PltnPermitApp.doc 01103 Plumbing Permit Application - City of Tigard Page 2- Supplemental Information Fee Schedule: Residential Fire Suppression Systems: ^'t' ME Square Footage:_ _ -- Permit fte: Fooling drain-1'100' 55.00 1 0 to MW $115.00 Fooling drain-each additional 100' 46,40 2,001 to 3,600 `— $160.00 3,601 to 7,200 S220$309.00 ---- Sewer-1st 100' 55.00 7,201 and 5309 star .00 Sewer-each additional 100' 46.40 Water Service- 1st 100' 55.00 Medical Gas Systems: Water Service-each additional 100' 4640 Valuation: -- Permit Fee: Slomt&Rain Drain-1 st 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50 _ Storrs&Rain Drain-each additional 1 46.40 $5,001.00 to 510,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional S 100.00 or fraction thereof,to and Fixtgt'e or ltfm including$10,000.00. Commercial Back Flow Prevention Devi a 40.40 $10,001.00 to$25,000.00 $148.50 err the first 510,000.00 and 51.54 for Residential Backflow Prevention Device each ditional$100.00 or faction thereof,to minimum permit fec$36.25 27.55 an ncluding$25,000.00. Rain Thain,single family dwelling 65.25 $25,001.00 to$50,000.00 V9.50 for the first$25,000.00 and$1.45 for ach additional$100.00 or fraction thereof,to Inspection of existing plumbing or and includin 550 000.00. s ciall requested inspections- r hour 72.30 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replac;ng x\i5ncreas tures? If "yes",please indicate work performed by Failure to accurately report fixtures could result in d sewer fiees*. uantl b ><turr" rfa 4: Comments regarding fixture work: Type: , '" .New Mould � .�_ ----- — Ba tis /Font Bath -Tub/Shower KV- -Jacuzzi/Whirlpool – -- Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher -Commerciai — — — -- -Domestic _ Drinking Fountain Eye Wash — -- – — Floor Drain/!:ink 2" -4" Car Wash Drain *Note: f the fixture work under this permit results in an Garbage -rkimestic U. DisposLl Commercial increase o ewer EDTA,a sewer permit will be issued and -Industrial fees assesse r the sewer increase must be paid before the F" Ice Mach./Refri .Drains _ plumbing perm can be issued. Oil Separator Gas Station Rec.Vehicle Dump Station Shower -Gang m -Stall aSink -Bar/1-avatory _ W -Bradley --t -Commercial _ -Service Swimmiag Pool Filler Washer-Clothes Water Extractor Water Closet-Toilet Urinal Other Fixtures: is\Dsts\Permit Forms\PlmPermit.AppPg2.doc 01/03 Mechanical Permit Applie_ ation Received Mechanical Date/By— Permit No.: Planning Approval Building City of Tigard Date/By: Permit No.: _ 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Datc/B : Case No.: Internet: www.ci.tigard.or.us Contact Juris.: 1 0 see 4Islte 2 far 24-hour Inspection Request: 503-639-4175Name/ANethad� Su plertental lnformatlon. TYPE OF WORK COMMERCIAL FEE'SCHEDULE-USE CHECKLIST New construction I Lj Demolition Mechanical p-mit fees*are based on the total value of the work Addition/altrration/re laeement Other:' performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. I—&-2-Family dwelling Lj Commercial/Industrial value: $ See Page 2 for Fee Schedule Accessory Building Multi-Tamil ~RESIDENTIAL UIPMENT/SYSUM&FE ULE Description �_ t Fee ea. Total Master Builder Other: Heath eooling JOB SITE INFORMATION and LOCATION _ Furnace-add-on sit conditioning•• 14.00 _ Job site address: fC-j�C'� Gas heat pump 14.00 Suite#: Duct work 14.00 Project Name: H tunic h_ot water system 14.00 Residential boiler Cross street/Directions to job site: for radiator or hydronic system) 14.00 Unit heaters(fuel,not electric) in wall,in-duct,sus nded,etc.) 14.00 Flue/vent for any of above 10.00 Subdivisiont Lot#: Repair units 12.15 _ Other Fuel_Api illeaces Tax ma / arcel #: Water heater �~ 10.00 _ DESCRIPTION OF WORK Gas fireplace _ 10.00 Flue vent water heater/was—fi lace^ 10.00 — �LL-- --�-- Log lighter(gas) 10.00 Wood/Pellet stove �10.00 Wood fire lace/insett10.00 Chimne /liner/flue/vent10.00 OPERTY OWNER I El TENANT Other: _ 10.00 Eavlroatne Bt6aMln&VaatWation _ Name:��Jl�� Range hood/other kitchen equipment 10.00 Address: Al Clothes dryer exhaust 10.00 City/State/Zip: L 91/ Single duct exhaust phone: ,>J / Fax: (bathrooms,toilet compartments, A1C'>pL1CANT CONTACT P.li>a0 ;�: utility rooms) 6.80 Name: — Attic/ s ace fans 10.0(1 Address: Other: pad!A41 10.01 Zip: ••(S5.40 for Ant a,;1.00 each additional 4 City/State,/ p� Phone: _ Fax: — _ _ Furnace etc. — •• Gas heat um _ •• _ F' E-mail: Wall/suspended/unit nded/unit heater —� rn -- 1- ce Water heater _ •' Jt Business Name: � �c= Fir_She _ m Address: / t -fie - -- °• L7 BB •• W City/State/Zip: ) ' Z/ Clothes dryer(gas) _ •• _ -I Phone: •" Fax: Other: •• CCB Lic. #: L — -- Total: Authorized Subtotal: S Signature: Date: g T Minimum Permit Fee$72.50 S Plan Review Fee 25•/.of Permit Fee S _ —— — -- State Surchar a 8°/.of Permit Fee S (Please print name) TOTAL PERMIT FEF. S Notice: This permit application expires I(&permit Is not obtained within *Fee methodolM set by Tri-County Building indnstry Service Board. iSO days after It has been accepted as complete. "Site playa required for extetior A/C unit►. 013stslPermit ForrrolMecPermitApp.doc 01/03 Mechanical Permit Appiication -City of Tigard Page 2 -Supplemental Information Commercial Fee Schedule: Total Valuation: Permit I1'ee: _ $l.00 to$5,000.00 Minimum fee.$72.50 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.51 for each additional$100.00 or fraction thereof,to and including$10,000.00._ 510,001.00 to$25,000.00 $148.50 for the first 310,000.00 and $1.34 for each additional$100.00 or fraction th-reof,to and including $25,000.00. $23,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional 5100.00 or fraction thereof,to and including $50'0W.00. 550,001.00 and up 742.00 for the first$50,000.00 and 1.20 for each additional$100.00 or ction thereof. Assumed Valuations Per Apel nee: ---- Value To Description: _ t Ea A unt Furnace to 100,000 BTU,including 955 ducts&vents Furnace>100,000 BTU including ducts 1,170 &vents Floor furnace i;cludins vent 9s Suspended heater,wall heater or floor 5 mounted heater Vcnt not included in appliance it 445 Rc it units 695 <3 lip;absorb.unit,-- 9 to 100k BTU 3-15 hp;absorb.unit, 1,700 101k to 500k BTU _ 15-30 hp;absorb.unit,501k to I in 1,310 BTU 30-50 hp; absorb.unit, —3,400 1-1.75 mil.BTU >50 hp;absorb.unit, 5,725 >1.75 mil.BTU Air handling unit to 10,096cfm _ 656 Airhandling unit>10,900 cfm I1'10 Non- rtable evapopfie cooler 656 Vent fan connec to a single duct 446 Vent system no ncluded in appliance 656 \ (mit Hood served mechanical exhaust 656 Domestic i inersim 1,170 CommercI or industrial incinerator 4,590 Other t4,including wood stoves, 656 CL inserts tc. (Y Gas poing 14 outlets _ _ 360 VEachAdditionel outlet 63 TOTAL COMMERCIAL S VALUATION: t9 W J i:\Dsts\Permit Forms\MecPermitAppPg2.doc 01/03 q711-2 Aw. iA!'1 '•D11Nt�.:ii! ti�9� � ter, ;. �.-:; ' �;: '{•: :.. �,,,�� S►�, � Ss iracs�.r •�� Cam __ I�;�(';d�► we I � 1 0OV-- + W CITY OF TIGARD - SITF PLAN 11 FVI ENN, I 1)YNG PER MIT NO : I)LANNING DIVISION: Rctitilred S't-fhacks- D Approved 0 N Side Street Side: irom. C­irr!--,e; — vistlaf i.lonrance 0 Anpro Wrl, -d feet CWS Service I)rovidet Ml FNGlNFF_ Actual ope:_% El Approved Cj Not Xppmved "it - on: Q Approved Not Appmed V: Date: Notes: CITY OF TICARD- SITE PLAN REVIEW BUILDING VERMITNO.; !'CANNING DIVISION: Required Setbacks: P Approved 0 Not Approved Side: S Street Side: I r I front. (larage- Rear: /E Visual Clearance: AV roved 0 Not Approved maxillimll Building Height. 1evi CWS Service wider Letter Required: 0 Yes xNo 0 Its--rived Date: A LN(ANEFRIN(i R' lf'N'I: Actual Slope; % Approved 0 Not Approved d Site 111all. [�rApproved V'Vpprovel I By: Date: 3 LU CITY OF TIGARD 24-Hour BUILDING • Inspection Line- � ) 9-475 MST 9_ INSPECTION DIVISION Business Llne r; 83 171 ` BUP _ Received Date e<Iuested—( AM -✓ PM___ BUP Location ____ q 716 Suite MEC _ Contact Person ____ _ _— _, Ph( —) ��y—�a PLM Contractor _— —..__ Ph( ) _ SWR _ BUILDING _ Tenant/Owner _ _—_ ELC Footing Foundation ELC Access: Ftg DrainL � � W ELR Crawl Drain Svib Inspecticn Notes: n2 SIT Post& Beam -- u� t2 Q a 7 Shear Anchors l 1 t R� /d Z VV\.Af C Ext Sheath/Shear > Int Sheath/Shear 1 '7 /i "� © o a Framing Insulation c/'Z) 0/p Drywall Nailing Firewall Fire Sprinkler Fire Alarm _—�Z, 0 L V'j S ` Susp'd Ceiling Roof Other: — Final PASS PART FAIL 1 / �— PLUMBING Post&Beam el - ----- Under Slab -- Rough-In Water Service --.� Sanitary Sewer iin Drain, — t.;atch Basin/Manhole Storm Drain —--— — Shower Pan ` Y Other:_ - e ART FAIL4affieR — _ANICAL Post&Beam Rough-In IL Gas Ling p� Smoke Dampers y Final PASS PART FAIL -- ---- --- ---- ELECT:?ICAL J Service— -- - -- — m Rough-In W UG/Slab W -i Low Voltage _—_-- __-- -- -_ Fire Alarm Final Reinspection fee of$ r ureore nox n P� —-— � i "before t Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE r � Please call for reinspection RE: U !.)nAbie to inspect-no soosss Fire Supply Line Daub IteeMa�ar "' - —� ADA Approach/Sidewalk Other: _ Final DO NOT RtMO 9 this hl—Peade Irr•Ool1y tion go bbr11b. PASS PART FAB. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)638-4175 MST Z f q INSPECTION DIVISION Business Line: (503)639-4171 SUP _-- Received _ _ Date Requested & _ _. AM_ PM —_ BUP Location Suit//e-- — MEC Contact Person — C—� _^ Ph( ) cP `ZPLM 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 Shoath/Shear Int Sheath/Shear Framing — Insulation Drywall Nailing -- Firewall Fire Sprinkler -- Fire Alarm Susp'd Ceiling Roof _ Other: - el Z Final PASS PART FAIL 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 tZ Smoke Dampers — --- — F- Final N PASS PART FAIL -- - ELECTRICAL Service m Rough-In - 5 UG/Slab JI_ow Voltage — _ - -- ------- Rw Alarm rPAS��PART FAIL l i Reinspection fie of$___ required before mixt h ispection. Pay of City Hell, 13125 SW Nell Blvd. SITE _ �� Please calf for reinspection RE: - _ Unable to inspect- no sooese Fire Supply Line 6 - 1, ,7 .AQ {� ADA Dates Approach/Sidewalk Other: Final DO NOT REMOW ibis IMpedba re0orr*ion tM fob GR& PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection LI 3)6311-4175 MST ;1" 2w—L INSPECTION DIVISION Business LI (603)63"171 OUP Received Date Req ested AM PM 8UP Location _ 710 1 rat, Suite _ MEC Contact Person Ph( ) 7-=z?b-r6cY�q PLM Contractor Ph( ) SWR BUILDING Tenant/Owner _ ELC Footing ELC Foundation Acce j J- Ftg Drain "�9 ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors _ Ext Sheath/Shear Int Sheath/Shear Framing aJ Insulation C� 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 i Manhole Sturm Drain - - Shower Pan Other: - — Final -�_---�--- P T FAILMIEQHAN!QA Po'"--ye—am Rough-In Gas Line Smoke Dampers 1FASS_/PART FAIL -ELECTRICAL Service -� - Rough-In W UG/Slab --- -��— Low Voltage Fire Alarm —� Final Reinspection fee of g__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART_ FAIL Q Plesse call for reinspection RE:_� _ _ _._ Unable to Inspect-no access Fi-e Stahply Line ADA Datt if-e*2�Z4 Approach/Sidewalk ---- ilk - Other: Final DO NOT R11EM01R tills IIIsP eolde s Mftm an fob oft PASS PART FAIL CITY 4F TIGARD 24410ur .tiBUILDWG Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Li/-- A �T BUP — Received _Date Requested— r M BUP Location . �ly � —_ MEGContact Person _ ins � PhPLMContractor __ JPh8WR _BUILDING Tenani/Owner _ ELC Footing ELC FoundationAccess: Fig Drain L_ ISO Sd ELR Crawl Drain Slab Inspection Notes: SIT -- Post&Beam `. Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - ®------ Firmvall Fire Sprinkler - - -- Fire Alarm Aor Susp'd Ceiling -- — - - Roof PART FAIL — - 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 IL Smoke Dampers — — - w Final F' PASS PART FAIL — N ELECTRICAL Service Rough-in _ UG/Slab W Low Voltage Fire Alarm Final Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE F] Please call for reinspection RE: _ __ Ej Unable to inspect-no access Fire Supply Line ADA Approsch/Sidewalk Qab O --- In Other: Final DO NOT REMOVE#hle IAep"UM hr111! N JOr e1bL PASS PART FAIL 14 AAAAA AAAAAi AAAAAAAAAAAAAAA'lAAAAAAAAAAAAA a � ► A o ► LU QU ► > o rev, ► fV ► ill ► nc m ► . ► M.y a pop. o o poll cu Poo. ol 1-4t4w ► poll r Poo.'. Poo. ss H A '0 O ► v� 0 ► v .! v j . A t Q ► ILCK ; v ► m pol. w t ► >PCI pop. ► 1 ► o .R � Q H w ► / PCI �' Oct 30 2003 11s31RM GeoPacific Engineering, 1 503-59U-U'/U5 P. 1 ReN-Wold Gwtadr M�oN111ess 11 me Design•ConshmMoin tiuppml October 30, 2103 RECEIVED Project No.02-8072 Vista Northwest NOV 3 M11-4 P.O. Box 91459 Portia id, OR 97291 CITY OF TIGARD (Fox 603-64&2714) BUILDING OIVcc,r- Subject'. GEOTECHNICAL ENGINEER'S FOUNDATION EXCAVATION REVIEW GREENBURG Pities Lora 2,6,7,8, AND 9 CITY OF TIDARD,OREGON (OeoPacffIc Engineer, Jim Imbrie, has visited the abovo-referenced kat on October 20 and 3CP. The purpose of our vieft Was primarily to review the foundation excavation subgrads. The nat to subgrade soils consist of medium stiff silt that is prone to softening in wet weather. We r000rnmended ovorexcavation beneath footings and placement of 4 to 8 inches of oompacted crushed rock to prevent softening in wet Weather. This thin laycw of gravel need not be tested for oompactlon,but should be visibly oornpact_ The current subgrade Is considered adequate for spread foundation support. Based on our observations, the foundation subgrade and excavation setbacks should be acoeptabie for support of the proposed singWfamlly home to a maxirnurn allowable bearing pressure of 1,500 pef. No patio, sidewalk or deok footing subgrades were observed. The minimum steel relMomement should be Inoorporated(two no. 4 bars in the footing and one In ttte stem wall.) If foundation cracking is desired to be inhibited. Our work scope for this phase of geu*eohnkxil review pertains to foundation bearing oonditions only and is lirfihed to the oonditions en ling and exposed at the limo of air site visite. tf you have any further questions, please call. Sincerely, GwPAawe Eno1NEERock W- Sq S a �Rtio fit 7 2 D �s� �ewslnf�q 7-7 1 p � 14743 7� m OREGON James D. Imbrie, P.E. ✓,� W Principal Englnesr ✓,� 'r ta, 1,�� �O-c�s 7312 9W Dualism Bread Td(50 3164MO P+XthW4 QnAsoa X9224 1 C -ales I Oct 30 2003 11:31RM GeoPaeifie Engineering, i 5u3-bad-a'/u5 P. 1 U aeo RMI-Wodd 49obdrNod SoNAioM InraatlOnUw•oNlOn•CaMMuctlon Support October 30,2003 RECEIVED Project No.02-9072 Vista Northwest NOV 3 )AP-4 P.O. Box 91459 Portland, OR 97291 CITY OF TIGA14L (Fax 603-845-2714) BUILDING DIvir,r, Subject: GEOTECHNICAL ENGINEER'S FOUNDATION EXCAVATION REVIEW GRE sum PrNEa LoTs 2,6,7,S, Ano 9 CITY OF TIGARD,OREQON GeoPacl lc Engineer, Jim Irnbrie, has visited the above referenced lot on October 241h and 30"'. The purpose of our Velt was primarily to review the foundation excavation subgrade. The native aubgrade Bolla consist of medium stiff silt that is prune to softening In wet weather. We rsoommerxied overexcavation beneath lootirogs and placement of 4 to 6 inches of 00wacted c"AhOd rock to prevent ming in wet weather. 'This thin layer of gravel need nal be tested for compaction,but should be visibt/compact. The current subgrads Is considered adequate for spread fcxmdatlon support. Based on our obeervations, the foundation subgrade and exr:avedon wdvm s should be acceptable for support of the proposed singlefamiiy home to a maximurn allowable bearing pressure of 1,500 pef. No path, sldewaik or deck footing subgrades were observed. The minimum steel reinforcement should be Incorporated(two no.4 bars in the fooling and one In the stem wall.)If foundation cracking Is desired to be Inhibited. Our work scope for this phase of geoteohnlcal review pertains to foundation bearing conditions only and Is limited to the oondMons existing and exposed at the time of our site Welts. If you have any further questions,please call. Sincerely, Get)PAc tm EmeweEmmm,Inc. 1�REo FM J� 2 0'2 S IN 14743 f7 O 00 OREGON O James D. Imbrue, P.E. 143 Principal Englneer v,F '�: 13, 1+� 7312 9W Parham Road Td(503)"841 43 Aordaad,Urvew !7221 Far.(SOLI)5!&14783 • I 14 kAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA pool 0w Q on 6 > `" < > ► w ps ► U. c� ► ► 14. L4 POO. Qj t ' w v z oil. w oa Poo. t v y A j v ► IL ' rx ' ENOl � b pool ca ; ► � 0 0 lip. m � ► � � n A ► ►