The URL can be used to link to this page

12713 SW ROCKY MOUNTAIN COURT r 1271"') SW Rocky Mountain Court 4 -%/Y M4� GeoPaclflc � M 17700 SW Upper Boones Ferry Road,Suite 100 Portland,Oregon£7224 Tel(503)598-8445 • Fax(503)598-8705 March 6, 2002 Job No, 01-7491 Millenium Homes. Inc. Mac Even 2208 SE 182"d Avenue Portland, OR 97233 GEOTECHNICAL ENGINEERING REVIEW OF FOUNDATION PLAN AND SITE LOT 2113v- ELK14ORN RIDGE ESTATES TIGARD, OREGON GeoPacific's Principal Engineer, Jim Imbrie, visited the site on March 6, 2002 and reviewed and hand probed the house foundation excavation subgrade. We understand that the proposed residence is a two-story single-family home with a daylight basement with a crawlspace. The lot is below Rocky Mountain Court and is situated on a short fill embankment resting on an approximately 20 percent natural slope. The excavation was carried through this fill and reached competent native silt soils. In our opinion, the observed subgrade is adequate for support to an allowable bearing pressure of 1,500 psf. The observed slope conditions indicate that the site has a very low to negligible probability of experiencing slope instability that could be detrimental to the proposed house. Based on observation of the short, stepped cut terraces, footing-to-slope setbacks are also considered adequate; no footing should rest near a vertical cut or inside of a 1 H;1 V plane extending from the bottom of a vertical cut. Continuous horizontal steel reinforcing is recommended in the stem wall (one No. 4)and footing (two No. 4) for all continuous footings. If wet weather further softens the subgrade,they some mucking of the upper one to two Inches may be required prior to pouring concrete. Our work scope pertains to a geotechnk;al engineer's foundation excavation review only and the conditions existing and exposed at the time of our site visit. No detailed subsurface geotechnical studies of the site have been performed, nor are they considered necessary given the generally favorable conditions exposed. If you have any questions, please call. We trust this information meets your needs. If you have any questions, please call. Sincerely, GeoPacific Engineering, Inc. 0 PRG�r EhSINf fR ry �'?4743 OREGON James D. Imbrie, P.E., C.E.G. l Geotechnical Engineer qM\ D. 0A CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503.1639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP - — Received Date Requested. -_-�. 2- LIP-. _ PM__ BLIP Location ��w 1�-��1�,.m C �- _Suite MEC _ Contact Person _ —� t�?a- c ' Fh(— I 3vf-�Ga Z' PLM - Contractor_ __ ___ Ph( ) _—.— _ SWR BUILDING Tenant!Owner _ . ELC Footing --- ELC Foundation Access: Ftg Drain �. �C (j �C ''/ ELR -- Crawl Drain Slab Inspection Nates: 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_ -post&Beam Under Slab - --- —. — — -------- Rough-In - ---Rough-In Water Service —_—_.__ Sanitary Sewer Rain Drains -- ---- Catch Basin/Manhole Storm Drain - —v� --' - Shower Pan Other: VASSART FAIL __ -___ ------- _---------------- ost& Beam — — — Rough-In — Gas Line .Smoe Dampers &AS PART FAIL EL CT Rough-In UG/Slab Low VoltageEJW,A larm - --• Reinspection fee of$ required before next inspection. Pay at City Hale, 13125 SW Hall Blvd. As PART FAIL FOw Please call for reinspection RE: Unable to inspect-no access re Supply LineADA 1 9 Otb I ExtApproach/Sidewalk -_ Other:.� ��`►-_ _ Fina: DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4, MST �pQ� Od.� INSPECTION DIVISION Business Line: (503) 639-4171 -- BLIP -- Received ___ _ _ Date Requested +��%_ AM __ -_ PM _ BLIP --_ - Location Suite MEC Contact Person _ _. —_- _._ Ph 3q�' 53�0d PLM Contractor __ _ -__ Ph(. _ _—) _ _ SWIP BUILD;NG Tenant/Owner _ __ ELC Footing ELC Foundation Accescl' Ftg Drain 7_13-oxz, ELR Crawl Drain _ Slab Inspection Notes: �;— SIT Post&Beam _ Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Dry vall Nailing Fin wall Fin Sprinkler Fire Alarm SusF'd Ceiling -- - Roof Other: - ------- F%_-SL- --- S T FAIL PLUMBING Post 8 Beam Under -- Under Slab — Rough-In Water Service -- ----- —.— --� _ Sanitary Sewer Rain Drains ---- ----- -- -- Catch Basin/Manhole Storm Drain -- - --- -- --- -- Shower Pan Other: — Final -�- -- PASS PART FAIL MECHANICAL.�_�_ Post 8 Beam Rough-In ---_-- Gas Line Smoke Dampers - --------- _—__ __._�—_ Final -- PASS PART FAIL -- --- — - ------- ELECTRICAL Service �--- ---- - ' '-! Rough-In UG/Slab -- —__ Low Voltage Fire Alarm Final ❑ Relnspectlon fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL_ SITE _ [:] Please call for reinspection RE: _ Unable to inspect-no access Fire Supply Line f ADA Date /Z Z7-`6 t Inspector —_Ext_ Other: Final - — — DO NOT REMOVE this Inspection record from the joie s1to. PASS PART FAIL CITY OF TIGARD 131125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE R K ELECTRIC INC 24495 NW OAK DR HILLSBORO, OR 97124 Electrical Signature Form Permit #: MST2001-00579 Date Issued: 2!4102 Parcel: 2S109AD-08200 Site Address: 12713 SW ROCKY MOUNTAIN CT Subdivision: ELK HORN RIDGE ESTATES Block: Lot026 ,lug isdiction: TIG Zoning: R-7 R--narks: Construction of new single family detached residence. Your company has been indicated as the electrical contractor for the permit indicated above. In order for tie electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electricai inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MILLENIUM HOMES INC R K ELECTRIC INC 2208 SE 182ND AVE 24495 NW OAK DR r PORTLAND, OR 97233 HILLSBORO, OR 97124 Phone #: 503-489-0763 Phone #. 640-1344 Req #: LIC 094275 SU13 ,36366 I J ELE 34.375C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervi 'ng Electrician e If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD MASTER PERMIT PERMIT#: MST2001-00579 DEVELOPMENT SERVICES DATE ISSUED: 2/4/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS. 12713 SW ROCKY MOUNTAIN CT PARCEL: 2S109AD-08200 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING- R-7 BLOCK: LOT: 026 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REOUIRF)SETBACKS REQUIRED CLASS OF WORK: NL-VV HEIGHT: 26 FIRST: 1,154 of BASEMENT: 14000 of t ^. 9 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND. 852 of GARAGE: 480 al 1°p 22 PARKING SPACES 2 TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: of RIC' 9 VALUE: $2q9,52840 OCCUPANCY GRP: R3 BDRM: 4 BATH: 4 TCT,*.:., 2.00600 of HEAR: 29 PLUMBING SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVAI ORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS, 1 CATCH BASINS: TUBISHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCK.FLw PREVNTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIUCMP<3HP: VENT FANS: 5 r,LOTHES DRYER: 1 GAS FURN>MOOK: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: t MAX INP: btu FLOOR FURNANCES: VENTS: i WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDER9 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 SOOSF: 6 201 400 amp: 201 400 amp: tat WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600#rP: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT• MANU HMISVCIFDR: 601 1000 amp: 601+4mpe•1000v: MINOR LABEL. 1000.amplvolt PLAN REVIEW SECTION Reconnect only: >■4 RES UNITS: 9VCIFDR>■225 A.: >800 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL a.COMMERCIAL AUDIO A STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOWPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH- BOILER: HVAC LANDSCAPEIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 8,086.25 NIUM HOMES INC MILLENIUM HOMES INC This permit Is subject to the regulations contained in the MILLE 2208 NI 182ND AVE 2208 NI 182 Tigard Municipal Code,State of OR. Specialty Codes and PORTLAND,OR 97233 PORTLAND,OR 97233 all other applicable laws. All work will be done i accordance with approved plans. This permit will expire ff work Is not started within 180 days of Issuance,or If the work is suspended for more than 180 days. ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rng N: LIC 79766 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 Insp 8, Slab Insp Footing/Foundation Dr; Electrical Service Low Voltage Water Line Insp Grading Inspection Post/Beem Structural Plm/undsiab Insp Electrical Rough In Gas Line Insp Appr/SdWk Insp Sewer Inspection Post/Beam Mechanica PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Footing Insp Underfloor Insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Foundation Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Ins[ Rain drain Insp Plumb Final 1 Issued By : _ t_� r._ C��'Z Permittee Signature Call (503) 639-4175 by 7:00 p.m, for an inspection needed the next business day CITY '` � �� /� �® SEWER CONNECTION PERMIT IT�/ r O A'1 PERMIT#: SWR2001-00329 DEVELOPMENT SERVICES DATE ISSUED: 2/4/02 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639.4171 PARCEL: 2S 109AD-08200 SITE ADDRESS; 12713 SW ROCKY MOUNTAIN C I SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 026 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS. 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new single family residence. Owner: _ FEES MILLENIUM HOMES INC Type By Date Amount Receipt 2208 SE 182ND — 2208 SE 182LAND, D AVEVE PRMT CTR 2/4/02 $2,300.00 27200200000 PORINSP CTR 2/4/02 $35.00 27200200000 Phone: 503-489-0763 Total $2,335.00 Contractor: Phone: Reg #: Require J Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 1 eO 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 Permittee Signature' Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application �^ Dale received: Permit no.: City of Tigard -- — ------__ Project/appl.no.: Expire date: CirvofTigard Address: 13125 SW Hall Blvd.Tigard,OR 97223 - - ---- Phone: (503) 639-4171 Gate issued: J By: Receipt no.: _ - Fax: (503) 598-1960 Case file no.: Payment type: 1&1 family:Simple Complex: Land Icsc approval: -- -------------- -- XI &2 fancily dwelling or accessory J Commercial/industrial U Multi-lamily 0 New construction 0 Demolition U Additinn/alteration/replacement A Tenant improvement '_1 fire tipnnklerfakirm O Other: � O; SITEINFORMATION ~ t Joh address: 'f 3 SW OL([ y Bldg.no.: Suite no.: Lot: Block: Sulxf isian: p 1 Tax map/tax lot/account no.: / k; Project name: Description and location of work on prcmises/special conditions: OWNI It FOR SPECIAL INFORMATION, USE(:IIF('KI,ISI' Name: Wir M111,1112 -ffAWqF (Floodplain,septic capacit It'.solar,etc.) Mailing address: ' Q S� I &2 family dwelling: GG City: State: ZIP: Valuation of work....,;?.;�.:f.,.. ................... 'Ir 3 Phone: q& D?io3 Fax: 13 mail: No.of hedr(oms/baths................................. Owner's representative: F{ti`Mr¢5 Tv1G Total number of floors............... ................. Phone: P.u: F mail: G1C(_( New dwelling area(sq. ft.) .......................... APPLICANT Garage/carport area(sq. ft.)........... .. - ' l ,L C Covered porch area(sq. ft.) ......................... Name: ►11 � Cl � Deck area(sq. ft.) ........................................ Mailing address: 7_.1P:R"��33 Other structure area(sq. ft,l ........................ City: State: Phone: p 3 Fax: 3o ICD) Commercid/industriallmultf-family: tValuation of work........................................ $ Existing bldg.area(sq. ft.) ........................ . Business name: ( �a`t�(„��Sy1[ . New bldg.area(sq. ft.) ................................ — Address: t D ox Number of stories Type of construction. City: State: ZIP:°17. 33 ....................................... Phone:y 4) •nFaxes E-mail: Occupancy group(s): Existing: CCB no.: q')-�� _ New: _ t o"nietro lic.no.: Notice:All contractors and subcontractor-.re required to be licensed with the Oregon Construction Contractors Board under Name:�1 ti•y`_ provisions of ORS 701 and may be required to be licensed in the Address: ( 3u j NtV f s+t-- (�L"f jurisdiction where work is being performed. If the applicant is exempt from licensing.the following reason applies: City: ( E�-1�Gt.c� arc: ZIP: -- Contact person: '41/'1 yt Ma.t<ey Plan no.: I Phone: ;rj• !,Fay - mail: - t Name: It ontact person: Fees due upon application ........... ............... $ Address: Date received: City: .......... State: ZIP: Amount received ......................................... Phone: Fax: E-mail: Please refer to fie schedule. 1 hereby certify I have read and examined this application and the Not all iunsdicliaro wmpl credit cards.please call dun.dation tot mote Wm"Lamson attached checklist. All provisions of laws and ordinances governing this ❑Visa J MasterCard work will he complied with,whether specified herein or not. Credit""t"01fl — ---- Expitel Authorized sig lure: c .1 - 4 `_- t . Date: / Nome r><cardholder as drown on credit card S Print name: M("( ./ e!l _ Cardholder upiature r Amount Notice:This permit application expires if a permit is not obtained H ithin 190 days after it has been accepted as complete. 4404613 ttLQ1COM) One- and Two-Family Dwelling Building Permit Application Checklist Rel'erenceno. City Associated permits: y ♦� �'� J Electrical Plumbing 0 Mechanical Addre�,, 13125 SW Hall Blvd,Tigard,OR 97223 >ntherr Phone (903) 639-4171 __-- I,;a"- (',I)I 598.11)(10 THE FOLLOWING 1 1 FOR PLAN REVIEW Yet No N/A _1 band use actions completed,See lurr;diriwn, rucmi I,,r tit urrent revacws. 2 f.oning. Flood plain,solar halance points. wi,,nu,. ,oalti Ic-,iunauon. storstrict,etc. historic di 71—Verification Verication of approved plat/Int. --- _ 4 Fire district approval required. 5 lepric s}stem permit or aunhonzation fir remodel Existing system capacity _ h Screer permit. -- 7 %1;tter di,rricr approval. _ 8 Soils n'imi 1. ',lii carryoriginal applicable stamp;arid �igtuturc on l'ile or with;application. 9 Erosion control ,plan is permit required. Include dra inave-way protection,sill fence design aid location of catch-baa,sin protection,etc. IU 3 Complete sets of legible plans.Must he drawn to scale.showing conformance to;applicable local and state building code's. Lateral design details and connections must he nu•orporated into the plans or on a separate full-size sheet attached to the plans with cross references h.tween plan location and details. Plan review cannot be completed _ it'copyright violations exist. 11 5itelplot plan drawn to scale.The plan must show lot and hudding setback dimensions;property comer elevations(it' there is more than a 441.elevation differential,plan must show contour lines at 24i.intervtds);fixation of easements and driveway;footprint of structure(including decks);location of wells/Septic systems;utility locations:direction indicator,lot arra;building coverage area;percentaee of coverage:impervious arca:existing structures on site;and surface drainap.. 12 Foundation plan.Show dimensions. anchor bolts,any hold-downs and reinforcing pads,connection details, vent _ sire and location. 13 Floor plans.Show ;all dimensions,room identification, window size,location of smoke detectors,water heater, furnace, senlalation Baas, plum hing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than one cross Section may he required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insultauon,etc. 15 Elevation views. Provide elevations for new construction:numnium of two elevations fior additions;and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater(hall four foot at huilding envelope. Full-size sheet addendunas showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral:ria plans. ~lust indicate details and locations;for nun-prescriptive path analysis provide specilicauon�.uul,.alo ul,uaons to engineering standards. — 17 fluor/roof framing.Provide plans for all tloordroof&;wimblies,indicating nmemhcr sizing,spacing,and heating _ locations. Show;attic ventilation. 18 Basement and retaining walls. Prop ide cross srcuons and details showing placement of rebar, For engineered systems,see item 22,"Engineer's calculations." _ 19 Beam calculations. Provide two sets of calr.ulatirons using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. -- 2o Manufactured floor/roof truss design details. 1 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is tequmred I or four or more appliances. _ 21 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by;in engineer or architect licrnsed in Oregon and shall be shown to be applicable to the project undrr review. �,imil Lill LEI UJIM11111 Now Kalil Lik� 23 Five-(.2 i site plans are required for Item 1 I above. Siteplans must he R-1/2"x 1 I"or 11" x 17"-- 24 Two( )sets each arc requ,red for Items 10, 19, 21)&. 22:above. —-- 25 Building plans shall not contain red lines of tape-ons. _ 26 No rolled, reversed or mirrored building plans will he accepted. 27 28 Checklist must be completed before plan review strut date. Minor changes or notes on submitted plans may he in blue or bl 'c ink. Red ink is reserved for department use only. +*)-dais ibt)ac'osm Electrical Permit Application —-- --' Fatereceived: city '(if Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,"Tigard,OR 97223 Date issued: By: pt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval' OF PERMIT. 1 &2 family dwelling or accessory U ConunercIal/lid Usti tal J Multi-family U Tenant improvement ❑ New construction O Addition/itlteration/replacement U Other: U Panial AOIN S11i INFORMATION Joh address: I2 113 Su) UC,ICv-1 N�O-A4�+I l t__ Bldg. no.: Suite no.: Tax map/tax lot account no,: Lot: Block: Suhdrvision: - - t .� �_ GS Project name: Description and location oT work on premises: Estimated date of corrlpletion/inspection: C11V111111111111I pee Max Job no: _ -- Description Qty. Ira 1 Total no.insp Business name: Newit-wieotW.�sornMtltl-fitnllyper Addfess; dwellingunit.includes a t eltedgaiop. City: '1 tN 0 State: 'ZIP: servicebtcluded Phone: Rax: D. 3 Email: 1000 sq.ft.or less Each additional 500 sy,ft.or portion thereof L Elec.bus.lic. no: CCB no.: � EimOed energy,residential 2 Luniled City/metro lie.no.: energy,non-residential 2 Each manufactured home or modular dwelling - Service and/m feeder 2 Signature of supervising electrician(re uired) Date --_ Services or feedety-installation, Sup.elect.name(print): 71,:-rise no alteration or relocation: 1 200 amps or less 2 201 amps to 4W amps _ 2 Name(print): ink 401 amps to 600 amps2 Mailingaddress: D E 8 -A 601 ams in 12.1 amps _ 2 City: State: ZIP_ _ over IWo amps or volts 2 Phone: 3 Fax: E-mail:Rtt.lA %%VA Reconnect only 1 IN Temporary services or fecderx- Owner installation:'The installation is being made on pripe 0 a►1 Insmllelion,altentlon,arrelacation: which is not intended for sale, lease,rent,or exchange according to 200 amps or less 2 ORS 447,455,479,670,701. 201 amps to 400 amps 2 Owner's si nature: Dale: 401 to 6W ams 2 Branch circuits-new,alteration. or extension per panel: Name: _ A Fee for branch circuits with purchase of - _ service or feeder fee,each branch circuit 2 Address: _ City: State: ZIP: H. Fee for branch circuits without purchase _ of service or feeder fee,first branch circuit: 2 Phone- Fax: E-mail' Each additional branch circuit IWLA Mise.(Service or feeder not Included): [rich pump or Imgati m circle U Service over 225 amps-commercial U Health-care facilnv Each sign or outline lighting _ 2 Ll Service aver 320 amps-rating of 1&2 U Hazardous location Signal chcui0sl or a limited energy panel. family dwellings U Building over 10,(x10 square feet four or g 1-3 System over 600 volts nominal more residential units in one structure alteration,or extension" U Building over three stories; U Fcedem,41x1 amps or more •Desch ion U Occupant load over 99 persons U Manufactured structures or RV park Fick additional Inspection over the allowable in any of the above: J Egressllightingplan U Other -- letmspecuon I Submit sets of plans with any of the above. Investigation fcc The shove are not applicable to temporary construction service. Other Not all jadadlcdons accept credit cards.rle&w cal jurisdiction f«more infomtation. Notice:This permit application Plan review(at e. %) $ U Visa U MasterCard expires if a permit is not obtained _�_L_ widtjn 180 days after it has been State surcharge(lid) ....$ i twin cud number -------.— tsapima TOTAL ................... .. $ accepted as complete. — Name of o der eG sown on credit card $ Cardholder i_tum Amount 440415(&MUOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed) (FUR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential•per unit 1000 sq ft.or less $145.15 4 Audio and Stereo S;.tems` Each additional 500 sq ft or portion thereof $3340 1 Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Garage Door Opener" Dwelling Service or Feeder _ $90.90 2 Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' installation,alteration,or relocation 200 amps or less $3030 2 � Vacuum Systems' 201 amps to 400 amps $106.85 _ 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Feefor each system.......................................................... $75 00 Installation,alteration,or relocation 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 $13375 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)The fee for hranch circuits with purchase of service or ❑ Clock Systems feeder fee. E=ach branch circuit _ $6.65 2 ❑ Data Telecommunication Installation b)The fee for branch dreuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 HVAC Each additional branch circuit $6.65 ❑ Miscellaneous ❑ instrumentation (Service or feeder not Included) Each pump or irrigation circle _ $53.40 Intercom and Paging Systems Each sign or outline lighting $53.40 Signal dreuit(s)u•a limited energy panel,alteration or extension $75.00 Landscape In#+gation Control' Minor Labels(10) $125.00 Medical Each additional inspection over the allowable in any of the above ❑ Nurse Calls Per Inspection $62.50 Per hour $62.50 In Plant __� $73.75 _ Outdoor Landscape Lighting' Fees: [] Protective Signaling Erter total of above fees $ ❑ Other_ _ 8%State Surcharge $ _ Number of Systems 25%Plan Review Fee ' No licenses are required. Licenses are required for ell 01.her Installations See"Plan Review"section on $ __ front of application _ Fees: Total Balance Due $ Enter total of above tees ❑ Trust Account# 8%State Surcharge $ -- -� Total Balance Due $ i:\dsts\fbrms\elc•fces.doc 06/07/01 A \ Mechanical Permit Application Date received:/�w�j Perm itno.: City of Tigard Ptoiect/appl.no.: Expire date: City ojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt nu.: Phone: (503) 639-4171 -- ------ Fax: (503) 59$-1960 Case file no.: Payment type: Land use approval: __. Building permit no.. e 1 &2 family dwvllinu or accessory O Commercial/industrial J Multi-family : Tenant improvement 0 New construction, U Additi(ln/alteration/replacement O Other: JORSITE INFORM11ONtSCHEDULE Job address: ,SW Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials.equipment.labor,overhead, Tax map/tax Iot/accountnu.: profit. Value$ _ Lot: Block_ Subdivision: *See checklist for important application intormation and Project name: jurisdiction's 1'ee schedule for residential permit fce. City/county: i— 7_IP t "i t Description an lu Ion of word on premises. 1 ( 1 x w 1 _ 1 eerru.{ 1 dal Est.date of completion/ir pection: Dost lipthm (Av. Res.oniv Res.only Tenant improvement or change of use: Is existing space heated or conditioned' U Yes No Air handling unit CFM Air conditioning(site plan required) _ Is existing space insulated?O Yes A No Alteration of existing f AC system _ MECIIIANICAL t of er/compressors Business name: State boiler permit nu.: HP —Tons BTU/14 Address: rj() Litt. I irc/smokc dampers/duct smoke detectors City: XIf State: ZIP: "1�3� teat pump t,,uc----Tn required) Phone: Fax: E-mail: Instal repIacv Iurnace/burner Including ductwork/vent liner U Yes U No _ CCD no.: I 1 _ nstalVrep ace/relor:ate icaters-suspended, City/metro lic. no.: I wall,or flour mounted Name(please print): Vent for a, Hance other than turnace t o efngeralion: Absorption units BTU/H Name: Chillers _ lip - Address: Corn ressors _ HP ronnsenta ex ausl and-ventilation: laity: State: ZIP: Appliancevent - — Phone: I E-mail: Dryerexhaust _ oods,' ype / res.kitchewhazmat hood fire suppression system Name: IL, Exhaust fan with single duct(hath fans) _ Mailing address: Exhaust s stem a an from heating or AC City. State: ZIP: Fuelpiping andistribution(up to outlets) Type: 1-116 NG ()if _ Phone: p Fax: Q E-mail: Fuel piping each additional over 4 outlets 31111:1 M 11011 a Process piping(schematic required) _ Number of outlets Name: ter MqliZ applliance or equipment: Address: _ Decorative fireplace _ City: - _—- State: 7.IP: _ nsert-type _ Phone: I E-mail: ao siove/pelletstove Other: Applicant's signature: Date: ter_: _ Name (print): _ — Not all lnrefdlClloflr aclepl credit cauls,pleas call pmalirnMW on fur information Permit fee..................... U Visa U ns crCard Notice: This permit application Minimum fee................$ _ expires if a permit is not obtained plan review(at ,_ `°h) $ Credit card number. -- - I__ within 180 days eller i1 has been Num of c oas a r shown an credit card - accepted as complete. State surcharge(896) ....$ $ TOTAL .......................$ --- Cardholder signature Amount 446.1617(WYCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code olY (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 14.00 fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000.00. including ducts&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 14.00 fraction thereof,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 $50,000.00. 12.15 $50,001.00 and rip $742.00 for the first$50,000.00 and Check all that apply: Boiler Heal Air $1.20 for each additional$100.00 or For items 7.11,see or Pump Cond fraction thereof. footnotes below. Com ` 7)<3W;absorb unit to 100K BTU 14.00 ASS UMED_VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb Value Total unit 100k to 500k BTU 1 25.60 Description: City Ea Amount 9)15-30 HP;absorb Fumace to 100,000 BTU,including 955 unit.5-1 mil BTU 1 35.00 ducts&vents 10)30-50 HP;absorb Furnace> 100,000 BTL'Including 1,170 unit 1-1.75 mil BTU 52.20 ducts&vents 11)>50FIP-absorb Floor furnace including vent 955 unit>1.75 mil BTU 87.20 Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM floor mounted heater _ - - 10.00 Vent not included in applicance 445 13)Air handling unit 10,000 CFM+ permit 17.20 Repair units 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 10.00 to 100k BTU _ 15)Vent fan connected to a single duct 3-15 hp;absorb.unit, 1,700 6.80 - 101k to 500k BTU -- 16)Ventilation system not included in 15-30 hp;absorb.unit,501k to 1 2,310 appliance permit 10.00 mil.BTU 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 10.00 1-1.75 mil.BTU 18)Domestic incinerators >50 hp;absorb.unit, 5,725 17.40 >1.75 mil.BTU 19)CormnpWal or industrial type incinerator Air handling unit to 10,000 cfm 656 69.95 Air handl1,170 20)Other units,including wood stoves Non- actable eva orate cooler 656 _ 10.00 Vent fan connected to a single duct 446 21)Gas piping one to four outlets Vent system not included in 656 5.40 a Alia a permft 22)More than 4-per outlet(each) Hood served by mechanfcal exhaust 656 1.00 Domestic Incinerator 1,170 Minimum Permit Fee$72.50 SUBTOTAL: $ Commercial or Industrial Incinerator 4,590 Other unit,including wood stoves,&360 8%State Surcharge $ Inserts,etc. _ Gas�i in�_1-4 outlets 26%Plan Review Fee(of subtotal) $ Each additional outlet Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $ Qther Inspections and Fees: I Inspections outside of normal business hours(minimum charge-two hours) $12 50 per hour 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by changes,additions nr revisions to plans(minimum chargoone-half hour)$72.50 per hour 'State Contractor Boller Certification required for units a200k BTU. "Residential AIC requires alta plan showing placement of unit. i:\dstsUonnsVnech-fees.doc 10/11/00 Plumbing Permit Application Date received: /P Permit no.:/1srpew/ ev')57y City of rf,igard Sewer permit no.: Building permit no.: 2i Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of"Tigard Phone: (503) 639-0171 Projecl/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: F,eceipt no.: Land use approval: Case file no.: Payment type: ",.2 y dwelling or accessory ❑Commercial/industrial ❑Multi-family D Tenant improvement ruction ❑Addition/alteration/replacement p Food service U Other: _ 111111111P111;K1111 I / �. Ilr�unftion iOty. Frx(ea.) "total Job address: 'JL Iti' 1'S C_.�j f 1 L`r�tt [Ed.ri.. -- - ` NeN I Nnit Z-INIf11I V'(I NCIIIn Qti IIn I1': �— Bldg.no.: _ �111K tl" -- (Includes loon.for cacti utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot: Block: Subdivision: FR(2)bath Project name: SFR(3)bath City/county_ r Each additional bath/kitcnen — I)escription and l ation of wok on premises: Site Utilities: e_ o ; o Catch basin/area drain --�-- Drywells/leach line/trench drain Est.date of completion/insix:ctiun: Footing drain(no. lin.ft.) ! ' _Manufactured home utilities _ Business name: _ Manholes T _— Address: — — Rain drain connector City: . State: ZIP: Sanitary sewer(no. lin. ft.) Phone: p Fax: E-mail: Storm sewer(no.lin. ft.) ate scr�ice(no.lin.ft.) CCB no.: Lp Plumb.bus.reg. no: 1 IIxture or item: City/metro lic.no.: _ Absorption valve _ Contractor's representative signature: Hack flow preventer __ _ Print name: j Date: 1 Backwater valve_ y CONTAUt PERSON Basins/lavatory _ Clothes washer _ Name: Dishwasher Address: Drinking fountain(s) Ejectors/sump Phone: Fax: E-mail: Expansion tank _ Fixture/sewer cap _ floor drains/floor sinks/hub Name(print): ' Garbage disposal Mailing;address: t�$ S Hose bibb State: Ice maker — Phone:' Fax: a E snail: Interce tor/ rease trap Owner installation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I nwn as per ORS Chapter 447. Smk(s),hasin(s), lays(s) Owner's signature: Date: Sump Tubs/shower/shower pau Urinal _Name: Water closet Address: _ Water heater _ City: State: Z[P: Other: Phone: Fax E-mail: Total Minimum fee................S Not tdl juriadlcdotts accept credit cards.please call jurisdkdon far mote lnfarrrtatton. Notice:This permit application Plan review(at — %) S O Visa O MasterCard expires if a permit is not obtained —__L / within 180 days after it has been State surcharge(8%) ....S Ea tree p accepted as complete. TOTAL ....................... Name of cardholder ui&r awn on credit card S ---- Cardholder sip ture�'! — Amount 4/114616(6MWOM) PLUMBING PERMIT FEES: — PRICE TOTAL New 1 and 2-family dwellings only: — FIXTURES Sindivldual _ QTY ea AMOUNT i (Includes all plumbing fixtures In PRICE 'TOTAL Sink 16 60 the dwelling and the first100 ft. QTY (ea) AMOUNT t6 60 fo_r_each utility connection)—__ Lavatory _ —��--'— — One 1 bath $249.20 Tub or Tub/Shower Comb. 16.60 Two(2)bath $350.00 Shower Only —�- 16.60 Three � _(3ath $399.00 Water Closet 16.60 SUBTQTAL Urinel a 16.60 8%STATE SU_Ri;HARGE Dishwasher 1660 PLAN REVIEW 25%OF SUBTOTAL — Garbage Disposal — 1660 TOTAL I.aundry Tray 1660 Washing Machine 1660 Floor Dram/Floor Sink+ 2" 1660 3" tfi sn - PLEASE COMPLETE: a- --- tsSn Water Heater O conversion O like kind 16.60 Quanti b I Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ omit —. —_--._— — _ Capped MFG Home New Water Service 46.40 Sink MFG—Home New rU SaStorm Sewer Lavato 46.40 _ Tub or Tub/Shower Hose Bibs 1660 _ Combination_ --,—_ Roof Drains 16.60 Shower Only Drinking Fountain— — _ 16.60 Water Closet — 16 60 Urinal Ot her Fixtures(Specify) Dishwasher Garbage Disposal --- Laund Room Tray _ -- Washing Machine Floor Drain/Sink: 2" Sewer-1 sI 100' 55.00 3" — -- _ Sewer-each additional 100' 46.40 _ 4" _ Water Service- 1st 100' 55,00 Water Heater Other Fixtures Water Service-each additional 200' 4640 - Storm R Rain Drain-1 st 100' 55.00 -- Storm RRain Drain-each additional 100' 46,d0 ---- Commercial Back Flow Prevention Device 4640 --- — Residential Backflow Prevenlion Device' 27.55 — C atch Basin — 1660 Insp.W-of Existing Plumbing or Specially — 72 50 Requested Inspections perthr _ COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 Grease Traps — — 1660 — — - -- QUANTITY TOTAL Isometric or riser diagram is required it _ Quantity Total is >9 -- 'SUBTOTAL -- - 8%STATE SURCHARGE --- -- "PLAN REVIEW 25%OF SUBTOTAL Required only if fixture qty total is>9 TOTAL E .Minimum permit fee is$72.50•8%state surcharge,except Residential Backnow Prevention Device,which Is S:111 25 ,8%state surcharge "All Now Commefclal Buildings require plans with Isometric or riser diagram and plan review I:\dstsVorms\plm-fee,s.doc 10110/00 02 09: 56A Millennium Homes 503 666 3047 P . 02 nA/^RA1 1fi:JF] �,tJ�D7tfr1/►r: •i •r •,•,• .-. rM�e1P 17700 eW Upper boon"Ferry!load,Bulls 100 Portland,orWon 07224 Tel(503)tl♦Wi81 • Fax(503)0014705 December 2U•2001 Job No 01-7491 MIII©nium Homos, Inc. Mac Even 2208 SE 182n0 Avenue Portland,OR P7233 GEOTECHNICAL ENGINEERING REVIEW OF FOUNDATION pLAN AND SITE LOT 26- ELKHORN RIDGE ESTATES TIGARD,OREGON Q.t your roquest, we have rovlowod the lot and proposed totindatlon plan for Elkhorn Ridge Lstates, lot numbar 26 The purpose of our review was to mare uoncfusions tend recommendations for foundation support of the proposed single-family home and comment nn the geotechnical feasibility of the building plan. The lot is moderately sloping from nn estimated 16 to 25 percent grade, ing 1'hs plan shows a 2- story home with a daylight besenrant level cut into the penile to moderately ddwth of front cwardy olic hs lot Na sign, of stupe instability were obaRrvc'd Up to 6 fret FlII appears to be p ade tot I he fill embankment is covered with recent spoils end franchise utility trench spoils such that more th8n 3 to 4 toot of excavation should be anticipeted in a localized area towards the front of the house to reach sultoblo native soilR or adequataly compactrad engineal-nd fill, The remainder of the lot appuarx natural and 18 to 24 inches of excavation is expected oven these areas. The native Silt soils and engineered fill are stiff and suitable for foundation support. The cuts in the t•,se area ts)rouhl b a sloped to near 1 N.1 V If any footingb lie within a 1N•1V plane extending from thn 13880 of on interior vorttCal stop, the fooling ehn,otd eeed to the ot ctsncaletie of ooptneere Step, the footin1 x shouid be deepened, or a retaining well tthould be constructed. A p should review the foundation subgrade during formintl. it is our opinion that the observed native and compaclad fill Boils are surivOle for isprt+ad foundation support to a mnximum allowable bearing pressure of 1,600 psf. The review d plan is a3n6idercd feasible, from the georr3chnic til perSper,G+e Maximum Column Toads should not exceed 30 kips; if rrresonry chimneys are plan-M. a m(n rnum of 3 feet(,A compacted mrt)*d rock shouid be placod beneath their lootrnps Softening of unprotectw areas due to frost or rain may necessitate mucking of a softened surf;e layer. We trutit tf115 infurtnetion meets your ne6d9- if you have any questions, please earl Sincerely, Oeopecif+c Fnlyinnedng,Inc_ 'that&o P1f�rS, it1GINE f% roy 4� 14743 OREGON O James D Irrsbrie,P E.,C-E. Geotw-.hnicef Engineer 4fS p IMV O1 Nov 2B 14:32 24 n M\L T26(,WC r dwg FIDS ............... as S 89*51'52' E 64 20' -X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X-X*.X. -A-y' 6 I•OL 9 8" .................. LOWER FLOOR 4 EL 3.0* DE� en LP! lh Ci MAI FLOOR ID EL -'4130 0' 01c; b GARAGE 77— 0 9 a" 1 1 9 14 9--f ........... 13'-8" S 6459-53.w II I 9'.6;" 1 1 3 V.8' --4 Pi f I t�fo r b 25-00 9 rN 29 0 111 0 LEGEND S W GREENWAY - - - COURT 89'51'L2'1,111 YYX-X- St f fFAC[ 39 20* 10 11/28/2001 RDS S 1;-_A L E-- 1 2-0 0 AAAN MASCOW DEPM A$()O-AT[t, PC r, JIA&E FOR III ACCLPIACY OF TK VOKGn;�,, CITY OF TIGARD 'WORVATOK IT 8 TW 50tt PIEVORMov RIDGE wArAq to YEW,All RIF C,.T.. r* "41ELKHO N 2120 C 'a I..0 opo THE SITE NO wol:�r L OT 26 001164M Or AMI POFINTW Mb~r-01014 • ALM WASOCIND OtSM Alloc"ITIFS.W, BY MAC EVEN 6,750 SO. fT.) MILLENNIUM HOMES, 19NC CITYOF TIGARD _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00233 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/7/03 SITE ADDRESS: 12713 SW ROCKY MOUNTAIN CT PARCEL: 2S109AD-08200 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 02(1 ,JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: _ BOILERS/COMPRE_SSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: 3 - 15 HP: COMML, INCIN: MAX INPUT: BTU '65 - 30 HP: FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: _AIR HANDLING UNITS CLO DRYERS: FURN >=100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Install exterior A(' unit. A('cannot he pkicc l in the requiral sethacks. Owner: T FEES DAVID SEIBOLD Description Date _v Amount 12713 SW ROCKY MOUNTAIN CT. - — — TIGARD, OR 97224 IMFUIII Permit Fee 5/7/03 $72.50 I"I AXI N 5/7/03 $.5.80 Phone: 503-620-5999 Total $78.30 Contractor: WESTERN HEATING + A/C 1.4.314 SW ALLEN BLVD STE 220 REQUIRED INSPECTIONS BEAVERTON, OR 97005 — --- Phone: 6.18-5808 Cooling Unt Insp Final Inspection Reg#: LIC 76978 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done it accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued By: / ( `' '_y Permittee Signatut r Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day NLY Mechanical Permit Application Received , ,+�yy,, Mechanical, Datc/B : `U 3 ►/ Permit No.:Yh EL U3—oaa3 Planning Approval Building City of Tigard Date/B :_ Permit No.: 13125 SW Hall Blvd. Plan Review Other Date/By:: Permit No.: Tigard,Oregon 97223 Phone: 503-639-4171 Fax: 503-598-1960 �.,Y Date/By:Post-RevLand Use Date/By: ('ase No.: Internet: www.ci.tigard.orms Contact Juris: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method _ Su Icmental Inrormatlon. TYPE OF WORK COMMF,RCIAL FEE*SCHEDULE-USE CHECKLIST New construction _ Demolition Mechanical permit tees*are based on the total value of the work _ Other performed. Indicate the value(rounded to the nearest dollar)of all R-Addition/alteration/repla cement CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. ❑ I &2-Farr dwellin Commercial/Industrial slue: $ -- _-- See Page 2 for Fee Schedule I &2-Accessoryily dweMulti-Hamel RESIDENTIAL E UIPMENT/SYSTEMS FEE*SCHEDULE Building_ Description t Fee ea. Total _Master Builder Other: _IfeatinizWooling JOB SITE INFORMATION and LOCATION Furnace-add-on air conditionin ** 1 14.00 Job site address „ .%C/ Gas heat pump 14.00 Suite#: BIdB•/A t.#: Ductwork 14.00 H dronic hot waters stem 14.00 _ Project Name: Residential boiler Cross street/Directions to job site: for radiator or h dronic system _ 14.00 Unit heaters(fuel,not electric) in wall,in-duct,suspended,etc. 14.00 Flue/vent for any of above 10.00 Lt�t#: Repair units - 12.15 Subdivision: _- Other Fuel Ap iliances Tax map/parcel#: _ Water heater 10.00 _ DESCRIPTION OF WORK � Oas fireplace 10.00 Flue vent water heater/gas fireplace) 10.00 Log lighter as 10.00 ----- Wood/Pellet stove 10.00 _ Wood fireplace/insert — 10.00 Chimney/liner/flue/vent 10.00 PROPERTY jW- NER I OTENANT Other: _ 10,00 Environmental Exhaust&Ventilation Name: k,J/,1/ f) i l_ Range hood/other kitchen equipment I QAO Address: ` -�� Clothes dryer exhaust 10.00 Cit /State/Zi : /- 1 �� _ _� �__-;�� _.L�� Single duct exhaust Phone: Fax: _ (bathrooms,toilet compartments, APPLICANT I U.CONTACT PERSON i ity rooms) G.80 Name: - Attic/crawls ace fans 10.00 L Other: 10,00 Address: Fuel Piping City/State/Zip' **55.40 for first 4,$1.00 each additional ---- — Furnace,etc, •« LZ Fax: --- Phone: Gas heat pump " F-mail: __--_ _Wall/sus ended/unit heater `« — CONTRACTR_(_'_ Water heater Business Name: — Firc lace " � � �� r i�j��, � .. — Range Address: / LL3 1%D a — *« _ City/State/Zip:_ J 1 / -' v—! Clothes dryer(gas) Phones 7 4' Fax Other: •• 'total: CCB Lic. #• -7 ce' _� • � E � �f�' Mechanical Permit Fees* Authorized r- Subtotal: S '—G Signature: ��- Date'- 3 Minimum Permit Fee$72.50 S 5 _ Plan Review Fec 25°/a of Pcrtnit Fee S ��D l,�/.- max/ :: — - - — • (Please print Hamel State Surchar c 8/o of Permit Fee S �" -_ TOTAL.PERMIT FEE $ VXO Notice: This permit application expires it a permit is not obtained'A'thin *Fee methodology set by Tri-County Building Industry Serslce Board. 1110 days after It has been accepted as complete. "She plan required for exterior A/('units. is\Dsts\Pcmtit Fom,s\Mecl'cmritApp,doc 01103 Mechanical Perm it_Application - City of Tigard _ Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.0(1 to$5,000.00 Minimum fee$72.50 $5,00100 to 510.000.00 $72.50 for the first$5,000.00 and$1.52 lir each additional$100.00 or fraction thereof,to and including$10000.00, $10,001.00 to$25,000.00 $146.50 for the first$10,000.00 and $1.54 for each additional$100.00 or fraction thereof,to and including $25,00010 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or Faction thereof',to and including $50000.00 $50,001.M and up $742.00 for the first$50,000.00 and $1.20 for each additional$100-M or fraction thereof. Assume d Valuations Per APP11ance: Value Total —Description: _4t (:a Amount Fumacc to 100,000 BTU,including 955 ducts&vents Furnace> 100,000 BTU including ducts 1,170 &vents _ Floor furnace including vent 955 Suspended heater,wail heater or floor 955 mounted heater �- Vent not included in appliance pennit 445 Rt air units 605 <3 hp;absorb.unit, 955 to 100k BTU 3-15 hp;absorb.unit, 1.700 I Ol k to 500k BTU 15.30 hp;absorb,unit,501k to I mil 2,310 13TU 30.50 hp;absorb.unit, 3,400 1.1.75 mil.BTU >50 hp;absorb.unit, 3,725 >1.75 mil.BTU Air handling unit to 10,000 cfm 656 Air handlitiR unit>I 0,(M cfm 1,170 Non-portable evaporate cooler 656 Vent fan connected to a single duct 446 _ Vent system not included in appliance 656 permit Ifood served by mechanical exhaust 656 Domestic incinerator 1,170 Commercial or industrial incinerator 4 590 F Other unit,including wood stoves, 656 inserts,etc. (las i InR 14 outlets 360 Each additional outlet 63 ,rOTAL COMMERCIAL $ VALUATION: is\Dstc\[elmit l.'onms\MccpcmutAppl'g2.doc 01/03 i - ----------------- i V I� r Cy N F - •� V _, L.- .\ I I 4 rry OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST � BLIPReceived M -t C� 1 _ Date Requested 5��3 -- AM f U 7 PM BLIP '_oration - –7/3 -- -�W elSuite___- MEC 3 "-49OL-3k.3 3 -- Contact Person Ph( ) 7 _ � , PLM - Contractor— - -- — Ph(– ) - - -- --- SWR BUILDING Tenant/Owner _-___ _ _-----__. — _-- - ELC Footing Foundation Access: ELC -_ Ftg Drain ELR Crawl Drain _ Slab Inspection Notes: \/� j SIT Post& Beam -- - -. _ _ _ r !/�(iv�_c�✓ lam. Shear Anchors -�/ -- Ext Sheath/Shear Int Sheath/Shear - Framing Insulation Drywall Nailing Firewall Fire Sprinkler - --- Fire Alarm Susp'd Ceiling — ��— - - - ------- Roof V'1 Other: Final PASS PART FAIL -- — PLUMBING — i'ost& Beam �! Under Slab Hough-In o Water Service Sanitary Sewer Rain Drains a--_ Catch Basin/Manhole V / Storm Drain - t Shower Pan �+ Other: Final PASS PART FAIL ` I�C.A L Post& Beam Rough-In Gas Line Se Dampers� L _ IRICAASS PART FAIL _ E __ Service — Rough-In UG/Slab — Low Voltage Fire Alarm Final El Reinspection fee of$ required before next ins PASS _PART FAIL p p inspection. Pay at City Hall, 13125 SW Holl Blvd. SITE _ E] Please call for reinspection RE: F1 Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Data Inspector _.. ��/ _ _ Ext Other: FinalDO NOT REMOVE this inspection record from the Job site. PASS PART FAIL w w W ~ n CL � C � a _ w o I �1 rD y n Er ru o a o o 0 0 F.