14120 SW 131ST PLACE I
i
• ••• ••• • • •
• • NOTES
• • '•' •' 1). lrstall or revise automatic fire sprinklers to provide coverage as shown.
2). Piping and spacing per N.F.P.A #13 and City of - Fire
Department.
3). Sprinklers:
_ _ —;,-.-- •- --- - -- —. __ —. — ,— __ .�_ , ---�fi-1-^-� _ �--�---;---- . � 165 Brass upright 1/2" orifice.
165 Semi-recessed 1,2" orifice.10
' 4
I Llvl �G f SIN IuG
aIN, 7 r 7 _4 3 A711
4). Hangers:
��1�11 L , I • z � � � •o
• '` ry ti 3/8" A.T.R. cnd pipe rings to structure kith i �'`� + '•�
3A7"
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3 I't 2 2 I M ] ` -------1 1 L�� I - I v J '� o 01115
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12. OF BATT OR
BLOWN-IN INSULATION
FF-25 BARRIER
r BRANCHUNE OVER UNE PIPING
IN/ NPE STRAP
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V -_ _
• ' LA
1" X DROP
(SEE PLAN)
SAII,,'' I n. � /� \ � .� GLO. �•
4 D ICY __ / \ I 4t
i 2X FRAMING
GYP. BOARID OR
ACC TILE Ct'UJNG
'•• ' I Al3r7v�.
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TYPICAL INSULATION COVER ;
I o y TO BE PROVIDED BY OTHERS
rJ,� AFTER PIPING INSTALLATION
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U P P E R LES EL PI 11\1 G 'r d = I O
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MA 1 N 114 ' '�" CITY OF TIGARD ..•........
AW
Conditionally Approved............
I'TV"'r For only the works descri in:
�r 11,14 FL 5,4 -ia OMhir/ 1 PERMIT NO. �.. ..... ........(
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Job r Date:
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WYATT FIRE PROTECTION INC.
INSTALLATION AND MAINTENANC •
9095 S W BURNHAM
O -' t Y • TIGARD, OREGON 97223
S
TOTAL SPRINKLERS DATE
--- - - � 1 �-r'<��_•� THIS SHEET
-
CONTRACT SCALE
_ REVISIONS-LOCATE BY GRID COORDINATES HANGER LEGEND DEVICES - irn.NDARD SY ABOLS STANDARD SYMBOLS SPRINKLER HEAD SYMBOLS REVISIONS-LOCATE 4Y GRID COORDINATES APPRCVAJS j INSPECTION PHONE CONTRACT WITH t� ;�1;�E: r;
ilOOKS LENGTH AS DESI"TED SPRINKLERS TYPE �- DEGREE I QTY. t _ PUST INDICATOR VALVE 3 - ALARM CHECK VALVE - VPRIC+HT ON 1;2" OUTLET — 1
,� ENGINEER SHEET
# 5 - FIG. 116 CEILING FIG., ROD & RING CE rii t� R O.G. 't' '� +! _ -'! _ r,EY VALVE - RISER w/ALARM VALVE -9• - PENDENT ON 1/2- OUTLET 2 -- --�— r --
3 I
# 6 - FIG. 159 CEILING FLG., i(OD 6 RING ~- q — - -
- - r• 7 - COACH SCREW, ROD i RING ------ �- � - FIRE HYDRANT 0 - RISER */DRY VALVE - UPRIGHT ON 1" STUB9•UP I CITY - � �
# R - CONC. INSERT, ROD 6 RING �— _ `( - FIRE DEP?. CONNECTION 00 - RISER w/ELEC. FLOW SWITCH 4 -- PENDENT ON I" DROP 6 -____L----- �N _
P - EXPANSION CASE, ROD RING - RISER w DQl1GE VALVE $ - FLUSH SPR. ON 1" CROP WATER DEM. L.�. .�
# - O.S. 6 Y GATE VALVE /
10 - EYE ROD 6 SING _ WATER MOTOR D81 - DRY PENDENT ON 1" DROP —
#+ 1 i -• "C-CLAM?, ROD SRING - --' {� - SWING CHECK VAI.VE g S _.-• SIDEWALL ON 1/2" OUTLET ADDRESS At30R�
#f 12 - -J"ROD ANGLE CLIP, ROD 6 RING - - 1r rot - NEW UNDERGROUND -�. - ELECTRIC BELL 19 - UP & DN AT SAME LOCATION CITY — 4TY
- 13 - ANGLE IRON CLIP, ROD 6 RING ! —/C� 'A �' a -4 - EXIST UNDERGROUND ii -- FL:bH FIRE DE!'T. CONN. 1
NOTICE: IF THE PRINT OR TYPE ON ANY I IIr�rIIllll IIIIIII Iltlt t II11tll VIII tltTtlr Tf rr TJT g11-1V_�
illl Illlllt IIIIIII Illlltllllllt�l III(I I Iltlt�r VIII I tlllllt 111 I I IIIb�I Ilr�t�l !IIII�I VIII I ,,Ct 1 a
IMAGE IS NOT AS CLEAR AS THIS NOTICE, I I I I ;�I ' I IsI.'�_� . ,1 9 10 11 12
IT IS DUE TO THE QUALITY OF THE _ _ _ No.M O• "•
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1ORIGINAL DOCUMENT ll11111111 ll
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14120 SW 131sT TERRACE
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CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00517
" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/25/03
SITE ADDRESS: 14120 SW 131ST T ERR PARCEL: 2S 109AB-08000
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS:
CAS PRESSURE: fi0 + Hp: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10900 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Install exterior A/C unit. Do not place within the wkluired setbacks
Owner: _ FEES _
PEVZNER CONSTRUCT ION Description Date Amount
13470 SW TAPADERA ST — —
BEAVERTON, OR 97008 [NIECH] Permit Fee 8/25/03 $72.50
[TAX] 8"/u StateTax 8/25/03 $5.80
Phone: 503-313-2466 Total $78.30
Contractor:
�' rJ r3/1 s5 14L-7771VC--
REQUIRED INSPECTIONS
Phone: Final Inspection
Reg#:
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 in 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 9.52-001-00
Issued By: _ � _ Permittee Signature:
Call (50 639-4175 by 7:00 P.M. for inspections needed the t/iext business dW
- BUILD!NGPERMIT
CITY OF TfGARD
PERMIT#: BUP2002-00208
DEVELOPMENT SERVICE:: DATE ISSUED: 6/13/02
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S109AB-08000
S!TE ADDRESS: 14120 S'N 131 ST TERR
SUBDIVISION: RAVEN R;)GE ZONING: R-7
BLOCK: LOT: 009 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT_OPENINGS?
TYPE OF CONST: 5-1 HR sf N: S: E: W: —�
OCCUPANCY GRP: TOTAL AREA: 000 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft Y FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKIN":
VALUE: $ 5,500.00
MRemarks: Residential fire sprinkler system with water flow alarms in the bedrooms
Owner: Contractor:
PEVZNER CONSTRUCTION WYATT FIRE PROTECTION INC.
13470 SW TAPADERA ST 9095 SW BURNHAM
BEAVERTON, OR 97008 TIGARD, OR 97233
Phone: 593-648-8621 Phone: 684-2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
nRMT CTR 5/30/02 $100.90 27200200000 Sprinkler Final
5PCT CTR 5/30/02 $8.07 27200200000 Fire Alarm Insp
FIRE CTR 5/30/02 $40.36 27200200000
PRMT DLH 5/30/02 $40.36 2002-1987
(additional fees not listed here)
Total $283.36
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through O 52-001-198P You may obtain a copy of the!.ie ruins or direct questions to OUNC by
calling (503)2.46-6699 or 1AR 00-?32-2%eod.
Penn lttee �•
Signature:
Issued By:
Call 639-4175 b,1 7 p.m. for an inspection the next business day
Building Permit Application n
City of Tigard Date received:Jr/3010;1- P,�(tn(i
'
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: —
City /Tigard Phone: (503) 639-4171 Date issued: By. ''! Receipt no.
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: 1'Vf;'20r -4fe 1&2 family:Simple Complex:
I &2 family dwelling or accessory U Commercial/industrial U Multi-family A New construction U Demolition
U AdditiLn/alteration/replacement U Tenant impn %rmem j,FJ:Fire sprinkler/alarm U Other:
1 . SITE INFORMATION
J�addres •1 2-C, 1' Bldg.no.: Suite no.:
Lot: I Block: Subdivision: I Tax map/tax lot/account no.:
Project name: \/?_rU--, I LlI Ct G C)C-C.
Description and location of work on premises/special conditions:
OWNER FOR SPE(JAIL INFORMATRK, ME CHECKLIST
Name: S r t�iV Z n R t t
dplialin,septic coloacity,solar,etc.)
Mailing address: Q S(.IJ i r 1&2 fnnril __..
City: Co Vf R Statc: ZIP: Naluatiun of work ... $
Phon :fos 3 -1 VoO Fax: E-mail: l-1Vo.o hedrooms/baths.................................
Ownc?s re iresentative: Total number of flours.......,; ......................
Phone: Fax: E-mail: New dwelling area(sq.ft.) ..........................
Garage/carport area(sq.ft.) ........................ _ -_-
Name: 2/►� /? ��S u P p� Covered porch area(sq. A.) .........................
Mailing address: Y S S beck area(sq.ft.) ...... ..............I..........
City: e v—�1�o,� State: I ZIP. Other structure arra t',y ti i_. ..................... _
Phon .S� - I ax: E-mail: ('ommerciallindustriiiihnulti-family:
Valuation of work....................................... -
Existing bldg.area(sq.R.) ..........................
Business name: VJ 1 -ZVCA-i` �� t "
t New bldg.area(sq.A.) ................................ -
Address: C --
Cit State: Gtr ZIP: -i.� � � Number of stories........................................
y• u Type of construction
Phone: XA 2f Fax: , A E-mail: Occupancy group(s): Existing:
CCB no.: ( A L, 1 _ . New:
City/metro tic.no.: r( Notice: All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to he licensed in the
Address: - jurisdiction where work is being performed. If the applicant is
State: ZIP: from licensing,the following reason applies:
Cit
Contact person: I'lan no.: — ------�- — -
Phone: Fax: Ii-mail:
if.
lContact.person: Fees due utwirr atri*eMion ............... .......
Address: 1371te received: x , ' J• , — l
city: -- State: _ ZIP: — Arm»rnt teceiw-d .T..4.!JA........— ''Y3
e'z
Phone: -TFax: E-mail: Please refer to tee schedule,
herchy certify I have read and exam! this appllcat and the Not all jurisdictions a•cept credit cards.please call jurisdiction for more information.
attached checklist. All provisions d urdipf e'Cs govcm1 g tills Uvi,a UMasterCard
Credit card number
work will he complied with, a mor not. -- — sicer
Authorized signature--_ _ ate: W 2 —mune of cardhoddet as shown on credit card p
2KQQ s
1f'[ Print name: � R _ Cardholder signature � Amount
Notice:This permit application expires if a permit is not obtained within 180 days oiler it has been accepted 440-4611(601000M)
Fire Protection Permit Check List
-- --
---- ------
-- I A L) New ❑ Addition ❑ Alter ation ` e air
B.) Modification to sprinkler heads only:
Describe work to 1 . 1-10 heads: No plan review required.
be done: I 2. 11+ heads: Plan review required.
Number of sprinkler heads:_._ —
Additional description of work:
Type of System Complete A, B or C as applicable D ❑
A. i —
S rinkler Wet —Standpipes
Additional Haz_�__.______--
Information Density
Desi n Area
K. Factor Z
- _--_— Sprinkler Pro ect Valuation: $ r oo
B. Type I - Hood Flre Suppression System
Hood Project Valuation $ —
C. Fire Alarm -
Submittal shall Battery CalculatfOs
Yesinclude: Individual CompJ Yes ❑
I Cut Sheets —
Fire Alarm Project Valuation: $_
Pro ect Valuation Subtotal LA B & C
Permit fee_based on valuation see chart
—_ 8% State Surch_ar e: $_ F C'' Z) 9 93
FLS Plan Review 40% of Permit: $ — 40 3 (y�-- �1
TOTAL: $— _ 1
1),-72M/r
*W"M9%FP8chfi6k118t.d0c 08/07/01
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223 RE/' EiVED
IMPORTANT PERMIT NOTICE JUN 1 7 2002
YURY PLUMBING Cis I u ii rpt'
18330 SW BROAD OAK CT BUILDWo nrr ►or,
ALOHA, OR 97007
Plumbing Signature Form
Permit #: MST2002-00221
Date Issued: 6/13102
Parcel: 2S109AB-08000
Site Address: 14120 SW 131ST TERR
Subdivision: RAVEN RIDGE
Block: Lot: 009
Jurisdiction: TIG
Zoning: R-7
Remarks: New SF detached, Path 1. FIRE SPRINKLER ARE REQUIRED
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
PEVZNER CONSTRUCTION YURY PLUMBING
1:3470 SW TAPADERA ST 18330 SW BROAD OAK CT
BEA✓ERTON, OR 07003 A`OH A., OR 97007
Phone Il: 503-313-2466 Phone #: 503-649-8334
Reg # I Ir- 137889
PI M 34-359PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
CITYOF T I GA R D _ MASTER PERMIT
DEVELOPMENT SERVICES PERMIT#: MOU221
DATE ISSUED: 6/113/023/02
13125 SW Hall 31vd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 14120 SW 131ST TERR PARCEL: 2S109AB-08000
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 009 JURISDICTION: TIG
REMARKS: New SF detached, Path 1 FIRE SPRIW ER ARE REQUIRED
BUILDING
REISSUE: STORIESFLOOR AREAS _REQUIRED SETBACKS REQUIRE
CLASS OF WORK: NEVV HEIGHT 26 FIRST: 1,220 of BASEMENT: st LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SI FLOOR LOAD: 40 SECOND. 1 520 of GARAGE: 565 st FRONT: 22 PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT. of RIGHT: 5
OCCUPANCY GRP: R.3 BDRrd� :1 BATH: 3 TOTAL: 74u 00 of VALUE: $26495740,
REAR: 15
PLUMBING
SINKS 1 WATER CLOSETS. ASHING MACH: t LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
L>VATORiES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
IUB/SHOWERS, 1 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS:
MECHANICAL OTHER FIXTURES:
FUEL TYPES FURN<10OK: BOIL/CMP�3HP: VENT FANS: 5 CLOTHES DRYER: I
FURN's=10011: I UNIT HEATERS HOODS: 1 OTHER UNITS: 1
MAX INP btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1
---- ELECTRICAL
— RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANFOUS ADO'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FOR: t PUMP/IRRIGATION: PER INSPECTION:
EA AOD'L 800SF: 5 201 - 400 anlp 201 400 amp: tat W/O SVC/FDR: 00 SIGN/OUT LIN LT: PER HOUR•
LIMITED ENERGY: 401 600 amp 401 600 amp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT:
MANU HM./SVC/FDR: 601 • 1000 amp: 6014ampa•1000v: MINOR LABEL:
1000+amp/volt:
Reconnect only: PLAN REVIEW SECTION
-4 RES UNITS: SVCIFDR>=226 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY _
A,SF RESIDENTIAL B.COMMERCIAL.
AUDIO 6 STEREO: VACUUM SYS1 EM. AUDIO 6 STEREO: FIRE ALARM: INTERCOWPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OrH BOILER: HVAC: LANDSCAPEARR10: PROTECTIVE SIGNI:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATArtFLF.COMM: NURSE r,ALLs: TOTAL a SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,392.92
This permit Is subject to the regulations contained in the
PEVZNER CONSTRUCTION PEVZNER CONSTRUCTION LLC
Tigard Municipal Code,State OR Specialty Codes and
13470 S!N TAPADERA ST 13470 SW TAPADERA ST all other applicable laws All work will be done i
BEAVERTON,OR 97008 BEAVERTON,OR 97008 t
accordance with approved plans, This permit will expue H
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
Rep N: LIC 146853 forth in OAR 952-001-0010 through 952.001-0080 You
may obtain copies of these rules or direct questions to
-6y4`1 OUNC by calling(503)246-1987.
(
REQUIRED INSPECTIONS
I Erosion Control Insp& Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp
Sewer Inspectlor, Underfloor insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Electrical Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Mechanical Final
Foundatlon Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Sprinkler Rough-In Plumb Final
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Sprinkler Final _Final inspection
Ar
Issued By : -- Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next bus'Ine -da 7
CITYOF TIGARD SEWER CONNECTION PERMIT_
DEVELOPMENT SERVICES PERMIT#: S 00150
13125 SW Hall Blvd., Tigard, CIR 97223 (503) 639-4171 DATE ISSUED: 6/113/023/02
PARCEL: 2S 109AB-08000
SITE ADDRESS; 141209W 131ST TERR
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 009 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UN TS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF.
Owner_— _FEES _
PEVZNER CONSTRUCTION Type By Date Amount Receipt
134 70 SW TAPADERA ST -- ----
BEAVERTON, OR 97008 PP,M r CTR 6/13/02 $2,300.00 27200200000
IN P CTR 6/13/02 $35.00 27200200000
Phone: 503-313-2.466 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 nut so located,the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: _._
Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business dad/
1900,
1,
Building Permit Application
Date received:
City of Tigard Projectiappl.no.: Ex ire date:
Ciryn/'Tigard Address: 13125 SW Ifall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: 139 Receipt no.: n
Fax: (503) 598-1960 Case file no.: Payment type: \l
Ladd Use approval: _ _- ��__ 1&2 family:Simple Complex:
TYPE OF
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-lamily JM New construction U Demolition
U Add ition/al teral ion/replacement U T'rnant impor;rnwnt U Pira' 1prink1rr1a0arm U Other: _ —•
t O' r ( n
Job address: Sin/ / 1 I' Bldg.na.: Suite no.:
Lot: Block: Subdivision: tA ; c Tax map/tax lot/account no.: ', /D —d QlYJ
Project name: r '1
Description and location of work on premises/special conditions:— - —--
Name: C'V 2 pie J2 ci�S
Mailing address: y? (V S ",/ 1 &2 family duelling:
City: czvt 2 e- Statc: Q , I ZIP. �ZC VJ' Valuation of work........................•...•........... $a /
Phone sv 2 lr 0 Faj. Sn3 S ?Q9 E-mail: No.o('i>rdrooms/baths................................. S
Ownc s representative: n Q P e d 2 Av R Total number of floors............................. .1
Phone: 3i� C 4 Fax: 112-mail: New dwelling area(sq.ft.) ..............`�,7•;L
Garage/carport area(sq. ft.)......•...........••....•
Name: p L C y'nP R. Covered porch area(sq.ft.) .... ....................
— neck area(sq. ft.) ........................................ -- --
Mailing address: --
City: ,�Qa vt K .*'t Statc:Q�' ZIP: � Other structurearea(sq. ft.)......................... _..
Phony, Fax: E-mail: CommerclallindustrinUmulti-family:
Valuation of work.... ......................... ........ $
Elm
Existing bldg.area(sq.ft.) .•....... --
Business name: 'V"'w P (6".&v e ; c.�. New bldg.area(sq.n. ...
Address: i�-f�tV c✓ c Number of stories
City: , VC p -u,. State:/ :.'.1P: G Type of construction......... .. ....
-- —
Phone 'S 3 '; 2y Pax- A_ LE_rnail: Uccupanc) group(s): / fisting: _
CC.B no.:
City/metro lie.no.: Notice:All contractors and subcontractors are required to be
6 11117111111 So fr7i licensed with the Oregon Construction Contractors Board under
Name: ( �, �.' c .� i. 4 /j 5�r', provisions of ORS 701 and may he required to be licensed in the
3 C•' W� y<,-- - jurisdiction where work is being performed. If the applicant is
Address: exert
t from licensing,the following reason applies:
9
City: )otr o State: , ' ZIP. ZE p R R Pp '
Contactperson: < — Plan no.: v --
Phour 1r + 2•'3 '9r a I 1 . F
Dame:"jog ! r }_ a t unlad pci mill: Ires due ulwn application ........................... $
Address: S fo 1 _ Date received: __—
City: ter, li .., Stale: (,y *lip: 1;'?/.6 Amount received ................... ............I........ $
Phone: S y b 1 92 Fax: _ Email: Please refer to fee schedule,
hereby certify 1 have read and examined this application and the Nd all Iurimbrilms seep credit cards,please call jurisdiction for nnwe mfurmatinn
attached checklist. All provisions9tlaws and ur nces governing this Uv1sa U MasterCard
work will be complied with er s ••' erein or not. c•reda crud mmmbet
:spires
Authorized signature: Date: Q y t arae or cardholder ea shown on credit card
Print name: �*e'( t'ardholder elEnature $
Amnrrnt
Notice:This permit applicatit xpire�if a permit is not obtained within IAO days ener it hes been Accepted as complete "10,11 1MMK'OMr
One-and Two-Family Dwelling
Building Permit Application Checklist Reference"°.:
Associated permits:
Ciryaffigard City of Tigard ❑Electrical J 1'lumhiny J Meehanical
Address: 13125 SW Ball Blvd,Tigard,OR 97223 UOthcr:
Phone: (503) 639-4171
Fax: (503) 599-1960
Kiln
1 1
71 ---
5
7em(c completed.See jurisdiction criteria for concurrent reviews. -
ain,solar balance points,srasmic soils designation,historic district,etc.
proved plotllot.approvalrequired.Septic system permit or authorization for remodel.Existing system
6 Sewer permit. --
7 Water district approval. —
9 Soils report.Must carry original applicable stamp and signature on file or with application.
9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of
ch-basin pr,tection,etc. –
10 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state
I Ing
crxlrs. Lateral design details;rod connections must be incorporated into the plans or on a separate full-siie ✓
sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed
•opynght violations exist. —
11 St plot pt a drawn to scale.The plan must show lot and building setback dimensions;property corner elevations 1 1'
etc is more than a 4-ft.elevation differential,plan must show contour lines at 241.intervals);location of easements and
driveway;footprint ol'structure(including decks);location,it systems,utility locations;direction indicator;lot V
area;building coverage area;Percentage ol'coverage;impervious arca;existing structures onsite;and surface drainage.
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
sirs and location.
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater.
furnace,ventilation facts,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details.Show all framing-member sizes and spacing such as Iltxar txums,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,roo4 slope,ceiling height,siding material,routings and foundation,stairs,
fire lace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new constnic11011.111111i11jurn of two elevations for additions and remodels.
Exterior elevations roust reflect the actual grade it the t:ha nry it,grade is greater than four foot at building envelope.
1,1111-sirs sheet addendums showing foundation elevations�k oil cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. N1u.t indicate details and locations:for
non-prescriptive path analysis provide specifications and calx Mations to engineering standards.
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing.and hearing
locations.Show attic ventilation. _
19 Basement and retaining walls.Provide cross sectiams and details showing placement of rchar. For engineered
sv,jems,sce lteni 22."Engineer's calculations."
19 Beam cations.Provide two sets of calculations using current code design values for all beams and multiple jo
alculis
over 10 feet long and/or any beam/joist carrying a non-uniform load. =quired 20 Manufactured floor/roof trussdesign details.
7.1 Energy Code eompfianee.Identify the prescriptive path or provide calculations. A gas-piping fur four or more a fiance __22 Engineer's calculations.When required or provided,0-c_'hom a a ll, root In1W 11,dl ha•dam
architect licensed in Oregon and shall he shown to he nppl r'
JURISDICTIONAL
23 Five(5)site plans are required for Item I I above. Site plans rust he K-1/2" x I I"ur 1 I" x I"7 _
24 Two(2)sets each are required for Items 16, 19.20&22 above.
25 Building plans shall not contain red lines or jape-ons. "Mirrored"building plans will he not accepted.
26 "Reversed"building plans tnust meet criteria outlined in the Permit& System bcvarlopment I-ees document. _
27 "brawn to scale"indicates standard architect or engineer scale. _ _
29 Site plan to include tree sirs,type&location Per approved project street tree plan(if applicable),and COT Street'frec Lisl.
Checklist must he completed before plan review start date. Minor changes or notes an submitted plans ma} he in blue or black ink.
Red ink is reserved tier department use only. .a.aa 4h 14 acv MOM)
Plumbing Permit Application
----- Date received: Permit no.: -001,?'-
City of Tigard Sewer permit no.:_ Building permit no.:
Address: 13125 SW [fall Blvd,Tigard,OR 97223 Projecdappl.no.: Expire date:
City of Tigard Phone: (503) 639-4171
Fax: (503) 558-196() Date issued: By: Receipt no.:
Case file no.: Payment type:
Land use approval: --
1 '
U Multi-family U Tenant improvement
7LJ
I &2 Imuily dwelling or accessory U Commercial/industrial y J Other:
New construction U Addition/alier,ition/replaceinent U Food service
1111111111111T1 1 ' 1 ,
t
DescrF tior�__ Qty. Fee(ea.) 'Total
Job addre,�: S K - Neh 1-and 2 family dwellings only:
Bldg.no.: -- -- Suite n,: (includes loon.for each utility connection)
Tax map/tax lot/account no.: SFR(1)bath _
Lot: Block: Subdivision: G✓ n 1 P SFR(2)bath _ —
Project name: SFR(3)bath
sitZrenilipses'—
Fixtumisewer
Bach additional bath kitchen
City/county: �tSiteutillties:
Description and I tion of w on _ — Catch basin/area drain --_-
- - — Drywells/Icach line/trench drain _
Est.date of completion/;t,spe,-tirni: Footing drain(no.lin.ft.)
OR Manulacturcd home utilities
Business name: ,K K R H w e/� Manholes —
Address: Hain drain connector --_
State: ZIP: Sanitary sewer(no.lin.ft.)
City: _ - Storm sewer(no.lin,ft.)
Phone: Fax: Email: Water service(no. lin.ft.) -
Plumb.bus.reg.no: 3� -JJ
CCB no.: � -- Fixture or item:
Cityimetrolic.n: JU l Absorption valve -
Contractor's representative signature: Back flow preventer --
- -- nate Backwater valve
Print name: — -
Basins/lavatory _
Clothes washer — _ -
Name: _ Dishwasher _ ---
Address: Drinking fountain(s) _ -
Ciry; -- State: ZIP: -- Ejectors/sump --
Phony: E-mail: Expansion tank _cup --- --
Floor drains/lloor sinksA ub _—
Name(print): S� t'�tl2/ 2 Garbage disposal
Mailing address: 3Y X S Hose bibb
City��' j
� " State: ZIP: ��� Ice maker
Phorax: E-mail: Int- ve tor/greasc trap
Owner installation/residential maintenance only: The actual installation Primer(s) _ —will be made by me or the maintenance and repair trade by my regular Roof drain(commcrcial) _ --
employee on the property I o%l as per ORS Chapter 447. Sink(;),basin(s),lays(s)
Date: _ Sump
Owner's signature: -- rubs/shower/shower pan
Urinal
Name: _ Water closet —
Address: _ _ _- Water heater — --
City: State: LIF': Uthet:
——.
_ ' a'c*
Fnx: Email: lbtrtl
Phone: ---- _
Mtnunum fee................$ �.
Not all juriadicUonr accept credit card".ptea"e call jutirdicaon Im rttore infonnsuon. Notice:,this pe.nnit application Plan review, (at — %) $ --
vias U MasterCard expires if a pennit is not obtained Slate surf large(8%)....$ _------
Ctedit card numhe: — -- "puny within 190 days atter it has been TOTAL .......................$
tecccpted as complete.Named cardhol r u shown on a card $
� Cmtholder alEnutme
Amount 44("616 1611aK OM t
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTUReS (irtdividu_!D_r QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 i the dwelling and the first100 ft. QTY (ea) AMOUNT
__O
Lavatory i 16 c0 for each utility connection
— _ _ ne(1)bath �� $249.20
Tub or Tub/Shower Comb 16.60 Two(2)hath T $350.00
Shower Only 16.60 _Three bath — $399.00
Water Closet _ 16.60 _ SUBTOTAL
Urinal 16.60 _ e r-- 1
8/.STATE SURCHARGE
Dishwasher — 1660 PLAN REVIEW 25%OF SUBTOTAL
— ------ -• - --- TOTAL i
Garbage Disposal 16.60 ---- — --
Laundry Tray 16.60
Washing Machine � — 16,60
Floor Drain/Floor Sink —
T3.. ---- ,s.6o- PLEASE COMPLETE:
4" 16,60 _
Water Healer O conversion O like kind 16.60 — Quantity b Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit _ —_ — —_ Caped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
_ -- — Tub or Tub/Shower
Hose Bibs 16.60 i Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 1660 _Water Closet
Other Fixtures(Specify) 1660 Urinal
—_. Dishwasher
_Garbage Disposal
--
Laundry Room Tray
-- — — Washing Machine
__— Floor Drain/Sink: 2"
Sewer-1st 100' 55.00 — 3„ ^—
Sewer-each additional 100' 4640 4"
Water Service-1st 100' 55.00 Water Heater
Water Service-each additional 200' 46.40 Other Fixtures
_ — (Specify)
Storm&Rain Drain-1st 100' 55,00 _
Storm&Rain Drain-each additional 100' 4640
r',omrnercial Back Flow Prevention Device 4640 — ---
Residential Backflow Prey tion Device' 27.55
:alch Basin — 16.60 — -- —
inspection of Existing Plumbing or Specially 6250 — — —
Re uected Inspectionsper/fir _ COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 6525 -- --_ _ —
Grease Traps 1660 _ ------
QUANTITY TOTAL — — —
Isometric nr riser dwgram is required If
_— Quantity total is >R _ _ ------
'SUBTOTAL - - ----- —
8%STATE SURCHARGE — — ----
"PLAN REVIEW 2.5%OF SUBTOTAL
_ Required only If Ex—,& qty tntal Is-9
TOTAL $
"Minimum permit lee Is$72 50 f B%stale surcharge,except Residentiat Backflow
Prevnnlion Device.which is SIO 25•B'%+tale surcharge
..All Now Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
I:\dsts\forms\plm-fees doc 12J26/01
Electrical Permit 1-pplication
Date received: Permit no.: LT-2-0
City of Tigard Project/appl.nu Expire date:
CityufTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ _
roI &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
New construction U Add ition/al terat ion/re place nunt fJ Other: U Parlial
INFORMATIONJOB.SITE
Job address: �, >� 3 ' �Q R Bldg,no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision: p ¢.N (�,
Project name: _ Description and location of work on premi yes:
Estimated date of con lotion/ins ection
Job no: Fee Max
!e
Business name: M S - r �: „� , Uc.crfption Qt). (ca.) Total no.insp
Address: 2$2-0 M In/ — V_Aa'I New reshkntlal-single or multi-family Per
dwelling unit.Inciudc-%allaclse d garage.
City: a State: V#1 ZIP: y f V/ Service Included:
Phone: Fax: E-mail: 1000 sq Ir or le..c 4
CCB no.: // t'7 7? Elec.His.lic.no: 3'7—7 A (� Each additional Sun sy fd or portion thcrcof
_. Limited energy.residential 2
City/metro lic.no.: L ( J Limited energy,non residential 2
Each manufactured home or modular dwelling
Signature of—supervising electrician(required) ate ; _. Service and/or feeder t
Sup.dcct.name(print): Llcensdo: a�'j Servicesorfeeders-hntallation,
alteration or relocation:
200 amps or less 2
c 201 amps to 4W muI is 2
Name(print): ���� e 2✓2 re. P
Mailing_address: f 3"Y I V HJ 401 amps to 6W amps 2
s 601 amps to 1(NN)amps 2
City: g �- Slate:V f ZI P: y o fv Over 1000 amps or volts - 2
Phone: -313- y Fax: I E-mail: Reconnrctonly _ -- I
O�cner installation:The installation is being made on property I own remlwwaryscrilcmorfeeders
which is not intended for sale.(case,rent,or exchange according to Installation,alteration,orrciocation:
200 amps or less 2
OItS 447,455.479,670,701. 2111 amps to 41X1 amps --- _ 2
Ops ner's signature: Date: 401 do 6W mn s 2
Branch circuits-new,alteration.
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: Slate: ZIP: B. Fee for braach circuits without purchase
of service or feeder fee,first branch circuit: 2
Phone: lax: E-mail: --
Bach additional branch circuit
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U licahh-care facility Each pump or irrigation circle 2
UService over l2(lamps-rating of I&2 UIlarardoushxation Each sign or outline lighting_ 2
family dwellings U Building over MAN)square feet four or Signal curuit(s)or a limited energy panel.
U System over 600 volts nominal mese residential units in one structure alteration,or extension*
U Building over three stories U Feeders,4(N)amps or more •fkscri urns:
U Oucupam load aver 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
U Egrexs/lightinpld:ud U Other: —__--- Per inspection
%uhntit sen of pians with tiny of the obove. Itivestiliallonfee
be almve arc not applicable in temporary condruetion service. Other —
Not all jurisdictions wcepd credit cants,please coil jurisdiction rda mar inhmttalim Notice:This permit application Permit fee..... ...... . ......$
U visa U Mastercard cspires il'a permit is not obtained Plan review fat _ %) $
credit card number __._ _ —__ ._L_� %%dthin 180 days after it has been State surcharge(8%)....$
fixpires accepted as complete. TOTAL . S _
Name cs of res shown on credit c
Cardhofdet signature e AmounlLL 440-4611 MKI[ flkl)
Mechanical-Permit Application Permit no.
Date received:
City of Tigard Projecdappl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: :eiptno.:
Phone: (503) 639-4171 LBuild:ing
file no.: Payment type:
Fax: (503) 598-1960
permit no.:
Land use approval: - —
MUM
Ll 1 lir,2 family dwelling or accessory U Commercial/industrial
U Multi-family LJ Tenant improvement
U New construction U Add ition/a;tcration/replacrmc[it U Ocher: limilow
I �
1
iIndicate equipincnt quauttttc:,in boxes below.Indicate the dollar
Job address: �e r
Suite no.: value of all mechanical materials,equipment,labor,overhead.
Bldg•no.: — profit.Value$
Tax map/tax lot/account no.:
Black: Subdivision: Q 'P n t � 'See checklist for important application information and
Lot:
jurisdiction's fee schedule for residential permit fee.
Project name: - I t
City/county: ZIP;
I 1
Description and loci(ton f wor on premises: pee(ca•) Total
- lk-A-ription Rrs.onh' Rcs.onl�
Est.date of completion/inspection:
Tenant improvement or change of use: Air handling unit ___CFM-- _ - -
Is existing space heated or conditioned?U Yes U No Air conditioning(site plan require )
Is existing space insulated?'J Yes U No A tcration of existing system - I
of er compressors
State boiler permit no.:
Business name: ry�a "� k�' n cunt IIP Tons_-BTU/11 — ---
Address: — r_1 r,'i '�' ire smo a clamper. uct smo c electors
City: Stale: ZIP: eat pump(sne p an rcqurreJ
— nsta rep acefurnac burner
—
Phone: fax: E-mail: Including doctworkivent liner U Yes U No
CCB no.: /''J.( '/ __-_ _- nsta /rep ac relocate caters-suspen e
City/metro lic.no.: — wall,or floor mounted _ --
Vent or a t iance other than furnace
Name(please print): a gerat nn:
CONIV PERSON Absorption units _ __-_ If H I I _
Chillers
Namc: --- coni ressors-
Addis —-_ nv ronmenta ex ust an vent at on:
('icy. Al,phancc vent
Phone: 1 Gmail; Dryerex aunt --Hoods,Type res. tc en/hazmai
Vic hood fire suppression system ---
Name• e/[ Exhaust fan with single duct(hath fans)
CJ .x iaust system a art frorn hcatin or AC
Mailing address: 3 tJ /r v L: Ue p p nR an st ut on(up to out ets)
Blate:
ZIP: _LPr _ No --- tail ---
TYpc:
Phone: Fax E Innil: Muc i in g each a itiona over 4 outlets
3 _
rocessp p ngtsc rcmaticrrywre I - —
Number of outlets -
Name: t er ,it app once or equ pment:
Address: Decorative hreptacc _
-- -State: ZIP: Inscti-typc
City: — - - to stm�e pe et stove _—
Phone-- Fax: E-mail: (n tcr.— —
Applicant's signature: ^ _ Date:
Name (print): _— $ -
- Permit fee................. ---
Nd all)urirdicliom occerN credit card+,pease cnll)udadlcarxr for m to intrxrnath n Notice:'Phis permit application Minimum fee................$ _ -
U visa U MasterCard expires if a permit is not ohtaincd Plan review(at —. %) $ --
t rcdu card number: -- L_-L- within IRO days after it has been
I / State surcharge(8%) $
_
—
- _ _—m—o-c_r'ardCold_er-aS
accepted as complete.
—
440-1617(60KOM)TOiAI .......................
Amount
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION PERMIT FEE: - Description:
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Prt� Total
$5,001.0U to X10,000.00 $72.50 for the first$5,600.00 and 1) Furnace to Mechanical
BTU Qry LEa) _ Amt
$1.52 for each additional$100.00 or includin ducts&vents 14.00
fraction thereof,to and inciuo(ng 2) Furnace 100,000 BTU+
$10000.00. includin ducts&vents
x10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furna-e 17.40
$1.54 for each additional$100.00 or including vent
fraction thereof,to and including 4) SuspendFd heater,wall heater 14.00
$2
$25,000.00. _ or floor m junted heater 5,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit 14.00
$1.45 for each additional$100.00 or
fractio,1 thereof,to and Including 6) Repair units 6.80
$50,060.00.
$50,001.00 and up $742.00 for the first$50,000.00 and12.15
Check all that apply; Boller Hoar Air
$1.20 for each additional$100.00 or For Items 7.11,see or Pump Cond y
fraction thereof. footnotes below. Comp ••
Minimum Permit Fee$72.50 SUBTOTAL: $ - 7)<3HP;absorb unit --
__ to 100K BTU 14.00
8%StatO Surcharge $ --- 8)3.15 HP;absorb -
_ unit 100h to 500k BTU 25.60
25•/.Plan Review Foe(o%subtotal) $ 9)15-30 HP;absorb
R_equlrecl for ALL commercial permits on unit.5-1 trai BTU
TOTAL COMMERCIAL PERMIT FEE: $-- 10)30-50 HP;absorb 35.00
- unit 1-1.75 mil BTU 52.20
----- 11)>50HP;absorb -
_ _ unit>1.75 mil HTU 87.20
ASSUMED VALUATIO__NS PER APPLIANCE: 12)Alr handling unit to 16,060 CFM -
Desai>t lion; Qt Value Total 10.00
Furnace to 100,000 BTU,Including EAmount 1d)Air handling unit 10,000 CFM+ -
955 -
ducts&vents 14)Nen-portable evaporate cooler 17.20
Furnace>--I- 000 BTU Including 1,170
ducts&vents 15)Vent fan connected to a single duct 10.00
Flr furnace inin vent b55 oociud
SiSi ispended heater,wall heater or955 16)Ventilation system not included In 6.80
floor mounted heater appliance permit
Vent not Included in appliance 10.00
�ermlt 445 17)Hood served by me,a,anical exhaust
_Repair units �--
absorb.unit, 805 1 j Domestic Incinerators 10.00
to 100k BTU 955 1740
)Commercial or industrial type incinerator
3-15 hp;absorb.unit, 1,700
19
1013 to BTU __ 20)Other unll�, wood stoves 6B 95
15.30 hp;;a absorb.unit,501k to 1 2,310 � 'Including 10.00
frill.BTU 21)Gas piping one to four outlets
30-50 hp;abs- orb,unit, - 3,400 -
1-1.75 mil.Bl'U 22)More than 4-per outlet(each) 5.40
>56 hp;absorJ.U unit, _5,725
>1,75 mil.BTU Minimum Permit Fee$72.50 SUBTOTAL; 1.00
Air handling unit to 10,00` 658 $
Alr handlin --t>1 000c, " 1 170 I 8%State Surcharge
Non- ortabie evaporate cooler 856
Vent tan conntto sin Is duct TOTAL RESIDENTIAL PERMIT FEE:
Vent system emnotoiincluus 446
ad In 856 $
ap�lan�enriit
Hood served by mechanical exhaust
Domestic incinerator 656 titer a ctigne and Fees:
1,176 1 Inspections outside of normal business hours(minimum charge-two hours)
Commercial or Industrial incinerator 4,590 $62 50 per hour
Other unit,Indu.. Ing wood vs a et s, 858 2 Inspections for which no fee Is specifically indicated (minimum charge-half hour)
Inserts etc. $62 50 per hour
Gas I In 14 outlAdditional plan review required by changes,additions or revs ions to plans(minimum
Each additional outlet 380 _
charge-one-half hour)$82 50 per hour
63 State Contractor Boller Certification required to,units>200k BTU
TOTAL COMMERCIAL : `*Residential A/C requites site Clan showing placement of unit
VALUATION: __
All New Commercial Buildings require 2 sets of plans.
1:ldst8lfom1slmech-fees.doc 02/11/07.
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST L _ 6)(2 2,-2- 1
INSPECTION DIVISION Business Line: (503)639-4171
BLIP —
Received ____ Date Requested-- AM__ PM BUP
Location _--�`t I a G' �:-� I / —suite_ MEC ._.
Contact Person __ -- �`� '`"�� - Ph( ) � �� '� PLM
Co ctor._ Ph ( ) _. SWR
Z4
imp
Tenant/Owner _ _ ELC —
ELC
oundation Access: �� t',
Ftg Drain (.77ST _ ELR
Crawl Grain
Slab Inspection Notes: SIT
Post& Beam
Shear Ancho-s
Ext Sheath/Shear —
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ----- -�
Fire
Susp'd Ceiling -- --- -
Roof
ART FAIL'MMKNG —
Post& Beam
Under Slab -- -- —�. --— ---
Rough-In
Watur Service ---- ---- ---- -�
Sanitary Sewer
Rain Drains - __- --- —
Catch Basin/Manhole
Storm Drain _..---
Shower Pan
Other:Final
Othe
PASS PART FAIL
MECHANICAL __— ---- -..-
[lost&Beam
Hough-In ----- ---------__.__- — _— — _.— —
Gas Line
Smoke Dampers ----- — --- ------
Final
PASS PART FAIL -------- - --` _ --
_ELECTRICAL -- ----- -- - --- — — --,--
Service
Rough-In --
UG/Slab
Low Voltage ---------- - --- -----
Fire Alarm
Final El Reinspection fee of$ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd
PASS PART FAIL
SITE _ _-- F] Please call for relnsp ction RE: —_.-_ _---_._- Unable to inspect-no access
Fire Supply Line
ADA
Date
Approach/Sidewalk —_ Inspector
Other-
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIOARD 24-Hour,
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received ." Date Requested_ S S AM —PM _ BUP _
Location _ 141 �L b 14 2 Z3 Suite. 161EC —
Contact Person Jl Ph(—) PLM —
Contractor__ Cj- -- Ph( _) _ SWR _
BUILDING Tenant/Owner ELC _
Footing ELC _
Foundation Access: -
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes- SIT
Post&Beam -
Shear Anchors ----
Ext Shnath/Shear
Int Shoath/Shear
Framing
Insulation
Drywall Nailing -.----- - -- ----- _
Firewall
Fire Sprinkler --- ------- - ----- ----
Fire Alarm
Susp'd Ceiling ------ - - -
Roof
Other: _ -" - ----- -
Final
PASS PART FAIL - - -- - -"--
PLUMBING
Post&Beam - _---- .- --- --V ---
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 Lire
Smoke Dampers - --• _ -
Final
PASS PART FAIL --�
ELECTRICAL
Service -- -_..------- -- - ----
Rough-In -
UG/Slab
W
❑ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ART FAIL_ ❑ Please call for reinspection RE: ❑ Unable to;aspect-no access
Fire Supply Line 'l
Approach/Sidewalk Drvtfar }.moi G Inspe L - �✓�' :��S.
Other:Final DO NOT REMOVE this Inspection record fr m the job
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST �� Z
INSPECTION DIVISION Business Line: (503)639-4171 BUP
Received _� t Date Requested_— AM —PM BUP
Location `� Z 0 - -Suite_ MEC
Contact Person _— — Ph(- ) � —� — PLM
Contractor — — -
— Ph( ) _— _ SWR
BUILDING Tenant/Owner —__ — ELC
Footing ELC _
Foundation Access: ELR
Ftg Drain
Crawl Drain SIT
Stab Incaection Notes:
Post&Beam - -`
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear
Framing
Insuta,ion _ -
Drywall Nailing — ---- /
Firewall
ire —
e_ pnnkler — -
Fire 7�farm -
Susp'd Ceiling ------
Roof _ -
Ot r:
PASS PART FAIL
Post&Beam
Under Slab -----
Rough-In - -- -
Water Service ---� - - _
Sanitary Sewer -
Rain Drains ---- ^-
Catch Basin/Manhole -- -
Storm Drain —
Shower Pan -
O
Sj PART FAIL
"RANICAL -- - -- --
Post& Beam _-
Rough-In -- -
Gas Line _ -
Smoke Dampers - - --- -- ---
Final _-
PASS PART FAIL -- — - -
ELECTRICAL ---------_------ _-_
Service
Rough-In _-_--_--------
UG/Slab --
Low Voltage - - --
Fire Alarm
Final F] Rein:pection fee of$. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please rail for ieinspeclion RE: Unable to inspect-no access
-- -
Fire Supply Line Q
ADA Dlte " /�G3 �Ileeldr ------ - Ext
Approach/Sidewalk !`--- - —
Other:
Final DO NUT REMOVE thIS Impeetloe record from the job site.
PASS PART FAIL ji
CITY OF TIGARD 24-Hour
BUILDING ` Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171
Q;�(0 BUP
Received _ Date Renested ��- '�-� AM _-_ PM BUP _
Location Z - ?7 -�f Suite- MEC --
Contact Person _— _ ��� Ph( )7t _ 2 6 PLM
Contractor-,,- Ph( _) SWR _ —
UILDI _ TenanbOwner __, - ELC _
067ing ELC _
Foation Access: �Q� �' ELR -_-
Ftg Drain
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam _ _--._-_-_—
Shear Anchors - -
Ext Sheath/Shear
Int Sheath/Shear
Framing ------- ----------- - -- - ---- -----
Insulation
Drywall Nailing --- -- --__-_
Firewall
Fire Sprinkler - -- - ---- --- -
Fire Alarm
Susp'd Ceiling -- -- ----- --
Roof
Other:
AS PART FAIL -� �_-- _-- ---- -__-. -- _
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service -
Sanitary Sewer _ --
Rain Drains ------ --- ---- - -- - --- -_------ -- -
Catch Basin/Manhole
Storm Drain - . -- ------ -- ---- -- ---- -
Shower Pan
Other. — - --- -- -- - - --- ---------
Final -----------
PASS PART FAIL ---- -- ----- ----�---- --
ECHA_N ..AL
Rough-In
Gas Line
SrnQ.ke Dampers
%LSD
PART FAIL
-
ETRICAL
Service
Rough-In ------ ------- -- ---- ---- - --
UG/Slab
Low Voltage _
Fire Ala m -- -
Final ❑ Reinspection fee of$_ -..__regfiired 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
ADA -
Approach/Sidewalk DrKfa
Other:
Final -- DO NOT REMOVE this Inspection record from the job site.
r PASS PART FAIL
CITYOF T I GA R D - BUILDING PERMIT
DEVELOPMENT SERVICES DATE IS UIED: 8/25/03 3-00507
13125 SW Hall Blvd., Tioard, OR 97223 (503) 639-4171
SITE ADDRESS: 14120 SW 131 S I' TERR PARCEL: 2S109AB-08000
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: _LOT: _009 _JURISDICTION: TIG
REISSUE: FLOOR AREAS A EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S E: W:
TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: st OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKSREQUIRED
FLOOR LOAD: pst LEFT: ft RGHT: ft _ FIR SPKL:_ SMOK DET:---
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,615.00
Remarks: 158 sq.f,. deck
Owner: Contractor:
PEVZNER CONSTRUCTION PEVZNER CONSTRUCTION LLC
l,"070 SW TAPADERA ST 13470 SW TAPADERA ST.
HEAVERTON, OR 97006 BEAVERTON, OR 97008
Phone: 503-313-2466
Phone: 503-313-2466
Reg : LIC 148853
FEES _ _ REQUIRED INSPECTIONS__
Description Date A Amount Footing Insp
�Itl II I)I I1runii Fes 8/25/03 $72.50 Framing Insp
I \18'%,State"fax 8/25/03 $5.77
Final Inspection
M I'PI.N) Pln Rv 8/25/03 $4687
Total °;125.14
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done In accordance with approved plans. This permit will expire it work is
not started within 180 days of issuance, or if worts is suspended for more than 180 days. ATTENTION: Oregon law
requires you to fallow the rules adopted by the Oregon Utility Notification Center. Those niles arc set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-6699 or 1-800-332-2344.
Issued By:
Pe mi ittee
Signature: 71>
/Call 639-4175 by 7 p.m. for an inspection the next business day
I ISE
NILY
Building Pcrn;iit Application Received ' OFFICE Building ,
Date/By: Permit No..
City of Tigard Planning Approval- LL Other
DateB Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: -. .. Permit No.:
Phone: 503-6394171 Fax: 503-598-1960 kDate/B
st-Review Land Use
Internet: www.ci.ri ard,ot.us : Case No. ,g ntact Juns- See Page-for
24-hour Inspection Request 503-639-4175 me/Methid: Supplemental Information
-
�t N TY F OF RK ., ti' D
l-1 New co_nstructtonEl Q Demolition .. A 1.
Y r
- — -- ; 1 DLT.1�Y(Y
Addition/alteration/re lacement 7 Other:
:• ' j Q 'If)( _ Note: Permit fees"are based on the total value of the work performed. Indicate
&2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor,
overhead and profit for the work indicated on this application.
Accessory Building ❑ Multi-Family
Master Builder Other: Valuation................... ..................................... $
sa. B h P; OR TTON and CUATION. "� No.of bedrooms: No.of baths:_—
_�_— _ - —
Job site address: I 2 D 5 t-J f-3 4e ri!', Total of floors.... _
New dwellin%elfin g area(sq.ft.).........................•....
Suite#: Bld ./A t.#: Garage/carport area(sq. ft.)............................
Project Name: Covered porch area(sq. ft.)...................•......... -_
Cross street/Directions to job site: Deck area(sq.ft.)............. ........•.....•.•............
Other structure area(sq. 1t i ..........................
Subdivision: Pave- 101 _ �; c— Lot#: -
Tax ma / arcel #: Note: Permit fees*are based on the total value of the work performed. Indicate
~•r ` RIPIhION t7P r` --77,7",.' the value(rounded to the nearest dollar)of all equipment,materials,labor,
-- overhead and profit for the work indicated on this application
Valuation......................................................... S
- Existing building area(sq.ft.).........................
_ -- - ------— - New building area(sq. ft.)...............................
Number of stones............................................ --
'R 'Type of construction........I.............................. _
Name: -!&e 2 1 t ? V 2 n f R Occupancy group(s): Existing: !^
Address: 3 "1 - /l 0 E 0-' 3d New:
City/State/Zip: l3 cove'n 610,_
Phone: >o s S�9_f 3 6z Fax: NOTICE: All contractors and subcontractors are required to be
DNTAC�11 EIt3AN — licensed with the Oregon Construction Contractors Board under
if] AMM�ANT- = -• n provisions of ORS 701 and may be required to be licensed in the
Business Name: [e V /7+'k Q�<✓rf e�r , jurisdiction where work is being performed. If the applicant is exempt
Contact Name: SF oy2/?4-o' from licensing,the following reason applies
Address: / `/ ?-® S ctl ] A /���L pe — —
Cit /State/Zi --
Phone: 31 5,79 43 6 2 Faxv - -, -- --- 77 -
- BUILDING PERMIT FEES*
E"mail• Please refer to fee schedule•
Business Name: /' Fees due upon application
Address:_ •3 `f> 5-w 7 A s t
City/state/zip: —Aear Q-/, 9 11'0 1 o Atnuuni received......... ..... .......... .... ........... .
Phonef 03 Date received:
CCB tic. ---
Authorized Notice: This permit rppllcatfnn expires If a permit Is not obtained within
Signature: _— � — Date' 2S f 180 days after It has been accepted as complete.
C,�1 A e, Q *Fee methodoingy set by Tri-County Building Industry Service Board.
----�
(Pleasi p t name) --- �—
i 111stsiTermit Forms\BldgPermitApp.doc 01103
One-and Two-Family Dwelling
Building Permit Application Checklist Referenceno.
Chyofrigard City of 'Tigard Associated permits:
Address: 13125 SW Hall Blvd,'I igard,OR 47223 C3 Electrical ❑Plumbing O Mechanical❑Other:
Phone: (503) 639-4171 --_––-- –
Fax: (503) 598-1960
t
I Land use actions completed.Sec jurisdiction criteria for concurrent reviews.
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel.Existing system capacity
ti Sewer permit._
7 Water district approval. -- —
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control U plan 0 permit required.Include drainage-way protection,silt fence design and location of
catch-basin protection,etc.
10 3 Complete sets of legibi plana.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 be completed
if copyright violations exist.
I I Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if
u, re is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot
area;building coverage area;percentage of coverage;impervious area;existing stnrctures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing 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 secdon(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 be 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 insulation,etc.
15 Elevation views.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.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-pnoscriptiveeppath analysisrovide specifications and calculations to engineering standards, _
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing
locations.Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems,see item 22,"Engineer's calculations."
19 Ream calculations.Provide two sets of calculations using current code design values for all beams and multiple.joists
over In feet long and/or any heam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details.
21 Energy Code compliance.Identify the prescriptive path or provide calculations.A gas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall he shown to he applicable to the project under review
.11 IR ISDICUIONAL S11 Ull I.WS
23 Five(5)-s i le plans are required for Item 1 I above. Site plans must be 8.1/2" x I I"or 1 I"x 17".
24 Two(2)sets each are required for Items 16, l9,20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accepted. —
26 "Reversed"building plans must meet criteria,outlined 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. 440.4614(60YCONU
— — _S 0'1507 v;
—77 ---�
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MAIN FLOOR R
EL _100 0
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GARAGE
I EL :995'
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it
1 4' CONC '
DRIVEWAY �I
I3500 PSII
\ — N 0'05'57' . �
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S W 131st TERRACE
04/05/02 tPW
. lan C{� �S�C� y 4•..
t , r, CITY OF 11GARD 2258BA
RAVEN RIDGE
LOT 9
Al"A r.,scoao Of LCH•ssocuTfs "c PEVZ`�ER RESIDENCE
/5.161 so fI
CITY OF TIGARD-SITE PLAN RFV1rW
BUII.DING PERMIT NO.:
PLANNING DIVISION' 7
Required Setbacks' C4-Ap"o%ed (] Nol AM-,m vd
Side: .__ tirr�rr dirt, _!O--
Fruitt. -15-._ 1 �ar.►u. v Ktar S
Visual 0carntrcc ,V-Aliprovcd 0 Not Appr"► ,:d
MaN irtium Huilrliug Haight .4 feet
CWS `iervicc pnwi,icr I..crser Rrrlurrrd: 0 Ye. ,�Na
❑ Received
I3 : �' 4� l.C4ti-rim 1►u! `R. 57-o'?
It I*Ni ENT:
Actua�. `lig Ir.'. _ .--"o I& nhpr,rvcd ❑ Not Approved
`ii!c I'lau �3 Appruvcd ❑ Not Approved
+_, . Date: -o
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It
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EL :100 0'
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m v� m01
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CL :99 5'
1 d'• CONTI m
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!]500 PSI I — !�'•
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0'o5'5W
ti
S W 131st TERRACE
04/05/02 TPW
�f;�V115$Q�.•� rr. 5r.. .iTY OF TIGAAo �L58BA
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CITY OF TIGARD z4-H`wr
BUILDING Inspection Line: (503)639-4175 MST -
INSPECTION DIVISION Business Line: (503)639-4171
X
BLIP
Received - Date Requested �...- AM_. X PM BLIP
r Suite _ - 3- 00
Location --�._ L.- --fit ---L 5' _—_--- -
Contact Person Ph(—____) 7L3 y� PLM _----
Contractor-_- _- _ - ____-- Ph( ) _ -- - SWR
ILDI i Tenanvowner — _ - ELC
-Footin, ELC
Foundation Access:
Ftg Drain y\1 6-iz ��. �j t EI.R --
Crawl Drain SIT
Slab Inspection Notes: --
Post& Beam -------- -- - - _. ..--
Shear Anchors
Ext Sheath/Shear ---- --
Int Sheath/Shear
Framing �, '_ _ ,- ---------- - --...---- -----_-----
Insulation
Drywall Nailing ----- --------._.-.__.._----.___--__-_-
Firewall
Fire Sprinkler -- ---�---- -
Fire Alarm
Susp'd Ceiling ---
Roof
Other: -- - -
Final
PASS PART FAIL,
P_LUM6ING ----
Post& Beam
Under Slab ---- - --- - — - -
Rough-In
Water Service ----- -
Sanitary Sewer --
Rain Dreins - —
Catch Basin/Manhole -
Storm Drain - -- - ---- —
Shower Pan
-
Final --
PASS PART_ FAIL
- HANI L — _-
am
Rough-In ----
Gas Line
Smol Dampers - ---- -- ---- -- - ---
SS PART FAIL --
Service
Rough-in - --- - _-- --- - _---_
UGiSlab
Low Voltage —._ ----- --- ----------- -- -- -
Fire Alarm
Final n Reinspection fee of$-. _ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
�ASL--*� RT FAIL
_G�--- Unable to inspect-no access
SITE Please call for reinspection RF:-- - �..�
Fire Supply Line 7
ADAData �_ f� Inslpecto
Approach/Sidewalk. r
Other:
Final DO NOT REMOVE this Inspection record ram the Job site.
PASS PART FAIL
SEE., 35MM
ROLL #21
FOR
OVERSIZED
DOCUMENT