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14195 SW 131ST PLACE cD U1 N w y 0 W 14195 SW 131't Plate C=ITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 Z OS� <_MST �– INSPECTION DIVISION Business Line: (503)639-4171 ` BUP Received — Date Requested—�! aJ AM — PM pUP _ 1 Location `'j �( pG� Suite MEC __-- Contact Person C'-��-�� -a-� Ph(-) U ( PLM Contractor Ph( ) SWR BUILDING Tenant/Owner _— — _ ELC Footing CLC Foundation Access: Ftg Drain ` ELR Crawl Drain Slab Inspectiontes SIT Post&Beam __ —,-- Shear Anchors -- — Ext Sheath/Shear Int Sheath/Shear Framing -- — Insulation Drywall Nailing — Firewall 2C Fire Sprinkib• v Fire Alarm Susp 4 Ceiling ------- — Hoof Other: — Final PASS PART FAIL PLUMBING Post&Beam Under Slab - ------ --- ----------- -- Rough-In Water Service ------- --- --- ---——_—� Sanitary Sewer Rain Drains -- -- ----- -- --- — Catch Basin/Manhole Storm Drain Shower Pan Other:_ --- --- - —------ --- — F-FAAM PART FAIL --�----------------_�__ _�—_ — LCHA_N_IC_AL -- ------- - --- --.�—. _ -- - --- Post&Beam — Rough-In ------ _—_. - - _ —_— ------ — — Gas Line Smoke Dampers ---- --- ---------- — - --- — _ — Final PASS PART FAIL ELECTRICAL Service Rough-In --- UG/Slab Low Voltage — ----- �.-- - —..-- -- — Fire Alarm Final Reinspection fee of$__— required before next Inspection. Pay a'City .call, 13125 SW Hall Blvd. PASS PART FAIL_ SITE [] Please call for reinspection RE: ,Jneble to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date /�v __.. Inspector Other: Final DO NOT REMOVE this Inspection record from the)rrb site. PAS 8 PART FAIL b BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Businessline: (503)639-4171 MST BUP _ Received Date Requested_ L�3 AM., _ PM _ BUF _ Location Lel Suite MEC Contact Person --_-_-- �t�j��Qs Ph(�_-----) S -<v l PLM ---- Contractor Ph( ) __— SWR el Tenant/Owner — _ -___ ELC ruundation ELC Ftg Drain Access: — Crawl Drain �l"` ELR — Slab Inspection Notes: SIT Post& Beam Shear Anchors Ext Shrath/Shoar Int Sheath/Shear -- --- - --- Framing � Insulation - Drywall Nailing --- �� r✓ C� / rC�'�/S C�Q.'Y` Firewall rA- <Fife Sprinkleyli Fire Alarm Susp'd Ceiling ---------------.----- Roof -- ---- -- - Other: PART FAIL - - - ------.. -- [I�PASS INC Post&Beam - - -- Under Slab Rough-In Water Service -- Sanitary Sewer / Rain Drains ____._ Catch Basin/Manhole Storm Drain _ Shower Pan Other: Final PASS PART FAIL - --- vIECHANICAL Post&Beem •- Rough-in Gas Line — — Smoke Dampers Final --- "- PASS PART FAIL --------- -- _ ELECTRICAL Se,viceRough-In _ UG/Slab — -- — -- I_ow Voltage Fire Alarm "� ----- —_—.— Fin it ❑ Reinspectlon fee of d required before next Inspection. 13ay at City Hall, 13125 SW Hall 910. PASS PART FAIL SITE ❑ Please call for reinspection RE: F\ �.-, ❑ Unable to inspect-no access Fire Supply Line ADA (`. Approach/Sidewalk �� ---- Inspector _. Ext Other. — Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL i r 0 � n 0 o rn G� rn CA -will rn � X m rri m Io m n rn D cli rn T c• O � � 8 a WOJd 7d Wdt t:90 aoop- 90 'das 06£b609£0S 'ON XUA � C O O a 0 _ •` AI� L T3 W O V� 'r►.`+. r �o O Cry ^O A ^r Qe i �O �0 / CITY 0TY C—IffT i GA R D _ _PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#.: PLM2002-00200 13125 SVV Hall Blvcl., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/5/02 SITE ADDRESS: 14195 SW 131ST PL PARCEL: 2S109AB-08800 SUBDIVISION: RAVEN RIDGE -ZONING: R-7 BLOCK: LOT: 017 JURISDICTION: 'IG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: _ _ URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS- RAIN DRAIN: ft Remarks: Installation of irrigation back flow preventer. FEES Owner: - Type By Date Amount Receipt ROYAL CONSTRUCTION PRMT CTR 6/5/02 $36.25 27200200000 16655 SW IVY GLENN ST. BEAVERTON, OR 97007 5PCT CTR 6/5/02 $2.90 27200200000 — Total $39.15 Phone 1: 50?-649-0778 Contractor: ANCTIL PLUMBING INC 16900 SW MERLO RD BEAVERTON, OR 97008 REQUIRED INSPECTIONS Phone 1: 503-642 7323 RP/Backflow Preventer Reg #: LIC 24184 Final Inspection PLM '16-162PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 1,452-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: f ,' Permittee Signature Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 05/29/2002 10:08 5036427755 ANCTIL PLUMBING PAG, Plumbing Permit Application City of Tigard I� Permit no Qac Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permitno.: Building pemlitno.: CiryojTigarJ phone: (503) 639-4171 Project/appl.no.: Uptrcdate, i Fax: (503) 598.1460 Date issued: ByL Rece - ipt no.. ---- Lartd use appr;tval: Case file no.: Payment type. i A 2 family dwelling or wvessory U c'ommervial/Induvrrial O Multi-family I ❑Tenant improvement U New construction ktldlttor✓alreraticn>/rrhlarr.ment 0 P(xxi wrvice I LI Other Joraddresa: I y l`�S 5 t�I 13 ! 5f_ L_!{ E Descrl tirHt I rr ca.) 'rota( Bldg,no.: _-- 1 Suite no.: New I-and 2-f y Tdwdlings uly: `— -`-- (Includes l00 R.for each visit(y co on) Tax map/tax lot/account no. _ - Lor Block: -_� - -- i FR (I)bath - Subdivision: SFR(th — Project name_ e 1. C%ur•�SSV( 0►-� SftJt(31 baht— -- Cit /county: ZIP. Each ukldlhcmal bath/kitchcn— — - Description and location of work on premises: _ lgltentWfles: I -` rr� �. � �L, IJ Catch hasin/are-a drain I Bat.date of com letion/inspection. jjj�D '(' ench dune �- fin.ft.) Business name. tilities Address: n•I c J Cc d'1 o d r Lb "PD. wain 3nttn orrnc-' tot -- City: State: Q 7Jp_3 pip Saru sewer no.lite..ft. - Phre; Fax S E-mail: tornt sewer(no.lin.ft.) CCB no.: Z�-f I SN Plumb.bris,reg. o: z6 Water service no.lin. City/rrteUo lie.no.: _ Matures or Item Contractor's reptcseutative signature: ,�� hso tion valve ('tint name; 1I,t Dats:s-Z A Hack flow pl>±vrntnl . ! — Hackwatcr valve 1 � aa1n.02vatory --� Name. -,-- Clothe,,wisTier f5is WaC K'try _ State: Zpp; -- Nil cfin r f`cnmta-fou 1'flttllC: FA l: bjectors/sum mail I.ut sion� — �.--.yam_ Fixture/sewer cap Na7M ., Fluor inn ns/ :�:r:«,e«� Mais— — Stant: 21P Nose i Phone: 1FA.x: &mall: -__. ce r Owner install tial maintenance only: e scar instal atian �_ ree(pt�c�r Th will be made by me or the ntaintesiancc and lepair made by my re-gulm. f crnployee on rhe property 1('w'1 a s per(SKS Chapter 447. ( ink(.+)•Iris;n s, ays(i)—�- Ownces st nature; pate: Tubs/showcl/ ower pan Nairn' Unnal Address -- Cit _�_— -_-- I Z:Ills .p Phono: Fax; Email; Na is IcMdtr+cotr Reulpl creNt canal,pore Ia tall lsttZ700 rm Inas htAtReal. O Visa UMatee('tvd Notice:This permit uppllcatlan Minimum{fix . ,.,,,•.,,,,,•$ _.3G.•Z,5 cewat cad eannAa expires if a hermit is not obtained Plan revidw(at _ %) S -- - , - within Ito days after it has heen State accepted as ccxnplete TOTAL I....... aau�ele tAAIetDMt CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE HOTWIRE ELECTRIC INC. 2020 NW ALOCLEK, #120 HILLSBORO, OR 97124 Electrical Signature Form Permit #: MST2001-00565 Date Issued: 1110/2002 Parcel: 2 S 109A B-08800 Site Addres3: 14195 SVV 131ST PL Subdivision RAVEN RIDGE Block: Lot 017 Jurisdiction. TIG Zoning: R-7 Remarks: New SF detached residence FIRE SPRINKLER ARE REQUIRE Your company has been indicated as the electrical contractor for the permit indicated above. In order for the 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 electrical inspections will be authorized until this completed form is received 01/\rNf_ R ELECTi:ICAL CONTRAC I UR: ROYAL. CONSTRUCTION HOTWIRE ELECTRIC INC. 16655 SW IVY GLENN ST. 2020 NW ALOC LEK, #120 BEAVERTON, OR Q7007 HILLSBORO, OR 97124 Phone # 503-549-0778 hone # 503-533-5452 Reg # LIC 146276 34654 C SUP 4487S AN INK SIGNATU7ZE IS REQUIRED ON THIS FORM X Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY, OF TIGA►RD _ MASTER PERMIT T PERMIT#: MST2001-00565 DEVELOPMENT SERVICES DATE ISSUED: 1110102 1'125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 14195 SW 131ST PL PARCEL: 2S109AB-08800 SUBDIVISION: RAVEN RIDGE ZONING: R-7 BLOCK: LOT: 017 JURISDICTION: TIG REMARKS: New SF detached residence FIRE SPRINKLED ARE REQUIRE BUILDING REISSUI STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 30 FIRST: 1.302 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: v TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 950 a1 GARAGE: 1,242 of FRONT 20 PARKING SPACES TYPE OF CONST: 5N DWFLLING UNITS: 1 FINBSMENT: of RIGHT: 7 OCCUPANCY GRP: R7 BDRM: 3 BATH: 3 TOTAL: 2252 00 of VAL E: $236,061.60 REAR: 43 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHEHs: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: t GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN c 100K: BOILICMP<3HP: VENT FANS: 5 CLOTHES DRYER: 2 GAS FURN-100K, 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES! TENTS: + WOODSTOVES: GAS OUTLETS: 1 L ECTRICAI_ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUSAOD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMP/IRRIGATION- PER INSPECTION: EA ADD'L 5003F: 5 201 400 amp: 201 400 amp: lit WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVCIFDR: 601 • 1600 amp: 601+8mpo•1000v: MINOR LABEL: 1000+amplvoll: Reconnect only: PLAN REVIEW SEC''ON --- >•4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS ARCAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIU d STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE hIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: 1,THR: HVAC: DATA/TELE COMM: NURSE.CALLS TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,166.31 This permit is subject to the regulations contained in the ROYAL CONSTRUCTION ROYAL CONST. Tigard Municipal Code,State of OR. Specialty Codes and 1065E SW IVY GLENN ST. 16655 SW IVY GLENN ST. all other applicable laws. All work will be done In BEAVERTON,OR 97007 BEAVERTON,OR 97007 accordance with approved plans, This permit will expire If work Is not started within 180 days of Issuance,or if the work Is suspended for more than 180 days. ATTENTIOf Phone: Phone 515.6011(ceu) Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep#: LI(. 171534 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 Rough In Gas Line Insp Water Line Insp Grading Inspection Post/Beam Structura! PLM/Underfloor Framing Insp Gas Fireplace Sprinkler Rough-In Sewer Inspection Post/Beam Mechanica Mechanical Insp Snear Wall Insp Insulation Insp Sprink'er Final Footing Insp Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Gyp Board Insp Ap r/Sdwlk Insp Foundation Insp Crawl Drain/Backwater Electrical Service Low Voltage Rain drain"p, to anal lFisued By : �� i�� /r y%, �_ _ Permittee Signature T Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGAR® _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SV'JR2001-00317 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/10/02 SITE ADDRESS; 14195 SW 131ST PL PARCEL: 2S109AB-08800 SUBDIVISION: RAVEN RIDGE ZONING: R-7 BLOCK: LOT: 017 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNi1 S. 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new SF residence. Owner: FEES ROYAL CONSTRUCTION 16655 SW IVY GLENN ST. Type By Date — Amount Receipt BEA.VERTON, OR 97007 PRMT CTR 1/10/02 $2,300.00 27200200000 INSP CTR 1110102 $35.00 27200200000 Phone: 503-649-0778 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections I 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 ali directions from the distance given. If not so located,the installer shall purchase a "Tap and Side Sewer" Perm Issi,gd byE , _.�. �� --: Permittee Signature;. Call (503) 6394175 by 7:00 P.M. for an Inspectlon needeMhe next business de., �F�".+, lir"�tTl l�-'__. ,, c-1 ; /G • Building Permit Application n J` � � Z. ; f �.It� Of Tigard / -' t,,tereceived: /l h f' 1 Permit no.:/11/,/ ��'' l i �C-I Address: 13125 SW Hall Blvd,'I'i ard,(N�-9%223 Project/appl.no.: Expire date: Ci{v q/'Tignr,t R Phone: (503) 639-4171 Uate issued: fiy: 1 � Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: TYPE-OF 11"F1161 I I 116 1 &2 family dwelling or accessory U Comrnercial/induu,t,tl U Multi-family U New construction U Demoh'ion U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: JOB SITEINFORMATION Job address: / IT 1"2 A Bldg, no.: Suite no. t.ot: Block: Suhdivision: Tax map/tax l0t/3CL ant no.: Project name: Des:ription and location fwo4 on premrs s/spccia ,con1 ons: r� Name �y rp, Mailing address: r I & 2 family 6sellilig: City: t �y State: ti - 'LIP: C (� Valuation tit work......... . `j Phone: q. . - r - Fux: !:•moil: -�— Y.�f bedrooms/baths."............................... r Owner's representative.; Total number of floors V� ; Phone: F•ux: E-mail: - Z New dwelling area(sq. ft.) .......................... Z Z_ -- i r Garage/carport area(sq. ft.) —/1_ `/ Z_ Covered porch area(sq.ft.) ......................... G Mailing addres4: - ��` :r Deck area(sq. fc) ..................................•..... 1� hn -- Other sinrcture area(sq. ft.) _ City: r�. �,�`trl Stair: ZIP ......................... Phone: (•- T Fax ( E-mail: ('ommercial/industrial/multi-family: LIN KI Valuation of work...........................•....• •..... $ Business name: 61)j , ,, 7� C• Existing bldg.area(sq. ft.) ........•. Address: ,c- :, -, e ._ ..n I New bldg.h.area(sq. ft.) ............... Cit Nunlhe:r of Stories ............... • Y� � 1 Sate: 7..IP�C,' Phone: Y Fux: E moil: I.Y[v of construction-,..... ....••.. ,.......... CC13 no.: I l c, � Occupancy group(s): Existing: City/metro lic.no.: r ti.: —— — New: _ Notice:All contractors and subcontractors are required tube licensed with the Oregon Construction Contractors Hoard under Name: (V Am f-t,Y .( (,, ( _ provisions of OILS 701 and may he required to he licensed in the Address: `:fir';—t t� �, jurisdiction where,work is being performed. If the applicant is City: (t.), Starc: ?.IY: exempt from licensing,the foll,)wing reascn applies: C onlact person 1 I' flan no.: L-Ic -- -- - f'Innu11i mail - -- Name: Cuntuct pr:rsnn: Fees due'upon application $ Address: � - i - .........................•� --------- y Date received: City_ r Soule: Amount received .......... $ I'hnlr ` Fnx_ E-until: Please refer to fee schedule hereby certify I have read and examined this application and the Not all Judwhi:tlan wcetN credit VZKq,pteam C'_ .•;. row,mxr inl,mnnn,m attached checklist. All provisions of lavia'fiVor4ininces governing this U Visa U MaMeWard work will be complied wi lc04crein or not. credit Caro number G iporn Authorized signature: -( /. i.� Date: - - r u wn nn crc!ucad Print Hume: — -- An>nun, Notice:This permit applie,tuuu cxpir.. if a permit is not obtained within 190 days after it has been accepted s<complete. wo.•,— „sly Plumbing Pennit Application "Datereceived: Permit no.: &Lm _{fir t City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/a I no.: Expire date: ctn q(/i/and Phone: (503) 639-4171 pp' Fax: (503) 598-1960 Date issued: By: Rer,ipt no.: Land us--approval: Case file no.: Payment type: 1 "I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: --_ _—- 1 1A I i s li A7rM=1 Dc•�ccri rtiou _ Qty. Fcc(ea.)_ T Bldg•no.: total Job audress: ' t � 1 1 1" �_ - - New 1-and 2-family dwellings only: xttle no - (includes 100tt.foreachutilityconnection) Tax map/tax lothr no.: �` -- SPR (1)bath - - - Lot: �t �, ,k: Subdivision: SFR(2)bath Project name: I cJ SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description I atio f ork rem's s: Site utilities: _ I �j { ;� Catch basin/area drain late of completion/inspection r:Ywells/leach line/trench drain Footing in(no. lin.ft.) Manufactured home utilities —_ Business name: _ Manholes Address: 7.c • . ( Rain drain cannectot City: ' State: 7..IP: C Sanitaryserver(no.lin.ft.) Phone: c -i 1� Fax: E-mail: Storm sewer(no.lin.ft.) CCB no.: Plumb.bus. no: _a Water service(no. lin.ft.) Fixture or item: City/metro lic.no.: Absorption valve Contractor's representative signature: I/ Back now revenler Print name: '",�-• e: C' Backwater valve�ffq 10 F1111111 MidlIM: asins/lavatory Clothes washer _ Name: Dishwasher Address: _ t S t Drinking fountain(s) — City: S ate: ZIP: Y' Ejectors/sump -^ I'honc rl c" Fax:t1 :'t l moil: Expansion tank fixture/sewer cap Fluor drains/noor sinks/hub Name(print): 'l Garbage disposal — Mailinc address: n- -city: - _ Hose bibb - City: State: ZIP: _ Ice maker Phone: Fax: E moil: Interco torlasc tea Owner installation/residential maintcnancc only: The actual installation Primer(,) will be,made by me or(lie maintenance and repair mado by my regular Roof drain(comtr• rcial) employee on the property I .)wn as per ORS Chapter 447. Sink(,). lasin(s),!a Owner's signature; __ ___ Date: _ Sum _ ubs/shower/shower pan _ lJrinal _ _ Name: _ _ ater closet Address: -- Water heater — City: _ State:_ ZIP: Ot cr: Phone: Fax: E-mail: ota -�� Minimum fee................$ Not all}oda l,.+ns n:ceM cmtll canis,pleau call Jurlydicuon for more inforrtut{on. Notice:This permit applicdtion Plan review(at %) $ ._._ U Visa U MastetCard expires if a permit is not obtained O CmAll card mmber: _._ within 180 days atter it has been Tsurcharge(896) ....$ _. —�--- xp{res --�d- eaten Rder u shown on c h cud s accepted as complete. TOTAL .......................$ Cardholder sig"twe Amoort Mn-1616(NUM'0MI PLUMBING PERMIT FEES: -- PRICE TOTAL New 1 and 2-family dwellings FIXTURES (IndividualL QTY_ _Jea AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. OTY (ea) AMOUNT 16.60 for each utilityonn cection)_ _ One 1 bath $249.20 --- - - 16.60 ---- - - $350.00 Tub or TublShowr r Comb. Two 2ZbaBt - -- — -- - Three(3)bath $399_00 Shower Only 16.60 _------ � - -- — Water Clasel 1660 - _SURTO i AL Urnal 1660 8%STATE SURCHARGE Q:shwasher -- 1660 PLAN REVIEW 25%OF SUBTOTAL _ rb Gaage Disposal 1C+60 -___-TOTAL Laundry 1rav 16.60 Wabhing Machine 16.60 Floor Drain IoorSink 2.' 16.60 PLEASE COMPLETE: 4-,-- - -- 1660 ---- - — Water Heater O conversion O like kind 16.60 _ Ouantity b Work Pertonned Fixture Type: New Moved Replaced Removed! Gas piping requires a separate mechanical Capped permit. -- MFG Hunte Now Water Service 46.40 Sink MFG Home New San/Storm Sewer 4640 Lavato --_-- — — . _ Tub or-1ub/Shower Hose Bibs 16.60 _ Combination Roof Drains 16.60 Shower On-y _— Drinking fountain 16.60 Water Closet —_ Urinal --- [ether Fixtures(Specify) — 16.60 DishwasherV - — -- — --- _Garbage Disposal - - - -- - _Lar n Room Tray ----- -_ - -- Washing Machine — Floor Drp;n/Sink: 2" _ Sewer-tsl 100' 55.00 --` 3^ --- Sewer-each additional 100' :+46 4o �____— 4" -- Water Service-1st 100' — 5500 u ater Heater -- Olhsr Fixtures Water Service-each adrtilional 200' 46 40 (Specify) Storm 8 Rain Drain-1st i00' --- 55.00 Storm&Rain Drain-earl(additional 100' 46.40 - Commercial Back Flow P^vention Device 4640 ----- -- 1 teaidenlial backflow Prevention Device' 27.55 — alch Dasln 1660 Irspeclion of Existing Plumbing of Specially 72 50 .<eueq siod Inspections _ - perthr COMMENTS REGARDING ABOVE: Pain Drain,single family 'hng 65.25 G 9abe Trope ---- --' 16 60 --- ---" ------ -----�--GUANTITY TOTAL - - — - -----_--_ _--_— Isometric or riser diagrain Is required II Quantity Total is >0 _ __— "SUBTOTAL --'--- 81/6 STATE SURCHARGE ---- -- ---- - -- ""PLAN REVIEW 25%OF SUBTOTAL - Required only II fixture qty total is>9 TOTAL .Mir'�rum permit fee is$12 50•R%state surcharge,except Residential Baon. Purvendon Device,which la$39 25•9%stale surcharge ""All New Commercial Buildings require 2 sets of piens with I%ometrlc or riser ningram for pian review. 0dstr\fofms\plm-fees.doc 08/29!01 I`a m Electrical Permit Application Date received: Permit no.:/ City of Tigard Project/appl.no.: Expiredate: Gry„f, ,,ard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 pate issued: By: Receipt no.: Fax: (503) 598-1 Q60 Case file no.: Payment type: Land use approval: irviaiir'6117 PERMIT. &2 family dwelling or accessory U Commercial/industrial J Mulct-0,011)11) U'f cnant improvement U New construction U Addition/alteration/replacement U Other: iJ Partial .1101111 Sirl E'INFORMATION Joh address: I Suite no.: Tax map/tax lot/account no.: Lot_ Block: — Subdivision: Project name: Description and location of rk on premises: p 3 Estimated date o1'completion/inspecoo n. 4 fyr r Job not rtY• ata. Business name: - i M�.�� -__ De.kcriplion (fit, (ea.t Iota) no,insp Address: - - ` v� VrN n-%his-ilial-singk or multi-faml!r per dNelfingunil.Inchvie%anachedgatrane. OILY: Slate: ZIP: tienitriuelutled: Phonc: Fax: E-mail' — t1N)sq.rt.or less 4 C'CB no.: L U I G� , �r - Each additions)SW s .ft.or onion the �Iec.bis. lic.no: Limited energy,residential 2 ('ity/metro l M._ Limited energy,non-residential 2 _ Ench manufactured home or modular dwelling Signnturc f rvlsin a eclrician(required) - (laic / C � Service and/or(ceder 2 Sup.elect,name(print). ( License no G' Services orfeeders-Installation, alleration or relocation! ff 2W amps or lest, Nam,-(print): �Yt�N�-<' �yh 201 amps m.400 amps -- — 2 - - --- Mailing address: At-e 401 amps 10 600 amps - 2 City: State: 601 amps to 1000 amps 2 ZIP:�3 �0C Over I(KX)amps or volts - - - — - - 2 Phone: r 9, 1 FaX: E-mail: Reconnectonly - I (honer installation:The installation is being made on property I own Temporary services orfredem- which is not intended for sal 'rete, 'AAlinge according to Installation.alteration,orrelocallon: ORS 447,455,479,670.' 2(10 amps of less 2 201 amps to 4(X1 amps 2 Owner's si mature: tale: 101 to 600 amps 2 .L Branch circuits new,alteration, Name: or ratension per pr A: I -- A. Nee for branch circuits with purchase of Address: service or feeder fee,each branch circuit t City: —State: ZIP: H. Fee for branch circuits without purchase Phone: h'ax: F-Iitail: of service or feeder fee,first branch circuit: 2 Lach addithn it branch circuit: - Misc.(Service or feeder not included): U Service over 225 amps-conmterciat U health-care facility Lach pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous IIx•ation Fach sign or outline lighting - - 2 farm'.Dwellings U Building over MAN)square fret four of Signal circuit(s)or a limited energy panel U syst, "over((X)Volo nominal mere residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders.400 amps orn4xe •Ikscrition-_ U(kcupant load over IMI twtm, s U Manufactured structures or RV park Fich additional imspectlnrl Ilrrr rhe aII11NaIdr in a111/1f rite AIN/1 P: U Ngress/lightingplan U Other -- per mspe,u.nl -- -- Submit_- sets of plans wish an.,orthe above. L---1— Invrstignllonfee The above tree not appilcabie to temporary construction service. (nher - - --- Not nil J uiHhctionA crept cretin cants,plense can iruiuhchon Irn nuxr IntixntnUtMt Notice:This permit application Permit fee U visa U MastrWard expires if a permit is not obtained Plan review(al _ ri;) $ Credit cool nutntwt —_ within 180 days after it has been Stale surcharge(8%),...$ - Name of cExpires accepted as complete TOTAL . S ttn�iohlrt u shown—an c Ir creel W-� _- C�hol r sl�c--pulure�---- s AmMarl 440 4615(6101 W1)A11 ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below Restricted OF WORK INVOLVED -RESIDENTIAL ONLY Restricted Energy Fee...................................................... $75.00 _Number of Inspections pet,permit allowed (FOR ALI.SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-rjer unit 1000 sq n ui less $145.15 _ 4 ❑ Audio and Stereo Systems' Each additional 500 sq it or portion theieol $33,40 —__ 1 ❑ Burglar Alarm Limited Energy $75.00 L_ach Manufd Home or Modular Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 Imps or less $80.30 2 201 amps to 400 amps $10685 2 ❑ Vacuum Systems' 401 amps to 600 amps _ $160.60 2 601 amps to 1000 amps $240,60 _ 2 ❑ Other _ Over 1000 amps or volts _ $454.65 _ 2 Reconnect only _ $6685_ _ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Instalation,alteration,or reloco Zinn Fee for each system.......................................................... $75.00 2C,)amps or less __ $66.85 2 (SEE OAR 918.260-260) 201 amps to 400 amps _ _ $100.30 2 401 amps to 600 amps _ TT133 75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Brar,ch Circuits ❑ New,alteration or extension per panel Boiler Controls a)1 tie fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee Eac ri branch circuit _ $6.65 _ 2 ❑ Hata Telecommunication Installation h)the fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $48.85 Earh additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle __ $53.40 ❑ Each sign or oulline lighting $53.40 Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension _ $75.00 ❑ Landscape Irrigation Control' MinorLabels(10) $125.00 _ Medical Each additional inspection over ❑ the allowable in any of the above ❑ Par inspection _ $62 50 _ Nurse Calls Per hrur __ $62 50 In Plant $73.75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees g Other 8%State Surcharre $ _ _ Number of Systems 25%Plan Review Fee See"Plan Review"sechrui nn $ ' No license%are reeuired L ifnnses are required for all nther Instalbflofm front of application -- ----- - - Fees: Total Balance Due g -- ---" Enter total of above fees S EJTrust Account N 8%State Surcharge $ Total Balance Due $- All New Commercial Buildings require 2 sets of plans. i:\dsts\fhtM\eIC-fM.dnc 09/30/01 Mechanical Permit Applicatiop Datereceived: Permit no.: f /� City of Tigard Project/appl.no.: Expire date: City of Tigard 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: --- --_ -- _ Building permit r — mommol all 1 I &2 family dwelling or accessory U COIlnrlerCMUI11dustrial U (`lulu t,unilc LI Tenant improvement U New construction U A(fdilion/alteration/replacement U()dict. _ SCHEDULE Job address._� S Indicate equipment yuautities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead. profit. Value Tax map/tax llot/account110.: I.ot: Block: bdivision: e - 'See checklist for important application information and Project n me: - jurise'otion's fee schedule tier residential permit fee. City/county: ZIP: NOON Descri tion locate n work on emises: �_1 I I 3t 5li-r,I Total Fsl.da :of completion/inspection' �Lf P' I S Ikwcription _ (jly. Rry.only Res.only A(': Tenant improvement or change of use: `� Air handling unit CFM Is existing space heated or co�n��di}�'onedT L' Yes U No Air conditioning(site plan reywr 1d))-- _ Is existing space insulated'/U`Yc s U Nu Alteration o existing AC syst im - oi . compressors State boiler permit no.: Business name: 11 0, ►,� � !'YV�� HP Tons IFF1.1/H Address: = _ it smo c amper uctsmoke detectors City: I �' ) State(7ZIP: cl 2 are require ) Phone: Fax: E-mail: nsta rep ace urnace urner /f Including ductwork/vent liner U Yes U No CCI C71 nstall/rep ace re ocateeaters-susp�enc suspended, City/metro lie.no.: _— — wall,or floor mounted Name(please print): Vent fill a r lianceof ter than furnace Refrigeration: Absorptionunits______ _ BTU/H Name: i4 7J Chilbrrs_- III' Compressors III' Address: tx_ Environmental eximusl and vent lar on: City: Slate: ZIP: Appliance Veto - Phone: Fax: E-mail: )ry e-x- aust 0o s, ype /res. itc tell-/ia�mal hood fire suppression system _ Name: fixhaust fan with single duct(bath fans) T :xaV-St sy:dem a earl from hentin g or A Mailing address:___ 166CI-17 T •uelpiping and d1#41ribution(up to 4 o ut ets) City: t M Slate: 7I Type. LI'l; NU __ C rax: AAE-mail: Fuelpiring each c additional over 4 outlets sProcess pVptng(schematic requirec) Number of outlets Name: l er 1lst app trace or equipment: Address: DLcoralivefireplace _ City: Slate: ZIP: _ Insert-type _ - oo siov pe et stove .—Lax:Phone: x: E-mail: -- (A er: Applicant's signature: --- Date: Name (print): _— W4 01)udarticlimli accept cerdil crud+,plena•call turiNliction fill nxxr InlormntiunPermit fee.....................$ _ U Visa U MasterCard Notice:'11iis permit application Minimum fee................$ — expires if a permit is not obtained Plan review(at -- %) $ t'ndn ctrd mantle( _- ---- ---- .xpirea - accepted as complete. 190 days alter it has beenlete. State surcharge(9%) ....$ - — ane of r n r a s own mann creditcr�i-- s P ' p TOTAL .......................$ -- _ Cmarolder signature ---- --Amount ")4617 MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 i&2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Oty (Ea) Amt $5,001'.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or including ducts&vents 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 $125,001.00 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 680 fraction thereof,to and including 6) Repair units $50,000.00, _ 1215 $50,001.00 and up $742.00 for the first$50,000.00 and Cneck all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7.11,see or Puinp Cond fraction thereof. footnotes below. Comp •• Minimum Permit Fee$72.50 100K to 100K SUBTOTAL: $ 7) absorb unit BTU 14.00 8%State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb -- Required for ALL commerclalLermita onl unit.5-1 mil BTU _ 35.00 TOTAL COMMERCIAL PERMIT FEE: $ 10)30-50 HP;absorb unit 1-1.75 mil BTU 52.20 ____ unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM - �- -- - - - 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description: Qty E) Amount Furnace to 100,000 BTU,Including 955 17.20 ducts&vents 14)Non-portable evaporate cooler _ Furnace>100,000 BTU Including 1,170 10.00 ducts&vents 15)Vent fan connected to a single duct Floor furnace including vont 955 -� - 6.80 Suspended heater,wall heater or 955 -- 16)Ventilation system not included In floor mounted heater appliance permit ___ _10.00 Vent not Included In applicance� 445 17)Hood served by mechanical exhaust hermit .__._----- 10.00 Repair units 805 18)Domestic incinerators -- <3 hp;absorb.unit, 955 17.40 to 100k BTU 19)Commercial or Industrial type incinerator 3-15 hp;absorb.unit, 1,700 ---- _ 6995 101k to 500k BTU 20)Other units,including wood stoves 15 30 hp;absorb.unit,501k to 1 2,310 -- - 1000 mil.BTU 21)Gas piping one to four outlets 30-50 hp;absorb.unit, 3,400 5.40 1-1.75 mil.BTU 22)More than 4-per outlet(each) >50 hp;absorb.unit, 5,725 - _ _ 1 00 >1.75 fill.BTU Minimum Permit Fee$72.50 SUBTOTAL: $ Air handlln ug nit to 10,000 cim Air handling unit>10,000 cfm _ 1,170 8%State Surcharge $ Non- orta',Ie evaporate cooler 658 Vent fan connected to a single duct 446 - ` TOTAL RESIDENTIAL PERMIT FEE: $ -Vent system not Included In 656 appliance permit --'- Hood served by mechanical exhaust 656 Other Insuecttons and Fees: Domestic Indnerator 1,170 t Inspections outside of normal business hours(minimum charge-two hours) - $72 50 per hour Commercial or industrial incinerator 4 590 2 Inspections for which no fee is specifically indicated (minimum charge-half tour) Other unit,including wood staves, 656 $72 50 per hour Inserts,etc. 3 Addit,onol plan review required by changes,additions or revisions to plans(minimum Gas piping 1.4 outlets360 dinar -one-half hour)$72 50 per hour Each additional outlet 83 'State Contractor Boiler Certification required for units>200k BTU. TOTAL COMMERCIAL -Residential AIC requires site plan showing placement of unit. VALUATION: _ �Y- All New Commercial Buildings require 2 sets of plans. I\dstsVonnsUnech-fees doc 08/29/01 i I I i rr tg' i I --_3200 __`�h"-- � r I r I i I I I I � I � I s 01 I '•0 51n 'VAIN FLOOR EL�5t1.0' I ald 1 _j_ Ebob' GARAG •, El_6020"'. �` I 504 " •0 I DfiWEWAY -- Oe �..—_. �' T' a 0'05 67• V4 X'K:{';�r SAP �— �(�— — po6 S2 00 -.---� ►9 I 7y�9� S W 131ST PLACE I '2f/01 MRR /29/01 MRR A E Z- ;I 011gr!1A0uhRW- Ip WI b" �ccwkr d rN re•e.,p'0 CITY OF TIGAFp 22109 MIR t °�M "�'01�"'o'M HAVEN RIDGE at0��r0�l4ir�u f(tt D0M)'tp1�p .:%Z./� R'filµ•�110 NNY0(0�E10 1 LOT 1) 14196 SW 13181 PALCE BY - CHARLES KIM /..wry w .i.r.wr .�.•...rrv. 51061 So, fl.