14229 SW 131ST PLACE i
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14229 SW# 131"' Place
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 `
I:dcPECTION DIVISION Business Line: (503)639-4171 (11�0
1
B U P
Received _ Date Requested�� _� z-_ AM PM— BLIP
Location --
_ Suite MEC
Contact Person -c-��y�. Ph( ) I'7- 3��r PLM _
Contractor Ph( ) _ SWR
'ITenant/Owner_� — ELC
Footing ---- - -_.
cuodation IAccesELC
=tg Drain s:
Crawl Drain ELR
I slab
Post& Beam Inspection Notes: SIT
Shear Anchors `----- -- -- ------ --
Ext Sheath/Shear --
Int Sheath/Shear
Framing
Insulation
Drywall Nailing C.; LA r
F irewal I -----�--
F ire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
in
AS ART FAIL
Pos Bean. ---- - --- -- _- --_ -- - _
Under Slab
Rough-In
Water Service
Sanitary Sewer --- _
Rain Drains
Catch Basin/Manhole —� - —
Storm Drain --
Shower Pan -
Other. -
_S PART FAIL + -- A I L
Post& Beam — - -----.__--
Rough-In
Gas Line
Smoke Dampet 3
Final —
PASS PART FAIL --
ELECT_RICA�_ ----
Service -- -------------- - -
Rough-In —
UG/Slab - ---- ---
Low Voltage
Fire Alarm —- ----- _
Final r •
PASS PART FAR L-� Reinspection fee of$__-__-_,__—_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE n Please call for reinspection RE:___
Fire Supply Line --- ------------ �] Unable to inspect-no access
ADA ?/Z� /d - (�
Approach/Sidewalk E.ate /- ( �- Inspector e Y
Other: —
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTI DN DIVISION Business Line: (503)639-4171
BUP
Received __ __e Date Requested, 3) AM____ PM BLIP
Location -__ 2- Z ;/ -3 l .dam �L Suite-_ MEC
Contact Person Ph 7 V PLM
Gentractor __—� ___ -_ _ Ph( _) SWR
BUILDING Tenant/Owner _ — _ ELC
Footing ELC
Foundation Access:
Ftg Drain / � ' - ELR
Crawl Drain '
4-!:Ly V�
Slab Inspec o Notes: SIT --- --__ --- --
Post& Beam
Shear Anchors —
Ext Sheath/Shear
Int Sheath/Shear
Framing _ -- ---- -------- ---- - -- -
Insulation
Drywall Nailing ---- - -- -------- —
Firewall
Fire Sprinkler ---- - -- ----- --- -- ---
Fire Alarm
Susp d Ceiling -- - ------- --- -
Roof
Final
_PASS PART FAIL
PLUMBING
Post& Beam
Under Slab
Rough-In
Water Service ---
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain - -
Shower Pan /
Other: - -
Final
PASS_PART FALL - ----- - ---- --__ - - --- -- - _. - - -
MECHANICAL — ___ _-- _- -----
Post& Beam
Rough-In
Gas Line
Smoke Dampers
Final
P 8S PA FAIL_
=ECTRIC.A
Rough-In
UG/Slah
Low Voltage
Firs Alarm
mal\ f Reins c ction fee of$_—_-.______ required before next inspection, Pe at Cit Hall, 3125 SW Hall Blvd.
S _ AT FAIL l-� P q� P Y Y
Please call for reinspection RE:_-______-_.._-.--_.....____- --_-_ [A Unable to inspect-no access
Fire Supply Line
ADAZ �� `L J �f�,---'
Approach/Sidewalk Date - - 3 - Inspector f _Ext
Other:
Final - DO N"IT REMOVE this Inspecti: ., record from the Job site.
I PA,S PART FAIL
F NU'1 FAX N0. : 503 697 4533 Mar. 04 2002 07:59AM F�
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CITY OF TIGARD 24-Hour
BU;LDING Inspection Line: (503)639-4175
INSPEC JON DIVISION Business Line: (503)639-4171SI --_
/
BLIP _-
Received �� Date Rec;uested 7 d�' _ AM_ — PM BLIP
s+-
Location 7�7- % Suitc —_ MEC
Contact Person - �--R-= Ph(___ ) 6r/7- i6 C.,.� PLM -
Contractor __- _ Ph(__ ) SWR _ - �_-
UILDIN Tenant/Owner _,-_�._ -_ E L C
Foundation ELC
Access:
Ftg Drain ELR _
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation -"-
Drywall Nailing
Firewall
Fire Sprinkler - -
Fire Alarm
Susp'dCalling
Roof
Other: _ Q
-mass ---PART AIL �� ---���
LIMBI _ _- �' - � � 01 '� V �` V%A-.0-N 0
-Patrleam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains - -- __-- -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
PASS PART A.:
_ ECHAN
Post&Beam
Rough-In
Gas Line `
rS e Dampers
nal i
_ SS PART FAIL - - -
RICAL
Service --- -- - --- ---- --- -
Rough-In
UGiSlab
Low Voltage
Fire Alarm --- --�- -
Final Reinspection fee of$______�_-_._required before next inspection. Pe at Ci Hall, 13125 SW Hall Blvd.
PASS PART FAIL L- P� q p y ry
SITE _ Ij Please call for reinspection RE: ❑ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dots �V Z, _ Inspoetor-_ `� L^v _--_----- ExtT l
Of ier.
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
/ ���� �� ������ MASTER PERMIT
PERMIT#: MST2001-00400
DEVELOPMENT SERVICES DATE ISSUED: 8/1/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-417
SITE ADDRESS: 14229 SW 131 ST PL PARCEL: 2S109AB-08600
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT:015 JURISDICTION: TIG
REMARKS: New SF detached. Fath 1 fire sprinkler require
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,370 of BASEMENT: of LEFT: 7 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 922 at GARAGE: 430 of FRONT: 31 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 F'NSSMENT: of VALUE: S 212.025.00 RIGHT 5
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,29.00 of REAR: 19
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
L4VATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: GARBAGE LISP: i WATER HEATERS: 1 WATER LINES: 100 BCKFI W PREVNTR: I GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<IOOK: BOIL/CMP<3HP: VENT FANS: 4 CLOTHES DRIER: 1
GAS FURN>•ICPK: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1
MAX INP: btu FI.00R FURNANCES, VENTS: 1 WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR I.eS9: 1 0 200 amp: 0 200 amp: WISVC OR FDR: I FUMPIIRRIGATION. PER INSPECTION.
EA ADD'L SOOSF: 4 201 400 amp: 201 400 amp: tat WIO SVCIFDR: 00 SIGNIOUT LIN LT: PEP HOUR:
LIMITED EI:ERGY: 401 600 sing): 401 • 600 amp: EA ADDL OR CIR: SIGNAI.'PANEL: IN PLANT:
MANU riMISVCIFDR: 601 • 1000 amp: 6014Impr100Ov: MINOR L 48IS1.:
1000+amp/volt: PLAN REVIEW SECTION
Reconnect only: a a 600 V NOMINAL: CLI AREA/SPC OCC:
>•4 4E3 UNITS: VCIFDR>•225 A.•
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL _ B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT'
BURGLAR ALARM: OTFI: BOILER: HVAC: LANDSCAPEnRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL.: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
TOTAL FEES: S 6,830.96
Owner: Contractor: This permit is subject to the regulations crvltained in the
SHARONE O'MARA SHARONE O'MARA Tigard Municipal Code, State of OR Specialty Codes and
2 OSWEGO SUMMIT 2 OSWEGO SUMMIT all uther applicable laws. All work will be done in
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 accordance with approve I plans This permit will expire it
work is not started within 180 days of issuance,or if the
work Is suspended for more then 180 days ATTENTION
Phone: ahnna: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Ceniar. Those lulea are set
Reg r, uc 124527 forth in OAR 952-001-0.00 through 952-001-0080. You
may obtain copies of these rules or direct questkuns to
OUNC by calling(503)248-1987.
REQUIRED INSPECTIONS
3-Erosion control Insp& PostlBeam Structural Plmrundslab Insp Electrical Rough In Gas Line Insp Sprinkler PouQh•In
Grading nspection PosVBeam Mechanics PLM/Underfloor Flaming Insp Gas Fireplace Sprinkler Final
Sewer Inspection Underfloor Insulation Mechanical Insp Shear Wall Insp Insulation Insp ApprlSdwlk Insp
Footing Insp Crawl Draln/Backwater Plumb Top Out exterior SheathinE Insl Italy drain Insp Electrical Final
Foundation Insp Footing/Foundation On Electrical Service Low Voltage Water Line Insp Mechanical Final
Issued By : Ai� - Permittee Signature:: �" e
�` Call(503)639.4175 by 7:00 p.m.for an inspection needed the ndit business day
CITYOF T'IGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES
PERMIT#: SWR2001-00201
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/1/01
SITE ADDRESS, 14229 SW 131 S1 Pl_ PARCEL: 2S109AB-08600
SUBDIVISION: RAVEN RIDGE
ZONING: R-7
015 _ `JURISDICTION: TIG
TENANT NAIVIE: — --
USA NO:
CLASS OF WORK: NEW FIXTURE UNITS:
TYPE OF USE: SF DWELLING UNITS: �
'NSTALL TYPE: LTPSWR NO. OF BUILDINGS: 1
IMPERV SURFACE:
Ownsr: Remarks; Sewer connection for new SF detached.
SHARONE OWARA _ FEES V
2 OSWEGO SUMMIT Type By Date
LAKE OSWEGO, OR 97035 Amount Receipt
PRMT CTR 8/1/01 $2,300.00 27200100000
Phone: 503-697-4385 INSP CTR 8/1/01 $35.00 27200100000
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
ermit
180 days from the date issued The total amount paid will be forfeited if the permit expires The Agency dues notres
guarantee th ;^ccur icy of the side sewer laterals. If the sewer is not located at the measurement given,the installer
shall prospE i - !%;et in all directions from the distance given. If not so located, the installer shall purchase a"Tap and
Side Sewer Permit and the Agency wil! install a lateral. ATTENTION Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952.001-0080.
You may obtaln copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issby: '
-�—_: Permittee Signature;
Call (503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day
�W o/ —O d•c; /
Building Permit Application
City of Tigard —F/ Date received:la/2 fl,4/ Ponritno.4/5rZOA/-00`!0C
City oj'I'igurd
Address: 13125 SW Hall Blvd,Tigard,OR 97 '3"—`- Project/appl.no.: Expire date:
Phone: (503) 639-4171 Date issued: B Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: 1&2 family:Simple Complex: �-
I i &2 family dwelling or accessory U Commercial/industrial U Multi-gamily , �Iew construction U Demolition
U Addition/alteration/replacement U Tenant improvement 0 Fire sprinkler/alarm J Other:
JOB SITIF INFAMMION
Job address:
Bldg.no.: _ Suite no.:
Lot: 15 l DGS Tax map/tax lot/account no.:.2_T/,j 3-0,04 -N
Project name:
Description and location of work on pt smises/special conditions: /✓- 7
Name: -_59A( _(,Zr/A2 Q ' Val
Mailing address:�Z__ oS _ T - 1 &2 family dwcllinf:
ZIP:p tatp Valuation_ of work...e!,. K....... r: . $
Phone:V05 Fax:so q7- E-mail: No.of bedrooms/baths................................. .—Z--
_ 2•5
Owner's representativeg�AJIE,�/ 5C40C� $f Total number of floors..................
Phone 3 I:tx 531 -Of10 G.mail: New dwelling area(sq ft.) ... .... � ��--
Garage/carport area tsq• ft.)...... . ... .....I..... 430
Mailing addra� �� - Deck area st . ft.% ..(..p.. ..�...�... .........
Name:g �_— Covered porch i areas . ft.) ......' ...✓.. ...... _
City: State: ZIP: Other structure arca(sq. ft.)................... ... �_
Phone: Fax F mail ('ommercinUindustrlaUmulti-family:
MValuation of work...................................•.... $
Business name: A Existing bldg.area(sq, ft.) .......•.... ............ -
-- ' New bldg.area(sq. ft.) ..........
Numberof stories..••..........•...... .................
City r/ State ZIP:q 7 Type of construction —
_ E-mail: .....•........ ...... ........g:
Phor�� - Fax I ' —
UB no.: I Z4 517 -- Occupancy group(,): Ez .tin
New:
City/metro lie.no.: Notice:All contractors and subcontractors arc required to he
licensed with the Oregon Construction Contractors Board un•'2r
Name: SC�iioMA�I. 514IJ L l�(1K provisions of ORS 701 and may he required to he licensed in the
Address —�,• �� jurisdiction where work is being performed. If the applicant is
Cit 1' exempt from licensing,lire following reason applies:
Y: TL State: ZIP: 5�
Contact person: L,Tcl Plan no.: V1 — --- --
Phone:2tj (� Fax: r- ILO [i-mail: ------___-- __-- ---.___--
Ogg W
Name: ?41x/1 C0AjS0LjMj4 I Contact person: M,4 pe Fees due upon application ........................... $
Address: l-:� S4 5•E• l z Co A q Date received: _ _-
City:CLjV,6AN4S state: 7.1P: 7 S Amount received ......................................... $ __
Piwnr:� ?�S7 Fax:(.gA- E-mail: Please refer to fee, schedule.
1 hereby certify 1 have read and examined this application and the NrM dl Jurirliclioru"credit cardr,Meaw till)uris&tlnn im mm inflxttmion.
attacht:d checklist.All provisions of laws and ordinances governing this U Vita U Masteif'srd
work will he complied IN ,whether ecified herein or not. e•redu cord number
l:+tplra
Authorized sign L� L etc: -. N �r r reedit cord
Print name:---- � E_ �'MA1e Q — c.rdbotn�slp,u
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 44046u(tiMWOM)
One-and Two-Family Dwelling
Building Permit Applica lion Checklist Reference no.: —
Associated permits:
City t ffigard City of Tigard U Electrical U Plumbing U Mechanical
Address: 13125 SW Ball Blvd,Tigard,OR 9723 U Other: —_
Phone: (503) 639-4171
Fax: (503) 598-1960
I Land use actions completed.lice jurisdiction criteria fur cwwurrent reviews.
2 Zoning.Flood plain,solar balance points.seismic soils designation,historic district,etc.
3 Verification of approved platllot.
4 Fire district__.____approval required.
—3-Septic system permit or authorization for remodel. Existing system capacity
6 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 U permit required.Include drainage-way protection,silt fence design and location of
_ catch-basin protection,etc. _
10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes.Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
il'copyright violations exist. _ —
I I Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(it'
there is more th)ut a 4-11.elevation dilTerential,plan must show contour iines at 2-ft.intervals);location ofersemcnis and
(iriveway;ftx)tprint of structs• (including decks);location of wells/septic systems.utility locations;direction indicator,lot
area;building coverage urea;percentage of covc•lgc;impervious area;existing structures on site:and surface drainage.
12 Foundation plan.Show.u,nensions,anchor belts,any hold-downs and reinforcing pads.connection details,vent
size and location.
I ; Floor plans.Show all dimensions,room identification,window sirs,location of smoke detectors.water heater,
furnace,ventilation fans plumbing fixtures balconies and decks 30 inches above grade,etc.
14 Goss section(s)and details.Show all framing-member sins and spacing such as floor beams,headers,joists,sub floor,
Cr
wall construction,roof construction. More than one cross section may he required to clearly portray construction.Show
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,
fireplace const;._lion, 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 foundatit n elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or latt,of analysis plans.Must indicate details and locations.for
nun- rescn�ive path analysis provide specifications and calculations to engineering standanls. _
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and tearing
locations.Show attic ventilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rehat.For engineered
s stems,sec item 22,"Engineer's calculations." _
19 Beam calculations. Provide two sets of calculations using current code design values fur all beams and multiple joists
over 10 feet long and/or any hcutn joist carrying a non-uniform load._
20 Manufactured floor/roof truss design detafls. _
21 Energy Code compliance.Identify the prescriptive path or provide calculations.Agas-piping schematic is reyuhed
for four or more appliances.
22 Engineer's calculations.When required or provided,ti r •Jwar wall,roof truss)shall he stamped by an engineer or
architect licensed in Oregon and shall bL shown to he. i•' twt-to the project ander review.
JURISOU110NALSPLUIFICS
21 Five(5)site plans ore required for Item I I above. Site plans"lust be h-1/2"x 11"ur I L x 171 —
24 Two(2)sets each are required fur Items 16, 19,20&22 ahuve.
25 Building plans shall not contain red lines or tape-ons. _
26 No rolled,reversed or min-orcd building plans will be accepted.
27
28
Checklist must he completed before plan review start date. Minor changes or notes oil submitted plans ma} he in blue or black ink.
Red ink is reserved for department use only, 4104614(601rOM)
Electrical Permit Application
IDamereceived: to ail•/ PermiIno.: y/&I _,,,b�4V
C>t•
ty Of Tigard ProjccUappl.no.: Expire date:
City of"Tigard Address: 13125 S W I]all Blvd,Tigard,OR 97223 D:uc issued: By: Receipt ria:
Phone: (503) 639-4171
Fax: (503)598-1960 Case file ria.: Payment type:
Land use approval:
gal W t
&2 family dwelling or accessory 0 Commercial/industrial ❑Multi-family ❑Tenant improvement
ew construction ❑Addition/alteration/replacement J Other: U Partial
JOB SITE t
Joh address: Bldg.no.: Suite no.: Tax map/tax lot/account no.:
Lett � Block: Subdivision: �'p, E �j -1_'/L)46-
Project
4 -Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
s
Job no: rde Nia%
Business name: L7 Y Uevcriptiun ljly. (ca.) 'total no.:nsp
- New residential-single or multi iamily per
Address: . dwelling unit.Includes auaela-lgarnge.
City: State: ZIP: Seniceincluded:
Phone: Fax: I E-mail: I ax)sq.It.ter less a
Each additional 5W sq.R.or portion thereof
CCB no.: Elec,bus.tic. no: - l.inutrdenergy,residemiol _ _ 2
City/r,etro tic.no.: Limited energy,non residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician(required) _Dole Seryice and/or feeder 2
Sup.eh ct.name(print).(',fl fl f ,.,.,, ,,,, -- - Sentees or feeders-Installniion,
alteration or relocation:
f 2nn snips or less _ 2
Name(print): 2O1 am s to 4(x)amps 2
Mailing address: 401
.in
to bun amps _-__ 2
601 am s to I(XX)amps _ 2
C'lly: Slate: ZIP: _ Over 1(x 0 amps or vola 2
Phone: Fax: Email: Reconnect onlyI
Owner installation:The installation is being made on property I own famporaryservices orfeeders-
which is not intended for sale,lease,amt,or exchange according to batallation,alteralIon,orrelocatlon:
ORS 447,455.479,670,701. 200 amps or less _ 2
201 strips to 400snips 2
Owners si;nature: ale: _ Itl tnrdxlamps 2
Till 1,9111 Branch circuits.new,alteration,
or extension per panel:
Name: -v_. A Fee for branch circuits with purchase of
Address: _ service or feeder fee,each branch circuit 2
City: StalC: ZIP: B. Fee for branch circuits without purchase
-'- - -- of service or feeder fee,first branch circuit: 2
Phone: E-mail: Bach additional branch circus;
Misc.(Service or feeder not Ins luded):
U Service over 225 amps-c innicrulal U Health care lacility Each pump rnr trngauon circle __ 2
U Service river 320 amps-toting of 1&2 U Hazardous location Fach sign(ir oudinr lighting -- -2
familydwellings U Building over 10014)square feet four or Sigt at circulus)or a limited enerr!y panel
U System over 6(yl volts nominal more residential units I i one structure olterition,ar ettension• 2
U Hu ld+ng over three stories U Fordets,40()strips nr parte olkscn tion --- _--- -_— �-
U Occ•upnn(lood over 99 pemmts U Manofactuntt strucmre:or RV park Each additional Inver,tlou over the allowable in any of the above:
U Iigress/lighting plan U(thee -----------_-�--. Per urspeoum
Submit_.seta of plata with any of the abov.r. Investigation fee
The above are nM applicable to teati,_orary construction service. Other
Not all jurisdictions weep credit rants,plea"ca jw,.dr ti.kt Ls ri(hr mf,xntation Notice:This permit applicatioe Permit lee $
U Visa U MasterCard expires if a permit is not obtained Plan revi l,t __ %) $
Credit card number _—__ __ ( / within 180 days alter it has been State surcharge(8%)....$
selves accepted as completeTOTAL .......................$
_ .dame rd carr�ioidTer u s�c�ii�airT--- . —
S
----- C h der signature -- Arrawnt�
440461`1(NmtY(.'OM)
Electrical Permit Fees: Limited EInergy Fees:
_ —-- - 'TYPE OF WORK INVr)LVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee..................................................
Number of Inspections per permit allowed)I (F-OR ALL SYSTEMS)
Service included: Items Cost Total y Check Type o.Worh,evolved:
Residential-per unit 5i t, 1, 4 Audio and Stereo Systems
1000 sq.It or less _--
Each additional 500 sq it or Burglar Alarm
portion thereof -- $75.00
Limited Energy
Each Manufd Home or Modular 2 Garage Door Opener'
Dwelling Service or Feeder $90.90
� Heating,Ventilation and Air Conditioning System'
Services or Feedrrs
Installation,alteration,or relocation $80.30 _ 2Vacuum Systems"
200 amps or less $106.85 2
201 amps to 400 amps $160.60
401 amps to 600 amps _ 2 Other—
601 amps to 1000 amps $240.60 _ _
454.65 — 2
Over 1000 amps or volts $$66.85 2
Reconnect only ---- TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary Services or Feeders Fee for each system......................................
Installation,altP it' ar reloc al-1 1 $66 85 _ 2 (SEE OAR 918-260-260)
200 amps f 1, $100.30 - 7
201 amps U amps $133.75 7 Check Type of Work involved.
401 amps to 6UU amps
Uver 600 amps to 1000 volts, Audio and Stere-Systems
sae"b"above.
Rranch Circuits Boller Controls
New,alteration or extension per panel
a)The fee for branch circuits L I Clock Systems
with purchase of service or
feeder fee. $665 _- Oata Tefecrmmuni(,ation Installation
Each branch circuit
b)The fee for branch circuits L Fire Alarn Installation
without purchase of service
or feeder fee. $46.35
First branch circuit HVAC
Each additional branch circuit $6.65 _
[J Instrumentation
Miscellaneous
(Service or feedor eecirc e
notIncluded)
_ $53.40 _ Intercom and Paging Systems
EacEach sign or outline lighting $53.40 _
Signal circult(s)or a limited energy $75.00 El
Landscape Irrigation Control'
panel,alteration or extension
Minor labels 110) $125 00 Medical
ach additional It spection over ❑
,tie allowable in any of the r bove Nurse Calls
Per Inspection
—_ 582.50 _
Per hour $62.50 Outdoor Lan iscape Lighting'
In Plant $73.75
Fees: Protective Signaling
IOther - -
Enter total of above fees $ -
18%State Surcharge $ _ - --Number of SyMems
25%Plan Review Fee $ ' No licensee .re required Licenses are required for all other Installations _
See 19011 Review"sc iion f'n
Inud ol'�i,ph,allon Fees:
Total Balance Due $ Enter total of above fees $
❑ Trust Account#_- 8%State Surcharge 5--- -- ---
Total Balance nue :
Odsti,formsWc•fees.doc l0KW 00
Mechanical Perw-*t Application
+- �— Uatereceiv,;d: G 5 p 9BY ;7
City of 'Tigard ►��
Address: 13125 SW Hall Blvd,Ti oral;Oh 97223 1'roJecUappl.no.:Ciry u;;igurd gPhone: (503) 639-4171 Uate issued:Fax: (503) 598-1960 Case fileno.: Payment typ
Land use approval: _ _ building permit no.:
t
&2 family dwelling or accessory U Co
mmercialJindustrrl U Multi-famil
New construction ❑Adcliticm/altcrati(,n/replacement U Other: y U Tenant improvement
Job address 1
Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.:
value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivsion: ' tAl e r) *See checklist for important application information and
Project pante: "7 I l TOre(A4 lurisdiction's fee schedule for residential permit fee.
City/county: t(,A/Z v p2 ZIP: t 7 7
, t
Description and location of work on premises: t t
_ r
Est,date of completion/inspection: 1'�(ea.) Total
lhsnilNion Qty. Rt4i.onh' Rcx.onl)
Tenant improvement or change of use:
—
Is existing space heated or conditioned?U Yes U No Air handling unit CFM
Is existingspace insulated?U Yes U Noircon iuonmg(sitep anreg6irc ) -
p -A-lit-rationof existing I system
of er,:�mpr ssors
Business name• 1 ����� State boile permit no.:
Address: �• / IIP —Tons— BTUM
hie•smo e i amper ductsmo a electors
City: LD SZIP:���Z� eat pump(s to p an require
ne: Inn
)
Pho3zo7 Fax: G E-mail: sta cePlace frnac urner -
CCB no.: 4 8 �� t Including ductwork/vent liner U Yes U No
City/metro lic.no.: '1 — IIsta rep ac re ooatc eaters-suspen e
_ wall,or floor mounted
Name(please print): 2A b cnt ora ;ianccottCcert an Turnace
e gerat on:
Name: Ahsorptionunts__ _ BTLWI
_ Chillers_ _ _ Hp
Address: G m rrssors )Jp
City: Stale: Z)p; -- I:nv ronmenta exhaust an ventilation:
Phone: Appliance vent
Fax: E-mail: hyercx gust
Hoods,Type res. tc a lo,cmat -
Name: herd fire suppression system
Exhaust fan with single duct(bath fans)
Mailing address: '-x aust system a -irt rom cattn of -
City: State: 'ZIP: - -- ue p p ng an sl m on i to out ets)
Phone: f r. E-mail: Ty -- LI'O NO Oil
Tuci piping each iiiiijitional o,r-•.4 outlets �—
rocesspiping(sc ematic requlre )
kAid—rrsq —
ame: Number of outlets
: t r t app Ikcorative fireplace
ity: _ Sllc: ZIP: nsert- tyhone: 14,x: Wcmdstov� et slit nve --
Applicant'- signaluic: Dav: t her: -
Name (print): —
NN all JurbdkNom sccepi crrdii cud.,please call juNkdiction for m xe inffxnmhm Permit lee.....................
UVisa UMusterCan Notice:'l his permit application Minimum fee................$ -
credu
cod number � expires if a permit is not obtained plan review(at _ 96)
within 190 days aver it has been
;-Nat-CiT `- accepted as complete. State surcharge(8%)....$
ci�nuure --
$ TG 1'AL ...................... $ --
Amouni
440-4611(60a)COM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLINj FEE SCHEDULE:
TOTAL VALUATION: FEE: Descnption: ---- _
$1.Oi1 to$5,000.00 Minimum fee$72.50 _ Table 1A Mechanical Code Pr's Total
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 11 Furnace to 100,000 BTU ----- Oty (Ea)_ Amt
$1.52 for each additional$100 00 or includin ducts&vents 14.00
fraction thereof,to and including 2) Furnace 100,000 BTU+ ---
$10,000 00. includingducts&vents 1740
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace -- -
$1 54 for each additional$100.00 or includin vent _ 14.00
fraction thereof to and including 4) Suspends$heater,wall heater -- - --
$25,000.00. or Floor mounted heater 14 00
$25,001.00 to$10,000.00 $379.50 for the first$25,000.00 and 5) Vent not in
in appliance permit --
$1.45 for each additional$100.00 or
fraction thereof :j and including 6) Repair units - _ 6.80
__ $50,000.0C. _ __
$50,C01.00 and up $742.00 for the ftrst$50,007.00 and Check all that apply Bol el Meat Air - 12 15
$1.20 for each additional$100.00 or For Items 7.11,see or PUMP Cond
fractlon thereof. footnotes below. Com ' ••
_ 7)<3HP;absorb unit -
FDesc
SSUMED VALUATIONS -E APPLIANCE: to I""RTU 14 00
Value Total 8)3-15 H1 absorb - 0
ntion: Qt to Amount unit 100k to "(BTU 25 60
Furnace to 100,000 BTU,Including 9J5 9)15-30 HP;absorb
ducts&vent, unit.5-1 mil BTU 3500 -
Furnace>100,000 BTU Including -1,170 10)30.50 HP;2bsorb -- --
ducts&vents unit 1-1.75 mil BTU 52 20
Floor fumace Includi�vent -955 11)>50HP:absorb
Suspended hsater,wall heater or955 unit>1.75 mil BTU
flcwr mounted heater 12j Air handling unitto 10,000 CFM 87.20
�-
Vent riot Indudod In applicance 445 -- 10.00
-Permit _ 13)Air handling unit 10,000 CFM+ -
Re air units '- 5 -- 17.20
<3 tip;absorb.unit, 955 14)Non-portable evaporate c color
to 100k BTU _
3-15 hp;absorb.unit, 1,700 --- 15)Vent fan cor+nected to a single duct 10.00
1U1k to 500k BTU
15•-30 hp;•absorb.unit,501k to 1 2,310 16)Ventilation system not included In 6.80
mil,BTU a (lance ermit 10.00
30.5 Itp;absorb.unit, 3,400 17)Hood served by mechanical exhaust
1.1.75 mil.BTU
>
p;50 habsort.unit, 5 725 18)Domestic Incinerators 10.00
>1.75 mil.
BTU
Alr handlh�y unit to10 000 cfm - 17.40
856 19)Commercial or Industrial type Incinerator
r andlinp unit>10,000 chn 1.170 -
Non-portable evaporate cooler 69.95
656 20)Other units,Including wood stoves
Vent fan co,mected to a single duct 446 -'
Vant system not included in 21)Gas piping one to four outlets --- 10.00
_a nce^ tit
(la858 -
Hood serv, . :y mecha,llcal exhaust 656 - 22)More than 4-per outlet(each) - 5.40
Domestic Incinerator 1 170 - 1.00
Commercial or Industrial Incinerator 4 590 - Minimum Permlt Fee$72.50
Other unit,including wood stoves, SUBTOTAL: a
Inserts,etc. 656 _
Gas piping 14 outlets _. 8%State Surcharge $ `
Each additional out-t 380
--- -_ 83 _ _ 25"/.Pial Review Fee(of subtotal) $ -
Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE:
(_VALUATION: _ --- 1 $
Other Insnectlons s�Fees: e`
I
Inspect ons outside of normal business hours(rninimum charge-two hours)
$72 50 per hour
S720Inspections
per hofor
which no fee is speciflcrilly indicated (minimum chargo-hnlr hour)
3 Additional plan review required by changes,additions or revisions to pians(rr,nimum
charge-one-half hour)$72 50 per hour
*State Contractcr Boller Certification required for units>200k BTU.
~Residential A/C:
a)
Plumbing Permit Application r
Date received. (�(oJ'/ t'/ Permitno.: �>'j/ C�-!'r 'CG'
City of Tigard Sewer permit no.: Building permit no
Addre.s: 13125 SW Hail Bivd,Tigard,OR 97223 —
Cinr+Jli) tool PI.^ae: (�ual 639-4171 1'rojecVappl.no.: Expire date:
FaA. (503) 598-1960 Date issued: By: Receipt no.:
Land use approval: - — Case file no.: Payment type.
`(�1 &2 famil:dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
New constrJ Addition/alteration/re place file III U 1�ood service U Other
1
c S 7 Description (i*tv. 'ee(ea.) 'Total
Job address: HCl � / �. J"f l._�( f C,AG�
Bldg.no.: Suite no.: _- - New 1-and 2-fhmily&i-ellings oily:
-- - (include%100 ft.for each nilityconnection)
Tax map/tax lot/account no.: _ s R (I)bath _
Lot: _ IBlock: Subdivision: SFR(2)hath -- -- — -- -- _—
Project name: -T/1f, V/ ----- SFR(3)bath -
City/county:_ /(a/l c' p ) ZIP: 67-7 Each additional bath/kitchen
Description and location of wort,on premises: Siteutilitles.
Catch basin/area drain
,t.date of -- Drywells/leach line/trench drain
Fi: n_
Footing drain(no.lin.ft.) _
Manufactured home utilities
Business nt.me: L u
I�iCJ�'�11 +Jr;Y 1j�Lf lte=(� t U(til'+ihManholes
Address: T.o. Rain drain connector
City: *n 6,+12D IState: LIP: Sanitary sewer(no,lin.ft.)
Phone: Fax: I E-mail: Storm sewer(no.lin.ft.)
CCB oro.: Plumb.bus.reg.no: Water service(no.lin.ft_)
City/metro lic.no.: - —_ --- Fixture or item:
Contractor's representative signature: Absorption valve
Back flow preventer
Print name: z i .,---- - Date Backwater valve -- _ --
Basins/lavatory
Name: Clothes washer
Address: Dishwasher
_ tate: LIP: Dunkin fountains)
City: S
-- - -- Ejectors/samp -
Phone: Fax: E-mail: Expansion tank
Fixture/sewer cap —_
Name(print): Floor drains/floor sinkA.ut;
Mailing address: - Garbage dis rsal —
Hose hibb _
City: _ State:_ 21P: Ice maker
Phone: — F;tx: �E-mail: 'Interceptor/grease trap
Owner instal lation/residential maintenance only: The actual insta"lation Primer(s) _
"Owner's
me or the maintenance and repair made by my itgular Roof drain(commercial)
e property I own as per ORS Chapter 447. Sink(s),basin(s), nvs(s) _ure: _ Date: ;Sum
- Tuhs/shower/shower rt __
Name Urinal -
- -- Water closet
Address: _ Water heater
City: -- State: ZIP: _ — Other: _ —
Phone: lax: E-mail: ot»tl
Not all jurisdictians accept ctedi'cards,pleaw call jutlydlcilm Ino mar informalirai. Minimum fee................$
Notice:'iltis jx:mtit application
U Visa U MasterCard expires if a permit is not obtained Plan review(at — 96) $
Credit card number -___ -- --L- within 180 days after it has been Slate surcharge(8%)....$
aplrn
----- accepted as complete. 7'07'AL .......................$
---Nerve rd cardholder u rtrown nn�redlt cent
t'.ardh(lder Blfpii`we Amount I 410-46161610 OMNI)
PLUMBING PERMIT FEES:
—RICE TOTAL New 1 and 2-family dwellings only:
FIXTURES (individual) _ QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 1660 the dwelling and the first100 ft. QTY (ea) AMOUNT
— for each utility connection
Lavatory 16.60
One 1 bath --_ $249.20
Tub or Tub/Shower Comb 1660 _Twoo 2 bath _ _ $350.00
Shower Only — 16,60 _ Three 3)bath ___--_ $399.00
Water Closet 16 60 _ — — SUBTOTAL
Urinal^ 1660 _ v 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _
GarbayeDisposal --- 16.60 TOTAL
Laundry Tray — 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" - 1660 _- PLEASE COMPLETE:
16.60
4" -- - —
1660
Quart!— Work Performed
Water Heater O conversior O like kind 1660 s —
Gas piping requires a sepac,te mechanical Fixture type: New Moved Replaced Removed/
permit Capped
MFG Home New Water Srrvice 46.40 Sink _—
MHome New San/Sf�rm Sewnr 46.40 - Lavatory
FG
Tub or Tub/Shower
Hose Bibs 1660 Combination
Roof Drains 16.60 — Shower Only
Drinking Fountain — 16.60 Water Closet
— Urinal —
Other Fixtures(Specify) 16,60 _ Dishwasher
Garbage Disposal -- -- _ --
-------'— -- -- — Laundry Rrwm Tri _ -
--- -- -- Washing Machine
Floor Drain/Sink: 2'_
Sewer-1 st 100' 55.00 3„
Sewer-each additional TOCF �^ 46.40 __ _ 4"
Water Service- I sl 100' 55.00 Water Heater
Water Service-each addition r:1200' 46.40 Other Fixtures
Storm&Rain Drain-1st 100' 55.00 _
Storm 8 Rain Drain-each additional 100' 46,40
Commercial Back Flow Prevention Device 4640 -- -- --- -- —
Residential Backflow Prevention Device' 27.55 ---- -" — -
Catch Basin — 16.60 _
Inspection of Existing Plumbing or Specially 72.50
_Roquesled Inspections perthr _ COMMENfS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 —
Grease Traps - --- --- 1660 —------___..�-- -- --------
QUANTITY TOTAL ---�-- -- - -- - —--
Isonwlric no riser diagram Is required If — — --— -- — --
Quantity Intal Is >g --- ----- ----- --- ..
'SUBTOTAL _ - -- - --- ---- ---
8%STATE SURCHARGE _.-._-- -- ___ ----------- ----- --—
"PLAN REVIEW 25%OF SUBTOTAL.
,Redulred uu�_d future c 1 total Is>g
TOTAL S-
Minimum permil tee Is$n hu•a%state surch ie,except Residential Backflow
Prevention Device.which Is$36 25+P%slate surcharge
"AIL New Commercial Buildings reg0te plans with Isonwtric or riser diagram and
plan review
i\fists\forms\plm-fees doc 10/10/00
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COMIMICUONFWRANCE
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—J.
5.W. 1315t FLACE
14229 ,5.W. 1,315t. flare
Tigard, Oregon
Lot 15, Raven Ricloc
Book 136, Page 12
Lot Size: 53.51 x 97.36 = 5,0945f
Coverage: 2,0125f (39.49%,)
5 1TE FLAN NR
CITY OF TIGARD
13125 S.W. HALL. BL`E'D,
TIGARD, OR 97123
IMPORTANT PERMIT NOTICE
NORTHWEST PREMIER PLUMBING
P.O. BOX 23338
TIGARD, OR 97281
Flumbing Signature Form
Permit #: MST2001-00400
Date Issued: 81110
Parcol: 2S109^.B-08800
Site Address: 14229 SW 131 ST PL
Subdivision: RAVEN RIDGE-
Block:
IDGEBlock: Lot: 015
Jurisdiction: TIG
Zoning: R-7
Remarks: New SF detached. Path 1 fire sprinkler require
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:
SHARONE O'MAP PA NORTHWEST PREMIER PLUMBING
2 OSWEGO SUMMIT P.O. BOX 23338
LAKE OSWEGO, OR 97035 TIGARD, OR 97281
Phone #: 503-697-4385 Phone #: 503-624-0582
Reg #: I IC 135022
P1 M 34-348PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
4ignituyreofO&Authorized
ol dumber
If you have any questions, please call (503) 639-4' 71, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD
TIGARD, OR 97223
E C E E
IMPORTANT PERMIT NOTICE AUG 0 2 2001
DRYER + SONS i,, „ „ t: N, NS
5536 SE WOODSTOCK BLVD � �� �= jj'u co
PORTLAND, OR 97206
Electrical Signature Form
Permit#: MST2001-00400
Date Issued: 811101
Parcel: 2S109AB•086^0
Site Address: 14229 SW 131ST PL
Subdivision: RAVEN RIDGE
Block: Lot: 015
Jurisdiction: TIG
Zoning: R-7 R,
Remarks: New SF detached. Path 1 fire sprinkler require
has been indicated as the electrical contractor for the permit
indicated
above.
In order
r er for the
Your Company
electrical permit to be valid, thersignatureon sign belowrandn supervising
this Electrical Signature Form prior to the
appropriate individual from you company
start of the work to the address above, ATT N: Building Dept.
No electrical inspections will be authorized until this completed forrrn is received
ELECTRICAL CONTRACTOR.
OWNER:
DRYER + SONS
SHARONE O'MARA 5536 SE WOODSTOCK BLVD
2 OSWEGO SUMMIT nr,ctTLAI:�, OR 97206
Phone #: 774-1606
Phone #: 503-697-4385 LIC 00001114
Req #' SUP 23115
ELE 26-43C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310