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16310 SW PALERMO LANE a a) c,a rr a 1 16310 SW M-ERMO LANE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-417G MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received — Date Reque�ted_j_ �" AM_—__-__ PM SUP Location 3�� Suite __ MFG Contact Person __ __ _ Ph(--.----) —� PLM Contractor - -- - — — -- Ph(- _ ) SWR BUILDING Tenant/Owner _— ELC Footing - - ELC Foundation Access: Ftg Drain ELR Crawl Drain — Siab Inspection Notes: SIT - Post&Beam Shear Anchors Ext Sheath/Shear r ._.. Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL ` PLUMBING_ Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Hain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: Final _PASS PART FAIL MECHANICAL _ Post&Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab Low Voltage i� -- -- -- --- Fire Alarm n 4__4_ _ PRT FAIL LJ Reinspection fee of$— required before next inspection. Pay at C4Hall, 13125 SW Hall Blvd. SITE _ [] Please call for reinspection RE: —.__. rl Unable to inspect-no access Fire Supply Line / > ADA C' Its I►snree�rt�r,C_ _ �l �Ltt---- Approach/Sidewalk Other: Final DO N071 REMOVE this Inspection viRcorld lKrdm the)01) !Jt0. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Ir spection Line: (503)639-4175 MST _------------------ INSPECTION DIVISION Business line: (503)639-4171 BUP - Received —__— _Date Request _ — AM – PM BLIP T;Location _- �!� 1�1Suite _-- MEC Contact Person — _—.__ Ph( ) �_` -= -� PLM Contractor Ph( ) _ _—__. SWR BUILDING Tenant/Owner __ __ ELC _- F.)oting ELC foundation Access: f, Ftg Drain ELR -__.-.- Crawl Drain Sieb Inspection Notes: SIT _ Post&Beam Shear Anchors - Ext Sheath/Shear _ Int Sheath/Shear Framing _ �� J.��+o wcr T.c.w _P 16 _l I o 7° o� r -n Insulation Drywall Nailing --- ----- - - --- - Firewall Fire Sprinkler Fire Alarm Susti d Ceiling I Rool Other: Final PASS PART FAIL ---~-- ----- -- -- �--- --�-- POLUMBING - Post& Beam Under Slab -- ---- - -- - _- - ------- - - - - Rough-In Water Service - - -- - -- - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: aSNWE-H S PART FAIL _A_NICALL Post&Beam Rough-in Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Hough-In UG/Slab Low Voltage --- -- ----------- --- -...__ . Fire Alarm Final F1 Reinspection fee of$__-___-required before next inspection. Pay at City Hall, 13125 SW Hale Blvd. PASS _PART FAIL SITE -�__ j Please call for reinspection RE:-___ �� Unable to inspect-no access Fire Supply Ling ADA �►s-v✓� 1��w� Approach/Sidewalk Date C_�-r�'7 inspector .__- - - _cart Other: Fine: DO NOT REMOVE this Inspection (record from trio Job site. PASS PART FAIL AAAAAAAAAAAAAAAAAAAAAA`AAAAAAAAAAAAA AAAAAAAA� 4 O ► cn ► 4 t7 ► :I - ZA 4 ► 4 �1 ► 4 b( ► ® �� ► d ► .41 W CD d ► 4 `� pil. Ln b `C ► 4rD > ' `° ► 4 `� poll M `� I p o ► 4 ' �° cm � ► �.,,� �► 4 o ► 4 �� ` j Poo \ ` i popC- p ~ ► � o ► j ► d 10. ► 4 4 p 4 �► `'►vvvvvvivvvi►s� lwvvpvvvvvvvvvvv ivvvvvvv:v v G w � N NC � «� G oh = /� O G w r H H A � n S O i' F, 'D CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503 175 MST INSPECTION DIVISION Business Line: (5 1 1, -- BUP Received __. Date Requested_ .gip -_ AM _- -__-___ PM _ BUP Location ______l �/D J M2-(� AA Suite— _ MEC Contact Person Ph PLM Contractor_— Ph( ) _ SWR BUILDING Tenant/Owner -__ ELC Footing Foundation �--- -- ELC __-- Access: Ftg Drain ELF! Crawl Drain Slab Inspection Noter, SIT - Post& Beam -_-_ Shear Anchors ,?- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing - - Fi,-ewall Fire Sprinkler -- ----- --- -- - Fire Alarm Susp'd Ceiling - ------ -- Roof Other: - -._____.--.----�- Inlh ` S PART FAIL ------------------------ -- - - -- BINGi -- ast&Beam Under Slab Rough-Ir. Water Service --- -- - -------------- -- - - Sanitary Sewer Rain Drains ---------------- - - - -- - --- Catch Basin/Manhole Storm Drain -� ------ - - --- Shower Pan Other: __ - -- - -------- - - - - - Final - _PASS PART FAIL 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$-_ inquired before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FALL_ SITE _ �� Please call for reinspection RE:- Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date _-, / _ -. Inspector Ext Other: 'incl DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL �� w�� MASTER PERMIT (�-'+ PERMIT#: MST2003-00168 DEVELOPMENT SERVICES DATE ISSUED: 5/27/03 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4111 SITE ADDRESS: 16310 SW PALERMO LN PARCEL: 2S105CC-70024 SUBDIVISION: TUSCANY ZONING: R-7 BLOCK: LOT: 024 JURISDICTION: URB REMARKS: Const. new SF Detached residence. BUILDING PEISSUE: CEN2811 W STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,296 sf BACEMENT. 4f LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: Sr FLOOR LOAD: 40 SECOND: 1,515 of GARAGE: 440 of FRONT: 15 FARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 Haan of RIGHT: 5 426 00 OCCUPANCY GRP: R9 BDRM: 5 BATH: 3 TOTAL: 2.511 of VALUE: 270. REAR. 15 PLUMBING _ SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 Sr RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 3 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 10o BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<10uK. BOILICMP<AHP: VENT FANS. 5 CLOTHES DRYER: 1 GAS FURN>-100K: I UNIT HEATERS: HOODS: I OTHER UNITS: 1 MAX INF: htu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS —MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 -200 amp 0 •200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 400 snip: 201 400 amp: 1 of Wb SVC IF DR: RIGNIOUT LIN LT, PER HOUR: LIMITFD ENERGY. 401 600 amp: 401 600 amp: EAADOL BR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVCIFDR: 601 1000 amu: 801-amps•1000v: MINOR LABEL: 1000+Amplvolt PLAN RNIEW SECTION Reconnect only: >-4 RES UNITS: SVC/FOR>=225 A. >800 V NOMINAL. CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ B.COMMERCIAL _ AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO d STIRREO. FIRE ALARA: INTERCOMIPAGING OUTDOOR LNDSC LT BURGLAR ALARM. OTH: BOILER: HVAC LANDSCAFFARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC DATA/TELE CGMM: NURSE CALLS: TOLL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,784.34 This permit Is subject to the regulations contained in the CENTEX HOMES CENTEX HOMES Tigard Municipal Code,State o,OR. Specialty Codes and 16520 SW UPPER BOONES FERRY 16520 SW UPPER BOONES FERRY all other applicable laws. All work will be done in PORTLAND,OR 97224 #200 accordance with approved plans. This permit will expire H PORTLAND,r)R 97224 work is not started within 180 days of issuance,or if:he work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 9U3-60�-30Gp Phone SU?-608 3000 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You Rap N 1 IC 124490 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Pest/Beam Mechanical Plumb Top Out Exterior Sheathing Inst Rain drain Insp Electrical Final Sewer Inspection Underfloor Insulation Electrical Service Low Voltage Roof Nailing Mechanical Final Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp Issued By '1_�, Permittee Signature Call (303) 639-4175 by T:00 p.rn. for an inspection needed the ne t bu iness clay SANITARY u leanWater Services 97124 Sly R FACE WATERLO j PF1 kc Du, 'L,�� COnNEr-TION PFRMT ISSUE DA'L'E: 050903 EXPIRATION DATE: 110503 EC: EXP DATE 050805 PERMIT 124063 STRUCTURE ADDRESS 16310 PROJECT 8610 "TRUCTURE STREET SW PALERMO LANE LOT 24 BLOCK 'YPE CONNECTION- NF':�r OF TUS"ANY SUBDIVISION ('YPE; INSTALLATION- ( 19 ) BLD SWR/ERO CON/SDC 'YP'E OCCUPANCY- ( 1 ) SINGLE FAMILY PARCEL 2S1 5CC 1170.10 QTR SEC; 4413 MH 24059 �WNFR CENTEX HOMES DDRESS 1652"0 SW UPPER BC.1ONES FER TPEATMENT PI ANT DURHAM PORTLAND OR 97224 HONE 503 -308-3160 WATER DISTRICT TIGARD FT.XTURE EQUIVALENT DWELL INC, RESIDENTIAL. INITS SERVICE; UNIT; 0 , 0 UNITS 1. SERVICE UNITS 1 CONNECTION FEES SURFACE; WATER DEVELOPMENT FEES .II:WER. CONNECTION 2.300 .00 WATEP QUALITY 225 . 00 LESS CREDIT 225 .00 - WATER QUANTITY 275 .01a RF(�,--'c N ED .LESS CREDIT 0 . 00> �Ay 2 2003 EROSION CONTROL, %CITY OF TIGARD INSPECTION 64 .00 BUILDIt"IC,[)IVIS'.ON PLAN CHECK 41 . 60 SUBTOTAL. :2300.00 SUBTOTAL 380. 60 TOTAl, 2680, 60 P.PPI, NAME MI-KE PHONE AFFILLIATION PEP P.EMARK3 LOT 24 , TUSCANY, #8610 ° Number &.1 I tfor INSPECTION--846-8444 • • ' • . IGNATURF.; _1 _. __.... ...,,� _...__ . .___._.. ISSUED BY WILSONM Permit Conditions The applicant agrees to comply vnlh all niles and regulations of the Unities' Sew eracr Agency, With, rallirxt tot an inspection, please refer to the Permit Nmrtw The Permit expires one hrmdmct eighty (180) days from the date of imsi mn The Agerxy does not q.rarantee the amrrarw of the location of side sewer laterals. 7193 WHITE USA, BLUE - Accounting, GREEN -Inspection, YELLOW - Custompt IN1015ECTE.1) Py CON T R AC T OR/I NST AL L F.R I m oF 0:PE Inspector, Pleasr skotich I)olow I StrPpt L ri�,,Orpst rrf)sl. ? 1,ncat ion of r wc t ur o tw io .1 Rout,p. of Service I i riF, f e om connccts, to the of service tine, ilelr)th at 0 - (Ililitn s r v n c ';n.1 tic, i L UL and/or corners, otc , I Nor Lh arrow T� ?.! S-ao — c'3 M AJ Building Permit ApplicationOFFICE�USE, ONLY, City of Tigard Date receive .Q � Permit no.: T -OD j 'r Project/appl. no.: Expire date: C1ry ojTlgard Address: 13125 SW Hall Blvd,Tigard, OR 97223 Phone: (503) 639-4171 Dat:issued: B Receipt no.: Fax: (503) 598.1960 pp Case file no.: Payment type: Land use approval: _ y 1&2 family, Simple Complex: I &2 family dwelling or accecsoty O Commercial/industrial O Multi-family )(New construction 0 Demolition 0 Addition/altetation/replacement 0 Tenant improvement O Fire sprinkler/alarm 0 Other: JOB a Job address: I Bldg.no.: Suite no,: Lot: BlTax map/tax lot/account no.: Project name: Description and location of wor on premises/special conditions: t � t Name:CtENTEX' NOM Mailing address; ��gW PIS FF ]I &2 family dwelling: City: F0 State: ZIP:CI-72.24 Valuation of work .......... $ Phone: D -3Oto O I Fax:(06?- E-mail: No.of bedrooms/baths.................................. _—� 2. _r Owner's representative: MXEL I EN I NE Total number of floors .................................. Phone: - Fax: F-toad: New dwelling area(sq. fl.)............................ e Garage/carport area(sq.ft.) .......................... Name: E, Covered porch area(sq. ft.) .......................... —_—_—� Mailing address: Deck area(sq.ft.).......................................... _—,----.-- Other structure area(s ft. City: State: ZIP: q ).......................... —----- Phone: Fax: E-mail: Commercial/industriallmulti-family: Al to , Valuation of work ......................................... $ ----- E Existing bldg.area(sq. ft.)............................ _-- Business name: New bldg.area(sq,ft.) Address: _— ................................. --- State: ZIP: Number of stories......................................... _— City: Fa Type of construction Phone: Fax: E-mail: Existing: �� - --_ �_ Occupancy group(s): g:= — CCB no.: �. � New; _ City/metro lic.no.: INotice:All contractors and subcontractors are required to be ARMrEt7r0X91PN licensed with the Oregon Construction Contractors Board under Name: provisiot)s of ORS 701 and may be required to be licensed in the jurisdiction where work is being periormeT If the applicant is Address City; State: ZIP: exempt from licensing,the following rcasr l applies: Contact person: _ Plan no.: -- Phone: Fac E-mail: --- a Name; Contact person: Fees due upon application.. Address: J Date received: -- --- — City: State: ZIP: —_ Amount rereived...........................................S _ Phone; — Fax; E marl: Please refer to fee schedule,—_ I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please tall jt risdicuon for more information. attached checklist.All provisions of laws and ordinances gove in his U via U Mutetfard work will be complied wijh.whetherene terl herein or not. crease rue number �_ —_ Exp_ ires 1—_ Authorized s ` 0 Date: , Name n ardho der a(shown on crap ere it�- _ _ $ Print name: S Cardlinider rigraturc Amount Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440.4613(6100/COM) Electrical Permit Application b1U4111 A� �- Date received: Permit no,: ,U ., Clity.of 1 T.1 ward Projectiappl. no.: Expire date: ' City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 6394171 Fax: (503) 598-1960 Case file no.: 1 Payment type: Land use approval: OF PERMIT 1 &2 family dwelling or accessory 17 Commercial/industrial ❑Multi-family ❑Tenant irnprovcmznt New construction 17 Add itiori/alteration/replacement Q Other: O Partial 1 { SITE INFORMATION Job addres �� ,t/E Bldg. no.: Suite no.. Tax map/tax lot/account no.: LUt: Block; Subdivision: Project name:/^ L� Description and location of work on premises: C,�.E IAL Estimated date o completion/in ection: CONTRACTOR 1SCHEDULE Job no: Fee Me. $USineSS name: -_--_ Dencripllon Qry. (a) Total no.lnip Address; New residential-single or multi-famlly per dwellingunit.l nclude sattached garage. City: Stale: ZIP: Servlcelncluded: Phone: 9 b_ Fax: E-mail: 1000 sq.fl.or less 4 C'CB no.: Elea bus.tic.no: -y 5 t Each additional 500 sq,fl.or portion thereof Limitr•° mc.gy, residential 2 City/metro lic.no.: Limited energy, non-residential 2 _ �- ��-y•tib Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup.elect. name(print): Z( I Services or feeders-Installation,b3S` dteratlonurrelocation: 1PERTV 1 VNER 200 amps or less 2 Name(print): zol amps to d00 amps _ 2 401 ams to 600 amps _ _ 2 Mailin address: t, Q 601 amps to 1000 amps 2 City ;ND State: ZIP: 7 22 Over 1000 amps or volts 2 Phone: Fax: - E-mail: Reconnect only I Owner installation: The installation is being made on property I own Temporaryservic�sorfeeders- which is not intended for sale,lease,.rent,or exchange according to installation,alteration,or relocation: ORS 447,455,479,701. 200 am a or las 2 ,�.—'� 201 amps to 400 am - _ 2 Owner's si Wifu- � �1 / hate: 401 lu 600 am 2 Branch circuits-new,alteration, or extmnslon per panel: Name: A. Fee lot branch circuits with purchase of Address; service feeder --State: ZIP:_ B. Feefur bran hti uit scircuit without purchs, 2 Y of service or feeder fee,first brunch circuit: 2 Phone: I;ts I E-mail: -Each additional branch circuit: __ M isc.(Service or feeder not Included): •Service over 225 amps-commercial U Healthcare facility Each pump or irrigation circle 2 U Service over 320 amps-rating of A2 O Hazardous location Each sign or outline lighting _ 2 family dwellings Q Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel, U System over 600 volt nominal more tesidential units in one structure alteration,or extension* _� 2 •Building over three stories t]Faders,400 amps or more 'Description: •Occupant lad over 99 persona ❑Manufactured structures or RV park Each additional Inspection over the allowable in nq of the above. U Egress/lighting plan O Other - Per inspection Submit_,_sets of pians with any of the above. Investigation fee _ The above are not applicable to temporary construction service. Other — Not all jurisdictions accept crudlt cards, lease all jurisdiction for more Infli matron. Notice: This _ Permit fee ......................S ep p 1 permit application a 13 viae O MuterCard expires if a permit is not obtained Plan review(at_ /o) S Credit card number. �_Z within 180 days after it has been State surcharge(8%).....S Exp1fC1 accepted as complete. TOTAL.........................S _ Name of cardholder u shown on ate nand S _ Cardholder sifneture Amount 4111.4615(6N01COM) ELECTRICAL_ PERMIT FEES: LIMITED ENERGY PERMIT FEES: ��—_"�--- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY _ Complete Fee Schedu:e Below: Restricted Energy Fee.............................................. ..... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Ser.ire Included: Items Cost Total 1 GhecY.Type of Work Involved: Residential•per unit ❑ 1000 sq.ft or less _ $145.15 4 Audio and Stereo Systems' Each additional 500 sq.f1.or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy _ $75.00 Each Manufd Horne or Modular F1 Garage Dior Opener* Dwelling Service or reedir $90.90 2 Services or Feeders ❑ Healing,Ventilation and Air Conditir- ng System' Installation,alterallon,or relocallon 200 amps or less $80,30 1 �, Vacuum Syslams' 2G1 amps to 400 amps $106.05 _ _ 2 401 amps to 600 amps $160.60 _ 2 601 amps to 1000 amps $240.60 2 ❑ OtherOver 1000 amps or volls $454.65 2 Reconnect only $86.65� 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or reluc toder Fee for each system.......................................................... $75.100 200 amps or leas $66.85_ l (SEE OAR 916-7.60.260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ sea"b"above. Audio and Stereo Systems Branch Circuits ❑ Boiler Controls Now,alteration or extension per panel a)The fee for branch circuits ❑ with purchase of service or Clocx Systems feeder fee. Each branch clrcull _ $6.65 2 ❑I Date Telecommunication Installation b)Thu fee for branrh circuits wlfhouf purchase of service ❑ Fire Alarm Inniallalion or feeder fee. First branch circuit _ $40.85_ _ Each addltlonal branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not Incl„dnd) Each pump or Irrigation circle $53.40 ❑� Intercom and Paging Systems Each sign or ouulne lighting $53.40 Slgnul circuit(s)or a limiter',unerg:1 panel,alteration or oxtr.nslon $75.00_ ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 Each additional Inspection over LI Medical S the allowable In any of the above F-1 Nurse Calls Per Inspectlun _ $62 r�0_ Pur hour $62.50 In f lent $73.75 DOutdoor Landscape Lighllnp' Fees: ❑ Protective Signaling Enter total of above fees $ ❑ Other 811:Stale Surcharge $ Numher of Systems 25%plan Review Fee No tiranses are requand Licenses are required for all other inatellallons See'Plan Review'sedlun un $ front of applicallon. Fees: Total Balance Due $ _-- Er,ler total of above fees S --- ❑ Trust Acrounl# _-. 8%State Sureharp- S_ Total Valance Due Ail New New Commercial Buildings require 2 sets of plans. I:\ds— orma\elc-fees,doc 02/05102 OWN Plumbing Permit Application 1 D:t!e rec:ived: Permit no.: City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,'l'igard,OR 97223 City of Tigard Phone: (503) 639.4171 Proiect/appi, no.: Expire date: Fax: (503) 598-1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: Payment type: 1 ❑ I &2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family ❑Tenant improvement ❑New construction ❑Addition/alteration/replacement ❑Food service ❑Other: it 1 ' Oft FEFSCIIEDULE(for.%peciatinforniationtisec6eckli.,41) Job address: ? Description Qty. Fee(ea.) Total w�--- Nen 1-and 2-family dwellings only: Bldg. no.: _ _ Suite no.: Tax map/ta lot/account no: � ---- (includes IUU ft.for trach utility connection) SFR(1)bath Lot: Oq IBlock: I Subdivision; SFR(2)beth Project name; /u _ SFR(3)bath City/county: r ZiP: Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Est.date of completion inspection: Drywelli/leach line/trench drain Footin 11 drain(no. lin.ft.) Manufactured home utilities gassiness nameCO MSR SySTE1'►-15, �I�i Manholes Address: 00 Sin/ Rain drain connector City: State;� Z[P: a,Z Sanitary sewer(no.lin.ft.) Phone: g-(� F>tx:4, _ E•meil: Storm sewer(no. lin,ft.) CCB no.: 1 r Plumb. s.reg.no:34•-3S 6 PE Fater service no.lin.ft. City/metrolic.no.: Cp Fixture or Item: Contractor's representative signature: _ Absorption valve — Print t=ame: �) STD - D nate: Bat clow p cr Gackwater valve 1WAU' PERS0144Basins/lavntary Name; A Y } A Y)0\"S e,h Clothes washer Address: ;3,3�O c� `1 Dishwasher city: r„rA Ir state: - ZIP: ] 3 Drinking fountain(s) —�--� -- � Ejectors/sumo-� Phone: $o�•.yg•y�gfr Fax:5,o3.io39oy -mail: Expansion tank Fixture/sewer cap Name(print):j!�:,ENrTFX flDMEG Floor drains/floor sinks/hub Garbs a _ Mailing address: disposal Nova bibb City: VQ StatenK 1zlP:cT7R@4 Ice maker Phone _ Fax-.01. E-mail: interceptor/grease trap Owner instal lation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date: Sump Tubs/shower/shower pan - Name: Urinal -- -- - Water closet Address Water henier_ City: Statc: ZiP: Other Phone! Fax: I E-mail: • otal Not an jurisdictions wcept credit anp,please art jurisdiction Ibr more intbmution. Notice: This permit application Minimum fee................S U via ❑MasterCard expires if o Plan review(at_ /o) S p permit is not obtained Credit card number �--1-- y within I 8 days after it ttas been State surcharge(8%).... S i prroe Name ocardholder as shown one t accepted as complete. TOTAL........................ S r r nue mount 4404616(111000M) PLUMBING PERMIT FEES: PRICE TOT h 4ew 1 and 2•family dwnllings only: FIXTURES (Individual) CITY _ (ea) AMOUNT i r.nciudas all plumbing fixtures In PRICE TOTAL 1',ik -- 16.60 the dwelling and the flrst100 It. QTY (ea) AMOUNT Lavatory j8,80 - for each utilityconnection _ _ One(1)bath $249.20 Tub or Tub/Shower Comb. -�I 18.60 Two 2 bath S35C.00 Shower Only 16.60 Three 3 bath _ _ $399.00 Water Close! 16.60 SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.80 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Float Drain/Floor SInY. 2' � 18.60 - - PLEASE COMPLETE: 3' 1660 4' F16.60 --^� ____ Water Healer O conversion O like kind 18.80 ��-^ _ CIuantit b Work PerfotTnod Gas piping raqulrsS a Soparata mechanical Fixture Type: hew Moved Replaced Removed/pe permit. _ _-_ Ca d MFG Home New Water Service - 46.40 Slnk MFG Home New SanlSlofm Sewer 46.40 Lavatory _ _ - Tub or Tub/Shower Hose Bibs 16.60 Combination_ Roof Drains 18.60 _Shower Only Drinking Fountain - 10.60 Wator Closet Unreal Other FlAures(Specify) V 18.38.3 50 _ - _ Dishwasher _ - Garbage Disposal -- -`-� - Laundry Room Tray _ - -- - Waving Machine -. -.-- Floc,DrainlSlnk: 2' Sewer-tet 100' 55.00 -- -- 3' ---- Sewer-each additional 100' 46.40 _ -4' _- Waist Servlre-tel 100' T 55.00 Water Healer - _ Water Service-each additional 200' 46.40 Other Fixtures _ _ S eci - Storm&Rain Drain-1tit 100' 55.00 Storm&Rain Drnin-each additional 100' 46.40 _ Commerclal Back Flow Prevention Device 40.40 `Roe_Iclentlal Backflow Prevention Devlca'- 27.55 -� Catch Basin 16.60 ___j Irspectlon of Exlating Plumbing or Speclally_ 62..50 Ru uey stad Inspectlons _ edhr -. COMMENTS REGARDING ABOVE: Rain Drain,single Earn ly dwelling 65.25 Grease Traps 16.60 _ -- QUANTITY TOTAL: Isomatd'or riser ilagrern le recurred if Quantity Total Is - -- -- "SUBTOTAL: -----" ' - - 8%STATE SURCHARGE: ----- -' `- "PLAN REVIEW 25%OF SUB"TOTAL: qe uired an If fixture total Is>9 -. TOTAL PERMIT FEE: Minimum permit fel In S 2.SO•914 e1a:2 surcharge,except 130111usneal ear,..now Prevention Oevire,which Is 136.23+a%state surcharge. r s �Ail Now Commerclol Buildings require 1 tete cr pians with renmstric or riser diagram for plan review. 0dstslformslpim-foe3.ur;c 0:"05!02 s Mechanical Permit Application ' Date received: P;=mit no.: ' .:.�; Cit of Tigard ----- - �- --- - — - - City Project/appl.no.: Expire date: G o Tigard Address 13125 SW hall Blvd,Tigard,OR 97223 — ty f B Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Bu+'ding permit no.: OF PERMIT I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement XNew construction ❑Addition/alteration/replacement U Other: JdR SlITE 1INFORMATIOrkil1 Job address: p / Indicate equipment quantities in boxes below, Indicate the dollar Bldg. no.: Suite no alue of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.. profit.Value$ Lot: Block: I Subdivision: •See checklist for Important application information and Project name; _ jurisdiction's fee schedule for residential permit fee. City/county: _ ZIP: — i,&21FAMILY DWELLING rtffirm-fi- r9E SCHEDULE, Description and location of work on premises: _- d 1 1 l Fee(ex.)I Total Est,date of completion/inspcction: Description _ Qty. Res,onl Res.only Tenant improvement or change of use: Is existing apace heated or conditioned?O Yes O No Air handling unit CFM Air conditioning(site plan require ) Is existing space insulated"J Yca `J Nr) Alteration of exis-tmg-TrV7M system _ TO I Y.101 lifill 1 1 of er/compressors Business Warne: T, ��- n State boiler permit no.: =N��S.�HEA v HP—Tons-.. BTU/H Address;PC � _ _ FiT-,;T ampere uct smoke detectors City: ICOD55U State: ZIP: D� eat pump(su,^tan required)_ Fax: a_ ag E-mail: nsta rep ace urnece urner .�_ CCB no.: �- Including ductwork vent liner U Yes U No _—_ _--_ install/replace/relocate caters-suspen c , City/metro lic,no,: __ wall,or floor mounted _ Name(please print): - Veut forappliance other than furnace CONTACT PERSON e r gerahon: Absorption units_ BTU/Il Name: Chillers HP - --- -- . . - -- - - Address: Compressors _--_ _ HP -- ----- - - ----- 'nrintnmenlal ex rttuat■n vent atlun: Uty _--- Stale: ZIP: -- Appliance vent _ Phone Fax E-mail: Dryer exhaust _ 1 Hoods,Type I/II/res. itchen/hexmal G hood fire suppression system Name. t - GS _ Exhaust fan with single duct(bath fens) Mailing address: — QN�—� Exhaust system apart fmm hcatin or AC City: lfst�tc:OKI7.IP. ue piping and str button(up to 4 outlets) r`IType. LPG 1`G Oil Phone: VtOD Fax: E-mail: uc i In eac a ntona over outlets Met ell 10 Process piping(schematic required) 7Phone: Number of outlets - therTfate app plfrnce of equ pment: _ Decorative fiteplace State: ZIP: nsert-type Fax: E-mail: oo stove pe et stove Ot er Applicant's signature: Datc: t ter: -- Name(print): — - --Not All Jurisdiction accept credit cards,please call jurisdiction fo,more Inkumation.� Permit fee..................... S O visa U MasterCard Notice: This permit application Mirimum fee........•....... S _ i �L_ expires 'f a permit is not obtained Plan review(at_ %) S Credo card number —— - Exprtes within 160 days after it has been o _ State surcharge(8%).... S Name of cardholder as shown an credits accepted as complete. S TOTAL........................ $ Cardholder signature A noont_ " 4404617(ISMICONI) • MECHANICAL PERMIT FEES -0MMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: 1 r TAL VALUATION: _ PERMIT FEE: _ ^_ Desch plion -- Price 1 etas 1 $1.00 to$5,000 00 Mtnimurrfee$72.50 _ Table 1A Mechanlcal Code oty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1} Furnace to !00,000 BTU '.00 for each additional$100.00 or including ducts&vents 14,00 fraction thereof,to and Including 2) Furnace 100.000 BTU+ _ $10,000.00. includingducts&vents 17.40 25_00 $1(',001.00 to S ,0 .0_0 $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 thuroof,to and including 4) Suspended heater,wall healer _ $25,0_00,00. or floor mounted healer 14.00 f $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included In appliance permit $1.45 for each additional$100.00 or _ _ 6.80 fraction thereof,to and Including 6) Repair units _ $_5_0,0(10.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.7.0 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereuf.� footnotes below. Comp '• Minimum Permit Fee$72.50 SUBTOTAL: 7) 3HP,absorb unit -- to 100K BTU 14,(10 - -�--- 8%State Surcharge $ - 8)3-15�,^;absorb 25.50 _ unit 1 O o 500k BTU _ 25%Plan Review Fee(of subtotal) $ 9)15-31 il absorb _ r _Reaulred for ALL comercial mits _ mperos�_ unit 5-1 frill BTU 3.,00 TOTAL COMMERCIAL PERMIT FEE: $ 10)30-50 IIP;absorb unit 1-1.75 mil B fU 4 52 20 11)>50HP;absorb unit>1.75;nil BTU 87.20 ASSUMED VALUATIE_ R APPLIAN_C_E: 12)Air handling unit to 10,000 CFM ONS P v Value Total 13)Air handling unit 10,000 CFM+ Descr�llon: _ Ot (Fa Amount 17,20 Furnace to 100,000 BTU,Including V 955 14)Non-portable evaporate cooler ducts&vents _ 10.00 Furnace> 100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&_vents_ _ _ _ 6.80 _ Floor furnace Including vent _ 955 Suspended heater,wall healer 16)Ventilation system not Included In o_r _ 955 _entiance permit 10.00 Boor mounted heater 17)Hood served by mechanl al exho!"! Vent not included In applicance 445 10.00 _ _P_o_rrY!t______ ---- 18)Domestic Incinerators Repair units _ -- - 805 _ 17.40 c 3 hp;absorb.unit, 955 to 100k RTU _ 19)Commorcidl or Industrial type incinerator 69.95 3.15 h;;absorb.unit, - 11700 101k to 500k BTU 20)Other units,inclu&ig wood stoves _ 10_.00 15-30 hp;absorb.unit,501k to 1 2,310 Y 21)Gas piping one to four eutlels mil BTU _ _ _ 5.40_ 30••50 hp;absorb.unit, 3,400 22)More than 4-par outlet(each) 1-1.75 mil.BTLt 1.00 _ >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mill.BTU___ _ Air handling unit to 10,000 cfm 656 8%State Surcharge $ Air handling unit>10,000 clm_ 11,1170 Non-portable evaporate cooler _ 658 TOTAL RESIDENTIAL.PERMIT FEE: S Vent Ian connected to a single duct _ 446 Vent system not included In 656 appliance permit _ _ -_ _ - r nand Fe4: Hood served b henlcal exhaust 656 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic Incinerator_ 1,170 $62 50 rer hour Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee is specifically Indicated (minimum rherge-half hour) Other unit Including wood stoves, 856 $62.50 per hour Inserts,etc. J Additional plan review required by changes,additions or revisions to plans Iminirnum Gas !ping 1-4 outlets 360 _ cnerge one-half hour)$62 50 der hour Each additional outlet_ _ 63 •State Contractor Boiler Codification required for units>200k BTU. TOTAL COMMERCIAL °°Rnldmll■ NC requires elle plan showing placement of unit. I VALUATION: _ _ _� All Now Commercial Buildings require 2 sets of plans. kiidstslformalmech-fees doc 02/05102 SCALE "THE WOODS" 1"=20' PUBLIC PUBLIC STORM �D DRAINAGE 361.30 . STM LAT 363.16 EASEMENT D=8.3' 50.00' \ s s -s — 15' BUILDING `LOT i74 j SETBnCKS I 5,157 SF i 5'7M / \ \�c 5' ! , LOT 23 -- LOT 25 Po�otm I - - -- 5 25' 1 5.25' 39.5�' o I S \ I ! `o \ TELEPHONE P��rSTAL / UTILITY RISERS LOT 24 I \ 1 STREET LIGHT 11 i —-- — __, i \\ ELECTRICAL 7.D75TAL 15.2'— — n —— }c`0 �! WATER METER N�i 366 50.00' 1 I PROPOSED TC=366.33Y T =36th 1 LANDSCAPING -- TREE(TYP.) S.W. PALERMO LANE I s7� ___— - -- — -- — --- -- — CENTEX HOMES T TUSCANY 16520 UPPER BOONES FERRY ROAC 16310 S.W. PALERMO LANE SUITE 200 PORTLAND,OREGON 97224 LOT 24 PLAN 2811 A . 1 (503)608_3060 N% 4 Is 7 c C� 4 N G Nary O G CECL d Q i Is x 'r v ! G p O i Ci ,< �� f► � ! "� -L� y oe OW ji or •' is F i. /