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16330 SW PALERMO LANE b 16330 SW PALERMO LANE CITU' OF TIGA,RD 24-Hour Q� BUILDING Inspection Line: (503)63P 4175 MST Od 4 S) INSPECTION DIVISION Busirecs Line: (503) 639.4171 BUP Received . Date Requested C �' AM PM - -- OUP Location __. _ U Sult©. MEC � �,_ Contact Person - �`•—-- Ph( -) � !<v PLM — Contractor Ph( ) — SWR BUILDING Tenant/Owner — --- ELC - Footing ELC _- Foundation Access: Ftg Drain ELR _-- Crawl Drain SIT Slab Inspection Notes: _- - Post&Beam ------- - Shear Anchors Ext Sheath/Shear - - - -- Int Sheath/Shear Framing - - Insulation —i--- Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 'F PASS-) PART FAIL P MBING Post&Beam Under Slab —— _- Rough-in Water Service — `— Sanitary Sewer Rain Drains - - Catch Basin/Manhole Storm Drain - - Shower Pan Othe •t� Ai PART FAIL _ _AN I CCA_L -- Post&Beam Rough-In — Gas Line Smoke Dampers "rinal S, PART FAIL - ..•4L Service Rough-In UG/Slab Low Voltage — ---- ----- - —— ----- -- -- F}[alarm Fina Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW V-"Blvd SS PART FAIL. Please call for reinspection RE:-. Unab',;io inspect-no access Vire Supply Line - �� ` �4 � ADA Oititb._ (v Ir+eµ+sctor Ext Approach/Sidewalk Other: Final DO NOT REIV'OVE this In4pectioli record from the Jeb site. PASS PART FAIL CITY OF TI G,A R D _ _ MASTER PERMIT PERMIT#: MST2003-UU158 4' DEVELOPMENT SERVICE=S Df1TE ISSUED: E: 21,03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 16330 SW PALERMO LN PARCEL: 2S105ZC T0025 SUBDIVISION: TUSC=ANY ZONING: P - BLOCK: LOT: 025 JURISDICTION: I PH REMARKS: Construction new SF detached residL-nce. BUILDING REISSUE: CEN2230 STORIES. 2 FLOOR AREAS _ REQUIRED SETBACKS REQUIRED CLASS OF W01(K: NEW HEIGHT: 24 FIRS' 1,033 of BASEMENT. of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND 1.235 of GARAGE: 449 of FRONT: 15 PARKING SPACES: 0 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD of RIGHT: 5 OCCUPANCY GRP: R,1 BDRM: 3 BATH: ? TOTAL: 2.268 of VALUE: 221.858 JO REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: GARBAGE DISP: 1 V.ATER HEATERS: t WATER LINES: 100 BCKFLW PREVNTR: G,IEASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN c 101)K: SOILJCMP c AHP: VENT FANS: CLOTHES DRYER 1 15 FURN s.UrOK: 1 UNIT HEATERS: HOODS OTHER UNITS: t MAX INP: btu FLOOR FURNAI CES: VENTS: 1 WOODSTOVES GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT - SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OH LESG, 1 0 •200 amp 0 •200 amp WISVC OR FOR: PLIMPIIRRIGATION: PER INSPECTION: EA A.-IDT 500SF: 4 201 - 400 amp 201 400 amp tat W/O 8VCIFDR. SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY 401 600 amu: 401 - 000 amp: EAADDL GR r,IR. ;YGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 001 1000 amn: 001+ampo•t00ov: MINOR LABEL: 1000♦amp/volt. PLAN REVIEW SECTION Roconnect only —'-- -4 RES UNITS: SVCIFDRa.225 A. -000 V NOMINAL CLS AREAISPC OCC. ELECTRICAL•RESTRICTED ENERGY A.SF RESIDEN I IAL _ B.COMMERCIAL AUDIO 8 STEREO VACUUM SYSTEM AUDIO 6 STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM OtH BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER CLOCK: INSTRUMENTATION: PdEDICAL: OTHR: HVAC DATA(TELE COMM: NURSE CALLS: TnTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 8,412.83 CENTER HOMES CENTER HOMES This permit is subject to the regulations contained in the 16520 SW UPPER BOONES FERRY 16520 SW UPPER BOONES FERRY Tigard Municipal Code,State OR. Specialty Codes and all other applicable laws. All woo rk will be done In PORTLAND,OR 97224 #200 PORTLAND,OR 97224 acoordanae with approved plans. This permit will expire N work Is nL..started within 180 days of issuance,or if the work Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503-605-3060 Phone: 503-608-3060 Oregon Utillh Notification Center. Those rules are set forth in OAR 1,32-001-0010 through 952-001-0080 You Rep N: LIC.' 124490 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Merhanica Plumb Top Out Exterior 5neathil g Inst Rain drain Insp Electrical Final Sewer Inspection (lnderlloor Insulation Electrical Service Low Voltage Roof Nailing Mechanical Final Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp W iter Line Insp Plumb Final Foundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Post/Beam Str'.ctural Mechanical Int-) Shear Wall Insp Insulation Insp Appr/Sd Insp Isstied By : �c..,rti c <c Permittee Signature : L' Call (503) 639-4175 by 7:00 p.m for an inspection needed t e nex business day SANITARY• D Y L4_"0JeanWatcr Serviccs 7,.,97,24 SURFACE WATER 6jm,:1,:' rTON PERMIT 7SST.JE DATE 05090:3 EXPIRATION DA'Z'E 110503 EC EXP DA'L'E 050805 PERMIT 124064 ISTRUCTURE ADDRESS 16330 PROJECT 8610 STRUCTURE STREET fiW PALERMO LANs; Id)T 2 5 BLOCK YPE CONNECTION- NEW OF' TUSCANY SUBDTVISION TYPE .TNSTALLATIOM-- ( 19 ) BLD WR,'FPO CON/SDC TYPE OCCUPANCY- ( 1 ) SINGLE FAMILY PARCEL 2S1 5C:C 117000 C,)'I'R SEC 441.E MH 24059 OWNER CENTEX HOMES ADDRESS 16520 SW UPPER BOONS � FEET TREATMENT PLANT DURHAM PORTLAND OR 97224 PHONE 503- 308--3060 _ .... ____WI 'fEF. DSS'CItJCCT_'I'IGA>�-I?_.___._ FIXTURE_ EQUIVALENT DWELLING RESIDE 14TIA'L Tir?T'T,3 SERVICE, UNIT'S 0 . 0 UNITS 1 SERVICE UNITS 1 C(INNEC'1''ION FEES SURFACE.; WATE P DEVELOPMENT FEES iaWF:R CONNECTION 300 . 00 WATER QUALITY 225 . 00 LESS CREDIT { 225 . 00, WATER QUANTITY 275 . 061 i E33 C,PF:DIT < 0 , 00> EROSION CONTROL I.NSPEC:TION 64 ,00 FLAN CHECK 41 . 60 SUBTOTAL 2:300. 00 SUBTOTAL 300. 60 TOTAL 2680 - 60 PPI, NAME, MIKE PHONE 1FFILLIATION REP +E;M.ARKS LOT 25 , TUSCANY , #8610 Number 6, c J 1 f.' rr INSPEC'TION • _84ib-8444 f'.NAT(JRE� 7 SeilEE? BY WTI,SI�NM t'ermit Conditions, The applicant agrees to oomoy with all nibs and regUlations of the Unitiad Scawrage Agency When (;ailing fro an;nspedion, please refer to the Pemiif Number The Permit expires one hundmd eighty 1180) days from tha date(f issuance The Aqency does not quarantee the,acairary of the location of side sewer laterals 7193 WHITE - USA, BLUE - Accounting, GREEN -Inspection, YELLOW - CUat('M r INSPECIE1) by CONTRACTOR/I NSI ALL a T Y'PF OF PIPE DI ANIF ll P W. PIN Inspector, Please sketch hPlnw or attach the fr11` l,7wir.; infcrmll' ir: ' } 1 Strut & nearest Cro�,S Strr'pt f P LOcatiGn Of structure beinri Served 3 Route of service line frj:,nn Str'uc..turr to prop«:rty ling who're, it .connprt> f,a the sh " 1 � r vice. lateral . fms-. lu!1A lorulth & zi,7FnF�•;,nr I of Service l irr!, 'ricpth at tha structure K propl?rtY dimensions rf�'lprP.ncing line t.-.) structure, pr'opU,rt,y' llit and/or (..ornr�rs, etc . f4 North ai row 1 I i I i I e i 9 i i ' 1 z ! I 1 I Building Permit Application ' Date rcccPie L1: / Permit no.:I7-7 i ' Cite of TigardProjecUappl. no.: Exp a date:Ti oral Address; 13125 SW Hall Blvd,Tigard,OR 97223 ty of Phone: (503) 639-4171 \ Date issued: Bye, Receipt no.: Fax: (503) 598.1960 / Case file no.: Payment type: Land use approval: 1&2 family: Simple Complex: I &2 family dwelling or accessory ❑Commercial/industrial O Multi-family %New construction ❑Demolition r F'U' Addition/alteration/replacement ❑Tenant improvement D Fire sprinkler alarm ❑Other: jos sr*.INIFORMATION Job address: y zn a L r7Bldg. no.: Suite no.: Lot: Block: Subdivision: j14Ct .#iV V — Tax ma /tax lot/account no.: Project name: 'T U A JY_ Description and location of work on premises/special conditions- i Name: M Mailing address: g PIS 1 & lantily dwelling: City: p T- � e: ZIP: Valuation of work ......................................... S ZW j4q ' — Phone: 0 -3oto o Fax.(pnE-mail: Nu, :r b drourns/baths... 3 Z. Owner's representative: E _r___NN I P Total number of Floors ................................. Fhonc: -DFaxIE-mail: New dwelling area(sq. ft)............................ Garage/carport area(sq,ft.) .......................... Name: ("Am I, E Covered porch area(sq, ft.) _ — -�- Deck area(sq. ft.) Mailing address: _ .................................. —� ----- -- "--- h Oter structure area(s City: Stnte: _ZIP: q.ft.).......................... Phone: �Fa Email — Cummereiallindustrial/multi-ramily: t t Valuation of work ......................................... S Existing bldg.area(sq, ft.)............................ Business name r 1 E- New bldg. area(sq.ft.).................................. Address: City: - State: ZIP: Number of stories.......................................... _ -- — Type of construction ..................................... Phone; Fax: _ E-mr:iL• Occupancy group(s): Existing: CCB no.: li4acl D New: City/metro lir,,no.: Notice:All contractors and subcontractors art,-equired to be ARCHITECTIJASIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORF,701 and may be required to be licensed in the -— ---- - -- Address: jurisdiction where work is being performed. If the applicant is exempt from li:ensuig,the following reason applies: City — State: ZIP: Contact person: Plan no.: —" Fhonc: Fax: Email: - VNGINFUR OFFIM USE_"LV Name: Contact persot.: Fees due upon application............................S Address: Date r^ceived: City: State: ZIP: Amount received............................I.............. Phone: I Fax: E-mail: Please refer to fee schedule. 1 hereby certify I have read and#examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more information attached checklist.All provisions of laws and ordinances governing this U visa U MasterCard work will be complied wish.whetherene tt•.d herein or n�oLl f;1Credit card number: -- — Expires Authorized s I G V /Date: �1 1�' Name of card o der as shown on credit cud Print na nee -� A t ( J Gr older nanature s Amount Notice: '?as permit application expires if a pennit is not obtained within 180 days ager it !,as been accepted as complete. 440.4613(y00/C0M) Electrical Permit Application ' — Date received; Permit no.: T, City of Tigard Project/appl.no.: Expire date: 00,of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Rccctpt no.• Phone: (503) 639-4171 _ Fax: (503) 598-1960 Case file no.: Paymut type: Land use approval: OF PERMFF I &2 family dwelling or accessory ❑Commercial/industrial 0 Multi-family ^O'Cenant improvement New construction ❑Addition/alteration/replacement ❑ Other: ❑Partial JOB SITE INFORMATION Job address; /6 m Dldg. no.: Suite no : Tax map/tax lot/account no.: Lot: Block; Subdivision: Project name: T Description and location of work on premises: SIN(o4F_-_FAMJL �F� IA(- Estimated date of completion/inspection: CON'I'RACTOR APPLicvjrlONSCHEDULE Job no: Fee ntov $u51nC55+:dtr:°: Description Qty. (ea.) Total no.lnsp New residential-single ormuld-family per Address: dwelllngunit.Includes attached gange. City: State: ZIP: FS Serviceincluded: Phone: �j U- Fax: E-mail: 1000 aq.ft.a Icaa — 4 >^CA no.: Elec.bus.tic,no: l Each additional 500 l . R.or rtion lhercof _ sf Limited energy, residential 2 City/metro lic.no.: Limited energy, non-residential _ 2 )�—y.Cls Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service andror fecdc: 2 ;up.elect. name(print): - ( License no: 46,1'75 Servlresorfeedera—InaIallNlon, alterationorrelu stion: 1 1 200 amps or Icrt 2 Name(print): TX � 201 sm st l0 40U amps 2 Mailing address: 10� V � sol emp:t�coo amps ?_._ All amps to 1000 ams _ City: State: ZIP: Over 1000 amps or volts — — _ 2 _ Phone: Fax; E-mail: Renonncet only Owner installation: The installation is being made on property I own Temporary services or fredera- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: 200 amps or leu 2 ORS 447,455,479 6701. _ 201 amps to 400 amps 2 _ Owner's signifurcr D Date: 401 to 600 ams — 2 Branch circuits-rip",alteration, or extension per panel? Name: _ A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 .. City: IState: ZIP: B. Fee for branch circuits without purehac --- -- — - - _ '—' of service or feeder fee,tint branch circuit. 2 Phone: F.x L mail: Each additional branch circuit: PLAN REVIEV(Please clieck all lilitat apply) till tic.(Service or feeder not Included): U Service over 225 run{n.:onunercialU Health-care facility Foch pump or irrigation circle _ 2 U Service over 32G amps-rating of 1&2 O Ha7srdous locationEach sign or outline lighting _ 2 family dwellings 0 Building over 10,000 square feet four or Signal circuitts)or a limited energy panel, •Synm• .rver 600 volts nominal mote residential units in one structure alteration, or extension*_ - 2_ O StdWng ever throe stories O Feeders,400 amps or more 'Description: _ ❑Occupant lad over 99 persons O Manufactured structures or RVrk --� � Each additional Inspection over the allowable in any of rine above: p EgrcssAighling plan ❑Other:,. Per insp"tinn Submit_seta of plana with any of the above. Investilitotion fee _- The above are not applicable to temporary construction service. Othcr Not all jurisdictions accept credit cards,please call jurisdiction for move Information. Notice: This permit application Permit fee .....................S O vias Q MosterCard expires if a permit is not obtained Plan review(at_,_ %) S ._. Credit card number: / _ within 180 days after it has been State surcharge(11%).....S Expires accepted as complete. TOTAL ...........S Name of ardhoidtr as shown on credit card S Cadhol er staneturt Amoum 4104613(11 WCOY ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: --�_— - --- — TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: -- __ kaslrlcted Energy Fee...................................................... 575.00 Numbe of Inrpections per permit allowed) (FOR ALL SYSTEMS) Service Included: Items Cost Total I Cherk Type )f Work Involved. Residential-por unit 1000 sq.fit or lees $145.15 4 Audio and Stereo Systems" Each additional 500 sq.It.or portion thereof T__ $33.40 1 Burglar Alarm Limited Energy $75.00 _ Each Manufd Home or Mod,tlar Garage Cour Opener" Dwelling Service or Feeder __ $90.90 2 Services or Feeders Healing,Ventilation and Air Conditioning System' installation,alteration,or relocation 200 amps or less $80.30 < ❑ 201 amps to 400 amps A $106.85 Y 2 VaCLUrn Systems" 401 amps to 600 amps $160.60 _ 2 6U1 amps to 1000 amps $240.60 2 Other — Ovsr 1000 amps or volts $454.65 2 Reconnect only _—_— $86.65—.__._ 2 Temporary Services nr Feeders TYPE OF WORK INVOLVED COMMERCIAL ONLY Installation,alteration,or relucation Fee for each systorn.......................................................... $.'5.CJ 200 ampr jr less $66.85_ 2 (SEE OAR 918-260.260) 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 u Boiler Controls New,alteration or extenslon par panel e)The fee for branch clrculLs, with purchase of service or Cluck Systems loader fee. Each branch circuit —___- $6.65 2 F-1 Cate Telecommunicaf. Installation b)The Ian for branch cimulls without purchase of service Fire Alarm Installation or feeder fee. First branch clrcul; $46.85 Each additional branch circuli $6.65 LJ HVrkC Miscellaneous El Instrumentation (Service or feeder not Included) Each pump or Irdgallon circle $53 40 1___J Intercom and Paging Systems Each sign or outline lighting $53,40 Signal clrcult(s)or a!lmlted energy panel,alteration or extension —�� $75.00 Landscape Irrigation Control' Minor Labels(10) $125.00 _ Medical Each additional Inspection over the allowable in any of the above Nurae Calls Per Inspection $62.50 —.�_- Per hnur _ $6250 In I'lenl —__ $73.75 Outdoor Londocape Lighting' Fees: Protective Signaling Enter total of above linea $ _ �� Other --- 8%State Surcharge $ —_ Number of Systems 251/.Plan Review Fee S No 4censea are required L consea era required for all other inatallallona See'Plan RevteW section on front of appiieativn -- ---- Fees: Total Balance Due $ — —�" Fnts r total of above fees Trust Account q _. —�I 8%State Surcharge Total Balance Due S--All Flew Commercial Buildings;equlre 7 sets of plans. i:\dsts\fornss\elc-fees.doc 02/05102 t Plumbing Permit Application7,,.-, . ' : Permit no. /4 Cit of Ti and City g no.: Building permit no.. Address: 13125 SW Hall Blvd,Tigard,OR 97223 ecano.: Expire date: Ciry IfTigardphone: (503) 639-4171 pp Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ Case rile no.: Payment type: C1 1 &2 family dwelling or accessory 0 Commercial/industrial O Multi-family 0 Tenant improvement 0 New construction O Addition/alteration/replacement O Food service ❑Other: _ � � Description Qty. Eee(ea.) Total Job address: A 3 New 1-and 2-family dwellings only: Bldg. no.: Suite no.: (includes 100 ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath _ __ Lot: Block: Subdivision: SFR(2',bath _ _ Project name: ,!�-� SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Dwells/leach line/trench drain Est.date ofcompletion/inspection: T11 1W N Footing drain(no.lin.ft.) l t Manufactured home utilities Business nomeCO (�"j- S y,�Es fi� Manholes Address: Q SW/ _ Rain drain connector City: T1 State: (' ZIP. 7- Sanitary sewer(no.lin.tt.) Phone: Fax:(p r Email: Storm sewer(no.lin.ft.) Isa21 Water service no.lin.ft.) _ CCB no.: , Plttmb. s.reg.no:3t}-351oP8 Fixture or item: City/metro lic.no.: Ca AS Absorption valve _— Coniractor's representative signature: Back flow preventer _ Print name: UL STIP . o Date: Backwater valve \ Basins/lavatory _ Name: A Y-} n n I\t"A h Clothes washer Dishwasher Addrass: '1„100 S + � Drinking fountains) City;T. a� State: IZ ZIP: "j qt23 Ejectors/sum ^hone: $tr3`S $-y'lgf( Fex:ko3.le39a4 :mail: Expansion tank Fixture/sewer cad_ Floor drains/floor smkn/hub Name(printl: — Garbage disposal Mailing address: Noie bi b Ci State ZIP: Ice maker Phone Fax: 10 E-mail: Interco tor/ reg ase trap_i Owner installation/residential maintenance only: The aztual 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),levs(s) Owner's signature: __ Date: _ Sum Tubsishower/shower pan _ Urinal Name: Water closet Aduresss-_� _ Ater heater Swr;: City Zip: Other: _ Phone: Fax: E-mail: o _ Minimum fee................S Nntdl pri:dietion%accept cmdit tarda.plain call jurisdiction for move infortutton. Idotice: -this permit application a L7 Visa 0 MasterCard expires if a permit is not obtained Plan review(at_ /o) S State surcharge -, L-- (8°/a).... S Credit card number.�.-- Ex iris within ISO days after it has been accepted es complete. TOTAL........................ S Nam°of cardholder u shown rn ercdit card f C older flanature 44"16(6l0alCOM) PLUMBING PERMIT FEES: _ PRICE I TOTAL Now 1 and 2damlly dwollings�onl�y:�� FIXTURES Individual CITY ee AMOUNT (Includes all plumbing Hxturos ^. I PRICE TOTAL - 16.60 the dwelling and the flrst100 ft. I ^iY (ea) AMOUNT Sink for each utill connectlon _ Lavatory 16.60_ One 1 bath _ _ $249.20 Tub or Tub/Shower Comb, 18.80 Two 2 bath - $350.00 18.80 Three 3 hath $399.00 Shower Only --- Water Closet 18.60 SUBTOTAL Urinal 16.60 - 8%STATE SURCHARGE =� Dishwasher 16.60 - PLAN REVIEW 25%OF SUBTOTAL - _ _ 18.80 TOTAL Garbage Olspoaal _ Laundry Tray 18.60 Washing Machine 16.60 Floor Drain/Floor Sink 2' 18.80 18.80 PLEASE COMPLETE: 3• 4• 16.80 _ _ --- 16.80 Quantic b 1M1ork Performs _ d Water Heater O conversion O like kind Fixture Type: Naw Moved Replaced Removed/ Gas piping requires a separate mechanical -Capped permit. MFG Home New Water Service 46.40 Sink MFG Home New 46.40 Lavato-San/Storm Sewer Tub or 7ub/Showor Have Blbs 16.60 Combination Root Drelna 18.80 Shower Onl Drinking Fountain 18.60 Water Closet Urinal Other Fixtures(Specify) 18.60 Dishwasher Garbage Disposal Laundry Room Tra Washing Machine _ Flcor Drain/Slnk: 2' Sewer-1 st 100' 55.00 _ 3' Sewer-each additional 100' Water48.40 4' - Weter Service-1st 100' Oth 55.00 - Heater 48.40 011ier Fixtures Water Service•each additional 200' _ 3 eci _ - Storm 8 Rata Drain-1 a 100' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 4640 -- Residentlal Backflow Preventlon Device' 21.55 - Catch Basin 18.80 - Inepectlon of Existing Plumbing or pact 11 62.50 Requested Ins ec:tion$ or/hr - COMMENTS REGARDING ABOVE: Rein Drain,single family dwelling 65.25 Grease Traps 16.80 ------- - _ QUANTITY TOTAL: ------ Isometric or riser diagram Is requlrad If -_ -- - - Ouentity •SUBTOTAL: 8%STATE SURCHARGE: `- LAN REVIEW HI OF SUBTOTAL: Rs uirsd�f fixture qN facet Ie>9 _ -- TOTAL PERMIT FEE: S ------------ •Minimum permit he Is S72.5o.s%state surcharge,except Residential Recxflow Prevention Device,which Is 136.25>a%stats surcharge. i **All Now Commercial Buildings require 1 sats of plans with Isometric or riser diagram for plan review. is\dsts\forms\plm-fees.dcC 02/05/02 Mechanical Permit Application ' Date received: Permit City of Tigard Project/appl.no.: Expire date: L^ 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 no.: ` TYPE OF PERMIT bi 1 &2 family dwelling or accessory O Cor,amercial/industrial 0 Multi-family 0 Tenant improvement ANew construction C)Addition/alteration/replucemert ❑Other: t i '!WATION VALUATt0tN-SCHED1JLE- Job address: /h 33y Au.�t/Vl Q Z pment quantities in boxes below. Indicate the duflar Bldg. no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ —_ Lot: -r Block: Subdivision: *See checklist for important application information and Project name_:MAC, AAjt4 jurisdiction's fee schedule for residential permit fee. City/county: yJZ[P: ► 11-IF 9' Description and location of work on premises: _ _ r t11 1 __ _ f�•�•(ea.)� t ural Est.date of completion/inspection: Description Qty. Res.ool ties.unit Tenant improvement or change of use: handling ' 1s existing space heated or conditioned?Q Yes O No Air condilio unit_ CFM Is existinga lace insulated?O Yes O No Air con�ore—x�tens plan rcauirr_ �{ terauo- o extsung " system Boi cr compressors Business name: �ENTr=� EAm M Stat boiler permit no.: HP—Tons—BTU/ii Address: Fire/smo a ampere uct smoke detectors _ City: epveo State:0 Z1P: � tIleat pump de—plan required) Phone: a I Fax:9 Ja_(baJ4E-mail: asta rep ace mace umer -- -- — Including ductwork/vent liner 0 Yes 0 No CCB no.: �— nsta TTe—plece rcio at-a heaters-suspended, City/metro lie.no.: _ wall,or floor mounted Narr.:(please print); Vent for appliance other than furnace ONRefrigeration: Absorption units BTU/FI Name: Chillers HP --.- - -- -- _ - - __ _.--- -- . _____ Coors HP Address: _ nREenta ex oust an tent don: City: State: ZIP` Appliance rent Phone: Fax: E-mail: Dryer exhaust s ocil-'Typed/res.kitchenthazmal hood I re suppression system Namc: s, � �� Exhaust fan with single duct(bath fans Mailing address: luel;,,pExhaust s,•ssttemm apart from heating ACC Li State: ZIP. Fing ardor buNnn(up to t)) outle Type. _ LPG NO Oil Photc: ,Qg- .0&lD_ Fix: E-mail: uTueT pipingeach a utona over 4 outlets Process piping Ise emetic required) Name: Number of outlets ter listed appliance or equipment: Address: Decorative fireplace City: State: ZIP: Insert-type Phone: Fax: E-mail: Woodstove/pellat stove OEM Applicant's signature: Date: ter: Name(print): Not all Jurisdictions accept Credit Cards,plesse call jurisdiction for more infhrmed n. Permit fee.....................S 0 Vim O MuterCard Notice: This permit application Minimum fee................S Credo card number. expires if a permit is not obtained plan review(at_— %) S _Y xpiree within 180 days after it has been State surcharge(8%' .... S Acme of cordo der as shown°n t lira c�.r -- accepted as complete. sTOTAL........................ S _ _ 1 ar s anal-- Amount +:B iel7(61001[0!') 1-hS7-a003— 3 SCALE (� ` PUBLIC STORM "THE WOODY 1":20' 0 DRAINAGE 363.16 STMT. Del EASEMENT D=6.3 50.00' --yLLs" r in iris 15-- 364.86 366 LOT 25 I — 7 \ / 5,158 5F - �� 8UILDIN6--\ I I 77 \ SETBACK5\ i I i LOT 24 \ !I l lr 5' LOT 26 \ 5 -- - 368 iv \\ \\ p 5. / 0. _5.25' I \ \ v o �i UTILITY RISER.5 LOT 25 / I / / FLECTRIc:AL PEDES TAL \ UNDER6ROUND L -j- - --- UTILITY VAULT TELEPHONE PED E5TALAIR REDUCTION _ 15'. VALVE — I � 11 I 5 . 0' M _---M—__ WA TER METER TC=369.07 TC=368.12 t� 5. W. P,LEPMO DRIVE CENTEX HOMES TOSCANY y -1 1652n UPPER BOONE.5 FERRY ROAD 16330 S.W PALERMO LANE SUITE 200 9 a PORTLAND,ORE60N 97224 LOT?5 PLAN 2268 A /5nV AAA-inti o ?? on Z CL V, tw, ft � O C ' O 7 r9 v Q � n %wd T N s c a'