The URL can be used to link to this page

16370 SW PALERMO LANE as c 16370 SW PAI ERM ' LANE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST 3b0/ INSPECTION UIViSiON Business Line: (503)639-4171 BUP Received Date Requested �- AM — PM BUP Location �(l�?2'71� r�� I,GYI� Suite- MEC Contact Person jdh2�- Ph(.—) � ' ��'� PLM Contractor Ph( ) __ _. SWR ILDIN Tenant/Owner _ _- — ELC Footing Foundation - ELC Ftg Drain ACCG2) Crawl Drain / X 2 Z �� ' �1 L;S ELR _-- Cr Stab Inspection Notes: �/ /�� SIT - Post&Beam l� ?C•(/� Shear Anchors Ext Sheath/Shear Int Sheath/Shear Fra:ling Insulation, Drywall Nailing % — —--- Firewall Fire Sprinkler l --- — Fire Alarm V Susp'd Ceiling --- - - - - - Roof Other:_ -- n Ld ASS ART AILVA - Post$Beam Under Slab Rough-In Water Service - ----- -- Sanitary Sewer Rain Drains --- Catch Basin/In, [C' Storm Drain — A Shower Pan u Other:- — - — -- ASS PART ASL —. - - - - - - -- Post& Beam V Rough-In Gas Line l Smoke Dampers ----- _ n AS PART AIL � — --- -- _ ce Rough-In -- UG/Slab Low Volt Fir i PART FAIL Reinspection foe of$._ _.___- quired fore next inspection. Pay at City Hall. 13125 SW Hall Blvd. [] Please call for reinspection RE: Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Hate Inspector Other: Final DO NOT REMOVE: this Inspeci:,vn record from the job site. PASS PART FAIL AAAAAAAAAAAAL .AAAAAAAAAAAAAIA . JAAAAAAAAAAA A i a b ' 4 y ► tTl ► �--' ► i . � w � z ' 4 \ � � ► M b - • ► 4 \ ► i 0 i o cr ► p CL Y > �, �' ► 4 t?f r?i � p �s.� � ► �1 rm ► . rSl ; o o ► 1 �' o' J ► 4 Cc 1 ~ ► 4 ► a� . o ► 4 I w I ► � l/v o ► . ► 4 ► 4 Poo. 4 Q ► . ► t ► . ► � p t / rvvvTTTTTTTTT IITTTT`'TTTTTTT\�,..� ..... _ _. ....... ..... . ...._.._......_. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)6�9-4175 MST INSPECTION DIVISION Business Line: (503,}639-4171 � �� j� BLIP �— Received Dat quos ed .� _AM �PM BUP Location _ _ �s 3 7a �'1 Suite MEC Contact Person - Ph( ) �-� SOS PLM Contractor_�_ - _ Ph SWR BUILDING _ Tenant/Owner _ - --_ ELC Footing Foundation ELC Access: �� r S c�ti. ,� I Ftg Drain Wl 1`r O ELR - -- - Crawl Drain lit/ Slab Inspection N.,Ies: SIT Post✓3,Beam Shear Anchors - - D.1 Sheath/Shear nt Sheath/Shear - Framing -- Insulation IV,Q Drywall Nailing -- - -- Firewall Fire Sprinkler - -- -- --- Fire Alarm Susp'd Ceiling - Roof /� / -�j - -- - "'/Other: � -� �`------(----- PASS PARI AIL PLUMBING v --- Post&Bearn Under Slab -- -- -- ---- - Rough-In Water Service - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain -- -- --_-_.____-_._._. Shower Pan +na _ AT ECF NICA Post&Beam Rough-In --_---- Gss Line Smoke Dampers - -m RT - -- -- - _ ----- - --- ---_.- 41-CTRICA Service --- ----- -- -- -------------------- Rough-In UG/Slab Low Voltage --_- - ----- -- -- -- --- --- --- - ' ice Alarm Final PART FAIL F-1Peinspection fee of$- required hefore next inspection. Pay 3t City Hall, 13125 SW Hall Bivd SITE _ �_ ❑ Please call for reinspection RE: _ ____.-_ __-___._. LHabio to inspect-no access Fire Supply Line ADA / Approach/Sidewalk Gift ` l! Inspector Other. Find -�—� DO NOT REMOVE this Inspection record from the fob SHOO PASS PART FAIL ro ` ry O r e a a °V\ S � C �• �—� con EL ro � v ro s 7 71 v ro g ro 0U °, G F Q C r_ CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 �- 2 _ /ti/� INSPECTION DIVISION Business Line: (503)639-4171 MST ,L—�� _ / SUP Received _ _ _Date Re ested._ '2r- _ AM____— PM BUP Location 1.L.,',za _Suite _MEC Contact Person Ph(—) - S PLM Contractor — Ph(_ ) — SWR VTenant/nwner —_ ELC Foundation Access: ELC Ftg Drain ELR Crawl Drain _ Slab Inspection Notes: SIT Post&Beam ShAar Anchors -- - Ext Sheath/Shear Int Sheath/Shear - Framing Insulation Drywall Nailing - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - — - —---- Roof E' Other:-- — ---- ---- - --- �.___�_ ,r SS ART FAIL ---------- - ,i� P MBING --- ------ --- --- ---- Post& Beam Under Slab Rough-In - Water Service ---- ------ Sanitary Sewer Rain Drains ,_-- Catch Basin/Manhole Storm Drain — ----- Shower Pan Other: Final PASS PART FAIL MECHANICAL _ Post&Bearrr Rough-In ----- -- -- —---- -------- -- --------- — - Gas Line Smoke Dampers ---- Final PASS PART FAIL — ELECTRICAL _ Service Rough-In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fne of$ _—_required before next inspection Pa;at City Hall, 13125 SW Hail Blvd PASS PART FAIL SITZ: Please call for re inspection RE: _._ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date I !� _ Inspector Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL ®� ��CITYMASTER PERMIT PERMIT#: MI-72003-00159 DEVELOPMENT SERVICES DATE ISSUED: 5/30/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE .ADDRESS: 10370 SW PALERMO LN PARCEL: 2S105CC-T0027 SUBDIVISION: TUSCANY ZONING: R-7 BLOCK: LOT: 027 JURISDICTION: URB REMARKS: Const new SF detached residence. BUILDING REISSUE: GEN2811 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,296 9f BASEMENT. sf LEFT: 5 SMOKE DETECrORS. Y TYPE OF USE: BE FLOOR LOAD: 40 SECOND: 1 515 of GARAGE: 440 at FRONT, 15 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: I THRD at RIGHT: 5 OCCUPANCY ORP: k3 BDRM: 5 BATH: 3 TOTAL: 2.011 d VALUE: 27178960 RE4R: 15 PLUMBING _ SINKS: 1 WATER CLOSETS: 3 WASHING MACH: t LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 10U SF RAIN DRAINS: t CATCH BASINS: TUBISHON+ER9: 3 GARBAGE DISP: t WATER HEATERS: 1 WATER LINES: 100 BCKFLW PR°VNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP<3HP. VENT FANS. 5 CLOTHES DRYER: + G A 5 FURN>000K: I UNIT HEATERS: HOODS: t OTHER UNITS: t MAX INP btu FLOOR FURNANCES: VENTS: t 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. W/SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 400 amp: 201 400 amp: 1st WIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 500 amp: 401 °00 amp. EAADDL BR CIR SIGNALIPANEL: IN PLANT: MANU HWSVC/FDR: 601 1000 amp: Ool+8mps-10oo V MINOR'.ABEL: 10004 amolvolt PLAN REVIEW 9ECT+ON Reconnect only: >u4 RES UNITS: SVCIFDR>=225 A.: >800 V NOMINAL: CLS ARE'AISPC OCC: ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B.CV.1MERCIAL _ AUDIO A STEREO: VACUUM SYSTEM: AUDIO&STEREO: F.RE ALARM. INrERCOM/PAAING OUTDOOR LNDSC IT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL. GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR. HVAC: DATA/TELE COMM: NURSE CALLS. TOTAL a SYSTEMS: Owner: Contrac'nr: TOTAL FEES: $ 5,784.34 CENTER HOMES CENTER HOMES This permit is subject to the regulations contained in thR 16520 SW UPPER BOONES FERRY 16520 SW UPPER BOONES FERRY Tigard other Municipal a lawCodeState o OR. Specialty Codes and PORTLAND, DR 97224 #P00 all other applicable laws. All work will he done PORTLAND,OR 97224 accordance with approved plans. This permit will expire H work is not 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: 303-608-3060 "hone: 503-608-3060 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You Rao N: LIC 124490 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Cnntrol Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Inst Rain drain Insp Electrical Final Sewer Inspection Underfloor Insulation Electrical Service Low Voltage Roof Nailing MechaAral Final Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final Foundation Insp PLM/Underfloor Framing Insp Gas Firepla,,e Water Service Insp Building Final Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk I p Issued By : A 1 1 b.�L�L:_�.____— Permittee Signattfre : 1►�' Co!I (503) 639-4175 by 7:00 p.m. for an inspection needed the ext b siness day 1 Ii !n iii' ❑� SANITARY• . Ino I ` ikleanWater Services y7114 SURFACE WATER U _ CONNECTION EERMIT ISSUE DATE 050903 EXPIRATION DATE 11.0503 EC EXP DATE 050805 PERMIT 12406E STRUCTURE ADDRESS 16370 PROJECT 8610 STRUCTURE STREET SW PALERMO LANE LOT '7 BLOCK PYPE; CONNECTION-- NEW OF TUSCANY SUBDIVISION TYPE INSTALLATION - ( 19 ) BLD SWR/ERO CON/SDC TYPE OCCUPANCY— ( 1 ) SINGLE FAMILY PARCEL 2S1 5CC 1.1700 QTR SEC 441.3 MH 24059 OWNER CEN"T'EX HOMES ADDRESS 1652.0 SW UPPER BOONE;S ):ER TREATMENT PLAN,r DURHAM PORTLAND OR 97224 PHONE; 503-30d-:3060 WATER DISTRICT TIGARD FI�;TVRE, _ r .^` - EQUIVALENTY DWELLING RESIDEN'T'IAL IJNIT5 SERVICE, UNIT ' 0.0 UNITS t 5F.'P.VICT; UNITS 1 CONNECTION FEES SURFACE. WATER DEVELOPMENT FEES SEWER. CONNECTION 2300-00 WATER QUAL[TY 225 . 00 LESS CREDIT < 225 .00> WATER QUANTITY 275 .00 LESS CREDIT 0,00> EROSION CONTROL INSPECTION 64 .00 PLAN CHECK 41 . 60 SUBTOTAL 2300 , 00 SUBTOTAL 180 . 60 TO'T'AL 2680 . 60 APPL NAME MIKE; PHONE AFFILLIATTON REP REMARKS LrT '17 , TUSCANY , #E1610 . . . . Ni __ 8444 . « . . . Ni n) r t c I tdr NSPETION- - B 6 '!INA`i'URF, __.__. ISSUED BY WI L;3c7NM Pennit Co,dilfons The.ipplirant agrees, to jor ply with all Odes and regulations o1 the Unified Seweraq.je Agency When calling for an inspersion, please toter to the Porrul Nuntvr The Perinif erf*ms one hundred eighty (180) days from the date of issuance The Agency d m not guarantee the acarracy of the location of side sewer laterals 7/93 WHITE - USA, SLUE - Accounting, GREEN - Inspection, YCLLOW - Customer fNSfE(,1E1) BY f)n'F C.ONIRACT0R!INS7ALLFR 1Yi%i f)F PIPE I)1 AMI i! P Inspector+ Please sketch below or att."ch I i?a f r i lryv,i t 1 Street & nearest cross stra,Pt ?_ Location of structure bring ,nrvfd ' 3 R iif service_ Iine froom ,tr ,,(t lire to prOPert,y ' 0 t..o c� con ner,ts to the s,?r-4 ico 1,3tara I Inc ) .,de, lenri►.' of Service Iimr, depth it thfr StrLa^t,W & propw, [y dimon,inns rt�ferr,nciny line to c,triir,i.1., prupert:y dnCl;Or ,:irrnf"r;, ,,rr , n North arri?w I i l i i i -a;a- 03 MAV Building Permit Application ' City of Tigard 7LL)a recrrnu nu ;, 17 cUappl. no.: Expire date: City oji7gard Address: 13125 SW Hall Blvd,Tigard,OR 97223 — Phone: (503) 639-4171 /� to issued: By: Reccipt no.: Fax: (503) 598-1960 t-A('r OF I i Caj file no.: Payment type: Land use approval: y&2 family: simple Cumpiex: TYPE OF PERMUF OC1 &2 family dwelling or accessory 0 Commercial/industrial 0 Multi-family )(New construction 0 Demolition t� 1,ldditinn'alteratitm%rcpt;u:ement J'renantimprovement JFire sprinklerlalairr, 0Other: Jub addr s: O p L Bldg. no.: Suite no.: Lot: Block: Subdivision: Tax map/tax lot/account no,: Project name: -7Uel A#JY i Description and location of work on premises/special conditions: _._ OWNFR FOR SPECIAL INFORMATION, kJSE CHECKLIST Name:CNTEX. ND�"�F='f ,E Mailing address:U62.0 sw Uppa — I &2 tumily dwelling: �• State: ZIP:g j Valuation of work i City: � ......... SZKS Phone: i 8- E-mail: No.of bedrooms/baths.................................. Owner's representative: M F 0 EN N( IG4121 Total number of Floors .................................. Phone: - Fax: E-mail: New dwelling area(sq. R.)............................ tSYD Garage/carport area(sq.ft.) .......................... _yy¢ Name: Covered porch area(sq. ft.) .......................... — Mailing address: Deck area(sq. ft.).......................................... City: State: 7IP: Othrr structure area(sq.ft.)......................... Phone: Tr r Y E-mail: Commerciul/industrial/multi-latnily: r t Valuation of work ......................................... S _-- Business name: a Existing bldg.area(sq.ft.)............................ Address: — New bldg.area(sq, ft.).................................. _ City: State: TZ,—P.. Number of stories.......................................... — Type of construction ......... ........................... _ Phone- Fax: E-mail:, Occupancy group(s): Existing: _ CCB no.: _ _ New: _ City/metro lic.no.: Notice:All contractors and subcontractors are required to be EICTIDESIGNER licensed with the Oregon Construction Contractors Board under Name: - provisiogs of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed.If the applicant is City: — State: Zip: exempt from licensing,the following reason applies: Contact person: Plan no.: — — Phone: IFax: I E-mail: — ENGINEER Name: ALRO Contact person: Fees due upon application.............................S Address: Date received: City: State: ZIP: _ Amount received S — Phone: i Fax: E-mail: - Please refer to fee schedule. 1 hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cards,please cell jundretlon for mom information. attached checklist. All provisions of laws and ordinances governing this Ct vin 0 MasterCard work will be complied with. whether ticCe ri herein or tint. credo card number:— — Expires Authorized a' lCl Date: Oa 3 Name of eardhulder es- own on credit card Print name: S // Cardholder uansture f Amount-1 Notice;This permit application expires if a permit is not obtained within 180 days after it has been accepted as completk 440•4613(WOCUM) Electrical Permit Application ��— Date received: Permit no.: J Jp',?, City Of T lard Project/appl. no.: Expire date: City of T(gard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date.issued: Ay: Receipt no.: Phone: (503) 6394171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 1 &2 family dwelling or accessory ❑Commercial/industrial Cl Multi-family ❑Tenant improvement New construction 0 Additi')n/alteration/replacement ❑Otber: D Partial Job address: 16S-70 Q l D L_A0[ Bldg. no.: I Suite no.: ITax map/tax lot/account no.: Lot: Block: — Subdivision; Project name: Description and location of work on premise_yeW—SIN FAMI IAL Estimated date of completion/inspection: ii6 6 a s t Job no: Fee Max Business name: A&IN A EL ( ('QC_ Description Qty. (ea.) Total no.lnep Address: 1 New residential•single or multi-family per dweiling uniLlncludcaattached garage. --E7 Stale: ZIP: Service included: Phone:89 b- Fax: E-mail: 1000 sq.rt.or tees 4 Each additional 500 sq.ft.or portion thereof CCB no.: Elec.bus.lic.no: 2 q y Limited cncrgy, residential 2 City/metro li� Limited energy, nmrre°idcntial 2 J y.().2_ Each mamufaclurr?iwme or m..'•der dwelling Signature of supervising electrician Date Service and/or feeder 2 w K • t ` rfeeden-Imullallon,Sup.elect, name(p ant): � License "1637S Serlcao siterallonorrelocatlon: PROPERTY OWN-11 200 amps a:less _ 2 Name(print): �- o2011 am.:to 400 amps 2 Mallin address: y 401 amps to 600 am 2 8 Yr a ZO 601 amps to 1000 amps 2 City_ Stater ZIP: _ Over 1000 ams or volts 2 Phanc: _M(p Fax; (p E-mail: Reconnect only I Owtrcr installation; Th'e installation is being made on property 1 own Temporary services orfeeders- which is not intended fur sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,4 701. 200 am s or less _ 2 _ - I01 am s to 400 ern _ 2 owner's Si tdreC—� yY1 / llntc: 401 to 600 amps2 Branch circuits-new,alteration, or ettension per panel: Name: _ A. Fee for branch circuits wide purchase of Address: service or feeder fee,each branch circuit City: Slate: 7_IP: S. Fee for branch circuits without purchase -- - of service or feeder fee,IUst')mnch circuit: 2 Phonr: Fax: E-mail: Each additional branch circuit: Mlsc.(Servlee or feeder not Included): C)Service ova 225 amps-conuncrcial U Health-care facility Eachp=p.or irrigation circle _ 2 ❑Servic:over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2- family dwelfingr U Building over 10,0)0 square feet four or Signal chruit(s)or a limited energy panel, U System over 600 volts nominal more residential units in one strucnue alteration,or extension, 2 U Building over three stories U Feeders,400 amps or more 'Description: ❑Occupant lad over 99 persona U Manufactured structures or Rv park $ash additional Inspection over the allowable In any of the above: U Egres0ighling plan U Other__ Per inspection _ Submit_sets of plana with any of the above. Investi ation fee The above are not applicable to temporary construction service. Other _ Not all jurisdictions accept credit ids,pleats call)urisdtctlon for more information. Ntp'ee: This Plan permit application fee......................S cetion an review fat %) S . U via MasterCard expires if a permit is not obtained --- Credit card number. _ _ within 180 days atter it has been State surcharge(8%).....S ^_ — tptrm accepted as complete. a Name of cardholder as shown on ere it cud S Cardholder signature Amount 440.4615(NOOrCOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORT: INVOLVED -RESIDENTIAL ONLY restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL S(STEMS) Service Included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.fL or less _ 1145.15_ 4 ❑ Audio and Stereo Systems' Each additional 501,sq.ft.or portion thereof $33.40 1 ❑ Burglar Alarm Limited Enr $75.00 Each Monu home or Modular Dwelling Service or Feeder —,_ $60.17 _ 2 ❑ Garage Door Opener' Services or Feeder L7 Installation,aiteratlon,or relocation Heeling,Ventilation and Air Conditioning System' 200 amps or less $80,30 2 201 amps to 400 amps _—_ $106.85 2 ❑ Vacuum Systems' 401 amps to 60J amps $160.60 _ 2 I_ 601 amps to 1000 amps $240.60 _—_ 2 L1 Other Over 1000 amps or volts _ $454.65 2 Reconnec!only $66.85 2 Temporary SerllCes or Feeders TYPE OF WORK !NVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or 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, see"b"above. ❑ Audio and Stereo Systems Brancii Circults ❑ Now,alivratlon or exlensinn per panel Boller Controls o)The;go for branch circuits r , with purchase of service or u Clock Systems feeder r've. Loch branch circuit __— 48.65 2 Data Telecommunication Installation b)The lee for`ranch circuits without purchase if service ❑ or recreer fee. Fire Alarm installation First branch circuit $46.85 Each addillonpl branch circuit 56.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not Included) Each pump or Irrigation circle $53.40 _ r, Each sign or outline lighting $53.40— —_ LJ Intercom and Paging Systoms Signal clicull(s)or a I1m0ed anergy panel,alteration ur extension $75.00 _ _ ❑ Landscape Irrigirion Control' Minor Lgbels(10) $125.00—�— ❑ Each additional Inspection over Medical the allowable in any or the above Per Inspection $62.50 ❑ Nurse Calls Par hour _ $62.50 In I`lant — $73.75 ❑ Outdoor Londsanpe Lighting' Fees: ❑ Protective Signaling Enter total of above fens $ L� Other — 8%StaleSurcharga $ _ _,_-_ Number of Systems 25%Plan Review Fes See'Plan RevIeW sedlon on $ ' No Ilcernes aro required Licanzes are required for all other installations (tont of applic(tion. —_-.__ ----- -- Fees; Total Balance Due $ -- Enter total of above fees S ❑ Trust Account# 8%State Surcharge $ All New Ce fnmerclal Buildings require 2 sets of plana. Total Balance Due i:ldils\formsklc-fe0s.doc OV05/02 0FFJCrJJS1:"_ ONLY Plumbint! Permit Application Date received: Permit no.:111',, -^ City sof Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 pro ect/a I no.: Expire Jate: City ofTlgard phone: (503) 639-4171 j pp Fax: (503) 598-1960 1 Date Issued: By: Rt:eipt no.: Land use approval: Case file no.: Payment type: s 1] 1 &2 family dwelling or accessory 0 Commercial/industrial ❑Multi-family U Tenant improvement U New construction U Ad(lition/alteration/replacement Q Food service U Other:MI Description Qty. Fee(ea.) Total fo Job address: C) V_M C' � � New I-and 2-family dwrIlings only: Bldg.no.: Suite no.: (includes too ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath — Lot. Z Block: Subdivision. SFR(2)bath _ Project name: _ __ _ SFR(3)bath Ci /county: ZIP: Each additional bath/kitchen _ b Description and location of work on premises: _ Catcchh lboae sin/ _ Cad area drain _ Drywells/leach line/trench drain _ Est, date of completion/inspectiow Footin drain(no.lin.ft.) PLUMBING t Manufactured home utilities Business namer-p��R � � Manholes Address: SW Rain drain connector City; State: I ZIP; Z Sanitary sewer(no.lin.ft.) Phone: Fax:/0 E-mail: Storm sewer(no.lin.ft.) Water service no.lin.ft.) CCB no.; (5eZ7� Plumb.Isps,reg. no:3t}-3S la PS Fixture or item: City/metro Iic.no. (y — Absorption valve Contractor's representative signature: Back flow preventer Print name. LIL STD 0 Date: Backwater valve _ t t ff—asinsilavatorY _ Clothes washer Name: A Y-A- n Y1 6 f Y Y1 Dishwasher Address: 1, 13 t70 S Drinking fountajn(s) City: State: R 7.IP: ;La -4 Ejectors/sum ^hone: 503 4•Llljf Fax:c,c -61 - mail: Expansion tank t Fixture/sewer ca _ Floor drains/floor sinks/hub Name(print): HCH Garbo a disposal _ Mailing address: nose bib _ City: State IZIPPING4 Ice maker Phone - 1 Fax: - E mail: -ceptor/greasetra Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by mi.regular Roof drain commercial empluyee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: __ Date: Sum Tubs/shower/showor pan Urinal Name: Water closet - Address: Water heater City: State: ZIP_ _ Other: _ _— Phone: Fax: E-mail: Tota -- - Minimum fee................S Not all junsdictlom accept cmdlt code,pieea coil JuNdletian W m-s Information Notice: this permit application Plan review(at_-- %) S u trig U MasterCard expires if a permit is not obtained State surcharge(8%).... S Cmdlt card numberpine within 180 days after it has been accepted as complete. TOTAL ........................S Noma of cardholder u shown on credit cud $ Cardial er signature Amount 41"16(GWCOM) R PLUMBING PERMIT FEES: - PRICE TOTAL New 1 and 2-family ..rings only: FIXTURES (Individual) QTY ea I AMOUNT (Includes SII p'umblr,g fixtures In PRICE TOTAL Sink 16.60 the dwelling,and t',e first100 ft. QTY (ea) AMOUNT Lavatory 1660 for each jtlll connection) _ One bath _ _ $249.20 _ Tub or Tub/Shower Comb. 16.60 _ Two 2 bath $150.00 Shower Only 16.60 Three(3)oath v $399.00 Water Closet 18.60 - - _ _SUBTOTAL U:'nal 16.60 _ 0%STATE SURCHARGE Dishwavher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 -.-,_-_ TOTAL - Laundry Trey 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2' 16.60 3' `-- _16.60 PLEASE COMPLETE: 4' 16.60 Water Heater U converslon O Ilke kind _ 16.60 Quantity b I WorK Performed Gas piping raqulres a soparalc mechanical Fixture Type: New Moved Replaced Removed/ emill. _ Capped MFG some Now Water Service 46.40 Sink MFG Home Now San/Storm Sewer 16.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 Combination fRout Drains - 16.6U -- Showor Only Urinking Fountain 16.60 Water Closet Other Fixtures(Specify) �.nQ - Urinal -_ Dishwasher Disposal LaundryRoom Tray --- -- Washing Machine _ -_ --� _ -- Floor Drain/Sink: 2' sewer-1st 100' 55.00 -- Sewer-each addillonal 100' J 46.40 - 4' 1 __- Water Service-1st 100' 55.00 - Water H paler _ -u Wats•Service-each additional 200' 46.40 Other_Fl Klures (Specify) Storm aRin Drain-1s1 100' 55.00 -- -- Storm&Rah Drain-each additional 100' 46.40 Commercial Bark Flow Prevention Devine 46.40 --- -- - --- Rasidential Backflow Prevention Devine' 27,55 -- -- -�- Catch Basin 16.60 -- - inspectlon of E tl�ting Plumbing br Specially 62.50 Requested Inspectionsper/hr _- COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65 25 Grease Traps 16.60 - QUANTITY TOTAL: Isometric or Near diagram a required if -`�- - -- -- QuarrUt,Total 9>3 _ -- ---- -------- --' --- 'SUBTOTAL: - -- 8%STATE SURCHARGE: ------- -- - "PLAN REVIEW 25%OF L_1 SUBTOTAL: Ra ulred onl If flviure qty total Is L9 LY TOTAL PERMIT FEE: 'Minimum pemlt lee Is$7:.550-9%stave surcharge,except Reelderdlal Backflow Preventlor•r)e•rlre,which Is S30.R$.BR stale surcharge. "Alt New Commer cel eulldings require 2 seta of plane with Isometric or riser diagram fcr plan review. I:ldslslformslplm-fees.doc 02/05102 Mechanical Permit Application Date received: _ Permit no.:)MC l ' t'✓ •i M City of Tigard Project/appl. no.: Expire date: Ciry 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.: Payment type: Land use approval: Buil,Jing permit no.: b. TYPE OF PERMIT \ Yk I &2 family dwelling or accessory U Commercial/industrial ❑Multi-family ❑Tenant improvement XNew con.stnictiun ❑Addition/alteration/replacement ❑Other: 1 . SITE INFORMATIONCOON*CIIIEDULE Job address: 3?o O LpAJC, Indicate equipment quantities in boxes below. Indic:to the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: _ profit.Value S Lot: Block: Subdivision: *See checklist for important application information and Project name: jurisdiction's fcc schedule for residential permit fee. City/county: I ZIP: i i Description and location of work on premises. 7cr/compressors 1 WifFee(ea.) Total Est,date of complction/inspection: Description . Res.onl Res.onl Tenant improvement or change of rise:is existing space heated or conditioned?O Yes ❑No unit CFMing(stteplan required) Is cxi,,ting space insulmcd"'Ll Ycs '_1 No existing system MECHANWAL 1 t /� State boiler permit no.: Business name. KE N�T7C-G� l' _ HF Tons BTU/H Address: Q_P3'�_2 IDN Fire/smoke dan.rers/duct smoke uc::^tors City; t�reu State: LIP: 9eat pump(site plan required) Phone: ,1 Fax:tj 3M_1a7E-mail: i nsui rep aceTurnace umer CCB no.: Including ductwork/vent liner ❑Yes C3 No _ Instal rep ace re ucate heaters-suspect ed, City/metro lic.no.: _ wall,or floor mounted Name(please print): Vent for a Bance other than furnace CO1 e r gUn: eral Absorption units_ _ BTU/H Name: Chillers _ lip Compressors IIF Address: — - - .nr ronmenta -exhaust and ventilation: City: State: ZIP; Appliance vent _ - Phone: Fax: E-mail: Dryer exhaust Hoods,Type U lures..kitche azmst hood fire suppression system Name: �� _ �5 Exhaust fan with single duct(bath fans Mailing address_ �= � � Exhaust system apart from heatingor AC ?� uel p p ng amstrilut Un(up to 4 outlets) Ciry: State: I ZIP. Type: LPG_ Na Oil i'hune: (1 UoD I Fax: E-mail: uel i to each addiTionn over outets rocess piping(schematic required) Number of outlets Name: tiserlTaterTapp once or equ pmen Address: Decorative fireplace _ City; i State: ZIP: _Fun-type _ Phone: Fax: E-mail: Woodstove/pellet stove Other: Applicant's signature: Date_ ter. E __ Name(print): _ Not all jurisdictions accept credit cutis,pleas qtl jurisdtoaon for more Infh=00n. Permit fee ................ S O Via O MasterCard Notice: This permit application Minimum feeee................S . expires if a permit is not obtainer' Plan review(at_ c.' S cremt cud number. within 190 days after it has been e xplres State surcharge(B/o).... S Name of eprilholder as shown on c rd accepted as complete. s TOTAL........................S Cardlicider signature Amount 4441617(MICOM) e MECHANICAL PERMIT FEES COMMERCIAL , __ SCHEDULE; 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VAI., "IN: PERMIT FEE: V Desr_riplion: Price Total $1.00 to$5,GJ( Minimum fco$72.50 _�_ Table 1A Mechanical Code_ sly (Ea) Amt 65,001.00 to$ .00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for wich additional$100.00 or including ducts&vents 14.00 !;acucr!hereof,to and It 2) Furnace 100,000 BTU+ $10,000.00. including ducts&vents 17.40 _ $10,0U1.00 to$25,000.00 $148.50 for the first$10,0)0.00 and 3) Floor Furnace $1.54 for each additionr.,$100 00 or including vent 14.00 - fraction thereof,to and,ncluding 4) Suspended heater,wall heater _ $25,000.00. _ or floor mounted heater -- 14.00 _ $25,001.00 to$50,000 00 $379.50 for the first$25,000.00 and 5) Vent riot Included In appliance permit $1.45 for each additional$100 00 or 61.80 fraction thereof,to and Including 6) Repair units _ $50,000.00. _ _ 1215 $50_,001.00 ii d up $742.00 for the first$50,0150.00 and_ Check all that apply. Boiler Heat Air $1.20 fol each additional$10U.00 or For Items 7.11,see or Pump Cond fraction thereof. footnotes below. Comp •" Minlmuna Permit Fee$72.50 SUBTOTAL: $ - 7)<3HP,absorb unit - l0 100K BTU 14.00 B•/.State Surcharge $ �a 8)3.15 HP;absorb unit 100k to 500k BTU _ 25.60 _ 25%Plan Review Fee(of subtotal) a T- 9)15-30 HP,absorb _ kegulred for ALL co_mmerclal.permIts only _ unit.5-1 trill BTU i _ 35.00 TOTAL COMMERCIAL PERMIT FEE: $ unit 30absorb - - I unit 1-11.7.7 5 mmil BTU 52.20 - - ---_-- _--_---_ - - _--_-- - _ 11)>50HP;absorb unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Ali-handling unit to 10,000 UFM ----- -- - _ __ 10.00_ Value Total 13)Air handling unit 10,000 CFM+ Description__ Ot E_o Am_o_u_It 17.20 Furnace to 100,000 UTU,Including 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 orl 955 16)Ventilation system not Included In floor mounted heater appliance permit 10.00 Vont not included In applicants 445 _ 17)Hood served by mechanical exhaust 10.00 permit 18)Domestic IncinratorsRe air units 805 T _ 17,40 t 3 hp;absorb.unit, 955 19)Commercial or Industrial typo Incinerator to 100k BTU __ _ _ ____-___-__._ 89.95 3.15 hp;absorb.unit, 1,700 - -- -- -- 101k to 500k BTU 20)Other units,InclUding wood stoves - _ 10.00 _ 15-30 hp;absorb unit,501 k to 1 2,310 21)Gas piping one to four outlets ill,BTU _ -�__- 5.40 30-50 hp;absorb.unit, 3,400 - 1-1.75 mil.BTU 22)More than 4 per outlet(each) >50 hp;absorb.unit, 5,725 -- _ _ 1.00 >1.75 mll.BTU Minimum Permit Fee$72.50 SUDTOTAL: $ Air handling unit to 10,000 cfm 656 - - - - Air handlln unit;-10 000 cfm 1 170 - 8%State Surcharge $ Non-port,,ible evaporate cooler 656 __�-___ TOTAL F'ESIDENTIAL PERMIT FEE: $ Vent fan c.inected to a single duct 446 Vent system not Included in _ 656 appliance permll _ __ Hood served by_mechanical exhaust 056 Qth•'Insvesl4ris end F%9;: Domestic Incinerator _ 1,170 1. Inspections outside of,.oimel business huure(m nimum charge-two hours) $62 50 per hour Cornm_errial or industrial Incinerator _ 4,590 2 Inspections to;which no lee Is specifically indicated (minimum charge-half hour) Other wiit,including wood stoves, 656 $132.50 par hour Inserts,etc. 3 Additional plan review required by changes,additions or revisions to plana(minimum Go-, iping 14 outlets _ 360_ _ _ _~ cherge-ona-half hour)$8:50 per hour Each additional outlet 63 --- - ----- •Stale%ontnctor Hollar CMlncaeon reyulruJ for units>200k BTU. TOTAL COMMERCIAL "Raaldentlai Arc requires tits plan showing placernent of unlL VALUATION: - =T' W_-_-_ --- -- All New Commercial Buildings require 2 sets of plans. 1:\dstslforn,s\mech-fees doc 02/05/02 SCALE_ PUBLIC S(ORM "THE WOODS" DRAINAGE STM LAT 366.17 V EASEMENT 50.00' - -- -7-- -r--* ---- 7-- 365- --- ----- - --- ------�— 15' STOP=365.2 - - - -- - - - - - - - -� \\ TOE= 62.7 LOT 27 I \ t 5,160 5F \ _ I I RETAINING WALL \\ BUILDING-- I 5ETRACK5 I I LOT 29 \\ 5' \ __i` LOT 26 /� III TOP=366.3 I TOE=362.7 kiP 6R 5- - - 40 00' 5�0, � � N I N g IIII LOT 28 CABLE TV PEDESTAL ELECTRICAL PEDESTAL \� I I I UTILT RISERS 1 ILOT WATER METER TELEPHONE PEDE5 TAL \ I 15' L 20p Tp \\� J p A�� / 7 o itr z I - ----— 368 61 �� a • 50.00' �_366.77 -- —� STREETLIGHT M- -M M.. PROP03EDTC=368.8C LANDSC TREE _- -- - - -- - - - -- TC-361.37 --- TREE(TYP.) --- r 5.W. PALERMO DRIVE I t �CENTEX HOME �� Tv5CANY gg 16520 UPPCR BOONE5 FFRRY ROAD r 16370 S.W PALERMO LANE 81 SUITE 200 -_ -- ---- -- --- -- - - PORII.AND,OREGON 97224 LOT 27 PLAN 2540 A 1 (503)608-3060 -- .yo p)n►>>ddy loo U paAojddv�] pastoidtiy 10,NpOnoidd l % E :PdoiS Iun1ab :.l,N3W.LNv �'ic! '�N121'.1:.l�vl!)N:1 :atn(l pa,uaaa� [] c?N saA [] :paatnbaN nlixi U%p!AtUff B116111! H utruutxtsl� p.moiddV ION (] panwdd or :a�uN.�eaIJ Igt�s!A pajIS g :ap!S panOaddd ION [] paroiddV,.S' sw.,i yyaS pajtnba?I 'NO'SIAIU t)NINNV"I,1 ! :%6N JANMI-d ON1011 OU M31A'3M NV'1c1 311%'-ONVD11.40 All.)