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11103 SW 81ST AVENUE w A C tp I CITY OF TIGARD 24-Flour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIL',SION Business Line: (503) 639-4171 BUP Received _ /—Date Requested-�=��- AM _ PM— 8UP Location -__ Li-� 1 `�- _Suite MEC Contact Person Ph( ) ��� J �' L' PLM �- Contractor __.._ -__ _ Ph( ) - SWR - BUILDING Tenant/Owner ELC � �'e2 5- 1'U Footing ELC Foundation 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 ZZ, Fire Alarm _ Susp'd Ceiling - — Root Othe,: ._.. Fine I PN_S_S PART FAIL - ---- ..<---�- - - PI_.UMBING ---_ - - f Post&BeamL C Under Slab Rough-In 'Nater Service - Sanr;Lry Sewer Rain 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 UG/Slab Low Voltage - ----- ---- -- ---- Fire Alarm ef n F] Reinspection fee of$.____ required before next inspe.tlon. Pay at City Hall, 13125 SW Hall Blvd. S PART FAIL _ g Please call for reinspection RE:__ .--. - Ej Unabip to insi)eet-no access Fire Supply Line �b = ADA Approach/Sidewalk 0 - ��� - ru Inspe..tor _ c Other. ------ --- Final DO NOT REMOVE thk inspection record from the Job site. PASS PART FAIL CITY OF TIGA,RD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 0----MST BUP / Received _Ctate Requested__�M `� AM PM_2 I_. '13UP') W3 ' 06 O 9 Location << U S 1 Suite Contact Person 29tj — Ph( 2-71_) [ — 13 y(o PLM Contractor ___- _. Ph(_ ) — SWR — BUILDING _ Tenant/Owner _ __ ELC ._— Footing Foundation _ ELC Access: Ftg Drain Crawl Drain �A ELR - ------- --_- Slab Inspection Notes: Q�J SIT Post&Bearn Shear Anchors —�- Ext Sheath/Shear Int Sheath/Shear lmmrg'ion 2-00 ' 00bIC�V Drywall Nailing - Firewall Fire Sprinkler — Fire Alarm Susp'd Ceiling Roof i "PPASIIJBINQRT FAIL n2 a�--- Post&Beam Under Slab '__ t� C _—_ Rough-In Water Service -- ---- — Sar+!tar•;Sewer Rain Drains -- �— -- Catch Basin/Manhole Storm DrainShowerPan Other: - -- Final -----. _._ _PASS PART FAIL - -- MECHANICAL_ Post&BeamCQ' -- —-- Z Rough U�(n --_ Gas Lin i S'Moke D mpers --- --4-TRW VX"S't PART FAIL - - - E_ RICAL Service - -- Rough-In UG/Slab ---- - - _ Low Voltage Fire Alarm Final u Reinspection tee of required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd. PASS PART FAIL SITE v Please cell for Ninspection RE: _ _ Unable to inspect-no access Fire Supply Line ADA Dab_ ! r Inspector `' Ext Approach/Sidewalk - Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL �\ CITY OF TIGARD MASTER RERMIT DEVELOPMENT SERVICES F,ERMIT #. . . . . . . : MST99-0090 13125 SW Hall Blvd. Tigard,0F197223 j503j 639.4171 DATE. ISSUED: 03/23/99 F}ARCEL: 1 S 136CB--07400 SITE ADDRESS. . . : 1 1 1.03a SW B i ST AVE SUBD I V 13 1 ON. . . . :HERB R P,EGGY' S (='LACE LONIN(3: R-4. 5 BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :009 JURISDICTI0N: TIG Remarks: Alter roof gable. AND ADDING A PORCH 08 ---- BUILDiNG ------------------ ——-—--------------------------- REISSUE: .--_- --------------------------------------------------------- REISSUE: STORIES.......: 0 FLOOR AREAS---------- BASEMENT... : 0 sf REQUIRED SETBACKS---- REQUIRED------------- CLASS OF WORK.:ALT 14EIGHT........; 0 FIRST....: 0 sf GARAGE__: 0 sf LEFT..........: 0 SMOKE DETECTRS: TYPE OF USE...:SF FLOOR LOAD....: 0 SECOND...: 0 sf FRONT.........: 15 PARKING SPACES: 0 TYPE OF CONST.:SN DWELLING UNITS: 0 FINBSMFNT: 0 sf RICYT.........: 0 OCCUPANCY GRP.:R3 81)RM: 0 3ATH: 0 TOTAL------: 0 sf VALUE..$: 5000 REAR..........: 0 --------------------•--------------------------------------- SINKS.........: 0 WATER CLOSETS,: 0 WASHING MACH..: 0 LAUNDRY TRAYS.. 0 RAIN DRAIN ft: 0 TRAPS........... 0 LAVATORIES....: 0 DISHWASHERS... : 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB/SHOWERS...: 2 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE f+: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 ----------------------------.-..------------------------------- MECHANICAL -- --------------- ------ ---------------------------------- FUEL TYPES----------- FURN ( ION ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0 FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS........, : 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 0 ---------------------- ELECTRICAL --------------------------------------------------------- --RESIDENTIAL UNIT--- ---SERV CE/FEEDER---- -•-TEMP SRVC/FEET►ERS-- ----BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'1_ INSPECTIONS-- 1000 SF OR LESS: 0 0 - '.00 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 '01 - 400 amp..: 0 ?01 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/O(JT LIN LT: 0 PER HOUR......: 0 LIMITED ENERGY.: 0 401 - (00 amp..: 0 401 - 600 amp..: 0 EA ADDI_ BR CIR: 0 SIGNAL/PANEL...: 0 1N PLANT......: 0 MANE HM/SVC/FDR: 0 G'j1 - 1000 amp.: 0 60I+amps-1000 v: 0 MINOR LABEL --10: 0 10001+ amp/volt.: 0 ----------- • -------------------- PLPII REVIEW SECTION -•-•-------------------------------- Reconnect only,: 0 )=4 RES UNITS... SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC: --------------------••----------------------------• ELECTRICAL - REST^ICTED ENERGY ----------- A. SF RESIDENTIAL- ------------ -------- B. COMMERCIAL-------------------------------------------------------------------------- AUDIO 6 STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/P46ING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: :: BOILER.........: HVAC. ........: LANDSCAPE/IRRI6! PROTECTIVE SIGNL: CARA6E OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR: HVAC...........: DATA/TELE COMM.: NURSE CAL.LS....: TOTAL I SYSTEMS: 0 Owner: - -------------Contractor: -----------------------•------- TOTAL FEES:1 85.86 GREG RUSSELL R BRADBURN CONST This permit is subject to the regulations contained in the 11103 SW 61ST 12190 SW 158TH Tigard Municipal Code, State of Ore. Specialty Codes and all TIGARD UR 97223 BEAVERTON OR 97007 other aoplicable laws. All work will be done in accordance with ap{ruved plans. This permit will expire if work is Phone A: Phone N: 604-051 not started within 180 days of issuance, or if the work is Reg 11..: 000545 suspended for more than 180 days. ATTENTION: Oregon law --------------------------------------------------------------- requires you to follow rules adopted by the Oregon Utility Notification Cente-. Those rules are set forth in OAR 95x^-001-0010 through DAR 952-001-0080. You may obtain copies of :hese rules or direct questions to OUNC by calling (503)246-1987. --------------------------- --- _ --_ _-- REQUIRED INSPECTIONS - -----------------•------------------------------------ Erosion 844-8444 Footing Insp Framing Insp Building Final — --__-- — _ I Sy �.1 c� P,rr-mitten. Signatr-tr•e: T f' + ++++++ + +- 4+f+++++++++ ++++r•++ +++++4 ++++++ +++++ + +f++++ ++ +++—+++++++4-++++�+4+ Call 639--41'75 by 7:00 p. m. for an inspection needed the next bi,tsiness day s� CITY OF TIGARD Residential Building Permit Application Plan Check#C'I' 43 13125 SW HALL BLVD. Additions or Alterations Rcc'd By v'} TIGARD, OR 97223 Single Family Detached or Attached /Duplex) Date Recd c Date to P.E. V 503-639-417'1 ' Date to DST .3•. 1 503-684-7297 Permit# Print or Type Called Incomplete or illegible applications will not be accepted * V// Name of Project Name Job I e < < �� architect Mailing Address --- Address Site Address, --- NaM City/State Zip Phone Name Owner Mailing Address c,y (J C�/St?te Zip Phone Engineer Mailing Address� City/State Zip Phone General N 1 Contractor b ` r r'('t i�G����a/ Describe work New O Addition Alteration Repair O Mailing Addressto be done: Prior to permit :,-LV i / -5745 LA- Additional Description of Wo .W issuance,a copy /state Zip Phon /�"//!? �,�� of ell licenses w C- ' are required if Oregon Cons Cont.Bgard Exp.Dao PROJECT t,�) expired in COT Lic# ) database yt -�L VALUATION _$ �(��� --- Mechanical Name . - NEW CONSTRU ION ONLY: Sub- 6 `, Sq. Ft. House: Sq. Ft. Garage Contractor Maiiind/'address _ Prior to permit Indicate the restricted energy installation by the electrical issuance,a copy City/State Zip Phone subcontractor in the following areas of all licenses Restricted Audio/Stereo are required If Oregon Const.Cont.Board Exp.Date Energy System Alarms expired in COT Lic.# Installations Vacuum Irrigation _database System System Plumbing Name r (check a;; :''at Other: Sub- apply) Contractor Mailing Address ——_- Corner Lot YES NO Flag Lot YES NO (check ane (check oneN Prior to permit City/State Zip Phone Has the Subdivision Plat recorded? NIA YES NO issuance,a copy of all licenses are Oregon Const Cont.Board Exp Date required if Lic# _ expired in COT I hearby acknowledge that I have read this application, that the database Plumbing Lic.# Exp Date information given is correct,tha I am the owner or authorized agent of the owne nd that p;?! bmitted are in compliance with Oregon a laws _ Name �C_ / nt ` Da Electrical , SubMaihrlg Address - Cont ct Person Mame hon # Contractor 0 'V City/State Zip Phone Phot to permit issuance,a copy FOR OFFICE USE ONLY of all licenses are Oregon Const.Cont Board Exp Date - required if Lic.# Plat t" MepIT expired in COT �o G database Electrical Lic.0 Exp Date —v Setcks Zone: Solar: / brIft) /,moo P Electrical?upervisor Lic # Exp. Date Engineering Approval: Planning Approval TIF: I ldsts\formslatadde t doc 11/20/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUIP _ Date Requested Jt" a `' U u _AM �! PM BLD G S� Location l l .3 c -j) D� Suite MEC Contact Person C)r-t Q PyS&t t Ph 4, `-f 3.x.3 PLM — Contractor _ Ph 5 S SWR BUILDING _ Tenant/Owner _ ELC --- Retaining Wall — ELR Footing ACG ass: Foundation FPS Ftg Drain SIGN Crawl Drain Inspection Notes., Slab � - - SIT Post&Beam ! - ---- -'— Ext Sheath/Shear i _ UJ iL Int Sheath/Shear rammg Insulation --- ---- - -- --------- Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -__ Roof -- (Fin A PART FAIL — ---- _---- -- - -- - PLUMBING Post& Beam Under Slab TopOut — ------- -- — ---— ---.�_..._ - - ------- Water Service Sanitary Sewer ----- Rain Drains 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 Fire Alarm — Final PASS PART FAIL —SITE Backfill/Grading --"--- --- - - Sanitaiy Sawer Storm Drain ( ]Reinspection fee of E, required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please cell for reinspection RE: _ [ J Unable to inspect-no access ADA Approach/Sidewalk � Other Date —Inspector �_/ t Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the lob site. BUILDING PERMIT _ _ CITY OF '" IGARD PERMIT #- BUP2003-00029 DEVELOPMENT I SERVICES DATE ISSUED: 1/17103 PARCEL: 1 S136C,, 07400 13125 SW Hall Blvd..TiUard, OR 97223 (503) 639-4171 ZONING: R-4.5 HERB SITEADDRESS: 1 ER + PEGGY'S PLACE SW 81ST AVE JURISDICTION: TIG SUBDIVISION: LOT-- 009 __ BLOCK: EXTERIOR WALL CONSTRUCTION _ ——– --- FLOOR AREAS: E: W S REISSUE: RST_ ____ sf N' f PROJECT OPENINGS? s CLASS OF WORK: ALT SECOND: -- E: W: TYPE OF USE: SF sf N: S' TYPE OF CONS1: TOTAL AREA: 0 sf ROOF CONST: FIRE RET? BASEMENT: sf AREA SEP. RATED: OCLOAD:CUPANCY ORP: R3 OCCU SEP. RATED: OCCUPANCY GARAGE: sf HT: ft REQUIRED _ STOR: REDID SETBACKS — — ---- SMOK DET: BSMT?. MEZZ?: LEFT: ft RGHT. ^ft FIR SPKL: HNr)ICP ACC: FLOG." LOAD: psf FRNT: ft REAR: ft FIR ALRM : PARKING: DWELLING UNITS: IMP SURFACE: PRO CORR: BFf)RMS' BATHS: VALUE: 006" Remarks: Fire repair. Electrical permit required. Contractor: Owner: OHI CONSTRUCTION TROY &MARY ACOTT 17255 PILKINGTON 11103 SW 81ST AVE LAKE OSWEGO, OR 97035 TIGARD, OR 97223 Phone: 503-860-6084 Phone: 503-635-6248 Reg#: LIC 34908 REQUIRED INSPECTIONS FEES _ Amount Framing Insp Description Date Final Inspection 1117/03 $129'70 [Ll 111)J Permit Fee $10.38 [TAX]89,1, +ate't'3" 1117 11171003 3 $84.31 [DIJPPLNI I'ln Its Total $224.39 oe with approved plans. This permit will expire ifnwoorNk Is 's issued subject to the regulations contained inane Tigard Municipal Code, State of OR. SpecialtyreCo es This permit t and all other applicable law. All work will be done in accore than farted within 180 days of issuance, or if work isos'sUend Notification CenterSOThos© roles aNe seNforth in OAR ed for mor not s the Oregon requires you to follow the rulers adopted by You may obtain a copy of these rules or direct questions to OUNC by 952-001-0100. calling alli g(503)246-6699 or1ough 4R-'300 332-2344 Issued By: � 7 Permittee Signature: — Call 639-4175 by 7 p.rn. for an inspection the next business day tOFFICE 11$E ONLYQuildin ; PtLt-mit Application 77"k Building, C Permit No.:Other city' t)I ngal•d permitNo.: 13125 SW Hall Blvd. Other Date/By: Permit No.: Tigard,Oregon 97223 Post-Review land Use Phone: 503-639-4171 Fax: 503-598-1960 Date/By: Case No. _ Internet: www.ci.tigard.or.us Contact Juris.: N See Palle 2 for summlemental 24-hour Inspection Request: 503-639-4175 Name/Method: -Infonuation TYPE OF WORIG REQUIRED DATA: New construction LJ-i- Demolition I &2 FAMILY DWELLING ddii / ltation/re lacement Q Other: CATEGORY OF CONSTRUCTION Note: Permit fees"are based on the total value of the work performed. Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor, —1 &2-Family dwellin LJ CommerciaUIndustrial overhead and profit for the work indicated on this application. Accessory Building Multi f,aei..•e,�T" 7 -- Other: Valuation.... 1.r..,....... �Q........................... S,� Master guilder t!o.of bedrooms: L No.of baths: 0 PJob JOB SITE INFORMATION and LOCATION TotJ number of floors.. ...i.............................. siteaddress: ►1tio 5 % aW a New dwelling area(sq. ft.)..............................te#: Bld&/Apt.#: - Garage/carport area(sq. R.)...................... ... Pro eCt Name: Covered porch area(sq.ft.)............................. Deck area(sq. ft)............................. . ............ _ Cross streeetiDirections to job site: Other structure area(sq.ft.)............................ s/ QI GI(er REQUIRED DATA: 1 f� COMMERCIAL-USE CHECKLIST Subdivision: Lot#: _ Tax ma / Note: Permit lets'are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and prnfit for the work indicated on this application. ,gee 'AW kL 1 e,, r — Valuation......................................................... -S cTkP -- — - Existing building area(sq.ft.)......................... New building arca(sq. ft.)............................... -- - Number of stories.................. PROPERTY OWNER TENANT Type of construction....................................... Occupancy group(s): Existing: Name: Tao /—'w,&f lie n 1� New: Address: I t 10' -- — Cit /State/ZI : Tr cLee) o� 7 --- NOTICE: All contractors and subcontractors are required to be Phone:5 - 0-bo Fax: licensed with the Oregon Construction Contractors Board under APPLICANT CONTACT PERSON provisions of OR5 701 and may be required to be licensed in the Business Name: D Cu+l��rf wr f te'� jurisdiction where work is being performed. If the applicant is exempt Contact Name: a�� from licensing,the following reason app! es: _ — Address: 1�ZS 5 Cit /State/Zit:Lake osw-�� OR• _ Phone: 3S' (02 y �x 1�3b+ 1�3 BUILDING PERMIT FEES" E-mail: 0 0 tc e a 1• r' Please refer to fee schedule. — CONTRACTOR Business Name: 0 M 1 Cc a^ri f" Fees due upon application.............. .... Address: tr t Amount received.................. ........ ... ........... b city/State/ziu t!,' 0►' q'703,5 Phone: (45' 0-If Fax:636 -71' Date received:_—_ _-- CCB Lic. #: ' y 0 45 — Authorizx Notice: This permit application expires If a permit is not obtained within Signature: Date: �' �/ 190 days after H has been accepted as complete. n f A") •Fee methodology set by Tri-County Building Industry Service Hoard 1 (Please print name) r�l l;_(J 0 i mt)sts\Pcrmit Forts\HldgPermitApp.doc 01103 N .vjl F 1O,7,t One-and Two-Family Dwelling Building Permit Application CheekliSt Reference no.: City gffigardCit' y of Tigard Associated permits: Electrical U Plumbing U Mechanical 13125 SW Hall Blvd,Tigard,OR 97223 J❑ElecElecr: Phone: (503)639-4171 Fax: (503) 598-1960 2111 RIMt 1 Land use actions completed.See jurisdiction criteria lirr cow.urrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district, 3 Verification of approved plat/lot. 4 Tire district _ approval required. 5 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 he drawn to scale,showing conformance to applicable local and state building codes. Lateen design details and connections must he incorporated into the plans or on it separate full-Aze sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. I 1 She/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there.:is more than a 4-ft.elevation differential,plan must show contour lines at 24 intervals);location of easement,and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot arca;building coverage arra:percentage of coverage;impervious arca;existing structures on site;and surface drainage. 1'foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent _ size and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, 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,rool'slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, 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 lent at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptahle. I r, Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate dctail�,and locations;for non prescriptive path analysis provide specificatio n%and calculations to engineering standards, 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rehar. For rneincered systems,see item 22,"Engineer's calculations." IBeam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. '(t Manufactured floor/roof truss design details. I Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more.appliances. 22 Engineer's calculations.When required or provided.(i.e..shear%% ill. n )t aims)shall be stamped by an engineer or architect lice iscd in Oregon and shall he shoN'n to he apphC;lhle b I tar 1110Irt t under review. I r.r 1 st site plays are required lot Item I I above, Site plan.irivl he k.112" s I I"or I I"x 17". 24 Two(2)sets each are required for Items 16, 19,20& 22 ahovc 25 Buildine plans shall not contain reit kit,!s or tape-ons. "Mirrored" huildmt! plains ill he not accepted, _ 26 "Reversed" 1•110::•,11 Mans must meet criteria outlined in the Permit & tiestrm Development Fees docutnent. 27 "Drawn to scale" indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable).and('OT Street Tree List. Checklist must he completed before plan revicuv start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 4.ar 4614 WMrn•osr) a 37'7" r �1 . 5 W Y X O 3'1' I .� 0 ' N l{.• G -- 0 I--- IV ----^ ' Y �t . . � err I r m m r �1 u � o r moo . a GLoS� GI-ore RcPL•4c C Z X6*—K i. r D � • y�1 i arr it � r r 3 _ s - �Nf trl / N C � o £ �D 1� %Ll m CITYOF T I G A R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00021 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/21/03 PARCEL: 1 S136CB-07400 SITE ADDRESS: 11103 SW 81ST AVE SUBDIVISION: HERB + PEGGY'S PLACE ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY ORP: R3 VENTS W/O ADPL: VENT SYSTEMS:. 1 STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS_ OTHER UNITS: FURN >=100K BTU: <-- 10000 cfm: _ GAS OUTLETS: > 10000 cfm: Remarks: Fire repair. Replace duct'Mork. Owner: __ _ _ FEES-- TROY EES —TROY & MARY ACOTT Description Date Amount 11103 SW 81 ST AVE [MECH] Permit Fee 1/21/03 $72.' TIGARD, OR 97223 [TAX]8NO StateTat 1/21/03 $5.80 ^Total $78.30 Phone: 503-860-0084 Contractor: FOUR SEASONS HEATING&A/C PO BOX 66409 PORTLAND, OR 97290 REQUIRED INSPECTIONS Duct Inspection Phone: 503-775-5919 Final Inspection Reg#: LIC 48283 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore, Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those tyles are set forth in OAR 952-001-00 Issued By: Prarmittee Signature . _ '1�_ Call (503) 6394175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Received Mechanical -- Date/By: 03 -Permit No.: ECLOD11-14 00 / City of Tigard Planning Approval Building p Date/By: Permit No.:61(1-.20O 'DUO 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-6394171 Fax: 503-598-1960 Post-Review Land Use Date/By: Case No.: Internet: www.ci.tigard.onusContact Juris,: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: supplemental Information. TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST New construction _ I I I Demolition Mechanical permit fees'are based on the total value of the work Addition/alteration/re lacement 1 ❑Other: performed. Indicate the value(rounded to the nearest dollar)of all _ CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. 1 &2-Family dwelli� ❑Commercial/Industrial Value: S_ Ste Page 2 for Fee Schedule Accessory Buildin t_ Multi-Family RESIDENTIAL F. UQ IPMENT/SYSTEMS FEE*SCHEDULE Description Qty I Fcc ea. Total Master Builder Other: HcatIn&11Conlin .JOB SITE INFORMATION and LOCATION Furnace-add-on air conditionin "" 14.00 Job site address: S W/ �– Gas heat pump_ 14.00 Suite#: Bldg./Apt.#: — Duct work 14.00 Project Name: H dronic hot waters stem 14.00 --- Residential boiler Cross street/Directions to jo site: (for radiator or h dronic system), 14.00 Unit heaters(fuel,.mot electric) in wall in-duct,suspended,etc. 14.00 Flue/vent for any of above _ 10.00 Subdivision: Lot#: Repair units 12.15 --- Other Fuel An Iitnces Tax ma / arcel #: Water heater 10.00 DESCRIPTION OF WORK — Gas fireplace 10.00 — _ Flue vent(water heater/gas fireplace) 10.00 Log lighter as 10.00 --•— ---- -- Wood/Pellet stove 10.00 Wood fireplace/insert 10.00 Chimney/liner/flue/vent 10.00 PROPERTY OWNER TENANT Other: IU_GO Name: Environmental Exhaust do Ventilation -- -- Range hood/other kitchen equipment 10.00 Address: _,A, le __— _ Clothes dryer exhaust 10.00 City/State/Zip: _ Single duct exhaust Phone: C _� -/7 4U FBX: (bathrooms,toilet compartments, APPLICANT I Lj CONTACT PERSON utility rooms __—_— 6.80 Name: Attic/crawls ace fans 10.00 —-- —--- ---- Other: 10.00 Address: _ _ Fuel Piping City/State/Zip:/State/Zi **05.40 for first $1.00 each additional -- Furnace etc. Phone: Fax: _- - Gas heat pump •' E-mail: Wall/sus ended/unit heater CONTRACTOR Water heater Business Name: � .,�.:+ Fireplace Range Address: C^ _ yC' — BB "•--' Cit /State/Zi ( L:- � Clothes dye!(gas) Phone: Q3 Fax:5z)3 TJ 5 iiy i Other: _ •• CCB Lic. #: g g 3 Total: _Mechanical Permit Fm* Authorized / Subtotal: S Signature: �. Uate:, / / Q Minimum Permit Fee$72.50 S Plan Review Fee(25%of Permit Fee) S _ -- �'-- -- State Surchar e'8%OLP ermit Fee $ • '� (Please print name) TOTAL PERMIT FF.F. S p Notice: This permit application expires If I permit Is not obtained within *Fee methodology set by Tri-County Building Industry Service Board. 1 180 days trier It hal been accepted as complete. "Site plan required for exterior A/C units. i\DstaV'rriit rormavNecPermnnpp duc 01103 Mechanical.Permit_ApPlication - City of Tigard Page 2 -Supplemental Information Commercial Fee Schedule: _ Total Valuation: Permit Fee: _ $1.00 to$5,000.00 Minimum fce$72.50 $5,001.00 to$10,(1)0.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof to and mcludin S10 000.00. $10,001.00 to 525,000.00 5148.50 for the first$10,000.00 and $1.54 for each additional 5100.00 or fraction thereof,to and including $25,000.00. $25,001.00 to 550,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional 5100.00 or fraction thereof,to and including $50 000.00. $50,001.W and up $742.00 for the first$50,000.00 and $1.20 for cacti additional$100.00 or fraction thereof. Assumed Valuations Per Appliance: _ Value Total Descri tion: t En Amount furnace to 100,000 BTU,including 955 ducts&vents Furnace>100,0))BTU including ducts 1,170 &vents Floor fumace includin vent 955 Suspended heater,wall in or floor 955 mounted heater Vent not included in appliance 'mit 445 Re air units 8U5 <3 hp;absorb.unit, 955 to 100k BTU _ 3.15 hp;absorb.unit, 1,700 101 k to 500k BTU 15-30 hp;absorb.unit,501k to I mil. 2,310 BTU_ 30-50 hp;absorb,unit, 3,400 1-1.75 mil.BTU >50 hp;absorb.unit, 5,725 >1.75 mil.BTU Air handlin unit to 10 OW cfm 656 Air handl;-»unit>10,000 cfm 1 170 Non- or evaporate cooler 656 _ Vent len connected to a single duct 446 Vent system not included in appliance 656 t)crmit I loud served by mechanical exhaust 656 Domestic incinerat'ir 1 170 -- Commercial or industrial incinerator 4 590 Other unit,including wood stoves, 656 inserts,eta -- (]as piping 14 outlets 360 Each additional outlet 63 TOTAL COMMERCIAL S VALUATION: \DstaVhrmitForms\MecPcrmitAppPg2.doc 01/03 CITY OF TI G w ^HK D —_ ELECTRICAL PERMIT j PERMIT#: ELC2003-00020 DEVELOPMENT SERVICES DATE ISSUED: 1/21/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136CB-07400 SITE ADDRESS: 11103 SW 81ST AVE ZONING: R-4.5 SUBDIVISION: HERB+ PEGGY'S PLACE BLOCK: LOT: 009 JURISDICTION: TIG Project Description: Install 3 branch circuits. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st V�/O SRVC r FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT: 601 - 1000 amp: _PLAN REVIEW SECTION 1000+ amp/volt: —4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: SVCIFDR>=22°AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: TROY&MARY ACOTT VANDER STOEP ELECTRIC 11103 SW 81ST AVE 23765 THIRD ST NE TIGARD,OR 97223 AURORA,OR 97002 Phone: 503-860-6084 Phone: Reg #: LIC 89417 -- SUP 4360S FEES ELF 24-304cr Description Date Amount Required Inspections [TAX]8%State Tax 1/21/03 $4.82 � --- (ELPRMT]ELC Permit 1 21 n3 $60.15 Rough-In _ Elect')Final Total $64.97 This Permit Is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or 1-800.332-2344. IssuedBy: , � ti ��� i (�1�t j Permit Signature: OWNER INSTALLATION ONLY f he installation Is being made on property I own which is not intended for sale, lease, or rent OWNER'S SIGNATURE: _. .__— DATE: CONTRACTOR INSTALLATION ONLY SIr;NATURE OF SUPR, ELEC'N: _ ___ DATE l I"k N S E N O Call 639-4175 by 7:00pm for an inspection the next business day FOR CE USE ON LY Electrical Permit Application Received v) 8 Electrical r'' i t : — P- — 0 � Permit Nol'lt? J3 _Dae/L'yr OpOZB Planning Approval Sign City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review other Date/By: Permit No.: _— Tigard,Oregon 97223 Post-Review Land Use Phone: 503-6394171 Fax: 503-598-1960 Date/By: Case No.: Internet: www.ci.tigard.or.us Contact Juns: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: _ Supplemental Information. TYPE OF WORK PLAN REVIEW Please check all that apply) H [1 Demolition Service over 225 amps- Health-care facility New construction commercial ❑hazardous location Addition/alteration/re lacement ❑Other: ❑Service ow.r 3210 amps-rating of ❑Building over 10,000 square feet. CATEGORY OF CONSTRUCTION 1 &2 family dwellings four or more residential units in Elsystem over 600 volts nominal one structure 1 &2-Famil dwellin Commercial/Industrial ❑Building oscr three stories ❑Feeders,400 amps or more Aceesso Buildin Multi-Family ❑Occupant load over 99 person. Q Manufactured structures or RV part, Other Master Builder Other: ❑Igress/lighting plan _ Submit sets of plans with any of the above. _ JOB SiTE INFORMATION and LOCATION i'hc above are not applicable to t-uporsry construction service. _ Job site address: S l,l) +a �� FEE•SCHEDULE $ld ./A t.#: Number of Ins)cctionsperfermit allowed Suite#: _p---- ——�— Description QI) Fee(es.) Tola� Pro'ect Name: New residential-single or multi-fandly per Cross street/Directions to job site: dwelling unit.Includes anached garage. Service Included: 1000 sq.0.or less 145.1 S 4 Each additional 500 sq.tt.or portion thereof 33.40 1 Limited energy,residential 75.00 2 Subdivision: I.Ot Limited ener non residential 73 2 Tax map/parcel#: Each manufactured home or modular dwelling 90.90 2 DESCRIPTION OF WORK service and/or feeder _ ._. Services or feeders-Installation, alteration or relocation: 80.30 2 — _f----_— _--._ ----.--- 06011M ol less 2 to 400 ams IOG.85 —_ _�'_ ------------- ----- 160.60 2 to emus _ 2 to 1000 ams2�'�PROPEi2TYOWNER TENANT 0am orvolts454.65Name: -- - ctonl 66'85 2 Address: `— 'temporary services or feeders-Installation. alteration.or relocation: 66-85 1 City/State/Zip: 200 am s or less - 100.30 — 2 201 amps to 400 ems _ 133.75 2 _ Phone: FaX: 401 to 600 am s APPLICANT 0_CONTACT PERSON Branch circuits-new,alteration,or Name: _ ___ extension per panel: A Fee for branch circuits with purchase of 6.65 2 Address: service or feeder fee each branch circuit _ Clt /State/ZI : i_ _ B Fee for branch circuits without purchase of 46.85 2 service or feeder fee,first branch circuit 2 Phone: FaX: Each additional branch circuit 6.65 �— - ---- Misc.(Service or feeder not included): 5340 2 E-mail: Each rump or irrigation circle CONTRACTOR /���+ Eac1.ait;n or outline lighting 53.40 2 Job No: N _� 6 P '� l Sii,nal circuits)or a limned enPee 2 2 allrration,or extension Business Name: __ Df,sctiation: Address: Each additional Inspection llowable in an of lite above: Ctt /State/Zl Per ins clion per hour(min. I hour) 62.50 FaX: Invests alion fee: Phone: _ Other: CCB Lic. #: Lic. #: Permit Fees•Supervisingelectricign subtnta� Ssi nature required: /'�+-'��—' U' Plan Rcvicf Penrtit Fee SLiC. State Surchar reI mit Fee S Print Name: ERMIT FEE S Authorized Notice: This permit application expires if a permit Is not obtained within Signature: _ hate'__- 180 da)s arter It has been accepted as complete. Service Board. •Fee melht.doiolp set In Tri-('aunty Ilnilding Industry (Please print name) I:\Dsts\Permit Forms\ElcPcrmitApp.doc 01/03 Electrical Permit Application -City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: hESIDENTIAL WORK ONLY: Feefor all systems............................................................ $75.00 Check Type of Work Involved: F1Audio and Stereo Systems* 0 Burglar Alarm Ll Garage Door Opener* ElHcat ng,Ventilation and Air Conditioning System* 11 Vacuum Systems* Ej Other_._- COMMERCIAL WORK ONLY: Fee for each system........................................................ $75.00 (5FF.OAR 918-260-260) Check Type of Work Involved: ❑ A and Stereo Systema ED Boiler Controls Clock Systems ❑ Data Telecommunication installation Fire Alarm Installation HVAC Instrumentation Intercom and Paging Systems Landscape Irrigation Control* Medical Nurse Calls outdoor lAndscrpc Lighting* F-1 Signaling Other------------- - ---_.�. — Number of Systems * No licences are required. l,icenc,ts are required for all other installations ' is\Usts\I'crmit l:orms\IilcPcnnitAppPg2.doc 01103 CITY OF TIGARD Electrical Permit Application Plan Check# 13125 Sv'J HALL BLVD. Recd By__ TIGARD OR 97223 Date Recd Print of Type Phone(503)639-4171, x304 Pryp Date to P.E. o DST t Date _ Inspection (503)639-4175 Incomplete or illegible will not be accepted DaDaePermit q Fax (503) 598-1960 Called 9. Job Address: 4. Complete Fee Schedule Below: Number of Inspections per permit allowed Name of Development_ Name(or name of business) Ls Service included: Items Cost Total Address _ �' )4-r- _ 4a. Residential-per unit 1000 sq A.or less $147.15 4 City/State/Zip__.. 1 LL:� _ Each additional 500 sq ft.or tom. portion thereof $33.40 1 Commercial ❑ Residential Limited Energy $7500 Each Manurd Home or Modular Dwelling Service or Feeder $90.90 2 2a. Contractor installation only: (Prior to permit Issuance,applicants must provide contractor license 4b.Services or Feeders information for COT data b e). Installation,alteration,or relocaticn (DEk? to ` �� A 200 amps less _ $80.30 2 Electrical Contractor t/,$N Jj� t-�C � 201 amps l0 400 amps $10685 _ z Address 401 amps to 600 amps $16060 — 2 city _> ' State Zip 601 amps to 1000 amps $24060 _� _ 2 Phone No. `7�'1 /�`� Over 1000 amps or volts $454 65 2 Job No. _ Reconnect only $66 85 2 Elec. Cont. Lice. No –30 C�– Exp.Date 4c.Temporary Services or Feeders OR State CC8 Reg. No. Exp.Date O D Installation,alteration,or relocation 200 amps orr less _ $66.85 2 COT Business Tax or Metro No _ Exp.Date 201 amps to 400 amps $100.30 2 401 amps to 600 amps _ $133,75 2 Signature of Supr. Elec'n �" Over 600 amps to 1000 volts, D see"b"above. License No. - 3� Exp.Date IU�/ 2 4d.Branch Circuits Phone No. © – __- � New,alteration or extension per panel a)The fee for branch circuits 2b. For owner installations: I with purchase of service or feeder fee. Each branch circuit _ $6.65 Print Owner's Name b)The fee for branch circuits Address _ without purchase of service City _State _Zip or feeder fee.- First branch circuit / $4Fi 85 Phone N0 — _ ---_ Each additional branch circuit $6.65 The installation Is being made on property I own which is not 4e.Miscellaneous (Service or feeder not Included) intended for sale,lease or rent. Each pump or irrigation circle $53.40_ Each sign or outline lighting $53.40_ Owner's Signature _ _ Signal circuits)or a limited energy �— panel,alteration or extension $75.00 3. Plan Review section (if required):* Minor Labels(10) $125.00 4f Each additional Inspection over Please check appropriate Item and enter fee in section 513. the allowable In any of the above 4 or more residential units In one structure Per Inspectinn _ $62.50 Service and feeder 225 amps or more Per hour $62.50 _—System over 600 volts nominal In Plant $7375 Classified area or structure containing special occupancy as 5. Fees: described In N E C Chapter 5 Sa.Enter total of above fees $ Submit 2 sets of plans with application where any of the above apply 8%Surcharge(08 X total tees) $ --Not required for temporary construction services. Subtotal $ 5b.Enter 25%of line 6a for NOTICE Plan Review If required(Sec 3) $ Subtotal $ _ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAY,3,OR IF CONSTRUCTION OR ❑ Trust Account M WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ I\dsblformsklectric rev.doc-9100