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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # _Y
Permit # Lf 1 - 02(F y _
Phone (503) 639-4171 Date Issued 9
CITY OF TIGARD FAX (503) 684-7297 Issued by r°7 MiA,k ,,t ti t.^-
TDD No. (503) 684-2772
Inspection (503) 639-4175
1 ,lob Address: �j 4. Complete Fee Sc sledule Below.
Name of Development / �1 f Number of Inspections per permit allowed
Addre3s Service included Iterns Costlea) Sum
1,
City/State/Zip ` ' C 4a. Residential-per unit n o
1000 nq It or less A- $11000 1��
Poch -
Name (or name of SineSS) mon t thereof� iere f so ft or
portion ol $2500
Commercial❑ Residential [] Limned Energy $2500 _
Each Manufd Home or Modular 2
DwalAng Service or Feeder $68 00
2a. Contractor installation only: 4b.Services or Feeders
Installation,alteration,or relocation
Electrical Contractor zoo amps or less boo 00 _
Address 201 amps to 400 amps $8000
401 amps to CAO amps $12000
City State w Zip` 6o1 amps to 1000 amps $18000 2
Phone No. Over 1000 amps or volts $340 00 2
Contractor's License No. Reconnect cnly $5000
Contractor's Board Reg. No. 4c.Temporary Services or Feeders
Installation,altmalion.or relocation
Signature of Supr. Elec'n_ 200 amps or less 55000
License No. Phone No. 201 amps 10 400 amps $7500
.— — 401 amps to 600 amps $100 00
Over 600 amps to 1000 volts
2b. For owner installations: see•b•above
4d. Branch Circuits
Print Owner's Nem _ Now,altarahcn or extension psi panel
Address F�G1_'L�_ a)The tee for branch circuits With
Cir�� State 71 n [% purcho"of eavlce or gds►herr.
`r_.__. X—
./ �- p ./- Each branch cvaut 5'-,on _
Phone No. 4 rx2 S' —z�! b)The fes for branch circuits Yrtrhouf
The installation 1s being made on property I own which is pumhese of service or keder Ne
First branch
riot intended for sale, lease or rent. circuit $3500
_
Each adddrorwlbranch circuit $500
Owner's Signrtur ��� 4e. Miscellaneous
(Service or leader not included) 2
3. Plan Review section (if required): Each primp or irrigation circle $40 00 — 2
Fach sign or outline lighting $4000
Signal rrn;uil(s)or a hinged energy 2
Please check appropriate item and enter fee in section 5B. panel agerntion or extension $4000 ^_
4 or more residwitial units in one structure Minor Lahels(10) $10006
Service and feeder 225 amps or more
F— System overr 600 volts nominal 41. Each additionri inspection over
Classified area or structure containing special occupancy the allowable in any of the abovePor inspection $'1h no
as described in N E C Chapter 5 p°r ---
Per how 56F n0
In Plant 51! on
Submit 2 set-q of plans with application where or/of the above
apply. Not required for temporary construction se►viras
5. Fees:
NOTICE 5s. Entor total of above fees $
5'/Surcharge(.05 X total foes) $ 7L'_
PERMITS BECOME VOID IF WORK OH CONSTRUCTION Subtotal $ _
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 251�of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED ❑ Trust Account# $
B,ala.-Ice Otte
$
.nr ....f.rWcPT rR`
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FIN
Foundation Water Line Ceiling
Post/Beam Mach. Shear/Sheath Framing ech.
PIbg.Unrl/Flr/Slab Plbg,Top Out Insulation lei•
Post/Beam Struct. Mech. Rough-in Gyp. Bid. Id .
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: -
Date: A.M. P.M. Fntry: —
Address:
Tenant: __. Ste:—_ MST: 9 S
BUP: -
Con/Own: - _ __ _ MEC:
PLM:
EI_C: _
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
��
S; �"�,r ri,< C �T
Inspector: _
�/ a Date:�/2
ROVED _DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Faoting Rain Drain Cover/Sorvice r IN
Foundation Water I-ine Ceiling Mka
Post/Beam Mach. Shear/Sheath Framing e
Plbg,Und/Flr/Slab Plbg.Top Out Insulation �c .
Post/Seam Struct. Mach. Rough-in Gyp. Bd. -Bldg. .
San. Sewer Gas'_ine Appr/Sdwlk Reins.
Other:
Date: A.M. Er4y:
Address:
Tenant: _ Ste:..-_ --- _9.�f�2
Con/Own:
THE FOLLOWING CORRECTIONS ARE REQUIRED
Un
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Inspector __. Date:' - _4�
___APPROVED DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-PhonE)- 639-4175 Business Phone: 639-4171
7 Inspection:
%�ZF__Qoting Susp. Ceiling Sprink. Rough in Appr/Sdwlk
Foundation Plbg. Underslab M-_-ch. Rough-in Fireplace
Post/Beam Slruct. Plbg. Top Out Elec. Rough-in FINAL:
Pn;t/Beam Mech. Sen. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_ —7,�!/C/ 5 Time: AM PM
Address:' —
Builder: [v ( ) � Permit #: 5—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
J
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Inspector: _ Date: 7 z,
_APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
__Call For Rei isp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rer,-0-Phone): 639-4175 Business Phcne: 639 i
4 r
Inspection:
Fuoting Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation P'bg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Lir Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: X_ �� ( ' Time: / AM _PM
Address: 6j-,5-
21?/ ---
Builder: Permit #: / S THE FOLLOWING CORRECTIONS ARE REQUIREU:
C, ,r, ry/ Lae`yL!;
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Date:,-)
-`_APPROVED _DISAPPROVED APPROVED SUBJE TO A OVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspt,c^.ion Line (Rec-O-Phone): 639-4175 Busi ,ess Phone: 639-417
Inspection:, 4L I,
i
Footing Susp. Ceiling Sprink ough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
IbUUnderfloo Rain Drain Framing -Plumb.
Alarm 6_Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: %�� `1 Time: AM PM
r
Address:_ �e C Z� / .�— )LFC 41+
Builder: q ( 7 �� _ Permit ay: C'15-_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector. DateL�/
�APPROVEO —DISAPPROVED __APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 63.1.-A171
Inspection:_! _
Footing Susp. Ceiling Sprink. Rough-in p /Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Z
Post/Beam Struct. fig p Oui) ' Elec. Rough-in FINAL:
Post/Beam Mech. Sari. Sewer Gas Line -Bldg
Plbg. Underfloor Rain Drain Framing Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Recuestnd: (r>> Time: AM PM
Address: C' 7 ��/L!C–• q
Builder:_ Permit. #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector-
--�� Date:
—APPROVED DISAPPROVED APPROVED SUBJ CT TO ABOVE
Call For Reinsp.
CITY OF 1 iGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: ) AQ yYL4--_r4
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beare Struct. Plbg. Top Out e).
Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Meth.
Underflr. Insul. Shear Wail Gyp. Bd. -Elect.
Date Requested: —�1--�_-1 ` Time: ,AM PM
Address:���
Builder: _Permit #: cJ n (4'
THE FOLLOWING CORRECTI, NS-ARE REQUIRED:
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Inspector: ' L�c7P Date: ��i
NPPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
all For Reinsp.
CITIr OF TIG:IRD BUILDING IN;PECTiON NOTICE
Inspection Line ;Rec-O-Phone): 639-4175 Business Phone: 639-4171 J/
Inspection:_
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg Underslab Mech. Rougn-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FiNAi-:
Post/Be3rn Mech. San. Sewer Cas Line -Bldg.
Plbg. Underfloor Rain Drain �g_Framin -Plumb.
Alarm Water Line sulati i -Mech.
Underflr. Insul. Shaar Wcalll/ Gyps. Bd. -Elect.
Date Requested: Time: AM _,PM
Addrass: l L
Builder. 42&A,rdri 4:;a6e:– 1782 _Permit#: U a 4 T
THEFOLLOWINGCORRECTIONS ARE REQUIRED:
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Inspector: Date: %L/�Q �
APPROVED DISAPPROVED ZAFrFyhOVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone;: 639-4175 Business Phone: 639.4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plhg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San, Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul, Shear Wall Gyp. Ed. -Elect.
Date Requested:_ Time: AM PM
Address: -
Builder: Permit# S����(e
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector. T �� �� Date �C y
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp. /�
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plba. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Pibg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plog. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. insul. Shear W.ilyp, Bd -Elect.
Date Requested- / Time: AM PM
r
Address:
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: r
„_APPROVES _DISAPPROVED G—fWPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-_yPhone): 639-4175 Business Phone: 639-4171
Inspection:— Y %.4
f=ooting Susp. Oeiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech, Rough-in Fireplace
Post/Beam Struct. Plbg, Top Ou! Bei Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: 'r; �� Time: AM PM
Addre, C�
` 4
Builder; �--
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: i l� Date: --7
/
APPROVED _DISAPPROVED `APPROVED SUBJECT TO ABOVE
--Call For Rein-,p. � � ^
CITY OF T,GARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab MecR, Rough-in Fireplace
Po-.t/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL.:
Post/Beam Mech. Sar,. SewerGa�� -Bldg.
Plbg. Underfloor Hain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
UndeHIr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_ i Time: AM PM
Addr, mss:�(4c �� -T2-^^_ _
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REOUIREO:
Inspector: Dat9:
_,APPROVED _DISAPPROVED '*FPQQYED SUBJECT TO ABOVE
Call For Reinsp.
11
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11 f"Hylyfi, NI ANCIIINI PAID 1 TIM It 1'4 tit I-"A Y MF N I 141VIC11.114 1 1114.1
V0.00 ST. PU 11. D Pf R !-,yeti
MASTER PERMIT
CITY OF TIGARD PERMIT #. . . . . . . : I'll a TO 5- 0
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 2.17/06/95
0125 SW Hall Blvd.'r,gard.Oregon 97223*8199 (503)639-4171
PARCEL: 2S1141AD-003-01ZI
ITL i&075 SW 92NID �-'ivL.
'JBD I V I S I ON. . . . : ZONING: R-4. 5
,.CK. . . . . . . . . . . LOT. . . . . . . . . . . . .
BUILDING
ISSUE-. DWI..LLING UNITS-. 1 BASEMENT. . . . . . . . :0 s
:-IISS OF WORK. :ADD BEDRMS: LSA THS: 1 GARAGE. . . . . . . . . . :0 S f
YPE Or USE. . . .01-' FLOOR AREAS----- - REQUIRED
TYPE OF CONST. :5N FIRST. . . . -. 1000 s LEFT. . : I I ft RIGHT. .5 f I
=JPANCY GRP. : R3 SECO'\'D. . . -0 5 f FRONT. -.66 ft REAR. . :30 f
TORIES. . . . . . . : 1 rINBSMENT:0 5 f REDU I
HEIGHT. — . . . . . .; '4) ft: TOT(iL.- 1000 5f SMOKE DETECTORS. :Y
FLOOR I-DAD. . . . :40 psf VALUE. . . . . $: 64660 PARKING SPACES. . :0
Remarks : ADDITION TO EXISTING HDMr= 1000 00 FT
PLUMBING
S I 1 11;I-IN S. . . . . . . . . . : 1 FLOOR BRAINS. , . . -0 FACKFLOW PREYNTRS. . . 1
LAVATORIES. . . . . :2 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . : 1 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :10
il TZ R CLOSETS. . : 1 SEWER LINE (ft ) . ;0 GREASE TRAPS. . . . . . . :0
I C--J IWASHERG. . . . . 1 WATER LINE ( ft ) . :0 OTHER FIXTURES. . . . . .0
.'IRBAGE DISP. . . -. 1 RAIN DRAIN (ft) . :O
(4,G H I N G M A C IA. . . : 1 SF RAIN DRAINS. . Ll
MECHANICAL FEES
JLL UNIT HTPS. . :0 type amill-kilt by date V-ec-pt
VENTS . . . . . :4 SPRT $ 3128. 00 SW 07/06/95
5AS/
IX INPUT :0 D1 VENT rANs. . i 1?'PI-C $ .-:.A L".2 BON 00/; 0/95 '35-26747''
URN i 100K, . . :0 HOODS I DSPC $ 16. 40 5W 07/06/95
FURN '1 =1001-1, -Q1 WOODSTOVES. :0 MPRT $ /44. 30 :-W W 0 7/1�6/CK5
LOOR FURN, . . . :0 CLD DRYERS. : I MPLC $ 11. 13 SW 07/06/95
�011-/CMP ( 31-IP:0 -'. 11+7106/95OTHER UNITS:0 m5PC 1, " C.3 SW 17/0G/D5
GAS OUTLETS: 1 PPRT $, 1 '0. 00 SW 07/06/955
Owriev-. 1, G. 00 SL 1717/06/`35
'AURICE ALBIN ER03 $ 40. 00 SW 07,106,/95
':::7:'5 NW cRor-, ur ERPC t 1::'x. 00 GW 07/06/'35
ERPC $ 13. 00 SW 07/06/95
'.A,,1KS OR 97106
"icme to 64,2-1789
anti-actov,:
4NER
Ul) 110rip
807. 46 TOTAL
oermit is issued subject to the regulations contained in the REQUIRED INSPECTIONS
cc Bard Municipal Code, State of Ore. Specialty Codes and ali othet, Footing Insp Fr-aming Insp
pl;cablt laws. All work will be done in accordance with approved FOUndation Insp Ins�tlation Insp
- j ars, This persit will expire if work it not stat-ted within 180 Post/Steam Stt-Llut Gyp Board Insp
ys of issuance, or if work is suspended for ta-p than 180 das. 177*1ost/BeAm Meehan Rain drain Insp
Crawl Drain Mechanical Final
�&eze`-. PLM/Under-fluor P11-1mb Final
BLtildiiig Final
Mechanical Insp
P11-11flb [ Up OUt Erosion Cant:i--(jl
Call for inspec.,tion 639-4175
r � �
IV
C I Tv OF T I C3ARD R!~:CF 1 PT OF F'AYr-lF.NT Rf'C;F.I P'r NO. •95•-c'674.7
CHECK F.)MOUNT r R 1.3. 1'0
HOME c ALB I N, N41aI_M I Cf_ C. CASH AMOUNT 0. 00
ADDRE SG a '335 NW C.Q 0V, CT. P()YME.NT Dorm r 0f,!30/')'
r. BA14KSI OR SUBDIVISION a
971Q�C,..
G>I.JRPOSF.•. OF t='t1YmFN r AMOUNT PAID PURPOSE ,IF PAYMENT AMOUNT PA 11)
a
f FLAN CHECK FE 6-97R i"l13. 20
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16075 OW ')P-Nd, AVE.
TOlf-iL.. AMOUNT PAID - — »> F' t 3.
14y
CITY OF TIGARD RECEIPT OF PAYMENT RFCEIPT NO. :95--P676be
CHECK AMOUNT a 94. 26
NAME s Al.SIN, MAURICE C. CASH AMOUNT s 0. 00
ADDRESS a 4234.5 NW CROP CT PAYMENT DATE a 07/06/95
PANKS9 OR SUBDIVISION
9 7 106—
PURPOSE OF PAYMENT AMOUNT PA I D PLIRPOFlF OF PAYMENT AMOUNT PAID
FCljWPiN6 ERM 120. 00
MECHANICAL PE 44. 150 GiT. BUILD PER ;24. 63
PLAN CHECK FE 11. 13 FRGS ICIN CONTROL_ rlr-PMITF-'FF 40. 00
EROSION CONTROL PLAN CK 13. 00 EROSION CONTROL 13. 00
160'75 SW 9«ND AVE
TOIAL AMOUNT PAID 594. 26
Residential Building Permit A_p�lication
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Subdivision: Lot # Office Use OnIY
4 ut Contact Date / l _Initials _
Valuation: U • Result
Planck/Rec # (X, �I
New Construction Only: (Square Footage) Permit # m.5 �-
House: _,LO" Garage: Reissue of
Map & TL# 7-'s 6 OoU OCi
Zone _6.410-5
Plat #
Corner Lot? - mag Lot? Y N
lx), l Approvals Required
Owner: 1� •Lv
Planning Setbacks I/dicSvlar
Address: Engineering
X210 Other
Phone: 2 ty�- _ Items Required
Contractor: f Subcontractors
- Truss Details
Other
Address.
Notes
Phone:
Contractor's License
(attach copy of current Oregon license)
Contact Name:
Contact Phone:
i- Subcontractors: Architect/Englneer:
Plumbing: Address:
J
Mechanical: _
(attach copy of current OR Contractors License)
Phone: ( )
JOB DESCRIPTION
A lica t Signature Applic nt Phone nu ober
PP 9 �1,� b•�� v 2
Received by: C. Date Received:
Nl IQ'L�Y� �lD�rt�t"P61 SL.l1CIl.�
Yo�a
Permit 0 Account Description Amount Amt Pd. Bal. Due.
M5L-02 � Bldg. Permit (BUILD) S,2f,&0 3 z-Y ---
Plumb. Permit (PLUMB) '
�2.0
Mech. Permit (MECH) ti
State Tax (TAX) 6-3
Bldg: U
Plumb: •v U
Moch:
Plan Check (PLANCK) AIP(13 ze
Bldg: w
Plumb:
Mech: r 3
Sewer Connection (SWUSA) _
Sewer Inspection (SWINSP)
Parks Dov Charge (PKSOC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-I) —
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WOUAL)
(Mater Quantity (WOUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion PlancklUSA (ERPL4N)
l3 , �
Erosion Planck/COT (EROSN) _
�
TOTALS: �' '°'?
� I
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I
1p'1p''
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PLAN CHECK FE//ES LIST
PLAN CHECK# lo- PERMIT# 719 q) 'O.9G DATE
ADDRESS /(pD ?) SW .dJ TAX/MAP/LOT �Sl 1r4Q—ov3�tl
SUBDIVISION 1 Bmf LOT # LAND USE 12 .
VALUALATIONlv�d SETBACK FRONT REAR>6 LEFTRIGHT S
WORK CLASS GI_HEIGHT , TOTAL AREA
USE TYPE S 'F FLOOR LOAD �10 lst FLOOR
CONST TYPE_ HEAT TYPE 66J 2nd FLOOR
OCCUP GROUP_ DWELL,/UNITS / 3rd FLOOR
OCCUP LOAD BED ROOM BASEMENT
STORIES 1BATHS _GARAGE__
PERMIT # DESCRIP'T'ION AMOUNT AMOUNT PD BAL DUE
g5ty5y BUILING PERMIT FEES ,�2Y _ 3? .N
PLUMB PERMIT FEES - 12-10 , •
MECH PERMIT FEES
STATES BUILD TAX d? .G3 __ <�•G,3
BUILDING1(,,40
PLUMBING G .Cv _
MECHIAN ICAL .?.23
PLAN CHECK FEES e2�y,33dl•ui U- 13
BUILDING
PLUMBING
ME CH I ANCAL__ILL3_
__SEWER CONNECTION FEE _
SEWER INSPECTION FEE
PARKS
RESIDENTIAL TIF
MASS TRANSIT _
WATER QUALITY
WATER QUANTITY
EROSION CNTRL PERMIT o,w o •�
EROSION PLAN CK USA
EROSION PLAN CK COT •. 13 , 0.
TOTALS : �( a/3,Z� Sjg-26_
City of Tigard
131.25 SW Hall 81vd.
Tigard, OR 91223
(503) 639-4171 ------- - -
MINIMUM $25.00 PERMIT FEE + ST. SURCHARC
U�scnpeon New Single Faruly Raldences Only
Table 311 Medtanical Code CITY PRICE I AMT 11
❑ t BATH HOUSE$140.00 ❑2 BATH HOUSE$195.0(
1) Permit Foe o- .0. t 0.00 ❑ 3 BATH HOUSE 3225.00
Fee includes all pkunbing tbctttres in the dwellLig and the flat 100 fee,
21 Supplement.;! Permit 3.00 I of water service, sanitary server and storm sewer. See fees below.
ruloace to FIXTURES QTY PRICE AMT
t) incl. duds S vents I 6.00 I + Sink 9.00
FurnaceLavatory 9.00
2) incl. ducts b vents I 7.50
r rumancw Tub or TutvShcwer Comb. 9.00
3) incl. vent I + 6.00 I Shower Only 9.00
suspc water.vest neater Water Closet 9.00
+) or floor mounted heater , 600 I Dishwasher 9,Cp
Vent not incL in Garbage Disposal 9.00
5) appGanp permit I 3.00
W-ashinq Maciline 9.00
r+eparr of nraaong,ruing.
6) cooling, absorption unit I 6.00 I Fkw Orn 9.00
iouv or comp, swat pump. air;,orad. - Water Heater 9.00
"1 ;0 3 4P;absorp unit;a tool BTU , 6.00 I I Laundry Roam Tray 9.36
ooner or comp, wait pump, au sono. ! Unna) 9.00
3) 3.15 HP; absorp unit to 500K BTU 1 1.00 , Other Fixtures (opec.'fy) 9.00
tier or comp, neat pump, air conn.
9) 15.30 HP;absorp unit.5-1 mil BTU I 15.00 I j 9.00
! 3aiiiiw or comp, neat pump, air cons. -j 9.00
10) 30.50 HP;absorp unit 1.1.75 mil BTU ! I C2 50
:30uer or comp, Twat pump,au caro. Sewer 1st 100' 20.00
t 1) >50 HP;absarp unit 1.75 mil BTU i I 37.50 Sewer•ma. Addit 100' Z5.043r nam mg unit _
12) 10,000 CFM ' 4.50 ' Water Service tat 100' 20.00
Air nam " unit Water Service ea- AddtL 200' 25.00
13) 1n C00 CTM
on pertaoie Storm 3 Rain Drain tet 100' 20.00
t 4) evaporate cooler I i 4.50 Storm &Rain Orcin AddiL 100' 25.00
'Vent tan connected '
15) Mobile Home Space I 25.00
o a single dud #- 3.00
entuaaan system nor Back Flow Preventktn
161 included;n appliance Permit +� 4.50 I Device or Atrti-Palluftri ^evitx I 9 Co 4
r1co-3 sarvec Dy Any Tao ar'Neste Not
17) medtanical exhaust I 4 Connerwed to a F'Lmrs + 9.00
wmnw7a@ or inaustrIalCatcli Basin 9.00
181 type incinerator 30.00 I ! c
Insp. of .�ctst Plumbing 40 CdhrZchI
er t.isolar,w scow,water q � I Specialty Requested Insoectans SO COlhr
19) heater, dothes dryers, etc. ! [/ , 450 � y
Rain Drain, single (amity dwelling I I 30.00 Su
Ln 20) Gas piping one b bur outlets I 2.00 I Residential badr9cw prevention
devices I 15.00
21) Mcre rian 4-per outlet
'(Except resrderrn'al backflow
LD praventdon devices)
LL; Minimum Fee 525.00 SUBTOTAL
-' •Minimum Fee S^.5.00 SUBTOTAL I I 7
5%SURCHARGE
! !� 5!: SURCHARGc
PLAN AEYIEN 25°G OF SUBTOTAL !
ICTAL I I PLAN REVIEW:51: OF 3UBT07AL
TOTAL -
Scec:al Canoibons -
Cate Sllued :y
10
F&6
449-
28-1-91 63
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