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InitiallyGood r. 14900 SW 103RD AVE CITYOF TIGARD i_ PL.UP49INGPERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-0002 13125 SW Hall Bled., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/22/03 PARCEL: 2S1 .1 CB-00800 SITE ADDRESS- 14900 SW 103RD AVE SUBDIVISION: DEL MONTE SUBDIVISION ZONING: R-3.5 BLOCK: LOT: 007 JURE)DICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAP",: S'�ORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: UPINALS. GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEINER LINE: 90 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks Installation of approximately 90 of sewer line to connect to sewer lateral. Septic tank is to be pumped, filled and inspected. FEES _ Owner: Description Date Amount SMELTER, CRAIG C +JULIE A II'l.UMI31 Pcnnit Fee 1/22/03 $72.50 14900 SW 103RD AVE TIGARD, OR 97224 11'AXi K"' State Tax 1/22/03 _ $5.80 Total $78.30 Phone Contractor: _ OW N I- REQUIRED INSPECTIONS Phone Sewer Inspection Misc. Inspection Reg 0: Final Inspection 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 if work is suspended for more than 180 clays. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon j Issued By f�j ! (-rZ !' • i i_ _ Permittee Signature: Call (503)839-4175 by 7:00 P.M.for an Inspection needed the next business day PlumbinoPermit Application Received ' ate_... � - j-� -� Plumh+,q Uatc/B YJ�� Permit Planning Approval Sewer City of Tigard Date/By: Permit No. 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Date/ e: Land Use Datc/B Case No.: lntenlet: www.ci.tigard.or.us Contact luris.: Sec Page 1 for 24-hour Inspection Request: 503-639-4175 Name/Method: _ Sup�cm^ntal Information. TYPE OF WORK FEE*SCHEDULE(forspecial Information use checklist New construction +Demolition Description Qty. I Fee(ea.) Total New 1-&2-famlly dwellings Addition/alteration/re lacement Other: Inch,des 100 ft.for each utllit y connection CATEGORY OF CONSTRUCTION SFR(f)bath 249.20 1 &2-Family dwelling LJ Commercial/Industrial SPR 2 bath 350.00 _ElAccessory Building _ Multi-Family SFR 3 bath 399.00 Master Builder Ej Other: _ Each additional bath/kitchen 45.00 iOB SITE INFORMATION and JOCATION Fire sprinkler-sq.A.: Pae 2 Job site address: Seo 5ta1 /o i;, re_ Site Utilities Bld ./A t.#: Catch basin/arca drain 16.60 Suite#: Dr cll/leach line/trench drain 16.60 Project Name: C s.vAJ Footing drain no.linear fl. Page 2 Cross street/Directions to job site: Manufactured home utilities I iii 00 ON ,V-S,4 /3,ti.rso•a-4,N Manholes 16.60 4-"y /I11 0-0cfe,-i 0111;4- Rain drain connector � 16.60 Sanitary sewer(no. linear ft.) Page 2 _ Storm sewer no. linear ft. Page 2 Subdivision: Lot#: Water service(no.linear R. Page 2 Tax ma / arcel M Fixture or(tent DESCRIPTION OF WORK Absor tion valve Ib.60 P/94. 4r L>g- A0411 /L,V*OV40 Backflow prcvcntcr Pae 2 its e v Slt� IJiL. Ce ,s_CrVN4-c I' Tb L,N ( Backwater valve 16.00 Clothes washer 16.60 �,v�, q,.l non! S.t�''r� '� -F'e�,►iO_ Dishwasher 16.60 �'Izr�L " ;rt/ �,�rr4� Drinking fountain 16.60 _ PROPERTY OWNERTENAN'" Eicctors/sum 16.60 Expansion tank 16.60 Name: (�,Z.,q-/ . s,wY,�-�;�� --- Fixture/sewcrcap IG.GO Address: J y-i c+o S#-J !03• --- City/State/Zip: T/C�A�CT �� V7l ? ''� Floor drain/floor sink/hub— 16.60 Garbage disposal 16.60 Phone: <v 3i c,t -�9 ;s Fax: c,, 119 /er;;y Hose bib _ 16,60 APPLICANT CONTACT PERSON Ice maker W60 Name: - 5,Vr1R 5 ¢�VSE _ Interceptor/grease trap 115.50 --- Medical gas-value: S Pa c 2 Address: —_— Primer _ 16.60 Cit /State'Zip: Roof drain commercial 16.60 ?hone: Fax: Sink/basin/lavatory 16.60 E-mail: `,n via ft -/,S .if' i 7 ti c oM Tub/shower/shown un 16.60 - ---- Urinal 16.60 CONTRACTOR heater 16.60 _ Business Name: n u) r )( Ic __ Water _ - Water hcatrr I6.60 Address: _ other: City/ e/Zi — Other: Phone: Fax: PlumbingPermit Fees* Subtotal S CCB Lic. #:_ Plumb. LIC.#: Minimum Permit --cc 572.511 S Authorized J +� Residential Backflow Minimum Fee S36.25 Signature: _ _ ___._ _ bate Plan Rcvtew 25°0 of Permit Feet S _ State Surcharge(Po of Permit Fee) $ =5 t 61 — _ -- (Please print Hamel TOTAL PERMIT FEE S - Notice- I'mi permit application expire%If a permit Is not oblaincd�%ithlo All new commercial buildings require 2 sets of plans Nath Isometric or 160 days after It has been accepted as complete. riser diagram for plan review. *Fee methodoio0.v set by Tri-County Building Industry service hoard. i\Dsts\Permit Forrnc\PlmPcrmitApp.doc 01'03 Plum_ bine Permit MliSatiqn - City of Tigard Page 2 _ Supplemental Information Residential Fire Su ression Systems: Fee Schedule: TOtAI S ware Footage: r Permit Fee: Site Ctflitics Qt V- -' $115.00 _ -�5 W 0 to 2,000 $160.00 --- Fnotmg drain-I"'101)' 2 001 to 3,600 $220.00 46,4%' 3,601 to 7,2(X1 Footing drain-each additional 100' $309.00 55.00 7,201 and realer Sewer-Ist 100' Sewer-each additional 100' 40.40 55.00 Medical :;as S stems: Water Service 1st 100' g6.4C Valuation: Permit Fee: Water Service-each additional 100' $I UO u,$5 000 00 Minimum fee$72.50 55.00 Storm ,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each 46.40 additional$100.00 or fraction thereof,to and Stone Rain Drain-each additional 100' Total includin $10,000.00. Fixtureor Item (qty. Fee(ca) or!I t 54 for 'umntercial I ow prevention Device 46.411 $10,001.00 to$25,OOU.W eac0h additional$100.00 orf fraction n t and ereof,to and mcludin $25,000.00. Residential Backflow Prevention Device 27,55 m e $36.25 GS 25 $25,001.00 to$50,000.00 (minimurmit fee $379.50 for the first$25,000.00 and$1.4-5 for Rain Drain,single family dwelling each additional$100.00 or fraction thereof,to and includin $50,000.00. Inspection of existing plumbing or 72 50 $742.00 for the first$50,OU0.00 and$I.20 for s ecioll reucsted ins ecuons- er hour �SSG,OOI.OU and up each additional 5100.00 or fraction thereof. Subtotal: Fixture WrA: Are.you capping-nun`ini� or replacing;existing fixtures'! If "yes please indicate woes performed by fixture. h:lilure to ac;' ccurateIN rort fixtures could result in increased se%scr fees*. ;`trmments regarding fixture%cork: uanlit b Pilon l`Work Performed _ Itepix,e — FixtureType: New Moved l'sxlxlln, Ca led Baptistry/F onl Bolh fuhlshnwer --------'-� —` -Jacuzzi/Whirl ool Car Wash -Each Stall _-- -Drive Thnt cu idor/Water As irator Dishwasher Commercial -Domestic Drinkui Fountain - I'loor Drain/sink -21, -_- Y 4" Car Wash Drain *Note: If the fixture work under this perndt results in un Domestic increase of sewer j,,I)t1s,a sewer permit %sill be Issued and Garbage - Disl,nsnl Commercial fees assessed for the sewer increase n►upt be paid before the -Industrial I►lunlbin{;permit can he issued. Ice Mach.IRefri .Drains Oil sc orator Lias St¢tiun Ree Vehicle Duni Station Shower -Gang - -Stall - Sink -Dar/Lavatory _ -Bradley - -commercial -service swimmin,Poul Filter Washer-Clothes Water Extractor Water Closet•Toilet Urinal ___ Other Fixtures. is\Data\permit forms\plmPetmitAppPg2 doc 01/03 CITY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: S�'/R2003-00037 13 X25 SW Hall Blvd., Tigard, OR 97223 (103) 639-4171 DATE ISSUED: 1/22/03 SITE ADDRESS; 14J00 SW 103RD AVE PARCEL: 2S111CB-00800 SUBDIVISION: DEL MONTF,SUBDIVISION' ZONING: R-. .5 BLOCK: LOT: Of) .JURISDICTION: I'I(i TENANT NAME: U3A NO: FOXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS- 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPE-RV SURFACE: Remarks: Sewer rnnnection. Reimbursement district#16 fees paid. Owner: — FEES _ SMELTER,CRAIG C +JULIE A 14900 SW 103RD AVE Description date Amount TIGARD, OR 97224 1 S\VUSA I Swr Conned 1/22/03 $2,300.00 1 SWUSA I Swr Connect 1/22/03 $0.00 Phone: ISWINSI=l Swr Insilect 1/22/03 $3,5.()0 1SWINSI11 Swr Inspect 1/22/03 $0.00 Contractor: ------ --- — Total $2,335.00 Phone: Reg#: Required Inspections I This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. 1 he Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not I icated at the measurement given, the installer shall prospect 3 feet in all directions from the distance given If not so located,the installer shall purchase a "Tap and Side Sewer" Perm Issued by: �' rc�Y!r 1 �cc��. ,�t Permittee Signature:' Call (!303) 639-4175 by 7:00 P.M.for an inspection needed the next business day MASTER PERMIT CITY OF TIGARD PERMIT #: MST2003-00064 DEVELOPMENT SERVICES DATE ISSUED: 3/13/03 13125 SW Hail Blvd., Tigard, OR 97223 (503') 6394171 SITE ADDRESS: '14900 SW 103RD AVE PARCEL: 2S111CB-00800 9UBDIVIS;ON: DEL MONTE SUBDIVISION ZONING: R-3.5 BLOCK: LOT: uu JURISDICTION: TIG Rr MARKS: Addition of approximately 212 sq. ft. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 10 FIRST: 115 of BASEMENT: 97 a1 LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: of GARAGE: at FRONT: 20 PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: I Tfvc at RIGHT: 5 VALUE: tg,50e6o OCCUPANCY GRP: R3 BDRM: BATH. TOTAL: 115 at REAR, 20 PLUMBING SINKS: WATER CLOSETS: I WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: I TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: 0 SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS: 2 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVN I R: GREASE TRAPS: uTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: CLOTHES DRYER: TURN>•100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SI...VICE FEEDER TEMP SRVC�FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 •200 amp 0 -200 amp WISVC OR FDR, PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp, 201 400 amp tat W/O 5VCIFDR. 01 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 BDO amp: 401 600 amp: EAADDL 13R CIR: +00 SIGNAL/PANEL: IN PLANT: MANU HWSVCIFDR: 601 1000 ami: 601+snps•t000y: MINOR LABEL: 1000+a mp;yolt: PLAN REVIEW SECTION Reconnect only: )--4 RES U 'TS: SVCIFDR>-225 A.. >500 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL-RESTRILI ED ENERGY A.SF RESIDENTIAL B COMMERCIAL AUDIO 6 STEREO: VACUUM SYS rEM: AUDIO 6 STEREO: FIRE ALARM: INTEPCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPE/IRRIO: PROTECTIVE SIGNI.. GARAGE OPENER: CLOCK: INSTRUMENTATION: MFDICAL: OTHR HVAC: DATAI7E1 E COMM: NURSE CALLS: TOTAL 0 SYSTEMS: TOTAL FEES: $ 694.34 Owner: Contrantor: This permit is subject to the regulations contained in the SMELTER,CRAIG C+ JULIE A HOMECRAFT CONSTRUCTION,INC.rigard Municipal Code,State of OR. Specialty Codes and 14900 SW 103RD AVE 17790 SW BELTON all other applicable laws, All work will be done in TIGARD,OR 97224 SHERWOOD,OR 97140 accordance with approved plans. This permit will expire If 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•. Phone: 5Q9-209-2197 Oregon Ut1ity Notification Center. Those rules are set forth In OAR 952-001-0010 through 952.001-0080 You Reg"' LIC' 144514 may obtain copies of these rules or direct questions to OUNC by calling(503)246.1987. REQUIRED INSPECTIONS Sewer Inspection Footing/Foundation Drl Exterior Sheathing Insl Plumb Final Footing Insp Plumb Top Out Insulation Insp Final Inspection Foundation Insp Electrical Rough In Rain drain Insp Slab Insp Framing Insp Electrical Final Underfloor Insulation Shear Wall Insp Mechanical Final I I Permittee SI natIssued By : L'c ure : Call (503)639.4178 by 7:00 p.m.for an inspection needed the next business day Tv %'T -/03FOR OFFICE I7!`SE0Nl,N' M A J Building Permit A lieation Received Building • RECEIVED - _ 'P t Perrnit No.h ILI 7 U Planning Approval Other City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review other FEBDate/B : Permit No.: _ Tigard,Oregon 97223 B 13 2UO3 Post-Review Land Use Phone: 503-639-4171 g03-598-1960 Date/B Case No. OF TIGARD Juns.: See Page 2 for Internet: www.ci.tigart I N Contact Su Iementallnfonnation 24-hour Inspection R W%§L0� Name/Method: �nn — Q�J TYPE OF WORK REQUIRED DATA: [�New construction �1)eolition 1 &2 FAMILY DW'3LLiNG ^ Addition/alteration/re cement er: \}�1 CATEGORY OF CONSTRUCTION Note: Permit fees•are based on the total value of the work performed. Indicate rAccessoo!Lg!��ld!in ir commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, n, • overhead and profit for the work indicated on this application. r 4,��j �•�J� _ Multi-Famil Other: valuation......................................................... $ No.of bedrooms: No.of baths: JOG SITE INFORMATION and L CATION Total number of(loors..................................... Job site address: / ' Y0c) f,;&J 10 Y `&VI New dwelling area(sq.fl.)............................ �— r Suite#: Bld ./A to Garage/carport area(sq, ft.)............................ \ ProjectName: Si►+k•-� 'ftJ •4- r�� • r. N Covered porch area(sq.ft.)............................. ' Deck area(sq.ft.)..................................... . Cross street/Direetions to job site: Other structure area(sq.R.)................... . .. .. a, �5i�50vv nt C N 10 1%•A F,t•.a.rt M Vn.,ou L REQUIRED DATA: /t -3• COMMERCIAL-USE CHECKLIST Subdivision: Tax ma / areal#: Note: Permit fees•are based on the total value of the work performed. Indicate 1 DESCRIPTION OF WORK he value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application 4A^`f9trsc+un 1>Ir/,A�ri0�. S.'a'Li}�.it- �Cro,n Valuation......................................................... S �. Existing building area(sq.R.)......................... C7'vo a. V,a a.-.J , Olt s>Ati.-rio^1 .._ ---- Now building area(sq. ft.)............................... —.._ Number of stories............................................ _--- TENANT' Type of construction....................................... _ PROPER—Y OWNER Occupancy group(5): Existing: Name: C" i d �M�l• t-r0-A- — New: Address: 1 y f c o 5," o s rt%u,Y Cit /State/Zi �� A-+�o o 9 7 z- Zu �,�- �;.f�� 3 y NOTICE: All contractors and subcontractors are required to be Phone: y4,3 2-4 a 3& S faX: � 3 licensed with the Oregon Construction Contractors Board under APPLICANT CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: F{a,�rhL,t,��r r•.d.> 0,4 jurisdiction where work is being performed. If the applicant is exempt Nr,e,,�G from licensing,the folliwing reason applies: Contact Name: Address: 0 City/State/Zt Phone:5c3 FaX:y`'3 BUILDING PERMIT FEES' E-mail- ' '�� " Please refer to fee schedule. CONTRACTOR Business Name: 14 ,"AQtf.r►f r t^..v rra *.••u J viLd Fees due upon application.............................. Address: 17 7 t: s w 'SA I V,, ,,� fQ.f, _ Cit /State/Zip: e*t.-�",�o� ek 9 71 y � Amount received......... . ................................. 5 Phor*E to"t- Z/-9 7 Pax: fr t3 a0t�_ bate received:__- 7 J cJ Authorized ,� , 1 1- Notice: 7'hl+permit application-Pares if a permit Ic not ohtaincd%%lihin Signature: w _ Date: 3 tpo da.%i after it ha%heen accepted as completc. •Fee methodolop sct b% I rl-fount Hulldhrg Inductr� ser%ice Board. (Please print name) is\Data\permit Forms\RldgPermitApp.doe 01/03 One-and Two-Family Dwelling Building Permit ApplicaLn Checklist Reference no.: Associated permits: Cityl ffflgald City of Tigard O Electrical ❑Plumbing U Mechani, Address: 13125 SW Hall Blvd,Tigard,OR 97223 ❑Other: Phone: (503) 639-4171 Fax: (50?, 598-1960 tZI t t t _I Land use ac.. completed.See ju.isdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district.etc. Verification of approved plat/lot. 4 Fire district—._—approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. 8 Solis report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control 0 plan ❑permit inquired.Include drainage-way protection,silt fence design and location of 'mtch-b4isin protection,etc. IO A mplete sets of legible plans.Must he drawn to scale,showing conl'ormancc to applicable local and state NAttfing codes. Lateral design details and connections must he incorporated into the plans or on it separate full-sine sheet attached to the plans with cross refer ccs between plan location and details. Plan review cannot he completed ill co yri hI violations exist. 11 Sitelplot plan drawn to scale.The plan must show lot and building setback chnaensi�ms;property corner elevations(if there is more than a 4-Il.elevation differential,plan must show contour lines at 2 Ii. Wo vl ca location of e n indicate-ments and driveway;footprint of structure(inclu ing decks);location of well%/septic systems;uulrty locations,direction indicator;lot of coverage;im ,vious area;existing structures on site;and surface drainage. ar a;building coverage area;pen!!E1. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent sire and location. – 13 Floor plans.Show all dimensions,room identification,window sire•location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross sections)and details.Show all framit g-member sires and spacing such as floor heams,headers,joists,sub-floor, wall construction,roof construction.More than one cross:action may he required to clearly portray constriction.Show details of all wall and root'sheathing,roofing,roof slope,ceiling freight•siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. is Elevation views.Provide elevations for new constnrctio m nuninnnn..I'own elevaCons for additions and remodels. Exterior elevations must reflect the actual grade if the•clr;ur,1t• m grain is treater than lour foot at building envelope. Full-size sheet addendums showing foundation clevation�,�Ith,11 wi,witces are acceptable. _ I6 all bracing(prescriptive path)and/or lateral analyst.plans.Must unlrurtc details and locations;for non-pre:.cri Live path analysis provide specifications and calculations to cngoreering standards. 17 Floor/roof framing.Provide plans for all floors/roof assenthlfes,indicating member siring,spacing.and hearing locations,Show attic ventilation _ 18 Basement and retaining wa .Provide cross sections and derails showing placement of rehar. Far engineered lls syslems,see item 22,"Engineer's calculations." Iam calculations.Provide two sets of calculations using current cudr olesi)m s,rlucs for all Kearns and multiple jnisls i Be over 10 feet long and/or any heani/joisl carrying a non-uniform load. 20 Manufactured floor/roof truss design details. _ 21 Energy Code compliance.Identify the prescriptive path or provude calculations. A gas-piping schematic is required for four or more appliances. _ _ 22 Engineer's calculations.When required or pro, (I,It c In ,u \c all.rt,ol truss)shall he stamped by an engineer or architect licensed in Oregon and shall he shown i, ;r►,I trot un�lrr revirw. Evil Im lam MOM 23 Five(5)site plans tore required for Item I 1 above. Site.plans must he 8-I/2' x I I"or I I" x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Minored"building plans will he not accepted. 26 "ReverFed"building plans must nivel criteria outlined in the Penni►& System Ucvclupment Fees dw,unient. 27 "Drawn to scale" indicates ,tandam archtect or engineer scale. 28_site plan to include tree size,type&locution per approved project street tree plan(if applic:ihlc),and CO f Street Tree List. checklist must he completed before plan review start date. Mieor changes or notes on submitted plans tray he in blue or black ink. Red ink is reserved tor department use only. 4ar14614 ftMYCOW 02 13.2003 08:16 FAX 0001 04/23i2002 15:21 FAI 5035981960 CITE' OF TIGARD U002 Fledbical Permk Appli+cation t Date rot:cived: Prtn»t no.•� .- -;j yr.,r'-./ City o Tigard ProecUappi.no.: ` Expire date: Add13125 SW Hall Plvd r1wale,Ort 0772 CuynjTgaid mss: bateir7lued: `— S�'/ Receipt no.: Phone (503) 639-4171 Fax: (503) 595.1960 Caw fila no.- Payment type: Land use approval: 41 1 &2 family dwelling or acccbs)ry U Cotitmez6al/industrial 0 Multi-family 0 Tenant improvement Q,Nevi conatrucdon Q Additrnnlalteration/rr_plac:emcnt j Otl+t:r. _. ❑Pamal Job address ) Q L - Bldg, no. Suitm no., Tax map/wx lodaccountnc,.. _ j,pt; $lock, Subdivision: _ project name' — _ - 1�ictiPtioo and location of work o`er misaa: i Estimated date of a umpleAiordinSPec:rjvu. \ • Job iso: _ ,. ha C� Iiea47'1 eel Qh'. (csl ?a.l nc.trap Business oemta; de;rteL1 � �-- r�ltr' tai • •x P, Addmss:` d•udirseltlf.lttetaiarsetotla.4prege. City,r State:p� 6arvie•buftaea E-mail; 1!100 sq.h er±ea 4 Q1TOrie: EaX: gorh•ddldonel 50011.R or portion dtateof CCB ata.: City/tile ic.no-' Uv%itodeaerpy.rm-mei ent1J oh Iuanuhatumd home or modular WalUng gi psi g cleuneten tnqui „ Datc ' — 9ewxxaneyerttsttdci 2 1led�atawe ? Senicaorteedan-ina41L oa, S•p.deer_none(prinq: 1111Aretl•r .r.elo.ytrw: NEI100 u pt or leu 2 . C L 2011mps to 400 AMW — 2 Name.(p"t)' ]fY 401 amps 1e 600 anis -— Mrilin bQl abpe to 1000 on+ s I 1 City: ' St%W Z1p: Over rt valla Phan: 41• 03'.'s- Owner 3'.fOwner{n9Wla4,)r*The U+scWtttton being made on pteperry I own `a• �p°"ty '°'LOt - whlrh is not intended for salt.lame,rout,or excheo socticiling to ��dOO'•�w°'�� _ 2200 an p,at imr. ORS 447.455,479.50.701` ILII tunpa w 400 antpt »u (z � /2 r S S - -- 2 QWtt�'S Sl aIUP" r aUl W�_ -..__ I•Atchh�rcNbratw,•�ierrrlon. ore:txtrtion p�ptueel: !AtE k kc fat Maseh circeiu with;wrJ aro of egs: sc";c&ur taed"6n.each hrbMb umult _ `try 7�: Fce fee hrwc6 urtYtll.rtmout puresrase _ —1-� --- of tetvics ur frder fee,lint Sratwh drowt: Z k'Iwoe; Fzx - f3-nt�til• Faohaddi4o"elbrtureftnRttlr. Mtge.(mid'er Ierderetot�lellati): hwA tr"nvp nnle I U Serrioe a,rer 7'27 arnFseenvne.c�l U Arelth een fsaiLty dt sltotem tun•it hmg I ::t S.avim or►r 330 omp_+ bnr of 1N U►{asodrnn IM4Udl fsa+Uyd,relllnA1 0 building ova I9,000sgt=hx.1611,of sly-- �a�1°ra fiitcd'-^ergy pertel, G9yw�noverGOUvellsnnnvnv moterafidsrtialanllsleamrlocule alruation.deeteysien• L I3 U i3v Oiling ever ttum+loam U Pwdae,400 amps ar more pt, — 0 Ocrvpant Iced are"stunt r d M.,lufarm"d tavctuw"r RV pant 1 b h1 oterr tM vv+ebk(r••a>r ewi rtat+ra fl FgmeJl�ghtlr.,a e'en Q tLlt.r -_— Pct is n��ua__ 15u{taek�- cess o[p1w with MY Mhe above. ►w fee --- ilteabler tlpl rias s IIabb ttg tsldr1 eoltrproglloat twrioe. purl — rm a0 Jw cage eadr eeAa pM am lam re am SOUL&:This pers.-1it"pLivalon taettniN tee. . umh Plan t (at Q vla � an 0 Ma.• Ct enpors if a permit b not oMwnrd !6) S e.dtt nae nawA,r. within 110 def!Oct 1,has been Starr sutt#tatEt(1196)....f acraptrd as complete TOTAL ..... ..............._S _'—�I"aes aTeoJlI,.tar.�a�«a on pari,a3 — __'�rdy„Idu 4YLa•ts I60aN7nno Plumbing Permit AAPlieation ' Received Plumbing Date/B . Permit No.: O Cit Of Tigard Planning Approval Sewer City g Date/By: Permit No.: 13125 SW liall Blvd. Plan Review Other Tigard,Oregon 97223 Date/ti • Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Revicw Land Use Internet: www.ci.tigard.or.u:; Date/By: Case No.: Contact Juris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental information. - TYPE OF WORM FEE*SCHEDULE forspecial Information use checklist) New construction I ❑Demolition Description Qty. I Fee(ca.) •total Addition/alteration/re lacement 0 Other: New 1-&2-family dwellings CATEGORY OF CONSTRUCTION Includes 100 ft.for each utility connection _ 1 &2-Family dwell#Y0Commercial/Industrial SFR i bath 249.20 - Accessory BuildingMulti-Panni SFR(2 bath 350.00 SFR 3 bath 399.00 Master Builder Other: Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION Firesprinkler-sq.ft.: Pa gc 2 Job sine address: p:_ S LJ U 3AP 'ST' Site Utilities Suite#: Bldg./Apt.#: Catch basin.'area drain 16.60 - D cll/leach linc'trench drain 16.60 Project Name: Footing drain(no. linear ft.) Pae 2 Cross street/Directions to job site: Mai;ufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 _ - Sanitary sewer(no. linear R.) Page 2 Subdivision: - _ Lot# Storni sewer no linear ft. Page 2 Tax ma / area) #: - Water service no.linear ft. Pu e 2 DESCRIPTION OF WORD' Fixture or Iter Ahsorption van ic 16.00 Backflow prev Inter Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 _ PROPERTY OWNER -_�TENANT Eicctors/sump 16.60 Expansion tank 16.60 Address: 14 i o Fixture/sewer ca _ 16.60 Cil /Stale/Z1 : Floor drain/floor sinkliub 16.60 ' k Garbage disposal 16.60 Phone: 5c 3 -d s(.3 Fax: 5:03 & s 1 16 1,--/ Hose bib 16.60 APPLICANT - CONTACT PERSON Ice maker 16.60 Name: _141&x#}-G- rE- L Intcrcc tor/ rcase trap 16.60 Address_ /7790 St.J /!-1E,4 1-11 R-t', - Medical gas-vrluc: $ Pae 2 C t /State/Zip: 5 tt4,t,Je*e o (3 AL y 7/`/U Primer J 16.60 Roof drain kcotnmcrcial l '0 60 Phone: '`moo' Zv 9 z/n rFax: 5 o 3 0 6C s F v tH Sink'basin/lavato 1060 E-mail: Tub/shower/shower pan 16.60 CONTRACTOR Urinal 16.60 BUSIneSS Nettle: c41F ,y Water closet 16.60 Water heater 16.60 Address: u caw a{- L- Other: _-- Cil ,;t _ Other: Phone:S7j3�70"� Fax: _ Plumbing Pertnit Fees* „ Suhtnlal $ _ CCB LIC. #' � sJ _ f'IUn1b. Lie.+,:3y IV: �'_ Mininuam Pcmut I'ee$72.50 $ Authorized ; Residenli:.i V,ickflow Minimum[-cc 536.25 �Z._- Date: 2 J 't I - Signature: _ �_ Plan Review 25%of Permit FeeL $ State Surcharge(8%of Pcrmit Fee) $ U' •ase lm : iamei _- _ TOTAL PERMIT FEE I $ _- Notice: Phis permit rppllestin„i expires It a permit I+not obtained within All new commerc:.i buildings require 2 sets of pian with Isometric or 1R0 days aner it has been accepted as complo-. riser diagram for Mian review. *Fee methodology set by Tri-Countl Banding Industry Service hoard. 1:09IMPernut Fornis\l')ml'eimitAlip,doc 01103 Plumbing Permit ADDlication - Cit,' of Tigard Page 2 -Supplemental Information Fee Schedule: _— Residential Fire Suppression Systems: Site Utilities Qq. Fee(ea) Total Square Foota e: Permit Fee: hooting drain-I"100' 55.00 0 to 2,000 $115.00 Footinv drain-each additional 100' 46.40 2 001 to 3 600 $160.00 3,601 to 7,200 $220.00 _ Se wet-1st 100' 55 00 _ 7,201 and greater $309.00 Sewer-each additional 100' 46.40 Water Service-ist 100' 55.00 Medical Gas S stems' Water Service-each additional I(W 46.40 Valuation: Permit Fee: Storm&Rain Drain-Ist 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,00100 to$10,000.00 $72.50 for the first$5,000.00 and 51.52 for each additional$100.00 or fraction thereof,to and Fixture or Item Qty. Fee(ca) Totaladditional $10 000.00. Commercial Back Flow Prevention Ikvice 46.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for Residential 13ackllow Prevention Device each additional$100.00 or fraction thereof,to (minimi;Tj rmit fee$36.25) 27,55 and including$25,000.00. Rain Drain,aingic family dwelling 65.25 $25,(1(11.00 to$50,000.(:' $379.50 for the first$25,000.00 and$1.45 for Inspectian of existing plumbing or each additional$100.00 or fraction thereof',to and includin $SO,OOU.O0. specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Areyou capping,moving or replacing;existing fixtures! It' ",yes",please indicate work perfortned by fixture. Failure to areurafely reporf fixtures could result in increased sewer fees*. Ounnllty (Fixture)Work 1'rrformed Corn uen(s regard-.ag fixture work: Fixture Type: Replace _ New Moved Fxloing Capped -- — --- Ha tilt /font Itath -'rub/Shower - jacuzzi/Whirlpool — - ('at Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator - - Dishwasher -Commercial -Domestic --� — - --- Drinking I�ountain Eye Wash _ Floor Drum/sink .2" -Y --- - -4" Cor Wash Drain *Note: If the fixture work under this rerndt results In an Uarbage -Domestic I Disposal -Commercinl increase of sewer EDUs,a sewer permit will he Issued and -Industrial fees assessed for the sewer increase must be paid before the Ice Much./Regi .Drains I 1•1umhing permit can be issued. Oil Separator (ins Station) Rec.Vehicle Dump Station Shower -Gang -Stall Sink -Ilar'l uvatory - -Bradley -Commercial -Service — - Swimming Pool l titer Washer-Clothes _ Watcr Extractor Water Closel-Toilet Urinal Other Fixtures: i\DstOerniit 1,*nrms`l'hnl'ermitAppl'g2.doc 01/03 w FFICE NLY Mechanical Permit Application Received FOR ` Mechai.i ,il` Date/By: Planning Approval Building City of Tigard Dalu/B : Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone; 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date!B : Case No.: Internet: www.ci.tigard.or.us Contact Juris.: See Pag, 2 for 24-hour Inspect'on Request: 503-639-4175 Name/Method: Supplemental Inion ration. TYPE OF WORK COMMERCIAL FEF`SCHEDULE-USE CHECKLIST New construction Demolition Mechanical perm, .,!s*arc based on the total value of the work Addition/alteration/replacement Other: performed. Indica(::the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhea(!,md profit. 1 &2-Family dwelling ❑ Commercial/Industrial value: $ See Page 2 for Fee Schedule -7—Accessory$uildin r Multi-Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE _ L Descri tion tv Fee ea. Total ❑ Master Builder I Other: lleatln Conlin _ JOB SITE INFORMAI ION and LOCATION Furnace-add-on air condttionin�** 14.00 Job site address:J g — ,,} s I Gas heat u!n 14.00 Suite#: Bldg./Apt.#: _ Ducc work — 14.00 -- Project Namc: S H dronic hot water system — 14.00 Residential boiler Cross street/Directions to job site: for radiator or h dronic system) 14.00 Unit heaters(fuel,not electric) (in walt,in-duct,su ended,etc.) _14.00 Flue/vent for any of above 10.00 Subdivision: Loth#: Repair units 12.15 _1� - Othcr_Fuel A Ilances Tax map/parcel #: Water heater 10.00 DESCRIPTIO OF WO 2K Gas fireplace 10.00 a Flue vent(water heater/.Has lire lace) 10.00 l I.og lighter(gas) 10.00 Wood/Pellet stove 10.00 Wood fireplace/insert 10.00 Chimney/liner/flue/vent _ 10.00 IN PROPrwry OWNER TENANT Other: 10.00 _Name: (1My Environmental Exhau• nttlation ��-� '�'f'�'f�- Range hood/other kitchen equipment 10.00 Address: /4�7t-� _�W /y3r� Sr _._ Clothes dryerexhaust 10.00 ( /State/Zl: -rye O b/ g 1 � Single duct exhaust Phone: 5Z3-b1>-a�93 Fax: (bathrooms,toilet compartments. APPLICANT CONTACT PERSON utility rooms — 6.80 Namc: Attic/crawl space fans _ 10.00 -- �— — Other: 10.00 Address: / -79U 5L0 L�yy i _ Fuel Piping Cit /State/Zip: / '�A i �i / **(S5.40 for first 4,$1.00 each additionolL Furnace,etc. " Phone:�--zc,9 -a 19 Fax: 5Z,3-&ee 34 Gas hce,etc. E-mail: _ — Wall/suspended/unit hew it " CONTRACTOR Water heater Fire lace " Business Name 1� _p Address 7 U_�_�Ir�� -- -- 13BQ - - Cit /State/_7p.-�' (i,J�C) c r_—I' 7_!Y L-) Clothes dryer(gas " Phone: ��lQ�,.�� ax: .��'__3�-- Other: l_-------- - CCB Li(,. I'J: l �-3 __�-- _� _ Total: -- _M1techanlcal Permit Fees' _ Authorized Subtotal. S Si;�nature: _ Date O'1 _63 Minimurn Permit Fee$72.50 S _ XG, }h A�4 _`_ ,_ Plan Review Fee 25%of Permit Fee) S (Please print name) _ State Surcharge(8%of Permit Fee $ _ TOTAL PERMIT FEE S Notice: Thls permit application expires it a permit h not obtained%,W-In 'Fee methodology*,'by Fri-County Building Industry Service Board. ISO days slier It ha%been accepted as complete. "Sale plan required for exterior A/C units. i:U)stsV'crmit Fonns\MrcPcrnmApp dtx 01103 Mechanical Permit Application - City of Tigard Page 2- Supplemental Information C.)mmercial Fee Schedule: Total Valuation: Permit Fee: $i.00 to 55,000,00 Minimum fee 572 50 55,001.00 to$10,000.00 ?"2.50 for the first 55,000.00 and 51.52 for each additional 5100.00 or fraction thereof,to and includin $10,000.00. $10,001.00 to$25,000.00 S148.50 for►hc first$10,000.00 anJ $1.54 for each additional$100.00 or fraction thereof,to and including $25000'00- $25,001.00 to$50,000..10 $379.50for the first 525,000.00 and $1.45 for each additional 5100.00 or fraction thereof,to and including $50000.00. $50,001.00 and up $742.00 for the first$50,000.00 and $1.20 for each additional$100.00 or Fraction thereof. Assumed Valuations Per A>t Hance: Val-ic T Total bescri tion: t Ea Amount Furnace to 100,01)013T11,including 955 ducts&vents l urnace>100,000(?'rU including ducts 1,170 &vents Floor furnace includin vent 955 Suspended heater,wall heater or floor 955 mounted heater Vent not included in a liance ermit 445 Repair units 805 <3 hp;absorb.unit, 955 to100kBTU — 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 h!ndlin unit to IU 000 cfm 656 Air..,tndlin unit>I 0 000 cfm �1,170 Nott- ortable evaporate cooler 656 _ Vent fan connected to a sin le duct 44G Vent system not included in appliance 056 nermit- I loud served b mechanical exhaust 656 faimestic incinerator 1 170 -- Commercial or industrial incinerator ___41590 Other unit,including wow stoves, 656 ituerts,elc. Gas i2ing 1.4 outlets 300 Each it outlet _ G3 TOTAI.COMMFRCIA1. VA1,tIATION: i OstOetmit homu\MecPermnAppPg2 doc OI r03 SW lo3RD AVE ----------- - I20m0' -- - -- ---♦ ELEV.0�' ---------- --------- : : I ELEV.OD' 1 i I : 1 I : 1 I : --- ---- - 1 I 1 24 I I 1 „ I 1 I I I I I I I I I I II 1 I ---•------- --------------- ____ - - ADDITION ON i NEw BASEMENT , I i I I I I L------------ --------DECK I : I I I I 1 I 2ND STORY I BAY WINDOW ADDITION � I I 1 I ------------- I ----------------------- : I ELEV. -9� 1900' NOM 14' AO"E -.-------- ESV. -s0 SITE PLAN __ GRIAG t JULIE "LTER SCALE: 1"•90 14900 SW 103RD AVE TIGARD, OREGON CITY OF TIGARD 24-hour BUILDING Inspec4ion Line: (503)639-417G INSPECTION DIVISION Business Line: (503) 639-4171 - T� DIL�l BUP _--- - Received 1 2-�-- , Date Requested 312(4 AM— PM._ BUP Location -- 1465' :. — S� _Suite------- -- MEC Contact Person 1 - Ph( sv3) Y�; Z ( _7 PI.M Contractor. _ __ Ph( ) — — - SWR BUILDING Tenant/Owner ELC _ Footing Foundation Access: ELC Fig Drain ELR Crawl Drain _ "- -- Slab Inspection Notes: SIT - Post& Beam -- C OL r/ s� Shear Anchors - - ------ -_-_ _ - Ext Sheath/Shear Int Sheath/Shear -- ------` Framing Insulation ,1 , 1'�'�, Drywall Nailing W Firewall Fire Sprinkler - e_ Fire Alarm Susp'd Ceiling ------- --- - - Roof .F. then - T FAIL L BINE - - - Pos Re Under Slab Rough-In Water Service _ Sanitary Sewer Rain Drains -- -- -- - - --- T _. Catch Basin/Manhole Storm Drain Shower Pa.i ------- Fin _ PART FAIL --- - - -- - - MECHANICAL Post& Beam_ Rough-In -- -- --- - -------- — - ---- _ — Gas Line Smoke Dampers ---.------ -___-- -- _ __._. -- _-_ -- FinaL PART FAIL CTRI L SeYvTce ------- ----— ---- ---- Rough-In UG/Slab ---� - -- Low Voltage FinaL [� Reinspection fee of$__ required before next Inspection. Pay at Cly Hall, 13125 SW Hall Blvd. 'PART FAIL_ SI [-� Please call for reinspection RE: _ F] Unable to Inspect-no access Fire Supply LineADA z / Approach/Sidewalk Data �� —� `�.,< Inspector Other- Final DO NOT REMOVE this Inspisction record from the Job site, PASS PART FAIL MECHANICAL PERMIT CITY OF TIG�AR® PERMIT#: MEC2001-00452 DEVELOPMENT SERVICES DATE ISSUED: 12/13/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S1 11CB-00800 SITE ADDRESS: 14900 SW 103RD AVE ZONING: R-3.5 SUBDIVISION: DEL MONTE SUBDIVISION LOT: 007 JURISDICTION: TIG - BLOCK: FLOOR FURN: EVAP COOLERS: CLASS OF WORK: ALT UNIT HEATERS: VENT FANS: TYPE OF USE: SF VENTS W/O APPL: VENT SYSTEMS: OCCUPANCY GRP: R3 HOODS: STORIES: BOILERS/COMPRESSORS — DOMES. INCIN: FUEL TYPES 0 3 HP: 3 - 15 HP: COMML. INCIN: LPG MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 _ AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Replacement of gas furnace _ _ FEES _— Owner:_ .- fPR�MT -- - e By Date Amount Receipt SMELTER, CRAIG C + JULIE A 14900 SW 10 3RD AVE CTR 12/13/01 $72.50 272001000CTIGARD, OR 972?_4C1 CTR 12/13/01 $5.80 272001000C Total $78.30 Phone: Contractor: ARROW MECHANICAL_ 10330 SW TUAL_ATIN RD REQUIRED INSPECTIONS TUALATIN, OR 97062 Mechanical Insp Heating Unt Insp Phone:692-1565 Reg#:LIC 5193 Final Inspection This permit is issued subject to the regulations contained in the Tigard N.�unicipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling Issue By: X11, - / " /_(, Permittee Signature: 1 --- Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit App licatinn 1 Date received:;�' Permit no.. Cit of Ti and T/c=� 3' Project/appl.no,: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigar -fills Date issued: By: Phone:Phone: (503) 639-4171 Fax: (503) X96 1960 Case file no.: Payment type: Land use approval: _ Building permit no.: IA'PE OF PERMIT L&2 family dwelling or accessory U Commercial/ir dustrial U Multi-family U Tenant improvement U New construction W Add ition/alterition/replacement U Other: lot 1011110 IN 11711121111111111111 LUM "'obad tress: Q Indicate equipment quantities in boxes below. Indicate the dollar ildg.no.: Suite no.: value of all mechanical materials,equipment,labor,ovetnead, Tax map/tax lot/account no.: profit.Value$ _ Lot: Block: Subdivision: *See checklist for important application information and Project name: yt jurisdiction's fee schedule for residential permit fee. City/county; (_ WwJ4 ZIP: -2 22 _3 IULM a 31 MILIt 10 Descripti�on and locati n of work on premises: _ _ 71iandlirilg t IGC�LI]Cr- LA_5 rtif k'NA�t�G" 1 ee(M-11 7mal Est.date of completion/inspection: DeKrlption (lty. Rty.only Rm.oulr Tenant improvement or change of use: Is existing space heated or conditioned'?U Yes U No unit _CFM ning(site p an rcqu rc ) Is existing space insulated'?U Yes U No f existing HVAC system lioi er/compressors Business name: ; iv/ /ji) ?c t el Slate hoiler permit no.: i E'L., �— — -� IIP Tvns---BTU/H Address: �5W 71-(A t A,T) O Fire/smo a dampers/duct smoke detectors City: atVf 4ZIP:C- ) - I lent pump(site plan required) Insta rep acel'urnac Phone: / Fax E-mail _ urner Y'fi no. Including ductwork/vent caner U Yes U No ltstA rep ace/re locate heaters—suspended, Ciiy/metro lie.-,to.: !-�`� G7 wall,or Boor mounted -� Name(please print): I- Z. Vent for appliance other than furnace e geral on: W111 FAA W;I Ahsorprlon units__. _ BTU/11 Name: )t� 1 ('hiller, IIP Address: L I — ('nm urssurs III' Lm ronmental exhaust and vent laI on: City: State: ZIP: z Appliance vent _ Phone: Fax: E-mail: I Dryerexhaust LIAM 0o s,' ype res. itc cn/hazmii hood fire suppression system Name: / 61 Exhaust fan with single duct(hath fans) Mailing address: G" ! Z t7 x taunts stem apart front beating or AC City; Slate. 7.11' Fuelpiping an sl ul on(up to outlets) Type: 1_110 _ NU Oil Pill,I../- - C __ I F nlad Duel piping each additional over 4 outlets EMrncesipiping(sc ticmaucrequired) _ vuniberofoutlets Nano: ( : er h app once or equ pment: - Address: _ Decorative fireplace City: �— -_ State: 1.11' Insert-type Phone: Fax: E-mail oo stove(x etstuve Applicant's signature` Other: ' _ Dale:/ ter: Name (print): I L_Not WI Jurisdiction accept ctaht code,plena Call poiediction I-n move infontnttlonPermit fee.....................$ U Viso U MasteWerd Notice:'l his perntiapplication Minimum fee................$ 1 - •-w Credit card noinher:_ __ _ LJ a'sl'ires if a perntit isnot obtained Minimum review(nt _ %) $ _ l;ephr, %%tibio 180 days after it has been State surcharge(896)....$ N—nmeof c r�iol _91ioWn nu crea3n cud ac.:cpted as complete. TOTAL $ Codholder signature --- Annum 4404617(&MCOM) MECHANICAL PERMIT FEES 1 & 2 FAMILY DWELLING FEE SCHEDULE: COfV'MERCIAL FEE SCHEDULE: Price Total _- - - - - -- ) Description: Qty (Ea) Amt TOTAL VAI.U_ATI0N: FEE: -_-____--{J Table 1A Mechanical Code Minimum fee$72.50 1) Furnace to 100,000 BTU 14.00 $1.0_0 to$S,000.w T includin ducts&vents $5,001.00 to$10,001.00 $1.52 fofrr each or the fladdit on0a�$100.00 or 2) Furnace 100,000 BTI1+ 17.40 fraction thereof,to and including including ducts&vents $10000.00. 3) Floor Furnace 14.00 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and includin of nt ----- $1.54 for each additional$100.00 or4) Suspender heater,wall heater fraction thereof,to and Including 14.00 or floor mounted heater $25 000.00. g) Vent not included in appliance permit 6.80 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or 6) Repair units 12.15 fraction thereof,to and Including $50 000.00. - Check all that apply: Boiler Heat Air $742.00 for the first$50,000.00 ana For Items 7-11,see or Pump C ond $50,001.00 and up $1.20 for each additional$100.00 or fraction thereof. footnotes below. Com 7)<3HP;absorb unit 14.00 to 100K BTU - ASSUMED V LA UATIONS PER APPLIANCE: 8)3-15 HP;:,toOak I 25.60 Value Total unit 100k to 500k BTU at Ea Amount 9)15-30 HP;absorb 35.00 Desai tion: 955 unit.5-1 mil BTU -"- Furnace to 100,000 BTU,Including 10)30-50 t'P;absorb 52.20 ducts&vents 1,170 unit 1-1.75 mil BTU Furnace>100,000 BTU including 11) 50HP:absorb 87.20 ducts&vents 955 unit>1.75 mil BTU Floor furnace including vent 955 12)Air handling unit to 10,000 CFM 10.00 Suspended heater,wall heater or floor mounted heater 445 13)Air handling unit 10,000 CFM+ 17.20 Vent not Included in applicance ermit_ 805 14)Non-portable evaporate cooler 10 00 Re air units 955 <3 hp;absorb.unit, 15)Vent fan connected to a single duct 6.80 to 100k BTU 1,700 3-15 hp;absorb.unit, 16)Ventilation system not Included In 10.00 _ 101k to 500k BTU- 2,310 a liance ermil 15-30 hp;absorb.unit,501k fo 1 17)Hood served by mechanical exhaust 10.00 mil.BTU3,400 -- 30-50 hp;absorb.unit, 18)Domestic incinerators 17.40 1-1.75 mil.BTU 5,725 >50 hp;absorb.unit, 19)Commerclal or Industrial type incinerator 69.95_ _ >1.75 mil.BTU 656 Air hand unit b 10 000 dm 170 20)Other units,including wood stoves 10.00 Air ha-dlingunit>10 000 ctm 656 Non- ortable evaporat-a cooler 446 21)Gas piping one to four outlets 5.40 Vent fan connected to a sin Is duct 956 Vents not Included in 22)More than 4-per outlet(each I 1.00 a Ilaemtlt 658 Hood served b mechanical exhaust 1 170 Minimum Permlt Fee$72.50 SUBTOTAL: Domestic incinerator __ 4 590 Commercial or industrial Incinerator_ 858 ------ gni.S atf-Surcharge s Other unit,Including wood stoves, _ inserts,etc. - -- 360 25%Plan Review Fee(%,if subtotal) pas I in 1-4 oitlets B3 Required for ALL comm erGat permits only ',U Each additional outlet - ___ $ TOTAL RESIDENTIAL PERMIT FEE: ;Io TOTAL COMMERCIAL - VALUATION: _ _ - I run pectiotns outside of normal business hours(minimumAnd I" charge-two hours) $72 50 per hourminimum charge-half he 2 Inspections for which no fee Is specifically indicated $72.50 per hour - plans minimum I Additional plan review requimd by changes.eddlllons or revisions tv p a s charge one-half hour)$12 50 per hour State Contractor Boller Certification required for unds�200k BTI1. "Residential AIC requires site plan showing placement of unit IAdstsVotms\mech-fees.doc 10111100 CITY OF TIG-PRD 24-Hour BUILDING Inspection Line: (5031639-4175 MST ! INSPECTION DIVISION BuGineSS Line: (503) 639-4171 BUP — -- ----- Received _ Date Requested AM _ _--_ PM BUP Location Suite _ MEC QDi- -5-2 Contact Person Ph ( �) _-_ PLM Contractor _. Ph (-- ) SWR BUILDING Tenant/Owner ELC _ ---- Footing - Foundation Access: ELC _- Flo Drain ELR Crawl Drain - -- Slab Inspection Note-: SIT _---_-_ _- Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear ---- -- Framingc4 GL fir.r_�.vc.� �/1�, ; _ > /7;5.K Insulation Drywall Nailing Firewall Fire Sprinkler -- _ Fire Alarm Susp'd Ceiling - Roof Other:�— - - -- - - - Final PASS PART FAIL. - PLUMBING Post& Beam Under Slab Rough-In _ ---- -- Water Service _ Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain - Shower Pan Other: Final PPAfi T FAIL -- eHA,�4tr Post&Beam -- - ---- -- Rough-In Gas Line Smoke Dampers PART FAIL --- - --- - - ------- ELECTRICAL Service - --------- Rough-In UG/Slab Low Voltage - Fire Alarm Final El Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _-� Please call to, reinspection RE: _ _ - _ Unable to irspect-no access Fire Supply Line ADA Approach/Sidewalk Date Z 2 Y>r' d JIL- Inspector Ext __-- Other:_ Final DO NOT REMOVE this inspection record from the lab site. PASS PART FAIL