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11175 SW 114TH PLACE Ln U) 11175 SW 114"' Pl"lce CITY OF TlGARD BUII DING INSPECTION DIVISION MST �U�-GD �/Z t ' 24-Hour Inspection Line: 63S 175 Business Line: 639-41. . -- BUP _ Date Requested_ `�� AM PM BLD Location /l/ S�� /1 A. ilk _ Suite MEC ' Contact Person Ph .5!/�/—�� 7� PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: ;� Foundation /JQ Ko fi� FPS Fig Drain Crawl Drain Ins ction Notes: SGN Slab SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing t�t� 0 C�� a QC t/ '' � �._+ A(f"Ac f!.... C,� Insulationl t s- /�V ol_ /N✓px Drywall Nailing ,/ _GT�'S k� Firewall Fire Sprinkler _ Fire Alarm Susp'd Ceiling — Roof Misc: — _ —�— Final PA PART FAIL — —• - - L Post& Beam - — —� Under Slab Top Out -- Water Service Sanitary Sewer �- rains PART FAIL MECHANICAL_ Po ct& Beam -- —- Rough In Gas Line Smoke Dampers - PASfi PART FAIL ELECTRICAL — -" --- Service Rough In UG/Slab r _� Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading - "— Sanitary Sewer Storm Drain ( J Reinspection fee of$ _--required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Benin [ J Pleese call for reinspection RE: -- [ J Unable to Inspect-no access Fire Surply Line ADA Approach/&Iewal� ''Date C � Inspector rJ SPA,'-#• Ext Other Final PASS PART FAIL DO NOT REMOVE this Inspection accord from the Job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MSr .�_ 24-Hour Inspection Line. ,39-4175 Business Line: 6 4171 IUP ---Date Requested-121——2-v AM PM _ -- BLD Location Suite MEC Ph 70 P L.MI -- -— --—— Contact Person _ Contractor Ph SWR � �— i BUILDING Tenant/Owner — ELC Retaining Wall ELR Footing Access: FPS Foundation _ 5 G Ftg Drain - - --- - ---- Crawl Drain Inspection Notes: Slut, - --------- SIT — -- Post&Beam _ Ext Sheath/Shear Int Sheath/Shear Fraw.in9 Insulatioi Drywall Na9ing -- Firewall Fire Sprinkler -- - - - - - Fire Alarm Susp'd Ceiling - Roof Mises --- —_ Finai PASS PART FAIT_ -- PLUMBING Fo8 Beam Under S stlab Top Out Water Service Sanitary Sewer Rain Drains _ - Final PASS PART FAIL rEANIC��13e�ii7 InneSmoe Dampers Final PASS FART FAIL Serv^e Ro�gn In UGISIeb -- Low Voltage JEIEagarm Fi PART F 7Firesu,.!)Iv n9 _--- Sewer required before next inspection Pay at City Hell, 13125 SW Hall Blvd rain [ ]Reinspection tee of$ asin ( j Please call for reinspection RE. _ _— ( ]Unable to inspect no acres, Line ADA _ Approech/Sidewalk Date / ,.... � . _ 2 - In lector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from tho job site. C�� ®� �� MASTER PERMIT PERMIT #: MST2001-00425 DEVELOPMENT SERVICES DATE ISSUED: 8/17/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11175 SW 114TH PL PARCEL: 1 S134DB-00700 SUBDIVISION: WINTERS ADDITION ZONING: R-4.5 El K: LOT: 001 JURISDICTION: TIG REM. i,S: Add;tion of 525 sq. ft. room. BUILDING REISSUE: STORIES: I FLOOR AREAS v RFOUIRED SETBACKS REQUIRED CLASS OF WCRK: ADD HEIGHT. 1 FIRST: 552 of BASEMENI of LEFT. SMOKE DETECTORS: Y TYPE OF USE: LIF FLOOR LOAD: 10 SECOND: sf GARAGF. sf FRONT: PARKING SPACES: TYPE OF CONST: SN DWELLING UNITS: FINBSMENT. 5f VALUE RIGHT: . 5'�.��^i:7�:� OCCUPANCY GRP: R3 BDRM: I BATH: rOTAI.: .`.5,,00 of REAR. PLUMBING -- SINKS: 1 WATER CLOSETS. WASHING MACH. LAUNDRY TRAYS. RAIN DRAIN: 100 TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: TUBISHOWERS: 1 GARBAGE DISP: I WATER HEATERS. I WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS'. OTHER FIXTURL 5: MECHANICAL FUEL TYPES FURN<100K: 130ILlCMP<3HP: VENT FANS: i CLOTHES DRYER: FURN�-100K: UNIT HEATERS: HOODS: OTHER UNI r3: 1 MAX INP: btu FLOOR FURNANCES. VENTS: WOODSTOVES: GAS OUTLETS, ELECTRICAL —_ RESIDENTIAL UNIT SERVICE FEFDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS _ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp 0 200 amp: WISVC OR FOR: 1 PUMPIIRRIGA T ION: PER INSPECTION: EA ADO'L 500SF• 201 - 100 amp 201 400 amp: tot W/O SVCIFDR: 00 SIGNIOUT LIN LT. PER HOUR: LIMITED ENERGY: 401 600 snip: 401 600 amp: EA ADDL OR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: flat • 1000 smp: 601•alnpsA000v: MINOR LABEL: 10004 emplvolt: PLAN REVIEW SECTION Reconnect only: ,-4 RES UNI,4: SVCIFDR--225 A.: t100 V NOMINAL: C ,AREA13PC OCC ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO A STEREO: VACUUM SYSTi M: AUDIO&STEREO. FIRE.:LARM: INTERCOWPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH: BOILER HVAC. LANDSCAPEIIRRIG: PROTECTIVE SIGNL GARAGE OPENER CLOCK: INSTRUMENTATION: MEDICAL: 0iHR: HVAC: DATAITELE COMM: NURSE CA'-LS TOTAL N SYSTEMS: TOTAL FEES: $ 3,098.59 Owner: Contractor: This permit is subject to the regulations contained In the VIOLETTE,LORITTA COLLEEN JLM SERVICES INC Tigard Municipal Cade,State of OR Specialty Codes and 11175 SW 114TH PLACE 12220 SW Wf LNUT ST all other applicable laws All work will be done in TIGARD,OR 97223 TIGARD,OR 97 223 accordance with approved plans This permit will expire U work is not started within 160 days of Issuance,or if the work Is suspended for more than 160 days. ATTEOTION Phone•. Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep e: UC moe. forth in OAR 952-001.0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Boam Mechanica Electrinal Service Insulation Insp Electrical Final Sewer Inspectiun Underfloor insulation Electrical Rough In Roof Nailing tvAechanical Final Footing Insp PLM/Underfloor Framing Insp Wat9r Line Insp Plumb Final FoundrIlon Insp Mechanical Insp Shear Wall Insp Water Service Insp Final Inspection Post/Beam Structural Plumb Top Out Exterior Sheathing Insl Appr/Sdwlk Insp Issued B �.�� C '1 Permittee Signature y Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day t -7 kqci Building Permit Application �® mate received: ' �i r Permit no.: ("7� City of `Tigard It Project/appl.no.: Expire date: r It,ofTigo,d Address: 13125 SIN Hall Blvd,Tigard, 223 Phone: (503) 639-4171 Date issued: By: Receipt no.: _ Fax: (503) 598-1960 Case fide no.: Payment type: �II Land use approval _ 1&2 family:Simple Coaplex: a ;Jo &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction l]Demolition ddition/alteration/replacenicnt U Tenant improvement U Fire sprir,der/darn U Other:addres:: Bldg.no.: Suite no.: Lot; Block: Subdivision- !, Tax map/taz lot/account no.: �Ir�t Project name: r r-},e',f r-&-e/, — 4/A._e' 0tC11V - Description and location of work on premises/special conditions: -_- - - _- — ----- -- U 0 To IS 0 1241 N mmc: __G&I e ve �' _Mailing address S / 1 &2 family dwelling: State: Z.IP: q Z 2 Valuation of work............................. .......... $ — .. �! Phone: �" c� 7% Fax: E-mai No.of bedrooms/baths................................. --_ Owner's n:presentative: Total autnbcr of floors................................. -- Phone: Fax: E:-mail: New dwelling area(sq.ft.) .......................... Garagr/carport area(sq.ft.).................I....... Covered porch area(sq.ft.) ......................... Name: Gn Deck area(sq.ft.) Mailing address: i 7. 2. Z rU �J ✓ n State ZIP: l Other structure area(sq.ft.).. ...•..•. — City: ic: ✓ ('ommercloVindustrialimulti-family: Phone: _ Fax E-mail: Valuation of work........................................ . 11 Existing bldg. area(sq.ft.) .......................... _ Rusini;s name: _ e / 'e'S ' New bldg.area(sq.ft.) ................................ — nudrr s• /Z ZZ u�4�/ �et� Number of stories........................................ t -- 5tatc /' ZlP: �' tt>: Type of conswction ••••• PhoneFax: E-mail _ Occupancy group(s): Existing: — CCB no.: Cl New: City/metro lic.no.: Netice:All contractors and subcontractors are required to be KV Yi 11 m licensed with the Oregon Construction Contractors Board under Name: - provisions of ORS 701 and may he required to he licensed in the - jurisdiction where work is being performed.If the applicant It Address' exempt from licensing,the following reason applies: City: I State: ZIP: Contact person; I Plan no,: Phone: Fnx: Email: — it M 1011; Name: Contact person: Fees due upon application .............I........... , $ _ Address: Date received: ('dd State: ZIP: Amount received ......................................... $ —--- — ►,,nc. Fax: E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Nd all iuridictions tcela credit cards,please Lail iundkll It Int mows InOwmilon attached checklist. All provisions of laws and ordinances governing this U visot U MtuterCard Credit card number- --• work will he complied atll�h,wh they specified herein or not. _ sp a (! Authorized 9lsnatUit" Date: ,� —" Hama d caNholaer u shown w+c it car t' Print name: $ � Notice this petrttit Oplication expires if a permit is not obtained within 190 daps after it has been accepted as complete. `' 4"11 WXWOM' One- and 'Uivo-FamAy Dwelling Building Permit Application Checklist Referenceno.: — - —� —--� - Associated permits: C'irygffigard C'illl of Tigard arJ City g J Electrical l7 Plumbing []Mechanical Address: 13125 SY-✓Hall Blvd,Tigard,OR 07223 J Other: Ph,me: (503) 639-4171 Fax: (503) 598-1960 I HE FOLLOWING .1 1 FQR PJAN REVJEW I No NIA 1 land use actions completed.Sec jurisdiction criteria for concurrent reN rev 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic_d_isttict,etc. 3 Verification of approved platilot. 4 Fire district approval required. 5 Septic sy: to permit or authorization for remodel. Existing system capacity v _6 Sewer permit. 7 Water dis'rict approval. 8 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control v plan LI permit required.Include drainage-way protection,silt fencc design and location of cutch-hasin protection,etc. 10 3 "Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state building codes Lateral design details and connections must be incorporated into the plans or on a separate full-sire sheet attached to :plans with cross references between plan location and details. Plan review cannot be completed if crpyright viola r ins exist. IT Sitelplot plan drawn to scale.The plan must show Ici and building setback dimensions;properly corner elevations(if there is more than a 4-ft.elevation differential,pleat must show contour lines at 24t.intervals);location of easements and driveway;footprint of'structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot area building coverage arra;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details, vent --size and location. 1 t Moor plans.Show all dimensions,room identification,window sire,location of smoke detectors,water heater, Furnace,ventilation tans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member siz.-:.nd 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,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal in-mlation,etc. _ 15 Elevation views,Provide elevations for new construction;minimum of two clevatiot.,,for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendunts showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for nun-prescriptive path analysis provide specifications 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. _ IT Basement and retaining walls. Provide cross sections and details showing placement of rchar.For engineered systems,sec item 22,"Engineer's calculations." 19 Beam calculations, Provide two sets of calculations using current code design values for all beams and multiple joists aver 10 I'cet long and/or any beam/joist carrying a non-uniform l(iad. 2t) Manufactured floortroof truss design details. _ 21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required Ior four or more appliances. __ 22 Engineer's calculations.When required or provided,hX.,shLar wall,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall be shown to by applirahle to the pro0v under review. 23 Five(5)site plans are requiwd_f�rr Item I 1 above. Site plans must he 8-112" x I I"or I I"x 17". 24 Two(2)sets each arc required fir hems 16, 19.20& 22 above. 25 Building plans shall not contain red lines or tape-ons. 26 No rolled,reversed or mirrored building plans will be accepted. _ 27 2F� Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink. Red ink is reserved for department use only. "14614 WKWOM) Mechanical Permit Application Date received: Permit no.R5/'dVP/•00'/-a7 City of Tigard Project/appl.no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: Building permit no.: — 1 U 1 &2 family dwelling or accessory ❑Commercial/indusinal U Multi-family U Tenant improvement O New construction U Addition/alteration/replacement U Other: IOB SITE INFORMATIONt Job address: _ Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suit,no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: Subdivision: — 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: t Desc,iption and location of work on premises: t 1 11 6111 Ul Al 0 111 W0131011kt Fcc(ca.) total Est.date of completion/inspection: Description t11y. Res.only Rrc.only ;Business ant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air handling unit _, CFM 03 Air conditioning(site plan require ) Is existing space insulated?U Yes ❑No teration of existing V system _ t oiler compressors name: Ltat-gym 9 Low- State hailer permit no.: _ HP Tons BTU/H Address: j OCJ t^' ( Fire/smoke dampers/duct smoke detectors City:I tV4-+'t-t7 StateC}ati ZIP: n-72-Z-5 . eatpump(sitepanrequire ) Phone: 270 1 Fax: b-6270 E-mail: nsta rep ace furnac urner__BTU/11 Including ductwork/vent liner U Yes U No CCB no.: %(� c{ nsta rep—T(T ace relocate to Icrs—suspen e . City/metro lic.no.:.44 `1 (.C3 I wall,or floor mounted ITA C- print)- ;-jr `�c,HErL_ Vent forapplianceother l an furnace e germ on: 111113 Absorption units n rU/H Name. Chillers HP Address: Com ressors __ HP Environmental ex ust an vent ■t oar: City: State: ZII': I A,�pliancevent Phone: Fax: F:mail: I Dryercxhaunt 0o s, Type / res. itc a azmat hood fire suppression system — I Name: — Exhaust fan with single duel(bath fans) Mailing address: x png just system a art from heating or C_' City: Stale: ZIP: are p an( ( str wl on(up to outlets) Type: __[Pli Na -- Oil ib Fax: E-mail: are t�trio.ac a itiona over 4 out e-(s_ recec.q pip ng(schematic required) ) Number of outlets Name: ther (stems lance or equipment: Address: _ Decorative fireplace City: I State: ZIP: Insert -type — "' oo.siove/pC et stove Phone: r`ax: fi-mail: —Other: Applicant's sign ur Date: Other. Name (print): Na dl fudidictions wcep cadit tarda,please call JudwHctlon fM mme infortnatinn Permit fe(`.....................$ _ U Visa U MoaterCard Notice:'nils permit i application Minimum fee................$ 1---1 c�pires if a prmit s not obtained Plan review(at ?f) $ cmtu card number _�_ _. — — ��ithin Ig(i days after it btu been -- — fiaplirr- State surcharge(8%) ....$ Name of u—n tiol�u almn on c ii cardP complete.test ted as tom . s TOTAL ......................$ — -- C r dpw(are v Amount_ 410-',617(tSMrOM) MECHANICAL PERMIT FEES COMMERCIAL FEEL. - .EDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total $1.00 to$5,000.00 Minimum-teeVzw Fable 1A Mechanical Code Qty (Ea) _Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or Including ducts&vents _ 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ _ $10,000.00. Including ducts&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or Including vent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in applian;e permit $1.45 for each additional$100.00 or _ 680 fraction thereof,to and including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1 2.0 for each additional$100.00 or For items 7.11,see or Pump Cond fraction thereof. _ footnotes below. Comp* 7)<3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00 Value Total 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 Description: of al Amount Furnace to 100,000 BTU,Including 955 9)15-30 HP;absorb ducts 8 vents unit.5-1 mil BTU 35.00 Furnace>100,000 BTU including 1,170 unit 30absorb unit 1-11.7.7 5 mmil BTU 52.20 ducts&vents - 11)>50HP:absorb Flcor furnace Includin vent 955 unit>1.75 mil BTU 87.20 Suspended heater,we!'heater or 955 floor mounted heater 12)Air handling unit to 10,000 CFM _ ---- 10.00 Vent not Included in applicance 445 permit 13)Air handling unit 10,000 CFM+ - 17.20 Repair units _ 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 10.00 to 100k BTU 3-15 hp;absorb.unit, 1,700 15)Vent fan connected to a single duct 6.80 101k to 500k BTU 15-30 hp;absorb.unit,501k to 1 2,310 16)Ventilation system not Included In mil.BTU appliance permit 10.00 30-50 hp;absorb.unit, 3,400 17)Hood served by mechanical exhaust 1.1.75 mil.BTU t0.00 >50 hp;absorb.unit 5,725 18)Domestic incinerators 17.40 >1.75 mil.BTU 19)Commercial or industrial type Incinerator Air handlingunit to 10,000 cfm 656 69.95 Air handling unit>10,000 cfm 1,170 20)Other units,including wood stoves Non-portable evaporate cooler 656 _ 1000 Vent fan connected to a single duct 446 21)Gas piping one to four outlets Vent system not Included In 656 _5.40 a liancepermlt 22)More than 4-per outlet(each) Hodoserved by mechanical exhaust 656 t 00 _ Domestic Incinerator 1 170 Minimum Permit Foe$72.50 SUBTOTAL-: $ Commercial or Industrial Incinerator _ 4,590 _ Other unit,including wood stoves, 65e 8Y.State Surcharge $ inserts,etc. Gas piping 1-4 outlets 360 -- 25%plan Review Fee(of subtotal) $ Each additional outlet_ �63 Required for ALL commercial permits only TOTAL COMMERCIAL s TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: Other Inspections and FNe: I Inspections outside of normal business hours(minimum charge-trvo hi urs) $72 50 per hour 2 Inspections for which no fee Is specifically indicated (minimum c'na ge-half hour) $72%per hour 3 Additional plan review required by chenges.additions or revisions to plans(minimum charge-one-half hour)$72 53 per hour 'State Contractor Boller Certhlcation required for units>200k BTU. "Res'dentlal AIC requires site plan showing placement of unit. I:%dsts'dormslmech-fees.doc 10/11/00 Electrical Pcrnitit Appliklation -- —•-----� rrrcrned. Permit no. l'0_0 111_11`6 city Uf rigard Project/appl.no.: Expire date: Ciry ajTigard Address: 13125 SW Hall B!vd,Tigard,OR 97223 Date issued: By: Receipt no_ Phone: (503) 639-4171 Case file no.: Payment type: Fax: (503) 598-1960 Land use approval: — 7LINew amily dwelling or accessory ❑Commercial/industnal UMulti-family U Tenant improvement nstruction � Addilinn/alteratio,n/n placement U Other: U Partial Job address: 11176-. 5t"-' /i�/ j 131dg. no.: Suite no.: ITax map/tax lot/account no.: Lot: Bir ':; Subdivision: _ Project name: — Description and location of work on premises: Estimated date of con•pit firm/ins ro ction: I rc tit: Job no: Description Vt'J (ca.) 1 ulel no.ince Business name: f" — ryrw resldnt8al-singe or multi(amity per -c- Address: dorllingurdt.Inc lude%attached garage. CityZIP: Service included:StAIC:&�/G': 1(1(x)sy.It.of less 4 Phone:,3i,j ?_41 z)Z. Fax: S4rtt E-mail: Each additional SIX)s ft.or uruun thereof CCD no.: �' Elec.hos.lie.no: 3 - 7L Limitcdenergy,residemial 2 _ Limited energy,non-residential 2 City/metro lie.no.: /�)3 — s� Fia:h manufactured home or modular dwelling 2 Service and/or feeder s store of aupervising electrician(required) arc Services or feeders—Instal teflon, Sup elect.name(print): / I ic'rnse no: alteration or relocation: t 200 amps or less _ 2 / /` 201 amps m 4 W amps 2 Name(pant) ! C'C(' t' i/� 1 V i�'`d n e 401 amps to 6W amps _ 2 Mailing address: 175 �� 601 amps to IO(10 amps_ 2 City: Slate: r� ZIP: 71; Over 1000 amps or volts _ 2 _., l Fax: E mai: Reconnectonl Phone: �C' n --� Temporary serHces or feeder- Owner installation:The installation is being made on property 1 own installation,alteration,or relocation: which is not intended for sale,lease,rent,or exchange according to 2W amps or less 2 ORS 447,455,479,670,701. 201 amps to 4txl amps 2 Date: 401 to hfNl ams 2 nit're's signature: — Branch circuits-nen,alteration, or exienslon per panel: Nance: _ A. Fee for branch circuits with purchase of 2 Address service or feeder fee,each branch circuit State: �il : B. Fee fm branch circuits without purchase City: of service or larder fee,first branch circuit: j Phone: hax�-. �r [inch additional branch circuit Misc.(Service or feeder not Included): Each ump or irrigation circle 2 UService over 22Santps-oxmmtrnial UHenlUrcarePocility Each signtlinehghtfng r_ 2 ❑service over 320 amps-rating of 1&2 U Hazardous lor outline signal or out or n limited energy panel. family dwellings U Building over I II,INx)square feet ti,m'�:' alteration,or extension$ 2 U System over 6(x1 volts notntnal more residential units in one structure U Building over three stories U Feelers.4110 amps or more •Deschtion.— _- U tkcupant load over 4U per ons U Manufactured structures or Rv para FAN additional Inspection over the allowable in any of the above: U Flim- lightingplat U(hhrr _—_ ___ Prr ins cctiun _ _F Suhmll srI%of plans vvith any of the above. Invc ligation for _� The above are not applicable to temporary construction service. (ether Permit fee.....�............5 Not di Jurisdictions arcept credit cards,rleoe call Jurisdiction for mar,inktrntation. Notice:'this permit application Plan tvview(at 1 It ;�Visa U MasarCerd expires if a permit is not obtained 1___ within 180 days eller it has been State surcharge(9%) •••• rimit card number .---_ ---- spires _ accepted as complete. TOTAL ....................... — Nime of cirdF�o�i—ctwn on c is e S c'trdh r slRnature Anwuni 410�a13 ltiptYC'uMl ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: -------- -- ---1 TYPE OF WORK INVOLVED -RESIDENTIAL ONLY i Complete Fee Schedule Below: Restricted Energy Fae............................. ....................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved. Residential-per unit --^ $145.15 4 Audio and Stereo Systems' 1000 sq It of less Each additional 5U0 sq It or $33.40 1 Burglar Alarm portion thereof $75.00 Limited Energy Each Manufd Home or Modular 2 Garage Door Opener' Dwelling Service or Feeder — r_ $90.90 Heating,Ventilation and Air Conditioning System' Services or Feeders Installation,alteration,or relocation $80.30 200 amps or:ess — LJ Vacuum Systems' $106.85 2 201 amps to 400 amps 401 amps to 600 amps $160.60 2 n Other 601 amps to 1000 amps $240.60 Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 TYPE OF WORK INVOLVED -COMMERCIAL.ONLY Temporary Services or Feeders S:'S.00 Fee`or each c�stem.......................................... ..... installation,alteration,or relocation $66.E5 __ 2 (SC:c OAR 918-260-260) 200 amps or less $100.30 2 201 amps to 400 amps ---- $133.75 2 Check .,pe of Work Involved. 401 amps to 600 amps -- Over 600 amps to 1000 volts, F I Audio and Stereo Systems see"b"above. Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)The fee for branch circuits Clock Systems with purchase of service or feeder fee. $6 65 Data Telecommunication Installation Each branch circuit --� -- b)The fee for branch circuits ❑ without purchase of service Fire Alarm Installation or feeder fee. $46 85 First branch circuit -- ❑ HVAC Each additional branch circuit $6.65 Miscellaneous Instrumentation (Service or feeder not Included) Each pump or irrigation circle $53 40_ ---- ❑ Intercom and Paging Systems Each sign or outline lighting __-- $5340 Signal circuit(s)or a limited energy Landscape Irrigation Control' panel,alleratlon or extensio $75.00 Minor Labels(10) __ $125.00 _ ❑ Medical Each additional Inspection over the allowable in any of the above $62-50 Nurse Calls Per inspection $62.50 _— Per hour -- ----- D Outdoor Landscape Lighting' Plant E]IIn Plant _ — $l3 75—^J_. In PProlective Signaling ter total of above fees $ —_- - Other _— --- -- 8%State Surcharge $ — Number of Systems 25%Plan Review Fee $ ' No licenses are required Licenses are required for all other installations See-Plan Review"section on front of aFplicallon —— Fees: Total Balance Due $ s ---- Enter total of above fees — ❑ Ti ust Account# — 0%State Surcharge $ -- --- —_— ----- Total Balance Due $ i\lata\f0m1s\e1c-fees.doc 06/07/01 Plambing Permit Application — — Dateroceived: Permit no.: City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Bk(I.Tigard,OR 97223 Project/appl.no.: Expire date: !'iry ,f7unrd Phone: (503) 639-4171 — ---- Fax: (503)598-1960 Date issued: By: Rereiptno.: Case file nc.: Payment type: Land use approval: U I &2 family dwelling or accessory U Conunercialhudusu ial U Multi-family U Tenant improvement 7U New construction ❑Addition/alteration/replacement U Food service :1 Olhcr: ! IIforin Desert tion Qt}'. Fec(ca.) Ictal Job address: /�/ �S SCU /� _t — �_ �—�—-- New I-and t-Tamil)41�1elline,only: Bldg.no.: _ Suite no.: (Includes 101)11.foreachutllitvconnection) Tax map/tax IoUaccount no.: _ SFR(1)bath Lot: Block: Subdivision: SFR T2—)b a th _ _ --.-- Project name: SFR(3)balls - City/county: ZIP: Each additional bath/kit -1 Description and location of work rn premises: Siteutilities: basin/area drain Drywells/lea, ch slue/trench drain Est.date of conlpletion/inspection: Footing drain(no.lin.ft.) _ t t ' Manufactured home.utilities Business name: Alp rL`11.t t.�c< e _d • Manholes Address: Ztr?o L W LZ I T Up (p Rain drain connector City: 7 ( ,2v _ Statc:O?Z ZIP: /Z-?� Sanitary sewer(no.lin.ft.) Fax:(f -5` E-mail: Storm sewer(no.lin.ft.) Phone:vy2'?YXo? Water service(no.lin.ft.) CCB no.: 772 y"3 Pluffb. Fixture or item: City/metro 1' no.: — Absorption valve Contractor's re.-p�-ress-ennttative signature: Back tow .�_ lLlrevrnter Prins nnnlr: �/�/ » Datr: Backwater valve — Basins/lavatory C othes washer Name: C E' « !'o �= - _—_ Dishwasher Address: Drinking fountain(s) City: State: ZIP: E'ectors/sump Phone�t , ZO E-nail: Ex ansion tank Phone �2C ixhlre/sewer cap _ Floor drains/floor sinks/hub rMai'li,ng e(print): _ Gafia a dis sal address: _ Hose bibb : State: ZIP: Ice m er: Fax: E-mail: Interce for/grease tra FOwner installation/residential maintenance only: I he actual installation Primer(s)be made by me or the maintenance and repair made by my regular Roof drain(commercial)oyee on the property I own ns per ORS Chapter 447. Sin (s),basin(s),lays(s)Date: Sumer's si nature: _ -lo Tubs/shower/shower pan _ Urinal Name: Water closet Address: ___ _ Water heater City: .1P: _ Other: Phone: X: Total Email: Minimum fee................S _ -- Nrq dl luti«Iictions accept crtsar cords.please call Jot{adictian for ttxve infonnan,, Notice.I hu,po"111,n!^. cation plan review(al ) U Visa U MunerCard exr,res if a permit is not obtolned State surcharge(8%)....$ Ctedli cud numbrr: — --�— wi hin 180 days after it has been s rirn TOTAL ....................... accepted as complete. Nime d cardholder u shown nn ctcdiu—cuT-- s 4N1A6161&W'OMI —Golder siffINIU e � � PLUMBING PERMIT FEES: ---- PRICE TOTAL New 1 and 2-family dwellings only: FIXTU ES individual QTY ea AMOUNT (includes all plumbing rIxtures in PRICE TOTAL Sink 1660 the dwelling and the first100 ft. QTY (ea) AMOUNT 1660 for each util ter connection _ Lavatory _ One(1)bath $249.20 rub or Tub/Shower Comb. 16.60 Two(2)bath __.___ __ $350.00 __ _ Shower Only 16,36- Three 3 bath $399.60 Water Closet 16 60_ SUBTOTAL _ Urinal 16.60 8%STATE SURCHARGE Dishwash:,r 16.60 PLAN REVIEW 25%OF SUBTOTAL TOTAL Garbage Disposal 16.60 Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" - 16.60 PLEASE COMPLETE: 3" 16.60 4" 16.60 Water Neater O conversion O like kind 16.60 �- J _ °ruantity b I Worif performed _ Gas piping requires a separate mechanical Fixture Type: Nov, Moved Replaced Removed/ permit. _ Capped MFG Home New Water Service 46.40 MFG Home New San/Storm Sewer 46.40 Lavatory _ --- Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 _Shower Only - Drinking Fountain 16.60 Water Closet Urinal Other Fixtures(Specify) 16.60 - Dishwasher- Garbage ishwasherGarba a Disposal _ Laundry Room Tray Washing Machine _ Floor Drain/Sink: 2" _ Sewer•1st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater Other Fixtures Water Service-each additional 200' 46.40 (specify) _- Storm 8 Rain Drain-1st 100' 55.00 Storm b Rain Drain-each additloltal 100' 46.40 Commercial Back Flow Prevention Device 46.40 Rasidential Backflow Prevention Device' 27.55 Catch Basin 16.60 - Inspection of Existing Plumbing or Specially 72.50 Re nested Inspections perthr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 - QUANTITY TOTAL _ Isometric or riser diagram Is required if Ouentlt Total is ;,9 "SUBTOTAL -- 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Reol,lred only if fixture qty total Is�9 TOTAL, $ "Minimum permit fee Is$72 50•a%state surcharge,except Residential Backflow Prevention Device,which Is$36 25•8%"late surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review I:\dsts\forma\plm-fees.c)c 10/10/00 DAT[ PLANS CHECK NO Aug 15 2001 MST2000-00425 _ Violette Accessory Residential Dwelling COUNTYWIDE 7EE TRAFFIC IMPACTWORKSHEETAPPLICANT. Loritta C. Violette ---- — (FOR NON-SINGLE FAMILY USES) MAILING ADDI EE s 11175 SW 114 I. CITY/ZIP/PHONE Tigard, 97223 _ TAX MAP NO.: 1 S134DB00700 SITES NO ADDRESS: 1 1 175 SW 1 141h Pl. LAND USE CATEGORY RATE PER TRIP -- X RESIDENTIAL $226.00 BUSINESS AND COMMERCIAL $ 57.00 OFFICE $ 207.00 This worksheet is to document the reasoning for INDUSTRIAL $217.00 The land use category used (266) see notes INSTITUTIONAL $ 94.00 below PAYMENT METHOD. CASH/CHECK CREDIT BANCROFT(PROMIFSORY NOTE) I.AND USE CATEGORY DESCRIPTIONOF USE WEEKDAY AVG INSTITUTIONAL ONLY 260 Recreation Home TRIP RATE WEEKEND AVG TRIP RATE DEFER TO OCCUPANCY 3.16 -----------------"_--------__- BASIS: Applicant rroposed construction of a new 528 Sq Ft. Accessory Residential dwelling unit. TIF = Wk Day trips X Units X Trip Rate $714 = 3.16 X 1 X $226 PROJECT TRIP GENERATION 3 FEE $714 -- ---- -- FOR ACCOUNTING PURPOSES ONLY ADDITIONAL NOTES As a result ol'discussions with Brian Rager and Washington Co. the use category of ROAD AMT Recreational I lotne 1260)is being used to indicate the smallest impact due to the limitations $663 imposed on a land use of"Accessory Residential duelling" TRANSIT AMT $51 PREPARED BY S.S. Casper I:TIFWKST.DOC (DST) EFF: 07-01-98 —� T m m T T w co C) 0 co T� x con T O co n n CO n '' O -'1 0 C,) —_ _ __ - ° r r r r r r r r r � f zt 0 0 o o c� o c chi (D r L N r� N 0 m m a VOLn i ON (_n Ln N N N Ln Ji JO'. N N L'I ON 1D im S 7— 7 K K K K it !m m K r. K m n cn cn cn cn (A cn cn cn cn cn N cn cn v, v> d --I -1 -i -i —i -I -i --1 -1 --1 -i -1 -1 u1 pOpA pp0A N D N N N N N N N N N N N N N O O O O O O 88 OOO 0 Z0O 2 22 - Si OO - O ph A A o A p P �n (Nn (Nn (Nn lT (Nn (NIS (Nl7 N cnn LnU N (Nn Ln (Nn m �D v N D m cn o6 T =1 ,pro m o c (D O D v c (h cn0 z o -0n m a T TI T T Co m w r m n oo IBJ C7 C7 O .Z7 ..° r o K 0 F 7 Q x _ x x k H � N to 0 DI (D a :3 d o m u+ CA m M c (n c N err �noQ � 0 SCP � n 0Qb p q s C s C s p G G O 0 0Q O j GQ U s O 'P s G OQ QO c t. N0)pO O00 � o w oN w w vN N0) 00 0 OD 4 �' wI� Wi. co ON pO CD N N cn aLn !O p N o �0 OC IP V V V V V V V V W W 41 W W W W W W W W fD O O O O O O O O O O O O b O O O O O O O U O O O O O O n U TJ U tJ ZJ Z TJ W cn cn n V D d O D O U q D D r W phi CL O 40 0) N cr N N N N N N A N N W 3 V - A A N J W V IJ N Q O ID w �j O N N N (b Q7 O N N N V Q' LnOgD -4 N A L N � WN(�J V N N N v ttj 4J C1 O -� n cp t0 Ut N OD Q) O u O cr o 0 i i 1 1 / M { Nj OA \�U� \ #V m N -- 5 aoe a 4-7 d O 7 � N � 1 , C O. co 7i VA w a o .d a n 1 t4 O s o a �J y'1 3 S, 3 CITY OF TIGARD DUI' DING INSPECTION DIVISION -7;k- MST =� 24-Hour Inspection Line: 63z,-.*175 E ,iness I-ine: 6394, — BUP _ _Date Requested ZZ J Z -AM PM BLD Location r' 7 �_ ZSuite MEC Contact Person Ph 57 V F2 75il PLM Contractnr Ph _ SWR BUILDING Tenant/Owner ELC Retaining Wall ELIR _ — �_— Footing Access: FPS Foundation — - --- Ftg Drain SGN Crawl Drain Inspection Notes. Slab _ __-- -___-- -___.__—_ SIT — Post&Beam Ext Sheath/Shear ----- ----- -- Int Sheath/Shear Framing _—.._ - ------ -- --------- Insulation Drywall Nailing ----- Firewall - Fire Sprinkler - ---- —------ ------- --- - --- ---- Fire Alarm Susp'd Calling Roof Misc: -- ----- --- ---- ------ ----- - ----- ------- i PASS PART FAIL --- - -- ---- ---------— - -- ------- ING Post& Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& Hearn -- --- - -- - _. .-- --- - ----- --- Rough In GasLine ------ ---------_ -- - ------- -- -- ---- -- Smoke Dampers -- —— —--_-_. -_-_--- Final -— -------- -- PASS PART FAIL E'_ECTRICAI. Service --- __. ----- -- R:)ugh In UG/Slab __.----.-- - - - — - ---- Lew Voltage Fiie Alarm ------ ---- -- ---- ------ Final PASS PART FAIL - --- -- -- SItE Backfill/Grading - - — - Sani ary Sewer Storm Drain [ ]Reinspection fee of$_-_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RE:—_ [ ]Unable to Inspect-no 4ccess ADA Approach/SidewalkDate Inspector Ext Other ---- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-4171 �w Date Requested: ` 4 5/1q /� 7 A.M. P.M.L 2 MST: _ Location: S u Ll BUT: Tenant: nn'- Suite: Bldg: ME,C: Contractor: d�-(�.(�rQSl- Phone: 3 'S� 3 ci PLM: nwncr: – Phone: ELC: / _ _ .�� ELR: SIT: B DING BLDG(con't) PLUMBur, ELECTRICAL SITE Site Post/Beam Post/Beatn Post/Bcam Cover/Service Sewer/Storm Footing Roof Undf;i/Slab Rough-In Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer Ifood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approved Appr/Sdwlk Not Approved Not Approved roved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL Cl Call for I3 Reimpection fee of 3 required beiore next inspection Ll Unable to inspect Inspector. —-- "_fir- --- ------__ Date:_ Pegof—.— J1 J 6 � � CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone. 6394171 �f Date Requested: f�� A.M. _ P.M. MST: Location c' _ W i —� _,_ BUP: Tenant._ f -7 - Suite:-—Bldg: _ MEC: Contractor: J41�-moi' _ Phone: PLM: Owner r— V Phone: ELC:16 -D 7-7-.5 �,-_-- - D" GL ELR: -IT: AL B _tN BLDG(coni) PLUMBING MECHANICAL. ELECCTRIri SITE Site Post/Ream Post/Beam Post/Beant Sewer/Storm Footing Roof Un4Fl/Slah Rough-In Ceiling Water Line Out Gas line Rough-In UG Sprinkler Slab Framing Top i ut Vault Foundation Insulation Sewer Hood/Duct Reconnect Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Thain A/C UG Slab Shcar/Sheath Fire Spklr/Alm Crawl/Found Ir 1� leaf Pump Low Volt Approved APProvixl Approved Approved Approved Appr/Sdwlk Not Approved Not Approved Not Approved Not oved Not Approved FINAL FINAL FINAL FINAL' � FINAL of _.�___----------------------- _7I C 5 i `��'i ----- C]Call for c C3 ReinspLction fee of S __r uired before next inspection 0 Unable to inspect Inspector Date. Page_______of CITY QF TIGARD MECHANICAL. DEVELOPMENT SERVICES PIE RMIT 13125 SW Hall Bled., Tigard,OR 97223 (503)639.4171 F'ERM I T #. . . . . . . : MEC96--0-3,97 DATE ISSUED: 11/15/96 PARCEL: 1S134D13-00700 S I I E ADDRESS. . . : 111.75 SW 1. 1.4 T H PL SUBDIVISION. . . . : WINTERS ADDITION ZONING; R--4. 5 BLOCK. . . . . . . . . . . 1-0 T. . . . . . . . . . . . . : 1 CLASS OF WORK. . :ALT FLOOR TURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 (3CCUF-''AP:'CY GRF,. . :A) VENTS W/O AFFIL_: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMF,RESSORS HOODS. . . . . . . : 0 FUEL. TYPES---------------- 0 HF'. . . . : 0 DOMES. I NC I N: 0 3_.15 HF-. . . . : 0 COMML. INCIN: 0 MAX I INPUT: 0 BTU 15•-30 HF'. . . . : 0 REF'A I R UNITS- 0 FIRE DAMFIF_RS?. . : ,0--50 HF,. . . . : 0 WOODSTOVES. . : 0 ( A5 PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 0 F-+-)RN < LOOP; BTU: 1 (= 10000 cfm: 0 GAS 01.I1-LETS. : 1 FURN > =100K BTU: 0 > 10000 cf;m : V, Remarks : INSTALLING ALC & GAS PIFIE FOR GAS LOGS Owner: -________________.__._..__-_---__- __.______________________._ FEES - - -_..----._____--- I_AURE VIOLETTE type amount by date recpt 11175 SW 114TH PL_ PRMT $ 25. 00 TAT 11/15/96 96-286"-Ji-' SPCT $ 1 . 25 TAT 1. 1/15/96 96-286"-,-;' 7 I I GARD OR 97223 Flhone M: Contractor: - ----______-----._ ROSE HEATING CO 9945 NE 6TH DR F'ORTL.AND OR 97211 --------------------------------------- Ph o n e #: 503-283-5183- $ 26. 25 TOTAL Reg #. . : 002084 --------- RECU I RED I NSF,ECT I ONS - This permit is issued subject to ,ne regulations contained in the Gas Line Insp Tigard M-nicipal Code, State of Ore. Specialti Codes and all other Mechanical. Insp applicable laws. All work will be done in accordance with Misc. Inspection npproved pians. This permit will expire if work is not started Final Inspection within IFW days o+ issuance, or if work is suspended for more than 19N days. Permittee Sig/t)�Atl-i1'e : I s s I..i e d B y' _ 'Call for inspection - 639- 4175 Plan Check e CITY OF TIGARD Mechanical Permit Application Recd By 13125 $W HALL BLVD. Commercial and Residential Date Recd TIGARD, OR 97223 Date tr P.E, (503) 639-4171, x304 Date to DST Print or Type Permit#.N1&Uj!(g ' Incomplete or illegible applications will not be accepted Called Name of DevelopmenVPrulm Description -� *_ _ V-- Table 1A Mect)anical Code QTY PRICE Ahrr Job ShaetAddreM 5uul0 A) PennftFee 0 -0- 10,00 Address s� 1c: Gjl_� �� ' t•I Wage C tylsiate iia B) Supplemental Pelmet 3.00 Name(ername o euaineui 1.) Furrow to 100,000 BTU 6,00 Owner incl.ducts 3 vents au ng Addnas 2) Furnace 100,000 S U+ � 7.50 incl ducts R vents CrtyrSwii - 2,p Pnene r'.j Floor Furnace 6.00 -- Inca.vent Name[of name Of r,�e noes) 4.) Swtpended haste',wall heater 6.00 n;floor mounle0 heater Occupant Madtng�ddresa 5.) Vent not incl.in 3 appliance pertni G tyrsuie " "` ZIp anone 6.) SniOr or comp,heat pump,air'wrid. I 600 _ to 3 HP;absorp unit to 100K BTU orni - 7) Bailer or comp,heat pump,air cond. 11.00 C 3-15 Hr absorp unit to SOUK STU I Contractor Mai' 'q Adana, 9,1 boiler fr comp,heat pump,air eond. 1500 ' ,- C \ 1, 15.3015-30_HP.absorp unit 5-1 mil BTU Attach copy of Cay/swe Lip PhoneS l' gpi;er or comp,heat pump, air=no 22.50 Cunent Licenses ") Z,— m, , �1�� 1� '` -, c ��`� 10-50 HP absoM unit 1-1.75 mil W1- Cregan C �a1n eL BBoaaue./ Lip., 10.) Bo Boder Or comp,heat pump,air cond. '37.50 �- I —_t5O H_P;sbSorp unit 1.75 mil BTU C OT 9uae+m Tea ore*"0 aDoe 11 ) Air handling unit to 4.50 1 c 10.000 CFM _ Architect Name 17,) Air handling unit 7.50 10.000 CTfA _ orbbdfnp Aeare s 13.) Non portable 4,50 eve orale cooler Engineer cry' lees zip none 14) vent fan connected — - 3.LU to a single duct Describe work New O Addition 0 Alteration U Repair O 16.) Venplation system not 450 to be done Resideeti■ _Non-realdentiol O included;n appiiarioe permit Addthoral Description O(wol, + 1 .) Hood served by merharocai exnaust --- - 450 • c AIt. 1`-4 17) Domestl0 incinerators 150 E)iistinq use of 1d) Commercial or Industrial y 3000 building or property __--- type ircinerojor --- - —_ _ 19.) lothes dryers etc 4.50 proposed use of 0) Otherunds +-----— 4,5U build rg or property_ -- Type of fuel-oil 0 natural gas LPG O electric.0 1) 01 piping one to tour outlets 1 hereby aCkoOwledpe teal I have read this 21501104tlOn,that the 22) Mure than 4-per outlet (each) 50 Information given is correct.that I am the owner or authorized agent of _ the Owner,that plans submitted ere in compliance with Oregon State —�0'`I—SUBTOTAL laws, — signature of bwnrrr gent Data 'SLIER 11)1 AL y I �Y ll K / II �' 5%SURCHARGE --- ul} J Contact Persom Name PLAN REVIEW 25'1 5F SLID tU FAL _ Lam..__._-- _ - __ Y rOrAL - 1:%6IVMechpmt.dee 'Minimum permit ha is t25+55If Suri nafge Rev 7 S n f �J i i I I CITY OF TIGARD DEVELOPMENT SERVICES ELECTRICAL PERMIT PERM:T #: ELC96-0775 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 12/10/96 PARCEL: 1S134DB-00700 r.TE ADDRESS. . . : 111.75 SW 1. 14TFI PL -.JBDIVISION. . . . : WINTERS ADDITION ZONING:R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . : 1 Project Description: instla I branch circuit ---R1=SIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS----- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : u'_, EACH ADD' L 5O0SF. . . : 0 201. - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : a LIMITED ENERGY. . . . . : 0 4O1. - FOO amp. . . . . . . : 0 SIGNAL/QANEL. . . . . . . : 0 MANF. HM/ SVC/FAR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : V! ----SERVICE/FEEDER----- ----BRANCH CIRCUITS------ -• -----ADD' L INSPECTIONS 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 C,01. - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 - 6O0 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 601. - 1000 amp. . . . . : 0 _-____--_---.._._._....-_PL.AN REVIEW SECT ION------.---------- 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : f,:econnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: ---------------------------------------------------- FEES -----------_---- L.OUIE VIOI_ETTE type amoi.tnt by date recpt 11175 SW 114TH PL PRMT $ 35. 00 TAT 12/10/96 96-287484 SPCT $ 1. 75 TAT 12/10/96 96-587484 T T(BARD OR 97223 Phone #: Contractor: -------------____----.-----------------------.------------______--_._ 13RF ELECTRIC S 36. 75 TOTAL. 15460 SE Pr1RAD I SE LN ------- REQUIRED INSPECTIONS - ---- MiJI_..IIVO OR C. Ceiling Cover Underground Cove Phone #: 503--829--41.46 Wall Covet, Elect' 1 Service Reg #. . : 101.543 This permit is issued eubject to the regulations contained in the _L� �._ _ Tigard Municipal Coder State of Ore. Specialty Codes and all other Perm .*7 Si gnat l..ir- 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. issuancer or if wor4 is suspended for more YJ _ than !80 days. I s s i-t e d Fly -OWNER INSTAI_I_ATION ONLY-_._._ The installation is being made on property I own which is not intended for, sale, leaser ar rent. OWNER' S SIGNATURE: DATE .-_-__-CON'TRACTOR INSTALLATION SIGNATURE OF SUPR. EI..EC' N: DATE: I._I CENSE NO: Call for inspection -- 639-41.75 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # r r L�JF Date Issued Phone (503) 639-4171 FAX (503) 684.7297 CITY C)F TIGARD TDD No (503) 684-2772 Inspection (503) 639-4175 _ 7. Job Address: 14. Complete Fee Schedule Below: r _ N a Irl a o€9eveto Blit ��11. V Number of Inspections per permit allowed "� Service rncluded Items Cost(ea) Sum Address� � // --==�—— CitylStatelZip �i� (�--r`- da. sgft Residential -per unit —` J 1000 sq h or less $11000 Each additional 500 sq it or $2500 Name (or name of business) portion thereof — $2500 Limited Energy _ _ ,ommercial ❑ Residential Each Manurd Home or Modular — Dwelling service or Feeder $6800 2a. Contractor installation only: 4b. Services or Feeders t Installation alteration,or relocation $6000 _ Electrical Contractor L r ` l -l-i+--�= — 200 amps or less — -- $8000 1 201 amps to 400 amps 2 Address F �'�► lJ.(:t -t 401 amps to 800 amps s12o 2 Cit State_ ZIP 601 amps lit 1000 amps slat oo _ y_ $340 00 7 Phones No� LS��ti �l f l Q-- over 11.-00 amps or volts -- $5000 T— Reconnect only Job NO - COntraCtor'S license NO 7� := 4c. Temporary services or Feeders Contractor's Board Reg. No ^,.y installation,0amps alteration,or relocation 200 amps or lass Signature of Supr. Elec'n — - 201 amps to 400 amps $5000 License No.ZF: hone N . � �," - 401 amps to 600 amps $00 00 1J0'_' Over 609 amps to 1000 volts $100 00 2b. For owner installations: see"b"above 4d. Branch Circuits Print Owner's Name New,alteration or extension per pane al The fee for branch circuits with Address __ purchase or service or feeder fin, City . _ State Zip _ Each branch circuli _ $500 -- Phone No. I))The fee for branch circuits without purchase of service or fNdter ree. The Installation is being made on property I own which is First branch circuit $35 00 _ not intended for sale, lease or rent. Each additional branch circuit $500 Owner's Signature_ -__._. 4e. Miscellaneous (Service or feeder not included) Each pump or Irrigation circle $4000 3. Plan Review section (if required): Each sign or outline lighting —� $4000 Signal clrcua(s)or a limited energy Please check appropriate item and enter fee in section 5B Mpanel,snerston or extension __ _ $ $inor Labels(10) 40 o _ -� 4 or more residential units in one structure _ Service and feeder 225 amps or more 0. Each additional Inspection over System over 600 volts nominal the allowable in any of the above Classified area or structure containing special occupancy Pal inspection S35 00 as described In N E C Chapter 5 Per hour $55 00 In Plant $5500 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: Ka Enter total of above fees S NOTICE_ 5% Surcharge (05 X total fees) g Subtotal $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5b. Enter 25%of line A for AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review if required (Sec 3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal a A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Trust Acrount ak COMMENCED S ------ rm n r � Balance Due $ _ __ AL C I T'v' 9 AMOUN r NAME 3 GORDON F[ RRIG- E-1-eC rnic : 15460 S PARODISt.. LN CASH AMOUN f PAYMMI VATE SUBDIVISION MU!_1140, UR 97042- AMOUNT PAID WURPME CW I-JAYMLN-1 nMDUNT PAID P.E L V*C'T P I C'ft 1, 1 OrRM I T 35. 00 ST. BUILD Ph.R F"OR lil '75 SW 1141H PL FOR PLPM11 f4 101"PL. "Mut1w fopv -mom w Cl 11, 1 1,11 1.14YMFNI CWCV, 14MIJI.-IN r CASH WUUN r O„ vla) t4omls HEW I NG 994b Nl,.-. b'M DP PAYMI-NI URIE j 1 , SULAD I V I S i UN 97P1 1- I "ILJrtF!OSE 7P11- -ILIRPOSE UP PAYMI-M AMOUN"t PAID AMOUNT PA 11) f4% I t 75 SW I t 4 H W Pk%km 11 4 011 17 C)6 APPION'T t:'4410 CITY OF TIGARD ENGINEERING PERMIT PERMIT#: ENG2000-00051 DEVELOPMENT SERVICES ? 7"RIM. P1AIT#: ENG2000 00051 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE �..,oUED: 08/25/2000 SITE ADDRESS: 11175 SW 114TH PL PARCEL: 1S134DB-00700 SUBDIVISION: WINTERS ADDITION ZONING: R-4.5 BLOCK: LOT: 00'1 JURISDICTION: TIG PE=RMIT TYPE: SOP PUBLIC IMPRV QUANTITY LIN FT VALUE AGREEMENT DATE: GRAIEROS: ASSURANCE EXPIRATION STREET: — — SAN SEW: " PERFORMANCE: STM SEW: MAINTENANCE: PATHWAYS: " ALL OTHER: """ $600.00 TOTAL: $600.00 Remarks: STREET CPENING, TO INSTALL A CONCRETE DRIVEWAY APPROACH. _ FEES Owner: VIOLETTE, LORITTA COLLEEN Type By Date Amount Receipt 11175 SW 114TH PLACE OPEN JSH 08/25/2000 $150.00 0004672 TIGARD, OR 97223 BOND JSH 08/25/2000 $600.00 Total $750.00 Phone: Engineer: Phone: _ _ REQUIRED INSPECTIONS _ STM/SAN SEWER_ _S_TREET _ Permittee I Applicant: �MHIC:B/CO CRB LINE & GRADE VIOLET i E, LOUIS & I_ORIT-TA PIPE LN & GRD SUBGRADE 11175 S.W 114TH PLACE BCKFLL & CMPCT EASE ROCK TIGARD, OR 97223 AIR &TV TEST LEVEL_ COURSE WEARING COURSE TRAFF & PFD CONT Phone: _ _ GRADING MONUMENTATION CONTOURS STREETI_IGHTING DRAINAGE WALWAPRONIRAMP Permittee) EROSION CNTL. Applicant Signature: RE.PR'SIADJ'S PATHWAYS Issued By FOR INSPECTIONS, CONTACT THE CITY OF TIPARD, SPECIAL CONDITIONS: (SEE ATTACHED) ENGINEERING DEPARTMENT, AT: (so!,, 639-4171