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14355 SW 114TH AVENUE w v� CD C fD 14355 SW 114"' Avenue CITY OF TIGARDJ 24-Hour BUILDING Inspection Line: (603)639-4175 (� MST INSPECTION DIVISION Business Line: (503)639-4171 ,,9, BUP Received t�q '�e1 .�' Date Requested– '!�– / 5 AM PM __ BLIP Location 4�� -�? cy //y '`4.7--A" —Suite-_ MEC —_ Contact Person � y( Ph(- ).751? 4063Z_— PQM Contractor— —. Ph(_ _) SWR UILDINO _ Tenant/Owner _ _—._-- ELC _—_— Footing ELC __-- Foundation Arcess: Ftg Drain ELR ---_-- Crawl Drain Slab Inspection Notes: SIT Post&Beam -'' �' _ Shear Anrhors T �- Ext Sheath/Shear Int Sheath/Shear Framing - ---- - - --- -- I,isulation �------------- ----- Drywall Nailing - -- --- -- - ---- - ----- Firewall Fire Sprinkler ---------- ---- -- -- ---------------- ----.� Fire Alarm Susp'd Ceiling --- --__.---- - ------------------- ------------- Roo' Other: _-___--------_.._.._._._ ----.- _----- -__.._...--- ---- --- ----- -------__- a S>: T FAIL Post 'B am Und SI ---—---- - -- - -- -._.- - --- --- � Rou Wa S® tza0a�G Wer RainDr s - ---- -- ------------- - - -- Cdtch Ba /Munhor.a SIlorm D n - ---- - _-._ - - - - - - -- --- -- ---- - Shower Pan Other: - ---__.,_-----_- ----- ----------- --_- -- - - -- ---- i PAJ&�,1 PARS FAIL ------------- ---..._._..____----------- -__.___--- ------ __. ..--------- -_ MECHANICAL ----- --- ----- --------- .._.._ - --_.-_ --- Post& Beam Rough-In ---- --- -- --- ---- ----- ------ --._...... - - --------- _ _-. Gas Line Smoke Dampers - -- - ---- - ----- - -- . _- --- ------- _ _- - Final PASS Af FAIL ------------- --_ _- - ------------------------- LECTRIC — Rough-In ------ UG/Slab -------- .-_ -- -------- --------- - Low Voltage ----- -6 _ FirAlarm _.. - - -- -- ------ - -- RT_ FAIL Reinspection fee of$ _--required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Fire -,lease call for reinspection RE:--_____-. Unable to inspect- no access Fire Supply Line ADA Dab Ext Approach/Sidewalk - / _- Inspector - __- Other. - - - Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 13125 S.W. HALL BLVD. ¢ e TIGARD, OR 97223 FREC IMPORTANT PERMIT NOTICE c+i r Ur t t_}`iL) MORANS PLUMBING PLANNINGIENC-It1EERING DONALD M MORAN 17577 S HATTAN RD OREGON CITY, OR 97045 Plumbing Signature Form Permit #: MST2002-00501 Date Issued: '1127103 Parcel: 2S11 OAB-02800 Site Address: 14355 SW 114TH AVE Subdivision: COLE'S ACRES Block: Lot: 01? Jurisdiction: TIG Zoning- R-2 Rernarks: 250sf kitchen addition. cr Your company has been indicated as the plumbing contahfromryour company indicated s gn below return the plumbing permit to be valid, please have the appropriat,Pndiv dua this Plumbing Signature Form prior to the start of the work to the address above, ATTN-. Building Division. No plurnbing inspections will be authorized until this completed form is received "� I 3 �' 5 � . PLUMBING CONTRACTOR: OWNLN HUGUS, ZONA GAY DONALD PLUMBING DONALD M MORAN 14355 SW 1114TH !%v E 17577 S HATTAN RD TIGARD. O;". 97223 OREGON CITY, OR 97045 Phone it: t, Phone #: , Reg It LIC 00007449 14L41l PLM 4227P" AN INK SIGNATURE IS REQUIRED ON THIS C=ORM X Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 /� �� MASTER PERMIT CITY OF T I V (DEVELOPMENT SERVICES PERMIT#: M -00501 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED 1/227/037/03 SITE ADDRESS: 14355 SW 114TH AVF PARCEL: 2S110AB-02800 SUBDIVISION: COLE'S ACRES ZONING: R-2 BLOCK: LOT: 013 JURISDICTION: 'FIG REMARKS: 250sf kitchen addition. BUILDING REISSUE, STORIES: 1 FLOOR AREAS - RF.pUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 250 at BASEMENT: of LEFT: SMOKE DETECTORS: TYPE uF ULE: SF FLOOR LOAD: 40 SECOND: d GARAGE: at FRONT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: THFD of VALUE: RIGHT: OCCUPANCY GRP: R3 BORM: BATH: TOTAL: :50 at 53.000 00 REAR: PLUMBING SINKS: I WATER CLOSET S: I WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS LAVATORIES: DISHWASHEPS: 1 FLOOR DRAINS, SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUSISHOWERS: 1 GARBAGE DISP: I WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN c 100K: --- SOIL/CMP ,3HP: VENT FANS: CLOTHES DRYER: FURN>•100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAXINP btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: —'- -- LLECTRICAI- RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS &RANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 8F OR LESS. 0 -200 amp: 0 201)amp V IISVC OR FD R: PUMP7IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 4uo amp. 201 400 amp: iat W,O SVCIFDR: CHI SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 000 amp: EAAULIL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp: 601+11Imps-1000v: MINOR LABEL: 1000+amplvolt: Reconnect only: PLAN R@VIE W SECTION -4 RES UNITS: SVCIFDW> 223 A,: >eu0 V NORILAAL: CLS AREA/SPC r)CC -- ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM. INTERCOM/PAGING: OUTDOOR LNUSC L r BURGLAR ALARM: OTI1: BOILER; HVAC: LANDSCAPE/IRRIG: PROTECTIVE 91CNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL M SYSTEMS: Owner: Contractor: TOTAL FEES: $ 1,050.07 HUGUS,ZONA GAY TOM MILLER RE MODELING,INC, This permit is subject to the regulations contained in the 14355 SW 114TH AVE 3636 BE GLENWOOD Tigard Municipal Code,State OR. Specialty Cedes and TIGARD,OR 97223 PORTLAND,OR 97202 all other applicable laws. All woo rk win' 3 done In accordance with apprroved plans. This permit will expire H work Is not started within 180 days of issuanoe,or If the u:•ork Is suspended for more than 180 days ATTENTION: Panna: Phone: Oregon law requires you to followrules adopted by the 503-31 F.6632 Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through 952-001-0080. You Rap N: LIC 106900 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Footing Insp PLM/Underfloor Framing Insp Electrical Final Foundation Insp Mechanical Insp Shear Wall Insp Mechanical Final Post/Beam Structural Plumb Top Out Insulation Insp Plumb F nal Post/Bearn Mechanics Electrical Service Raln drain Insp Building Final Crawl Drain/Backwater Electrical Rough In Water L.Ine Insp Issued By : " ' -_ Permittee Signature : �� ' 7"' Call (503) 839.4175 by 7:00 p.m. for an Inapectior needed the nl#�busl41s day I�itl�C�l�il _Pe>< nuon FOR OFFICE, - DatetBy: Date/ -.t% Building Permit No.:/i 'T '. City of TigardPlanning Approval Other 13125 SW Hall Blvd. DEC 3 2d�2 Date/By: Permit No.: Plan Revicw Other V Tigard,Oregon 97223Y ,�F TIGAR Date/BY: Permit No.: Phone: 503-639-4171 Fax:`S � WJICiV '` Post-Review Lend Use Internet: www.ci.tigard.or.uSJ L Date/R • Case No. 24-hour Inspection Request: 503-639-4175 contact Juris.: See Page 2 for Name/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: New construction Demolition 1&2 FAMILY DWELLING Addition/alteration/re lacement Other: _ CATEGORY OF CONSTRUCTION Note: Permit fees•are based on the total value the work performed. Indicate 1 &2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, AcCesso Building Multi-Famil overhead and profit lirr the work indicated on this application. Master Builder Other: Valuation................ „•, $ 61' alb . .................................... JOB SITE INFORMATION and LOCATION No.of bedrooms: O No.of baths: "- Job site address: /435'57 S/,tl // �(t/E• j Total number of flonrs.............. Eildg•/Apt.#: New dwelling arca(s R.)............................. Suite#: g q� —� ---- -. stage/carport arca(sq. ft.)... ........................ _-�_--- - Project Name: (�, A(V,;US RLFNlr1REG Covered porch area(sq. R.)............................. Cross strcct/Directions to job site: Dcck arca(sq. .)......•............ ........................ �— Other structure arca(sq. R.I... .................... ... _ REQUIRED DATA: Subdivision; Lot#;- COMMERCIAL-USE CHECKLIST _ — Tax Ina / arcel #: — _ Note. Permit fees*are based on the total value of the work performed. Indicate DESCRIPTION OFWORK Oic value(rounded to the nearest dollar)of all equipment,materials,labor, -�VDt'fI K ITC1}IE1.1 overhead and profit for the work indicated on this application. -- - Valuation............................................... ......... $ Existing building arca(sq. R.)......................... ------` New building area(sq. R.) Number of stories....... .... ............................... - ------- PROPERTYOWNER TENANT Type of construction........ .............................. - --- Name: SVS �- Occupancygroup(s): Existing: — Address:-/y3SS SuJ //¢� q✓E. a New = -- Cit /State/Zip: T1655- �Fa�x: i Phone:Sa3 -(op3)- �- NOTICE: All contractors andsubcontractors arc required to be APPLICANT ACI PERSON licensed with the Oregon Construction Contractors Board under Business Name: TDA i{//LL _RE�NppEU,tIG ,�/�, provisions of ORS 701 and may be required to be licensed in the jurisdiction where work is being performed. If the applicant is exempt Contact Name: 7, from licensing,the following reason applies: Address: -- Cit /State/Zip: PDrCTG�fr✓f� 9 7 ZO Z- _. _ —_� Phone: So; E-mail: �- --� BUILDING PERMIT FEES' _ —�CONTRACTOR Please refer to fee schedule. Business Name: 7�,K W1&wi� I�KaCI�i+�yb , < - --- —. Fees dor upon application................ ... ...... .. $ Address: 3&g4P_ 5E &,t&JW&p6 - Clty/State/Z _ PBI�fiLMA/f) 0K, 9 ZD?- Amount received. ........ .... .............. ......... .... $---. Ph0ne_Sb3 •3/8 .(p(oaj:-::J—Fax: - Date received: -- — - CCB Lic. #: /OG�oo i7Authorized �_ �-----� � - fL _t - 0 Signature.: Date: OL Notice: This permit application expires If a permit Is not obtained within IRO days after It has been accepted as complete. 'Fee methodolop set by Tri-County Bulldinit Industry Service Board. (Please print name) GG vJs-- i:\Dsts\Permit F'orms\nldgPemtitApp.doc 01/03 One-and Two-Family Dwelling Alw Building Permit Application Checklist Reference nu - Associated permits: City-f Tigard City of Tigard L)Electrical ❑Plumbing Ll Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 ❑Other: Phone: (503) 639-4171 Fax: (503) 598-1960 Erm 1 1 Land use actions completed.See jurisdiction,I itch loll comvill(clot I Ic\\'S. 2 Zoning.Flood plain,solar balance points,sclsnuc soils designation,historic district,etc. 3 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 Soils report.Must cavy original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required.Include drainagr-way protection,silt fence design and location of-- s rich-basin protection,etc. I(► Complete sets of legible plans.Must be drawn to scale, flowing conformance to applicable local nn�l~laic building codes.Lateral design details and connections must be incorporated into thplans or on a separate f e ull-sv_e sheet attached to elle plans with cross references belwoen plan location and detail. flan review cannot ale completed ifco yright violations exist. _ _ I I 5ite/plot plan drawn to scale.'rhe plan must show lot and building sctbu�; dimensions;property comer elevations 1 il' there is more than a 4-0,elevation differential,plan must show contour lines at 2 I't.interval~);locution of easements unci driveway;footprint of structure(including decks);location of wells/septic systems;utility on site;a direction indicator;lot arca building coverage area;percentage of coverage;mlpervious_area;existing structures on site;noir surface drainage. 12 Foundation plan.Shaw drmen ons ,anchor bolts,any hold de oils and reinforcing pads,connection derails,vent i size and location. _ °--- 3 Floor pians.Show all dimensions,room identification,window size,lOcalion of smoke detectors,water heater, -- furnace,ventilation fans,plumbing fixtures,balconies and decks 311 incic:;above grade,etc. 14 Crow seelion(s)and details.Show all framing-mcmher sizes and spacing such as Ilcxor beams,benders,joixts,suh•Ilcxrr, wall construction,roof construction.More than one cross secllton may hr required to clearly portray construction.~how details of all Willi and roof sheathing,roofing.roof slope,ceiling height,siding material,foolings and foundation,stairs, fireplace construction, thermal insulation,etc. _ - 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions unto remodels. Exterior elevations must reflect the actual grade it the change in grade is greater than four foot at huifdhlg envelope. Full-size sheet addendums showi1 I'Oundt��,lltiolls Willi cross references are acceptable. — 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate detail• and rdcuions;for non prescriptive nth.analysis rovide s ecificalions and calculations to engineering standanls. 17 Floorlroof framing.Provide plans for all flours/roof assemblies,indicating member sizing,spacing.and bearing localions,Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rchau, roc engineered sysl:ms,see item 22,"Engineer's calculations.' I'r Beam calculations.Provide two sets of calculations using current code design values 1'or all beams and muhiple.joists ov,.r 10 feel long and/or an beam/joist carrying a nun-uniform load. -- 20 Manufactured floorlroof truss design details. 21 Energy('ode compllunce.Identify the prescriptive.path or provide calculations. Agas-piping schemalie is required for four or more 1► pliances. 22 Engineer's calculations.When required Irl.(i.r.,shear wall,roof truss)shall hr stamped by an engineer or architect licensed ill Orcgoll and Shall tic `l i ' , I ,ho .Il+l)lh;lblc li t Illi' project under review. 1 23 Five(5)site plans are required for hero 1 I ally %, Site plans must he 8.1/2" x I I"or 11"x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines ur tape-ons. "Mirrored"building plans will he not accepted. 26 "Reversed"building plans must"feel criteria outlined in the Permit& System Development Fees document 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site pian to include tree size,type&location per approved project street tree plan(if upplicablel,and COT Street Tree List. Checklist must he completed before plan review start data:. %minor changes or notes on submitted plans may he In blue -41,14 M I OM) Red ink is reserved lirr department use only. Plumbing Permit Application -- Received Plumbing Date/By: City of Tigard Planning Approval Sewer 13125 SW Hall Blvd. Date/By: Permit No.: Plan Review Other Tigard,Oregon 97223 Date/By: I Permit No.: Phone: 503-6394171 Fax: 503-598-1960Post-Review Land Use Internet: www.ci.tigard.onus _. Datc/[3 : Case No.: 24-hour Inspection Request: 503-639.4175 Contact Juris.: See Page 2 for Name/Method: Su rlementallnformation. TYPE OF WORK FEE*SCHEDULE(forspecial Information use checklist) New construction I M Demolition Description Qty. Fce(ea.) Total Addition/alteration/replacement Other: New 1-&2-family dwellings _ CATEGORY OF CONSTRUCTION includes 100 ft.for each utility connection 1 &2-Family dwelling_ Commercial/Industrial SFR(1 bath znq.2o Accesso Buildin Multi-Family SFR 2 bath 350.00 -Y SFR 3 bath 39q.00 Master Builder Other: Each additional bath/kitchen 45.00 JOB SITE INFORMATION and LOCATION Fire sprinkler- R: Pu gc 2 FJob site address: 145 sS Sru //y�1N E, jig., Site Utilities e#: $Idg./Apt.#: Catch basin/area drain 16.60 'eetNa :e: �. /�j�yJS ;y(Dv�L Dr well/leach line/trench drain 16.60 ss street/Directions to job site: I'ootiI drain no. linear R. _ Page 2 Manufucturcd home utilities �I 10.00 Manholes 16.60 Rain dram connector 16.60 Sanitary sewer nolinear fi Pubic 2 Subdivision: _ Lot#: Storm sewer no, I iear R. Pam 2 Tax ma / arcel #: Water service no.dricar R. page 2 DESCRIPTION OF WORK Fixture or hens Absoetion valve 16.60�J T! _ Backflow rcvcntcr Pa gc 2 Backwater valve 16.60 _ Clothes washer 16.60 - Dishwasher 16.60 PROPERTY OWNER TENANT Drinkm fountain 16.60 E'ectors/suIii fi0 Name: (pAt m Ex ansion tank Address: - 16.60 - �'f 3SS Stu-/ ' 7� fes. _ Fixture/sewer can I6.60 Cit /State/ZI : 1�j�-/2.p _ Floor drain/Boor sink/hub 16.60 Phone: cr 639 SS$ Fax: Garbage disposal 16.60 APPLICANT CONTACT PERSON IIce Ibib _ 16.60 ntukct 16.60 Na111C: Tdjbf �lf�G>rt�4 /D��1N�i Intcrcc tor/ reasc trap 16.60 Address: 5E k Alv"AW Medical gas-value: S Page 2 Cit /State/Zip_ FeA_rc4rvy C/2 °J 7U2- Rout'd 16,60 Phone: O Roufdrain(commercial) IG.60 _� 3 3/sg • (pCo3 Fax: Sink/basin/lavatory I6.60 E-mail: _ Tub/si-o_wer/shower un r I6.60 CONTRACTOR Urinal 16.60 Business Name: t Water Closet 16.60 Address: /7T7 y ,S' A4rr� 0. water heater 16.60 Cit /State/Zi 09et,wn! err - Other: --� �- �Z�'}fs Other: Phone:S"oJ-ter - 30se Fax: PlumbingPermit Fees* - CCB Lic. #: �f� Plumb. LiC.#: ,�`, rm Subtotal $ Authorized �'�►o 7i y2Z - Minimum Permit Fee 572.50 S Signature: Date: Residential Backilow Minimum Fee$36.25 -- - Plan Review(25%of Permit Fee) S _ ------ State Surcharge 8%of Permit Fee) $ (Please print name) I TOTAL PERMIT FEE S Notice, This permit application e:.pires If a permit Is not obta ned within All new commercial buildings require 2 sets of plans wltme 180 days after It has been accepted as complete. riser diagram for pian review. or 'Fee methodology set by Tri-County Building Industry Serylce Board. i\Dsts\Pcrmit Forms\PlmPermilAnp doc 01/03 MEW+1EN�I�'' Plumbing Permit Application -City of Figal d Page 2 - Supplemental Information Fee Schedule: Residential Fire Su ression Systems: _ site Utilities Qty. Fee(ea) Total Square Footage: Permlt Fee: —� 55.(1() U to 2,000 $115.00 Footing d s t"tUO' _ 2 001 to 3 600 $160.00 Footing drain-e,, i additional 100' 46.40 3,601 to 7,200 $220.00 Sewer-1st 100' 55.00 7,201 and greater _ $309.00 Sewer•each additional 100' 46.40 Water Service-Ist 100' 55.00 Medical Cas stems: Watcr Service-tach additional 100' 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' 4640 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and Fixture or Item Qty. Fee fell) 'total - including$10000.00. Commercial Back Flow Prevention Ikvicc 4640 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for each additional$100.00 or fraction thereof,to Residential Backflow Prevention Device and including$25,00.00. minimum permit fee$36.25 27.55 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for Rein Drain,single family dwelling 65.25 each additional$100.00 or fraction thereof.to Inspection of existing plumbing or and includin $50.000.00, seciall re ucsted ins cetions- er hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for L— subtotal: _— _ each additional$100,00 or fraction thereof'. Fixture Work: Are you capping,moving or repla4,ing existing fixtures? If "yes",please indicate work performed by fixture. Failure to accuratfixtures could result in increased sewer fees*. Conuner Is regarding fixture work: _(�oanlil b Fixture Work Performed Fixture Type: ReplaceNew Moved F.xlslin capped 11•r hist /Font — -- — --� -- — Itath -Tub/Shower -Jacuzzi/Wlurl ool Car Wash -Foch Stall — - -Drivc Thru Cuspidor/Water Aspirator Dishwasher -Commercial — — — - -Domestic —Drinking Fountain Fountain Eye Wash _ — Flcxrr Drain/sink 2" __—• -- —-- i.. 4" Cat Wash Drain *Note: If the fixture work under this permit results in :tit (inrhagc -Domestic _ increase of sewer t I)tJs,a sewer permit w-Ill be issued and Disposal -Comme•cial — fees assessed for the sewer Increase must he paid before the -Industrial Ice Much./Refri bruins Ill umbing permit can he Issued. Oil Separator Gas St,iion Rec.Vehicle Dump Station Shower -Gang -Stall Sink •Bar/Luvatory -Bradley — -Commerciul -- -Service -- Swimming I'rxrl Filter -- Washer-Clothes — _ -- Water Latructor Water Closet-Toilet Urinal --- Other Fixtures. I:\I)sts\Permit Forms\l'ImPemiitAopl'g2.doc 01103 es s Electrical Permit Application Received electrical Date/B Permit No.: Planning Approval Star City OfTigard Date/B : PermitNo.: Plan Review Other 13125 SW Hall Blvd. Ian R : Permit No.: Tigard,Oregon 97223 Date/By: Land Use Phone: 503-639-4171 Fax: 503-598-1960 ffCoa_net, l /g ; Case No.: ct . Page 2 for Internet: www.ci.tigard.or.us ame/Method: Su lemenul information. 24-hour Inspection Request: 503-639-4175 _ -- TYPE OF WORK _ PLAN REVIE-- V Please check all that a i Service over 225 amps- Health-care facility New construction Demolition commercial ❑Hazardous location Addition!alteration/replace_mr rat ❑Other: service over 320 amps-rating of aur or more residuilding over ential units ivare feet, _ CATEGORY OF CONSTRUCTION 1 y 2 family dwellings ❑System over 000 volts nominal one structure 1 &2-Family 'welling _ Commercial/Industrial (�Building over three stories ❑Feeders,400 imps or more Accessory Buildin r Multi-Family ❑Occupant load over 99 persons 0 OM>�neufactured structures or RV park Other: ❑Ggress/lighting plan Master Builder_ Submit—sets of pians with any of the above. JUB SITE INFORMATION at_�d I,--- 101\'__- The above are not a licable to tem rorar construction service. Job site addres.: _ _ FEE' SCHEDULE Bldg_ Number of Ins cctions er ermit allowed Suite#: - ---�—p---- — Descri tion Q►y tee lea.) 1'�rrst Pro'ect Name: _--_�._ - New residential-single or multi-family per Cross street/Directtous to job site: dwelling unit.Includes attached garage. Service Included: 145.15 _ 4 1000 s .fl.or Icss - 33.40 I Each additional SW s .ft.or rtion thereof 75 40 - 2 Limited ener residential 75 00 2 Subdivision: Lot#' Limited encr no residentiul - --- Fach mamdactured home or modular dwelling W,9n 2 Tax map/parcel#: -- service and/or feeder 1JESCk1PT10111 OF WORK services or feeders-Instalstion, alteration or relocation: 80.30 2 _ —---.-- ----- 200amps or less 106.85 2 201 am s to 400 am s 160-60 — 2 — - -- - 401 am to 600 ams 240.60 2 TENANT 601 amps to 1000 ramps 454.65 2 PROPERTY OWNER Over 10(X)am of volts 66.85 2 _ ) Reconnect onl Name: ries_ Temporary services or feeders-Installatlon, Address: 5W ��� A alteration,or relocation: 66.85 1 Cit /State/Zi . Tibor A4 2C10 am s or less —. -- 100.30 2 _Y_� p - 201 am s to 400 a-L" _. - 133.75 2 Phonc:p?l G�� - $sty Fax: 401 to 600 am APPLICI-FANT _ CONTACT PERSON Branch circuits-new,alteration,or Mtu�p_ p�(qb jy� extension per panel: Name: j f 6gllzic __ -- A.Fee for branch circuits with purchase of 6.65 2 Address: service or feeder fee each branch circuit B.Fee for branch circuits without purchase of I — 46.85 2 Cit /State/Zl Ta.is✓� - service or feeder fell first branch circuit 665 2 Ph_on_e`PV -grit '447# Fax' ----_- — Each additional branch circuit Misc.(Service or feeder not included) 53.40 2 E-mail: —_ — Each um or fill anon circle 53.40 2 CONTRACTOR Fisch si or outline lighting : Signal circuit(#)or a limited enetgy panel. Pec 2 2 Jeb No: _ _ --, alteration,or extension -- Business Nam �1� Description: Address: Ae' to v ✓ w� 9 yv7� Each additional inspection over the allowable In an of the abov per ins ction r hour(min. I hour _ 62.50 Gity/State/Zi �v0 �!✓ - —� --- tr Fax: Qe� Investigation fee: — Phone: 88s Other. _ Lic. #: 2 Electrical Permit Fees• CC'B Lic. #: c$ D _� subtotal s Supervising electric ipnl-l.)1 r= _ signature required: _- _ -- Pan Rcviats, /0 of Permit Fee S Lie #: State Surchar c Baia of Permit Fee S Print Name: __ 'TOTAL PERMIT FEE S t' ___'�` Noticr. This permit application expire,If a permit Is not dtiUlned At filo Authorised Igo days after It has been accepted as complete. signature: _.___ ---- _ Date: --- 'Fee methodolop set by TrWounty Building Industry Service Board. (Please print name) i\Dsts\Pemtft Fomm\F:lcPer.nitApp doc 01/03 Electrical Permit Application -City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDEN'T'IAL WORK ONLY: Feefor all systems............................................................ Q7S.00 ('heck Type of Work Involved: Audio and Stereo Systems* Burclar Alarm ElGarage Door Opener* Heating,Ventilation and Air Conditioning System* Vacuum Systems* Other ---- COMMERCIAL WORK ONLY: Fee for each system.......................................................... $75.00 (SEE OAR 918-260-260) Check Type of Work Involved: Audio and Stereo Systema n Boiler Controls Clock Systems LJ Data Telecommunication Inhwilation fire Alarm Installation F] IIV.N(- F7 Instrumentation Intercom and Paging Systems landscape Irrigation Control* F-1 Medical L_1 Nurse Calls El Outdoor Landscape Lighting* Protective Signaling Number of Svstemq * No licenses arc required. Licenses sire required fur all other Installations ' i:\Dsts\Pcrmit Forms\ElcPermitAppl'92 diw 01/03 FOR USIE FFfCE Mechanical Permit Application ' M_chanical' Received Date/By: Permit No.J►IJ J�! Planning Approval Building City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Ilan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Revicw Land Use Date/By: Case No.: Internet: www.ci.tigard.or.us Contact Juris.: See Pag. for 24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information. TYPE OF WORK COMMERCIAL FEE"SCHEDULE-USE CHECKLIST FI New construction_ _ i)t'r.7olition Mechanical pennit fees'are based on the total value of the work 1;71P ddition/alteration/re lacement Other: performed. Indicate the value(rounded to the nearest dollar)of all Jonli CATEGORY OF cemcntCONSTUC`lON mechanical materials,equipment,labor,overhead and profit. 1 &2-Familydwelling Commercial/Industrial value: Sec Page 2 for Fee Schedule ACCeS50 Building _ Multi-Family_ RESIDENTIAL EQUIPMENT/SYSTEMS FEE-SCHEDULE Description , Q(y I Fee ea. Total Master Builder _ Other: Heatin Coolw �^ JOB SITE INFORMATION and LOCATION Furnace-add-on air conditioning" 14.00 Je,.t site address: / S SW / � A✓6_._ /� � Gas heat umnp_ 14.00 Suite#: Bldg./Apt.#: Duct work _ 14.00 Pro ect Name: Co• AW05 AMw0EL H dronic hot waters stem 14.00 Z- Residential boiler Cross street/Directions to job site: (for radiator or t ironic system 14.00 Unit heatcis(,uel,not electric) in wall,in-duct suspended,etc. _ 14.00 Fluc/venter any of above 10.00 Subdivision: Lot#: Repair units 12.15 _ � Other Fuel A Ilances Taxmap/rarcel #: _ water heater _ 10.00 DESCRIPTION OF WORK Gas fireplace 10.00 250 10 KITC *-^I /4PP1T& / _ Flue vert(wate-hcater/gas fireplace) 10.00- Log lighter(gas) 10.00 Wood/Pellet stove_ 10.00 Wood fire lace/inscrt 10.00 Chi mne /_liner/fiuc/vent 10.00 PROPERTY OWNER TENANT Other: 10.00 _Name: �0 4V6,VS Environmental Exhaust&Ventllotlon - -- Range hood/other kitchen equipment 10.00 Address: /¢'S S'S- _5trJ //' i+✓E _ Clothes dryer exhaust 10.00 Cit /State/Zip: /(/� OR, Single duct exhaust Phone:S-D3-G3y • K8 Fax: (bathrooms,toilet compartments, APPLICANT CONTACT PERSON utility rooms) _ 6.80 � Name: e �{it,�R RE�lfohE/�Wb T�t1�. - Attic/crawl space fans I0.00 --- —� - -- Other: 10.00 Address: 3&.3/, Fuel Piping Cq)�State/Zip: 0�/t�t#Wo J9K. 97202-- "(S5.40 for first 4,$1.00 each additional Fua ,etc. '• Phone: p3 3x8 �eG3 Fax: ---- rnce,Gas heat pump__ •• _ E-mail: Wall/suspended/unit heater •• _ CONTRACTOR _ Water heater -�-- � _ •' Business Name: "D�TdM Miy�ZL _ Fire lace — Address: Ran cBBQ _ City/StatO%1_PArt WA 4-9--i1 2-___ 0othes dryer(gas) Other: Phone: 03 %44-0_• S Fax: _ ___ --- — - — CCB Lic. #: 00 _ Total: ��� -- Mechanical Permit Fen' Authorized _-- Subtotal: $ Signature: --------_.__-.---__-_-- Date: - - -- Minimum Permit Fee$72_.50 S Plun Review Fee(25%of Permit Fee) S --- ---- - -- _ -- _ State Surcharge 8°o of Permit Fee) $ _ (Please Mint nnmc - TOTAL PERMIT FEE S Notice: This permit application expires If a permit it not obtained althin *Fee methodology set by Tri-County Building Industry Servlee Board. IRO days alter II hai been accepted as complete. "Site plan required for exterior A/C units. is\Dsts\Peimit I otnis\MecPermiiApp doc 01103 Mechanical Permit AU)lication - City of Tigard Page 2 •• Supplemental Information Commercial Fee Schedule: _ Total Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction _ thereof,to and including$10,000.00. $10,001.00 to$25,000.00 $148.50 for the first$10,00(,.00 and $1.54 for each additional$100.00 or fraction thereof,to and including $25,000-00, $25,001,00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or fraction thcreor,to and including $50.000.00. $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 Appliance: ValueTotal D icription: Qty Ea Amount 1 -• cc to 100,000 BT IJ,including 955 ducts ' vents _ Fuma,.>100,000 BTU including ducts 1,170 &vents Floor fumace including vent 955 _ Suspended heater,wall heater or floor 955 mounted heater _ Vent not included in appliance permit 445 Repair units 805 <3 hp;absorb.unit, 955 to 100k BTU 3-15 hp;absorb.unit, 1,700 101 k to 500k BTU 15.30 hp;absorb.unit,501k to I mil. 2,310 B ru _ 30.50 hp;ahsorb unit, 3,400 1.1.75 mil.13TIJ >50 hp;absorb.unit, 5,725 >1.75 mil.BTU _ _Air h,nidli ig unit to 10,000 crm 656 Air handling unit>10,000 crm 1,170 Non-portable evgwmte cooler _ 656 _ Vent fan connected to a single duct 446 Vent system not included in appliance 656 permit I lood served by mechanical exhaust 656 _ Domestic incinerator 1170 commercial or industrial incinerrtor 4 590 _ Other unit,including wood stoves, 656 inserts etc. _ Gasi tp ng 14 outlets+_ 360 Fach additional outlet 63 TOTAL.COMMERCIAL VALUATION: i:IDsts\Permit Forms\Mccl'ermitApppg2 doc 01/03 ' M I T- 29'-0" NEW ADDITION-- 1z._o. r------- ------ I I I I r 39 I • I 1 . I EXISTING HOUSE I I I I I I IS1'-8' I 1• SEWER LINE'S------ UNDEkGROUND--- UNDERGROUND -- V WATER LINT -- SEPTIC TANK ELECTRICAL Ef-3" KITCHEN ADD'TION FOR '• GAY HUGUS "•' PROJECT ADDRESS 14755 S.V. I144h Ave . . Tlpord Oregon I •... CITY OF TIQARD Appro"ed............................... u 52'-5' t:undRionelly Approved............ RECEIVED `or only the work as described in, PFHMIT No.Mf�T2�.s�,1.i(D� p SAe i.etter to- Follow. DEC 31 2002 Job Addretu; L`!� r s (y r±<" I CITY OF TIGARD By.- -t'''" bete:._L 2 .�-y.�` I I 3UILDIND DIVISION n SITE PLAN SCALE - V = 30'0' .R i D I �J I o � o I I 00 C3 � C I z C I --- (� i w - � � I Q, I Fri 1 i r I � I I I I I _ 5'0'-6'10' O I I = I 1Ul 4 I I to f I to s ry I ' I I I I I I CD ID 10) D z © Q z �c �reJl l00 ( O �- I \1/ —1 __ ` s� � 9' 00I err, ••. 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HALL BLVD, TIGARD, OR 97223 IMPORTANT PERMIT NOTICE AERO ELECTRIC 16828 MTVIEW LANE WOODBURN, OR 97071 Electrical Signature Form Permit #: MST2002-00501 Date Issued: 1/27/03 Parcel: 2S110AB-02800 Site Address: 14355 SW 114TH AVE Subdivision: COLE'S ACRES Block: L OL 013 Jurisdiction: TIG Zoning: R-2 Remarks: 250sf kitchen addition. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR- HUGUS, ZONA GAY AERO ELECTRIC 14355 SW 114TH AVE 16828 MT VIEW LANE TIGARD. OR 97223 W00r)RURN, OR 97071 Phone #: Phone #: 503-982-1044 Reg #: LU )(,-491c uc 48304 Slip 2971S AN INK SIGNATURE IS REQUIRED ON THIS FORM X :. Signature of Supervising Electrician If you have ar,y questions, please call (503) 639-4171, ext. # 310 I