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14130 SW 116TH TERRACE a .p w C) cn 7 CD m 0 CD 14130 SW 116"' Terrace CITY O F TIGARD = -_MASTER PER�•.lL t PERMIT#: MST2001-00325 DEVELOPMENT SERVICES DATE ISSUED: 6/11/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 14130 SW 116TH TERR PARCEL: 2S110BA-08300 SUBDIVISION: EVERGRFEN SPRINGS ZONING: R-4.5 BLOCK: LOT:008 JURISDICTION: TIG REMARKS: Convert crawl space into habitable space. 795 sq. ft.@ 86.30/sq ft BUILDING REISSUE: STORIES: FLOOR AREAS _REQUIRED SETBACKS_ REQUIRED _ CLASS OF WORK: ADD HEIGHT: FIRST: of BASEMENT: 79500 of LEFT: SMOKE DETECTQRS: TYPE OF USE: SF FLOOR LOAD: 40 SECOND: of GARAGE: at FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: of RIGHT: OCCUPANCY GRP: R3 BDRM: 1 OATH: 1 TOTAL: 000 of VALUE: S 68ma 5G REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAU JDRY TRAYS: i RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS. OTHER FIXTURES MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP<JHP: VENT FANS: 7 CLOTHES DRYER: 1 GAS FURN>000K: UNIT HEATERS: HOODS: OTHER UNITS: MAX I btu FLOOR FURNANCES: VENTS: 4 Woc.:i OVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 -100 amp: 0 200 amp: W/SVC OR FDR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'I.500SF: 201 400 amp: 201 40n amp: lel W/O SVC/FDR: h.0 QOUT LIN LT: PER HOUR LIMITED ENERGY: 401 600 amp: 401 600 amp: EA AUDL SR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVCIFDR: 601 • 1000 amp: 601*ampa•1000v: MINOR LABEL: 1000•■mplvoll: PLAN REVIEW SECTION Reconnnctonly: >•4 RES UNITS-. SVCIFDR>e225 A.: >600 V NOMINAL: CLS AREA/SPC OCC ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO A STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH: BOILER: HVAC LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/r LE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: TOTAL FEES: $ 1,280.64 Owner: Contractor: This permit is subject to the rr gulations contained in the ROB, KAREN O'GORMAN KEN NIELSON CONSTRUCTION Tigard Municipal Code, State of OR Specialty Codes and 14130 SW 118TH 1,1488 SW COLE LANE all other applicable laws All work will be done in TIGARD,OR 97224 TIGARD,OR 97224 accordance with approved plans. IYlis permit will expire if work is not started within 180 days of issuanoe,or If the work is suspended for more than 180 days. ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Or:gon Utility Notification Center. Those rules are set Reo6: LIC. 32871 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)248-1987. REQUIRED INSPECTIONS Footing Insp Mechanical Insp Low Voltane Final Inspection Post/Beam Structural Plumb top Out Insulation Insp Post/Beam Mechanica Electrical Service Electrical Final Underfloor Insulation Electrical Rough In Mechanical Final PLM/Underfloor Framing Insp Plumb Final Issued By : PArmittee Signature Call (503) 639-4175 by 7:00 p.m.for an inspection needed fie next busin"s day SII L9 - Built -- -� Date received!', ' !/ 1'ermano.: city Oi Address: 1:5 a A.,a w nat rscvo, i igard,Oft 97223 Nroject/ap,I.no.: Expire date: City nf'1'ignrd Pt onc: (503) 6394171 Date issued: By'j % Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: 61;.1 DK-lijam-falm U I &2 fancily dwelling or accessory U commercial/industrial U Multi-family U New construction ❑Demolition U,Nddition/alteration/replacemerit U Tenant improvement _I I.m. tipnnklrr/alarm 'J Other JOHNi'll t. 1 w Job address: Lot: Block: Sul�livision: Tax map/tax lot/account no.: Project name: N Description and locaJon of work on premises/special conditions: 111Pill I 111r,11111 Name: (t' 11 /CG ft r!u \ `4a2 m�a ►, Mailing address Q i 1 &2 family dwelling: City: tZE Statc: 7.IP:-_ 72? Val ration of work..... ................... ............ $ Phonc: I:cx: — Email--- No.of hedrooms/baths................................. I __ Owner's representative- lc-alh ► Total number of floors............... Phone.: it r-'/ Fax I' il: w New dwelling area(sq.ft.) .......................... 7r3n Garage/carport area(sq.ft.)......................... WoNc Covered porch area(sq.ft.) �f Q% Name: d ......................... o �. Mailing address: — Deck area(sq, ft.) ........................................ City: r State: ) 7..t 2 Other structure arca(sq.ft.)......................... a tig., Phonc c Fax� r if: Commercial/industriatlmulti-family: Valuation of work.................... ................... $ -- --- . Existing bldg.area(sq. ft.) ................ ....... . Business name: k z. ( - i New bldg.area(sq.ft.)................... ..... ... .. ---- Address: LN-0-9 r i City: _ State: / 7.1►': � - Number of stories...................... ... ..... ....... _ ryp of constructiow.. .................. . ............ —. Phone: / Fnx:� �y57c3j 7i� 6G�lL ----- � Occupancypadp(s): Fxisting: CCB no.: _. New: _ City/metro lic.no.: Notice:All contractors and subcontractor arc required to be li 061 U102 licensed with the Oregon Construction Contractors Board ender rNamc: J l„� r c� �A ii:f„L previsions ofORS 701 and may be required to t>P licenser',in the ress: jurisdiction where work is being performed. If tl.e applicant is State: _ e tempt from licensing,the following reason applies: Contact person: Plan Phone: I ,t MEN1 Nnn,eju2he/ti I Contact pci,ion: Fees due upon application Address: _ -- _ Date received: _ _— State: 7.1 P: Amount received city: ........................................ LPhone: Fax: Email: Please refer to fee schedule. I hereby certify I have read and examined this application and the NM dl iuriadictkaa accept credit cnida,pleaw call Jurisdiction(or truxe InRKttWinn. attached checklist. All provisions of laws agrf ordinances governing this Uvlaa U Mastercard work will be complied with,wl e,oW K s led herein or riot. Credit cod numher _ -- — -- ,-�. � Hspirce Authorize signature' Date: Name or c lckn as shown Mctalit cim S Print name: _ —--` Cadtiolde►dpWure —'— Amount Notice:Th rmit appo ation ire;if a pertnit is not obtained within 190 days after it has been accepted as complete, 4404611(6000 :OM) One-and Two-Family Dwelling R�� Building Permit Application Checklist Referenc^no.: Associated permits. City of Tigard City of Tigard ❑Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Other: Phone: (503) 639-4171 rax: (503) 598-1960 RE REQUIRED FOR PLAN REVIEW Ves N(; N/AI Land use actions completed.Sec juriviictinn criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,scoanic soils designation,historic district,etc. 3 Verification of approved plat/lot. 4 Fire district---approval required. 5 Septic system permit or authorization for remkidel. Existing system capacity – 6 Sewer permit. 7 Water district approval. 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required. Include drainage-way pmtection,silt fence design and location of catch-basin protection,etc. _ 10 _ 3. Complete sets of legible plans. Must M-t drawn to scale,showing conformance to applicable local and state huilchng codes.lateral design details and connections must he incorporated into the plans or on a separate full-size sheet attached to the plans with cross retertoces I'etween plan location and details. Plan review cannot be completed if copyright violations exist.__ I I Site/plot plrn drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 44i.elevation differential,plan riust show contour lines at 241. intervals);location of casements and driveway;footptint of structure(including decks);(c cation of wells/septic systems;utility locations;direction indicator;lot arca;building coverage arta;percentage of covet age;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. _ 13 Flottr plans.Show all dimensions,r(ktm identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plurnhinj�fixlures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framinp-mermber sizes and spacing such as floor beams,headers,joists,sub-floor, –� wall construction,roof construction.More than one gross section mal,he required to clearly portray construction.Show details of all wall and r ol'sheathing,rooting,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, dtennal insulation,i,tc. 15 Elevation views. Provide elevations for new construction;minimum of two clevations for additions and remodels. Exterior elevations must reflect the actual grade il'thc change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are ac,e table. _ 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive th analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all fltx.rs/roof assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rchat. For engineered systems,see item 22,"Engineer's calculations." _ 19 Beam calculations.Provide two sets of cii1culatlons using current code design values for all beams and ^,ultiple joists over 10 feet long and/or any beant/joist c.. tying it non-uniform load. 20 Manufactured floor/roof truss design details. —' 21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or mor:appliances. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the project under review. 23 Five(5)site plans are required for Item I I above. Site plans must be 8-1/2"x 11"or I V x 17". 24 Two(2)sets each art required for Items Ib, 19,20&22 above. 25 Building plans shall not contain red lints or tape-ons. 26 No rolled,reversed or mirrored building plans will he accepted. _ 27 Checklist must he completed before plant 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. 4 a461e ttv)WOMt Plumbing Peemit Application - --- pate received: / Permit no.: 'O!-' City of Tigard Sewer permit n0.: Building permit no.: Address. 13125 SW liall Blvd,'figard,OR 9722.3 project/appl.no.: Expire date: City of Tigard Pnone: (503) 639-4171 Receiptno.: Fax: (503)598-1960 Date issued: B Y Case file no.: I l'aymen'.type: Land use approval: - 1 M� 7LUINew 2 family dwelling or accessory U Commercial/industrial U Multi family U Tenant improvement construction U Acldition/alteration/repiacement U Food service 0 Other: _ Urm Dcscri Ilion Qtr'. hec(ca.) 1'rrtal Job address: /L/ /3 U `a s� I Y1- 7dy a N New 1-r.nd 2-family d"ellints only: Bldg.no.: _ Suiteno.: .-- (includes too it.Ioreac•hutility connectirru) Tax map/tax lot/account no.: SFR(1)bath - - Lot; _Block Subdivision: SFR(2)bath ---1—T� Project name: Q G SFR(3)bath — Z!P: Each additional bath/kitchcn City/county: — — Site utilities: Description and location of w Zon premises:— 4 Catch basin/area drain _L.�__'z 7)6 g"M Drywells/leach line/trench_drain Fast.date of completion/inspection: Footing drain(no.lin. ft.) MMEM= Manufactured home utilities _Business name: - - fivr21� Manholes Address: /S�3 _ _ Rain drain connector State: or e ZIP:y'71Z Sanitary sewer(no.lin.ft.) _City: �r +i1.� Storm sewcr(no.lin.ft.) Phone: Fax: E-mail —" — ;:'ater servicemen.ft.) CCB no.: Plumb.bus.reg.no 305P Fixture or item: City/metro P,_no,: JSD G Absorption valve Contractor's mprcsentative signature: _._ ld�SE Bac Flow reventcr Print came: Bate: Backwater valve Basins/lavatory Clothes washer Name: - Dis washer Address: _— Drinking fountain(s) Slate:LS II l.IP: Oct; City ( — �:L_ E' Phone: Fax: E-maul: Expansion tank __— Fixturelsewer cap Floor drains/tloor sinks/hub Name(print): a_ Uarbn a dis rsal Mailing address: Nose hibb _ City: State: ZIP.___ Ice maker — Phon^: Fax_ E-mail: Interceptor/greaseirap --- Owner installation/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made b,my regular Rcwf drain(commercial) Y h employee on the property I own as per ORS Chapter 447. Sin (s), asin(s), ays(s) _ Sum -- — Owner's si nature: Date:__- Tuhslshowerlshower an — Unnal _ Name: F1d)Lj .sem --- Water closet Address: __ Water eater City: SG,ro, ZIP: Other: Totaone: Fax: rE-mail: L_Ph _ Minimum fee................$ Not it,)utidtcti,u wee"credal ca*,plea Call Iunsdioinn for mwxe INotice:This permit application Plan review(at — %) $ -- J V'ian U Magi-Ward expires if a permit is not obtained State surcharge(8%)....$it rrher _---__. ____�!�L_ within ISO days after it has been Credit cad nur t.Rp rcr TOTAL ....................... --- accepted accepted as complete. Name cardholder as 0---on a c r $ Cadholder ai6naturc -- 410616(pIp01COMl Amormr PLUMBING PERMIT FEES:, PRICE TOTAL r hew 1 and 2-family dwellings only: -f- FIXTURES individual) QTY- (on). AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavato 16.60 for each utility connection_ ry ( One 1 bath _ $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath $350.00 _ Shower Only 4016.60 Three 3 bath _ _ $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL _ LaundryTray _ r►1 ,�t ( _ 16.60 Washing Machine y.0 I 16.60 Floor Drain/Floor Sink' 2" 16s0 PLEASE COMPLETE: 3" -�_ 16.60 4" - 16.60 - _ Water Heater O conversion O like kind 16.60 Quanti b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ .-Permit. MFC,Home New Water Service 46.40 Sink r _ MFG dome New San/Slonn 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 Garbaga Disposal Laund Room Tray1 -- Washing Machine Floor Drain/Sink: 2" Sewer-1st 100' 55.00 3" Sewer-each additional 100' 46.40 _ 4" Water Scrvice-Int 100' 55.00 i Water Heater Water Service-oach additional 200' 46.40 Other Fixtures _ (S eclN) __ Storm&Rain Drain-1st 100' 55.00 Storm&Rain Drain•each additional 100' 46.40 -• Commerclai Back Flow Prevention Device 46.40 - --� Residantlai Backflow Prevention Device' 27.55 - Catch Basin --- 16,80 - Inspection of Existing Plumbing or Speclaliy 72.50 Requested lMeMclionaper/hr _ COMMENTS REGARDING ABOVE- Rain Drain,single family dwelling 65.25 Grer,se 1reps -- 16.60 - QUANTITY TOTAL Isometric or ritier diagram Is required It _Ouanthy Total is ?g *SUBTOTAL --� -- _ 8e/.STATE SURCHARGE -- ----- ---- •'PLAN REVIEW 25%OF SUBTOTAL _ Required onlYhtxturo gty_intel le?A TOTAL s "Minimum permit tee Is S72 50+8%stale surcharge,except Residential BacABow Prevention Uevlce,which Is$96 25+e%state surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review l:%dsls\fonns\plm•fees.doc 10/10/00 Mechanical Perinit Application Date rece6ved./'; UJ Permit no. City Of Tigard Project/appl.no.: Expire date: CitynJTigaid Address: 13125 SW Hall Blvd, I ilvmd. OR (Y7':' Phone: (503) 639-4171 Date issued: fs Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: fr 1 U l A.' dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U Nenstruction U Addition/alteration/replacement U Other: _- ( 1 1 1 Job address L/�j U •5 (, *�' r� 1C� t% Indicate equipment quantitive in boxes below. fp,:.:ate the dollar Bldg.no.: Suite no.: _ value of all mechanical materials,equipment,labor,c verhead, Tax map/tax lot/account no.: profit.Value$ Lot: _ Block: � Subdivision: 'See checklist for important application information and Project name: /,� rnQ,y.. // jurisdiction's fee schedule fix residential permit fee. City/county: '�T ZIP: 2�Jrim It t Description and locntio work on premises: JAirhand7hng t 1 Est.date of completion/inspection: Ikwcril>tion (py. Res.only Res.onh Tenant improvement or change of use: it `CFM Is existing space heated or conditioned?U Yes U No Aircondiuomng(stb,p an requu )Is existing space insulated?U Yes ".J No Alteration of exlsu�gsystem of cr/compressoe Business name: 't'��r py�,� �, - I State boiler perm) no.: -= f�- HP —Tons BTU/ll _ Address: /S4, c lm%nG it smo e t,rapers/duct smoke detectors — City: ' , State:a 7.IP eat pump•a le plan require ) —"- Phone: ZZ I ax: E-mail: nstu rep ACC urtiacc�unrer RUM / -- -- Including ductwork/vent liner iJ Yes 0 No o nssuspui.JedCCB no.: City/metro lic.no.: -�--—" wall,or floor mounted Name(please print)- Vent for appliance of er than furnace 1 1 e genal on: Absorption units-.-- Is7'U/H Name: ,fir j Chillers—__ HP — Address: / Q Compressors_____,__ IIP Environmental ex must and ventilation: City: , State Z,IP:� -Z Appliance vent Phone:/,.&C §*"il: / h erexraust _ — Hoods,Type res. rte a atlnal hood fire suppression system Name: �r� �l�/7 ,� —� Exhaust fan will,single duct(beth fans) Mailing address: /y/j S t-t �� +naust syslem a art rum eat n or AC ud piping and distributiorit up to 4 o-Mets) City: t'1'7U State- �, ZIPS Type. 1,116 NG Oil Phone: FaxC-mail ucT-i,iii�cac additional� — over outlets rocesspiping(schematic require ) Number of outlets Name -- —�_ 1 eR 111s,ed appliance or equipment: -- Address: _ Decorativefircplace City: St=IP: Tnsert-�t __— �� OIt al7VC/ II pCCI SIOVC - Phone_: _ Fax: E-mail: — (Jter: Applicant's signature: Date: i ter Name (print): Not all Jurisdiction,am-plu c"I cards,pleme call JurHdictimi rg rtuw InGwrnntioo Permit fee...............•.,.,.$ Uvisa UMasterCard Notice:ifa enininermli not Minimum fee................$ Credit card number:_ — _ expires if a permit is not has Platt review(at —_ %) $ _ within 180 days eller It has i>een State surcharge(89h)....$ Nmne o!c o drr m shown on c n c -- accepted as complete. _ s TOTAL .......................$ - ('ardh elder dputtee Arrow 4404617(tilOaROM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE. 9 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUA_T 10N: FEE: Description: Price Total $1.00 to$5,000.GJ Minimum fee$72.50 Table 1A Mechanical C,-1e oty (ES) Amt $5,001.00 to$1U,Ou0:;G'- $72.50 for the first$5,000.00 ani 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& gents 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 indudinp 4) F ispended heater,wall heater $25000.00. or floor mounte%heater 14.00 $25,001.00 to,550,000.00 $379.50 for the first$25,000.00 and 5) Vent not inc'uded in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units _ $50 000.00. 12.15 $50.Opi 00 and up .__ $742.00 for the fir;:t$50,000.00 and Check all thatapi4 Boller Heat Air $1.20 for each additional$100.00 or I For Items 7.11,use or Pump Cond J fraction thereof. fl footnotes belovi. Com ' *' 7)<3HP;aosorb unit ASSUMED VALUATIONS PER APPLIANCE: -� to 100K BTU _ 14,00 Value Total 8)3-15 HP;absorb Description: Q Ea Amount unit 100k to 500k BTU 25 60 Furnace to 100,000 BTU,Including 955 9)15-30 HP;absorb M- ducts&vents unit.5-1 mil BTU 35.00 Furnace>100,000 BTU including 1,170 10)30-;i0 HP;absorb ducts&vents unit 1-1.75 mil BTU 52,20 Floor furnace including vent 95unit>1.75 mil BTU 5 --- 11)>50HP:absorb - Suspended heater,wall heater or 955 87.20 --II floor mounted heater 12)Air handling unit to 10,000 CFM Vent not Included in appliance 445 10.00 permit 13)Air handling unit 10,000 CFM+ Repair units 805 __� 17.20 <3 hp;absorb.unit, -'955 14)Non-portable evaporate cooler to 100k BTU _ 10.00 3-15 hp;absorb.unit, 1,700 15)Vent tan connected to a single duct 101k to 500k BTU 6.80 15-30 hp;absorb.unit,501k to' 2,310 16)Ventilation system not included In mil.BTU appliance permit 10.00 30.50:'1p;absorb.unit, 3,400 17)Hood served by mechanical exhaust 1.1.75 mil.BTU 1000 >50 hp;absorb.unit,`^~ 5,725 18)Domestic inclnerators >1.75 mil.BTU 17.40 Air handling unit to 10,000 dm 656 19)Commeictlal or industrial type incinerator Air handlingunit>10,000 cfrn _ 1,170 - 69.95 Non-portable evaporate cooler 85B "- 20)Other units,Including wood stoves Vent fan connected to a single duct 446 _ 1000 Vent sys!em not Included in 656 21)Gas piping one to four outlets a liance-Mermlt 5.40 Hood served b mechanical exhaust 858 - --- 22)More than 4-per outlet(each) y Domestic incinerator 1 1.00 mum V Minimum Permit Foe 572.80 SUBTOTAL: Commercial or Industrial Indneralor 4,590 - $ Other unit,Including wood stoves, 656 Inserts,is 8%State Surcharge $ Gas piping 14 outlets 360 - Each additional outlet 25%Plan Revlew Fee(of subtotal) _ 63 Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RE:'IIDENTIAL PERMIT FEE: $^ VALUATION: Qther Insaectlona aid Fee$: 1 Inspecllons outside of normal business hours(minimum charge-two hours) $12 50 per hour 2 Inspections for which no fee is specifically indicated (minimum charge-thalf hour) $72 60 per hour 3 Additional plan reviow required by changes.additions c-revisions to plans(minimum ohargeone-half hour)$72.50 per hour "SUte Contractor Boller Cerilflcatlon required for units 400k BTU. "Residential A/C requires site plan showing placement of unit. I%d¢tslformsVne..%i-foes,doc 10/11/00 Electrical Permit Application Date receivcd.4 Pertnn:r, City of Tigard Project/appl.no.. - Expire".L. CifynfTigard 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: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alter ition/repiacemrnt U Other: U Partial JOB StIVE INFORMAIJON Job address: _(,�( err' Bldg.no.: Suite no.!" lot/account rnap/tax lot/account no.: Lilt: Block: Subdivision: Project name: Description and location of work on premise Estimated date of co: Ipletion/inspc,tion: COINTIM 1 OR APPLIkX111ONI Fee max Job no: !�( ,� VY1C4 v. t --- IMccriptinn Qt . eu Total nolnr Business name! � r&C C l New nsidetitial-sink or muni-f�mih Ix•r Addres3: 1 diselling unk.Include-%attacirt 1`l garage. City: 6 SlalC /� ZIP, Seniceincluded: Phone: Fax: F mail: (M)sq.n.or less 4 _ -- -- Each additional 5(x1 sq,ft.or portion thereof CCB no.: Elec.bus,lic.no: _ Limitedenergy,residential _ 2 City/metro lic.no.: Limited energy.non-residential 2 Hach manufactured home or modular dwelling Signature of d rvisin electrician(required) i)me _ Service and/or feeder 2 Sup. Lure name btiperisin — _ l cDaeno: Services or feeders-Installation, rlterallon or relocallon: 1 t 20U umps or less 2 Name(print)! 201 ams s to 400 amps 2 Cy D K 17 1 3 1` _-- 4U 1 it)f(x)amps 2 Mailing address: I q / 3 O 5 �' 13� 601 amps to I WO amps - 2 City: G1 Staled ZIPQ Over I(xx)amps or volts _ 2 Phone: Fax: I E-mail: Reconnect mdy I owner installation:The installation is t ing made on property I own Temporary services or feeders- Installation,rdterstIon.orrelocation: which is not intended for sale,lease.Teat,or exchange according tet 211)amps or less _ ORS 447,4:.5.479,670.701 201 amps to 4W amps 2 Owner's si nature: Date: 401 to 61x1 ams 2 Branch circuits-nen,alteration, or extension per paueli Name: /LC►l F A, Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit A - 2 city: ,�Slate: ��I I B. Fee for branch circuits wlthcu►purchase --- — -- --- mf service or feeder fe1,1`11`1111 Will circuit 2 Phone: Fax; 1:-ntai1: f ach additional branch circuit: Mhlc.(Service or feeder not Included): U Service over 225 aonps-cimmercial U Health-care facility F:ech unite of irrigation circle _ 2 U Service river 320 amps-rai.,g of 1&2 U Il:umciouslocation Each also or outline lighting 2 fatally dwellings U Building over 10,000%quart feet four of Signal circuits)or a limited energy panel. U Sy11tem overW)volts nomina: more residential units in one structure alteration,or extension' _ Z_ U Building over three stories U Feeders,4(x)mnps of more +Ikscription. -- U Occupant Ioml over 99 petsons U Manufactured structures or RV pink par•h additional Inspection over the allowable In any of the above: U I'pvss/lightingolan U Other -_ -�_- _--_— l'etmspection Submit_sets of plans with any of the above. Investigation fee The above ore not applicable to temporary construction service. Oth.-r - — Permit fee.....................$ NM all)uHsdkito ns acept credit randsplease cell)uriulicntin 14"mime inl,xmation Notice:This permit application U Visa U MasterCrud expires if a permit is not obtained Plan review(at -_ %) $ . credit card numlat: _ _ within 180 days after it has been Slate surcharge(11%)....$ sp nes accepted as Complete. of eirc�iol shnvun un c 1 and --- cardlnA�e�r ii�rt—azure i— -- Atnoimi 44o, G1s iWWOM) Electrical Permit Fees. Limited Energy Fees: _ TYPE OF WORK INVOLVED-RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee................... $75.00 Number of Inspections pet permit allowed (FOR ALL SYSTEMS) Sorvice included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less $145 15 _ 4 ❑ Audio and Stereo Systems Each additional 500 sq.ft.or porton thereof $33.40 _ 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Dwelling Service or Feeder $9090 2 Garage Door Opener' Services or Feederb ® Heating,Ventilation and Air Conditiuning System' Installation,alteration,or relocation 200 amps or less ;80.30 2 201 amps to 400 amps _ $106.85 _ 2 ❑ Vacuum Systems 401 amps to 600 amps $160.60_ 2 601 amps to 1000 amps _ $240.60 2 ❑ Other Over 1000 amp;or volts $454.65 _ 2 Reconnect only $66.85 2 Temporary Survices or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteratior,or relocation Fee for each system..................... .......... .......... ........_ . $75.00 200 amps or less $66.85 2 (SEE OAR 918-260.260) 201 amps to 400 amps _ $100.30 _ 2 401 amps to 600 amps _ $133.75_ _ 2 Check Type of Work Involved: Over 6U0 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits [jNew,aiteralion or extension per panel Boiler Controls a) rhe fee for branch circuils with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit , $6.65 v 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ pr feeder fee. Fire Alarm Installation First branch circuit _ $46.85 ❑ HVAC Each additional branch circuit $6.65 Miscellaneous ❑ Instrumentation (Service or feeder not Included) h pump or irrigation circle _ $53.46Intercom and Paging Systems AL olgn or outline lighting $5340 � ❑ Sitpr.. -Ircud(s)or a limited energy —_ panel,alteration or extension $75.00 _ ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 Each additional Inspectie over ' ❑ Medical the allowaule In any of it ,above Per inspection $6250 _ ❑ Nurse Calls H,::hour $62.50 In Hant _ $73.75 ❑ Outdoor Landscape Lillhting' Fees: ❑ Protective Signaling Entor total of above fees $ __ ❑ Other 8%Statu Surcharge $ -------,Number of Systems 25%Plan Review Fee See"Plan Review"ser_tioo on $ Na licenses aro required Licenses ere required for all other installations fiord of application —"— Fees: Tofal Balance Due $ �•-� Enter total of above fees =_ lJ Trust Accot nt N 8%State Surcharge = Total Balance Due 0d%ts\rorms\eic•Rxa.dty l0ffig On 1 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 RECEIuFr', IMPORTANT PERMIT NOTICE JUN 14 2009 205 ELECTRIC 7331 SE JOHNSON CK BLVD COMMI{NITY I)FVEIUPMEVI PORTLAND, OR 97206 Electrical Signature Form Permit #: MST2001-00325 Date Is.�ued: 06!11!2001 Parcel: 2S110BA-08300 Site Address. 14130 SW 116TH TERR Subdivision: EVERGREEN SPRINGS Block: L-ot: 008 Jurisdiction: TIG Zoning: R-4.5 Remarks: Convert crawl space into habitable space. 795 sq. ft.@ 86.30/sq ft 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, ATM Building Dept. No electrical inspections will be authorized until this completed form is received MVNFR: ELECTRICAL. CONTRACT OR ROB, KAREN O'GORMAN 205 ELECTRIC 14130 SW 116TH 7831 SE JOHNSON rK BLVD PORTLAND. nR 9720(. Phone #: 503-624-2902 Phone #: 771-5491 Req #: sup 3805S LIC 34255 ELE 3-4520 AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE PECEIVEi,. AAPPLE PLUMBING JUN 14 2001 PO BOX 1543 COMMUNITY DEVEtI�PMENT HILLSBORO, OR 97123 Plum."ing Sigr -ature Fora Permit #: MST2001-00325 Gate Issued: u/1 1/0 1 Parcel: "S1 I OBA-08300 Site Address: 14130 SW 116TH TERR Subdivision: EVERGREEN SPRINGS Block: Lot: 008 Jurisdiction- 7IG Zoniry: R-4.5 Remarks: Convert crawl space into habitable space. 795 sq. ft.@ 86.30/sq ft Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorize ' until this completed form is received OVvNFR PLUMBING CONTRACTOR ROB, KAREN O'GORMAN AAPPLE PLUMBING 14130 SW 116TH PO BOX 1543 TIGARD, OP 9722! Ni1_.1 SBORO, OR 97173 Phone #: 50:3-624-2902 Phone #: Reg #: I Ir 104311 PI M 34-308PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD BI "ILDING INSPECTION DIVISION 24-Hour Inspection Line: b..,-4175Business Line; w,39 71 MST - ��=07 Date Requested _ / - AM PM BUP_ BLD Location_ / Li( 3� j �(��` T� �. — Suite _ MEC Contact Person iia-v�_. Ph "J S76) <j,;Z ip.M Contractor Ph SWR BUILDING Tenant/Owner ESC Retaining Wall - Footing ELR Foundation FPS FP5 Ftg Drain — - Crawl Drain Inspection Notes: 3GN Slab - Post& Beam — — - SIT Ext Sheath/Shear Int Sheath/Shear Framing Insulation Driwall Nailing Firewall Fire Sprinkler Fire Alarm -— -- -- — Susp'd Ceiling Roof Misc: Final - PASS PART FAIL _ PLUMBING - Post& Feam Under Slab Top Out -- Water Service Sanitary Sewer --�' - Rain Drains Final PASS PART FAIL MECHANICAL -- — Post& Beam -- Rough In '-- Gas Line _ Smoke Dampers - - Final S PA FAIL ELECTRICAL -- _ Rough In i - UG/Slab Low Voltage Fir arm PASS jPART FAIL Backfill/Grarf ing — Sanitary Sewer Storm Drain ( )Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line f ]Please call for reinspection RE _ I Unable to inspect-no access ADA Approach/Sidewalk Other Date ` CL/--Inspector Ext Final PASS PART r-AIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUI' 7iNG INSPEC"ION DIVISION MST `�aZ�� --�z'��-5- 24-Hour Inspection Line: 639--.176 Business Line: 639-4'. - BUP v Date Requested j� / _AM_ ' _PM BLD _ Location f' `�i' 3 U (, --F------- Suite MEC Contact Person - • ?h c�_ / -<-PLM Contractor Ph SWR — BUILDING TenanUOwnerELC Retaininct Wail -- - — ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes ---_ — ---- Slab SIT Post& Beam --~"--"--- W Ext Sheath/St-ear _ Int Sheath/Shear - Framing Insulation Drywall Nailing Firewall --------. - -- — ____------- - - Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ASS PART FAIL - - - --------- -_.. 'PLUMBING Post&Beam - - Under Slab Top Out -- - --- - Water Service Sanitary Sewer - - Rain Drains _ Final PASS PART FAIL !.MECHANICAL Post&Beam Rough In Gas Line _- _ - - - _ ------ ----^. Smoke Dampers Ass ..-OART FAIL ELEICTRICAL Service Rough In .----- -------- UG/Slab Low Voltage Fire Alarm Final PASS PART 17AIL SITE _ Backfill/Grading Sanitary Sewer Storm Drain [ J Reinspection fee of$_i required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ J Please call for reinspection RE: ( J Unable io inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date / C� In,4@r!nrExt --- Final PASS PART FAIL DO NOT REMOVE this Inspection record from the Job sit*. CITY OF TIGARD BUI' DING INSPECTION DIVISION MST -^ �( -�'3.-z5 24-Hour Inspection Line: 63- .175 Business Line: 639-4, . 1 BtJP -- —__[late Requested 7 AM PM .� BL7 Lor ation / L,i!l 3 CJ /16 �- �- .L Suite ----- M E C ---- Contact Person C Ph _ (0 DC7 'l Z PLPA Contractor Ph SWR E3UILDING Ten�-nt/Owner _ _ EL.C' _ Retaining Wall ~ ELR Fooling Ac Foundation c sS: r� r:tg Drain . D - /l`>' - 601- l•✓ - //Iv r FPS Crawl Drain Inspection Notes: �+ j,,, SGN Slab Post&Beam _____ --------__-- SIT 'Ext Sheath/Shear Int Sheath/Shear Framing Insulation - - — Drywall Nailing Firewall Fire Sprinkler Fire Alarm - - - - Susp'd Ceiling Roof - -- - --- Misc:— -- —-- Final PASS PART FAIL --- PLUMBING Post&Beam ----- -�_ — ---_- - - - -- - ender Slab Top Out --- --' Water Service Sanitary -- - - .ewer Rair Drains PART FAIL MECHANICAL. - Post& Beam Plough In - Gas Line Smoke Dampers Final -- _ PASS PART FAIT_ ELECTRICAL Service Rough In — - - UG/Slab Low Voltage — Fire Alarm Final - - - PASS PART FAIL. --- --- -SITE Backfill/Grading - Sanitary Sewer — Storm Drain j ]Reinspectiun fee of _ -_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( )Please call for reinspection RE: _ ( j Unable to inspect-no access ADA // ,-, 4ae-e- Ext Approach/Sidewalk Other ZDate � Inspector e Final PASS PART FAIL nO NOT REMOVE this inspection record from the job site.