Loading...
12020 SW 118TH AVENUE r (D C 12020 SW 118'" Avenue —, PLUMBING PERMIT CITY OF TIGARD PERMIT#: 11/27/PLM2002-00460 DEVELOPMENT SERVICES DA7F ISSUED: 11/27/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL. 1S134CD-01800 SITE ADDRESS: 17.020 SW 118TH AVF7_ONING: SUBDIVISION: JURISDICTION: ---BLOCK: - CLASS OF WORK- ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: S� WA1t "1G MACH: BACKFLOW PREVNTRS: FLOOr DRAINS; TRAPS: OCCUPANCY GRP: CATCH BASINS: STORIES: WATER HEATERS: FIXTURES_ G LAUNDRY TRAYS: RAIN DRAINS: _ SINKS. URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWER-j,. SEWER, LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: kAIN DRAIN: ft Remarks: back flow preventer 1-EES Owner: - Description Date Amount COMSTOCK, DONALD R HELEN [PLUM13] Peimit fee 11/27/02 $36.25 12020 SW 118TH [PLIJMI3J Permit fee 11/27/02 $0.00 TIGARD, OR 97223 [TAX]8%State Tar 11/27/02 $2.90 [TAX] 8%State"rax 11127/02 $0.00 Phone 1: 503-590-1808 Total $39.15 Contractor: CEDAR LANDSCAPE 14145 SW GALBREATH DRIVE SHERWOOD, OR 97140 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 625-3700 Reg#: MF,r 00001581 LIC 75535 PLM 5843 LANDSCAPE. This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: E t r Permittee Signature: _ Call (503) 639-4175 by 7.00 P.M. for an inspection needed the next busin6ss`day ,.Sent byrCEDAR LANDSCAPE INC Nov-26-02 02s56om from 503 6258623*5035981960 Pagb . i Plumbing Permit Application r'•) POMOFerntereceived: pp,;Tk; City of Tigard Sewer permit no-: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97:1 (AryofTigarJ Picone: (503) 639-4171 '0 t) tuul Prujecdappl no.: Expircdete: Fax: (503) 598.1960 ,,;i TY OF i IUAHU Date issued: 9y: Receipt no.: Land use approval: 3UICDING DIVCase file no.: Payment type_ l 2 farnily dwslling or accessory U Commercial./industrial U Multi-family U Tc;nant improvement U New construction J Addition/alteration/replau.ment _.)Food servii r J Other. 1I 10N (flit SI)VVJjij h'ee(es. 'total - N". I-and 2,-family dwellhrgs only: Bldg.no.: Suite no.: Tax trw tax lot/account fit).: (itxludr+100 N.for each rrtlllty cnnrnnliop) _ SFT (1)hulk Lot: Block: Subdivision: SFR('i bath Project name: �'Ntis+g /vr. f�'[� - _ CF_R ( City/county; TMP' 4j-- 0_3 Each additional hath,/kitchen Description and I ation of work on premises: _ Shetatllltles: -- kotc t6f( - Catch buin/ama drain Est.date of co letlon/inspection: 7 7 q-0-A- D we ls/leach ine/trenc drain Footin tarn(no.lin, t.) Manufactured home utilities Business name: C E 0 okl- LA NO SC A P C T AIC, anholes Address: /y/yS*- S&A QlAre4 f// DeRin drain onnector �'- City! Sher we state:0k�IP: g7/HU Sanitary sewer(rro.lin. t) Rwnc; = I arz:(ot�'�gest 13 maul: Sturm sewer CCH no.: `SE?q3 e43 Plumb,bus.reg.no: Water aervice(no, City/metra lic.no.: 1,5W_-- Fixttrtre or trent C ori tof i"! muntative sillnature: A��o tion valve e (;acic flow reventer �.,.yl Dare.i(- 6,-= -Backwater valve �- p, / uine/lavato Name: -Gt` Kr4 --- —.- -_ (__Iodws wa - Addrass: / S s ' UA em>`r- t) "' Dib washer ri n fountain r - - City: 5/er__ d Statc:o" ZIP: 1 I yU Apansion Phone: b U� )7Cn F'ax: 25 tL &mail: tank rtture/mewor ca Name(print), Floor drains/floor sink u -- - -_ --- a&a e a is s7— MailiAl address; 14>.c 1 -City: State: ZIP: Ice mail - Phone: v Far<: -- I:mail; T nterccptor/grease trap _ ---- owner installaiion/residential ntaintenantx: only. Vic actual Installation rinter(a) will he.made by me or the maintenance find repair made by my regular Roof drain(ccmtmerciZ - empinyee on the pruperty I own Its per QRS Chapter 447. owner's ai natulc. Date. um -,�-- __ _ Tubslshowerhihower an Urin Nemo:a- - Addresses _ _ Water eater _ City: Stage: - _ - (get! Phone: E-mail: Total _ v s Na dldt uudknau.:00 uaul crds.pkw cdt lwididion for mm Intormwuo. Minimum fee.. ... 1 Notirx: Thla permit application �--� Ansa 13 Ma 'ard expires It a permit is not obtained Plan review(at %) $ 1 -1�X11=6U�� within IRo da s after it h,s been Smote surcharge(8%). . S __ Credi d rwmtw. ._ ___ � r yt S;-- /-me, me _ TOTAL ......................$ �I�nu i•�aii�-a'3'��- S Q/s ncceptert�►a rnmplete -- -��+� t�A.�-a - I - CrdhMet N INR a Aroma 16 t&owY UMr ELECTRICAL PERMIT- CITY OF TIGARD _ RESTRICTED ENERGY _ PERMIT#: ELR2002-00266 DEVELOPMENT SERVICES SSUED: 11/27/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE PAPARCEL: 1S 34CD-01800 SITE ADDRESS: '12020 SW 118TH AVE ZONING: R-4.5 SUBDIVISION: LERON HEIGHTS NO.3 JURISDICTION: TIG BLOCK: LOT: 046 Project Description: Back flow preventer T —_ A. RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUD;O & STEREO: INTERCOM & PAGING. P.URGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TEL.E COMM: NURSE CALLS: VACUUM SYSTE=M: FIRE ALr.RM: OUTDOOR LANDSC LITE: OTHER: BACK FLOW X HVAC: PROTECTIVE SIGNAL.: INSTRUMENTATION: OTHER: L , TOTAL # OF SYSTEMS_. Owner: Contractor: COMSTOCK, DONALD R HELEN 12020 SW 118TH i 41 4 TIGARD, OR 97223 r) -7( q C' Phone: 503-590-1808 Phone: 625-3700 625-3700 Reg#: FEES Required Inspections --, Description Date Amount Elect'I Final 1'IAXf S"i,titalc'Iax 11/27/02 $4.27 I{I,I'ItM I'l FI.R Permit 11/27/02 $5340 Tot31 $57.67 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699. Issued by ,: � _.__ Permittee Signature L. 1, OWNER INSTALLATION ONLY The instaliati%zi is bei,ig made on property I own which is not Intended for sale, lease, or rent. OWNFR'S SIGNATURE: _ DATE:_ CONTRACTOF INSTALLATION ONLY _ SIGNATURE OF SUPR. ELEC'N DATE: LICENSE N O: _ —. -- ---- ---_— Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day Sent bytCEDFlR LANDSCAPE INC Nov-26-02 02156pra from 503 625962315035981960 page 3 Electrical PerntitAkffiW t�ii "Ditercccived: Pwrmitnof City of Tigard NUJV 4 0 2002 Projecdappl,no,: Upiredate: (;ry.•t7[rani Addrtesa: 13125SWHall Blvd,Tiffo iQ,F9 777a AHL) Dateiaturd:— RY liecelptno.: Phone: (503) 639-4171 3DILDING DIVISION Case flleno.: Paymcnttype: Fax: (503) 598-1960 Land use approval: -- - -�_- U Multi-family imprnvement 21 &2 family dwelling or accessory Addititm/alte attionheplaeement U Other:J, -- U Partial U New construction Job address: G,�(j <; W Bldg.no.: Suite no.: Tax naap/tax lot/account no.: fit; g►ock: Subdivision: Project Dame: C�47 ck Y Gam- L)escripdott and location of work on premises: riilufror. I?stirnated date of eompletion/inspectinn: - MIX Job go. awl t i/�e -+�-"�•^^.'_r— BUBin086 name: S New tvekt*nttal-rittpk w aatlti fanffy err Address:/�i/r/,S G �FJretz'�r br drrenirt;uu;t.[ncludesrdtui+K1 ►aRc• State:p� ZIP: q I e Cl &r rMr itx 4tled 4 City: 5 L o I_'sq - phone d, Fax: S E-mail: n addition.[Sao ,fL or ion metc.•r CCB no.: Ar_W Aq -SW'y - Elec,bus,Pic,no: LimiteA cne ,reg dentia)__- - 1 Ci /metro lic.no.' LirtUied erter ,nen-residential 4 Bach menutoclumd tame or moduli dwdliM Service and/or feeder ` 91 afore e1 au isi alecVict4n(raqulred)— dao 5erv(ceaorfees4rr-Inaulbtloa, Sup.olact.name rint. - - Wenn no: dterarlt t orreloatlen: 200 snips or last 2 21111 smlra to 400 amps Z Name(print): _ 401 amps to 600 amts` Mailing address: 601 amps to IT � -- Cit,,: - $talc ZIP Ovor 1000 amps of rola __ l -- l�-IYlail: P.acmmect otdv _ . Phone: Pax' frnpurwrl trnkn nr Gedon- Owner installation:The installation is being made on property I own tn9lauaUun,.ltrratiat,mrclncedrru: 2 which is not intended for salt-,lease.,rem or exchange according to �tW}amps,x kss _ URS 447,455,479,670,7n 1 zn i ani rtt 4tlo amps - Owtlees si nature: _ 111te: 401 to 600 ami naaY clrrtllts•new,alter.tlea, or eatirmlon per paste[' Name: ___, ------ A.Fee for branch cimuiu with putchue of ferviee or feeder fee,each branch Utcuit Address: p, Fee for branch State: ZIP: 1 �-- of service or feeder fee.Ntst branch circuit'- Phone- _ Phone: l flz: F{-m:ut. Each widitionii branch circuit. Mbc.(Senlce of feederaot Inchltled): Gach unlp or Ittl 4tlon circle l•_ _ Q$erviroovcrll. nrupa•Lonvnrrctal Jllealth-cmcln,:itt� _- 6ecJ,si ar autllne IighHn ` Q Service over 720 amps-rating of 1 dt2 U"Amtjouslocaurm Skitnal circuit s)or a "I ad energy panel, -T family dwellings Ll Building ever 10,000 square feet four nr alteration,or ealension" morn residential units in ons structure U 9yatemaverti00vcdlsnrtndnal . 0 6nllding aver thee[aktrfea 0 paring,400 arppa or ntme •peseri don, -- ©pu:upant loaf over 99 penatu Q Manufactured stmeaues or AV par) [ t J en ovr r the Blow.we awe of the aborrt: E)Utessilightingplan 0 WirtPerinapactloa S ubmit__4019 of plaaa a with nv of tho above. � nvesd .lion lee ether 'Ihe above Am not Ipplicatble 1t-tmlpor•ar y coaatrtawfltNa a0t11ce, _. �._—_._.-_,.---- ------ l'rtmlt fee...... .............. �----- Nd all)tutxlkri ->n rpt cretgi cardr,pkaM t all}utisdtetlon roe orae Infamaaon Notice:Ibis permit Wlicstiull Men review(at __,_ %) S U hfaskrCatd expires if a permit is not obtained 975 4_S'd zog -- 0 within 190 days aRu it has born State surcharge(Nt+E) .•S C" c rwmta rel accepted as corllpleta. TOTAL ......,..... $ — .7_--- �� n Oso-46[7(6aWcMs) r sl,mnrc mounl _ r MASTER PERMIT CITY O F T I G A R D � PERM11 #: MST2002-00259 DEVELOPMENT SERVICES DATE ISSUED: 6/6102 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 1 S134CD-01800 G!TE ADDRESS: 12020 SW 1 1 uThi AVF ZONING: 12-4.5 SUBDIVISION: JUFIISD!CTION: TIG BLOCK: LOT: �4G REMARKS: Add 1440 sf attached garage. BUILDING REISSUE: STORIES; 1 FLOOR AREAS REOUIREO SETBACKS REQUIRED CLASS OF WORK: AnD HEIGHT: IS FIRST: of BASEMENT: sl LEFT: 5 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: so SECOND: of GARAGE: 1,440 of FRONT: PARKING SPACES RIGHT: TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: of VALUE: 9,609.60 OCCUPANCY GRP: R, BDRM: HATH: TOTAL: 0 of REAR: 25 PLUMBING -- - SINKS: WATER CLOSETS: I WASHING MACH: LAUNDRY TRAYS: RAIN GRAIN: TkAP3. LAVATORIES: t DISHWASHERS. FLOOR DRAINS: WATER LINES: SF RAIN W PREDRAINS: SEWER LINES: TR: I CATCH BASINS: TUBISHOWERS: GARBAGE DISP: WATER HEATERS: OTHER FIXTURES: MECHANICAL —� FURN<100K: BOIUCMP<JHP: VENT FANS: 1 CLOTHES DRYER: _ FUEL'tYPES OTHER UNITS: FURN>-100K: UNIT HEATERS: HOODS: MAX INP: btu FLOOR FURNANCE9: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL ___RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVC!FrFDERS_ BRAIN ZH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS PER INSPECTION: 1000 SF OR LESS: 0 200 amp: 0 200 amo WISVC OR FDR: 1 PUMPIIRRIGATION: PER HOUR: EA ADD'L 5009F: 201 •400 amps 201 400 amp: tat WIO SVC/FDR: Sig IOUI LI NLT: IN PLAN?: LIMITED ENERGY. 401 600 amp: 401 - 600 amp: EA ADDL OR CIR MANU HMISVCIFDR: 601 1000 amp• 01014amos•1000v: MINOR LABEL 1000•ampIvolt: PLAN REVIEW SECTION Reconnect only: i4 RES UNITS: SVC/FDR +225 A.: r 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY e.COMMERCIAL A.SF RESIDENTIAL AUDIO 6 STEREO, VACUUM SYSTEM: A�1DIU a STEREO: FIRE ALARM: IN7ERCOMIPAOING: OUTDOOR LND9C LT: 07H: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: BURGLAR ALARM: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: GARAGE OPENER: DA7M eLE COMM: NURSE CALLS: TOTAL N SYSTEMS: HVAC: TOTAL FEES: $ 857.79 Owner: Contractor: This permit Is subject to the regulations contained in the COMSTOCK,DONALD R HELEN OWNER Tigard Municipal Code,State of OR. Specialty Codes and 12020 SW 118tH SIGNED RESPONSIBILITY all other applicable laws. All work will be done In T'IGARD,OR 97223 FORM IN FILE accordance with approved plans. This permit will,Apire If work is nLd started within 180 days of issuance,of if the work is s spended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: Oregon Utility Notification Center. Those rules are set Phone: 503-590.1808 forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to Rag 0. OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Plmlundslab Insp Shear Wall Insp Plumb Final Sewer Inspection Mechanical Insp Exterior Sheathing Ins; Final inspection Fooling Insp Plumb Top Out Insulation Insp Foundation Insp Electrical Rough In Rain drain Insp C Underfloor Insulation Framing Insp Mechanical Final , Issued By \� l �4 Permittee Signature Call (503) 1,_3-4175 by 7:00 p.m. for an inspect o-1 needed the next business day Building Permit Application 7, ed: '� d'J r7� Permit no.: - (� CityCi of Tigard C�. g pl.no.: Expire date: CilyujTigard Address: 13125 SW Ha Blvd.Tigard,OR 972— Phone: (503) 639-4171 Date issued: 13y: keceipt no.: Fax: (503) 595-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: (1 U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Addition/alteration/replacement '.J Tenant improvement U Fisc sprinkler/aiarm U Other: _. it I ' I \ Joh address: /Z,L) ; Bldg.no.: Suite no.: Lot: _ Block: Suhdivision: — Tax map/tax lot/account no.: cj L/ OZZ C Project name: - _ - ) -- Description and location of work on premises/special conditions: ( r Name: I c �•- Mailing address: 1 ar 2 fandlr dssc•IIing! City: ( State ZIP: _ Valuation of work.. ...... ... ................ . Phone: Fax: ! E-mail No.of hcdrooms/hatlr ...........................'.. Owner's representative: Total number of fl xtt Phone; ax: Email: New dwelling area(sq. ft.) .... .................... _-- „t• Garage/carlxm area(sq.ft.).....� y ....... —. Name: Covered porch arca(sq.ft.) . e -- Deck area(sq.I't.) ................-...................... _. Mailing address: C City: —-^ State: ZIP: Other structure arca(sq.ft.)............... ......... Phone: f'tlx C•maiI: ('otmmercial/industrialimulti-family: Valuation of work........................................ $- Existing,bldg.area(sq,ft.) ................ .. •.... Business nano• New bldg.area(sq. ft.) ................. .......... Address: Number of stories City: State: ZIP: Type of construction �. E�EE� Phone: Fax: E-mail: Occupancy proup(s): Existing: — -- CCB no.: New: City/metro lie.no.: Notice:All contractors and subcontractors tire required to be licensed with the Oregon Construction Contractors Board und— Name: provisions of oRS 701 and may be required to be licensed in thr tt -- ,jurisdiction where work is being performed.If the applicant is Address: — exempt from licensing,the following reason applies: City:Contact person: flan no.:Phone: Fax: Email Name: lContact person: Fees due upon application ........................... $ Address: _ _ Date received: City: State: ZIP. Amount icceivtd ......................................... Phone: I nx: — E-mail: 11Icuse refer .0 Ice schedule. _ I hereby certify I have Lead d rxat ned thus ypplication and the Nai an Jul,arirtlnna accep credit cmd+,please cal:Jurisdiction far moa infnrmntlon. attached checklist.All prov' s I ws frdinances governing this U Visa U MasterCard Credit card uumrw _ .. --- --�— work will he complied w el a _if, herein or n9l. rapires Authorized signature:.- Date:y d Name of ardholder u shown nn credit cant s Amouni Print name:.-- _ _ '-- c' oldei Nptature Notice:This permit application expires if a it is not obtained within 190 days after it has been accepted as complete. 410 IG1�fufaorcoMi Commercial Plan Submittal Requirement Matrix City of Tigard TYPE OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessi' 3 parking) Plumbing - Site Utilities 2 Building �* Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level 1" technicians. I w-;ts\ton,is\COM-matrlx.doc 9/24101 Electrical Permit Application Date received: Permit no.:11 r-.t J City of Tigard Project/appl.no.: Expire date: CityufTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503)598-1960 Case the no.: Payment type: Land use approval: -- — 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Add ition/al wration/replace inent U Other: .__ U Partial 1 FORMATION. Joh address: SGS Bldg.no.: I Suile it() :Tax map/lax lot/account no):15 ID Lou Block: Subdivision: Project name: I Description and location of work on premises: et,�—G•�, � Estimated date of completion/inspection: U0NTRACrOR APPLICATION I et ax mmau Job no: ( U 1 -( ,h` _J Ileccril,liou Olt. (ca.') total no.n Business nante: New residential-%Ingle ormuhi randh lK•r Address: ?-Q I dwelling unit.Inc usky altaclrsvl garage. City: f! Slate: ZIP: Z;2S SerticeinclmNrf: Phone: ,a' S s 2 Fax: T tjOl Email: 1000 sq.it.or less 4 CCB iau:,bus. lie.no: Each additional 5(x1 sq,ft.or portion thereof no.: Limited energy,residential City/metro lie.no.: _ Untitedenergy,uon-residential 2 Each manufactured home or modular dwelling Signature of supervisint lectrician(required) Service and/or feeder 2 Sup.elect.name(print) i T ,, .no: Services or feeders-Installation, alteration or relocation: ' ' t OWNER' 20()amps or less 2 201 amps to 401 amps Name zT .r ` 401 amps to 60(1 amps _ - --- Mailing address: _ 601 amps to lax)amps 2 City; State: P: Over 11xx1 amps or volts _ 2 Phone: I-ax: E- ail: Recounect onlyI Owner installation:Tlk install it I 's Nein ade on property 1 own Temp ovary services orfeeders- which is not intended s of-exchange accordi g to Installation.alteration,orrelocation: 2a)amps of less ORS 447,455,47 ) -- '`- � 201 amps to 4(x1 amps 2 Owner's si mature: Date: 401 to 601 ams 2 Branch circuits-new,alteration, or exd'mion per panel: Name: _ A Fee for branch circuits with purchase of Addrr:a: service or feeder fee,each branch circuit 2 City: State: I l I I' H Fee for branch circuits without purchase - -- of service ur feeder fee,first branch circuit: 2 Phone: fax E-mail Each additional branch circuit: Misc.(Service or feeder not Included): um or U Service over 225U�mps commercial Ileuhh-carchi,thEach tr _. .trrigatior:circle 2 -- U Service over 320mnps-nuing(if 1&2 U Hazarduushwaflon tischsignoroutlineHohting — _2 famllydwellings UBuildingoverlu,txxlsquarefeetfouror Signalcitcuias)nralinrlledCllergypnllCl. USystem over6(N)volts ntiminal nitre residential units in nue structure alteration,or extension* U Building over three stories U Feeders,4a0 amps of more 'Description: U(kcupsnt load over 99 persmts U Manufactured strictures or Rv park Fach additional inspection over the allowable In any of the above: U EgressAightrlip plall U Other - -.-_-_-_-. Perimpecuon Submit__sets of plane with any of the above. Investigation fee The above are not applicable to temporary construction service, Other _ Not all jurisdictions accep credit cant,pleaw call Jurisrliction 6a mtac Infoonatien. Noticc:'171is permit application Permit fee..................... U Visa U MasterCmsl expires if a permit is not obtained Plan review(at _ %) $ r,wu cord number: __._ ___ —L_ within Igo days alter it has been Slate surcharge(8%) ....$ nccepted as complete, TOTAL .......................$ _ Now w cNl�lr1 r a1 shown on rR a C -- C r sl/,rialure Amoum "I 4611 W101CONI) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: ------- --�— - — TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections er email allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit $145.15 Audio and Stereo Systems" 1000 sq it.or less Each additional 500 sq ft or $33.40 1 n portion thereof _ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular 2 (� Garage Door Opener' Dwelling Service or Feeder $90.90 _ Heating,Ventilation and Air Conditioning System' Services or Feeders Installation,alteration,or relocation —$80.30 o, 3 0 2 200 amps or less _ .� Vacuum Systems' 201 amps to 400 amps _ _ $106.85_ 401 amps to 600 smps $160.60 2 $240.60 Other 601 amps to 1000 amps — 2 Over 1000 amps or volts $454.65 Reconnect only $66.85 2 - TYPE OF WORK INVOLVED -COMMERCIAL ONLY Temporary Services or Feeders Fee for each system...................................................... ... $75.00 Installation,alteration,or relocation $66.85 2 (SEE OAR 918-260.260) 200 amps or less 2 7.01 amps to 400 amps $100.30 401 amps to 600 amps $133.75_ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, 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 lar. Each branch circuit _j $6.6,i.L 1 t 4 ' � Data Telecommunication Installatian b)The fee for branch circuits ❑ wifhout purchase ofsorvlce 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) $53.40 Each pump or irrigation circle — Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit($)or a limited energy Landscape!.rlgation Control" panel,alteration or extension $75.OD Minor Labels(10) __ $125.00 _ D Medical Each additional Inspection over the allowable In any of the above $62.50 Nurse Calls Per inspection ---Per hour _ $6250 — Outdoor Landscape Lighting' In Plant $71.75 Fres: Protective Signaling Euler total ofabove fens $ Jl� '�' Other — S �' 1 Number of Systems 8`h Strb Surcharge —_--Number 25%Plan Review Foe No licenses are required Licenses are required for all other installations See"Plan Review"section on $ front of application. - Fees: Total Balance Due $ ,_— $ Euler total of above tees Trust Account# _ _ 8°:State Surcharge g' ----- Total Balance Due All New Commerclal Buildings require 2 sets of plans. 0dsts\farms\etc-fees.doc 09/30/01 Plumbing Permit Application -- Date received: Permitno.y�1�.17 !)tea City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of7'lgard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: i Receipt no.: Land use approval: Case file no.: Payment type: TYPE 0 U 1 & 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: JORSITE INFORMATIONiInformation ine check Ist) Job address: Description (py. hee(ea.) Total Z� 5� _ Bldg.no.: Suite no.: Nen 1-and 2-family dnellings only: Tax map/tax lot/account no.: (includes IOU It.foreach utility connection) —_ SFR(1)bath Lot: Block: I Subdivision: -- - - SFR(2)bath Project name: _ _ SFR(3)bath _ City/county:— ZIP: Each additional bath/kitchen _ Description yd location of work on prerms: Site utilities: r /4!f_, 7 Catch basin/arca drain Est.date of completion/inspection: Drywells/Icach line/trench drai-i Footing drain(no.lin. ft.) 1 Manufactured home utilities Business name: 41Manholes Address: E_O_L)� Rain drain connector City: _ State: ZIP; Sanitary sewer(no.lin.ft.) Phone: Fax: E-mail: Storm sewer(no.lin.ft.) CCB no.: Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro lic.no.: Fixture or item: Contractor's representative signature: Abso tion valve Print name: l!ii — Back flow preventer Backwater valve PERSON11asins/lavaurry _ Nome: Clothes washer _- -d SSDishwasher Address' -- Drinking fountain(s) City _- State- ZIP: __- jectorslsum�p - Phone: - IIx I ni;til Expansion tank Fixture/sewer cap Name(print): (�Pt/T., s i o_�.LC Moor drains/floor sinksthub Mailing address: / Garbage disposal ' Bose bibb _ City: ,,Al IS(ate:& ZIP. � 3 Ice maker — Phone: Y Fax: E-mail: Intcrce tor/grease trap _ owner iiistallation/residct)ii,,il.nuilit n e only: The actual installation Primer(s) will tx made by me or the.Ai . d repair made by my regular Roof drnin(commercial)employee on the propert ARS Chapter 447. Sink(s), aasin(s), ays(s) Owner's signature: _ Date:' ,�_ Sump - Tu s/shower/shower pan Name: XjUrin ----- - - - - - ---- -- Water closet Address: ater heater City_ - - -_ State: 71P: Other: Phone: rax: Email:_ Tota _ Nen dl Jurisdkdnns accede crani cards.pteaw cdl Jurisdiction fro more infmtmilmNotice•'Ibis permit application Minimum fee................$ ---_U Viso U MasterC'otd expires if a permit is not obtained Plan review(al ,— 96) credit cad number:_ State surcharge(8%)....$ — —------- within I RO days eller it has been sphrs-- —— accepted as complete. TOTAL .......................S Norm of cardho der as own a n credit cru s _ --� Cesar l I&orpaiure —Amnum 41046I6 1tAX 1I(0M! PLUMBING PERMIT FEES: PRICE TOTAL New 1 .•nd 2-famlly dwellings only: FIXTURES (individual) QTY ea AMOUNT (incluees ,lumbing fixtures inPRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection Tub or Tub/Shower Comb. 18.60 One 1 bath $249.20 wo T (2)bath - $350.00 Shower Only 16.60 Three 3 bath _ $399.00 Water Closet 16.60 SUBTOTAL _ Urinal 16.60 3%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" - 16.60 -- PLEASE COMPLETE: 4- 16.60 __- Water Hea'9r O conversion O I, hind 16.60 _ Quantit b Work Performed Gas piping requires a serarate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink_ MFG Home New San/Storm Sewer 46.40 Lavatory Tuh orT-lb/Shower Hose Bibs _ - 16.60 Combination Roof Drains 16.60 Shower Only �- Drinking Founta l 16.80 Water Closet Other Fixtures(Specify) 16.60 Urinal -- Dishwasher Garbage Disposal Laundry Room Tray Washing Machine _ Sewer-1st 100' 55.00 Floor Drain/Sink: 2"3„ -- Sewer-each addii,onal 100' 46.40 - 4^ Water Service-1 at 100' � 55.00 Water Heater _ Water Service-each additional 200' 46.40 Other Fixtures Storm 8 Rain Drain-1st 100' 55.00 (specify) --- -- Storm&Rain Crain-each additional 100' 46.40 _ Commercial Back Flow Prevention Device 4640 Residential Backflow Prevention Device' 27.55 -- - - - Catch Basin 16.60 -'--- - -- Inspection of Existing Plumbing or Specially 62.50 Re uq este_Inapectlons per/hr _ COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps � 18.60 � --_----�_. QUANTITY TOTAL r --- --- -- -- Isometric or riser diagrarn Is required If - --- ----- -__ Quantity _.-- - 'SUBTOTAL - 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only Lf fixture qty total Is>8 TOTAL s "Minimum permit fn Is$72 50+5%state surcharge,except Residantial Backttow Prevention Device,whlrh Is$38 25•8%stale surcharge ""Ail New Commercial Buildings require 2 sole of pians with Isometric or riser diagram for plan review. i:klstslforms\plm-fees.doc 12/26/01 Permit #: Address: 124-)2-0 - : . o Ln Date: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to -�gn the following statement before a building permit can be issued, This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under URS 701.010(7), need not subs • 'his statement. This statement will be filed with the permit. Fill inlanks and initiuf hexes I and 2, and either box 3 r 3B: tov,7�� n, reside in, or will re,,idc in the completed struct e, 2, 1 understand that I must register as a con tcti contractor if the structure is sold or offered for sale before or upon completion. "E 3A. My general contractor i. l 6 l Z 3 ( << Contractor regis. # I will instruct my general cont•acto hat all subcontractors who work on the structure must he registered with the Construction Contractors Board. OR 3B. I will he my own general contractor. % It' 1 hire suhc•ontractors, 1 will hire only subcontract( . registered with the Construction Contractors Board. If I change my mind and hire a general c tractor, I will contract with a contractor who is registered with the CCB and will inim«'diatel otify the office issuing this building permit oi'the name of the contractor, i 1 hereby c•ertily that the al we' is/)rrect and Ihai I have read and do understand the Information Notice to Property Owne a ►ut 'o • ion Responsibilities on the reverse side of th'. form. i 1 l'rmlt plica );ttr t llite copy to iss►eing agency permitfile, pink cop�v to applicant) CITY OF TIGf-rib 24-Hour BUILDING Inspection Line: (5U3) 639-41','5 MST _ INSPc.CTION DIVISION Business Line: (503) 6394171 BLIP Received __-- - - -Date Requested �__ �'- - AM PM---- _-_- BUP _ Location /2, LL/ 44? ..��---Suite MEC �� - Ph t--) 0Z 47 PLM Contact Person ( - Contractor Ph(--.) — SWR — �— Tenant/Owner ELC --- -- Footing ELC - ---- Foundation Access: ;_)d AJ o 7" o•=r iv A-G L-1/& 0_1 Q ELR Ftg Drain ►1(�/JUG l=rJ�+/}-'fr�"�1 . --- - - - Crawl Drain SIT Slab Inspection Notes: r1 Post&Bean; r" /l2 _ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -b'/ � i= -�.�c%�� y'..��.4 4:57. Insulation U Drywall Nailing Firewall Fire Sprinkler -- - Fire Alarm - Susp'd Ceiling -- --- - - - Roof Other:-----,--.-. --- -- Ffn� - --- PART FAIL PLUMBING ___.---- - -_... -- ------- - __- Post&Beam — _- Under Slab — -_---. - __- 1--- -- Rough-In -, Water Service -- Sanitary Sewer Rain Drains - --- ----------- -- -v- -. Catch Basin/Manhole _ StormDrain ------_..__- ---.. --- -------.-_._.�___ -�-- Shower Pan - Other: Final PASS PART -FAIL MECHANICAL -- Post& Beam - Rough-In ------ ... --- �.- �-- - ------- Gas Line --- Smoke Dampers - - -- ----- - Final - PASS PART FAIL - -- --------------- -----___�__.-- FA ELECTRICAL - -_ _-- -- Service Rough-In -------------— ---- - - -_. UG/Slab Low Voltage — Fire Alarm Final LJ Reinspection fee of$_- _ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART_ FAIL SITE Please call for reinspection RE: Unable to inspect-no access Fire Supply LineADA ^� Approach/sidewalk Date /` 177 3 Inspector ._ Other: - -- --._ Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TI+GARD 24-Hour Inspection Lire: (r�,i) 639-4175 MST BUILDING INSPECTION DIVISION Business Line: (503) 639-4171 BLIP e--� Received _ Date Requested _- AM- PM - BLIP Location ____ _____� �-' U �� "-" Suite -- MEC Contact Person __ h1r`. Ph(-- -- -_) 3 12 - 7D,Z PLMContractor ., _. __. .__------- - __._-- Ph(--.,,, ) SWR - --- -- -- - __-- BUILDING Tenant/Owner _- - __- ELC Footing ELC Foundation Access: Fig Drain ELR Crawl DrainlC. Slab Inspection Notes: ��, Post&Beam __ _--___ SIT Shear Anchors Ext Sheath/Shear Int Sheath/Shear � w^ Framing �• L�U`Z G Q- �� `T (/�U - Insulation ��..� S s uvv,t - 0 Drywall Nailing 1 -- Firewall �. a Z - UCJ Fire Sprinkler Fire Alarm �'` � G 104r.", Susp'd Ceiling Roof Other: PASS PART FAI PLUMBING - v Post&Beam a- � ��� lAS _ Under Slab — Rough-In Water Service Sanitary Sewer Rain Drains SO Basin/Manhole Storm 41 Drain ---- Shower Pan Other: - --1^^ I \-A=.✓� ---- Pinel PASS PART FAIL073 _ Rough In -- aS "7PART FAIL -- -- -- �- - --_- CTRICAL Service Rough-In - UG/Slab ^ Low Voltage _ Fire Alarm Final F1 Reinspection fee of$__ _required before next inspection. Pay at City Hell, 13125 SW Hail Blvd. PASS PART_ FAIL_ 31TE �� Please call for reinspection RE: Unablo to inspect-no access Fire Supply Line ADA Z ` Approach,'Sidewalk Date __.__ _ InspectorExt Other: Final ^__- - DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST a c' cz S INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received __ _ -- -/—�—Date Requested CCyy f - �� -___ AM - --_ PM _ - BLIP -- __ .- - -----. Locaiion —_ ( _ _� 7___ 2�-___ Suite "AEC Contact Person Ph PLM ---- --_-_ ---- Contractor --- ------.. -- ._. .. — Fh(-- ) -- -----_ SWR BUILDING Tenant/Owner —-__ _.____ ELC Footing ELC Foundation - - - - Acce.>s: Ftg Drain l� 7 ELR -- --- -- - -- Crawl Drain _ Slab IrspeCitai NoIeS: SIT _- Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- Insulation Drywall Nailing - - Firewall r-ire Sprinkler Fire:larm Susp'd Genu; Roof Other:_ Final PASS PART FAIL PLUMBING Post&Beam Under Slab -- Rough In Water Service Sanitary Sewer Rain Drains - Catch Basin/Manhole Storm Drain -- Shower Pan Other: - - _.— a PA_S _PART FAIL. -- -- -� - -- ANICAL _�—_— Post& Beam Rough-In --- -- - Gas line Smoke Dampers ---- Final PASS PART FAIL - ELECTRICAL Service -- --------...._ _ Rough-In UG/Slab Low Voltage Fire Alarm _ - — Final Reinspection fee of s required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS _ PART_ _FAIL 817E - �_ ❑ Please all fo reinspection RE: Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date D Inspector _ Ext Other. Final _ - DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF— dGARD 24-Hour BUILDINta Inspection Line: (503) (19-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP — Received Date Requested �Z AM_--_-- - F M -- --- BUP _ __ ------- -- 0 oZ L __ `" --Suite _ MEC -- - Location -— Contact Person - —___-_------- Ph(----) �.-L_�>�- PLM SWR Contractor -- --" _ ---- - --- ph _ ELC - " -- - BUILDING Tenant!Owner ELC - Footing _- Foundation Access: - ---- - EL --. Ftg Drain Crawl Drain --- SIT - - - - Slab Inspection Notes: Post&Beam - - Shear Anchors _ - Ext Sheath/Shear Int Sheath/Shear Framing y. Insulation Drywall Nailing -- --� � ���✓� e Firewall (•- Fire Sprinkler Fire Alarm -- Susp'd Ceiling Roof - - Other:__-- Final - - -y---- PASS PART FAIL P-LUMBING Post&Beam Under Slab Rough-In -- Water Service - - Sanitary Sewer - - - Rain Drains Catch Basin/Manhole _ -- Storm Drain — - Shower Pan -- Other:---- - -- �- Final - --__--_� - -- - --- PASS PART FAIL - MECHANICAL �"------ Post&Beam --- -- Rough-In Gas Line - Smoke Dampers Final - FAIL ery _ --- Low Voltage Fire m F' LJ Reinspection fee of$-____ -required before next inspection. Pay at City Ila 125 SW Hall Blvd, PART FAIL — Un e to spect-no access -- —�- � Please call for reinspection RE: --- Fire Supply Line �/ ADA ' Inspector -�- — Ext -- Approach/Sidewalk Data -- --- Other: _..-_._._ DO NOT REMOVE this Inspection record from the job site. Final PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Ii.spection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 _ BUP Received _ Date Requested( - AM -_,..__ PM _..... BLIP Location _-____ L U 1 U Il _ ___Suite MEC ''ll Contact Person _ "'�__— Ph(____) _ �'" `� PLM Contractor-- -- - - --- - Ph( -) — - SWR BUILDING ��� TenanUOwner ELC Footing----___.-�---- Foundatior: ELC Fig Drain Access:` / /� / ELR Crawl Drain -- - -- -- - Slab Inspecti ,Notes: SIT -- Post& Beam Shear Anchors - - - Ext Sheath/Shear Int Sheath/Shear Framing - -- Insulation Drywall Nailing - ------ -- Firewall Fire Sprinkler - - / - Fire Alarm Susp'd Ceiling Roof Other. Final _PASS PART FAIL PLUMBING _- Post& Beam ^! Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan QA PART_ FAIL ANICAL _ Post& Beam Ror ugh-In Gas Line Smoke Dampers Final PASS PART FAIL - ELECTRICAL Service .-._------- -- - ------ Rough-In -------- ----� UG/Slab Low Voltage Fire Alarm Final �J Reinspection fee of$_- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _PASS PART FAA SITE _ Please call for reinspection RE:_ _ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date __.� v Inspector Other: ,. r-in al DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL