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13489 SW 128TH PLACE 4► = F. G f . f� IOU 2? lb 3o-7. 6 .15 W \ i 7� /� � /� - ...�.�.----�-. �- _. -•.�....._.._._�.,_.. �..... _ � Q X00 OOAILnib r. � ' �/ � Z '� s� �` � -.r -t�� 1 "�-� _•�-_ #-2s10N �- 643.0 I 11JT 4�! x -a l 251 ,p�` \ Z I C�INDLcArt 13y�1 sU) 12� CT — WALL h 1 � 2-3'"earl p G� VOL,, CONTE -3)E AOS& MA WMPN ti omce- cert- "]��i 3gDq ti Ir TOY- s�o 'SILT FL►�='t- (�V(clrfCI GONSfCvtT YV why. S Imo. .LI�a OT = 18,55? S.F, � q sIiAN Cuv ► � Zq�� 6•F 9'o DF ewEfb�(aE= I� NOTICE: IF THE PRINT OR TYPE ON ANY �( r1r � I � � I � � I � � I � � 1 � � 1 � � I � � 1 � � I � i �r rlT r1r ��T rTT111 �114r1r 111 111 r.1i 11 � 11i Ili hili rIli -� 1 , r� r r �1 ! 1r r1 � Ili i lt il � ilil � l � Ili ip ! i il ! i IIII i 'T 1 I I � I ' 1 I II I I /or IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 2 3 _ _ _ _ Fj _ . $ 10 1 ` //� 7 T IS DUE TO THE QUALITY F ---—__.------ —__ _.-- -------------� - ----- — ___— --- %T__�_.__._ ----- ----------- 1 , � 1 O THE No.36 ORIGINAL DOCUMENT — — ---- -- -- - - --- E 6Z 61 81 L 6 i!II1111IIII�IIiIII! IIIIIIIIIIIIIIIIIIIII{I 11111!. 1!11111! IIIIIIILIIII1111IIIIiIIIIIIIIIIIIIIIIIIIIIIIIII{ Illi�llllll!IIII IIII IIII IIII IIII IIII IIII.IIII loll 111 IIII Illl IIII IIII�IIII L11.1 _ llll.11llllll ll_� IIIIINIII i 13489 S "V 128"' Place CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP --._ Received --______ __Date RequestedAMPM BUP —_— Location _ �' � �- 1- -- -- -- - _.._ _-_ Suite- ----- MEC Contact Person _____ ____T Ph ( ) LJ_`��(> _ PLM - Contractor - -- --- ---- ------- Ph ) - --�----- --_------- SWR -_..--__--- BUILDING Tenant/Owner __.._... ELC Footing Foundation ELG Access: Ftg Drain ELR __-- Crawl Drain Slab Inspection 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 PI'SS PART FAIL — PLUMB - - -- --- ---- - Post& Beam Under Slab — Rough-In / Water Service --- -------� -- Sanitary Sewer Rain Drains ----- ---- -- - Catch Basin/Manhole — Storm Drain --- _ - -- ———---- Shower Pan Other: —— — F - - _ PART FAIL Post& Beam — -- -- 'Hough-In - Gas Line — Srnoke Dampers --- - -- ---- -- — ir ,L-VPART _FAIL - - ------ - _ _ TRICAL _ Service ------ --- — �.—T _. -- ---- Rough-In -- -- -- ---- -- -- UG/Slab Low Voltage --- ------____-- - -------_..____ Fire Alarm 114W PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call fo,reinspection RE:_ __._ r-� Unable to inspect -no access Fire Supply Line ADA Approach/Sidewalk DOU( /`/ Z Inspector / r� Ext Other: sinal DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF T I G A R D MASTER PERMIT PERMIT#: MST2002-00199 DEVELOPMENT SERVICES DATE ISSUED: 4/16/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13489 SW 128TH PL PARCEL: 2S104DA-02300 SUBDIVISION: QUAIL HOLLOW -WEST ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIG REMARKS: New SF, Path 1. BUILDING REISSUE: S'ORIES. 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1.620 of BASEMENT: st LEFT: 5 SMOKE DETECTORS: r TYPE.OF USE: SF FLOOR LOAD: 40 SECOND: 1.730 of GARAGE: 752 sf FRONT: 5b PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT. sl RIGHT: VALUE: 5 927,406,00 OCCUPANCYGRP: R3 BDRM. 4 BATH: 3 TOTAL: 1 15000 sf REAR PLUMBING SINKS. I WATER CLOSI TS: 3 WASHING MACH: I LAUNDRY PRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: a DISHWASHERS: I FLOOR DRAINS SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: _ GARVACE^-SP: I WATLR HEATERS I WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL _FUEL TYPES FURN<100K: BOIL/CMP c 3HP VENT FANS: CLOTHES DRYER: 1 ,qS FURN»TOOK: I UNIT HEATERS: HOODS: I OTHER UNITS. I MAX IJP. btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS- I ELECTRICAL , RESIDENTIAL UNIT SERVICE FEEDER__ –TEMP SRVCIFEEDERS `BRANCH CIRCUIIS _ MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp 0 - 200 a,,., WISVC OR FUR. I PUMPIIRRIGATION. PER INSPECTION: EA ADD'L 500SF-. 1 201 400 arnp: 201 400 Ann, tat WIO SVCIFDR: 01 SIGNIOUT LIN LT. PER HOUR. LIMITED ENERGY: 401 600 amp: 401 - 600 amu: EA ADDL eR CIP SIGNAI_IPANEL: IN PLANT. MANU HMISVCIFDR: 601 • 1000 amp: 601•ampa-1000v- MINOR LA13EL: 1000-amplvolt PLAN RL. SECTION Reconnect only: —4 RES UNITS: SVCIFDR>=225 A: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO. VACUUM SYSTEM AUDIO 6 STEREO. FIRE ALARM: INTERCOM/PAGING. OUTDOOR LNDSC LT: BURGLAR ALARM. OTH. BOILER HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE.OPENER. CLOCK: INSTRUMENTATION: MEDICAL OTHR: HVAC: DATA/TELE COMM: NURSE CAL 1 5 TOTAL N SYSTEMS'. Owner: Contractor: TOTAL FEES: $ 5,664.29 This permit is subject to the reLlUlations contained In the DEANNE MAHONEY MAHONEY HOMES Tigard Municipal Code,State of OR. Specialty Codes and 9725 SW 168TH PLACE 9725 SW 168TH PL. all other applicable laws. All work will be done In BEAVERTON,OR 97007 BEAVERTON,OR 97007 accordance with approved plans This permit will expire If work Is not started within 180 days of Issuance,or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Rea M: LIC 150610 forth in OAR 952-001-0010 through 952-001.0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Grading Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Post/Beatp-6tructurat PLM/Underfloor Framing Insp Gas Fireplace Ele trical Final Issue By : _n_ � /'l -�� Permittee Signature : / 1 Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day CITY OF T I GARD SEWER CONNECTION PERMIT PERMIT#: SWR2002-00139 DEVELOPMENT SERVICES DATE ISSUED: 4116/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 PARCEL: 2S104DA-02300 SITE ADDRESS; 13489 SW '128TH PL ZONING: R-4.5 SUBDIVISION: QUAIL HOLLOW -L T T009 JURISDICTION: TIG BLOCK: TENANT NAME: FIXTURE UNI"i S: 0 USA NO: DWELLING UNITS: 1 CLASS OF WORK: NEW NO. OF BUILDINGS: 1 TYPE OF USE: SF IMPERV SURFACE: INSTALL TYPE: LTPSWR Remarks: Sewer connection for new SF. _ -- Owner: FEES DEANNE MAHONEY FINSP By Date Amount Receipt —__ 9725 SW 168TH PLACE 1" CTR 4116/02 $2,300.00 27200200000 BEAVERTON, OR 97007 CTR 4116/0?_ $35.00 2'7200200000 Phone: 503-590-3909 Tota! $2,335.00 Contractor: Phone: Reg#: Required Inspections fied Agency it res This Applicant agrees to comply with all rules ulawilregulations of the l be forfeited f the permit t expies Sewage he Agencyhdoes not guarantee l0 days from the date issued. The total a paid the accuracy of the side sewer laterals. If the sewer iso located tatehetthe installer shall purchasurement ase a tn Tapa dlSide Sewee' Perm 3 feel in all directions from the d given. Permittee Signature: y1 Issued by: i r- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day l 5 Lt)4 o Building Permit Application City of �['i��rd Date received:r1� j " -_ Permit nAtr'�l.a fX'� 66;/ City ofTigard Address- 13125 SW Hail Bled,Tigard,OR 97223 ), Project/appl.no.: Ex re da : Phone: (503) 639-4171 Date issued: B n Receipt no.: Fax: (503) 598-1960 Case file no.: nttype: Land use approval: _ 1&2 family:simple Complex: IJ I &2 family dwelling or accessory U Commercial/industrial U Multi-family W New construction U Demolition U Addition/alteratiort/replacemep; U Tenant improvement U Dire sprinkler/alarm U Other: poll Job address: I- <'1 p 7 a`, Bldg.no.: Suite no.: Lot: _ Block: Suhdivision Tax map/tax lot/account no.: a 3 Project name 1C _ Description and location of work on premises/special conditions:_ Name: �_llfl 1 ]& Maiiing address: , l (le 1 & 2 family dwelling: City Stute: Zl_P. I'P)U Valuation of work 2 !i, Phone: `' '�()e'1 Fax: " P E-mail: �hVr (�.� No bedrooms/halhs................................. Owner's representative: I r o ("1 o(u�number of floors L Phone: '' Fax ti mail: New dwelling area(sq. ft.) 5�O .......................... APPIACANT Garagc/c.arport area(sq. 11t.)......................... _ 2:�,_ Name: J Covered porch area(sq. ft.) ......................... Mailing address: r, r Deck area(sq, ft.).....................{ to.)...... ,3 y Z_ City: Mate: ZIP_ Other structure area(sq. R.)... ..................... Phone: I - T1_ : „ ,;iil Commercial/Indest rial/multi-family: t Valuation of work............................. ....... $ Business name: Existing bldg.area(sq. f ........ Address: .... ... _ ` .. r r New bldg.arca(sq.tt.) ... �' i t � .............. - City: 1 1, ', _ State Number of stories ZIP:( . �. - ............. ................ Phone: r> I ax: ” !( E-mail: I 1 r�{rl i, , Type of construction....,.. .......... CCB no.: l.'.i�r I(� �?,�l�tia, .�c�pancy group(s): E ing: City/metro lic.no.: N Notice:All contractors and subcontractors tyre required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may he required to he licensed in the. Address: _ 1 jurisdiction where work is being performed. If the applicant is State: ZIP: exempt from licensing,the following reason af;,iic, Contact person. Plan no.: Phone: Fax: E-mail: — Numc: C ct person:t I"t Fees due upon application Address: , ?,. Date received: City Stat 7_IP: Amount received ... .............••.... $_ Phone: 1L. ' Fax: E-mail: _ Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all)udwichom accept credit cads,pleas call lurisdiciino for rmxe infcxmariix, attached checklist. All provisions of laws and ordinances governing this U Visa U Mastercard work will he complieWith whether s(ec'fI herein or not, Credit cad number _ —1_L— Authorized sign re: i(�a ne e; Noor ardhol ,etr, a atioo on crrrtii caExplres d — Print name: > $ Cahrder 11palum --- Amount Notice:This permit application expires if a permit is not obtain4 within 190 days after it has been accepted as complete. 4104613(600WOM) 02 -300 One-and Two-Family Dwelling Building Permit Application Checklist Referenceno.: Gtyof7'b"r`l City of Tigard Associated Address: 13125 SW Hall Blvd Tigard,OR 97223 ❑Electrical U Plumbing U Mechanical Phone: (503) 639-4171 U Other: Fax: (503) 598-1( o I Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Floud plain,solar balance points,seismic soils designation,historic distract.etc. - 3 Verification otapproved plaUlot. 4 Fire district— approval required. 5 Septic system permit or authorization I-or remodel. 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-wary protection,silt fence design and location of catch-hasin protection,etc. 10 3 .Complete sets of legible plans.Must he drawn to scale,showing conformance to applicably.local and state building codes, Lateral design details and connections must he incorporated into the plans or on a separ,.tc furl-size sheetattached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. I I Sfte/plot plan drawn to scale.The an must show lot and building setback dimensions;property corner cicvations(il' -- there is more than it 4-fi.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of stmctury(including del:ks);loation of welIvseptic systems,.ulilitylsts;uliS�ns,direction indicator;lot arca;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drninage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connccfion main size and lucariyu 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors, —" furnace, ventilation fans,_plumbing fixtures,balconies and decks 30 inches above grade,etc. water heater, 14 Cross section(s)and details.Show all framing-mernber sires and spacing such as floor heams,headers,joists,sub-floor, wall construction,roof construction.More than one cross section may he required to clearly portray construction.Show details of all wall and roof sheathing,roofing,rx,f slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two cicvations fur additions and rcmodc!s. _ I:xteriur cicvations must reflect the actual grade if the change in grade is greater than four foot as building envelope, Full-size sheet addendums showing foundation elevations with cross references are acceptable I racIfWall bing( rescrplive path)and/or lateral'analysis Must anchcate details and Icx ations;for non- rescriplive path analysis pmvidc s ecifications and calculations to engineering standards. a 17 Floor/roof framing.Provide plans for all flours/ro of assemblies,indicating member sizing,spacing,and hearing locations,Show attic ventiltion, 18 Basement and retaining walls. I'mvidc cross sections and details showing placement of rebar. For engineered systenms,see item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current code design values for all heams and multiple joists over Ill feet long and/or any hLam/dist carrying it non-uniform load. 20_Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or pmvidc calculations. A gas-piping schematic is required for four or more aapphances. 22 Engineer's calculations.When required or provided,(i.e., shear wall,roof truss)shall he stamped by an architect licensed in Oregon and shall he shown to fit,apph, illy to thy project under review. engineer or 23 Fivc 5)site plans tyre required for Item I I above. Site I,I:uus must be 8 I/2"x I I (n I I" 24 Two(2)acts each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he nut accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer - 28 Site plan to include tree sire,type`atlon per approved project street tree plan if applicable),and COT Street Tree List. Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink. S I Ur f'vl Red ink is reserved for department use only. �P.UX I NDYI A r►Illi) W4614(anrua onri "Air Plumbing Permit Application Date received: Permit no.: City of TigTigard`� b Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97221 — CiryofTigard phone: (503) 639-4171 Project/appl.no.: Expiredate: Fax: (503) 598-1960 Date issued: Ry; Receipt no.: Land use approval: _ Case file no.: Payment type: W I &2 family dwelling or accessory U Conuncrci it/industrial (>Multi-family U Tenant improvement U New construction U Addition/alteration/replacement ❑Food service U Other: JOKSITE INFOKMATION FLE SCHEDULE(for special information use chechlio) Job address: � f t_i t Descri tion (N . Fee(ea.) Total Bldg.no.: Suite no.: New 1-and 2-family dwellings only: /tax lot/account no.: ^ !1)/- (includes 100 ft.foreach utility connection) Tax ma p SM(1)bath Lot: j Block: Subdivision: SFR(2)bath Project name: SFR(3)bath City/county:-, ZIP: as — Each additional bath/kitchen -- — -- Description and 1 aeon of w rk on p emises; _ Siteutilities: e ;')/ r Catch basin/area drain _ Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no. lin. ft.) Manufactured home utilities Business name:I /I)9_�j rIA Manholes _ Address: -b 0, Rain drain connector _ City: = State: ZIP:,�j Sanitary sewer(no.lin.ft.) Phone:, _ e Fax: I E-mail: Storni sewer(no.lin,ft.) CCB no.: Plumh.bus, reg.no: 3apri Water service(no. f ft.) City/metro lic.no.: <<. t Fixture or Item: -- -- Absotption valve. Contractor's representative signature: J__- Back flow reventer Print name: Date: Backwater valveCONTACT PE1111SON Basins/lavatory Name: Clothes washer _ - Dishwasher Address: Drinking fountain(s) _ City: Slalc ZIP: Ejectors/sump Phone: Fa'K I.-mail: Expansion tank Fixture/sewer cap _ Name(print): f (_, Floor drains/floor sinks/hub _ Mailing address: Garbage disposal Hose bibb City: _State: ZIP: lee maker Phone: Fax: Email: Interceptor/grease trap Owner instal lation/residential maintenance only: The actual installation Primer(s) will he made by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's si nature: _ Date: Sum _ Tubs/shower/shower pan Name: Urinal _ --- -- --- Water closet Address: _ _Water heater City: stateZIP_� Other: Phone: Fax: E-nail: Total Not all Jurisdictions"it credit cards,please call jurisdiction for tteee information. Notice:'This permit application Minimum fee..... ..........$ LJ visa O MasterCardexpires if a permit isnot obtained Plan review(at �. 7I) $ s` Credit card number: _ _ _�.__1__ within 180 days after it has been State surcharge(8%) ....$ r'.+oplleR None d cardholderu ul shown or credit ca accepted as complete. TOTAL ............ ..........$ _---('ardh(Adet signalumm �Antount 440-4616(MWWOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (Individual) QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 96.b0 for each utility�onnectlon Lavatory One 1 bath $249.20 - Tub or Tub/Shower Comb. 16.60 Two 2 bath - $350.00 Shower Only 16.60 Three(3)bath _ $399.00 _ Water Closet 16.60 SUBTOTAL Urinal 16.60 - 8%STATE SURCHARGE Dishwasher 16.60 -- -PI __LAN REVIEW 25'/.OF SUBTOTAL TOTAL Garbage Disposal 16.60 _ _ Laundry Tray - 16.60 Washing Machine 16.60 Floor DrainlFloorSink z" 16.60 PLEASE COMPLETE: g• 1(i.60 q•• 16.60 - Quant�it/b F Work Performed Water Heater-0conversion O like kind 16.60 Fixture Type: New Moved Replaced Removed/ Gas piping requires a separate mechanical _ Capped hermit. Sink -- MFG Home New Water Service 46.40 _ - 46.40 Lavalor� MFG Home New San/Storm Sewer Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 - Shower Only _16.60 Water Closet Drinking Fountain - Urinal r Other Fixtures(Specify) 15.60 Dishwasher - Garbage Disposal - Laundry Room Tray _ Washing Machine _ -- Floor Drain/Sink. 2" _ Sewer-1 st 100' --- - 55.00 3" - Sewer•each additional 100' 46.40 _ 4- -- Water Service•1st 100' 55.00 Water Heater _ _ _ --- Other Fixtures Water Service-each additional 200' 46.40 _ ecify) StorRain Drain-1st 100' 55.00 ni 8 _ - Storm 8 Rain Drain-each additionaFt 00' 46.40 - --- Commerclal Back Flow Prevention Devlco 46.40 - Residential Backflow Prevention Device' 27.55 -- - Catch Basin 16,60 - -- Inspection of Existing Plumbing or Specially 62.50 Requested Inspections -- _ PerIhr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 - Grease Traps 16.60 - ---- '-- QUANTITY TOTAL - - Isometric or riser diagram Is required if Quantity Total Is >9 - •SUBTOTAIL 8%STATE SURCHARGE - •'PLAN REVIEW 25°/s OF SUBTOTAL Required only if fixture qty total Is>9 - -- TOTAL S *Minimum permit fee is$72 50•P"6 state surcharge,except Reskfenlivl Barkflow Prevention Device,which is$38.25�a state surcharge. "All New Commercia Buildings require 2 sets of plans with Isometric or riser dlrgram for plan review. i\dsts\forms\plm-'ees.doc 12/26/01 r Mechanical Permit Application Date received: Permit no.: City of Tigard Pro,ject/appl.no;: Expire date: Cin„t I tgard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date it:ued: By: Receipt ne.: Phone: (503) 639-1171 -- --- - Fax: (503) 598-1960 Case file no__ _ Payment type: Land use approval: __ Building permit no.: U I d'c 2 family dwrlling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U OTher:JOH.ShV INFORMATION COMMERCIAL _W VALUATION Job address: � i ,"� Inducatc equipment quantities in N)xcs below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax IoUaccount no.: ;j> profit. Value$ Lot; Block: Subdivision: 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county, ZIP: 3 t 10 W I W All If 10111 W!!! Description and ation of wok on pr raises: t JLZ&,I� 7� lee(ea.) Total E_ date of completion/inspet;tion: Dsscrl ion Qty. Kes.unly Krc.only feimnt improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?0 Yes U No Air conditioning(site plan require ) fs existing space insulated?U Yes U No Alteration of existing I1VAC system Bot er/compres,iors State boiler permit no.: Business name: _ HP runs BTU/H Address: it smo c amper •• smo c etectors Slate• ZIP ' '- -{ cat pump(sitep aan requ,rc ) _ City: / _ Insta rcp aceurnace urner /11 Fa IrA Phone: ' x:' -)` E-mail: Including duetwork/vent liner U Yes U No CCB no.: J(d 3�iq nsT taTlTreplace/relocate caters-suspende , City/metro lic.no.: wall,or floor mounted Vent forappliance other than furnace Name(please print): Refrigeration: Absorption units__,-, BTU/II Chillers Name: -- - Com ressors Address: _ ,n ronmenta exhaust and ventilation: City: --^ State: ZIP:_ Appliancevent Phone: 1-.ax: E-mail: )ryerex oust oo s, ypc res. nc en hazmat hood fire suppression system Name: 1 ' i 1 Exhaust fan with single duct(bath fans) Mailing address: x aust s stem apart from eaun or C State: 7,IP: ue p ping m distribution(up to out cts) City: Type: ---_LPG -_ NG Oil - Phone: Fax: E-mail: �ucl t in eac o iuona over outlets recess piping(sc ematicre(Imrec) Number of outlets Name: 1 er ap-plance or equipment: Address: _ DLcurativcfire lace City: Stat,: LIP: nsert type —�--� Phone: 0tiIOV pe ClBInVC _ Fax: 1111,111: 0 — (h d Applicant's signature).( / -; D; e:` ' ter: _— Name (print): r I I? 9 ! -- - - Permit fee.....................$ _------ Nur all Jurisdlcrlonx accept credit cardx,please can jurisdiction for rnme i tion. Notice:'Phisermit application P PP Minimum fee................$ .--- U yea U MasterCard expires if a permit is not obtained , credit card number — __._L1— Plan review(at �{) $ Expires within 180 days after -- it has been State surcharge(8%)....S ---- accepted as complete. arae n<carrlholdrr ax s n on c . It c TOTAL .................$ -----" cardholder dpsoure Amount 4444617(69"M) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: _TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5_,000.00_ Minimum-fee$72.50 Table--i-) Furnace Mechanical Code Qty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU including ducts&vents 14.00 $1.52 for each additional$100.00 or 2) Furnace 100,000 81'0+ fraction thereof,to and including 1 .40 $10,000.00. including ducts&vents $10,001 AO to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or _ incluoiny vent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater _ $25,000.00, or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or - fraction thereof,to and including 6) Repair units 12.15 $50,000.00. $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For items 7-11,see r Pump Cod d fraction thereof. _. footnotes below. Comp __ ____ - 1_- 7)<3HP;absorb unit Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14.00 -- - - 8)3-15 HP;absorb - 8%State Surcharge $ unit 100k to 500k BTU 25.60 _ - -- --- -- - 9)15.30 HP;absorb - - 25%Plan Review Fee(of subtotal) $ unit 5.1 mil BTU 35.00 Reyulred for ALL commercial permits onlyI 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20 11)>50HP;absorb 87.20 unit>1.75 mil BTU _ - 12)Air handling unit to 10,000 CFM ASSUMED VALUATIONS PER APPLIANCE: _ 10.00 "- Value Total 13)Air handling unit 10,000 CFM+ Descri tion: City Ea Amount 17 20 Furnace to 100.000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTU Including 1,170 15)Vent fan connected to a single duct ducts&vents _ _- 6 80 Floor furnace Includln vent_-_ 955 , � _._ 16)Ventilation system not Included in Suspended heater,wall healer or 955 alliance permit 1000 floor mounted heater _ - - 17)Hood served by mechanical exhaust Vent not Included in appliance _ 445 10.00 rmit 805 18)Domestic Incinerators 17 40 Re air units _ _._ <3 hp;absorb.unit, 955 19)Cnmmercial or Industrial type Incinerator lu 100k BTU - __ 6995 3-15 hp;absorb.unit, 1,700 2U)Other units,including wood stoves 101k to 500k BTU 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mll.BTU 5 40 30-50 hp;absorb,unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU 1,00 >50 hp;absorb,unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL. $ >1.75 Rill.BTU Air handy unit to 10,000 cfm 656 - -- 8%State Surcharge $ Air handlingunit>10,000 cfm 1,170 _ ___� Non- ortable eva orate cooler -F56 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not Included in 656 -__ -- appliance permit _ Other Instactlons and Fees: Hood served by mechanical exhaust 656 t Inspections outside of nonnal business hours(minimum charge-two hours) Domestic incinerator 1,170 $62 50 per hour Commercial or Industrial Incinerator 4,590 _Y 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 $62 50 per hour Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas piping 1-4 outlets _360 charge-one-half hour)$62.50 per hour Each additional outlet __ 83 `State Contractor Boiler Certification required for units>200k BTU. "Residential A/C requires site plan showing placement of unit. TOTAL COMMERCIAL VALUATION: All Now Commercial Buildings require 2 sets of plans. I\fists\forms\mech-fees doc 02/11/02 'Electrical Permit Application Date recei vcd: Permit no.: City of Tigard Projecl/appl.no.: Expire date: City u(Tigard Address: 13125 SW I lall 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 &;family dwelling or accessory U Commercial/industrial U Multi-I:anlily U Tenant improvement W Neuction U Addition/alteration/replacement U Other: U Partial Joh adr �'+ J ?` Bldg.no.: Suite no.: Tax map/tax lot/accounl no.:,�S Lot: Block: I Subdivision: ) Project name: Description and location of work on premises: ) ^rat r� Estimated date of completion/inspection: Job no: Fre Max Business name: W-scriplion Qt)'. (ea.) total no.ins Nen residential single orwoltl-familylxr Address: j dwellingunil.tncludesatlaclwilgarage. Cily: State: ZIP: r Service Included: Phone: r rn Fax: 11 E-mail: 1000 sq.li.or less —_- --— a CCB no.: I Elec. US.1ic,no: Each additional 500 sq.It (it ponumthereof _ Limited energy,residential 2 City/metrolic.no.: 60o _ Limited energy,non-residential 2 Fach manufactured home or niodulur dwelling Signature of supervising electrician(required) _ Dale Service and/or feeder 2 Sup.elect.name(print) License no: Services or feeders-Installation, alteration or relocation: 200 amps or less 2 Name(print): I J(�li�2_j�f ,1 r t 201 amps to 400 amps 2 Mailing address: ` 401 amps to 600 ams ? 601 amps to 1000 amps City: Stale: 'LIP: _ Over 1000 amps or volts — — 2 Phone: (. Fax: E-mail: Rv,ofinr,-lorlV' - � -- -� Owner installation:The installation is being made on F upelty 1 owl, Temporary services or feeders- which is not intended for sale,lease,rent,or exchar,,e according to +its+anaunn,alterauon,nrrelneauon: ORS 447,455,479,670,701. 200 umps or less 201 amps to 400 amps 2 Owners signature: Dale: 401 to 600 amps 2 Branch circuits-new.alteration, or extension per pastel: Name: A free fur branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: T Slate: ZIP: B. Fee for branch circuits without purchase -- ---' of servi.a or feeder fee,first branch circuit: 2 Phone: Pax: Email: — Each additional branch circuit. Mise.(Service or feeder nol Included): •Service over 225 amps-commercial U Health-care facility Foch pump or ungauon code 2 U Service over 320 amps-rating of 1&2 U Harardouslocation "ch signor oulline Itghtmg 2 family dwellings U Pudding over 10,IxN)square feet four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders,400 amps or more •Ilescrition U oLcupant load over 99 persons U Manufactured structures or kV park filch additional Inspection over the allowable In any of the above: U Fgress/lightingplan U Other- —_-- Perurspccuon f Submit___sets of plans with am'of the above. Investigation fee The above are not applicable to temporary construction serHce. Other Na all jurisdictions accept credo cards,please call jurisdiction for more Information. Notice:'111is permit application Penilit fee.....................$ U Visa U MasterCard expires il'a pennit is not obtained Plan review(at __ %) $ Credit cad number within 180 days alter it hes been State surcharge(896)....$ ApiflA accepted as complete. ---- — -- TOTAL .......................$ NoutK�tr cup t�olc�er a down on credit cod - i —-- - - l'rdhotder dj nature --- Amount 44114615(6tOWOM) SEE 35MM ROLL # 21 FOR rJVERSIZED DOCUMENT ELECTRICA CITY OF TIGARD RESTRICT LP NERIGY DEVELOPMENT SERVICES PERM T#: ELR2002-00073 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 5/1/02 SITE ADDRESS: 13489 SW 128TH PL PARCEL: 2S104DA-02300 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4.5 BLOCK: LOT: 009 JURISDICTION: TIG Proiect Description: Low voltage permit. All Encompassing, A. RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: AUDIO &STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL EMCOMP . X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL# OF SYSTEMS: Owner: Contractor: DEANNE MAHONEY OWNER 9725 SW 168TH PLACE BEAVERTON, OR 97007 Phone: 503-590-3909 Phone: Reg #: FEES _ Required Inspect; ns Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 5/1/02 $75.00 272C,;?0000 Elect'I Final 5PCT CTR 5/1/02 $6.00 272002J000 Total $81.00 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. ATi'ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 th ough OAR 952-001-0080. You may obtain copies of these rul or direct questions to OUNC at (503) 246-1987. Issued by � � � ll<�,C,t �� Permittee Signature 1`1Q I l v OWNER INSTALLATION ONLY The installation is being made on property I cwn which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY_ SIGNATURE OF SUPR. ELEC'N `t`yt rp�f DATE: LICENSENO: *�"� -- -----� Call 639-4175 by 7:00 P.M. for an inspection needed the next business day r6$1_- Zeoz - BU Electrical Permit Application �� D� Date received:ti i � Permit no.: Ci tTigard of agar Projecdappl.no.: Expire date: Citynj'/'igard Address: 13125 SW Hall Blvd.Tigard,OR 97223 Date issued: T By: — Receipt no.: Phone: (503) 639-4171 -- Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: T TVPE OF PERMIT U I &2 family dwelling or accessory U Commercial/industrial U Multi-family Ll Tenant improvement U New construction U Addition/alteration/replacement U Other: _ U Partial 1 ' SITE INFORMATION Joh address: Bldg.no.: Suite no.: Tax map/lax lot/account no.: Lot: Block: Subdivision: QJA12AI R Project name: Description and locution of work on premises: I1 Iryj7ll Estimated date of cons letion/ins •c(ion: ROME M111 K11140,111 Job dot Fee Max BUSIneSS nIIinC: Description Qly. (ea.) 7blal no.insp New residential-single or mohi-family per Addicss: 1 _i dwelling unit.Includesattacht gnrnTe. City: ` t Ip ,'hale: I ZIPVI= Service included: Phone: Fax Gnutil: IOr10sq.ft.orless __— _� _ _4 Each additional 5(x1 s .fl.or portion thereof CCB no.: face.bus.Ile.no: Limited energy,residential 2 _ City/metro lie.no.: Limited energy,non-residential _ _ 2 Each manufactured home or modular d welling Signature of supervising electrician(required) bate Service and/or feeder ?`— Sup.elect.name(print): I.icenseno: Services or feeders—installation, alteration or relocation: 200 amps or less 2_ Name(print): I ►�_r 201 amps to 41x1 amps 2 — 401 amps to 600 amps 2— Mailing address: 601 am s to 1000 amps 2 City: Stale: ZIP: Over 1000 amps or volts _-2 — Phone: Fax: E-mail: Reconnectonly I Owner installation:The installation is being made on property I own Temporary services orfeeders- which is not intended for sale,lease,rent,or exchange according to InUllation,alteration,orrelocation: ORS 447,455.479,670,701. 100 amps or less -2 201 amps to 400 amps 2 _ Owner's signature. hale: 401 to 600 ams 2 Branch circuits-new,alteration, or extension per panel: :Name., A. Fee for branch circuits with purchase of ddres service or feeder fee,each branch circuit 2ity: Stale: ZIP: B. Fee for branch circuits without purchase of service or ferdrr fee,tint branch circuit:hone: I r, E-mail: ch --- linch additionnl branch circuit. _ Misc.(Service or feeder not Included): OService ov;:,2.5anii Guano tial Jlicalth-carefacihty Each pumporirrigation circle 2 U Service over 320 amps-rating of I R 2 L' laxatdous location Each sign or outline lighting 2 familydwell ings U Building over 10,(x10 square feet four or Signal circuits)or a limited energy panel, U System over 601)volts nominal more residential units in one structure . eraUun,or extension• --- 2 U Building over three stories U Feeders,4(x1 amps or more •I h sc n tion U OLcupam load over 99 persons U Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above: U Egres.Jlightingplan U Other --- Pcrins coon r—T—� -- Submit sets of plan%with any of the shove. Investigation fee _ 11te above are not applicable to temporary consiructlon service. Other Nis all jurisdictioaccept credit earls,please call jurisdiction far more inkanuruan Notice:This permit application Permit fee..................... _ -(,0 ns U visa U MasterCard expires if a permit is not obtained Plan review(al _ %) $ Credit card ounther _ _ within 180 days after it has been State surcharge(8%)....$ ..0 spires accepted as complete. TOTAI, $ N,the of c"older ass own on c It c S — — Cardholder Rignstun _ -- Amount 4404615(6KWOM; ELECTRICAL PERMIT FEES: LIMNED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY' p Restricted Energy Fee...................................................... $75.00 Number of Inspections Ear permit allowad (FOR ALL SYSTEMS) Service included: Items Cost Total I Check Type of Work Involved: Residential-per unit 1000 sq.ft or less _ $14515 _ 4 Audio and Stereo Systems" Each additional 500 sq 0 or portion thereof $33.40 1 ❑ Burglar Aiarm Limited Energy $75.00 Each Manul'd Home or Modular dwelling Service or Feeder __ $9090 2 E] Garage Door Opener' Services or Feeders F-] Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 201 amps to 400 amps $1n6,85 2 ❑ Vacuum Systems' 401 amps to 600 amps _ $160.60 2 C ) 601 amps to 1000 amps $240.60 _ 2 Over 1000 amps or volts $454.65 2 Reconnect only 566.85_ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less _ $6685 _ _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 _ 2 401 amps to 600 amps $133 7,,1 T 2 Check 1 ype of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits O New,alteration or exlensiun per panel f3oiier Controls a)1 he fee for branch circuits with purchase of service or Clock Systems feeder fee. Each branch circuit _ $6.65 2 Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder lee. First branch circuit _ $46.85_ Fach additional branch circuit $6.65 HVAC M scellaneous Instrumentation (service or feeder not Included) '.:ach pump or irrigation circle _ $5340 1 Each sign or outline lighting $5340 �--J Intercom and Paging Systems Signal cirruit(s)or a limited energy panel,alteration or extension $7500 Lardscape Irrigation Control' 'Ainor Labels(10) $125.00 Each additional Inspection over ❑ Medical the allowable In any of the above ❑ Per inspection $6250 Nurse Calls Per hour —v $6250 --— In Plant $73 15 _ El Outdoor Landscape Ligh,ing' Fees: Prolective Signaling Enter total of ab*)ve fees $ _ F-1 Other___ 8%State Surcharge $ _ Number of Systems 25%Plan Review Fee See"Pieti Review" 1 rv1 $ No licenses are required Licenses are required for all other'istallations front of application — — --_- Fees: Total Balance Due $ --""-- Enter total of above fees $ Trust Account# 8%State Surcharge Total Balance Due $_ O All New Commercial Buildings require 2 sets of plans. i Ws15UbrnuklC-feesAoc 08/30/01 to io i �jIS ► � � � pop.► y ► ► CD z � ► Q, �* ► Ln N ► U p t ► ► (D r' ► pool G` r ► pol- Poo rvvvvvvvvvviiivvvvvvvivvvvvvvvvwvivvviivvvvV,4 q c� r, C a ° N w a , ryCon flt r �. r� Po .r. 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