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13433 SW 129TH AVENUE t sa , X9 �uL g 3 326 North -� 94.62 33235'-7 1/8" z77 322 209.47 SEWER330 CONNECTION GRADE PAD LEVEL MAIN FLOOR 3' high erosion control fence staked every 10' 00- 70 .6„ 5'_0"_ � l 1 5'-6 7/8" BUILDING COVERAGE AREA Main floor= 1426 sq. ft. CONCRETE I Garage = 840 sq. ft. DRIVEV Y i Total = 2266 sq. ft. Driveway = 1349 sq. ft. GARAGE Percentage ofcoverage with driveway 28.95 to �I LOT 26 �� QUAIL HOLLOW W loop TIGARD OREGON 151-411 / STORM l CHATEAU DEVELOPMENT INC. _p N WATE P.O. BOX 1406 334 MET ': 46.95 �, SHERWOOD OR. 97140 Storm drain to daylight at P/L line. 328 SITE PLAN 3 2 gTEL. 503-538-5116 Scale t 200 , �.R[h a r...w i........ r -. w... .. _yn'. N..., .....:T. -,.i',,;1.... .. a r+�i..l'.S...r.,.w�. 14ti^ '+Y4 N'h�„M`,.x111 Y�.) r:�.9w`� ._..: v..��'xr•r7” jr qi NOTICE. IF THE PRINT OR TYPE ON ANY Tr� I ► � � � � � � � � � � � � � � � � � 111 ► � � �� T l � � � �T -[ IT r( 1TFfT T�r1I`f 1 r � r�i rjr r� r i � � � ( i � � i 1 i r r r r r r1 _�. .r 1 _i.. r �. i r i ► � �. i 1 I I I I I '� l 1 I i ! i � n l 1Tr r iii ! 1 _ I I I I I i iii MAGE S NOT AS CLEAR AS THIS NOTICE, 1 � � � � 4 7 8 _ 10 11 12 IT IS DUE TO THE QUALITY OF THE Na.36ORIt;INAL DOCUMENT _ r E 6Z8Z L ?, 8Z Z fiZ EZ Z TZ OZ 6T 8T LI 8T 9T fiT el ZT TI t 6 8 L 8 4 i► 1 E , Z T !!!►�!►!Jill!1 !!!1Illi! ilii ilii ilii ilii ilii i�!i �u ill! �.i .iii!- i!c 1111111 �� !�l� �!!! !i�� ilii. iii iiia �� ii� �� .�� ►« l��l �l��u�� 5 I w w w cn N �O z D CD c CD 13433 SW 129'x' Avenue i CITY Ole TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP �- Received Date Requested_- :Z��e -AM_ - PM--_ BUP -_ - Location &:le`f Suite -_ MEC Contact Person Ph( ) _ pp PL I Contractor_ Ph( ) �..��_l�: 3 ��SWR -__- BUILDING _ Tenant/Owner _ ELC - Footing - ELC _— Foundation Access: Ftg Drain �) > /_ ELR Crawl Drain `�' Slab Inspection Notes: SIT _---- Post&Beam _C a-izi_ Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing -}��- Insulation ti 1� "1J w�f� 11 1yzy - o �J Drywall Nailing — firewall Fire Sprinkler - Fire Alarm --� �� (- - _- - Susp'd Ceiling Roof Other: -- Final - PASS PART _FAIL - - PLUMBING - Post&Beam Under Slab --- -- -- Rough-In Water SFrvice - ------ Sanitary --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 -- -- - - - -- ---- --_- __ _ - ------ --- Finel PASS PART FAIL - - --- --- - --- ------ ELECTRICAL Servic9 Rough-In _ -- ---------- Low Volta0) -__-- ----- -- --- ---- -- - 74ia'rin f AS PART FAIL D Reinspection fee of$_ -_required before next inspection. Pay at City Hall, 13125 SW Hall f'vd. SrM Please call for reinspection RE: _ _ __ - E] Unable to inspect-no access Fire Supply Line ADA � Approach/Sidewalk Date� P -- Other: _ Final DO NOT REMOVE this Inspection record from the fob site. PASS PART FAIL • CITY OF TIGAIRU our In H ction Line: (503) 639-4175 p0 BUILDING MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP .S 2 Received --_.___- _— Date Requested -- AM AM__ - PM __�--- BUP -------- Location Suite ---- MEC ----- --- Contact Person _._ �_ – _ Ph(—_—) 196 6---10 PLM Contractor_..---- ---- – Ph( -) - SWR – - --- ----- BUILDING TenanUOwner _ ELC - -_- - -- ----- --------- Footing ELC - Foundation Access: Ftg Drain ELR -_- - - -- Crawl Drain SIT Slab Inspection Notes: -- Post& Beam - —-- Shear Anchors Ext Sheath/Shear ill )L ------�_---- Int Sheath/Shear i Framing ------ Insulation ,. � A LL_ Drywall Nailing 4 _' / ,/ / Firewall ! � C?��v ' �PE l'� !�J e��SfL r�'�hi1✓"e — Fire Sprinkler Fire Alarm Susp'd Ceiling Root � 'AL >�D S!u/l./ r6t,122 — — Other- PASS ther _rAIL PASS PART PLUMBING — — — PoM& Beam �- — Under Slab Rough-In _ Water Service - ------- Sanitary Sewer Rain Drains - Catch Basin/Manhole _ Storm Drain - Shower Pan Other. - - - - Final - -- - ------ PASS PART FAIL ECHANICA R)st&Beam R wgh-In _ --- Ge s Line S liir rJampers - - - ----- - — - - ------ 4k SAS^' PART FAIL CT_RICA_L_ -- Service — Rough-In ---- - ------ UG/Slab - --_------ Low Voltage -- ---— - —- Fire Alarm Final [ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAR. SITE _ L_I Please call for reinspection RE._____ Unable to inspect-no access Fire Supply Line ADA S _ Inspector �• Ext Approach/Sidewalk Date____- 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 'DIST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Date Requested AM_ _ -_ PM _-- BLIP Location 13433 /_ L` ;cite_ — MEC Contact Person � 10" Ph(—) 4340407 d/ _ PLM Contractor_ — Ph( _ ) SWR BUILDING Tenant/Owner —_ ELC Footing Foundation Access: ELC 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 Sprink,er - - 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 Other ---- _ PARI FAIL -- ----- ---------------- _ MECHANICAL Post&Beam --- Rough-In Gas Line Smoke Dampers — --- Final PASS_ PART FAIL ------- — - - -- - — ---- --- ELECTRICAL _ Service — Rough-In --— ----_ — -- UG/Slab Low Voltage — _-- -_—_---— _ -- _-- — _--- Fire Alarm Final Reinspectlon fee of$___—_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _PASS PANT FAIL SITE _ - — Please call for reinspection R5: Unable to Inspect-no access Fire Supply Line ADA ' Approach/Sidewalk Data. - — Inspector Ext _ Other: _ Final —� DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL �kAAAA♦AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA Ar : o d ► • n '� d (� ► a � ► m o 040 CL p > �� ► . d C7 o �: o n ► 0 44 ► : �� Tei � � � ►► : c � ?? c o Con '6 N f� I� EL 9 01 a \ , ry 71 � n � p o 1 a' O 5 a O +V 5 � 0 c z CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP — - Received ..____ __—_ . Date Requested____... !G— AM -. _ PM _ __ BLIP — Location __._.._. �.1 —L a pp _ Suite p MEC Contact Persoi Ph( —) yam, o - PLM - Contractor Ph(- ) _-. - --- SWR ------ BUIL_DING Tenant/Owner — ELC --_--_ Footing ELC - --- Foundation Access: Ftg Drain ELR - ----- _-_- Crawl Drain ------ SIT - Slab Inspection Notes: ---- Post& Beam Shear Anchors Ext Sheath/Shear L - --- Int Sheath/Shear Framing - -- Insulation Drywall Nailing - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof othQ -_ -_ S) PART FAIL Post& Beam Under Slab -- ---- - --- ---- _.. ----- -- .- Rough-In Water Service ------ - - -- - - . ----- -- - ---- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain ------- --------- -- ---------- _-- ------- Shower Pan Other: — Final PASS PART FAIL. MECHANICAL - --— - -- --------- ------ ----- -- - Post& Beam Rough-In -- Gas Line Smoke Dampers - Final PASS PART FAIL -- -� -- -- —" — __-- Service Rough.-In _.v — ------ - -- - UG/Slab Low Voltage - .-- ------ Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE __ — F-1Pleasecall for reinspection RE: _ [� Unable to Inspect-no access Fire Supply LineADA / Approach/Sidewalk nate SO �'r�' Inspector ut — Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00208 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/20!03 SITE ADDRESS: 3433 SW 129TH AVE PARCEL: 2S104DA-04000 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4.5 BLOCK: LOT: 026 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow prevention device. Owner: — - FEES - _— Description Date Amount CHATEAU DEVELOPMENT ----- P.O. BOX 1406 1'[ UM131 I'ernni I cc 5/20/03 $30.25 SHERWOOD, OR 97140 5/20/03 $2.90 Total $39.15 Phone : 503-538-5116 Contractor: GROVER'S LANDSCAPE SERVICES 26485 S. MERIDIAN RD. AURORA, OR 97002 REQUIRED INSPECTIONS Phone : 5111-678-1799 RP/E9ckflow Preventer ^�- Final Inspection Reg#: LIC 11807 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 i, ��tork is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTR NTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: ( , l i_ ' i�Iv_ Permittee Signature: Z Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Bullaing r ixtures I FOR OFFICE I TSE ONLY Plumbing Pernxit Application_ ReceivedPb--Ling_ Dalc/B : 'S �l o -- Permit No.: 1L _.T_'-!—Y Planning Approval Sewer City of Tipad Date/13 : Permit No.: 13125 SW Hall Blvd. Plan Review other Da,WB : Permit No.: -- -_ -- Tigard,Oregon 97223 Post-Review land Use Phone: 503-6394171. Fax: 503-598-1960 Date/By: Case No.: _ Internet: www.ci.tigard.or.us Contact 1u 'c.�. s 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: / l Information. TYPE OF WORK FEE*SCHEDULE(for special information use t Demolition Drscri t1tion Qty* Fre(ea.) Total Cw Construction New I-&2-family dwellings _Addition/alteration/re lacement Other: _ includes 100 ft.for each Utllit�r connection — CATEGORY OF CONSTRUCTION SFR I bath 1 249.20 &2-Familydwelling H Commercial/Industrial SFR 2 bath 350.00 Accessol�Buildin Multi-Family SFR 3 bath 399.00 ❑Other: Each additional bath/kitche:i 45.00 _Master Builder -- Pa c 2 JOB SITE INFORMATION and LOCATION Firesprinkler . R. Site Utilities Job site address: �-G 16.60 Bld ./A t.#: Catch basic/arca drain Suite#: - - D ell/leach line/trench drain 16.60 Pro'ect Footin drain no.linear R. Pae 2 Cross strcet/Directions to job site: Manufactured home utilities 11 ,�v r/�7 Manholes I6..60 0 ate/-� �� Rain drain connector 16.60 Sanitary sewer no.linear fl. Pae 2 Storm sewer no. linear 11. Pae 2 Subdivision: Lot#: Page 2 _ Water service no.linear R. TaX ma Flxture or Item DESCVIPTIO OF WORK — Absorption valve _ 16.60 Backflow revcnter — Pae 2 +` Backwater valve I6.60 -- - — Clothes washer 16.60 Dishwasher 16.60 _N _ Drinking fountain 16.60 ROPER OWN R TENAN _ E'cctors/sum _ 16.60 Name: _r. _fit/ ��'d k _ Expansion tank _ 16.60 _ Fixtere/sewer ca 16.60 Address: _. -- Floor drain/floor sink/hub 16.60 City/State/Zip: _ _ - -- Garba a disposal 16.60 Phone: Fax: _ hose bib V 16.60 APPWCANT CONTACT PERSON Ice maker IG.GO Interce tor/ rcase trap 16.60 Name: Page 2 - -- Medical as-value- $ — Address: - Primer 16.60 Cit /State/Zi p: _ _ Roof drain commercial 16.60 Phone: Fax: Sink/basin/lavator 16.60 — "— Tub/shower/shower ;m _ IG•60 E-mail: Urinal 16.60 CUNTRACTOR Water closet 16.60 Business Natiie: io.�' ' �w A' Water heater _ 16.6.0 Address: Other: _ — City/Stat^/Zi v fL'OY�'✓f ''�• L77Q0 Other: e (7 Fax: Plumbing Permit Fees* Phon _ d. Subtotal S CCB Lic. #: _ Plum,,. UC.#__ Minimum Pet.mt Fee$72.50 S i' nL/ Authorixcd _ Residential Backflow Minimum Fee S36.25 Signature: ___ Dater�Cr�Z` Plan Review 25%of Permit Fee S State Surcharge 80io of Permit Fee S - (Please print name) _ _ TOTAL PERMIT FEE I S Notice: Phis permit application expires If a permit Is not obtaii.ed within All new cnntmerc{al bullding+require 2 arts of plots with Isometric or 180 days after II has been accepted as compieir. riser dlagram foi It- •I re tnrthodoiop %ci h.N I ri-('ounh Building Industry Service Board. i:\DstsU'etmit I;ornis\PlmPcrmitApp.doc 011W Plumbinja Permit Application - Cite of Tigard - Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- I" I MY 55 00 0 to 7,000 $115.00 Footing drain-each additional 100' 46AV 2,001 to 3,600 $160.00 — 601 to 7 200 $220.00 Sewer-lst 100' 553,00 7,201 and eater $309MSewer-each additional 100' 46,10 Water Service- Ist 100' 55.00 Medical Gas S sterns' Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain brain-Ist 100' 55 00 $1 011 to$5,0(10.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$1 ,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof',to and Fixture or Item Qty. Fe.(ea) Total including S10 000.00. Commercial Back Flow Prevention Dc%icc 46.40 510,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device ,vch additional$100.00 or fraction thereof,to mininnrm permit fee$36.25 27.55 and including$25000.00. Rain Drain,single family dwelling 6.5 75 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 51.45 for each additional$100.00 or fraction thereof,to Inspection of existing plumbing or and including$50,000.00. specially rc uested inspections-pei horn 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100,00 or fraction thereof. Fixture work: Are you capping,moving or replacing existing; fixtures? If "Yes",please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer I'ees*. uantlt y b Fixture Work Performed Comments regarding fixture work: Fixture Type: Replace _ New Moved Mating Capped — — — Ba tistryTonl Bath -Tub/Shower — �— -Jecuzzi/Whirl of -- ---- ---- C'ar Wash -Each Stall -Drive Thru — — -- --- v-- Cuspidor/Water Aspirator — _— -- -- — ----- Dishwasher -Commercial -borneslicDrinking Fountain _ — —— -------- — ---Eye Wash PlcxrrDr:m/sink .2" __.__ — ---- --- —.--- - 4., — Car Wash Drain *Note: If the fixture work under tiffs permit results in an Garbage -Domestic Disposal -Commercial increase of sever EDUs,a sewer permit will be issued and -Industrial fees assessed for the sewer Increase must be paid before fhc Ice Mach./Refri .Drains _ plumbing permit can he issued. Oil Separator (las Statio:j Rec.Vehicle Dump Station Shower -Clang -Stall Sink -(lar/lavatory -Bradley _ -Commercial -Service Swimming Pool Filter Washer-Clothes Water Extractor Water Closet-Toilet — Urinal Other Fixtures 1ADsts\Permit Forms\I1Iml1ermitAppPg2 doc 01/03 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (5031 C:39-4171 MST Received —_ .__ Date Requested �a( AM.__ _ PM _— BUP Location L _✓_� _ 1 �h Suite MEC Contact Person Ph( } —�9 a. PLM . J � Contractor Ph( ) SWR BUILDING Tenant/Owner Footing --- -- - ---- -- _ ELC - —_--- - --- Foundation Access: ELC Ftg Drain Crawl Drain ELR _ Slab Inspection Notes: SIT Post& Beam -- -- Shear Anchors _ Ext Sheath/Shear Int Sheath/Shear — Framing --- ------------ Insulation — Drywall Nailing --- _- _ Firewall / — Fire Sprinkler - --- _ Fire Alarm A — 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 Other _ -- S PART FAIL CHANIC�IL -Post& Beam. ._—-- - Rough-In Gas Line Smoke Dampse Final PASS PART FAIL ELECTRICAL Service _ Rough-In UG/Slab - -- — . Low Voltage Fire Alarm - -- --- --_ -- --- - --- Final Reinspection fee of$ _ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _- — [] Please call for reinspection RE:- n Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext_ Other: Final - DO NOT REMOVE this Inspection record from the job site. PASS PAtiT FAIL CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE NORTH STAR PLUMBING 1445 SE OREGON ST SHERWOOD, OR 97140 Plumbing Signature Form Permit #: MST2001-00483 Date Issued: 9118101 Parcel: 2 S 104DA•04000 Site Address: 13433 SW 129TH AVE Subdivision: QUAIL HOLLOW - WEST Block: L.ot: 026 Jurisdiction: TIG Zoning: R-4.5 Remarks: New SF detached. path 1 Your company teas been indicated as the plumbing contractor for the permit indicated above. !n order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Fnrm prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: CHATEAU DEVELOPMENT NORTH STAR PLUMBING P.O. BOX 1406 1445 SE OREGON �T SHERWOOD, OP. 97110 SHFRwonn, OR 97140 Phone #: 503-538-5116 Phone #: 625-2679 Reg fl I Ir. 00090697 PI M 34-255PB AN INK SIGNATURE IS REQUIR D ON THIS FORM Signrc of Authorized Plumber I If you have any questions, please call (503) 639-4171, ext. # 310 SEP 18 '00 10:23AM P.1 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE BEAR ELECTRIC P O BOX 389 DONALD, OR 97020 Electrical Signature Form Permit #: MST2001-00483 Date Issued: Oil 8/01- _.. . _ - ._.. - --.-_ , Parcel: 2S104DA-04000 Site Address: 13433 SW 129TH AVE Subdivision: QUAIL HOLLOW -WEST Block: Let: 026 Jurisdiction: TIG Zoning: R-4,5 Reri-iarks: New SF detached. path 1 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 electrici&.1 i3 required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN-. Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: CHATLAU DEVELOPMENT BEAR ELECTRIC P.O. BOX 1406 P O BOX 389 rxHC-RWOOD, OR-97140 UONALD,-JR 97020. - Phone #: 503-538.5116 Phone #: 503.678-1355 Reg #: 1-1G 20919 ELF 24.1070 SUP 3162.9 AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising ElecL-idan If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF T I G A R D MASTER PERMIT DEVELOPMENT SERVICES DATEEISSUED: 9/18/01 101 00483 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRI=SS: 13433 SW 129TH AVE PARCEL: 2S104DA-04000 SUBDIVISION: QUAIL HOLLOW -WEST ZONING: R-4.5 BLOCK: LOT: 026 JURISDICTION: TIG REMARKS: New SF detached. path 1 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS ?EC'IIRED CLASSOFWOPNEW HEIGHT ., FIRST: 1,426 of BASEMENT. el LEFT: SMOK ')ETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 4q SECOND: 2.044 of GARAGE: 861 of FRONT: PARKING SPAC`IS: 2 TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: of RIGHT 5 OCCUPANCY GRP: R3 BDRM: 3 BATH: 4 TOTAL: 3,470.00 of VALUE: $335476,VO REAR: 80 PLUMBING_ _ SINKS: 1 WATER CLOSETS. 4 WASHING MACH: 1 LAUNDRITRAYS: 1 RAIN DRAIN 100 TRAPS: LAVATORIES: 5 DISHWASHERS I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUI.SHOWERS 4 GARBAGE DISP: I WATER HEA.Eha I WATFA LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: MECHANICAL OTHER FIXTURES. FUEL TYPES FURN-100K: BOIL/CMP<3HP: VENT FANS: 6 CLOTHES DRYER: I ';AS FURN>•100K: I UNIT HEATERS: HOODS: 1 OTHER''TS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1 -_ ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEN P SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS GDD'L INSPECTIONS 1000 SF OR LESS, 1 0 200 amu. 0 200 amp: W/SVC OR FDR: 1 PUMP/IRRIG<.TION: PFR INSPECTION EA ADD'L 500SF: 201 400 amp: 201 400 amp: Ist WIO SVCIFDR: un SIGNIOUT LIN LT: PFR HOUR: 1'MITED ENERGY. 401 600 amc: 401 600 an,p' EA ADDL OR CIR: SIGNAL/PANEL: IN PLANT. MANU HNVSVC/FDR: 601 • 1000 amp: 6014anu)3•1000v: MINOR LABEL: 1000, amplvolt: Reconnect only: PLAN REVIEW SECTION _ >-4 RES UNITS- SVC/FDR>•225 A.: >600 V NOMINAL. C'_S ARENSPC OCC. --- ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B COMMERCIAL AUDIO B STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING. OUTDOOR I.NDSC LT. BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTEC FIVE SIGNL. GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL: OTHR. HVAC: DATAf7LLE COMM: NURSE CALLS: TOTAL 0 SYSTEMS. Owner: Contra Aor: TOTAL FEES: $ 5,874.05 CHATEAU DEVELOPMENT CHATEAU DEVELOPMENT INC This permit is subject to the regulations contained In the P.O.BOX 1406 PO BOX 1406 Tigard Municipal Code,State of OR. Specialty Cases and SHERWOOD.OR 9't 140 SHERWOOD,OR 97140 all other applicable laws. All work will be done in accordance with approved plans. This permit will expire If work Is not started with In 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 Rep N: LII: 147098 forth in OAR 952-001-0010 through 9.32-001-0080. You may obtain copies of these rules or direct questions to CLINIC by calling(503)246.1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanlca Mechanical Insp Sheur Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain Jraln Insp Plumb Final Footing Insp Crawl Draln/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection I Foundation Insp Footing/Foundatlon Electrical Rough In Gas Line Insp Appr/Sdwlk Insp PostlBeam Structural PLM/Underfloor Framing I.Tsp Gas Fireplace Electrical Final Issued By: _ Permittee Signature] Call(803)639-4175 by 7:00 p.m. for an inspection needed the next hug ss day'�/ SEWER PERF,rIT CITY OF TIGARD DEVELOPMENT SERVICES PERMIT#: SWR2001-00252 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/18/01 SITS ADDRESS; 13433 SW 129TH AVE PARCEL: 2S104DA-04000 SUBDIVISION: QUAIL HOLLOW- WEST ZONING: R-4.5 BLOCK: LOT: 026 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DVIELL114G !NITS: 1 TYPE OF USE: SF NO. OF BUILDINGf : 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new SF residence. Owner: FEES CHATEAU DEVELOPMENT" — -- P.O. BOX 1406 Type BY Date Amount Receipt SHERWOOD, Opt 97140 PRMT CTR 9%18/01 $2.300.00 27200100000 INSP CTR 91,18/01 $35.00 27200100000 Phone: 503-538-5116 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agencv does riot guarantee the accuracy of the side sewer laterals. If ;e sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer' Perm Issued by: L__ � �� Permittee Signature. �- Call (503)639-4175 by 7:00 P.M. for an inspection needed the next busirvf/s day �� 77j J Building Permit A►pplicftton Date received: Pcnnn no.: ' City of Tigard ��, Cit (;,"Tigard Address: 13125 SW Hall Blvd,TigardOR 9 3 ProjecUappl.no.: Expire date: y '-- Phone: (503) 639-4171 Date issued: BTJReceipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _.� 1&2 family:Simple Complex: 0 1 &2 family dwelling or accessory U Commercial/industrial J Multi-family &� ew construction: ❑Demolition U Addition/alteration/replacement U'(enant improvemrnr U Fire sprinkler/alarm U Other: _ INFORMATIONJOU SITE Job address: I 4 `5 td Z`2' N Ai1�1 Bldg.no.: Suite no.: Lot: 131ock:_ Subdivision: (JAL.1I&I ri J-1 Tax map/tax lo/account no.: 20�/ Project name: Description and location of work on premises/special conditions: Name: C f-�ATF��J �E1/�Lea r�/1iJF?!i / _ solar, Mailing address: 177-0530)e .9,E, 1 &2 family dwelling: rity:S &j2 Statc:p ZIP: Valuation of work........................................ $ Pnone:�.5�5/I I-ax; " '�,2A -mail: CZ u.of ixdrooms/baths............... Owner's representative: CZ,YS-1 Total number of floors................................. Z _ Phone: Fax f' mail New dwelling area(sq.ft.) .......................... — YY 7 G Garage/carport areit(sq. 11.) ........................ _ 641 — Covered porch areaft. 37 Name: _rte,+ Po (sq. ) ........................ Mailing address: ---- .- - Deck area(sq.ft.) ....................................... -_ -- --�-- - — Other structure.area(s ft )......... ............... -' City: State: ZIP: q• Phone: I•: maul ('ommercial/industrial/multi-family: Valuation of work........................................ $ 3usiness narne:GNi) LNv Existing bldg.area(sq. ft.) ................ Ao4ress:j--:;1 -- New bldg.area(sq.ft.)...................... ....... _� _ k� City;so State:p ZIP: Number of stories......................... ..... 11..... 7 14e� Type of construction.................................... Phone: // 6 Fax:may �, E-mailC,? 1Gj 1C Occupancy group(s): Existing: — — CCBno.: (q.7O fJ�.- New: •- City/neon tic,no. Notice:All contractors and subcontractors are required to be- licensed elicensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: — jurisdiLtion where work is being performed. If the applicant is City: exempt from licensing,the following reason applies: Contact person: J -- —- --- Plan no.: -- — - ------- --— - Phone: 1•� I mail - —- ------- - Name: + roan I Iti t „m Fees due upon application ........................... 9 -_._.--------, _Address: _ Date received: _ City: _ _ — Stttte: LIP: Amount received . ....................................... $ Phone: _ Fa X: E-mail: t'lease refer to fee schedule. hereby certify I have read and examined this application and the Na at jurisdictions accept creat cords,pleere;all jurisdiction nor mote Info mulan attached checklist.All pruvisions of laws and ordinances governing this U visa to MasterCard work will be complied with,whether specilled herein or not. credit card number ---- _ _ L_ _ Authori7cd signutL.'e: _—_ _-, Date: ---.__ Nene of cartlboWer d drown on c It ciad — S Prinl name. ---- cardholder rdpuue —- Amount- Nonce This permit apr'cation expires if a permit is not obtained within 190 days after it has been accepted as complete. —4444613(6It101MM) One-and Two-l' mils Dwelling Building Permit Application Checklist Referenceno.: Ciqu/"1'ignrrl City of Tigard Associatedpernuls: Address: 13125 SW f fall Blvd,Tigard,OR 97223 ❑Electrical U Plumbing U Mechanical Phone: (503) 639-4171 U Other: Fax: (503) 598-1960EXAM _ -- FI Land use actions completed. .) ,c imisdiction criteria forconcur,w'nt review,. 2. Toning.Fl(x)d plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved platllot. 4 Fire district approval required. 5 Septic system permit or authorization for rcincxlcl.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 protection,sill fence design and location of — catch-basin protection,etc. IO 3- Complete sets of leglble pliwt.Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details a+A connections must he incorporated into the plans or on a separate full-size sheet attached to the plans with cross references hetween plan location and details. Plan review cannot he co if copyright violations exist, mpleted I 1 Siteiplod plan drawn to scale.The plan must show lot and building setback dirncnsions;prol>Lrty comer elevations(it' -- thew:is more than a 4-11.elevation difl'crentiul,plan must show contour lines ul 2-fl.intervals);lex cttiun of easement and driveway;fcx)tprint of structure(including decks):Icx noon of wells/septic systems;utility lacaliuns;direction indicator;lot area;building coverage area;Ix rcentage ol'coverage;impervious area;existing structures on site;and suri'ace drainage. rrndalion plan.Show dimensions i2 ho ,anchor halts,any hold downs and reinforcing pads,connection de size and location. tails,vent 13 Moor plans.Shu+,all dimensions,rcx)m furnace,veidentilicaUon,window size,location of smoke detectors,water heater, ntilation funs, lurching fixtures,balconies ant decks 30 inches above grade,etc. _ 14 Cross seetion(s)and details.Show all Ir;uning member sires and wall conslnspacing such ns floor beams,hea rers,joists,suh-floor, rcliou,nu,f runswction. More Brun one cross cctiun may he required to clearly portray construction.Show details of all v;all and roof sheathing, ion.eg,rcx)f slope,ceiling height,siding material,footings and fi,undation,stairs, lire)lac+•construct;m, Thermal insulation,etc. _ 15 Elevation views. Provide elevations for new construction;minimum of two ele•ratfons for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four Foot al building envelope, Full-sine sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations:for non-prescri tive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all Ilcrors/ratf assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. 13 Basement and retaining*•ells. Provide cross sections and details showing plaLcment of celiac. For engineered systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current codz design values for all beams and multiple joists over 10 tact long and/or any heani/joist carrying it nun-uniform hmd. 20PAanufActured noor/roof truss design details. 21 Energy Code compliance. Identity the prescriptive path or provide caleulnti( A gas-piping schematic is required for four or more appliances. 22 Engineer's calculations.-When required or provided,t�r.,shear will,roof truss)shall he stamped by an engineer or arrhitrct licensed in Oregon and shall be shown to h[•applicable to the 1 1,; •et under review. lot 23 Five(5)site plans are required for Item I I ahoNr. tier plans n,u,i Ix x_I/�" x I I"or 24 Two(2)sets each are required ti,r Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. 26 No rolled, reversed or mirrored building plans will be accepted. 27 28 _ Checklist must be completed before plan review start date. Minor changes or notes on submitted plans niav he in blue or black Ink. Red ink is reserved for department use only. 440-4614(&UYCoM) 83 326 North wa 332 \\ . /8/ n 5 7 1 \\\ \ 322 SEWER \ 330 CONNECTION GRADE PAD LEVEL MA1N P1ADR 3'hllh armlon conal fence raked every 10' 70'-6" g 0 y r 5'-6 7 .RUILDINO CO COVP.RAOE AREA Mein!loot.1426 I9 ft CONCRE"'q deme 840 IQ fl 5.40.--� _ DRIVRw Y r Total .2266 eq ft. I Ddvewey "',IQ 1319p h. OARAOE Nrcentape ofc .pt with dnvewny 21.95% j LOT 26 t aV%3 sW. 1391 F QUAIL HOLLOW ` w rd, TIOARD OREGON STORM �/ CHATEAU DEVELOPMENT INC. SAI_ WA P.O,BOX 1406 SHERWOOD OR.97140 w.w.MeW.et sin PLAN 728 TEL.503.538.5116 e.w n.,ae• Mechanical Permit Application Tigard Date received: Permit no.: r}lc��r_e City of igard Project/appl.ao.: Expire date: City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 9777.1 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _— Building permit no.: UI�r 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement e v construction U Addition/alteration/rcplacement U Other: lob address: 'r" / Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: '--Z aC t profit. Value$ Lot: Block: Subdivision: `See checklist for important application information and Project name: _ jurisdiction's tee schedule for residential perry it fee. City/county: cL7�2.— t Description and location of work on premises: 7Anhandlingunit t 1 I I ee(ea.) Total Est.date of completion/inspection: __ Desert on tpy. Res.only Res.only Tenant improvement or change of use: — _ Is existing space heated or conditioned'?U Yes U No CFM Air conditioning(site plan require ) -- -- Is exislint,space insulalccT.p U Y s U No Alteration of existing HVAC system -- -- 1 1 {oi erTr /compressors — ---- Business name: r State boiler permit no.: Address: c4Z30 SE— 6` T"M Lv0'P -1'IfCSOU? c aHa Tons -- - - - _ ntper. act smo C ClectClnrsrS City_ gexWe_o tate:0&I ZIP: mat pump(site p an require ) - Phone: -Vr .4Euj•024Fax: E-mail: nsta I repinccfurnace/ urncr /1 -- CC 3 no.: (2-71-0 Including ductwork/vent liner U Yes U No -- tircp ac relocate caters-suspen c City/unclro lic.no.: -- floor mounted Name gplcase print): r a ,liance other than ILrnace - -- - st on: tionunits Name: _ s_`_Address: _ ssorsnnienla ex aust an vent et on:City: - Slate: ZIP cevPatI'lutnc: I . (:-mail: aunt iloods,Type /[I/res. itc en/hazrnat - hood fire suppression system Name: > E��n t�"1.1 Exhaust fan with single duct(bath fans) Mailing address:-T1! _L , xansTi I.system apart Irotit Itcaiin g or At' City Ln Stalc:� LIP:cy 7 O, uc piping endistribution tap to :put ets) -a LPG -v NG Oil Phone;A; 1 :plcl 0—ping 0—pingeach a itton t over outlet❑ - rocesspiping!schcmaiicrequired) _ Name: Number of owlets --- --- --- t cr sle�rpl al nee or equipment: Address' _ Decorative fireplace City: — — State: ZIP: nsT e -type --- Phone: Fax: Email o..,slov pe Ietstove other: — Applicant's signature: Date: ter: Name (print): — --- -- — Not all)uriadiclirxtt accept credit cmar Je,pleapall)urindicUm for Imxe Inrumualon permit fee.....................$ U visa U MasterCard Notice: This permit application Minimum fee................$ - Credit card numbet:_ expires if a permit is not obtained Plan review(at — %) $ -n- .xpirea within 180 days aver it has been State surcharge(8%)....$ _ ame of cu pohkr es rhow�n-on-cretin earl aCCCpICd a.4�,omplele. - __ $ TOTA1. .......................$ Cardholder dRnamre — Amnunt — —— MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: _ Price Total $1.00 to$5,000.00 _ Minimum fee$72.50 T Table Mechanical Code__ _ Qty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to & 0 BTU $1.52 for each additional$100.00 or including d duccts vents 14 00 fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000.00. including ducts&vents 17_40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater $_25,000.00. or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units $50,000.00. 1215 $50,001.00 and up $742.00 for the first$50,000.00 ano Check,all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. footnotes below. Comp" 7)<3HP;a sorb unit AS£JW-ED-VALUATIONS PER APPLIANCE_ : to 100K B1 1400 8)3-15 HP,absorb Value Total ur„!100k to 500k BTU 1 25.60 _ Description: _ Ot Ea Amount g)15-30 HP;absorb Furnace to 100,000 BTU,including 955 unit.5-1 mil OTU _ 35.00 ducts&vents 10)30-50 HP;absorb Furnace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU _ _ 52 26 ducts&vents 11)>50HP:absorb Floor furnace including vent 955 unit>1.75 mil BTU 87.20 Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM Floor mounteu heater _ 10.00 Vent not Included In applicance 445 13)Air handling unit 10,000 CFM+ korai( __ 17.20 Repair units - 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 10.00 to 100k BTU 15)Vent fan connected to a single duct 3-15 hp;absorb.unit, 1,700 _ 6.80 101k to 500k BTU 16)Ventilation system not Included In 15-30 hp;absorb,unit,501k to 1 2,310 appliance permit 10.00 _ mil.BTU - 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 1000 1-1.75 mil.BTU - -! 18)Domestic Incinerators >50 hp;absorb.unit, 5,725 17.40 >1.75 mil.BTU 19)Commercial or Industrial type Incinerator Air handling unit to 10,000 cfm 656 _ 69,95 Air handling unit>10,000 cfm 1_,170 20)Other units,Including wood stoves Non-portable evaporate cooler 656 to 00 _ Vent fan connected to a single duct 446 _ 21)Gas piping one to four outlets Vent syslern not Included in 656 540 appliance permit 22)More than 4-per outlet(each) Hood served by mechanical exhaust _ 656 1.00 _ Domestic Incinerator 1,170 _ - Minimum Permit Fee$72.50 SUBTOTAL: $ Commercial or industrial incinerator 4,590 0 Other unit,Including wood stoves, 656 8%State Surcharge $ Inserts,etc. Gas P1 Ing 14 outlets_ 360 Each additional outlet 63 - 25%Plan Review Fee(of subtotal) $ - --- Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FIE: � $ VALUATION: Qther Insuectlons and Fees: 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour 2 Inspection,for which no lee Is specifically indicated (minimum chane-half hour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plant,(mir Lim charge-one-hall four)$72 50 per hour "State Contractor Boiler Certification required for units>200k BTU. -Residential A/C requires site plan showing placement of unit is\dsts\forms\mech-fees.doc 10111/00 Plumbing Permit Application Datereceived: Penitis no.: (�g'I c-ce I DD� City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: CityofTigard Phone: (503) 6394171 Project/appl.no.: Expire date: Fax: (503)598-1960 Date issued: By: Rcrcipino.: Land use approval: Case file no.: Payment type. t U 10,2 family dwelling or accessory U Commercial/industrial U Multi-family -I Tenant improvement 3'New construction U Addition/alteration/replacement U Foal service U Other. JOB t Job address: S yU 1TN P� Descri tion "Y. Fee(ea.) 'Total [;Idg.no.: _ Suite no.: -- Neir I slid 2-fainily dwellings only: r' Tax map/tax IoUaccountno.: -- (Inclues1000.forcactiutilityconnection) SFR ,1)bath Lot: oc : I Subdivision• - C SFP.(2)bath Project name:_ SFR(3)bath _ City/county: "i"1G/�i` ZIP: q-7 724 Each additional baflAitchen Description and location of work on premises:_—__—� Siteutilities: Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain —� t Footing drain(no.lin.ft.) Manufactured home utilities Business name: 1 ��, Tl tTtl r Manholes _ Address: fqt45 SLkj 0Vje;4U -.T Rain drain connector _ City_(" _ Stntc�Q ZIP: l Sanitary sewer(no.lin. ft.) _ Phone: (paS _a..0Fax: E-mail: Storm sewer(no.lin. ft.) _- CCB no.: go/ Plumb.bus.reg,no: 3y.6lSSh I'� Water scriice(no.lin.ft.) t fixture or item: City/metro lie.no Contractor's representative signature: Absorption valve ---� I I,�ir. "---- Back flow preventer Print name: - Backwater valve _ Basins lavatory Name: Clothes washer _ -- Dishwasher Address: .—.-- -- ----- ---- City: — — - rSt;dc. ;II ---- Drinking fountain(s) --1 -�-.-- Ejectors/sump Phonc: -- Fax: E-nutil: Expansion tank Fixture/sewer cap Name(print): Gk! i E° tJ , • Flan drains/floor sinks/huh Garbage disposal Mailing address:•: pp(2) -- Hose bibb Cityzs fj g_ — State: Zlpfj7 / Ice maker Phone: - Fax: ,4-9-VIA rInterce for/grease trap, Owner installation/residential maintenance Daly: 'The actual installation Primei(s) will be made by me or the maintenance and repair made by my regular Roof drain(comm rcial) employee on the pmp rty I own its per ORS Chapter 447. Sink(s), asin(s),lays(s) _ Owner's signature: _ _ __ Date: Sum +_ TutiVshowedshower pan Name: Urinal Water closet _ Address: - _ _ Water heater City: State: ZIP: other: - — Phone: _— Fax: E-mail: Total NM ell JuNadktirxn arcrya credit crdx,please call Iudr11c0on for more inftxttuNrxt Minimum fee................$ U Visa U Ma lerc•anl Notice:if permit application Plan review(at _ ) $ expires if a permit is not obtained credit card number:__. _. — _L_1— within 180 days after it has been State.surcharge(8%) ....$ Expires TOTAL ........... ..........$ Name of c older u d iwn an credit card accepted as complete. - 1 Cardholder at nature -- Amou•it 110I6I6(NtIDK OM) PLUMBING PERMIT FEES: -- PRICE TOTAL New 1 and 24amily dwellings only: FIXTURES (individual) QTY _lea AMOUNT (includes all plumbing fixtures in PRICE TOTAL 16.60 the dwelling and the first100 ft. QTY (ea) AMIOUNT Sink _ for each utility connection 16 60 --- ——�..— — - $249.20 Lavatory _ One 1 bath — Tub or Tub/Shower Comb 16.60 Two 2 bath $350.00 -------- — $399.00 Shower Only — 16.60 Thre131 bath Water Closet — 16 60 — SUBTOTAL _ Urinal16.60 _ __8•/.STATE SURCH_ARG_E Dishwasher 16 ti0 PLAN REVIIW 25%OTS -- -"-- 16.60 TOTAL Garbage Disposal -�—" -- - Laundry Tray 16.60 Wushing Machine 16.00 -- FloorDrainlFloorSink 2 --- 1660 -- PLEASE COMPLETE: 3• 16.60 4•,---- - —16.60 _ Quantity b Work Performed Water Healer O conversion O like kind 1660 Gas piping requires a separate mecnanical — Fixture Type: Now Moved Replaced Removed/ Capped permit MFG Home New Water Service 46,40 Sink --._ - LavalarY MFG Home New San/Storm Sewer 46 _.40 _ Tub or Tub/Shower — Hose Bibs 16.60 - Combination_ — Rcot Drains 16.60 Shower Only 16.60 Water Closet _ Drink ng Fountain UrinalTk Other Fixtures(Sperify) 1660 DishwasherGarbage DispoLaundry Room Washing MachFloor Drain/SinSewer-1st 100' 5L00 �Sewer-each additional 100' 46.40 — Water Service-1st 100' — 515.00 Water Healer �— _ Other Fixtures Water Service-each additional 7.00' 46.40 (S eci — --- Storm$Rain Drain-1st 100' 55.00 — —_ Storm 8 Rain Drain-each additional 100' 46.40 _— --- — -- — -- Commercial Ba:k Flow Prevention Device 46.40 Residential Backflow Prevention Device'— 27.55 Catch Basin ----- 16.60 - -- --_ -- —_ Inspection of Existing Plumbing or Specially 72.50 Re uerted Inspections_ erlhr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps _ — 1660 - -- --- - - QUANTITY TOTAL Isometric or nser dia{tram is raprired II _— ---_ ___ Ouat2y Total Il9— 'SUBTOTAL v�8%STATE SURCHARGE -- — — -- "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture t total Is>9 _ TOTAL S "Minimum permit tee Is$72 50-8%state surcharge,except Residential Backflow prevrrdian D:vice,which is$fie 25+8%state surcharge "All New Commercial Buildings require plane with Isometric or riser diagram and plan review I:Wsts\forms\plm-fees.doc 10/10100 Electrical Permit Application plication Uatereceived: Permit no.:fijSj-,p,,-5i/.0043 City Of Tigard Project/appl.no.: Expire date: City of Tigard Address: 1312".SW Hall Bled,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 1 Case file no.: Payment type: Land use approval: U 1,&2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement cw construction U A(J(lition/alteration/replacement U Qther: U Partial JOB SITE INFORMAT116N Job address: -7_yTy 1 _ Bldg.iia. Suite no.: Tax maphax IMt/ ccount flo.:V 11:2 Lot: Z Block: Subdivision e Project name: I Description and location of work on premises: Estimated date of completion/inspection: Job no: Fes. Max Business name: -T7 - -- - '� __ De%criptlon try. (ea.l I ntat no.fnsp �� Neu rmidential-single or multi(amilt per Address: dwelling unit.Include%anachrrl garage. City: State: tkrviceinciuded: Phone: 355 fax: I E-mail: 1000 sq.ft.or less 4 CCB noI.lie.no-Of `/O Hach additional 500 .fl.or portion(hereof .: ^�_ Llec.buI.imiteeenergy,residential 2 City/metro Iic.no.: Limited energy,non-residential 2 Hach mat,ufactured home or modular dwelling Si nature of'supervising cl,,itician(required) Dale Service and/or feeder _ 2 Sup.elect.name(print): I i.voseno: Seri Ices or fredem-In%fallation, 111�4011`kRY�'OWN ER alteration or relocation: 2t0 amps or less 2 Name(print): OtIA14i i i.l 201 amps to 400 amps -—- - — - 2 Mailing address2 v k-, 401 amps to 6(0 amps - - 2 _ 601 amps to I(K0 amps 2 City: . SltllC:rj� TIP: � _ Over I W)amps or volts — -- - -- 2 Phone: Fax E-mail r _, econnec(onl I Owner installation:The installation is being made on property I own Temporaryservicesorfeedem- which is not intended for sale,lease,rent,of exchange according to installation,at,rratlon,orrelocation: ORS 447,455,479,67n,701. 200 amps tit I,.s — 201 amps to 400 amps 2 Owner's si mature: - vale: 401 to 604)ramps _-- -- - Branch circuits-nen,alteration, or extension per panel: Name: or F'ee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 _ City: State: ZIP: B. Fee for branch circuits without purchase Fe sctN ice or feeder fee,first branch circuit: Phone: Fax: E-mall: Hnchnd"hnmalhtnnchcinmt Misc.Itiervlce or freder not bncludedl: O Service over 225 antps con i nercinl U Health-clue facility Fach pump of irrigation circle 2 U crvice over 120 amps-rating of I&2 U Hazardous location Hach sign or outline lighting 2 family dwellings U Building over 10,(XX)square feet four or Signal circuit(%)ur a limited energy panel. U Systemover6(K)valls nominal more residential units in one structure alteration,or extension" 2 U Building over three stories U Feeders,4(0 amps or mem •1 k.,cti cion - U tkcupant load over 99 persons U Manufactured structures or RV part: tach additional Inspection over the allowable In any of the above: U l:gress/lightingplmn U Other -- —— Per tot,pet:non Submit_sets of laws with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all ptNedictions accept ctedu cants,please call iudrAliction fta ttxxe inftinnanion Notice:This permit application Permit fee.....................$ U Visa U MuterCard expires if a permit is not obtained Plan review(at _ %) Credit card number:— within 180 days after it has been State surcharge(8%)....$ __- x�re' accepted as complete TOTAL $ Name of cardholder us-- :-fown rni-c Uri trd — Crdholder signature Ann" 440461 (MUCOM) Electrical Permit Fees: Limited Energy Res: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee.. ..................I..... ........ $75.00 _ Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved Residential-per unit $145 15 4 Audio and Stereo Systems 1000 sq.ft,or lessEach additional 500 sq it or portion thereof 40 1 Burglar Alarm $7500 Limited Energy �J_ 575 — Each Manufd Home or Modular $90 90 Garage Door Opener' Dwelling Service or Feeder ----- Heating,Ve�tilaticn and Air Conditioning System' Services or Feeders Installation,alteration,or relocation $80 30 2 ❑ 200 amps or less _ 2 Vacuum Systems' 201 amps to 400 amps $106 85 401 amps to 600 amps $160 60 2 ,, Other ---. ------ 601 amps to 1000 amps $240 60 _ Over 1000 amps or volts $$65 2 6 8 _ 2 2 Reconnect only $66,85 -�--'- 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 -- 2 201 amps to 400 amps _ — $100.30 __ 4 _ 2 Check Type of Work Involved: 01 amps to 600 amps $133.75 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 serrice or feeder lee. 7 f--I Each branch circuit $6 65 _- L_J Data Telecommunication Installation b)the fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. $q6 85 First branch circuit - HVAC Each additional branch circuit $6 65 Miscellaneous C7 Instrumentation (Service or feeder not included) . Each pump or Irrigation gation circle -- Intercom and Paging Systems Each sign or outline lighting _ $5340 Signal circuit(s)or a limited energyEl Landscape Irrigation Control' panel,alteration or extension $1300 - Minor Labels(10) $125.00 _ r� IJ Medical Each additional inspection over the allowable Iri any of the above $6250 Nurse Calls Per inspection Per hour $62.50 _ $73.75 Outdoor Landscape Lighting' In Plant — - — Fees: Protective Signaling Enter total o1 above fees $ _- I Other - 894 State Surcharge $ Number of Systems 25%Plan Review Fee $ No licenses are required Licenses are required for all other installati See"Plan Review'section on — front of application --_- Fees: Total Balance Due g -- Enter total of above fees : ❑ Trust Account 11_ —_ 8%Stale Surcharge s— - - —g^-- Total Balance Due i)&ts\foims\elc-fees.doc 10A)")O