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11050 SW FONNER STREET 11050 SW Fenner Street CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP ' - AM—_l- PM�— BUP ----- . Received Date Requested____-,. -- Location _ 1 C �� "/I� �.- Suite -- MEC -_--.---- - Contact Person --- - - -- _ Ph PLM _---- Contractor _— - - Ph( ) 2a b _ SWR - �- O _ BUILDINGy Tenant/ n"�' _ __ FLC-- ELC--- Footing r Foundation r1nsp7_ection ss: ELR _ Fty Drain Crawl Drain --- ----" SIT - c ab Notes: 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 r -- -----_. --------- OthAr:.--_ --- —_-- ------.. Final —pp,7.s PART FAIL Mt:CNANICAL Post& Seam -- -- — - -- Rough-In --- - _ Gas Lino ------------ —_� — -- — Smoke Dampers —" ---�- --- Final RASq PART FAIL �--- — -- -� — —_ Service -- Rough-In --- -- ----- -- --- ------------ UG/Slah _ ------ Low Voltage tPA arm - rr Reinspc►ction fee of$—__ required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd. l_� PART FAIL __ Unable to Inspect-no access -- - Please call for reinspectionRE:--- SIT __ - Fire Su, ly LineADA L� _ Approach/Sidewalk DMOC.S - -- _ - (omother: - DO NOT REMOVE'hls inspectloa record ob SHOO Final PASS PART FAIL ___ELECTRICAL PERM. _ CITY OF TIGARD PERMIT#- ELC2001-00251 DEVELOPMENT SERVICES DATE ISSUED: 5/16/01 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S103AD-00802 SITE ADDRESS: 1 1()50 SW FONNER ST ZONING: R-4.5 SUBDIVISION: LOT : JURISDICTION: TIG BLOCK: Project Description: Installation of 4 branch c;rcuits. _RESIDENTIAL UNIT _ TEMP SRVCIFEEDERS MISCELLANEOUS__ 1000 S_F6 R LESS: 0 - 200 amp: PUMP/IRRIGATION: — 201 - 40U amp: SIGN/OUT LINE LTG: EACH ADD'L 500SF: 401 - 600 arnp: SIGNAL/PANEL: LIMITED ENERGY: MINOR LABEL_ (1U): MANF HMI SVC/ FDR: 601+amps 1000 volts SERVICE/FEEDER _ BRANCH CIRCUITS _ADD'L INSPECTIONS W/SERVICE OR FEEDER:— PER INSPECTION: 0 200 amp: PER HOUR: 201 - 406 amp: 1st W/O SRVC OR FDR: IN P'LAN'T: 401 600 amp: EA ADD'L BRNCH CIRC. `3 601 1600 amp: PLAN REVIEW SECTION > 600 VOLT NOMINAL. 1000+ amp/,/ >=4 RES UNITS:olt: CLASS AREAISPEC_OC� Reconnect orate: _ SVCIFDR >= 225 AMPS: -- Contractor: Owner: PORTLAND STATE ELECTRIC FAGAN, JOSEPH I AND pp UOX 230933 BUSHELL, DIANE E TIGARD, OR 97281 11050 SW FONNER ST -TIGARD, OR 97223 Phono: 233-8030 Phone: Reg#: LIC 96644 SUP 4125s ELE 26-854C FEES Required Inspections Date Amount Receipt Rough-in Type BY Elect'I Final PRMT CTR 5/16101 $66.80 27200'1000()( 5PCT CTR 5116/01 $5.34 2720010000( Total $72.14 Tigard Code,State of OR. Specialty Codes and all othei applicable laws This Permit is issued subject to the regulations contained in the Tiga 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 low suspended for more than 180 days.OAR 952-001-0010 through ON, Oregon law requires you to O R 9.52-001-0080, You may obtain nules copietl of fth se rules or directby the Oregon llity q questions tolon OUNCtat(503�se rules are set forth In 246-6699 or 1.800-332-2344. 1=2, Issued By: Permit Signature: _4 �1`r-G �G► - _ OWNER INSTALLATION ONLY ThA installation is being made on property I own which is not intended for sale, lease, or rent. DATE:-,-- OWNER'S SIGNATURE: -- —' CONTRACTOR INSTALLATION ONLY DATE: SI 3NATURE OF SUPR. ELEC'N: _ - -- — L.ICENSE. NO: Call 635.4175 by 7:00pm for an inspection the next liusiness day Electrical Permit Application Date received: /6 4/ Perm itno.: r�cl ,4 City of Tigard Project/appl.no.: Expire date: Cifyn(Tigard Address: 13125 SW Hall Blvd,'I'igard,OR 97223 Date issued: By Receipino.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: _ t TI 2 family dwelling;or accessory U Commer6al/indii meal U Multi-family U Tenant improvement lJ New construction U nddilion/altcrilion/rcplarcnu•nl U Other: U Partial t Job address: I j O s(.J D ner 5tfpt FSuima _ Itldg.no.: te nta.: Tax p/tax lot/account no.: Lot: T hxk: Subdivision: - _ Project name: I Description and location of work on premises: Estimated date of corn Lebon/ins etion Job no: fer Mas Business name: — S;p ��ELT�rG �o • Daces Um _ pty. (ea.) total no.tn• - New residential- ormulr+ amily per Address: dwelling ill.Iecladesamrehmgarage. City: State:" ZIP: S"Acelncluded: Phone: yp Fax: E-mail: I Wo sq.ft.or less _— 4 ZG Bach additional 500 syIt,or portion thcrcul CCB no.: �(! EIeC.bus.LIC.no: Limited energy,residential 2 City/metro lic.no.: dY n Linilledenergy,non-resident al 2_ en Each manufactured home or modular dwelling Signature of supr:rvising electricidn(rc uuc Date Scrviceand/orfeeder 2 Sup.elcct.namctprintt '� (Zck License no: l� Services or feeders-Installation. alteration or relocation: t 2(NI amps or less _ 2 Name(print): 201 amps to 4(10 amps 2 --- _-- — 401 amps to 600 amps 2 Mailing address: __ 601 amps to 1000 ams _ 2 City: Slatc: ZIP: Overlt)DOampsorvolts 2 _ Phone: Fax: I E-mail: Reconnect only - I Owner installation:The installation is being made on property I own Temp)rnryservices orG den which is not intended forsale.lease,rent,or exchange according to brstallntion,slteralloti,orren. nu,on: ORS 447,4.'5,479.670,701. 200 amps leas 2 201 amps to to 4(x1 amps _ 2 _ Owner's signature: Date; 401 to 600 ams — 2 Brancnslh clrcuils-ner,all ration, or evteon pen panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: Stale: ZIP: B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone I'nx' F..Mall: Final additional branch circuit: Misc.(Service or feeder not included►: U Service over 225 amps-commercial U Health-care facility Each um or irrigation circle 2 U Service over 320 amps-rating of 1W U Hazardous location Fach sign or outline lighting 2 family dwellings U Building over 10,001t square feet four or Signal circuit(s)or a limited energy panel. •System over 6W volts nominal toore residential uyiisinonestrucmre alteration,or extension* F9 2 U Building over three stories U Feeders,400 amps or more *Description: --- U OLcupaM load over 99 persons U Manufactured structurcs or RV park Each additional inspection over the allowable In any of the above: U Egress/Iightingpiat U Other: -- Petinspectioo Submit__sets of plans with any of the above. Investigation fee The above are not applicable to temporary constructlon service. other Not alt nop Jurisdictions incept cretpt carie,please call jurisdiction far e infomoaUanPlan re. Notice:This permit application Permit gat _ $l fee.................96)) $ U Visa U Mastercard expires if a permit is not obtained State surcharge(896) $ _`- Cr.Jit card number. _�,_l— within ISO days after it hes been •••• ' Expires accepted as complete. TOTAL a '/ 37 _. Narne of c 1 r neje• s— Down on c ilre� s —`---- C der dgnature tttount 4144615(trUtYCOM) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Restricted Energy Fee...................................................... $75.00 Number of Inseaccons per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total _ Check Type of Work Involved: Residential-per unit 1000 sq ft or less -- $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq it of portion thereof T $33.40_ 1 ❑ Burglar Alarm Limited Energy _ J $75.00 Each Manufd Home or Modular El Garage Door Opener' Dwelling Service or Feeder $9090 2 Services or Feer!e;rs ❑ Heating,Ventilation and Air Conditioning System' Installation,-koration,or relocation 200.ops or less $80.30 2 ❑ 201 amps to 400 amps $106.85^ 2 Vacuum Systems ----401 amps amps to 600 amps $160.80 _ _ 2 601 amps to 1000 amps $240.60 2 F Other_ Over 1000 amps or volts _ $454.65 2 Reconnect only $66.85 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 _ $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 — 2 I Check type of Work Involved: Cver 600 an,'os I-.1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel ❑ Boller Controls al 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 fee. pp First branch circuit $46.85 '� _ 4_,_q.5 Each additional branch circuit $6,68�1�7 E-] HVAC Miscellaneuus ❑ Instrumentation (Service or feeder not Included) Each pump or irrigation circle $53.40— Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuits)or a limited energy panel,alteration or extension $7500 ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 ___ Each additional Inspection over F-1 Medica' the allowable In any of Nho,.:hove Par Inspection _ $82.50 ❑ Nurse Calls Per hour $62.50 In Plant — $73.75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ ❑ Oiler 8%State Su"charge $ _—Number of Systems 25%Plan Review Fee See"Plan Review"section on g No licenses aro required. Licenses are required for all other insta!latlons front of application __— ---- — Fees: Total Balance Due $ 7�, i j` Enter total of above fees $_ Trust Account!t_ 8%State Surcharge Total Balance Due $_ i:\dsts\forrns\elc-fees doc 10/09/00 I �� I�� MASTER PERMIT PERMIT#: MST2001-00131 -� DEVELOPMENT SERVICES DATE ISSUED: 4/2/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITF. ADDRESS: 11050 SW FONNER ST PARCEL: 2S103AD-00802 SUBDIVISION: ZONING: R-4.5 BLOCK: LOT: JURISDIC'rION: TIG REMARKS: Addition of living room and screened porch. Path 1 BUILDING REISSUE: STORIES: 1 FLOOR AREAS _REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 10 FIRST: 163 of BASEMENT: of LEFT: SMOKE DETECTORS- TYPE OF USE: Sr FLOOR LOAD: 40 SECOND: of GARAGE: of FRONT: PARKING SPACES: TYPE OF CONST: 6N DWELLING UNITS: FINBSMENT: of VALUE: $30,000 00 RIGHT: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 16300 of REAR: PLUMBING SINKS: WATER CLOSFTS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS. CATCH BASINS: TUBISHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL _ FUEL TYPES FURN<100K: BOILICMP c 3HP: VENT FANS: 0 CLOTHES DRYER. GAS FURN>000K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS 0 200 amp: 0 200 amp: WISVC OR FDR: PUMPIIRRIGATIOW PER INSPECTION: EA ADD'L 500SF: 201 400 amp: 201 400 amp: 101 WIG SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 800 amp: EA ADDL BR CIR- SIGNAL/PANEL- IN PLANT: MANU HMISVCIFDR: 601 . 1000 amp: 501+empa•1000v. MINOR LABEL: 10004 amplvolt PLAN REVIEW SECTION Reconnect only: >•0 RES UNITS: 9VCIFDR>•225 A.: >600 V NOMINAL.: CLS AREABPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO lL STERFOVACUUM SYSTEM: AUDIO d STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPE14F.R CLOCK. INSTRUMENTATION- MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS TOTAL FEES: S 72" 'a Owner: Contractor: This permit Is subject to the rpo •.n� twined in the FAGAN,JOSEPH I AND TIMOTHY J WARNER Tigard Municipal Code,Sta ,y Codes and BUSHELL,DIANE E 932 N SHAVER ST all other applicable laws W , done in 11050 SW FONNER ST PORTLAND,OR 97227-0069 accordance with approved plans. '^is permit will expire if TIGARD,OR 97223 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 Thoss rules are set Rad 0: LIC 60831 forth in OAP,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 Footing Insp Crawl Drain/Backwater Framing Insp Rain drain Insp Foundatlon Insp Footing/Foundation Dr; Shear Wall Insp Electrical Final Post/Beam Structural Mechanical Insp Exterior Sheathing Inst Mechanical Final Post/Benm Mechanlca Electrical Service Low Voltage Final Inspection Underfloor Insulation Electrical Rough In Insulation Insp rz Issued B �� `�_ Permittee Signature ;/ '- Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day Building Permit Application rDateceived:� �G/0 / Permit no.: City of Tigard Project/appl.no.: Expire date: ('itrujli�ard Address: 13125 SW hall Rlvd.'I'i}::+rd,OK '17223 Phone: (503) 639-4171 p` nate issued: By. Receiptno.: Fax: (503) 598-1960 1�F Case file no.: Payment type: Land use approval: I&2 family:Simple Complex: 1 & 2 tanuly dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition )Q Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: X lob address: 11 O i$C) s LkD �rCSYtXL.�T�ZLC. a, Bldg.no.: "Suite no.: Lot: ^ Block: Subdivision: I Tax map/tax lot/account no.: Project name: �( Description and location of work on premises/special conditions: %AA 00.. �t VV1M�ee y� -4 5cuViQ d- (ICcapacit*4 War,etc.) - 0%%N1 It FOR SPECIAL INFORMATION9' USE CHECKLIST 5�--� �-'�_ Mailing address: Dao Sit) -rs�1.,r.an 5 1 &2 family dwelling: t�° " City: AACA State: ZIP: `�o^� Valuation of work........................................ Phone -14 Fax: alt E-mail: r No.of drooms/baths................................. 4 Owner's representative: Total num r of floors................................. / Phone: Fax: E-mail: New dwelling area(sq.ft.) ...............I.......... 1 3(t Qarage/carpott area(sq.ft.)...... ................. Name: Covered porch area(sq.ft.) ......................... -- Mailing addn,sDeck area(sq. t.) ........................................ City: State: ZIP: Other structure area(sq.ft.)...... .................. Phone; I Fax: _Mmail: t'onrmereiallindustriallmultl-fAmili: Valuation of work...................................._ 4 Existing bldg.area(sq.ft.) ........ ............... Business name. j V• %of�VNew bldg.area(sq.ft.) Addressq 5,Q VS Number of stories ...................... ....... City:9 7-L State: CJL I zip: ��7 Phone: Fax. E-mail: Tye of construction................ ./........ ... _ - Occupancy group(s): Existir CCB no.: (p 3 __ _ ----_ _ --- N, City/metro lic,no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Neme: provisions of ORS 701 and may be required to he licensed in the jurisdiction where work is being perfornied.If the applicant is Address: _ Cit State:�.IP: exempt from licensing,the following reason applies: Contact person: flan no.: Phone: Fax: E-mail: Name: Contact person: Fees due upon application ........................... $ .,Z4 ` Address: Date received: — City: State: 7.11': Amount received ......................................... $ Phone: Fax: E-mail: _ Please refer to fee schedule. I hereby certify I have read and examined this application and the Nru all junsdictions accept credit coda,Meade cdl jurisdiction rot more Information. attached checklist. All pmvisions of laws and ordinances governing this U Visa U Mastercard if I work will be complied with,whether cifieate:or not. c colic cord^umber _-.- 2 Eaplres Authorized signature: _ Neme of cardholdrr u shown nn credit cud S Print nam -- ---- ----- Cardholder sipature Amami Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 4613(tt+Oa+COM) One-and Two-Family Dwelling 7A,f,ociated "M Building Permit Application Checklist m.1'Plumbing U MechanicalCity q(Tigard City of Tigard Address: 13125 SW Ilall Blvd,Tigard.OR 97223 Phone: (503) 639-4171 Pax: (503) 595-1960 ( rx completed.See jurisdiction criteria for concurrent reviews. - I Land Ilse acts n P -- __..- 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Veriflcatlon of approved platllot, 4 Fire district- =approval required._ _ 5 Septic system permit or authorization for rc nodcl.Existing system capacity —_----— 6 Sewer permit. 7 Water district approval. 5 Soils report.Must carry original a plicahlc stamp and signature on IIIc design and or With application• 9 Erosion control U plan U pennit required.Include drainage way protection,silt fence location of catch-basin rotection,etc. 10 3_ Complete sets of legible plans.Must he d�ttion4wn tmu tlbc incorporated drintoa he plane Decor a separate full-Size building codes.Lateral design details and connections sheet attached to the plans with cross references between plan location and details.Plan review cannot he complete it'copyright violations exist. r elevations I I Site/plot plan drawn to scale•The plan must shlan lmust show ot and lcontour lines at 2-11.intervals);location of easementr;tatnd there is mon Than❑4-ft.elevation differential,putility driveway;footprint of structure(including llut cc vernge;timlreMous area;tion of 'existing structutx s on sitenand tsurface drainage. "t karea;building coverage amu,percentage Foundation plan.Show dimensions,anchor Ixrlts,any hold-downs and reinforcing pads,connection details,vent size and locatior_�__ I- Floor plans.Show tiro c e—nsio n rxtn Cbalccmic ks43lJ in het_nt s shove grade,e1:-n—,water eater, ' furnace ventilation ,n 14 i'ro+�sectlon(s)and details.Show a�(�hnn Membone fssizes and n saaZi required! floor Ica beams, portray construction.Show mr wall construction,roof construction. details of all wall and roof sheathing,rcxmltng,roof slope,ceiling height,riding material,footings and foundation,stairs, .)elevations fire lace construction, them�al insulation,etc. and inlura 01 two 15 Elevation views.Provide,elevadhc afor ctual it the I>n hectiow ti grade is greater than four foot atbuild ng envelope. Exterior elevations must reflect t gs are acceptable Full-size sheet addenda tfsvelt(wing foundatatb)andlor Iateralion Lanalysl pl n+.vations with cross tf in este details a d Icx ations;for I(;Wall bracing(prescriptive p g standards. non-nescri Live path analysis provides cifications and calculations to en incering 17 Flootlroot teaming.Provide plans for all floorslrmf assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. I5 Basement and retrinlnq walk.Provide cross sections and details showing placement of rebar.For engineers systems,see item 22, Cr's calculations." 19 Ream calculations.Provide twor et(rot calculationsaeusing n fern current �e design values for all beams and multiple joists - over 10 feet long and/or any bi J 2(J Mnutactuted iloorltoot truss design detail_s_ 21 Energy(a a Compllanee.Identify the prescriptive path or provide calculations. A gas piping schematic is required for four or more applianc sem_-__----- 22 Engineer's calrulalions.Whvnlr quir'1d Ir�pvarvta h•�a11,Grahlshee to the project under rrvicw.tmlxd by nn engineer or architect licensed in()n 1 n a 2.3 Five(5)site plans arc required for Item 111 above. Site plans must he t;-1/2" X I1"or 11" x 17". 24 Two(2)sets each are required for Items 16,E.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. 25 440-4615 1(�nIN('OMI Checklist must he completed before plan review sis reservetd for department use onlyuhmitttd plans may he in blue or black ink. _ Red ink tart Mechanical Permit Application Daterec:eived: Permit no f/ ;- City of Tigard Profect/appl.no.: Expire dale: Cirvr Address: 13125 SW Hall Blvd,Tigard,OR 97223 �Tirnrd Date issued• By:' Receipt no Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type. Land ust,approval: _ _ Building permit no.: U I &2 family dwelling or accessory llU__Commercial/inclustrial U Multi-family U Tenant improvement U New construction Addition/alteration!rcpincemcnt U(Wer:— Job address: 1105,0 $ Indicate equipment quantities i❑boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, "rax map/tax lot/account no.: profit. Value$ L,ot: Block: Sutxlivision; *See checklist for important application information and Project name: -�-y - jurisdiction', fee schedule for rc,Jd(•nti;il pormit frr City/county:--r1dg1 k— ZIP: Description and loss ti`on`of work on premises: 7AirhaLling t ov\ �, borr, t-StJ2.G4Jr -(.10- I cc(ra.► 'I otal Est.date of complelion/inspeciion: D wc•rilAlan (hy. Res.only Rts.orrh Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No unit CfM VAir conton ng(site p an require ) Is existing space insulated?0 Yes U No erauon o existing C system iler compressors Business name. V w0 tate boiler permit no.: HP 1'ons__BTU/H Address:Q 82 '-h 4SPC%V4.A, Sit Pi-rVsmok-edampe�, uc�3c ctsmo c detectors City: 1pl+jam, Stole ZIP: _ eat pump(site plan required) nsto rep ace urnac urner /Fax: -_Phone: - Including ductwork/vent liner U Yes U No CCB no.: _ nsla rep ace re ocale heaters-suspended, �- City/meim lie.no.: / wall,or r'oor mounted Name(please print): -`� r - eat fora lance other than furnace Refrigeration: Absorption units _ _ BTU/H _ Name: Chillers— HP _ Address: -- Compressors _. HP ,n ronmenul ex mt an .eM.at on: City: _ Slate: Z.IP Appliance vent Phone: — I ;�t_ - - -T L=mail• --- �ryer�ex�iaust 4 Hoods, 'ype res. tc en/haz.mat fire suppression system T Name: y j VShe,�1 ` p�L Exhaust ust fan with single duct(hath fans) - x aurs stem a art from ieaun or C Mailing address:'1��) SW �-yvy%IJL�Cit �:q ne.p p ng an su ut on(up to outlets) Y�T- Stalc:�, ZII-1Cmail -Tylte: I,Ni _ NG Oil x It I piping each additional over out etsPhonr� ha El'IFM-I'm RIF rocm piping(sc emat c require ) Name: Number of outlets _- —__ ter listed appliance or equipment: Address: Ihcoralivefireplace City: `--_ Slate: Insert-type _ Phone: --- Fax: I E-mail: Woodstovwpe et stove Other: Applicant's signature: Date: er. Name (Print): Not all jurisdictions accept credit canis,please call jurisdiction fix more InfamntionPenult fee.....................$ U visa ❑MasterCard Notice:'I'his permit application Minimum fee................$ 1� - expires if a permit is not ohtaint d Plan review(at ql) $ Credit card number. _ --- — Fxpires within 1 g0 days after it has been accepted as complete. State surcharge(896) ....$ -_ Name of candhol r as s awn on credit card S P p (aorii, er Jnvure Amount 440-4617(MUCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: ° TOTAL VALUATION: FEE: Descdptlom -^�- -- Price Total $1.00 to$5,000.00 _ Minimum fee$72.50 Table 1A 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 $1.52 for each additional$100.00 or including ducts&vents 14 00 fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000.00. including ducts&_vents_ 17 40 $10,001.00 to$25,000.00 $148.50'or the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent _ 1400 fraction thereof,to and Including 4) Suspended heater,wall heater $25,000.00._ or floor mounted heater 14 t00$25,001.00 to$50000.00 $379.50 for tt:a first$25,000.00 and- 5) Vent nct included in appliance permit $1.45 for each additional$100.00 or 6 fraction thereof,to and including 6) Repair units _ __ 00. $50,000. _ 12.15 $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 or Pump Cond I fraction thereof. footnotes below. Com • •� _ 7)<3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14 00 Value Total 8)3-15 HP;absorb V Description: Qt al Amount unit 100k to 500k BTU 25.60 Fumace to 100,000 BTU,including 955 - 9)15-30 HP;absorb ducts&vents unit.5-1 mil BTI) 35.00 Furnace>100,000 BTU including1170 - 10)30-50 HP;absorb , ducts&vents unit 1-1.75 mil BTU 52.20 Floor furnace Includin vent g55 11)>50HP:absorb - - Suspended heater,wall heater or 955 -- unit>1.75 mil BTU 87.20 floor mounted heater 12)Air handling unit to 10,000 CFM Vent not Included in applicance 445 10.00 permit 13)Air handling unit 10,000 CFM+ Repair units 805 - 17.20 <3 hp;absorb.unit, 955 14)Non-portable evaporate cooler to 100k BTU 10.00 3-15 hp;absorb.unit_ 1,700 --'- 15)Vent fan connected to a single duct 101k to 500k BTU 6.80 15-30 hp;absorb.unit,501k to 1 2,310 --- 16)Ventilation system not included in mil.BTU appliance permit 10.00 30-50 hp;absorb.unit, 3,400 17)Hood served by mechanical exhaust 1-1.75 mil.BTU10.00 >50 hp;absorb.unit, - 5,725 18)Domestic incinerators >1.75 mil.BTU 17.40 Air handling unit to 10,000 cfm _ 858 -- 19)Commercial or industrial type incinerator Air handling unit>10,000 ch _ 1,170 69.95 Non- ortable evaporate cooler 836 20)Other units,Including wood stoves Vent fan connected to a single duct ;656 10.00 Vent system not Included in 21)Gas piping one to four outlets appliance permit 5.40 Hood served by mechanical exhaust 22)More than 4-per outlet(each) Domestic Incinerator 100 Commercial or industrlal Inclnerator 4 590 Minimum Perrnit Fee$72.50 SUBTOTAL $ Other unit,including wood stoves, 658 - --- - - Inserts,etc. 8%State Surcharge $ Gasdit 1 4 additional outlet outlets _ 363 ad Each addit25%Plan Review Fee(of subtotal) s Required for ALL commercial permits only ` TOTAL_ COMMERCIAL- $ I TOTAL RESIDENTIAL. PERMIT FEF: $ VALUATION: i tthher Inaoectionstand Fees: 1 Inspections outside of normal business hours(mi,,,mum charge-Iwo hours) $72 50 per hour 2 Inspeclions for which no fee Is specifically indicated (minimum charge-half hour) 572..50 per hour 3 Additional plan review required by changes.additions or revisions to plans(minimum charge-one half hour)$72 50 per hour State Contractor Boller Certification required for units 400 B 1U. **Residential A/C requires site plan showing placement of unit. I:\dsts\forms\mech-fees,dnc. 10111/00 Electrical Permit Application Date received: _ Permit no.:/.ST.ZOU/—00/-j City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Rrceiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval _ ----- U 1 =family g or accc<,sory U Cunnnercial/industnal U Multi-family U Tenant improvement U N '-,U Addition/alteration/replacement U Other: _ U Partial JOB SITE 1Nj,'0ljMAj'10N MEN Joh address: 1\05 D 5W �_ Bldg•no.: j Suite no: Tax map/tax lot/account no.: Lot: Block: ulullsision: — Project name: bcscription and location of work on premises: Estimated date of completion/ins ra cticm: fee Mat Job no: — -- I)escrlption (}1y. (ea.) lirtal no.ins Business name: Nev.reshknlial-single or rnulll lami4 Pr' -- Address: dwelling unit.Includes Mllached garage. City: SlalC: ZIP: Senisrhn•luded: Phone: Fax: Email: I Olxl sy i� or less 4 Fach additional 500 s .fl.or porion thereof CCB no.: Elcc.bus,lic.no: Limited energv,residential 2 Cit-/metro lie.no.: I.imitedenerg ,non-residential 2 Each manufactured home or modular dwelling Date Service and/or feeder 2 Signature of su rvisin electricidn(required) servleaorfeeden—irtstellation, Sup.elect.name(print): License no Ed uiteretlon or reloallon: 200.m s or less 2 r [^�,^ ), 201 amps to 400 amps 2 Name(print): 1—r zlrr7 401 amps to 600 amps 2 Mailing address: 0 5 601 ams to 1000 amps 2 City: State: ZIP. 1-0 3 Over 1000 amps or volts - I Phone: 6a —1405 Fax: E-mail ' Reconnvctonly Temporary services or feeder Owner installation:The installation is ening made on property I own ositstloa„alteration,orrelocation: which is not intended for sale,lease,rent,or exchange according to 2W amps of leas 2 ORS 447,455,479,670,701. 201 amps to 4tx)amps—L2 Owner's signature: _ Date: 1 401 b,600 0111125 2 — drench circts-new,alteration, or extension per panel: A. Fee for branch circuits with purchase of _— — — 2 .idress: service or feeder fee,each branch circuit city: ale St : 71 P: B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fn X: E mall: Each additional branch circuit: Misc.(service or feeder not Included): F.ach pump or irriltation circle 2 "US.Mvi...22Ssmps-commercial U Health-care facility Mach sign or outline lighting 2 UService over 320amps-rating of l&2 dHazardouslocation al-nalon.orextnilimitedenergypanel. family dwellings UHuildingoverl0,tl(x)square feet Gturor R U System over 600 volts nominal more residential units in one structure nitrrution,or extension U Building over three stories U Feeders,4(x1 amps or more 40escri tion. --- U tkcupwit load over 99 persons U Manufactured structures or RV park Fach additional Inspection oter the allowable In any of the above: U Egress/lightingl,' : U other: I'ennspecuon �Z Rubmh___sets of plans with any of the above. Investigation fee 'lite alta.r are not applicable to temporary construction service. other —_ Pe fee.................... $ Not all jurtutiaiom rccepr cirdit cards,please call jurisdiction for more information. Notice:This permit application Plan rCVICW(al — ) -- U Visa U Mastercard expires if a permit is not obtained within Igo days aflrr it has been State surchnrae(8%) ....$ Crept card number:_- --------- spires accepted as complete. TOT AI. .......................$ Nune rd�r as shovn on credit c $ Cordholdef sipstave Amowi WAAIs(N'rW t Electrical Permit Fees: Limited Energy Fees: v WORK INVOLVED RESIDENTIAL. ONLY _ __.----------- T Vit_OF .. s75.00 -------' Fee......estricted Energy Complete Fee Schedule Below: R Number of Ins ectic ns r Prntit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total J Check Type of Work Involved: Residential•per unit 4 ❑ Audio and Sit 0 Systems 4 $1515 --T__- 1000 sq ft or 1055 -- - ❑ Each additional 500 sq it Of t Burglar Alarm $33.40 portion thereof — $75-000() 75.00 - Limited Energy Garage Door Opener' Each Manut'd Home or Modular $90.90 Dwelling Service or Feeder ____-- ❑ Heating,Ventilation and Air Conditioning System' Services or Feeders ❑ Installation,alteration,or relocation $80.30 2 Vacuum Systems' 200 amps or less — $106 85 2 201 amps l0 400 amps - $160.60 2 n lather - 401 amps to 600 amps - $Y40.60 2 601 amps to 1000 amps $454.65 �_ 2 Over 1000 amps or volts $56.85_„____. 2 C Reconnect only i YPE OF WORK INVOLVED OMMERCIAL ONLY$7.9.00 Temporary Services or Feeders Fee for each system...I............................ (SEE OAR 918.260-260) Installation,alteration.or r0lrx;atiun $86.85�_- 200 amps or less $100.30____ 1 Check Type of Work Involved: 201 amps to 400 amps $133.75 _ 1 401 amps to 600 amps ---- ❑ Audio and Stereo Systems Over 600 amps to 1000 volts, see"b”above. ❑ Boiler Controls Branch Circuits New,alteration or extension per panel f 1 Clock Systems a)The fee for branch JrcuilS LJ with purchase of service or ❑ . z Data Telecommunication installation feeder fee $6.65 Each branch circuit ❑ b)The fee for branch circuits Fire Alarm Installation without purchase of service or feeder fee. $46.85__ HVAC F irsl branch circuit _ $6.65 Lich additional branch circuit ❑ Instrumentation Miscellaneous ❑ in Systems (Service or feeder not Included) $53.40 __-_ Intercom and P9g g Y Each pump Or irrigation circle -• $53.40 _. -- Each sign or outline lighting _ Ej Landscape Irrigation Control' signal circuit(s)or a limited energy $75.00 panel,atleration or e:aenstOo $125.00 _-- ❑ Medical Minor Labels(10) --- Each additional Inspection over ❑ Nurse Calls theallowable in any of the above S62 50 - Per inspecti"n $62 50 ❑ Outdoor Landscape Lighting' Per hour $73.75 Plant — ❑ Protective Signaling Fees: ❑ -- -- $ Other -- Enter total of above fees Number of Systems S S%State Surcharge �- No licenses are required Licenses are required fur all other installations 25%Plan Review Fee g _ see"Plan ROview"snctign on Fees: front of application 5 Enter total 01 above toes = Total Balance Due >i g%State Surcharge ❑ Trust Account r9 -.- - - S - Total Balance Due I 4lsts\rnrms\cic-recs duc 10/119/1111 CITY OF TICARD MASTERPERMIT PERMIT fi: MST2001-00131 DEVELOPMENT SERVICES DATE ISSUED: 412101 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11050 SW FONNER ST PARCEL: 2S103AD-00802 SUBDIVISION: ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG REMARKS: Addition of living room BUILDING REISSUE: J STORIES: 1 FLOOR AREAS REUUIRE.D SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 10 FIRST: 320 at BASEMENT: SI LEFT. SMOKE DETECTORS. TYPE OF USE: SF FLOOR LOAD: 40 SECOND: at GARAGE: Sr FRONT. PARKING SPACES-. TYPE OF CONST: 5N DWELLING UNITS: F114BSMENT at RIGHT. VALUE: S 30,000 r10 OCCUPANCY GRP: R3 SDRM: BATH, TOTAL: 32000 at REAR PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOILICMP,3HP VENT FANS: 0 CLOTHES DRYER: GAS FURN>00014: UNIT HEATERS HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TFMP SRVCIFEEDERS _ BRANCH CIRCUITS MISCELLANEOUS AOD'I 'ISr.0 TIONS 1000 SF OR LESS: 0 200 amp: 0 •200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 5008F: 201 400 amp: 201 400 amp: 1st WIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 500 amp: 401 600 amp: EA AODL OR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 601 • 1000 amp 601+amps•1000v: MINOR LABEL: 1000+amplvolt: PLAN REVIEW SECTION Reconnect only: >•4 RES UNITS. SVCIFDR>-225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL S.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR .NDSC LT. BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROT=r'TVIE SIGNL: GARAGE OPENER: CLOCK•. INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: TOTAL FEES: $ 773.88 Owner: Contractor: This permit is subject to the regulations contained in the FAGAN,JOSEPH I AND TIMOTHY J WARNER Tigard Municipal Code,State of OR Specialty Codes and BU SHELL,DIANE E 932 N SHAVER ST all other applicable laws All work will be done in 11050 SW FONNER ST PORTLAND,OR 97227-0069 accordance with approved plans This permit will expired TIGARD,OR 97223 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 Rag N• LIC c„ra'' forth in OAR 952-001-0010 through 952-001-0080. You may ol�)Wn copies of these rules or direct questions to OUNe;by calling(503)246-1987. REQUIRED INSPECTIONS Footing Insp Crawl Drain!Backwater Framing Insp Rain drain Insp Foundation Insp FootingtFoundation Dr Shear Wail Insp Electrical Final Post/Beam Structural Mechanical Insp Exterior Shr:athing Inst Mechanical Final Post/Beam Mechanical Electrical Service Low Voltage Final inspection Underfloor Insulation Electrical Rough In Insulation Insp ISsUed B i Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITY OF TIGAIRr i 14-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 SUP Received _..— _ Date Reques'ed __ 1_ AM PM__,. _ SUP Location �� ,�� t�2_-� Suite.l�' MEC Contact Person Ph(_. ) _ PLM Contractor- _ Ph( ) I - �a b S SWR BUILDING TenanV r��_—____ •� Y / ELC Footing ELC Foundation Access: Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors --�— Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing FirewallFire Sprinkler - ---- -- Fire Alarm Susp'd Ceiling -- - — Root Other: --- Final PASS PART FAIL PLUMBING Post&Beam Under SlabRoug Water Se Water Service �---�- --.------ Sanitary Sewer Rein Drains Catch Basin/Manhole Storni Dram --- — Shower Pan Other: - ,1 Final PASS PART_ FAIL MECHANICAL P^st&Beam Rough-In _ Gas Line Smoke Dampers - -- Final PASS PART FAIL ---- ------ ---- E6TALIi�AL`> Service Rough-In UG/Slab Low Voltage Fir Alarm PASS PART FAIL -� Reinspection tee of$-- —�required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE— _ - Please ca!I for reinspection RE:_ Unable to inspect-no access Fire Supply Line ADA _ 4� Approach/Sidewalk Dat�t.�=�_ ._--___ 111spe�lOt_ ''— �_Ext Other: Final -- DO NOT REMOVE this Inspection record irom the fob site. PASS PART FAIL CITY OF T'IGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 r� BUP ---- --— - Received —__ ___Date Requested._j�_ _� —_ AM �_.__ PM _. BUP Location .. 1iL{r --_ ___Suite MEC Contact Person Ph(1�_ _) 12�4j PLM Co lraet® --- — ---- ---- ----- --— - Ph(— ) ---- SWR — — --- �- UIL TenanUOwner - -__..._ __- ELC Fou ACC@SS: ELC -_ — Ftg Drain r �/ �- ELR ��G f C � C �'� � C-'� Inspection Notes: , j SIT Post& Beam -__ -_-_. '�� 1 �'�� Shoar Anchors - Ext Sheath/Shear Int Sheath/Shoar Framing Insulation i Drywall Nailing Firewall Fire Sprinkler -----_ `_, Fire Alarm Susp'd Ceiling - - - - "`— Roof r S ART FAIL _ - -----.. ------------ -- - --------- ost& Beam - Under Slab - - - -- --- --- Hough-In Water Service - - - ----- - Sanitary Sewbr -art cTi1as 1/Manhole Storm Drain Shower Pan Other: - - - - - - ---- Final PASS PART FAIL -- ------ ---- MECHANICAL Post&Beam Rough-In - - ----- Gas Line Smoke Dampers Final PASS PART FAIL -- ELECTRICAL- Service Rough-In - _-- UG/slab ---- ------ -- - 1 ow Voltage Fire Alarm Final Rei-rspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL _ SITE _ Prease call for reinspection RE:___ Unable to inspect- no access Fire Supply Line --- ADA Approach/Sidewalk Data ��/ ��Inspector �--� � Fxt Other: Final i DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL