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12850 SW Fonner Pond Place
CITY OF TIGA,RD 24-Hour
BUILDING Inspection Line: (503)639-4170
INSPECTION DIVISION Business Line: (503)639-4171 MST - —-
BUP
Received __— /._— —c-D-aa1te Requested____ _ _ AM__.__ PM
� ____ _-. BLIP
I.ocation 1�Zvn-� —Stlite___._L__�____ _ MEG
Contact Person _ ______ � -___ Ph(_—_)
_ _._.-__ PLM
Contractor - - - -- Ph(_ ) SWF' - - -
B_UILDING Tenant/Owner _ _ _ ?LC - _-
��oting - ------
Foundation E LC
Ft g Drain Access:
LC� S�� rLR - -- -
Crawl Drain _. /
Slab Inspectirm Notes: SIT
Post&Beam II _
--
Shear Anchors
Ext Sheath/Shear _
;nt 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 Sew
Rain Drains ---- -— --
Catch Basin/Manhole
Storm Drain ----
Shower Pan
Other: -- — -"
Final ---------___ �
PASS PART FAIL
MECHANICAL —
Post& Beam
Rough-In — ------ --
Gas Line
Smoke Dampers - - -- ----- —
Final
�P-A�S-�S_ PART FAIL - �-
. '�tCT y AL
orrice
Rough-In
UG/Slab
L.uw Voltage --
Fire Alarm
n Reinspuction fee of$ . _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS _PART FAIL
_ Pleas,-,--,.ill for reinspection RE: _ Unable to inspect-no access
Fire Supply Line
ADA I �] /, T�71�
Approach/Sidewalk Date _-'� / _ _l--_-v ----- inspector ___------ -------Ext -
Other: _
Final r0 NOT REMOVE this Inspection record from the Jab site.
PASS PART FAIL
CITY OF T'IGARD 24-dour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 BUP
Received —__ Date Requested— 5__tf - AM PM BUP -- ---- --
Location j k 7570 _ MEC
Contact Person _- — —_-- Ph( ) - PLM --
Contractor_ -- - -- — Ph(--) --�L��� SWR - --
BUILDING TenantrOwner __— _� _ ELC _
Fouting -� - ELC
Foundation Access:
Ftg Drain ELR -_
Crawl Drain SIT
SI&;, Inspection Notes:
Post&Beam -------- -- - - —--
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shoar
Framing - - -
Insulation ✓/ C --
Drywall Nailing y
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling "�_ -�•--�)
Roof I - ��/✓ Q '� l L —
Other: __
Final -
PASS PART FAIL
PLUMBING -- — —
Post& Beam
Under Slab -- - --- —
Rough-In
Water Service -- -
Sanitary Sewer —
Rain Drains
Catch Basin/Manhoo _
Storm Drain
Shower Pan
Ot
RT I /
PosT& earn
Rough-In -- ---
Gas
Gas Line
Smoke Dampeis
Ft•aal
PASS PART FAIL
ELECTRICAL
Service ------ - ------- -
Rough-In -- —
UG/Slab —
Low Voltage --- -— _ - -
Fire Alarm
Final Reinspection fee of$_ —_____required before next inspection. Pay at City Hell, 13125 Sit)Hall Rlvd.
PASS PART FAIL
SITE — E.] Please ca l for reinspection RE:-- -- �— Unable to Ir-pert-no access
Fi,e Supply Line
i',Irpru�!h Sklewalk Date Inspector - -- -.
('then
Final DO NOT REMOVE this Lespectlon record 1 rom the Job ,Rite:.
PASS PART FAIL
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WESTERN CASCADE ELECTRIC IN
11867 SW WILTON AVE ' V
TIGARD, OR 97223
o
D
Electrical Signature,,'gW\0�
Permit #: MST2002-00430
Date Issued: 11/26102
Parcel: 2S103AC-OFP01
Site Address. 128:;0 SW FONNER POND PL
Subdivision: ON FONNER POND TOWNHOMES
Block. Lot: 001
Jurisdictions TIG
Zoning: R-4.5
Remarks: New SFA attached, Path 1.
Your company has been indicated as the electril:al contractor for the permit indi,-ated above. In order for the
electrical permit to r e valid. thr signature of the supervising r,le,16cian is required. Please have the
appropriate individual from vour company sign below and retun this Electrical Signature Form prior to the
start of the work to the address above, ATTN Building Division.
No electrical inspections will be authorized until this completed form is received
OWN EF ELECTRICAL. CONTRACTOR.
NUPARK DEVELOPMENT WESTERN CASCADE ELECTRIC INC
PO BOX 230421 '11867 SW WIL fON AVE
TIGARD, Oil 97281-0421 TIGARD, OR 97223
Phone ft 503-504-1998 hone #- 503-521.0000
Rey #: ELE 34-r,10(
SUP 4025"'
LIC 153.116
AN INK SIGNATURE IS REQUIRED ON THIS FORI"A
X
Sign r Supervising Tectnaan
If you have any questions, please call (503) 639-4171, ext # Vfib
�� �� ������ MASTER PERMIT
PERMIT#: MS1'2002-00430
DEVELOPMENT SERVICES DATE ISSUED: 11126/02
1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12850 SW FONNER POND PL PARCEL: 2S103AC-0FP01
SUBDIVISION: ON FONNER POND TOWNHOMES ZONING: R4.5
BLOCK: LOT: 001 JURISDICTION: I'It 1
REMARKS: New SFA attached, Path 1
BUILDING
REISSUE: J STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NLW HEIGHT: 25 FIRST ,',F s1 BASEMENT of LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 411 SECOND 941 if GARAGE 112. sf FRONT: 27 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT sf RIGHT:
IS
OCCUPANCY ORP: R9 BbRM: 4 BATH: 1 TOTAL: 1,599 sl VALUE: 1511.815 20 t,REAR.
PLUMBING
SINKS: 1WATER CLOSETS: 1 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORI_S: :1 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS
TUB/SHOWERS: 2 GARBAGE DISP: I WATER HEATERS I WATER LINES: 100 eCKFLW PREVNTR: 1 GREASE TRAPS:
O i HER FIXTURES:
MECHANICAL _
FUEL TYPES FURN<100K: 1 BOILICMP<3HP VENT FANS: 4 CLOTHES DRYER: 1
n; FURN>000K: UNIT HEATERS: HOODS: I OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNI1 _SERVICE FEEDER TEMP SRVCIFEEDERS - !:RANCH CIRCUITS MISCE''ANEOUS ADO'L INSPECTIONS
1000 SF OR LESS. 1 0 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPIIRA,GATION: PER INSPECTION:
EA ADD'L 500SF: 2 201 400 amp: 201 400 amp: tel W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 8110 amp: 401 - 000 amp: EA ADDL SR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 001 • 1000 amp: e01+amp6-1000v: MINOR LABEL:
1000♦amolvolt
FLAN REVIEW SECTION
Reconnect nnly:
>-4 RES UNITS: SVCIFDR>=225 A.: >600 V NOMINAL: CLS AREABPC OCC-
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC, LANDSCAPEIIRRIG: PROTECTIVE SfGNL:
GARAGE OPENER: CLOCK, INSTRUMENTATION: MEDICAL OTHR:
HVA:: DATA/TELE COMM: NURSE CALLS TOTAI "SYSTEMS•.
Owner: Contractor: TOTAL. FEES: $ 6,019.60
NUPARK DEVELOPMENT INTERLOCKING ENTEF?RISES INC This d rmitMunicipal
IslGsubject to the regulations contained in the
PO BOX 230421 10740 NW CORNELIUS PASS RD. Tigard Municipal a de,law State o OR. Specialty Codes and
all other applicable laws. All work will be done In
TIGARD,OR 97281-0421 PORTLAND,OR 97231 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:
Oregon law requires you to follow rules adopted by the
Phone: 503-S0µ• 1998 Phone: 503.531-3635 Oregon Utility Notification Center. Those rules are set
forth In OAR 1152-001-0010 through 952.001-0080. You
R°11"' LIC 90272 may obtain cuples of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Structural Underfloor Insulation Plumbing Top Out Shear Wall Insp Rain Drain Insp
Sewer Inspection Post/Beam Mechanica Electrical Service Framing Insp Exterior Sheathing Inst Water Line Insp
Footing Insp Plm/Underfloor Electrical Rough-in Gas Line Insp Firewall Insp Appr/Sdwlk Insp
Foundation Insp Crawl Drain/Backwalpr Mechanical Insp Gas Fireplace Gyp Board Insp Smoke Detector
Erosion Control Ftg Drain Bsm't Walls Low Voltage Insulation Insp Engineered grading fin Backflow Preventor
Issued By : �� '_ 'L''' ti��'f-' Permittee Signature _
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWEkCONNECTION PERMIT_
DEVELOPMENT SERVICES PERMIT#: SV00285
DATE ISSUED: 11/26/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S103AC-OFP01
SITE ADDRESS; 12850 SW FONNER POND PL
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICI ION: —
TENANT NAME:
USA NO. FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SFA.
Owner: — FEES__
NUPARK DEVELOPMEN r Description Date Amount
PO BOX 230421
TIGARD, OR 97281-0421 1 SWUSAI Swr Connect 11/26/02 $2,300.00 l
ISWINSP)Swr Inspect 11/26/02 $35.00
Phone: 503-504-1998 Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply -,vith all the rules and regulations of the Clean Water Services. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the 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: i'Z _ Permittee Signature:
Call (503) 639-4175 by 7:00 r.M. for an inspection needed the next business day
a
'-7 J 5 r // J111 e, Z- R
'Building Permit Application
a Date received:/ole, C1 Permitno.:etL
City of Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: edalc
qu/7igurrl Uatcissucd; c1'f/ kccciptnu.:
Phone: (503) 639-4171 _.
Fax: (503) 599-1960 Case file no.: Payment type:
Land use approval:
I&2 family:Simple Complex:
_ �
U I &2 family dwelling or accessory U t ,mow i�iuliind-11 ctl U Multi-family ew construction U Demolition
U Addition/alteratiott/replacement U Tenant improvement U Fire sprinkler/ amt U Other: r'
INFORMATION
Joh address: ,� ate- r_ tV J Bldg.no.. Suite no.:
Lot: Br ck: Subdivision: _—,fax reap/tux lot/account no.;
Project name: Lr
��� l
Description and location of work on premises/special conditions:-J k- kL -- -- -- -.__-
1011 Sill ( IAL 1
Mailing address: ' [ i I &2 tamilr 11"elling: C� y, \
Cit :' titate: ` 'l.IP. e� Valuation of wort, .................................. $ 5 6/j,.
Ph I ux: li mail: No.ol'bedrooms/hath .............. ...... ...........
O e 'srepresentativr: .�/' _ Total number of tl m it ............................... _--
p .. - Fac Email: New dwelling arra I l l.) ....(.:?..`<.Y.........
Garage/carport area(sq. Il.).....:'ZZ.........
Nate: _ QIJG gry'�'gplR1S6S Covered porch area(sq. 1).) ..........�..�.......... — --
Mailing address: t01�ON,�! KWW Deck area(sq. ft.) ........ .......... ...... .......... 1
C'itp(nAW,� a c. ZIP: Usher structure arca(sq. Il.). .......
.. . ... . .. _-_--
yCommerciallindustriallmulti-fanally:
Phone: Fax: E-mail:
Valuation of work...................................
Existing bldg.area(sq.ft.) .. .......... ..........
Business name: New bldg.arca N. ft.).............. —
Address: _ MUMIINGBN1ERP ___--- Number of stories................
City X C("NtN gQ6t l.IP: Type of construction..,.... .,
e ........................ —
Phonc: i3 -3( 3� I�ORi'ilt>�• rl' Occupancy group(s): Existing: _—"- __.--
CCF,no.: q 02,7i - —�jfc]1 (AI 1 'qM)F>- New:
City/metro lic.no.: Notlee:All contractors and subcontractors are required ha he
licensed with the Oregon Construction Contractors Board under
Name: �r � provisions of ORS 701 and may be required to he licensed in the
jurisdiction whets work is being Performed. If the applicant is
Address: &V exempt from licensing,the following reason applies:
City: StateZIP:
('(,p'Verson:: C Plan no.: -- --- �_ -—
Ph nal. Fax:,_ 3 : mail:
Name: le Contact perso6 t ees due upon application ........................ .. $ —
Address: -- Date received: _ —
City: State: ZIP: Amount received .........•...................... ........ $..__—___--
Phone: - Fax: E-mail Pleuse refer Its tee schedule.
I hereby certify I have read and examined this application and the Nm alt Judsdlcaons accept credit cards,please call JuNadictior for more mfmmntton
attached checklist. All provisions of lawx7and ordinances governing this U visa U MasterCard
work will he complied wi ,whetJaer em"or not. Credit card number — — _._ lmxpitea
Authorized signature. Xt l / me Dale: / Y'r. Naof c ,ol r as shown on credit card S
Print name:_=L.1'C'ti 71 l ��/ 1�1�� — C older signature
Amount
Notice:'Phis permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-461.1 rtsAorvd'oM)
a
f
('ommercial Plan Submittal
Requirement Matrix
TYPE. OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building �*
Fire Protection System 3**
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
L -----
Plan review is dependent upon submitta! olf a completE d application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over-the-counter commercial tenant improvements, submit 2 sets of plans.
New' fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\dsts\forms\COM-matrix.doc 9/24/01
Plumbing Permit Application
Date received:/s /�' 0•`t Permit no.:
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,•Tigard,OR 97223
City of Tigard phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approval: _ Case file no.: Payment type:
❑ 1 &2 family dwelling or accessory U Commercial/industrial ❑Multi-family J Tenant improvement
ew construction U Addition/alteration/replacement ❑Food service U Other:
Description kh . Fee(ea.) Total
Job address: )_���� . _� ��1 - New 1-and 2-family dwellings only:
Bldg,no.: Suite no.: (includes 100 ft.for each utility connection)
Tax map/tax lot/account no.: 1 SFR(1)bath
Lot: Block: ISubdivision: SFR(2)bath
Project name: SFR(3)bath
City/county: igaAAA ` ZIP: Each additional bath/kitchen _
Description and atimt of work on premises: _ Siteutllitles:
_ _ _ __ ___ Catch basin/area drain _
Est.date of complelion/inspection: D wells/leach line/trench drain_
Footing drain(no,lin.ft.)
Manufactured home utilities -
Business name: w Manholes
Address: Rain drain connector
City: State Sanitary sewer(no.lin.ft.)
Phone: -,3LI I Fax: E-mail: Storm sewer(no,lin.ft.)
CCB no.: Plumb,bus.reg.no:
Water service(no. lin. ft.)
City/metro tic.no.: Fixture or Item:
Contractor's representative signature: Absor tion valve
Back flow preventer
Print name: Date: l Backwater valve
Basins lavatory _
Name: IBRPR�6Sf � Clothes washer _
Address: IOL40N.W.CORN J1l/SPASS ROAD _ Drinkin ie�s) _
Drinking fountain(s)
City: PORMM,ORHGO SPII�l: Zip: Ejectors/sump
Phone: Fax:Li 7 :mail: pansion tank
Fixture/sewer cap
�_— -.. _
Name(print): - Floor drains/floor sin s/hub „_
Mailing address: Garbage disposal _
Hose bibb
City: State: 7,IP:q y ce maker _
Phone: Fax: E-mail: nterce�tor/grease trap _
Owner instailation/residential maintenance only: The actual installation Pomer(s) _
will be 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. in (s),basin(s), ays(s)
Owner's si nature: Date: Sum
Tubs/shower/shower pan
_ _ Urinal
Ndmc: --- --- - - — --
�'" Water close
Address: Water heater
City: State: ZIP: Other:
Phone: Y Fax: I E-mail: Total
401 all Jurisdictions accept credit cards,please call Jurisdiction for more Infomratlon. Notice:This permit application Minimum fee................$,
Ll Visa ❑MasterCard expires if a permit is not obtained Plan review(at ._ %) $ _
Crean card number State surcharge(8%)....$
— Expires within 180 days ager it has been
Name or cardholder u shown on credit carol
accepted as complete. TOTAL .................. ....$ _
S
Cardholder elpature -- Amouni_ 440.4616(60"M)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIX'rURES (individual QTY ea' AMOUNT (includes all plumbing fixtures in PRICE TOTAL.
Sink ` e 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
16.60 for each utility c_o_n_nection -_
Lavatory One 1 bath__ _ $249.20
Tub or Tub/Shower lamb- 16.60 Two 2 bath __ $350.00
Shower Only
- -- 16.60 Three 3 bath _ $399.00
Water Closet 16.60 SUBTOTAL
U incl - 16.60 8'/.STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
TOTAL
Garbage Disposal _ 16.60 -
Laundry Tray 18.80
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16'60 PLEASE COMPLETE:
3" 16.60
4^ 16.60 - ---
-- Quantity b Work Performed
Water Healer O conversion O like kind 16.60 Fixture Type: New Moved Replaced Removed/
Gas piping requires a separate mechanical Capped
_permit. -- - -�
MFG Home Now Water Service 46.40 Sink__
46.40 Lavatory --
MFG Holne Now San/Storm Sewer Tub or Tub/Shower
Hose Biba 16.60 Combination _
Roof Drains 16.60 Shower Onl
Drinking Fountain 16.60 Water Closet
Urinal --
Other Fixtures(Specify) 16.60 Dishwasher-
Garbage
ishwasherGarba a Dis osal
Laundry Room Tray
Washing Machine
Floor Drain/Sln1,: 2"
Sewer-1 st 100' 65.00 3"
Sewer-each addilional 100' 46.40 4"
Water Service-tat 100 55.00 Water Heater
48.40 Other Fixtures
Water Service e each additional 200' (specify) -_
Storm&Rain Drain-1st 100' 55.00
Storm&Rain Drain-each additional 100' 46.40 -
Commercial Back Flow Prevention Device 46.40
Residentlal Backflow Prevention Device' 27.55 _
Catch Basin 16.60 ---
Inspection of Existing Plumbing or Specially 62 50
Rriuested Inspections _ er/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 -
Grease Traps 18.60
QUANTITY TOTAL -
Isometric or riser diagram Is required If ---
_ Quantif Total is >9 -
"SUBTOTAL
8%STATE SURCHARGE -
""PLAN REVIEW 25%OF SUBTOTAL
Required only II fixture qty.total Is 9
TOTAL $
"Minimum permit fee Is S7250•8%state surcharge,except Residential Backflow
Prevention Device,which Is 536.25+8%state surcharg9.
""AIL Now Comma•clsi Buildings require 2 sets of plans with ItOms'rtc .r riser
diagram for plan review.
l:\dcts\fomis\plm-fees.doc 12/26/01
Mechanical Permit Application
,1
"Dateeived:/( �� r Permit no.: �' �-
City of Tigard Project/appl.no: Expire date:
C 5ry of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no
Phone: (503) 639-4171 ------ --- -..
Fax: (503) 598-1960 Case file no.: Payment type
Land use approval: Building permit no.:
t
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family 'J Tenant improvement
cw construction U A(ldition/alteration/replacement U Other: __
0; SITE INFORMATION COMMERCIAL VAIAWI[ON SCHLIDULF
Job address: � ,`y, j. 0wi T; �e_ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: I Suite no.: value of all mechanical material-,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: Subdivision:
*See checklist for important application information and
Project name: r,a icjurisdiction's fee schedule for residential permit fee.
City/county: ZIP: FEg"SCIIEDUE
Description and I alio of work on premises: t � t t i
I�rlre•) Iulal
Est.date of completion/inspection: _ Deecrlpdon th>_ Roy.onh
Tenant improvement or change of use:
Is existing space heated or conditioned'?U Yes U No Air handling unit Cf M
r con tionmg(alio Tan required)
Is existing space insulated?U Yes U No Alteration of existing- ` � system
of er compressors
Business name: s CFTC State boiler permit no.:
NP Tons B-U/H
Address: _ it•smo a amper. uct smoke detectors
Cil : State: ZIP: eat pump(sttc p an requ re )
Ph t t Fax: E-mail: nstu rep ace urnace urner
Including ductwork/vent liner U Yes U No
CCB no.: � ,� nsla replacr re ocale heaters-suspended.
City/metro lic.no.: wall,or floor mounted
Name(please print): i'Y- , �G�tVent for appliance other than furnace
Refrigeration:
Ah.urrplron units BTU/11
Name: b FWASPRISESINC. ChillersHP _
Address: -- eW IV W r'.. IIP
u,re5soi., _--
Tills vironmental exhaust and ventilation:
City-- : ZIP: Appliancevent
Phone`: t r- f rx: f f: m;�i! )ryerex oust
0o s, ype res. tic a ar.mat
hood fire xuppression system
Name: Exhaust fan with single duct(bath fans)
Maili-Ig addres.: Exhaust system apart from heatingor C
Cil Slutc: ZIP. Fuelpiping an et it on(up to outlets)
Type: LI'CJ NO Oil
PI - Fa x: Email ue t r n sac additional over out ets
rocesepiping(wc emaucr"—' required)
Name: Number of outlets
1OtherTr %ed appliance or equipment:
ment:
Address: _ Uecolntivcfiireplace
City: --- _ State: ZIP:
ty _
Phone:+ 'ax: Email: coo stov pe et stove
Other:
Applica)rt's signature;
Name(print):_- it JLIJ, jab
Not 0 Jurisdictions accept cretin canis,please cell jurisdiction for move Infonmtion Permit fee.....................$ _
UViae fl IdaslerCerd Notice:This pernit application Minimum fee............ $ _^
expires if a permit ie not obtained Plan review(al — 96) $
(n•da earl numlwr
r.xpirer within 190 days after it hes been State surcharge(896)....$ _
sMuir of cardholder as shown on c t card accepted as complete.
Cardholder sipalure Arn)wit 1444617(OWW OM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
�: _�-
-- -- Price Total
_TOTAL VALUATIO_ N: PERMIT FEE:
Description: Qty (Ea) Amt
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code _ Amt-
$1.00
to$10,000.00 $72.50 for the first$5,030.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional$100.00 or Includina ducts&vents 14.00
2) Furnace 100,000 BTU+
fraction thereof,to and Including
$10 000.00. indudin 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 6.80
$1.45 for each additional$100,00 or -
fraction thereof,to enr''nduding 6) Repair units 12,15
$50000.00. -
$50,001.00 and up 5742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
fraclior.thereof, footnotes below. Comp
7)<3HP;absorb unit
Minimum Permit Fee$72.80 OTAL: $ to 100K BTU 1$.00
8%State Surcharge $ 8) 15 absorb 25.60
unit t 100kk t to 500k BTU _
25%Plan Review Fee(of subtotal) $ 9) HP;absorb 35.00
Required for ALL commercial permits only unit
.5-1.5-1 mil BTU
10)30.50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20
_ 11)>50HP;absorC
- unit>1.75 mil BTU 87.20
12)Air handling unit to 10,000 CFM
ASSUMED VALUATIONS PER APPLIANCE: 10.00
Value Total 13)Air handling unit 10,000 CFM+
Desai tion: Ql 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 including vent 955 16)Ventilation system not Ind, ded in
Suspended heater,wall heater or 955 a liance permit 10.00
floor mounted heater 445 17)Hood served by mechanical echaust 10.00
Vent not Included in applicance _-
_permit 805 18)Domestic incinerators 17.40
Re air units
<3 hp;absorb.unit, 955 19)Co. mercial or Industrial type Incinerator
to 100k BTU _ 69.95
3-15 hp;absorb.unit, 1,700 20)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
mil.BTU 5.a0
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1,75 mil,BTU
>50 hp;sbsorb.unit, 5,725 -Minimum Permit Fee$72.50 SUBTOTAL: 5
>1.75 mil.BTU
Alr handlingunit to 10,000 cfm 656 8%State Surcharge $
Air handlinunit>10 000 cfm _ 1,170g _
Non-portable eva orate cooler 858 _ TOTAL RESIDENTIAL• PERMIT
Vent fan connecte'l to a single duct 446
Vent system not Included In 656 ---
appliance permit Other Insoectlon and es:
Hood served by mechanical exhaust 656 1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic Incinerator _ __ .170 $6250 per hour
Commerdal or Industrial Incinerator 45902 Inspections for which no fee is specifically Indicated (minimum charge-half hour)
Other unit,Including wood stoves, 656 Additi per hour
In98rts,etc. _ __ _ 3 ddillonal plan review required by changes,additions or revisions to plena(minimum
Gas I Ing 1 4 outlets 380 charge-one-half hour)$82 S0 per hour
Each additlonal outlet _ _- 83 State Contractor Boiler Certiflcatlnn required for units>200k BTU.
_ . "Residential AIC requires site plan showing placement of unit.
TOTAL COMMER_.CIAL_ _
VALUATION: _. __--_�_ All New Commercial Buildings require 2 sets of plans.
IAdst%\forms\meth-fees.doc 12/26/01
Electrical Permit Application
Datereteived:/0/D Permit no.:
City of Tigard Project/appl.no.: Expire date:
Ca)r,f 7 igard Address: 13125 SW Nall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case fiileno.: Payment type,
Land use approval: _
XVPE OF
&2 family dwelling or accessory U Commercial/industrial U Multi-fantily U Tenant improvement
New construction U Addition/aheration/replace❑t,.nt U Other: J Partial
)oh address: Bldg,no.: Suite no.: ITax map/tax lotfaccount no,:96165
Block: Subdivision:
Projeci name: Description and Ir,, i,nm of work on premises:
Estimated date of conipletion/inspection:
CONTRAC11'0111 APPLICATION FEC SCUMULIE
Job not tee nix.
-- Description (e&) 1 otal no.Ins
Business name: tift,t,t_.� [=)ei_:jr^r
Ne"m+irkurral single ormulti-fxmil)per
Address (� �( I i', f jL� dr+cllingunit.lot ludryaltacIK41gxrage.
City. '( Shite: R_ ZlP:-rj Servicehsciuded:
E-mail: ft or less --- 4—
C'CB no.; Elec.bus.lic.nn: Each additional SW sq.ft.or union thereof `
Linoed energy,residential
City/metro lic, no.: C se-A syy - Liruitcdenc_r y,non-resrdennpl 2
e el- i� F.aclt munufnm
ctured hoe(it modular dwelling
Service and/or feeder
titf+,n;nurr of sl ery electrician(requiredf --- I' t
-�—
-- Services or feeders-Installation,
alterallon or relocation:
200 amps or less 2
Nome(print): �(f (� 2O1 amps to 400 amps 2
401 amps!o 600 amps 2
Mailing address: _ 601 amps to 1000 amps 2
City• State: Z . Over iOW amps or vol s 2
Ph1'9�rax: E trail: Keczmncclonly I
Ove ner installation:The installation is being mnde on property 1 own Temporary services or feeders-
++luch is not intended for sale,(ease,rent,or exchange according to in.t,illation,alterst Ion,or relocation:
200 amps or less
(WS 447,455,479,670,701. �- 2
201 Amps to 41w amps
Ot+tlef 5 SI nulUfe: i);Ili': _ _ 101 to 6W mus '_
Branch circuits•new,alteration,
or extension per panel:
Name: A Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit
�;,y: _ sate: zlP: It Fee for branch circuits without purchase
_--. __ ---— of service or feeder fee,first branch circuit: 2
I'Itnnr. I rix l' ilea l Gachadditional branch c:rcoo
Mise.(Service or feeder not included):
U Service over 225 amps-conttnerctal U Hr,rhh care Wilily Bach pump or irrigation circle
J Service over 320 amps•tating of 1&2 U Hazardous location Each sign or outline lighting 2
fantilydwellings U Building over 10,(100 square feet four or Signal circuil(s)or n limited energy panel,
U Svstem over 6W volts nominal more residential units in one structure alteration,or extension' _
U Hudding ovet three stories U Feeders,4(x1 amps or more *Dest:n uow —
J t kcurant load over 99 persons U Manulactured structures or IAV park Loch additional Inspection over the allo"able in any of the above:
J I,fiess/lil!lnutpPIall U Other ----_ -_--_.- --.^- Per inspection F-- —=-
-7
submit sets of plans with any of the above. alvesugal on fee
The above are not applicable to tempo my construction service. other —
------
Nor all IuNsdrerlorn srreM credit cards,please call Jurisdiction for more inflttmauon Notice: irttts permit application
Permit fee.....................
U Visa U Mamerc'ard expires if a permit is not obtained Plan review(at _ %) $ -
utedu cud number / within 180 days alter it has been State surcharge(8311 . ..S _
accepted as complete. TOTAL .......................$ _
Name of csNholder a shown on c x card
S _
Cudholdet si ature -- - Amount 4404615 INIV W 1
-----
St�t1fX F,ttaNT 1U!•an p6E t7c:
LOT 1 ---__I 15.00•
oj---s oo• '
--39'-�----�. BUILDING 111 o
GRAU�Z I r2-9 I--LOT LINE (TYP)
LOT 2 0
----zi•-ir IZ BUILDING 2 0
LUT 3 I-�j 15.00
--27.00• -- BUILDING J -'+ -5.00•
LOT 4 I
_ 6JILDING 4
27.00 . .. LOT 5 v j-`:1500•
' BUILDING 5 —I �-�.00
I I
LOT 6 I
BUILDING 6 I
ti
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a rp e r H ou f av►cnrrvc SMACKS
_ „r=on —--
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171
BUP
Received � �SL'Z __�Date Requested_ �~ r�3 AM-_ _ PM _ BUP —__--
Location _.Suite___._—_ _____ MEC -
Contact Person ___ Ph( ) 51 �l�Z PLM
Contractor ----------.------- _ -_--- Ph( ) —-- SWR --
UILD Tenant/Owner _ ELC
— -- -------
Footi ng
IELC
Foundation
I Access:
•I ,-i t , : ,. ,. �=-U r��..., L. y,n
Fig 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 4N 511_ 02
-in€11,,,� ---
A3�liART FAIL -- —_
ISL BINQr
_.. ---
Post&6eam
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
ELECTAICAL
— --- -- -----------
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:-- —_ [j Unable to inspect-no access
Fire Supply Line
ADA O
Approach/Sidewalk fate _ � ' Inspector ._ ��_�_ _ Ext
Other
Final DO NOT REMOVE this Intslpoctlon rec rd from the Jobs site.
PASS PART FAIL
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
SUPERIOR PLUMBING LLC
830 JOHNSON STREET
WOODBURN, OR 97071
Plumbing Signature Form
Permit #: PLM2002-00175
Date Issued: 5/23/02
Parcel: 2S 103AC-OFP01
Site Address: 12850 SW FONNER POND PL
Subdivision: ON FONNER POND TOWNHOMES
Block: Lot: 001
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Water Service as a condition of SUB2001-00002, Install a minimum 1 1/4" water
service.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work .
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
NUPARK DEVELOPMENT LLC SUPERIOR PLUMBING LLC
PO BOX 230421 830 JOHNSON STREET
TIGARD, OR 97281 WOODBURN, OR 97071
Plicne #: 503-297-6551 Phone #: 503-982-2517
Req #: LIC 133461
PLM 24-373PB
SUP 5819JP
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X/
Siqnature of Authorized Plumber
If you have anv questions, please call (503) 639-4171, ext. # 310
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: P 00175
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/22 3;023/02
PARCEL: 2S103AC OFP01
SITE ADDRESS: 12850 SW FONNER POND PL
SUBDIVISION: ON FONNER POND TOWNHOMES ZONING: R-4.5
BLOCK: LOT- 001 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE. SFA WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
';INKS: URINALS: GREASE TRAPS:
LAVATO.',IES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS. WATER LINE: 265 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Water Service as a condition of SUB2001-00002, Install a minimum 1 1/4" water service. --_
_V EES
Owner: Type By Da.e Amount Receipt
NUPARK DEVELOPMENT I-LC PRMT CTR 5/2.in? $101.40 27200200000
PO BOX 230421 PLCK CTR 5/22/02 $25.35 27200200000
1IGARD, OR 97281 5PCT CTR 5/:e2i02 $8.11 27200200000
Total $134.86
Phone 1: 503-297-6551 ----
Contractor:_ ----
SUPERIOR PLUMBING LLC
830 JOHNSON STREET
WOODBURN, OR 97071 REQUIRED INSPEC71ONS
Water Service Insp
Phone 1: 503-982-2517 Final Inspection
Reg #: LIC 133461
PLM 24-373PB
SUP 5819JP
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 clone in accordance with approved plans.
This permit will expire it work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules rjr direct questions to OUNC by calling (503) 246-1987.
Issued B _ Permittee Signature:
Call (563) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
17
Plumbing Permit Application 00000"iiiii
Datereceived: 2 a7; PermitnoeM;M2
City of Tigard Sewer permit no.: Building permit no.:
At Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of Tigard phone: (503) 639-4171 Projecl/appl.no.: Expire date:
Fax: (503)598-1960 Date issued: By: Receipt no
Land use approval: S�� OD 1 -baa D a. Case file no,: Payment type:
TYPE OF PERM'111
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
J New construction U Addition/alteration/replacement U F(x)d service U Oflier:
JOB SITE INFORMATION + ' '
Job address: �� -, t> �Ct� A/NF/( YvN� �a� Description (1t}. hcc(ca.) 'Total
Bldg.no.: Suite no.: Ne" I-and 2-fandis dnellings oul}.
(inc•lude.too 11.foreachutilit}conncctlun)
Tax map/tax lot/account no.: _- SFR(I)bath —,
Lot: Block: Subdivision: pN rjA,,,sN Lw; SFR(2)bath
Project name: d'y F.'V'V oyt ,:*-, SFR(3)bath _
City/county: ZIP: Each additional hath/kitchen
Description and location of work on premises: a �wv,'ut- SlteutlUties:
_ Catch basin/area drain _
Est.date of completion inspection: S 7 o Z Drywells/leach line/trench drain
Footing drain(no.lin, ft.)
PLUMBING CONTRAU7OR Manufactured home utilities
Business name: ` h/nk• _ Manholes
Address: 8,60- ,t/ S Rain drain connector
Cit : u O v+rn State: ZIP: / Sanitarysewer(no.lin.ft.)
y ---4— Storm sewer(no.lin,ft.)
Phone: j;-SSI Fax: E-mail:
CCB no.: Plumb,bus,reg.no: Water service(no. in.ft.) G O
City/metro lic.I _,�'�' Fixture or{tem:
Absorption valve _
Contractor's representative signature: Back flow preventer
Print name: AA 17 Z Backwater valve
1 Basins/lavatory
Clothes washer
Name: ^ Dishwashher -- --— _
Address: Drinking fountain(s)
City: State:_ ZIP: Ejectors/sump
Phone: I ax: E-mail Expansion tank
Fixtute/sewer cap _
c, t L e— Hoor drains/floor sinks/hub
Name(print): N it Garbage disposal
Hose
Mailing address: ----,---- b
bibb
City: State: ZIP: ce maker
Phone-,, �-f • '; Fax: jr—mall: lnterce for/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _
employee on die property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) _
Owner's signature: Date: SumpLei 10 N I
Tubs/showcUshower pan
Urinal
Name: ---�- ---_--�__ _ Water closet
Addtess: Water heater
City: State: ZIP_ Othe.:� --- ^ —
Phone: —V Fax: E-mail: Coral _
Mininwm fee... _
Not all jWtatieUons accept credit cords,pleau call lurisdicdo n far more information Notice:'this permit application e.5 %
OVtaa ❑MasterCard expires if a perntit is not obtainePlan review( pS
d State surcharge(8%) ....$ I
Cradlt cord number:__�_--_ _ u -- within Igo days after it has been APM
Exp rea accepted as complete. ""......"""'S
Name of cardholder o rhown on etedu coals
$
T-D4' ^'I 3
Cardholder ai6natute Amount r•-- "o-1616(INUM YAM