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12870 SW FONNER POND PLACE-1 N O O lcn C n O 7 O fD O 7 CL 13 m 0 m 12870 SW Fonner Pond Place CITY 4F TIGARID 24-4our BUILDING MST Line: (503)639-417L MST .INSPECTION DIVISION DI`dISION Business Line: (503) 639-4171 BUp Received ___...__-_�-CTDate /Requested -� - _ AM .._-— -- PM SUP _ - Location 2 -L-� - {tom.--F-� ��-Suite MEC _ Contact Person Ph ( ___�) Sid S� - - PLM - Contractor, v Ph ( ) SWR BUILDING Tenant/Owner ELC_ -VO-6i 1'n9- ELC - Foundation Access: ) ELR Ftg Drain - Crawl Drain - I SIT Slab Inspection 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 Other: Final - PASS PART FAIT MECHANICAL -- --� Post&Bbarr. Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL - Service - Rough-In ---- - - UG/Slab Low Voltag- - - --— FRir -Alarm L'�y'+! �� Reinspection tee of$ --_-requi,-ed before next inspection. Pay at City Hall, 131?I; Sva Hall Blvd. `PASS PART FAIL -- Please call for rrmspection RE UnAble to inspect-no access Fire Supply Line ADA Inspector Approach/Sidewalk Dots 0'her: Final �- DO NOf (REMOVE this Inspection record from the job site. LPASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST T ReBLIP�__ ._� Date Requested__ `o pM P - — - - - BLIP �__- -� $7 U ��rt�-1st'. P Suite �-'"_- _ MEC -- Contact Person y - Ph(— --) PLM Contractor - - --- - �-- Ph SWR _- BUILDING TenanUOwner _ -_- Footing - —._ ELC —. Foundation ELC Ftg Drain Access: --- Crawl Drain _ U � �� ELF! Slab Inspection r4otes: SIT Poll&Beam - - - Shear Anchors --- Ext Sheath/Shear - - Int Sheath/Shear Framing - -- —.. Insulation _ Drywall Np+': ,g Firewall Fire Sprinkler -ire Alnrm --- Susp'd Ceiling Roof — Other: --- --r - ---- -- — — Final - - PA S,-_!7Rf FAIL - -- P MBING — -- - - Po �e — - — -- Under Slab Rough-In Water Service �--- -� Sanitary Sewer _ Rain Drains Catch Basin/Manhole - - - - - ---- - — Storm Drain -ShowerPan - Other: -- r S_ PART_ FAIL MEC ANICAL _ - — Post ---- ,aam - - -- -- _ Rough-In Gas Lino Smoke'.7ampe,; Finpl -- — PASS PART FAIL. ELECTRICAL - - - - _ Service - - - Rough-In UG/Slab Low Voltage — Fire Alarm - - -- -- - Final Reinspection fee of$ __required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ITE F] Please call for rr i,ispeclion RE:_ Fire Supply Line ---- �] Unable to inspect-no access ADA Approach/Sidewalk Date Insasctor Other. --- - Final DO NOT REMOVE this; Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Bus;ness Line: (503)639-4171 BLIP _ —__-- Received __ Dale Requested S fa�AM__- PM BUP Location ____ ,�_p_LJvyr, l< 4,nlgr &Suite_ _- -- _ _ - MEC -- Contact Person ____ _- Ph( ) - PLM - Contractor.— — -- - — ---- Ph( ) SWR - -BUILDING-___–, Tenant/Owner _ _ ELC Footing Foundation Access' [.�/ ELC -- _-- Fig Drain R ?� q - -- - Crawl Dr,.ir� / �b�c Slab Inspection Notes: `SIT Post&Beam Shear Anchors - - - Ext Sheath/Shear Int Sheath/Shear Framing Insulation _ Drywall Nailing `^ Firewall Fire Sprinkler - --- --- — ------ - — Fire Alarm Susp'd Ceiling —--- Roof Other: Fmaf --- _ MBI Post& Beam -- Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL ECHAtVic Post 6am Rough-In Gas Line Smoke Dampers Fin PA PART FAIT_ I NLECT_R_ICAL Service R)ugh-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�sll for reinspection RE: ___--__ _ Unable to inspect-no access Fire Supply Line ,ADA Approach/Sidewalk Data 214.7�_ Insppector -Lv Ext Other: Final DO NOT REMOVE this InspectNim:i re mrd frim the job site. PASS PART FAIL CITY OF TIGARD MASTER PERMIT DEVELOPMENT SERVICESPERMIT#: MST2002-00403 13125 SW Nall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 10/15/02 SITE ADDRESS: 12870 SW FONNER POND PL SUBDIVISION: PARCEL: 2S103AC-OFP03 BLOCK: ZONING: R-4.5 LOT: 003 JURISDICTION: TIG REMARKS: New SFA, Path 1 - model home#1. BUILDING REISSUE: STORIES: 1 FLOOR AREAS CLASS OF WORK: NEW REQUIRED SETS I:KS REQUIRED HEIGHT: 25 FIRST: 656 of BASEMENT: TYPE OF USE: SFA s1 LEFT: ;, SMOKE DETECTORS: Y FLOOR LOAD: 40 SECOND: 943 of GARAGE: 312 of FRONT: 27 TYPE OF CONST: 5N DWELLING UNITS: 1 PARKING SPACES FINBSMENT: of RIGHT: 0 OCCUPANCY GRP: R3 13DRM: 3 BATH: 3 TOTAL: !,599 of VALUE: 158 615:o REAR: 15 PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH: LAUNDRY TR<YS: RAIN DP,4IM: 10G LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: TRAPS SEWER LINES: 100 SF RAIN DNAINS: 1 CATCH BASINS:: rUBISHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: WATERLINES: 100 BCKFLWPRFVNTR: t GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN 100W 1 BOIL/CMP<3HP: VENT FAN": I LPG CLOTHES DRYER: 1 FURN>-100K: UNIT HEATERS: HOODS: MAX INP: 100,000 hit) FLOOR FURNANCES: OTHER UNITS: t VENTS: 1 WOODSTOVES: 1 GAS OUTLETS: 0 ELECTRICAL RESIDENTIALUNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS 1000 SF OR LESS: I MISCELLANEOUS_ ADD'L INSPECTIONS 0 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMP/IRRIGATION: PER INSPECTION, EA AOD'L SOOSF: 2 201 400 amp: 201 400 amp: 1st W/O SVCIFDR: 00 SIGN/OUT LIN LT: LIMITED ENERGY: 401 800 amp. PER HOUR 401 509 amp: EA ADDL OR CIR: SIGNAL/PANEL:MANU HMISVCIFDR: 891 • 1000 amp: IN PLANT. 801rompa•1000v: MINOR LABEL: 10004 amplvoll: Reconnect only: PLAN REVIEW SeCTION >-4 RES UNITS: SVCIFDR>-225 A.: >800 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL-RESTRICTED ENERGY A.SF RE31DENTIAL _ B.COMMERCIAL AUDIO fi STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOMIPAGING, OUTDOOR LNDSC LT: BURGLAR ALARM OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE_CALLS: TGTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,019.130 NUPARK DEVELOPMENT INTERLOCKING ENTERPRISES INC This permit is sutlect to the regulation;•contained in the PO BOX 23042.1 10740 NW CORNELIUS PASS RD. all other Municipal Code,Slate o OR. S3edone Codes and TIGARD.OR 97281-0421 PORTLAND,OR 97231 ,all other ce with hie laws. All work will he done it accordance with apNroved plans. This Hermit 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: Oregon law requires you to follow rules adopted by the Phone: 50 .297-6551 Phon.: 503-531.3535 Oregon Utility Notification Center Those rules are set forth in OAR 952-001.0010 through 952-001-0080. You Rep r: LIC 90272 may obtair,copies of these ruler.or direct questions to OUNC by calling(503)246-1987. REQUIRED!r'SPECTIONS Gvp Board Insp Erosion Control Electrical Service Fireplace Ins Firewall Insp Posf/Beam Structural Electrical Rough-in r Line Ins/ Exterior Sheathing h!sl Electrical Final Erosion Control Ins 8� p Gyp Burd Insp Plumb Final P Post/Beam Mechanica Mechanical Insp l Fireplace Rain Urain Ins Footing Insp Plm/Underfloor Plumbing Tap Out Insulation Ins P Mechanical Final Foundation Insp P Smoke Detector Building Final Crawl Drain/Backwater Framing Insp Shear Wa l Insp Backflow Preventorr Final inspection Issued By : Permittee Signature :� C Call)(503) 6394175 by 7:00 p.ni.for an Inspection needed the next sinews day CITYOF TIGARD SEWERCONIJECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-GO263 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10!15102 SITE ADDRESS; 12870 SW FONNER FOND PL PARCEL: 2S103AC-OFP03 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: 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: Ret .irks: Sewer connection for new SFA. Owner: — _ FEES NUPARK DEVELOPMENT Description Date Amount PO BOX 230421 TIGARD, OR 97281-0421 �SWI ISA I Swr Conned 10/15/02 $2,300.00 1SWINS111 Swr Inspect 10115!02 $35.00 Phone: 503-297-0551 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections I his Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The pe►mit 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: ,'-a� Permittee Signature: � • Gjl1� Call (503)639-4175 by 7:00 P.M. for an inspection needed the niness day Building Permit Application u -- Permit Datereceived:� ' t City of Tigard Project/appl.no.: edate- Address: 13125 SW Hall Blvd,'Tigard,OR 97223 Date issued: By Receipt no.: C'iiy of Tigard phone: (503) 639-4171 Case rile no.: Payment type: Fax: (503) 598-1960 f�100 OG6omplex: Land use approval: .Ju�iKoa%' i Rc2 f;tmily:Simple C JIM-720) l� ew construction U Demolition U 1 !'z 2 family dwelling or accessory U Commercial/industrial UMulti-family _ U Addition/alteration/replucement U Tenant improvement U Fire sprinkler/alarm U Other: t 7_ ' C ' 't tIy Bldg.no.: Suite no.: Job address: Lint no.. I .,` G t Lot: r-(7--C>,5 Block: S_ubdivisiun: r lf�s_POc x:+L __ _— Project name:Description and and location of work on premiscs/special conditions: Nan,e: N tf �. (. )1 I &2 family dwelling: Mailing address: D ZIP Valuation of work.... 4 City: Statct 17 I' ' /hths .......... No.of bedroomsa ................. ...... i,it�\•�,. � C' Fax: f?-mail: r Total number of floors..................... c �,�U- Q _Owncr's representative: 1'�., _ � I�:rx: II in . New dwelling sten(sq.ft.) .....l..�S..�,9........ , Phon r , Garage/carport arca(sq.ft.) � Covered porch area(sq. ft.) ..........J-0...... Name: - ....................................... ' Dcck rites(sq.ft.) . Mailing address: — Other structure area(sq. ft.)......................... City: CommerclaUlndusI allmuld•family: Phone: Vnluation of work................................... Existing bldg.area(sq. ft.) ................. ....... Business name: New bldg.arca(sq.ft.) ................ Address: Number of stories •.... ......•• City tT+ ' — 'Type of construction. Phorlti<"� 7 1 �tP flInil: Occupancy group(s): Existing: _ J3 j--�6 AW,e F ; . c N c�s: --- CCB no.: iL Z _ City/metro lie.no.: Notice:All contractors and suhcontracturs are required to he r licensed with the Oregon Construction Contrnctors Guard uncia provisions of ORS 701 and may be required to he licensed in the Name: Ain�� 1 `*'C 'Ck U-'"` 1^ ' jurisdiction%k here work is being performed. If the applicant is exempt from licensing,the following reason applies: City: , State .I ._ ZIP: IYJ= PI^n no.: _---- Contact person: - Phonc: Fax: c •' 1: mail: fees clue upon application ........................... $ Name: F(e.' r t Contact person: 1PRr J. )N �A pc Pp Date -- received: Address: State: Amount received ......................................... $ 77 SZIP::_ City: Please refer to fee schedule. Fax: E mail: Phone: 503 5(9 L= ---- FNot all juriulictioro accept credit erode,pi, call juriuliction rot mrnr information I hereby certify I have read and examined this application and the vrso U MaoletCard attached checklist. All provisions of la sand ordinances governing this dit card number __-__ ---- -' r; _ work will he complied wit ,whet e s ecilieh�lein or not. — Date: 12.- Norm of cardholder u shown on credit card $ Authorized signature: - nmount Cardholder dltnatore Print name: 440-4611 t�KY'u,t Noticc:This permit application expires if a permit is not obtained within IRU days oiler it has been accepted as complete. One-and Two-Family Dwelling Building Permit Application Checklist ttrference no.: Associated permits: City Of Tigard City of Tigard U Electrical U Plumhing J Mechanical Addresr,: 13125 SW Hall Blvd,Tigard,OR 97223 Anther: Phone: (503) 639-4171 Fax: 1503) 598.1960 T111F, F01,LOWING ITEMS ARE REQUIREDFOR PLAN REVIEW Ves No NIA I Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved platllot. 4 Fire disttict approval required. _ 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewer permit. 7 Water district approval. 8 Soils report.Must carry original applicable stump and signature on file or with application. 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. _ 10 3 Complete sets of legible pians.Must be drawn to settle,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with antis references between plan location and details. Plan review cannot be completed If copyright violations exist. LL I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if them is more than a 44 elevation differential,plan must show contour lines at 2-ft.intervals),location of casements and driveway;footprint of structure(including decks);location or wells/septic systems;utility locations;direction indicator;lot ar w building coverage arra;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation pian.Show dimensions,anchor bolts,tiny hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor pians.Show all dimensions,room identification,window size,locution of stroke detectors,water henter, _ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _ 1,1 Cross sectlon(s)and details.Show all framing-nienther sizes and spacing such us Moor beams,headers,joists,sub-floor, wall construction,moi'construction.More than one cross section may he required to clearly portray construction.Show details oral)wall and morsheathing,roofing,mor slope,ceiling height,siding material,footings and foundation,stairs, _ fireplace construction, thermal Insulation,etc. 1. Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must rcllect the actual grade if the change in grade is greater than four foot at building envelope. Cull-size sheet addendums showing foundation elevations with cross references arc acceptable. lo Wall bracing(prescriptive pant)and/or latera analysiti pians.Must indicnte details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. _ 17 Ploortroof framing.Provide plans for all floors/moi assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. 18 asement and retaining walls,Provide cross sections and details showing placement of rebar.For engineered systems,see item 22,"Engineer's calculations." 19 Ream calculations.Provide two sets of calculations using current code design values for till bentms find multiple joists over 10 feet long and/or any heam/ofst carrying a non-uniform load. 20 ianutactured flooriroof truss design detgllm. 21 ttergy Code rumplance,Identify the prescriptive path or provide calculations.A gas-piping schematic i:3 required for four or more arpliancc.q. 22 Engineer's calculations.When required or pmvided,(i.e.,shenr wall,roof truss)shall he stamped by an engineer or architect licensed In Oregon and shall he shown to',c applicable to thy pm;ect under review. 23 Five(5)site plans are required for Item 11 above. Site plans must be 8-1/2" x I I"or 11" x 17". 24 Two(2)sets each are re !fired for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and CUT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be In blue or hlaLk ink. Red ink Is reserved for department use only. 44(t 4614 twxM'oM) Building Fixtures Plumbia�g Permit Application ' NLV Date received: �� Permit no.: Sra Cr_ City of Tigm.i Sewer permit no.: Building permit no.: Address: 13125 SW Hall .31vd,Tigard,OR 97223 Cit of Tigard Phone: (503) 619-4171 Projecdappl.no: Expire date: Fax: (503) 598-1960 Date issued: By: _ Receipt no.: Land use approval Case file no.: Payment type. _ U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U Addition/alteration/replacement 1_1 rood service U Other: _ Job address: M Vj, �-O(V e( at j bi-t V-R- Description Qty. ree(ea.) Total Bldg. no.: Suite no.: New I-and 2-(artily dwellings only: (Includes 100 fr for each utility connection) Tax map/tax lot/account no.: O SFR(1)bath Lot: -�j�j Block: _ Subdivision: � t SIR(2)bath Project name: �{' SFR(3)bath City/county: ZIP: Brach additional bath/kitchen Description an ocati n of work on premises: Site utilities: Catch basin/area drain Est.date of completion/inspection: 2 Urywel s/leac ine/trench rain Footing drain(no.lin.ft.) Manufactured ome utilities Business name: ♦`i Manholes Address: -44i Rain rain connector City: State: Z.[PC — Sanitary sewer(no.lin. R.) — Ph Fax: E-mail: Stone sewer(no. lin. (l.) CCB no.: c Plumb.bus.re;.no:' Water service(no.lin. R. Fixture or item: City/metro lie.no.: — - - Absorption valve _ Contractor'sr_ presentative signature: Back Clow preventer Print name: Date: �_ ackwatcr valve _ CONTACT1 Basins/lavatory _ :Name: Clothes washer Dishwasher dress: Drinking fountain(s) Slate: 'ZIP: Ejectors/sump ne: Fax: -�' E-mail• Expansion tank _ - Fixture/sewer cap _ Floor drains/floor sinks/hub Name(print): 1/ f -- (3arba a isosal _ Mailing address: �{'ZI Ilose ibb City: I I(Ia,ycl, State ZIPj - Ice maker Pho Fax: I E-mail: Interceptor/grease trap _ Owner installation/residential maintenance only: The actual it s Ila ion Primer(s) _ will be made by me or the niaintenarlev and repair made by nt y lar Roof drain(comtnercial) employee on the property I ow t as a er 447.hi Sink(s),basin(s),lays(s) Owner's si nature: `�J( t.t t l r ' pate: Sump Tubs/shower/shower pan _^ Urine Name: e I It ___ __ Water closet Address: _ _ Water heater _ City: State: ZII': Other: Phone: Fax: E-mail: _ ota Minimum fee................ $ Not all Jurisdictions accept credit cards,please call Jurisdiction for more Information. Notice: This perm!! application U visa U MasterCard expires if a permit is not obtained Plan review(at u °'o) $ Credit card number �—L— within 180 days after it has been State surcharge(8/o).... $ •x Ives _ • p accepted as complete. TOTAL........................ .`.— Name of cardhol er a shown on meal,car - Cardholder signature S Amount 440.4616(6MCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2•famlly dwellings only: FIXTURES 'IndividuateCITY (so).60 AMOUNT the dwelling and the sincludes all plumbing 1t100 ft.xtures in QTY PRICE AMOUNT Sink TOTAL 18. 16.60 for each utility connection) Lavatory One 1 bath $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath _ _ $350.00 Shower Only 16.60 Three(3)bath $399.00 - Water Closet 16.60 SUBTOTAL Urinal 16.60 _ 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25•/a OF SUBTOTAL -- - _ TOTAL Garbage Disposal 1G.60 -- - - Laundry Tray 16.60 '."lashing Moc)lne 16.60 Floor Drain/FioorSink -1680 PLEASE COMPLETE: 3" 16.60 4^ 16.60 Quantity by Work Performed Water Heater O conversion O like kind 16.60 Fixture Type: New Moved Replaced Removed/ Gas piping requires a separate mechanical Capped permit. MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 4640 Lavato Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fl�.iures(Specify) 16.60 Dishwasher Garbage Dis osal '- Laundry Room Troy Washing Machine Floor Drain/Sink: 2" Sewer-1st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater -- 48.40 Other Fixtures Water Service-each additional 200' S tact Storm 8 Rein Draln-1st 100' 55.00 Storm&-Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 --- Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 62.50 Re nested Ins perthr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 18.60 -- -T-- QUANTITY TOTAL - Isometric or riser diagram is required If -- Quantity Total is >9 "SUBTO'i 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Requited oidy If fixture t total Is>9 TOTAL 5 "Minimum permit fee Is$72.60 4 8'.( state surcharge,except Residential Backflow Prevention Device,which Is$36 25+8%slate surcharge "All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. i:tdsts\forms\plm-fees.djc 12/26/01 Mechanical Permit Application rDatereceived. y /3 py Permit no.:t/yT .Ga'j O City of Tigard Projecl/appl.no.: Expire date: Of /7ih-mj Address: 13125 SW Hat' Blvd,Tigard,OR 9722:3 Date issued: By: I Receipt no,: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ Building permit no.: TVPE OF PERMIT U I &2 family dwelling or accessory U Commercial/indw trial U 7777 U Tenant improvement *New construction U Addition/alteration/replacement U Other•• I + t ) SCHEDULE O' Job address- 1 Indicate eouipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all wcchanical materials,equipment,labor.overhead, Tax map/tax lot/account no.: ' I profit. value$ Lot: 7j Block: Subdivision: 'See checklist for Important application information and _ t jurisdiction's fee schedule for residential pernsit fcc Project name: . t City/county. Y a ZIP: Description and )cation of work on premises: Total Ue.criptiun QIt. Ites.only Res.only Est.date of completion/inspection: UI _ Tenant improvement or change of use: Air handling unit __CFM Is existing space heated or conditioned?U Yes U No Air conditioning(site plan require ) Is existing space insulated'?U Yes U No Alteratiun o existing system WMIUM a er compressors State boiler permit no.: Business name: HP Tons BTU/H _ Address: _ it smo c amper sect smoke defectors Cit : _ State: ZI P:C 7 IL -Heat pumps to p( nn requtre ) r r ax, l E-mail: nsta rep ace urnac urner Ph _]] - Including ductwork/vent liner U Yes U No CCB no.: rj nsta rep ac re ocate seaters-suspen e d. City/metro lic.nc.: ICt:35 wall,or hoer mounted Vent orappliance other than furnace Name(please print): �� l Re r gent on: Absorption units— BTU/H Chillers _ HP Name: IIV16RUING F1V1'FlPlR11ES fN(; _ III, Com resscrs Address: 107 N. ranmcnta ex tau.•t an vent at on: City' rt7d +late:E:-mailZIP: Appliamevent _ Phone: Fax; .- -r : )rycrex aunt _ oo s, ypc res. nc en aztnat -_ hood fire suppression system Exhaust fan with single duct(both i �, ix taust system a amatinName: 1 Al _ -- Mailing addn`ss: see p p ng an str set on(up to 4 outlets) Cit Stale: ' ZIP 1 J Ty c: _•_LPO NO Oil I'h c. Fax E-mail: sec t to I each aaditiona over out els roress piping(sc emal.,required) Nunthei of outlets Other limiled appliance or equ pment: Address: �- Decorative fireplace State: ZIP: nscrt-ty a ---- City: oo stov pe el stove Phone: ax: Email: Applicant's signature V — D:stL�Nd1 M� --- — Permit fee....... .............$ — Not 0 judadicaons wcept credit cards,please cell jirdstlictlon rot tnorc inrortnation. Notice:'1115 permit application Minimum fel'................ U visa U MasterCard expires Kit permsi is not obtained Plan review(at — %) $ _ Credit card numher: __ within 190 days after it has been State surcharge(896)....$ accepted as complete. Name nr car n r ea a own on ere it c S TOTAL .......................$ .--- -- 4144G17 iNrxut OMt Cardholder signature �Atttount MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: _ Price Total Table IA $1.00 to$+,000.00 Minimum fee$72.50 Mechanical Code Qry (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU i $1.52 for each additional$100.00 or including ducts&vents 1a o0 Ju 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) including vent Floor Furnece 14.00 $1.54 for each additional$100.00 or Suspended heater,wall heater fraction thereof,to and Including 4) P 1a OU $25,000.00. or floor mounted heater $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit 6 80 $1.45 for each additional$100.00 or fraction thereof,to and Including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 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 fraction thereof. footnotes below. Comp Minimum Permit Fee$72.50 SUBTOTAL: 7) absorb unit $ to 1100K00K BTU 14.00 8%State Surcharge unit 100k to 500krBTU 25.60 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb 35.00 Red for ALL commercial ermits onl unit.5-1 mil BTU �_ 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20 11I �501113;absorb unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00 -- -- Value Total 13)Air handling unit 10,000 CFM+ Descri tion: Qt 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 vent Floor furnace Includin 055 16)Ventilation system not Included in Suspended heater,wall heater or 955 appliance permit 10.00 floor mounted heater 17)Hood served by mechanical exhar Vent not Included in appliance 445 10.00 permit Repair units 805 18 Domestic incinerators 17.40 <3 hp;absorb.unit, 955 IF)Commercial or Industrial type Incinerator to 100k BTU _ 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 1101k to 500k BTU 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU_ 5.4n _ 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1,75 mil.BTU 1.00 _ 3,50 hp;absorb.unit, 5,725 Minimum Permit Fee 572.50 SUBTOTAL: $ >1.75 mil.BTU _ Alr handlin unit o 10,000 c►m 656 8%State Surcharge $ Air handling unit>10,000 cfm _ 1 170 Non-portable evaporate cooler 656 TOTAL RESIDENI IAL PERMIT FEE: $ Vent fan connected to a single duct 446 I Vent system not included in 658 a Id ser ermll mechanical exhaust 656 Other Inspections and Fe": two hours) Hood served ne rator 1170 _ 1 Inspections outside of normal business hours(minimum chergo- Domestic Incinerator $62.50 per hour Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee is specifically Indicatted (minimum charge-half hour) Other unit,including wood stoves, 656 $62 50 per hour Inserts,etc. 3 Additional plan review required by champr<, Oditlons or revisions to plans(minimum Gas piping 1-4 outlets _ 380 charge-one-half hour)$62.50 per hour Each additional outlet 83 L 'State Contractor Boller Certiticatioc required for units>200k BTU. '"Residential A/C requires site plan showing placement of unit. TOTAL COMMERCIAL $ VALUATION: All New Commercial Buildingto require 2 sets of plans. I:\dst,\formsUnech-fees.doc 02/11/02 D•� Electrical Permit Application rDatereccived: y /3 Permit no.: City of 'Tigard Project/appl.no.: Expiredate: City uf'/'igard Address: 13125 SW Hall nivel,'!i)::trd,OR 97223 ---- Phone: (503) 639-4171 bate issued: Fly Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TYPE OF ' U I Ac 2 family dwelling or accessory U Comnu:rual/:Irdustrlal U Multi-family U 7'enant improvement fl New construction U Addition/alleration/r•eplacemertl U Other: U Partial JORSITE INVORMATION Joh address: O ,� S 1ti 1t nu. -�Suite no.: Tax map/tax lot/account no.:;-'3Ip Lot: Block: Subdivision: pray��_ Project name: i Description and location of work on premises: Aft.-� Estimated date of completion/insperlion t, — -- t ' t t Job no: GP t��• Max Business name: iii --- r — Description Qty. (ca.) 'total no.ins, Address: C Ncw rrshhmlial-stmt k or nudti family per -' dnelling unit.Inclurk�alta clx•d{Ixrn�•. C t r Slate: 1. ZIP: U � ,�.� ticrrlcclncbtdcd: 'a r" Fax: , ; r G-mail: I(xl0 sq.II.or less CCB ltO,: Elcc. bus, lie.no. _ ICS 1 Each additional 500 s .ft.or onion thereof Limited energy,residential 2 City/mete I.c.no.: f�C�Cfif� t.lmited energy,non-residential _ U L1 L F,ach manufactured home or modulardwelling S!g or supervising electrician(required) bare Service and/or feeder 2 Sup.elect.name(print): V�Ltti – ; Z, Services or feeders–Installation, alteration or relocallon: 200 amps or less 2 Name(print): y 201 amps to 400 amps _ 2 Moiling address: 401 amps to 600 amps 2 601 amps to 1000 amps 2 City: 114� State: ZIP:'J Over IOOO amps or voila 2 Pito : - - Fax: E-mail: Iteconnectonl 1 Owner installption:The installation is being made on property I own Temporary services orfeeden- which i,not intended for sale,lease,rent.or exchange according to Installation,alteration,or relocation: OR S 447,455,479,670,701. 200 amps or less 2 201 amps to 400 amps —2 Owner's signature: I,,u, _ _ 401 to60o,un s 2 Branch circuits-new,alteration, Narne: c or exlenslon per panel: Address: A. Fee for hmnch circuits with purchase of service cr feeder fee,each branch circuit 2 City: –� Slate: _ ZIP: B. Fee for branch circuits without purchase Phone: I;tx: E-mail: or service or feeder fec,first brunch circuit: 2 Each additional branch circuit hh-- Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Health-care facility Each pump or 1!i atinn circle 2 U Service over 320 amps-rating of 1&2 U Hazardouslocstlon Each sign or outline lighting 2 familydwelltnps U Building over 10,000 square feet fouror Cignal cirLuit(s)or a limited energy panel, USystem over WOvolts aominal more resideitialunits intine structure alteration,orextension* 2 U Building over three stories U Feeders,411tiamps ormore *lkscrf tion U Occupant load over 99 persons CI Manufactured structures or RV pork _ U Fies0i thtlngpInn U Other- FAch additional Inspection over the allowable in any of the above: F'erinspecuon Submit_sets of plans with any of the above. Investigation fec __I'he vbove are not applicable to temporary construction service. other Not all jurisdictions accept credit canis,please call Jurisdiction f,x more infa mahx, Notice:11iis permit application Permit fee.....................$ U visa U MasterCard expires il'a permit is not obtained Plan review(at __ %) $ _ within 180 days after it has been State surcharge(8%) , .,$ Expiresacceptedas complete. TOTAL . $ ---- —_ ...................... Name of caMholder a shown nn ere n c O'ardholderdtnalure s Amount 440-4aIS INOWOM, ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: _TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Number of Inspections per permit allowed Restricted Energy Fee..................................................... $75.00 (FOR ALL SYSTEMS) Service Included: Items Cost Total Residential-per unit Check Type of Work Involved: 1000 sq.R or less $145 15 4 Each additional 500 sq ft.or —__ ❑ Audio and Stereo Systems' portion thereof $33.40 1 Limited Energy ---..�-- $7 00 ❑ Burglar Alarm Each Manufd Home or Mudular Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener' Services or Feeders �I In,tallation,alteration,or relocation u Heating,Ventilation and Air Conuitioning System' 200 amps or less _ _ 680 30 2 201 amps to 400 amps _ $106.85 2 ❑ Vacuum Svstems' 401 amps to 600 amps $1170 60 _ 2 601 amps to 1000 amps a $2060 2 ❑ Other Over 1000 amps or volts _--- $45465 2 -- - Reronnect only $66 85 -- 2 — Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee f)r each system......................................................... $75.00 200 amps or less _ $66.115__ 2 (SEE OAR 918-260-260) 201 amp.to 400 amps _ $100,30 2 401 amps to 600 amps — ;133.75 Check Type of Work Involved Over 600 amps to 1000 volts, see"b"above. �❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel F�] Boiler Controls e)The fee for branch circuits with purchase of service cr ❑ feeder fee. Clock Systems Each branch circuit -_ $6 K ❑ b) rhe fee for branch. rcuits �` -- Data Telecommunication Installation without purchase of service or feeder fee. ❑ Fire Alarm Installation First branch circuit $4685 Fach additional branch circuit $665 _ F-1 HVAC Miscellaneous (Service or feeder not included) ❑ Instrumentation Each pump or Irrigation circle $53.40 Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal Orcuil(s)or a limited anergy panel,alteration or extension $75.00_ ❑ Landscape Irrigation Control' Minor Lar,• s(10) _ _ $125.00 Each additional Inspection over ❑ Medical the allowable In any of the above Per inspection __ $62.5(1 ❑ Nurse Calls I ter hour _ $62.50 - In Plant $71 75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ _ _— Other 8%State Surcharge $ —�-- - _Number of Systems 25%Plan Review Fee See"Plan Revlew"sect on on $ No licenses are required licenses ate required for all other installations frmt of application T01fal Balance Due It Fees: Enter total of above fees ❑ Trust Account q 8%State Surcharge $ All New Commerclol Buildings require 2 sets of plans. luta!Ralance Due $ — i:\dsts\furrna\cic-fees.doc 09130rot Mechanical Permit Application Date received: Permitno- Cityof Tigard Pro)ect/appl.no.: _ y: RecExpiredate. City n)'Figard Address: 13125 SW 11,111 Illvd.Tigard.OR '1722 3 Date issued: ileipt no.: Thune: (503) 639-4171 Fax: (503) 599-1960Building file no.: Payment type-- -, Building permit no Land use approval: — U I &2 family dwelling or accessory U Commercial/industrial U Multi-fami,v U Tenant improvement ❑New constniction U A(ldition/alteration/replacement U()thel Job address: Indicate equipment quantiles in boxes helow. Indicate the dollar Bldg.no.: - _ Suite no.; _ _ value of all mechanical materials,equipment,Ichor,overhead, profit.Value$ Tax map/tax lot/account no.: __ I'ot; Bbxk: Subdivision: 'Se-checklist for important application information and Project name: jurisfiirtion's Ice schedule for resdential permit fcc. City/county: ZIP: yj _ t Description and fixation of work on premises:__ ___.._— Frc(ra.) 'Total Est.date of completion inspection: - - — Desct•iption may Rrs.only Res.only r Tenant improvement or change of use: Air handling unit --CFM-- Is FM`_Is existing space heated or conditioned?U Yes U No Air con iuoning(site p an requ re ) Is existing space insulated?U Yes U No terationofexisting HVAC systemMECHANICAL CONT"(10,11 __- oi er compressors State boiler permit no,: Business name: _ _ HP Torts BTU/14 Address: _ Firsmoke dampers/duct smoke electors City: Slate: ZIP. cat pump(-rte p an require ) � I:tx: E-mail: nsta /rep ace urnac burner__ l / - Fhone: Including ductwork/vent liner U Yes U No CCB no.: _ nsta rep ace re ovate eaters--suspended, City/metro lie.no.: - wall,or floor mounted Name(please print) Vent ora iance other t an urnacc e gest on: PERSONAbsorption units __ lt'Ili/II Chill — HI Nance: Com nc isors. III' -- Address: _— _ nv ronrnenta !II' ex must an venaon: ApplianccventCity: Phone: Int I m,il )ryerex aunt J _ _TTo_o_d_s7Ty_P_e V I I/res.kite a azmat hood fire suppression system - Name: Exhau.t fan with single duct(hath fans) - x)ousts stem 11mrt from leali_ng or AC Mailing addrt.ss: __ ur p p ng andistribution(up to outlets) tate: /.I I'_ .-_ Type: LPG NU ()it City: S Phone: Fnx: E-mail :uc i in eac t ad itiona over 4 outlets Process piping(sc cmaticrequired) Number of outlets Name: _ Iter stc7 app nncr o�rq�eipmrnti •Address: Decorative firepdacc _ Cit State, LIP:_ nsert-type y - stov pe et stove _ Phone: Fay: E-mail: cri cr. Applicant's signature: Date: ter. Name (pant): — Permit fee..................... Not all)urisdicnons taxers ctmit cants,pier je call)uriuiicri rK mare Information. Notice:this permit application Minimum fee•...............$ Ll Visa IJ MasterCard , / expires if a permit is not obtained Plan review(at _ %) $ _ Cledll CNtI number: —__ -- Fxpirt' within 180 days after it has been State surcharge(9%).. $ —__--- accepted as complete. Name of cudhol r as ahuwn nn credit TOTAL ................. .....$ C'erdholder�I�nuure $ Amount 44DA617(6MCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE_: Descrlptlon: Price Total $1.00 to$5,000,00 Minimum fee$72.50 Table 1A Mechanical Code Oty (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 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. 12.15 $50,001.00 and up $742.00 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 fraction thereof. footnotes below. Comp •• Minimum Permit Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit $ to IOOK BTU 14.00 8%State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 _ 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb _ Required for ALL commerclel permits onlL unit.5-1 mll BTU 35.00 TOTAL COMMERCIAL PERMIT FEE: ^$ unit 301.7 mil absorb 52.20 unit 1-1.75 mil BTU 11)>50HP;absorb 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+ Description: _ City Ea Amount 11.20 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 _ 8.80 Floor furnace Including vent 955 16Ventilation system not Include In ) Suspended heater,wall heater or 955 appliance permit A44-.1A 10.00 floor mounted heater 17)Hood served by mechanical exhaust Vent not included in appliance 445 / 10.00 _ ermit -- 18)Domestic Incinerators Repair units 805 17.40 <3 hp;absorb.unit, 955 to 100k BTU 19)Commercial or Industrial type Incinerator 69.95 3-15 hp;absorb.unit, 1,700 _ ldiwand. 101k to 500k BTU 20)Other units,including ws .15 t-110.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mll.BTU _ 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1,75 mill.BTU 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 _S 7F>1.75 mill.BTU iTOTAL: a Air handling unit to 10,000 cfm 656 - -- Alr handlin unit>10,000 efm-_ 1,170 6°:State Surcharge $ Non-portable evaporate cooler 656 Vent fan connected to a single duct 446 TOTAL RESIDENTIAL PERMIT FEE: $ Vent system not Included In 656 _ appliance permit Hood served b mechanical exhaust 656 Other Inspections end Fess: Domestic Incinerator1,170 T_-Inspections outside of normal business hours(minimum charge-two hours) $62 50 per hour Commercial or Industrial Incinerator 4 590 2 Inspections for which no fee is sperfliically indicated (minimum charge-half tour) Other unit,Including wood stoves, 656 $62 50 per hour Inserts etc. 3 Additional plan review required by changes.additions or revisions to plans(minimum Gas piping 1.4 Outlets 380 charge-one-half hour)$62 50 per hour Each additional outlet 63 'State Contractor Boller Certlfii.%con required for units>20uk BTU. TOTAL COMMERCIAL $ *'Residential AIC requires site plan showing placement of unit. VALUATION: All New Commercial Buildings require 2 sets of plans. IAdsts\forms\mech-fees.doc 02/11/02 TEMPORARY USE PERMITS HOLD HARMLESS AGREEMENT am/representing the owner of property Print Name located at � �) j[AJ fdIVIvrx rum ;(Yl�r do hold the City of Tigard, Address or General Location its agents, and employees harmless in the event that any injury (monetarily or otherwise) is realized as a result of proceeding with the building or construction associated with _C��/ & ^/c�M� _—�D% 3 Project Name or Casefile Further, I acknowledge that I may not convey the subject properties until final plat recordation. Signatuf Owner Date Or Authorized Agent �• LOT 115,°0• = o s.00• BUILDING 1 4 o F-- �— I•--LOT L*w (TYp) 'LOT 2 0 1� --- UILDING 2 w l �.�, � .JlLi4i(� Sc`bu2�"�I��'S�ii►- Ie3To"P1b�'�•.—.. -� _ _ kC-JaR s" M A. LOT 3 w I —T---j1s.00• F.�.al Pta+ ?poor j l z�37c) BUILDING 3 -�-I ---sood�c�ry•r�i4h�P �,l�r, 17s+B� LOT 4 I� �� d BUILDING 4 i„AN kpie 15-7141 A)ISE►�1�+'�"'- --1� ��liR 570k.r: . 2yoo -- LOT 5 , --��s.00• " i }� IZgI•a BUILDIN 5 .D { 126100 LOT 6 1 BUILDING 6 41 l�1Rr p / ]� i'• 1� / 119 L 1�Ilil/�({ t r /os 1 SiREt.T R'tt�> �,('f DPS ► t)AI�iC� ik6ra", � arper Houf ghellis, Inc, BUR-DING SMACKS ON FONNER POND r(� •� WNF QMES 1 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WESTERN CASCADE ELECTRIC INC RECEIVED 11867 SW WILTON AVE TIGARD, OR 97223 JAN a 2003 ,, ,7c TIGAK Electrical Signature Form Permit #: MST2002-00403 Date Issued: 10/15/02 Parcel: 2S103AC-0FP03 Site Address: 12870 SW FONNER POND PL Subdivision: ON FONNER POND TOWNHOMES Block: Lot: 003 Jurisdiction: TIG Zoning: R-4.5 Remarks: New SFA, Path 1 - model home #1. Your company his been indicated as the electriail contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appi-C,^..ri?+p 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 Division. Nn electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: NUPARK DEVELOPMENT WESTERN CASCADE ELECTRIC INC PO BOX 230421 11867 SW WILTON AVE TIGARD, OR 97281-0421 TIGARD, OR 97223 Phone #: 503-297-6551 hone #: 503-521-0000 Reg #: ELE 34-616(' SUP 4625~ 1.1c 153416 AN INK SIGNATURE IS REQUIRED ON THIS FORM X ---�_— — Signa re Supervising Fiectrician if you have any question~, please call (503) 639-4171, ext. #��0;� i ♦AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA o b ► . Q d � d �\ c> �� ► . G 4 � � ► . _ d ► oil- oil,► pol- Un 4 t� r� � � ► . . � �; �. ► 4 �� , ► VI 7 ,-� ► . r i � O' o y H � h S � n V o t1 rAN !+ ti Er G � � CSD i 0 rt ti o O � e C a J N R" O ti 'D 3� it CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00177 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/23/02 SITE ADDRESS: 12870 SW FONNER POND PL PARCEL: 2S103AC-OFP03 SUBDIVISION: ON FONNER POND TOWNHOMES ZONING: R-4.5 BLOCK: LOT: 003 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: SINKS: URIN al-S: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 222 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Water Service as a condition of SUB2001-00002, install a minimum 1 1/4"water service FEES Owner: --- Type By Date Amount Receipt PJUPARK DEVELOPMENT LLC PRMT CTR 5/22/02 $101.40 27200200000 PO BOX 230421 PLCK CTR 5/22/02 $2.5.35 272.00200000 TIGARD, OR 97281 5PCT CTR 5/22/02 $8.11 27200200000 Phone 1: 503-297-6551 Total $134.86 Contractor: SUPERIOR PLUMBING LLC 830 JOHNSON STREET WOODBURN, OR 97071 REQUIRED INSPECTIONS Phone 1: 503-982-2517 Water Service Insp Reg #: LIC 133461 Final Inspection 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 done in accordance with approved plans. This permit will expire if work is riot 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 or direct questions to OILING by calling (503) 246-1987. Issued By: _ �'-�1L i Permittee Signature: Call (503)'639-4175 by 7:00 P.M. for an inspection needed the next business day l Plumbing Permit Application — — "Datemceived: 5-/-,?,Z- D Permit -4a 7 City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: city of hard phone: (503) 639-4171 Fax: (503) 598-1960 Date issued: By: Receipt no. Land use approval: Case file no.: Payment type: TYPE OF I &2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement l/in New construction U Addition/alieratiort/replacement U Food service U Other: PUL : Description Qt . Fee(ea.) To(al Job address: 1.2970 ;>fJ� I't�IvN P�I ONd. Q� -N—cit 1-and 2-fin mily dHelling.,only: Bldg.nn.: Suite no.: (includes 100 A.for each utility connection) Tax map/tax lot/account no.: SIT.(1)bath [w,t: t ,� Block: Subdivision: a v GwnrNoft uN SFR(2)bath - Pro ect name: bN �NN 0A oi� —___ _ SFR(3)bath _. CitJ/count ZIP: Each additional ath/kir.:hen Y Y Slleutilitles: Description and location of work on premises:_k a ,fiy,'u�__ Catch basin area drain — — — - Drywells/leach line/trench drain Est.date of completion/inspection: Y7—= nNeFootin drain(no.lin.ft.) Manufactured home utilities Business name: �(r.r^ ni�� Manholes _ — Address: $p ,t/ Rain drain connector City: �J rrr� Slate: ZIP: j Sancta sewer(nn. in.ft.) Storm sewer(no.lin. ft.) Phone: r 9;-p7;I Fax: Email: _ Water service(no. in.ft.) .7 CCB no.: ,�_ Plumb.bus.reg.no: Fixture or Item: City/metro lic.no.: e � Absorption valve Contractor's re �resvc signature: � _ Back Clow preventer Print name: Gam. '" 17 Backwater valve _ PERSON Basins/lavatory - Clothes washer Name: _ Dishwasher Address: _ .._ pifountain(s) _- City- State: ZIP: Ej. tors/sump fl Phone: Fax; Gmail: Expansion tank ixlure/sewer cap _ L F Icx�r de disposal sinks/hub Nat(print): Jp /► �_ -- Garbage dispnsal Mailing address - _ Hose bibb City: _ State; 'LIP: Ice maker Phone: 1'ax: E-mail: Interco for/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) ---1) -- will be made by me or the maintenance and repair,wade by my regular Rcx,f drain(commercial) _— employee on the pioperty 1 own as per ORS chapter 447. Sink(s),basin(s),lays(s) Uwt%,% signature: Date: Sump Tubs/shower/shower pan_ Uripal -- Name: __ Water closet -- Address: aloe eater _ City: -- =State: IP: Other:Oki 0 Minimum fee................$ Not dl ltuisdlctions nrrep crnlIt cards,pleae cd1 iudrdicrion rttr mrae inrorrrutlon Notice:Vlis permit npplication Plan review(at�%) $ U Visa U Mastcrc'nrd expires if a permit is not obtained State surcharge(8%)....$ Credit card numtwr �pitra within Igo days after it has been lder u Naecceptai as complete, "R1r� me of cersarodrown on credit card $ V `fes Crdr— ratenature Animt 410-4616(6Aa,C.'nM) CITY OF TIGARD 24-Hour BUILD114G inspection Line: (503)639-4175 MST 6�3 INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Date Requested —�& - AM.----_—_- PM BUP —_—_ _--- Location YyYL' t 1�G i c� Suite�� L— MEC ------------- Contact Person _ �/ -- -- Ph PLM Contractor -- SWR BUILDING TenanVOwner _ _-- ELC --------------- Footing FLC -- Foundation Access: ELR Ftg Drain Crawl Drain - Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear - Int Sheath/Shear _--- nsulation ------ - - ----- - Drywall Nailing - - — - Firuwail Fire Sprinkler - - Fire Alarm - - Susfid Ceiling - Roof ----_--_. -- Other: Fi _ -------- --- --- A PART FAIL P UMBING -- --- Post&Beam Under Slab - Hough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole - - - - Storm Drain - Shower Pan - - Other: Final -- PASS PANT FAIL - MECHANICAL Post&Beam ,t C�' 0/I ---- —_--- . Smoke Dampers —f-� -- - Fin , ----- ------ -_ -----_ A PART FAIL ------�� — --AIL CTRICAL ----__..——_—_ - — -- - Service Rough-In ------- --- -- -- --- _ UG/Slab Low Voltage Fire Alarm Final D Reinspection lee of$--_- —_required before next inspection. Pay at City Hall, 13125 SW Nall Blvd. PASS PART' FAiL _ __ -� Unable to inspect-no access SITTE___ r-1 Please call for reinspection File Supi,ly Line � ADA Data Inspector text Approach Sidewalk Other: Final DO NOT REMOVE this Inspection record frolnr the Jolt 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 #: PLM2002-00177 Date Issued: 5/23/02 Parcel: 2S103AC-0FP03 Site Address. '12b70 SW FONNER POND PL Subdivision: ON FONNER POND TOWNHOMES Block: Lot: 003 ,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 ►peen indicated as the plumbing contractor for cne 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 Phone #: 503-297-6551 Phone #: 503-982-2517 Req #: LIC 133461 PLM 24-373PB SUP 5819JP AN INK SIGNATURE IS REQUIRED ON THIS FORM X41 &f I _ Si nature of uthori7et9 Per -- If you have anv questions, please call (503) 639-4171, ext. # 310