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13160 SW HOOD VISTA LANE w W 0 0 c in n� r m m 13160 SW Hoodvista Lane CITY OF TIGARD 2441our BUILDING Inspection Line: (503) 839-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST - - -- - ---- - SUP Received Date Requested AM. -_ PPI BUP Location _-_— �'� _ !k--1 - r� Suite_ MEC Contact Person _ —_-S::T �. Ph - - C / ( �Ss_ PLM Contra _—__.—.- Ph(_ ) _ ----- SWR - ___._ TenanUOwner o -� ELC -- - -- - 0 Ftg D in1�7;0. n Access: /` EL C l L �( _ } I Dr in ELR --- - -_— _- Slab Inspection Notes: SIT Post&Bea — -- - - - Shear Ancho� _ Ex;S!.eath!Sheur Int Sheath/Shear -- ---- - —--- - Framing Insulation Drywah Nailing ----Firewall Fire Sprinkler )^ire Alarm Sum ' cling - R of 01 _ PART FAIL `---- — - — - PLUMsifiti — Post&Beam _ Under Slab Rough-In ------ ---- -----._— Water Service --- - _ Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain - --. Shower Pan Other. - - - - -- — --- — PART_ FAIL --- MECHANICAL _ ! -- Post,g Beam / — `- Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ---- -- _ ELECTRICAL — Service - ------ ---.—. - — — -- - ----�-- Rough-In UG/Slab --- ----- Low Voltage Fire Alarm �- m [_] Reinspect',)n fee of$ required Wore next P!,RT FAIL -�— q Inspection. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinsp ction RF:._____.____ —.___ Unable to inspect-no access Fue Supply Line ADA Approach/Sidewalk Daftw --- —V Inspector - �- ut 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 INSPEt:T'ION DIVISION Busass ' Ine: (503)639-4171 SUP Received —_ __ Date Requested PM SUP Location _ _ �% ( � � Suite MEC �— — Contact Person -_ -_ _ Ph( ) c�� PLM t;optraCt-c r_ -_ _ - Ph( ) SWR _. BUILDING enant/Ownei _- ELC Foundation ELC CCesS:� Ftg Drain L � �=� ELR Crawl Drain - Slab Inspection Notes- SIT or &Beam ---� „� Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - � 1� �--------- -- Insulation Drywa!i Nailing - - - ---- --- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other. - -- no S PART FAI'_ PLY"ING Post&Beam - - - -- Under Slab Rouah !,, , -- Walor Service Sanitary 5ewa, liain Drains Catch Basin/Manhole Storm Drain -------------� -7�'' -_ Shower f an Other: --- ---- --- ------- Final. _ _ASS PAR-t., FAIL__ --- - --- MECHANICAL �- Post& Beam ---- Rough-In Lias Line _—..----------- -.-__. §_M, Dampers --- --- ------- - -- -- ih-d SS ' PART FAIL ---- ------- -- -- --- ------- E _RICAL Service --- - - -- ------------- -- ----- Rough-In UG/Slab ------- - --_--- ----- Low Voltage Fire Alarm -- --" Fina: F j Reinspection fee of$_—_-__.-required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL_ SITE ❑ Please call for reinspection RE.-______ Unable to inspect-no access Fire Supply Llne ADA Approach/Sidewalk Data -- ` _ Inapfactor --.-. Ext Other: Final DO NOT REMO%E this Inspoo-tion record from the,lob site. PASS PART FAIL CI I l OF T;GARD 24-Hoar BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISV,)N Business Line: (503) 639-4171 MST BUP - _- Received _—_______�_—_ Date Requested _ -' AM__ _ _ PM BUP Location _ / ?/�2 G i't Suite__ MEC _ Contact Person _ -- Ph PLM Contractor Ph SWR BUILDING _ Tenant/Owner ELC Footing Foundation --'ass: ELC Fig Drain LL ' -� ESR Crawl Drain /�C�d�L. ` /C<<(s - Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear �CSL Framing . Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- ----- - Roof Other: -- Final PASS_ PART FAIL - --- PLURABINd --- -- Post& Beam - ---- Under Slab RoughSe Water Service Sanitary SF,wer Rain Drains - --- Catch Basin/Manhole Storm Drain — — Shower Pan ., Other: 'L14PA"SIV PART FAIL -- _ HANI_CAL Post 8 Beam -------- -- ---- — Rough-In — Gas Line Smoke Dampers Final PASS PART FAIL_ - - - - - -- ---- ELECTRICAL Service — _— _-- -- -----___--- Rough-In UG/Slab --- --------------- — - ---. Low Voltage Fire Alarm -- ------ - ..___. Final Reinspection fee of$. ___- required before next insp9ction. Pay at City Hall, 13125 SW Hall Blvd. PASS _PART FAIL SITE _ Please cell for reinspection 9E �� Unable to inspect-no access Fire Supply Line ADA2_ Approach/Sidewalk DMO �- Inspector/ - �_�� _ Ext Other: Final DO NOT REMOVE this Inspection record from t!:e Jab site. PASS PART FAIL CITY OF T I GA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2002-00047 13125 SVV Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/15/02 PARCEL: 2S109AB-09900 SITE ADDRESS: 13160 SW HOODVISTA LN SUBDIVISION: RAVEN RIDGE ZONING: R-7 BLOCK: LOT: 028 _ JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS- FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS _ T SINKS: URINALS: GREASE TRAPS: LAVArORIES: OTHER FIXTURES: TUB/SHOWERS. SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of backflow pieventer device. FEES Owner: Type By Date Amount Receipt J A SWEE DEVELOPMENT CUA 1PANY PRMT CTR 2/15/02 $36.25 27200200000 19543 SW SCROLLS FERRY RD 5PCT CTR 2/15/02 $2.90 27200200000 BEAVERTON, OR 97007 Total $39.15 Phone 1: 503-628-0182 Contractor: EXSTREAM LANDSCAPING 6950 SE DEARDORFT ROAD PORTLAND, OR 97236 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 503-788-7906 Final Inspection Reg #: PLM 7094 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 it accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in ^AR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct q, tions to OUNC by calling (503) 246-1987. Issued By: c i- >'(� Permittee Signature: < < �s, Call (503) 639-4175 by 7:00 P.M. for an inspection needed thq next business day Plumbing Permit Application Datereceived:Y 1> / - Permit no.: L J City of Tigard Sewer permit no.: Building permit no.: Addreaa: 13125 SW Hall Blvd,Tigard,OR 97223 — City ofTigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1 aAt• - Date issued: By: Pf Receipt no.: t Case file no.. Payment type: Land use approval — OF PER M IT U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction J Addition/alteration/replacement U Food service U Other: JOB SITE INFORMATIONSCHEDULE , Job address: �' S.Cc•. c _l)t seri,tion 4H Fee(ea.) Total -- _. I Bldg.no.: Suite no.: Ne" and 2-family dncllint,x onl}: Tax map/lax lot/account no.: - (includes 1N00ft.foreachutilitconnection) __ SFR(1)bath Lot: I Block: Subdivision: SFR(2)bath Project name: SFR(3)bath ^---� -- City/county: T, 0 eA. :;IP: Each additional bath/kitchen _ ------ - Description and location of work on premises:-� 5 e Siteutilities: Wbw Catch basin/area drain Est.date of comply utm/imlx rltun: rywclls/leach lineltrench drain Footing drain(no.lin. ft.) BING CONTRAC-FOR — Manufactured home utilities Business name: FxS7(/q til gi)c�SC� li /t— Manholes Address: 50 S,e ioq✓ C; 14 Rain drain zonnector City: p✓? ✓I State:pre ZIP:9 7 Sanitary sewer(no. lin.ft.) Phone: Fax: 7-i,1-q/S E-mail: Storm sewer(no. lin. ft.) CCB no.: / L Plumb.bus.reg.no: -,7a L Water service(no. lin. ft,) City/metro lic.no.: Fixture or Item: Contractor's representative signature: Absorption valve _ Back flow reventer _ Print name: Date: Backwater valve i-ONTAt'll'PERSON Clothes washer Name: CI V✓ Z. ,i Dis washer _ Address: q->o s/ p6, ")o f te d Drinking fountain(s) City- � ,1 _ State:a R ZIP: Cj 7 3 L FJecwrs/sump Phone: Fax: E-mail: Expansion tank Vixture/sewer car. Floor drains/floor sinks/hub _ N:n_ne(prim): j,,�, S t. / w� .L✓�C� Garbage disposal Mailing address: _ — Hose bibb _ City: _ State: ZIPi lee maker - Phone: - Fax E-mail: Interceptor/ rease trap _ Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my tegular Roof drain(commercial) employee on the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: ____ Date: Sum act"116110 0 Tubs/shower/shower pan _ Urinal Water closet Addnr,, Water heater City: State: ZIP: Other: Phone ax:-� E-mail: Total Not all Jurisdictiam accept cmtit earth,please call Jurisdiction for ate inrormadon. Notice:This permit application Minimum fee................a 7 U visa U MasterCardexpires if a permit is not obtained Plan review(at _ %) $ number: —�_ State surcharge(8%)....$ r,ca+,card number: ' - splKs - within 180 days after it has been Name of cardholder as shown on cmdlt card accepted as complete. TOTAL .......................$ _ —� Csadhoide:sigmure Amount — 440-4616(ISMCOM) PLUMBING PERMIT FEES: PRICE _TOTAI. New 1 and 2-family dwellings only: FIXTURES individual r QTY_ ea AMOUNT (includes all plurnbing fixtures In PRICE TOTAL �' L.:� _ 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Sink for each utility-connection)_ Lavatory --- - 16.60 One 1 bath _ - __ $249.20 _ 16.60 Two 2 bath $350.00 Tub or Tub/Shower Comb. -" $399.00 Shower Only 16.60 Three 3�bath �. Water Closet 16.60 SUBTOTAL Urinal 16.60 8%.STATE SURCHARGE _ Dishwasher 16.60 PLAN REVIEW 25%°OF SUBTOTAL i Garbage Disposal 16.60 - _TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE' 3" 16.60 4" 16.60 - -- - _2nt t b Work Performed Water Heater O conversion O like kind 16.60 Fixture Type: New Moved Replaced Removed/ Gas piping requires a separate mechanical -_- Ca ed ermit. Sink - MFG Homn New Water Service 46.40 - Lavalol 48.40 - MFG Homr.iJew Gan/Storm Sewer Tub or Tub/Showor Hose Blba 16.60 Combination - Roof Drains 16A0 Shower Onl _ 16.60 Water Closet Drinking Fountain Urinal Other Fixtures(Specify) 16.60 Dishwasher Garbage Disposal _ Laundry Room Tray Washin Machine Floor Drain/Sink: 2" Sewer-1 s''00' 55.00 3" _ 0 4" Sewer-each additional 100' 55 0 55.00 Water Heater Water Service-1st 100' _ Other Fixtures Water Service-each additional 200' 46.40 -- Sar -.i&Rain Drain-1st 100' 55.00 Storm&Rain Dreln-each additional 100' 46.40 - Commercial Back Flow Prevention Device 46.40 _ Residential Backflow Prevention Device' Catch Basin 18.80 Inspection of Existing Plumbing or Specially 62.50 Re uested Ins actions P,+r/hr COMMENTS REGARDING ABOVE: _ - Rain Drain,single famlly dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL --- Isometric or riser diagram Is required If - --� Ouantlt Totol Is >A -- 'SUBTOTAL 8%STATE SUP.CHARGE - - "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture qty.total-Is,.9 TOTAL S "Minimum permit foe Is$72,50 4 a%state surcharge,exceM Residential Backllow Prevention Device,which Is$3e 25•8%state surcharge "All New Commercial Buildings require 2 sets of plans with Isometric or riser dlagrani for plan review. I.\dsts\forms\plrn-fees.doc 12'26/(11 t i CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE NORTHSIDE ELECTRIC PO BOX 12323 SALEM, OR 97309 RE0E`IVi_D Electrical Signature Form SEP 17 2001 Permit #: MST2001-00465 NORTHSIDE ELECTRIC Date Issued: 9114101 Parcel: 23i09AB-05900 Site Address: 13160 SW HOODVISTA LN Subdivision: RAVEN RIDGE Block: Lot: 028 Jurisdiction: TIG Zoning: R-7 Remarks: Construction of now single family detached residence. path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNFR. EL.ECTRICAL CONTRACTOR: J A SWEF_ DEVELOPMENT COMPANY NORTHSIDE ELECTRIC 19543 SW SCHOLLS FERRY RD PO BOX 12323 BEAVERTON, OR 97007 SALEM, OR 97309 Phone #: 503-628-0182 Phone #: 503-585-4879 Req #: suP 41995 LIC 90593 ELF 21-114C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician It you have any questions, please call (503) 639-4171, ext. # 310 s f9 H 0. � y C •�. ^I cr N R c' CY H. CL ro D N O � Q v .o o � o � ot � N Re It O 4 i a� 00 MASTER PERMIT CITYO F T I G A R D PERMIT #: MST2001-00465 DEVELOPMENT SERVICES DATE ISSUED: 9/14/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13160 SW HOODVISTA LN 09AB-09900 PARCEL:PARCEL: 2S1S1 SUBDIVISION: RAVEN RIDGE BLOCK: LAT: 028 JURISDICTION: TIC REMARKS: Construction of new sirlyle family detached residence, path 1 BUILDING --RE ��— STORIES: FLGUR ARFA_5 REQU,RED BETB,�CKS REQUIRED IS3UE: CLASS OF WORK: NE'.N HEIGHT: 28 FIRST: 1.138 sl BPSCMENT: of LEFT: 20 SMOKE DETECTORS: Y TYPE OF USE: 9F FLOOR LOAD: 40 SECOND: 1.433 sI GARAGE: 986 of FRONT: 20 PARKING SPACES: 2 s1 RIGHT: 7 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: VAI UE $290.716 90 OCCUPANCY ORP: R3 BDRM: A BATH: 3 TOTAL: 2,H64 ort sl REAR: 20 PLUMBING TRAPS: SINKS: 1 WATER CLOSETS: 3 WASHING MACH- 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAI45. I CATCH BASINS: GREASE TRAPS: TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEA/ERS: 1 WATER LIf.E9: 100 BCKFLW PREVN7R: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN a 100K: BOIUCMP<oHP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN 3-000K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS. 1 VENTS: I WOODSTOVES: 0 GAS OUTLETS. I MAX INP: btu FLOOR FURNANCE..r: 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 FOR: 1 PUMPIIRRIGATION: PER INSPECTION 201 •400 amp201 400 amp: tat WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR. EA ADD'L 5009F: 5 SIGNAL/PANEL: IN PLANT 600 amp: 401 -600 amp: EA AODL SR CIR: LIMITED ENERGY: MINOR/ABEL: MANU HMISVCIFDR: $01 1000 amp: 601+ampe•11000v: 1000+amplvolt: PLAN REVIEW SECTION Reconnect only: >0 RES UNITS: SVCIFDR>•215 A: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL-RESTRICTED ENERGY B.COMMERCIAL A.SF RESIDENTIAL AUDIO 6 STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LND9C LT: AUDIO 8 STEREO: VACUUM SYSTEM: ATH: BOILER: HVAC: LANOSCAPEIIRRIG: PROTECTIVE SIGNL: BURGLAR ALARM: MEDICAL.: OTHR: GARAGE OPENER: .LOCK: INSTRUMENTATION: nRF A'AI,E COMM: NURSE CALLS: TOTAL 0 SYSTEMS: HVAC: TOTAL FEES: $ 7,563.17 Owner: Contractor This permit is subject to the regulations contained in the J A SWEE DLVELOPMENT COMPANY J A SWEE DEVELOPMENT CO ING Tigard Municipal Code,State of OR. Specialty Codes and 1Y543 SW SCHOLL S FERRY RD 19543 SW SCHOLLS FERRY RD all other applloable laws. All work will be done In BEAVE k,ON,OR 97007 BEAVERTON,OR 97007 accordance with approved plans. This permit will expire K work is not started within 180 days of Issuance,or If the work is suspended for more than 180 days. ATTENTION: Phone: Oregon law requires you to follow rules adopted by the Phone: Oregon Utility Notification Center. Those rules are set Reg N: LIC 76214 forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Structural PLM/Linderfloor Framing Insp Gas Fireplace Electrical Final Mechanical Final Grading Inspection Posl/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Final inspection Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Electrical Service Low Voltage Water LindW Insp Footing Insp Crawl Drain/Backwater Foundation Insp Footing/Foundation Dn Electrical Rough In Special Insp.required Appr/Sdwlk Insp - Issued ey : Permittee Sigrafure : ----- ---- Cali (503) 639-4175 by 7:00 p.m. for an inspection needed the next IS n ay CITY O F TIG /� R® SEWER�::1NNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00241 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/14/01 SITE ADDRESS; 131 fi0 `.;W HOOD\/IS i J PARCEL: 2S 109AB-U9a00 SUBDIVISION: RAVEN RIDGE ZONING: R-7 BLOCK: LOT: 028 JURISDICTION: TIG TENANT NAME: 05A NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: SewE r connection for new single family residence. Owner: FEES_ J A SWEE DEVELOPMENT COMPANY I ypa By Date Amount Receipt 9543 SW SCROLLS FERRY RD -- — BEAVERTON, OR 97007 PRMT CTR 9/14/01 $2,300.00 27200100000 INSP CTR 9/14/01 $35.00 27200100000 Phone: 503-628-0182 Total $2,335.00 Contractor: Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 18C 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 insaller shall prospect 3 feet In all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewee' Perm Issued by:l � __f' _ Permittee Signature Call (503) 639-4175 by 7:n0 P.M. for an Inspection needed the ne tbusiness day e1 _cnGl1 Building Per mit Application - -��- I)atereceived: g 90 p/ Permit no. G5 City of Tigard -- Address: 13125 SW Hall lilvd,'rigard•OR 97223 Nojeel/appt no.: Expire date: City ro(!it rrrrl Date issued: By: Receipt no.'. Phone: (503) h39-4171 — P Fax: (503) 598-1960 Case file no: Payment type: Land use approval 1&2 family:Simple Complex:OF TVPE lk 2 family dwelling or accessory U Commercial/industrial J Multi-family )WNew construction U Demolition U Addition/alteration/replacement U'Tenant improvenlenl J File sprinkler/alarm U(ether: Fill fall 10 W all"Nil 111 Is I I Joh address _ / � (nP�SW_�'iDc%Z�; ",;Ti}_�.-�' � [31dg.no.: Swtc rte.; ` I d ?`�, ilnck: lurtdrvtston: fat map/tax lot/account no.:2 a 1A t 1)" l,il 11nl :uu1 I"tulion of work on prrrnises/special conditions:. t ' ul li Ielc % c" j AyeNL C. 1 & 2 familt, drtelling: yo 4�Lk.",j 2 ('VA c7 Tax E-mail: I hrdrolnnslha It• /'t 2-•C7 I sir ut;nr'`' t.r`!vyv %.J�(1.--- lural 1101111101 nl Il„ r. Z I';�. I�ux: I:-ntuil: Ncw dwelling arra Icy ft ) 1, f. (�ate)!t'/Carpool .tlr�,Itiy II.I f {� �:!nc l'ut.n'd porch:ora Ill. Ill �� _ -- -- - � I este atl•:t ltiy 11,1 . •. t)Iht•r stluurcctarra(tiy fl.). ... elle' -- ' -- -�• - --y�-- - ('ommcrcfallindustriallmultl-farnilt. I'1n,u.' I�aa: 1: ntutl: �'ahiaU��n ul wore. � I I•.xttilnl>•bldg arra I,y li i __ Custn. n.unr ----- ------- _ New hldit arca(tiy It I 1111 I Nuiiiht ltfsh,rhs lily _ -tale: ZIP: I'huti, — .,I ctHl9ltUCllutl hax -�h mail: ---- - l).cuhancy group(s): I{xt. ing. Notice: All contrtrtun and suhconlractors are rryuin•1I ARCHITECTIDESIGNERhccnxd with the Oregon Construction Contractors Board im i N:unr: X' l v.0 provisions of ORS 701 and may he required to he licensed It il, J-'�' ---'-- lurisdictiou where work is tieing performed. If the applicant Address: Iu. _fit_ ti 2.1 L -- _ -_—_ ('ily n y Stutr• , .) I_II': �1�(I ( S rxrrnpl tnnn licensing,the following mason applies: Contact person: -t ►` Plan nu.: J i _ - -.-- - Phone: -XC hax: f: mail - Name: lContact Fees due upon application ........... .......... .... $_ Address: �� l- 1 1�* f_ Date received: City:_C., JL( i State:(, 7-IP: -?_?21? 1- Amount received ...........•..... . .... ................ $ Phone.q-j" 1'r*, -mail: Please refer to tee schedule. 1 hereby certify I have rend and examined this application and the Na all rynsdicnons wcep crecbt cants.pkme toll iuri,<ar•unn r«nae Inr,x,ruarx, attached checklist. All provisi9nss'f laws and ordinances govvniint!11uc U visa U MasterCard L4f 1• work will be c9mj1 specified herein or not l rrdlr card number rilifes 1—L Authorized sig natU ._ _ _ i,!�L.'( UatC: 1 Nene d cardhnlder u ih�wn cm crrAn card Y � --- -- -s -- Print name:__ _.__r�_ ('ardholder ttputurc -c - Amount Notice. This permit application expires If a penult is not obtained w tthin 180 days afler it has leen 9ccepted its complete ran14 rfnxvr OM) One-and Two-Fainfly Dwelflili ; Building Permit Application Checklist Referenceno Associated pernvts Ctiv,o/Tigard City of Tigard J f?Icctrlcal J I'lunlhnit' J f\1"(hanl,.11 Address: 13125 SW Hall Bl,I 11;',11(1 I ll. ')?': { Jtnher Thune: (503) 639-4171 ` I ;Ix. (501) 599-1960 Lei FMOMMUMAN1 I hind Ilse actions completed.Svc IurIsdIc11if), IIlenit Iur cot wrlell t LevIt'\\ /IlIling. Flood plain,solar balanLr Ix)ilIK . rrmc soils designation,histont dr-Il l(t,etc, ✓ Verification of approved platllot. t I'iredi%f iri approval required. Septi• ,\'.tem perntil oraulltnriia11un fnr rvnlndrl I•,islinit syslrin capacity - -=___`�_� __- •� I Seiler pernlil. 11 ate(dist l icl approral. SIlII rep,ui. ,1111 1 , 11 ;Ipllllcahlc�I:uup and tillrn;ulur„n Ulr n; \\U1,,lpphr:lhurt. rosiou tonlrol 3 pLul -11x'111111 n q11 ucd Include(1l,11n µ al'c a} plutet 11(111.slit lend design and I(1cauun III I hail l protection,etc. '1,) ', (•nntphte cels of legible plans. Must hr drawn to scab,sh(1w'ilip c(Ili furntaulce 10 apphcahlt' local :Ind~talc I h: 1.11111' , I I nlrral design d011lI',anld c1)nne(11ons must by nu,ltpot alvd Ifit u Ihr plans(1r nn a separate lull sur li .Iii.1r hell I„Ills' I)l:lll; N'Idl Call'.',rt'IVIt'llt't',11(Tµrill 1)lall 1,1,.1111111 ;111,1 tit-1;111` Platt it,\It'\\ t.;IIIINtI httnlllpl, 1,',1 ;I „ I�\111'111 \n1l.luun„'\i,I 1 11 ,bile/plol pian draon to scale. I ho plan 11111,1,114 Iw Iol unl h11dlhll^•vlhr(:l 41,111,it d,ins;pt(1I, 11v corner 1'l, \,III„n,I I! I neer 111:111.1 , 11 cir\nnufl ill IIcicnlcll,pLul nit)'I ',hu\\ 111111 11 lilt's alt .' II narrvni,):It Kill it Ill 111 1.l,rtn,•ut .111,1 itlit lilt 11t '.11llt'nnrinn111111111,1IA1.sr lut;dnIll IIf \\rllu.l•ptlt syslrm, ill l[IN ltKa11(1ns,(1111'(11(111 Ill'Ili;nnl. I,'1 h1111dtIII- Cl v'1'a1r,1.111•It rntapr nl\„\rlapr,11nl,t'n it Ill',a1 r,1.1'xI,I11111 111 It 11111',un dlt,and,,uta,I' I.' 1'nundation plan. SII(1\\ dem n,Inns ,1nt III'I hall, un\ hold duµus;Ind Icu1111n Inp pad .((1nnrrunn drl;ul, \rel • •;unl lu'.'a11„u I 1 1 loor plans. till, ,111 (11 Itl,'l11111i Ill(1II, \4ltltlt,ll ,v, . 111taInul 111 .nl11k, d1'lrti u,. \\:ail 1,c'111'1 lulu;,.,' u'nul.1u11n I;nl,, plunll 1'111' II\tilt', h.1l•Ilei .Ind drt t ;II nl.hc, ;Ih,INC I-r;ulr rte I 1 1 Toss sectiou(s)and details.Shu'.\ all fl.1nnnl, r11clilhet sues un,l ,p,1,111V sit h Al floor Ix ants,hradvls, 1111,!'• ,1111 Il,rtlf. N d1 tllll,lllttIl,gl,11u,t C1)111tIIIC11(1II Mltlt'Illaa ntlC(II1`ti~1'(111 71111.11 hr 1t'gtlll(d(11(Ic';It1\ 1)ollrll\ CIIII`•I111,11 'if tilal\'• dclulls Ill 1111 \,;111 :Ind it ,I wall itelfill,.I,1(11 ',Inpr.,., !1111' 111'11,111. Idtnlr lnalrllnl 14itit 1's and Itluntl,uun Ntalt Incl l,1)r t,m,un,u(1n. 11,crn1al ulsula11on,1'lI. _.. - - _ 1 I, \alien tietls. I'n»'it ell v:l0till',IIs n1'\\ tun%1111(11(111,nnnununl Ill 1\\11 rlrcnu11n, lot ❑(1dt11uns and Irnuuh l I Ii 11 n , Ir\,111uns Innst n•Ilecl Ill(. :1 111,11 et;lilt it Ihr(hallpt• to slack Is}Ical rr Ihan I(1111 loot al �ullJln)!CMCklilt' addt'Ildlllni sh(1win' I nnJau11n t I, II,)ns",Jill t it rt•Icn•n((•,aur :n t rpwhle--- _f---- - -- Ir, \1•sil bracing(prescrlpllve path):uldlor laleral anal,sis plans. \lust ouhcaly defall',and I(1ca11uns;lir m n I'll",rI11111\r 1'1111 altlal}'tit'. In l, .11,ul.11l(1II,I1)cnvinl t rlllp stand rd1 I I loot/root lr:uning. Plovld, Id 111. I'n ,111 11„ I 10 ,I ., 11(11111',. nldlcnlnly int 11(1•1 t suing. spat111g,anld hr,uuly Yw\' 1111. \rn11l,1111111 --_ -- I Basement and retaining halls. !'I'�%Id, I r ruin,and drl;ul.showlll}v plm volew(11 rr•hal. For eugulrrtrd' •.t, IWlll, '.rt•iienl 22,'Tngt v(_-I1,,.11,Ill Il i,yi I'1 Besun ealculatlotts.Provide two set ,I 11 11,111 Ill• [11,111P curtrnt I. dc,lvn \,Ilur, 1,11 all I .,ins vol nnll11hlr „\1'1 III Irct lung and/or an\ he.m, I-.1 , Ili,I n,' 1 111111 undotnl luau 1 Manufactured tloarlroot truss de-iot detail. _ - 1 Itner{s 1 o(1t'compliance. lilt-fit II 111, I,I,".,111'11. 11,111,111 1,,1)\IIll.t,ll(ul;uutn,, A 1'as pt 11111 %LIWIT IR I,rryuur(1 I �, IIII „i ni,'I, 111IIu1nlr•, Fngineer's calculations. When required of Ilro\'Idrd,(1_c .shrill wail.11)(11 1111„)shall he stamped by an cngrru•t 1 Ill arclutect licensed in Oregon and shall be shown 11)hr applicable 111 the pngccl under review. 2; lave(5)site plans are required for Item I I above Site plans must he 9-112" x I I"or 11" x 1', 2.3 '1 a1)(_')sets each are required till Items I(,, 19, 20 K 22 ,- 25 Building plans shall not contain led Intl S or tape-ons. - 26 No rolled,reversed or mirrored building plans will Ix accepted. 27 29 - -- - _----- Checklist must be completed before plan review start date. Minor changes or notes on submitted plans ma} he in blue or black ink Red ink is reserved lift department use only. I Mechanical Perr-it Application Uatera.e.ived: it/.ao O/ Permit no.: City of Tigard n ojecl/appl—no•.: Expiredate: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 alc issued: 13y: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval _ - Building perrnil no 'I YPIE Of PERMIT 1 rk 2 family dwelling or accessory U C'omriercial/industrial J Multi fan,ik U'fenanl improvement �Ncw construction U Addilion/allerliioii/replaccnlcnl J Uhler _ --- - Job address �' �(rJ FMOJY/6 . �� Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: I Suite no,: s slue of all mechanical materials,equipment,labor,ovenccari Tax map/tax lot/account no.: G9 oo prolil. Value$ _-`----__- . Lett: Z _... Rlock: Subdivision:— - - 'See checl lis1 for important applicalion information and Project nanlc: I jurisdiction's fec schedulc Ion residential permit Iee City/county: ZIP: �'7�-_ ~ SCHEDULE fAscriplion antion o work on premises: Q -- — �- - —�-- �. ev((•A.) feud Esl.date ofcolnpletion/inspeclunl: � Ikssription — "y. Rcs.onl, Reimitly Tenant improvement of use. Air handling unit Is cxrslin spit :,1u-a , ,n -:TVLJ Ycs U A No ---_n- — - con illo� nlrrg(site jrl:urrcyuucJJ Is existing . it i 'I J ', _TNO Ir�CrBhonalexisting I vAc'sysaln `-- -- COKTkA1 ' InilcF//c01t1prCRAUrS - - ------ Busin Stale holler permit no IIP Ioils ---- IiTI1/11 Address: I (�, .. - ---- -- 1%�K _-__W— •ur.snu,ke •lmper. uct smoke cocoons City: T--t +�,, ,T tilalc� �It�:�'j- 9 'Teal pump(site plan reguircd) - M F'Itune: r ace furnace/hi rner- ---- i' 1//-TT- --- ' -- 111x: G mall: L_ Trsra reI Including ductwork/venl liner j Yv,,U No CCB no.: L - ---- -— Install/rclTce re locate Ilealer -- Cily/melro lit no.: _ _ wall,or floor mounted Name(please print): Vent r; r�Cl i v V ent lin n r liance of leril%ui Refrigeration: ----- -_ Ahsorpuonunils _._._ IrII Al Narnc: -- -_ r',un ncss,n� _ -- Address: I<nvlronmcnta exhaust and ventilation: City: I Slate ZIP: ---_-_- ---- -- 1pplumccveal Phone: l , I', mail. 1 a. floods,Type hos itc lcn azma1_ - ho A fire suppressunr s,,slcm - - Name: r C �Lc�. � sj l ( L_vG• Exhaust fan with single duct(bath fans)_ Mailing address: 1 9r� <k\,Z (1S- ke - it roust systema arl from catin or AU Stale: C� 7.EP:_ C a�r -- Fuel piping an ti til on lop to 4 out cos) — Phone a�% Fax r' E?-mail: Fuel pi in each h addi6or.al ovrUoctlets ii Process piping(scematicrequirec) — Name: Number of outlets - -- �ler 16ieeipp�ance or equ praen1: Address: - _ Decorativefireplw- City: _ Slate: IP: nscit- ty — _ - Phone: - E-mail: st,)Vctpcllet stove - - -- Applicant's signature: Date: (>t er - ---- PAF-7-77-7- tName (print): _��-�_ --1--•-- Not dl furi"Winm accere cm it earls,pleam cdl Iwirdicam for marc Infarmdfan Perlrr:.ice.....................a U isa U MasterCard Notice:Kit permit application Minimum fee................S expires Kit permit is not obtained - Credal ora number _. _ _ -_L_ sphes within I k0 days alter i1 has been Plan review(at _ %)State surcharge(8%) .... NJW_ - urse of cat&,,der u n mr crcrfa cam.. accepted ac complete. - -- cudrardrr dVnaawe -- - Amormi aar4617(VIM1OM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TGTAL VAI..0ATION: PERMIT FEE-. Description: P Total - --- -- -' Table 1A Mechanical Cade Oty (Ea) Arnt $1.00 to$5,000.00 Minimum fee$72.50 - 1) Furnace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vents 14.00 $1.52 for each additional$100.00 or -- fraction thereof,to and Including 2) Furnace 100,000 BTU+ $10,000-00. including ducts&vents _ 17.40 $10,001.Tr)-Tc-)$2 5,000.00 $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 healer _ $25,000.00. or floor mounted heater 14.00 _- $25,001.00 to$50,0_00.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 nr 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: Boiler Heat Air $1.20 for each additional$100.00 or For sterns 7-11,see or Pump Cond fraction thereof. footnotes below. Comp" " 7)<3HP;absorb unit Minimum Permit Fes$72.50 SUBTOTAL: s to 100K BTU _ 14.00 _ 8)3-15 HP;absorb �- -! ----8%State Surcharge : unit 100k to 500k i3TU -- 25.60 9)15-30 HP;absnrb - 25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU 3500 Requi,ed for ALL commercial permits on) - ,_ _- _ 10)30-50 HP;absorb i TOl AL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 5220 1 t)>50HP:absorb _ unit>1.75 mil_B_TU 81.20 - _ 12)Air handling unit to 10,000 CFM [ ASSUMED VALUATIONS PER APPLIANCE: 10.00 r - -- Value Totk. 13)Air handling unit 10,000 CFM+ Descr tion: _ Ot __(Ea) Amount _ 1�J- Furn'a-c-e-> Furnace to 100,000 BTU,including 955 _ 14)Non-portable evaporate cooler ducts&vents 1 100,000 i3TU Including 1,110 15)Vent fan connected to a single duct duels&venls 6.80 Floor furnace including vent 955 16)Ventilation system not included in Suspended heater,wall healer or 955 appliance permit 1000 - Boor mounted hpetei _ 17)Hood served by mechanical exhaust Vent not Included in applicance 445 10.00 - permit-___ _______-_ 18)Domestic inclnerators 1740 Repairunits- ----- --. 805 __--- <3 hp;absorb.unit, 955 19)Commercial 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 __ 1000 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU __ ---_. -. --_ 540 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU _ _ _ - 100 >50 hp;absorb.unit, 5,725 - Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil BTU _ __ Air handling unit to 10,000 dm _ 656 _ - 8%State Surcharge $ Air hanaling urdt>10,000 ctm 1,170 _ Non-portable ev mrate cooler 656 TOTAL RESIDENTIAL PEi'MIT FEE: S _Vent fan connected to a single dud 446 Vent system not included in 656 - -- - ap Ip ianoepennit __ - OfherJn�!ctlons and Fees: t,00d served by mechanical exhaust 656 1 Inspectw.ns outside of normal business tours(minimum charge-two hours) Domestic Incinerator -_ - 1,170 _ $72 50 pe-hour Commercial or Industrial incinerator_ 4,560 2 Inspections for which no fee is specifically Indicated (minimum charge-hall hour) our Other unit,includingwood stoves, 856 $72 50 per plan 3 Additional plan review required by changes.additions or revisions to plans(minimul Inserts,etc. ___--_ _ ___ charge-one half hour)$72 50 per hour Gas piping 1-4 outlets 360 Each additional outlet - 63 __- State Contractor Boller Certification required for units 3-200k BTU. -Residential AK requires site plan showing placement of unit. TOTAL COMMERCIAL $ VALUATION: is\dsts\forms\mech-fees doc 08/06101 Electrical Permit Application ID&tcreccived:t /., Permit no.:k/9 'e f4 City of Tigard Project/appi.no.: Expire date: Citi,offigard Addre�, 11125 SW Hall Blvd,Tigard,()It 97223 hate issued: -_... Hy: Receiptno.: Phone 1503) 639-4171 — - ---Fax i 5()1) 198-1960 Case file no.: Payment type: Land use approval: �1 &2 family dwelling ur acerssory U Cominerciai/industrial U Multi-latnily J•I'enanl inlprovenlent ,' New construction U A(hlition/alll rltinnhrplaeenu nl J Other: _ J Partial ITEIN)FOR14ATION .loh address: 7.3140 kk) #00bVfSTfj �. S "I,I il' tion n., T'ax reap/tax fol/account mit`. 11,1: Z Stuck: stint •,I,1 nr Ihlllect name: 111ea'riplioll and location of wu o,pretniseti l:slintated date of cunt llr urm/111spection: CON I'll ACTO It APPLICATION FEEkHEDULE Job no: I Max Business nano: a I - I UeveripNou 011. (ra.) local so ins Welvresldslltlr -single ormulli tamilyper Address: :Roy.-_I_Zr57- _ __ ___ divellingwill.Inchidesaitac•hed garage. Cit til,dr C,i I.II' -SeniceIncluded: ' 1� I 11:111 I(NN)sy fl otless fill,; f�tlr, Inc ^ liacballchnonal SlNlsq II m punumlhcn,t !hone.- - I ay I LLA-{y-L _- ---- -- --- --_ �' _ I.imired me rgv,n sideuuul _ 2 ('110111PIrr111c_ 1111 _ - _ 1.lnnlcd cnrrgy,111111 n•sulrnual _ Fault 111:n1ulacluIt"dh11111r1,1fit.u111111fdwr11111i' - - - --- 5lgnalure of supelllvnf.clerinu:ul rlequllvdi Sen-itc;nlrl/m Irrdui -.Sup.elect name(print), - -- _- V by tars ZZZ Services or feeders-installation, alteratlon or relnc i llon: t t 2W au:ps alt Ice. 2 Nome(print): - � �� '�-_p 211)amps to 6W anipv ,Mailing address c- C 1 4111 anlpsulGlNlamps - - ?_ 1_ � . .. 6K -_^ .� -- _ (1111 amps to I(NNI amps 2 City: __.� � �� ___-- _(1vc1 11NNlatnp•"t lnhN '. Pl1onC: 7 I'aX l: tllall: Reunuust only - -- -- -I Owner installation:The installation being made on pr(ipl•ll, 1111411 Temporary services orfeedem which is not intendiM fill tide. It-;i- rent,alt crclimipc a,1 1�Idillp fit insiallalilln,alteration,orrelocation: OILS 447,455,471) W70 7111 2M nntps alt less 2 _201 amps to CHI alnps 2 Owner's si'natule. Date _ 401lit 6Wanilis - --- yl Rranc•h circuits oe,r,■hrralioa. or estenslon per panel: Nalne: _ A 1-tic fill branch cul arts%kith purchase nt Address: _ scivlcr lir feeder fee,each branch circuit 2 City: - -- SIatc: Lip: It Fre tot hranch circuit%without purchase - - ----- of service or feeder fer,first branch cur mi 2 Phnm• I � f. I11alI — -�._.___ - - a.h addmm..al inaurh cur u11 PLAN RFVI EW(Pleatte cherk all flint apply) Misc.(Service or Feeder not included): U Service over 22.5 amps-commercial U Health cue facihr, i-.acn pump or irngauon code - 2 U Service over 120 snip%rating of I R2 U Ilaimi lws Ilx'allnn i:ach sign or outline hghtlog 2 family dwellings U al l ilve1 10.111Kl%yuan•feet lout(it Signal cal l (it it Itmilvdrne.rpv pnnel. U sysivol over(0)volts 11,11111113) nam residential units 111 rine strticium allerahon,of cil few ,n' _ 2 U Building overdueeslont's U Fredets.41X)ampsill noon• "Description _ Ll occupant load over 91)persons U Mallufacmrrd struclures of RV pall, Fich additional inspection over the■lloaable In any of the above: U I:gr"AirhunRplatt U other Per iuspecooll %baht___sets of plans with any of(lie above. Investigation fee TLe above are not applicable to temporary,construction service. nihel ----- ---Petinll fee........ ..._..... $_- . . Not ur, all rcrym x chl cads,pleu�e can rylixlfcnnrtxx n for e information Notice:This petmtl application '- - U Visa U Mastert•ard rxlllre%if a permit is riot obtained flan review(at -- - %) $ _ Credit cod number _ / / within 190 days aper it has been State surcharge(8`161 ....$ —_- I accepted a2:Complete TOTAL .. ................._.$ __ Native of cudholrfrr u ihown on r It cird - — __ S _..._ i'YrIhrlldeliiRnaiute — -- - Amoum 4404615 OR W ON11 l Electrical Permit Fees: Limited Energy Fees: -- — TYPE OF WORK INVOLVED -RESIDENTIAL ONLY _ , -- . 75.0 Fee ee Schedule Below: ftestricted Energy Fee....................... .............................. Number of inspections Nr Dermit allowad (FOR ALL SYSTEMS) Items Cost Total^ Check Type of Work Involved: Service inc�huded: Residentlal-per unit $145 15 4 Audin and Stereo Systems 11000 sq.M a less — — Each additional 500 sq A or $33.40 __ — 1 [7urglar Alarm portion thereof limited Energy -- 575.00—_ _ __-- Lach Manufd Nome or Modular , Garage Door Opener' Dwelling Service or I eeder _ $90 90 _ L] Heating,Ventilation and Air Conditioning System' Services or Feeders i Installation,alteration,or relocaliun $60.30 7Vacuum Systems' 200 amps or less —--- 5106 85 201 amps to 400 amps ---- $160 60 Other -- dp00 1 amps to 6amps — — - 7 601 amps l0 1000 amps $240 6U $454 652 Over 1000 amps or volts ----- $66.65 _ 7 Reconnect only -_ -- TYPE OF WORK INVOLVED -COMMERCIAL ONLY Temporary Services or Feeders $75.00 Fee for each system................................. Installation,alteration.(x relocation 2 (SEE OAR 918-260-260) 200 amps or less $b6.65 --- $loo 30 —— -- 201 amps to 400 amps $173 75 Check Type of Work Involved. 401 amps to Goo amps ----- Over 600 amps to 1000 volts, F'� Audio and Stereo Systems see"b"above. Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch circuits Clock Systems with purchase o/service or feeder fee. $665 —_ Ej Data Telecommunication Installation Each branch circuit b)The fee for branch circuits Fire Alarm Installation without purchase of service Fj or feeder fee. $46 65 First branch circuit — -- HVAC Each additional branch circuit $6.65-- Instrumentation Miscellaneous (Service or feeder not included) $53 40 _____ _ intercom and Paging Systems Each pump a Inigation circle ------ Ej $53A0 Each sign or outline fighting ___� ----- Signal circult(s)or a limited energy $7500 Landscape irrigation Control* panel,alteration or extension — $12500--- Minor Labels(10) - ----- -- Medical Each additional Inspection over the allowable In any of the above L Nurse Calls clef inspection ------- $62.50 Per hour - — — $73 75 Outdoor Landscape Lighting' In Plant --- —" Protective Signaling Fees: Enter total of above fees $ ---- — Other---- ... - -- fl"/.Stale Surcharge $ -- -- - -- - Number of Svslems 25%Plan Review Fee No Hcenses are required Licenses are required for all othrr installations see'Plan RavkW se+.c(An ro $ — ~— front of appl"tk)n ----- - Fees: Total Balan(.e Due $ ----- Enter total of above fees $-- �-1 Trust Account N 8%Stale Surcharge 5 ---- LJ -- - Total Balance Due 5-- — i\fists\forrnshelc-fees doc 10/09/00 Plumbing Permit Application Permit �Jf2U0 �� ` Date received: apl� City of Tigard Sewer permit no.: Building permit no.: 26 ik Address: 13125 SW Hall Blvd, l igao-d,' R ')7221 Projecdappl.no.: Expire date: Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval _ _ -- 13 1 U Multi-family U Tenant improvement &2 family dwelling or accessory U Conunerci;ll/indust Tal J()IN-1 � '}f New cunsUnctiun U Addition>/alteratiolt/replacement U F( A service imill 1111771'T 11111• Fee ea. Total Ikscri tion _ � ( ) Job address i 3 ; Z0 ' '�r"'OeD J��, Ncr� I and 2 family anellingsonly: — Suiteno... (include.Ilton.fureachutilityconnectionl Bldg.no.: — SFR(I)bath Tax map/tax Iot/account no.: �� •- Lot: - plcx k: Subdivision: ,1J SFR(2) ath - SFR(3)bath Project name: - Each additional halll/kilchell -City/county: g1ti ZIP: "1 23 - Niteutilities: Description and I ation o work on premises:__ batch basin/area drain Urywells/leach lineArcrich drain Est.date of cnmpietwn/rllspection hcxtting drain(no.lin. ft.) — Manufactured home utilities c Business name: C ,f.P.s�„t } Manholes uti c r '+�^ �� 'SA drain connector - Address: r, ( Sanitary sewer(co. _Cit c State:' ZIP: Z2 3 Storm sewer(no.lin.ft.) Phone:� Z FaxE-mail: Water service(no.lin.11.) (CB no �LI,Q lam _ plumb,bus.reg.no: - � _ Fixture or Item: City/metro Tic.no.: _tto __ -- Absorption valve -- contractor's representative signature: _ Back slow pn.vr.nter ~ B t sal, acwe katr valve Print name: Basins/lavatory Clothes washer _ Name: ---- Dishwasher _ - --- Address: _� -- Drinking fountain(s) City: State: ZIP: E _ jectors/sum i'iwne: Fax: E-mail: Expansion tank— •ixturelsewercap loon drains/ cwr sink tib Narne(print): Garbage disposal -Mallin address: � 7, ` tiJ ��` Husebibb City: t A State(} ZIP: � Ice maker - a' Z Fax: 1:mail: interceptor/grease trap Phone: -- Owner installation/residential maintenance only: T11e actual installation Primer(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. Sump),basin(s),IWO) I dtr Uwnces signature: _ — Tubs/sho _ /grewrhow r Pan Urinal _ Water closet Name_ --- Water hheater--- eater — Address: — -- City: tate: ZIP: _.__.. Toter: Fax: E-snail: _ oral Phone: Minimum tee................S WAtit • ,�„� art j,.Wktjon f«more inra"na on Notice:This permit application Plan review(at .— `16) S ----- expires if a permit is not obtained State surcharge(8%) .... U Vis. U MlslerCud S . - --- ,•�;o csrA number _----- ��_—_ —LJ within I8( days after it has been TOTAL S -- —` Frpiar __. accepted as complete. -- Name or— c °t.,.sewn on CIO — s 44G,1616(6"VCOM) PLUMBING PERMIT FEES: PRICE TOTAL Now 1 and 2-family dwellings only: FUCTURES (Individual) Ql"Y ea AMOUN"r (Includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 60 for each utilf connaction) 16 -__ Lavatory _ — � One 1 bath _—_- - - -- $249.20 -- Tub or Tub/Shower Comb. 16.60 J^ Two(2)bath _ _ $350.00 Shower Only 16.60 Three 3 bath $399.00 Water Closet 1660 - _-- _ SUBTOTAL Urinal 16.60 8%STATE SURCHARGE - -- Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _ TOTAL Garbage Disposal 16.60 Laundry Tray 1660 - Washing Machine 16 F0 Floor Drain/Floor Sink 2- 16.60 PLEASE COMPLETE: �^ 16.60 q- 16.60 _--- ---- - Water Heater U conversion O like kind 16 60 _ Quantity b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ Capped MFG Home New Water Service 46.40 Sink MFG Home New Sart/Stonn Sewer qg 40 TubLavor Tub or Tub/Shower Hose Bibs 16.60 Combination Roor Drains 16.60 Shower Onl Drinking Fountain -W 1660 Water Closet Urinal _ — Other Fixtures(Specify) 16.60 Dishwasher Garbage Disposal Laundry Room Tray -- Washing Machine Floor Drain/Sink: 2" iig t 100' 55.00 3, ch additional 100' 4640 4" -- ice-1 sl 100' 5500----- Water Heater Other Fixtures Service—each each additional 200' ^� 4640 S ciain Drain-1st 100' 5500 ain Drain-each additional 100' 4640 al Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27 55 Catch Basin 16.60 Inspection of Existing Plumbing or Specialty 72.50 R nested Ins actions r/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 - Grease Traps 1660 - OUANTITY TOTAL _ Isometric,or riser diagram Is required If QuantMy Tatai Is Y 9 *SUBTOTAL — - B%STATE SURCHARGE ---- "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture_qty total 1s>9 TOTAL S "Minimum permit fee is$72 50•e%state surcharge,except Residential 9ackilow Prevention Uevire,which is fie 25•e%stale surcharge "All New Commercial Buildings require plans wNh.soinetrlc or riser didgram and plan review I\dst,\forrns\pim-fees doc 10/10/00 J. A. SWEEE DEVELOPMUN T CO1 ANW, IM;• _ 19543 SW SCHOILS FRY.M. BEAVERTON,OR 97roJ7 aMm(M)628-0182 W503)628-1085 w W �l i11 Lo,r# �$ iZAVEr�1S S V' o PIAN # 2rb�9 T G, Lo' MSi Of'T �� •- --C-- --r 5 II P- urr,urr, LTq LiAL'A NN&0T S14 �So 0 LOT- J 1 o crOEeAt `0 @ 2.'W9 Lo v 10 co v' 1 l - Q 7- op Np S L)F_..lJ A LJ4- t "IN DP-A 3Z hd {��AGE SEWpanLAT�d�1 -Tv STaCeT _ ZONED R- -7 SCALE 2`-I s ca� I inj Pt_AcE