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13999 SW HILLSHIRE DRIVE a. tD tD tp 2 r r 2 m v i i I q! t i i i t i 1 13999 SW H;LLSHIRE DR # a CITY OF TIGARD 1312.5 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE AC ELECTRIC INC d�- 18820 3HENANDOAH DR OREGON CITY, OR 97045 EI�ctricol Signature Form Permit #: MST_0k)3-00489 Date Issued' 1("'10/03 Parcel: 2S104CC-93000 Site Address: 13999 SW HILLSHIRE DR Subdivision: HILLSHIRE ESTATES NO. 2 Block: Lot 136 Jurisdiction. TIG Zoning: R-7 Remarks: Remodel existing crawl space. 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 requireG. Please have the appropriate individui i from your company sign below and return this E'ectrical Signature Form prior to the s+ , of the work to the address above, ATTN: Buildir)g Division. No electrical inspections will be authorized uni`.il this completed form is receiN,ed OWNIR ELECTRICAL CONTRACTOR WHITE, RICHARD L. + CANDACE J AC ELECTRIC INC 13999 SW HILLSHIRE Det 18820 SHENANDOAH DR TIGARD, OR 97223 OREGON CITY, OR 97045 Phone #: Phone #: 232-BC-,56 Reg #: LI(' 055015 Sul, 45275 hLI 3-201(' AN INK SIGNATURE IS REQUIRED ON THIS FORM X Sign � ising Electrician If yoi1 have any gijestions, please call 503.718.2433. CITY OF TIGARD 24-Hour BUILDING Inspection Line: ( 3y 4175 -- cc MST _ INSPE�.;'00N DIVISION Business Lina: ( 03) 39-4171 BUP Received _ — _ Date/(ReAuested_ �� AM.., PM� BLIP Locatic i �-?�7—� / '—' �__ __--_Suite r Contact Person _ ___ —._ s Ph — __ PLM Contractor ---- ------------- - - -------_ Ph( ) SWR BUILDING Tenant/Owner _ _ --- — ------ -- ELC -- ---- _—� -- Footing EIC -- Foundation Access: Ftg Drain ELR _ _ ___ ---- Crawl --Crawl Drain Slab Inspection Notes: SIT _ Post& Beam �.-_. Shear Anchors -- - - -- Ext Sheath/Shear Int Sheath/Shear Framing - Inrulation Drywall Nailing -- - ------ __ Firewall Fire Sprinkler - - -- -- - - - Fire Alarm Susp'd Ceiling Roof I Othe. - _--. --- -- --- --- -- — Final - - --_-- - PASS PART FAIL --- -�- - ---- PLUMBING Post& Beam Under Slab - — - --- --- - --- Rough-In Water Service - - -- - - -- Sanitary Sewer Ra;n Drains — ---- - Catch Basin/Manhole Storm Drain Shower Pan Other Final PASS_. T FAIL - -- CHA AL Post& Heam Rough-In - - - --------- -- Gas Line Smoka,Dampers ----- PART FAIL - -- v-- -EtEtTRICAL _ Service Rough-In UG/Slab Low Voltage Fire Alarm Fwal Reinspection fee of$_--_._--_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL_ SITE Please call for reinspection RE: _-__-___- Unable to inspect-no access Fire Supply Line ADA Date _-- Inspector Approach/Sidewalk - Other: Final DO NOT RiMOVE this Inspection record from the job site, L.PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 539-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 ..� BUP ---- — _ Received __ __Date Requested. — AM_________ PM BUP I-ocation __—_�� __ t��D��✓1, ._._Suite— — MEC Contact Person — _— _ _�:a_lna ___ Ph( ) 70-0 2�0 PLM ContractorPh (. ) — _ __- SWR BUILDING _ Tenant/Owner __-_—_ ____- —__ _-__ ELC - Footing _--� - Foundation ELC - -- - Access: Fig Drain ELR Crawl Drain - - - - - - Slab Inspection Notes: , SIT Post& Beam - Shear Anchors - - Ext Sheath/Shear Int Sheath/Shear Framing — — ---- -- Insulatio Drywall N, 1, -- - --- -- _ -- Firewall Fire Sprinkler -- - - - Fire Alarm Susp'd Ceiling —�--� - - - Roof Other: -- - - --- - Final PASS _PART FAIL tl PLUMBING _ Post& Beam - Under Slab Rough-In Water Service ----- - - -- Sanitary Sewer Rain Drains --- - --------- -- ------ Catch Basin/Manhole Storm Drain --_- _- -------._---- _._--- Shower Pan Other Final PASS PART FAIL - ----- - ------- - - MECHANICAL --—---- ----- - ----- -- - - --- Post&Beam Rough-In __- - ---- - -- -- Gas Line Smoke Dampers --- _-_-_ - Final PASS PART _FAIL ELECTRICAL Service --- -- - - -- Rough-in UG/Slab - Low Voltage - --- -- -- ------- ---- --- --- Fire Alarm m U Reinspection fee of$-_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS" PART FAIL SI Please call for reinspection RE:_---_____- -- ._ -_ Unable to inspect-no access Fire Supply Line 7 ADA G p -� _ Approach,'Sidewalk Date_� Ins sato Ext Other. Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TICARD 24-Hour BUILDING Inspection Line: (50 4175 -5— OQ 44W. INSPECTION DIVISION Business Line: BUP Location Received _— Da'e R quest �q AM _— PM__— BUP lz -'+ _Suite Contact Person PLM _ Contractor _ —_ Ph( _) .— _ SWR _ LDI �— Tenant/Owrer _ — ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain — Slab Inspection Notes: SIT Post&Beam Shear Anchors — — Ext Sheath/Shear Int Sheath/Shear -- --- Framing Insulation Drywall Nailing Firewall Fire Sprinkler ----- -- _ Fire Alarm Susp'd Ceiling — Roof Other: -- -- -- -- — ina RT FAIL - -- L � Post& Beam --- —� — Under Slab Rough-In Water Service - Sanitary Sewer Rain Drains - —� Catch Basin/Manhole Storm Drain - Shower Pan Other- --- -- — iePART FAIL_ ---�-- CHA LPmill-g — eam --- -- Rough-In Gas Line Smoke Dampers/fA ----- _- _—_.— — SS PART FAILft- —� — -- —. _ RICA_L _ Service — -- --- Rough-In UG/Slab Low Voltage Fire Alarm �— Final [� Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE F� Please call for reinspection RE:_ _ _ Unable to inspect-no access Fire Supply Line ADA 1 Approach/Sidewalk Date. Inttapeator Other: Final --�—� DO NOT REMOVE this inspection r000rd from the fob site. PASS PART FAIL / CITY ITY ^U F TIGARD 'GARD _ v_^ MASTER PERMIT PERMIT#: MST2003-00,69 DEVELOPMENT SERVICES DATE ISSUED: 10/10/03 13125 SW Hall Blvd., Tigard, OR 972.23 (503) 6391171 SITE ADDRESS: 13999 SW HILLSHIRE DR PARCEL: 2S104CC-03000 SUBDIVISION: HILLSHIRE ESTATES NO. 2 ZONING: R-7 BLOCK: LOT: 130 JURISDICTION: TIG REMARKS: Remodel existing crawl space. BUILDING REISSUE CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: at BASEMENT: 1.055 at LEFT: SMOKE DETECTORS: r TYPE OF USE: SF FLOOR LOAD: SECOND: at GARAGE: at FRnNT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: THRO 51 RIGHT: 000 00 OCCUPANCY GRP: R7 BDRM: BATH: TOTAL: U of VALUE: 25 REAR: _ PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: i GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFL W PREVNTR GREASE TRAPS OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN c 100K: BOIL/CMP c 7HP: VENT FANS: 1 CLOTHES DRYER: FURN>-100K: UNIT HEATERS: HOODS: OTHER UNITS: I MAX INP: htu FLOOR FURNANCES: VENTS: 2 WOOUSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUI rS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 200 amp: 0 200 amp: WISVC OR FOR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 5005F: 201 400 amp: 201 400 amp: tat WIO SVCIFDR: (XI SIGNIOUT LIN LT: PER HOUR. LIMITED ENERGY: 401 -600 amp: 401 600 amp: EAADDL OR CIR: T SIGNALIPANEL: IN PLANT: MANUHMISVC/FDR: 601 1000 amp: 601+mpa•t000V: MINOR LABEL: 1000+amplvolt: PLAN REVIEW SECTION Reconnect only: >-4 RES UNITS: SVCIFDR),-225 A.: 600 V NOMINAL: CLS AREAISPC OCC: ELECTR'�.L.•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 sTEREO VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER. HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAtTELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 776.85 WHITE,RICHARD t_+CANDACE J WHITEHOUSE COLLECTION INC This permit cisubject to the regulations contained in the 13999 SW HILLSHIRE DR 13999 SW HILLSHIRE Tigard Municipal Code,State o OR,k w Specialty Codes and TIGARD,OR 97223 TIGARD,OR 97223 all other applicable laws. All work will be done it accordance with approved pians. This permit will expire N work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: Phone: S90-0209 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080 You Rep N: LIC 1 ZL)1(15 may obtain copies of these rd les or direct questions to CLINIC by calling(503)246-1987. REQUIRED INSPECTIONS Footing Insp Electrical Rough In Electrical Final Slab Insp Framing Insp Mechanical Final PLM/Underfloor Gas Lino Insp Plumb Final Mechanical Insp Gas Fireplace Building Final i Plumb Top t Insulation Insp \ L ►V� Issue By : ( Permittee Signature Call (503 9 4175 by 7:00 p.m. f,r,)r an inspection needed the next business day ItO ICE I.TSE ONLY Quildinz Permit Application ' �� _ Received � FF Building Date/B ��� .7 Permit No.: -.00 Planning Approv I Other City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 -Date/By: M4V U - "3 Permit No.: Phone: 503-639-4171 Fax: 503.598-1960 ' '' Post-Review I.and Use Date/By, _ Case No. Internet: www.ci.tigard.or.us - - g Contact � Juris. See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method Su lemental Information _ » > NewconstructionDemolition Addition/alteration/replacement Other: -x- Note. Permit fees"are based on the total value of the work performed. Indicate I &2-Family dwelling Cotnmercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. Accesso Buildin Multi-Famil Master Builder Other: Valuation......................................................... S25,000 id I;O .VON s' No,of bedrooms:I No.of baths:_Ju Job site address: Total number of floors...... 13999 S�j1.LSHlRE DRIVE New dwelling area(sq.ft.).............................. Suite#: I Bldg./Apt.#: Garage/carport area(sq, ft.)............................ Project Name: AUBE RESIDENCE REMODEL Covered porch area(sq.ft.)............................. _ Cross street/Directions to job site: Deck area(sq.ft.)............................................ — Other structure area(sq.ft.)............................ 40< 01' 2783_, REQl11RFD D 1TA. :, L'011t1h..K( IAl -INE CHH KLIS'1 l Subdivision: HILLSHIRE ESTAI49 _- --- -- -------- Tax ma / arcel#: /� i t 'C)t'�G 1 Note: Permit fees*are based on the total value of the work perfo Indicate the value( ridded to the nearest dollar)of all equipment,m_fials,labor. RESIDENCE REMODEL Ta-EXISTING overhead an ofrt for the work indicated on this appl' on. Valuation.......>arsq. ....................... ...... $ _ ** NO STRUCTURAL CHANGES REQUIRED Existing build .ft.)........ ...............New building ... ....................... Number of sto ....... ................... Type of const .......Narne: KAREN AND GREG AUBEOccupancy grExistt - Address: 13999 SW HILLSHIRE DRIVE New: Cit /y State/Z :TIGARD OREGON 97223 —_. — NOTICE: All contractors and subcontractors are required to be Phone: 503.521 .819:_ _ Fax- C_ ad'.' licensed with the Oregon Construction Contractors Board under uAP . NT ' 'CONTAPEiEL4JpN provisions of ORS 701 and may be required to be licensed in the Business Name- jurisdiction where work is being performed. If the applicant is exempt Contact Name: 1 f from licensing,the following reason applies: Address: City/state/Zip: Phone: — ------I I1llt.ulyc PCR,u r hrEs• E-mail: Please refer to fee schedule. Business Name: THE WHI E 0 UULLECTIO LLCpees due upon application... _Address: 13817 13817 SW BENCHVIEW TERRACE Cit, /State/Zip: TIGARD, OREGON 97223 Amount received.................. .. .................. ... S_ Phone:503,590.7425, _ Fax: 503.590.2905 Date received: CCB Lic. #: 129105 6 �-- Authorized Notice: This permit application expires If a permit is not obtained within Signature o — -- Date:09/24/03 Igo days after It has been accepted ns complete. ko' la j '�+t�'-+` _ *Fee methodology set by Tri-County Building Industry Service Board. (Please print name) ` i\Dsts\Permit Forms\Bldgl'ertnitApp doc 01/03 I One- and'Uwn-Family Dwelling; Building Permit Application Checklist Reference no.: -- --- Associated permits: Ci City Lit Uf Tigard and O Electrical ❑Plumbing O Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 0 Other: Phone: (503) 639-4171 Fax: (503) 598-1960 I IIE FOLLOWING ITEMS AR�,*9QUlftED FOR PLAN REVIEW Ves No N/k i Land use actions completed.Sec jurisdiction criteria fur concurrent reviews. 2 _Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. 4 Fire district 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 stamp and signature on file or with application. 9 Erosion control ❑plan ❑permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 3 Complete sets of legible plans.Must be drawn to scale,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 cross references between plan location and details,plan review cannot be completed if copyright violations exist. 1 I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a O4 elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;l t _ area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. I foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent sue and location. _ 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height.siding material.footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Well bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/mof assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. 18 Basement and retaining walla.Provide cross sections and details showing placement of rebar. For engineered systems,see item 22,"Engineer's calculations," 19 Beam calcu!atians.Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code.ompl[once. Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. 23 Five(5)site plans are requited for item I 1 above. Site plans must be 8-1/2" x l 1"or 1 I"x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall net 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 COT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440.4614(6MCOM) Mechanical Permit Application .__._ Received I Stihanwal Date/B}. CityCit of Tigard Planning Approval Building g Dates: Permit No.: 13125 SW Hall Blvd. Plan Review Ocher Tigard,Oregon 97223 Date/Fs _ Permit No.: ^_ ^ Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date/By: Case No.: rn _ Inteet: www.ci,tigard.or.us — - g Contact 1UrI5.. ticC Page.tirr 24-hour Inspection Request: 503-639-4175 Name/Method: _ Supplemental information. TYPE OF WORK COMMERCIAL FFE*SCILEDULE-USE CHECKLIST New construction I F1 Demolition Mechanical permit fees*are based on the total value of the work © Addition/alteration/re lacement I ❑Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. I & 2-Family dwelling Commercial/Industrial Value: S _ _ See Page 2 for Fee Schedule Accessory Building Multi-Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE Descri tiontv Fee W. T _ Master Builder Other: _ Heauooh tai n Ci. JOB SITE INFORMATION and LOCATION Furnace-add-on air conditionin " 14.00 Job site address:13999 SW HILLSHIg pgIVE Gas heat pump 14.00 _ Sui.ce #:_ I Bld ./A t.#: Duct work 14.00 Project Name: AUBE RESIDENCE REMODELH�onic hot water system 14.00 _ Residential boiler Cress street/Directions to job site: for radiator or hydronic system 14.00 _ Unit heaters(fuel,not electric) in wall,in-duct,suspended,etc.) 14.00 Flue/vent for any of above 10.00 Subdivision: HiLLSHIRE ESTATES Lot#: 45 Repair units 12.15 Other Fuel A Ilancea Tax map/parcel#: Water heater 10.00 DESCRIPTION OF WORK Gas fire lace ___T 10.00 _ RESIDENCE REMODEL TO EXIST LNG CRAWL SPACE Flue vent(water heater.' as fireplace) 10.00 _ Log li hter as 10.00 Wood/Pellet stove 10.00 ** NO STRUCTURAL CHANGES REQUIRED Wood fireplace/insert 10.00 Chimney,liner/fluc/vent 10.00 PROPERTY 0 OTENANT Other: 10.00 Name: GgEC AND KAgEN AUBE Environmental Exhaust&Ventilation Range hood/other kitchen equipment 10.00 Address: 13999 SW HILLSHIRE DRIVE Clothesdryerexhaust 10.00 City/State/Zip: TIGARD, OREGON 97223 Single duct exhaust Phone: 503.521.8192 Fax: (bathrooms,toilet compartments, APPLICANT CONTACT PERSON_ utility rooms) 6.80 Name: Attic/crawls ace Fans 10.00 Address: - Other: _ 10.00 Futl PlpinQ City/State/Zip: **(S5.40 for nrst 4,$1.00 each additional Phone: Fax: Furnace,etc. •• — Gas heat um •' E-mail: Wall/suspended/unit heater '• CONTRACTOR Water heater •• Business Name: ADVANCED HEATING & AIR CONDITION Hire lace _ ••� Address: 5825 SE FOSTER ROAD Range •' City/State/Zip:pURT AND OREGON 97 ZO6 Clothes dryer(gas) Pttone: 503.774.0161 Fax: Ocher: •• _ CCB Lic. #:98573 ,?r; Total. Authorized Mechanical Permit Feer• Signatute Date: 9 4Q3 Subtotal S --— Minimum Pennit Fee$72.50 S Plan Review Fee L5°o of Permit Fee) S (Please print name) State Surcharge 8"o of Petmit Feel S TOTAL PERMIT FEE S Notice: This permit application expires if a permit i%tint obtained within -Fee methodology set b%y Tri-Count lluitdinR Induxtry Ser%fcr Hoard. 180 days after It has been accepted as complete. **Site plan required for exterior,V( unit. i\DstsTermit FormcMrcPermirApp doe 01.03 Mechanical Permit Application - City of Tigard Pale 2 - Supplemental Information Commercial Fee Schedule: TOTAL VALUATION: PERMIT FEE: $1.00 to$2,000.00 _ Minimum fee$72,50 $2,001.00 to$5,000.00 $72,50 for the first$2,000.00 and$2.30 for each additional$100.00 or fraction thereof,to and including$5,000.00. K5,001,00 to$10,000.00 $141.50 for the first$5,000,00 and$1.80 for each additional 5100 00 or fraction thereof,to and including$10,000.00. $10,001.00 to 550,000.00 $231.50 for the first$10,000.00 and$1.35 for each additional$100.00 or fraction thereof,to and including$50,000.00. $50,001.00 to$100,000.00 $771 50 for the first$50,000.00 and$1.25 for each additional$100.00 or fraction thereof,to and including$100,000.00. $100,001 OG and up $1,396-50 for the first$100,000.000 and $1.10 for each additional$100.00 or fraction thereof All New Commercial Buildings require 2 sets of plans. i\Ouilding\Permit Forms\MecPermitAppPgZ 09-01.03 doe Building FixturesF0R'OFF10EtTJMM__ PlurtRbing Permit Application Received Date/B _ Perm.t No. Planning Approval Sewer City of Tigard Date/B : Permit No.: Plan Review Other 13125 SW Hall Blvd. Datc/B : Permit No.: Tigard,Oregon 97223 Post-Review Land Use Phone: 503-639-4171 Fax: 503-598-1960 Date/B : Case No.: Internet: www.ci,tigard.or.us contact Juris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information. TYPE OF WORK F-FEE-SCHEDULE(for special information use checklist) r Description New construction Demolition tlq. F'celea•1 total -"-1- New 1-&2-family dwellings Addition/alteration/re lacement Other: (includes too tc.for nen aria cohneetbn CATEGORY OF CONS7'RUCTIUN SFR(I bath _ _ 249.20 - 1 &,2-1.,imil dwellin Commercial/Industrial SFR 2)bath 350.00 -- ®_ ----�- 399.00 Accessory BuildinMulti-Family SFR 3 bath - Other: Each additional bath kitchen 45.00 Master Builder Pae 2 JOB SITE INFORMATION and LOCATION Fires rinkler ft.: Site Utilities -Job site address: 13999 SW HILLSHIRE DRIVE Catch basin/area drain 16.60 Suite#: Bldg./AMA. Or ell/leach line/trench drain 16.60 Pro'ect Name: AUBE RESIDENCE REMODEL Footin drain no.linear fl.) Pa e 2 Cross street/Di,eetions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanita sewer nolinear ft.) Pae 2 Storm sewer no. linear ft.) _- P`o- '- Subdivision: HILLSHIRE ESTATES Lot#: 45 water service(no. linear ft 1 Pa e2 Tax ma / arcel #: ____Fixture or Item DESCRIPTION OF WORK Abso tion valve 16.60 RESIDENCE REMODEL TO EXISTING Backflow reventer Pa c2 Backwater valve 16.60 _ CRAWL SPACE Clothes washer 16.60 Dishwasher 16.60 Drinkin fountain 16.60 PROPERTY OWNER TENANT E ectors/sum 16.60 Ex ansion tank 16.60 Name: KAREN AND GREG AUBE 16.60 Address: 13999 SW HILLSHIRE DRIVE Fixture/sewer ca Floor drain/floor sinklhub 16.60 Cit /State/Zi :TIGAR.D OR 97223 _ Garbage dis osal 16.60 Phone: 503.5 1.8192 Fax: _ Hose bib 16.60 APPLICANT CONTACT PERSON Ice maker 16.60 Interce tor' Tease tra 16.60 Name' _ ---- Medical as-value: S _ Pa e 2 -_ Address: ------ Primer 16.60 Cit /Slate/Zi _ Roof drain commercial) 16.60 Fg�;- Sink/basin/lavator 16.60 Phone: 16.60 Tub/showeNFhower an E-mail: Urinal 16.60 CONTRACTOR Water closet 16.60 -- Business Name: MODERN PLUMBING COMPANY Water heater 16.60 Address: 1112 SW INDUSTRIAL WAY _ Other: - Cit /State/Zi : TUALArIN, OREGON 97062 Other: - PlumbhoQ Permit Fees' Phone: 503.691.6166 Fax: 503. _ Subtotal S CCB Lic. #: 6 Plumb. Lie.#: 34-250PB Minimum Permit Fee$72.50 S Authorized Residential Backflow Minimum Fee$36.25 SignatureDate: 09 24 03 plan Review 25"0 of Permit Feel S /�► A 111F State Surcharge(89"of Permit Feel �lhI. TOTAL PERMIT FEE S _ (['lease print names Notice: This permit application expire-Of a permit is not obtained N%ithin All new commercial buildings require 2 urs of plans with Isometric or riser diagram for plan re%lew. IRO drys after It has been accepted as complete. *Fee methodology set M Tri-Counh Building Industry Service Board. t Dsts'perm,t Fomts`PlmpermitApp.doc 01,03 Plumbine Permit Aimlication - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Pernut Fee: Foonnr 'gain-I'100' 55.00 010 2,000 $11500 Footv ain-each additional 100' 46.40 •'.001 to 3,600 $16000 _ 3,601 to 7,200 $220(11(1 Sewer - 1st 100' 55.00 7,201 and greater $30900 Sewer•each additional 100' 4640 Water Service-Ist 100' 55.00 Medical Gas Systems' Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain Drain-Ist I00' 55.00 $1,00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46,40 $5,001.00 to$10,000.00 372.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof',to and Fixture or Item Qty. Fee(ea) Total including$10,000 00. Commercial Back Flow Prevention Device 4(1 40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to (minimum permit fee$36.25) 27 55 and including$25,000.00. Ram Drain,single family dwt Ilmg 65 25 $25,001.00 to$50,000.00 $379.50 tar the first$25,000.00 and$1.45 for Inspection ot'existing plumbing or each addit-oval$100.00 or fraction thereof,to and includin $50,000.00. s eciall requested inspections-per hour 72.50 $50.Wl.00 and up $742.00 for the first$50,000.00 and V20 for Subtotal: each additional$100.00 or fraction thereof Fixture Work: Are you capping, moving or replacing existing fixtures? If "Yes",please indicate work performed by fixture. Failure to accurately report fixtures could result in increased ses er fee,.*. uantlilby Fixture Work performed Comments regarding fixture work: Fixture Type: R,placeT— New Moved Exiatinj C'a '!. - Baptistry/Font _ Bath -Tub/Shower _ i - -Jacuzzi'Whirl of -- -- Car Wash -Each Stall -Drive Thru Cus :dor Water Aspirator - --- --— ---- Dishwasher -Commercial -Domestic Drinking Fountain _ - —'-- Fre Wash _ — ------ --- -- Floor Drain,sink 2" .4" Car Wash Drain *Note: If the fixture work under this permit results in an Garbage -Domestic Disposal -Commercial increase of sewer EDUs,a setter permit will be issued and -Industrial fees assessed for the sewer increase must he paid befnre the Ice Mach Refirij Drains plumbing permit can be issued. Oil Separator (Jas Station) _ Rec Vehicle Dump Station Shower -Gang ..Stall Sink Sink -Bar Lavatory -Bradley -Commercial -Service Swimming Poral Filter Washer-Clothes _ Water Extractor µater Closet-Toilet Unnal _ Other Fixtures. Dsts Permit Formas':•ImPermnAppPg2 doe 01 03 Electrical Permit Application Received ' ' Date/B,: PermitNo.0 Cit of Tigard Planning Approval Sign Y g Date/By: Permit No.. 13125 SW Hall Blvd. Plan Review Other — Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-6394171 Fax: 503-598-1960 Post-Review Land Use Dat"y: Cabc No.: Internet: www.ci.tigard.or,us Contact Juris 0 Sec Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information. TYPE OF WORK PLAN REVIEW(Please check all that>tpply) New construction E Demolition Service over 225 amps- health-care facility Addition/alteration;'replacement ❑ Other: commercial ❑tiazr�do�s location ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, CATEGORY OF CONSTRUCTION 1&2 family dwellings four or more residential units to 1 & 2-Family dwelling Commercial/Industrial CI System over 600 volts nominal one structure � ACcr'S50 $LLlldln Multi-Family ❑Building over three stories ❑Feeders,400 amps or more _ _�__. IS- ❑Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder 011ier: ❑Egress/lighting plan ❑Other:_ JOB SITE INFORMATION and LOCATION Submit__sets or pin ns with am of the abose. The above are nota licatile h.tem orar%construction ser%ice. Job site address: 13999 SW HILLSHIRE DRIVE _ FEE*SCHEDULE Suite#: Bld ,/A t.#: Number of ins ections per ermit allowed Project Name: AUBE RESIDENCE REMODEL —Description —�_ Qty I Fee(tn.) Total Cross street/Directions to Ob Site: New restrlem,al-single or multi-lama.per dwelling unit.Includes attached garage. Service included: 1000 sq.A.or less 14515 4 Each additional 500 sq.ft.or portion thereof 33 40 I Lot#: LimitedenerliZ.residential 75.00 __ 2 4g Subdivision: HILLSHIRE ESTAjESLimited energy,non residential 75.00 _ 2 Tax map/parcel#: Each manufactured home or modular dwelling — DESCRIPTION OF WORK service and or feeder 90.90 2 ServicRESIDENCE REMODEL TO EXISTING CRAWL SPACE alteraesor[erel catinetrllation, _ alleratlon or relocation: 200 amps or less 80.30 _ 2 201 amps to 4(A)ams 106,85 2 **NO STRUCTURAL CHANGES REQUIRED 401 ampr to 6( amps — _ 160.60 2 13 PROPERTY OWNER TENANT 601 ams to 10M ams 240.60 2 GREG AND KAREN AUBE - over INK)amps or volts 454.65 2 Name Reconnect only 66.85 2 Address: 13999 SW HILLSHIRE DRIVE Temporary services orfeeders-installation. City/State/Zip: TIGARD, OREGON 97223 alteration.amps tless relocation: 200 am s or less 66.85 1 Phone: 503.521.8192 Fax: 201 amps to 400 amps — IM.30 —� APPLICANT CONTACT PERSON 401 to 600 ams 133 75 --- Branch circuits-new,alteration,or Name: extension per panel: Address: — A Fee for branch cocwts with purchase of 6.65 2 service or feeder fee,each branch circuit City/State/Zip: B.Fee for branch circuits without purchase of — — service or feeder fee,first branch circuit 46.85 21 Phone: ;ax: _ -- 2 Each additional branch circuit 6.65 E-mail: Misc.(Servicc or fecdcr not included) CONTRACTOR Each pumpor irrigation circle _53.40 _ 2 ---—------ --- Each sign or outline iighting 53.40 2 Job No: Signal circuit(%)or a limited energy panel. � Pae 2 Business Name: AC ELECTRIC alteration,or extension Description Address:18820 SHENANDOAH DRIVE City/State/Zip: OREGON CITY, OREGON 97045 Each additional inspection oser the allowable in stn of the abose: �3�Sb51; Per inspection per hour min. I hour) 62.50 _ Phone: ' Investigation fee CCB Lic. #: 55615 Lie. #: 3-261C Other Electrical Permit Ft.aR Supervising electrician _ Subtotal S signature required: Plan Re%iew 125%of Permit Feel S Print Name: Lic. #: 3442S State Surcharge 810 of Perttut Fee) S — — TOTAL PERMIT FEE S Authorized Notice: This perm?t application expires ifs permit is not obtained within Signature: _ �'1u Date: 9/24/03 180 days after It has been accepted a%complete. .Fee methodolog-s set M Tri-Counts Building Industry Service Board. (Please print name) c Dsts\Permit Fottns\ElcPermitApp.dm 01 03 Electrical Permit Application - City of Tigard ' Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Feefor all systems............................................................ S75.00 cheek'rype of Work Involved: Audio and Stereo Systems* Burglar Alarm Garage Door Opener* I leating,Ventilation and Air Conditioning System* Vacuum Systems* COMMERCIAL WORK ONLY: Feefor each system.......................................................... $75.00 itiI I n,\R()18-260.260► (lieck I$pe of Mork Involved: E] Audio and Stereo Systems Boiler Controls Clock Systems Data Telecommunication Installation Fire Alarm Installation E] I1VAC u Instrumentauun Intercom and Paging Systems ElLandscape Irrigation Control* Medical Nurse Calls C� Outdoor landscape lighting* nProtcitnC Signaluig (hhei Number of Systems * No licenses are required. Licenses are required for all other Installations i Dsts\Permit Fomn\Eici'ermitAppPg2.doc 01'03 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN, OR 97062 Plumbing Signature Fo~m Permit #: MST2003-00489 Date Issued: 10110/03 Parcel: 2S104CC-03000 Site Address: 13999 SW HILLSHIRE DR Subdivision: HILLSHIRE ESTATES NO. 2 Block: Lot: 136 jurisdiction: TIG Zoning: R-7 Remarks: Remodel existing crawl space. YoUr company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: WHITE, RICHARD L + CAI4DACE J MODERN PLUMBING 13999 SW HILLSHIRE DR 11120 SW INDUSTRIAL WAY TIGARD, OR 97223 TUALATIN, OR 97062 Phone #. Phone #. 503-691-6166 Reg # MET 00002486 LIC 87906 PLM 34-250PB AN INK SIGNATURE IS REQUIRED ON THIS FORM � I 'i � r tfio lumber gnafu e of Au If you have any questions, please calf 503.718.2433. CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00633 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 DATE ISSUED: 10/29/03 PARCEL: 2S104CC-0300 SITE ADDRESS: 13' 99 SW HILI-SHIRE DR SUBDIVISION: HILLSHIRE ESTATES NO. 2 ZONING: R-7 BLOCK: LOT: '136 JURISDICTION: -TIG CLASS OF WORK: ALT FLOOR TURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: _BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LNG 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: In;l;i11 i,ii, 1'iInnt, ��illi H )I cullet and tirelflaee insert. Owner: FEES WHITE, RICHARD L + CANDACE J Description Date Amount 13999 SW HILLSHIRE DR INIF('I11 Permit Fee 10/29/03 $72.50 TIGARD, OR 97223 I"I'AX) 91%titate 4urchart 10/29103 $5.80 Phone: Total $78.30 --- Contractor: ADVANCED HEATING & AIR COND 5825 SE FOSTER PORTLAND, OR 97206 REQUIRED INSPECTIONS Gas Line Insp Phone: 503-235 u )olr Mechanical lnsp Reg #: LIC 98573 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-00 Issued By: . -'iA Z;7 Permittee Signature - — T_---- Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Sent By: Hf' t.aserJet 3100; 503 774 4391 ; Oct-28-03 8:18PM; Page 111 u Vr.VtlI NOJa -? navarlood Heotirtp; pea• 2 0 /04/200' 00 +3 FAX 5035919833g S Kea Design i 0 002/003 t Mechanical Permit Application Date received: I4 9 G P ri . ! ,P etntlt oto„, 44City of Tigard -- - Prof_act/app.oto.: Expire date ` C rl,of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97123 Phone: (503) 639.4171 ate issued! _ BYaC. Receipt no.: __ Fox, (503) $98.1960 Case the no.• Pa acnt type: Land use approval: huflding permit na.� 2 family dwelling of accessory U CornrnerciaUinduscrial O Multifamily 0 Tenant improvement 13 New construction U Addition/alteration/replacetncnt U Other. Job eddreaa: fndiaete a ui ant uanl(tles ir.boxes below Indicate the dollir _ h1 r 4 9 Aldg nu.: Suue no valutt of Oil 1`11e4blinicel materials, equipment,labor,Overhead. MEM Tax map/tax lodoccoultt no _ profit.Value S Lot, 131ock �5ubdiv gron — asee checklisi tor important application infiamation and Project name jurilrJcutcrcn', 11 11 schcdulr fbr residential persnit flee, Gty/county L1P: ��`. Description and I cation of work on prctnteoa. Fee(ea.) foist Est.data of complotiorr/inrpaction, Doncrf tion Rea unlylRel.Dolt Tenant improvement or change of wc. A i I.existing,pace heated or conditioned"C!Yes O No Air h dlin unit _TM COM Ak cdn tort ( Ito lenr t 1•rrl,nl)y share iusidated7 UYes UN* Bratton n SIF n TA eiyetern` v~� m v eompre,sUrt nustness namz. State boiler permit,no.. 141,1Tons BTU/11 Address tr sinaitt ftm duot!moa tactors city. RT�AN� $Cate• xlp. zy ur urn t to ro u y Pltona _ (Fix;' /y3� E•mni); nitn. ep ace a c Unna= , CCB no,�QS1� latlu t duuwarkIveni lincr to Yat 0 No - 119 ey scerc a pawn-Suspended, City/tticlro Ire no well,o floor mou�tad Name lease rim : etrl� rat Det Abeotptlon untie 9TLr/H Name Chillers Irp Addrwa — - :om tlatanHIP 5tote. 21A. nv a merit ex art a ren at an: - - yllsnee tent Phone. Pax E-moil: T. aoJ a, r vp�t lr Jt'r�9 k ti chew namai— - hand "ire tupprr,airin systcnt Name: E,,:,z use to w1th III A e duct Qbuh fins) —� Mailiu address: -�"` xlNutc s�stetr.I e t L has!n�T or qC-- Ci 5txtc. 2IP; 0f p Ai oto ellen(up to cuu jft4 st ty �: LPt3 Not o Phone: Far: YE-rnaii ue n tae a ane ovor ou cit rncare p ptet(se ame4c requur e1tIC #I�1 1 L f ` �umbe:cf nuaerf or feTi Opo r •ur e�a`1p w i; E — !9 " "'W ��e--�.� Uctorative }LcplaCa� -- ttY O 'JA AJ b 51114011 01V_ j 2M rZOb (r.otn -- t_ hone _ Fax. _ E-mail o t e ps ei a yr, fir' . Ilcrnt's signature ,_ rite.° r LnBle(print) 1 , • ----•--r _-..�_ter_ _ tll,..ntdtNiom.eeepr arNM4:ar.,a cut a.lr N-t IW7j.,f!r,,nwE rarrNlndran Yet it fee.........•.... .,.... s .... Notice Thlt Mini ant fee ! in t]Mwm,'�.r permit rlppNeatlan !P0 11W e:r �'ri �'• _��i�1 1 expires if a permit It hot obtained - 00- ��' rpt within 110 dq rRer it hat bcch Sitnta aurnt,,"cw hvp o caith' t.;n bit a u seemed at enmplcto. TOTAL. - i , Cr TOM �rprw�n� MMaln, / �.Ilrcri , i, 1