12285 SW MILLVIEW COURT 12285 SW Millview Court
CITY OF TIGARD ----- MASTER PERMIT
PERMIT 1: MST2001-00243
DEVELOPMENT SERVICES DATE ISSUED. 5001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12285 SW MILLVIEW C1 PARCEL: 1S134CB-11300
SUBDIVISION: MILLVIEW ZONING: R-4.5
BLOCK: LOT: 013 JURISDICTION: TIG
REMARKS: Addition of 150 so. t. family room and 90 sq. ft. deck. Path 1
BUILr 'IG _
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK, ADD HEIGHT: 16 FIRST: 150 at BASEL .T: at LEFT: 5 SMriKE DETECTORS:
TYPE OF USE: SF rLOOR LOAD: 40 SECOND: of GARAGE: of FRONT: 34 PARKING SPACES
TYPE OF CONST: 5N DWELL04 UNITS: FIN13SMENT: at RIGHT:
VALUE: E 22,500 00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 150 oo of REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: AUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 1ARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES
MECHANICAL
FUEL TYPES FURN<100K: SOILICMP<3HP: VENT FANS: CLOTHES DRYER:
FURN-110314: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODS'rOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS i MISCELLANEOUS ADD'L INSPECTIONS
1000 sr OR LESS: 0 - 200 amp: 0 200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 400 amp: 201 400 amp: tat W/O SVCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 000 omp: 401 500 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 601 • 1000 amp: 501•ampa•110�0v: MINOR LABEL:
1000♦amptvolt
PLAN REVIEW SECTION _
Reconnect only: >•4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENEaGY
A.SF RESIDEN1:AL B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMWAGING: OUTDOOR LNDSC LT
BURGLAR ALARM: 0TH: BOILER: HVAC. LANDSCAPEIIRRIG: PRO iECTIVESIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATArtELE COMM: NURSE CALLS: TorAL 0 SYSTEMS:
TOTAL FEES: $ 684.10
Owner: Contractor: This permit is subject to the regulations contained in the
KOVACH,GREGORY J/SHIRLEY M GRANT NEW IOUSE Tigard Municipal Code,State Of OR Specialty Codes and
1'085 SW MILLVIEW CT 16242 S HILLTOP RD all other applicable laws All work will be done in
T IGARD,OR 97223 OREGON CITY, OR 97045 accordance with approved plans. This permit will expire If
work is rot started within 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION.
Phone Phone Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg 0: 1 IC 19979 `orth in OAR 952-001-0010 through 952.001-0080. You
n By obtain copies of these rules or direct questions to
CUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Footing Insp Crawl DraildBackwater Framing Insp Plumb Fine,
Foundatlon Insp Footing/Foundation Dr; Insulation Insp FI•lai Inspection
Post/Beam Structural Mechanical Insp Rain drain Insp
Post/Beam Merhanlca Electrical Service Electrical Final
Underfloor Insulation Electrical Rough In Mechanical Final
Isstled By : L - Permittee Signature
Call (503j 639-4175 by 7:00 p.m. for an inspection needed the next business day
building Permit Application
City of j1�ul'd —� rllrojectU/a�ppl.
d: a /7 Q Permit no.:17s , Q - i7
no.. Expiredate:
Address: 13125 SW Flan Blvd,Tigard,UR 97223 �
City of Tigard . 1
Phone: (503) 639-4171 Date issued: By:L Receipt no.,
Fax: (503) 598-1960 Case file no.: Payment type:
Laud use approval: - — 1 R2.family:Simple Complex:
t
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction D Demolition
)W(Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: -
lob address: Q� _ C Bldg.no.: Suite no.:
Lot: Block: Subdivision:i,e/t tI Tax map/tax lot/account no.:
Project name: k- , - i L
Description and location of work on premises/sr>"ciat conditions:
SPECIAUNFORMAtION,
Name: ,• .
blni##ep'lictipacity,,solar,etc.)
Mailing address: ' S l 1&2 famill dwelling:
Cit State ZIP:
Y�� Valuation of work........................................ $Lam}
Phone: t).. ) ax: E-mail; No.of bedrooms/baths................................. _
Owner's representative: Total number of floors................................. —
I'!ir nr: Fax: I, nuul. New dwelling artia(sq.ft.)
..........................
Garage/carport area(sq. ft.)
Name: Covered porch area(sq.ft.).........................
---- y.ft.)Deck area(s
Mailing address: ........................................
LIP: Other structure.area(sq. ft.).........................
City: State: — —
Phone: Fax: I E-mail: Commercial/industrial/ittulti-famlly:
Valuation of work........................................ $ _�
-- Existing hldg.area(sq.ft.) .............. ....I.....
Business name: ) � —
New i;!-'.�;.area(sq, ft.)
Address: > �, -
City:()'a tat . ZIP: fj ( Number of stories............... ....................
-- --
Type of construction.................. ................
Phone: - � ax: ,.,�'�'/ -maul: -- ---
CCB no �� <� — Occupancy group(s): Eitisting:
® �E �_—T --- New: _
Ci(y/meh',)lic.no.: Notice:All contractors and subcontractors are required to he
161 EM I licensed with the Oregon Constructien Contractors Board under
Name: provisions of ORS 701 and may he required to be licensed in the
Address: jurisdiction where work is being perforated.If the applicant is
— State: Z(p; exempt from licensing,the following reason applies:
Contact person:_ Plan no.: --_—
Phone: — Fax:
Name: Contact person: _ Fees due upon application ........................... $_�L[' �i„1
Eddn, Date received:
State: ZIP: Amount rer;ived ......................................... $Fax: h-mail: !^ ['lease refer to fee schedule. _
hereby certify 1 have read and examined this application and the NW di ,diction accept credit cards,pleaw call jurisdiction frx rwrr infiYmaunn
attached checklist.Ail proviAons of laws and ordinances governing this U Visa U MasterCard
work will be complied th,a hetherw
il�ed herein or not.` y, credil cad m mba
//
Authorized til a Ure: % Date: Name d cardtolder u shown on credit card Expires
Print name: / -- --- $
cardholder alrAature An=ot
Notice:This permit application expires if a permit is not obtained within 120 days after it has been accepted as complete. 4#)4611(60"M)
One-and Two-Family ®welling
Building Permit Application Checklist Refec,nceno.:
Associated permits:
CiryafTigard Cit of Tigard City � O Electrical U Plumbing U Mechanical
Address: 13125 SW II Blvd,'Tigard,OR 97223 UOther:
Phone: (503) 639-41')
fax 001) 598-1900
1 1'FOR
I band use actions completed.Secjurisdiction criteria )Fn �(m.urr.ni n vn•Wr,.
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 applicahic stamp and signature on file or with application. —
9 Erosion control I.1 plan L1 permit required. Include drainage-way protection,silt fence design and location of
catch-hasin protection,etc.
, 107_3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state
building codes. La(cral design details and connections must be incorporated into the plans or on a separate full-sine
sheet attached to the plans with cross reference r between plan location and details.Plan review cannot be completed
_if co yiight violations exist.
I I ,tithe/plat plan drawn to scale.The plan must show kri and building setback dimensions;property comer elevations(if
Uu rc r,nu rn•than it 4-11.elevation differential,plan must show contour lines at 2-11.intervals);location of easements and
driveway:tis)tprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot
ny/f area;building cov^.rage area;percentage of coverage;impervious w-ea,existing structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor bolls,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 !Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,wales heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. _
14 Cross section(s)and details.Show all framing-memhLr sizes and spacing such as floor heam%headers,joists,sub-floor,
wall construction,roof construction.More than one cross section may he required to clearly portray construction.Show
details of all wall and tTxof 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 remodel;:.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building cavelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall 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/roof assemhliec,indicating member sizing,spacing,acid bearing
locations.Show attic ventilation.
18 Basement and retaining wallq. Provide cross sections and details showing placement c`rebar.For nginc^red
systerns,see item 22,"fingincer's calculations."
19 Beam calculations. 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 compliance.Identify the prescriptive path or provide calculations.A gas-piping schematic is required
.A)r four or more appliances.
2 Engineer's calculations.When required or provided,(i.c <hcar wall,roof truss)shall be stamped by an engineer or
! architect licensed in Oregon and shall he shown to he apph ,,tile to the proje.t under review.
l
23 rive(5)site plans are required for Item I 1 above. Site plans must he 8-1/2"x 1 I"or I l" x 17".
24 Two(2)sets each are required for Items 16, 19,20&32 above. -
25 Building plans shall not contain red lines or tape-ons.
26 No rolled,reversed or mirrored building plans will he accepted.
27 --
28 -- — -- -- - — —
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved for depattment use only. 440 4614 MW'OM)
Mechanical Permit Application
Date received: Permit no'/t „P
City of Tigard Project/appl.no.: Expire date:
City nfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no:
Phone: (503) 639-1171
Fax: (503) 598-19(0 Case file no.: _ Payment type:
Land use approval: _ Huilding permit no.:
TUNew
2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement
construction ,,Addition/alteration/replacement U()III(
Job address: L�L/! Indicate cyaipment yuantitics in boxes belcw. Indicate the dollar
Bldg.no.; Suite no.; -- value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ __—
Lar: Block: Subdivision: *See checklist for important application information and
Project name: r Jurisdiction's fee schedule for residential permit flee.
City/county ZIP: ING ERMIT t
Description and location of work on premises:
_ __ Feclt•:+.) Intal
Est.date of completion/inspection: Dmripflon (Xy. Res-mil) Rxs_onl}
Tenant improvement or change of use: Air handling unit --CFM----------
Is existing space heated or conditioned?U Yes U Na dr con itioning(sue p an reyulre )
Is existing space insulated?U Yes U No A teration of existing system
ofer compressors
State boiler permit no.:
Business name: fL _ HP Tons, ISTU/H
Address: Fire/smoke_ dampers7duct smoke detectors —
City_ _State: �ump(siteplan required) _
Phone; —_ Fr3x: Email: nstall/repTce urnac urnet /
Including ductwork/vent liner U Yes U No _
CCB no.: 9 _ 6 nsta rep ac re-ncate eaters-suspended,
City/metro lic.no.: wall,or floor mounted
Name(please printf: ent or a lance ogler than furnace
e gest on:
tTNUTPERSON Absorption units BTU/H
Name: Chillers HP
_- Com nessors_ _ HP
dress: nr+ronm
Adental ex and and ventilation:
City: — _7T1tabs: ZIP: r Applianccvent
Phone: ��— — F t I,11):10 Uryerex ausl
t I o s, 'ype I/I I He s.k itchen ta71nat
hood fire suppression system --
Name: Exhaust fan with single duct(hath fans)
Mailing ad n s: ' x aunts stem a art from heatingor AC
Stale ZIP: 11e piping an st ul on(up Io outlets)
City —.. 7ppc: _—_LPt; NU __ Oil
E-mail: ueTpiping eac additional over 4 outlets
rocesspiping(sc ematicrequlre )
Number of outlets
Name: _ 1 er lsleaa�fance or equT�menr
Address: _ Decoraiivefireplace
City: — State — Zip: _ nscrt-type
Oo sloVW lrwTe C
Phone: j E-mail I own Other: --
Applicant's signature: Uatc: ter: --_
Name (print): ""
Permit fee......................$
NM all)uri"Wrins acce(M credit cards,please call Jurisdiction for nrrne information. Nrltice:This permit application
Minimum fee................$ —
U Visa U MasterCard expires if a permit is not obtained
Credit card nundKr: .. Plan review(Al 96) $
-- -- — Exp/ ire within 180 days after it has been Stale surcharge(8%)....$ _
---- credit card -- acceptedcomplete.as
Name of cardholder u shown ar S
TOTAL .......................$
5,Jhotder aisnalure Amount 4441617 WN nrOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: able pilon: Price Total
T
$1.00 to$5,000.00 Minimum fee S72 50 Table 1A Mechanical Code Qh (Ea) Amt_
$.5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 0 BTU
Including ducts cls&vents _ 14.00
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+ �-
fraction thereof,to and Including Including ducts&vents 17.40 _
$10 000.00. 3) Floor Furnace
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and Including vent 14.00 _
$1.54 for each additional$100.00 or 4) Suspended heater,wall heater
traction thereof,to and including p 14 00
_
$25,090.00. or floor mounted heater _
$25,001.00 to$50,000.00 i $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 uniis
12.15
_ $50,000.00.
$50,001 AO and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp*
7)<3HP;absorb unit
- to 100K BTU 14.00
ASSUMED VAi.UATIONS PER APPLIANCE: 8)3-15 HP;absorb
Value Total unit 100k to 500k BTU _25_60
Descr![t1cn:__- d 1Ea Amount 9)15-30 HP;absorb
Furnace to 100,000 B'U,Including 955 unit.5-1 mil BTU 35.00
ducts&vents _ 10)3010)30-50 HP;FHP; osorb
Furnace>100,000 B(U Including 1,170 unit 1-1.75 mil BTU 52.20
ducts&vents _ - 11)>50HP:absorb
Floor furnace inch ding vent �- _ 955 unit>1.75 mil BTU 1 87.20
Suspended heats,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted hiatei -----10.00
Vent not inclue.ed In appli(.ance 445 13)Air handling unit 10,000 CFM+
permit 17.20
Repair LAW _ 805 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 10.00
to 100k BTU 15)Vent fan connr,cted to a single duct
3-15 hp;absorb.unit, 1,700 6.80 _
101k to 500k BTU 16)Ventilation sys'em not included in
15-30 hp;absorb.unit,501k to 1 2,310 appliance perIT,i1 10.00
mill.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10.00
1-1.75 mil.BTU - -- 18)Domestic incinerators
>50 hp;absorb.unit, 5,725 17.40
>1.75 mil.BTU -- 19)Commercial or Industrial type Inalnerator
Air handling unit 10 10,000 cfm 856 69.95
Air handli g unit>101000 cfm 1,170 20)Other units,including wood stoves
Non-portable evaporate cooler 658 10.00
Vent fan connected to a Fin irk a duct _ 446 21)Gas piping one to four ouilots
V it system not Included In 656 5.40
appliance permit �_ 22)More than 4-per outlet(each)
Hood,terved_by mechanical exhaust 656 1.00
Domestic Incinerator 1 170 _ Minimum Permit Fee$72.50 !SUBTOTAL: $
Cornmercial or industrial incinerator 4 590
Other unit,including wood stoves, 656 '--- - 8%State Surcharge $
Inserts,etc. _ _- _
Gasp�ing 1 4 oulle_ls 380 25°/.Plan Review Fee(of subtotal) $
Each additional outlet __ 63 Required for ALL commercial permit,,nly
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:
-- Other Inactions and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72.50 per hour
2 Inspections for which no fee is specifically indicated (minimum charge half hour)
$72 50 per hour
3 Additional plan review required by changes,additions or revisions to plans(minimum
charge-one-half hour)$72 50 per hour
"State Contractor Boller Certification required for units>200k BTU.
"Residential A/C requires site plan%hawing placement of unit.
I:\dstsUormsUnech-feas.doc 10/11/00
Electrical Permit Application
-- — — -- Date received: Permit no.:
City Of Tigard Project/appl.no.: Expire date:
City(if Tigard Address: 13125 SW liall likd,I ward. OR ()7'?l Date issued: By: - Receiptno.:
Phone: (503) 639-4171 --
Fax: (503) 5915-1960 Case file no.: Payrnerttype:
Land use r.,pproval:
t
S I &2 family dwelling or accessory J l'onuncrclal/nulu,taral J Multi-lamily U Tenant improver-w
U New construction 'W Addition/alteration/replacement U Other: U Partial
0
Job address. `�
dg.no ni,. nu.: Tax map/tax lot/account no.:
Lot: Block Subdivision:
Project name: I Description and location of work on premises: �-
Estimated dale of completion/inspection -`—--
t
Job no: F'ee stat
Business name: Oty. (ea.) lbtal 110.Ins
New residentioll-iingk-ormula famlls lw,
Address: dwellinganit.Includes attaclwd garage
City: Slate: ZlP: Serviceincluded:
Phone: Fax: E-mail: 1000 sq.rt.or less _ __ 4
C( no,: < r ' EIcc.bus.lie.nu: 7. �'' Each additional SW Mi.ft.or pnrtiun thereo
-- Limitedenergy,residential 2
City/metro lic.no.: �, ; -
Limited energy,non•n•sidratial 2
_ Each manufactured home or modular dwelling
Signature of supervising electrician Requited) Dale it l .r, Service arid/at feeder 2
Sup.elect.name(print): �ZlLicensena: r. , Services orfeeder�-Installation,
alteration or relocatlon:
2(N)amps or Ics, 1 2
Name(print): ) N)1 amps to 4W amps 2
Mailing address:
401 snips to 600 amps 2
°y r.;'� ' / � 601 amps to 1000 amps _ —-� 2
City: ,cal Stale ZIP: over 1000 amps or volts - __ 2
Phone: Fax: E-mail: Reconnect only _I
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation:
ORS 447,455,479,670,701. 200 amps or h•^s — _ 2
201 amps to 4W snips 2
Owner's si mature: Date: 401 to 600 ams -` - 2
Branch circuits-new,siterstiov,
or extension per pope!:
Name: - - X Fee for branch circuits with purhase of
Address: `- - _ service or feeder fee,each brom h circuit _ 2
State: ZIP:Y R. �ecfor branch circuits without prrchase
Phone: _ lax: E-mail• of service or feeder fee,rust bran•h circuit: 2
Bach additional branch circuit:
Misc.(Service or feeder not—Include,1):
U Service over 225 amps-commercial U Health-care 1a,i I Each pump or irrigation circle 2
U Service over 320 amps-rating of 1&2 U Hazardous locnun„ Each sign or outline IigWing 2
familydwellings U Building over 1110)0 square feet four or Signal circuits)or a limited energy pent 1.
U System over 600soils nominal more residential units in ones:ructure alteration,or extension* 2
LJ Building over three stories U Feeders,4(x)amps or more •lkscrition:
U(keupant load over 99 persons U Manufactured structures or RV park "ch additional hapection over the alloy obie In any of the sbo.e:
U Egress/lightingplan U Ober ---- Per inspection _
Submit_sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Odur -
Not all Jurisdictions accept credit cards,please cull Suriadiction too more infonnailon. Nouse:This permit npplication Permit fee....................$ _
U Visa U MasterCard expires if a Plan review at — % _
p permit is not obtained ( ) $
Credit card nurnhtt .------ __-_- _ �1__ within IAO days after it hits been State surcharge (8%)....$
Nine o/cardhn! t u shown nn credit cud Expires accepted as complete. TOTAL $
--
- f
Cardholder elpsture Amount 440.1615(69WOM)
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below:
Restricted Energy Fee...................................................... $75.00
Number of Inspections perpe-al allowed (FUR ALL SYSTEMS)
Service includsd: Items Cost Total
Check Type of Work Involved:
Residential-per unit
1000 sq.ft.or less $145.15 _ 4 ❑ Audio and Stereo Systems
Each additional 500 sq.ft.or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener'
Serv!ces or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2
201 ampa to 400 amps i $106.85 �— 2 ❑ Vacuum Systems'
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other .
Over 1000 amps or volts _ $454.65 2
Reconnect only _ $66 65 2
Temporary Services or Feedem TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each systam.......................................................... $75.00
200 amps or less $66 8; _ 2 (SEE OAR 918-260-260)
201 amps to 400 amps _ $100.30 2
401 amps to 600 ampa $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. ❑ P-idlo and Stereo Systems
Branch Circuits ❑
New,alteration or extension per panel Boller Controls
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $665 2 ❑ Data Telecommunia3tlon Installation
b)The fee for branch circuits
without pwchaseofservice ❑ Fire AlarmInstallation
or feeder tee.
First branch circuit 1 _ $46.85
Each additional branch cirr:uil $6.65 ❑
— HVAC
Miscellaneous ❑
Instrumentation
(Service or feeder not Included)
Each pump or Irrigation circle $53.40
Each sign or outline lighting _ _y $53.40 ❑ Intercom and Paging Systems
Signal circuits)or a limited energy
panel,alteration or extension _ _ $75.00 ❑ Landscape Irrigation Control'
Minor Labels(10) _ $12500
Each additional Inspection over ❑ Medical
the allowable In any of the above ❑
Per Inspection $6250 Nurse Calls
Per hour $62 50 _
In Plant $73 75 ,— ❑ Outdoor Landscape Lighting'
Fees: ❑ Prolective Signaling
Enter total of above fees $ ❑ Other
8%State Surcharge $
_Number of Systr.ns
25%Plan Review Foe No licenses are required Licenses are required for all other installations
See"Plan Review"section on $
front of application
Fees:
Total Balance Due $
---`— Enter total of shave fees $ _
❑ Trust Account 8
6"/.State Surch rrge $
Total Balance I)rje i
0dsU\fbt,0elc-fees.doc 10/09/00
05/13/1994 OLSON ELECTRIC PAGE 01
CITY OF TIGARD
13126 S.W. HALL BLVD.
TIGARD. OR 5722:1
IMPORTANT PERMIT NOTICE
OLSON ELEC'T'RIC CO INC
PO BOX 830
VANCOUVER, WA 98666
SUN .
Electrical Signature Form CMMca 'lir,
�
Permit #: MST2001-00243 uFpfriji�
Date Issucd: 'S!3/01 fNi
Parcol: 1 S134CB-11300
Site Address: 12285 SW MILLVIEW CT
Subdivision: MILLVIEW
Block. Lot: 013
Jurisdiction. TIG
Zoning; R-4.5
Remarks- Addition of 150 sq. ft. family room and 90 sq, ft. deck. 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 Llectrical Signature Form prior to the
start of the work to the address above, ATTN.- Building Dept
No electrical inspections will bo authorized until this completed form is received
OWNFR: Ll.FCTRICAI CONTRACTOR
KOVACH, GREGORY J/SHIRL.EY M OLSON ELECTRIC CO INC
12.285 SW MILLVIEW CT PO BOX 830
TIGARD, OR 97223 VANCOUVER, WA 98666
Phone Wfa 6-1 o a Phone N' 360-694-6585
Req #: I-ic 4670
A SUP RROS
FILL 17 32r_
era
AN INK SIGNATURE IS REQUIRED ON THIS FORM
SignaA- ��Ljpervis� Electrician
you havo any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD Bl' DING INSPECTION DIVISIO' MST , ' /e3C) �3
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
_
BLIP
--Date Requested Z _AKA P"" ---___--- BLD -
Location / � 2 9 '- �'
�_ �� E L C-..�-�c-� �-'�� Suite --- - ---_--- MEC
Contact Person Ph PLM
Contractor _ _ _ l Ph SWR
BUILDING Tenant/Owner _SJy 5Z' 7c) CLC
Retai ging Wall 61 ELR
Footing
Access:
Foundation FPS
Fig Drain
Crawl Drain Inspection Notes SGN
Slab SIT
Poet& Beam __-_---___-
Ext Sheath/Ghear
Int Sheath/Shear
Framing
Insulation - --
Drywall NailingFirewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -. - ---- -- -
Roof
Mise
Final
PASS PART FAIL --
PLUMBING
Po l& Beam
Under Slab
Top Out -
Water Service
-
Sanitary Sewer v
Rain Drains
Final — --'— —
PASS PART FAIL
MECHANICAL
Pnst& Beam P
Rough In
Gas Line
Smoke Dampers
Final
r„SS PART FAIL_
ELECTRICAL
Service
Rough In
UG/Slah _
Low Voltage —
Fire Alarm
Ir
hik
PART F0L —_-_-- —_— --.-----_-----__— ___
Backfill/Grading
Sanitary Sewer
Storm Drain ( J Reinspection fee of$! —required before next inspection. Pay at City Hall, 13 125 SW Hall Rivet
Catch Basin
Fire Supply line [ J Please call for reinspection RE — _ [ )Unable to inspect-no access
ADA --
Approach/Sidewalk s'� n< _�
Other — Date v' l �� Inspector `'��'�" Ext
Final /
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.