13102 SW ST JAMES LANE 13102 SW St James Lane
CITY 0F1 .,a NRD 24-Hour
BUILDING inspection Line: (503) 639-4175 MST �-z) c�'y
INSPECTION DIVISION Business Line: (503) 639-4171
BUP
c
Received .._ — Date Requested AM PM BUP
Location __-_ �L1_l1 _- --- Suite --r/__L-/-z--- MEC _r------ _------
Contact Person Ph PLM --- -
Contractor._ —_ - _ Ph( ) ._ SWR -
BUILDING _ Tenant/Owner - _ ELC
Footing _ ELC
Foundation Access:
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.
Final --- - __
PASS_ PART Ff.IL
PLUMBING -
Post&Beam
Under Slab -
Rougl -In
Water Service -- - ---- - - ------ --- -
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other..____-.
Final
PASS PARI FAIL
EC
MHANICAL
Post&Beam
Hough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL. -
ELECTRICAL
Service
Rough-In - - -- ------ ----
UG/Slab
Low Voltage __--
_F1_mAla�m - —
Final U Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AS PART FAIL
Please call for reinspection REQ __ _ Unable to inspect-no acces,,
Fire Supply Line
ADA1)1_ (Y// ,, 0 �"t Ext--
Approach/Sidewalk pate -- Inspsee
Other:.—�_---_ /
Final DO NOT REMOVE this inspection record from the jslte.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) G39-4175 6 0 O �3
INSPECTION DIVISION Business Line: (503) 639-4171 MST
Blip --- _.
Received —_ --__ _Date Requested _- _._ .- AM PM BUP
LocationU 2.� y `� -YKk'-� Suite_ — -
4 �'Yj _ __ _ MEC
Contact Person — Ph(—) f LLQ - PLM
Contractor Ph( _ ) -- SWR -
BUILDING Tenant/Owner _.—__--_- ELC
Foo'ing -- ----
ELC
Ftg
Foundation
Access: L� l ELR
Crawl Drain f
Slab InspectionNotes: SIT
Post&Beam
Shear Anchors J
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ' -Y- �` `+� •-f2�-r� ` ���'
Fire Alarm
Susp'd Ceiling - — -- - --
Roof
Other:
PASS PAR EAI ---- —_ - -- - ---------
PLU_M_BING_ -_ —
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 -- -- ---- -- -
rna
AS RT FAIL -
. TRICAL
Service � --------------._.—__._.--.___---- ------------ -__-
Rough-In
UG/Slab
Low Voltnge —! -- ---_—r_-�_--_-_--
Fire Alarm
Final Reinspection fee of$�— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ ( Please call for reinspection RE:---.- -.---- -___ Unable to inspect-no access
Fire Suppiy_Line
ADA
Approach!Sidewalk Date ,__"/V_4%�-r Inspector - _ �(A Ext_
Other:
hinal _ DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITU' OF TIGARD 24-Hour �� d
BUILDING Inspection Line: (503)639-4175 MST o2-
INSPECTION DIVISION Business Line: (503)639-4171
AM
Received Date Requested 17 — AM - PM_
BUP
Location
_- �� ,,� ,,✓ ryt ate ___ Suite MEC
___ r��--r-r
Contact Person . Ph( —) ���7 3 PLM
Contractor .— ---
Ph( ) SWR --
BUILDING
Tenant/Owner ELC
Footing ELC
Foundation Access: ELR
Ftg Drain
Crawl Drain - SIT
Slab Inspection Notes: '
Post&Beam - --- --
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ---- -
Framing
Insulation ----
Drywall Nailing -
Firewall -- —
Fire Sprinkler F —
Fire Alarm _ -----
Susp'd Ceiling
Roof —
Other: ----------- —.
mAS FAIL — —-- --� ---_ —`
PLUMBI — — -- --
Post&Beam —
Under Slab ---- ----"--"--
Rough-In ---
Water Service - -- -- - --
Sanitary Sewer --—
Rain Drains -- ---
Catch Basin/Manhole _—
Storm Drain
Shower Pan - -- -- _— -- --_,_ ---
Other:
Final
PASS PART FAIL
MECHANICAL --r
Post&Beam ---
Gas Line --
Smoke Dampers -
Final __ _—__ -- -- ----- —
PASS PART FAIL —
ELECTRICAL ----
Service
Rough-In — --- —
UG/Slab --
Low Voltage _— ---- ----�--
Fire Alarm
Final Relnspaction fee of$ _required before next inspection. Pay at City Hell, 13125 SW Hall Blvd.
PASS PART FAILUnable to inspect--no access
SITE
Fire Supply Lin [� Please call for reinspection RE: --
e
ADA --O �-- InspedOr___ ! 1 - -- — --—�---
Approach/Sidewalk Dote_ �—
Other:_ ._.
Final pQ NOT REMOVE this Instpectlo" record from the Joky site.
PASS PART FAIL
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S.W. ST. JAMES
TY OF
T I G A R DBUILDING PERMIT
PERMIT #: BUP2002-00384
DEVELOPMENT SERVICES DATE ISSUED: 9/9/02
1312'5 SW Hall Blvd.,Tiqard. OR 97223 (503) 639-4171 PARCE'_: 2S109AB-11000
SITE ADDRESS: 13102 SW ST. JAMES LN
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 039 JURISDICTION: TIG
REISSUE: L FLOOR AREAS EXTERIOR WALL CONSTRUCTION _
CLASS OF WORK: � b- FIRST: sf N: S: E W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? _
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: _ _REQD SETBACKS __ R_EQUIRED______
FLOOR LOAD: psf LEFT: 4 ft RGHT: 10 ft FIR SPKL SMOK DET:
DWELLING UNITS: FRNT: 20 ft REAR: 24 ft FIR AL.RM : HNDICP A...C:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 6,424.20
Remarks: Addition of 380 sq. ft. deck.
Owner: Contractor:
JIM DAIKH AMERICAN HERITAGE HOMES
8865 SW DAVIES P O BOX 742
TIGARD, OR 97008 WILSONVILLE, OR 97070
Phone: Phone: 682-8846
Reg #: LIC 00070270
FEES---- REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing Insp
FLCK CTR 9/4/02 $59.35 27200200000 Framing Insp
PRMT CTR 9/9/02 $110.50 27200200000 Final Inspection
5PCT CTR 9/9/02 $8.84 27200200000
PLCK CTR 9/9/02 $12.48 27200200000
(additional fees not listed here)
Total $211.17
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. ." '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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-6699 or 1-800-332-2344.
Permittee k .--
Signature: ,–c-� 7
-7'
Issued By: ----
Call 639.4175 by 7 p tin. for an Inspection the next business day
Building Permit Application
Datereceived: Permit no.
City of 'Tigard
ProjecUappl.no.: Expire date:
Citynj7'iga►d Address: 13125 SW Hall Blvd,Tigard,OR 97223 �
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Paymenttype:
Land use approval: 1&2 family:Simple Complex:
1
R 1 &2 family dwelling or accessory U Commercial/industrial O Multi-family U New construction U Demolition I
U Addition/alteration/replacement U Tenant improvement U Fire.•I,tinkier/alarm ®Other: :
JOB SITE INFORMATION'
Job address: vi �> �Z t �•Y.L� fir,, �•� v ' Bldg.no.: ;iuite no.: :.
Lot: I Block: Subdivision: �+.(y�, C'1�y, Q J Tax map/tax lot/account no.:
Project name: J
Description and location of work on premises/specinl conditions:Ja �-,
Name: �� bill&_ii.- nil III I
Mailing address: 1 &2 family dwelling:
City: vs. IStaff: ZIP: 9 _r Valuation of work........... $
Phone: 17--7 "'7y Fax: E-mail: No.of bedrooms/baths.................................
Owner's representative: Total number of floors................. ......
Phone: - — 11 1-ax: B moil: New dwelling area(sq. ft.) .......................... ----_ - --
Garage/carport area(sq.ft.).........................
Name: Covered porch area(sq.ft.) .........................
Deck area(sq. ft,)
Mailing address: ........................................ ... .
City: State: ZIP: Y Other structure area(sq.ft,).........................
Phone: Fax: E-mail ('onttnerciallindustrlal/multi-fantlly:
Valuation of work........................... ............
l
Business name: Existing bldg.area(sq. ft.) .......................... ---
/�.r..s�tr^, -� ),- v...R•�'-}
Address: 7 tI c.i — ', A -t• tJ v A,v,W New bldg.area(sq.ft.)................................
Number of stories . ............*..................... —
City: •ti Stale: ZIP: 4 (t•y Type of con tru (ion ................
Phone: C_.9U.-4,- 15YXI I FaxCYL E-mail:
( �-7 (Q Occupancy group(s): 15gisting:
CCB no.: U
- - -- New:
City/mctio tic. m Notice:All contractors and subcontractorsare required to be `
t ' licensed with the Oregon Construction Contractors Board under _
Name: provisions of URS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: Stam. ZIP: exempt from licensing,the following reason applies:
Contact person: Plan nl,
Phone: I ,t I ni;ul
Name: WAN 1011 jcontwct person: Fees d,tc upon application ........................... $
Address: Date received:
City: State: ZIP: Amount received .........................................
Phone: Fax: E-mail: Please refer to fee schedule.
hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please Call juri%dictlon for nrore Intorrop Ion
attached checkli�t. All provisions of laws and ordinances governing this U visa U MasterCard
work will be complied with,whether specified herein or notcredit card nunther
Expires
Authorized signature: � Dale: Narne of cardholder as shown on credit card
$
Print name: Cardholder sIttnoture Amour,
Notice:This permit application expires if a permit is not obtained within 190 days after it hes been accepted as complete. 44r-4613(Mxv('oM)
One-and Two-Family Dvaelling
*' Building Permit Application Checklist Reference no.:
Associated permits:
cit of Tigard�' � ❑Electrical U Plumbing U Mechanical
Address: 13125 SW Hall lilvd,'rigard,OR 97223 UOther:
Phone: (503) 639-4171
Fax: (503) 59R-1960
THE-11701CLOWING ITEMS ARF, RE10111111111D FOR PLAN REVIEW
I band use actions completed.See jurisdiction criteria for concurrent reviews.
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved 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.
R Soils report.Must carry original applicable stamp and signature on Iile or with application.
9 Etodqn control U plan U pennit required. Include drainage-way prot.xtion,silt fence design and location of
itch asin protection,etc.
I 3 `omplete sets of legible plans. Must by drawn to scale,showing conformance to applicable local and state.
�h
it
codes. Lateral design details and connections trust he incorporated into the plans or on it separate full-sire
sT o attached to the plans with cross ICIVIenccs between plan location and details. flan review cannot he completed
il'copygtt violations exist. _
I I Sitelpiod plan drawn to scale,'rhe phut must show lot and building setback dimensions;property corner elevations(if
flu•w is more than a 44t.elevation diffrrrnlial,plan must show contour lines at 24t.intervals);location of casements and
driveway;footprint ofstructure(including decks);location of wells/%eptic systems;utility locations:direction indicator;lot
arca;building coverage area;percentage ol'coverage;impervious arca;existing structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor hulls,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,water heater,
furnace.Vcnlilation falls,Plumbing fixtures,balconies and decks 30 inches aho\e grade,etc. _
14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor heants,headers,joists,soh-flour,
wall construction,roof construction.More than one cross section may he required to clearly portray constriction. Show
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation.stairs,
fireplace constuction, thennal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimum of Iwo elevations for additions and rcnuadols.
Gxterior elevations must reflect the actual grade if the change in grade is greater than four foot at building emclope.
Full-size sheet addendums shoo 'oumdation elevation%with cross references are acceptable.
16 ltiall bracing(prescriptive pat,u), Ilor lateral analysis plans. Mint indicate details unit locations;I'or —
non-prescriptive path analysis pro to specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all tloors/roof assemblies,indicating member sizing,spacing,and hearing
locations,Show attic ventilation,
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems,see item 22,"ra+gineer's ullcul,uioM."
IO Beam calcolallons. Provide I\eO set,.0I L,11,111,111 k 111',11.i111'current code design values for all beams and multiple joists — --
0VCI Ill feet long and/or tiny heart/101.1 rut�111 ,1 moo uolfornl load._ _
20 Manufactured floor/root truss design detadl%.
21 Energy Code compliance. Identify the prescriptive path or provide ca:culation%. A gas-piping schematic is required
for four or more appliances.
22 Engineer'%calculatlons.When required r provided,(i.e.,shear wall.rooffro, hall be stamped by an engineer or
;urllilecl licensed in Oregon Mid shall he `hown to be applicable to the Pali i 1111110rteViM
JURISDIC-117110NAL
3 Five(5 .ite plans are required for Item I 1 above. Site Plans must heti L/2' .\ I I"0a 11"x 17".
24 Two(2)sets each are required for Items 16, 19,20& 22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accreted.
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees dost ment.
27 "brawn to scale" indicates standard architect or engineer scale.
28 Site plan to include tree size,type& location per approved pr�jecl street tree plan(it applicable),and CC r Street"tree List.
Checklist must he completed before plan re\ie\. stall date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved Im department use only. 4404614(tJnal+ostl
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
HARVEY ROSE ELECTRIC SERVICES
PO BOX 128
NORTH PLAINS, OR 97133
Electrical Sfgnature Form
Permit #: MST2002-00023
Uate Issued: 3i11 iU2
Parcel: 2S109AB-11000
Site Address: 13102 SW ST. JAMES LN
Subdivision: RAVEN RIDGE
Block: Lot: 039
Jurisdiction: TIG
Zoning- R-7
Remarks: Construction of new SF detached residence. Path 1 MUST HAVE FIRE
SPRINKLER PLAN IN AND APPROVED BEFORE FRAM114G INSPECTION
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 Forret 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
OWNER: ELECTRICAL CONTRACTOR
HERITAGE HOMES HARVEY ROSE ELECTRIC SERVICES
21145 NW WEST UNION PO BOX 128
HILLS60iO, Or'. 37124 11`20P-1 Pi !N"S OR 97133
Phone #: 503-690-8388 Phone #:
Req #: ELE 34-130C
LIC 00043C84
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Sig ature of S ervising Electrician
If you have any questions, please call (.503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CRAFTWORK PLUMBING INC
7736 SW NIMBUS AVE
BEAVERTON, OR 97008
Plumbing Signature Form
Permit #: MST2002-00023
Date Issued: 317.1102
Parcel: 2 S 109AB-11000
Site Address: 13102 SW ST. JAMES LN
Subdivision: RAVEN RIDGE
Block: Lot: 039
Jurisdiction: TIG
Zoning: R•7
Remarks: Construction of new SF detached residence. Patti 1 MUST HAVE FIRE
SPRINKLER PLAN IN AND APPROVED BEFORE FRAMING INSPECTION
Your company has beer 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 Dept.
No plumbing inspections will be authorized until this completed form is received
OWNFR PLUMBING CONTRACTOR:
HERITAGE HOMES CRAFTWORK PLUMBING INC
21145 NW WEST UNION 7736 SW NIMBUS AVE
HIL_LSBORO, OR 97124 RFAVFRTON. OR 47008
Phone # 503-590.8388 Phone #: 644-8698
Reg #. I Ir 79666
PI M 20-148PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X _
Signature of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
MASTER PERMIT
CITYOF T I G A R D PERMIT #: MST2002-00023
SERVICES DATE ISSUED: 3/21!02
DEVELOPMENT
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13102 SW ST. JAMES L.N PARCEL: 2S109AB-11000
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 039 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence. Path 1 MUST HAVE FIRE SPRINKLER PLAN IN AND
APPROVED BEFORE FRAMING INSPECTION
BUILDING
REISSUE: STORIES. _ FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 1'i FIRST. I.-At st BASEMENT: 71.00 sf LEFT 6 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD. 40 SECOND 1,173 sf GARAOE: 1,177 of FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS. 1 FINBSMENT. 91 VALUE: S 256,180.90 RIGHT: 10
OCCUPANCY ORP: R0 BURM 1 BATH: 3 TOTAL: 2.417.00 sf
REAR: 32
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: Ino TRAPS.
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS. 1 CATCH BASINS.
TUBISHOWERS: 1 GARBAGE DISP- I WATER HEATERS, I WATER LINES: 100 BCKFLW PREVNTR. I GREASE TRAPS
OTHER FIXTURES.
MECHANICAL
FUEL TYPESFURN<100K BOILlCMP<3HP VENT FANS: 5 CLOTHES DRYER: I
GAS FURN:-000K: I UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES:
VENTS: I WOODSTOVES: OAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS,
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L SOOSF: r 701 100 amp:
201 400 amp: tai W/O SVCIFDR: OL) SIGNIOUT LIN LT,. PER HOUR,
LIMITED ENERGY, 401 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNALIPANEL: IN PLANT:
MANUHMISVCIFDR: 801 1000amp: 601-amps-1000v:
MINOR LABEL:
1000+amplvolt: PLAN REVIEW SECTION
Reconnect only: >,4 RES UNITS: SVCIFDR-225 A.� >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
B.COMMERCIAL
A.SF RESIDENTIAL
RLNDSC LT:
AUDIO IL STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE
IIRRIO: PROTECTIVE SIGNL:
GARAGE OPENER:
CLOCK: INSTRUMENTATION: MEDICAL: OTHR
HVAC.
DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
TOTAL FEES: $ 7,389.04
Owner: Contractor: This permit is subject to the regulations contained in the
HERITAGE HOMES HERITAGE HOMES Tigard Municipal Code,State of OR. Specialty Codes and
21145 NW WEST UNION 21145 NW WEST UNION all other applicable laws. All work will be done In
HILLSBORO,OR 97124 HILLSBORO,OR 97124 accordance with approved plans This permit will expire if
work Is not started within 180 days of Issuance,or If the
work is suspended for more than 180 days. ATTENTION:
Phone: Oregon law requires you to follow rules adopted by the
rhonel Oregon Utility Notification Center. Those rules are set
Rap N• LIC 99659 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&
Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Sprinkler Rough-In
Grading Inspection Post/Beam Mechanica Ftng Drain Bsm l Wells Framing Insp Gas Fireplace Sprinkler Final
Sewer Inspection Underfloor insulation
Mechanical Insp Shear Wall Insp Insulation Insp Appr/SdWk Insp
Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Electrical Final
Foundation Insp Footing/Foundation Dn Electrical Service Low Voltage Water Line Insp Mechanical Final
Issued By
Permittee Signature '
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD _ SEWER CONNECTION PERMIT
SERVICES PERMIT#: SWR2002-00015
DEVELOPMENT S DATE ISSUED: 3/21/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S109AB-11000
SITE ADDRESS; 13102 SW ST. JAMES LN
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 039 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: L.TPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new SFresidence
Owner: _ FEES
HERITAGE HOMES Type By Date Arnount Receipt
21145 NW WEST UNION
HILLSBORO, OR 97124 PRMT CTR 3/21/02 $2,300.00 27200200000
INSP CTR 3/2.1/02 $35.00 27200200000
Phone: 503-690-8386 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 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer' Perm
--��44__`` ((//�``� i Permittee Signature:, +,i,..A •�-f
Issued by: J� GC ,t
Call (503) 639-4175 by 7:00 P.M.for an inspection needed the next business day
a
Building Permit Application
Date received:) s t % Permit no. -
City of Tigard (� i�
Cit offigard Address: 13125 SW Hall Blvd,•Tigard,611--V'/223 ProjecUappl.no.: Expire date: - �•
Phone: (503) 639-4171 Date issued: ByPo I Receipt no.:
Fax: (503) 598-1960 Case rile no.: Payment type:
_ n
family:Simple c'nnplex:
Land use approval: _ `
TYPE OF
U I & 2 family dwelling or accessory 0 Commercial/industrial J Multi-family A New construction J I)emolilion
u Add ition/allerat ion/replaccmcnI U•Tenant improvement J Fire sprinkler/alann U Olhcr:
Job address: L N e _ Fildg,tit) lutlr 11(1.: -
Lot: �_ BloLk: Subdivision: AV EK ��l G Tax map/tax lot/account no.: ZS. j /
Project name: 16 L - h Ar
Description and location of work on premises/special condjtions:
OWNER FORSOKIAL INFORMATION,
Name: --��'�t (Floodplain pcapacity, of
Mailing address: 1 &2 family dwelling;: � �
City: Stale: ZIP: Valuation of work......................•••I.............. $-,d��_fCsa_—'—
Phone: Fax: E-mail: No.of Ikdrooms/haths...........................•••.•.
Owner's representative: Total number of floors.................................
I'lu nr: Fax: Email: New dwelling area(sq. ft.) ..........................
Garage/carport area(sq. ft.).........................
Nance: T V ryi E S Covered porch area(sq. ft.) ......................... __dDeck area(sq. ft.)
Mailing address: E T LkNICN _--
City: �� 1 State: �,` IP: � Othrr structure area(sq. ft.).........................
C
hunr; Fax: 1 Ly F-
? nraiL ('onrrrrercial/Industriallmulli-famliv:
,
Valuation of work........................................ $
Existing bldg.area(sq.ft.) ..................r,�•.•.
Business name: 'fY� ` New bldg.area(sq.ft.)
Address: c ,,,; _ N,E s T V_A i rJ Number of stories
City: x c f-1; State: o �. ZI 1 .•........•...•••...............
Phone: •.:.
Fax: 4 •1KS'o E-mail: Type of construction..•.........;. _A—
��--- Occupancy group(s): Existing: ,
CCB no.: US�) �_ y {/ ----- New: _
(icyhnctnt lir.no.: �- Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Name: ALAN Rx �l t IJc�I�h R55_,7.tr ___ provisions of ORS 701 and may he required to be licensed in the
Address: i 3 C 5 1- U E jurisdiction where work is being performed. If the applicant is
Cil b L State:t-` 7.IP: ri 20 exempt from licensing,the following reason applies:
Contact person: I1pv E PIE10 Plan no.: -i)AI K R
Phonr:71.� 'I lI 5 Fax:-2,)5-- E-mail:
Name: &Q)NL- qtr N tNC-6�vr Contact Person:P,c,jl,N 9.0 Fces due upon application ...........................
Address:tj 5- Sc 10 "-� Date received:
City: PC M AN State:v j< ZIP: 71.1 It Amount received .........................................
Phone: Fax:IS-4 14 11 E-mail: _ Please refer to fee schedule.
hereby certify I have read and examined this application and the Not all jurisdictions acarpr credit cards•piense can jurisdiction lot more Infornurtion
attached checklist. All provisions of laws and ordinances governing this uviso OMasietCnrd '
work will be complied wIt�.whc� er specified herein or not. Credit card number _
Expires
Authorized signature: f)' tiDate: Name of cardholder as shown on credit card
— S
Print name: ' -----._.�� __— —_ Cardholder signature -- Amount
Notice:71ris permit application expires if a permit is not obtained within 180 days ager it has been accepted as complete. aa-4613(t UW'oM)
One- and'Uwo-Fanjily Dwelling �
Building Permit Application Checklist "erenceno.
--"-- Associatedpmnils:
citrnfliRarJ city of Tigard U filectnr;O 'J Plumrnng J Mecharucal
Address 11125 SW Hall Blvd,Tigard,OR vi:"+ J Other
Phone: (503) 639-4171
Fax: (503) 598-1960
T11F1 FOLLOWING ITEMS1 ARE REQUIRED FOR
I Land use actions completed.Sce.jurisduclion criteria for concurrent Wws.
Fl
2 "honing.
-Food plain,solar balance points,seisrniC sails desiglwit, n i,iric district,�i
3 Verification of approved plat/lot.
4 Fire district_ _approval required. u^
5 Septic system permit or authorization for remodel. Existing syslenl rupncity ^_ _
6 Sewer permit.
7 Water district approval. _ —
8 Solis report. Must carry original applicable stamp and signature on file or with application. _
9 Frosion control U plan U permit required. Include drainage-way protection.silt fence design and location of
catch-basin protection,etc. _
10 _3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and stale
building codes. Lateral design details and connections must he incorporated into the plans or on a separate lull-sl/C
sheet attached to the plans with cross references between plan location and details. flan review cannot he completed
if co yrigltl violations exist,
I I Mlelplot plan drawn to scule.'I'he plan must show lot and building setback diniefvoons•property comer elevations(if
there is num than a 4-ft.CICt,ation differential,plan must show contour lines at 2 ft. inteu,also:I,K noun of e,lsenunls and
driveway;I'm1print of structure(ink fooling decks);location ol'wclls/scptic syslrnls,uulny I xatiuns;direction illdlr;llor:lot
arca;building coverage•area•percentage of coverage;impervious area;existing structures on site;and surface drvnagc.
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 tdrutilic,uiun.Window eve, location of smoke detectors.water heater.
Ininace,ventilation tins,plumbing fixtures.halronres Mill decks in IIlLhes above rade,etc. —
i a (Toss sectlon(s)and details.Shaw till framing-numb(•r fives;rod spachut ouch as Ilii,.r hcams,headers,joists,sub-fluor,
Wall consulaclion,roof cnnsiruclion. More than one crit,art.tion nun he required In Nearly portray construction.Showdetails of all wall and rout sheathing,r(lofing.111,1 dope.ceulrne lu ii ht. sling material,f(x)tings and foundation,stairs.
fireplace construction, thermal insulation,etc.
15 h:Ievatlon views.Provide elevations fur neck (eauslnactiun;mininwm of two elevations for additions and remodel,;.
l-.xteriur elevations must reflect the actual grade it the change ill grade is greater than four foot at building eau•lope.
Full-size sheet addendums showing foundation ele,atnms with cross references arc acceptable.
I t, Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for
non-prescriptive path analysis provide specifications and c;drulntiuns to engineering standards.
17 Floor/roof framing. Provide plans lilt all floors/roof assemblies,indicating member sizing,spacing,and hearing
locations.Chow attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. Dor engineered
_systems,see item 22,"Engineer'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 tiny beam/joist carrying it nun-uniform load.
20 Manufactured iloorlroof truss design details.
I Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required
for four or more appliances. _ —
22 FnglneerN calculations.When required or provided,(i.e-shear wall,runt muss)shall he stamped by an engineer or
urlitrrt h,('11"01 Ill t h-egoo and shall he sho n to hr apphcahlc lit 0W 11101CL I undeu reg 10%%
JURISQIC-fIONAL
23 Five(5)site plans arc required for Item I 1 above. site plans must he 5-I/d 1x I I-tit I I" x 17".
24 Two(2)sets each are required for Rents I6, 19.20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted.
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document.
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree.plan(if applicable),and COT Strect Trec List.
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 department use only. 440 4614(pro OM)
Mechanical Permit Application
-�- Date received• Permit no. ' v -0v0
City Of Tigard Project/appl.no.: � Expire date:
CitynfTigard Address: 13125 SW Hall Blvd.Tigard,OR 97223 Date issued: By: I Receipt no.::
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval _ Building permit no.:
❑ I &2 family dwelling or accessory U Conimercuil/industrial J Multi-family J Tenant improvement
New construction U Addition/alteration/replaccme:tt J Ocher:
KKM 10 11'AN K11197TEURGOLINI
Job address: li S W !:5 a�- {Jr IV C Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: ISuite no.: value of all mechanical materials,equipment,labor,overhead,
profit.Value$
Tax map/tax lot/account no.: —
Lot: Z d Block: Subdivision: /aV CA) RIS C 'See checklist for important application information and
_ jurisdiction's fee schedule for residential permit fee.
Project name: . I b S C -
City/county: w 4 7IP:
Description and Kation of work on premises:
lrr(ra.) Intal
Est.date of completion/inspection: 1><u'riton_ Ifl} Ileti_onl} Kcw.onh
Tenant improvement or change of use: Air handling unit __ CFM
Is existing space heated or conditioned?U Yes U No Ail conditioning(site plan required)
Is existing space insulated?U Yes U No Alteration of existing IIVAC system
Boiler/compressors
State boiler permit no.:
Business name:!,k; t_ �� Si(tt T m r 1��a7fN G — HP _ Tons BTU/14
Address: y 3 V N E it smoke amper.Yuct smoke electors
Slate:D l; ZIP: mac pump(sue p an require )
Fax: E-mail: nstn rep ace.furnaceAwrncr__
Phone: I ` 4 3� Including ductwork/vent liner U Yes U No
CCB no.: �$ __ nsta rep ac-re ocate caters-suspen e
d.
C'ily/metro tic,no.: wall,or floor mounted
- -
Name(please tint): -- _- - v cnt rot a iance other than furnace
Refrigeration:
Name:
C Lhky, w I L F C—RT �iiu r, In' --- --
S
Address: ii 4,I V r - 4odronmentsl rzhaud and vrnU at on:
City: I LL5 L, p Slate: VL ZIP: 1 r ApplianrC ecnl ----- — -- -- _._.
Phone: &49 - 15-6 Fax:';y)-ou ' E-mail: I)ryerexhaust _-
0o s-fiypcl res. itc lei azmat
hood fire suppression system ---
Name: �,J T I}b E 0 fy1 t Exhaust tan with single duct(bath fans)
7T, Seecm apart from catin+or
Mailing address: S W S (kl O N — ur p ping and and t str rut on(up to4 outlets)
City: ll Scale:0 r; 'ZIP: q d 14 byte: t.l'c; NG c)il
Phone: o ,�K I'ax:f 0 -13 0 r mail Fuel i in eacha iuona over out ets
Process piping(schematic required-)
Number of outlets
Name: N 1A
Address: - -___ Decorative fireplace _
City: -- State: l.11': nsert- type _ -- _--
Woodstove/pel let stove —
Phone: i Fax: I E-mail: t Whet.
Applicant's signature: _ Date_
Name (print):
-- Permit fee.....................$
Na all Jurisdictions ccep credit cnntr,pleaw call jurisdiction for mute infomution. Notice:This permit application Minimum fee................$
U visa U MasterCard expires if a permit is not obtained Plan review(al — %) $Credit,wrd number: wit
_ -- hin 180 days after it has been
. les State surcharge,(896)....$
Now I nal r u s own on c t c accepted as complete.
$ TOTAL .......................$ --- ----
Cadhoidet Amount 4401617(bl WOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 Ff,MILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
-- Table 1A Mechanical Code qty (Eat Amt
$1.00 to$5,0_00.00 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 of Furnace 100,000 BTU+
fraction thereof,to and Including 2) including ducts 0 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
fraction thereof,to and including
$25,000.00. or floor mounted heater 14.00
_ ---
$26,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent riot included In appliance permit 6.80
$1.45 for each additional$100.00 or
fraction thereof,to and including 6) Repair units 12 15
$50,000.00. _
$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 Items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp
_m7)<3HP;absorb unit
Minium Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14.00
8%State Surcharge $ 8) 15 k t absorb -
unit 100k to 500k BTU 25.60
25616 Plan Review Fee(of subtotal) $ 9)15.30 HP;absorb 35.00 -
unit.5.1 mil BTU
Required for ALL.commercialeermits ons 10)30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20
11)>50HP;absorb 87.20
unit>1.75 mil BTU
12)Air handling unit to 10,000 CFM
ASSUMED VALUATIONS PER APPLIANCE: 10.00
Value Total 13)Air handling unit 10,000 CFM+
Description: _ Ql Ea Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
_ducts&_vents 10.OU
Furnace>100,000 BTII Including- 1.170 15)Vent fan connected to a single duct
ducts&vents 6.80
Floor furnace including vent 955 16)Ventilation system not Included in
Suspended heater,wall heater or 955 appliance Permit 10.00
floor mounted heater - 17)Hood served by mechanical exhaust
Vent not Included in applicance 445 10.00
permit 18)Domestic Incinerators
Repair units _ 17.40
805
<3 hp;absorb.unit, 555 19)Commercial or industrial type incinerator
to 100k BTU _ 6995
3-15 hp;absorb.unit, 1.700 20)Other units,Including wood stoves
101k to 500k BTU 10.00
15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
mil.BTU 5 40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlEt(each)
1-1.75 mil.BTU 1 00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU _ ------ $ -
Air handlingunit to 10 000 Cfm 858 8%State Surcharge
Air handling unit>1%000 Cfm1,170
Non
ortabla evaporate cooler 656 - TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446 -
Vent system not Inducted In 656 ----
appliance permit - other Insoer Ions and Fees:
Hood served bLr meChenlcel exhaust 658 __ 1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic Incinerator1,170 -- $62 50 per hour
Commercial or Industrial Incinerator 4 590 2 Inspections for which no fee is specifically indicated (minimum charge-hall hour)
Other unit,Including wood stoves, 656 $92.50 per hour
inserts etc. _ 3 Additional plan review required by changes,additions or revisions to plans(minimum
380 charge-one-half hour)$62 50 per hour
Gas piping 1 4 outlets -- -Each addlUonal outlet 83 - 'State Contractor Boiler Certification required for units>200k BTU.
"Residential AIC requires site plan showing placement of unit.
TOTAL COMMERCIAL
VALUATION: ' - All Now Commercial Buildings require 2 sets of plans.
IAdsta\forms\mech-fees.doc 12126/01
Electrical Permit Application
Date received: Permit no. ) 3
City of Tigard Project/appl.no.: Expire date:
Cite of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 pate issued: By: Receipt no.:
Phone; (503) 639-4171 --
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: TVPV
t
U I & 2 family dwelling or accessory U Commercial/industrial U Multi-family U'renant improvement
New construction U Addition/ahcration/replacement U Other:_ U Partial
JOB SH E INFORMATION
Job address: Q s W S 0=7 Iildg. nu.^ tiuite no.: Tax map/tax lot/account no.:
Lot: 3 Block: Suhdivisiun: V " - -
Project name: g)6'3 C - p4lKj+ _- Df.scription and location of work on premises:
Estimated date of completion/inspection:
CONIHAUFOR APPLICATION FEE SU111111_11111111,�
Job no: Fcr nfax
is
Business name: V 0 LEI.TRIL SV L Ilescridli Qly. (ea l Total nn.ins
New tcsioknlinl dn(;Ic nr nndli-hrmilr I—
Address: PIDRClag dwellingurdt.Int holes attachedgaragc.
city: Ga p� state: p P, I ZIP: q,7 3' Serwieelnchnhei:
Phone: Fax: E-mail: nu)0 sq li or testi _ 4
Bach additional SW sq.R.or portion thereof
CCB no.: Elec.bus.lic.no: y Q(; Limited energy,residenliul 2
City/metro lic.no,: Lnnitedenergy,nonresidential 2
Bach manufactured home or modular dwelling
Signature of supervising elects,i ui p' cd) Dale Service an(Unr feeder 2
Services or feeders—installation,
Sup.elect name(print) n ellse 110: 4
alteration or relocation:
PROPERTY OWNER 2N1 amps on Icas 2
Name(print): L F(t n`k 5 201 amps to 4nu amps 2
441 amps to 6011 lamps 2
Mailing address: I kiIN IAJ S 0 641 amps to 10011 amps 2
City: Pki UOO t^o _ State: ZIP: q I over Iixsoamps orvohs - 2
Phone: . 4
.• Fax: C p - S� I'.-IImi1: Reconnectolll' _ I
Owner installation:The installation is being made on property I own remporaryservicesorfeeden-
Y
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
1-011 amps less
ORS 447,455,479,670,701. to - ---
2(1I amps k,4tN)amps
owner's signature, Dale: ioi towsoamps _ 2
Branch circuits•new.alteration,
A; / n xtension per panel:
Name:Nae: A.eL.- /'C A. Nee for branch circuits with purchase of
Address; service or feeder fee,each branch circuit T 2
City: Slate: 1 i'I I' R. Fee for brunch circuits without purchase - - -
--- —- --- of service or feeder fee,first branch circuit
Phone: Each additional branch circuit
PLAN REVIFAV(Please check all dial apply) Misc.(Service or feeder nal Included):
U Service over 225 unfits culunterLml U Ile;dlh-Laic Iarthh Fach pump or irrigation cucle _ =
U Service over.420 amps-rating of 1&2 U Harardoush,cation Each sign or outline Ilghtingl� —
familydwellings U Building over Io,ONNI square feel four or Signal circuins)or a limited energy panel.
U System river Will volts nominal more residential units in one structure alteration,or extension* _ 2
U Building over ditee stories U Feeders,41N1 amps or more 'Ikscn tion. —
U Occupant load over 99 persons U Manufactured stniomes or RV park Fich additional inspection over the allowable In any of the abuse:
U Egress/lighdngplan U Other —_ Per inspection E__l—
Submit__sets of plans with any of the above. Investigation fce _
The above are not applicable to len.porar,t constructionservice, Other
�. _ Permit fee.....................$
Not all jurisdictions accept cnedil raid%,Pleaa•cn11 pn,uhc(am ft"more mfonnanion N,ltice:This permit application
U visit U Mastercard expires if n permit is not obtained Plan review(at __ r9•) $
Credit card number _ ___._- _,_L__L__ within 184 days after it has been Slate surcharge(9%) ....$ _
Expires I +ccepted as complete TOTAL. .......................$ —
one of cardho clef u s own on c It c
Cardholder siaaatttre t Amount 4404613(MWOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
f�--� -- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type M Work Involved:
Residential-per unit
1000 sq It or less _ $lab 1`> _ a 1u' and Stereo Systems'
Each additional 500 sq ft or
portion thereof $43.40 1 E] Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular Garage Door Opener'
Dwelling Service or Feeder $90.90 _
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 _ 2 O
201 amps to 400 amps $106.85 Vacuum Systems
401 amps to 600 amps $160.60 r—t
601 amps to 1000 amps $240.60_ 2 IJ Other
Over 1000 amps or volts $454.65 2
Reconnect only $68.85_ 2
Feeders TYPE OF WORK INVOLVED -COMMERCIAL. ONLY
Temporary Services or Feeders Fee for each system......................... ................................ $75.00
Installation,alteration,or relocation
200 amps or less $66.85 __ (SEE OAR 916-260-260)
201 amps to 400 amps $100.30Check Type of Work Involved:
401 amps to 600 amps $133.75— 2 yp
Over 600 amps to 1000 volts, Audio and Stereo Systems
see'b"above.
Branch Circuits Boiler Controls
New,alteration cr extension per panel
a)The lee for branch circuits ❑
w!fh purchase of service or Clock Systems
feeder lee.
Each branch circuit _ _ $6.65 F-� Data Telecommunication Installation
b)1 ho fee for brunch circuits
without purchase of service Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 -_ HVAC
Each additional branch circuit $6.65
Miscellaneous Instrumentation
(Service or feeder not Included)
Each pump or irrigation circle $53.40 _ F-1 Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s)or a limited energy
panel,allegation or extension _ $7500 _ Landscape Irrigation Control'
Minor Labels(10) $125.00 ❑
Medical
Each additional inspection over
the allowable in any of the above F-1NurseCalls
Per inspection $62 50
Per hour _ $6250 Q
In Plant — — $7375 Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ Other _ ------
8%State Surcharge S _ —Number of Systems
25%Plan Review Fee ' No licenses are required Licenses are required lot all other installations
See"Plan Review"section on S
front of appllcatlon —-----�---
-- Fees:
Total Balance Due $ ._._
Enter total of above fees s
EJTrust Account# — 8%State Surcharge $`
- — - ---- - —- Total Balance Due $
All New Commercial Buildings require 2 sets of plans.
i:\dsu\forms\cic-fees.doc 08/30/01
Plumbing Permit Application MMM
rDaterece�ived:_ Permitno.:AT
City of Tigard Sewer permit no.: Building Address: 13125 SW Hall Blvd,Tigard,OR ' 7223 _ gpermit no.:
City ofTigard Phone: (503) 639-4171 Projcct/appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approval: Case file no,: Payment type:
U I & 2 family dwelling or accessory Ll Commercial/industrial U Multi-family U Tenant improvement
O� New construction U Add ition/alteration/replacement U Food xcn i(r U Other:
Job address: �' Si J G bcKcripNon 111 E ee(ea.) Total
1 0 -��
Blain.no.; Nen I-and 2-family d"ellings only:
Suite no.:
Tax map/lux lot/accounl no.: - (Includes IOOn.for eadtutilityconnect ion)
Sl,R(1)bath
Lot: 3 cl I Block: Subdivision:' V SPR(2)bath - - -
Project name: al 6.3 C " pA l K 1( SFR(3)bath ----�
City/county: / t�L9—WI ZIP: _-_ Each additional hath/kitchen -
Description an ovation of work on premises: Siteutilities:
Calch basks/area drain
Est.date of completion/inspection: - Drywells/leach line/trench drain
Ferning drain(no, lin. li.)
Manufactured home utilities _
Business name: (:RAFT WNQUL, Ql.Umg)N 6- _ Manholes
Address: -7)1,44.�w �Irn6As 4 v Rain drain connector
City: i State: L)K I ZIP: q7ooS Sanitary sewer(no.lin.ft.) _ ------ _
Phone: t,4 q -9(,9 6 I Fax:6 q,S9 Sq I E-mail: Storni sewer(no,lin.ft.)
CCB no.: Plumb.bus.reg.no: Water service(no. lin.ft.)
`7 �bb6 g� t c�l f^B
City/metro lic.no.: t C) I Fixture or item:
Contractor's representative signature: Absorption valve -_
Print name: ,kdr — Back flow preventer
Backwater valve
Basins/lavatory
Name: NAw, L Clothes wisher
Address: tN n� Dishwasher
City: y State:0 'LIP: 1 Dc'g Drinking fountain(s)
Ejectors/sump
Phone: . 4 q L I Fax: 1. 4 -1; E-mail: Expansion tank
'ixture/scwcr cap
Name(print): Ft ef,I1 A C- F}t)►1'\E S Moor drains/Iloor sinks/hub
Mailing address: 5 t — Garba:;e disixisal
Hose Bibb
_CRY: W l l State:u ZIP:,97al4 Ice maker
Phone: 0 , Fax: o .lb 5 C I E-mail: Interco for/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial) —
employee on the properly I own as per URS Chapter 447. Sink(s),hasin(s),lays(s) -
Owner's signature: Date: _ Sump
Tubs/shower/shower pan
Urinal
Name: ► �� Water closet
Address: — __-__ _ Water heater
City: State: LIP: Other:
Phone: Fax: E-mail: Total
Not all jurisdictions weep credit card.,Meaw call judedictinn fa rune infomuuionNotice:This permit application Minimum fee................$ _
U Visa U MexterCard expires if a permit is not obtained Plan review(at _ %) $
t',rdit card numher: _. _ within 180 days after it has been State surcharge(8%)....$
TOTAL
Name nr cardholder e�ah�wn on credl�i ear
accepted as complete. .......................$
-Cvdhoide:Opolum At mmi
-----— 410.1616(6IOaK'OM)
PLUMBING PERMIT FEES:
— -- PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURESJindividual QTY ea AMOIJNT (includes all plumbing fixtures in PRICE TOTAL
AMOUNT
16 60 the dwelling and the first100 ft. QTY (ea)
Sink for each utility connection) -
Lavatory 16 66 _ One 1 bath --- $249.20
Tub or Tub/Shower Comb 1660 Two 2)bath _ _ $350.00 _
- - Three 3 bath _ $399.00 _
Shower Or.ly J6
Water Closet 1660 —� SUBTOTAL
Urinal 16.60 _ 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
TOTAL
Garbage Disposal 16.60 J �—
Laundry Tray _ 16.00
Washing Machine 16.60
Floor Drain/Floor Sink E7" 16.60 PLEASE COMPLETE:
16.60
-- 16.60 __ -- Quantit 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
permit 1&nki. - ---
MFG 1�ome New Water Service 46.40
AP46.4 — ---
MFG Home Now San/Storm SewerTub or Tub/Shower
Hose Bibs Combination
Root Drains ShowerOnl Water Closet _ —
Drinking Fountain — _- Urinal
Other Fixtures(Specify) 16.00 Dishwasher_ —
Garbage Disposal
Laundry Room Tra —
Washin Machine
_ Floor Drain/Sink: 2"
Sewer-1st 100' 55.00 3 -------
Sewer-each additional 100' 48.40 4" -
55.00 HeaterWater SP-rvire-1st 100' ]Water
ther Fixtures
Water Service-each additional 200' 48.40 S eci
Storm 8 Rain Drefn-1st 100' 55.00 _
Storm A Rain Drain-each additional 100' 46 0 —
Commerdal Pack Flow Prevention Device 46 4-0-0
0 0
r
Residential backflow Prevention Device' 27 55 ——
Catch Basin 16.60 —
Inspection of Existing Plumbing or Specially 62,50
_Re nested Inspections per1hr COMMENTS REGARDING ABOVE: —
Rain Drain,single family dwelling 65.25
Grease Traps 18.60
QUANTITY TOTAL
Isometric or riser diagram Is required it _-
Quanlity Total Is 19 _
"SUBTOTAL --
— 8./7-STATE SURCHARGE _----
"'PLAN REVIEW 251/6 OF SUBTOTAL
Required only II fixture t total
TOTAL $
"Minimum perrnit fee is$72 50•B%slate surcharge,except Residential Backflow
Prevention Device,which is$36 25+a%state surcharge
"All New Commercial Buildings require 2 sets of plans with Isometric or riser
dlagrsri for plan review.
1:\dsts\forms\plm-fees.doc 12/26101
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ALAN WA -Afll INC
'52 SO f7)
CITY OF TIGARD 24-Hour -0uo'
BUILDING Inspection Line: (503)639-4175
------- - _
INSPECTION DIVISION Business Line: (503) 639-4171 MST
- BLIP - ---
Received _ _ ____ ___ Date Requested. - �/� AM -- -_-_ PM BUP
Location _--- _-�� � �• Suite - MEC
Contact Person _ _ Ph( _-) __ __- PLM --
Contractor __. - Ph(--) -_—_ _ _ _ SWR —
_BUILDING Tenant/Owner ELC _—
Footing
ELC
Foundation Access:
Fig Drain ELR --- -_-- __-_-
Crawl Drain
Slab Inspection Notes: - SIT ---_-_-- —
Post& Beam
Shear Anchors
Ext Sheath/Shear '
Int Sheath/Shear ,
Framing
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler - -- ---
Fire Alarm
Susp'd Ceiling —
Roof
Other: -`
Final
PASS_ PART FAIL --- -- - --- -- - ---PLUMBING _ -
Post&Beam
Under Slab 7 -T
Water Service
Sanitary Sewer
Rain Drains - --
Catch Basin/Manhole
Storm Drain
Shower Pan %
Other: -- i�- -- ----
%-�grri PART FAIL - - - - - - - -- - - -- - --
r
NEZAANICAL
Post& Beam
Rough-In _--_�.---------------. -r---
Gas Line
Smoke Dampers ---- ------
Final
PASS PART FAIL
ELECTRICAL— —
Service ---- —
Rough-In
UG/Slab _-
Low Voltage
Fire Alarm
Final L] Reinspection tee of$._—_ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL _
SITE _ [ Please cal for reinspection RE: ______.___-.___-_- —_--� [- Unable to inspect-no access
Fire Supply Line
ADA Approach/Sidewalk Data Inspector Ext_
Other:_____ _ .
ord from the Job site.
Final DO NOT REMOVE this Inspection r c
PASS PART FAIL