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10745 SW LADY MARION DRIVE M .i 0 r o, CL l< 3 o� o' 0 CD 10745 SW Lady Marion Drive 1 CITY ITY O F T I G A R D MASTER PERMIT PERMIT#: MST2002-00209 CLEVELQPMENT SERVICES DATE ISSUED: 5/k3/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10741) :,W LADY MARIGR DR PARCEL: 2S110DA-08400 SUBDIVISION: ERIC'KSON HEIGHTS ZONING: R-3.5 BLOCK. LOT: 045 JURISL ICTION: TIG REMARKS: New SF r,e' shed, Fath 1. BUILDING i"EISSUE '—� ST'r�<IES: FLOOR AREAS REQUIRLDSETBACKS REQUIRCD CLASS OF WORK- NEW hEIGHT: FIRST: 1.291 it BASEMENT: of 1 EFT 10 SMOKE DETECTORS: Y TYPE nr USE: SF f LOOR LOAD: 40 :ECOND: 1 685 of GARAGE: 550 at FRur.T0 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSN",alIT: at RIGF T. 5 VALUE f 207.918 7, OCCUPANCY i3RP: R3 BDRM: 4 BATH: 3 TOTAL: 2,970.00 at REAR. 45 PLUMBING _ 3 MKS: 1 WATER CI OSETS: 3 WA3HING MACH: 2 I AUNDRY'RAYS: RAW DRAIN: 100 TRAPS: LAVA'DRIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEN'cR LINES: 100 SF RAIN DFAINS. 1 CATCH BASINS: 1 UBISHOWERS: :1 GARBAGE OISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR i GREASE TRAPS: OTHER FIXTURES: MECHANICAL _ _ rUEL TYPES TURN<100K: BOIUCMP<3HP: VENT FANS: 6 CLOTHES DRYER: 2 {AS FURN>•1100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 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: 1 PUMPIIRRIGATiC PER INSPECTION: EA ADD'L 9005F: 5 201 400 amp: 201 - 400 amp: lel WIG SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 •600 amp: 401 600 amp EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANUHMISVC/FDR: 601 • 1000amp: 601•amp3•1000v MINOR LABEL: 1000•ampNolt: PLAN REVIEW SECTION Reconnect only: >•4 RES UNITS: SVCIFDR>-225 A.: i 600 V NOMINAL: CLS I.REAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _s B.COMMERCIAL - AUDIO 6 STFREO: VACUUM SYSIEM AUDIO S STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT BURGLAR ALARM: OTH BOILER. HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK, INSTRUMENI'ATIO 1: MEDICAL: OTPR: HVAC. DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: T01-AL FEES: $ 7,812.62 Owner: Contractor: This perm t,s subject tD J.7 regulations contained in the RENAISSANCE CUSTOM HOMES INC RENAISSANCE CUSTOM HOMES Tigard Municipal Code State of OR Sp,cialty Codes and 1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS OR all other aHplirable laws All work will be done in WEST LINN,OR 97068 WEST LINN,OR 97068 accordence watt approved plans. This permit will expire if work is not started within 180 days of issuance or if the work.s suspended for more than 180 days. ATI ENTION Phone: Phone: Orf gon Ian/requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rap a 1 IC '10449 forth In OAR 952-001-0010 through 952-001-0080 You may obtain copleh of these rules or direct questions to OUNC by calling(503)"46-1Pe7, REQUIRED INSPECTIONS r Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear:":wi Insp Insulation Insp Mechanica'I Final Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing lnsl Rain drain Insp Plumb Final Footing Insp Crawl Drain/Ba:kwater Electrical Service Low Voltage Water Line Insp Final Inspec'lon Foundation Insp Footing/Foundatlon Dr Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final _ By :issued B : ti Permittee Signature � � >',s- �.1/y. _ Call (503) 619-4175 by 7:00 p.m. for an inspection needed the next S)usiness day CITYOF TIGA►RD SEINERCONNECHON PERMIT DEVELOPMENT SER"11 IES PERMIT #- SWR2002-00146 13125 SW Kali Blvd., Tigard, OR 9723 (503) 639-4171 DATE ISSUED: 5l2'?i01 SITE ADDRESS; 10745 SW ; ADl' MARION DR PARCEL: 2S110DA 06400 SUBDIVISION: ERICKSON HEIGHTS ZONING- R-3 5 -- - -- BLOCK: _ LOT: 045 _ ---- ------ — AUPISDiGTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW r)WELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE. I-1 PSWR IMPERV SURFACE: Rerr.arks: Sewer connection for new SF Owner: -------- -- -- FEES RENAISSANCE CUSTOM HOMES INC; Type By Date Amount Receipt 1672 SW WILLAMETTE FALLS DR _ WEST LINN, OR 97068 PRMT CTR 5/23/02 $2,300.00 27200200000 INSP CTR 5/23/02 $35.00 27200200000 Phone: 503-557-8000 II Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage A(.tency. The permit expires 180 days from the date issued. i lie tota.! 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 ell directions from the distance given If not s,located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Noti+icat.on Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies, of these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: �` t /j� �J _ Permittee Signalrire: ` Call (503) 639-4175 by 7:00 P.M. for an inspectio,i needed the next business day F r :pi- V 1Y 0- V 7 t s / Buil-ding Permit Application --- -- Uatereceived: V /6�l%4 Permit ria.: City of 'Tigard Project/appl.no.: G edate: _ Address: 13125 SW I lall Blvd,Tigard,OR 974-1 Cttyu(Tignrd ` Phone: (503) 639-4171 Date issued: _ B 4 Receipt no.: / I�� Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ 1&2 family:Simple Complex: -TYPE OFill"ERMIT �Q 1 &2 family dwelling or accessory U Commercial/industrial J Multi-family IfNew construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: t ' INFORM wh .idress: Q ' 5 tcJ �CG��� /�'►"�1Z, 07 V�►' Bldg.ria.: Suite no.: ,,t Blcxk: Subdivision: slr�s _ Tax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: fg/,�Y - "e'� — - Name: (10o,rf4aC, Mailingaddress: /67z S't✓ l✓,/16 •//r 1 &2familydwelllnq: /� Valuation of work City: t,✓i >`' 1,.,,n sate: LIP: J7,A(,� ........................................ $ZU, ` Phone: ;l111c+^ Fax: •SL /Eal/ IE-mail. No.of hedrooms/bAhs................................. Owner's representative: Sf'eve F/u..I` Total number of floors................................. Phone: L 70 0 fZ► Far:e70 1?663 E mail: New dwelling area(sq.ft.) .......................... Z �-- Garage/carport area(sq.ft.) S Covered porch area(sq, ft.) ......................... _ 7 •-- Name: Deck area(sq.ft.) Mailing address State: ZIP: Other structure area(sq.ft.).................... City: ..... _ Cit Pkqjo-- I�;,Y, F: mail: Commercl�UinduatrlaUmulti-famil V,uuation of work.......................... Existing bldg.area(sy. Business name: s'e,tn New bldg.area(sq.ft.) ......... Address: --- Number of stories............. .......... ............. City: State: L1P: Type of construction..... .... Phone: — Fax:_ -- E-mail: Occupancy group(s): Cxisting. ' CCB no.: 3 _ New: City/metro lic.no �, , ? rn,, Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Name: -- jurisdiction where work is being performed. If the applicant is Address: _ ---- exempt frorr licensing,the following reason applies: Citv• T State: 'LIP: Contact person: Plan no.: _— Phone: Fat E-mail• Name: Contact person: _ Fees due upon application ........................... S Address: Date received: City: State: ZIP: Amount received ......................................... $ Phone: Fax: E-mail: Please refer to fee schedule. r Not all Jurisdictions accept credit cards,please call Jurisdiction(of more tnimmsnon I hereby certify 1 have read and examined this a plication and the visa rq`atercard attached checklist. All provisions of laws n u 'rtatfces gove�ning this Credit cud number_ — work will be complied with, V her spe rein or nut. , Expires Authorized signature: " Date: ( 'isnw of cardholder as sn3wn on credit ca•d� % S�-e✓. �..1 Cudholder cig^uW• Amount Print name:_ _ — Notice:This permit application expires if a permit is not obtained within 1 g0 days after it has been accepted as complett. JM)-4611(hroolCOM) One- and Tivo-F.-Ilmily Dwelling _ Building hermit application Checklist Referencero.: Ciryn Ti aryl Associated permits l 8 C City of T Tigard J Electrical J Plumbing o Mechanical Audress: I +125 SW Hall Blvd,Tigard,r'h 97223 Other Phone: (503) 639-4171 Fax- (503) 50»-196(1 THE FOLLOWING 1*,VIVIIS ARE REQUIRED FOR PLAN REVIIEW Yes 1% NIA I band he artionN conydeted. ',rr 1u1r.lictii n criteria for umcurlefit reviews. - 2 Zoning_1 1-0 plmnu i.,, I alance points,sc�smic soils designation,historic district,etc. 3yerineation of appriived pliatllot. 4 Eire district approval required._ 5 Septic system permit ur authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district apprmal. _ 8 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design imd 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 irto the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. I I Site/plot plan drawn fo scale..The plan must show lot and building setback dimensions;property comer elevations(if' there is more than a 4-Il,elevation differential,plan must show contour lines at 241.intervals);location of easements and 1 driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot _ area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 foundation plan.Show dimensions,anchor holts,any hold-downs and reinforcing pads,connection details, vent size and location 13 floor plans.Show all oimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fan.: 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-flour, wall construction,roof construction. More than one cross section may be required to clearly portray construction.Show details of all wail and roof sheathing,roofing,roof;lope,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 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and location.;for nun-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and beanng locations. Show attic ventila,ton, 18 Basement and retaining wAls. Provide cross sections and details showing placement of rebar. For engineeted systems,see itern 22,"Engint, is calculations." 19 Beam calculations. Provide tw-sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any heath/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 for four or mor:-appliances. 22 Engineer's calculations.When required or provided.(i.e.,shear wall,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the project under review, 23 Five(5)site plans ar.-required for Item I I above. Site plans must he 8-I/2"x I I"or I I"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. _ 26 "Reversed"building plans must meet criteria outlined in the Permit 8r System Development Fees document, 27 No"mirrored" )uilding plans will he accepted. 28 "brawn to scale' indicates standard architect or engineer scale. 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 onl%. 440-4614,6roYCO..t Plumbing Permit Application i,,pie received: I C�A Permit no.3/<-rA ,eAe, City of Tigard Sewer permit no. Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 proecVappl.nn Expire date: Cay of Tigard Phone: (503) 639-4171 Fax: (503) 598-1960 Date issued: _ By: Receipt no.: Land use appr fvA: r caa,i file n�.YPayment type: all W mom WIN 1 &2 family dwelling or accessory (J Commercial/industrial U Multi-famlly J Tenant improvement New construction J Atltlitiorl/alteration/replacemenl ❑Foot.' service U Other: 1 7�/ _ 9escripli„n . Fee(ea.) Total Jab address: 6 W4-Not- df— N,.. I•and t-family dwellings only: Bldg.no.: Suite no.: (ini:ludes 100 ft.for each utility connection) Tax map/tax lot/account no.: SFR(1)baht Lot: Block: Subdivision: /�, �, SFR(2)hath Pmect na nem,, / ,,, /,rte, !, _ SFR (,)bath City/conn y' Each aflditional bath/kitchen Description and location of work on premises: c .M Site ulilirls; IL214L Catch basin/area drain _ - Dr5 ells/leach line/trench drain Est.date of completion/inspecuw ui Footing drain(no.lin.ft.) PLUMBING CONTRAC.I'011 Manufactured home utilities Business name: G,,, /° Manholes Address: 7 s',i 4" Rain drain connector City: [State: .0,< I ZIP: 9 7100,9r Sanitary sewer(no, lin. ft.) Fax: E-maiL Storm sewer(no. lin. ft.) _ Phone:sa'j-6 -f� 7 Water service(no. in.ft.) CCB no.: 7,76;66 Plumb.bus.reg.no: +tq_ � � Fixture or stern: City/metro lic.no.: 25,0/ Absorption valve Contractor's representative signature: Back flow preventer _ Print name: Date.: Backwater valve CONTACT IIIAISON Basins/lavatory Clothes washer Name: ya, Dishwasher _ Address Drinking fountains) _ City: State: ZIP: _ Ejectors/sum Phone: Fnx: Email: Expansion tank _ Fix►ure/sewer cap _ D floor drains/floor sinks/hub rNament): /��/'+ Gprba a dis salddress: 6 7 S / r' �' /!� Hose bibb ---- City: State: ryt ZIP: 70t 9' Ice maker Phone: 5',r.5 C.5776"!'L Fat: E-mail: lnterce for/grease trap Owner installation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property I own as per ORS Chapter W. Sink(s),basin(s), lays(s) Owner's signature: Date: Sum Tubs/shower/shower pan _ Urinal ---- Name: Water closet _ Address: Water heater City: State: ZIP: Other: —� Phone: Fax: Email: o 11 Minimum fee................$ Not all junsdictions accept credit cards,please call Jurisdiction for more information. Notice:This permit application Plan review(at _ %) $ - U visa ❑MasterCard expires if a permit is not obtained Slate surcharge(8%) ....$ — Credit card number, / within 180 days atter it has been Expire TOTAL .......................$ accepted as complete. Name of cardholder ss shown on credit card s 4404616 t6nxl t Cardholder uEnatwe Mnount PLUMBING PERMIT FEES: PRICE TOTAL New 1 and!-family dwellings only: FIXTURES (individi, t QTY ea AMOUNI (includes all plumbing fixtures In PRICE TOTAL Sink 16.!n the dwelling and the first100 ft. QTY (ea) AMO%INT 16,60 for each utilityconnertlon _ _ _ Lavatory One(1)bath $249.2C _ Tub or Tub/Shower Comb. 1660 Two 2 b ith $350.00 Shower Only 16.60 Three 3 bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 _ 8%STATE SURCHARGE Dishwasher 16.00 PLAN REVIEW 25%OF SUBTOTAL -- Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.50 Floor Drain/Floor Sink 2" - 16.60 PLEASE COMPLETE: 3^ 16.60 4^ 16.60 Water Heater O conversion 0 like kind 16.60 Quantity by Work Performed Gas piping requires a saparate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Home T New San/Storm Sewer 46.40 Lavatory or Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet _ Urinal Other Fixtures(Specify) 16.60 Dishwasher_ Garbage Disposal --- Laundry Room Tray Washing Machine Floor Draln/Sink 2" Sewer 1st 100' 55.00 3„ Se.ver-each additional 100' 46.40 4" Water:;ervico-1st 100' 55.00 Water Heater Other Fixtures Water Service-each additional 200' 46.40 (Specify) Storm 8 Rain Drain-tat 100' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 - -- Residential Backflow Prevention Device' 27.55 Catch Basin 16,60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 -- Grease Traps 1660 - --- - QUANTITY TOTAL Isometric or riser diagram Is required if Quantity Total Is >9 'SUBTOTAL -- ---- --`- _ 8%STATE SURCHARGE - -- --- - - -' "PLAN REVIEW 251/e OF SUBTOTAL __-Required uni,if fixture rity lutal Is>9 TOTAL $ "Minimum permit fee is$72.50-a%state surcharge.except Residential Backflow Prevention Device,which is$36 25+8%slate surcharge "All New Commercial Buildings reqs a plans with isometric or riser diagram and plan review l:Wsts\forms\pim-fees.doc 10/10/00 Mechanical Permit Application —--- -- -- 1Datereccivcd:::,/ /J Permit no.:/ / City of Tigard ProjecUappl.no.: Expire date: Cityo.ffigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: 1Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: 1 1 &2 family dwelling or accessory tJ Ctnnmcrualhndu>.urtl U Multi-larnily U Tenant improvement ,kllPj 1cw construction D Addition/al!eration/replacem::nt ,Other:.__u________.__ INFORMATION.100 SITE 1 1 1 Job address: C, 1, i ii ems! fit_ _ Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: _ Suite no, value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ Lot: IBlock: Subdivision: ���/,sr„ �, G *See checklist for important application information and Project name: Ei,c a ►s r, J'a jurisdiction's fee schedule for residential permit fee. City/county: G✓a �,, �,,, ZIP: _ &IIIIIIA1111111 Description and location of work on premises: .x• • 4 1 1 t 1 ter+✓ Far(e�.) 7olal Est.date of completion/inspection: 1*,wri tion Oly. Res.only I Res.only Tenant improvement or change of use: CFM Air handling unit _ Is existing space heated or conditioned?U Yes U No Air conditioning(site flan require ) _ __ Is existing space insulated'?C Yes Ll No Alteration o existing 1 system _ Boiler/compressors Business pante: State boiler permit no.: a f ' C��n/i'.+u Hp _Tons BTU/11 Address: 619,0 5, �4,4W 4, �C,/ Fire/smoke dampers/duct smoke detectors City: 61„c 4p IState:6,,r Z_IP: 9 70 eat pump(site plan require ) Phone: '266 2 Fax: '266 T g E-mail: nstal rep acefurnace/hurner BTU/TIT TIT Including ductwork/vent liner U Yes U No CCB no.: / 9;r$ Install/replace/relocate heaters-suspended, City/metro lic.no.: 4. / 2 _ wall,or flour mounted Name(please print): / n•t r:� ,.. Ment for a Iiance other than furnace e gent on: Absorption units BTU/H Name: a Chillers Hp Address: Com pressors�— Hp -- -- Environmental exhaust and vent at on: City: State: ZIP: Appliance vent _ Phone: Fax F-mail: )ryerex aunt o s, ype res, tc en/hazmat / hood fire suppression system Name: /C r✓tt,�,f f Mi.tC (-NJ4� �1 f�rs+�F t Exhaust fan with single duct(bath fans) Mailing address: 161Z 5t,,, 1rf /n,w t1'P `P//x Exhaust system a art from heating or A City: iq/a� State: .'W ZIP: Ael piping endistribution(up to 4 outlets Type LPG _ NG Oil Phone: S;S7 VDCW Fax 6s(i6Pl IF nuul: ueeli in each additional over 4 outlets Man lizi rocesspiping(sc ematicrequire ) Name: Number of outlets - ter lWed appliance or equipment: Address: Decorative fireplace City: State: ZIP: _ - poen-type vp peel stove - - Phone: -- fax: E mail: W c-1—J -- — Applicant's signature: _ Date: _ ter: _ Name (print): Tf'+✓e Not NI jurisdictions accept cresbt card✓,,please call junsdiction for more infrumaaon, Permit fee.....................$ U Visa U MasterCmd Notice:This permit application Minimum fee................$ Credit cad number: expires if a permit is not obtained Plan review(at _. %) $ _ _ �__ ��.._ Expires within 190 days after it has been State surcharge(8%) ....$ Nam M c"older u x on c' tre�ca�— accepted as complete. s TOTAL .......................$ Cardholder signature Amount — 440.4617(60(YfOMt MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: --_- - Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code _ Oty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$103.00 or including ducts&vents 1400 fraction thereof,to and including 2) Furnace 100,000 BTU+ $1_0,000.00. including ducts&vents _ 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or Including vent 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and Including 6) Repair units _ $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air $1.20 for each additional$100.00 or For Items 7-11 see or Pump Cond fraction thereof. footnotes below. Comp •• Minimum Permit Fee$72.50 SUBTOTAL:T$ 7)<3HP;absorb unit to 100K BTU _ 14.00 8%State Surcnargea 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb __Required for ALL commercial�ermIts onl unit.5-1 mil ETU 35.00 TOTAL COMMERCIAL PERMIT FEE: $ 10)30-50 HP;absorb unit 1-1.75 mil B'U 52.20 ------ - - --�- _____ __ 11)>50HP;absorb unit>1.75 mil BTJ 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM -- 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description: Q Ea Amount 17 20 Furnace to 100,000 BTU,including 955 14)Non-portAble evaporate cooler ducts&vents Furnace>100,000 BTU including 1,170 10.0015)Vent fan connected to a single duct ducts&vents Floor furnace including vent 955 1 16)Ventilation system not included In 6.80 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 _ _ i 805 _ 17.a0 t 3 hp;absorb.unit, 955 19)Commercial or Industrial to 100k BTU type Incinerator 3-15 hp;absorb.unit, 1,700 69.95 101k to 500k BTU 20)Other units,Including wood stoves 15-30 hp;aEsorb.unit,501k to 1 2,310 10.00 mll.BTU 21)Gas piping one to four outlets 30-50 hp;absorb.unit, 3,400 5.40 1-1.75 mil.BTU 22)More than 4-per outier(each) >50 hp;absorb.unit, 5,725 1 00 >1.75 mil.BTI( Minimum Permit Fee$72.50 SUBTOTAL: a Air handling unit to 10,000 cfm 656 Air handling unit>10,000 cfm 1,170 1 8%State Surcharge $ Nonportable evaporate cooler 658 TOTAL RESIDENTIAL PERMIT FEE: $ Venttconnected nnectcted to a single duct 448 Vent system not Included in 658 appliance permit - Hood served by mechanical exhaust 656 Other Inspections and Fees: 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic InGnerator 1,170 Etz 50 per Hour Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee is spec,fically indicated (minimum charge-half four) Other unit,including wood stoves, 656 $72 50 per hour Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas piping 14 outlets _ 360 charge-one-half how)$72 50 per hour Each additional o Met 63 - `Sate Contractor Boller Certification required for units>200k BTU, TOTAL COMMERCIAL s "Residential AJC requires site plan showing placement of unit. VALUATION: - V _ All New Commercial Buildings require 2 sets of plans. i:\dsts\formsUnech-fees.doc 08/29101 Electrical Permit Api7lication --- -- — l 1atc received: y% "r"JA Permit no.:f f j;�A City -� Cit ' of Tigard r— b Address: 13125 SW HProjecUappi.no.: Expiredate: all Blvd, Tigard,OR 97223 pate issued: g Phone: (503) 639-4171 Y Receipt no.: Fax: (503) 598-1960 Case file no.: Paymeru type: LarJ use approval: TYPE OF &2 family dwelling gor accessory U Commercial/industrial U Multi-farnily U'Fenant improvernent New construction U Aflditirm/alteration/replacentcnt U(Aller:- U Partial Joh address: /Q 71e, W 1i4,ID 4,v} %gAt At— Bldg. no.: I Suite no.: ITax map/tax lot/account no.: Lot: _YC Block: Subdivision: �,.r/ j•,,r r Li -- Project name: %s bescription and location of work on prem! vs: _ Eslimaled date of complelii m/ins ection: - SCHEDULEFEE Business name: .- � J`/✓c rr,G __ Uesciiption Qty. (ea.) Total no.lrrxp Address: /Dp rC3�'a �Z New rrsidentlai-single or multi-family per dwelling unit.Includes avached garage. City: State: CrjQ ZIP: 17©J S Seniceincluded: Phone: L-mail: 1000 sq.It.or less a CCB no.: Qy 3 SVt/ _ f31ec.hUs. Ile. no: Each additional 500 s .ft.or,portion thereof Limited energy,residential 2 City/metro lie.no.: /Zf/ 3 Limited energy,non-residential 2 ___ F.ach manufactured home or modular dwelling signalure of supervising clectician(required) — pole Service andlor feeder Sup elect name(pnnt) C.14 ���3 Services or feeders-Installation, t License nn: a'lerallon or relocation: 200 amps or less 2 Name(pnnl)cCr,�cs.'.5c+rrLe 6114 ��,x,,, � 201 amps to 400 amps -- 2 Mailing address: 14 7 Z S �/ A r.A 401 amps to 600 amps , 601 amps to 1000 arnps 2 City: esf -�r+Tof State:(.WZIP: 97 ry Over 1000 amps or volts 2 Phone: pi;S , Tom Fax:sem: 's j'® Email: _ Reconnectunl 1 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 arnps or less 2 201 amps u,41x1 amps ---�-- � Owner's signature: f m;ut -- - _ _ 401 to 600 amps Branch circuits•new,alteration, Nattte: or extension per panel: --- A. Fee for branch circuits with purchase of Address _ service or feeder fee,each branch circuit City: I t..tr /_IP; B. Fee for branch circuits without purchase - �— f oservice or feeder fee,first branci.circuit 2 Phone: �I :�� �E-mail: _ — Fnch additional branch circuit: (Please clieck all thin apply) %11 Ench (Service oranchcfeeder cuit: luded): ❑Service ovri?:S amps cuinmarciui J Health clue facility Iia•h pump or irrigation circle i U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over I0,W0 square feet four or .Signal circuit(s)ora limited energy panel, 0 System over 600 volts nominal more residential units in one structure alteration,or extension* , O Building over three stories U Feeders,4W ampscrmore •bescri tion: - U Occupant load over 99 persons U Manufactured structures or RV park EJch addiflonalln1=11-1 r over the allowable In any of the above: U Egress/lightingplan U Other --�_ Per inspection r' - Submit sets of plans with any of the above. Investigation fee The above are not applicable►o temporary construction service,_ Other Not all Jurisdictions accept credit cards,please call jurisdiction for inose infommtion. Notice:This permit application Permit fee....I................$ U Visa U Master(vd expires if a permit is not obtained Nan review(at _ %) $ Credit card number,_ — I / within 180 day after i!has been State surcharge(8%) ....$ expires accepted as complete. TOTAL $ None of cardholder u shown on ere a rale Cardholder signalure s Amount 4/0.4615 16/(10/C O M ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: --------- TYPE OF WORK INVOLVED -RESIDENTIAL Complete Fee Schedule Below: —-- Restricted Energy Fee................... .................................. $75.00 Number of Ins pectiommi ermit allowed (FuR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit �I IJOO sq ft.or less $145 15 _ 4 u Audio and Stereo Systems' Fach addilloml 500 al.ft.or 1 portion th4 roof $3340 r__j Burglar Alarm Limited Ener lY _ $75.00 Each Manuf I Home or Modular Garage Door Opener' Dwelling lervice or Feeder $9090 _^ ` Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 Vacuum Systems' 201 amps to 400 amps _ _ $106 85_ 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 _ 2 Other Over 1000 amps or volts $45465 2 Reconnect only _ $6685 2 Temporary Services or Fraders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system....................................................•.. . $75 00 200 amps or less $68.85 2 (SEE OAR 918-260-260) 201 dips to 400 amps $100.30— _ 2 401 amps to 600 ernes $133.75 2 Check Type r 'N^rk Involved: Over 600 amps to 1000 volts, F-1 Audio and Stereo Systems see"b"above. Branch Circuits Boller Controls New,alteration or extension per panel a)The fee for branch clrcuils Clock Systems with purchase of service or /seder lee. i � Each branch circuit _— $6.65 - Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or leader leo. First branch circuit _ $46.85 - -- HVAC Each additional branch dtcult $6.65 Miscellaneous E] Instrumentation (Service or feeder not Included) $53 40 Each pump or irrigation circle — intercom and Paging Systems Each sign or outline lighting $5340 Signal circuit(s)or a limited energy Landscape Irrigation Control' panel,alteration or extension $75.00 Minor Labels(10) $125.00 ❑ Medical Each additional Inspection over the allowable In any of the above Nurse Calls Per inspection $62.50 _ Pei hour $62.50 Elm Punt $73.75 — Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of lbove fees $ _ Other 8%State Surcharge $ —.,-- __Number of Systems 25%Plan Review Fee ' No licenses are required Licenses are required for all other installations See"Plan Review"section on $ front of application `--- Fees: rToltal Balance nus ----- Enter total of above fees i LJ Trust Account M _-_- 8%State Surchat- .ie : Total Balance Due s i.Wsts\fomts\cic-fees,doc 06/07/01 CITY r TIGARD 24-Hour ILDING Inspection Line: (503)639-4i7S MST INSPECTION DIVISION Businesn Line: (503) 639-4171 BLIP Received —Date Requested. K AM _-_ PM - BUP - - Location ��� -5 �'" �-�' ��_. �/�`" �✓ —Swte __—_ MEC Contact Person —. - Ph 3/G Z'" PLM Contractor ___ Ph(_ ) _ SWR --- ILD Tenant/Owner _— ELC Ila ing ELC Foundation Access: Ftg Drain ELR Crawl grain SIT — Slab inspection Notes: — — Post&Beam —— — -- Shear Anchors Ext Sheath/Shear — Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof -- --- Other:L A q QndSPPART FAIL PLUMBING -- Post& Bearn Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhoie Storm Drain Shower Pen Other: Final — PASS PART FAIL MEcklt .AL — t — Gas Line Smoke Dampers —� ins — — _ PART FAIL_ � _ELECTRIC_AL� Service Rough-In -- --- -- UG/Slab Low Voltage — — Fire Alarm Final F] Relnspectbn fee of$ required before next Inspection. Pay at City Hall, 13125 3W Hall Blvd. _PASS PART FAIL SITE _ Please call for reinspection RE:__- _ — Unable to inspect—no access sire Supply Line ADA Dab i�_ �8 0 "`s'" Inspector _'� � --- Approach/Sidewalk Other:__ Final DO NOT REMOVE this Inspectloln record from the Job site. PASS PART FAIL :l ► ov 44 r •• I ► ► z . A Poo Q _ �n' ►„ T 44 . J c, r- 7 Old ► )Nolook (� \ n loo. . I ► 44 414 44 Q j I ; ► CITY OF TIGARD 24-Hour Inspection Line: (503)639-4175 BUILDING MST — �.-.- INSPECTION DIVISION Business Line: (503)639-4171 BUP Recuived —�__ __._ Date Requested_a`�`�70;2 AM _PM BUP Location .7. d I Ar;0SUite ___ MEC Contact Person -n-ftU ----- _ Ph Contractor - --___-S=1s�c -_.. —.__— Ph( ) — SWR ---_-_- ----- BUILDING Tenant/Owner __—_ -_ ELC Footing _— EI C Foundation Access: Ftg Drain ELR ---_.--------_.__ - Crawl Drain ---- Slab Inspection Notes: SIT Post& Beam - -- - -- - - -- ---- Shear Anchors Ext Sheaih/Shear Int Sheath/Shear c? Framing - Insulation Drywall Nailing ----- --- --- -- -Firewall - Fire Sprinkler ----- -7 --- - - - -- - Fire Alarm —/ Susp'd Ceiling -- Root Other Final Ct���/' _ l i^,�✓ ! 1 PASS PART FAIL - Post 8 Beam Under Slab - - -- --�" ---- - --- Rough-In Water Service Sanitary Sewer Rain Grains ----- �- ---- ----- -- Catch Basin/Manhole Storm Drain -- -- -- -- -- - c Shower Pan Other: Final _ ------ _r PASS_ PART FAIL_ MECHANICAL - Post& Beam - Rough-Ire --- - -- - -------- - - --- Gas Line Smoke Dampers - - --- ------------ - - Final PASS PART' FAIL ------ ------- -------- ELECTRICAL -- ---- ---- - Service Rough-In --- - _ UG/Siab Low Voitage --- - ---. ------ ---- ---------- Fire Alarm -� Reinspection fee of$__- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd, PARI FAIL SITE ( Please call for reinspection RE:__________ __._.-_-_-..__-._ _- Unable to inspect-•no access Fire Supply Line ADA inspector Ext Approach/Sidewalk Date *- Other: LFind DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (501)639-4175 MST 6 0 2- INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received ------ Date Requested AM-- PM BUP Location U Suite MEC Contact Person Ph PLM Contractor _-----—------ Ph SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Accoss: Ftg Drain ELR Crawl Drain Slab Inspection Nolle.--,: SIT Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Root Other: Final _#49G=:3,VkRT FAIL Fo:,f& Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: PART FAIL MECHANICAL Post& Beam Rough-In Gas Line '-tmoke Dampers PASS PART FAIL '--Reivice Rnu h I 111-f ire RT FAII J Reinspection fee of$ required before next inspection. Pav- City Hall, 13125 SW Hall Blvd. I j Please call for reinspection RE:---- Unable to inspect-no access Fire Supply Line ADA Date /0/0?9/02­_ Inspector Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PAR'r FAIL qq � S ry c rD a N a 7 ry T T n ` r 71 ro < a a ° O s o � Z 3 x a x