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11400 SW LAUREL GLEN COURT 0 0 cn c 1 YI n 0 c 1 , i 11400 SW Laurel Glen Court CITY OF TIGARD 24-Hour BUILDING Ir sPection Line: (503)639-4175 MST'_1.016.5 O-Z-51/3 c') INSPECTION DIVISION Easiness Line. (503)C39-4171 ?W /,- ' ­/r I'/� i BUP _ Received ___— . Date Requested. -�U '�`�AMPM ___ BUP Location MEC _ Contact Person - _ ��- �' Ph(—) 2! � P'-M - — Contractor _ -_ _-_ Ph( ) SWR BUILDING - Q Tenant/O-Nier _ ELC Footing Foundation - ELC Arcess: - - . Ftg Drain �� ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear _ Int Sheath/Shear , Framing u � ►� "t/>,: al Drywall ivycSJ L�, C�1c(.,4 L /-r..!/jC_ . l EL /t T c •vc5i� O Drywalll Nailing - -�---.-�---�� Firewall Fire Sprinkler E�C7 (�C" e.tA L PO - O— -_ - A, --- Fire Alarm Susp'd Ceiliny ---- - Roof -------------------- I=inal BING _ Post& Beam Under Slab Rough-In — - - --- --- _ -- Water Service ----_._-- --------_--___-- -- _-- _ __-- Sanitary Sower Rain Drains Catch Basin/Manhole Storm Drain --- ----- -- - - ----- - --- Shower Pan Other: -----.___-- Final - PA.%S--"AT-, FAIL Post& Beam Rough-In - ---- - -- -- Gas Line ------ -- --------- Sm a Dampers -- ----- - --- ---- — --in gS ) PART FAIL - - --- - -- -- - - CTRICAL Service ---- -- - -- --------_—__._ __ _- Rough-In UG/Slab ---_ Low Voltage Fire Alarm Final Reinspection fee of g required before Mt inspection. Pay at City Hall, 13126 SW Hall Blvd. _PASS PART_ FAIL SITE Please call for rc in�.pection FlE.___ _- Unable to inspect-r access Fire Supply Line AD.A Approach/Sidewalk Date S_. Z G" d 4'- InsPactor-.__: - _ Ext Other, Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL :AAAAAAIAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA w r ►4 �ti o t � y b �� � '4I No. 4 C7 •`!, ► t `� ►. 11� ► t �� ► 4 V j . f, � ► C� 4 d ► •4 ( ► 1 ?� ► 44 ITJ ► . 7 r * ► . R ` A ► 44 ( cra ► � ] • ' loo- CD 1 � ► �I O ► .44 G . mayI I Poo. • `-4 ~+ ► 0 4 j (A � � ISI ► 44 ► �FTYVV VVVTVVVVTVVVTVVvvvvsvivvvvvvvvvvvvvvvv,� 7 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 sT�� ��/ � INSPECTION DIVISION Business Line: (503)639-4171 BUP Reserved ---_Date Request d____ AM__�._—_. PM __— BUP Location suit( --- --- MEC --- ---- Contact F arson _-- _— ��-..---- ----- Ph ( f PLM Contractor -- Ph (-- ) - SWR . Contractor ,_--—_�_ __ ----- --- BUILDING� TenanUowner _ _ ------_.--- — -- ELC __------_--- Footing ------�— ELC Foundation I Acc-Gs: Ftg Drain 9 ELR °-- Crawl Drain Siab Inspection Notes: SIT Post& Beam Shear Anchors - - - - — Ext Sheath/Shear - - Int Sheat:/Shear Framing - - --- -- - --- -- Insulation Drywall Nailing - -- - - -- -.._. ---- ---- --- - - -- Firewall Fire Sprinkler r --- --- -- - --- -- ---_- ---- - ----�___.—.— Fire Alarm Susp'd Ceiling - -- Roof Other- ------- Final PASS PART FAIL - -- Post& Beam �— Under Slab - - -- - - - -- Rough-In Water Service — Sanitary Sewer Rain Drains - - --- --- -__ Catch Basin/Manhol Storm Drain _- -- - - -- Shower Pan - Other: --- - - - Final PASS PART FAIL MECHANICAL - -_ - - Post& Boam -- Rough-In - - Gas Line Smoke Dampers - - Final PASS PART FAIL - - -- --- - - ELECTRICAL - - --- - _...--------._-_--- --- Service Rough-In UG/Slab Low Voltage -- - ----- -.... .. --- ------- -IF e L] Reinspe,tion fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PART FAIL�—� 1-1 Please call for reinspection RE:_—__ _--__—^_ -_—_ Unable to inspect-no access Fi-e Supply Line q , 1 Q�J�.fJ`I( -- _ . Ext - Approach/Sidewalk Datfa - 1.�1 `� 0 � - Inspector ��` ' --- -`/- J� Other- F!,-al therFinal DO NOT REMOVE this Inspection record from the job site. PA SS PART FAIL CITY 4F TICARD 24-Hour BUILDING Inspection Line: (503)639-4175MST �-/)O00 INSPECTION DIVISION Business Line: (503)639-4171 BUP Received __- Date Requested_ "� �_AM - __ PM ________ BUP Location �f 7LOO G���- C"�r Suite MEC --- -- Coltact Person _ __ i�= _.__ Ph(—) 3 ��� PL1,A SWA ----- --- - 3UILDING Tenant/Owner -_ ELC Footing ------------ ELC Foundation Access: •!�� �— Drain 1- r` 76- ELR Cr Crawl Drain /��- Slab Inspection Notes: SIT Post&Beam ------ - - _" - ---- ---- --- Shear Anchors - ----- --- Ext Sheath/Sha�r _ _ Int Sheath/Shear yw •�1 /�.� N�� � __ IRtO� — uW.--- Framing - ----- --- -- ------ — Insulation Drywall Nailing ---- -- -- - - _,--- - ----- ----------- Firewall Fire Sprinkler - . _ - --- -- - - - — ---- ------ - - - Fire Alarm Susp'd Ceiling -t1 Roof E �.Tr,G.�T CL! 1`Y 0 4 O vim. Other: Final PASS PART FAIL T.-till[� ►r11 NEXt- L-A6L . ��? - . `r Uider Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin i Manhole Stern,Drain - _.— -------------- -______.. Shower Pan Other: ---- - ----__ fA_JS PART FAIL -- MECHANICAL Post& Beam -- Rough-In - -- ----- -- - -- - ------- - - Gas Line Smoke Dampers ----_------ - -- - -------- - - - Final PASS PART FAIL - --- ------- ---- ----- ------- .�. ----- -- --------- ELECTRICAL Service Rough-In UG/Slab Low Voltage __ _ Fire Alarm ina Reinspection fee of$ iequireO before nem inspection. Pay at City Hall, 13125 SW Hall Blvd `PAS PART AIL SITE —i_ Please call for reinspection RE: Unabie to inspect-no accPs3 Fire Supply Line ADA Approach/Sidewalk Dater ` ` U .�_ Inspe for _ .vel] t ____Ext I Other Final DE, NOT REMOVE this Inspection record ►:om thf Job site. PASS PART FAIL ASTER ERMIT /A CITY OF TIGARD - PERMIT MSI2 / \ PERMIT#: MS1'20U3-OU130 DEVELOPMENT SERVICES DATE ISSUED: 5/7/03 13125 SW Hall Blvd.; Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11400 SW LAUREL_ GLEN CT PARCEL: 2S110AC-01800 SUBDIVISION: LAUREL GLEN ZONING: R-4.� BLOCK: LOT: 001 JURISDICTION: TIC REMARKS: Const. new SF detached •'_I;�nr�, ✓ BUILDING REISSUE CUSTOM aTORIE5. FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT. '4 FIRS': 1,288 of BASEMENT: of LEFT: SMOKE DETECTORS: v TYPE OF USE: SF FLOOR LOAD. n' SECOND: 1,391 of GARAGE: 825 of FRONT 10 PACKING SPACES TYPE OF CONST: 51`1 DWELLING UNITS THRU of RIGHT: 16 OCCUPA,NCYGRP: R3 RDRM. 3 9VALUE: 487,142.70 ATH TOTAL: 2,879 of REAR. PLUMBING _— - SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS I RAIN DRAIN: 1130 TRAPS: LAVATORIES: 5 DISHWASHERS 1 FLOOR DFAINS: SEWER LINES: 100 SF RAIN DRAI'IS: 1 CATCH BASINS: 7URIShOWERS: J GARBAGE DISP: I WATER HEAT 3RS. 1 WATER LINES: 1C0 BCKFI'.'.rw-.VNTR: GREASE TRAPS: OTHER 9xTURES: MECHANICAL FUEL TYPES FURi'<100K: BOILICMP<3HP VENT FANS: 1 CLOTHES DRYER: I t;A S FURN>•100K. 1 UNIT HEATERS HOODS: I OTHER UNI-3: I MAX INP: btu FLOOR FURNA'4CES. VENTS. I WOODSTOVES: GAS OUTLETS. 4 ELECTRICAL _ RESIDENTIAL.UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS _MISCELLANEOUS_. ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 -200 amp: n - 700 amp '"/SVC OR FD PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF201 400 arnp: 201 - 4n0 amp 1st WIO SVC/F DR-. SIGNOUT LIN LT. PER HOUR: LIMITEn ENERGY 401 800 omp: 401 - 500 arnp EAADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR. 801 1000 alp: 001 ramps-1 Ol1Ov MINOR LABEL 1000+amplvolt PLAN REVIEW SECTION Rocomuct only: >=4 RES UNITS SVCIFDR>=225 A. >000 V NOMINAL* CLS AREA/SPC OCC: _ ELECTRICAL•RESTRICTED ENERGY RESIDENTIAL _ B,COMMERCIAL AVL 10 8 STEREO. VACUUM SYSTEM: AUDIO A STEREO: FIRE At.ARM: INTERCOMIPAGING. OUTROr .<LNDSC LT: BURG,AR ALARM. OTH: BOILER HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION, MEDICAL: OTHR: H'AC DATA/TELE COMM: NURSE CALLS: TOTAL-0 SYSTEMS: Owner: Contractor: TOTAL '.EES• $ 7,832.56 ALPENGLUW HOME , ALPENGLOW HOMES This permit Is sul• act to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and 5620 SW KELLY AVE. 5620 SW KELLY AVE. all other applicaole laws. All work will be done in PORTLAND,OR 97201 accordance with app.oved plans. This pf'rmit will expire If work is not started within 180 days of issuance,or If the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adupted by the P"one: 503-79.1-38.,6 P"pno: 503-245-7720 Oregon Utility Notification Center. Those rules are set forth in Of 2 952-Of 1-0010 through 952.001-0080. You Rep N: LIC 111912 may obtain copies of these rules or dire;t questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Electrical Service Low Voltage Roof Nailing Electrical Final Sewer Inspection Underfloor insulation Electrical Rough In Gas Line Insp Roof Nailing Mechanical Final Footing Insr Crawl Dre.in/Backwater Framing Insp Gas Firepla;a Water Line Insp f3lurnb Final Foundation Insp Mechanical Insp Shear Wall Insp Insulation losp WLter Service Insp Building Final Post/Beam Structural Plumb Top Out Exterior Sheathing Ins[ Rain drain Insp Appr/Sdwlk Insp Issued By: � cti r_.2� Permittee Signature : - Call (503)639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: 5/7/03SWR2300104 �� ''t'il 639-4171 DATE ISSUED: 517/03 13125 SW Hall Blvd., Tigard, O.. 97223 (..• PARCEL: 2S1 1 OAC-01 800 SITE ADDRESS; 11400 . +V LAUREL_ GLEN CT SUBDIVISION: LAURcI_GLEN ZONING: R-a.5 BLOCK: LOT: tNil JURISDICTION: 'I[(I TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL T)'PE: L 1 r SWR IMPERV SURFACE: Remarks: Sewer connection for new detached. Owner: �—_ _ FEE_S _ ALPENGI.OW HOMES Description Date Amount 5620 SW KELLY AVE. — PORTLAND,OR 97201 jSWUSAI Swr Connect 5/7/03 $2,300.00 1'4\VUSAJ SwrCot..iect 5/7/03 $0.00 Phone: S03-793-3866 ISWINSP) Swr Inspect 5/7/03 $35.00 ItiWINSPj Swr Inspect 5/7/03 $0.00 Contractor. _ _ Total $2,335.00 Phone: Rr!g#: Required Irspections _ This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. Tne 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 net so located, the installer shall purchase a"Tap and Side Sewer" Perm Issued by: ,�,. % :4: Permittee Signature: 1a _ Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day tt� FOR OFFICE USE ONI'N' Building Permit Applieajloll D Received Burldir.g Q f)ate/H : '� Permit Not)eo�Ay3 -LQ It ' of Tigard(� Planning Appro\ Other Date/li Permit N .�� 03 - y/ 13125 SW Hall Blvd. APR 2 Plan Review Other Tigard,Oregon 972: , Date'B : V T:ff�3 Permit No.: Phone: 503-639-4171 Fax: 503-5111xM460( 1 I' Post-Review Land Use Contact Internet: www.ci.tigard.or.us SUI1_DIN" C : — Case No. \ g Contact Juris.: See Page 2 for n 24-hour Inspection Request: 503-630-4175 Name/Method: — supplemental Information uJ TYPE OF WORK _—_ REQUIRED DATA: New construction Demolition— I&2 FAMILY DWELLING ❑ Addition/alteration/replacement Other: CATEGORY OF CONSTRUCTION _ Note: Permit fees*are based on the total value of the work performed. Indicate 1 &2-Family dwellin L1 Commercial/Industrial the vale(rounded to the nearest dollar)of all equipment,materials,lahgn, — overhead and profit for the work indicated on this application. (-r El Accessory Buildin 11 Multi-Family ❑ Master Builder _ Other: Valuation...................................................�, $_ - 3011 SITE INFOP'li1AT10N and LOCATION No.of bedrooms �� No,of baths:,�_k _ ----- Total number of floors....................... Job site address: J uU V �W !a•(.rel_ (� s►� _ e'.a.... -- —- -L-`1-- ----- New dwelling area(sq. ft.)....�a't.. . Suite#: Bld,/,A t.#: Garage/carport area(sq.ft.).,...� U............ Project Name: Covered porch area(sq. ft.)..... `.?............ Cross stt'eep Deck area(sq. ft.)........ .................................. trecttons to Job site: father structure area(sq.ft.) ............................ -- ---- 1+�,Kn� G�leh C4. REQUIRED DATA: _ COMMERCIAL-USE CHECKLIST Subdivision: IA,4,tl 64..E Lot#_ Tax map/parcel #: /f •4' < r f'oc) Note: Permit fees*are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)ol'all equipment,materials,labor, --- - — overhead k nd profit for the work indicated on this application Valuation............................................. .......... - - ------. _----------W Existing Buildin^area(sq.ft.)......................... --- --- ------- — — New building area(sq. ft.)............................... _ Number of stories...................... ..................... PROPERTY OWNER 1 T::NANT Type ol'constructIUn........ Name: 1}1oatn uJ �Q�1)/� Occupancy group(s): ExistNewing -�--_- Address: — _ G�� 5� -ell — Cit /State/ZiE. _ 4 0 ii.- 1 7 7,3 Phone: 713-381(' Fax: ., 774 NOTICE: All contractors and subcontractors are required to be APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Namc: - & X JpvjJ#L'#.' I4O nve jurisdiction where work is being performed. If the applicant is exempt Contact Name:---_T—T,-C W from licensing,the following reason applies: Address: - ---- -_ City/state/Zip: --3�+�-E----- — ---- -- - -- -- ------------ Phone: FI3ll�l-- Fax_ Lys_ 7763_ ---- - - --- - I3UIIAINC;PERMIT FEF,5* _.E-mail: - _ Plcase refer to fee schedule. _ CONTRACTOR ----- Business Name: wtFees due upon application............................ g Address: City/State/Zip: Amount received............................................ Phone: — Fax —� Date received:— CCB Lic. #: -- °13 L �_r^ - - -- -- - Authorized Notice: 1 hie Permit applicallon espires if n permil is nut obtained ssilhio Signature Si ( - L y�z"� B Date: � Ixtl dn\s eller It ha. been accepted ac canydrle. if *Pee melhudoioa; et by I ri-(411111(} Building;I11duslry Sersire Board (Please print name) is\bsts\Permit Fonns\nldgPermitApp.doc 01/03 i Commercial Plan. Submittal Requirement Matrix City of Tigard TYPE OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Building Fire Protection System k* Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application ane', plans. After t.;an review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor. City of Ti7ard, Washington County, and Tualatin Valley Fire & Rescue). V *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the r)riginal seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i\dsts\forms\C0M-mat0x.doc 9124/01 flpr 02 03 06: 37a Matt Weber 503 620 G019 P. 1 Werhesday,April 02 2003 6 33 AM Boo McCurdy(503)245-7765 p 01 Electiric.9l Permit Application Rrcr� Electricil — �1�.� _�_ Pr!rrtot Nc.��•II��,r1TY3L. Cy))-70 PlanningApptovel — city or Tigard 1�tdBy --- - PenmI No 13125 SW Hat!Rlvd Piun Bev err Other I igard,Orr.Lon !7223 �QeccrHrf_, Ptrrnrt No _---._-_---- Phone 503-639 4171 Fav SUS-S9a-19(7U pose-Ne+new - Can LIM;: ms_ _ Gu No, lnlcmet- wA.%%,cr trgerd.or.f7s r•Pry 2 for 24 firm inspection Request. 503 635 4171 /Merhod ---_J Sup I�emmt,l lnMrTNion. L_ Sr 225 t nf-vlC W aAe eled— - enf wok New construction Dcvq):ttun teal aTHPly�- - - Heahhaere 4utiry --- cntnrtletc al ❑Nvardouf Incanon 1 ' alleratOnf t8Ce1TCnI ULl1CC _ _ q owi 770 arrp,ry ric of C�Building uvt+IQOIIo square ket. Add race/ _��7 -,S•CA Y (jQ(S Tj�^'�'�(jt�1v- - _- I 1&2 Umly d,K-R;npt four m more reudrniml tn,ts to ] &2 Fattll dwelling CurnmercialRndushtal CJ Syuern ow,67,"1 vona rinTtnal nm rnurrue ._.___ ---- r,]BuOd-ns ow, 'ser stairs ❑Feeders.400 amp,or mote ACCtssm BW1dUlg M l]r'F'MTr� l.3 occupr r w4i ov.r a pertont (]Manufuuned structure%nr RV park _ Master Bullder _ Othcr-� D Ferasr'trhtnte pint U ober:_ -- {r, JbB 501 F.INEJRIYIA land Af in" " Suhw,tl -__aI a(plae% vMh any erlha acre. Tk a e,rwY a are net a r;cehk t0 teTYnrarT cdrralruetloat amrc_ y_ Job site addre is I DO �W LtK�I - -- - l -- Suite M: 8�_-Apt*-, - _..__ _ _�_Namlxi of ice e-__ r errrlN allswe Desciptas Fe lea-I .N.•1� Pru CC 1tifle: - — ryt,,rtfiAeerlal-sleek yr TrW-belly par �_ Dolls&fteVDv=1miojoh site: dwrltlat aau.lecledt%an,ttndtww- Srnkt leekrde -- 100(%% 11 ,r lett t '4 Each jt1dw^ou S22 lj,_11V09 parties tboteor _ ). -- �m,ft�aoer�,vmidaMgl 75.00 •,� Su11dIVI51on: t_a_�•tYIL_ r1 �' ► !I'•Jtt : -l.fmnedeneto•Tft 'fax map//7a rce)�l v e T.nurrnutA vers a ar feudal,% ve •�- :Alt.SCRIr'h'IU�I•.OIF:I'14dRK_ +a1�6!�:_. ,:i'_- , srr.ne andlot(cede _ _ _ 10- -------- - Strvkaorhtdm in.•a1LIMe. alkraMoe ar relscuron• — — - _.J..�-- _.------ 700�e ur lef•__ _,___ 10.70 701 J00 tetye 105. nn� f1i0AO wl aTfe to A00 ctrl_-Lf_—�• .— ,r Il 'R. 7' - r t:1.�.:_.••1 AdamIo1100a _ 'K0. (tvur IOIOimp-mvoh-_ 474Af Nffil0� 0 an/ I wl�s _ Rewnne_xt o r�_�_ f4 85 Ttmporsr7 aerv,crt sr feedtn-Issttdletlee, Address: eN reBoe,0 relaratio" City/StetelZi _. Q ?� '-� :�, nrk% l Phone 711- Fax: 1I.--_ .S al N: 'r,)17,7�/U�;�—,f:!� N Nreec►tiscakt•eea.rnaralhn.or Name: ralenrlan per penal: A Fee Kx tfran;h oreutta w h purehue 3J Addresservi cca of fiehi Tree_ rh Manc" Mil cun_ A 6s (✓1ty�lA1C/ZiQ: W B.Fac for I,S ,A&,,a.,, ist purekw or _ tervice - or leader ht,r9!!brancircult 46.eS Phone: rax: _ avitoNtb.nt►ercuit 6.65 ---.1 (sha(Sewire a feeder nm tfc:irdr�' E ti r, hot of n�allancirtle }1s.10 r; '4 hamar Aline b f]A Sub A10: Signal chcuills)or a IbnOed !r f� aller2 Business None: .�( ,G eTerL__ -- =L AddreS a Vaal 1p, !dote ova the easwehk u a • the e0eae: �City/State/Zip To tIl Q-__7 Phone -j1 11stLp_ F'•x� -b CC13 Lit:.A�h� __-An-q,��s� 4�t:,r r• Supervising electrrco,a�rl __Sulitotal S pawre requirt�: ___•_ Plan Revkw1tlli of Pemrn Fee ~h- _ Print Name 1 'C� i — Stwte Surchu a 115 of Perenll Fee S Llc M - - -{------LF >N - 1�� _TOTAL PERMIT FEE S Aulhomr-ed Nat.rr: 7811 permit opplka at eapire%K it wfn1,sot nbulard ivithle Si .lure _ Dow'�-- 190 rrava anet-It bea lsere acceplyd as Complete. -------- - - - _---- _- aF.,,n,•thod3lupv ert by Tri-Coenty 115n0"Inducart Servlet Board .. - IPleate pant name) t Uktr%]'ernat Fortm%mPemulAtfp dnt: 01703 r Apr 02 03 09: 49a PLU. cnN. INC. (5031658-5232 P. 1 Rpr 02 03 19: 29a Bob Mccurdto 1503)P45-77G5 P. ) Building Fixture!, PlumhinyPermit A pplication Rett,vrd � - Mambme Kumasi MMM DudDY_ rr,,,n�Nw..:�,�,`�8dJ3-Ql1L•'•1 City of Tigard PlavAtir A(gtnnal - Starr )stem 131?S%w Hall Blvd, p --- - Permit Nv - -- llgard•Oregon 97223 Ua-d L- Phone ',01-639.1171 Fax: 543 598-1960 Ptnt•Rcv t% Ia,M Use - �- Interna www ci ugard.or us Datels _ - Case No _ )arta Ser tape 2 for 24 haat Ilnptcltun P-quest )UJ 63Y-41!) Na lonuci Eflhotl Su Iemeaid infdrwethn, YPE UF'WORK -- _ RIE`WHEDULE(foryedal information we tbeeN11s1l- New construction - Demolition Dascriptiun Qfy.14".) Ta1a1 Add MoNallerauon/replacemenl Qlhet I - New I.d;1-farally dvrtrusat _�AjECORY OF CONV IX.'TIO�— taclula te6 A.Ar cath aidity ceaaecgm I &2-Family dwelling m ercialMdustnal srR 1 bath ldy 70 - SrR2 bathJ�� I Mon Accessary Building _ Multi-familyL -- ---- SFR 3 hrlh_ !Yy 00 Manter Builder ether, - F.ach atldmo I balWkdclten -� 4500 JO/ TE INFORMATION aad LOCATION Fire nnkler• .A -. _ _ _-- .�.__ ?9 _.. _ _- Job site addreaa 1�ypC Jt,� LA44 y� Ste.ueulslee Bld / t.N Cahh buln/ara drain Ifi 60 -�-y �'- br IUkath Nne/ttenc',drain 16 60 r_g5ct Name `Ru✓ ! �eK-�11� Ftwun tinm m tr a ei i, e 2 +� Cross streeK)irechons to job S,tc. Fto unit herrn tear i) I It,00 - 'S.tt.�t� ••, 91 � 62,'5 k�- off IJtd i 1 l'Al . Manholes �5��' e. 11q tr-4 e.n Lart/er/ew, �, Run dnitieannenor L� _ I Saniur sy fMHf(no imca A► Pae 2 Subdivision: fir, _ `- ,- �p(# Stam sewer(no.linear 0.) Pat'; f 1 vt red,_M _T Wali smv,ce(no linear R.) t e 2 I DESCpIrTION 0 WORK,--_ Fltture or Itepi Aha+ ,on valve __ 10 60 Backllowpmvenlet _- Page 2 -- -- - ----.1 FJackweret Valu 1660 Clothes washer 16.60 Ihahwash" 16.60_ — - DrinkkM fountain 1660 PROPERTY OWNEk_ T$IVAN 1 Arctwww�. 16 60 Name_ /�4 Uponson lank Addroet S`to f , 1�• tie F1xwrNsewerwn _. — - 16.60 - ri /Stale/Zip pl ) 7 95i" Floor dram.'tinot vnk/hub 16.60 _--- Ti t - - .--94�- - �� Garbage disposal _ 1660 Phone: 7 4G. -- Fax.L45-17LS Huse bib 16.60 -- PPLICANT^ ON•M(;T PFRS_UIV lfuerceplonfncase tray 16.60 Address: /05 Sw -7/7/t,4�{ r_ . Mrt1Ka) value s __ P:a 2 tall /$tatC/Zi C/� . Z.2 �- Primer . 16.60 _ � ._L_ _ _ .. S Roof drain(commercial) nk/b __ Fax: Zt Y$='l7ti S. StJwloavatory -_ 16- l E-mail. dao�,r w c Ler. .cow%^ I ubkhowe'rshowespan�--- 10 60 -- CON•t 4CMR _ - urinal 1660 Susines3 Namc: l ,tr water CI09el _ .- 16,60 ,,�,;-.y-_.�trri+"s.-?x . —� Witte,h -- — 0 addf�: �o aax /Ori— tither ealer 166- —City/Stale/Zip _— Phoete lbj-& 6t s 31 Rt F'hriblptPernUtFe". Sublotal S CC9 Lit. +tl: f?j ��_ ,Plumh Lic# �gap(j M nmtum Pcrtrlil Fee 57210 s - --`- AutlWnred_ Mir Rea,dential Natkllow Minotxrm Fee S36)S ftn�F• --�-"~�• — _ Ytat,Renew(:51:of('Crows Fec) F !_"2 zvemad ---_ -- Slate Sulite_rehar a of Penral K S -` Pitste-Mtm ttane) TOTAL PERMIT MM". TAU permi,applltMtos"Arse its permit it aM tiWalmd arwis AN nrw restmerekl balldirmo require 2 wit of plan.wilb Ps"rk at Ih Nrt after it Mt boos­40W of tompkttr ;1tt,dtatr"for plan It,,,or, *tee methoddeey col hr Tri•Coutov Ni lidisa IodetNry st"We award. V)ttstPt-tnilFmm�Wlmt::nsiApp,kK nUnl Mechanical Permit Application Received Mechanical` Date/By. _ Permit No.:l/��� City of Tigard ai:Approval Building DPlanning ate/e/B Permit No.: 13125 SW Hall Blvd Plan Review Other 'Tigard,Oregon 97223 Datc/By: Pemut No. Phow: 503-639-4171 Fax: •503-598-1960 Post-Review land Use '''' Date/9y: Case No.: interaet: www.ei•tigard.or.us Contw t Juris.: See Page.,for 24-hour Inspection Request: 503-639-4175 Name/M Su lemenld Information._ 'TYPE OF WORK V CnMMERCIAL FEE*S, ►1FDULE-USE CHECKI 7ST New construction Demolition Mechanical permit fees*are bas::d on the total value of the work Addition/alteration/replacement ❑Other: _ performed. Indicate the value(vounded to the nearest dollar)of all mechanical materials,equipment,labor,overhead and profit. CATEGORY OF CONSTRUCTION _ 1 & 2-Family dwelling ❑ ('ommercial/Industrial - value: s_ See Page z for Fee schedule RESiDENTIAi,EQUIPMENT/5YS'rF,MS FEE*SCHEDULE Accessory Building, Multi-Family Dcscriptiun 'Total Master Builder Other: Heaton 11"11 JOB SITE INFORMATION and LOCATION Furnace-add-on air conditionin ••` 14.00 Job site address: I I y do S w L k-ej _ Gas heat pump — _ 14.00 Suite#: 131dg./Apt.#: Duct work _ 14.00 I'ro act Nanie: H dronic hot water system — 14.00 �--- — Residential boiler Cre-s street/Dircetions to job site: (for radiator or hydronic system) 14.00 Unit heaters(fuel,not electric) in-.all,in-duct,suspended,eta 14.00 _ Flue/vent for any of above 10.00 Subdivision: Lx-A•�l &k-% X14}es Lot#: 1 Re A r UtlltS _� 12.15 _ — Othc_r Fuel Ap liances _ Tax neap/parcel #: _ Water heater -- 10.00 DESCRiPTIO_N OF WORK— Gas,ire Ip ace 10.00 _ Flue Nent(water heater/gas Fireplace) 10.00 Log lighter as 10.00 — -- — --- Woo.1/Pellet stove _ 10.00 Wocd fireplace/insert Chirine !y liner/flue/vent ,'ROPERTY OWNER TENANT' Other: Environmental Exhaust&Ventilation Name:---- .,K 44,o m s 4 �-_ Range hood/other kitchen equipment 10.00 Address: —2 0Clothes dryer exhaust 10.00 City/State/Zip::_ f j V 0 Single duct exhaust Phone: 793-384�, I Fax: ZH –77(, S (bathrooms,toilet compartments, AE'PLICANT CONTACT PERSON utility rooms) Name: vY Attic/cravrl!Race fans �— y 10.00 1—� Address - — —_ Other: 10.00 City/.State/Zip: (55.40 for first 4,$1.00 each additional) Fax: _ Furnace,etc. ** Phon.,. ^_ Gas heat pump�_ �_ •• _ E-mail:— Wall/sus ended/snit heater ** _ CONTRACTOR Water heater •• Business Namt.- Ars- M, Mttfxif i Fireplace •* Address: __ 684 11/ RangeBBQ *• City/state/Zip: Qor - 4 JR-• q 7007 -- -- Clothes d1n!A&as__q •• _ 1 Phone: s/ s77(, r 7flFax: 5" Other:— -- •* Total: CCA Lic. #: I Z Y 7 Mechanical Permit Permit Fees" Authorized ���.�j Subtotal: $ Signature: _ � ^ Date: Minimum Permit Ft.-!$72.50 $ Plan Review Fee(25%of Perriit Fce $ T (Please print name) State Surcharge(8%of Permit Fee) $ __ TOTAL PERMIT FEE $ Notice: This nerndt application exph es if a permit Is n4,1 obtained within 'Fec mcthndology set by Tri-County Building Industry Service hoard. I>a days after It has been accepted as ct mplele. '"Site plan requirrd for exterior A/C units. \DstsTermit i•unns\MecPcrTv1App.dx 01/03 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to$5.000.00 Minimum fee$72.50 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and including$10,000.00. $10,001.00 t $$25,000.00 $148.50 for the first$10,000.00 and $1.54 for each additional$100.00,)t fraction thereof,to and including $25,000.00. $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or fraction thereof,to and including $5-0,000-00. _- $50,001.00 and up $742.00 for the first$50,000.09 and $1.20 for each additionai$100.00 or fraction thereof. _ Assumed Valuations Per Appliance: _ —'-- _ ( Value Total Description: O;v _ Ca Amount rurnace to 100,000 BTU,including 955 ducts&vents _ --- Furnace>100,000 BTU including ducts 1,170 &vents _ ------ Floor furnace including vent 955 Suspended heater,wall heater or floor 955 mounted heater Vent not included in appliance etmit 445 Repair units _ 805 <3 hp;absorb.unit, 955 to 100k BTU — 3-15 hp;absorb.unit, — 1,700 101k to 500k BTU - 15-30 hp;absorb.unit,SOIk to I mil. 2,310 BTU 30-55-hp;absorb.unit, 3,400 1-1.75 mil.BTU >50 hp;absorb.unit, 5,725 >1.75 mil.BTU Air handhng unit to 10 000 cfm 656 Air handling unit>10,000 cfm 1,170 Non-portable evaporate cooler 656 Vent fan connected to a single duct 446 Vent syr em not included in appliance 656 rmft _ Flood serves 1,mechanic it exhaust 656 Domestic iminerator 1,170 _ Commercial or industrial incinerator 4,590 Other unit,i c!udmg wood stoves, 656 inserts,etc. Gas i ink 1-4 outlets 360 ` Each at.' ,onal outlet _ 63 TOTAL COMMERCIAL $ VALUATION: — is\Dsts\Permit Fotms\MccPcmiitAppl'g2.do: 01/03 / 1q00 S.W. LAUREL GLEN UT. 'O /,wry/y1 v'�I r+wa+.�,--.+.Yy• � 7y -__. �.�+ir -- V rep vL r� cf cm o \ 2Rj cu a +� 15.17 d.2 ENTRYH Wo W18 Q I r 5.00 C!) 17.78 I / L AR PAJ10 &PORGH. jl I �� � - �•, .OHO 7 � r � cel _ ---'"—•_.-_. (., SCALE 1 16 1 0 PLAN 7,200 SQUARE FEET A UA E EE LOT ARE -w LAUREL GLEN 2,280 SQUARE FEET LOT COVERAGE L"' # WASH of UCOUNTY, OREGON NCLUDING PORCHESE s M fD .-q f7 o (� o n n � a s � f b n � w a � 0 o O r. r o a (� �y 1 a O ;e r