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11467 SW LAUREL GLEN COURT rn (n r c ID G) c� C) 0 c 11467 SW Laurel Glen Court CITY OF TIGARD 13125 S.W. HALL BLVD. ' TIGARD, OR 97223 RECFIUF_0 IMPORTANT PERMIT NOTICE COMMUNIII UFVFI(�FN�Ni WEBER ELECTRIC INC 14524 SW CHARDONNAY AVE TIGARD, OR 97224 Electrical Signature Form Permit #: MST2001-00344 Gate Issued: 713/01 Parcel: 2S110AC-02300 Site Address: 11467 SW LAUREL GLEN CT Subdivision: LAUREL GLEN Block: Lot: 006 Jurisdiction: TIG Zoning: R-4.5 Remarks: SIF Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required Please have the appropriate individual from your company sign below and return this Electrical Signature Form 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: DONALD BUSS WEBER ELECTRIC INC 440 NW HILLTOP ROAD 14524 SW CHARDONNAY AVE PORTLAND, OR 97 21a TI.,Ar^.D, Ot: 37 224 Phone #: 503-248-9876 Phone #: 579-5168 Req #: uc 44087 SUP 4u28S ELE 54-442c AN INK SIGNAL URE IS REQUIRED ON THIS FORM X -- Signature of Supervising Electrician If you h�3ve any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 PECEIVEp IMPORTANT PERMIT NOTICE JUL . „ .� � fpr, PLUMBING CONCEPTS INC COMMrlrrr►r �,►,, PO BOX 1068 CLACKAMAS, OR 97015 Plumbing Signature Farm Permit #: MST2001-00344 Date Issued: 7/3101 Parcel: 2S110AC-02300 Site Address: 11467 SW LAUREL GLEN CT Subdivision: LAUREL GLEN 3lock: Lot: 006 lrisdictlon: TIG Zoning: R-4.5 Remarks: S/F Path 1 Your company has been indicated as the plumbing contractc,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 OWNER: PLUMBING CONTRACTOR: DONALD BUSS PLUMBING CONCEPTS INC 440 NW HILLTOP ROAD PO BOX 1068 _ LTi,nND, OR "7210 rr_n.CKAMAS, OR 97015 Phone #: 503-248-9876 Phone /?: 658-5232 Reg #: 1 Ir. 97587 PI M 3-293PB AN INK SIGNATURE IS REQUIRED ON THIS FORM IQ- ZJ Signature of Autho ; c PlumbT er If you have any questions, please call (503) 639-4171, ext. # 310 �...._`_.� UtAk' 7 `, CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24--Hour Inspection Line: 6: 175 Business Line: 639-4 BLIP _Date Requested - al AM_ PM BLD _ _ — Location _ I y / �y� �� Suite / MEC Contact Person Ph '�/ PLM Contractor _ Ph SWR BUILDING _ Tenant/Owner __ ELC �_— Retaining Wall ELR _,— Footing Access: FPS Foundation - --- - Ftg Drain SGN Crawl Drain Inspection Notes: Slab — S IT Post&Beam Ext Sheath/Shear - —- - -- Int Sheath/Shear ' Framing -E/�� ")fit-� 70L�_1�S Ale�'f - Insulation Drywall Nailing -- Firewall Fire Sprinkler - -- - -- - Fire Alarm Susp'd Ceiling Roof Mics: Inas PART FAIL - ING Post&Beam Under Slab Top Out Water Service Sanitary Sewer — Rain Drains -- Final PASS PART FAIL — — ------------ ----- MECHANICAL Post 8 ficam Rough In Gas Line - — - - Smoke Dampers Final -- ---- - -_ PASS PART FAIL ELECTRICAL Service ------ Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL -SITE _ Backfill/Grading Sanitary Sewer Storm Drair [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ )Please call for reinspection RE: [ J Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk E� Date 2- O _Inspector �, Ext _- Other Final L.P1,88 PART FAIL Do NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 63 175 Business Line: 639-4 1 ' BUP Date Requested l ' AM----- PM �`� BLD Location�1 �P� 77 i - �"�'"L1 68uite MEC Contact Person �� Ph _ 3Y� PLM Contractor _ _ Ph _ SWR - BUILDING enant/Owner ELC Retaining Wall EI.R Footing Access Foundation FPS Ftg Drain -- SGN Crawl Drain Inspection Notes: -- -- - Slab __ ---- SIT - - ---------- Post&Beam --------------- ----- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing __ ')! — Firewall Fire Sprinkler __ — ------ - Fire Alarm Susp'd Gelling --- /z_ Roof Roof —— a Lit c, l - -1 _ �� ,� _� �j�c d b Mise f--�-�-�-4�— —, Final --- PASS PART FAIL - -- -- - PLUMBING Post&Beam Under Slab Top Out Water Service ,r. '�" ` �� ilia ��1 a 'Q- 1 1 , n D��✓ Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam Rough In 'r Gas Line - - Smoke Dampers Final PASS PART FAIL ELECTRICAL - Service - Rough In UG/Slab Low Voltage Fire Alarm - i A PART FAIL Backfill/Grading — Sanitary Sewer Storm Drain I J Reinspertion fee of$ _ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I J Please call for reinspection, RF — ( J Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Date 1O,1 4�/,-/_-_- Inspector__�~G�_—(�� Ext Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. 14kAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAr i a b ► CL b ► CD ► 0 ►� � m rb lot c ~- (► OCD °-' ► w 4 a. 1/�� ► J' O� 0' p ► ' 1 � c4 Ull ;1 ► ' ► 4 Iii tTf U ► p U ► 4 � (-) ; O4 CD f3 o 0 0-1 4 ; 4 o' ► e ` p ° Poo. 4 o � ► 4 � � y ► 4 ► a ► 4 ► -- - --- -- --�► CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 63 176 ,p(S aMv-e T—�Cv Eiusin�ess Line: 639-4 C� ----_Date Requested -,d •�� O/ �AM - —�� BUP l_ocatlon` _ BLD '� � Suite Contact Person -- _ MEC Ph Contractor_ -- - -- - --------- Ph FILM SWR BUILDING —_ -- - - - - ----Tenant/Owner ELC Retaining Wall — --_— Footing - ELR — Foundation Access: — Ftg Drain FPS Crawl Drain Inspection Notes. SIGN Slate ---- ---------- R Geam - --- --------- SIT E. ,Sheath/Shear Int Sheath/Shear Framing Insulation — — �. �,•'�/lf- -''-�J Drywall Na.!ing — Firewall --- Fire Sprinkler —-' ---- Fire Alarm — Susp'd Ceiling -� ------ --- —-- Roof -- —T_—_ Misc I --- ---- ---- - Final ---_ - _.----_----------------- PASS PART FAIL fUnd UMBING st& Beam -- --- - —- --- _ - - - — er Slapp Outater Service --"—` — ----- — Sanitary Sewer --- Rain Drains .--.—..__.,_-----------------.—_—..__--_—_--------- Final PASS PART FAIL cst 8 Beam - -------..--.------ -- - - Rough In -- ------------ ----_ Gas Line Smoke Dampeis -- ---------._-- in- AS PART FAIL ----- —_-- — ------ —.___.__ .CTRICAL - - - -- Service —.._--- ----�---------------- -------------------- Rough In - UG/Slab -------- - --- - ------- ------------- ow Voltage -- - - ---- Fire Alarm -- ----- Final PASS PART FAIL - --- —� �— --- SITE �- ------------- --- ---- Backfill/Grading ----- Sanitary Sewer - — — Storm Drain ] ]Reinspection fee of S Catch Basin —required before next inspection Pay at City Hall, 13125 SW Hall Blvd --- Fire Supply Line l )Please call fr; reinspection RE ADA -_ ----- —__ [ ]Unable to inspect-no access Approach/SidewalkOtheI �/, / Final - Date - 7 r/--V Inspector_ Final --' �--- Ext 1 _PASS PART -FAILJ 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD 13011 DING INSPECTION DIVISION MST 24-Hour Inspection Line: 53� 175 Business Line: 639•-4 BLIP _ Date Requested �G' �� AM PM _ BLD Location—j ` Suite _ _ MEC Contact Person Ph 79 2) _ PLM Contractor Ph SWR BUILDING Tenant/Owner — ELC Retaining Wall ELR Footing Access Foundation _ ,tNFPS Ftg Drain l/ 1 _ y C ``'r .�1 "`` SGN Crawl Drain Inspection Notes Slab - ---- ----- -- - - --- SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear Framing - --- - ----- - - - Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — — - --- - Roof Misc: ----- - --- -- ---- Final PASS PART FAIL - - —. --- - --------- PLUMBING Post& Beam Under Slab Top Out Water Service Sanitary Sewer ---- - ---- -- ----- -- ------- _ - Pain Drains - - ----- — - ---- - - - PART FAIL IffI.HANIGAI_ ------- '--A— - Fost 8 Beam ---------- -------- --- - - Rough In Gas Line - -- - - ------ ---- -- - _ -- Smoke Dampers Final PASS PART FAIL ELECTRICAL_ - - - - - --- Seivice Rough In UG/Slab -_-- ---- _ Low Voltage Fire Alarm — - - - - ---- - -- - — Final PASS PART FAIT- - - -- --- - -SITE Backfill/Grading Sanitary Sewer Storm Drain I ] Reinspection tee ni$ _-_ - requirert before nex! nspec tion y at City Hall, 1?125 SW Hall Blvd Catch Basin Please call for tmnspectwrt !?F _. _ —_ [ j Unable to inspect-no access Fire Supply Line ADA /5 Approach/Sidewalk nate /C�l Z L 161 Inspector _ Ext Other - '- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. City of Tigard Washington County Oregon Voluntary Compliance Agraement and Temporary Certificate of Occ,.:�ancy To: A.Ipenglow Homes 5620 SW Kelly Ave Portland, OR 97201 i i Re: Temporary Certificate of Occupancy FILE COPY I, Erik Ostmo, as responsible person for 11467 SW Laurel Glen Ct Tax Map 2511 OAC, Tax Lot 02300, agree to the following conditions: A temporary Certificate of Occupancy is hereby issued on a conditional basis for a period not to exceed 30 days from this date, by which time the following conditions must have been met and approved by inspection by the City of Tigard Building Department: Permit MST2001-00344 must be completed and approved, including all outstanding corrections, ancillary permits and fees. Specifically; Provide a code complying egress window in the east bedroom over the garage. I understand the City will withhold action until November 30, 2001 . Upon compliance with all above conditions, this case will be closed and the Certificate of Occupancy will become permanent. I further understand that if these conditions are not complied with fully, I may be served with a Summons and Complaint without further notice for violation of requirements set forth in the Oregon One and Two Family Dwelling Specialty Code(Final approval required prior to occLipancy). Sigr.ed:l�� Cr- Date:. iV 3U G L Signed: D . . �_� _ ate: vl� _ (I pedon Supervisor) CITY OF a�IGARD MASTER PERMIT PERMIT#: MST2001-00344 DEVELOPMENT SERVICES DATE ISSUED: 7/3/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11467 SW LAUREL GLEN CT PARCEL: 2S110AC-02300 SUBDIVISION: LAUREL GLEN ZONING: R-4.5 BLOCK: LOT: 006 JURISDICTION: TIG REMARKS: S/F Bath 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS - REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,241 sl BASEMENT sl LEFT: 11 SMOKE DETECTORS: Y TYPE OF USE: Sr FLOOR LUAU: 40 SECOND: 1,356 sl GARAGE. 605 sf FRONT: 40 PARKING SPACES: 2 TYPE OF CONST: 5N DWELL ING UNITS. t rINBSMENT: sl RIGHT: 15 VALUE: $240,086.60 OCCUPANCY GRP: R3 BDRM: 4 BATH: '1 TOTAL: 2.597 00 sf REAR: 50 PLUMBING SINKS: 1 WATER CLOSETS: I WASHING MACH: I LAUNDRY TRAYS: i RAIN DRAIN: 100 TRAPS: LAVATORIES: r, DISHWASHERS: I FLOOR DRAINS SEWER LINES: 100 SF RAIN DRAINS I CATCH BASINS: TUBISHOWERS. 3 GARBAGE DISP. I WATER HEATERS. 1 WATER LINES: 100 BCKFLW PREVNTR. GREASE TRAPS: OTHER FIXTURES: MECHANICAL _ FUEL TYPES _ FURN<TOOK BOIL/CMP<$HP: VENT FANS: 5 CLOTHES DRYER: 1 r;AS FURN—100K: t UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLE79: 1 _ ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS _AOD'L INSPECTIONS 1000 SF OR LESS 1 0 200 amp: 0 200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF 201 - 400 amp: 201 •400 amp: 1st W/O SVCIFDR JO SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 40 t 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNALIPANFI.: IN PLANT: MANU HM/SVC/FOR. 601 • 1000 amp: 601+amps•1000r. MINOR LABEL: 1000-amplvolt PLAN REVIEW SECTION Reconnect only: >a4 RES UNITS: SVCIFDR>=225 A: >600 V NOMINAL: CLS AREAI9PC OCC: _ ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENr1AL _ B.COMMERCIAL AUDIO 6 STEREO: X VACUUM SYSTEM: X AUDIO 6 STEREO: F'RE ALARM: INTERCOMIPAGING: OUTDOOR LIN DSC LT: BURGLAR ALARM: X OTH: ALL ENCOM BOIL ER: MVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER - CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC Y DATA7TELE COMM: NURSE CALLS TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,419.30 This permit is subject to the regulations contained in the DONALD BUSS ALPENGLOW HOMES Tigard Municipal Code,State Of OR Specialty Codes and 440 NW HILLIOP ROAD 5620 SW KELLY AVE all other applicable laws All work will be done in P0R1 LAND,OR 97'110 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: Phone: Oregon law requires you to follov:rules adopted by the Oregon Utility Notification Center T ,)se rules are.et Rog 0: LIC 1.719.3.' 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 84 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Inrp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing/Foundation Dr, Electrical Rough In Gas Line Insp Appr/Sdwtk Insp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical 1=1nal Issued By : Permittee Signature : t.t �• _W_� Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day ar CITYOF TIGARD _SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001-00189 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/3/01 SITE ADDRESS; 11467 SW LAUREL GLEN CT PARCEL: 2S110AC-02300 SUBDIVISION: LAUREL GLEN ZONING: R-4.5 BLOCK: LOT: 006 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELL ING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSW- IMPERV SURFACE: Remarks: Sewer connection permit for new SF residence. Owner. -_-'_--'-- FEES DONALD BUSS Type By Gate Amount Receipt 440 NW HILLTOP ROAD — PORTLAND, OR 97210 PRMT CTR 7/?i01 $2,300.00 27200100000 INSP CTR 7/3/01 $35.00 27200100000 Phone: 503-248-9876 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date is med The total amount paid will be forfeited if the pen-nit expires The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is riot located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 throug;i OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: Permittee Signature Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application ) ---- IJalerecclved: % PerrAA City of TigardIIf Address: 13125 SW Nall Blvd,Tigattl,OV 97'2.1 I'rojecVappl.no.: Expirt date: Ci(v of Tigard hone: (503)639-4171 Date issued: ecei t no,: _ Fax: (503) 59$-1960 Case file no.: Payment type: Land use approval _ - I&2 family:Simple Complex: v U I &2 family dwelling or accessory U Commercial/indus(rial U Multi-family 0 New construction O Demolition U Addition/alteration/replacement J'I'vilaw impr,rvrnu-nt U Firy tiprmkler/alarm 0 Other: Job address: 14 7 Sur' Lq✓re/ 6/e, c.t. Bldg.no.: __ Suite no.: la)t: (,, 113lock: Subdivision: �uwe 1 Glet) 6s ift it's— Tax map/tax lot/account to.: aS 1/D AG_ Project name: Description and location of work on premises/special conditions:._________ 011 N1 It FOR Npk('I,%L INFA)IRMATION, USE Cli[KRUST Name: Q , A. R CKs Mailing address: I &2 famllY d"elling: City: P _ Sta e: OK ZIP: 87211. Valuation of work........................................ s-140,Q97__ Phone: yp - -1,+l Fax: E-mail: No.of bedrooms/baths....y.../. .... .. Owner's representative: 'total numberof floors...........;................•... Phone: Fax: E-mail: New dwelling area(sq.ft.) ..... ........... i 24, !2 I Garage/carport area(sq. f.)......4.0.5........... ____i3_'1A4_— Name: Fr,'k 0 5 fm Covered porch area(sq. ft.) .....).3............. t z w 2• Mailing address: 5. z Sry kelfy A e Deck area(sq.ft.) .......................l .............. City: �n,y Slate:pQ Zll' 9 7?c�/ Other structure arca(sq. ft.)........Q?.............. Phone:5,3. yJ.3r1oB Fax: yy&, 11 nail ('ommercial/industrial/multi-family: Valuation of work................................. . .... $ Business name: Existing bldg.area(sq.ft.) .. ........... ......... Address: New bldg.area(sq.ft.)................ ............ City: 1 7 State: '0 Z[P 720` Number of stories................... .. . . ..., __. Q Type of construction Phone:5v3-t ys-.7.76 Fax: - s E-mail.. -- 1 -- CCB no.: J 31 4 31 Occupancy group(s): Existing: New: City/metro tic.no': Notice:All contractors and subcuntractors are required to be licensed with the Oregon Construction Contractors Board under r7ame: provisions of ORS 701 and may bee required to he licensed in the jurisdiction where work is being performed. If the applicant is A,ldress: D th ,, . City: ZIP: q ) exempt from licensing,the following reason applies. Contact person: Plan no.: 22 3() -- --- -- Phone: I a — I nut;/: Name: � I( ,attar! person: Fees due upon application ........................... $- -- Address: Date received: _ City: State: Zp. Amount received .........................................$-_ Phone: Fax: I E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the No&H juriedtcrnnn am%"crnlit cads.please call)udidictlon for more iraarmnion. attached checklist. All provisions of laws and ordinances governing this U visa U MasterCard work will he complied with,whether specified herein or not. creast cud number Esplrn Authorized signature:_Gc � I late: G 0 I ---Nome or cudhnldn as damn as credit crd Print name: Er,'k Qsimn _ C'rdholder slVwute Amount Notice:This permit application expires ira permit is not obtained within 180 days afler it has been accepted as complete 114161.1(6llaU014) One-ar�d Two-i''arnily t)welling Building Permit Application Checklist Reference no.: Associated permits: City of Tigardg L]Electrical U F'lumbin U Mechanical Address: 13125 SW HMI Blvd,Tigard,OR 97223 ❑Otho i __ _ Phone: (503) 639-4171 — Fax: (50:3) 598-1960 I IJIE FOLLOWING ]ITEMS ARE t r FOR I Land use actions completed. ',v jurisdict.- n criteria for cuncu i, ni reviews. _ 2 Zoning.Flood plain,solar balance points,seismic soils designao- n,historic district,ctc, 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 H Solis 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 and fixation of catch-basin protection,etc. 1 1 i 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes. Later:(I design details and connections must be incorporatt'd into the plans or on a separate full-size sheet attached to the plans with cross references ixtween plan location and details. Plan review cannot be completed if co yright violations exist. I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions:property comer elevations(if Uu•n,v,more than a 4-ft.elevation d(0hrenoial,plan must show contour lines at 2-11.Intervals):location ofeaserneri s and driveway;footprint of structure onlluding decks);location of well systems;utility locations;direction indicator:lot area;building coverage arca;Imcentnge 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 Icxation. _. I i Floor plans.Show all :limensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation_fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross sections)and details,Show all framing•mentber sizes and spacing such as floor beams,heaL.ers,joists,sub-floor, wall construction,roof construction. More than one cross section may he required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,C:xtings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elev-itions 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. n Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing fixations.Show;otic ventilation. 18 Basement and retaining wills.Provide cross sections and details showing placement of rebar, For engineered systems,see item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current code der.ign values for all heams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more appliances. _ 22 Engineer's calculations.When required or prop idvd-(i c. �hvar wall,n-1 truss)shall he stamped by an enpincer or LX111tcct Iict'nseel in t heron and shall be sho-i n,hr apphrable to tilt'1i11r0 under reviow 23 Five(5)site plans are required for Item I I above. Site plans ntu"t he x I" \ 11'_0-11 1 1". _- 24 Two(2)sets each in,required for Hems 16, 19,20&22 above. _ 25 Building plans shall not contain red lines or tape-ons. 26 No rolled,reversed or mirrored building plans will be accepted. _ 27 _. 28 _ __— Checklist must be completed before plan review scan date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614(t VWOMi r _ Electrical Permit Application Date received: Permit no.: ,' City of Tigard Project/appl.no.: Expire date: City uJ77gard Address: 13125 SW liall Blvd,Tigard,OR 97223 Date issued: By: Rcceiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement Iii New construction U Addition/alteration/:eplacement U Other: U Partial .1011 S1 I E INFORMATION Job address: I (,7 t,v/ levee./ J'en G Bldg.no.: Suite no.: Tax map/lax lot/account no.: 23 l/c,AL Lot: I Black: Subdivision: t-ewre l Glt,r ESlifii Project name: Description and locution o1•work on premises: - Estimated date of com letion/ins ction: Job not Fee Max Business nama: W-scnption (11y. (ea) focal no.Ins tN e-hei El r c fr', — New residential-single or multi-lamily per Address: v dwelling unit.Inclrrrles attacked garage. City: T1,11fird I State:ojt ZIP: q727-Ll Senimincluded: Phone: Fax: I E-mail: I(xx)sg ft.orless _1 Hoch additional 500 sq.ft.or portion thereof CCB no,; Elec.bus.lice no: 3 y- y y 2 C Limited energy,residential City/metro lic.no.: i - /L Limited energy,non-residential Each manufactured home or modular dwelling Signature of supervising electrician(requited Uate Service and/or feeder _ "III, rlr,t nome(ptinn License no: Scrvlcaorfeeden-Inslallatlon ■Iteration or relocation: 200 oraps or less 2 Name(print): 201 .in to 4011 amps 2 - --- — 401 amps to 600 amps -' Mailing address: 6O1 atnpsm IWOan,ps City: _ _A Slate: ZIP: o•, X)0 amps or volts 2 77 Phone: — - Fax: E-mail: 1, .,�cl only I Owner installation:The installation is king made on property I own Temnor.rytttervkesorfeeders- which is not intended for sale,lease,rent,or exchange according to Inst.. ,tlon,alteratlon,orrelocation: 200 amps or less 2 ORS 447,455,479,670,701. __ 201 amps to 4(x)amps _ _ 2 Owner's signature: Date: not to OW ,t - 2 V-11 ft 10 It I Branch circuits-new,altercation, or extension per panel: Name: A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: f— State. 7,1{,.� B Fee for branch circuits without purchase _ - -- — ---- — — of service or feeder fee,first branch circuit: 2 Phone: I'ax: E-mail: Fachadditional branch cir-uiU Mise.(Service or feeder not Included): U Service over 225 amps-contnterciul U Health-care facility Each pump or irrigation circle -' U Service over 320 amps-rating of 1&2 U Hazardous location Each signor outline lighting familydwellings U Fluddiog over Itl,(xx1 square feet four or Signal circuit(s)or o limited energy panel. USystem over 6lx)volts nominal more residential units in one structure alteration,or extension• U Building over three stores U Feeders.400 amps or more •Desert tion: — - U Mcupant load over 99In•rsons U Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above: —{ U Egreasnightagplan U"her' Per inspection Submit _sets of plans with any of the above. Investigation fee _ The above are not applicable to temporary construction service._ other _ J Nor all jurisdictions accetrt credit cards,please call jurisdiction for more Inforaisticxt Notice.This permit application Permit fee.....................$ U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ _ creditcard number —_ within 180 days after it has been State surcharge(8%)....$ _ n"pl1e' accepted as complete. TOTAL $ NauK of cardhol r as shown nn c it cant S — Cardholder slputroe amount 44x}4615 16KIWOMI ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: —'—`— ----! TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee....................................I................ $75.00 Number of Inspections per rmit allowed) (FOR ALL SYSTEMS) Serv!ce included: Items Cost Total k Check Type of Work Involve, Residential-per unit 1000 sq ft or less $145 15—!__—_ 4 Audio and Stereo Systems' Each additional 500 sq ft or portion thereof —_�. $33.40 _ 1 Burglar Alarm Limited Energy —_ $75.00 Each Manufd Hone nr Modular Garage Door Opener' Dwelling Service or�b.-der T� $9090 1 Services or Feeders LTJ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $8030 2 Vacuum Systems' 201 amps to 400 amps _ $106.85 2 1, Z 401 amps to 600 amps $160.60 2 ❑ Other 601 amps to 1000 amps _J $240.60 2 — Over 1000 amps or volts $454 65 _. 2 U Reconnect only _ $66.85 2 Temporary Services or Feeders TYPE. OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system..................................................... .... $75.00 Installation,alteration,or relocation 200 amps of less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amp,. $100.30 J 2 401 amps to 600 amps —___ $13375 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ Audio and stereo Systems see"b"ur` .. Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch circuits ❑ with purchase of service or L, Clock Systems feeder lee. Each branch circuit _—_ $665 2 E] Data Telecommunication Installation b)The fee for branch circuit without purchase of service Fire Alarm Installation or feeder fee. First branch circuit $46.85 _ _- Each additional branch circult —�— $665 HVAC Miscellaneous L_1 Instrumentation (Service or feeder not included) Each pump or Inigation circle $53.40 _ Intercom and Paging Systems Each sign or outline lighting A $5340 Signal clrcutt(s)or a limited energy L� Landscape Irrigation Control' panel,alteration or extension $75.00 A —_._. Minor Labels(10) �--- $125 00 Medical Each additional inspection over the allowable in any of the above Nurse Calls Per inspection _f, $6250 Per hour — $62.50 ---- In Plant $73 15 — LJ Outdoor Landscape Lighting' Fees: L 1 Protective Signaling Enter total of above fees $ F] Uthei 8%State Surcharge $ —._--- __Number of Systems 25%Plan Review Fee No licenses are required Licenses are required for all other installations See"Plan Review"ser3inn on $ front of application -- -- Fees: Total Balance Due $ Enter total of above foes $ -- ❑ Trust Account# __ - _ 8%State Surcharge S — — Total Balance Due $---- — I 41sts\formsklc-fees-doc 06/0'/111 Plumbing Permit Application - Date received: Permit no ' �� ff -..G City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,'T'igard,OR 97223 project/appl.no.: Expire date: City ofTigard phone: (503) 639-4171 Fax: (503) 598-1960 Date issued: By: Receipt no.: Case file no.: Payment type: Land use approval: — maw N =New ily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improv(nient struction U Addition/altcratiun/replacement U Food service U Other: .. Job address: t S►�/ L4t/�c G r Description QMY. Fee(ea.) Total _LL�1f_7- --��-- - New 1-and 2-famlly dwellin{s only: Bldg.no.: Suite no.:_ __ (includes 10011.for each tit flityconnect Ion) Tax map/tax lot/account no•: 2-,) /ju& SFR(1)bath Lot: L Block: Subdivision: Lovrcl r:l C-sO f SFR(2)bath _ Project name: SFR(3)bath City/county: Ti „ ZIP: _ tach adJitional bath/kitchen Description and.1 ation of work on premises: Siteutilities: Catch basin/area drain _ -` Drywells/I/leach line/trench drain fist.dill(..of completion/inspection: Footing drain(no. lin ft.) Manufactured home utilities Business name: P)o m b i r C�,,A - Manholes - _ -- Address: P.o Rain drain connector----- 'tate onnector _ City: c��Fax: Statc.p Zip: 701 _ Sanitary sewer(no.lin.ft.) Phone: &mail: Storm sewer(no.lin. ft.) —_ Water service(no.lin.ft.) CCB no.: (17 19 7 IPlumb.bus.reg.no: 9- Z 93 0/3 T— - Fixture or Item: Cilyhnetro tic.no.: (,S _ ( ' 'U - Absorption valve _ Contractor's representative signature: Btick flow preventer _- print name: hale: Backwater valve — D:sins/lavatory Clothes washer Name: - -�--- -- -_� Address: __ ___ — Drinking fountains) ------- - City: Stale: l.11': - _ _ __ _-- - _ OF I'hunc---- Fax -- I: nutil: Expansion tank _ Fixtur ewer cap Floor drains/floor sinks/hub _ tNaamc(print): Garbagedisposalg address: - Idose bibb Stat(: LII: _- : I ax: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Ptimer(s) _ will be made by me or the in-tintenance and repair made by my regular RmA drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Dale: Sump Tubs/shower/shower pan _ Urinal -� Name: _ - --- Water_closet Address: Water heater _ City: _- State: _ ZIP: Other: Phone: Fax: I E-mail: _ Total Minimum fee............... $ -- -- Not all jurisdictions accept credit Carrs,pleau call jurisdiction fa mrxe infrxmatiart. Notice:This permit application Plan review(at _ %) $ — ❑visa ']MasterCard expires if a permit is not obtained Credit cud number:-. —.--- --- ------f--1— within Igo days after it has been State surcharge(896)....$ — t sptrea TOTAI. .......................$ - accepted as complete. Name cr cardholder a shown on credit card S Cardholder signature �� Amount J 4404GI616A1n/('C)Ml PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES individuate QTY —Sea AMOUNT (Includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (as) AMOUNT Lavatory 16.60 -- for each utili connection _ One(1)bath - $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath $350.00 — -- Three 3 bath $359.00 Shower Only 16 60 ---�-�---- ---- - -- Water Closet — 15.60 --TSUBTOTAL Urinal 16.60 8%STATE SURCHARGE — Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL ----------------- Garbage Disposal 1f, TOTAL 60 ---- ------- - --- - -- --------- Laundry Tray 16.60 Washing Machine 16.60 Fluor Drain/Floor Sink 2" 16 60 PLEASE COMPLETE: Water linater O conversion O like kind 16.60 Quantic b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permitCapped MFG Home New Water Service _ 46.40 Sink _--- —_ — Lavato MFG Home New San/Storm Sewer 46.40 � — — __— Tub or Tub/Shower Hose Bibs 1660 _ Combination Roof Drains — 16.60 — Shower Or11y Drinking Fountain L 16.60 Water Closet —_ Urinal Other Fixtures(Specify) I 1660 — _ _ Dishwasher — Garble Disposal — — — Laun!jT Room Tray _--- -- Washiro l`iachine Floor Ln;in/3ink: 2" Sewer-1st 100'— — 55 00 -- 3" — --- SPwer-each additional 100' 46.40 Water Service- 1s1 100' — — 55.00 Water Heate, Water Service-each additional 200' 46.40 Other Fixtures (Specify) -- _ — Storm&Rain Drain- 1st 100' 55.00 r Storm&Rain Drain-each additional 100' 46 40 Commercial Back Flow Prevention Device 46.40 — — — — Residential Backflov,Prevention Device' 2755 — — Catch Basin 16.60 — Inspection of Existing Plumbing or Specially — 72 50 — Roquested Inspections COMMENTS REGARDING ABUVt. Rain Drain,vingle family dwelling — 65 25 __--_-- Grease Traps 1660 -------- ----- QUANT TY TOTAL ---� --- --- _ ..--- — Isometric or user diagra i is required If -J-- -- ---T Quantity Total Is >9 -- *SUBTOTAL — ------ -�--- - 8%STATE SURCHARGE ------ —-------------- "PLAN REVIEW 25%OF SUBTOTAL __ Requlrod only it fixture qty total Is>li TOTAL S "Minimum permit fee is 672 50•ii%state surcharge,except Residential Backflow Prevention Devic,!,which Is$ari 25+8%state surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan rnview 1:\dsts\forms\plm-fees.doc 10/10/00 Mechanical Permit Application -- �- hale received: City Of Tigard Project/appl.no.: Expiredatc: Cityn(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 batt issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: I Paymcnt type: Land use approval' _ _ Building permit no.: U I &2 family dwelling or accessory U Commercial/industrial U Mnln-holly U Tenant improvement W New construction U Addition/alteration/replacement '.1(tiller: 7 1 '.10 11 S I'll E I N FO It NIA]I ON CONIN11FRU11AL VALUATION NUIEDULE Job address: y 5 I l L vie _�e��f____ - Indicate equipmenl quamiues in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: 2S i ,4r-___ profit. Value$ Lot: (,, Block: Subdivision: _Lowe I 6jej f,M teJ 'See checklist for importUlt application information one, Project name: jurisdiction's fee schedule for residential Permit fee. City/county: 7-i�o rd ZIP: -Description and location of work on premises: _ Total Fat.date of completion/inspection: Description Qt . Rtx.only Res.on]) Tenant improvement or change of use: Is existing space heated or conditioned?IJ Yes U No Air handhn.),unit _CFM_ Is existing space lce insulated?U Yes U No Air cont itioning(site plan require ) A ` Alteration ofexisting VAC'system OI 1 Cr i ompre!Tors -- _ --- Business name: 0. ,,,J,,,,, - State ht iter p.rmit no.: �- _ HP Tuns BTIJ/H Address: (� (� � x /// Fire/smoke.smo c dampers/duct smoke defectors City: Stale: ZIP:� 9 - -TFea pwnp(site plan- rquired) - — _ ��- nsta /rep acc- f- 'I urnace/hurner 3 J Phone: sv 3. Fax: E-mail: Including ductwork/vent liner U Yes U No CCB no,: 12 y 7,y 7 _ _ nsta /rel)lacc re ocatc scalers-suspen cd, Cify/metro lic.no.: _ wall,or floor mounted Name(please print): ?r in/h a Vent fora lance other than furnace - UNIX e gerat on: Ahsorptionunas Nrme: 6 r I t ,-)TAn, , Address: � ---�- _ - i--- Cum xcssors--e-xx —an -- nv ronmenta aust vent at on: City: Porflr.M� Sate: LI(': -7[a� Appliancevent Phone: r03-7 -jg Fax:SDS z .roar E-mail:- )ryerex laust Mom) r ype I/ 1/res.kite a azmat hood fire suppression system _ Name: Exhaust fan with single duct(hath fans) Mailing address----- ----- Exhaust system apart from Icahn or A(- - ue piping an st ut on(up to outlets) City: State: LIP: _ LIYi ___ NG __ (til Phone: I at E-mail: Type:- ---T— I ucl Plpi�itiona over 4 outlets �- rocesspiping(sr ematicrequirer) Name: Number ofoullets - - - OW1 er st anpTlrnce or equipment: Address: _— _ _ Decorative fireplace: _ City: �`- State: ZIP: Insert-type Phone: Fax: 1 E-mail tx stov pe.,etstove t)•Ter: A,pplicanl's signature: Date: t Name (print): _ Nnt all judsdiclions accetacredit card%,please call jnriuliclinn Im mirr information' .... fee`.................$ Notice:'Ibis permit application _ _---- U Visa U MasterCard Minimum far................$ expires if'a permit is not obtained , �ctrdit card number: -_- -_ ---.(�_ Flan review(at -- 96) $ _-__ -- x ire% within 130 days alter it has bce,l Noneof cardholder as shmvn on c it card s aceepterl as complete. Seale surcharge(896)...$ - $ TOTAL .......................$ - - -- cadlioldef signature Amount 4404611(60WOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWEr`&_ING FEE SCHEDULE: Description: Price Total TOTAL VALUATION: FEE: _ - - Table 1A Mechanical Code_ Qty (Ea) _Amt $1.00 to$5 000.00 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 includingducts&vents _ 14.00 $1 52 52 for each additional$100 00 or 2) Furnace 100,000 BTU+ fraction thereof,to and ircluding including ducts&vents 17.40 -� _ _ $10,000.00. 3) Floor Furnace $10,001.00 M$25,000.00 $148.50 for the first$10,1)00.00 and includinwent 14 00 $1.54 for etch additional$100.00 or 4) Suspended heater,wall heater fraction(hereof,to and Including or floor mounted heater _ to 00 - __ $25,000,00,_._.__ - - - 5) Vent not included in appliance permit $25,001.00 to$60,000.00 $379.50 for the first$25,(700.00 and 6 t3o _ $1.45 for each additional$100.00 or 6) Repair unit; frartion themof,to and including 12 15 $50,000.00. --- 550,001.00 eno up $742.00 for the first$50,000.00 end Check all that apply: Boiler Heat Air $1.20 for each additiondl$100.00 or For Items 7.11,see or Pump Cond frarffon ittereof. footnctes below. Comp* - - - — 7)<3HP;absorb unit _ to 100K BTU 14 00 ASSUMED VALUATIONS PER APPLIANCE: — -6')-3-15 HP;absorb Value Total unit 100k to 500k BTU — - 25 so - Description: Q Amount 9)15-30 HP;absorb 35.00 Furnace to 100,000 BTU,Including 955 unit.5-1 mil BTU ducts&vents _ I 10)30-50 HP;absorb 52 20 Furnace>100,000 BTU including 1,170 unit 1.1.75 mil BTU -- ducts&vents _ 11)>50HP:absorb Floor ace Including vent 955 unit>1.75 mil BTU 87.20 furn Suspended heater,wall heater or 9E5 12)Air handling unit to 10,000 CFM r172O floor mounted heater -- — Vent not Included In applfrance 445 13)Air handling unit 10,000 CFM+ permit Repair units 80514)Non-portable evaporate cooler<3 hp;absorb.unit, 955 _ to 100k BTU -- 15)Vent fan connected to a single duct 6.80 3-15 hp;absorb.unit, 1,700 101k to 500k BTU _ - -- 16)Ventilation system not Included in 15-30 hp;absorb.unit,501k l0 1 2,310 a Ilant:o ermit _ 10 00 Rill.BTU - -- 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 1000 1-1.75 mil.BTU --- 18)Domestic incinerators >5'0 hp;absorb.unit, 5,725 1140 >1.75 mit.9TU19)Commercial or Industrial type Incinerator Air handlit g unit to 10,000 drn 658 — _ 69.95 _ Air handlin unit>10,000 cfm 1 170 _ 20)Other units,including wood stoves NonTgrtable evaporate cooler _656 10.00 Vent fan connected to a single duct 446 _ 21)Gas piping one to four outlets 540 Vent system not Included In Y 656 applianc*perm't 22)More than 4-per outlet(each) 1.00 Hood served by mechanical exhaust 656 _ --- Domesticc fnclnerator _ 1170.. -- Mlnimum Permit Fee 72.50 SUB TOTAL: $ Commercial or industrial Incinerator 4,590 _ f Other unit,including wood stovE: 656 8%State Surcharge inserts,etc. - - iew - Gas piping 1-4 outlets 360 2511.Pian RevFee(of subtotal) s Each additional outlet 63 --- Required for ALL commercial permits only tOTAL COMMERCIAL TOTAL RESIDENTIAL PERMIT FEE: s VALUATION: -- Other Insuedions and Ftq 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour 2 Inspections for which no fee is sr,ecifically indicated (minimum charge-half hour) $72 50 per hour 3 Additional plan review required by changes.additions or revisions to pleas(minimum charge-one-half hour)$72 50 per hour 'slate contractor Boiler Certification required for units>.00k 9TU �x "Residential A/C requires site plan showing placement of unit. i\dsts\forms\mech-fees.doc 10/11/00 ERIK Osrn+ o 793- 3a'6 8' ►aa� 60 . 17 ' Ips• I 5 C= A L E so' LOT (� Lo+ Main F/ooi FFE N s' 104.0 /5 -- 6gro9e � rrE I o3.0 4 i 29' aV+�► ��e�+' �o�.' V1. 37 � 9S � � o app � 1 lfafcl LOTf'n A �f - / /,/(, 7 S. Iti. L/' UPEL CLEW C.r. ,00 P/q,l .2230 CC LAUREL CDLE-; Gr. s. ro n n .d O S = ro ry G G' 7 G. Q w Ak CD \ J n .r O ro n a O T, T ro