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13714 SW LEAH TERRACE 55. 00 16. 01 r�,, 40. 00 R — L 62. 83 ' N3 PATRICK SCHMITT designer Inc. S • Wild, L CuMfn Horas 0disign Manning&Corwturoo; * 5 128 8W marivid Strew Pwlwd,Oregon 97219 T ERR R_ Tel (503)78"573 41-ritatit.tichon"Otaittoon.com 0 10 20 (Z._-.Z.-nd 0 the" drawq shot ?14v8 Oroceftom owr scoffed dirrentoonis" Cowroctar "I assume saporsbARy (a, alt dimarrsia L 890531' 12 and conditlen Of job. PATRIG9 SCHMIrT, -4 d"9nsr.ww. i 105. 81 1,.:, It DO Plot fold and COMW.t to my �r. tion al, d�mwsions set forth Nerem. SITE FL ,4N NOTE This documffinl is the poopwfy of PATOWN SCHIOTT, d*91,,,per lAc. and Is 10(dthe use only (to and R sposeflf project *4 ,019 bsow. "o ,ou" ar roprooQctiourl 0 Orly form 'I allowed without the OXOrdlis written CCA"At )I PAMICK SCHMJTT. - 46f ,' LEGAL DESCRIPTION desloirer L 91 Lot Daffodil Will .............J) Iloilo 0. 0 16.,,28 30. 53 L— 44. SITE ADDRESS GAU,Leah Terrace Tigard,Oregarl 9122A 13 L 55 Bio aL..rio�_i •� D. 5 --� I - oil / LOT 0-p-'-0VERACzE 4" '_CT AREA - 4 /A x OUILDIN03 AREA - 2,14 1 - 011 (WLUDING EAVES) TOTAL LOT COVSRAAC - 2,11A lairt Q) /,!,,/r,,,/!///' X, X 0, EROSION CONTROL NOTES: (0b lot A40 TW610N CONTROL MANUAL' 1)1111111�11R TO THE CITY Old PORTLAND PON ADOITIONA� DETAILA AND EROSION C40NTPOOL P0013, ill � -R UTW MULCH,6M,GRA",PLASTIC OR /01\� ft 11 X/ 0 21 CC%IkP ALI. 1�)ISTUMED GROUND AREA BETUNEN OCT.I TO : Z, APRIL 3.0. C) OTHER APPRO"ED MATERIALS AS 6PECOHED IN THE I!RO610N 'IXA /X j'/,' CONTROL MANUA,. 00' 111=11MENT BARRIEk Tel IBE INSTALLED PRIOR TO RAPIRW111,1011111111C, CN I �' REMOVE ONLY ARM11111!0111111OUND COVER 16 E67ABLIONIM. or 0 romiiii 41 NO 601L ALLOWED TO 1111111OD2 OR M TRACKED OPP SITE. pi—Lal-p- LEGEND X 00 GRAVEL CONSTRUCTION ENTPtA-,WX - SEE ft DETAIL 41A AT LEFT OR IN THE CITY OF �1te.r� � law. •i=,///, '/%// , I6 747 S. F. PORTLA,40 "EmOaKm CONTROL.mCONTROL. MANUAL' CC '0 ' ' ",/, , ' .1 _�__ I I COVERED STOCKFDIL96 7 S. F. 147 CONIC 0111111"OE ft"p - , /'. "', WOW STAGW.1 MATERIAL &rORA3E AREAS 01%W 7, 28 1 S. F. , . I - lawlsl , 6 CD .0mommo ,0.— z --- =1 -a \\ /or, I KL I I cwaostwraoft WOODEN CURD RAMP - SEE DETAIL AJA AT oe— -41=kOX. 4' �415H LECONFTTROOR MAIN THENUAL'CrrY,,')p PORTLA�ho 'EROSION'EROSIONL R . ESTIS. ROCK WAL -- SETBACK Y, I - 011 WRAP 41`0 PROTECT ALL CATCH Do"#*PER L DETAIL 4JW IN THE CITY OP PORTLAND DETAJL DRAWNeb 4JA -GRAVEL CONSTRUCTION ENTRANCEUIAL 'EROSION CONTROL MANUAL' Date: January 23,2003 r -00-��a SEDIMENT 104JER F&41W AkW La L Plan: site Pian Jr.,WA #Cus afarew ramt W(USWTFftLINE FROM METER TO HOUSE) Job No.: PS-1257-02-remned 80 a 6TO1111M 60JAM LINE - Revision: USE 3' AM LINE PROM LATERAL To HOUSE) at s. -- I is SANITARY GWIR (USE A'Pvc:LINE FRIO!"I LATERAL TO HOUSE) PUSILC UTILITY EASEMENTSheet Title: a WATER to WATR METIER Lot 3 Site 0 P). AWA Go A9AW ANOW Pion Atha now diftefflioll MA S%412JP44%T ly MMWW misc. 7-0 is 1) A 209 ADJUSTMENT TO THE REAR YARD SETBACK HAS BEEN GRANTED + FOR THIS SITE. V Tr_)f =7:� -SEE CASE No. VAR2002-00021 _ - n. ____ Ln 147 of _ _ - rn- R (C. R. OAD UNTAIN S, W. BULL. MO _ _ DETAIL DRAWING 42A TEMPORARY WDIMIM?11111th" N 8601 1 13 1 OCOPYRIGHT2002 PATNICXICHMI17, anignerine. J 1111111 1111111 TT17.1 I-I'VIT _TTr11 IT91111 III Jill 11 -111 [ 1-111 Iill IJill I II1 111-11- 11111-1 1 1NOTICE- IF THE PRINT OR TYPE ON ANY TT P TIII I-1 I 1--i p- il I I 0 , rJ ��! Cow/ IMAGE IS NOT AS CLEAR AS THIS NOTICE, - 21 4 5 6 9 1 1 121 2 IT IS DUE TO THE QUALITY OF THE No.36 ........................ ORIGINAL DOCUMENT 09 1 6 C, )III )III Illi Iiil illi )III Ilii )III )III ILII I�I1 l.11l. 111 11l_ ll�l <<1l lll��llll. III.) Illi )III )III )III )III )III (III )III )III �� Ilii )III �� Lill l illi ill_ 1111 Llil lll� l.l.l.l ISI lli.l � 11ll LIIIP1�11 0 t J CA) V A Cn W m n fD i 13714 SW Leah Terrane CITY OF TIGARD Inspection Line: (503)639-4175 BUILDING MST =,F INSPECTION DIVISION Bushiness Line: (503)639-4171 BUP - Received __-.___-_ Date Requested _____L_��-_ _ AM PM- BUP Location __ / 1.,' --Suite------ MEC Contact Person _ _ -- Ph PLM --- Contractor _______-___ _._ Ph (--) SWR - BUILDING Tenant/Owner __ ELC Footing — - ELC - Foundation Access: Ftg Drain ELR Crawl Drain SIT _— Slab Inspection Notes: Post& Beam - ---- ----- - ----- --- —_ -- - --.. _ Shear Anchois Ext Sheath/Shear - Int Sheath/Shear Framing __._.____------------- ----- -- Insulation �► _ _ _ Grywall Nailing Firewall - Fire Sprinkler - Fire Alarm _ 3usp'd Ceiling �-_...----- - -Roof Other: - -- ------- _.-- - Other: - PASS ART FAIL --- -- L _ B _ ING - ---- Post Under Slab Rough-In Water Service - --- - - - - ------- -- _ - --. -----_— Sanitary Sewer Rain Drains Urains --- ----- -----...----------- Catch Basin/Manhole Storm Drain - ----_ Shower Pan Other: Final PASS PART FAIL MECHANICAL - ---- ----- ---- - - Post&Beam Rough-In Gas Line Smoke Dampers F:---. Maw- ZAPASS ART FAIL —_-_—___----- ----- -----_.--- -- RICAL -- Service �- - -- ------------ ---- Rough-In - UG/Slab Low Voltage - - - - Fire Alarm Final Reospection fee of$______- reouired before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL n SITE Please call for reinspection RE: ___---___- ___- �1 Unable to inspect-no access SITE ------- Fire Supply Line 1�- ADA Date-_` - 716 — inspector ___ ----- text Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MS _ O 0 INSPECTION DIVISION Business Line: (503)639-4171 BUP Received ___� -Da et Requested /?"_A AM-_ PM-- BUP - Location ____ 7 lr�- _____-_- Suite—�3_`�r MEC Contact Person __--- Z'Z-� Ph (_--) CY Z PLM - Contractor- -- - Ph _- SWR UILDIN , — - ELC _ Footing Foundation � � ELC Ft Drain AGCeS$ 9 (�� ELR Crawl Drain - Slab Inspection Notes: SIT -.. Post& Beam Shear Anchors — ---7�-------�— -- ____ - ---- T_- Ext Sheath/Shear Int Sheath/Shear -- Framing __� � 5. � ��. ..�i-c ��;r•,'r - -- - Insulation Drywall Nailing f`y /u s% 'J�i L ATI u L�l� -- -- Firewall .411r:U!C't2- Fire Sprinkler � -� �S`" -- Fire Alarm Susp'd Ceiling ------- ___� Roof final ASS_PA_RT _ -- -- --- — �— PLUMBING ...Post 8 Boam _— Under Slab Rough-In Water Service —--- ----- --------- Sanitary Sewer PainDrains ---------------- —----- ---- -- -- — — ----.— —. Catch Basin/Manhole Storm Drair7 --- Shower Pan Other -- --- --— -- — ---- Final — P 6-"- N1 RT FAIL �IAECAL Rough-In _ — Gas Line Smoke Dampers - -- - -.-.._— ---- - - - -..__ r , A _PART_ FAIL —_—_-- ELECTRICAL ._ - - - ---- ........_..------- Service — Rough-In -- --- —--- --- -- ---- UG/Slab Low Voltage Fire Alarm Final -� Reinspection fee of$ _-__- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE_ Please call for reinspection HE: Unable to inspect-no access Fire Supply Line ADA �D �J 3 Approach/Sidewalk Date�- -_-_--_ - Inspector r _ -- - -- ----- -- - -- Ext _ --- Other: _ Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received ---,----Date Requested_ Z� AM. PM_ BUP Location _.— L7 c� Suite MEC Contact Person Ph(_ _.) 70 3�c3 PLM Contractor--------_______ Ph SWR _- BUILDING Tenant/Owner -_ ELC Footing ELC Foundation Access: ------ Fin r?;ain gCt,V C J� , r ./� - ELR Crawl Drain Slab Inspection Notes: 1" L _ - ( SIT _ Post& Beam Shear Anchors ----- — Ext Sheath/Shear Int Sheath/Shear -- -----_--' Framing --- - --------- - -- ---- - -- Insulation Drywall Nailing -- -- - - ---- -- _ ------- -- - ---- - -- Firewall Fire Sprinkler --- ---- - ----- - ----- --.�� — -- ------- Fire Alarm Susp'd Ceiling — Roof Other: ----- - - ------- — ---_ _ - __.-------- Final PASS RT FAIL -- - - - - -- _------- - ----_ ---- FlL4 ING Post-&-Beam Under Slab _. Rough-In ---_._ --------------- ------------ ____ Water Service - Sanitary Sewer Rain Drains ----------- Catch --- -- _ . . ---------Catch Basin/Manhole Storm Drain -- ----- - ---- - -----..___. Shower Pan ------!'------- OtheL nal 7- PWS / - — F CL[ ✓Z /�C 1 �' 2 i�( E!"� C�� PASS 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 --- �----__--- ------ I-] Reinspection fee of$_ required be'-)re next inspection. Pay at City Hall, 13125 SW Hall Blvd. PAS PART FAIL Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA �n►ll r, , Approach/Sidewalk Date_ _2 ,2FIc 3 Inspector TI- Ext - Other. ----- Fina - DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD _ MASTER PERMIT PERMIT DEVELOPMENT SERVICES DATE IS UED: 1' 3 00039 /27/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 SITE ADDRESS: 13714 SW LEAH TERR PARCEL: 2S109BA-07700 SUBDIVISION: DAFFODIL HILL ZONING: R-7 BLOCK: LOT: 003 JURISDICTION: Ill; REMARKS: New SF detached dwelling. Path 1. 4/27/04, adding d/C unit. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: Zn FIRST: 1.012 of BASEMENT: of LEFT: r, SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: +,042 e1 GARAGE: 614 of FRONT: 29 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD sf RIGHT: 5 VALUE. OCCUPANCY GRP: R3 BDRM. 3 BATH: 3 TOTAL. 2 954 of 2y1 ;Q1 Of) REAR: 15 PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: I RAIN DRAIN. 100 TRAPS: LAVATORIES 11 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 101) SF RAIN DRAINS: I CATCH BASINS. TUBISHOWERS: 3 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS. OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<TOOK. BOILICMP<3HP* 1 VENT FANS: CLOTHES DRYER: I FURN-100K: i UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP. btu FLOOR FURNANCES VENTS 1 WOODSTOVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp 0 2011 aInp WISVC OR FDR. PUMPIIRRIGATION. PER INSPECTION: EA ADD'L 500SF4 201 400 unp. 201 400 amp 1st WIG SVC/FDR. SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amps 401 900 amp EAADDL BR CIR. SIGNALIPANEL: IN PLANT MANU HMSVCIFDR* 601 - 1000 amp 601-amps-1000v MINOR LABEL 1000.arnplvolt PLAN REVIEW 8FC1 ION Reconnect only -4 RES UNITS: SVCIHDRr 225 A.. >600 V NOMINAL. CLS AREAISPC OCC ELECTRICAL-RESTRICTED ENERGY A.SF RESIDENTIAL B,COMMERCIAL AUDIO&STEREO. VACUUM SYSTEM: AUDIO&STEREO FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM OTH: ALL ENCOMP BOILER: HVAC. LAP JSCAPEIIRRIG: PROTECTIVE SIGNL. GARAGE OPENER CLOCK: INSTRUMENTATION. MEDICAL. OTHR: HVAC. DATAJTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,743.59 GOODL.ET/MARSHALL BLDG&DEV GOODLETT/MAP,SHALL BLDG"USE T his permit subject t,State regulations contained in the Tigard Municipal Code, ale of OR. Specialty Codes and P.O.BOX 91551 OTHER all other applicable laws. All work will be done in PORTLAND.OR 97291 PO BOX 91551 accordance with approved plans. This permit will expire if PORTLAND,OR 97291 work is riot started within 180 days of issuance,o,if the work i3 suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted b,l the Phone: 503-768-4573 Phone: 503-297-1881 Oregon Utility Notification Center. Those rules arE set forth in OAR 952-001-00101hrough 952-001-0090, You Reg 0: LIC I(11)882 may obtain copies of these rules x direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8- Post/Beam Mechanica Plumb Top Out Shear Wall Insp Insulation Insp Appr/Sdwlk Insp Sewer Inspection Crawl Drain/Backwater Plumb Top Out Shear Wall Insp Insulation Insp Misc Inspection Fooling Insp Footing/Foundation Dri Electrical Sen ice Exterior Sheathing Insl Insul on Insp Electrical Final Foundal9!341` PLM/Underfloor Electrical Rough In Low Voltage Rail drain Ins Mechanical F' _ Po eam Structural 'Mechanical Insp Framing Insp Gas Line Insp Wa er Linens PI m al Issued By : �j �� Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next si ess day Median -Al Permit Application 1 n C ity of Tigard latuB1 Pl`oe� Pemtitvo 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date'By Other Permit Inspection Line: 503.639.4175 Date Ready/By: 11w" 0 See Page 2 fur Internet: www.ci.tigard.orus No tifted/tvlethod: — _ Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USECHECKLIST ❑ New construction EJ Addillon/alteration!replacement Mechanical permit fees'are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. ------- — -- - Value $ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SY` "EMS FEES" ❑ I•and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Descnption Qty. Ea I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Air conditioning or heat pump o Job die atii3rega: 13 7 l/1 S e, TFC wG(4 (requires site Ian showing placement) 14.OU City/State/ZIP: Furnace 100,000 BTU(ducts/vents) 14.00 Furnace 100,000+BTU ducWvents 17.90 Suite/bldg./apt.no.: Project name` ' ' I Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.0:1 H dronic hot waters stem 14.00 Residential boiler(radiator or h dronic) 14.00 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 10,00 Flue/vent for any of above _ 10.00 Subdivision: Lot no.: Other: 10.00 Tax map/parcel no.: Other fuel appliances Water healer 10.00 Gas fireplace 10.00 Flue vent for water heater of gas ------ - fireplace 10.00 Log lighter as 10.00 Wood/pellet stove 10.00 —--_ -- Wood fireplace/insert 10.00 --- Chimney/liner/flue/vent 10.00 PRUPF,RTY OWNER E' _' I, � ? ,p__,. Other _ 10.00 Name. — a Environmental exhaust and ventilation -- Range hood/other kitchen Address: equipment 10 00 City/Slate/ZIP: Clothes dryer exhaust 10.00 - -- Single-duct exhaust(bathrooms, Phone:( ) Fax:( ) toilet compartments,utility rooms) 6.80 ❑ APPLICANT T ❑ CONTACT PERSON Attic/crawls ace fans 10.00 --- — - — - ---�.- ---- — Other. 10.00 lil:sincss name _-�- Fuel pt in 1—contact name 35.40 for first four;$1.00 for each additional Furnace,etc. Address: Gas heat pump City/State/ZIP Wall/sus ended/unit heater Fax:: Water heater Fax: _ Phone:( 1 ) Firc lace F-mail: Range Barbecue - Clothes dryer(gas) — Business name: Other _ — Address:��y(�, �sj A- o _ MECHANICAL PERMIT FEES* r 9 Subtotal City/State/ZIP: �(/►K ff �L l - Minimum permit fee($72.50) Phone:( ) Fax:( ) _ Plan review(25%of permit fee) CCB lic.: — _ State surcharge(8%of per it fee) --•- TOTAL PERMIT FEE / This permit application expires If a permit is not obtained within IRO Authorized signatur ` days after It has been accepted as complete. Print name•._0—( Vrjj1 •,r ! Date: 2�o ' Fee methodology set by 7n-County Building Industry Service Board i\Buddmg`-PemoWMEC-PermitAppdoc 12/07 440.4617T(II/02/C0M/WEB) Mechanical Permit Applic,-ition -• City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total_Valuation: Permit Fee: $1.00 to$2,000.00 _ Minimum fee$72.50 $2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30 for each additional$100.00 or fraction _ thereof,to aad including$5,000.00. $5,001.00 to$10,000.00 $141.50 for the first$5,000.00 and $1.80 for each additional$100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and $1.35 for each additional$100.00 or fraction thereof,to and including _ $50,000.00. $50,001.00 to$100,000.00 $771.50 for the first$50,000.00 and $1.25 for each additional$100.00 or fraction thereof,to and including _ $100,000.00. $100,000.01 and up $1,396.50 for the first$100,000.00 and $1.10 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i Building\Pcrmits\MEC•PenuitApp doc 12/03 2 cc CITY OF TIGARD SEWERCONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00038 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 1/27/03 SITE ADDRESS; 13714 SW LEAH TERR PARCEL: 2S109BA-07700 SUBDIVISION: DAFFODIL BILL. ZONING: R-7 BLOCK: Lar: 003 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: FEES GOODLET/MARSHALL BLDG t3, DEV Description Date Amount P.O. BOX 9'1551 p PORTLAND, OR 97291 ISWUSA I Swr Connect 1/27/03 $0.00 ISWUSAJSwr Connect 1/27/03 $2,300.00 Phone: 503-768-4573 [SWINSP]Swr Inspect 1/27/03 $0.00 [SWINSP] Swr Inspect 1/27/03 $35.00 Contractor: Total $2,335.00 Phone: Reg#: Required Inspections 1 his Applicant agrees to comply with all the rules and regulations of tna Gi,7an Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions,from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer' Perm A /I Issued by: aztPermittee Signature; Y Jt._� � - - Call (503) 6394175 by 7:00 P.M. for an Inspection needed the nex business day �S<.� t/•'�'..,n � -DODO Builfline Permit Aplieation Received y, Ifndding f -— Date/B : ` '' �✓� 1'ernmiI No./�/`(—/ Ow CityCit of Tigard Planning Approval Other g Date/By. Permit No.: _ 13125 SW Hall Blvd. Plan Review other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Dete/B Internet: www.ci.tigard.or.us Case No. Contact — Ju �,, Sec Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method //�+'" s11llilen!enla1 Information TYPE OF WORK _ REQUIRED DATA: Vr New construction _ _❑_Demolition_ 1 &2 FAMILY DWELLING 'LjAddition/alteration/re lacement ❑ Other: --- -- CATEGORY OF CONSTRUCTION Note: Permit Ices'are based on the total value of the work performed. Indicate 1 &2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, Accessory Building _Multi-Family overhead and profit for the work indicated on this application, _ Master Builder ❑Other: Valuation......................................................� $ AP, `/0/. Ad JOB SiTE INFORMATION and LOCATION No.of bedrooms: .3 No.of baths: 2 I z Job site address: . co /,Cl-all Total number of floors..................................... Suite#: Bld /A t.#: New dwelling area(sq.ft.)..............••............. � , _ Garage/carport area(sq. ft.)...........................• Project Name: Covered porch area(sq.ft.)............................ Cross street/Directions to jo sit1 Deck area(sq. ft.)............................................ — t t�{, r wa 4 b��1 I t�4 1` Other structure area(sq.fl.)............................ — REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: d4f�pdic, N, iu—=nt#: -- Tax map/parcel#: Note: Permit fees'are based on the total value of the work performed. Indicate DESCRIPTION OF WORK — the value(rounded to the nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application. Valuation......................................................... 5 Existing building area(sq.ft.)......................... -- -- ----- New building area(sq.fl.)..................•........... Number of stories........................................... PROPEKTY OWNER _ TENAN'' Type of construction..................................... .. _ Name:— Occupancy group(s): Existing a-'�`z'--- New: Address: _ — -- City/State i 9�1yL—_i_-_--__ - — P ne:�JZiJ Ig Fax: vf:+9 7, 5 NOTICE: All contractors and subcontractors are required to be APPLICANT COfyT'.CT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Usiness Name: G ( y, jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing,the following reason applies: Address: - City/State/Zi —_—C�12y — ----- Phone: ? M, BUILDiNG PERMIT FEES* E-mai I: j >< �' vi i Ia r IlF Please refer to fee schedule. CONTRACTOR — --.--... Business Name: d Fees due upon application............... .............. 9s ,2 ,5-o , Address: S I —- --- -- ---- . Ci!y/State/Zip: ") 41 1 et- ��Z�-I f Amount received............................................. � Phone: ). S1 Fax. J(; �(1-} — - Date received:—/A-,.T ,f CCB Lie. #: - -- Authorized {{ Notice: I Itis permit application expires If a permit Is riot rMained within Signatu e: Date. 1 Y IM darn after it has been accepted as complete. *Fre 11 lodolog; set by 1'ri-fount% liolldinp Industn Service hoard. (Please print name) is\Dsts\Permit Forms\BldgPermitApp.doc 01103 One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: City ofDgard City of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Other. Phone: (503) 639-4171 Fax: (503) 598-1960 THE FOLLOWING ITEMS ARF, REQUIRED FOR I Land use actions completed.Sec jurisdiction criteria for concurrent reviews. _ 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. _ 4 Fire district approval required. 5 Septic system permit or authorization f^-remodel. Existing system capacity _ 6 Sewer permit. _ 7 Water district approval. _ 8 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 location of catch-basin protrction,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 find connections must he incorporated into 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 to scale.The plan must show lot and builuing setback dimensions;property corner elevations(if' there is more than a 44 elevation differential.plan must show contour lines at 2411,intervals):location of casements and driveway;faxnprint of structure(including decks);location of wells/septic systems;utility locations;di-ection indicator:lot arca;building coverage arca;percentage of coverage;imp-vious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location, I I Floor plans.Show all dimensions,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 section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,mor 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,footings and foundation,stairs, fireplace construction, thermal insulation,etc. is Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Fxterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Paull-size sheet addendums showing foundation elevations with cross references are acceptable. 16 'Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-presctiptive 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 bearing locations.Show attic ventilation. 18 Basement and retaining walls.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 design values for all bearns and multiple joists over 10 f+ct 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 provided,(i.e..shear wall,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall he shown to he applicable to the project under review. MIN 11 LN 11 to I Lima W W"Au 23 Five(5)site plans are required for Item 1 I above. Site plans must he 8-1/2" x I I"ur 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. "Mirrored"building plans will he not accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Developrnen, Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List. Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink Red ink is reserved for department use only. 440-4614 WWII(otiu MechanicalPerm1tAppitcatiion 0-7 p«m►tnol4p _ natErecelvod: Btrpire A city of Tigard ProjocthpPt.no J— OR 97223 By: Receipt no.: Address: 13125 SW Hall Blvd,'figard Datalsatred: _ yofTtgard phone: (503) 639-4171 PaymenttYPe:--- - _-__-- Case rile no.: _ Pax:(503)598-1960 Buildingpermittro.: Land use approval: ❑Multi-family � L)Tenant improvement dwelling or accessory O rn CometoiaUindustrial _�---- - 1 A 2 family B p Addition/alterationlreplacement pi Other 4'New constriction Indicate equipment quantities in bones below.Indicate he dollar t ru ment,labor,overttead, Job'yaddress: value of all me haruCal materials,eq -1 $WtE n0..�__ ___—.jjj .OflL Value$Bldg.no: -- Tax rttapltax Int/account no.: _--- --- +;;ee checklist for important application ir,`ormation an Subdivision: rui�diction,s fee schedule for residential Pemrit fce.oL y Block!_ ___ _Prr�ject nme QCock: rJ �- _� �Citylcounty: �(�� T_ Z[P: 7 Fee(ea.) Tow Description and location of work on premises: U_J 5�- Res-01111 Res.only _ letion/'inspection: p�date of a_►mp _ - Air hsadlin unit , -- Tenant improvunent of change of use: s to m regtrtr _ y" ❑No con t o n6� Is existing space heated or y°nditionedT Q to- o ex shn s stem 8 -is existing existing space insulated''O Yes ❑No i er compressors State briler pern»t no.: B N� tip -_Tons 7Address: P-0-80k. _ . __ _ uet smote etector"name__-2r,( ( - Tr ctra e__�r>.f30 2'� 1 ---r•--------- __- eatpurnp stle pan r'equ--_L-State:p ZIP:-`17.0/3 _. � aiiTreParn�� eail: Including ductwor`/vent lincr O ye:C3Noy , Gb�� _ nstat rep a rc ovate cater: l n-/oo 8 rP- - - w�or�>wuRtcd Um ro lit.no` /3en ar1 print): Go BTU/" -- Absorrtion units- HP Chillers ------- tip None: 1 f(i1Cal. �7 Com aers er-taeTaa veal at oW - ► p t1 1 -A — Adtlte8 / State:a ZIP. °� d - Appliance vent ---- City��b Dryer ust - Phone: YPe�rea. richadharma -- hood fire suppression syatetn Exhaust tan with single duct(bath fans) --- N_ame: C��JL�_ _LSF_-- Pz gust systems art 1 m hes-��n outlets) Jl�N t e.- -Zf' - - _in To up to A outlets)- __ rel p P`� o NO Oil Mailing address: -_U _bc' 7_IP: `��'t' i - --� -- - State:C�_ r - yr �-- uerc'' icrego)t�_-._ - City� � Number :- A Of Name: _ --- ---- - ---- -- DecorativPF Ice. _ Addres '- State: _ ZIP' �tov..pefTetato_vo -- Cit -------- ------ -_ ---- Y _-- -- &trail ----- Phone: Applicant's signature: $ Name( tiPrnt): r'�Clt SC 1 r t _----- Permit fee........ --- - -- -- --lnr mw„braertloa. it a lication S cie�t wds pkare caa JtlOO r oboe:This perm PP Minimum fee................ -- - NM aa)a 7°a a e,Pies if a permit is not obtained Plan review(at _%) s ------ t]Visa t7 AlastuCerd within ISO days after it has been State InyrchaW(8%).... ------ m accepted as complete. TOTAL......................-$ o atnor.ort a'eau c� 4"17%M C DM • Building Fixtures _Z)Vo 32 Plumbing Permit Application L�� Of Tigard Due received: permit nor p Y ft's sewer permit no,r Building p no.. Address: 13125 SW Hell Blvd,Tigw-d,Olt 97.2') City of71go►d phone: (503) 639.4171 Pr lect' I �oExpire dat�a:� Fax' (503) 598-1.960 Date ijousd: By` Land use approval' Case rileno. Payment type X1 &2 family dwelling or accessory O Commercial.'industrial ❑Muld-family a Teonrtt improvement � A New eonstru:tion ❑AdditionlalteralioiVreplacement Food service Q Olher: Job address; an Description1 ! .11700 W-) TOtal ,We- no.; an • y we Clea 0 l rri _ Jlldto. _ (includes 100 ft.for each utility connection) t Sr K(1.i bath Lat;_ 5 _ 17j1ock: Subdivision: - R t2) bath ~Pra)eci name: V F("otett. ,\iU _ ,IR(3)barn City!county• cz I ZIP.�'�Z� 4 - �� `:acad addtt,o_ rt'Wieth/ Ic Nens i Descr►ption at , 'ocnnon of work on premises; - N2V,) Sitectilitiet:_..� i Cguh bn►ln/areft drain - Dr7wellt^�/letioh lineltrenc r+l tai-�I y�- _��_ Pst.dsto of com letionlinspection: Footin ±-- Ofe li(no. lin. � .• Manufactuted home utililias Business name: ��IAAOQ�IYL�-►1�— -- _ �tanliol�i �.....�.._.,..1. ; Address , r _ Rein dli�ti connector .. _ le _ _ _ f,lty, � Strata: Zfp- Snntta-suwcr(nom. Phone: Fax o2 t`0 E•tnntl: _ Storm sewtr no. CG>5 un.: plumb. u� reg_no - 3_.!.L W.uer server tt no.lin.ft.) An Fixture or lttirniCltytmevo lie.nr>.: � Abse tion valveCI onuectui'sre tesentAtive siture; ?`�/'' T`1_� act: Clow ievent:r I _ _ Date Print name: Clothes washer Dtshwtis c: rAddress rjil(p �jW r~•a Lt D�� - - -- — Drinkiri�.ovn ._�_ __ 4 __ -__.__ _ I-_.__ Stose:G� zIP ��1,5_.. . 6jcet<itiiump Thong '7't Fac; Ftxtuic%st vet cap Floor diairerlloor sinksfhub 1-----�� Name(print}: 1'^u I+OK. � --.-- - _ _w.. 1 -. - :�rrbage di9�l nitultng add PQ�S - --- - -How brbb ice mal 'i Phone. 1 - AQ Kms'207-1 U 5 0 I •mail: � lntercepio'r/gretss rr�—_�� ,.,_ i Ovmcr instal laUott/r*0d0t1'!al trulntarlenca only: '!'6t: &cruel installatlun primer !!1 be mntle try the or the rnaintanance and repair trade by my regular Roo1'�raa►�cununerc:r►t Crrpinyr.e nn the p:opeNy I own ae per UltS Chapter M7 Sln_k n)�ns�n s), ova e� _ l)WTtlt S StgOanlrC. Date: Sump — TubslaTtow�Nshosiet pan „ Uritiol --r} Name'' Addrctt' _ _._. _. Water hcntcr state' - Z1P Other- Ali: otal _ ra .,,•,....r._..,...-.---- Minimum fee................$ _._..-•----•- �i�Mili;w�ei:Uwr.wr•,Atte.t&.v1•watu;v';aiedonMm+re�ennaue^ Nodce 71r1s pennit appliwtkn ) 8 alta Platt rCvlCw(at,__ U VlW a Muter:ud oxnirrs if a pnrtut is net obtained o S rvitldn Ito.Ityr after it has leen Sate surehaAe(9/e). _ acoeptec' at coMplero. TOTAL........................S ---- ---- `- n,mt of c•d�ie n N.heWC ne GtAlt� Electrical Permit Application -' Didereoeived: PenTw o�,. lj�a -►(,�10 Cityof Tigard Project/appl.no.: Explmdate: - - Cigyo(Tigord Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: ----- - - By: t`Reeeiptno.. Phone: ;503) 639-4171 ---- -- Fax: (.503) 598-1960 Case file no.: Payment type: Land use approval: _-- ------- -.. _-- _-- 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement ANew construction U Addition/aiieratlort/replacement U Other: U Partial 1 Job address: ? (p 77 P, _TGI Bldg.no.: Suite no,: Tax mapux kx/aocottnt no.: Block: Subdivision: 10 F7vOIi, — Project name: _ _ Description and location of work on premises: `Q f;(A) T✓stim ited date of completiow inspeetion: c^ , 1 Job mo: _ Flee MEN Business name: p� eSl L. e-Orr' - ( (ea.) Total no. Insp WwroddendellAddress S;.JD,+I�z ouN►6+db per _ _ wellrsgait.lndsdee+noettedprwg� City: " � t v!r 7ei`irt/ State:G'i IZIP,. 4170(),; savicektctiMetk Fax:( 1i� / &mail. loal.q.ft.orless - -- — 4--- Eadi additiomal 500 IL or portion thereof (CB no.: p ©ec,bus.lic.nd: 1 y- Limited encsgy,rnideatial _ z City/metra lc.no.: (01I-075� Urnitcdenergy,narrrrsidatdol 2 ,; s Each manufacouai hone or modular dwelling Sit lure of supervising electrician(required) Date Service emVor feedu _ 2 Sup.elect name(print):/ :uw T+e' Voemero: ) y-�,) �rvlcesorfeeden-Installatioe,- aNention or relocation: WMIUMNSIE11 Rim 200 naps or lea 2 Name(print). ?O � 201 amps to 400 arty - --- 2401 to 600 amps - Mailing addr m FC) ��`_ 6�1551 not amps amps It100amps__----------._._— 2 -�-1 _ -- -— r Over 1000 amps or volts — 2 — ('icy: �n.� _ State��1L ZIP: ) jp &waiL Recormectonly ----"--- I Owner installation:The installation is being made on property I own Temporary services orfeeders- which is not intended for sale,lease,rent,or exchange ac m.ding to inArdlatlaa,alleewtMta,orrelontbrn ORS 447,455,479,670,701. 200 amps or les` -- 2 201 amps to 400 amps2 Ownet"s signature: ])rite t 401 to 600 amps 2 Dry d coks-sew,alteratlos, or exteadon per pntek Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 _ -- ---- --- --- _— --- —-- - : y ---- Cit Stare: ZIP: - B. rroe for branch circults without purchase - -- -_ Phone: --- -A Fax: E-mail: orservice nrfeeder ree firubnncirdrealt: - 2 l sch additional branch circuit -- Mlsc.(Serdce erfeederoot lacludedir - LiSarvice over 225ampa-commercial UHealth-camfacility Fxh►wm�orlrrigadoncird_e __.� — 2-- U Service over 320 amps-muing of 1812 U Hazardous lavation Each sign or outline fighting _ M _ 2 family dwellings CI Building over 10,000 square fru four or Signal eircuit(s)or a limited energy panel, U System over 600 volts nominal more residentinl units in one strutinre alteratkmL orextensions — 2 U Building over three stories U Reders.400 amts or tare rr130wri ._ _ U Occupant load over 99 persons U Manoftietured structures or RV park Far!aiiflowd IrspWice over the allowaHa lla nny etf cite atom Ui°s� eressfilghtingplao U Oche --_.._-- _-- For on o__ gnbok_�.. sets of Flan+with any of the above. loveatlgation fee -The above are got trtpplicable to lImporm comtraction service. Other Permit - - - �- _._.. -- _ - Permit fee............. S Nd ONJomiadiddaaa atse1 creat camp,please call)trlsdkdan for rears iaru..doe Notice:7T»s permit application ... -- U visa U Mastercard expires if a permit is nut obtained Plan review(at — %) $ within 180 days after it has been State surcharge(8%)....$ R�wi or cinE_olI INa r�owe an aedu card_— accepted as complete. 'MTAL .......................$ _..---- S — - --" - Amount 4/04615(61110IMM) CITY OF TI GARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: P 24/03 00505 DATE ISSUED: 9/24103 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PArT^,EL: 2S1096A-07700 SITE ADDRESS: 13714 SW LEAH TERR ZONING: R-7 SUBDIVISION: DAFFODIL HILL JURISDICTION: TIG BLOCK: LOT. 003 — CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PRETRAPS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES-. OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install irrigation backflcw preventer. FEES Owner: Description Date Amount GOODLET/MARSHALL BLDG & DEV 11'I.t111111 11crmit Fcc 9/24/03 $36.25 P.O. BOX 91551 1 FA I x"„State]ati 9/24/03 $2.90 FOR i LAND, OR 97291 _. Total $39.15 Phone : 503-768-1573 Contractor: CATANDELLA IRRIGATION + BACKFLOW 5334 SE DEL RIO CT REQUIRED INSPECTIONS HILLSBORO, OR 97123 — RP/Backflow Preventer Phone : 356-9022 Final Inspection Reg#: MET 5351 LIC 1 11498 PLM 70„ This permit is issued subject to the regulations contained in the Tigard. Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done In accordance with approved plant. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 160 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: Permittee Signature: ,rte Call (503) 639-4'75 by 7:00 P.M. for an Inspection needed the nett business day Building Fixtures Plumbing Permit Application Received Plumbing Datc;B : �_19 Permit No,�1 !I1'C)dA City O}'Tigard RECEIVED Planning Appro al Scµer Date/B Permit No 13125 SW Hall Blvd. Plan Review other Tigard,Oregon 97223 >� E t l Date/By Permit No. Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land I Ise Internet! www.ci.tigard.or.tlg;;, Date/'By Case No. Contact -- Juris Sec Page 2 for• 24-hour Inspection Reques (¢p �639-4175 Name/Method: Supplemental Information. _TYPE OF WORK FEE*SCHEDULE(forspecial Information use checklist Ne",construction 1 7 Demolition Description I Qty. I Fec(c_a.) Total Add iIfon/alteration/replacement Other: New 1-&2-family dwellings CATEGORY OF CONSTRUCTION Includes 100 n.for each u lifity connection SFR(1)bath 249.20 1 & 2-Family dwelling Commercial/industrial _SFR(2)bath 350.00EAccesso� Building _ j _M_ulti Family SFR (3)bath 39900 ❑ Master Builder _ Other: Each additional bath/kitchen 45.00 JOB SITE INFORIVAT[ON and LOCATION_—_ Firesprinkler-sq. ft.: Page 2 Job site address: 1,3. 4 `)w r Site Utilities Suite #: Bld ./A t.#: i v Catch basin%area drain 1660 Pr_o eJ ct Name: Ll«Y', l �4 •1i Drywell/leach line/trench drain !6.60 Cross street/Directions to jab site: Footing drain(no. linear fl.) Pae 2 Manufactured home utilities _ I I0,00 Manholes 16.60 R"in dram connector _ 16,60 Sanitary sewer Ino, linear ft I Pae 2 Subdivision: Lot#: Storm sewer(no. linear Il ) - Page 2 Tax map/parcel #: J Water scrice(no linear ft ) - Pae 2 DESCRIPTION OF WORK Fixture or Item --1 Absorption valve _ 161.60 Ba- 'ow preventer `K Pae 2 Backwater valve 16.60 - - Clothesµ sher 16.60 Dishwasher _ 16.60 Drinking fountain 16.60 PROPERTY OWNER ICITENANT E cctors/sum 16.60 _NdI11e: t' _ Expansion tank — 16.60 Address: _ _ Fixture/sewer ca 16.60 City/State/Zip: Floor drain/floor sink.'hub 16.60 - - Phone: Fax: Garbage disposal 16.60 _ APPLICANT Hose bib 16.60 CONTACT PERSON — -- Ice maker _16.6' _ Name: y- ' fi!c(t Intcrceptovgrcasc trap _ 16.60 Address: 5 j f Q1.c, < Medical gas-value: $ _ Page 2 --- Cit /State/Zi : -, _Primer — 16.60 U Q_ Z� i Roofdrain(commercial) 16,60 Phone: 4, Fax: Sink basin/lavatory I6.611 E-mail: Tub,'showcr'showcr pan 16.60 CONTRACTOR Urinal 16.60 Business Name: ;1 v1�_� Water closet 16.60 _ Water heater 16.60 Address: _ other —-City/State/Zip: _ Jther. — Phone: Fax: Plumbing Permit Fees* CCB Lic. MO. LicA 1` 1E) 'MSubtotal 5 S inimum $72Pcrrnit Fee$72 50 5 Authorized Residenoal Backflow Minimum Fee$36 25 9/2-L1403 1 Plan Revieµ (25","of Permit Fee) 5 1��( ��✓ car �.J`\r� Stair Surcharge I&"a of Permit Feer 5 41 J iP ease print name) TOTAL PERMIT FEE I $ L� Nonce: 1 his permit application expires if a permit is not obtained miihin All new commercial buildings require 2 sets of plans with isometric or 140 rias s after it has been accepted as complete, riser diaRram for plan resiew. 'Fee methodology set I:k Tri-C•ounti Building Industry Service Board. i Dsts Permit FonmsTlmPermitApp.doc 01 n Plumbing Permit Application -City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Sestet.s: SPO Utilities Qty. Fee(to) Total Square Footage: Permit Fee: Footing drain-1" 100' 55.00 0 to 2,000 $11500 Footing drain•each additional l(V 46.40 2,001 to 3,600 $16000 3,601 to 7,200 $220,00_ Sewer- I st 100' 55.00 7,201 and greater�—— $309.00 Sewer-each additional 100' 4140 Water Servr:e. Ist IM' 55,00 Medical Gas Systems: Water Service-each additional 100' 46.40 Valuation: Permit Fee: _ Storm&Rain Drain- Ist 1011' 55.00 $1,00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 4640 $5,001 00 to$10,000.00 $72.50 for the.first$5,000.00 and$1.52 for each additional$100.00 or"radion thereof,to and Fixture or Item Qty. Fee(ea) Total includin $Io,000 00 Commercial[Jack Flow Prevention Device 4640 $10,001.00 to$25,000.00 $141.50 for the first$10,()()0 00 and$1.54 Ibr Residential Backilow Prevention Device each additional$100 00 or fraction thereof,to (minimum permit fe 25 27 SS and including$25,00.00. Rain Drain,single faint y elling 0 35 $25,001.00 to S5009) 10 $379 50 for the first$25.000.00 and$1.45 for Inspection of existing plumbing or each additional$100.00 or fraction thereof,to and including$50,000.00. specially requested mspecbons•per hour '= ;n $50,001.00 and up $742.00 for the first$50,000.00 and$1 20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures" if "yes",please indicate work performed by fixture. failure to accurately report fixtures could result in increased sewer fees*. uent ty b Fixture Mork Performed Continents regarding fixture work: Fixture Type: Replace New Moved Existing Capped --------- --- Le tisu Font _ Bath -Tub/Showei -Jacuzzi/Whirlpool _ — ---- -- — ('or Wash -Each Stall - -Drive Thru i ---- --- ._— C us idor Water Aspirator -- -- — --- — — Dishwasher -Commercial -Domestic -- -- ----- ------ Drinking Fountain — — — --- E e Wash Floor Drain sink .2" 3" -- — — — 4" Car Wash Drain *Note: If the fixture work under this permit results in an Garbage -Domestic Disposal -Commercial — increase of sewer EDUs, a sewer permit will he issued an,] -Industnal - fees assessed for the sewer increase must he paid before the Ice Mach.Refrig.Drains _ plumbing permit can be issued. Oil Separator Gas Station) _ Rec Vehicle Dump Station Showcr -Gang -Stall Sink -Barl,.avalory -Bradley -Commercial -Service Swimming Pool Filter Washer.Clothes Water Extractor water Closet-Toilet Urinal Other Fixtures i:\Dsts\Perrnit Forrns\PlmPermitAppPg2 doc 01 03 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received . — Date "Request d— "� �'� _ AM—_ PM-_ BUP Location _ �_�.__��l �re!L'L —Suite MEC Contact Person _____w��p� — Ph ( � AebPLM 5 —_G?6 S7�ti_ Contractor _ Ph (_ ) — _— SWR _ _BUILDING Tenant/Owner _ -- ELC Footing Foundation ELC Access: Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam ----------- Shear Anchors Ext Sheath/Shear r Int Sheath/Shear Framing ---------- Insulation Drywall Nailing - --- -- --- - Firewall i Fire Sprinkler - - -t- - - - Fire Alarm Susp'd Ceiling - - — Roof Other ------- - --- - - - Final PASS PART FAIL --��--- --- - _-J� Post&Beam -____-- --`---- - -- - �-- - Under Slab —_-- Rough-In Water Service Sanitary Sewer Rain Drains -- - - -- ----- T-. - -- — Catch Basin/Manhole Storm Drain Shower Pan LOther: -- fix 'PA PART_ FAIL CHANICAL Post&Beam Rough-In -_-- Gas Line Smoke Dampers --_-.__._ --_- --_--- ---_- --_-- Final PASS PART FAIL ELECTRICAL Service --- - ------:___..._.___-__._----- ------ -- -- ---- --___-__ Rough-In - - - ------ - - - - -- -- - UG/Slab Low Voltage Fire Alarm --- -------- Final FJ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE -- _-_ �- Please call for reinspection RE:__ _- --_--_.._— [� Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date . Inspector -_—_ _---___-- —_-_ Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspectioil Line: (503)639-4175 U o G INErIEC'TION DIVISION Business Line: (503)639-4171 MST . ____ [� BUP —_ Received _— Date R nestedT AM�__�_ PM _ BUP Location _____L_3� _ —l_��suite—_� MEC _ Contact Person `-'YY�. Ph(_ _1 �d!182 PLM Contractor —_— —__—..__._ _.. Ph (_____) SWR BUILDING Tenant/Owner ELC — Footing Foundation �- ELC —_- Access: Fig Drain ELR Crawl Drain Slab Inspnction Note,,;: SIT —_ Post R Beam Shear Anchors -- - - ----- Ext Sheath/Shear Int Sheath/Shear --___-_—_- Framing Insulation - -- _- Drywall Nailing - - - ----- -- --- ----- -- Firewall Fire Sprinkler - --- -- ----- Fire Alarm Susp'd Ceiling - - ------ -- Roof Other. ------------ - - Final PART FAIL -------- ---------- ------- -- __ UMBI _ ---------- __ _ _— Post eam Under Slab —---- - - ------ - -- — Rouah-In Water Service -- -- Sanitary Sewer Rain Drains ------ - - - --- - --- Ca'.ch Basin W1dnhnle Storm Drain ---- -- - - -- ---- -- Shower pan Other: --------c1r — -- — ---------------------- AS PART FAIL -- - -- -- -- ---- --�- �—__-- MECHANICAL -- Post& Beam Rough-In - --- -- ----------- - - -- -- Gas Line Smoke Dampers - -- ------ - Final PASS PART FAIL - ECTRICA - --- --- -- --- Se ice Rou -In UG/SI b Low V ge�� F lar - - F al� r � Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS P T FAIL SITE _ Please call for reinspection RE:_ __- -- n_ Unable to inspect-no access Fire Supply Line - ADA ^1 Approach/Sidewalk Date— O - Inspector ' " Ext Other: Find DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL i e o, 3 O L2 0 r � o CL o u XT •v Q c a� ry C C > O � v U � i. Q. CEJ v. o d Cy E y �^ t C v b C O ` a O D � �