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Permit (166) CITY OF TIGARD MASTER PERMIT �- /A ' I ' COMMUNITY DEVELOPMENT 111111 Permit#: MST2018-00199 T i 6 A R f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2018 �►/ Parcel: 2S104AC16100 Jurisdiction: Tigard Site address: 12839 SW 132ND AVE Subdivision: 2018-026 PARTITION PLAT Lot: 3 Project: Csokas Partition, Lot 3 Project Description: New SF. 9/18/19: REPRINT to add A/C. A/C unit must meet manufacturers placement requirements. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1516 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1855 sf Garage: 573 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3371 sf Value: $428,452.95 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 6 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-t 000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3371 Owner: Contractor: HT REMODELING&DESIGN LLC HT REMODELING&DESIGN LLC Required Items and Reports(Conditions) 24271 ROCK Ra 212719W ROCK RD _ EOM CAM 5O3.639-4i75 ALOHA,OR 97003 BEAVERTON,OR 97003 PHONE: 503-887-8247 PHONE: 503-887-8247 FAX: Total Fees: $37,420.85 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 52-001-0090. Y., may obtain a copy of the rul -or direct questions to OUNC by calling 503.232.1.800.332.2344. Issued By: ,(4. P, Permittee Signature: Lt j/ .. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application , .. , . FOR OFFICE USE ONLY Received City of Tigard i a 0 13125 SW Hall Blvd.,Tigard,OR 97223 14 ,, , ,, ,.;,,„ Plan Review ieNN. .. I i'l 411141)g)StS7d1-4/94:11/e /C?C, Phone: 503.718.2439 Fax: 503.598.1960 . ' ' Date/By: Other Permit: Inspection Line: 503.639.4175 TIGARD , - rate Ready/By: lutist Id See Page 2 for . - Internet: www.tigard-or.gov Notified/Method. Supplemental Information ,,:. ,,,4ye*-,.(04OkK,,,„'. ,,,- ,:',,. 4,:, .,-,,,'., 4V78.i ,, .: ,...',"10.10414 !:' 1-ti, ",:!i Pr,,,. .j3S ei.kl•• P:IT Mechanical permit fees*are based on the value of the work I . New construction 0 Addition/alteration/replacement 1,20‘,..'./, performed.Indicate the value(rounded to the nearest dollar)of all .. ... 0 Demolition 0 Other: mechanical materials,equipment.labor,overhead,and profit. *e.' ' -,4‘ . , Value:$ cATEGQVYF rONSTRVE7110N: 1-and 2-family dwelling 0 Commercial/industrial 0 Access . building For special Information use checklist El Multi-family 0 Master builder 0 Other: Description Qty. Fa, Total "-'40te,'Ispit.17t1E9g4 i0b‘At4D 1..0eit$11010;-, ,Ii: .III'- ,..: ":1:- ,' I Heating/cooling: Air conditioning _ 46.75 Job site address: 414S ' 50 ‘31,/'• kiti- "" Furnace 100,000 BTU(ducts/vents) 46.75 i 04 A City/State/ZIP: t I.! e : it V IN,* ..-127 Furnace W0,000+BTU(ducts/veins) 54.91 . : Suite/bldg./apt.no.. -4, ." ' *I' IMIIMMILP.' " .!4: Heat pump Duct work , , 61.06 23.32 f -. , Cross street/directions to job site: :... , I lydronic hot water system 23.32 ............ Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric). in-wall,in-duct,suspended,etc. 46.75 Flue/vent Iiir any of above 23.32 Other: 23.32 — Subdivision: Lot no.:3 Gther.fuel appliances: Tax map/parcel no.: Water heater 23.32 " .,1..--.. io ' ,est.' - --' (las fireplace/insert 3139 1tt-''90,7 OF..WORK -1,..- : ;`,I"',: -Ie- ',I'' -I! -' - ' Ai' Flue vent for water heater or gas 4 i : .2.0tig—two xft fireplace 23.32 Log lighter(gas) 23.32 - — Wood/pellet stove 33.39 Wood fireplace/insert ,. 23.32 „.......... Chimney/liner/flue/vent 23.32 IIOther: 23.32 ito-iiir ;oe41I4Tli4i Environmental exhaust and ventilation: Name: Range hood/other kitchen - ' equipment _ 33.39 Address: Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms, City/State/ZIP: — toilet compartments,utility rooms) . 23.32 / Atticierawlspace fans 23.32 Phone:( Fax ( _Other 23.32 # I Business name: 1-- # , •4 N- . "14* Ww-'NNOse ) (,L C Fuel piping: $14.15 for first four;$4.03 for each additional 1.- i . Contact name: Furnace,etc. Address: 2 x--4-.,.... .5‘,,,i K....,..x., Gas heat pump „ .. - Wallisuipended/unit heater City/State/ZIP: 0(z, 5 03 Water heater Phone. '( Q,3—U - l a ..,:. 1,4 A.--—Talk::( 1 Fauvist= E-mail: k C4e 1,44c5 () etv\ IL • Grl Barbecue ' ' ,: ' • 7.:, '',','- „:: ' - 'I',., eitii.,*ikeikc:,,,,..-: --,,,,,,,, ,, ,,,, , .-6-, ,,,,,- ,,,,,, ,,,,, -7,. , ,,,, Clothes dryer(gas) Other: Business name: _ ''''''' ''' '," 'Ivi'lit04eiii,-iiiEi.**:...::4441,: Address: Subtotal ---- Minimum permit fee($90.00) (ity/StatelZIP: — ___....— Plan review(25%of permit fee) ...... Phone:( ) Fax:( ) State surcharge(12%of permit fee)_ TOTAL PERMIT FEE ('('13 lie.: . This permit application expires if a permit is not obtained within ISO ---- days atter it has been accepted as complete. — I Authorized signatut . 1 .0 , _ Fee methodology set by id-County Building Industry Service Board - ' CI I Print name: t , , Date: a ,i le t , I mundmgMertnits\SIFC_PennitApp 0 .113 doe %A el D t. CS 0 v,,,,t,5 440-4517T I 1 1 121COMAVER) 1 ' CITY OF TIGARD MASTER PERMIT I. COMMUNITY DEVELOPMENT Permit#: MST2018-00199 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2018 T[ � � 9 Parcel: 2S104AC16100 Jurisdiction: Tigard Site address: 12839 SW 132ND AVE Subdivision: 2018-026 PARTITION PLAT Lot: 3 Project: Csokas Partition, Lot 3 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1516 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 1855 sf Garage: 573 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: 3371 sf Value: $428,452.95 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100 Drains: 0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 6 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: NEW SF VB R-3 3371 Owner: Contractor: 1 HT REMODELING&DESIGN LLC HT REMODELING&DESIGN LLC Required Items and Reports(Conditions) 1 21271 ROCK RD 21271 SW ROCK RD 1 Ersn Cntrl 503-639-4175 ALOHA,OR 97003 BEAVERTON,OR 97003 PHONE: 503-887-8247 PHONE: 503-887-8247 FAX: Total Fees: $37,323.49 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are se forth n AR 952-001-0010 through OAR 952-001-0090. You - •stain a •.• • • es or direct questions to OUNC by calling 503.232.1987 or . 0. 32.2344. s011r Issued By: .i,, — ...4111 %-;,�w _ Permittee Signature: t.,',i,.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 1 1 Building Permit Application Residential FOR OFFICE USE ONLY Received �,,.. � v City of Tigard -# 1�i PernvC�M /1/�y Ill � .4 ,1,." �,� Date/By: 7 �3' �� v v VV ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I g / C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: / I I vis A-A- Other Pe iO -ooly-`I TIGARD Inspection Line: 503.639.4175 J U L 3 2018 Date Ready/By: 7nris: H See Page 2 for Internet: www.tigard-or.gov t D < led/Method: i 44 /71/ Supplemental Information TYPE OF 6 `% REQ RED DATA:1-AND 2-FAMILY DWELLING BeNew construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the i CATEGORY OF CONSTRUCTION - work indicated on this application. dwellingValuation: $ 1-and 2-family ❑Commercial/industrial 7 ❑Accessory building [1]Multi-family Number of bedrooms: `!Af f if_52•75 ❑Master builder El Other: Number of bathrooms: 3 JOB SITE INFORMATION'AND LOCATION.- Total number of floors: a 3 cl 4 y Job site address: 12 b 3c 5\ 132 r AVz w' ''�` Ne Aea: square feet City/State/ZIP: 'T. J e2;ci C.3" Garage/carport area: 5 7 3 square feet t S l Suite/bldg./apt.no.: Project n a 5c.cr 4 PIcr .1 z 2 3c,co.. Covered porch area: 7L-/— square feet Cross street/directions to job site: / V2')--4- Deck area: square feet w Wz(4�tr.f S r...4.++ /5 k / 3 2 n`� V cA Other structure area: square feet /// REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision:5O K A Pa..-"fi:"'r;ors 1 Lot no.: "- Permit fees*are based on the value of the work performed. parcel.67.19-.5 y 0 Indicate the value(rounded to the nearest dollar)of all Tax map A i 5 E C -ra K 4v f- equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. r, , r /�G . ' ✓ ; . 4 ,r- ,r.'/ Valuation: $ i N�x``r'R '/060' f . j '!) J C-` Af`l e r: Existing building area: square feet AYNew building area: square feet 211 PROPERTY OWNER 0 TENANT ' Number of stories: Name: we, 2g.DDc.,44 ... yt4..1t Lt.L CLCIAr I 6S Type of construction: Address: itzii 54., Ret.te eh. Occupancy groups: City/State/ZIP: Ac.c,p4A. I DK 41603 Existing: Phone:(6o3) gel $z.N7 Fax:( )/ 144 New: d"APPLICANT I 'CONTACT PERSON 'BUILDING PERMIT FEES* Business name: / A (Please refer to fee schedule): kr R6 i1Di+x.„.4 1Z ES i 6r► i�G' Structural plan review fee(or deposit): Contact name: •'(:G_Cts t TYG 4+ Sca lire, �� J FLS plan review fee(if applicable): Address: ' z.-il 5 til ?oeK RD. Total fees due upon application: City/State/ZIP: �WNN ' m� 41coI ( 60.3 `s 7 -s l y Amount received: Phone:( -t �aK E-mail: t" 5+o" —r :� CA 5-ro t y‘ PHOTOVOLTAIC SOLAR PANEL;SYSTEM FEES* . ,rresidential prescriptive installation of �, Commercial and CONTRACTOR. roof-top mounted Photo Voltaic Solar Panel System. Business name: [ A Submit two(2)sets of roof plan with connection details *OVA Ai v bEs(lAi i and fire department access,along with the 2010 Oregon Address: 7_ 11 Skil toc4/ Solar Installation Specialty Code checklist. Permit Fee(includes plan review City/State/ZIP: ALOHA Om. q.)0a 3 $180.00 4 and administrative fees): 'hone:(50s) g 97_43 2.,,t I Fax:( ) State surcharge(12%of permit fee): $21.60 CB lic.: (Qqi 63 Total fee due upon application: $201.60 thorized signature: eAtijit'' ..._72 6.03 ' 514.^7 --C1 ! l This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. name: /;�-r�vvv s c,in j/ Date: �-�oh g *Fee methodology set by Tri-County Building Industry �J Service Board. ding\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY Received City of Tigard Date/By: Permit No.: v 13125 SW Hal1 B1vd.,Tigard,OR 97223 I,i+I"") .lan Review Phone: 503.718.2439 Fax: 503.598.1960 'i C,,,, �. ) hate/By: Other Permit: T I GA R D Inspection Line: 503.639.4175 Date Ready/By: lurts: H See Page 2 for Internet: www.tigard-or.gov J LJ! 3 O 018 Notified/Method: Supplemental Information ' TYPE OF WO Y'' -* 1 AR ` - COMMERCIAL-FEE*SCHEDULE _USE CHECKLIST Jit,fl9 N( fi !O s i Mechanical permit fees*are based on the value of the work [ New construction ❑Addition/alteration/replacement' performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit. . Value:$ CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES* �1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND_ LOCATION : Heating/cooling: Air conditioning 46.75 • Job site address: Furnace 100,000 BTU(ducts/vents) ( 46.75 City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 y Residential boiler(radiator or cj ‘414.1t t) -{`" 3 1;-C e+ 5kA, i j 2. 'x__ Ay'c hydronic) 23.32 f� Unit heatersfuel-t e not electric), YP � in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: Lot no.:3 Other fuel appliances: Tax map/parcel no.: Water heater I 23.32 I. DESCRIPTION OF WORK ' Gas fireplace/insert ' 33.39 Flue vent for water heater or gas fireplace 23.32 �$At. Wood/pellet lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 E(PROPERTY'OWNER ❑,TENANT Other: 23.32 Environmental exhaust and ventilation: Name: geolva<u44 4. b€ 44 I u.0. Range hood/other kitchen equipment 33.39 Address: 212-7 1 IZbC4 R,b. Clothes dryer exhaust 33.39 City/State/ZIP: �Ldt{ Single-duct exhaust(bathrooms, ‘ d$" a?0 S toilet compartments,utility rooms) 23.32 Phone:( Fax: 'rjp ) �.'�. ¢Ze{7 ( ) Attic/crawlspace fans 23.32 iT APPLICANT ErCONTACT PERSON Other: 23.32 Fuel piping: Business name: K'r izE#1Gbi L.1m bESi6,.1I LLC.. $14.15 for first four;$4.03 for each additional Contact name: -r*vh45 3Akv Furnace,etc. Address: z'v z i RooK (zi,. Gas heat pump WalUsuspended/unit heater City/State/ZIP: Ab� g obi Water heater rtLO HA1 Phone:(5o3) sir?. gZy-7 Fax::( ) Fireplace Range E-mail: 44C.3oKtA$14-111 6. %44l4„ . Cool Barbecue CONTRACTOR Clothes dryer(gas) Business name: But,6er NfA.rud6 1, Other: C�pLiwl�j JVIECHANI,CAL"PERMIT FEES* Address: / 3 s- s /7 7 71 ^ Subtotal City/State/ZIP:jj�Ar S.e S 970 x 5 Minimum permit fee($90.00) v vv / Plan review(25%of permit fee) Phone: )2?7. ,os----0 Fax:r ( G) State surcharge(12%of permit fee) CCB lie.: C ..-( 71 i 5,-- C /7 / 7 TOTAL PERMIT FEE ( This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: / * Fee methodology set by Tri-County Building Industry Service Board Print name: &re Cel pc e.( Date: `0/3//8a L\Building\Permits\MEC_PemitApp_040 I l c 440-4 7T(I t/02/COM/WEB) • Electrical Permit Applicatiott---,—• — k 1,4)u t)hri( i: l.SKONi 1 City gfTigard i � � a Rrrxivrvc pac1By: ran*..t I+i25SW'Hall Alvr..Tigard,pR 97223 O�tt Rime: 50+:/18.2439 hx: 503.598.190h r3 / 8rPn Rulal,:t ilanrit N Inspection Litre: 503.639.4175 Healy Ii;nerSy: >,„in El See Page 2 for I i 'ii�ii Irani net. %vim.'tgart:i tat guv 1 rI rii, _'�e V; ;,1.1; NCI ifi4'0'4abod. Shirr&rnrntui l wturnud into Taj :: construction r N#;k 1i' # I'sk�')t n -a., s; 01&:.`7)Ey ? f AW ' " QAdd itioniattcraticltJreplacement Please cheek ell dietapply(submit 2acts ofpiens w/itcrrssciecked): ❑Service or feeder400 alnps ortrove 0 0uldine overl1c,toris.QICiolltiQt tlifar hare the available Paha current 0 Yi:niota nod on:IlyanM. s .S' +. : _ a ':: +Q',RR",pC� F J�$II!2L1„f,:a1jT,f. 1.,,;;',, r.. _. ,,;�c .. ea.rrrl,l0,oxlamps et 159+01h or ❑Flowing buitdiogs. �1-and 2-family dwciling 0 CoirmerciaL'industrial 0 Accessory building less to armlet).or exeeeeia 14,000 17 conutxrcial toe agricultural 0 Alllttt tairnly 0Master builder 0 Other( amps for all otherinsWlations buildings Y _ i rnepaw. ❑toosatiunor[SOK.VAor JQl3: . ;lr(k,x1T10Ai .,. ,. _. ❑Laxcgciceysysteru. biter separately derived Q Addition of new nntar bad of imam Job P: lob Site address: 20o11P or more ❑A","a "1_, °t a`, City/State/LI i': ID Six or intimrraielsarpel units. occupaaoy. ❑lt'calth-eare facilities. ❑Rectemtional vehicle parts. Sit it/ O: Project name: 0 hazardous locations. 0 Supply voltage Mr mare titan ❑Ref vice m ixelur(dalBurly.trHarr* 6003013aoauoai. (lobs slfeetkiirectirins to job site: , a 11UT.g* . W a i fi IA ' ,-,_c* 1 2 '2- u Av-- • New reetdentiaresidential'singk-or mtdti-ft •dwelling unit. Subdivision: Lot it: 3 Includes attached garage. fax maplparcel it I,000 eq,ft.or leen r{,8.54 4 .r Cha.add'I 501)sq.ft.or portinn 33.92 1 i r,,; . :. RJLSCt..!"'tib-Fsr,,i WQitK, ,+,,, 'r , °�. r� �. . l.intiled t+atery,Y,rrrcideuliui i (with above q.ft.) 75.E 1 NSA Limited energy,multi-family 1 75.00 2 residential(with above sq.it) i P0Rt7Y5R r FQ 'khAT, i ` '` SReerne1wholnrfce nwdegrys Installation alCiter:teiconp,aagend2lor relocation r Natllt,. kr Tea_w.►et...14 t Drlkia!i Lt.G r 2n0 amps or fen 100.20 i 2 L l a i I S 1 13:i s6 2if R%Y5: .K 21)1 amps to 400 am RS , 400 mons iota amara 7.00:34 Cily+SiatcJZIP: _ ;: ALot4A.t_ Ott. $'te�o/ 601 amps to[,000 amps 30104 2 Phone:(t,,,,p f) S$7 82,44, Fax:( ) NA Over 1,000 anon:or volts 552,26 2 Temporary scrvlees or feeders installation,alteration,and/or Eluuil: HeSO'K 6 WeA47.•Gbt n relocation i Owner installation This installation is being made on property that 1 own which is not 200_anon or lets 59.36 I 1 intended for sale,lease,rent,or m(change,according ng tc ORS 447,449,670,and 701. 201 amps to 400 amps 025,05 ii 2 f Miter sIemattire Date: fpr amps in 599 amps 65,51 2 . ' it1 .. '`•1,fiv..,a i ._ , k+t1 L4 N 1 ."'''''',1''''':0'."'" '"---•""'" , .0'."' '"---•W . new, with alteration,01 extension,per panel 401 Brooch circuits .Fee for branch circuits with liminess name: k.{- izir i4.461.4.11 4DttSilt 44.t. above service or feeder fee, I t(intact name: r each branch circuit 7.42 2 �14tnd4Cj 1 ebd� 13,Fee for INnndr enrolls wirlwra k Address: ZI 21( rf!c ser vice cu better fee,lila! 5th.i8 2 Qp� 12,D. bialmlr¢irerte {11y1Statc17,IP: .414,44 I QIL 9/+ S Each Idd`I Mandl 6214161 7.42 2 Phrase:( ,i,p3)_ t Miscellaneous(service or feeder not included) el. $?!1'7 I Fax::( ) r t,a Fact( n:araf tilmin it or wcaiulur i 67.114 2 l Mail' / /,, �`+� dwelt iag,service,uaI/urfeeder 114'5 $0I."444 .]"' keconneti only 67.74 2 i QNTt{Atit0 :.r3) pump ur irrigation circlC 67.84 2 Business name: Egrokr. ELEtsratC, 1.1L• Sign or outline tighting 67.84 2 Address: et Stotts(circuit(s)or t(tnKcd-energy ❑ See Page 2 2 yb Mei,alteration,orc.YCcniot. _ City/State/ZIP: b01 4 Each additional inspection over allowable in any of the above " �� Additioitalinspection(1lir min) 66.25/hr Phone:(Q03)6?e, 4•34-5 Fax:( ) investigation(1 hr min) 90.00/hr Email: �`tirR�t industrial plant(t hr min) 78.181 hr TS & &rt IE.S6Z—1g4C--. +R.t Inspections fur which no fee is ((ti IJo: Zo tq Electrical Lie.:zsf.to Suprt.Lic.(.. sisccitrcatty1,i71 f lTn1n) „FF 9000'hr Supra`,Electrician n signature,rcxiuircxl: ' s nri6 .01.0f' a pE'FSRI/)it . s,°`$ ( - Suirtulal: Print name: ,w ' Dat01-1e,)9/7?"/ ❑Plsn 13rn iow Rrgniled(25%of t tut fig Statesouchir (12%of'kiln it fee), Authorized signature: 1 TOTAL PERMIT FGE; itlint name: lidx permit upldreniirrr uiph•rs irp prrattt is nrf nhlnlartl within 1815 Data: da}s atter it has been accepted as corapkte • Kander of iexaptitnies ellnwurl tar Ia.,ral, i'..ou;Idi4eiramara.bL.C_rae:nAVV_6LR„ERE d,,Rcv0611720;5 4(4Gt STii m t C111WWFR Plumbing Permit Application Building Fixtures �' CI ? �� FOR OFFICE USE ONLY City of Tigard II�''__'' Date/BReceived Permit No.: • e 13125 SW Hall Blvd.,Tigard,OR 971SU. . 3 2O1 y Plan Review ' Z Phone: 503.718.2439 Fax: 503.5&.196,0 (�� i,R Date/By: Other Permit No.: Inspection Line: 503.639.4175 Ui e y +tom t o .- . i.< Date Read/B Juris: Ef See Page 2 for TIGARD Internet: www.ti and-or. ov a. x`e w't' Ready y g g ULD Nt.3 D! wl�. `;i. Notified/Method: Supplemental Information TYPE OF"WORK FEE* SCHEDULE For special information use checklist. IiiNew construction Ill Demolition Description Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF'CONSTRUCTION SFR(1)bath 312.70 [r 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE"INFORMATION AND LOCATION„ Site utilities: Job site address: Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 5 Vi VI/CZ`) Si-rc.,-4- 'nil Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot no.: 3 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 ` Clothes washer 25.02 Dishwasher 25.02 NSFK Drinking fountain 25.02 �/ Ejectors/sump 25.02 [ PROPERTY OWNER I Li TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: K-r Ezem AeLIal ; b6444i I L.LC. Floor drain/floor sink/hub 25.02 Address: ZI'L"1I •t•«,K pi). Garbage disposal 25.02 City/State/ZIP: 4,..00* % °it- ollpp3 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 5a; _,( eft?. gz 1, ,( N� L✓J APPLICANT LI CONTACT PERSON , " Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: izg.„oDEW,,ti s beyi tl LLL.. I Primer 12.51 Contact name: TAvNks ,~I*, Roof drain(commercial) 12.51 Address: Z42:1I >IzOC.K gp. Sink/basin/lavatory 25.02 City/State/ZIP: rDNA I oz. 9)003 Solar units(potable water) 62.54 Phone:(o3) 08-7. 92,41 Fax: :( ) Mit Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: g�50K4.5,®6/.Att.. tpool Water closet 25.02 " CONTRACTOR' ` Water heater 37.52 Business name: , ,. _ /7,.(,,,„k/fly Water piping/DWV 56.29 Address: 7`13 s Ali. ei)//lam L Other: 25.02 City/State/ZIP: gra vt�-{�`'V /�/ -) 6)0 Subtotal Phone:(Sp/) 41 -.-- y `� Fax:( ) 7 i�� Minimum permit fee: $72.50 CCB Lie.: 71 ace4, A(vi Plumbing Lic.no.: !,,vF`�5 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE { L� �� Date: This permit application expires if a permit is not obtained within 180 days Print name: SCan 2 7/5/�75) after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. C\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(I.0/02/COM/WEB) J Albert Shields From: Kim McMillan Sent: Wednesday, August 1, 2018 5:34 PM To: 'mspnague@pd'grp.com' Cc: Albert Shields; Khoi Le; Kenny Fisher Subject: Stormwater Fees Hi Matt, Albert and I dug out the fee schedule and the fees are as follows: Water Quantity SDC$299.75 Water Quality SDC$245.25 Water Quality fee-in-lieu $2640 These fees are charged to each of the three lots. Kim Kim M ciViUlan Iiii411 City �_ —~ of Tigard � Assistant City Engineer 503-718-2642-work 503465-5784-mobile 13125 SW Hatt Boulevard Tigard,OR 97223 . . DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 1 • Albert Shields From: Albert Shields Sent: Thursday,July 26, 2018 3:24 PM To: 'Matt Sprague'; Monica Bilodeau; Khoi Le; Lina Smith; Kenny Fisher Cc: ross@stoneridgecustom.com; 'greg' Subject: RE:Walnut Street Partition (Csokas Partition) -- MST2018-00196, -00198, &-00199. Matt, installation of a LIDA might not have been required at the time of the Pre-App Conference on 12/15/15 but, effective 4/22/18 CleanWater Services(CWS) changed the stormwater treatment requirements to require a LIDA. The 3 permits in question were all submitted on 7/5/18 so they are subject to CWS's revised requirements. Accordingly, please revise your plans to include LIDAs as per my 7/12/18 email below to Greg. There are also stormwater quantity and quality fees to be paid,as noted in Condition#15, but these are not fees-in- lieu. Those fees are$245 for Lot 1 MST2018-00196,$300 for lot#2 MST2018-00198,and$270 for lot#3 MST2018- 00199 and I've added them to each permit. If you have any further question about the LIDA or the fees please contact Khoi Le in our Engineering Department. Albert Shields Permit Coordinator From:Albert Shields Sent:Thursday,July 12,2018 11:17 AM To:'greg@stoneridgecustom.com'<greg@stoneridgecustom.com> Cc:Allyson Armstrong<AllysonA@tigard-or.gov> Subject:Csokas Partition, MST2018-00196, MST2018-00198, MST2018-00199 Greg, on reviewing your application and plans for the above 3 permits Engineering has noted that in each case a revision to the site plan is required to show a water quality facility(LIDA)on the plan between the home and the storm line. Accordingly, I am coding these applications as"Revision Required". Plan Review will proceed but the permits will not be issued until a satisfactory revised plan has been received. Please submit revisions at your earliest convenience. Please let me know if you have any questions. Albert Shields. From: Matt Sprague<MSprague@pd-grp.com> Sent:Thursday,July 26,2018 2:02 PM To: Monica Bilodeau<MonicaB@tigard-or.gov>; Khoi Le<khoi@tigard-or.gov>; Lina Smith<LinaCS@tigard-or.gov> Cc:Albert Shields<albert@tigard-or.gov>; ross@stoneridgecustom.com Subject:Walnut Street Partition (Csokas Partition) Hi Lina, Nice chatting with you.You mentioned Monica was on leave which is great but that you would help me track down someone who could address this with Albert Shields.The builder has been requested by the City Engineering 1 department to provide LIDA rain gardens for each new home as a part of obtaining a building permit. However,at the pre-app conference it was stated and again confirmed in the conditions that the applicant would pay a fee in lieu for stormwater quantity and quality instead of constructing facilities. If we were required to construct LIDA's they would have been initially shown on our Engineering plans.The condition of approval is number 15 which reads "prior to commencing site improvements,pay stormwater quantity and quality fees." I presume the applicant, in order to obtain site development permits, has already paid their equivalency fees for each 2,640 SF of impervious area. If they have not,then it was missed and they need to do so. Could you please help get this rectified? Thanks, Matthew Sprague PRINCIPAL I PLANNING PROJECT MANAGER I D 971.708.6249 PIONEER DESIGN GROUP, INC. CIVIL I LAND USE PLANNING I SURVEY 9020 SW Washington Square Rd. Suite 170 Portland,OR 97223 P 503.643.8286 pd-grp.com Disclaimer: This e-mail may contain proprietary,confidential,and/or privileged information.If you are not the intended recipient(or have received this e-mail in error), please notify the sender immediately by email or telephone(503-643-8286)and delete this message along with any attachments without copying or disclosing the contents.Any unauthorized copying,disclosure or distribution of the material in this e-mail is strictly forbidden.Pioneer Design Group, Inc. (PDG)shall not be liable for any changes made to the electronic data transferred. Distribution of electronic data to others is prohibited without the express written consent of PDG. 2 Albert Shields From: Albert Shields Sent: Thursday,July 12, 2018 11:17 AM To: 'greg@stoneridgecustom.com' Cc: Allyson Armstrong Subject: Csokas Partition, MST2018-00196, MST2018-00198, MST2018-00199 Greg, on reviewing your application and plans for the above 3 permits Engineering has noted that in each case a revision to the site plan is required to show a water quality facility(LIDA) on the plan between the home and the storm line. Accordingly, I am coding these applications as"Revision Required". Plan Review will proceed but the permits will not be issued until a satisfactory revised plan has been received. Please submit revisions at your earliest convenience. Please let me know if you have any questions. Albert Shields. City of Tigard 111 " COMMUNITY DEVELOPMENT DEPARTMENT L - C }� Building Permit Review — Residential Building Permit #: ,/lii.5/x,20/ F/ 7 Site Address: A266 &) /ccQ, /9/-e r2W Project Name: Cs64yg 7) ii717 Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: A)0(4) ,2.7VJ V rift'site address/suite#exists and activ inermit system. p Y ' ver Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached SityPlan Elements: • xee(3)copies of site plan mi y 'sting structures on site • e plan must be on 8-1/2"x 11"or 11 x 17"paper ►a ootprint of new structure(including decks)with finishedraven to scale(standard architect or engineer scale) or elevations forth arrow VJ A tility locations&easements(required for new and additions) • e address,project or subdivision name and lot number i� is;walk/driveway approach Vplicant information(name and phone number) B 6,cation of wells/septic systems O t dimensions and building setback dimensions 7 - ting trees to be retained with drip line,and tree uare footage of buildings to be demolished otection measures it .t area,building coverage area,percentage of coverage and $freet tree size,type and location pervious area(applicable if R-7,R-12,R-25&R-40) Street names MI Property corner elevations(2 foot contour lines if more than >1,000 sf of impervious area created or replaced " Yes ❑ o 4 foot differential) If yes,is a storm water quality facility shown? Yes ICJ No tWlean Water Services—Service Provider Lett (lot platted prior to 9/10/1995): quired: ❑ Yes,applicant was notified qQ No Received: ❑ Yes ❑ No vie- Public Faciliti provement(PFI)Permit: oil,-00.2a0 aired: �� / q Yes,applicant was notified ❑ No Applied For: Cita/Yes ❑ No,stop intake d Use Case#: !V! )(p— 0O !!J oning: ,&L( Od ,QR�equired Setbacks: Front ,QC) Rear / Side S' Street Side K Garage e„2 0 0(Landscape Requirement % Cot Coverage Maximum: Building Height: Maximum Height 5� Actual Height o2.3 7( N P 0 isual Clearance !1 A:ensitive Lands: 0 Yes ❑ No Type IL Urban Forestry Plan 0 Conditions"Met"prior to issuance of building permit ,�Q _1 Notes: C.n 1my f srA. -J� J e 711P1-- fj7b,�7jlj /ix tos. tf Opt-- _/0 T Approved By Planning: _ _ . - — e/ Date: �13/l Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved ❑ Not Approved Revision 2: 0 Approved ❑ Not Approved Revision 3: 0 Approved ❑ Not Approved I:\Building\Forms\BldgPennitRvw_RES_061417.docx Building Permit Submittal Original Submittal Date: 7/s'/r Site Plans: # Building Plans: # 3 Building Permit#: nter building permit#above. Workflow Routing: Planning C:-Engineering Lrmit Coordinatoruilding Workflow Sign-off: Sign-off for Planning(include notes from planning review) Route Application Documents: Engineering: (1) copy of permit application, (1) site plan,(1)building plan and original plan review routing form. PF Building: original permit application, site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: / r `►.: By Permit Technician: i��ti, /��,4- ,Ii _.....ill" Date: 7A--gr Engineering Review Slope at building pad: Co Yp ,2—Conditions "Met"prior to issuance of building permit Easements (encroachments)per engineering conditions of approval and plat B rWater Quality/Quantity Facility: Assess Water Quality Fee in-lieu: Yes E No Assess Water Quantity Fee in-lieu es L'J N LIDA Facility on lot: f!0 a Yes b�'l�o [ NOT Approved by Engineering: (r , f--,s 14Date: 1-i Z—i Notes: 54 erv-) wahTt,2 610A-1-4 it-.1 ( L l boi\ , t., r(A 1...,.1 (k-c-w€t M -1--t.t. j1.v..t- k 4-L t S't�1?_.... LI U',- /� w f� t ``//-1 )at/1► _{ACL-Lc.. --2 L e off[. "ii i'xbi Approved by Engineering: (/ Date: Revisions (after Building Submittal only) Reviewer Date Revision 1: 0 Approved 0 Not Approved Revision 2: 0 Approved 0 Not Approved Revision 3: 0 Approved 0 Not Approved Permit Coordinator Review ❑ Conditions"Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) // Revision Notice 1: Date Sent to Applicant: 7-Z/Lk ice. etn�uZ,7,14K- Revision % d Revision Notice 2: Date Sent to Applicant: R,,,,.fievision Notice 3: Date Sent to Applicant: SDC Fees Entered: Wash Co Trans Dev Tax: e� Yes 0 N/A v� o. "`, Tigard Trans SDC: P:- Yes 0 N/A _ �� :� �� Parks SDC: i:: Yes 0 N/A LIDA I Yes /A )7' OK to Issue Permit _/ Approved by Permit Coordinator: Date: f I:\Building\Forms\BldgPernutRvw_RES 061417.docx FOR OFFICE USE ONLY–SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard Transmittal Letter • COMMUNITY DEVELOPMENT DEPARTMENT i i i_;n ii n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: /1-7( U/ DATE RECEIVED: DEPT: BUILDING DIVISION RtcP FROM: -- Scet".►�!1 AUG 1 2018 CITY u 1GARD p COMPANY: S'' nc r clGe C c.j Lra--. 6eve loror,en I'' 3U.JILD Ng"'G IVISM= PHONE: 5D3 r 54/7 ' S ) ciq By: RE: 3 C5o k.a5 iat-4:4'ao 5 1;20/8' ��/cj, (Site Address) i'X�'3 (PermIntum erit ) 5w Wcl(nk4 /5\, /32 IlL Avg (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. ?‹, Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: ic3fi -3 4s,S A ;0ec.r;n q FO OF ICE USE ONLY /1/4/ Routed to Permit Techni ' : Date: –i tq) l q7 Initials: Fees Due: ❑Yes o Fee Desc ptio : Amount Due: po)A.v $ i',.--- $ Special / Instructions: Reprint Permit(per PE): ❑ Yesoma— ElDone Applicant Notified: Date: 7 / i(?'`ii4/ Initials I:\Building\Forms\TransmittalLetter-Revisions_061316.doc FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT a 4 71 Transmittal Letter r c:;A 1:n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: /f/( DATE RECEIVED• DEPT: BUIL G DIVISION REC r ED // tT242Q18 FROM: CD" SCAnre ii CITY OF TIGARD I v BUILDING DIVISION COMPANY: 1I. 4nd 1 IRerY ©Ae,i s n3 / PHONE: Sa 3— — / ft y _ B//I RE: 12 31 S Lc, 132 n= ' vc Mss"-2o i3 - ov i q R (Site Address) (Permit Number) 5 W 4(fi u-fr S w / 2'-'-k Ayr (Project name or subdivision nam d lot number ATTACHED ARE THE FOLLOWING I` Copies: Description: r Copies: Description: Additional set(s) of plans. 1 7 Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): 1`'/ REMARKS: �+ S"ci c e.:+a,n, n� 1,vQl' FO OF ICE USE ONLY Routed to ermit T ician: Date: t0 25 (°) Initials: - Fees Due: Ye ❑No Fee Des 'ptio : Amount Due: $ by \ 1 , \Novi ��\G� i/tAk t) $ �{S !/ $ $ /Special ons: R nt Permit(per PE): ❑ Yes 1 o ❑ Done?c_ pplicant Notified: Date: t U/2 5.1}714_,V / Initials: I:\Building\Forms\TransmittalLetter-Revisions_061316.doc Electrical Permit Application . 01,:,,,11 it ipt City of Tigard .7. NIA" .47 n.:741 1)41"Y 7 'a/•Y - 13125 SW Hall 131vcl,Tigard,OR_97223 t:i ,i,' ,„:, 7 :„ 4.. .1c. Plan Re, o, 1 ir. Phone: 503.718.2439 Fax 503.598 1960 k--4--1 ' •-' ' ' Date.sr. Related Permit Inspection Line: 503.639.4175 L if .2....qAt Ready Dateif3v. Alm' Fif See Page Z for--- Internet. www.tigani-or.gov i':;11212MalagglitMEISME1MMTMEM:!•:11:0E25 :,:infigratialgEnr17171.14°4'71;57*Mili 4 New construction 0 Addition;alier.nion,replacement 0 Service or feeder 400 amps or uiore 0 Building over three stories i 0 Demolition 0 Other: where the available fault curt= 0 Marinas and boatyards. AZS1,:ltaikliZeialtEtatiK-,linel=irta,,,..4%*ME,r7:"':,,'„,Ailiaringf'.' lltX: ; exceeds 10.000 amps at I SO vas or 0 Floating buildings. i CS I-and 2-family dwelling 0 Commercial/industrial El Accessory building I less to ground,or exceeds 14,000 0 Commercial-use agricultural snips foe all other rostallatrotis. buildings.0 Multi-family 0 Master builder 0 Other: 0 Fire pump 0 Installation of 150 KVA or 0 Addition of new motor load of syStem 1;iiiMPSIMParriErr;:: ::151a.24:.:VnirantivlAta.Zile2710514g-rlIVYAti! E3Em"gencY sYstem larger sePemelY denved Job;t: 1 Job site address: 1.3,2'g,..4,ifo $ 1- crizcrT , i popas or more D"A","E","l-2","1.3", - ri--A-A6-- s d. t lunits. occuPancY- City/State/ZIP:11G-Itit.-41 0(L 9-4 27,5 /,2.,p3c7 /3„A..-5,:a:::::re:::,::a 0 Recreational vehicle parks i Suite/bldg./apt.4: Project name: CS*'4...AS P A if---rm01-4 0 Hazardous locations 0 Supoly voltage for more than 0 Service or feeder 600 amp,,,or too' 600'1.1611s nominal I i Cross street/directions to job site: 3119121M:"412.7,215777V•;:,..31,,PaitnEg New residential single-or multi-family dwelling unit. i Subdivision: I Lot 4.3 Includes attached garage. H I 'fax map/parcel#: 1,000 sq.ft or less 168.54 in Ea add'1500 sq ft.or portion 3392 IIIIIIIIIII :;a',Irt1tfgfitedrMietttrnr,I=B32.1gMr'MATAMEntatilrll 1-1100ed ener8Y,residential111111111 75.00 withabove'..ft. 1 04404,1 , , c . g' ',arc. 0t4 tsNcr . - ' cr Limited energy,multi-family 75 00 alilli 00159 residential with above .0. Renewable Ene vo. MI See Pa,e 2 111111111111111 i'?", .112ififtr:MEZIELEitillaZICAWA:21=7:1V,t04412:4; Services or feede-rs installation alteration,a-nd/or relocation Name: 'IT ikettoze‘...404.4. t .- ..mt-1 p ,s 3—A ir,,„ 200 amps or less 100.70 IIIIIIIMB Address: z 201 amps to 400 amps 133.56 IMO 1 Si,j szotit_ p_t, 401 amps to 600 amps 200.34 Min City/State/ZIP: Pr 1ok-k p, 0 ft_ 9-4.0 3 601 amps to 1,000 amps 301.04 9 Phone:(E03) Sal. -azy--/- Fax:( ) Over 1,000 amps or volts 552 26 Min Temporary services or feeders installation,alteration,and/or Email: H cso tr-As e, GtiA I L- G,t-i relocation Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 9 intended for sale, lease,rent,or exchange,according to ORS 447.449,670,and'701. 201 amps to 400 amps 125.08 ni , Owner signature: Date: 1 401 amps to 599 amps 168.54 MI 2 ' -'kcnrailliariL30411Ata:MailliettirrillIMATZIrrair? ,1:171,71:0:1: tsi circuits with "ex1111111rensi°1" r 'allei II . : Business name: sA rie As A,g above,o each branch circuit 11111111114- 111 ' I Contact name: B Fee for branch circuits without Address: branch circuit 56.18service or feeder fee,first City/State/ZIP: Each 742 9 Miscellaneous service or feeder not Included Phone:( ) Fax: :( ) Each manufactured or modular 67.84 - dwellin:,service andior feeder I i Email: Reconnect only 67.84 mom lkF:lk:'!lefia:ItStflin:q9EZlli':4C'::'.ii1355t,iAi'rn22ZFIVMV Pump or irrigation circle 67.s4 min 1 Business name: 16mb(AK, q..LE C.. :°• 1 C.... Sign or outline lighting 67.84 Min Signal oironit(s)dritnuted-eneW 0 See Page 2 II Address: ,).4 8G SHt1 5 IDE P---t) .anel alteration,or extension. Nr---assa--- -i Each additional ins.ection over allowable in any of the above I Cily/StateiZIP: s po,,e-tgt , ()O.. .9 i-3oG , Additional inspection(1 hr min) 66 25/hr 9 Phone:(PI a& — !ZS'S i,Fax:( ) Investigation(1 hr min) 90.00/hr 9 Email: 1 Industrial plant(1 hr min) ECEICIIIIIIIIIIIIIII Inspections. for which no fee is 90 00/hr allil i CCB Lic.: 1G vas g Electrical Lic.: ati-52.2 c. SuPr‘'Lk.:‘*113 S snec!!!caliv..,P3It hr mist) ,M.4,;j;'jt4:ifka%itS,I,MtfnAtz-Ari',,„A'Mt4 Suprv.Electrician signature,required: Kt.s....„ Subtotal. Print name: ittATADNI Sle IS e p,„ Date: 11 zb 1 I a 0 Plan Review Required(25%of permit fee) IIIIIIIIIIIIIII/ State surcharge(12%of permit fee)' aIIIIIIIIIII TOTAL PERMIT FEE IIIIIIIIIIIIIIIIII Authorized signature: Print name: A4 This permit application expires if a permit is not obtained within 180 "Ttirrli s Z•jell,loc,43 _ , Date: 126 ut days after it has been accepted as complete. 1It dogPersutELCPmnnAppFLX,,ERt de Rin 06 "flo: '- * /e/2-9' Plumbing Permit ADDitC2 lion Building Fixtures l'OR Milt 1 1 '•sl0\1 '1. City of 131SW Hall =,7),(' N4,7,-.5 /e2P.-00/2.9 25 Tigard Blvd.,Tigard,OR 97223 Penuit ligrilit_D fa . Plan Review 1 Phone, 503.7181439 Fax 503.598 196 ----- Date/By Other Permit NO.I; Inspection Line: 503.639 4175 f Date Rcadv By Jun s Et See Page 2 for Internet www.tigard-or gov I Notlficd Method . Sup ilementai Information i -,g,,,,,,,,,eipo&-gA:/,44m4imrfr.we4R,.,,,,;;Appmtf,Syr:1 OfirW,1141;iir,"13 ,',I1.7,4144,4 litfrifirfertirieWeilifelt:" ntAleRNViregg'i,';', 4111 ",:ttmeLtifilkilli''„itaillittiiplpaiktaalIALQ,,,''i,illig,iliShattraPtitiMEMtittiVilartigig '''''"'41.0iittrbAZ;i"al'1,:4,A,Ykr-,':-Pr '-i,;/•;,::',-i',,l',:',.'::,:"!0."3.;'1'.`4!rt':Var): 1 18.New construction 0 Demolition For special information use checklist. I Description I Qty. 1 Ea. 1 Total 0 Additionlalterationireplacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ix:',:i, ,1,4401,30Int.Vg5i:itp,illaxrgp.;,--;`,'„IrgiaN444.111,5110094.1W,Tr sFR ii)bath 111111 3 '2.70 MIMI tl:::':;q:;:ii,,,iglittik!":,:r4OI:iiib..6ariailiakiiirCiaigtilitaUAillagglirintligi435,a,gCLAVIW , k 1 N] 1-and 2-family dwelling, 0 Commerciabindustrial SFR(2)bath II 437.78 III SFR(3)bath 50032 0 Accessory building 0 Multi-family Each additional bath/kitchen 25 02 0 Master builder 0 Other: Fire sprinkler( sq ft.) Page 2 e,%''...,',417°M11,',491,111.ZY:21.„,„:1.:::',.:'.Iti4M1112Fg"Vitraist*IiMMKPPEir Site utilities. i:ft--''''iii:.:51t23:1r...msti4.44.a,w ,tiiitbssliadiettki1444::" AiradaMittiailaik,001.,;,-13C - , Catch basin or area drain 18.76 Job site address: leat57; - - - ' ' '--- -4 /3. "-• Drywell,leach line,or trench dram 18.76 City/State/ZIP:ImIC-41/4f.D1 oe-- 51 223 I Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: CS.aKA...5 c'A &'T in 014 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) _ Page 2 Storm sewer(no.linear ft., ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot no:3 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 25.02 we. ,, Lie . - 4.cx-t-. ot4 e Is NI cr- 1 Dishwasher 25.02 , P ' • tit = ST 2-‘) : - 00 '5 Drinking fountain 25.02 Ejectors/rump 25.02 WTI itirr.lirrIrAirr'VERFIPOrM;#0111rNielqin7'!!?'''.:',..r::": ,''.: EXPanStOn tank 12,51 1. ''.::. i15,104;44,44";w:k- ,Abtookir. VSiLtwetaoWAzitil.104.,,,,..2.4daihs,taIia' . :, ''. ,.. ' Fixtureisewer cap 25.02 ; Name: *tr..g.Eri.0 t)et!r4G 4 b•Cfi ev4 % U.C. if ilk tiA.$ 3-Av.° Floor drain/floor sink/hub 25.02 Address: Z12,1-1 6v4 12-siCl( ?-Ds , Garbage disposal 25.02 City/State/ZIP: Pc k.,9 H A 1 0 9- 45-.400 3 Hose bib ' 25.02 Phone:(543) 88:1- -61,41- ! Fax'( ) lee maker , 12.51 ,,,trar,,, Pi0,151iVrtrfitifP_,,,,'Firff.45.51PRITIMMISiffM„..--,,,,l,MIT:irt.alfre Interceptor/grease trap 25.02 , ......e,:'`r.::VilititarLIMMii"lititiftlariltik°11 ..111!!'.'Uriiiilik, -,Igliisir.taMgallta Medical gas(value:S ) Page 2 , , i Business name: Seke ibcs tocer34.6 - Primer .... 12.51 1, Contact name: Roof drain(commercial) . 12.51 Address: Sink/basin/lavatory , 25.02 1 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) lax: :( ) Tub'showerishower pan „ 12.51 E-mail: Urinal 25 02 ' WatW37 °set ncl . . 25 02 -*Li aliiiiitkailtMeLdn,41.41441SUAttiielr."'''It:-..s-,1°IstokYt Alr',-;;-aiz er heater 37,52 Business name: 41445-+-610t4tty-rrte- .11 Ac EA foc•-,r,- - , Water piping/DWV 56.29 Address: I/SO-. Se M -r" 9112-6ET Other. 25.02 - City/State/ZIP: 9*xi-LA m 5 I 06, `n2-3 3 Phone:(5-03) 541+- 11.5 0 Fax;( 'i MiSubtotalnimum permit fee: $72.50 _ Plan review (25%of permit fee) CCB Lic.: ta g I 1 4 Plumbing Lie.no.: 2-G-Lc 5 46 State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE ...._ Print nameA ills portant a ppliaaaitornapaisrz:fnaa:ce:Ztdisa::tazbptinteed within 180 days : -^1-1\ta Ns ,TA . Toate, ti 2, 41 ' *Fee mntho&logy set by Tri-County Building Industry Service Board I sauddang\PerrnitsPLART-PeimitApp doc 10(01,'09 440 46161(10/02•COWWFB)