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Permit Support Document (26) 4 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT2 '111 ,' = Request for Permit Action 'Jo, 8 2018 TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigatd cit 'TIGARD U)LbliNty UI VISION TO: CITY OF TIGARD Building DivisionV I 13125 SW Hall Blvd.,Tigard,OR 97223 7 /,1//j Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-dr gov FROM: ❑ Owner ❑ Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) �^ Mailing Address: City/State/Zip: Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): CANCEL/VOID PERMIT APPLICATION. -REffiN p JvIIT FEES (attach copy of original receipt and provide explanation below). e rw INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). I" 9r Permit#: /7.S 7,g0/6P — 00A-.5Y Site Address or Parcel#: /-3 7/ Set/ kW/7z- 6 p/— Project Name: t/ii1-47:6 Subdivision Name: Lot#: EXPLANATION: KJ (3(4. 5 _7- 1i(- /? Signature: Date: Print Name: fe a f// —04fc 4F , <� Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. Route to Sys Admin: Date By t Route to Records: Date/ c' /7 Refund Processed: Date ,.tra' B By '� y��C1 Invoice Processed: Date Permit Canceled: Date 7 f-Ak- By .. Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_ 2314:doc 1 • 7A04 -- Building Permit Application ' i Residential r FOR OFFICE USE ONLY log City of Tigard Received - DateB : _ l • 0' Permit No.: — f6 IQ�� q 13125 SW Hall Blvd.,Tigard,OR 7, `3 " Plan Review y �!� r Phone: 503.718.2439 Fax: 503.594`.1966' Date/B : Other Permit: TI GARD Inspection Line: 503.639.4175 11 _ e.N. Date Ready/By: ® See Page 2 for Internet: www.tigard-or.gov t f+4 , {-� r� Notified/Method: LPN Supplemental Information 3UIL SING o6 b S ON ''' ThiY,PESO -^�6-k' := REQUI D DAA•1 AND FAMJL IIWRIL1[N ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Z Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the ''TTE RY '2 a is RUTt t` _ work indicated on this application. ® Valuation:2-family dwellingValuation: $76,000 ❑Commercial/industrial [IIAccessory building 111Multi-familyNumber of bedrooms: 6 ❑Master builder ❑Other: Number of bathrooms: 5 B S4' INFO IAT41 1 A14.6'----,40-CA ON Total number of floors: 2 Job site address:13674 White Cedar P1 New dwelling area: 1161 square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: EX square feet Suite/bldg./apt.no.: Project name:Wanderscheid Residence Covered porch area: EX square feet Cross street/directions to job site:99 to Bull Mountain Deck area: EX square feet Other structure area: EX square feet nE DATA, OMl'4I cI1t"J ,I V-FIECIM1 T„ Subdivision:Hillshire Estates Lot no.:66 Permit fees*are based on the value of the work performed. Tax map/parcel no.:2S104CD06600 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the , cRW oNo Lf(? I work indicated on this application. Converting unfinished basement to heated living area with some changes to Valuation: $ structural for new window openings and headers as well as replacing crawl space Existing building area: square feet pony walls with beams in a few places-WITHIN PERIMTER OF EX.HOUSE ONLY New building area: square feet ,e ►4 PROPIY O'1tR ANT Number of stories: Name:Erin Wanderscheid ',; 5 69-1J I Type of construction: Address:13674 White Cedar P1 Occupancy groups: City/State/ZIP:Tigard,OR 97223 C) .503 _ 3/7 .5 7 Existing: Phone:,45 9641 �0T-6- ; Fax:( ) New: „,: d4 ii1'P�IANT ,,„k � ❑ (X1t1 "ACfR5C)FN ¢, ,: B ;��� I�L �r PE�1VI� �8 t a] Business name:PURE architecture AIA % -ttke t 1i u‘44 ,l Structural plan review fee(or deposit): Contact name:Peter Lyle Strauhal FLS plan review fee(if applicable): Address:685 Church St NE City/State/ZIP:Salem,OR 97301 Total fees due upon application: Phone:(503)763-9641 Fax::( ) Amount received: E-mail:peter@purearch.com *FIOTOO,T [C3LARPii1�lE�sI1O ,t. '211: �pN� fi�7 � �:'7,7'.: „.0....0� Commercial and residential prescriptivetive installation of -47,- : RAE�. R4 ,, i roof-top mounted PhotoVoltaic Solar Panel System. Business name:Owner as Contractor Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: (' Date:04-26-18 *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) A Mechanical Permit Application FOR OFFICE USE ONLY ) Cityof Tigard _ Received g r 1u Date/By: Permit No.: /y�J - , 13125 SW Hall Blvd.,Tigard,OR 9722 • Plan Review qlig r - Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TIG ARD Inspection Line: 503.639.4175 MAY 4` Date Ready/By: Sufis: See Page 2 for Internet: www.tigard-or.gov MA( 3 0 r 1) j Notified/Method: Supplemental Information h` I OF �� "' 1 GA 1O ERC1A k E* SCHEDULE 7 , O1IEG it '1.;, w ,1t Mechanical permit fees*are based on the value of the work ❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ .; AO12Y 6F CC *Ri11ONx. Tr_ B x,," ESJ 1AL EQUIPMENT 1 S ST ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total JOB 4 ST A INFORMATi N A* OCATIOI Heating/cooling: Air conditioning 1 46.75 46.75 Job site address:13674 White Cedar P1 Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75 City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 0 54.91 0 Heat pump 0 61.06 0 Suite/bldg./apt.no.: Project name:Wanderscheid Residence Duct work 0 23.32 0 Cross street/directions to job site:99 to Bull Mountain Hydronic hot water system 0 23.32 0 Residential boiler(radiator or hydronic) 0 23.32 0 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 0 46.75 0 Flue/vent for any of above 1 23.32 23.32 Subdivision:Hillshire Estates Lot no.:66 Other: 0 23.32 0 Other fuel appliances: Tax map/parcel no.:2S104CD06600 Water heater 1 23.32 23.32 r D��T1 OF WORK "r ,,s Gas fireplace/insert 0 33.39 33.69 '' Flue vent for water heater or gas Converting unfinished basement to heated living area with some changes to mech. fireplace 1 23.32 23.32 Log lighter(gas) 0 23.32 0 Wood/pellet stove 0 33.39 0 Wood fireplace/insert 0 23.32 0 Chimney/liner/flue/vent 0 23.32 0 Other0 0 23.32 0 ill OR © ANT ~❑ _ Environmental exhaust and ventilation: Name:Erin Wanderscheid Range hood/other kitchen Address:13674 White Cedar P1 equipment 1 33.39 33.69 Clothes dryer exhaust 1 33.39 33.69 City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 1 23.32 23.32 Phone:( ) Fax:( ) Attic/crawlspace fans 0 23.32 23.32 ❑ CANT ❑ COI ; PERSOr Other:0 0 23.32 0 Business name:PURE architecture AIA Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Peter Lyle Strauhal Furnace,etc. 1 0 14.15 Address:685 Church St NE Gas heat pump 0 0 0 Wall/suspended/unit heater 0 0 0 City/State/ZIP:Salem,OR 97301 Water heater 1 0 14.15 Phone:(503)763-9641 Fax::( ) Fireplace 0 0 0 Range 1 0 14.15 E-mail:peter@purearch.com Barbecue 0 0 0 " . Clothes dryer(gas) 0 0 0 Business name:Owner as Mechanical Contractor Other:0 0 0 0 Address: Subtotal City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) CCB lit.: 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: (.u,� r;ZDate:04-26-18 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) ) Mechanical Permit Application - City of Tigard ' Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Vah tion � i ft F $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 • Elect.!_Ol Permit Application FOR OFFICE USE ONLY City of Tigard , RECEIVE. Permit#: 1, •ate/Bv: 4 13125 SW Hall Blvd..Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 ry Date/B : Related Permit#: Inspection Line: 503.639.4175 tr t 016 Ready Date/By: EMI See Page 2 for TIGARD Internet: www.tigard-or.gov ti Notified/Method: Supplemental Information x , _ � W � " . - . ivv r•s •s .. . 4431111410111111:': t •M :7 � f/ .•m .v.»&,. s A.» .' ' s,sm zy.au .: E -.€f D .Nas eaw;c::»ovLcoi ._ ®s 4AdditioniaeitmiJ �1574., :7117§10—f; 1SIO. IN-' s : Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. •,,,€f s; s s€a € s=r ss # $,t $J �..tail._.. lAs s; (ls E - . T '1:'',= exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory bu.7"'.'''''77=!''''''''''''''' lding less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or 42 a Es l �, � v*l 1 #sl{ p Other,.... sklial t ❑Emergency. system. larger separately derived 0 Addition of new motor load of system. Job#: Job site address:13674 White Cedar P1 100HP or more. 0 `A","E',"1-2"."1-3", City/State/ZIP:Tigard,OR 97223 0 Six or more residential units. occupancy. 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:Wanderscheid Residence 0 Hazardous locations. ❑supply voltage for more than 0CService or feeder 600 amps or more. 600 volts nominal. ross street/directions to lob site:99 to Bull Mountain r:70:vrote 4:m f 5 42 4l �ttJ , f,,.,.�, -a i, — ilhAli Description Qty. Each Total New residential single-or multi-family dwelling unit. Subdivision:Hillshire Estates Lot#:66 Includes attached garage. 1,000 sq.ft.or less 0 168.54 0 4 Tax map/parcel#:2S104CD06600 3 1 :::�-•w, :......,,• ••_::: 500portion 0 33.92.92 0 s €:r:m:.<::a,s?i h.: y.. ..t c f r i s Ea asq.ft.or 0041 �—:€.,.�;m:;:112 L jI 6 f til ax i ssss i v ::-::::.:ea ... x r .; im, Limited energy,residential Converting unfinished basement to heated living area with some changes to elec. (with above sq.ft.) 0 75.00 0 2 Limited energy.multi-family 0 75.00 0 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 -51111411nx == x •• _•• —•••-•••„ >� -_ 1 - ••-a=••E--• `• -• _•• a =•._ ••-•: Services or feeders installation,alteration,and/or relocation Name:Erin Wanderscheid 200 amps or less 0 100.70 0 2 Address: 13674 White Cedar P1 201 amps to 400 amps 0 133.56 0 2 401 amps to 600 amps 0 200.34 00 2 City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 0 301.04 0 2 Phone:( ) Fax: ( ) Over 1,000 amps or volts 0 552.26 0 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 0 59.36 0 1 intended for sale,lease,rent,or exc nge,according to ORS 447,449,670,and 701. 201 amps to 400 amps 0 125.08 0 2 Owner signature: �/ ' Date: 05-30-18 401 amps to 599 amps 0 168.54 0 2 ^9a is i �� .t� ila 1 li••-ag y L, Branch circuits—new,alteration,or extension,per panel ..:..__ s,r_ ';* ,.._ .:<•_,_._.., _•_. Lam_ 1. ' 2 f_,::...)h_. A.Fee for branch circuits whiz Business name:PURE architecture AIA above service or feeder fee, 0 7 4� 0 2 each branch circuit Contact name:Peter Lyle Strauhal B.Fee for branch circuits without servAddress:685 Church St NE branche ircueder fee,first 1 56.18 56.18 2 branch circuit City/State/ZIP:Salem,OR 97301 Each add']branch circuit 5 7.42 37.10 2 Miscellaneous(service or feeder not included) Phone:(503)763-9641 Fax: : ( ) Each manufactured or modular dwelling,service and/or feeder 0 67.84 0 2 Email:peter@purearch.com Reconnect only 0 67.84 0 2 :sr i,• 3€ '.ril d rig-1 �1'* z "t m•a:,s's i ±r.... ,s 1131° 9 °y ',,. 1€ _...._;� .....W:: ....._... - rs *= Pump or irrigation circle 0 67.84 0 2 Business name:Owner as Electrical Contractor Sign or outline lighting 0 67.84 0 2 Signal circuit(s)or limited-energy 0 See Page 2 0 2 Address: panel,alteration,or extension. g City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 0 66.25/hr 0 Phone:( ) Fax:( ) Investigation(1 hr min) 0 90.00/hr 0 Industrial plant(1 hr min) 0 78.18/hr 0 Email: Inspections for which no fee is 0 90.00/hr 0 CCB Lie.: Electrical Lic.: Suprv.Lie.: s iecifically listed('/z hr min) f ;;,:'srzR"€4 , r.r , .Oar:. .. ,. . Bj'i4t l�'";:,I:i4:: `;.E�„ a l,.-,a3. Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: ��� j�iy2^� j, This permit applicationysrexpiresheef a permit is not obtained within 180 Print name: fwd/ Date: 04-26-18 days after it has been accepted as complete. . Number of inspections allowed per permit. 1:ABuildingA Permits\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB r �r •� Electrical Permit Application—City of Tigard • Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: E IDENTIAL o ONLY: R =stn F e' Description I Qty. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 0 100.70 0 2 5.01 to 15 kva 0 133.56 0 2 15.01 to 25 kva 0 200.34 0 2 ❑ Audio and Stereo Systems* Wind generation systems in excess of 25 kva: _ III Alarm 25.01 to 50 kva 0 301.04 0 2 50.01 to 100 kva 0 552.26 0 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 0 552.26 0 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 0 7.42 0 3 ❑ Vacuum Systems* >100 kva-no additional charge 0 0.0 0 3 Each additional inspection over allowable in any of the above: El Other: Each additional inspection is 0 66.25/hr 0 1 charged at an hourly(1 hr min) Inspections for which no fee is 0 90.00/hr 0 specifically listed(t/a hr min) GLI M IA =SIL ONLY: Fr cT .L .M t FEES >> $75.00 allowed al(Enter on Page 1): o S * Number of inspections allowed per permit. Fee for each commercial system: (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations C\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 P*lumbing Permit Applicatio>c' .a Building Fixtures E FOR OFFICE USE ONLY Cityof Tigard �I1 Ay 3 2018 Received - ll YI t f r3 ( 1 t a Date/By: Permit No.:/4/37016 i pr�do i 3 lig 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review i1 I Phone: 503.718.2439 Fax: 503.598. TIGARD Other Permit No.: Inspection Line: 503.639.4175 a `+ Date/By: T I GARD U D N w S y�"� ate Ready/By: Suns: BI See Pae 2 for Internet: www.tigard-or.govt�� t_y ?°1 �� ��° otified/Method: Supplemental Information ._ of w6,11,I� _ lien iti ❑New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATpOORY OFACONSTRJJCTI SFR(1)bath 0 312.70 0 ® 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 0 437.78 0 SFR(3)bath 0 500.32 0 ❑Accessory building ❑Multi-family Each additional bath/kitchen 0 25.02 0 ❑Master builder ❑Other: Fire sprinkler(0 sq.ft.) 0 Page 2 0 10p lITE.INFORMATION SND LOCATION '; Site utilities: Job site address:13674 White Cedar P1 Catch basin or area drain 0 18.76 0 City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 0 18.76 0 Footing drain(no.linear ft.:0) 0 Page 2 0 Suite/bldg./apt.no.: I Project name:Wanderscheid Residence Manufactured home utilities 0 50.03 0 Cross street/directions to job site:99 to Bull Mountain Manholes 0 18.76 0 Rain drain connector 0 18.76 0 Sanitary sewer(no.linear ft.:0) 0 Page 2 0 Storm sewer(no.linear ft.:0) 0 Page 2 0 Water service(no.linear ft.:0) 0 Page 2 0 Subdivision:Hillshire Estates I Lot no.:66 Fixture or item: Tax map/parcel no.:2S104CD06600 Backflow preventer 0 31.27 0 O SC hI �F ) A Backwater valve 0 12.51 0 Clothes washer 1 25.02 25.02 Converting unfinished basement to heated living area with some changes to plumb. Dishwasher 1 25.02 25.02 Drinking fountain 0 25.02 0 1 Ejectors/sump 0 25.02 0 �� o iuyOAR u 0 T+A - Expansion tank 0 12.51 0 Name:Erin Wanderscheid Fixture/sewer cap 0 25.02 0 Address:13674 White Cedar P1 Floor drain/floor sink/hub 0 25.02 0 Garbage disposal 1 25.02 25.02 City/State/ZIP:Tigard,OR 97223 Hose bib 0 25.02 0 Phone:(503)763-9641 Fax:( ) Ice maker 0 12.51 0 o Av ANT fF. ❑ AONTACT PERSON Interceptor/grease trap 0 25.02 0 Business name:PURE architecture AIA Medical gas(value:$0) 0 Page 2 0 Primer 0 12.51 0 Contact name:Peter Lyle Strauhal Roof drain(commercial) 0 12.51 0 Address:685 Church St NE Sink/basin/lavatory 3 25.02 75.06 City/State/ZIP:Salem,OR 97301 Solar units(potable water) 0 62.54 0 Phone:(503)763-9641 Fax::( ) Tub/shower/shower pan 1 12.51 12.51 E-mail:peter@purearch.com Urinal 0 25.02 0 01Water closet 1 25.02 25.02 1.s,< '"�ONTRA ro �.a Water heater 1 37.52 37.52 Business name:Owner as Plumbing Contractor Water piping/DWV 0 56.29 0 Address: Other:0 0 25.02 0 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: � / ' Date:04-26-18 This permit application expires if a permit is not obtained within 180 days 11 after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site titii tis.-. t i : F pts. ���.���� Total S+guare Footage. Permit Ferv� Footing drain-161 100' 0 50.03 0 0 to 2,000 $121.90 Footing drain-each additional 100' 0 37.52 0 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 0 62.54 0 7,201 and greater $327.54 Sewer-each additional 100' 0 37.52 0 Water Service-1st 100' 0 62.54 o Medical Gas Systems: Water Service-each additional 100' 0 37.52 0 -' t,-..:,.Storm&Rain Drain-1st 100' 0 62.54 0 Valuation: Permit t, °r. $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 0 37.52 0 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for ' the s o,Fees QtY. Fee tea) Totaleach additional$100.00 or fraction thereof,to and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 0 90.00/hr 0 each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 0 90.00/hr 0 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 0 90.00/hr 0 and including$50,000.00. Additional plan review for revisions 0 90.00/hr 0 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan!tine*f sr mu t$ing In 1110.4tC0, w Fixture Type for Retilacel Work Performed: . Capped Added Relocate Plan review is required for any of the following. Baptistry/Font 0 0 0 Please check all that apply. Bath Tub/Shower 0 0 0 ❑ Any new commercial building with water service 2"and -Jacuzzi/Whirlpool 0 0 0 greater,except systems designed and stamped by licensed Car Wash -Each Stall 0 0 0 engineer. -Drive Thru 0 0 0 ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator 0 0 0 as defined in OAR918-780-0040. Dishwasher -Commercial 0 0 0 ❑ Medical gas and vacuum systems for health care facilities. -Domestic 0 0 0 ❑ Any multipurpose fire sprinkler system. Drinking Fountain 0 0 0 ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash 0 0 0 Floor Drain/sink -2" 0 0 0 Submit 2 sets of plans with any of the above. 3" 0 0 0 0 0 0sometric lir Riser Piagratu, Car Wash Drain 0 0 0 Garbage -Domestic-non-food 0 0 0 ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related 0 0 0 that meet the qualifications above. -Commercial-food related 0 0 0 -Industrial-food related 0 0 0 Ice Mach./Refrig.Drains 0 0 0 Oil Separator(Gas Station) 0 0 o Comments regarding fixture work: Rec.Vehicle Dump Station 0 0 0 N/A Shower -Gang 0 0 0 -Stall 0 0 0 Sink/Lav -Non-food related 0 0 0 -Bradley 0 0 0 -Commercial-food related 0 0 0 -Service 0 0 0 Swimming Pool Filter 0 0 0 *Note: If the fixture work under this permit results in an Washer-Clothes 0 0 0 Water Extractor 0 0 0 increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet 0 0 0 fees assessed for the sewer increase must be paid before the Urinal 0 0 0 plumbing permit can be issued. Other Fixtures: 0 0 0 D:\Dropbox(PURE architecture)\PureArch All-Team Folder\OBK\Wande2sheid Residence\Plumbing Fixtures_PermitApp-City of Tigard.doc