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Permit F-ii,-r.'':l'a,T2R11 CITY OF TIGARD MASTER PERMIT 0 Permit #: MST2010 -00041 t : . ; :t: COMMUNITY DEVELOPMENT Date Issued: 04/06/2010 1TtGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S104DD02000 ir. `.1.4; k: Jurisdiction: Tigard Site address: 12876 SW RIDGEFIELD LN Subdivision: MOUNTAIN HIGHLANDS NO. 2 Lot: 17 Project: Bartazal Project Description: Excavating crawlspace to construct bathroom. BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 0 First: 0 st Basement: 182 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $21,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs /Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add9 500 sf: 0 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add! Br Cir. 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: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) BARTIZAL, JOHN J & AMY J REGAL GENERAL CONTRACTING INC 12876 SW RIDGEFIELD LN PO BOX 134 TIGARD, OR 97223 Wilsonville, OR 97070 PHONE: PHONE: 503 - 651 -7070 FAX Total Fees: $979.92 This pe ' ' ' ed subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes ��ff, all other apr' able law. All..work will b one in accordan - • ith a•proved plans. This permit will expire if work is not started within 180 days of issuance if work is spended fo ore the 180 days. ATTENTION: Ore• • la r:: ires you to follow the rules adopted by the Oregon Utility Notification j ter. Tho : rules - - set forth in OAR 952- 001 -0010 through ••• ' - 001 1 • S. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2:-4.6699 or 1.8 1 3 « • 4. Issued By: . /� _ ` _ ∎ . Permittee Signature: / � / .C.---1------ 13iiil'd ng Permit Application . )�' „I�( i ' .. z r ° a1,1 - g), r ' 1 (4R ()I I lc ir U \' � '" .W � ,�,�' 2 f "�t°' 1 Residential '�.t L � + �� 4 a .. , , " •� i" r~' � by 11 ifir 11iy, ,ixedw : City of Tigard d s t DateB Permit No.: S'� Q 13125 SW Hall Blvd., Tigard, OR 97223 M 9 201 Plan Review t 4 0 � Other Permit: ' : Phone: 503.639.4171 Fax: 503.598.1960 DateB I ' /S RI), • l Inspection Line: 503.639.4175 U! t ^� Date Ready /B : turfs. El See Page 2 for I c • nI OF I t'� ,, . is r. Inte www.tigard- or.gov ! li'- '�.'• "' Notified/Method Supplemental Information BU`LlNC ��iV4::lil_ TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY. DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all X Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the • CATEGORY OF CONSTRUCTION work indicated on this application. and 2 -famil dwelling ' s Valuation: Al 4 ©0 2-family g ❑Commercial /industrial ��""" Y M Vv ❑ Accessory building ❑ Multi- family Number of bedrooms: — ❑ Master builder ❑ Other: Number of bathrooms: • JOB SITE INFORMATION AND LOCATION Total number of floors: - - Job site address: ' 7_e3 • - 7(ip d , _Co lri "6r New dwelling area: l ?I. S square feet City /State /ZIP: -- ---C-. 0 e _ Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 7 a J / r Covered porch area: square feet — Cross street/directions to job site: tO r-r e CN -t-iLid Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL-USECIIECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the - DESCRIPTION OF WORK work indicated on this application. + _ r ■ ^ G � J � `,t 7L 64 Valuation: S Existing building area: square feet I- r /t7rn • New building area: square feet la PROPERTY OWNER ❑ TENANT Number of stories: Name: --scA, r` 0.r ci2 ` Type of construction: Address: 1Z 1 -7 Co e v il _ e (A �,_ Occupancy groups: City /State /ZIP: t ic�c r .A 0 Q. Existing: Phone: (S 0 3 ) 3 l 1 S / S Fax: ( ) New: ❑ AP ❑ CONTACT PERSON NOTICE • Business name: 2if 0 , ` Glen c,-.. ._t 0,c, ,1-. e fi el C • All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: \.' ILL 3 \ Az_ k_ under ORS 701 and may be required to be licensed in the Address: ..1 o ‘ 34 jurisdiction in which work is being performed. If the /State / "LIP: .1 applicant is exempt from licensing, the following reasons City/State/ZIP: Oa&, I we. 17 0-70 apply: Phone: (So3 ) (o S I - -7D-7 o ` Fax:: ( ) E -mail: 'y (.3`D g re... J ; c. \, .._v_ • C,: -a`. ' ' CONTRACTOR Business name: s ` IOL�Q � ,,a � ,,, c BUILDING PERMIT FEES* (Please refer to fee schedule) Address: ;>p 1` 13 tk Structural plan review fee (or deposit): a3 Sa City/State/ZIP: FLS plan review fee (if applicable): Phone: .,) to `s l - 1 01 p Fa : ( ) (� /611`) Total fees due upon application: CCB lie.: 60 SS Amount received: Authorized signatur . / This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: /(4 �'1„, / z / G L Date: 3/ * Fee methodology set by Tri -County Building Industry Service Board. y � I:\Buildin \PermitskBUP -RES PermitApp.doc 10/01/09 T t 4 46 (I I /02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling to , „,,,,,„$., 6 t�1i� 1c N ' '' '' City of Tigard R eceived Permit No.: ;- .. v 1312 SW Hall Blvd., Tigard, OR 97223 Date/By: :C III Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: l l dt �'A tJ 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical -jzr Internet: www.tigard- or.gov ❑ Other: tI aifI ©�V ST6 ITEMS ITEIKEV0IRF FT I li f�N ll1 � „ , ,; �, 't � ` '; , - i,1 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ 0 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, 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 and connections must be 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 be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 41. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious 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. 13 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, roof construction. More than one cross section may be 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. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and 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 beams and multiple joists X ❑ ❑ over 10 feet long and /or any beam/joist carrying a non - uniform Toad. 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 be stamped by an engineer or Ni ❑ ❑ architect licensed in Ore. on and shall be shown to be applicable to the .ro'ect under review. gs r r j ( , R j'. r i ry. 4 : - �� .+r I r^ j mi. r . c `fq{ w' t 7, � it t , { .,. � 'A e: ! F Rttk l tc . *T nR ".� r t 'Y . 7: q t T '64x ,,,, s.4 v �, . I/Q:�., :.... ��,.. r>-- -�...._ �--_ ��i-� ..,.a._.- n�..- .: :�... �`�., -.. a� I �. -Y �l'fd � ,,.:;' ,.,�- •+� ;1uta1 5Y ±. � o �l d'-�, slw4mu .. +: .._.L ,. .r`. 4. :� N.t sea .=.w+L ,a.. ,.. r: 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 1 1" x 17 ". ❑ ❑ 0 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1:\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440-461 3T(I I /02/CO /WEB) 03, 1/2010 08:27 5036425815 ROSS ELECTRIC INC PAGE 01/01 Electrical Penult Application , l • � • ' r!';, . k'i' FOR " Ill ( I tit t,N I . } City of Tigard , 1,«. ; ` - 31 re Hermit No.: 5 6x0 /0 -pa0$, 13125 SW hall Blvd., Tigard, OR 97223 MA P a Q,3 " _ , l trvicw Phone 503.639.4171 halt: 503.598.196E , . a/13y: t7ther Permit: i ,. , 1, , inspection I,inc: 503.639 Rondy/By: hair, ® Sec Patio 3 tot Internet: wmw- tigerd- or.Eov � � s.A CO: ' 44- :oalethod: — Supplemental ? i ` k • 3 `.� v ' .;� + * — — . :".T t•� ii♦ r� � ; El New con8ttucti0n ldditiolt /alteration ¢, .1:7. . Ent P1 Mae ceer< all +lat acts 0 i naawlhMR4 eluel�m w ❑Demolition Q Service or &vier 400 amps or more 1:1 building over three Karim d , , - ❑ Other' where the availablx fault wnrent In Msrinm nd boatyards. , ' ,Wire ,'• . arm ma ada 10,000 ps at ISO volts or 0 Floating bail dings. less to ground, or meads 14.0no ❑ Commercial -no agricnitaral 1. and z- fam ily dwelling ❑Com mercial /industria 0 Aocc tavory building amps ter an other innallationa, b:ldings. E] Multi- family ❑ Master builder ❑ Other: 0 Firo pump, ❑ lestali"tion .4 '75 KVA at n Eme hasty system. larger elydnrivad scpnrrt - 0 Addition of new motor load of © "A ". "15", "1-2 ", "1-3", Job iitc address: o / 7 - 100HPormorn. occupanc Job no.: R 7:7777 1 r•C l� � J ❑ Six or Moro rmddantinl units. ❑ Recreational , rchicic parks. City /Sttllc/7IP_ , l) GI Health -anti facilities. D Supply voltage for morn than b ❑ limglydoi IOEMionp. 000 volts nominal. Suite/bldg. /apt. no.: Project name: - x. .N.1 -rJ '_ ElBarvicoor&odor 600 AMA In ino . crions to job site: „ ` _ k. Cross street/dtrel � o�ip 1p on .: -, t2OM 1 tt i 11v >'s;, _ 7kfJ11 1 • New residential ample nr multi-family dwelling unit, Includes attached gunge. Subdivision: Lot no.: 1,000 sq. R or less 168.54 4 — — Ica. add'f $00 sq. Q or portion 33,92 1 Toni mttplparcel no.: Limiird energy. residential . b -' . . • . . . (tvitlt 8Q. ft.) 67.84 2 v a Lim1 Lon!! energy, multi- lami 67,84 2 . ,• a .• .. • l.. y • w \I..- .f- .•. reaidetttis� with above sq, 8.) Service" or feeders insinuation, situation, aad/aryelne tiann 200 amps or less _ 100,70 2 • :+11 .laittirg '. _ tt', '11i • . ' - 201 amps to 400 amps 133,56 2 Name: a f 401 "mps to 600 amps 200.34 2 t• 601 amts 1,000 ante, 301_04 — 2 Address: - 2._ 1" _ 1 • • .. OVer i amps or volts 552,26 _ 2 • • CitylStatel7l.P; IC- � ~ Temporary services or feeders in1tailadon, altera and/Dr . + • _ relocation Phone: ( 31, / (1 .j ■ Fax: ( ) 200 amps or teas 59.35 1 Owner installation: This in8tn11ation is being made on property dint T own which is not 201 amps m 400 amp _ 125.08 — 2 intended for sale. lea,. rent, or exchange, according to ORS 447, 449, 670, and 701. sat NT$ to 599 amps 168.54 2 se Owner ai nature: Rived circuits- new, alteration, or sxiormica per rand B .Datc: A, Fee for branch circuits with ' , .. ..... q above sot'iao er feeder fiC, g`+?1t�Ii t � lle" l 1» 11 1 T end bun • circuit 7,42 2 Busint:ss name: n. Fee fbr branch cirarits without Conflict name: t branch edlc foe, FIFO 1 / g 1t4t_ 56.18 t � 2 circuit TAO) n66'11fr9nCh drouit 7.42 a i Addr ess: Miscellaneous (service or feeder nut included) ;y - Each manuractUred or ntadttlar /State/TIP: t ►' ? p l ddwelli scrota and/or ihoder X7, 4 2 Cs Phone: (-. b ) 7D 0 Fax:: ( ) Reconnect only 67.84 2 E mall: U r , !ter Pump or irrigation circle 67.84 2 ' Si of outline lighting ` 87,84 2 K. � �! r r 8f8nal ohouft(9) or iirnitcd energy Business Hama: msaalterotior extenaim,, pane l , 2 F- C �" Each additiona 1nspcction o ver allowable In slmr of the above Addre � ,, -. - FL ec a� z,:, i - 3 Additional Inspection {1 hr min) 66.25(hr City/State2iP: �� p � _ C�"� ( - Z _ �� iiation(1 hr min) 6625I - Tndustrtal plant i hr min) r 78.18/hr � Phrn b o Fax (5.33 ) ___"" t5Vt5 Inspections Or Teh no fee is �57 91 Electrical Li ' 3 A , j 3�< ►ii al ('4 hr min) 90,00! hr CCI3 Lit:.: � c.: � � - u rv. Lis,; "� � Supra- T;'lectrician signature, required: i / F."0"1 Subtotal: ) ~ Plan review (25% of permit fee): rint tlanle: Sf 1I/ -S,S Date: — P State surehnrgc t l2% of permit fee) �j �� TOTA PF, RMIT Authorized signrltute: This penult application expires it a permit la not not oh within tan Print name: days After it h ■x heron aeoepkd as compute. Detr; • ?Timber a innpeetlone allowed per permit. t Alhail"a\Pannn+rELCrtreknpp,dee I0/0Po9 4404615TO r rosrcomfwEa fl . . a L a N ' ! i aut „ fi t lR F ", a `o7 V� r. T' / ' frift c ; '. ,r tp,::t . , M'techanical Permit Application ,� i1 { -, At ' .4 � I•O OFI Icl .it, c""�i�i , t�5t ,,= ,t r t� l A s a 1 a ,irelfAzi.L :+ r. st4ii.,iiAks1►Al4A4:,0 1. 0 Received ' ? Ci of Tigard - �� PermitN 13125 g Date/By: o ki S 1-7(14,1, ( .)(5/ 13125 SW Hall Blvd., Tigard, OR 97223 MAR 1 g 2 013 1 1 0 `'; Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Date/By: Other Permit: ` l 2 , Inspection Line: 503.639.417 c I( R D I I c A It Ready /By: CITY t, , Date Read B Juris ® See Page 2 for Internet: www.tigard- or.gov r Notified/Method: Supplemental Information BUILDING DIVISION TYPE OF WORK - COMMERCIAL FEE* SCHEDULE — USE - CHECKLIST ❑ New construction ❑ Addition/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. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT /SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: ` ; ` n �� ` ^I d Air conditioning \� C \ (requires site plan showing placement) 46.75 City /State /ZIP: Furnace 100,000 BTU (ducts /vents) 46.75 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump _ 61.06 Cross street/directions to job site: Duct work 23.32 • Hydronic 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 for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Tax map /parcel no.: Other fuel appliances . DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen equipment 33.39 City /State /ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, ii Phone: ( ) Fax: ( ) toilet compartments, utility rooms) \ 23.32 2 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: Fuel piping Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater- Fireplace E -mail: Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: b .; ∎ . . Other: Address: P° b ■, 47 - MECHANICAL PERMIT FEES* City /State /ZIP: IN k-ld�w� . - 91 ®f Subtotal 2,-3 t"�O, 32 / � Minimum permit fee ($90.00) (, Phone: ( i,-, - 6 3) (" (q 8 Fax: ( ) Plan review (25% of permit fee) CCB lic.: "'Z tO � Z44 State surcharge (12% of permit fee) Q .80 ii TOTAL PERMIT FE ,lPO. , signatu � \ This permit application expires if a permit is not obtained within 180 Authorized si g �� days after it has been accepted as complete. Print name: ;n ,, / /s(4 G L Date: .4 t /I * Fee methodology set by Tri- County Building Industry Service Board I:t Building \Permits\MEC- PermitApp.doc 10/01/09 4 - 4617T(1I /02 /COM/WEB) FERM A M61'W010 tt Plumbing Permit Apnlicatio IZECEIVED Building Fixtures � a� Y ,.: A _ 1,01: Olt It 1 I y'1 t •; yy� h 41 T i7ti"a` 404... ST A. •.•iy�fM .fie Received ? .� City of Tigard MAR 3 ^- DerrrB : . Q /o larmir -�J a 13125 SW Hall Blvd., Tigard, OR 97223 Plot Review ) ,. a ' Phone: 503.6.39,4171 Fax; $03.5984 tI , ...... Dated : Other Permit No.: I i ®� I Inspection Line: 503.639.4175 1 j is a GARD Date Ready/By: :uric ® See pate 2 for vt4- a A 4 I nternet: wwwtigard,or.gov BUIL N 1 vr ! 1 Notified/Method: Su .Iementel Information g 4.iJ" P lfa! t F 1,.!,,l,,:,,,„ z +,' a .: : •i 1 ., tit W.FP . yyi rt}i' � l � .,.} � �u ?i'�t, r �tYY • r '� b .6 a�. a:. �� ` � A • ,.7 YXr .i�ri..c L+: �r�u i t !��' ' n7 -.. � r. �. 1. "I ��t �. H , Y r' r f�4', V .r Bt i1.Cf ❑ New construction ❑ Demolition for s 1 1emotion Mat checklist Oescri - ion WM Fa- Toud VA Addition /alteration /replacement El Other: New 1 - 2-fa mil dwellln s (includes 100 ft. for NO utili connection 2, 7674.. ;, ' 4 x -Y' � �1 1 - c 1 1 , fir t t w r,t' S ( ) 312.70 NM J r l L . t I P R 1 bath � '� .4 iP'ii' �t ^ �:� krurx ;.9r.lr. �hf�t}>i++>�.s, � ��,4 "�'�� � ��.... ^ . 437.78 ❑ Commercial /industrial SFR (2) bath 12 1 - and 2- fatnily dwelling SFR (3) bath 500,32 ❑ Accessory building ❑ Multi- Ibmily Each additional bath /kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq, ft) Page 2 F '. ig ) T-A ` IL air ' x_ .,. ea r - R F ! Site utilities_ • ' • v r.,6- < r, r_ au 11:, Catch basin or area drain _ 18,76 Job site address: 12 • ..`` .. • P Dtywell, leach line, or trench drain _ 18.76 City /State /Z1P: Ib4Rp 4g Footing drain (no. linear t1.: _J Page 2 Suite/bldg. /apt. no.; Project name: Manufactured home utilities MI 50.03 Mill - Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 MEM Sanitary sewer (no. linear ft.; Page 2 Storm sewer (no. linear ft.: Page 2 Water service (no. linear fl,: 1 Page 2 Subdivision I Lot no,: Fixture or Item: Backflow preventer 31.27 Tax map /parcel no r t �P� y�. y � q �� ! r � I .+ ^ p� -T ,�, ,{{'� t Y ' A 1 Backwater valve ■N 12.51 i2 -S i ,�1'„ fi.a \1 .. r xfSl � x U;a41 &;,6 ,! , vrs- -, . q s, ' ' , !^f �,I :iL(g' 25.02 Clothes washer Dishwasher 25.02 Drinking fbunutin 25.02 Ejectors/sump J 25.02 050 1•, >:e r t t? ,' , ,A.' r •'''�" sion tank 12.51 ;,?...• ii �� iorA l rl y y - 1 �i rA�7 F ' + 1 4 n1� ' / x1 .1; Ex . " 'V ',7:1! a l!--r Q,! ..:.1:,s5L1i1,11,1]r; . , ' + M� i64� i �' '& -: t rI Fixture/sewer cap _ 25.02 Nye �+T��A�� Floor drain/lloor sink/hub 25.02 Address: I2 16 flipbEFielpp Garbage disposal 25,02 City/State/ZIP , City/State/ZIP:11A Flu OR Hose bib 25.02 Phone; ( ) Fax: ( ) !cc maker 12.51 `r "° ;;C,..1,331:./, „r�y�!rr, ap,p'av't' i , ` r ` 'i o ' • . a'- lntcrceptor/glease trill] 25 121 lt , . ••.'tlae 3.4 ":ir1 ,� }, i i.: I , 15x11 .1 1 .. aW l ;r�/ r a,', i Medical gas (value: 5 ) Page 2 Business name: ({ :,. 67eit1ega._ r ./ :a 12.51 Primer Contact name: • 1 ^ - ...1 Roof drain (commercial) 12.51 Address: S ink/basin/lavatory . 25.02 IMIE City/State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub/shower /shower pan 1 12 -51 12 Urinal 25.02 E marl -, 25.02 25.0 i 9 c r .. YY If ':',./ r�,7 i. � q F� 'i „ x 17 5 L 'r,'� � T .ti t i�, Water closet A:4% )ti' S. r >'' _+ L . r � `: Jib n"' -:,.! i t ,. b-, S Y .1v ' JSai. t3 +L6' r� � h'4; '• 37.52 , � t:,•:, 1 �, r +• , ... ' . Ir. Water. he eler Business name: CgY , t r ` /Ib INC . Water piping/DWV 56.29 Address: SO (I S. -: i PA , • • Other _ 25.02 City /Stute/ZIP: ::d / ,/ Subtotal (� � lY+ Minimum permit fee: $72.50 Phone: ;,. �� / n P lan review (25% of permit fee) Plumbing Lic, no.: i ,,;, State surcharge (12% of permit fee) ZOO Authorized s 4' �'i TOTAL PERMIT FEE ?In .ii. This permit epttll expiry' it a permit if not obtained within 180 days Print name: rail! ^ Date: .51..10 after It has been accepted es complete. IrdIP 'Fee methodology sot by 'M -County Building Industry Service Board. i.taissansT?hair \Pt.nt- Immltkep doc 10/01ro9 440- 46i6r(10/02JCOMrWEB) Z00 / 0 NI8i1111d 113hi1l080 Z61_1799ZE09 Xdd V0:80 0L0 /LE /C0 . r iL S \L UCH 0` / ( kp CROMWELL PLUMBING INC. To: Mark VanDomelen <-4R14A<4, City of Tigard E' J � Re: 4 q0 John Bartazal �. 2-' 11$ Ri field^ • Tigard Or. Plumbing Permit # MST2010 -00041 Fax# 503 - 624 -3681 Cromwell Plumbing proposes to install an alarmed sewage ejection system to service 1- toilet -1- shower and 1 -lav and ask for approval per section 301,2 Alternate Materials and Methods of the Uniform Plumbing Code to discharge the afore mentioned fixtures thru an ejection system into an existing 3" building drain. The house is supplied with a 3" abs sewer line which runs from the existing sewer main to the house which eliminates the possibility of increasing the building drain size. Although the plumbing code asks the ejection system connect to a 4" waste line, we feel a 3" line given the potential flow demands is adequate to service the fixtures involved even if all fixtures were discharged at the same time which is highly unlikely. The Liberty series pump we propose to install has adequate H.P and GPM to handle the max discharge as well as enough GPM to scour the drain line and do so while not overloading the drainage system. The homeowners are aware of the situation and would like to proceed. I am including the specification for the proposed ejection pump system for you review Thankyou Greg Cromwell CROMWELL PLUMBING INC. Providing the highest level of service with integrity in the marketplace" www.cromwellplumbing.com 30891 S. Kauffman Rd. Canby, OR 97013 Tel 503.266.4790 Fax 503.266 -4792 OFFICE COPY 900/ZOO 8NIBWnld 113MHOH3 zsztisszeos xe3 19:80 0L0/1/l0 04/12/2010 08'52 FAX 5032884792 CR0WWELL PLUNBING a V03/VV5 ' ' ' ' -- ' '' • .. . 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Ali. , . • . _ __, ; i .: !:,'''''' ' (1. : - si..... . 0 • t „..1 ,, z „,,, .- . , . ?f ; ) , • > ` / ` i L E4O-SER1ES TECHNICAL SPECIFICATIONS PUMP IMPELLIER The pump(s) shall be model The pump shall have a VORTEX style Impeller as manufactured by Liberty Pumps, Bergen, NY, capable of passing a 2" spherical solid. or equal. REAL The pump(s) shall have a capacity of at a total dynamic head of - feet. Motor size The shaft seal shall be of the carbon/ceramic shall be 4/10 horsepower, single phase, 60 hz. unitized design, with BUNA N elastomers and and 115 volt operation, stainless housings. MOTOR EXTERNAL CONSTRUCTION The pump motor shall be of the submersible The pump volute, legs and motor housing type, olI filled, hermetically sealed and shall be shall be gray Iron castings, ASTM class 25 or thermally protected. The overload element shall better. All castings shall be powder coated automatically reset when motor cools. before assembly. All fasteners shall be of 300 - Motor windings shall be of the class B Insulation series stainless steel or brass. rating. The rotor shaft shall be made of 416 stain- LEVEL CONTROL less steel and shall be supported by lower and upper ball bearings. Automatic units shall be controlled by an adjustable, mercury-free, wide angle float switch. The power cord shall be of the quick- disconnect Float cord shall be equipped with a series plug design allowing replacement of the cord without for manual bypass operation. breaking seals to the motor and /or oil chamber. MODELS HP VOLTS PHASE AMPS DISCHARGE AUTOMATIC IMPELLER LE41M 4/10 115 1 12 2" FNPT NO VORTEX LE41A 4/10 116 1 12 2" FNPT YES VORTEX 10' cord standard on above models. For 26' cord options, add a " -2" suffix to model number. Example: LE41A -2 for Model LE41A with 26' cord. DIMENSIONAL DATA: PERFORMANCE CURVE 178 RPM Weight: LE41M: 40 LBS. 20 Height 14" to 16 Major Width: 10.75" (manual models) 14 — Maximum fluid temperature 140' F. 112 s 10 8 { ythi a r Ujr« SR 4 - l � 10 20 30 40 60 BO 70 80 90 100 110 120 130 ...... c us U.S. Gallons Per Minute elpeolllueene me •ubleoc to 0e00e wnhuul "ova.. Liberty Pumps • 7000 Apple Thee Avenue • Bergen, New York 14418 • Phone 800 - 543 -2550 Fax (585) 494 -1839 www.11bertypumps.com copyneht ® Llberly Pumpe, leo. 2010 All rI9hte reamed. LLI7 2400 p02J10 c00 /1700 ONI8YIIlld 1131841080 Z8Lb99ZE09 nid Z9 80 OIOZ /ZL /b0 ip Riser aaih.3ws„ b C th of c i G£ c 'r o.72 'hut' ' - ySte dip ;? o a ��'la:cib'num �r-ic',:'(.' .. - .., E . . B. . ..• per • oil �J t' 'ee%bt 4r l• ,Yu l — r ...® 7 A convenient chamber for all your pump's - • electrical and piping connections — out Fits Pro370 and Pro380 Sories systems of sight and below grade. Riser simply • '.�.. _ Polyethylene Cover ,.,), + '(:r� iii li- ' "; "r�lii "::ii^i •-_ Cover is retained b : . slides over the scaled 370 system. •°''' . , ,..e - {' 4 stainless steel :,. -'' 4 '4._x; by ' ' - : . <:, t Padlock Provision bolts and features a twist' -lock design 4 :1t:.:,; . ......• ;•, y _ ':' • • ; ' � " •''' 4 tea,, with rovision for adlock to deter r 1, ,�!f '' -' . � ;I ".?'. P p t , : — , - Polyethylene Mee r , r r , r unwanted entry. ,I , .& i ,- Specs• icy C-,.rd: ' 1� r � ,, .' , 1 :Ci"1 : �. ]'. Yt' ' : ■V View Weight: 28 lbs.- (Riser and Cover) • f ,, 5 r, • - -• _•.' , lli I r,b A r Y . 1 4 w. 3 Riser Height: 78 -3/4" .v t ' � 3 - ti 4. Total Height with Cover 20-1/7" Diameter: 32 . ' : ? °' . , - . 2c 6 , ` • '' • ' : ix - . :, -, K. p aT g •;; i ; ,, ... .. MODEL DESCRIPTION , , ; i., ` �,,• " ti , ' i l g:> ti.: : r r i : 4 , ' , AR18 Access Riser AC18 Access RISor Cover (Environmental Green) a t ` " ' { a,,,.1,, ^ ' " 1 ARC18 Kit. Access Riser I t" ` � r_._ �''` with Cover "� ARCK1T115 Kit, Acoeee Riser with Cover and 2" Liberty's Installatlon kits provide all the components Com Installation accessories - 115V P P ARCKIT230 Kit, Accede Rear with Cover and 2" for a profeeslonel Installation Inside the ricer. KIt installation accessories - 230V Includes; JB- Serles wiring box and hardware, check IKIT2 -715 Installation Kit 2 ", 115V valve with a disconnect union feature, coupling and • IKIT2 -230 installation Klt 2 ", 230V elbows (PVC piping not included). Kits available in • . .... , ,,, .. , 2" discharge and vent size only . 1 . _ = 5!6G r ;44/. � °_�I. „JL-. • .y .Jl:.w.'�I r � "�Y.� ' y si ! — . - i la ..: . riw•+,m w---__ . y y,. .' n', lih;::..11,i •' �il ", ?'�, d�5114 ;:' ;ty; , ��i •:, � 9I l' la -' ALM -2W Now, have the assurance 1:' °W _ + •''r;^':I a, .early'; atilin ill , '; "'':' ':• J,' Outdoor Rated , event of a high- level,condltion. with an ! '' 11a volt Ale" " {I'' - ' . 1 • ,>:, I nst alled from the: (aat4r yhWe .do the woii ry4u q 1 H, ' (not shown) by mounting the alarmi its;proper',1 ^, ., . ` • ALM•2 (pictured) level •- no, need to .everl open; the,coveri ;SImpl , :: : " �,,'� ' i) -.,,.. Indoor 116V: dean; ,._ the . alarm.panelI Its', �cfesIredlocatIon „atuRply,,,''r +• a” ,l 1-' ;1 ':r ..— 1 with 6 volt Battery., power and Connect the alarm :1loat Ioadsl,Off. erect ''' Beck - u w i t h th. :' Iti P t' ajarr ri• gptione. 'ivrindapr,;or;'•∎' I';" ., }.. . . ,. � ; . outdoor appllcatlo ns:: .. . ,,:: • : r ;,ill• .: �:'i 'i;, , ? I, . :'',' 't,:,, ' ,' �; •,. O ',� • /��� / 7 : { { ,p� �'y�y�8/y ���•,.;: `,t,l: ,:,I ..' ' ' .,: • • ` : .l. .. ©tl�: ' ; tl c / ■per ■ow: o Onlekt:; : ' 1 0448 1 - I 1 , ' Alarm Model Add Suffix Ordering Example ALM�2 /A2 P372LE41/A2 '''i;,'1• +'r,';. . ALM -2W /A2W P372LE41 /A2W i� "`'': A LM - / A21 P372LE41/A21 ^ • . warmnoelapra• eei CkeBed at ,ln "� I;�j, �'' 1'`,,,i • • , , �, ".i' �'; • . I ,_ Y 1.. . A1srm penelP6 4rllh unit: : „i ; n . �� �^ , 1 , .' ' 'Y, ; : :. ti ;' :! ) - i�r.' . ",i' 1 ^i,i, , . , ' } ' i lo ::" • ' WWW. Libert yPimps•7ODO A p p le. 7i , tie 'Avenue % °Be en, N e r v !!o j r - 7441 cetera '• Pho p• 9 600 - 543 - 2550 „F x'; 3 6 r, • libertypumps � . . t70 eclrlcafono oro subject to chan without notice Copyright ® Lmerty.Pumps,')nc . 201,'O Alt tights resoryad. ,L1J1'fpo /tO f i� il'ri ,';'.l "�'I:1�11' . ? ill "pp }" i G00 /cOOt i JNI819f11d 11311 O O Z8Z1799ZE09 XvJ ZS:80 0L0Z /ZL /170 • Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi - Family Fee Schedule: Total Valuation: Permit Fee: $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 $1 00.00 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.doc 10/01/09 2