Permit 6(/i6 (10 CL94-1241S.4" e 1 -
k i CITY OF TIGARD MASTER PERMIT
w
u 13 'W COMMUNITY DEVELOPMENT Permit #: MST2010 -00094
Date Issued: 05/28/2010
TIGAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S103CC15300
Jurisdiction: Tigard
Site address: 12343 SW PLANTATION TER
Subdivision: STEPPING STONE ESTATES Lot: 3
Project: Bui
Project Description: Add outlets and sheetrock to unfinished room. 6/16/10, adding duct work.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 390 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: sf Value: $38,200.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Tvpes Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 1
Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders 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 addl 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)
BUI, GREGORY M & MICHELLE MOORE REMODELING &
12343 SW PLANTATION TER CONSTRUCTION LLC
TIGARD, OR 97223 32810 CHURCH ST
Warren, OR 97053
PHONE: 503- 367 -9087 PHONE: 503 - 239 -0877
FAX:
Total Fees: $1,646.91
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 ' ccordanc ith 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. TENTION: Grego law re•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 1 -0010 rough OAR 95 -00 -010x. u may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332 .
` � . � T,-6.....4..e.r.A____O
Issued IN—_--- Permittee Signature
Aii i` a r ip MASTER PERMIT
. ; CITY OF TIGARD
` g .= COMMUNITY DEVELOPMENT Permit #: MST2010 -00094
: 8 GARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 05/28/2010
Parcel: 2S103CC15300
Jurisdiction: Tigard
Site address: 12343 SW PLANTATION TER
Subdivision: STEPPING STONE ESTATES Lot: 3
Project: Bui
Project Description: Add outlets and sheetrock to unfinished room.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 390 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 si Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 si Right: 0 Detectors:
Total. sf Value: $38,200.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0
Tubs /Showers: 0 Garbage Disp • 0 Water Heaters: 0 Water Lines: 0
Drains: 0
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Fum <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add'I 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'I 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)
BUI, GREGORY M & MICHELLE MOORE REMODELING &
12343 SW PLANTATION TER CONSTRUCTION LLC
TIGARD, OR 97223 32810 CHURCH ST
Warren, OR 97053
PHONE: 503 - 367 -9087 PHONE: 503 - 239 -0877
FAX:
Total Fees: $1,546.11
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty 1 odes and all other appli - •le law. All work will
be d• e in accor.a with approved plans. This permit will expire if work is not started within 180 days of iss.ance, or if work is sus. - ded for more the 180
day.. ATTENTION: Oregon I- requires you to follow the rules adopted by the Oregon Utility Notificatio Center. Those ru -s are set forth in OAR
95 001 -0010 through OAR -001 • 0 se You may obtain a copy of the rules or direct questions to OUNC by calling 503 •46.6699 or 1.800.33 , 4.
Iss ed By: Permittee Signature: '� I / / di j
w
Building Permit Application /3
Residential r it . , d a r op f ICE USF ONLY K �, r
. SS
� t 3 5+ �F '! �. 4 i ��" j y i
ter / ' Received I ' H r fQ -,pCD
i City of Tigard i " �mM� Pemnt No.: R E C i DateBv:
`' ° 13125 SW Hall Blvd.. Tigard. OR 97223 Plan Review
.s. Phone: 503.639.4171 Fax: 503.598.1V(AY 2 S 2.010 Date /Bv ' tJ Other Perniit:
T rA Inspection Line: 503.639.4175 Date Ready /By: Jur /1 See Page 2 fur
a' - ' , -..; Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: h Supplemental Information
CITY DIVISION '
TYPE Of REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ N j�M��C ew construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 Addition /alteration /replacement ❑ Oilier: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION
work indicated on this application.
Valuation: $4 ?ii .�
® 1- and 2- fancily dwelling ❑ Commercial /industrial •ft 1' — '�'
i
❑ Accessory building ❑ Multi - family Number of bedrooms: e$, ate.
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12343 SW Plantation Terr. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite /bldg. /apt. no.: Project name: Bui Residence Covered porch area: square feet
Cross street/directions to job site: 1/2 Block East of 12Ist & Gaarde Deck area: square feet
Other structure area: square feet
' REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Lot no.: Pennit 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.
Adding outlets & sheetrocking an unfinshed room Valuation: S
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Greg & Michelle Bui Type of construction:
Address: 12343 SW Plantation Terr. Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: (503)367 - 9087 Fax: ( ) New
❑ APPLICANT ❑ CONTACT PERSON NOTICE,
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being perlbrnted. I f the
City /State /ZI I :
applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax::( )
E -mail:
CONTRACTOR
Business name: Moore Remodeling & Construction LLC BUILDING PERMIT FEES*
Address: 32810 Church RD (Please refer to fee schedule)
Structural plan review lee (or deposit):
City /State / /1P: Warren OR 97053
FLS plan review fee (if applicable):
Phone: (503) 239 - 0877 Fax: ( ) t I
CCI3 lie.: 184046 Total fees due upon application: '/ $7 _T
Amount received: it s 7 . ci5" .
Authorized signature: all: This permit application expires if a permit is not obtained
MO w ithin 180 days after it has been accepted as complete.
Print name: Jason Nlo� Date: * Fee methodology set by Tri- County Building Industry,
Building Permit Application Checklist
One- and Two-Family Dwelling o ', E
• Received
City o f Tigard Permit No.:
Date/By:
13125 SW Hall l3Iyd., "Tigard, OR 97223 Associated permits:
ya. C : Phone: 503.639.4171 Fax: 503.598. 1960
TIG'ARAD
24- 1-lour Inspection Line: 503.639.4175 ❑Electrical ❑ Plumbing ❑Mechanical
Internet: www.liaard- or.gov . ❑ Other:
r e.T4HE L L O WIjNGiTPE+MS :ARE,RCQUjIIRPD.F:O.R P�UAiN,REVIjFY -= - :
I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain. solar balance points. seismic soils designation. historic district. etc. ❑ ❑ ❑
3 Verification of approved plat /lot. ❑ ❑ ❑
4 Fire district approval required. 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 he incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
I 1 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 -0. elevation differential, plan must show contour lines at 2 -ft intervals): location of easements
and driveway: footprint of structure (including decks): location ofwells /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 More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing, rooting, roof slope. ceiling height, siding material, footings
and foundation. stairs. fireplace construction. thermal insulation. ete.
15 Elevation views. Provide elevations for new construction: minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade lithe 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 ofrebar. For engineered ❑ ❑ ❑
systems. sec item 22. "Engineer's calculations :'
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and /or any beam /joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided. (i.e.. shear wall. roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Oregon and shall be shown to be applicable to the protect under review.
s JUR1S'DD I'CTIL®NAL SP ., 11F1 S •,, x - 4.: a •
23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or I I" x 17 ". ❑ ❑ ❑
24 Two (2) sets each arc 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 he 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 free 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. 'free 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.
Electrical Permit 0 2010 pppelg : Applicatio -)F:' C, f�- FOR tits ( f tiSF 01N1.1V
City of Tigard L. '� °�'° i0 i P emiit No : , > Q ''
_ ate /8 5 /
13125 SW Haft Blvd. Tigard OR 97223 iltt�� pl Review
t Phone: 503.639417, , 1 Fax; 503,598,196B 2i Other Permit,
I' I i:Al' I, Inspection Line: 503.639.4175 Date Ready /By'. Jura, la see Pegs 2 for
Internet: www,tigerd•or,gov MY CF. T f RD Notified /Method: Su. dements] tnformetieu
' dt t .,.:... ....:.. .1 . r. h. ii a i 61 ... ":, . , , ) ; 1 4i 4 i l!l W
❑ New construction Addition /alteration /replacement Please check all that apply (submit 1 sets of plans w/items checked below):
❑ Service or feeder 400 amps or acorn ❑ 8uildlog over Three stories.
❑ Demolition ❑ Other:
where the available Dinh current ❑ Marinas and boatyards
Fit• 1J ' ' P'A atiti 7 l01 `"" t „ u ,u a r exceeds 10,000 amps at 150 volts or ❑ Floating buildings,
... .-..
" '• °`° leap to ground, or encode 14,000 1:1 Commarcini -use agricultural
1
• � - and 2-family dwelling ❑ Commercial /industrial ❑ .. Accessory building amps for all other inftallAtloas, buildings.
❑ l vulti- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 kVA or
'` a 5 0� n A. Mz} r,. / '. ❑Emergency system. larger aepatate:y aerWedsystem
.,„ iY . .., ` "" 1 F[�r�J.4 • LL �.0 1t : : iii! c , v„zRc��g�rr� (21 Addition ofLaw motor load of ❑ •, A'• ••H• "1_2 •
Job n0.: I Job site address: / Z 3 44 A sw p/c, /? 0 L4 100 or mare. o re ancy, 0 six or more residential units, ❑ eereatianal vehicle parks,
City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage fly more than
❑ 1 - fezandoua locations. 600 Nolte nominal,
Suite/bldg. /apt. no.: Project name: ❑ service or feeder 600 amps or more,
-- c , lG' F..T S D� ., r. .l ', :'.
Cross street /directions to job site: n I otr, I Fee, 1' 'rams 1 •
6/� (New residential single -or multi - famlly dwelling unit,
c•(. 4 L. U ' f% e i f a. ,--1.4.4 1 Includes attached garage.
Subdivision: .. r4S. VI r�A i t c Lot no,: 1,000 sq, ft. or less 165,54 4
J�� Ea adel 500 t.q, ft. or portion 33.92 1
Tax map /parcel no.:
w �.,.,..`, .
'" `fti �' nw f 0BSt�° � ' ' a n ' Limited rgy, (wia al"Ve se,' a') 67.54 2
residential
// ( / ii Li c ener mu ti- famlly 67.84 2
,,,
, d't 56.4, l ( 't (W C= C(^rl,, �.- ttl3 If � t - 4( (rv1 I. t,.4 residential (with above wt. ft) _
Services or feeders installatlon,alteratton, and/or relocation
` 4
II
'r lt� R . h;' s.. _.. " t i ::.. 201 200 amps npr to4 133.56
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary' services or feeders Installstlon, alteration, and /or
relocation _
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner Installation: This installation is being made on property that I own which 1s not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, peryanel
Owner signature: Date: A. Fes fbr branch circuits with
a ;• �1 3) k above service or feeder
,, •n.,,,1 ' e� w .! 1:, r{ . 1r ! `frill tg? _t, n:. ... ,P n .., *ON each branch circuit : 2 2
Business name: B. Fro fvr branch circuits w : . rt
service or feeder fie, II t ( 6. : 2
Contact name: _ branch circuit
Address:
Each add'l branch ci mu' ' .42 1 2
Miscellaneous (servl�or feeder not int , r edL
City/State/ZIP:
Each manufactured or dular ......7 67,ga 2
dwelling, service and/o ede- r
Phone: ( ) Fax: : ( Re onl 67,84 2
• - - Pump or irrigation circle 67.84 2
•ma11:
v sl ,a lr ... . ?J t n(" iwe A Sign or outline lighting 67.84 2
.:.uLL. *•>,ff' t .•'„ 1- �- ua ' ! signal circuit(?) t or limited- energy
Business name: e dt -k!`r i ,`�i 1 , t..-- L�e_cf panel, a dditio n, or extension, Page 2 2
Each additional tnapectlon over sllvwable In any of the abov
Address: A dditional inspection 1 hr min 66.25/ hr
t �e 13r,�k /Dr��f� p ( '
City/State/ZIP: `;mss- f-4-- el f p 9 7 z- Investigation t min) 66,25/ hr
( `" industrial plant (1 1 hr min) 78,18 /hr
Phone: (A33) .Y /.... ca• zo I Fax: (53: Z q >a ! / Inspections for which no fee is 90.00/hr
�y� s eciAcal]y listed (V. hr min)
CCB Lit,: /d 7 E lectrical Lic.:..577.,....5.—/ L-I Suprv. Lie.: I/gee/ ` 4 „r:4l. , ,:.,'tLzenuc i AggIT.:.I $ 11 , , '
Subtotal:
Suprv, Electrician signature, required' ' /
�j/ ✓,1( � Plan review (25% of permit fee):
Print nam . ; i„ ..3 42a.,-- , , L � Date: ""- -- /(G State surcharge (12% of permit fee):
/ .r TOTAL PERMIT FEE:
Authorized signature .� This p ermit a pp lic ation expire.; If a permit is ant obtained Withill 1b0
Print namC: /� Date �" /+!� days after it has been aecaptad as ...plat..
Print [� K . _J er r°'" ,/i1 t e -- t ti * Number of inspections allowed per permit.
1' 1HuttdinglPermlt5'BLC-PennItAppp duo 10/01 4440 :07(1 V011COM/WEn
I' d XdA 13Ca3SU1 dH 81 ' b 1 0102 62 R W
Mechanical Permit Applicati r r �+ "fgf+'�h 'd��x ""�� I� �� d� � H�y1 x'r �ic��i�i" y. � � v /
: t „ ; `1 ' OFI IC[ tU N1 " �M I� , "'p
l i i yz o ; _ OR .ya✓ aw,S a,w'b i a - uaeu s i2,r t tiCA*. .. ,t 7 (
:1 Rece ived
;- � Permit No.. C ity o f Tigard CEIVED Date/B Q "7I ?r 9j�O —r�Q?
13125 SW Hall Blvd., Tigard, OR 97223 v �
C Plan Review
Phone: 503.639.4171 Fax: 503.598.1964 U N 1 6 Other Permit:
I 1 Date/By:
li I c A 1CYI)j Inspection Line: 503.639.4175 J Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Mechanical permit fees* are based on the value of the work
❑ Addition /alteration /replacement 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*
f<and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION • ( Heating/cooling
Job site address: -- ) �r co n ditioning
.� S 1. �/ pCC.r� (. /l(re quires site plan showing placement) 46.75
City /State /ZIP: l Furnace 100,000 BTU (ducts /vents) 46.75
b Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: ' I Project name: E I 1 Heat pump 61.06
Cross street/directions to job site: Duct work 1 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: 1 Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
( Gas fireplace 33.39
I n gl rf V t S C Flue vent for water heater or gas
�' 4 < r L fireplace 23.32
i Y 1 Q � 1 " Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT C Other: himney /liner /Flue /vent 23.32
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,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
. • ❑ APPLICANT . ❑ CONTACT PERSON _ . Attic /crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping
Contact name: S14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater
Fireplace
E -mail: Range
• CONTRACTOR . Barbecue
r
Business name: 44 W v �/Q >t �C1r Clothes dryer (gas)
P P ri ) 4 y l/�l y am. (0 2 S I ati Other: I
Address: 3 2 _ 2 �7 I b � c K _ MECHANICAL PERMIT FEES* ' •
City /State /ZIP: 6 ,4S-- -- Subtotal
Minimum permit fee ($90.00) 'Q,
Phone: ( }'a 3 ) Z 3 . 1 _ OQ -7 Fax: ( ) Plan review (25% of permit fee)
CCB lic.: ( (� 0,1 , State surcharge (12% of permit fee) /0, ?a
"C TOTAL PERMIT FEE AO, O6
4C/le) 6 Ths permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: � J! l c Al s * Fee methodology set by Tri- County Building Industry Service Board
"^ ( � Date:
1: \Buitding\Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (11 /02/COM/WEB)
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 $100.00 or
fraction thereof, to and including
$10,000.00.
$1 0,000.01 to $50,000.00 $347.71 for the first $1 0,000.00 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.
1:\ Building \Permits\MEC - PermitApp.doc 10/01/09 2
Crawl Space Access Moore Remodeling L ' & Construction LLC s_
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New out lets to code
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Electrical Panel
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CITY OF TIGARD
Build Details: Approved -- ----------------------- - - - - -- [.>1
Conditionally Appro\,ed-------- - --- -- [ 1
Furring - 2x4 Framing 16" OC with 213 insulation See Letter to: Follow------------ - - - - -- [ ]
Attached ---------- - - - - -- E. ]
Permit Number: ,, 40,0 _ rr 04`
Address: - S/a
By: _Date:
Bui Residence
Greg & Michelle Bui
OFFIC COPY 12343 Plantation Ter.
11 Tigard OR, '17223
Page 2 of 2
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As Built Details:
Walls - 2x6 Framing with 21 insulation (no sheetroc:)
Ceiling - art, F3& insulation with no sheotrock
Floor - 2x6 T &G sub - flooring
But Residence
® & Michelle Bui
12343 Plantation Ter.
Tigard OR, 91223
Page 1 of 2