Permit MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2004 -00272
i DEVELOPMENT SERVICES DATE ISSUED: 12/8/2004
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10276 SW 90TH AVE PARCEL: 1S135AA-07500
SUBDIVISION: FINEVIEW FARM ZONING: R -4.5
BLOCK: LOT: 001 JURISDICTION: TIG
REMARKS: New SF detached
BUILDING
REISSUE: MD102R STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,205 sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,479 sf GARAGE: 531 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 262,946.70
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2.684 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: 1 VENT FANS: 6 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 5
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 • 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EAADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st W /OSVQFDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: ALL - ENCOMG BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner Contractor: TOTAL FEES: $ 8,588.83
BEACON HOMES NW INC BEACON HOMES NORTHWEST This permit is subject to the regulations contained in the
Tigard Municipal Code, State of OR. Specialty Codes
12703 SW 67TH AVE (151251) and all other applicable laws. All work will be done in
TIGARD, OR 97223 12703 SW 67TH AVE accordance with approved plans. This permit will expire
TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 570 - 8828 Phone: 503 - 570 - 8828 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 151251 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 -4444 Post/Beam Mechanical Electrical Service Low Voltage Storm drain Insp Mechanical Final
Sewer Inspection Underfloor insulation Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Footing Insp Crawl Drain /Backwater Framing Insp Gas Fireplace Water Service Insp Building Final
Foundation Insp PLM /Underfloor Shear Wall lnsp Insulation lnsp Appr /Sdwlk Ins 7
Post/Beam Structural Plumb Top Out Exterior Sheathing Insr Rain drain Insp Electrical Fi• .I
Issued By : , : j. A f .2 Permittee Signature :
411101("41"" _
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the n: ' f" bu s i ness day
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
TIP TOP PLUMBING
2193 PARK AVE NE
SALEM, OR 97303
Plumbing Signature Form
Permit #: MST2004 -00272
Date Issued:
Parcel: 1 S135AA -07500
Site Address: 10276 SW 90TH AVE
Subdivision: FINEVIEW FARM
Block: Lot: 001
Jurisdiction: TIG
Zoning: R -4.5
Remarks: New SF detached
Your company has been indicated as the plumbing contractor for the permit indicated above. I n order for
the plumbing permit to be valid, please have the appropriate individual from your company sign below and
return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
BEACON HOMES NW INC TIP TOP PLUMBING
12703 SW 67TH AVE 2193 PARK AVE NE
TIGARD, OR 97223 SALEM, OR 97303
Phone #: 503 Phone #: 503 - 881 -6724
Reg #: LIC 160062
PLM 24 -417PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X , /�
/i /�dlAet
Signature of A o ' es Plumber
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CONNECTIONS ELECTRIC
PO BOX 7136
SALEM, OR 97303
Electrical Signature Form
Permit #: MST2004 -00272
Date Issued:
Parcel: 1 S135AA -07500
Site Address: 10276 SW 90TH AVE
Subdivision: FINEVIEW FARM
Block: Lot: 001
Jurisdiction: TIG
Zoning: R -4.5
Remarks: New SF detached
Your company has been indicated as the electrical contractor for the permit indicated above. In order for
the electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
BEACON HOMES NW INC CONNECTIONS ELECTRIC
12703 SW 67TH AVE PO BOX 7136
TIGARD, OR 97223 SALEM, OR 97303
Phone #: 503 - 570 -8828 Phone #: 503 - 390 -7914
Reg #: LIC 65444
ELE 24 -248C
SUP 3611S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signa ure of Supervising Electrician
If you have any questions, please call 503.718.2433.
ECEIVE . E 1 U
Itui1QIn Permit A p ication FOR OFFICE USE ONLY
3 1UU� P 2M4 . Air Permit No.: L� 9..
City of T rc� SE Received ayy: , // '- // #, ?
13125 SW Hall lyd., Tigard, OR 97223 • F T AR Plan Review 4 , f,
Phone: 503.49.4171 Fax: t S 196�i�T 1I " Date/By: Other Permit:
Ins? t tii )165: 139:41 / BuiL ING �� • ''' I I Date Ready/By: /� I ® See Attached Checklist for
Int] rlet www.ci.tigard.or.us No 'fied/Method: "� —� 7 l � Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® New construction El 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
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $250000
® 1 - and 2 - family dwelling ❑ Commercial /industrial
Number of bedrooms: 4
❑ Accessory building ❑ Multi- family
❑ Master builder ❑ Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 10276 SW 90TH New dwelling area: 2684 square feet
City/State/ZIP: TIGARD, OR Garage /carport area: 531 square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: 123 square feet
Cross street/directions to job site: BETWEEN LOCUST & OAK ST. Deck area: 0 square feet
Other structure area: 0 square feet
REQUIRED DATA COMMERCIAL - USE CHECKLIST
Subdivision: FINEVIEW FARM PARTITION MLP2003 -00012 Lot no.: PARCEL 1 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.
NEW SINGLE FAMILY RESIDENCE Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: BEACON HOMES NW, INC. Type of construction:
Address: 12703 SW 67 AVENUE Occupancy groups:
City/State /ZIP: TIGARD, OR 97223 Existing:
Phone: (503)570 -8828 Fax: (503)570 -8869 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: BEACON HOMES NW, INC. All contractors and subcontractors are required to be
Contact name: DAVID DALBEY licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12703 SW 67TH AVENUE jurisdiction in which work is being performed. If the
City/State/ZIP: TIGARD, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 570 -8828 X 1/03 Fax: : (503) 570 -8869
E - mail: ddalbey @BeaconHomesNW.com
CONTRACTOR
Business name: BEACON HOMES NW, INC. BUILDING PERMIT FEES*
Address: 12703 SW 67TH AVENUE Please refer to fee schedule.
City/State /ZIP: TIGARD, OR 97223
Fees due upon application
Phone: (503) 570 -8828 Fax: (503) 570 -8869
Amount received
CCB lic.: 151251
(a.0 Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: DAVID DALBEY •, Date: 911- t ` * Fee methodology set by Tri-County Building Industry
( Service Board.
i:\ Bui iding\Permits\BUP- PermitApp.doc 12103 440-4613T( 11 /02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard EN ED
Date/By: Permit No.
G 9 �3 oS 1 ? �-
13125 SW Hall Blvd., Tigard, OR 9 Oh Plan Review
Phone: 503.639.4171 Fax: 503';,59 .,1 1 tit li R
tvo 1 1 I \ DateBy:pi / jZ • 1 •- e ti Other Permit:
Inspection Line: 503'.639.4175 .34 fl __ ' Date Ready/By: ® See Page 2 for
Internet: www.ci.tigar l.or ► • Notified/Method: / Su lemental Information
CF TIGARLSE RD �. PP
,°. ' I Mechanical permit fees* are based on the value of the work
' „ _ r , t ^C M MERCIAL FEE SCHEDU — USE CHECKLIST
❑ New construction ❑ . • • ition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
g1 �M g » i'' Value: $
. l .rte ,.. w... .. , ..� . ..�.� r.....; " l, ,
$ E QUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. Total
. , Q �- - D 0 n s- , Heating/cooling
Job site address: / t t1 Air conditioning or heat pump
` r)7.-7 b �'t J (requires site plan showing placement) 14.00
City/State/ZIP: TI c& Furnace 100,000 BTU (ducts/vents) 14.00
U Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: I Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
1 -' ' ` " fi t t P 3 g ,1 z. Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney, liner /flue /vent 10.00
e " " i i K ,; r Other: 10.00
Name: Be- 1t* rl TN G s (J W Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
yi , ` ti C'QN Attic/crawlspace fans _ 10.00
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 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
' t ?f
$ ' ' �. .
. " ,44 , i V ,€.' > 3 'g7,77- ,' i ',,, w � "�' , Barbecue
,._. 14-, r_ a� "' ?> , x. b. 4' . ate ,
Business name: S 1 �� N)��� Clothes dryer (gas)
Other:
Address: . : . . •. ... ,. - .
' ECHANICALPERMT EES*
City/State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized sign• This permit application expires if a permit is not obtained within 180
l,
days after it has been accepted as complete.
Print name: , , u 4� r). e . t ( Date: 9.1‘ I 0 y * Fee methodology set by Tri- County Building Industry Service Board
B \ ME
i:\uiiding\PennitsC- PermitApp.doc 12/03 440- 4617T(II/02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
EcEtvEy
Electric ti?n �4 FOR OFFICE USE ONLY
City of T#g y
1 ` III►
, D • 9 ,3 Q'/ Permit No.: K5/ 40)7 ._
13125 SW Hall Blvd., Tigard, OR 9 % t 1 Y
I.., P la n R eview
Phone: 503.639.4171 Fax: 503.59.. • 6 � / � r Y V ■ i' Date/By: Other Permit:
Inspection Line: 503.639.4175 I ,Gp o But \ t )� I IL, Date Ready/By: 1�_ WI See Page 2 for
Internet: www.ci.tigarC}.or.use r . Notified/Method• ( I m Supplemental Information
�; r '^� •+..�,. i...-2,„,..... . 4,.:..,, S 1 " � I e S'�, y "'°" ... t." s` if. x � , ' ;. t g U ' e rc ix � ; ; 1N, '41:10A. t
❑ New construction ❑ Addition/alter. 'on/replacement Please check all that apply:
❑ Demolition 11 Other: ❑Service over 225 amps, comm'l ['Hazardous location
,, ,., ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
,.
,� t� ,6 . ' .:. - of 1- and 2- family dwellings 4 or more new residential
El 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi - family ❑Master builder ❑Other: DBuilding over three stories ['Feeders, 400 amps or more
Occupant load over 99 persons ❑Manufactured structures or
., 1,,,,,,r2„,_ - t r d 4 d < a y u ' 'c v"` : ❑Egress/lighting plan RV park
Job no.: Job site address: a Te ❑Health - care facility ❑Other:
I d2 S 7� Submit 2 sets of plans with any of the above.
City/State /ZIP: T �p,A.D The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: • ct y .., :g� —
Description Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential I 75.00 2
�. ?,-77,.V17: , a te Limited energy, non - residential 75.00 2
�� ' � d _, a g� ,a l A, ,l„,„ 4 � Each manufactured or modular
dwelling, service and /or feeder 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
., ,,. �d ' � ;,� -_ , ca , ' � � , .. 201 amps to 400 amps 106.85 2
- a--- ; a �.' =- '. -� ..•° z-° - --= 401 amps to 600 amps 160.60 2
Name: it N e5 1 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps , 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
Lr 'It"... . a t x 1 " .- Mµ A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
& _ ,: ,,s ',2,..1s Zm , - 1.1 : energy panel, alteration, or 2 2
mow m1 _._. �_ ... extension. Describe: Page
Business name: C O N. . 11._ � �\ t ` v
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
A " ze d ., 4 a ; rte -:,- c'o-
CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
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: * Fee methodology set by Tri- County Building Industry Service Board
* Number of inspections per permit allowed.
is\ Building \Permits\ELC- PermitApp.doc 12103 440- 4615T(l0 /02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial system $75.00
(SEE OAR 918 260 - 260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
I] 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
is\ Building 'Pemuts\ELC•PemdtApp.doc 04/03
Building Fixtures
,Plumbing Permit Ap 1 li • • 1 ED FOR OFFICE USE ONLY
City of Tigard Date/By: 9 i 3 O ere' No.: 1//7nG/�/1a 2-7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �/'��
Phone: 503.639.4171 Fax: 503.598.19 0 4 //,�,� 1 ., Other Permit No.:
24- Hour Inspection Line: 503.639.4175 tr 20 ' ^f i \ Re Date
., Date ReadyB ® y: Juris: See Page 2 for
Internet: www.ci.tigard.or.us . 16 ' 0 `, - -. Notified/Method: Supplemental Information
- -3
,.'_ a,: � a ., *,=. a . : 4 . ' .1'' FEE SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description } Qty. 1 Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1 dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION .#
,,a Site utilities
Job site address: 1 1 0 2 ( c W "DT 1 Catch basin or area drain 16.60
City/State /ZIP: j 404-0 4 O n Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
N PROPERTY OWNER ❑ TENANT
Ejectors /sump 16.60
Name: ai. ej 1y
()" , ! Expansion tank 16.60
Address: �• Fixture /sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
: P�., �° ; Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City/ State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
Water closet 16.60
Business name: - f 1 Ne �., 0 17 "3 11∎•1v -�� . ,ti� Water heater 16.60
Address: Other:
City/State/ZIP: Subtotal
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature:
TOTAL PERMIT FEE
Print name: I Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\ Building \Pmnits\PLMF- PemtitApp.doc 12/03 440- 4616T(10/02 /COM/WEB)
Plumbing Permit Application - City of Tigard
•
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
`Total
, .
... ., ., , Square;Faotage ; Permit Fee:
Footing drain - 1' 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas S stems:
Water Service - each additional 100' 46.40
Storm & Rain Drain - 1st 100' 55.00 Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
l� - 1 p additional $100.00 or fraction thereof, to and
::! a.' f. ' ti ' including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work:
Are you capping, moving or replacing existing fixtures? If
"yes ", please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * .
•
Comments regarding fixture work:
Baptistry/Font
Bath - Tub /Shower
- Jacuzzi/Whiripool
Car Wash -Each Stall
-Drive Thru
Cuspidor /Water Aspirator
Dishwasher - Commercial
- Domestic
Drinking Fountain
Eye Wash
Floor Drain/sink - 2"
-3"
- 4"
Car Wash Drain
Garbage - Domestic
Disposal - Commercial *Note: If the fixture work under this permit results in an
-Industrial increase of sewer EDUs, a sewer permit will be issued and
• Ice Mach./Refrig. Drains
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
Shower -Gang
-Stall
Sink - Bar/Lavatory Quantity Total
-Bradley Isometric or riser diagram is required if fixture quantity
- Commercial
Service total is >9.
Swimming Pool Filter
Washer - Clothes
Water Extractor Plan Review
Water Closet - Toilet Plan review is required if fixture quantity total is >9.
Urinal
Other Fixtures:
i: \ Building \Pcnnits\PLM- PemdtApp.doc 3/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00272
13125 SW Hall Blvd., Tigard, OR 07223 DATE ISSUED: 1218/2004
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ..
INSPECTION WORKSHEET FOR DATE: 4/28/2005 TIME: 7:24AM PAGE: 60
SITE ADDRESS: 10276 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: FINEVIEW FARM LOT #: 001 TYPE OF USE:
PROJECT NAME: FINEVIEW FARM MLP
DESCRIPTION: New SF detached
OWNER: BEACON HOMES NW INC, PHONE #: 503-670-8828
CONTRACTOR: BEACON HOMES NORTHWEST (151251) PHONE #: 503- 570 -8828
Inspection Request Scheduled For: Date: 4/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005570 -03 603-407 -0680 N
Corrections/Comments/Instructions:
jPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: "4-4 y0 Date: T ` 24 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00272
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/8/2004
Phone: (503) 639 -4171 * „�i;�;� 1
Inspection Requests (24 Hrs.): (503) 639 -4175 _..
INSPECTION WORKSHEET FOR DATE: 613 TIME: 7:14AM PAGE: 52
SITE ADDRESS: 10276 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: FINEVIEW FARM LOT #: 001 TYPE OF USE:
PROJECT NAME: FINEVIEW FARM MLP
DESCRIPTION: New SF detached
OWNER: BEACON HOMES NW INC, PHONE #: 503570.8828
CONTRACTOR: BEACON HOMES NORTHWEST (151251) PHONE #: 503-570.8828
Inspection Request Scheduled For: Date: 5/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 00585302 503-407 -0580 N
Corrections /Comments /Instructions:
r
,
PASS ❑ PARTIAL APPROVAL LI CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1-1..A...A - Date: '° 3 /006 Phone #: (503) 718-
CITY OF TIGARD 1 -) -7 ��
BUILDING DIVISION 5w 67 , PERMIT #: MST2004 -00272
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1218/2004
N . Gna_7
Phone: (503) 639 -4171 iimoi4u lI ' W
Inspection Requests (24 Hrs.): (503) 639 -4175 __ I l
INSPECTION WORKSHEET FOR DATE: 5/20/2005 TIME: 7 :11AM PAGE: 20
SITE ADDRESS: 10276 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: FINEVIEW FARM LOT #: 001 TYPE OF USE:
PROJECT NAME: FINEVIEW FARM MLP
DESCRIPTION: New SF detached
OWNER: BEACON HOMES NW INC, PHONE #: 503..570 -8828
CONTRACTOR: BEACON HOMES NORTHWEST (151251) PHONE #: 503. 5748828
Inspection Request Scheduled For: Date: 55/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 007393 -06 503- 407 -0580 N
Corrections /Comments /Instructions:
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: p'1tt/ Date: 5 -05 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00277
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/0/2004
Phone: (503) 639 -4171 ����������IU�I�'I
Inspection Requests (24 Hrs.): (503) 639 -4175 "
INSPECTION WORKSHEET FOR DATE: 5/20/2005 TIME: 7:11AM PAGE: 19
SITE ADDRESS: 10276 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: FINEVIEW FARM LOT #: 001 TYPE OF USE:
PROJECT NAME: FINEVIEW FARM MLP
DESCRIPTION: New SF detached
OWNER: BEACON HOMES NW INC, PHONE #: 503-570 -8828
CONTRACTOR: BEACON HOMES NORTHWEST (151251) PHONE #: 503 - 570 -8828
Inspection Request Scheduled For: Date: 5/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 007393-06 503 -407 -0580 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: M 1 " / Date: 5--)O .., 0 .5 Phone #: (503) 718-
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Fineview Partitions
MLP 2003 -00011
1. The screening that is required along the north property line of the flag pole next
to tax lot '906' could be either a fence or vegetation. If the property owner of
tax lot '906' agrees, a vegetative screen will be placed on that property, in the
space between the retaining wall and the property fine. Otherwise, a 6' -high
wood fence will be constructed on the property line, as shown on the
construction drawings
2. Street trees are required along the north side of the driveway, since the
developer is not able to retain the six larger fir trees along the south side of the
proposed driveway (within the flag pole area of MLP 2003 - 00012). However,
because there is not enough room physically to create a suitable planter strip,
the developer will plant 4 or 5 trees elsewhere on the site in lieu of the street
trees.
3. The tree plan submitted with the application is adequate.
4. The developer will construct a sidewalk along the south side of the shared
driveways, in flag pole area of the Parcel 1 created via MLP 2003 - 00012.
MLP 2003 - 00012
1. The screening that is required along the south property line of the flag pole next
to tax lot `1001' could be either a fence or vegetation.
7 ( New street trees are not required because there is not enough room for both
street trees and the sidewalk along the south side of the driveway.
;,,L 3. The tree plan submitted with the application is adequate.
4. The City will not require a fire apparatus turn - around.
.5. The developer will construct a sidewalk along the south side of the flag pole.
There are also a couple items on the construction drawings that either were not
specifically required, or that are different from our previous understanding. I have
discussed these items with Craig Harris, LDC Design Group, and he concurs with
the following comments:
1. Two street lights are shown on the construction drawings. These were not
specifically required as a condition of approval, and normally street lights are
edmurphy /boyden/fineview/mattfax9 112/08/03 2