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Permit ---D(FI RaD Plumbing Permit Application LOR 1 1 1( 1: I_S1: O\Ll City of SW Dated 5 0'S d� err" r Permit No.:yriST F5-,^cy k 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ���+ t Phone: 503.639.4171 Fax: 503.598.1960 1 I '' Date/By: Other Permit No.: 24-Hour Inspection Line: 503.639.4175 _a_41, •,i Ready/By: lun'. Date Ready/By: id See Page 2 for I Internet: www.ci.tigard.or.us Notified/Method: 733/.9 Supplemental Information : TYPE OF-WORK jirj 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) lei!i l " �t,s '0)i RY OF;` vrnoN s: SFR(1)bath 249.20 at 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00 El jAccessory building ❑Multi-family SFR(3)bath ` 399.00 ?�� Each additional bath/kitchen ! 45.00 i f� ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 �cd �`13� ,-``" ' JOB INFORMATION N AND A N Site utilities Job site address: )6 S-i Y' 5W 124 phtee( Le) , Catch basin or area drain 16.60 City/State/ZIP:7.9a p e 'fl a a4-1 Drywell,leach line,or trench drain 16.60 J j I 1\ \J. sj�� Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: V "� �./` 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: e,t`A \J. -1C? I Lot no.: 'Z(! Water service(no.linear ft.: ) Page 2 Fixture or item Tax map/parcel no sorption valve . .l ... washer 661 I Li.4�. a .t ` OPERY iIR ,)" i Q TN_❑ TW . Ejectors/sump 16.60 Name: Li V /Y4;1 t.i.. !-''")12E'S . -YX_': - Expansion tank 16.60 Address: i)11 S iVW -n'l 6<'-r. tail # ?C,(--, .. 16.60 City/State/ZIP: 12\,viit.V',,y Yl (;)a 'q IOC)(l Floor drain/floor 16.60 Phone:(. )) k> -i -b h t7 Fax:((..;c - ) le/0 2 J 2 . . • `u e°rrrr s Business name: ILii Y,e,i'--31 Cat e 1---V .w S ; 1'►'1C.-- Interceptor/grease trap 16.60 Contact name: .,41-(f -,r A Medical gas(value:$ ) Page 2 Address: j U(2 5 .A W A n 2,..),‘; p✓(,.t..v&.A 7 ou Primer . .l City/State/ZIP: J Roof 16.60 Phone:( ) I Fax::( ) ii Tub/shower/shower pan E-mail: Urinal Business name: v pty,tyt I i h c V WI 6 r15 Water heater I 16.60 i(0 ,(G(;' Address: 2 S 05 S l�J . td ki5 1., .. i.1)(. Other: City/State/ZIP: 4!L h ( 2. 9 7o06 Subtotal (� ( L Minimum permit fee: $72.50 Phone:('5 ) e9,1),- h GS 7 ^Fax:(Do ) 7 Z.- 95 y 3 Residential backflow minimum permit fee: $36.25 3 •O CCB Lic.: 1 y 2 (1 I Plumbing Lic.no.: 3 y- 370 p(3 , / Plan review (25%of permit fee) Authorized signature.: bt(j� �/ ' State sttrchargeAL PERMIT fee) TOTAL PERMIT FEE —jr r.. Print name: 3-0A,t,..14.14 v, 8 f t I I Date: 2-e-. 0---_, 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 I dustry Service Bo . i:'Building\Pamits\PLM-PcemitApp.doc 12/03 440-4616T(10/02/COMIWEB) L1 $ Mechanical Permit Application FOR OFFICE USE ONLY 1 City of Tigard Received 3 C�S 63 Permit No..7 .v j & -,V!�? 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �� Phone: 503.639.4171 Fax: 503.598.1960 on Line: .41:4i A Date/By: Other Permit: Inspecti Li 503.639.4175 _ � � Date Ready/By: � 5 ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: 176 Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST -- -- -------------- ------------- New construction Li 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 I SYSTEMS FEES* E I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑ Master builder ❑Other: . Description Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: Gp/ j�f Air conditioning or heat pump "J- "7(9 Sky ,d. Gi,7`7C(t ( (requires site plan showing placement) I 14.00 I ti City/State/ZIP: t\9°"� I e„,2_ ct/anLk. ttt Furnace 100,000 BTU(ducts/vents) 14.00 l Suite/bldg./apt.no.: Project name:�e"Ct \1 sko, Gas heat 100,000+BTU(ducts/vents) 17.90 Y� 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: b-}-(� Lot no.: 24_ Flue/vent for any of above 10.00 A v Other: 10.00 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 le Gas fireplace 10.00 ICS Flue vent for water heater or gas fireplace 10.00 Log lighter(gas) 10.00 Wood/pellet stove 10.00 I Wood fireplace/insert 10.00 ❑ PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: b r er JI c 1 'Y]''LE:..>> , K1 Environmental exhaust and ventilation Address: /� / Range hood/other kitchen lei 5 A/IAJ Yyibe't 1 p�,f.VL) # �C' equipment I 10.00 atU'i j _ Clothes dryer exhaust 1 10.00 Iv City/State/ZIP: �{GCV�PiY�+`l �� �7�d� Single-duct exhaust(bathrooms, T Phone:(4 0-•) L.:..I-:_> -C `* r,r,. Fax:(9•, ) G,10-2-'1'V toilet compartments,utility rooms) - 6.80 1 ❑ APPLICANT ❑' 6 ` `PERSON Attic/crawlspace fans 10.00 10.00 Business name: <i y J/!%�k `v ✓t. j ....0--r-K2. - Fuel piping Contact name: L.L 4- cn x-4.4 $5.40 for first four;$1.00 for each additional Furnace,etc. Address: I4 25 AIVl/ 4b ei- •(Q,,_ pku.)Li f z 0 d Gas heat pump City/State/ZIP: t)c t,,vGY"4,,,.., (9-12..„(9-l2 q-7 0 0(! J Wall/suspended/unit heater Phone:(�1) i i(.4 S, 05 b c o Fax::(Q)3) 0 r,,21 Z Water heater Fireplace E-mail: Cana-6.)r I v ; - -c eY't� Range CONTRACTOR Barbecue 1 Clothes dryer(gas) Business name: kit - MA.�r,. A-a�/n.C 1 t-C 4 ) Other: Address: 4-N.-S r 2 8 -o ,l.)C kb ,..-- lz ci e,...AA, tk. 6 MECHANICAL PERMIT FEES* t 3, City/State/ZIP: r�c L 6,.." / 61 p Subtotal - -- - Minimum permit fee($72.50) Phone:(s-.3 ) "3 g I . 4/5- q. Fax:(5-5.1 ) 1;4 ,f - 3z,q- Plan review(25%of permit fee) CCB lie.: j 5 7.. `j 3 4 I 'State surcharge °vtrfpetmit fee) 21 TOTAL PERMIT FEE Authorized signature: �( This permit application sfr expires if a permit is not oobtained within 1 0 days after it has been accepted as complete. Print name: 2 r_ S a,�,.1, j! Date: Oz I C 0.16 r • Fee methodology set by Tri-County Building Industry Service Board is\Building\Permits\MEC-PermitApp.doe 12/03 440-4617T(11ro2/COM/WEB) 'Electrical Permit Application �(' FOR OFFICE USE ONLY f City of Tigard Received a : 3 O� ()V 0)7 Permit No.:/Y)57 W J-Uvv)y{ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ��� i Date/By: Other Permit Inspection Line: 503.639.4175 Date Ready/By: _tuns; 63 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW 5 New construction ❑Addition/alteration/replacement Please check all that apply: ❑Demolition ❑ Other: 0 Service over 225 amps,comm'l DHazardous location ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.ft., CATEGORY OF CONSTRUCTION of 1-and 2-family dwellings 4 or more new residential ® 1-and 2-family dwelling ❑ Commercial/industrial ❑Accessory building ❑System over 600 volts nominal units in one structure ❑Multi-family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders,400 amps or more ❑Occupant load over 99 persons OManufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: I 66'� s �/ P�y���p�(Health-care facility ❑ � Y _* submit 2 sets of plans with any of the above. City/State/ZIP:"""fl q ' 0 aP4 The above are not applicable to temporary construction service. Suite/bldg./apt.no.: J Project name: Or.. FEE* SCHEDULE . 1 tin. Description I Qn. 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 '1 174 Subdivision: ect V,,S,R Lot no.: Z(P Ea.add'l 500 sq.ft.or portion 33.40 a co,Zb 1 Limited energy,residential 75.00 2 Tax map/parcel no.. Limited energy,non-residential 75.00 2 DESCRIPTION OF WORK 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 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 n t 401 amps to 600 amps 160.60 2 Name: h-a V ti i."-,t C/i'e_ 1-16'm t-. '.' . nt!., 601 amps to 1,000 amps 240.60 2 Address: I t`/1 2 AAA) l i'1')�)h{,Y J '/KAx J t _G.L Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: lie I t V•;t!r f.L,� 012 '7v(j(e7 Temporary services or feeders installation,alteration,and/or relocation Phone:(SP)) 6,45' - 0`) ft' , Fax:(gt)) (p 10-- 2ai 42, 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 ❑ APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with _ service or feeder fee,each Business name: �L` 1/�X if:)4 H�. , .i-'Y'1C branch circuit 6.65 2 B.Fee for branch circuits Contact name: .-.L L.# S cf\A Jut without service or feeder fee, 46.85 2 a 1 each branch circuit Address: ) S /�11/ J�7 h'� Gem k tit)` G Each add'I branch circuit 6.65 2 _ City/State/ZIP: 8.eztv_eY"4_0Y) 0 ~]c-)U Miscellaneous(service or feeder not included) Phone: ( 72) ( Fax: t' Pump or irrigation circle 53.40 2 �`^1 (S ) (�'N4) '7`1 t-+ Sign or outline lighting 53.40 2 E-mail: r:crl'kc c.l t.% 1'i V'22'% 5i.e%(..i:i'1_':1.1-t , c c ,1.'k Signal circuit(s)or limited- CONTRACTOR energy panel,alteration,or extension.Describe: Page 2 2 J1 Business name: 132.,. ..r..__ I .c,-1-,..__. ..,`.c, f-- n Each additional inspection over allowable in any of the above Address- /� 0 C. Q a Per inspection 62.50 CityIState./ZIP: Investigation per hour(1 hr min) 62.50 Phone. Industrial plant per hour 73.75 �S ) G $ —1 3 S, I Fax:(tea 3) 6 7 $ —11 O 8 ELECTRICAL PERMIT FEES* CCB Lie.: 2,8 fir Electrical Lie.:j2,( /a;c. Suprv.Lie.:i 4,z 6 Subtotal 2q'. 35 Supry Electrician signature,regtrired �, Plan review(25%of permit fee) , Pnr t name: + Date: / � 27 State surcharge (of permit fee) a 9•.ti V '� �7< U`s TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 . Punt name: days after it has been accepted as complete Date: * Fee methodology set by Tri-County Building Industry Service Board **Number of inspections per permit allowed. is\Building\Pe nits\ELC-PermitApp.doc 12/03 440-4615T(10/02/COM/WEB A 'Electrical Permit Application rt)It ()rrl( I t SI O\I.1 City of Tigard Received !" O3 , Permit No.: • E. 13125 SW Hall Blvd.,Tigard,OR 97223 Received : O 11 Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Ili` Date/B : Other Permit: Inspection Line: 503.639.4175 ,- `•_'.. Date Ready/By: ions. ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW w construction ❑Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps,comm'I ['Hazardous location ['Service over 320 amps-rating ❑Buildng over 10,000 sq.ft., CATEGORY OF CONSTRUCTION of 1-and 2-family dwellings 4 or more new residential land 2-family dwelling ❑Commercial/industrial ❑Accessory building ❑System over 600 volts nominal units in one structure ❑Other: ❑Building over three stories ❑Feeders,400 amps or more ❑Multi-family ❑ Master builder ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lightingplan RV park Job no.: Job site address: 165 5 7 p, �y�, 12.4,p U( ❑Health-care facility ❑0��. t' vbmit 2 sets of plans with any of the above. City/State/ZIP:'-"'j e',{�,i//( f t 7 ei-7 -2_-21.4_, The above are not applicable to temporary construction service. Suite/bldg./apt.no.: U W' ( Project • name: 1 FEE* SCHEDULE *` P)I_ v I - J Description Qty. Fee I 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 1 1-4 Subdivision: ,}i. Lot no.:Z Ea.add'l 500 sq.ft.or portion 33.40 i(� �l 1 Tax map/parcel no.: V Limited energy,residential 75.00 2 Limited energy,non-residential 75.00 2 DESC.RIPT'ION WORK Each manufactured or modular V V /C) jA, r, E j ,C( I� / dwelling,service and/or feeder 90.90 2 V [(�(� l.Z "T j� ( Services or feeders installation,alteration,and/or relocation 200 amps or less 80.30 2 i J'PROPERTY OWNER 201 amps to 400 amps 106.85 2 ❑ TENAI �y `^^ © 401 amps to 600 amps 160.60 2 Name: t/�v/ J ii� r v tL5 / 1116_ , Z U L 601 amps to 1,000 amps 240.60 2 Address: vj 2_5" J f ij �J `iy4 av`w Over L000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: i t V&y (r',L e/ —700(e= Temporary services or feeders installation,alteration,and/or Phone:6e-j) /(.�.5')`7 Fax:(9),) (p 70--'7 L4 Z 200amion 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 APPLICAN 0 PERSON A.Fee for branch circuits with service or Business name: ^ branch circuit fee,each 6.65 2 Contact name: • ba ! L 1 B.wee for service circuits es t, without service or feeder fee, I each branch circuit 46.85 2 Address: l� 2 .j - V� ` -���t � ( Each add'1 branch circuit 6.65 2 City/State/ZIP: p'}t//1 /1/ " / C)(}( Miscellaneous(service or feeder not included) Phone:( )�,2L7L� --3 gip 1 Fax: :(5p))C4-76—2_9 q Pump or irrigation circle 53A0 2 Sign or outline lighting 53.40 2 E-mail: Signal circuit(s)or limited- CONTRgo energy panel,alteration,or extension.Describe: + Page 2 2 Business name: /U VIA/"- L 1//� .I ' Lt(", Address: 1 L1/5 /� f fnj f jI�//J/G �� pj'`w,f// G- Each additional inspection over allowable in any of the above f '`11 Sf "(! _Per inspection 62.50 City/State/ZIP: D.l �G1 ��/�/ �/1 I C ��(� � 4( G� Investigation per hour(1 hr min) 62.50 Phone:( ) s--�!1 C�s I Fax:(9)4�IL/Z[4 Z Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.:iUU( 5' Electrical Lic.: Suprv.Lic.: Subtotal -T y,j Suprv.Electrician signature,required: Plan review(25%of permit fee) State surcharge(8%of permit fee) H.& (/ Print name: Date: CV TOTAL PERMIT FEE Z(,c C v I Authorized signature: � ) This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: u"J/ / MG Date:/1•t;r OS : Fee methodology set by Tri-County Building Industry Service Board l A Mal •"Number of inspections per permit allowed. is\Building Termits\ELC-PermnApp.doc 12/03 440-4615T(10/02/COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: 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: COMMERCIAL WORK ONLY: 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 ❑ 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 i:\Building\Permits.ELC-PermitApp.doc 04.03 Building Division One & Two-Family Dwelling r i n K Fees Checklist PERMIT INFORMATION: Permit#: i j).57-, j8-onca9 Plan #: Date: Site Address: /SSy SW e_o,ek&.I L,v Parcel #: Subdivision: 3elk.t UiS.fw Lot #: 25. Zoning: Jurisdiction: m Setbacks: Front: Rear: Left: Right: Class of Work: 4 .0e u..) Stories: ,2 First Floor: 11.7/ it Type of Use: SF Height: 21 ' Second Floor: /3 O/ i Construction: JIB Floor Load: 5o Third Floor: ---1 Occupancy Group: 2.3 Dwelling Units: / Bonus Room: . -�� Valuation: X W 56, 7 zn. (Bedrooms: y Total Floors: ''V J. to Bathrooms: 3 Basement: ..—_____ Decks: /00 9' Garage: 4:5-8 ti Porches: 3G 0 Other: FEES: Description: Fee Amount: Amount Paid: Balance Due: Plan Check: Building: X 57. 79 , 75b • dc� I Zp-7. Extra Set: - Permit: Building: / 3. 53 Tax: /W. $,2 /Metro CET: 308 . O g School CET: „2 y.*A. CO Mechanical 93 . 4eV VTax: /1 • 20 Plumbing: 3cl,. Op • Tax: y"i. 88 Electrical: ,19-5-. 35 Tax: 7 • 9 ' Low Voltage: ;"25...0, Tax: ,, 00 CDC: CDC Ping. Rev.: Sib ,0a CDC LRP Fee: C,Op SDC: Parks: 5.2/5700 TIF Res.: • ‘.0.00 TIF MT: ,2 c/O .00 Erosion Permit: 8a . OD Erosion CWS: 28 , r;G Erosion COT: ag , CO Water Quality: - Water Quantity: .-9 5 Op SUB-TOTAL:4 /5, /85. 69 _ — 0 /4y, 935. G9 Sewer: Permit: Inspection: SUB-TOTAL: TOTAL MST & SWR: I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 1 • PLUMBING FEES (for special information use checklist) MECHANICAL FEES (reside_ntial equipment/systems) . Description I Qty. I Fee(ea.) I Total - Description Qty I Fee(ea.) I Total New 1-&2-family dwellings Heating/Cooling (includes 100 ft.for each utility connection) Air conditioning or heat pump* 14.00 SFR(1)bath 249.20 Furnace 100,000 BTU(ducts/vents) / 14.00 SFR(2)bath 350.00 Furnace 100,000+BTU(ducts/vents) 17.90 SFR(3)bath / 399.00 Gas heat pump 14.00 Each additional bath/kitchen 45.00 Duct work 10.00 Rain Drain,single family dwelling 65.25 Hydronic hot water system 14.00 Fire sprinkler-sq.ft. 0 to 2,000 115.00 Residential boiler Fire sprinkler-sq.ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00 Fire sprinkler-sq.ft. 3,601 to 7,200 220.00 Unit heaters(fuel,not electric) Fire sprinkler-sq.ft. 7,200 and greater 309.00 (in wall,in-duct,suspended,etc.) 14.00 Site Utilities Flue/vent(for any of above) 6.80 Catch basin/area drain 16.60 Repair units 12.15 Drywell/leach line/trench drain 16.60 Other Fuel Appliances Footing drain- Pt 100' 55.00 Water heater / 10.00 Footing drain-each additional 100' 46.40 Gas fireplace / 10.00 Manufactured home utilities 110.00 Flue vent(water heater/gas fireplace) 10.00 Manholes 16.60 Log lighter(gas) 10.00 Wood/Pellet stove 10.00 Rain drain connector 16.60 Wood fireplace/insert 10.00 Sanitary sewer- 1st 100' 55.00 Chimney/liner/flue/vent 10.00 Sanitary sewer-each additional 100' / 46.40 Other: 10.00 Storm sewer- 1st 100' 55.00 Environmental Exhaust&Ventilation Storm sewer-each additional 100' 1 46.40 Range hood/other kitchen equipment � 10.00 Water service- l' 100' 55.00 Clothes dryer exhaust 10.00 Water service each additional 100' ry 46.40 , / Fixture or Item Single duct exhaust Absorption valve 16.60 (bathrooms,toilet compartments, -5 Backflow preventer 27.45 utility rooms) 6.80 Backwater valve / 16.60 Attic/crawl space fans 10.00 Clothes washer / 16.60 Other: 10.00 Fuel Piping Dishwasher / 16.60 **($5.40 for first 4,$1.00 each additional) Drinking fountain 16.60 Furnace,etc. / ** Ejectors/sump 16.60 Gas heat pump ** Expansion tank 16.60 Wall/suspended/unit heater ** Fixture/sewer cap 16.60 Water heater / ** Floor drain/floor sink/hub 16.60 Fireplace / ** Garbage disposal / 16.60 Range ** Hose bib 2 16.60 BBQ ** Ice maker / 16.60 Clothes dryer(gas) ** Interceptor/grease trap 16.60 Other: ** Primer 16.60 Total: Roof drain(commercial) 16.60 Mechanical Permit Fees Sink/basin/lavatory //p/Si 5 16.60 Subtotal: $ 13. yin Tub/shower/shower pan 2// 3 16.60 Minimum Permit Fee$72.50 $ Urinal 16.60 Plan Review Fee(25%of Permit Fee) $ Water closet 3 16.60 State Surcharge(12%of Permit Fee) $ /l. .ZO Water heater / 16.60 TOTAL PERMIT FEE $ Other: Other: Plumbing Permit Fees ELECTRICAL FEES (residential single-or multi-family) Subtotal $ 3e(ej, to Description Qty. Fee Total Insp Minimum Permit Fee$72.50 $ 1,000 sq.ft.or less / 145.15 4 Plan Review(25%of Permit Fee) $ Ea.add'l 500 sq.ft. or portion 3 33.40 1 State Surcharge(12%of Permit Fee) $ 97, 88 Limited energy,residential / 75.00 2 TOTAL PERMIT FEE $ Each manufactured or modular dwelling,service and/or feeder 90.90 _ 2 Electrical Permit Fees Subtotal: $ 3,?p, 355 Plan review(25%of permit fee) $ State surcharge(12%of permit fee) $ J , 4./ / TOTAL PERMIT FEE $ , I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 2 • o cry ��- - SETBACKS N■�a.07� "E 0 �� FRONT 20' o REAR 20' N N ; RECEIVED Is SIDE 5' I nri_ri ....... UL .212008 DIAGRAM . CITY OF TIGARD HTS O o '8 _ ltiunING DIVISION 1 tt " 6,817 SF if,t VD W FF (. i D. r /I ,n�, 111 '' k '' /r Z A CO c\i`ji ' . f ' 64 Ake 2414, cV to ' . - /`/ � ' f . ~ i ,9 ct,.. .._ _ . _4:q.)" N88i6IO7W SURVEY �"') ,:' POINT 7 w 0, �• /�,►�� )5571, SW J�,P1i1t� . / ,N 2 y'12'4-4c 12.04,tos _o T� S .5r , ,o ' -----\--, %, S' 4.+ ND u4-1 Y CC 5 � (Tr/i (kr� o� N a 65\ / °5t oG 1, o cv 1j N co N . �T r 'n Q� s Im,p rev F \ � r% G)r-flies. Z r A* i, co ELLA VISTA LOT 24 SCALE: 1. - 20} v _ ENGINEERING & LAND SURVEYING iDESIGNEC' PREPARED FOR: a RJ ° It ,� �,� ` 8835 SW Canyon Ln. DRAM4 RIVERSIDE HOMES j =�,`,_ ,,,...e. \ Sint. 402 1925 NW AMBER GLEN PKWY, SUITE 200 i� A \�e,y \ Portland, OR 97225 SW BEAVERTON, OR 97006 0 ��n,A'_j 4. CHECKED: (503) 645-0986 • ,�� `\��'H,Inc. RJ (503) 690-2942 o°o DATE Q 4 �.-4 ■ 3 (503) 291-9398 6/20/03 3 (Fax) 291-1613 J j -- -- r�— SS 76 5 Zc.,f ..e.1 CITY OF TIGARD- SITE PLAN REVIEW BUILDING PERMIT NO.: 'V) T.Zc - 000 29 PLANNING DIVISION: Required Setbacks: 0 Approved, ❑ Not Approved Side: S Street Side: Front. i5 G age: 20 Rear: t Visual Clearance: atAppoved ❑ Not Approved Maximum Building Height feet CWS Service Provider Letter Required: ❑ Yes ❑ No ❑ Received B3: AtLLL4J1LL4C4i D ate: ?/3� Received ENGINEERING EPARTMENT: Actual Slope:2. % Approved ❑ Not Approved Site PI n: S:Approved ❑ Not Ap roved By: Date: 7/�d Notes: c ,r -en,m d CITY OF TIGARD-SITE PLAN REVIEW BUILDING PERMIT NO: Street Trees: el Approved ❑ Not Approved Protected T ® Approved ❑ N Approved By: 1ld 11 Date: 761 oc3 Notes: I z ' O SETBACKS ,•,N,�8.07 � FRONT Z.Z( '' C o REAR " N RECEIVED SIDE �' ! r JUL 212008 DIAGRAM CITY OF TIGARD I �,^ I . _ 9lJ��_riu'J DIVISION oz o ,. m� �, �� 6,817 SF �f,' , c. W c?v- j c ► Z : r.4 2qo 44'1. cv (N/ -jit ' iY sli . 4 O Ai4. P coC° • , Z � / °;, .-' ;88'16'©7"W t � : SURVEY o://^D e ,:((, POINT ÷ oc �.,::, r 12.oc�,OS ', S��•1�.'. ND 7u 5 � Ss _< 40 o (nom+ o - o 4,; y ° N kr 07 N $ 0 IIm,P(CV;w 5 � <<\ , \ t'l T . -5 -5 F oo o ELLA VISTA LOT 24 SCALE: - 25) • 0 /ENGINEERING & LAND SURVEYING (01D \ PREPARED FOR: n RJ 2 * A-ry o. * 8835 SW canyon ln. pRA RIVERSIDE HOMES �:�I�,. _\ suit. 402 • 1925 NW AMBER GLEN PKWY, SUITE 200 ro i•�;- y 1 Portland, OR 97225 SW BEAVERTON, OR 97006 0 lir � 1 a `� CHEa®: (503) 645-0986 0 "/ H Inc. RJ (503) 690-2942 g 1 4 1 I4 ii.V,"' DATE: Q i (503) 291-9398 6/20/03 s (Fox) 291-1613 j r� l 55-76 Sw Tac,O ..t CITY OF TIGARD-SITE PLAN REVIEW BUILDING PERMIT NO.: 'IY)5JAc - 000 2/ PLANNING DIVISION: Required Setbacks: CI Approved, CI Not Approved Side: Street Side: fu Front. .L Gyage: 29 Rear: I Visual Clearance: 15A proved ❑ Not Approved Maximum Building Height feet CWS Service Provider Letter Required: ❑ Yes ❑ No ❑ Received BN: jeit ..1/U--‘44 Date: '7/3°f/oY ENGINEERING DEPARTMENT: Actual Slope:% EI Approved ❑ Not Approved Site PI n: Csd____ Approved ❑ Nat proved By: Date: ?/2a Notes: oiee 'c-ttcct rum CITY OF TIGARD-SITE PLAN REVIEW BUILDING PERMIT NO: Street Trees: Approved 0 Not Approved Protected Trees: 0 Approved © N Approved BY: `.Talc{ 1?-,7 o- Date: os� Notes: 1 Branden Taggart To: amay @riversidehome.com Subject: Bella Vista lot 24 Hello Allison, I would just like to inform you that we completed plan review for lot 24 in your Bella Vista subdivision. The permit can be picked up between the hours of 8:00am -4:30pm Monday through Friday (permit: MST2008-00029). Also, the fees due are as follows: $14,435.69 (master permit) $2,835.00 (sewer connection) $17,270.69 (total fees) Thank you, Branden Taggart City of Tigard Building Permit Technician (503) 718-2439 /5•57c2' sal iO 11�(hJV c2'f?2 �I- Building Permit Application FOR OFFICE-USE ONLY ity of Tigard E 1 R, .' Fr 2 \ a! J Mo� 'II 'emvi SG-12S W Ha1I vdTigard,OR 97223 / /f ie Phone: 503.639.4171 Fax: 503.598.1 `' Date/B : ( M/, p I Other Permit: ° •. o Inspection Line: 503.639.4175 1_/' Date Ready/By: El See Attached Checklist for Internet: www.ci.tigard.or.us R 2 6 •'L1 MA � , Notified/Method: / 6 j Suppicmental Information TII .QF WORK REQUIRED DATA 1-AND 2-FAMILY DWELLING m New construction BOO& ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all.Q, ❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overheifl,and th•nmfit few the work indicated on this application:4(025:g CATEGORY OF CONSTRUCTION 30,36 1-and 2-family dwelling Valuation: S y L] Commercial industrial ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 7j Job site address: ] �)�--7( ' s iv / 4p/'72t / 14,-, New dwelling area: 24-7 Z square feet City/State/ZIP: 1 lartiA lard 0 CI 1 .- daLl". v Garage/carport area: LI 5 e square feet Suite/bldg./apt.no.: Project name:' Covered porch area: ?J46. square feet Cross street/directions to job site: Deck area: /CO square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: " ) Aci.... \1_\,SSC Lot no.: -7!/ 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 t he profit for the DESCRIPTIOORK work indicated on this application. �, t cr td ; RESIDENTIAL PERMIT APPLICATION REVIEW Permit No.: MST2008 -000 ,2q Site Address: /55-76 600 izete..1c ", Subdivision: Bella Vista Lot No.: 25/ Contact Name: Allison May Business: Riverside Homes Inc. Street: 1925 NW Amberglen Pkwy Suite 200 City: Beaverton State: OR Zip: 97006 As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and plans have been reviewed to determine if it is complete and if the plans are deemed "simple" or "complex" as defined in ORS 455.467 and 455.469. ❑ The application is complete. The application is incomplete for the following reason: / s feu r1-7/ /5 f . 16 c 4 CyeIk /, — rZ) Pc..G - / ;ca1 , 15 v e bin O ck.✓\ - s+ c �av� bvlS ;n;shcc) m(' aS 30 Y14vt 3 del);c usli Ctiric�e (t»1 t'run� IZtcti14 B anc) 2 6 /e va ice s. P 1e� 5 � ►rev u44 f 5 e r)r)/ s� .d s Sur- S grG.:'.r'l� ❑ The submitted plans will be reviewed; however, a permit cannot be issued until the above information is reviewed and /or approved. ❑ The submitted plans cannot be reviewed until the above information has been submitted and /or approved. ❑ The plans are deemed "simple ". ❑ The plans are deemed "complex ". • Signature: Name: Brandon Shaw Date Title: Plans Examiner Phone: 503 - 718 -2425 E -Mail: BrandonS @tigard - or.gov I: \Buildin Forms \RES- PemtitAppRevw- Blank.doc 1 /18/07