Permit • CITY OF TIGARD MASTER PERMIT
PERMIT #: MST99 -00049
: jj DEVELOPMENT SERVICES t � LATE ISSUED: 2/26/99
13125 SW Hall Blvd., Tigard; OR 97223 (503) 60-al I N
SITE ADDRESS: 09360 SW EDGEWOOD ST PARCEL: 2S102DC -02000
SUBDIVISION: EDGEWOOD ZONING: R -4.5
BLOCK: LOT: 018 JURISDICTION: TIG
REMARKS: Add to and remodel the existing kitchen for an existing single family dwelling.
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 14 FIRST: 169 sf BASEMENT: 0.00 sf LEFT: 5 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 0 sf GARAGE: 0 sf FRONT: 20 PARKING SPACES : 0
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT: 5
VALUE: $ 15,250.00
OCCUPANCY GRP: R3 BDRM: 0 BATH: 0 TOTAL: 169.00 sf REAR: 15
PLUMBING
SINKS: 2 WATER CLOSETS: 0 WASHING MACH: 0 LAUNDRY TRAYS: 0 RAIN DRAIN: 0 TRAPS: 0
LAVATORIES: 0 DISHWASHERS: 1 FLOOR DRAINS: 0 SEWER LINES: 0 SF RAIN DRAINS: 0 CATCH BASINS: 0
TUB /SHOWERS: 0 GARBAGE DISP: 1 WATER HEATERS: 0 WATER LINES: 0 BCKFLW PREVNTR: 0 GREASE TRAPS: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN < 100K: 0 BOIL/CMP < 3HP: 0 VENT FANS: 0 CLOTHES DRYER: 0
GAS FURN > =100K: 0 UNIT HEATERS: 0 HOODS: 1 OTHER UNITS: 0
MAX INP: 0 btu FLOOR FURNANCES: 0 VENTS: 0 W00DSTOVES: 0 GAS OUTLETS: 0
ELECTRICAL
•
RESIDENTIAL UNIT SERVICE FEEDER - TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS •
1000 SF OR LESS: 0 0 - 200 amp: 1 0 - 200 amp: 0 W /SVC OR FOR: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF: 0 201 - 400 amp: 0 201 - 400 amp: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR: 0
LIMITED ENERGY: 0 401 - 600 amp: 0 401 - 600 amp: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL: 0 IN PLANT: 0
MANU HM /SVC /FDR: 0 601 - 1000 amp: 0 601 +amps- 1000v: 0 MINOR LABEL: 0
1000+ amp /volt : 0
PLAN REVIEW SECTION
Reconnect only: 0
> =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: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: 0
Owner: Contractor: TOTAL FEES: $ 428.10
+ K CONSTRUCTION This permit is subject to the regulations contained in the
P ION
P + NE PRESCOTT Tigard Municipal Code, State of OR. Specialty Codes and
PORTLAND, OR 97220 all other applicable laws. All work will be done in
accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: 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
Footing Insp PLM /Underfloor Framing Insp Electrical Final
Foundation lnsp Mechanical lnsp Shear Wall Insp Mechanical Final
Post/Beam Structural Plumb Top Out • Low Voltage Plumb Final
Post/Beam Mechanical Electrical Service Insulation Insp Building Final
Crawl Drain /Backwater Electrical Rough In Rain drain Insp
'.. lA/TrILS k j IP) askyik4
Is' ed By : Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
07/12/1999 07:31 5036283076 HEBERLE PAGE 01
07,.'011(010 lkl 1u :S0 F'A.� BUt D8'" 1Hb0 emirs ur 104nnM 01
erre OF 11GARD Electrical Permit Application
PlanCheck0
Pp
13726 SW HAIL. BLVD_ Ret'd 8y
Date Recd ,
TIGARD OR 8 23 Date to P.E,
Phone (603) 639 -4171, x304 Date to DST
Inspection ( = •-4175 Print of Type permit a _MST Y
Pax (503) 698 -1960 Incomplete or illegible will not be accepted Called 7- f3 - 9 ;,5
_ a%/1) -t•
1. Job Address: ress: w 4. Complete Fee Schedule Blow:
Name of Development __ __ Number of Inspections per permit ollovred •
Name (or name of business) • Service included: Items Cost Sum 1
p
Addr0SS l (009 Ski C Z)( s f. 1:9 4a. Residential • per unit ...
p Q ,7 Z- .3 1060 sq. ft. or read $ t 17.75 4
l;i /SZatdZ fi.c�7 "1 Each additional 500 se. It. or
portion thereof S 20,26 1 •
Commercial ❑ Residential limited Energy S 80.00
S e /� , I ky r�set~i i,. `or Moar 2ai. C Con�cto sta only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, appllcanbs mint. _ vidr_ license 4b jp, deffiar F.adere
information for COT tats tea.). Installation, alteration, or relocation
Electrical Contractor r NEBER LECTRIC 200 amps or less J � ! $ 64.25 4 y ��
e 6 0 4 amps 4 85,50 2
Address Sgs$aSW Neuae` er d 40t a mp s to 000 amps _ �� S 128.60 2
City • $t t t igbnrr f4111h 601 amps to 1 000 amps $ 152.90 2
Phone No. C �l�O Q _� t t0 - "- Trp 7 1. F� Over 1000 amps or volts • $ 383.75 • 2
Job No. _ Reconnect_ only Y - S 3,50 2
Elec. Cont, Lice. No, 73Y- sb - Exp.D Le to -- !- f.f . , r& Teetporwy services or Feeders
OR State CCB ` Reg, No. 1 / Exp.Date ""7- Q -GO Inetaaettes, alteration, or relocation . ` _
COT Businet38 Tax or Metro No. 2 PJC
10'7 O.Date 'i 200 amps or lase l - �� 201 amps to 400 amps �� a 63.50 2
$ 80,26 _ _.___ , 2
•
401 amps to B00 amps --- 5 107.00 2
Signature of Supr. EJec'n _ Over 500 amps to 1000 volts,
q i
am. •b• above,
License No. _ 43 $ _ Exp.Date s9 - i, ' Q ad Branch Circuits No, _ - 7 --01-1 -- New. alteration or extension per panel
.) The fee for branch Circuits
2b. For owner Installations` with pun:hr+tra of service pr '
roed.r
epep‘e Print Owner's Name I � branch vrWh - b 8.36 _ 2
D) The fee for branch cacUlts
Address _ - *Mout purcla+fe of sary :co
City .State Zip -�-•-• a vM.
r.I .
Phone No. 7 -Go Q' nisi branch chord S 37.50
Each additional branch elrcuil -r $ 5.35'; $>
The installation is being made on property I own which is not ea. Miscellaneous
intended for sale, lease or refit_ (Service or leader not Induded)
Each pump or irrigation curie $ 42.75
u
Each sign or Wine lighting 5 42.75 a�
Owner's Signature • Signal arcult(e) or limited energy -' -----
panel, alteration or a ttension S 60.00
3. Plan Review section (if required): Minor Libels (10) r - $ 107.00
Please check appropriate item anti enter fee In section 6B. 41. Each additional Inspection over
4 or more residential units In one struogure tfla allowable in a1WY of the above •
Per Inspection _„ 5 60.00 _
Servfoe and feeder 225 amps a more Per hour _ S 30.00
System over 600 rolls nominal In Plant --- S 89.40 -
Classified area or structure containing special occupancy as
-w described in N.E.C. Chaptni 5 5. Fees: ' - . ---
ea, Enter total of above lees . • i . / -
' Submit! 2 sets of plena with application tither. arty of the above apply. 74 St Stasteree (,05 X total fees) • c r d ? : .`6
' Not required for temporary corwtruction services. Subtotal 4 �..
6b. Enter 25% of line as for
11OTICfe Ptan Review trey (Sac. 3) b
' PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED
Subtotal S
IS NOT COMMENCED WITHIN 1130 DAYS, OR IF CONSTRUCTION OR
1NORit. IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS ❑ Trust noun: * - • f 9
• AT ANY TIME AFTERWORK IS COMMENCED. Tote! balance Due $ �
is \fists \fbrmalelectric.ttuc
197: 06--P
1-
E I:P kt-n 4 '75, a'
1-4-x
CITY OF TIGARD MASTER PERMIT
��� „�� DEVELOPMENT SERVICES PERMIT # - MST99 -0049
: 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 0`1 `6/99
PARCEL: 2S102DC -02000
SITE ADDRESS...:O936O SW EDGEWOOD ST
SUBDIVISION :EDGEWOOD ZONING: R -4.5
BLOCK LOT -018 JURISDICTION: TIG
Remarks: Add to and remodel the existing kitchen for an existing single family dwelling.
BUILDING -- —
REISSUE: STORIES • 1 FLOOR AREAS— -- BASEMENT...: 0 sf REQUIRED SETBACKS - --- REQUIRED.
CLASS OF WORK.:ADD HEIGHT • 14 FIRST • 169 sf GARAGE • 0 sf LEFT : 5 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 0 sf FRONT : 20 PARKING SPACES: 0
TYPE OF CONST. :5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT • 5
OCCUPANCY GRP.:R3 BORN: 0 BATH: 0 TOTAL 169 sf VALUE..$: 15250 REAR : 15 '
------- ---- -- PLUMBING - ---- -- --- --
SINKS : 2 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 1 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
- -- ---- --- -- MECHANICAL ----- ----------------
FUEL TYPES FURN (100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
GAS FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 1 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES : 0 GAS OUTLETS...: 0
- - -- - — —
-----ELECTRICAL------- - --- - - - - -- ---- --
- RESIDENTIAL UNIT— — SERVICE /FEEDER ---- —TEMP SRVC /FEEDERS -- — BRANCH CIRCUITS — ---- MISCELLANEOUS — - -ADD'L INSPECTIONS -
1'n'0 SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 4v . amp..: 0 201 - 4w amp..: 0 1st W/0 SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR • 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 1 SIGNAL /PANEL...: 0 IN PLANT : 0
MANF HN /SVC /FDR: 0 601 - 1m amp.: 0 601 +amps- 1Y!'0' v: 0 MINOR LABEL -10: 0
1 w,+ amp /volt.: 0 ------------ ---- -- PLAN REVIEW SECTION -- --- - -- - - --
Reconnect only.: 0 }=4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC OCC:
— ---- - ----- ELECTRICAL - RESTRICTED. ENERGY ------------------------------------ ----- --------- —
A. SF RESIDENTIAL— B. COMMERCIAL -- -------- -- --
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: .. BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL OTHR: ..
HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL it SYSTEMS: 0
Owner: --- - - - - -- --- -- Contractor: ----------------------------- TOTAL FEES:$ 344.11
TWYLA BRADY P & K CONSTRUCTION This permit is subject to the regulations contained in the
9360 SW EDGEWOOD STREET 9530 NE PRESCOTT Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 PORTLAND OR 97220 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 0: Phone 0: 256 -2406 not started within 180 days of issuance, or if the work is
' Reg IL.: 116467 suspended for more than 180 days. ATTENTION: Oregon law
----- --- - ----- — requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
— ----- REQUIRED INSPECTIONS - - -- -- ---- --
Footing Insp PLM /Underfloor Framing Insp Electrical Final
Foundation Insp Mechanical Insp Shear Wall Insp Mechanical Final
Post /Beam Struct Plumb Top Out Low Voltage Plumb Final
Post /Beam Meehan Electrical Servi Insulation Insp Building Final
Crawl Drain /Back Electrical 'ough .Rain drain Insp f-
Issued By ' L, � /LL Permittee Signature: . L� t � l�L//
+ + + + + + + + ++ + + + + + + + + ++ -+++++++++++++++++ + + + + + + + + + + + + + + + + +. + + + + + + + + + + +/ + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed th /next busine s day
CITY OF TIGARD Residential Building Permit Application Plan Check# O — "7 3 6g -
13125 SWHALL BLVD. Alteration - Interior Remodel Only Recd By 4
Date Rec'd e2 3- 7
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. o? 5
V 503 - 639 -4171 Date to DST b /& -%'
F 503 - 684 -7297 Permit # /0,rep" (15
Print or Type Called 2 - / 9 -9 1 - 3:1
Incomplete or illegible applications will not be accepted 9A°Ox1P--- PO
Name of Project Name
Job '-r011-Fr sc� - ° t. ,
S it dres A rchitect Ma iling Addre t
Address e b 60 0 eao st c I� b 0 NW GUSA6J Su 1i 2C Zip Phone
Na � �(r y �e un n "` Y ( /S O l LA&i0 U f72 ?2 7 ZsZS
11 " v'` 61 • Name
Owner M �1 ,A . 1 D67aCIOD s# �
(�( lJ Engineer M i ng Aid
dress
City/State Zip Phone {
11 ITI f�j (� ! g '3(00-7 C i
n "� C F P - ` q 4901
General Name
City/State .� L.f7 Zip P o e
cttt ��y'J JJ 7233
Contractor ti'_ (;O) O 100A) Describe work New Addition #r Alteration 74 Repair 0
Ma ling Address 0 to be done:
Prior to permit 6 15 - 3n Ne K 0,6e_011 Additigpel Description of Work
issuance, a copy 9 Zip r�A Phone rff� one
of all licenses `b J E q Z2D In i ' ,Rqd 6
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lic.# \ 1 I u( 46 /
d 3� 00 VALUATION $ r j 2S0 • `—
database _
Mechanical Name NEW CONSTRUCTI ONLY.
Sub- TOW l Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address -
Prior to permit Indicate the restricted energy installation by the electrical
issuance, a copy City /State Zip Phone subcontractor in the following areas of all licenses Restricted Audio /Stereo
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms •
expired in COT Lic.# Installations Vacuum Irrigation
database System System
Plumbing Name (check all that Other:
Sub - j e apply) .
Contractor Mailing Address - - -- - • Comer Lot YES NO _ • Flag Lot • YES NO
(check one) (check one)
Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City/State Zip Phone
issuance, a copy Solar Compliance
of all licenses are Oregon Const. Cont. Board Exp. Date (Calculation Attached)
required if Lic.#
expired in COT I hearby acknowledge that I have read this application, that the
database Plumbing Lic. # Exp. Date information given is correct, that I am the owneror authorized agent
• of the owner, and tha -plans submitted are in compliance with
Oregon S ate Ia, s.
Name � of G i - Date
Electrical A +�/ ='� %�
M ailing Address Intact Person Name Phone #
Sub- &A94/1//) / it/DZiv 1 / 2'3 ° e)
Contractor FOR OFFICE USE ONLY:
City/State Zip Phone • Plat #: Map/TL #: Z
Prior to permit a 5/6 apJ - Q vZoDG
issuance, a copy
of all licenses are Oregon Const. Cont. Board . Exp. Date j acks: Zone: Solar:
required if Lic.# r _ - �� 5 _ ^
expired in COT Engineering Approval: Planning Approval: TIF:
database Electrical Lic. # Exp. Date
0 &PPG 4 -7 -.-- . .
I:SFREM2.DOC (DST) 8/11/98
02/15/1999 09:43 5036283076 HEBERLE PAGE 02
CITY OF TIGARD Electrical Permit Application Plan Check 4
Redd By 1
13125 SW HALL BLVD. Date Recd
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304
Print or Type Date to DST
InSp ion (503) 639 -4175 Permit it
Incomplete or Illegible will not be accepted caned
Fax (503) 684 -7297
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit Allowed
Name (or name of business)_ Service included: Items Cost Sum l
Address 4a. Residential - per unit •
t 1000 sq. ft. or leas $110.00 4
City /State/ZIP Each additional 600 sq. It. or
portion thereof $25.00 1
Commercial ❑ Residential ❑ umlted Energy - $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor int tallation,9J7ly' • gy Services or Feeders
(Attach copy of a current licenses) ` In alteration, orrelocation
Electrical C ntractor - -5! 1' e� . I 200 amps or less ,_ 880.00 2
A t •• f• 201 amps to 400 amps $80.00 _ 2
Address to to p _,.0_1) .'"/ 1 -7 , 401 amps to 600 amps $120.00 2
801 tuna to 1000 gimps - $180.00 2
Phone No. r0 - Over Itxx) amps or volts $340.00 .. 2
Job N / Reconnect only $50.00 2
Elec. Cont. Lice. No. y i IQ L� •'I Exp.Date lg► - ;" • ' .
OR State COB Reg. No. FE Exp.Date 7 - . : 4c. Temporary ServIC4r6 er
COT Business Tax or Metro No ; tll1.0 1 Z.- Exp.Date 't .1 - ' ' , Installation, alteration, or relocation
- amps or less J $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec n � - ..�, a o1 amps to 60o�amps n $100.00 = - 2'
■
y Over 600 amps to 1 ow volts,
License Noa> ate LP a ( - see "b" above.
3 I • . D
Phone No. ARCTI 4d. Branch Circuits .-m•
New, alteration or extension per panel
213. For'owner 1 y a) The tee fqr branch circuits with
purchase of service or
Print Owner's Name E ach feeder fee. branch,ancuit _ -, $5.00 2
Address b) 'The tee for branch circuits
City State Zip without purchase of .
Phone No. . tx - service or feeder fee.
First branch circuit 535 2
The installation is being made p roperty I o E
n which is not ach additional branch circus $5.00 2
intended for sale, lease or rerft. 4e. Miscellaneous
• (Service or feedernot Included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuits) or a limited energy
penal, alteration or extension $40.00 2
Minor Labels (10) .._ $100.00 a it i
Please check appropriate item and enter fee in section 58.
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection s " '$35.00 .
Classified area or structure containing glacial occupancy Per tow $55.00
as described in N.E.C. Chap 5 In Plant " $66,00
a Submit 2 sets of plans with appf • Nation where afty of the shove ap 5. Fees:
Not required for temporary construction services. 5a. Enter total of above tees $
5% Surcharge (.05 X total fees) $
NOTICt Subtotal $
5b. Enter 25% aline 5a for °
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS. OR IF CONSTRUCTION ORjWORK Subtotal $
iS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT'ANY' )
TIME AFTER WORK IS COMMENCED, . ❑ Trust Account It
T ojal balance Due $
3
. I
_
I:wsr9+Etc96.APP ne✓ 9186 1 � ;,1 • -'-"-" ,
i,yV
p ..
` 'Ca L3 l'c1
C '1 � V
,,.
..:1 . _,Y (
;� of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit #
itgard, OR 97223
. 603) 639 -4171
Description .
Table 3A Mechanical Code QTY PRICE AMT
Job
Address -> ,1413 Supplemental Supptsental Permit 3.00
, +. , w , w+, t'umace to iuu,utu YiiU
1) inci. ducts & vents 6 -
M.Lg Mara* +
�"� F u rnace .
Owner ca 2) Oct ducts & vents 77.50 ns+a. w Floor Fumance i
3) ind. vent 6
is.: Lei maw a a,w+wu ea er. w0- eater
4) or floor mounted heater 6.00
s .� ,..., ...... Vent not met In
.00
Occupant 5) appliance permit
wi ,,,, 4. 1 of heating, reing.
6) cooling. absorption unit 6.00
Radar or comp, neat pump, air cons
I�� 7) to 3 HP; absorp unit to 100K BTU 6.00
J rab.. Baiter or tromp, heat pump, au cond.
7 . j .e 8 ) 3-15 HP: absorp unit to 500K BTU 11.00
Contractor ,. -_ r . ,( • .•ter g � � > Roder or comp. Treat Rump. au coed. 15.00 1
'����y� / 9 ) 15-30 NP absoro unit .51 mil BTU
tea. Rte. a� / r 0-+ No- — Diger or con's, heat pump, air cond.
// 10) 30-50 HP; abeorp unit 1 -1.75 and BTU 22.50 1
r that ,de Boiler or comp, heat pump, air cond.
T Hereby earn. -� �e aa��aa f read this appiicaba�, 11) a 50 HP; absorp unit 1.75 min BTU 37.50
information given is Correct, that I am the owner or authorized
agent of the owner, that plans submitted are in compliance with 'i - ' g u • 4.50
State taws, that I am registered with the Construction Contractor's 12) 10,000 CFM
Board, that the number given is correct (if eXempt from state Air handing unit 7.50
registration, please give reason below.) 13) 10,000 CTM +
Non portable 4.50
14) evaporate cooler
Vent tan con . "`•' 3.00
15) to a single duct -
Ve enianon system not 4.50 -
r / - • r . . 16) itY•!UrlPd in ePRhance permit -
/erg .. _ t. , . " - Hood' served by
, \ : < ' w ,. d - % 1 7) mechanical exhaust 4.50
r r ir � ^ re,ai or industrial 30.00
Descr work new 0 addition 0 alteration U
non-residential 0 18) type incinerator
to be done residential 0 Other i.e., wovdsmve. water
build use of 19) heater, solar, clothes dryers, etc. 3 -50
building or property IIIII 200
Proposed use of 20) Gas piping one to four outlets
bulditfg or property 2.00
21) Mara than 4 PB< o utlet (each) 1111
Type of fuel • oil 0 natural gas 0
LPG 0 electric 0
• I Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5Y. •
SURCHARGE ��
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR
IF CONSTRUCTION OR WORK IS SUSPENDED OR ,
ABANDONED FOR, PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL 1
AFTER WORK IS COMMENCED. TOTAL
_— —
Spat Candiikons .
Date estied
{ •
iutoaar t .
� ie -
Id Wt07:80 6661 61 'GaA ZZLSZSZ 2OS : 'ON 3NOHd 6u? IooJ 2 6ui'l.2aH lIIDNU : 1..10bd
02/12/1999 13:36 5036427755 ANCTIL PLUMBING PAGE 01
:ITY OF TIGARD Plumbing Permit Application Plan Check a
13125.8W HALL BLVD. Commercial and Residential Redd By
r1OARD OR 97223 " ate R
'503) 039 -4171 cote to P.E.
Print or Type Oats to b8T
Incomplete or illegible applications will not be accepted '�
Related s1nR s
Coles
Name ofDewelap /Project *ZSr,1r731 { {i TN;�^1>, -
r .w L ' z r�.:;..
_ >jt _
Job silk 9.00
Address sire"' Addvss i Sun" Lavatory 9.00
Tub or TubWShowsr Cone. 9.00 •
Bldg A I tylSiale Zip . 9.00
Water Cleeet 9.00
Name
Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
- Yeasting beadine 9.00
any/State Zin 1 Phone Floor Drain/Floor sink r 9.00
Name 9' 0.00
4' 9.00
Occupant Mang Addres* Sndta Water Heater 0 ceeversen 0 like kind 1.00
Gas eking requites a separate medhanicat permit.
Cxy /State Zip I Phone Laundry Room Tray too
9.00
Name
Off Fbdues {Spnxily) 9.00
, an' L V/rl r' N • 9.00
Contractor 9q��
f/(D 9.00
Prior to . Issuance, a copy /5 V r `) � 6o 2 9343 sewer - eat 100' 30.00
at eb gooses ore Oregon Const. Crag. Simi Ua! Sewer - each addltlWtPl 100' 46.00
fO1q x 2- q / 8L/ j -` Water Service - 1st 100' 30.00
expired in COT Plumbkrg 1.1c. 9 C I pip water SMMce - each additional 200' 23.00
database , Z - / 6v _ f �o - ` fl Storms Rain Drat - , a 100' 30.00
Name Storm & Rein Drain - each addjtlona1100' 25.00
Architect _ Mobile Home space 25.00
Or Meeting Address Suite Conxnerdai Sack Flow Prevention Device or Anti- 20.00
Pollution Device
Engineer antstate BP Phone Residential Paddlokio Prevention Dew' 15.00
(Irrigation timing devices reouke a separate
Describe work 10 be done: restricted energy pemdl.) 1
New 0 Repdr 0 Replace with like kind: Yea 0 No O Any Trap or Waste Not Connected to $ Fldwe 9.00
Rvsid 0 Conmherdal 0 Catch BUM 9.00 -
Additional description or worts
Map. of [Skiing Plumbing
40.t)D
Perms
' Specially Requested Inspections 40.00
hew
Rein Drain, single tan* dwelling 30.00
Are you capping, moving or replacing; any fixtures?
Yes 0 No O Grease Traps 9.09
N yes, see back of form to Indicate work performed by QUANTITY TOTAL 1' ' = i •
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Immo* a rim Ammo a es�usee If Ow* Total la e ~
WORK COULD RESULT IN INCREASED SEWER FEES. 'SUBTOTAL f ._ M
I hereby that I have reed Via application, that the lnfarmagon
given Is aura , that I em the owner or a agent of the owner, and 5% SURCHARGE ( t
that plans are In compliance : • Slate lawn.
t OwtwrfAgent Dale *.PLAN REVIEW 26% OF SUBTOTAL r .. --- ..
Aze„.. e % Ragkrkrr0 eel rltNaw 919.109S > 9
TOTAL
' Contact Amon Hams Phone # i
'Minimum permit tee le 925 + 5% surcharge, except Resider0ai DeddAow
Proven don Device, which is 515 + 5% surcharge
�- "Alt New Commends' Buildings require plans with isometric or veer dorm
and plan review
helooliaurnapp.doc 712151
li
CITY OF TIGARD 24 -Hour
. ill, Inspection Line: ( 39 -4175 4 0 99' Oda
INSPECTION DIVISION Business Line: -4171
�0 BUP
Received Date Re• uested 1/Z 2O X AM M BUP
Location 0 .3 cam- 0 A .61 I 1 Suite MEC
Contact Person do ri 9‘...11a.---. Ph ( ) 4 /— ' �j 0 PLM
Contractor Ph ( ) SWR
r Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain.
Slab Inspection Notes: Ztjal T. .P SIT
Post & Beam
Shear Anchors // +I Z' / C v c1 ' / e; •-15 Ext Sheath /Shear �� �1 C/ �(
Int Sheath/Shear LL, Y W� =���t! C.L.-„,t--- ' S
Framing P
Insulation ( (3 Z //
Drywall Nailing �/ `
Firewall c "` "
Fire Sprinkler .' c) (
b IS
•
Fire Alarm (j -.� CV": - \ r -Q- `�
Susp'd Ceilin V
A ll f r: 6)1 711L"-' .2 ')
in f *� .
PASS PART IL 1
Z.-- S \-- /
Post & Beam . 'S � � I .(2 en -/
Under Slab 1 "� ��L v•---- Rough -In li ! 4 ‘
Water Service ` � j '
Sanitary Sewer J
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan —
Ot
final)
PA • T �' �
s.,144; � ,- AL A ` v�1 ,' S .
Post & Beam
Rough -In
Gas LinDampers G l.e 3" oo (oc1 Lobo �4 $ A3 )
4 inal i `l' �iv U� - a' 0 4 Z ' • ° • 1
, PART FAI ;;�� �
-'-'" CTRICAL
a d — 0 CO b 1 06 a-v—, • ' - V' Z.o 1 ,g.(-- •
Service
Rough -In
UG /Slab _ — INV NW W ■111111WW —
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE D Please call for reinspection RE: 111 Unable to inspect - no access
Fire Supply Line
ADA /
Approach/Sidewalk Date ` I nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 0) 639 -4175 CM" q9 _ Q c�
INSPECTION DIVISION • Business Line: (503) 639- 4171�
BUP
Received / 3 i Date Requested 2 AM PM BUP
i
Location _ _� ..1 Suite MEC
Contact Person M7,[Jr2 t ZL 1 Ph ( 5_(.2_ 4 ,4 9 / —c1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC •
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: j / SIT
Post & Beam GC .10 _GJ 0) A/1/L-Qit
Shear Anchors ` G
Ext Sheath/Shear Cl/ 1 /)40 1
Int Sheath /Shear
Framing •
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain •
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
I A/
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
‘E,LECT:SILAL
Service
Rough -In
UG /Slab
Low Voltage
Fi - - --
'A
ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date - G / Inspe r / Ext
-
Other:
Final DO NOT REMOVE this inspection record from the j . site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 , a rr P O l 9 — 0 S"
INSPECTION DIVISION Business Line: (503) 639 - 4171 4t��
BUP
Received " ;'/ 9 Y > Date Requested ° //0 /0<i AM PM BUP
Location G;36 4 C ,erA)V'Z. Suite MEC
Contact Person Ph ( 50.3) 2/ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear •
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
fna
'QV PART FAIL
ANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date / z Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspec ion Line: (503) 639 -4175 9,__-(Z)<
INSPECTION DIVISION Busine _ 'r: (503) 639 -4171
j _� BUP
/ 94 Received) � Date Requested 2 AM PM BUP
Location q 3 - '' of Suite MEC
Contact Person vr:. 1 _' //.
Ph ( 5 3 ) '2''/ 4P7D PLM
Contractor -F���) SWR
BUILDING Tenant/Ow ,-r n..P ✓���t�1 -e ELC
Footing
Foundation ELC
Ac - -ss:
Ftg Drain ELR
Crawl Drain
Slab nspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm r
Susp'd Ceiling
Roof
0,4) (N3—
titli
• SS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PA S . PART
CHA► A
:r eam rA ,A
Rough -In N / � 6 Gas Line S • ke Dampe ''1 \ Al`
_ << - ASS • L
R ICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
•
CITY OF TIGARD }° 24 -Hour
BUILDING ,! Inspection Line: (503) 639 -4175 difel G � CO 7 9 .
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received /4 f 2 ` / Date Requested w D AM PM BUP
Location lJlQv (' eL Suite MEC
Contact Person - 16b6') -16L Ph (23) Cqffic174 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation }� ZI CVC� - N1 ��p 1 7
Drywall Nailing 1�`
Firewall �/
Fire Sprinkler N O A� ��- u1 �`��\ •
Fire Alarm
Susp'd Ceiling
Roof
Fin
ASS PART FAIL
PLUMBING
Post & Beam
.Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service •
Rough -In N =
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE n Please call for reinspection RE: - ❑ Unable to inspect — no access
Fire Supply Line Q
ADA Date ' ' ) Ins C
Approach /Sidewalk p ector 1 �' Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL •