Permit CITY OF TIGARD
• MASTER PERMIT •
IN 0 . . - COMMUNITY DEVELOPMENT Permit #: MST2008 -00165
Date Issued: 04/15/2009
T I G ART- 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S135ACLC012
Jurisdiction: TIG
Site address: 9380 SW MANDAMUS CT
Subdivision: Lot:
Project: LONGSTAFF CONDOMINIUMS
Project Description: New MF, Building 2 (unit type B -1).
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 2 First: 1 073 sf Basement: sf Left: Parking Spaces:
Height: 23 Bathrooms: 2 Second: sf Garage: 229 sf Front: Smoke
Dwelling Units: 1 Third: sf Right: Detectors: Yes
Total: sf Value: $0.00 Rear:
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: Rain Drain: Catch Basins:
Lavatories: 3 Dishwashers: 1 Floor Drains: Sewer Lines: SF Rain Drains: Other Fixtures:
Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines:
Bckflw Prevntr:
MECHANICAL
Fuel Types Air Conditioning: Vent Fans: Clothes Dryers: 1
Heat Pump: Hoods: 1 Other Units:
Fum<100K: Vents: Woodstoves: Gas Outlets:
Fum > =100K:
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0 -200 amp: 0 -200 amp: W/ Svc or Fdr:
Ea add! 500 sf: 1 20 1-400 amp: 201 -400 amp: 1st W/O Svc/Fdr:
Limited Energy: 401 -600 amp: 401 -600 amp: Ea add! Br Cir:
601 -1000 amp: 601 +amp- 1000v:
1000 +amp /volt:
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: HVAC: Security Alarm: Vaccuum System: Garage Opener: All
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW Multi- Family VB R -2 1073
Owner: Contractor: Required Items and Reports (Conditions)
LONGSTAFF LLC RCM HOMES INC
7050 SW CLINTON 7050 SW CLINTON ST
TIGARD, OR '97223 Tigard, OR 97223
PHONE: PHONE: 503 -598 -7565
FAX: 503 - 620 -9965
Total Fees: $8,769.37
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 in accordance with 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throu. h OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
' Issued By: S� I t L - / _'. 4 J � 1 Permittee Signature: f � 1 , S oats. A
•
Building Permit Application
Commercial it FOIZ (FI.I('i us,.. O \ I.\
City of Ti and Rec
g Date : r I) ��.d
• 1 3125 SW Hall Blvd., Tigard, OR 97223 DEC 1 9 1 PI' ' plan Review /� Other Permit: • ' C Phone: 503.639.4171 Fax: 503.598.1960 DateB : V 1�■ • fY • '0 •
f I C. n it I) Inspection Line: 503.639.4175 CITY OF TIGA ��4 t o Read /B El See Page 2 for
Internet: www.tigard- or.gov tified/Metho Supplemental Information
gUIL®ING ®IUIS •
TYPE OF WORK REQUIRED DATA: 1- AND 2 ANKLY SMELLING
® New construction ❑ 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
r "^ work indicated on this application. y�
CATEGORY OF CONSTRUCITON Valuation: $ D'T� 78 r -7
❑ 1- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ® Multi- family Number of bedrooms: Z
❑ Master builder ❑ Other: Number of bathrooms: li
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9380 SW Mandamus Court New dwelling area: I b 73 square feet
City/Stat IP: Tigard, Oregon 97223 Garage/carport area: 22_,/ square feet
Suit Idg /apt. no.: 2. Project name: Longstaff Covered porch area: square feet
Cross street/directions to job site: SW 95 Avenue and SW Shady Lane Deck area: square feet
()i0 IT b "1 Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE casOcuST
Subdivision: Longstaff I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORIC work indicated on this application.
6 Plex Condominium Staked Flats
Valuation: $
R -2 Existing building area: square feet
Spruklered New building area: square feet
® PROPERTY OWNER I 0 TENANT Number of stories:
Name: Longstaff LLC Type of construction:
Address: 7050 SW Clinton Occupancy groups:
City/State/ZIP: Tigard, Oregon 97223 Existing:
Phone: (503)598 -7565 Fax: (503)620 -9965 New: R -2
El APPLICANT 0 CONTACT PERSON NOTICE
Business name: Longstaff LLC All contractors and subcontractors are required to be
Contact name: Ron Lightner licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7050 SW Clinton jurisdiction in which work is being performed. If the
City / State/ZIP: Tigard, Oregon 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 598 -7565 Fax: : (503) 620 -9965
E -mail: RLightner ®RCMHomes.net
CONTRACTOR
Business name: Longstaff LLC BUILDING PERMIT FEES*
Address: 7050 SW Clinton Street Meese rtjerro fee sci4e0afeJ
City/ State/ZIP: Tigard, Oregon 97223 Structural plan review fee (or deposit): q sg. 2
Phone: (503) 598 -7565 I Fax: (503) 620 -99 • FLS plan review fee (if applicable): 11 49 y-
CCB lic.: 158043 Total fees due upon application: Q!-
Amount received: 20 83 O 19
Authorized signature:
��_ ,�-` This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Ron Lightner Date: ' I I. * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 2/23/07 440 -4613T(11 /02 /COM/WEB)
Plumbing Permit Applica - i .,
t�N y
Building Fixtures a rc)IZ ()HALE usl: 0\1.,
City of Tigard D C C 1 9 2008
Received , Permit No. , • = . 0: -
l
• 13125 SW Hall Blvd., Tigard, OR 97
Date/By: •
Plan Re et her Permit No.
■ Phone: 503.639.41 Fax: 503. O
®� �0 ���® Date/By: (S�1�1 CO Z
Inspection Line: 503.639.4175
T I c ,� I: l) Internet: www.ti f �q A�� ®�� ®�U��� ®� Date Ready /By: inns: S upplemental Information
See Page 2 for
gard -0r.gov 'Ally Notified/Method: S
r TYPE OF WORK FEE* SCHEDULE
(g) New construction 0 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)
C CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 1 350.00 . 3'5!). CO
❑ 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 Site utilities
Job site address: 9380 SW Mandamus Court Catch basin or area drain 16.60
City/State/ZIP: Tigard, Oregon 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: B2 -12 I Project name: Longstaff Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW 95 Avenue and SW Shady Lane Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Longstaff I 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
Condominium Domestic Supply, Waste & Storm Drainage Backwater valve 16.60
Clothes washer ' 16.60
Dishwasher 1 16.60
® PROPERTY OWNER I ❑TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Longstaff LLC
Expansion tank 16.60
Address: 7050 SW Clinton Fixture/sewer cap 16.60
City/State/ZIP: Tigard, Oregon 97223 Floor drain/floor sink/hub 16.60
Phone: (503)598 -7565 Fax: (503)620 -9965 Garbage disposal ) 16.60
® APPLICANT ❑ CONTACT PERSON . Hose bib 16.60
- Ice maker 16.60
Business name: Longstal'f LLC
Interceptor /grease trap 16.60
Contact name: Ron Lightner Medical gas (value: $ ) Page 2
Address: 7050 SW Clinton Primer 16.60
City/State/ZIP: Tigard, Oregon 97223 Roof drain (commercial) 16.60
Sink/basin/lavatory 1 /) /? 4- 16.60
Phone: (503) 598-7565 I Fax: : (503) 620-9965
Tub /shower /shower pan 2.- 16.60
E -mail: RLightner @RCMHomes.net Urinal 16.60
CONTRACTOR Water closet 2,„, 16.60
Malmedal tnterpnses Inc Water heater ( 16.60
PO Box 207 Other:
I ' Banks OR 98106 Subtotal
Ph: 503 - 324 -0759, F: 503- 324 -0580 Minimum permit fee: $72.50
CCB: 102535 PLM: 34 276PB Residential backflow minimum permit fee: $36.25 ' j - �.
Plan review (25% of permit fee)
State surcharge (12% of perm it fee) 2.00
Authorized signature: TOTAL PERMIT FEE J 2t)
Print name: 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.
1:\ Building \Permits\PLMF - PermitApp.doc I2/27/06 440.4616T(10/02/COM/WEB)
Mechanical Permit Applica I' ���� '! 1� (a R OFFICE U S l ON
1, . • City of Tigard DEC 2008 Received 2. q : 0 ; , A Permit No.: LI zoos . c5 41
13125 SW Hall Blvd., Tigard, OR 97223 '-1
Date/By: Other Permit: i
Phone: 503.639.4171 Fax: 503.598.19b, ®F TI GA�7 j � y V W .• `e
1 - 1 c , RI , Inspection Line: 503.639.4175 i�1 Ilft�� Date Ready /By: B See Page 2 for
Internet: www.tigard - or.gov ® j ® 1NG DIM O ' . Notified /Method: iiifi Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
® New construction ❑ Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition • ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OP Value: $
RESIDENTIAL EQUIPMENT SYSTEMS nap
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
® Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
5013 SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9380 SW Mandamus Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: B2 -12 Project name: Longstaff Gas heat pump 14.00
Cross street/directions to job site: SW 95 Avenue and SW Shady Lane Duct work 10.00
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. 14.00
Subdivision: Longstaff Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Condominium Mecanical Ventilation
Flue vent for r water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
® PROPERTY OWNER I ❑ Chimney/liner /flue/vent 10.00
Other. 10.00
Name: Longstaff LLC Environmental exhaust and ventilation
Address: 7050 SW Clinton Range hood /other kitchen
equipment 1 10.00 _
City/ State/ZIP: Tigard, Oregon 97223 Clothes dryer exhaust ( 10.00
Single -duct exhaust (bathrooms,
Phone: (503)598 -7565 Fax: (503)620 -9965 toilet compartments, utility rooms) 3 6.80
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Longstaff LLC
Fuel piping
Contact name: Ron Lightgner $5.40 for first four; $1.00 for each additional
Address: 7050 SW Clinton Furnace, etc.
Gas heat pump
City/ State/ZIP: Tigard, Oregon 97223 Wall/suspended/unit heater
Phone: (503) 598 -7565 Fax: : (503) 620 -9965 Water heater
Fireplace
E -mail: RLighter ®RCMHomes.net Range
CONTRACTOR Barbecue
Clothes dryer (gas)
- Oregon Lomtort Heating Omer:
PO Box 190 MECHANICAL PERMIT FEES*
Eagle Creek OR 97022 Subtotal
Ph: 503 -655 -0221, F: 503 -650 -2933 Minimum permit fee ($72.50) -7z.50
CCB: 42519 Plan review (25% of permit fee)
_ _ . State surcharge (12% of permit fee) 4,707
TOTAL PERMIT FEE I ,?C.,;)
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
I:\ Building \Permes\MEC - PermitApp.doc 01/19/07 440-4617T(11/02/COM/WEB)
E lectrical Permit Appicatlo , - OR O F F I C I - UI.; ( -)N I.1' - - -- Cl of Ti and , E E CEN E I Received 1 Permit No.: _ . , Y
• 131 SW Hall Blvd., Tigard, OR 97223 P Review
°11 ' • , ' / `` g Phone: 50 F 503.598.1960 DEC 1 Q 1 i .' Date/B : OtherPermit:S( . , 1
l - i (_ A i , Inspection Line: 503.639.4175 Date Ready /By: EWE ® See Page 2 for
Internet: www.tigard - or.gov CITY OF MARL) Notified/Method: Supplemental Information
TYPE OF 1'Sl riwl7 owisiON PLAN REVIEW
® New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
' CATE(E RY Qt. ; cON u iON exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
® Multi- family ❑ Master builder El Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "l -3 ",
Job no.: Job site address: 9380 SW Mandamus Court 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, Oregon 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: B2 -12 Project name: Longstaff ['Service or feeder 600 amps or more.
FRE SCHEDULE
Cross street/directions to job site: SW 95 Avenue & Shady Lane Description I Qty. 1 Fee. I Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Longstaff Lot no.: 1,000 sq. ft. or less ( 145.15 ) fk-S, (6
Ea. add'I 500 sq. ft. or portion ( 33.40 3, 40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. f.) ( 75.00 -zsj CO 2
Limited energy, multi -family
Condominium Electrical, Low Voltage Phone & CATV 75.00 2
g residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
tgi PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Longstaff LLC 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 7050 SW Clinton Over 1,000 amps or volts 454.65 2
City/State/ZIP: Tigard, Oregon 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)598 -7565 Fax: (503)620 -9965 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 599 amps - 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
_a APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Longstaff LLC B. Fee for branch circuits
Contact name: Ron Lightner without service or feeder fee, 46.85 2
g fast branch circuit
Address: 7050 SW Clinton Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Tigard, Oregon 97223 Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (503) 598 -7565 Fax: : (503) 620 -9965 Reconnect only 66.85 _ 2
E- mail: RLightner@RCMIIomes.net Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Tj1Vl.� r leCtnc Signal circuit(s) or limited-
energy panel, alteration, or
-
8504 SE Stark extension. Describe: Page 2 2
Portland OR 97216 Each additional inspection over allowable in any of the above
CCB: 118073, ELC: 37 -742C, Sup: 4542S Per inspection 62.50
Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
I I "� • ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 253 =5
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): , 4'j-
Authorized signature: TOTAL PERMIT FEE: 72,.
Print name: Date: This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\EL.C- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
° Building Division
One & Two - Family Dwelling
TIGARD Fees Checklist
:PERMIT INFORMATION.::.. . . . . -( : 'i . ;J:‘ ::
Permit #: I[ sT gel - 0a Plan #: O IT - I Date: 1 1 (0
Site Address: . '3e0 ,... 'r (}6 LT' Parcel #:
Subdivision: Lo ik v. - 9' 1 ! of VM5 Lot #: Zoning:
Jurisdiction: 'Ti6 Setbacks: Front: Rear: Left: Right:
Class of Work: OW Stories: 2. First Floor:, 1 073
Type of Use: R E5 Height: ZV Second Floor: _ _
Construction: r 5 Floor Load: (/ eaK. Third Floor: .
Occupancy Group: R. a Dwelling Units: - 1 Bonus Room:
Valuation: 'V (O44 Bedrooms: Z Total Floors: ICr la-
Bathrooms: 2. Basement: /
Decks: Garage: '7 -75' I.
Porches: Other:
FE Description: . 'Fee'Amount::`'. Amount Paid: .
Plan Check: Building:
Extra Set:
Permit: Building: 3-
Tax: 17 66, 7
Metro CET: 4, 1 2
School CET: 4 107'3.00
Mechanical 4 '72, <3
Tax: `$ fi 70
Plumbing: • 4 .0::)
Tax: 4 Z , C0
Electrical: , 1 1 "jec,13�
Tax: 7 2( • 43
Low Voltage: '5 ` CO
Tax: / , CO
CDC: CDC Ping. Rev.: 'S 't .00
CDC LRP Fee: --, ,, 06
SDC: Parks: A 2_,72,_
TIF Res.: (7G , 1_
TIF MT: 140:7C)
Erosion Permit: k .
Erosion CWS: 7� J.8
Erosion COT: t 20. 8 0
Water Quality:
Water Quantity:
SUB - TOTAL:
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 (residential equipment/systems)
Description I Qty. I Fee(ea) I Total Description I Qty I Fee(ea.) I Total
New 1- & 2-family dwellings 1 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 7260.00 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 - 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 - 1' 100' 55.00 Water heater 10.00
Footing drain - each additional 100' 46.40 Gas fireplace 10.00
Flue vent (water heater /gas fireplace) 10.00
' Manufactured home utilities 110.00 Log lighter (gas) 10.00 •
Manholes 16.60 Wood/Pellet stove 10.00
Rain drain connector 16.60 Wood fireplace /insert 10.00
Sanitary sewer - 1 100' 55.00 Chimney /liner /flue /vent 10.00
Sanitary sewer - each additional 100' 46.40 Other: 10.00
Storm sewer - 1 100' 55.00 Environmental Exhaust & Ventilation
Storm sewer - each additional 100' 46.40 Range hood /other kitchen equipment 1 10.00
Water service 1 100' 55.00 Clothes dryer exhaust 10.00
• Water service - each additional 100' _ 46.40
. . Fixture or Item . . Single duct exhaust
Absorption valve 16.60 (bathrooms, toilet compartments,
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve 16.60 Attic /crawl space fans 10.00
Clothes washer 1 16.60 Other: 10.00
Dishwasher j 16.60 Fuel Piping
* *($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 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 , /0/S 16.60 Subtotal: $
Tub /shower /shower pan 16.60 Minimum Permit Fee $72.50 $ 72 ," )
Urinal . 16.60 Plan Review Fee (25% of Permit Fee) $
Water closet •Z 16.60 State Surcharge (12% of Permit Fee) $ • 7t�
Water heater 1 16.60 TOTAL PERMIT FEE $ ( , 2C
Other:
Other:
. Plumbing Perrnit_Fees ELECTRICAL FEES (residential single- or multi - family)
Subtotal $, (:)(2) Description _ Qty. Fee Total Insp
Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less 145.15 r, j!;; 4
Plan Review (25% of Permit Fee) $ Ea. add'l 500 sq. ft. or portion 33.40 ? ,46 1
State Surcharge (12% of Permit Fee) $ �)
Limited energy, residential 75.00 2
TOTAL PERMIT FEE $ jz . Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Electrical Permit Fees •
Subtotal: $ l (S.
Plan review (25% of permit fee) $
• . State surcharge (12% of permit fee) $ 2
TOTAL PERMIT FEE $ 19 ,
t t 1I l b - 1-S,
1: \Building \Forms \ResPlanCheckFces.doc 01/19/07 t 9 .op Page 2
•
I •
■
' DATE: PLANS CHECK NO.:
/ 2-- 3 / ? i vet)) /
•
PROJECT TITLE:
4w 79FF(2)ileGb�N VHS
COUNTYWIDE
TRAFFIC IMPACT FEE . ... X6.2
-- NT. - --- - - - - - oc
- .
WORKSHEET ,.._ .. .
. m A,. S I (FOR NON - SINGLE FAMILY USES) _ - - - -
- H�/ d 2 ` . 2-
TAX MAP NO •
RATE PER icS/3. O /Do J5oc) l( .f 7o0 •
AND USE CATEGORY TRIP
SITUS NO ADDRES 1
a RESIDENTIAL $339.00 !0 .r O 5' �� 9 Sih4 s J�
• BUSINESS AND COMMERCIAL $8
II OFFICE • $312.00
• INDUSTRIAL $327.00
III INSTITUTIONAL
$141.00
PAYMENT METHOD: •
CASH /CHECK
•
CREDIT INSTITUTIONAL ONLY:
BANCROFT (PROMISSORY NOTE) LAND USE CATEGORY I DES TI OF WEEKDAY AVG. /L IP WEEKEND A yG. P
DEFER TO OCCUPANCY a C) USE Y»Sf)O RATE S. jt I RATE 0 •4
BASIS: • 5 Ow,T O0'2 o lam[/ /PLE 2- - -;- y
--- Ogiere 7 7 7 2, -c i� .
CALCULATIONS r T> �' .13X 5 .252.. 'S
•
2 3 9 afl =A D 33( — / O 2 E il
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FOR ACCOUNTING PURPOSES
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ITIONAL : _
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June 30, 2008 Worksheet 08- 09.Coc `G
CC: WASHINGTON COUNTY TIF NOTEBOOK