Loading...
Permit ,: „ CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00103 y;�l� DE sE l H B M EN of RV 3CES 639171 DATE ISSUED: 4/27/04 SITE ADDRESS: 14210 SW WALNUT LN PARCEL: 2S104BC -BW010 SUBDIVISION: BAILEY WOODS ZONING: R - BLOCK: LOT: 010 JURISDICTION: TIG REMARKS: New SF detached. Other mechanical units include (2) gas fireplaces. BUILDING REISSUE: BVH2706 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1.186 sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.520 of GARAGE: 400 of FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD. sf RIGHT: 5 VALUE: 260 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2.706 of REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 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: VENT FANS: 5 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 1 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 FD R: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 • 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: SIGN/OUT UN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps - 1000x. MINOR LABEL: 1000. ampNolt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR> =225 A.: 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 b SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,825.15 BUENA VISTA CUSTOM HOMES BUENA VISTA HOMES This permit all othe Mu is Municipal C ode subject , State Specialty regulations contained Co i ode s and the 6932 SW MACADAM AVE STE C 6932 SW MACADAM HOMES Tigard r applicable laws. All w al C, work w ill be done Ce PORTLAND, OR 97219 PORTLAND, OR 97219 r aplic w doe i 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: Oregon law requires you to follow rules adopted by the Phone: 503 443 - 6033 Phone: 503 443 - 6033 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg a: LIC 152235 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 Plumb Top Out Exterior Sheathing Insl Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Post/Bea :tura! Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk Insp Iss d By : . / i -- - J,1;_i_ Permittee Signature : *4 a L /ii�� Call (503) . 9-4175 by 7:00 p.m. for an inspection needed the n usiness day r R ECEIVED • Building Permit Appyation tiOR OFFICE USE: ONLY MAR 4 Date/13 ced ra / Building Orate < AB Agra ∎_` . Permit No.: /1 City of Tigard Planning Ap royal Other '' 13125 SW Hall Blvd. CITY OF TIGARD Date/By: Permit No. 6/0 4 ODD BUILDING DIVISION Plan Review Other 1 . Tigard, Oregon 97223 Date/By :MA v - 9 - .z 6 - Permit No.: Phone: 503 - 639 4171 Fax: 503 - 598 -1960 i Post-Review Case Use www.ci.tigard.or.us Contact Juns.: 183 See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information - TYPE OF WORK - _ ., . - "_. • . . REQUIRED DA ���:.:. - ...:'-7..1 :.'• - , • - ® New construction [ Demolition 1 & 2 FAMILY DWELLIN G ;• . _ °' _ ❑ Addition/alteration/replacement [ Other: ` . CATEGORY OF CONSTRUCTION . Note: Permit fees* are based on the total value of the work performed. Indicate IN 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. [ Accessory Building ❑ Multi- Family Master Builder El Other: Valuation S JOB SITE INFORMATION -apd LOCATION No. of bedrooms: 3 k No. of baths: Job site address: I /y2 /0 `-u it)9 t - r Total number of floors a— New dwelling area (sq. ft.) °A Zi Suite #: I Bld . pt. #: Garage/carport area (sq. ft.) O Project Name: EP- -rA (A/ 6CY Covered porch area (sq. ft.) 1.1' Cross street/Directio is job site: Deck area (sq. ft.) Other structure area (sq. ft.) . ,Q– . :,..,'- REQUIRED DATA:. _ - : Subdivision: COMMERCIAL' =USE CHECKLIST .gig:. -- Lot #: /0 • - - - Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate • DESCRIPTION OF WORK - the value (rounded to the nearest dollar) of all equipment, materials, labor, NEW CONSTRUCTION – SINGLE FAMILY RES , overhead and profit for the work indicated on this application. DEATACHED RESIDENCE Valuation S Existing building area (sq. ft.) New building area (sq. ft.) Number of stories [a PROPERTY OWNER I ❑ TENANT - • •• Type of construction Name: Buena Vista Custom Homes Occupancy group(s): Existing: Address: 6932 SW Macadam Ave. Ste C New: City /State /Zip: Portland, OR 97219 Phone: 503-443-6033 Fax: 5 0 3- 4 4 3 - 2 4 4 3 NOTICE: All contractors and subcontractors are required to be APPLICANT �I CONTACT PERSON licensed with the Oregon Construction Contractors Board under El provisions of ORS 701 and may be required to be licensed in the Business Name: SAME AS ABOVE jurisdiction where work is being performed. If the applicant is exempt Contact Name: Eliabeth Moore from licensing, the following reason applies: Address: City /State /Zip: Phone: I Fax: • - • • • .• . • E -mail: • . • BUILDING. = • •• : - . -. • CONTRACTOR Please refer t o e feescLe"diile. Business Name: Buena V I s to Custom Homes Fees due upon application S Address:6932 SW Macadam Ave. Ste C City /State /Zip: Portland, OR 97219 Amount received S Phone: 503 - 443 -6033 I Fax:503- 443 -2443 Date received: CCB Lic. #: 152235 Authorized A Signature: Ll•_ ( Date: Notice: This permit application expires If a permit is not obtained within J 180 days after it has been accepted as complete. •Fee methodology set by Trl- County Building Industry Service Board. (Please print name) i :\Dsts\Permit Forms \BldgPermitApp.doc 01/03 A One- and Two - Family Dwelling • J .L. • Building Permit Application Checklist Reference no.: City of Tigard City of Tigard Associated permits: 0 Electrical 0 Plumbing 0 Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 Cl Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 • f11F: FOLLOWING 1TENIS ARE REQIIRED FOR PLAN REVIEW Yes No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. 3 Verification of approved plat/lot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control Cl plan CI permit required. Include drainage -way protection; silt fence design and location of catch -basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub - floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. Il RISI)l(`[IONA!. SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x I I" or 11" x 17 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not accepted. 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. 27 "Drawn to scale" indicates standard architect or engineer scale. 28 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440-4614 t6100/C0 ) 03/04/2004 15:11 5036425815 ROSS ELECTRIC INC PAGE 02 • Electrical Permit Applicati D Received Electrical EG E IN d Oatc+8y: Permit No.:/ --eve , 9 City of Tigard V Planning Approval Sign Date/By: Permit No.: 13125 SW Hall Blvd. 4, 4 I1 l i Plan Review Other — Tigard. Oregon 97223 MAR Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 - 598 -1960 Post•Re Land use Internet: www.ei.tigard.or.DS CITY O ? � • , ; ! Dat _Cave No.: Contact Juris.: I ® See Page 2 for YJ 24 -hour inspection Request: 503- 639- 40LDI'' -' - Name/Method: Suvlemteotel Information. :. .;,TYPE;oF'wo K ' • .. ; .. ' P,LAKREV1EW (P is:tkaltlf'ttit New construction — Demolition D Service over 225 amps- 0 Health-care facility ❑ Addition /alteration Other: commercial 0 Hazardous location ❑ Service over 320 amps rating of ❑ Building over 10.000 square feet. YCATEGORYi4F'CONSTRUCEION. 1 & 2 family dwellings four or more residential units in & 2- Family dwelling 0 CommerciaVIndustrial 0 Sys + over 600 volts nominal one structure Accessory $uildiriJ� Multi- Family ❑ Building over three stories ❑ Feeders, 400 amps or more []Occupant load over 99 persons 0 Manufactured structures or RV park ❑ Master Builder Ull Other: 0 Egress/lighting plan 0 Other: TORSI'i'E FORMATIoN I dl'LOCATION' Submit _ sets of plans with any of the above. Job site address: / a/Q WAl t r _ The above are not applicable to :i temporary construction service. Suite #: Bldg./Apt.#: ._ . WE* e4 ;K ' 5'': •••�' :7 -'-' : :1(... ....% =•:; • Number of inspections per permit allowed Project Name: Description Qty Pee (ea.) [ Tatar I Cross street/Directions to job site: New resideatiat.single or multifamily per duelling unit. iodides attached garage. Service lucleded: 1000 sq. R. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 73.40 I Subdivision: I 1. 1-0: Limited energy, residential .--, 75.00 2 Limited energy. non residential 75.00 2 Tax map /parcel #: Each manutaetured home or modular dwelling • 'DE KLOF - W©RK , ' • • service and/or feeder 90.90 2 iJ ' ��� �r Services or feeder - [nsfallatfan, e- Gorl S4ruei . 149k. Witty alteration or relocation: l e. # t e ct tom', den (.J�� 200 amps or leas 80.30 2 201 amps to 400 amps 106.85 2 � ,/ 401 amps to 600 smut 160.60 2 E{�+P 0P tTRTY OWNER • ' : :I•; ' •'iFR15Ri "601 amps to 1000 Imes 240.60 2 Name: } en a .1 G �,� Over 1000 am sp�„r volts .36 2 Y Iw 66gs 2 G ttewratect only Address: �p 3 j 1/( jf J((fidoi Aye, 44 Temporary services or feeders • instellatlon. City /State /Zi .: Per-l-I rr 0 /2- 9 '1 a-19 alteration, or relocation: 200 amps or leas 66.85 l Phon • 3- ' •'. Fax ' ` . 3 201 amps to 400 amps 100.30 2 401 to 600 amt 133.75 2 i - Iii sl•r ~ j ,: s )Y Branch circuits • new. alteration. or Name: ry i/.. / • SS extension per panel: Address • A. Foe for branch circuits with purchase of service or Rider fee. each branch circuit 6.63 2 City /State/Zip: B. Fee for branch circuits without purchase of ' Phone: service or feeder foe, first branch circuit 46.85 , 2 Fax: Each additional branch circuit 6.65 2 E-mail: Mise.(Scrvice or feeder not included): ' ;, : • • _ _ �aeh pmnp or ini Rdt i oet ci rcle 534 Each sign or outline lightint 53.40 2 Job No: Signal cireuigs) or a limited energy panel, Business Nam D$ 5 alteration, or extension Page 2 2 Address: q 8 ?O 5 it.) *Pi g l #` 96,3 De9t trptien: City /State/Zip: Hi !t S &o 1- t 17i 23 Each additlonal inspection over the allowable In an of the above: Per inwetion per hour (min. 1 hour) 62.50 Phone :$e 3 4 l iZ Z30 Fax: 0:3 / S investigation fee: CCB Lic. #'. tS 7/ Lic. #: 3 3 odxr: Supervising electrici . / - 8ir tiirslpelrml ' I ;• ,.: . ,: ;,;:� :. ..... �.: . X si& nature re. iced. Plan Review (25% a of Permit Subtotal Pee) S Permit Fee) ' S Print Name: I OSS Lic. #: ,Z , State Stacltat a (8% of Permit F ) , S Authorized TOTAL PERMIT FEE S Notice: This permit application expires If a permit is not obtained within Signature: Date: — 180 days after it has been accepted as complete. *Fee methodology set by Tel-County Building industry Service Board. (Please print name) - i :\Data \Permit Fnrm5 \ElCPermitApp.doe 01/03 03/04/2004 16:26 5032537693 SUN GLOW INC PAGE 02 Mechanical licatIon a„,d Planning Approval City of Tiga AR . Tek Da. :. �_. 13125 SW Hall Blvd. Plan view • ' NIRIIIMIIII Tigard, Oregon 97223' p A 0io . ' ' phone: 503 -634 -4171 xF (593Z�9� Foy ew Internet wrww,ci.tigard. ING D� I nn . � Gaet See Page ter . 24-hour Inspection R 4.`_503. 639 -4175 - - Nam: Method: :., . lntbrmadon. • -., • • • r ,.., -: • •: 4 E OFWORI C . S'All e" . ;;.4 :..ir -.'' .• : " CaBV4224CRATr-P iSkSCKEDt7UP :. ;..-m If New construction ■ Demolition Mechanical permit fees* arc based on the will value aft work MI Addition/altera • • •- • : �• ■ Other: performed. indicate the value (rounded to the nearest dollar) atilt �ti s y '� �- . / l �' 'Value. S See 4 i mechanical materials, equipment, labor, overhead and profit. ra .. 2 for Fee Schedule 9, Z- . r , ., . f,� 1■ IN Accessory Building; ❑Multi Fatrlil Deecripdon - Fee(m.) Total I. Master Builder ❑ Other: neatinerCoomeg • .410 : 'STt'E Q,FORBriAT[ON and LOCATION ' :. • furnace • add -out air conditioning" 14.00 Job site address: PNWIMIMIE Gas heat pump 14.00 Suite #: Duct work 14.00 Hydronic hot water system 14.00 Project Name: _ Residential boiler • Cross street/Directions to job site: (ibr radiator or hydronto system) • l4•00 , ' Unit heaters (fuel, not electric) (in wall, induct, suspended. del - 14.00 Flue/vent (for arty of above) 10.00 Lot #: Repair units Subdivision: Feet App Tax • - • - reel #: Water heatee t 0.00 • • • '• DES N : 1' ION . F • . • RK ' - Gas fireplace _ _ 10.00 NEW CONSTR • —SI ' GL - F ' I Flue vent (water hesterllrss titre lace) 10.00 — >tttecr(ttat) • 10.00 DETACHED RESIDENCE _ Wood/Pelletstove - 10.00 Woad 5teplaae/1nsert 10.00 Chimrig liner /fluelvent_ _ 10.00 10.00 3 n: Wit? : r ' -,4 g NJ : ' , iAFP><'ara +i . ` r_ Otter: _ = F - --- -- mm' Usenet A VeadtseGoa Name: 14-=4 _ . • U - ` Range hood/other kitchen equipment 10.00 Address; 6 7 _ SW Mac - _ - S - C Clothes dryer exhaust 10.00 Ci /State /Zi•: Portland OR 77219 Single duct rakhaust Phone • _ • _ . e Fax: t _ , • - • (bathrooms, toilet compartments, . .. WANT . am , .� Fici:":.. _ utility roorw) _ A— • 6.80 Attic/crawl space fans 1 10.00 Name: David Goloba_ - Other: L 10.00 Address: - Fee[ — ~� **(Mao first a Sa addioon,tll Ci /State/Zi • : Furnace, etc. Phone: Fax. Gas heat oum>' •• , 1 • is E -mail: Wall/suspended/unit heater •" CONXRACKIR '•, :. water heater •• • Business e: Sum GLOW Irta- F ieealaee • •• Addrees:2428 SE 105th Ave. Ran- BSQ •• C /State/Zi.:Portiand, OR 97216 Clothes ersPAC .• Phone :503 - 253 -7789 Fax:503 -25 -1 k• .. otter: Total: •CCB Lic. #: 481 _ M - -, p_ ;• Aurhot '� G 0 _ • . •1'_ J S Signature: Date li M' • Permit F � i r:Z 7 David Goloqy PI= RevlewFee % ofP- • ee) 5 ��Statt: Surcharge (856 o�PerrnTt� S (p ease prime mama) 't'O'l'M. T' PPB�E sv obtained within 'fee met edol• set try Tr- Couniy Be Board. S ., rd. Notice: T permit application expires If a permit is not o � **Site plan required for estertor A/C unit. 180 days after it tun been accepted complete. la3 t?ermit Racmt\NteSPermitApp. roc • Mechanical Permit Application - City of Tigard . " Page 2 - Supplemental Commercial Fee Schedule: TOTAL VALUATION: - PERMIT FEE: $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 55,000.00. - $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. $100,001.00 and up $1,396.50 for the first 5100,000.000 and $1.10 for each additional $100.00 or fraction thereof. • All New Commercial Buildings require 2 sets of plans. • 1:18updingWermlt Forms MecPermltAppPg2 09.01 .03.doc 03/04/2004 16:21 FAX 5036284633 THE MULLEN COMPANY + BUENNA VISTA ct 002/003 Plumbing Permit Application FoRorriCl•_ t.,L 0:.L1' Received Da e' B : 1..,�. ° &Mo • City of Tigard G �� Data/6r. Permit No.: ' PlatmiagApproval seer 13125 SW Hall Blvd. �SCj 1 Pla Review Wier Tigard, Oregon 97223 % Da R v; L'erttdt No.t Phone: 503- 639 -4111 Fax: 503 -598 -1 .A ` , . Past-Ravi ew (And Use Internet: wvrw.ci.agard.or.us R ^ 1 ` " ;i l l l DateJB See Page 2 (or 24 -hour Inspection Request: 503.639.417S 0.. - - $ --. L • 9a • lemmata! tntbrtaadoa 0 � o‘NG 0\11 1ig New conslnzction - Dertio]ition Daeri •upon Qtr. R • ea. Toal II Additiotl /ai0etatiotl/replacectlent VuiCi • �►e.. ; ' t j J . ••� 'l •t• :: a''l; rl�: �daliit�F c : �►t k�; •,,, ;.CASIEGOR F . . �f ied s ai> ioe'1 '-. . " ' ' " ' ' ' SFR 1 bath 249.20' F' 1 & 2- Farrlil dweflin: 171 Cosnmercial/Industt'ial SFR (2) bath 350,00 1iO • B ' 1. ► IA. • M i -_ _li_ 1 SFR (3) bath 399.00 I. Master Builder ■ Other: Each additional bath/kitchen 45.00 • ,•: , .IOB SITE INPORMATIOI'6aML'OC:IF'IION • ' • Fire sprinkler - se. rt.: i Job site address: /4,940 ako W in..A ihr j. � • • • •••• ` „.., • • .... Stir” Vtil tree •, '. ';'.., '•9: ' . Suite #: 1 Bldg. /Apt, #: Catch basin/arna drain 1 • •' Project Name: Dtywell/leaeh line/trench drain 16.60 Footing drain (ne. linear ft.) 11 Pa 2 Cross street/Directions to job site: manufactured hone utilities 110.00 Manholes •' Rain drain connector 16.60 Senit sewer no. linear ft. : - U- division: Lot #: Storm sewer (no. linear ft.) Page 2 map/parcel #' Water service (no. linear R.) Page 2 Tax ma P/P .,, , Fixture or Item .:` . ,..:•.' , • DRSCRL'P'FION OF WORK - Absorption valve 16.60 • NNW, ,CON'STRUCTION — SINGLE FAMILY Raddlowpreventer - Page 2 . P IMILY DETACHED RESIDENCE Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 DrinkiLt: fountain 16.60 . it : s. . G ' - - 31• '�`�"O101E11IItR ••:r� E ' ANT _ .... .. • SICCtOr$/iltttlp 16.60 Name: Buena Vista Custom Homes Expansion tank 16.60 Address: 6932 SW MaeS',dam AvIA _ St-p c Flxture/Sawar ea- 16.60 Ci /$tatP.JZ1 Portland OR 9 7 21 9 Floor drain/floor sink /hub 16.60 tY �: Garbage disposal 16.60 Phone: ir► 503 - 443 -60331 Fax: 503•443 -2443 Hose bib • 16.60 PPLICA.NT • • . . . ''f.F iCO C. 4N • . Ice maker 16.60 ' Name: Ray Mullen Interceptor /grease Otto 16.60 Address: Medical : as • value: S Pa . e 2 Ci /State/Zi • : I Primer 16.60 Roof drain (�cSc�) 16.60 Phone: Fax: sink/basis/lavatory 16.60 E -mail: Tub /shower/shower pan 16.60 CONTRACTOR Ur{nal 16 _60 16.60 II Water closet Business Name: ED Mullen P li m i na Water hesur 16.60 Address: 24470 SW Rainbow Lane Other: Ci /State/Zi.: , • _ .. . a . - • Other. Phone: 50 - 628 - `ax :5e3 _62R -4 13 ..alambtan'pr Nest: .. CCB L #: . 9 6 R 9 Plumb. Lio. #: 3 4 — L6 0PP Subtotal ' . Minimum Penult Fee S72.50 S Authorized -� �- (f R esidentia l Bacldlow Minimum Fee�S36.25 Signature: ✓ .4 �- ' l _ Plan Review QS%6 of Pmnu Fee) S Ray ul en State Surcharge (8% of Permit Fee) S (Please print name) TOTAL PERM FEE S Notice This permit application expires Ira permit is not obtained within . AU nowcommerelal build age require sets of p . • a with isometric or 180 days after L hat been accepted as complete. riser diagram Ibr plan review- , Pee methodology set by Tri -County Boltding Industry Servica Board. IADsta\Permit Fomu1P1mPerml!Aptr.doe 01,03 Plumbing Permit Application - City of Tigard • . • Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities , _Qty. Fee (ea) ' .E:Toea! : Square Footage: Permit Fee: Footing drain - I 100' 55.00 0 to 2,000 S1 15.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 Sewer - 1st 100' 55.00 3'601 to 7,200 $220.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' S5 00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $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 a additional $100.00 or fraction thereof, to and Fixture or Item F • - ' = ' .:Qty..: '. (i) , Tota_!'..: including $10,000.00. Commercial Back Row 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 51.45 for Inspection of existing plumbing or each additional 5100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: _ 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 *. • . Quantity .by(Fixture)WorkPerfofitietLz Comments regarding fixture work: Fixture Type: - r , . _ . ; a - . - • New _ , [Moved , . F.iliiHHng ..'l ippeb.� Baptistry/Font Bath - Tub/Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" -4" Car Wash Drain Garbage - Domestic *Note: If the fixture work under this permit results in an Disposal - Commercial increase of sewer EDUs, a sewer permit will be issued and - Industrial fees assessed for the sewer increase must be paid before the ice Mach. /Refrig. Drains plumbing permit can be issued. Oil Separator (Gas Station) Ree. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial • - Service Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: iADsts\Permit Fornis\PlmPermitAppPg2.doc 01/03 A/ S7oZoa `/- cry ® AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA A: 1 ► 1 Is T EE CE TIFICATION S TREET R R Is A ► ® IS IS 1 A A I, J /S , Owner/ gent for ( ,t , e A 4 V 7L 4 Is 44 i (PLEASE PRINT) (PERMIT HO ® Is ® ► ® ., ., ® • Do hereb, _ �y1 , l -;: f' + location ® meets f< . fix @ ; aTi . are' f ' on county ® land use and development standards for street tree installation. Is ® Is ® Is ® ADDRESS: 0 c,c, L Al B. f 10 0. A Is ® Is ® LOT: in SUBDIVISION: 13 C [ ,,,,,,,d s - is -44 Is ® '/ A BY: '' DATE: ‘ . 11* D 9/ vt. ® RECEIVED BY: _ . • - DATE 9 / � :, k CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MSTc� 00 D 3 BUP Received Date Requested $ 3 AM PM BUP Location J o -( C) g, Suite MEC Contact Person In /-1_,e7,6 Ph ( )(' (e,` Z ot ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC /Alb. Foundation Access: Ftg Drain ELR ,�— Crawl Drain / Slab Inspection Notes: SIT Post & Beam �4; AV 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 Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fl = Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PART FAIL SITE ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA .�• Approach/Sidewalk Date v I — O Inspector �J ' CI. tr 3t--- 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 MS R O -- ao 163 INSPECTION DIVISION Business Line: (503) 639 -4171 c BUP Received Date Requested O AM PM BUP Location / ( f ��� Suite MEC Contact Person — Ph ( ) 7/I ' - 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 Ot er: 3S - PART FAIL ' CHANICAL 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 Hail, 13125 SW Hail Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line /' ADA /� G Approach/Sidewalk j' Inspector Ext /71 Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour ad/ o Inspection Line:' (503) 639 -4175 MST 47 f d 1� INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested ' `( L- AM PM BUP Location 1 I d (�iylk Suite MEC Contact Person 9411>i Ph ( ) 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 . ' / 4 A/ C ckl‘= Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 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 Post & Beam Rough -In Gas Line Smoke Dampers Jir' 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 Inspector f' Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY BUI D inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST OD/ D1 6 3 4 -C> BUP Received Date Requested — fi AM PM BUP Location / 'j 7-/ 0 Lt) Suite MEC Contact Person Ph ( ) / 2l 0 — $/ iS 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: PART FAIL i BING 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 • a SS RT 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 El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date 3 0 ¢ Inspector . Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL