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Permit
. EXPIRED 3/ Building Permit Application FOR OFFICE USE ONLY Received Permit N. City of Tigard Date/13 : I 0 • 1:, II; 1:,0 ODc 13125 SW Hall Blvd., Tigard, OR 972 a �p �� ' Plan Review 'hone: 503 6394171 Fax. 503.1 A '�I Date /Bv Other •.-D� j r t,/ ,,.,,v , Inspection Line: 503.639 4175 i�� e• Date Ready/By: El See Attached Cher._--, for Internet: www.ci.tigard or us 1 r 2006 Notified/Method: Supplemental Information 10 nD �,��Fi��i�a J,O�1 : REQUIRED DATA 1--AND 2- FA DWELLING ' $[ New construction , u1t �� C e'molition Permit fees* are based on the value of the work performed. , Indicate the value (rounded to the nearest dollar) of all ❑ Addition/altcration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY. OF CONSTRUCTION • work indicated on this application. 4 ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ (f 2.12- ❑ Accessory building 181 Multi - family Number of bedrooms: Z ❑ Master builder ❑ Other: Number of bathrooms: 2 • 'S ' • JOB SITE INFORMATION AND LOCATION - • Total number of floors: 3 Job site address: jp.00 51,00 AKA LeA e New dwelling area: (2 ex, square feet City/State /ZIP: —1C, LC , c xz 9112,3 Garage /carport area: Z*¢ square feet Suit Id . pt. no.: 17. •-f Project name: piety_ tzec --1 014,A6S Covered porch area: ( ( square feet Cross street/directions to job site: Deck area: 9sp square feet 5W 9crvi" Ave • Other structure area: square feet U NS 7 - 7 '(9k , - b REQUIRED. DATA.: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: I 5 135AA03 8co 4- 03901 Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. — e;Ntt2.0c_i'1 OAI c' L.-&V IT 33 - • . Valuation: s -r -- : tdolu,_ 4(p W1 (TS Existing building area: square feet New building area: square feet g PROPERTY OWNER . . . 0 TENANT• Number of stories: Name: OAK Si1.E r "TZUIvf -iDM , I f r Type of construction: Address: [ 2 , ( 4 . - 7 0 S W (0Fs-+t, AN 1 • j -(6.40c) Occupancy groups: City/State/ZIP: —1 C'AirL') , C ci7 2,23 Existing: Phone: (503) X • 3104 Fax: (5Q3)5111 • 9081 New: Et , APPLICANT • ❑ CONTACT PERSON NOTICE - . Business name: (GpN c+-(I'MCTuge /Pt,Am1 N (n)G , (NG. All contractors and subcontractors are required to be Contact name: DAI, Ganj12(ct4 pz Ma sill_ 14c-62 licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 9-725 54 ' A veQ --T . {.• LI ('(Ley, $rE-•24ce jurisdiction in which work is being performed. If the City /State /ZIP: 'pJE pDNJ OR 9 - 1 applicant is exempt from licensing, the following reasons r apply: Phone: (503) Coo' 1G (O I Fax:: (So) (4744-1 (P(p9 E -mail: d [G1@p IC- Ot1 QYGEt ((Z°c4.CAV1n . CONTRACTOR =: - Business na Oak Street Town homes LLC - -. BUILDING PERMIT FEES* _ . • Address: I 12670 SW 68th Ave Ste 400 Please refer to fee schedule City/State /2 Tigard OR 97223 Phone: (6‘ P: 503 -639 -3104 F: 503 -598 -9081 Fees due upon applicatio B tic.: 14. CCB: 169524 Amount received 1 .i 1 1 I I i Date received: Authorized signature: t This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: © C. Date: ,Z3 .O * Fee methodology set by Tn -County Building Industry Service Board 1 \ Building \Permns\BUP- PermriApp doc 12/03 440.4613T(1 I /02/COMM'EB) • • .. leellanical Permit Application -, . .:...-.::.-..• .,:. City of Tiaicl Received fle.e'll,e. d P.:ne. i: N.A.5ir- 13125 SW Hall Blvd . Tv,rar, OR '.;7223 ii51V -.. 0 1 9nnk i Plan Review . . ' . :). :..., Phone. 503.n3C 4 1 71 l'a,i 5(3:l. i'l' [966 ' - " - LUUU Dan: By: 0:24:: I mpeznon Line: 503.o39.4 I 75 Date Rezidy•By: Lin -2 See l'iley 2 for erne:: ww‘t ..n.ligJi'd.:ii uz. - „ Notified:W.1110C: Supplemental I nfor TYPE Or 11 OM: COMMERCIAL FEE SCHEDULE - USE CHECKLIST Nlechanical permit Ices* an:: hasd on the value of the wort; El New consrmethm 0 AdditionlaiterationrreplJeentent perfomied. indicate die value ( mender! to the neanrst dollar) of all 0 Demolition 0 Other mechanical materials. cr3orpruent, labor, overhead, and pmfit Valuer: S CATEGORY. OfCONSTRUCT/OY! -.':- . • -• '':'•- '-.., , :• . RESIDENTIAI,t 0 I - and 2-family dwelling 0 Commerciallinclusttial 0 accessory building For special information US C checklist. 0 Nlulti-family 0 Master builder 0 Other: Description Qty E. Total ...... "JOB SITE INFORMATION A.' ‘LOCATION . .• • ,.. . i Heatinelcoolina I Air conditioning or heat pump Job site address: I 0400 w) m . L.. -TE-72.4e_A-C-e. I (requires site nlan Showing plattenten:1 ( 14.00 I - i 1 City/State/ZIP: _-- op 9 /iv-3 I Furnace 100.000 BTU Wu:as/vents) I 14.00 I - Suite/bIdg,./apt. no.: I Project name:C,AK STILLX-1 - 1011000+ BTU IducIsivn'tsl 17.90 • das hew pump J 14.00 I Cross street/directions to job site: I Duct work 14.00 I I Hydranic hot water system 14.00 I I SW 9041 Avr-. i Residential boiler (radiator or 1 I I hydronic) 14.00 Unit heaters (fuel-typc, not electric). in-wall, in-duct, suspended, etc. 10.00 I 1 Flue/vent for any of above t 10.00 I ID - I Subdivision: 1 Lot no.: Oth= 10.00 I Tax tnapiparcel no.: (Si 5 -4 15l354Ao3cipt Other Mel appliances I - . . • .: • wa heater I 10.00 I D - • . DESCiiIPTION:OF WORK' . - • - ... . - . . . Gas fireplace r 10.00 ID C- a u.crroi.s O Ltyl IT 3.3 Flue vent for water heater or pus . firenlace 2- 10.00 N .... • 1-45 V./ I 1.-1-- *14, LAYI fiS - TVTA - L . - Log lighter (gas) I I 10.00 I Wood/pellet stove 10.00 I Wood mplace/insert 10.00 I 1. • • . ,. Chimney/liner/flue/vent 10.00 .,0 :., ..... __I..: -;,..:,....; ',-:•"•-.•:. , 0 TENANT. _ . . .,i - Other I 10.00 I Name: O\ s - ro.Ai4i--1 0 me 1-1-4- Environmental exhaust and ventilation I Address: 19...L.4 3W 1 f-TAfe- , Ste.. -c2 m:nu City/St. - 11 & fiCa..13 , 04 912J3 r Range hood/other kitchen ea:no Clothes dryer exhaust 10.00 I I 10.00 I 10 - Single-duct exhaust (bathrooms, I Phone: (503 ) C . -5104 I Fax: (:)3) 593 ..9 og 1 toilet compartments. utility moms) I 5 I 6.80 I W. 40 i Are uca.. - , 1:-.:.--,.:.:-.1; , --20-•:toN - sACT PERSON.' - - ' • , . . Atticicrawlspace fans 1 1000 I . ... . ....... .. .. . Other I 10.00 I I Business name: -- -T-C-014 lk-g-{ tTge..11.4.E. /RA1.11,11/.16 , PSC . Fuel Opine I Contact name: DA , ceD12. I.C.H 1:5R MO m I C4 Slist keg_ 55.40 for first four; S1.00 for each additional Furnace. etc. I I 15401 5.1 0. I Addrem " SW fet-ev - HILLSDALS R u)y SR- . 2-4 OE I I i , Gas heat pumn City/State/ZIP: ,;: , cn cl7oc>5 lArallisuspendedfunit heater I I I Phone: ( ‘13,) (9 . j I Fax: : 6 i(P(Act Water ace I 1 heater I__I IS• I 5.40 Firr.pl I '101 6.4 E 641 5 01 C.ctictrc...hcte-a+ .00 v) Rangc I I .4D1 540' . .. . . ' ___ , ',' •• ,-. ,,-,:.' ' '. _:-.. ,..co.N _ - - Barb=ue I I I _ . , I I I Business Thermal Flo Inc Clothes dryer (gas) - - Other. i 1 1 I Address: 7236 SW Durham Rd Ste 100 ;,,....,....;.:.••-:.. -7 .mEcn.k.mcAL PERAIII FEES . . Ci ty!Statt ., . Portland OR 97224 1 ., _ Subtotal I P: 503-670-8343 F: 503-620-1953 Minimum permit ice (S72.50) I me: ( CCB: 151847 _1 Plan review (2.5 of punnit fee) I j CCB lie.: ,1 1 State surcharge (8% of permit fee) I qi 1 ii I L TOTAL P Einirr FEE This permit appficatinn expires if a permit IA nut obtained within ISO Authorized sior.ature: v • i days after it has been accepted as complete. i . I Print name: DAA4 . 1 c.1-4 I Da:c: C(,.. . 2. . cx,2_ • Fee atedx,dalore Net by1ri-Counly Building Inclus:.": &WIC: Beard i Ihuldirtgkl•c-nlit5 cl:K. 1:11:9 44114617 (11/02/COWWEII) Plumbing Permit Application FOR OFFICE USE ONLY • City of Tigard �_ t P Date/By: ` ' I _` "' 1 Permit N ...04,10 ...04,10 13125 SW Hall Blvd., Tigard, OR 9722Y V! _ . ; 20015 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Itill(11 Other Permit No.: 24- Hour Inspection Line: 503.639 4175 DateBy �u,s Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental Information - - TYPE OF WORK - - - . • FEE* • SCHEDULE . - IX New construction El 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 CATEGORY OF - CONSTRUCTION SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building JXI 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: I al 00 514 / (L.eA-NI 'f - P-A-Ce- Catch basin or area drain 16.60 City/State/ZIP: - 1 f C„ D Qi qi 223 Drywell, leach line, or trench drain 16.60 no.: Project name: Footing drain (no. linear ft.: _) Page 2 Suite/bldg./apt. J C K 51leeT' 'CAA Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 5w Q tC ' / Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 15 1 A<I CZ d- 15135A4-0390 Fixture or item Tax map/parcel no.: ' Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 .I - C-0/41MuC-1 DF L1V111' 33 Backwater valve 16.60 • 11-163 WILL- Px 4(.p 01 rr5 1 a"rACL . Clothes washer ( 16.60 I to , ( Dishwasher I 16.60 I(o. (oC Drinking fountain 16.60 PROPERTY OWNER • ❑ TENANT . Ejectors/sump 16.60 Name: °Al _ 51 T -rL7 W ►JI-1 OM ES , LL-C- Expansion tank 16.60 Address: 1 2 SW (p ff ALS , 5 LA . 11E 4D0 Fixture/sewer cap 16.60 City/ State/ZIP: -n (, //rezD A 012 q 7 Z23 Floor drain /floor sink/hub 16.60 Garbage disposal I 16.60 1(p. (p 0 Phone: (503) (039.31o Fax: (5D3) 591f .9 og 1 Hose bib 2 16.60 35. gf APPLICANT ❑ CONTACT PERSON Ice maker 16.60 Business name: I L' OIJ ft c.4I1 ru.e6. / PLA. N 00,3c, t L 1'iC . Interceptor /grease trap 16.60 Contact name: ( , A . 1 4 t . t»Z t ci 4 0(4, MONICA S'•RLUGE:YL Medical gas (value: $ ) Page 2 Address: 9 7 Z 5 SW 12,e,ory tt2Tda f-L (i LS DP +11ily , S'� 24 0E Primer 16.60 City/State /ZIP: �j�4 -j I DR_ 9 /005 Hoy Roof drain (commercial) 16.60 Phone: (503) C.014 .1(O(Oi Fax: : ( (p44 iCda9 Sink/basin/lavatory 16.60 (O(o.4� Tub /shower /shower pan 2.. 16.60 33. E -mail: d +et. +. C_oyvl Urinal 16.60 J CONTRACTOR ._ Water closet z.5 16.60 I, 5O Busit The Mullen Company Water heater I 16.60 10. Addr 1601 SE River Rd Other Ci Hillsboro OR 97123 Subtotal P: 503 -640 -01 13 Minimum permit fee: S72.50 Phon Residential backflow minimum permit fee: £36.25 - CCB: 92689 PLM: 34 -260PB Plan review (25% of permit fee) - CCB 1...._.. l _..____ State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: - E>A44 G pp•) a(CI -I Date: C Z3 .p� This permit application expires if a permit is not obtained msithin 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i\ k3wldmg \Permtts\PLM-PermttApp.doc 06/05 4404616T(I0/02/COM/PEB) . ' Electrical Permit Application FOR OFFICE USE ONLY Date/By a 1151,0,06- Ivoa�7 City of Tigard a Permit 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review Phone: 503 639 4171 Fax: 503.598. 1960 fit. , _ 2 0 Date/By: ' - " " �� Other Permit - L . i' Inspection Line: 503.639 4175 • . - I 4 Date Ready /By: runs El See Page 2 for . ntemet: www ci.tigard.or.us Notified/Method: Supplemental lofort - : TYPE OF Vi -- - - PLAN REVIEW - - E New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other. ❑ Service over 225 amps, comm'l ❑ Hazardous location ❑ Service over 320 amps - rating (glBuildng 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 0 System over 600 volts nominal units in one structure 21, Multi-family ❑Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more ❑ Occupant load over 99 persons ❑Manufactured structures or . • JOB SITE INFORMATION AND LOCATION • ❑ Egress/lighting plan RV park ❑Health -care facility ❑ Other. Job no.: Job site address: 10400 SW iW(L.E.Ak IFV/421t{t` Submit 2 sets of plans with any of the above. City/ State/ZIP: -(-((, /302.0 i C5r2. 9'I 223 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: p,A ze-i ,t1�J{ - 'r0(IQaks, FEE* SCHEDULE Description I Qty. I Fee. I Total I •• Cross street/directions to job site: New residential single- or multi- family dwelling unit. SW 0 A'1/ Includes attached garage. I 1,000 sq. ft. or less I I 145.15 14'3. 1 5 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: I S 13 S AAFo3 kao 4 - I S 135A - A0390 I Limited energy, residential 75.00 75, 00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90.90 2 (`�7NS'f72LICr ct OF LAVI (T 33 _ Services or feeders installation, alteration, and/or relocation un ITS - ta'rA't_ 200 amps or less I I 80.30 go .30 2 PROPERTY ,OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: OA - SI I2Cer'M(3kl H OM - , (-LC- 601 amps to 1,000 amps 240.60 2_ .ddress: 12-V10 5lAl (e - 41 ^ prvG t S-re e}O0 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 l 2 City/State/ZIP: -r1 GqY2'I) , OL ' 91223 Temporary services or feeders installation, alteration, and/or Phone: (5:)3 ) (4239 . '31 o .1 Fax: ( O3) 59 g. 90R I 2 am ion 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 g, APPLICANT ❑ CONTACT PERSON - A. Fee for branch circuits with service or feeder fee, each Business name: I Gp14 Al f-c4-t C' it-1.gs / PLY; 1Jh1 IA 6 (NC . branch circuit ( 6.65 6 ( 5 2 B. Fee for branch circuits Contact name: M �1 t C4 5 ..t k e_ 0 K L'N G a! 1t ¢.l O.4 without service or feeder fee, 46.85 2 Address: Ct'12 S X 60 1<:�= j i H lLLSfkL& , 1 le Y.J. .2.1pG first branch branch circuit cit Each nch circuit 6.65 2 City/State/ZIP: ,,ekKi O1,j i C5a, 9 Miscellaneous (service or feeder not included) Phone: (c o3) (044,"� I Fax:: (:)3) �4 (�Q Pump ig n p irrigation lighting 53.40 2 Sign or outline lighting 53.40 2 E -mail: c it p • 1 c-o rctej l-f- ct •C.OV Signal circuit(s) or limited- -: : - _ - energy pane alteration, r o Business n extension. Describe: Page 2 2 Ross Electric Inc Address: 2870 SE 75th Ave #203 Each additional inspection over allowable in any of the above Hillsboro OR 97123 Per inspection 62.50 City/State/: Investigation per hour (l hr min) 62.50 P: 503- 642 -2800 F: 503 - 642 -5815 Phone: ( Industrial plant per hour 73.75 CCB: 157891 ELC: 34 -436C SUP: 4232S ELECTRICAL PERMIT •FEES *H . CCB Lic.: I Electrical Lie.: I Suprv. Lic.: Subtotal -. 1prv. Electrician signature, re uired: Plan review (25% of permit fee) State surcharge (8% of permit fee) Print name: Date: TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 ,.s• ' /_ days after it has been accepted as complete Print name: "1) Al o G Diz1 t-'f , V Date: .2 . 660 ' Fee methodology set by Tri -County Building Industry Service Board " Number of inspections per permit allowed. t:\ Building \Permits\F1.C- PermitAppdoe 12/03 440- 46t5T(10 /02 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: i- " Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ff Garage Door Opener* 0 Heating, Ventilation and Air Conditioning System* • ❑ Vacuum Systems* ❑ Other: j COMMERCIAL, WORK ONLY: T -- • 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 is Building'Pumus\ELC- PmmitApp.doc 04/03 Plumbing Permit Application - City of Tigard . Page 2 - Supplemental Information • Fee Schedule: Residential Fire Suppression Systems: Site Utilities -.- - - -- -, _ -- ` -- Square Footage:= ,`Permit Fee: = =- - . -. : ; ,-:.;. Qh•: = ,Fee (ea) ' Total_ Footing drain - 1' 100' 55.00 0 to 2,000 5115.00 _ Footing drain - each additional 100' 46.40 2,001 to 3,600 $160 00 3,601 to 7,200 $220.00 Sewer- 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 , Water Service -1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Niiiiti _ - -r -_ : _ -_ -_ _ a oii �• "-, ; PermitFee '` °= �:=w '"_ -; 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 510,000.00 $72.50 for the first $5,000.00 and $1.52 for each F171t11re, 0YtCill ' _ Qty:• Fcc (en), Total: additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee S36.25) 27.55 and including 525,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing each additional $100.00 or fraction thereof, to g p g or and includin 550,000.00. 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: P lan R e v iew_for Complex Stiructiirs - ,. . , - Are you capping, adding or replacing futures? If "yes ", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria. accurately report fixtures could result in increased sewer fees*. Please check all that apply. - .- Quiin(ityby (Fixture) Work Performed ❑ Any new commercial building. Fixture Type: - . • . -.. = . Replace ❑ Any new exterior plumbing site utilities. • - - - - `Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi/Whiripool providing services to human beings. Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service - Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator are being installed for the food service area. Dishwasher - Commercial 54 Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any 1\TFPA 13 -D multipurpose fire sprinkler system. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" Car Wash Drain ` - -. = - , Isometr><c .or -Riser Diagram ; Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial Ice MachfRefrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in ar Water Extractor Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Unnal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. i-\ Buildmg■Permits\PLM- PermttApp.doc 07/06/05 '' • • 11 111 ' Building Division One & Two - Family Dwelling I `' n Ip Fees Checklist •PERMIT INFORMATION•:.: _ .. , 7-7 - 7, . ', - .. .. 4.: _ . ;1 • Permit #: MST 0 00_, 56 Plan #: 0 A.1( ST Z Date: ') - aC -0 ?� Site Address: J 0 i(oo f J A IC L h4 ,.1 744 &. Parcel #: Subdivision: 0 A - r S ' - rz & T Tc9f, j..J h/ bM S Lot #: 3 3 Zoning: ivb -; Jurisdiction: -j �- c, Setbacks: Front Rear: Left Right Class of Work: Alf u 7 Stories: g. First Floor. // N 0 Type of Use: 5 F A Height 3 S Second Floor. .5770 l b Construction: S ti Floor Load: .6 P S f Third Floor: 5 6 Occupancy Group: r2 > Dwelling Units: / Bonus Room: Valuation: 1l S/, 9 77, yn Bedrooms: 2 Total Floors: 1 ,21i0 It Bathrooms: 3 Basement ' Decks: q6 * Garage: 015 i/ !i Porches: dO ti Other \t7 , FEES - :..; • .. • Descciptio�n:•_..__ �::_.,, .. •: -Fee Aa>< oua�_ -. 3 . i 1 �Amomt t Paids - .noe Du.�.�- Plan Check: Building 53/. 9� , / = ,7s9g ____19- c'o iS- q5s Extra Set: Permit: Building X 14• Lin / S• 1 ],) Tax: C (i /S. /17 Metro CET: f y .7 7 /'1 2 . 77 MechanicaL 93 . 70 CJ 3 ?' /7 Tax 7 s - o 7.5 o Plumbing 3 'o 0 3 9%. vG Tax: 3/. elk 3/ •9 Electrical: f 75t . s s l'71, cs Tax: /t/ 2 S / /,) 9 Low Voltage: - 7570o 7 ov Tax: 6 , oo (, 00 SDC: CDC LRP Fee: 6.00 6 .00 CDC Ping. Rev.: </ Soo -/50o Parks: (iCQ 3• oo 1 40, 3. Uv TIF Res.: a eWO - op P roc, TIF MT: a2 00 a 2 0 , W Erosion Permit: 6'1 oO (, . 00 Erosion CWS: 20-g0 0O. 00 Erosion COT: a0. w ? 0. ?0 Water Quality: — Water Quantity: — SUB-TOTAL a, q g 7 D5 00 q a L 13 , a 7 Sewer: Permit: .700 - ') 700 Inspection: 3 s - 7', s SUB - TOTAL: ? - - S - ,--) 7 ? - TOTAL MST &SWR: /L 0 3 3.a.7 a5c?. c) c_ /I,, 7s3• 7 I•\ Building \Forms\RcsPlanCheckFees.doc 06/29/06 Page 1 PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential u ipment/ s ems) Description I Qty. Fee(ea.) I Total Descri pt ion Qty Fee(es.) Total .. • New 1- & 2- family dwellings ' • , Heating/Cooling • • (includes 100 R for cub 'natty eoi,neetiou) . ' - Air conditioning or heat pump' f 14.00 R./ - SFR (1) bath 249.20 Furnace 100,000 BTU (ducts/vents) 14.00 L'-1 SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts/vents) 17.90 SFR (3) bath ) 399.00 39 9 OC) Gas heat pump 14.00 Each additional bath/kitchen • 45.00 Duct work 14.00 Rain Drain, single famil 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 IJtlllitje : �_ Flue/vent (for any of above) 10.00 Catch basin/area drain 16.60 Repair units 12.15 Drywell/leach line/trench drain 16.60 Otter Feel Applasees Footing drain - l' 100' 1 55.00 Water heater / 10.00 10 -- Footing drain - each additional 100' 46.40 Gas fireplace / 10.00 /0 Manufactured home utilities 110.00 Flue vent (water beats /gas (replace) 10.00 Manholes 16.60 Lob lights (gas) 10.00 Rain drain connector 16.60 Wood/Pellet stove 10.00 Sanitary sewer - 1 100' I 55.00 Wood 6replaorinsert 10.00 Chimney/lina /flue/vent 10.00 Sanitary sewer - each additional 100' 46.40 Ott. 10.00 _ Storm sewer - 1 100' 1 55.00 Eavirosmentisl Exhaust & Vesti Storm sewer - each additional 100' 46.40 Range hood/other kitchen equipment / 10.00 I 0 - Water service - I 100' / 55.00 Water service - each additional 100' 46.40 Clothes dryer exhaust 10.00 /0 - ,. _ 1P1�ote er 1[tem Single duct exhaust Absorption valve 16.60 (bathrooms, toilet compartments, Backtlow preventer 27.55 utility rooms) 3 6.80 0 f7 Backwater valve 16.60 Attic/crawl space fans 10.00 Other: Clothes washer / 16.60 10.00 Pi Dishwasher / 16.60 FsdC Drinking fountain 16.60 " ($5.40 for first 4, $1.00 each additional) Furnace, etc. • np Ejectors/swu 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 R ange / •• Hose bib 16.60 BBQ •• Ice maker / 16.60 Clothes dryer (gas) • • Interceptor /grease trap 16.60 Other. • • Primer 16.60 Total: v J .5 y p Roof drain (commercial) 16.60 Mechanical Permit Fees Sink/basin/lavatory ) /O / -, L/ 16.60 Subtotal: $ 9 3 $o Tub/shower/shower pan 16.60 Minimum Permit Fee $72.50 $ Urinal 16.60 Plan Review Fee (25% of Permit Fee) $ Water closet 3 16.60 State Surcharge (8% of Permit Fee) $ 7<.., Water heater ) 16.60 TOTAL PERMIT FEE $ Other: Other: Plumbing Permit Fees ELECTRICAL FEES (residential single- or multi- family) Subtotal $ 35`/ GO Description Qty. Fee Total Imp Minimum Permit Fee $72.50 $ 1,000 sq. ft. or less / 145.15 4 Plan Review (25% of Permit Fee) $ addl 500 sq. ft or portion j 33.40 I Limited energy. residential 75.00 2 State Surcharge (8% of Permit Fee) $ 'S 1 ° I 2 Each manufactured or modular l TOTAL PERMIT FEE $ dwelling, service and/or feeder 90.90 2 Eketrieal Permit Fees Subtotal: $ ) 7c-r. S .5-' Plan review (25% of permit fee) $ State surcharge (8% of permit fee) $ 1 ? b TOTAL PERMIT FEE $ I :\Budding\Forms\ResPlanCheckFees doc 06/29/06 Page 2