Permit . EXP R D id / evvi iss z
Building Permit APIA' ti OrFICE IJSE ONLY c( E FOR ■
•
"������® R d ( /
II City of Tigard Received / - / O M le 'emit Nc me ed6 i J
° 13125 SW HaII Blvd., Tigard, OR 97223 DEC 1 5 2006 Plan Review '' ``
Phone: 503.639.4171 Fax: 503 598.1960 Date/By N ' 'as Other Perr"'JW r%� a .319
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By _ / )uns ® See Attached Checklist for
Internet www.tigard- or.gov BUILDING DIVISION Notified/Method,� o G Supplemental Information
r
Se o ■ .e. w / 1 6 S .\ \ y r /14) 6 6) -pa .,xt0 /
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING
® 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
CATEGORY OF CONSTRUCTION work indicated on this application.
® I- and 2- family dwelling El Commercial /industrial Valuation: $375,993.00
❑ Accessory building ❑ Multi - family Number of bedrooms: 4
❑ Master builder ❑Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 9645 SW Shady Place New dwelling area: 2725 square feet
City / State/ZIP: Tigard, OR 97223 Garage/carport area: 497 square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: SW Barbara Lane to Shady Place Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Ash Creek Gates I Lot no.: 3 Permit fees* are based on the value of the work performed.
ax map /parcel no.: 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.
SFR Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Ridgecrest Homes Type of construction:
Address: 6600 SW 92 Avenue Occupancy groups:
City /State/ZIP: Portland, OR 97223 Existing:
Phone: (503)246 -8808 Fax: (503)246 -3682 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Ridgecrest Homes All contractors and subcontractors are required to be
Contact name: Karl Hoffses licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6600 SW 92 Avenue jurisdiction in which work is being performed. If the
City / State/ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 246 -8808 Fax: : (503) 246-3682
E -mail: karlh @ridgecresthms.com
CONTRACTOR
Business name: Ridgecrest Homes BUILDING PERMIT FEES*
Address: 6600 SW 92 Ave (Please refer to fee schedule
Structural plan review fee (or deposit): �� , 4
City/State/ZIP: Portland, OR 97223
Phone: (503) 246 -8808 Fax: (503) 246 -3682 FLS plan review fee (if applicable):
CCB lie.: 59228 Total fees due upon application:
Amount received: : , `
Authorized signature 7r �d�
This permit application expires if a permit is not obtained •
within 180 days after it has been accepted as complete.
Print name: William Vaughan Date: 12/14/06 • Fee methodology set by Tri -County Building Industry
Service Board.
1 tBuddingTennas\Bt)P- Pemii1App doe 03/21/06 4404613T(11/02/COM/WEB)
. , . EXPIRE
g /. 4
Plumbing Permit Applica 1 ����E® l'012 OFFICE USE ONLY c
City of Tigard 3h ReReceeiveive d
. AV-a5317 l
a 13125 SW Hall Blvd., Tigard, OR 972, ( I 5 200 Plan Review
Permit No.
C Phone: 503.639.4171 Fax: 503.598. Date/By Other Permit No :
T I G A R D Inspection Line: 503.639.4175 orri OF TIG tRD Date Ready/By: kris. ® See Page 2 for
Internet: www.tigard nivisio Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ 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: 9645 SW Shady Place Catch basin or area drain 16.60
City/State/ZIP: Portland, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Barbara Lane to Shady Place
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft: ) Page 2
Subdivision: Ash Creek Gates I Lot no.: 3 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
SFR Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER I TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Ridgecrest Homes Expansion tank 16.60
Address: 6600 SW 92 Avenue Fixture/sewer cap 16.60
City/State/ZIP: Portland, OR 97223 Floor drain/floor sink/hub 16.60
Phone: (503)246 -8808 Fax: (503)246 -3682 Garbage disposal 16.60
® APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: SAME
Interceptor /grease trap 16.60
Contact name: Karl Hoffses Medical gas (value: $ ) Page 2
Address: Primer 16.60
City/State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: karlh @ridgecresthms.com Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Craftwork Plumbing Water heater 16.60
Address: 7732 SW Cirrus Dr. Other:
City/State/ZIP: Beaverton, OR 97006 Subtotal
Minimum permit fee: $72.50
Phone: (503) 644 -8698 Fax: (503) 644 -5989 Residential backflow minimum permit fee: $36.25
CCB Lic.: 79666 Plumbing Lic. no.: 20148PB Plan review (25% of permit fee)
(8% Authorized signature: `' / State surcharge TOTAL PERMIT fee)
TOTAL PERMIT FEE
Print name: Pete Pollard Date: /)._/c/ -eb 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.
I.\ Budding\PermusTLM- PerndtApp.doe 06/26/06 4404616T(10/02ICOM/WEB)
•
'Plum'bing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I ' 100' 55.00 0 to 2,000 $115.00
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
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
Fixture or Item Qty. Fee (ea) 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 $36.25) 27.55 and including $25,000.00.
Ram 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 or each additional $100.00 or fraction thereof, to
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50,001 and up $742.00 for the first $50,000 00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ Any new exterior plumbing site utilities.
Baptistry/Font ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub /Shower ❑ Any multipurpose fire sprinkler system.
- Jacuzzi/Whirlpool ❑ Any complex structure as defined in OAR918- 780 -0040.
Car Wash -Each Stall
-Drive Thru Submit 2 sets of plans with any of the above.
Cuspidor/Water Aspirator
Dishwasher - Commercial
Domestic Isometric or Riser Diagram
Drinking Fountain ❑ Isometric or riser diagram is required for new buildings
Eye Wash that meet the qualifications above.
Floor Drain/sink - 2"
Comments regarding fixture work:
g g
Car Wash Drain
Garbage - Domestic
Disposal -Commercial
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower - Gang *Note: If the fixture work under this permit results in an
- Stall increase of sewer EDUs, a sewer permit will be issued and
Sink - Bar/Lavatory fees assessed for the sewer increase must be paid before the
- Bradley
Commercial plumbing permit can be issued.
- Service
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures.
i \Bwlding\Permits\PLM- PermitApp doc 09/22/06
12/15/2006 09:37 5035828484 -PAGE 02/03
DeC 14 06 EX RED. 11:44a RidgeCroat Homoc bU31403006 N.'
Electrical Permit Application �; �` av �' I OR c: is I 1, I -1
City of Tigard W `� Received
eel _ QO - 0 1 5 31
1 3125 SW Hall Blvd., TiSard, OR 97223 DEC 1 5 200 0Ptan Rei
non= 503.639.41 r1 Ftac 503.598.1960 Dually: Other Ramie
:... 1 , , D Inspection Line: 503.639.4175 8'atc Rieedy/AY nor fa Sec vague i ear
h aRerfi w.d rgetd.ct _�
ger
CITY ����' _ . . Method: &typhoon.'toforgation
TYPE OF WORN " "s�'�`\\'e ®B� °V.A..,„ PLAN REVIEW
- us New construction ❑ Additiaa Raise sitar all that apply (etAudir i4 sea of plane wfitonu ehoelmd Wool:
08eviecor keda400 ampsormac p Puildn+at owe time stories.
❑ Demolition ❑ Other. %%here 4o awrt'tbte fault ement 0 Marinas and bowieda.
CATEGORY OF CONSTRUCTION among I0,000 AMU at 156 valuer 0 Rennin building.
lees in grand er =cob 14Aa0 ❑ ems nete6l -ne agricalmnl
® 1- and 2- family dwelling ❑ CoromerejoIrinduntriel ❑ Accessory bolding amps for as atm iwlnitatlnsw building:
❑Multi fmnily ❑Masts:builder 0 Other OFVm pump . 0 hamllationo(75KVA.
CI JOB SITE INFORMATION AND LOCATION 0Adak o n largc I. ", ayraem
Q Adak" arrow mar bud Of CPA". "g" "1.2 ". °� � +.
Job no.: 1 Job site address: 9645 SW Shady Play 10011' or man occupancy.
O 9ia or some tasldantol miss. 0 Revewionol vdddo pails.
City/State/ZIP: Tigard, OR 4823 DHeatdt.eaee thanes. 0 Swirly v ltam fa mere than
°Hazardous lworlaas 600 vain nomiedl.
Suitofbldgjapt no.: J Project nor= ` O aeviea or feeder 600 amps or from
. FES SCHEDULE
Cross atteet/diroctions is job site SW Barbara Law to Shady Place ' otawxal.. r Qt* 1 vet, r Toga I • ,
New rsodent,al single or multHratniy dwdlio sok.
_
!deludes attached ga
Subdivision: Ash Creek Gate, —____ Lot oo.: 3 1.000 se. ti. er Jon 145.15 4
map/parcel Ea anal 500 see. 8 or portion 33.40 _ 1
Tan Limped energy. residential 75.00 2
DESC7 .IPTION Or WORK (tee ahem M• R) _
SFR - Limited energy. multi- family 75.00 2
residential Net above sq. (L) _
Services or fe dera imlti8adon alseratlea. and/or reloesdoa _
200 maps or less 80.30 1 2
a PaoPE tY OWNER J 0 TENANT 201 apps to 400 ceps " 106.85 2
Name: Ridgecrest Horses 401 temps to600amps 160.60 2
601 amps to 1,000 amps 240.601 1 2
Address: 6600 SW Pr Avenue. Suite 100 Over 1,000 amps or robs 454.85 j 2
MY/State/ZIP: )POrti nit. OR 97233 Temporary service, or feeders inattention. 'thermion, and/or
retoeatiea
Phone: (503)2468808 1 Fax: (503F.46 - 3682 200 amps et lad 66.85 I
-
Owner installation: This installation is being made on ptopdp that I own which is lot 201 amps to 400 map 10030 2 ,
intended for sale, l case, rent. or exchange, according to ORS 447.449, 670, and 701. 401 amps on 599 autos _ 133.75 2
lnadr circuits - set. aitcratioa, or re, kasion panel
Owner aiBpatare: Date & Fee for branch circuits vim
® APPLICANT 1 ® CON ACr PERSON above service m feeder fee, 6.65 2
etch Munch circuit
Business nettle: SAME 8. Fee the branch cicoits
Contact name: Karl Mottles 46.85 service a finder > 46.85 2
tort brunch circuit
Address: Each add'I Minch circuit ( 1 6.65 I — 1 - 2 —
Matea/ancoaa (service or feeder trot Ineladed)
City/State/ZIP: Each manufactured or modular
- _ dwelling. service walks fecdcr 90.90 2
Phone: ( ) Eax:: ( ) Reconaeet only 66 85 2
Pi-mail: karth®ridgeeresthms.en a Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2 ,
Business name Lighthouse Electric LdrC
Signal pane l . (s) e r l. limited
u crgy panel. Aeration. of
Address: 27501 SW 95° Avenue, Suite 960 eemensio0. Describe: Page 2 2
City /StatelZJP:Wiisonville, OR 97070 Each additional inspnedon over allowableinan of am Mine
Inreatig
Photo: (503 -) 5829600 • : (503) 5
Fax Pa inspection
(t k " 62.50
per hour mid) 6L50
Cal Lie.: 154897 1 Electrical Li e . I Sum. Lie.: 30515 lnduebialplant per boor 7175
` ± �~s ado..K -f3' ELECTRICAL PIBIt Seb d:
:Lr,9
Sups,. Electrician si@oe. required: 3
Plan review (25% of penult tie):
Print name: Randy H1B I Da= -
Statc asdrarge (8% of ptarnit fee);
Authorized signature: TOTAL PERMIT FEE:
Print jatme I Datec hit pneill ap ilcattor eying a persit i wt okeoed within !8e
J rays after it bar lie. accepted so ammtmo.
Number ofioepwdens dined per pence.
HedWInOVemibNCLC- sbadlArw4ae nvinae atu.aarfttr UbsIOOhfAl7si
glec fica1 P ermit Application - City of Tigard
Page - - PP � tY g
age 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
IE and Stereo Systems*
2 Alarm
Garage Door Opener*
Heating, Ventilation and Air Conditioning System*
Zr Vacuum Systems*
Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(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
❑ Intcrcom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Budding\Permits\ELC- PermitApp doc 0323/06
Mech Permit Application EXP I D i FOR OFFICE USE ONLY
City of Tigard o2 / �° /0 Received Permit N
•
° 13125 SW Hall Blvd., Tigard, OR 972 Plan Review Q `✓
' : Phone: 503.639.4171 Fax: 503.598.1060 f Date/By Other Permit:
I - i li D Inspection Line 503.639.417 C Date Ready/By runs See Page 2 for
Internet: www.tigard - or.gov UEC 2006 ® Notified/Method Supplemental Information
fcTY OF Tic3AFI®
TYPE OF WQ,! Iri; 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 OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 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
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9645 SW Shady Place Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: SW Barbara Lane to Shady Place Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Ash Creek Gates I Lot no.: 3 Flue /vent for any of above 10.00
Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
SFR Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10 00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
® PROPERTY OWNER ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: Ridgecrest Homes Environmental exhaust and ventilation
Address: 6600 SW 92 °d Avenue Range hood /other kitchen
equipment 10.00
City/ State/ZIP: Portland, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)246 -8808 Fax: (503)246 -3682 toilet compartments, utility rooms) 6.80
® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: SAME
Fuel piping
Contact name: Karl Hoffses $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: karlh@ridgecresthms.com Range
CONTRACTOR Barbecue
Business name: Supreme Comfort Clothes dryer (gas)
Other:
Address: 9425 SW Commerce Circle MECHANICAL PERMIT FEES*
City / State/ZIP: Wilsonville, OR 97070 Subtotal
Phone: (503) 682 -1985 I Fax: (503) 682 -1018 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 21892 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: David Kropf Date: • Fee methodology set by Tn -County Building Industry Service Board
I.\ Building\ Permits \NEC- PcrmitAppdoe 04/06/06 4404617T(11/02/COM/WEB)
4 . vi., I
Mechanical Permit Adplication i FOR OFFICE USE ONLY
Ci ty of Tigard • Received Permit No
' 13125 SW Hall Blvd., Tigard, OR 97223 E X Date/By:
g i Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 _ 9 , i, ,' Daz Other Permit:
Inspection Line: 503.639.4175 `- - -- 4" 1 I /B Date Read iu� ®
s See Page 2 for
Internet: www.ci.tigard.or.us Ready /By. g
g Notified/Method: I Supplemental Information
TYPE OF WORK COMMERCIAL TEE* SCHEDULE — USE CHECKLIST
❑ A ddition/alteration/replacement Mechanical permit fees* are based on the value of the work
❑ New construction performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION I Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP: Fumace 100,000 BTU (ducts/vents) 14 00
Suite/bldg./apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump I 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10 00
Wood/pellet stove 10 00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: - - .- - - - - - • - --- -.
Other: . 10.00 -,.
Fuel piping
Contact name: $5.40 for first four; $1.00 for each a dditional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax :: ( ) Water heater
Fireplace
E -mail: . Range
- • CONTRACTOR Barbecue
Business name: Su.plre 4.e CaM , - 4 - /1014, Clothes dryer (gas)
Other:
Address: ci 4 25 S W 4M% KU v 0 - 34 ": i 1 S . . :MECHANICAL PERMIT FEES*
City/ State/Z1P: W 1 50A at{ r 0 ti 707 0 Subtotal
( 503) 6' ■ Ilg ( 03) ('o % Z (0 Minimum 25%
Phone: � Fa x: 7
Plan review (25% of permit fee)
CCB lic.: 2411 Z 6 (e7 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
d ays a fter it has been accepted as complete.
—
Print name: NW 4, K' Date: • • Fee methodology set by Tri -County Building Industry Service Board
i\ Building \PermitsMEC- PermitApp.doc 12103 440.4617T(I1 /02/COM/WEB)
City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
•
=. oe
.
*TY
RESIDENTIAL PERMIT APPLICATION REVIEW
Fermi[ \umhei t^ f\ \ _ $ • _ 0
S ul,J,\isic,n M► e "' MM
( : ()1u : ut \:unc r `O c- s
ace ,Si ij 4'z. r.J A4 L•
(:in or- \ \ C'�,,nrk State 1 (L I Zip I q--)
As required by the 1999 Legislative action (Senate Bill 587), your residential permit application
and plans have been reviewed to determine if it is complete and if the plans are deemed
"simple" or "complex" as defined in ORS 455.467 and 455.469.
The application is complete.
The application is incomplete for the following reason:
I ca. �e VtLX C Q \ C. is 4:0Y1. S try. i.7-,■,r\
I I The submitted plans will be reviewed; however, a permit cannot be issued until the
above information is reviewed and /or approved.
I I The submitted plans cannot be reviewed until the above information has been
submitted and /or approved.
I I The plans are deemed "simple ". i The plans are deemed "complex ".
If you have any questions please call Loraine Williams at (503) 718 -2708.
V A kJ , 2 . \s v OL
Name of Plans Reviewer Date
Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772
i
a " Building Division
T I G A R One & Two-Family Dwelling
Fees Checklist
PEItMT`T INF ORMATION: _ ._` .;..,_.. , _, __ , ; . :: -. - - ,.._..,
Permit #: 13� '�-' o - E30 33 ( Plan #: t2 ( 22 E : .= .. : .a te: , r -. :;
Date: � (/2 1 '��7 :<.: *- ..
Site Address: C( 6 4 'S RN() Parcel #:
Subdivision: A F{- . Lot #: 3 zoning:
Jurisdiction: 1 Setbacks: Front 'Z.) Rear: (65 Left S' Right S
Class of Work: Matt) Stories: 2 First Floor. (842
Type of Use: Fa•S Height . 2.C) Second Floor. 6 3 z.
Construction: (J Floor Load f Floor:
- ..0 Third Floo
Occupancy Group: K -3 Dwelling Units: ( Bonus Room: we' 4Tctk>- s
Valuation: a 7 7a 9-0, V) Bedrooms: Total Floors: 2$ ?ES
Bathrooms: Basement
Decks: Garage: A9 6. , s
Porches: Other:
FEES: ' •' ` :�`�.,T:�. . e «.��Y,w .'i°� - •r. ,
Off: -..a �..�,� -..r
-- - d �..� L::•: •,�.+,: Foe Am oua� 7 ......_,. :m .- ,..
Building: Ci -{ l' °-- ---- --� P�id_ ;,Ba�aaoe Di>�_ � -
Set e� v (0%4 �� • 1 &
Extra Se ie_
Plan Check Bu
I/
Permit: Budding: . I
Tax: 1 1
Metro CET: '. -) l
Mechanic -L• q i . 3n
Tax • ' c Z
Plumbing. 4 fi
Tax: 75t Qn
Electrical: ) ( a .1
Tax: (4. , q')
Low Voltage: -) SOCK .
Tax: (o • 00
SDC: CDC LRP Fee: (
CDC Ping. Rev.: 4 B. C)( )
Parks: '-c d a� .c.K.)
TIF Res.: nO. r
TIF MT: g O. 0(3
Erosion Permit: . 00
Erosion CWS: c& , e0
Erosion COT: o S %, (
Water Quality: Z
Water Quantity: 0
SUB - TOTAL• 1 I t t a. d O (G (o - d
Sewer: Permit:
Inspection:
SUB - TOTAL
TOTAL MST & SWR:
I. Building\FormsUtesPlanCheckFees doc 06/29/06 Page 1
•
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems) .
Description I Qty. ( Fee(m) I Total Description I Qty I Fee(ea.) I Total
' _ New 1- & 2- Csaill . dwAhP . `' c ,,,' e . ;;Z,' eatt.=/Cooua r: F . •
- . : - fhelndes 100 tt for each atuity'e aiteefien)' . Air conditioning or heat pump' 14.00
SFR (I) bath 249.20 Furnace 100,000 BTU ( ducts/vents) 14.00
SFR (2) bath 350.00 Furnace 100,000+ BTU (ducts/vents) 1 17.90
SFR (3) bath 1 399.00 Gas heat pump 14.00
Each additional bathhitchen . 45.00 Dud work 14.00
Rain Drain, single Tamil dwelling 65.25 Hydrunic 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 by droner system) 14.00
Fire sprinkler - sq. ft. 3,601 to 7,200 220.00 Unit heaters (fuel, not electric)
Fire sprinkler - sq. IL 7,200 and greater 309.00 ('m wall, in-duct, suspended, eta) 14.00
Syr. w+a -•e' -_ -• :gie Mildew ;,ygr;•. -• ,. •. . , _ . - Flue/vent (for any of above) 10.00
Catch basin/area drain 16.60 Repair units 12.15
Dowell/leach line/trench drain 16.60 Other Fuel Appliances
Footing drain - l" 100' 55.00 W heater 10.00
Footing drain - each additional 100' 46.40 Gas fireplace 10.00
Marufactrand home utilities 110.00 Flue vent (maw hate /pis fireplace) 10.00
Manholes 16.60 Log lighter (gat) 10.00
Rain drain connector 16.60 W stove 10.00
Sanitary sewer -1 ( 55.00 Wood 6replacefiatert 10.00
Sanitary sewer - each additional 100' 46.40 Ot /linad8tdvent 10.00
ch
Storm sewer - I" 100' 1 55.00 �� 10.00
Storm sewer - each additional 100' 46.4 Kassa & veer tL
Water service - 1" 100' 1 55.00 6 °° d / o ch er I° tchar equipment 1 Io.00
Water service - each additional 100' • 46.40 ' Clothes exhaust 1 10.00
_ .- • - - -,.: ,.-wy .ski r5�wc:r e whim `+"+*any »i•�•' -. +may*. Single duct exhaust
Absorption valve 16.60 (badtroonts, toilet campartmatts,
Ballow preventer 27.55 utility rooms) 5 6.80
Backwater valve 1 16.60 Amide:awl space fans 10.00
Clothes washer I 16.60 Other: - - 10.00
Dishwasher t 16.60 Fuel now
••(SS.40 for first 4, $1.M each additional)
Drinking fountain 16.60 Furnace, etc. - i • •
Ejectas/swnp 16.60 Gas heat Pip • •
Expansion tank 16.60 Wall/suspended/unit heater • •
Fixture/sewer cap 16.60. Water heater 1 • •
Floor drain/floor sink/hub 16.60 Fireplace • •
Garbage disposal 1 16.60 Range • •
Hose bib .1. 16.60 BBQ • •
Ice maker 1 16.60 Clothes drYer (Ps) • -
Interoeptar /grease trap 16.60 Other • -
Primer 16.60 Total:
Roof drain (commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory 2jt/ 5 €3 16.60 Subtotal: S T7 ..
Tub/shower/shows pan 3 16.60 Minimum Permit Fee $72.50 S
Urinal 16.60 Plan Review Fee (25% of Permit Fee) S
Water closet 16.60 State Surcharge (8•/. of Permit Fee) S "7 . 7
Water heater 16.60 TOTAL PERMIT FEE S
Other.
Other ELECTRICAL FEES (residential single- or multi-family)
• • Plumbing Permit Fees • • - • -
Subtotal S Description Qty. Fee Total lasp
Minimum Permit Fee $72.50 S 1,000 sq. ft. or less .1 145.15 , 4
Plan Review (25% of Permit Fee) S Ea add'1500 sq ft. or portion 33.40 I
State Surcharge (8% of Permit Fee) S Limited energy, residential ` 7 2
TOTAL PERMIT FEE S Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Metrical Permit Fees
Subtotal: S 1 a .1
Plan review (25% of permit fee) S
State surcharge (8% of permit fee) S 0 Y .Q
TOTAL PERMIT FEE S
I:\ Building\Forms'ResPlanCheckFees doer 06/29/06 Page 2
Apr 08 11:54a p.1
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RECE CITY OF TIGARD
BUILDING DIVISION
TELECOPY COVER SHEET
TRANSMISSION DATE: -V— ?- '
TIME: / 2 ,,,,,,,,
TO: )) fgiF A- , FAX # . 503 '578– /9:;�
FROM 8i! ,4 V FAX #503 -246 -3682
4
NUMBER OF PAGES, INCLUDING COVER: 07
< C WITH TIES TRANSMISSION, PLEASE
T'ELY
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JO 11 f- - , Tom? ..1.' -ems $ 024 "d .
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6600 S 92nd Ave., Ste. 100, Portland, OR 97223 t.503.246.8808 f.503.246.3682 www.Ridgecrestilms.com CCB #39228