Permit EXPIRED /02 % o io 4,,,
Building Permit Application A,t n ,t�.l_ FOR OFFICE USE ONLY
City of Tigard 7 O_ �/)- Perm . „ r
Er
Q I ; I �5 N\\ I1011 hied I ieaad (,R 1)7 23 / - -- - - -” ' 1 --+
ph 'I l,i ( il) .t 171 l ;1.\ jll : inS 19o0 °' IG/ 100 1 ( )thei I'cl —
S; r u L I),Ilcai\ l .. 0�0 L _ _ / a� — odd —
117- ad\ li\ 1,!!: El cc Attached ( hceLti>t f I
TIGARD Inspreuon Lme ;n:; r,;v I)rue lo
. ; ^! Y
OF 1IGAF
. II1telllet \\1111 tig:iI l -Ur S„\ M p�`�ul led' hlethvd N,g)plemental Inform :mon_j
BUILDING DIM]. .1
T% PE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING
® Ne\+ construction
❑ Demolition Permit tees* are based on the value or the work performed
Indicate the \aloe (rounded to the nearest dollar) aid!
❑ Addition/alter ation /ieplacentent ❑ Other equipment. materials. labor. overhead. and the profit ti)I the
cco k indicated on this application
CATEGORY OF CONSTRUCTION _—
Valuation S
5 I- and 2- 1and■ doedhng ❑ Commercial /industrial
❑ Accessory building ❑ Multi- fantil■ Numher ufbedrooms 7
Number 01 bathrooms
❑ Master builder ❑ Other _
—
JOB SITE INFORMATION AND LOCATION Total number of lloors
Job site address 15723 5w i31-1--- pax) New dwelling area il v iz ,y square fret
lit■/State /LII' --- . - ( 2 C1 - 7 2,.Vj3 Garage /carportarca i ) square leet
Suite /hide /apt. no Project name eiCte, J () f � Covered porch area. square let
Cross street/directions to Job site ! Deck area square diet
I1 Ti i - _Lf v_ on • ■ • Other structure area square feet
_ REQUIRED DATA: COMMERCIAL-USE C'IIiE('KI.IS I
0 'mild ivb,nm Lae ' .Y e_. -,j 5L ,IVI,S — I Lot no - �3 Permit ties* are based on the value or the %cork perlormed
Indicate the value (rounded to the nearest dollar) 01 -all
Iax map/parcel no
equipment. materials. labor. toerhead. and the profit lot the
DESCRIPTION OF WORK %cork indicated on this apLcation
Valuation S
- fY ) CAr\ E.- 1 —
l:\isticL' building area square feet
I Nell building area: square Icct
IZI PROPERTY OWNER ❑ TENANT Number or stories.
Name 1 / 11,.t ' 1 � � Id1V I )pc ofconstnrcunn
1
Address l 7f17 5� Le f).41'.\-- ("I M V'( I 3(iL1 k , I _J, T ) Occupancy groups:
--
City /State /LIl' -- r1� -i , O'(1 ,./.7z,,k3 Existing:
Phone ( 5 (m 310 ,4 Fay (59;) 54S O F/ New.
❑ APPLICANT ❑ CONTACT' PERSON NOTICE
Business name- CfAct{ I Y 11u_li lA3 n hDVnr" _-S j 1 LuJ All contractors and subcontractors are required to be
i
licensed with die Oregon Construction Contractors Board
Contact name "Ti ill S ff, ^ , �} . under ORS 701 and may he required to he licensed in the
Address 12.18 5w W p p ), `( !IC la jurisdiction in ohich work is being performed If the
Clt■/State: /ZIII -r) � . ►�d l l7 2 12.2- apt Ill'8111 b exempt tri m licensing. (lie li)Iloo In, ' reasons
Phone ((O3) i _ 31 D I a \ :. ( 5 0 3+ 518
f: -mall: 15 we s4-16t nag a,QI • corn
J CONTRACTOR
Business name t
�drl ✓ X11 w � p���v�h o v�S �_ 1 u�; BUILDING PERMIT FEES*
Address '� / 3 / /� (Please refer to fee aehrdule
I ZIP -70 50 J o 4 ' ItWe; l 3 l�L i - `1V�) Structural plan review fee r deposit 75o . Cl)
Ctv /State /ZIP. --r--/6.,...--r--/6.,...„--r--/6.,...„4.1,-,0 o 2 ' 11-2.12-• I'I.S plan review tee (if applicable)
j Phone: ( 503 ) 1i3q . 3 Joi.I Fa.: (503 g . 1tyi?
Total tees due upon application: ', , 90
LCCB lie • 7 „ ,
Amount received
Authorized signature
- This permit application e\pu•cs tl a permit is not obtained
+\ ithin 181) days after it has been accepted as complete.
Fruit name �;(/ Date ,
- -- �� s (. � �! �U� I ce methudulu_\ set h) I n- Count+ Building In(lustn
tiervIr• Board
i `n nnns\lit I' -Tenon \yr.1.: .i I io -!nl ; 11 I I1)]:( i) \l•V'I n,
. -
Mechanical Permit Application EX:r:!;:::::ED - -.- : - • ." :' :FQR OifF'11:' C4:(4N111' .'. ' . • .: . - ...
. ,
. -
:- .. •..,' , City of Tigard Received
'
• .. 13125 SW I tall IIINd . ligard ( >I< 0 722 ;
1,1 DateiBy
Dateifi) Nun"
.,
pianRevies,
I' - ph so; 63o 4 1 7 r Hs \ 503 5.ig 1060 , );hel Per nut
503 6
L
t
pecion line .3 9 -1175
TIGARD Ins D Read%/13% .i,,,, El See Page 25, ----
- . - Internet ww•w tigard go N
Noillicdrivieihod Supplemental Informanon
._ . . .. . L ___.. .
TYPE: OF WORK -I 1 COMMERCIAL FEL* SCHEDULE, - USE THE( LIST
-
lyi New construction 0 Addition/alteration/replacement Mechanical permit fees' are based tin the value of the work
performed Indicate the value (rounded to the nearest dollar) of all
0 Demolition rj Other mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
p I - and 2-family dwelling 11] Commercial/industrial 0 Accessory building --
For special information use checklist
111 Multi-famil■ 0 Master builder 0 Other
Description 1 Qty. Ea Total
JOB SITE INFORMATION AND LOCATION 'leafing/cooling
Air conditioning or heat pump
Job site address. 15- s iA) si c.,-)- ftv
trequires sae plan showing placement) 14 00
City/State/ZIP' - b-,,,q.2_D i of ci-72_77-- Furnace 100,000 BTU (ductsivents) 14.00
Fumace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg /apt. no . Project name C Sc, _. ii&c...
Gas heat pump 14 00
Cross street/directions to job site Duct work 14 00
Flydronic hot water system 14 00
dilld IP L- o da P • _A ° . Residential boiler (radiator or
hydrontc) 14 00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc 10 00
r
Flue/vent for any of above 10 00
Subdivision ( v 1 C_ I D tA i Lot no • 28
Other 10 00
Tax map/parcel no -
Other fuel appliances
DESCRIPTION OF WORK Water heater 4 _10 00 1
Gas fireplace 1 10 00
n-nA Flue vent for water heater or gas — 1
I i
fireplace 10 00
1 ----- Log lighter (gas) - 10 00 -- -
Wood/pellet stove 10 00
I ---
----
i Wood fireplace/insert 10 00
Chimney/liner/flue/vent 10 00
cg PROPERTY OWNER El TENANT
Other 10 00
Name C,_.(461 (Y) i IA :1 011, IC- , i_u , Environmental exhaust and ventilation
Range hood/other kitchen
Address. 12 0 C li p 5LAA,I..{,11Lv equipment 10 00
City/State/ZIP: "I vl-rz.„D a'2- /--7.3 Cloeths dryer exhaust 10 00
Single-duct exhaust (bathrooms,
Phone: ( ) 1, 6 . 3 1 D Li Fax: ( .(zz , ) 5 .... ; , / g . q02„.1 toilet compartments, utility rooms) 6 80
0 APPLICANT 0 CONTACT PERSON Anic/crawlspace fans 10.00
Other _ 10.00
;^
Business name. af‘ta V /
, V
1 I I tA/ - 10 IA*1.0 n IT I.4-0 Fuel piping
Contact name: - Si 01 5-\--1 \nay i ti3 $5.40 for first four; $1.00 for each additional
Furnace, etc
Address: t it j2 0 51-i) Li i 5iii i .16, LeDO
Gas heat pump
City/State/ZIP: - 012_ 0 1 L-2-3 Wall/suspended/unit heater
Phone: ( ) 1/3g . 3 i Fax: : (1 g .4 / Water heater
Fireplace
E-mail: 35 t "0 6 ,...,A..1 44.AA k aiii c orvu.../
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name. - r - bitVrvy k t , ,r10
Other
Address - 72314, SUO DIAVklrnAryl - EA ,e5i4ik,100 MECHANICAL PERMIT FEES*
City/State/ZIP. 170 (4-- 01 vVk I OrL. 6/1 7-2-14 Subtotal
Minimum permit fee ($72.50)
Phone: (503) 1 0 _ g 3 /.4 Fax (5,5) ( _ v im
Plan review (25% of permit fee)
CCB he : 15 I g Lir)
State surcharge (8% of permit fee)
III■ _____
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature • -
days after it has been accepted as complete
1 „ 4 _ r
tiWt '"I'v
EXPIRED
Plumbing Permit Application FOR OFFICE USE ONLY
City ) i/
IT•n Received aa27 00/ 77
of Tigard
r' c /I 3y Pei m i
v 13125 tiW I tall 11Ivd . I I_,ird OR 97223
I'I n Revn•ss
0 Th 503 039 4171 Fax ill i 598 1960 I oilier ',um No
Date!li\
TIGARD Inspection I Inc 5u3 6;9417
Dale Read% lip I Jun, 1 El see Page 2 lul
i U\\\\ I ptii i i goy NOW led 'Mel 11. >upplement.11 .mm'
TYPE OF WORK FEE* SCHEDULE
New construction ❑ Demolition loon For special information use checklist
Description I Qq 1 La Total
❑ Addition /alteration /replacement ❑ Other- New I- 2- family dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 24920
c si I - and 2- Lunilydwelling ❑Commercial /uxfustrial SFt (2) bath l ±5000
❑ Accessory building ❑ Multi- faiuiI SIR (;)bath 99 00
Each additional bath /kitchen 45 00
❑ Mister builder ❑ (.Other - -- —
I ire sprinkler ( sy ft 1 Page
JOB SITE INFORMATION AND LOCATION Site utilities
lob site address 15 -72.3 G RI 5 -j_ Catch basin or area drain 16 00
City /State /ZIP - 11(5)14124) t Ue_. cr27.-2 Drywall. leach line. or trench drain 1660
Suite /bldg. /apt no.• Project name. � il(J . .)2G �— Footing drain (no linear II _) Page 2
- Manufactured home utilities 110 00
Cross street/directions to job site
Manholes 16 60
I - -Fv L-. i l u0 ' - qv gl - e_/ Rain drain connector 16 60
Sanitary sewer (no linear ft l Pace 2
Storm sewer (no Illlear ft _) Page 2
Subdivision Ci1�e �}- wI,5t ()� 1 -ot no- 2� Water service Ono linear ft _) Page 2
}lf' Fi,ture or item
fax map /parcel no
Absorption valve 10 60
DESCRIPTION OF WORK
Back low pre'. enter Page 2
n -0/1 ) ( 01/1_5 'l;t 64 -- , Backwater salve 16 60
Clothes washer 16 60
Dishwasher 16 60
Drinking Ibuntain 16 60
(C] PROPERTY OWNER ❑ TENANT
n ' '� Electors /sump 16 60
Name- l /ter Y' 1 1 w Tro1..ov 0 , 5 / IA/ j Expansion tank 1660
Address L ! r--/0 S be (J 5t44 k qv Fixture /sewer cap 16 60
City/State/ZIP: Tibllca,ar O _Z ? _ Floor dram /floor sink /huh 16 60
('hone (5 �) i - 31 lax: ( 3 c 40g / Garbage disposal 16 60
❑ APPLICANT ❑ CONTACT Hose hih 16 60
PERSON
Ice maker 16 60
Business name Ce ,/ rn 1 IA 1 rAWAIn S ' ui Interceptor /grease trap 16 60
Contact name :1 r 5..1.- i rviv Medical gas (value $ ) Page 2
Address: I lir 0 SGO if X n l $'F'" y 5 -� Lio Primer 16 60
City /State /ZIP T &- 1 1 72Z3 l� Roof drain (commercial) 1660
(53 )ti G) - J I p Sink /basin /lavatory 16 60
) 31D 1 "(, `^'� � r t 8 Fax • ( ) •�1
' ✓ // � T 1 ub /shuyver /shoyvcr pan 16 60
L.- trail. JS011 -5 e_a 1. /.D►''') Urinal 16 60
CONTRACTOR Water closet 16 60
Business name. Th / , pn 14 () JA '. f yv pA v L Water hcatei 16 60
Address: I u D I 5f • , t vr,.ir -00t0I, Other.
Subtotal
City /State /ZIP: 14-1 I7 bp,V 7 - /1 3
1 l� Minimum permit fee $72 50
Phone (% (6440-0 3 Fax ( 503) ( yyg3 Residential hackflow minimum permit fee $36.25 -441 CCB Lic. / 2. Plumbing Lic. no. 3C1 .Z(.pr3 Plan review 12 5%'0 of permit fee)
- State surcharge (8% of permit fee)
Authorized signature
TOTAL PERMIT ELI;
Print name •1 emit, / I% .. . Date This perniil application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*I cc methodology set by Try - County Building Industry Service Board
I 'IRnldm SI- I'crmrI \pp doe uhi2t nn •1.10 -10 I,II ili112rt'U, \Vwl-I1)
08/29/2007 14:24 5036425815 ECt J . g � ROSS ELECTRIC INC PAGE 02/02
Electrical Permit Application J! L�'
City of Tigard wive
DateBy Fo mn ...00/ d0/ 7
13125 SW Hall Blvd,, Tigard, OR 97223 Plan
Phone: 503 639 4171 Fax, 503.598.1960
A •� i i . Date/By other Permit Inspection Line: 503 639,4175 - Dare Ready/BY' rwr RI gee Page 2 for
Internet: www.ci.tigard or.us Notified/Methed. Supplemental Information
1 i,_ ,! d;MzM M ., t 1'yv 9. " :f15E/'{, _; "`sli' .. .;, 1 ,L ,lS eYt"fl ,� �• _
„__�.. lam_, w!"T.."•y',?•,i.A "�3'Jry:Y , ,_ - 1 �. FP i�� �1 '. d���' r��r'_ IAVf�',.,...: �r..... .��dly� {� `.fH ���I,� i �' �
N New construction ` # y ' '
tcv 0 Please check all that apply,
El Demolition pia ❑Service over 225 amps, comm'1 ❑Hazardous location
( +� ��` 4' y o c r x: w ❑Service over 320 amps - rating ❑Bulldog over 10.000 sq h
� , •, > ? Z,i`+?,air.,��>: t ra s a�r�ra of 1- and 2- family dwellings 4 or more new residential
1- and 2- family dwelling ❑Commercial /industrial [] Accessory building ❑System over 600 volts nominal units in one structure Dyg
IC
Multi - family ❑Master builder ❑Other: ❑Building over three stones ❑Feeders, 400 amps or mot
� r , i '{ ,F?5 _ I,,!t . YET R °i ce "' 1 a , w , ❑Occupant load over 99 persons ❑Manufhchued structures o
i g.zit'•!R r`�.!(;F,W'i'1',Kk:e ', ' i 'i-.�.'. f: � i sit g 5 . f�' r yt.ff .�die,..0 °4 ❑& r ti
• , �ti:ailciakt � � , .: • .. �y,,:r;"�.;c� l;rsss/I•gh n6 Plan RV park
Job no.: Job site address: 157 1 5 () € i 5.f- ❑Realm care facility ❑outer
Submit .2 sets of plans with any of the above
City/State/ZiP: $ 'l . , I • Z The above are not applicable to temporary construction service.
Suite /bldg. /apt no Project name' C ► T7 [ _6 9...44 ' :;/. ,,.;. .' _ *ZiarEi � Lit1V-k
_ Description Q. Pee. Tote! "
Cross street/directions to job site New residential single- or multi - family dwelling unit.
II //'. Q
Includes attached garage.
Al A ■► l� �{/ � O I 5•1- a 1,000 sq. ft. or less _ _ 145.15 4
Subdivision: / ■111 , • 1 Lot no.: 2,g Ea add'I 500 sq ft. or poor 3140 1
Tax map /parcel no Limited energy, resident •�� 75.00 2
``��if '`r`�,�- {^tr,.s - k ,�,-� a ,. �, Limited energy, non -rase 5.
fig_.. ;,.�:�,.'IY9 1 1 �. c,�i�,ln E K 1' i 1 MS,ci:7'r —i�da • f f • ' 00 2
•-- +�'•yl��� fl _ ..+� � :'i.�'r �� �� Each manufactured or m • ��
dwellin . service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less II. 80.30 — 2
,B , 1 tT l;ili1 .t `i: 2 H ".�� r _ • lR - i r w• ., � •- r� -
106 85 2
i 1, a [ y .C.. 'mow [0! t x r 201 amps to 400 amps
r�ra of e„ r�,! r, i ? ?; • ,- ' s 'dv l�s, _t,: {..'nr , ' ,i:. 401 amps to 600 amps 1111 160.60 2
Name: C,. C d41/ ml LL- To (,c )nletnvnG 7[ / : 601 amps to 1,000 amps 1= 240.60 2
Address: 2.4 5L0 g -1 , J pr li Over 1,000 am • s or volts - 454 65 ` 2
Reconnect on 66.85 2
City/State/ZIP' T - 1 GI 1) i 0YZ ci 7 Z-Z3 Temporary services or feeders Installation, alteration, aced /or
relocation
Phone:
( / ) V3/ . bL F ax: ( .502,) S5' • q 0 R/ 200 amps or less 66.85 1 I
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, le. ex , . , • :c • • e •.: • -• 7, 449, 670, and 70 401 amps to 600 amps 133.75 2
Owner Signature: p • • -
Brand circuits - new, alteration, or extension, per panel
iT ` ,� �. ••. F P § .: : ; 1. :rii,.arly';'il a, r „, :,I . Fee for branch circuits with
=' ,0 ,• r app : mom, � :�, _';! A. aervme or feeder fee, each
Business name: _ t t A r / a , ! '+ branch circuit 6.65 2
B. Fee for branch circuits
Contact name: 1 d ry` • tri . without service or feeder fee, 46 85 2
Z �P 7 each branch circuit
Address: � J 84 - ( .: �Da Each edd'I branch circuit 6.65 2
City/State/ZIP: - I (a l4-V 17 o 6 / - 71-2-3 Miscellaneous (service or feeder not included)
Phone: �A Pump or irrigation circle 53 40 2
( Q ) Y CI - 1IL Fax: ( _ - D;
ims
Sign or outline lighting 53.40 2
■ 0 Signal circuit(s) or limited -
;5, ' 3 ski V3 .. , - 1 ., 14 r .. t '�` energy panel, attraction, or
I�0 ss e t. T- 1 G extension. D escr ib e:
Business name: Page 2 2
Address: ,Q g70 SE 7 51.7- � #•2A3 Each additional inspection over allowable in any of the above
• Per.inspeetion I 62 50
City/State/ZIP: 1+; i 5&,0) 0 r — q 7 (a """ investigation per hour (1 hr min) 62.50
Phone: (51)3 ) t/ tit Z 2 it 00 Fax: (g-0 Is y a 5"1( l,S' industrial •!ant per hour 73.75
Yr
CCB Lic.: := : W; _ " - y-- j1T 1(ri.', ° "T�i;_
T78'q ( E le ctrical Lie : 3 rjr . y 3� a S uprv. L i e.: y z3. 5 Yi;:R�r' ti R i us,., pi %� i to ,.,.�''a:''
p �� Subtotal
Suprv. Electrician signature, required: /'•-j" " " Plan review (25% of permit fee)
Print name. Ste-Pk .0 C S I Date: a I/ 11 ffl State surcharge (8% of permit fee)
— 7 " / TOTAL PERMIT' FEE
Authorized signature; lei, ermit a p permit is t
p pWiea6on n ires if a
Print name. � ) �� dap aRer it has been a ccepte d as sot comobplete ained within 180
4Af y . l / Date: I Fee method set by Tti County Building Industry Service Board
• .. Number of Inspections pa permit allowed
11.601101 errnitstaLC•PormiiApp dot 12/03 440.4617 T(la/a2rcOMJWEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined... $75.00
Check Type of Work Involved:
Audio and Stereo Systems*
L ✓Burglar Alarm
Garage Door Opener*
❑i /Heating, Ventilation and Air Conditioning System*
Q /Vacuum Svvs
n 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
n Fire Alarm Installation
❑ I-IVAC
❑ 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
I \Building \Permits \ELC•PcrmnApp doc 03/23/06
11111 I ° Building Di v i s i on
One & Two - Family Dwelling
T I G A R D Fees Checklist
: ' ii ,- ,, : �. h R ' • . : t4 i. . •f "'Y t !� - ��i V l•. y t3.1'', k i w.' -, ;'
_n.euA � �- .`,���x « u �� '� �n1 ��5: �.`�m.+t �,7`r'['�' Y'!1'Wvd��S.: i 4, '�� . . * • �C a �.... _ U `.' -. T �Y] ?law '' , 7f �,�'+r't .
Permit #: S\ a rC) - 001 i �7 Plan #: it \ s 1 p. — (' L. Date: ICS • Ito ' C31
Site Address: 15 7 a s o % \s 4 Av-p . Parcel #:
Subdivision: el r,a p :tire �— Lot #: c D _ Zoning:
Jurisdiction: lxv Setbacks: Front: Q.. Rear: \ C Left: Right:
Class of Work: �tp r Stories: (..') First Floor: 96(.0*
Type of Use: aF Height: a j ` Second Floor: yt)Qf Gr
Construction: n Floor Load: S 0 Third Floor: C1
Occupancy Group: ).4 Dwelling Units: s t Bonus Room:
Valuation: Bedrooms: 4 Total Floors: 1 3 '
Bathrooms: 3 Basement:
Decks: Garage: L{ 1 `T 4
Porches: l( 4 Other:
s : � : e r "K;.'w "� �Y!i =s„rr �� + �t 3.dt 'env '�'+'� 'Sc, . 1 �2'i:. r`., �
W .y .r . :— ; ?ee µA>nto . x ° ,�` i . i ig kt .; aT `i � : 2 1
Plan Check: Building: :'1TC ' { . �-- ' - 7 j , ( )C) 1;-. co a-
Extra Set: .
Permit: Building: •
Tax: IM
Metro CET:
Mechanical: 0 ,SCE
Tax: 7,r94
Plumbing: ?a(, cj',
Tax: � ? 1
Electrical:
Tax: D@. 30
Low Voltage: -- ) .0 c
Tax: •l )Ca
SDC: CDC LRP Fee: ` ' ® 3
CDC Ping. Rev.: 14 ( , Q G
Parks: Z5 i a , U 6
TIF Res.: ,'7 no . Q O
TIF MT: x '7 1 4 O , vG
Erosion Permit: RS QQ
Erosion CWS:
Erosion COT: at. Co 0
Water Quality:
Water Quantity: r '
SUB - TOTAL: I °► — 1 1 . °I La 11 (D \ , c1' 1 p
Sewer: Permit: •
Inspection:
SUB - TOTAL:
TOTAL MST & SWR:
I \Building \Forms \ResPlanCheckFees doc 01/19/07 Page 1
PLUMBING FEES (for special inform ation use checklist) MECHANICAL FEES (residential equipment/systems)
Descri ' tion Qty. Fee(ea.) Total Description I Qty I Fee(ea.) Total
5 y ' a n .u.. .. - ' "T' �' : ii• ;C. '; Ys emogr r C8 �COOIiOR ^'7»�..�: = iF i}= aaigo :
+[ x �- `,� � ' `- � � ,� <A ', •r k•- a ' _vur:�rJ�ss5�"••,�FSi'!ai i, 4t,'` -.- j�' x•.B: �•
' ,,, "d ' A.
p , i . ; „ ' I nib `' 3 , . ;. , ' , E-, 4 ,,,• 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 Furnace 100,000+ BTU (ducts /vents) 1 17.90
SFR (3) bath 1 399.00 Gas heat pump 14.00
Each additional bath/kitchen 45.00 Duct work 10.00
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 - sI. ft. 7,200 and :seater 309.00 (in wall, in -duct, suspended, etc.) 14.00
i ; =.-,� 7 , !ti' • >pa p tt a J (E' �,r �p� ,: g 4. Flue /vent (for any of above) 6.80
' LYt r �i�LLa�YI !`��tii:l+scf'i��Lfi��:2.� � .IJ:�::i�F9�i"'v.T�"u'•taZ= 7�. ��7�1'_�s`_`ti• ° .1
Catch basin/area drain 16.60 Repair units 12.15.
Drywell /leach line /trench drain 16.60 ?i 3 'l W :Qeh`If:Fue1 PRUs6'c'esLa� i `•;Mfi%; ii
Footing drain - 1 100' 55.00 • Water heater 10.00
Footing drain - each additional 100' 46.40 Gas fireplace 10.00
Manufactured home utilities 110.00 Flue vent (water heater /gas fireplace) 10.00
Manholes 16.60 Log lighter (gas) 10.00
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 - l' 100' I 55.00 O ba-J,30$ 7, Ojronmen(aYsE li" `+ Sa tiliitlod;:, W 3:r".
Storm sewer - each additional 100' • 46.40 Range hood /other kitchen equipment 1 10.00
Water service 1S 100' l 55.00 Clothes dryer exhaust 1 10.00
Water service - each additional 100' 46.40
=. •7 F. n _ b r �* 1 t '� Single duct exhaust Sin
-r � •�'�- -:.% `.fix. J _ •i'� ��rr�.��5.`.�',>;�`���•Y, g
Absorption valve 16.60 (bathrooms, toilet compartments,
L f
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve 16.60 Attic /crawl space fans 10.00
Clothes washer 1 16.60 Other: ii.tr 10.00
,:hsi�,?M
Dishwasher 1 16.60 i.`i..: :WgluelslpinaN,r.w;ri. ; W%.:gia.•::a,•'N
* *($5.40 for first 4, $1.00 each additional)
Drinking fountain 16.60 Furnace, etc. 1 **
Ejectors /sump 16.60 Gas heat pump **
. Expansion tank 16.60 Wall /suspended /unit heater **
Fixture /sewer cap 16.60 Water heater 1 **
Floor drain/floor sink/hub 16 60 Fireplace 1 **
Garbage disposal I 16.60 Range 1 **
Hose bib , 16.60 BBQ **
Ice maker I 16.60 Clothes dryer (gas) **
Interceptor /grease trap 16.60 Other: .«
Primer 16.60 Total:
Roof drain (commercial) r r • - ,.,,
0 1 16.60 ��:�'��� , ��; X11' Iitcbapfest 'P.,eFoilff:l"eeg y i'�T� `'gin, �`�`"�" '�
Sink/basin/lavatory I \ 1-1 16.60 Subtotal: $ 9 6, sr;
Tub /shower /shower pan 3 16.60 Minimum Permit Fee $72.50 $
Urinal 16.60
Plan Review Fee (25% of Permit Fee) $
Water closet . 16.60 State Surcharge (8% of Permit Fee) $ I ' 0
Water heater 1 16.60 TOTAL PERMIT FEE $
Other:
Other:
IS; . sEy V r IT z Z:,„ .g;_ ELECTRICAL FEES (residential single or multi family)
Subtotal $
Description Qty. Fee Total Insp
Minimum Permit Fee $72.50 $ 1,000 sq. R. or less • ( 145.15 4
Plan Review (25% of Permit Fee) $ Ea. add'l 500 sq. ft. or portion U 33.40 1
State Surcharge (8% of Permit Fee) -$ Limited energy, residential 1 75.00 2
TOTAL PERMIT FEE $ Each manufactured or modular
dwellin:, service and /or feeder 90.90 2
Subtotal: $ a's 7S
Plan review (25% of permit fee) $
State surcharge (8% of permit fee) $ O 7 ()
TOTAL PERMIT FEE $
I \ Building \ Forms \ResPlanChec Fees doc 01/19/07 Page 2
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