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12765 SW BUGLE COURT J, ,V ''a) Vw // , M/ W '^C W 0 C I 12765 SW Bugle Court --- CCC M a � c cr tp _ •� � O � i • b a ^ r' D `r01 V r O r C w � a � z r � 3 , C s � I ^� CITY OF Tic'�4►RD MASTER PERMIT PERMIT#: MST2002-00469 DEVELOPMENT SERVICES DATE ISSUED: 12/10/02 13125 SW Hall Blvd., Tigard, O: 97223 (503) 6394171 SITE ADDRESS: 12765 SW BUGLE CT PARCEL: 2S109AD-08600 SIJBD17VISION: ELK HORN RIDGE ESTATES ZONING: R-7 BI.00K: LOT: 030 JURISDICTION: 11(; REMARKS- New SF detached, Path 1. BUILDING REISSUE: STORIES: 2 !__ FLOOR AREAS _ REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST. 1.1(10 of BASEMENT: st LEFT. rf SMOKE DETECTORS: v TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,616 4f GARAGE: ''60 of FRONT: :'o PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: 1 THno: of RIGHT a VALUE: ;'90 1323 7c OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,998 of REAR: a PLUMBING _ SINKS: I WATER CLOSETS'. 1 WASHING MACH: I LAUNDRY TRA(S: I RAIN DRAIN: 100 TRAPS. LAVATORIES: DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DR!."5, I CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCf;FLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP c 3HP: VENT FANS CLOTHES DRYER: I ,;AS FURN>-100K: 1 UNIT HEATERS- HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT_ SERVICE FEEDER TEMP SRVCIFEEDER9 BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPF CTIONS 1000 SF OR LESS: 1 0 •2tlo amp: 0 •100 a lip: WISVC OR FDR: PUMPARRIGATION: PER INSPF.CTION. EA ADD'L 500SF: 6 201 4110 amp! 201 400 Mop. let WIO SVC/FDR, SIGN/OUT LIN LT: PER HOAR. LIMITED ENERGY: 401 600 amp: 401 - 600 atop: EAADDL OR CIR: SIGNALIPANEL: IN PLANT MANU HM/SVC/FUR: 601 1000 amp: 601.ampe-1000v: MINOR LABEL: 1000•ampholt PLAN REVIEW SECTION Reconnoct oniv: >•1 RES UNITS: SVCIiDR>e215 A. >600 V NOMINAL: CLS AREA/SPC CC('.: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO. VACUUM SYSTEM: AUDIO A STEREO: FIRE ALARM: INTERCOMIPAGING OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG. PROTECTIVE SIGNL: GARAGE OPENER. CLOCK: INSTRUMENTATION: MEDICAL OTHR: HVAC: DATA/TELECOMM! NURSE CALLS TUiAL0SYSTEMS: Owner: Contractor: TOTAL- FEES: $ 8,007.17 PAUL R CARNEY PAUL R CARNEY INC This permit Is subject to the regulations contained in the 1480 NW 102ND 1480 NW 102ND AVENUE Tigard Municipal Code,State of OR. Specialty Codes and PORTLAND,OR 97229 PORTLAND,OR 97229 all other applicable laws. All work wilTh be done it accordance with approved plans. This permit will expire K work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION: Oregor law requires you to follow rules adopted by the Phone: 503 297-11406 Phone 503-297-940G Oregon 1.103ty Notification Center. Those rules are set forth in OAR 952-001-107A0 through 952-001-0080. You R.66: L I( W'52 may obtain copies of these rules or direct questions to OUNC b) calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing/Ft,undation Dr; Electrical Rough In Gas Line Insp Appr/Sowlk Insp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Inal Issued By: Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF A IGARD SEWER CONNECTION PERMIT DEVELOPMENT SERViCES PERMIT#: SWR2002-00315 13-i26 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/10/02 SITE ADDRESS; 12765 SW BUGLE CT PARCEL: 2S 109AD-08600 SUBDIVISION: FLK HORN RIDGE ESTi.TES ZONING: i?-? BLOCK: LOT: 030 JURISDICTION: I TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE. LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF. Owner: —�-- — FEES PAUL R CARNEY �— 1480 NW 102ND Description Date Amount PORTLAND, OP 97229 [SWUSA]Swr Connect 12/10/02 $2,300.00 [SWUSA]Swr Connect 12/10/02 $0.00 Phone: 503-297-9406 [SWINSP] Swr Inspect 12/10/02 $35.00 [SWINSP]Swr Inspect 12/10/02 $0.00 Contractor: – — Total $2,335.00 Phone: Reg#: Req,rired Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 days from the date issued. The total amount paid will be forfeited if Il)e permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located o the measurement given, the installer shall prospect 3 feet In all directions from the distance given. If not so located,the Installer shall purchase a"Tap and Side Sewer" Perm Issued by: Permitlee Signature: ' Call (503) 639-4175 by 7:00 P.M. for ar inspection needed the next business lay I r✓r,U Q ROCS-��✓/`�- Building Permit Application City ,?�'. Permituo.:��r _a�� City of Tigard City n/'Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: rdate: Phone: (503) 639-4171 / Date issued: [I- Neceipt no.: Fax: (503) 598-1960 Aeo;A-eW , q Q rXoa_eX7g Case file no.: Payment type: Land use approval- �RiQ - �� 1&2 family:Simple Complex: __ U I & 2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Add ition/al!craiion/replacement U Tenant improvement _I Dire sprinkler/alarm 'J giber: TE JOB SI INFORMATION Joh address Z 7 S,W aJ btu "- Bldg.no.: Suite no.: Lot: I Block: Subdivision: iZt pc E Tax ma /tax lot/account no.: 0FA1 p-D Project name: Description and location of work on premises/special conditions _N W <�.�,�t�c'�t _A Z'Li U-NAWAM-011WAXAMEWITA, USE CHECKLIST Name: k�.. 1L C N e"I (Floodplain,scpIlccapacW,,solar,etc.) Mailing address:1 1&D&/Vj v L 't. 1 &2 family dwelling: 22 I'' City: State:(';; Z-ZIP: c 2 t Valuation of work..... .9� l.r.......... $ ' Phone: Zc ' -�L jFax:'L`t6 -fest E-mail• No.of bedrooms/baths...........!�..':..... ?�..... Owner's representative: S Total number of floors................................. 4 Phone:< � - ? Fax: E-mail. New dwelling area(sq. ft.) .......................... Garage/carport area(sq.ft.)......................... �L) _ Name: Q_/ Covered porch area(sq.ft.) rM2aiaddress: n µ Deck area(sq.ft.) ........................................ State: ZIP: Other structure area(sq. ft.)......................... Phone: Fax: E-mail: Commercial/industrial/multi-family: Valuation of work............... ................ ..... $ Business name: S A� /� ,�,L- Existing bldg.area(sq.R.) .... ......... ......... Address: - New bldg.area(sq.ft.) .............. .............. City: State: ZIP: Number of stories.................. ...........`....... Phone: _ Fax: F.mail• Type of construction......... ............. ...... CCB no.: S Occupancy group(s): Existing: --- New: City/metro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: �)✓f(�t_ I UWAlf- provisions of ORS 701 and may be required to be licensed in the Address: t '�I S f~' s flUr'"� jurisdiction where work is being performed. If the applicant is City: r�RLk71 State:cit ZIP: I L. L exempt from licensing,the following reason appli ss: Contact person:,t t Plan no.:M — Phonc:t;<;5 t~'3 77 1 Fax:J t)•11 L, E-mail: Name: Contact person: Fees due upon application ...........................$ Address: Date received: City: Stab;: ZIP: Amount received ......................................... $ _ Phone: Fax: I E-mail: Please refer to fee schedul.. hereby certify I have read and examined this application and the Not till jurisdictions accept credit cards,please call jurisdiction Im more infommmion attached checklist.All provisions of laws and ordinances governing this QI�isa U MacterCud work will be complied w tptIter specified herein or not. [Girdit cud nu �� i x'jL-Coy 7 /3L ' /06/C P �. L-� 1- - �l�a-� nnr'ts/ Authorized signature: Date: I� �� Name,otTardpulhr os shown on credit cud —_`. Print name: '�S 1-''�� _�,� riignuure ---- s Amount Notre:This permit application expires if a permit is not obtained wi0iin 180 days after it has been accepted as complete. 440 4613(awcom) Commercial Flan Submittal Requirement Matrix City of Tipird - - I TYPE OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing Site Utilities 2 Building Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan reviiw approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **", '?w" fire protection systems require that plans bear, the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. iAdstslforrns\COM-matrix.doc 9/24/01 Building; Fixtures Plumbing Permit Application OF1 ICE. 1f.SE ONLY City of Tigard Date received:// 17 /? Pcrnut no. ,,-Ay7 po 4,? •'' � Address: 13125 SW IJail Blvd,Tigard,OR 97223 -Sewer permit no.: Building permit no.: city ojTlgord Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use, approval: case file no.: Payment type: �YPE OF PERMIT U I & 2 family dwelling or accessory U C'ununcrcutliindustrtal J Multifamily J Tenant improvement O New construction U Addition/alteration/replacement ❑Food service U Other: JOB t ' FFE'9117HEDULE(for special inforen.= Job address: j Z 7(„j W L b f Description Qty.I Fee(ea.) I 'Total Bldg. no.: Suite no.: New 1-and 2-fam ly dwellings only: Tax map/tax lot/account no.: (includes 100 ft.for each utility connection) SFR(1)bath Lot: Block: Subdivisiontjj-tk_,,, a•t t�._ SFR(2)bath Project name: SFR(3)bath City/county: %C ZIP: L L Each additional bath/kitchen Description and location of work on premises: Siteutilities: Catch basin/area drain Fst.date of completion•/inspectirnl Drywells/leach line/trench drain Pill J M 81 �„QNrR ACTOR Fouting drain(no.lin. ft.) Business name: , Manufactured home utilities tl ejp0 t_ ) L�ttitP,tr� Manholes Address: I 11 4;. IRain drain connector City: 4./L, ��.H.cJ State: )f IP: Sanitary sewer(no.lin. ft.) -- Phone: 3(J Storm sewer(no. lin.fl.) C.:B nc.. lU L S_ 35- Plumb.bus. reg.no: A;$1 3,4-lry -p Fater service no.lin.fl. City/mttro lic.no.: Fixture or Item: Contractor's representative signature: Absorption valve — Back flow preventer Print name: `— Date: Backwater valve _ Basins/lavatory Clothes washer Address: Dishwasher Drinking fountain(s) City: State: ZIP: Ejectors,sump Phone: l )1, Fax: E-mail: Expansion tank Fixture/sewer cap Name(print): '- JL 6 n v'*4" Floor drains/floor sinks/hub Mailing address: ` 16 Z"-' Garbage disposal Nose bibb t State: Z[P: `'j L t q Ice maker Phone: t ' - vto Fax:ZJb r &ft E-mail: Interceptor/grease trap Owner instal lation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) #Name:#l,'\ ner' mature: Date: Sump Tubs/shower/shower pan Urinal q_c S i G �A ( f 1S — 1 Water closet Address; '7 j w s tree�' Water eater City: _-LAA L OrJ j l/rStated,1 u ZIP: �l"7►6 1 Other: — Phone: ", 4. i"17 1 Fax:-,'j, -gill E-mail: Total Not ail jurisdictions accept credit tarda,please call jurisdiction for more information Minimum fee................ $ _ Visa OMasterctud Notice: This permit application ., Plan review(at__ %) S Credit card number expires if a permit is not obtained t,S I CC.}L 'r "1 ' r' �'� State surcharge(8%).... $ i - Expires� within 180 days after it has been at u a accepted as tom late. TOTAL........................ $ No shown on c it arT— P P _ S Cardbolder signature Amount 4404616(6MCOM) PLUMBING PERMIT FEES: PRICE TOTAL I New 1 and 2-family dwellings only: l FIXTURES (individual) _ QTY ea AMOUNT (includes all plumbi ig fixtures in PRICE TOTAL Sink 16.60 the dwelling and th( first100 ft. QTY (ea) AMOUNT for each utilit cy onnection) Lavatory 16.60 One 1 bath $249.26 Tub or Tub/Shower Comb. 16.60 Two 2 bath $351,.00 Shower Only 16.60 Three 3)bath $399.00 Water Closet 16.60 SUBTOTAL _ Urinal 16.60 _ 8%STATE SURCHARGE _ Dishwasher 16.60 PLAN REVIEW 25`r.OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE: 3" 16.60 4" 16.60 Water Healer O conversion O like kind 16.60 Quantit b Work Performed _ Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. - -- Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory .._ _ Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures(Specify) 16.60 Urinal Dishwasher Garbage Disposal Laundry Room Tray _ Washin Machine Floor Drain/Sink: 2" Sewer-1 st 100' 55.00 3 Sewer-each additional 100' 46.40 4" _ Water Service-1 st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures _ _ (Specify) Storm 6 Rain Drain-1 st 100' 55.00 Storm d Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 - Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 62.50 Requested Inspections er/hr I COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 -- Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram Is required if Quantity Total Is �g `SUBTOTAL - -- 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Reqw ed only if fiztu eall Iola,Is>9 TOTAL S `Minimum permit fee Is$72 50•fl%stale surcharge.except Residential BackPaw Prevention Device.which Is$38 2°•9%slate surcharge "All New Commemlal Buildings require 2 sets of plans with Isometric or riser diagram for plan review. i.\dsts\forms\pim-fees.doc 12/26/01 Mechanical Permit Application Datereceived:// ;A *�. Permitno.;_�yrJeJ{/ � 9 Cit of Tigard• y g ProjecUappl.no.: Expire date: CitvofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 "—I - Phone: (503) 639-4171 Date issued: By: IReceipt no.: _ Fax: (503) 598-1960 Case file no.: Paymenttype: Land use approval: R Buildingpermitno.: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Other: Job address: 1 6S 5► �z,�t,uc- 4C Inuicate equipment quantitics in boxes below. Indicate(lie dollar Bldg.no.: Suitc no., value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: - CC Block: I Subdivision:E� f4DiZrA t6fxEs e 5 ee checklist for important application information and Project name: 0jurisdictlion's fee schedule for residential permit fee. City/county: Tl w�t:� ZIP: 9"),t z-3 Description and location of work on premises: i t Pcc(ca.) Total Est.date of completion/inspection: _melon (ata. Itrw.unly Ites.only Tenant improvement or change of use: _ C' Is existing space heated or conditioned?U Yes U No Air handling unit CFM_- space inudatec?U Yes 'J N ircon iuon ng(sitep anrequire ) Is existing •P Alteration of citis-ti-ngTiVA7 system Boiler/compressors - Business name: L: E L State boiler permit no.: Address: p l L� e,".Cnrz- Ha Tons ctors _ it smoke dampers/duct uct smo a electors City: i-.le, State: ZIP: t Z eat pump(site plan require ) - — — Phoqp, > (L, 4 V, -'6 Fax: E-mail: nsta rep ace urnac urner 3 - Including ductwork/vent liner U Yes U No CCB no.: U nsta rep ac re ocate eaters-suspended, -- City/metro lie.no.: wall,or floor mounted Name(please print): -pl r Vznt for appliance other than furnace C6NtACT PERSON e gerat on: Absorption units _ BTUM Name: ( t TL Chillers --__--- HP Address: Compressors _ IIP _ City: Stair: i Environmental exhaust an ventilation:- l' Appliance vent honc:< <s 7 S Fax: Drycrexhaust -^- 0o s,TypeIl/res. itc a hazmat — hood fire suppression system Name: A Exhaust fan with singl duct(hath fans) Mailing address: xhaust system a Can from h.-ating or AC City: y State:C' Z[P: -7 Z` ue piping ane str upon(up to 4 outlets) Typc: LPC __ NO Oil `-1 cFax: l I E-mail: uel Ct In each additional over 4 outlets — rocessp p ng(sc ematicrequirc ) Number of outlets Name: Alt tL �'v -- Other listed app--stance nr eq equipment: Address: 13'7 5 h_l 5 c ` Decorative fireplace City: t State:�� ZIP: • L' �(,` nscrt- type - Phone: Y. -('I AFax: `" 4f z Ll E-mail oo stove pc etstove — - ---��- — Applicant's signatul)Iher.re• Date: /6' .s/-�'�- t Name (print): Noi all jurisdictions accept credit cords,please rnll jwisdiction for nxxe information Permit fee.....................$ )d Visa U MnsterC�prd Notice:This permit application Minimum fee................$ _- t' it card number. Ll Y'Sl ICP/v,� expires if a permit is not obtained Plan review(at _ %) $ -- i t, Expires wttain 180 days after it has been State surcharge(896)....$ nt - r u own un credit c ori accepted es complete. s_ TOTAL .......................$ Cardholder signature Amoum 1411J617(6iCIniC'OMI MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,006.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or including ducts&vents 14.00 fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000.00. Including ducts&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and j) \r."1t not included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. _ footnotes below. Comp •• Minimum Permit Fee$71.50 SUBTOTAL: $ 7)<3HP;absorb unit to 100K BTU 14.00 8%State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 25°/.Flan Review Fee(of subtotal) $ 9)15-30 HP;absorb Required for ALL commercialpermits ony unit.5-1 mil BTU _ 35.00 TOTAL COMMERCIAL PERMIT FEE: $ unit 1-11.7.75 mil 10)30absorb unit BTU 52,20 _ - - - - -- ----._-._-- - 11)>50HP;absorb unit>1.75 mll BTU 87.20 ASSUMED VALUATIONS PEk APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description: Qt Ea Amount 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&vents 6.80 _ Floor furnace Including vent 955 16)Ventilation system not included In Suspended heater,wall heater or 955 appliance permit 10.00 _ floor mounted heater 17)Hood served by mechanical exhaust Vent not Included In appliance 445 10.00 permit - 18)Domestic incinerators Repair units 805 17.40 <3 hp;absorb.unit, 955 19 Commercial or industrial to 100k BTU ) type Incinerator 89.95 3-15 hp;absorb.unit, 1,700 101k to 500k BTU 20)Other units,including wood Moves 10.00 15-30 hp;absorb.unit,501k to 1 2,310 frill.BTU 21)Gas piping one to tour outlets - 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU 1.00 >:;0 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: a >1.75 mil.BTU Air handling unit to 10,000 cfm 656 - Air handlingunit>10,000 cfm 1,170 6568%State Surcharge E Non- ut taiule evaporate cooler 656 - - Vent fan connected to a single duct 446 TOTAL RESIDENTIAL PERMIT FEE $ Vent system not Included in 656 appliance permit Hood served by mechanical exhaust 858 Other Insuectlons pnd Fees: Domestic Incinerator _ 1,170 1 Inspections outside of normal business hours(minimum charge-two hours) $32 50 per hour Commercial or industrial Incinerator 4,590 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 $82 50 per hour inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas !� 1- outlet �^ 360 charge-one-half hour)$82 50 per hour Each additional outlet 83 -- ------- *State Contractor Boller Certification required for units>200k BTU. TOTAL COMMERCIAL $ "Residential A1C requires site plan showing placement of unit. VALUATION: All New Commercial Buildings require 2 sets of plans. I:\dsts\formsUnech-fees.doc 02/11/02 Electrical Permit Application MM Date received: ;L Permit no.: City of Tigard Project/appl.no.: Ex 'edate: City gfTigard Address: 13125 SW Hall BMW,Tigard,OR 97223 Date issued: Phone: (503) 639-4171 Y k. heceipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TYPE 1 f l 1 &2 family dwelling or accessory U Commercial/industrial U Multi-fanliiy U Tenant improvement U New constriction 'J Additiup/:iltcratinn/replacement U Oth^r: _ _ U Partial -001111 SITE INFORMATI1 Job address: j l `1( S S Vv eL.kL-{ Bldg.no.: Suite no,: ITax map/tax lot/account no.: Lot: 0 Block: Subdivision: t , = p-y��I e�> Project name: pL Description and location of work on premises: Estimated date of coin pletion/ins ction: SCIIIIEDULE Job no: I'cr Max Business name: t C — Description Qly. (ca.) Total no.ins r Address: 1 New resldenlial-single or multi-family Per T dwelling unit.Includes alraclxtil garage. City: C:,L�y is Ait%-i e:0 � ZIP: 91701po Seniceincluded: Phone: 3,2-l' L? Fax: E-mail: law sq It.or less 4 CCB no.: Elec,hos.tic,no: Each additional 5W sq.ft.or portion thereof I b I t? Limited energy,residential -- 2 City/metro tic.no,: Limited energy,non-residential 2 _ Each manufn_:red huwe or modular dwelling S l,nature of supervising electrician(required) Dale Service and/or feeoc: Snl, Asci nan,e(priut) t.;,,.,,.•,.,,, Services or feeders-Instails(lon, 'PROPFkTV OWNER alteration or relocation: 200 amps or less 2 Name(print): 7 �� (�, 201 amps tu400amps 2 401 amps to 600 amps 2 Mailing address: I "�,,> ,j t..�) l a Lh_ 601 amps to IOW amps 2 City: State: Z ZIP: 2 L`� Over IOW amps or volts 2 Phone: L�) 7 j, qtf, E-mail: Reconnectonl l Owner installation:The installation is being made on property I own Tetnporaryservicesorfeeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,670,701. 200 amps or less 2 201 amps to 4W amps 2 Owner's signature: Date: 401 to 600 ams 2 Branch circuits-new,alteration, or extension per panel: Name: Lj/F iL A-V A. Fee for branch circuits with purchase of A6dress: i<I rj 5 (V 6Lik service or feeder fee,each branch circuit a City: ,, r,,,) I Stale:2(1_ ZIP: cf'7c 6 2- B. Fee for branch circuits without purchase Phone: rax: [:_mail of service or feeder fee,first branch circuit. I Each additional branch circuit: IIIAN RUVII11",(I'lease check all flint apply) Mlsc.(Service or feeder not Included): U Service over 225 amps-countnercial U lic:dth-care facility Each pump or irrigation circle _ 2 U Service over 320 amps-rating of 18-2 U Hazardous location Each sign or outline lighting — 2 familydwellings U Building over 10,000 square feet four or Signal circuits)or a limited energy panel. U System over 6W volts nominal more residential units in one structure aheration,orextension* 2 U Building over three stories U Feeders,400 amps or more *Description: U(kcupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: U Egress/lighting plan U Other Per inspection Submit—sets of plans with am of the above. Investigation fee - The above are not applicable to temporary construction service. other - Na all junklictions accept credo cants,pleat-call p,rikaction far more Information Notice:This permit application Permit fee.....................$ 5zvisa U Maslercard expires il'o permit is not obtained Plan review(at _ %) $ Credit card number: _ � 7 ��'s'L (�l7 31��6 o6 within 180 days ager it has been State surcharge(8%)....$ _—L Na,. i 4 Rx�'e' accepted as complete. TOTAL .......................$ -- Name o town on c It card � -- y �. s C"oldet signature Amount 440 461 iMxin(A 1, ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Restricted Energy Fee lete Fee Scheduf-• Bel — ---- -- .............................................. Number of Inspections per permit allowed) (FOR ALI SYSTEMS) ........ $75.00 Service included: Items Cost Total 1 Check Type of Work Involved: Residential-per unit 1000 sq ft o-less _ $14515 _ _ 4 F] Audio and Stereo Systems' Each additional 500 sq R or portion thereof $33.40 _ 1 Burglar Alarm Limited Energy $f 5.00 _ Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 Garage Door Opener' Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 imps or less $80.30 2 201 amps to 400 amps $106.85 2 ❑ Vacuum Systems' 401 amps to 600 amps $160.60 2 601 amps to 1000 amps - _ $240.60_ 2 ❑ Other Over 1000 amps or volts _ $454.65 2 Reconnect only —— $66.85 2 Temporary Servicas or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $66.85 2 (SEE OAR 918-260.260) 201 amps to 400 amps $100.30 _ 2 401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits New,alteration or extension per panel ❑ Boiler Controls a) t he foe for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6.65 _ 2 ❑ Data Telecommunication Installation b)The fee for branch circuits withcvt purchase of service ❑ or feeder fee. Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ (Service or feeder not Included) instrumentation Each pump or Irrigation circle _ $53.40 _ Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) _ $125.00 Each sdditionul inspection over ❑ Medical the allowable In any of the above Per inspection $6250 ❑ Nurse Calls Per hour $6250 In Plant – $731-5 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ _ _ ❑ Other 8%State Surcharge $ Number of Systems 25%Plan Revliw Fee See"Plan Revle%"section on $ ' No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due 5 Enter total of above fees $_ ❑ Trust Account# 8%State Surcharge $ S_ All Now Commercial Buildings require 2 sets of plans. Total Balance Due i Asts\formsielc-fees.doc 08/30/01 2S7<- 6j SIN p Ce S � jig I � ` a k, , 143 s qft, LOT 30 ' rj 1 r `�- SF I �I Le"I 5, 040 sq. Al" ;% S �C4.5 2 mf CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE MALMEDAL PLUMBING INC 111 S 18TH AVE CORNELIUS, OR 97113 Plumbing Signature Form Permit #: MST2002-00469 Date Issued: 12110/02 Parcel: 2S109AD-08600 Site Address: 12765 SW BUGLE CT Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 030 ,Jurisdiction: TIG Zoning: R-7 Remarks: New SF detached, Path 1. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: PAUL R CARNEY MALMEDAL PLUMBING INC 1480 NW 102ND 111 S 18TH AVE PORTLAND, OR 97229 CORNELIUS, OR 97113 Phone #: 503-297-9406 Phone #: 503-310-9795 Reg #: ME l 4232 LIC 102535 PLM 34-276PB AN INK SIGNATURE IS REQUIRED ON THIS FORM / Sign ture of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HAIL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE FRANKLIN ELECTRIC INC 1031 SE 23RD COURT GRESHAM, OR 97080 Electrical Signature Form Permit #: MST2002-00469 Date Issued: 12/10%02 Parcel: 2S109AD-08600 Site Address: 12765 SW BUGLE CT Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 030 Jurisdiction: TIG Zoning: R-7 Remarks: New SF detached, Path 1. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspecticns will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: PAUL R CARNEY FRANKLIN ELECTRIC INC 1480 NW 102ND 1031 SE 23RD COURT PORTLAND, OR 97229 GRESHAM, OR 97080 Phone #: 503-297-9406 Phone #: 492-4651 Req #: LIC 140170 ELE 26-11141(' SUP 22600 AN INK SIGNATURE IS REQUIRED ON THIS FORM X —tee` Signature of Su ervising Electrician If you have any questions, please call (503) 630-4171, ext. # 310 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (50)639-41759 �. INSPECTION DIVISION Business L',ie: (503)639-4171 � Vz- BLIP — Received — Date Requiested !//U �' AM�) PM BLIP __ ___.. -- Location ___; 76--�� E Suite— _ _— MEC Contact Person Ph ( ) ___._.__— __—_ PLM Contractor _ Ph(—) SWR _RgiLDLW — Tenant/OwnerELC: Foundation ELC Access:,-_. � , 9 DlDrain r �`C f!t_/ � ` ELR Craw — - __---- 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 S8 PART FAIT. -- _ --- Post$Beam Under Slab Rough-In Water Service —__-- Sanitary Sewer Rain Drains -- — - --- Catch Basin/Manhole Storm Drain - --- - Shower Pan Other: - — -— — Final PART FAIL - - - st Ro In -_-- _ Gas Line Smoke Dampers - - - - - - - Fina AS PART FAIL — - - -- -- CTRIC L Ser-06a Rough-In UG/Slab - -- Low Voltage Fire Alarm - Final Reinspection fee of$ required before next ins •� PART FAIL 4 pection. Pay at City Hall, 13125 SW Hell Blvd. SITE ❑ Please call for reinspection RE:.—_ _ Unable to inspect-no access Fire Supply Line Y � ADA Approach/Sidewalk Date -- 3 -_ Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL