12766 SW BUGLE COURT r
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MASTER PERMIT
CITY
ITY. OF TIGARD
(C
/ PERMIT#: MST2002-00301
DEVELOPMENT SERVICES DATE ISSUED: 7/15/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12766 SW BUGLE CT PARCEL: 2.S109AD-09100
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7
BLOCK: LOT:035 JURISDICTION: TIG
REMARKS: New SF, Path 1.
BUILDING
REISSUE: STORIES: 2 F,OOR AREAS _ REQUIRED SETBACKS _ REQUIRED
CLASS OF WORK: NEW HEIGMT: 20 FIRST. 1,302 of BASEMEN r: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLC OR LOAD: 40 SECOND: 960 of GARAGE: 926 of FRONT: 20 PARKING SPACES 2
TYPE OF CONST: SN DWELLING UNITS: I FINBSMENT: s/ RIGHT: 5
VALUE: b 226.54 LUO
OCCUPANCY GRP: R3 SDRM: - BATH: i -OTAL ,26200 of REAR: 15
PLUMBING
SINKS; 1 WATER CLOSETS. I WASIVN._MACH 1 LAUNDRY TRAYS' 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR D'AINS SEWER LINES. 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 3 GARBAGE DISP' WA1 ER HEATERS: 1 .NATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL _
FUEL T YPES FURN<10OK: BOILICMP.3HP VENT VANS: I CLOTHES DRYER: 1
FURN—HOOK: I UNIT HEATERS. HOODS: I OTHER UNITS: 1
MA,'INP: bbl FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
_ ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 anw 0 - 206 amp: W/SVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION•.
EA ADD'L 500SF: 5 201 400 amu: 201 4n0 amp: 1st W/O SVCIFDR: 00 SIGN/OUI LIN LT: PER HOUR
LIMITED ENERGY: 401 - 800 amp: 401 - 600 amp: EA ADDL RR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDW 001 1000 amn: MINOR LABEL:
1000.amo/volt
PLAN REVIEW SECTION
Reconnect only
>=4 RES UNIT9� 9VCIFDR>n225 A.: >000 V NOMINAL: CLS ARENSPC OCC:
ELECI RICAL•RESTRICTED ENERGY
A SF RESIDENTIAL B COMMERCIAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURG'1 AR ALARM: OTI. BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE O-ENER: CLOCJ,: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATATTELE CO?IM NURSE CALLS: TOTAL 0 SYSTEMS:
Owner- Contractor TOTAL FEES: $ 7,418.98
This permit is subject to the regulations contained in the
PAUL R CARNEY INC PAUL R C:ARNEY INC Tigard Municipal Code,State of OR. Specialty Codes and
1480 NW 102ND AVE 1480 NW 102ND AVENUE all other applicable laws. All work will be done in
PORTLAND,OR 97229 PORTLAND,OR 97229 acwrdance with approved plans. This permit will expire If
work is not started within 180 days of issuance,or if the
work Is suspended for more than 180 days 11TTENTION:
Phons: Phona: Oregon law requires you to follow rules ado,! A by the
Oregon Utility Notification Center. Those rules are set
Rep 0 1 U FRF2 forth in OAR 952-001-0010 through 952-001-0080. You
may obfaln copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECIIONS
Erosion Control nsp 8, Post/Beam Structural Mechanical Insp Shew Well Insp Insulation Insp Mechanical Final
Grading Inspectlo,T Post/Beam Mechanica Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final
Sewer inspection Underfloor Insulation Electrical Service Low Voltage Water Line Insp Final inspection
Footing Insp Crawl Drain/Backwater Electrical Rough In Ga'i Lire Insp Appr/Sdwlk Inso
Founda erf nsp PLM/Underfloor Framing Insp Ge.s Fireplace Electrical F al
Issue By : ��- Permittee Signature
i
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the hw business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENTSERVICES PERMIT #: SWR2002-00209
13125 SW Hal; Blvd., Tigard, OF: 97223 (503) 639-4171 DATE ISSUED: 7i15102
SITE ADDRESS; 12766 SVV BUGLE CT PARCEL: 2-109AD-09100
SUBDIVISION: ELK HORI1 RIDGE ES-rATES ZONING: R-7
BLOCK: LOT: 035 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILD!NGS:
RN STALL TYPE: LTPSWR IMPERV SURFACE.:
Remarks. Sewer connection for SF
Owner: — FEES
PAUL R CARNEY INC —
1480 NW 102ND AVE TYPe� By _ Date Amount Receipt
PORTLAND, OR 97229 PRMT CTR 7/15/02 $2,300.00 21200200000
INSP CTR 7/15/02 $35.00 27200200000
Phone: 503.297-9406 Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer
shall prospect 3 feel in all directions from the distance given. If not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain,.00pies of these rules or direct questions to OUNC by cal!ing (503) 246-1987 �
lssr d by: -'`-� cue a Permittee Signature: ;1�
Gall (603) 639-4175 by 7:00 P.M. for an inspection needed the ne business day
7
Building Permit Application
A, City of Tigard Date received: /, Qa Permit no.
City ofrigard Address: 13125 SW 1lall Blvd,Tigard,OR 97223hoject/appl.no.: _ Ezpiredate:
Phone: (503) 6394171 .� Date issued:
Fax: (503) 59$-1960 f3 'Receiptno.;
JUN 1 7 20111 Case fileno.: Payment type:
Ladd use approval: _ r ;, tv t t ►, I&2 family:Simple Complex:
I & 2 family dwelling oraccessory U Commercial/industrial U Multi-family L]Aw construction ❑Demolition
U Aclditior/alteration/replacemc ilI U'I-cnant improvement U Fire sprinkler/alarm U Other:
Job address: /,2 761 6)
Lot: �� �57
` Bldg.no.: Suite no.:
S Block: Subdivision: -T (Project name: ---LL map.tax louaccount no.:
Description and location of work on premises/special conditions: `
1
Name:
Mailing addrese '` ` —�— �// �
^^ 1 & 2 family dwnliing:
City I� State:6 ZIP:
y 7,1 Vnluatiorr of work........................................ 7-
LNamePhone:S°S 1 7•� � a :S�_2 Y6 yG;F E-mail:wner's representative: ^ No.of bedrooms/paths................................. —Total number of floors.................................Phone: � 9y`'v Fax' 7yG 7�1i'/ E-mail: New dwelling arca(sq. R.) .......................... G_Garage/carport area(sq.R.)......................... y Z/GWCovercd porch area(sq.R,).............. '2
s: """""'Dcckarea(sq. ft.) .. 9(6 State: ZIP: Otherstnicture area 'sc� ft.) -- _Fax
E-mail: CommerciaUindustrinl/multi-fam!ly:
Valuation of work..................•..................... $
�� Existing bldg.arca(sq
Business name: ..,,.:- . ft.) ....... ........
Address: - New bldg.area(sq.R.)....... ....... .............
City: — State: ZIP: Number of stories....................
. ...............
_Phone: Fax: E-mail: Type of construction........... ...............
CCB no.: Occupancy group(s): Existing: _
City/metro lie,no.: New: _
N oil= Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Name: _ provisions of ORS 701 and may be required to be licensed in the
Address: _ jurisdiction where work is being performed. If the applicant is
City: State: ZIP: - exempt from licensing,the following reason applies:
Contact person: Plan no.:
Phone: E-mail:
not
Lddress:
Contact person: Fees due upon application ........................... $
Date received:
State: ZIP: Amount received
— $
I max - E mall' Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not All ludadicdom acceV credit cards,nleas.�call ludsdiclion for more Information
attached checklist. All provisio f laws and ordinances goverring this ,visa UM"
work will be complied' r ,eJf*1 spectated herein or o
� t. It cow au
con,he,
Authorized si atu . ( (
_ � .� Date. � ` fix,lrea
r#s ahnwu on c t card
Print name: f
ir.moum —
Notice:This permit application expires if a permit is not obtained-within I80 dnys after it has been accepted as complete.
1441613(&WroM)
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
ChyofTigard Cit of Tigard
Associated permits:
City g U Electrical U Plumbing U Mc^hanical
Address: 13125 SW hall liivd.Tigard,OR 97223 U Usher:
Phone: (503) 639-4171
Fax: (503) 599-1960
I
I Land use actions completed.Sec.lun;dicuun criteria fur c,utc'.rrrau revicWs.
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification of approved platflot. _
4 Fire dirtrict __.approval required.
5 Septic system permit or authorization for remodel.Existing system capacity _
6 Sewer permit.
7 Water district approval.
S Soils report. Must carry original applicable stamp and signature on rile or with application.
9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of
catch-basin protection,etc. _
10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes.Lateral design details and cont ections must he incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plat,review cannot be completed
if copyright violations exist.
1 I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations 01
thereis mom than a,141 elevation differential,plan must show contour lines at 2-t3.intervals);location of easements avmd
drivd,way;footprint of structure(including decks);location of wells/septic systems,utility locations;direction indicator;lot
area:building coverage area;percentage of coverage••inmpervioi,s area;existing structures on site;and surface drainage. _
12 Foundattun plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and location.
13 Floor plans.Show all dimensions,room identification,window size,location of stroke detectors,water heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross sections)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor,
wall construction,roof construction.More than one cross section may be required to clearly portray construction.Show
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,
fireplace construction, thermal insulation,etc. _
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
_ Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing
_locations.Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar.For engineered
systems,see item 22,"Engineer's calculations." _
19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non-unifornm load. _
20 (Manufactured floor/roof truss design details. _
21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or
am.hitect licensed in Oregon and shall be shown to be applicable to the project under review.
j LN 11minubm Ll"Aa
23 Five(5)site plans are required for Item I I above. Site plans must be 8-1/2"x I I"or I I"x 17". _
24 Two(2)sets each are required for Items 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted.
26 "Reversed" building dans must meet criteria outlined in the Permit&System Developmen- Fees document.
27 "Drawn to RINWIRIMitect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 4404614(6111Wor`t)
Plinsibing Permit Application
(
VL.� Date received:(p/,'�f Permit no.: 1i t e2?
City of Ti rk
`J g Sewer permit no.: Building permit no.:
Address: 11125 SW Hall Blvd;.Ti�ardr IaRO�7223
City of Tigard Phone: (503) 639-4171 ' [LUU Project/appl.no.: Expire date:
Fax: (503) 598-1960 U i Y k)r Date issued: By: Receipt no.:
Land use approval:
UIr n�yC Dl�n ��7 else file no.: Payment type: �A
I Is PE OF PERMIT
13 I &2 family dwelling or accessory 17 Commercial/industrial U Multi•family U Tenant improvement
{J New construction U A,'_iitlon/alteration/replacein;,nt U Food service J Other:
JOB SITE INFORMATION SCHEDULE
Job address: -7 �� ( - Description (p}. Fee(ea.) Total
Suite noNew l-and 2-family dwellinips only
.: :
Tax rnw /tax lot/account no.: (includes 100 A.for each ull its connection)
P —_ SFR(1)bath
Lut: Block: Subdivision; SFR(2)bash ---
Project name: SFR(3)bath
City/county: LIP: Each additional bath/kitchen
Description and location of work on premises: _ Sheutilities:
Catch basin/area drain
Est.date of completion/inspection: Drywells/leach line/trench drain
Footing drain(no.lin.ft.)
Nil IIIM= Manufactured home utilities
Business name: /*D,41 A �/; J/U Manholes
Address: S l k7r^ 4- _ Rain drain connector
City:�' ,�,;/,� Y State:O ZIP: t7 )1 j Sanitary sewer(no.lin.P..)
Phone: ?-310 9 M Fax: I E-mail: Storm sewer(no.lin.ft.)
CCB no.: O Z r-7 — Plumb.bus.reg.no: 3 Sh 2 76 x'3 Water service(no.lin.ft.)
City/metro lie.no.: Fixture or(tem:
Contractor's representative signature: Absorption valve
- --- — Back flow preventer
Print name: Date: Backwater valve
Basins/lavatnry
Name: Clothes washes _
Address: — Dishwasher _
-T--- Drinking fountain s)�
City: State: ZIP: Ejectors/sum
Phone: Fax: I E-mail: Expansion tank
Fixture/sewer cavi
Floor drains/floor sinks bub _
Name(print): — Garbage disposal
Mailing address: Hose bibb
City: State: 71P: Ice maker
Phone: Fax: I E-mail: Interceptor/grease trap
owner installation/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)
Owner's signature: Date: I Sump —
Tubs/shower/shower pan _
Urinal
Name:,_-- _ --- Water closet -
Address: Water heater
City: State: ZIP: Other:
Phone: Fax: TE-mail: - Total
Nd all Juriariciians accept reedit cads,please call Jurisdtction for more infunnatlon. Minimum fee................$
Notice:This permit application
U Visa U htaaterCard 611 Plan review(at _ %) $ _
I �t 6�tj/rr /o` expires if a permit is not obtained
Credit card rumba:. J Z — — —� within ISO days after it has been State surcharge(89h) ... $
Dr�r accepted as complete. TOTAL .......................$
ff�6�c_ Olde drawn ancfediYFtd s
der It i t 44D4616(61WCOM)
NOWLIUVII;. ai`rF'.3
PLUMBING PERMIT FEES:
PR CE TOTAL Now 1 and 24amlly dwellings only:
FIXTURES (Individual CITY _'aa AMOUNT (Includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
-- ----- - — for each utility 16.60 connectionZ
Lavatory _ One(1�bath $249.20 -_
Tub or Tub/Shower Comb. 16 60 Two 2 bath _ $350.00
Shower Only tiQ! Three 3 bath - $399.00 -
Water Closet 161'0 -- SUBTOTAL
Urinal Iii 60 -8%STATE SUkCHARGE
Dishwasher IG 60 PLAN REVIEW_ 25%OF SUBTOTAL
TOTAL
Garbage Disposal — 16.60 _
Laundry Tray 16.60
Washing Machine 1660
Floor Drain/Floor Sink 2" 16.60 PLEASE_ COMPLETE:
3" _- 16.60
q" 16.80 _
Water Heater O conversion O likind 16.60 Quantity b Work Performed
e k
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/Ghower
Hose Bibs 16.60 _ Combination -
Roof Drains 16.60 - Shower Only
Drinking Fountain 16.60 — Water Closet
Other Fixtures(Specify) 18,60 Urinal
- Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 st t�0' 55.00 3"
Sewer-each additional 100' 46.40 4"
Water Service-1st 100' 55.00 Water Heater -
Other Fixtures
Water Service-each additional 200' 46.40
_ (Specify)
Storm 8 Rain Drain-tsl 100' 55.00
Storm R Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55 -
Catch Basin 18.80 --
In-pection of Existing Plumbing or Spec!ally 62.50 -
Re uested Inspections er/hf _ COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 --
Grease Traps 16.80 ---- ---- -- -�
QUANTITY TOTAL -
Isometric or riser diagram is required If
_Ouentity Total Is >9
"SUBTOTAL --
-8%STATE SURCHARGE - -
°•PLAN REVIEW 25%OF SUBTOTAL
Re]uired only If fixture qty:total is>9 _
�- --
TOTAL
*Minimum
- s
*Minimum permit fee is(72.50+B%state surcharge,except Residential Backflow
Prevention Device.which Is$38 25+e%state surcharge
" All New commercial Bulidings require 2 sets M plans with Isometric or riser
diagram for plan review.
I:\dstsVormslplm-fees.doc 12/26/01
U -0 - - M__
Mechanical Permit ApOication
— Date received. Q y Permitn.t. �r -ai
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,Cis" 97223 Dateissued: By: Receipt no.
Phone: (503) 639-4171 Payment type:
Fax: (503) 598-1960 Case file no.: Y YP
Building permit no.:
Land use approval: — _ .___.-_- --
1; Commercial/industrialI &2 family dwelling or accessory ❑Commercial/industrial J Malin h my UTenantimprovement
-_ -— _ -_-
Ncw t o n5tnteli„tt U Addition/alteration/replacement J c)thrr:
t l
Job address: ' Z" u L __ _ In&cate equipment quantities in boxes below.Indicate the dollar
Suite no.: value of all mechanical materials,equipment,labor,overhead,
Bldg.no.: --- profit.Value$
Tax map/tax lot/account no.:
Blk: Subdivision: *Sec checklist for important application information and
Lot: ocjurisdiction's fee schedule for residential permit fee.
Project name:
City/county:
Description and location of work on premises: I:�Yyr•;,) [Wal
Uc�cripliutt — Qty. Res.only Res.only
Est.date of completion/inspection:
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned?U Yes U No Air con tuoning(site p an require )
Is existing space insulated?U Yes U No A teration nF existing HVAC system
MIKERLIvily of er compressors
State boiler permit no.:
Business name: _ r L t -lam.=t HP Tons BTU/1444
Address: ;z _ S w £ it smo a ampers/duct smo a electors
State:O ZIP: S'Z/1 eat pump(site plan require
City: G rlu nsta rep ace urnace urner /
Phone:y7 X29, 5�� Fax_ E-ntai�• -- Including ductwork/vent liner UYes UNo
CCB no.: /U 41 S 7 y _ nsta rep ace re ocate eaters-suspende ,
City/metro lic.no.: wall,or floor mounted
ent lot as lance of er t an urnace
Name(please print): a gest ou:
Absorption units BTU/H
Chillers -_ HP
Name: -_---- ----- Com ressors HP
Address: - — nv ronmenta ex must an vent a on:
City: Slate: ZIP: Appliance vent
Phone: Fax: E-mail: _I)ryerex oust
0o s, ype /res. itchen atmat
3UT0 IN hood fire suppression system
Exhaust fan with single duct(bath fans)
Name: -- x aunt s stem a art from teat ng or AC
Mailing address: __ ne p p ng on str but on(up to 4 outlets)
City: Sta!z:� ZIP: Type; --LPG __ NG Oil --
Phone Fax: F nutil: ue inn eat a itiona over out els
tocessP p ng(sc emalicrequired)
Number of outlets _ -
Name: ter !ttpiiince nr eqn pment:
Address: Decorativefireplace
Slate: ZInsen-type
City: o stov pr etsurvc
Phone: ---- xA E-mail: ee
Applicant's signature: - t Dale: t
Name (print): - t�', d ' .k `
Permit fee.....................$
Nto nil Jurisdictions accept credit tarda,please^ail Jaden ietion to mom infomatiom Notice:Thisrmit application PP lication
Minimum fee................ _�--
viso U MastuerC�ard p �� ��� w expires if a permit isnot ohtaincd Plan review(al _ %) $
Credit clad number: �s r/ J -� y within 180 days after it has been _
XFMe State surcharge(8%)....$
N ran t: t, accepted as complete. TOTAL
t $
$
`-� — —Amount 44(b4617(&WcoM)
(' older al`uwttme
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEF_ SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: v Price Total
Table 1A Mecham: a0 Code Qty (Ea) Amt
$1.00 to$5,000.00 Minimum fee$72.50 _
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnd_ c00,000 BTU
$1.52 for each additional$100.00 or includi�gducts&vents 14.00
fraction thereof,to and including 2) Fur:;oe 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 5) Vent not included in appliance permit 6.60
$1.45,'or each additional$100.00 or
fract;on thereof,to and including n) Repair units
$50 Oon.00. 12.16
$50,001.00 and up_ $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.2C`-ir each additional$100.00 or For items 7-11,see or Pump Cond
_ fractloi.thereof. footnotes below. Comp
Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<31HP;absorb unit
to 100K BTU _ 14.00
- 8°/.State Surcharge $ 8)3-15 HP,absorb 25.60
unit 100k to 500k BTU
25%Plan Review Fee of subtotal 9)15-30 HP;absorb
_ _Re wired for ALL commercial pear Its only) $ unit.5-1 mil BTU 35.00
g- --------- 10)30-50 HP;absorb
TOTAL COMMERCIAL_ PERMIT FEE: $ unit 1-1.75 mil BTU 52.20
11)>50HP;absorb
-_ ---�� --- unit>1.75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: v� 12)Air handling unit to 10,000 CFM 10.00
`- Value Total 13)Air handling unit 10,000 CFM+
Desai flon: Ql (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
permit805 - 18)Domestic Incinerators 17 40
Repair units
<3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator
to 100k BTU _ 69.95---.
3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves
101k to 500k BTU 10.00
15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
mil.BTU 5.4%1--
30-50
.4030-50 hp;absorb.unit, 3,400 22j MMore than 4-per outlet(each)
1-1.75 mil.BTU 1.00 _
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU
Air handling unit to 10,000 cfm 656
8%State Surcharge $
Air handling unit>101000 cfm 1.170
Non-portable evaporate cooler _ 656 TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 440
Vent system not Included in 656 -- L----
appliance permit Qther Inspections and Fees:
Hood served by mechanical exhaust 656 1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic Incinerator 1,,170 $02 5o per hour
-Comma rcial or Industrial Incinerator 4,590 _ 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour)
Other unit,inJuding wood stoves, 656 $62 5o per hour
Inserts,etc. :1 Additional plan review required by changes,additions or revisions to pians(minimum
Ga 1p±q 1-4 outlets 360 _ charge-one-holt hour)$62 50 per hour
_5_611h addiflonal outlet _63 *!;late Contractor Boller Certification requirod for units>200k 81 U
TOTAL COMMERCIAL $ '"Residential AIC requires site plan showing placement of unit
VALUATION: _- __ All New Commercial Buildings require 2 sets of plans.
I:ldstslforms\mech-fees doc 02111102
Electrical Permit Application7i,,,,vd
{// i Permit no.:ftw;-Z&
City of Tigard Expire date:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 A Recei tato.:
Ciq�ri/7•igurdY� P
Phone: (503) 639-4171 -'--
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
�I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family ❑Tenant improvement
New construction U Addition/a;terition/replacenm�nl U Other: ❑Partial
11 SITE INFORMATIO11
Joh address: a. Q (t) ul�L� (?/ Itlilg. nti Suitr nu.; Tax mar/tax lot/accnunt no.:
-- ---
Lot: Block: ubdivisiun:
Project name: I Description and location of work en premises: -
Estimated date of completion/inspec(ion:
CON141AUFOR APPLICATIONI
Job no: lee Max
--- —
Business name: E,/I-� ��/�,�— l �F��i lesrripttnn Qh. Ica.) ol:r nu.utyi
_ ` `7 �'T' Newrrsidenlial-sinRleornudli-L•unih per
Address: /0 -7/— ..-S C oC ` / dwellingunh.Includes anachedgnrage.
City: ,C s4o--. I State:6??_ ZIP: 77V,'U servicelnchided:
Phone:S-3• Vf 2- ,5/ I Fax: I E-mail_ IW)sq n.or less _ _a
CCB no.:
C Elec.bus,lic.no:
J - F.ach additional 300 sq.ft.or portion thereof
Limited energy,residential '-
City/metro lic.no.: Limited energy,non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician(required) Date Service and/or feeder 2
Sup.elect.name(print)- License no: Servlceaorkeden-Inslallallon,
alteration or relocation:
200 amps or less 2
Name(print): 201 amps to 400 amps __ 2
----- --- 401 amps to 600 amps _ 2
Mailing address 601 amps In 1000 amps 2
City: State: GIP: Over I000 amps or volts 2
Phone: Fax: I E-mail: Reconnect Only I
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocnilon:
or
ORS 447,455,479,670,701. 200 amps to less _ _ 2
201 amps to 400 amps —_ 2
Owner's signature: _ Dale: 401 to 61x1 amps _ 2
Branch circuits-new,■Iteration,
or extension per panel:
Nance: A. Fee fm hnmch circuits with purchase of
Address: service or feeder fee,each branch circuit
City: Slalc: ZIP B. Fee for branch circuit, without purchase — _--
of service or feeder fee,first branch circuit:
I'hime - lax: E-mail:
4ach additional branch circuit:
PLAN REVIEW(Please check'"1 111:11 ai��� Misc.(Service or feeder not included):
U$Vivi(-ovci 2_'S;11,111,,mn-uen rnl U Health-care facility Fach pump or irrigation circle
U Service over 320anips-rating of I&2 U Ilazardouslocation Each signor outline lighting
family dwellings U Building over 10,0W square feet four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal ntmr residential units in one structure alteration,or extension*
•Building over three stories U Feelers,4111(1 imps or more +D...,-ription: -
U Occupant load over 99 persons i_I Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
U Egress/lightingplan U Other: - Perinspection -
Suhmlt_—sets of plans with any of the above. Investigmionfee A
The above are not applicable to temimrary construction service. Other -A
Not all jurisdictions accept credit cards,please call Jurisdiction rot more information. Notice:This permit application Permit fee.....................$
-36ANA U MasterCard ty o3 expires if a permit is not obtained Plan review(at — %) $
CreNnrd nu bel:_ S� eoS'Z 6�yy � within 180 days after it has been State surcharge(8%)....$
). __/ '! A, Expires accepted as complete, TOTAL $
N WW01 u s one redAc wil
i -
'
Cardlilsildti sign - _--- Amount 440-461316AUCOMt
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Number of Inspections r permit allowed Restricted Energy Fee...................................................... $75.00
(FOR ALL SYSTEMS)
Service included: Items Cost Total
Residential per writ Check Type of Work Involved:
1000 sq.ft.or less $145,15 4 ❑
Each additional 500 sq.ft.or Audio and Stereo System5'
,ortion thereof _ $33.40 1
Limited Energy $75.00 �❑ Burglar Alarm
Each Manurd Horne or Modu!ar -- _
DwOling Service or Feeder $9090 2 ❑ Garage Door Opener'
Services or Feeders
Installation,aiteratinn,or relocation ❑ Heating,Ventilation and Air Conditioning System'
200 amps or less _ $80.30 _ 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems'
401 amps to 600 amps $16060 2
601 amps to 1000 amps __—_ $2,10.60 2 ❑ Other
Over 1000 smps or volts _ :954.65 _ 2
Reconnect only — $66.85 — 2.
Temporary Services or Feeders _ TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system......................................................... $75 OU
200 amps or less $u6.85 _ 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 000 amps to 1000 volts,
soo"b"above. ❑ Audio and "tereo Systems
Branch Circuits
New,alteration or extension per panel ❑ Boiler Controls
a)The fee for branch circuits
with purchase or service or ❑ Clock Systems
feeder tea.
Each f branch cirbranch
$6.65 __ __ 2 Data Telecommunication Installation
b)'.he foo for branch circuits �� -^ ❑
I without purchase of service
or feeder fee. I [� Fire Alarm Installation
First branch circuit $46 85
Each additional branch circuit i_ $6.65❑` ❑ HVAC
Miscellaneous f
(Serviceinstrumentation or feeder not included) CJ
Each pump or Irrigation circle $53.40_
Each sign or outline lighting $53.40 i— ❑ Intercom and Paging Systems
Signal circuit(s)or a limited energy
panel,alteration or extension $7500 _ �❑ Landscape Irrigation Control"
Minor Labels(10) $125.00
Each additional Inspection over ❑ Medical
the allowable In any of the rbove
Per inspection $6250 ❑ Nurse Calls
Per hour $62.50 —In Plant $73.75 ❑_� ❑ Outdoor Landscape Lighting"
Fees: ❑ Protsclive Signaling
Finer total of above fees $ _ ❑ Other
8'/e State Surcharge $
—� -----Number of Systems
25`h Plan Review Fee
See"Plan Review"section on $ No licenses are required. Licenses are required for all other Installations
front of application. _
----- Fees: i
Total Balance Due $
❑
'frust Account#
Enter total of above fees_
--� --- 8%State Surcharge $
All New Commercial Bwldin41s require 2 sets of plans Total Balance Due =
\dsts\fornm\elc-fees.doc 08/30/01
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24
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ILOT 35
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,, , -- ----- F 2
CITY OF TIGARD 24-14our
BUILDING Inspection Line: (503)639-4175 MST ��<2 �
INSPECTION DIVISION Business line: (503)639-4171
BLIP
-z
Received _ Date Requested C4 ii = _ AM--_-_—PM�— BLIP —
Location ___��- � ��� �Sulte_ MEC ._
v
Contact Person 1— .'__ Ph(_ ) — 1 7a k PLM
Contractor __— _ Ph( ) SWR _
BUILDING Tenant/Owner __— _. ELC ----
Footing- EL^ _-
Foundation Access:
Ftg Drain s-- � L°l�`fr1,�l-� �(- ELR _
Crawl Drain r t,
Slab inspection Notes: ----
Post&Beam _ -----• - ____ -
Shear Anchors
Ext Sheath/Shear --
Int Sheath/Shear
Framin t ---- ---- - -- -- -
Insulation
Drywall Nailing -- - ---- _ —
Firewall
Fire Sprinkler ---�'-�----- �'� --Y--�-_ __.- - - -- --- --
Fire Alarm
Susp'd Ceiling - -- -- - -- --
Root
Other: -"
PASS PART FAIL -
Post& Beam
Under Slab -_- --
Rough-In _
Water Service
Sanitary Sewer
Rain Dram, ---- - -- --
C filch Barin 'Manhole
Storm Drain -----�--- - --
Shower Pan _-_-
Other:
Final
PASS PART FAIL
MECHANICAL ------
Post& Beam
Rough-In ---
Gas Line
Smoke Dampers ---- -
Final
PASS PART FAIL - ----- -
ELECTRICAL
Send-,e
Rough-In _ - --�...------------
UG/Slab
LOW Voltage - ---
Fire Alarm -
Final u Reinspection fee of$ ___.. required before next inspection. Pay at Q'y Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _— FAPlease call for reinspection RE: Unable to inspect- no access
Fire Supply Lin-
Approach/Sidewalk
ADA Dib ``' 1 ( �'' a lnspoctor— -Ext --
Approach/Sidewalk -- _ -- - --- ___
Other:
Final QU NOT iREMOW this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171 — --
BUP — - ------ —
Received Date Requested �_` AM__—___ PM BUP
Location -7 (e t'o � � —__.Suite__— - _ MEC - -
Contact Person . _.-- ___— Ph(—,—) PLM
Contractor SWIl
BUILDING Tenant/Owner _.____ _—_ — _—_ `—__—_ ELC
Footing
Foundation ELC
Access:
Ftg r)rain ELR
Crawl brain ----- —
Blab Inspection Notes: SIT
Post&Beam
Shear Anchors -- -- - -
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Dry�.all Nailing --_ T T -.. - —----------- - --- -- -- - - -
Firewall
Fire Sprinkler -------- -- - -- -
Fire Alarm
Susp'd Coiling — --- - ------ --- -----y__..., ----- _..._. _
Roof
Other:
Final
____ ART FAIL
PLUMBIN
Un Slab
e�Slab - ---- -------- --- — -
Rough-In
Water Service -- - -
Sanitary Sewer
Rain Drains - -- - - -
Catch Basin/Manhole
Storm Drain - - -- --- -- ---_—
Shower Pan
-I!T.—al
: --
T FAIL
,: NICAL
Rough-In
Gas Line
$spoke Dampers -
na.3
SS PART FAIL --- ---- --- - -- --- ----
E_LECTRICAL -
Service - -------- -- --Rough-In
- -------------------
UG/Slab - -
Low Voltage
Fire Alarm
Final r� Reinspection fee of$-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PANT FAIL
Please call for reinspection RE: Unable to inspect-n access
Fire Supply Line
ADA 24.r ) 0 3 -
Approach/Sidewalk Date �-��1 In�Pectur �� Ext
Other:
Final DO NOT REMOVE this Ins+po ction record from the job site.
PASS PART FAIL
SENT BY: PAUL A. CAANFY, TNC. ; Sea 298 9881; JUL-15-02 8:58Pk1; PAW t/1
ti Paul wy' Im 603-207-W08608.208-NSI(Nx)
�M;NIIIIIIIIIIINOW
C
I
City of Tiga
Bureau of ings
Tigard,OR
Atte: Founda n Inspector
I
RE: (' nlcal Report 12766 SW Bugle Court,Tigard,O^ 97224; aka Lot 35 Elk Ham Ridge
Esiatoe M 002-00301
I have condu a ground level geotachnical evaluation for the above referonced address
All footings been de"ned intn stiff native softs and no hwardous geotechnical►slues exist.
V th oonsid. tion of the above and batted on a final visual examination, it is my opinion tnat the
current cord' of lot 35 Elk Flom Ridge tee is in geiieral oonfommanoe with Appendix Chapter 33
of the 1907 U iform Bulking Code tf you have further questions,please call.
S"rely yorr
rasp�Pon'L--"
Paul R Garm President trC3'' QRF. n+ `r'a
I Al f
�prM p cj*
A
CITY OF TIGARV 24-Hour
BUILDING Inspection Line: (503)639-4175 MST -C7 301
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Rece;ved _ _ _Date Regoe ed_____1�_ — AM PM _ BUP
Location ___ ���¢_c�_ JC� Com_ Suite MEC —_
Contact Person Ph(_ ) _ PLM
Contractor__ _ _ —.--__ Ph( _) —_ SWR
-BUILDING Tenant/Own.r —_ _ ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain ---_---i-------
Slab Inspection (Votes: SIT
Post& Beam _ -------_-__-_-_- __._--- -
--
ShearAnchors
Ext Sheath/Shear
Int Sheath/Shear
Frs.ming - --_ ---- - - -- ----
Insulation T
Drywall Nailing ---_ - -_ ------------ - -- ---- - -
Firewall
File Sprinkler --
Fi•e Alarm
'3usp'd Ceiling ------ - ._..._- ---- --------- - ----- -
Roof
Other:
- - - -
Final
PASS PART FAIL
PLUMBING -
Post& Beam
Under Slab
Rough-In
Water Service ------------ ---- -
a►YD ---- - -- - --- --- --_ __--_ ...... -
Catch Basin/Manhole
Storm Drain - -
Shower Pan
Other: --_--
FiJ*- --- --
r�A PART_ FAIL -- _--- -
CHANICAL---
Post& Beam
Rough-In ------------ -
Gas Line
Smoke Dampers
Final
PASS PART_ FAIL --
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage — ------ - -
Fire Alarm
Final U Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall B'vd.
PASS PART FAIL
SITE Please call for reinspection RE:----- Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date _7 /
Inspector Ext _
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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