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12785 SW BLUE HERON PLACE PO N r 'V 00 C" W m fD 1 O d h i 1 I 12785 SW Blva Heron Mace CITY OF TIGARD 11AASTcRPERMIT DEVELOPMENTvERV�CiEs DATEPERMIT03-00033 ISSUED: 2/ d'03 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 SITE ADVRESS: 12785 SUV BLUE HERON PL PARCEL: 2S103BC-09900 FUBDIVISION: BLUE HERON PARK ZONING: R-4.5 BLOCK: LOT: 016 JURISDICTION: TIG REMARKS: Construction new SFA BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,333 at BASEMENT: of LEFT: SMOKE DETECTORS: TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 653 of GARAGE: 290 at FRONT: 23 PARKING SPACES• 2 TYPE OF CONST: 5N DWELLING UNITS: 1 INFO if RIGHT: 5 553 40 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,906 It VALUE: 190. REAR: 22 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN D?AINS: 1 CATCH BASINS: TUB/SHOWERS: 2 GARBAGE DISP: 1 .PATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 2 CLOTHES DRYER: I VAS FURN"100K: I UNIT HEATERS: HOODS: 1 OTHER UNITS: I MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOCOSTOVFS: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRA' H CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OP LESS: 1 0 200 amp: 0 200 amp: t• QVC OR FOR: PUMPIIRRIGATIOII: PER INSPECTION: EA ADD'L 6005 : 3 201 400 amp: 201 400 amp: tat WIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 - WO amp: EAADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp: 601+amps-10rOv MINOR LAOEL: 1000+ampIvolt PIAN REVIEW SECTION Reconnect only: --- r•4 RES 1111'S: 3VCIFDR>•225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: _ ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ S.COMMERCIP.- AUDIO&STEREO: X VACUUM SYSTEM: X AUDIO 6 STERLU: FIRE ALARM: INTERCOWPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: x 0TH: ALL ENCOMP BOU.ER: HVAC: LANDSCAF EARRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENrATION: AEDICAL: OTHR: HVAC: X DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,390.20 WINDWOOD CONSTRUCTION,INC. WINDWOOD(SEE OTHER) This permit is to the regulations contained In the 12655 SW NORTH DAKOTA 12655 SW NORTH DAKOTA Tigard Municipalal Code, ode,State OR. Specialty Codes and TIGARD.OR 97223 TIGARD,OR 97223 all other applicable laws. All work will be done accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if the work is suspended for mora than 190 days. ATTENTION: Oregon law requires yuu to follow rules adopted by the Phone: 503.625-6526 Phone: 625-6526 Oregon Utility Notifi. tion Conter. Those rules are set forth in OAR 952.001-0010 through 952-001-0080. You Ree N: [ LIC 50196 may obtain copies of these n,les or direct quastk,ns to OUNC by calling(503)2146 987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica PLM/Underfloor Shear Wahl Insp Gas Urie Insp Rai;drair Insp Sewer Inspection Underfloor insulation Mechanical I '�N Shear Wall Insp Gas Fireplace Water Line In;p Footing Insp Crawl Draln!Backwater Plumb Top Out Shear Wall Insp Insulation Insp Water�3;lvice Insp Foundation Insp Footing/Foundation'lr1 Electrica!Service Exterior Sheathing Inst Gyp Board Insp Water Service Insp Post/Beam Structural PLM/Underfloor Electrical Rough In Low Voltage Firewall Insp Appr/5dWk Insp Issued By : LLA1U,f,1Z Permittee Signature Cali (503) 639-4175 by 7:10 p.m.for an inspection needed the next business day i d CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 pp p 3 MS INSPECTION DIVISION Business Line: (503)639-4171 BUF —� Received __-___ Date Requested 1 �� AM_ PM.—_______ BUP Location � - �Sr Suite MEC Contact Person Ph( 17- 37-Sr _ PLM ContractorPh(—) — SWR BUILDING Tenant/Owner __—_ ELC Footing ELC _- Foundation Access: Ftg Drain / l �� ELR Crawl Drain `-- Slab Inspection Notes: SIT --------- ..------.-_-_- Post&Beam Shear Anchors Ext Sheath/Soear Int Sheath/Shear Framing Insulation Drywall Nailing - - - Firewall Fire Sprinkler -- -- - - -- - - - - - . Fire Alarm - Susp'd Ceiling Roof Other. — - - - - - - - - - mal RT FAIL Post&Beam Under Slab ---- - — Rough-In Water Service Sanitary Sewer Rain Drains — - — Catch Basin/Manhole Storm Drain —V —�-- -- — Shower Pan i ASS PART FAIL)ARR ----- ANICAL_ Post&Beam Rough-In ------- _.. Gas Line Smoke Dampers — S JAJQT FAIL Service �-- ----- - ------ Rough-In -- -- - -- — — — — UG/Slab ire rm mal Reinspection fee of$_ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd. ASS TART FAIL -- F] Please call for reinspection RF _ _ _ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Sxt Other: _ Final ^� DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL a d V � z o 00 O V I y �.J o s o c lJ 0 . 0 !N rp c a, vti a u �T�iW � fn a1 v (� o H z u w u 0 06.09/2003 11 :19 FAX 5035798056 17J005 CITY OF TIGARD 13175 S.W. HALL BLVD. TI'GARD, OR 97223 IMPORTANT FERMI t NOTICE GREENWAY ELECTRIC COMPANY 15145 SW GULL DR BEAVERTON, OR 97007 1 Electrical Signature Form Pe-mit#. MIST2003-00033 Date Issued: 2J18103 Parcel: 2S103BC-09900 Site Address: 12785 SW BLUE HERON PL Subdivisiom BLUE HERON PARK Block: Lot: 016 Junsdiction. TIG Zoning, R-4.1) Kwmarks Corsl.luction new SFA Your company has been indicated as 0w, elect-ical contractor for the permit indicated P'jove. In order for the Electrical permit to be valid, the s',grrature of the supervising electrician is required. Please have " appropriate individual from you, company sign below and return this Electrical Signature Form prior to the start of the work to the address above, AI-TN: Building UNision. No electer-al inspections will be authorized until this completed toren is received �I OWNER: LLLC 1 RICAL CONTRACTOR: WINDWOOD CONSTRUCTION, INC. Gt"%EENWAY ELECTRIC COMPANY 12655 SW NORTH DAKOTA 15'145 SW GULL OR , 07 TIGARU.. UF'�, 97223 BEAVER-TON, R 970 Phone 0. 50_1-G25-6526 hone #; 503-57944054 Reg *; LIC 153421 M-F 3.1.617C SUP 5()21;s AN INK SIGNATURE IS REQUIRED ON THIS FORM x sly ature of Supervisin :lectncien !' you hav�� any questions,, pleaF.e all 503 718.?433. QM911 au .U.1.3 lR9ct'zAlnS T�� tl TT No1q co:80:Ao CITYOF TIGARD MASTER PERMIT PERMIT#: MST2003-00033 DEVELOPMENT SERVICES DATE ISSUED: 2/18/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 SITE ADDRESS: 12785 SW BLUE HERON PL. PARCEL: 2S103BC-09900 oUBDIVISION: BLUE HERON PARK ZONING: R-4.5 BLOCK: LOT: 016 JURISDICTION: TIG REMARKS: C r Ai �U,'A) 5 Fir BUILDING REISSUE. STORIES, 2 FLUOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1.373 sf BASEMENT: of LEFT: SMOKE DETECTORS: Y TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 653 of GARAGE. 290 of FRONT: 20 PARKING SPACES: 2 TYPI OF CONST: 5N DWELLING UNITS: 1 THIRD of RIGHT: 5 553.40 OCCUPANCY GRP: R3 BDRM: 7 OATH: 3 TOTAL: 1,986 of VALUE 190, REAR: .l PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN c IOOK: BOILICMP<THP: VENT FANS: CLOTHES DRYER: 1 GAS FURN>000K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: I MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS. I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 -200 amp: WISVC OR FDR: PUMPIIRRIGATION PER INSPECTION: EA ADD'L 500SF: 3 201 400 amp: 201 400 amp: tat W/O SVCIF DR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 000 amp, 401 no amp: EAADDL BR CIR SIGNALIPANEL: IN PLANT: MANU HWSVCIFDR: 601 1000 amp: 001+amps-I Wow MINOR LABEL: 1000+amolvolt: PLAN REVIEW SECTION Reconnect only: >�1 RES UNITS: SVCIFDR>•224 A.: >800 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SI'RESIDENTIAL _B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERC)MIPA3ING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDS:APEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL r SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,266.20 WINDWOOD CONSTRUCTION WINDWOOD HOMES INC This permit is subject to the regulations contained In the 12655 SW NORTH DAKOTA 12655 SW NORTH DAKOTA Tigard Muni ipal Code,State o OR. Specialty Codes and TIGARD,OR 97223 TIGARD,OR 97223 all other ce with a laws. All work will be done it accordance 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. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503-625-6526 Phone: 625-6526 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You Reor: 1 I(' 50196 may obtain copies of these rules or direct questions to OUNC by callir,g(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Exterior Sheathing Insl Gyp Board Insp Electrical Final Sewer Inspection Underfloor Insulation Plumb Top Out Low Voltage Firewall Insp Mechanical Final Footing Insp Cra"I Drain/Backwater Electrical Service Gas Line Insp Rai;1 drain Insp Plumb Final Foundatlon Insp Footlnn/Foundatlon Dr; Electrical Rough In Gas Fireplace Water Line Insp Final inspection Post/Beam Structural PLM/Underfloor Shear Wall Insp Insulation Insp Appr/Sdwik Insp �/ 'I� Issued By : `�' ► .f 1 t-(-./l._.; _ Permittee SignaturersL. � Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CTY OF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00032 • 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/18/03 09900 SITE ADDRESS; 12785 SW BLUE HERON PL PARCEL: 2S103BC- SUBDIVISION: BLUE HERON PARK ZONING: R-4.5 BLOCK: _ LOT: 016 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SFA NO. OF BUILDINGS: INSTALL TYPE: LTPSWR l IMPERV SURFACE: Remarks: S U04)1,, t Yvv��'f I Yv Owner: --- FEES WINDWOOD CONSTRUCTION Description i Date Amount 12655 SW NORTH DAKOTA _ _ TIGARD, OR 97223 ISWUSA) Swr Connect 2/18/03 $2,300.00 1SWUSAJ Swr Connect 2/18/03 $0.00 Phone: 503-625-6526 [SWINSP]Swr Inspect 2/18/03 $35.00 [SWINSP)Swr Inspect 2/18/03 $0.00 Contractor: Total $2,335.00 Phone: Reg#: Required 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 the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement -:van, 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: Permittee Call (503)639-4175 by 7:00 P.M.for an Inspection needed the next business day 4 s r n �•-- �, Building Permit Application City of TigardDate received- _p' Permit no.:/Vl<iT�?7yJ3-UD�� Address: 13125 SW Hall Blvd�l� c�,4JK 4i2�3 �ojecdappl.no.: Expire date: City of Tigard V 1 Phone: (503) 639-4114�� Date issued: By'.0 , Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: JAN 17 ZOOS __ 1&2 family:Simple Complex: ,_i" �&2 family dwelling or accessory ommerciaUindustria] U Mi ti-family U New ;onstruction J Demolition U Addition/alteration/replacement U Tenant improvement ❑Fire sprinkler/alarm U Other: t ' Job address: W e i7jv A M 7 _ Bldg.no.: Suite no.: Lot: Block: Subdivision: uC ,n Tax map/tax lot/account no-25/Oct(- ?L 3kal Project name: blk ro 4 U/- Description and location of work on premises/special conditions: _— (Floodlitain,septic etc.)Mailing address: e't v /t/br•�� -� e/c I & 2 fa ill} d"elling: City: r C( Stat ZIP: 0?;t93 Valuation of work........................................ $,190 SS3 Phone: _SOS G Fa 6 E-mail: No.of bedrooms/baths.......... 1 .................. _ .�- Owner's representative: /C Total number of floors c 1.. Phone: Fax: C-mail New dwelling area(sq.ft.) APPLICANT Garage/carport area(sq. ft.).. A14017......... a 10 Name: M Covered porch area(sq.ft.) ......rl 4........... Mailing address: Deck area(sq. ft.) ........................................ _ City: State: ZIP: Other structure area(sq.ft.)......................... Phone: Fax E-mail: Commereial/industrlaUmulti-family: Valuation of work..................................... --�. Business name: Existing bldg.area(sq.ft.) .... .............. .... ------------ Address: f M New bldg.area(sq.ft.).......... . .... City: State: ZIP: Number of stories................... Type if construction =� Phone: Fax: E-mail: --- CCB no.: Occupancy group(s): Existing: _ �— - - - -- New: City/metro lie.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: _ f��a m t�SLe provisions of ORS 701 and may be required to be licensed in the Addtrss: Al w / t jurisdiction where work is being performed.If the applicant is Cit / 5tated� GIP: Q .k/y exempt from licensing,the following reason applies: Contact person: q/� _T Plan no.: — -- Phone:�L)S-411(el 1FaxZPT'eJ331E-ma11: -- -- — Name: Contact person: Fees due upon application ...........................$ Address: Date received: City: - State x ZIP: ,� 4 Amount mceiv-d .. .................................. S Phone: Fa>':• `1� E-mail: PIL se refer to fee schedule. 1 hereby certify 1 have read and examined this application and the Na+u .mctiam accept�,m*.pwu cWt iuii+dktion for man infattrtiea. attached checklist.All provisions of laws and ordinances governing this 0 Visa W O MasterCard work will be complied with,whether s cified her-in or not. Credit end number: t_xptta Authorized signature _ Date: Nene or d t�ho+m on earl -- Print name: It, 75cudboW s e �Ar•wol Notice:This permit applicatior expires if a Permit is not obtained within 180 days after it has been accepted as complete. 44U 4t�t3(tLtAWOM) One- and `i"wo-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: City ofTigard city of rfigard O Electrical O Plumbing O Mechanical Address: 13125 SW Hall Blvd,Tigard,OR 97223 0Other: Phone: (503) 639-4171 Fax: (503) 598-1960 1 1 11 ' 1 Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved platilot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel.Existing system capacity _ 6 Sewer permit. 7 Water district approval. - --- 8 Soils report.Must carry original applicable stamp and signature on file 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 connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details.Plan review cannot be completed if copyright violations exist. -- 11 Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions,property corner elevations(if there is more than a O4 elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/sepuc systems;utility locations;direction indicator,lot area;building coverage arca;percentage of coverage;impervious area;existing structures on site;and surface drainage. -12 foundation 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 smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and dec,rs 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floo•, 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, fife lace 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 envc.ope. Full-sine sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locntlons;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,sl:acing,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 bcam/joist carrying a non-uniform 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 r-quires or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Oregon and shall be, shown it,he applicable to the project under review. JUMSDIVII'IONAL 23 Five(5)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or I I" x 17". 24 Two(2)sets each are required for Items 16, 19,20&2"above. — 25 Building plans shall not contain red lines or tape-ons. Mirrored"building plans will be not accepted. 26 "Reversed"building plans must meet criteria outl;aed in the permit&System Development Fees document. 27 "Drawn to scale"indicates standard architect 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. 440-614("t'a'c0") Mechanical Permit Application — Date received: Permit no.: City of Tigard Project/appl.no.: Expire date: Cir),of Tigard Address: 13125 SW Hall Blvd,T.gird,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 — Fax: (503) 598-1960 Case file.to.: Payment type: Land use approval: Buud.rg permit no.: t 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: .1101111 SITE t Job address: kC a/ Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: S/ d cL�3 ydO profit.Value$ Lot: Block: Subd *See checklist for important application information and Project name: k r k2. — u ,jurisdiction's fee schedule for residential permit fee. City/county: as H f r W I ZIP: C/72."Z= 1 Description and location,6f work on premises: 1 s 1 Est.date of completion/inspection: Uexai ion QI . Res.onl' >tes•oeay Tenant improvement or change of use: A " Air handlin,,,unit CFM Is existing space heated or conditioned?U Yes U No Air con itioning(site plan required) Is existing space insulated?U Yes U No Alteration of existing HVAC system _ Boiler/compressors Stalc boiler permit no.: Business name: r!!f!n C HP Tons BTU/II Address: d (, _ Fir smo a—dampers/duct smoke detectors _ City: �l 4M cnr IP: Q'� 3 eat pump(site p an requi— res) __ Phone: Fax: E-mail: nsia rep ace furnac urner /i` Including ductwork vent liner U Yes U No CCB m-.).: ��A _ Install rep ace/relocale eaters-suspen e , City/metro lic.nr.•.: e,—o 5—�, wall,or floor mounted Name(please print):./ V $d,1 Vent for appliance other than furnace e erat on: ti Absorption units �_ BTU/H Natne: SGf Chillers _ FIP — Com re 11 _ HP Address: _ � v ronmenta ex ust a vent ton: City: State: 7,IF'._ Appliance vent Phone: I•ax: E-mail:J Dryerexhaus, Hoods,Type res. itc a hazmat hood fire suppression system Name: 1U,r-puz w 6L-4A [(yy S T -4-A L Exhaust fan with single duct(bath(ans) Mailing address: Kc.,j cir A-fes,j1q x aust system apart from heating or AC State:J3 Fuelpiping adistribution(up to outlets) city: /2 ) rY Tyle: LPG N3 Oil Phone:Ga - bS.')G Fax: E-mail: Fuel piping each additional over ou ets Process p p (schemaucre,,uir ) _ Number of outlets Name: 011lier Ilded appnce or a,'.jp eet: Address: Decorative fireplace City: Stine: 7_IP.- Insert-type. Phone: Fax: E-mail: stov Move Other: Applicant's signuture: Date: t __ Name (print): No W juridicaoeu rxW credit cpleasetis.please crdl juridktiaa for mar i z;_d m Permit fee ................$ Notice:This permit application Minimum feeee................$ U Vise 0 M.tsterCard expires if a permit is not obtained $ _ Crani cud out Ow-_ — x within 180 days after it has been Plan review(at _ 96) State surcharge(896)....$ Nerve of canholdw as on t cud accepted as complete. S TOTAL .......................$ dptatute Amoss 4404617(15MUMM) I 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 Oty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Fum300 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 $146.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or includina 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 $1.45 for each additional$100.00 or 6 60 fraction thereof,to and including 6) Repair units $50,000.00. 12.15 350,001.60 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see Cor omp Pump Cond fraction thereof. footnotes below. Minimum Permit Fee$72.50 SUBTOTAL: 7)<3HP;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 35.00 Required for ALL commercial permits on unit.5-1 mil BTU 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20 11)>50HP;absorb unit>1.75 mi,BTU 87.20 ASSUME_D VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.(10 Value Total 13)Air handling unit 10,000 CFM+ Description: C_� 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 conn(,cted to a single duct ducts&vents 6.80 Floor furnace includit.g vent 955 16)Ventilation system not Included In Suspended heater,wall heater or 955 appliance permit 10.00 floor mounted healer - 17)Hood served by mechanical exhaust Vent riot included in applicance 445 10.00 permit 18)Domestic Indnerators Repair units 805 17,40 <3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator 0k to 10BTU 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves 101k to 500k BTU _ %00 15.30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets roll.BTU_ _ _ 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per nutlet(each) 1-1.75 mil.dT_U 1.00 >5U hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU Air handling unit to 10,000 c'n 656 _ 8%State Surcharge $ Air handling unit>10,000 cfm 1,170 __ Non- ortable evaporate cooler _ 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not included in 656 appliance p2nnit Other Inspections d Fees: Hood seryi Inspections ed b mechanical exhaust 651 - a �- Domestic Incinerator 1,170 - outside of normal business hours(minimum charge-two hours) $62 50 per hour Commercial or industrial incinerator 4,590 2 Inspections for which no fee is specifically Indicated (minimum charge-helf hour) Other unit,Indudi,,g wood stoves, 656 $62.50 per hour Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum Gas I Ing 1 d outlets 360 1 chbrgeone-half hour)$62.50 per hour Each nrldilional outlet 63 1 *State Contractor Boiler Certification required for units>200k BTU. TOTAL COMMERCIAL : ~Residential AIC requires site plan showing placement of unit mi VALUATION: All New Commercial Buildings require 2 sets of plans. IAdstsVorms\mech-fees.doc 12/26/01 Plumbing Permit Application Date received: Permjt no.: City of Tigard Sewer nermit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 CirvOfTigard Phone: (503) 639-4171 ProjecUappl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ Case file no.: Payment type: ;�J I &2 family dwelling or accessory O Commercial/industrial U Multi-family O Tenant improvement New construction U Addition/alteration/replacement ❑Food service O Other: 1 1h address: �r -�Q, -__� Descrition Fee ea. Total Bldg.no.: _ Suite no.: New I-and 2-fam8y dwellings only: (includes f 00 ft.for each utility connection) Tax map/tax lot/account no.: ;FIS/ V Lib LT 320 0 SFR(1)bath Lot: Block: Subdivision: W 'A-ra'i /Q SFR(2)bath Proji FR(3)bath -�— City/county: ZIP: Q j t Each additional bath/kitchen Description and loKtion of work on premises:_ SiteutQities: J�Catch basin/area drain Est.date of completion/inspecuotl: wells/leach line/trench drain 1 Footing drain(no.lin.ft.) Manufactured home utilities Business name: Manholes _ Address: P c) -21 (00 Rain drair connector City: A State;0 ZIP: 76Yj 7 Sanitary sewer(no,lin.ft.) Phone: y — G a/ Fax a32 Email: Storm sewer(no.lin.ft.) Water service CCP no.: '7/ p Plumb.bus.reg.no: — y�- : lin.ft.) City/metro lic.no.: /(0,95— Fixture or vent: Absorption valve Contractor's representative signature: 8/.// Back flow preventer Print name: t� Elate: Backwater valve Basins/lavatory Name: jr- — Clothes washer - Dishwashei Address: _ Drinking fountain(s) City: State: ZIP: Ejectors/sump Phone: Fax: I E-mail: Expansion tank ixture/sewer cap Name(print): ecm^r L Floor drains/floor sinksthub Garbage dis sal Mailing address: S+V Nr�tn '� /� Hose bibb City: 6L elIP: ;� lee maker Phone: Fax:(i, ^ E-mail: Interceptor/grease tra Owner instal lation/residential maintenance only: The actual irstallation Primer(s) 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 si natu ate: Sump _ Tubs/shower/shower pan - Urinal Name: _ Water closet — Address: Water heater _ City: State: ZIP: Other: Phone: Fax: m T91aI Na W juriadlcaaor u=W emdlt cardr,t�oaa juridktlon for mom infurmnioa Notice:This permit application Minimum fee............ ) $ _ O Via? O MutetCard expires if a permit is not obtained Platt review _ 96) $ Credo cad number. within ISO days after it has been State surchargg e(896)....S — ra - Kane of awdoldet r ahoao^ob cm&t evid — accepted as complete. TOTAL ....................... S a t Amami 4464616 OWCOM) i F PLUMBiNG PERL.iT FEES: -1 PRICE TOTAL New 1 and 2-famlly dwellings only: ':x URES e!, dividual) QTY �(ea) AMOUN'I (includes all plumbing(ixtu�es in PRICE TOTAL ,,Ink 16.600 ...e dwelling and the first100 ft. QTY .(ea) AMOUNT _-- 16.60 for each utility connection avaton One 1 _hath $249.20 or'T biShower Comb. 1650 Two r2 bad-_ $350.00 cn er Only 16.60 Three(3)bath _ -�� $399.00 ater GloTt 16.60 UBTOTAL I Jrinal 46.60 8%STATE SURCHARGE 1 ')'shwasheri 16.60 PLAN REVIEW 25%OF SUBTOTAL �..m.ge Disposal 16.60 _TOTAL -a .ry Tray 16.60 -- Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE: 3" 16.60 4" 16.60 - -- --- - Water Heater O conversion O like kind 16.60 _qQuantIty Work PerformedGas pipinp requires a separate mechanical Fixture Type: NewReplaced Removed! _pmrnit d MFG Home New Water Service 46.40 Sink tory MFG Home New San/Storm Sewer 46.40 Tub or _ Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only -� Drinkit.2 Fountain 16.60 Water Closet Other Fixtures(Specify) 16.60 UrinalDishwasher _ Garbage Disposal Laundry Room Tray Washifig Machine Floor Drain/Sink: 2" Sewer-1st 100' 5b(,U 3" Sewer-each additional 100' 46.40 4" _ Waley Service-1st 100' 55.00 Water Beater Other Fixtures Water Service-each additional 200' 46.40 (Specify) _ Storm b Rain Drain-1st 100' 55.00 Simi 8 Rain Dlaln-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 _ Catch Basin 16.60 _ Inspection of Exinting Plumbing or Specially 62.50 Requested inspections er/hr COMMENTS REGARDING AB+DVE: Rain Drain,single family dwelling 55.25 Grease Traps 16.60 - -- -- QUANTITY TOTAL V _ Isometric or riser diagram Is required tt Quantity Total Is �B *SUBTOTAL -- 8%STATE SURCHARGE - - "PLAN REVIEW 25%OF SUBTOTAL Required only It future qty total is 1 9 ---- TOTAL s Minimum pennll les is$72 50 4 s%stale surcharge,except Residential Backflow Preverdlon Device.which Is$36.25 4 E%state surcharge ""All New Commercial Buildings require 2 sate of plans with lsometrk or dear diagram Int plan review. I:Wsts\fortns\plm-fees.doc 12/28/01 1 Electrical Permit Application ,�Ce1V„� Electrical ON Permit No.: Planning Approval Sign City of Tigard Date/R,.,: __. Permit No.: 13125 SW Hall Blvd. Plan Review Other `' Tigard,Oregon 97223 Post-Ree _ Permit Post-Review land Use ''hone: 503-639-4171 Fax: 503-598-1960 Date/By: case No: Internet: WWW.ci.tigard.or.us Contact IJuris.: See Page 2 for 24-h,.ur Inspection Request: 503-6394175 Name/Method: Supplemental Information. PLAN REVIEW Please check all that apply) --- TYPE OF WORK �, (Please censtr'uction Demolition Service over 225 amps- Health-care facility commercial ❑Hazardous location 13Addition/alteration/re lacement 1�lthef: ❑Service over 320 amps-rating of ❑Building over 10,000 square feet, AT GORY OF CONSTRUCT ION 1&2 family dwellings fou-or more residential units in - ❑System over 600 volts nominal one structure 1 &2-Family dwelling _Commercial/Industrial ❑Building over three stories ❑Feeders,400 amps or more Acee,.,o Building _ Multi-Family ❑Occupant load over 99 persons ❑Manufactured structures or RV park Ot11Cf: ❑Egress lighting plan ❑Other:_ M,s jr Builder submit!_seri of plans with any of the above. JOB SITE INFORMATION_and LOCATION The above are not applicable to temporary construction service. FEE' SCHEDULE — Job Id /Apt.#: _ Number of ins actions er ermit allowed Suite#: —— --� t1t� Fee(ea.) Tata1 Description Project Name: — -- New residential-single or multi-1`91111) per Cross street/Directions to job site: dwelling unit.Includes attached garage. Service Included: 1000 ag_n.or less 145.15_ 4 Each additional 500 s .R.or rtion thereof _ 33.40 l _ Limited energy,residential 75.00 2 Subdivision: n Lot W Limited energy,non residential _75.00 2 / Tax ma arcel #: Each manufactured home or modular dwelling service and/or feeder -- 2 DESCRIPTION OF WORK Services or feeder-Installation, alteration or relocation: _ -- -- - 80.30 2 -- 200 amps or less — -- - 201 am s to 400 amw --— - 106.85 2 - - 401 am s to 600 ams 160.60 _ 2 601 amps to 1000 amps 240.60 2 NER _ TENANT_;_ -- 454.65 2 • '' Over 1000 am or-volts i Name: W4,ti a0c/!9 Ce; 6 rA`<' Reconnect only 66.85 2 1,e1 Temporary services or feeders-Installation. Address: ;La S C. ) s,terstion,or relocation: 66.85 1 Cit /State/Zi a� CtC `/ 7�'� 3 —_-- 200 amps or less—----,__--_ 201 amps to 400 amP_— 133 30 2 Phone: ,?5r=� . G Fax: S--/)5 401 to 6W ams ---- - 133.76 -- 2 ,JRKCPL[CA` NT CONTACT PERSON Branch clrctdts-new,alteration,or Name: - extension per panel: — -.---- A.Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 6.65 Cl /State/Zl - B.Fe-for branch circuits without purchase of ty service or feeder fee,first breach circuit 46.65 2 Phone: Fax: ___ -_- Each additional branch circuit 6.65 2 Misc.(Service or feeder not included): 2 E-mail: Each um or iri anon circle 53.40 _CONTRACTOR — Each sip or outline fighting 53.40 2 Job No: —� Signal circuits)or s limited energy panel, 2 alteration or extension Pae 2 Business Name: /h t,?,zr 4�rDescription: Address: - Each additional Inspection over the allowable In an of the rbove: City/State/Zip. Per:ns ction .r hour(min. I hour) 62.50 Phone: _ Fax: Investi anon fee. — - Other. CCB Lic #: _ I Lic.#: Electrical Pertult Fee`s _. Supervising cl.cj, 1cian Subtotal signature required: ' _ Plan Review 25%of Permit Fee S _ Print Name: I Lic.#: State Surchar a 8%of Permit Fee S TOTAL.PERMIT FEE $ __ Authorized Notice: This permit application expires If a permit Is not obtained withln Signature: bate: 190 days after It has been accepted as complete. *Fee methodology set by Tri-County Building Induatry Service Board. (Please print name) i\Dsts\Permit i orns\ElcPennitApp.doc 01/03 kii'vl0 kpoo dlie ai e6- Nc or-m- )-00655 110 00 9 ty r,L 3 \� 0 I i a. I I ��