12900 SW BLUE HERON PLACE i,,,,r,.ii,N....rww:s�,Yn.Y.n..w.....w.,.w,..........,»w.,�...u.ww......,�..�...r.ti..�..�.».r,.r........r......ww......,.....ww...+u.+.+w..w,.,.......n...............r._�n....r.......Y,_.�:.w..«+..o..u..,�,.....�.�,�...
i
12900 SW Blue Heron Place
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST A -010 _307
INSPECTION DIVISION Busines.. Jim. (503)639-4171
' _ BUP
Receivedi __Date Requested _Z=`� AM _ PM — BUP
Location ._--�� _ � ��i�riL -�'
- -Suite _ MCC ------_---- -_
Contact Person — _ Ph( ) 3 7S^ PLM
Contractor —___ Ph(_ ) __ SWR
_ UILDI Tenant/Owner __, _- EI.0
Footing
Foundation ELC
Access: / y
Ftg Drain VJU / l ELR
Crawl Drain
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
Root
1 nab-
- PART FAIL ---_ - -- ----� ------ - ----- _ - _-
Pest&Beari
Under Slab ------ ---------- ---- ---
Rough-In
Water Service ------- -----___--- -
Sanitary Sewer
Rain Drains —
Catch Basin/Manhole
Stone Drain - -- --- - --- ----
Shower Pan
Other: -- ---- -------- -
- Q J
RT FAIL �--- ---- - -- ---
_ NIC ----------- -
Post& Beam
Rough-In
Gas Line
Smoke Dampers ---
P PART FAIL -- - - ---- -- -
1.
Service _-__._.�.--------..--..-_--
Rough-In ----- ---- --- ------- - ----
Uy/Sl�b
oW Volta
FW54to, F Reinspection fee of$ _-required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
SITE [j Pleare call for reinspection RE:-_-_ _ _____ - Unable to inspect-no access
Fire Supply Line i
ADA
Approach/Sidewalk (Rate--( _2 S Inspector r ,�_ Ext —
Other
r--incl [)O NOT REMOVE this Inspe;rdio record from the job site.
PASS PART FAIL
CITY O F TIGARD MASTER PERMIT
DEVELOPMENT SERVICES PERMIT#: MST2002-00367
DATE ISSUED: 10/3/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12900 SW BLUE HERON PL PARCEL: 2S103BC-BHP12
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
REMARKS: New S/F attached, Path 1.
—. BIJILDING
REISSUE STORIES: 2 FLOOR AREAS� —"— —
REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: ?4 FIRST: 739 of BASEMENT
of LEFT: 0 SMOKE DETECTORS: 4
TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 951 of GARAGE: 400 of FRONT. 20 PARKING SPACES: t
TYPE OF CONST: 5N DWELLING UNITS: I FINSSMENT: of
RIGHT: 12
OCCUPANCY GRP: R3 BDRM: 3 BATH: .I VALUE:
TOTAL: 1,690 e1 165.876 00 REAR: 17
PLUMBING
SINKS: 1 WATER CLOSETS 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN. 100
TRAPS:
LAVATORIES: 4 DISHWASHERS: t FLOOR DRAINS: SEWER LINES: 100 Sr RAI14 DRAINS: 1
CATCH BASINS:
TUB/SHOWERS _ GA,'SArF DISP. I WATER HEATERS: t WATER LINES: 100 BCKFLW PREVNTR: t
GREASE TRAPS:
MECHANICAL OTHER FIXTURES:
FUEL TYPES FUHN�100K: I BOIL/CMP<aHP: VENT FANS: 5 CLOTHES DRYER: '
LAS FI)RN>=100K: UNIT HEATERS: HOODS: I
OTHER UNITS: 1
MAXINP: btu FLOOR FURNANCES VENTS: I 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. W/SVC OR FOR: I PUMPIIRr11CATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp: 201 400 amp: tat W/O SVC/FDR: 00
SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL r1R CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 601 • 1000 amn: 601+ampa•1000v MINOR LABEL:
1000.amp/volt:
Reconnect only: PLAN REVIEW SECTION
>-4 RES UNITS: SVC/FOR>•225 A.: >bO0 V NOMINAL: CLS ARFAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL_
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNOSC LT
IIIIRGL.AR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
3ARAGE OPENER: CLOCK: INSTRIJMENTATION
MEDICAL: OTHR:
HVAC: DArAITELE COMM- NURSE CALLS: TOTAL M SYSTEMS,
Owner: Contractor: TOTAL FEES: $ 6,116.07
This permit is subject to the regulations contained in the
WINDWOOD CONSTRUCTION INC WINDWOOD HOMES INC
12.655 SW NORTH DAKOTA 12655 SW NORTH DAKOTA Tigard Municipal Code,State Specialty Codes and
TIGARD,OR 97223 TIGARD,OR 97223 all other applicable laws. All woo ORrk will be done in
accordance with approved clans This pennit will expired
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION:
Phone: Oregon law requires you to follow rules adopted by the
503-625-6526 Phone: 625-6526 Oregon Utility Notification Center Those rules are set
forth in OAR 952-001-0010 through 9.52-001.0080 You
Roo A: LIC 50196 may obtain copies of these rules or direct questions to
C1UNC by calling(503)246-1987 I
REQUIRED INSPECTIONS
f_rGslon Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Tcp Out Exterior Sheathing Insl Rain drain Insp PI 1b F' I
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp nal i ection
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp App/Sdvylk In
Post/Beim Structural PLM/Underfloor Framing Insp Gas Fireplace EI tri F
Issued
L1�d5 _� Permittee Signature : l
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business d.-,j
I
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00244
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE !SSUED: 10/3/02
SITE ADDRESS; 12900 SW BLUE HERON PL PARCEL: 2S103BC-BHP12
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL TYPE: LT'PSWR IMPERV SURFACE:
Remarks: Sewer connection for new S/F.
Owner:
WiNDWOOD CONSTRUCTION INC TEES
12655 SW NORTH DAKOTA Description Date Amount
TIGARD, OR 9723 ISWUSA) Swr Connect 10/3/02
$2,300.70
Phoney 503-625-6526
1 SWINSP] Swr Inspect 10/3/02 $35.00
_
Total $2,335.00
Contractor:
Phone:
Reg #:
Re wired 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 given,ke irrts*.W4er
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall ur
p c�ase,a j* and
Side Sewer" Permit and the Agency will install a lateral, ATTENTION: Oregon law requires yqu to•1`ollo rub s adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 001-0010 thrpU OAFjY95 001-0100
You mayobtain ocpies of these rules or direct questions to OUNC by calling (503) 24 69@ j
Issue�,by: 14 Permittee Signature:
Call (503) Gl9-4175 by 7:00 P.M. for an inspection needed the next business day
i
" Buili inng Permit Application
1Date received: 8 7 ell, Permit no.:
City of Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Ex ire date: O
City of Tigard -
Phone: (503) 639-4171 :)ate issued: By. TjReceipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ 1&2 family:Simple Complex:
Ja'f� 2 family dwelling or accessory U Commercial/industrial U Multi-Family U New construction U Demolition
U Add ition/alterauoin/replacement U Tenant improvement U Fire sprink cr/alarm U Other:
i SITE INIFORMATIO
Job address: k ?!/l < (P _ _ Bldg.no.: Suite no.:
Lot: Block: Subdivision: � - Tax map/tax lot/account no.; S/�
Project name:
Description and location of work on premises/special conditions:----------.-_
Name: bj4-xo 6-tVO_ !—a t/S
Mailing address: g �crJ _•,�� s/z_ I &2 ramlily dwelling:
City: ��� Statc&'077 ZIP: Q7;2,-1=j Valuation of work............. $
...........................
Phone: �_� G Fa G E-mail: No.of bedrooms/baths...........3....................
Owner's representative: / --- . .................. ----
_ /�( [ Total number of(lox�rs..........saw..
Phone: jFax: 113-mail: New dwelling area(sq. ft.) ...../.(a.yl.7..........
Garage/ce+rport area(sq.ft.)..... ..........
Name: /12 Covered porch area(sq.ft.) ......M� ........... --
Mailing address: Deck area(sq. ft.) ........................................ —
City: � State: ZIP: Other structure area(sq.ft.).........................
Commercial/InduvtrinUmulti-family:
Y',
Phone: Fax: E-mail:
V iluation of work.................................. .. $
Business name: •
E::isting bldg.area(sq. ft.) ...... ...... ..........
Address:
-- --- New bldg.area(sq.ft.)............... . ............
Cit State: ZIP: Number of stories.................. ........... .....
Y'
'-----TP—ax:- — Type of construction............ .....
Phone: E-mail: .................
Occupancy wup(s): Existing:
CCB no.= /�G New: — -
City/metro lic.no.:
Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: — j! ACTe -_ provisions of ORS 701 and may be required to he licensed in the
Address: w t�1 jurisdiction where work is being performed. If the applicant is
�-- - exempt from licensing,the following reason applies:
City: Statetyr -
Conti Plan no.: — -- — - -------
Phone: e-mail: --- ---
Name: �i t94e/� 7V • Contact person: A4 tl6i Fees due upon application ........................... $--__
Address: 4j q Z- '1(0_2 Date received:
City: _ ( State �e ZIP: of Amount received .........................................
Phone t�_-�e� Fax: G,7 E-mail: — Please refer to fee schedt+le. --
I hereby certify 1 have read and examined this application and the Not all jurisdictions eccepr credit cards,please call jurisdiction for mere infexmuion,
attached checklist.All provisions of laws and ordinances governing this QVisa 0MastrrCsrd
wr.ck will he complied with,whether specified herein or not. Cmth cart number
_ Expires
Authorized signature:--% "-'- Date: - _— None of cudholder a drown on crrdil cud
Print name: Cardholder�i�rwure s Amount
Notice:This permit application expires if a lxrrnit is not obtained within 180 days after it has been accepted as complete. - 4404613(artxWOM)
Plumbing-Permit Application
Date received:Q '1-d r Permit no.: 4r '—'V-r417
City of Tigard Sewer permit no.: Building permit no.:
Address: 1312.5 SW Hall Blvd,Tigard,OR 97223
City of Tigard Phone: (503) 639-4171 Projecdappl.r.c.: Expire date:
Fax: (503) 598-1960 Date is:;red: By: I Receipt no.
Land use approval: Case file no.: Payment type:
'18PE-OF PERMIT
,Z1 &2 family dwelling or accessory CI Commercial/industrial U Multi-family 0 Tenant improvement
❑New construction U Addition/alteration/replacement 0 Food service 0 Other.
Description Qty. Cee(ea.) Total
]oh address:_ / Z �(S 4 lu I'°' New I-and 2-family dwellingq only:
Bldg.no.: —tom Suite no.: �— (includes l00ft.for each utility connection)
Tax map/tax lot/account no.: �$/ (>�� L 320 SFR(1)hath
Lot: Block J Subdivision: K kr✓n .1��'4 SFR(?.)bath _ —
Project name: �j�t p V11 a __ SFR(3)bath
City/county: ZIP: Q�� Each additional hath/kltchen
Description and I ation o Ca
work on premises:. si
Catcchh bbaasinn//
area drain
_ -- —` Drywells/leach line/trench drain _
Est.date of completion/inspection: Footing dr..in(no. lin. ft.) _
Manufactured home utilities
Business name: Manholes
Address: P U -Rain drain connector —
City: StateZIP: 6197 _ sewer(no.lin. ft.)
Phone: c( i/u�y Fax:6OW- d31 E-mail: Storm sewer(no. lin. ft.) —_
'-]�CJ Plumb.bus.re o: 3 Water service( lin. ft.)
CCB no.: g'ny-/6� Fixture or item::
City/metro lic.no.: Absorption valve _
"-":ns representative signature: �— Back flow prevcnter
r — Gate: Backwater valve —
.01 Basins/lavatory
Clothes washer
Name: �Cl/1�< — - - Dishwasher V--Address: Donkin fountain(s)
City: State: ZIP: Ejectors/sump _
phone; Fax E-mail: Expansion tank
Fixture/sewer cap
t,JchO ee'kyS 1� — �C1Or drains floor sinks hub
Nance(print): l(j Garbage disposal
Mailing address: - S�Nom^ n"� °� Huse bibh
City: n. State`r'9it ZIP: _ Ice maker —
Phone: a Fax:G> - , Email: Interceptor/grease trap
Owner instal Iation/residential maintenance only: The actual installation Ptimeris)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property l awn as per ORS Chapter 447. —sin (s),basin(s),lays(s) — __
��-------
Owner's si natur ' — _ Dafe: Sump —
Tuhs/show--r/shower pan _
Utinal _
Name:_ —_� ___-- Water deset
Address: Watcrheater _ --
Cit�: tate: ZIP: Ocher: ---
Phone:
Minimum fee................$
Nrx all imiadictiau.veer C"dt Cada,I*"aft)rrrivaedon for rtrrxe inrorrrrarion Notice:This permit application Plan review(at _— %) S .—._---
❑ iso ❑MasterCwti expires if a permit is not obtained
C"t card number within 180 days after it has been Smote surcharge(876) ....$
Expire, accepted as complete. TOTAL .......................S
Name ad ardwldar a dK+wm onmull!cad s
Cadhdda ti6natac Amami_ 440-4616(6MM- M)
I
iI
i
MechanicalPermit Application
em :City Uf Tigard
pDaTter=eived: Msf E .er
Project/appl.no.: Expire date:
City of Tigard Addreft: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503)598-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
0 1 &2 family dwelling or accessory 0 Commercial/industrial U Multi-family U Tenant improvement
0 New construction U Addition/alteration/replacement U Other:
�Illlllklylllll oil
Job address: �q 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 (j G 1-L 3 yCjt7 profit.Value$ —
Lot: Block: Subdivision_: a *See checklist for important application information and
Project name: 1&f, �� jurisdiction's fee schedule for residential permit tee.
City/county: U 47'14,t ZIP: [j7],�2 14, Kid I lay 11111111
Description and location46f workon premises:
Fee(a.) Total
Est.date of completion/inspection: Desna Qty. Res-onlyRes-only
Tenant improvement or change of use:
Is existing space heated or conditioned?0 Yes U No Airhandling unit
Is existing space insulated?0 Yes 0 No irconditioning(site plan required)
teration of existing system
of er compressors
Business name: / State boiler permit no.:
HP —Tons BTU!H
Address: d t smo a amper uct smoke detectorsCityeat pump(site require
Phone:
nsta rep.acefttrna. u-1e 6 mer /
CCB no.: l d C fl Including ductwork/vent liner O Yes U No
nstal Ureplaceirelocate eaters-suspen e .
City/metro lic.no.: wall,or Floor mounted
Name(please print): sp,� cut or a iancc o er t an urnace
e
Absorption units BTU/H
Name: _5Gc t•' Chillers yp
Address: _ Com ressors yp --
City: State: LIP: v nmenta ex ust and vent on:
A pliancevent
Phone: Fax. E-mail: r! gust
loods,Type res,kitchenthazmat
hood fire suppression system
Name: -A/ Cuoj-4 S r Exhaust fan with single duct(bath fans)
Mailing address: C'j )Uor"'14 1014421M Exhaust system a art from heating or
City: 3 A State:a/,,, ZIP: 7 sae p on(up to outlets)
T —LPG NO
Phone: -G$ Oil
f. Fax: 6 F.-mail: y Fuelpiping each additional over outlets
Process piping(sc ematicrequtre )
Name: Number of outlets
t app a or equipment:
Address: Decorative fireplace
City- _ State: ZIP: nsert-ty
Phone: Fax: E-mail: Woodstovelpellet stove
Applicant's signature: Date: (AheC: --
Name(print): _ —
Na as jarlrNctbn cap credit cards,please call jWilft lon for mase inforroatioa Permit fee.....................$
0 visa 0 MasterCard Notice:This peenit application Minimum fee................$
etedtt cord number: expires if a permit is not obtained Plan review(at — %) $ —�
es ., within ISO days after it has been State surcharge(8%)....$
Now as Wmm an mat end accepted es complete.
s TOTAL .......................$
—
41a.4617(6%MM)
Electrical permit Application
pity of Tigard Date received:9 7/.. Permit no.:j-I,,-,-
Address: 13125 SW Elall Blvd Ti ProjecVappl.no.: ire date:
C'IryojlYgard gal d,OR 97223
Phone: (503)639-4171 Date issued: Q , '. % Receipt no.:
Fax: (503)598-1960 Cane Cle no.:y
Payment type:
Land use approval:
0 1 &2 family dwelling or accessory I]Commercial/industrial
O New construction OAddition/alteration/re lacement 0 Multi-family 13 Tenant improvement
P O Other:,.__ O Partial
Job address:
flldg,no.: Suitc no.: Tax ma /tax lot/account no.:
Lot: Block: Subdivision.
Project name: Description and location of work on ptemiscs:
Estimated datefcom letio /inspection:
Job no:
Business name: Mete er Electric Inc—. Fee "
Address: 7 0 SW Le iman Street Newrealdentlal-rinslcornesultl-ramlly per tion OILTotal no,la
divel
City: Tlqard StateQR ZIP:97223 crvlingdin
uniincludes attached press.
Pho115:0 3 2 4 4. 9 0 2 ax: gam E-ma no
r less
CCB no.: 9 6 8 05 Elec.bus.lie,no: 4•_16 aci.iocul s3M, 4
.n.or pon;on mereof
City/metro lie.no.: 1 Lunited cueryy, res;demial
Luniled ens 2
ryry 'on-msidentiol 2
Si azure o supervlsin alae Iclau (re aired) — �[ Fecu manufactured home or modulo dwelling
Usk �'— Service and or feeder
Sup.elect pane(print): O is Court 3 OS Serdceaurfeeden-IneWlrtlon, 2
Licenac no:
alteration or relocation..
200 un s or less
Name !int): 201 unps to 400 arnps 2
Mailing address: _ani.inn..to boo.mpr 2
Ci�: 601 un s to 1000 corps 2
State: ZIP:
Phone: Over 1000 amps or volts 2
Over
2
Owner inatalladcm: The installation is being made on property e I own neC Temporary P rh' Ter. ry I
which is not intended for sale,lease,rent,or exchange according toInrtaaadon,mile lotion,orrelocation:
ORS A47,455,479,670, 701. 200 amps or less
Owneeii si ature: gni amps to 4n0 unps 2
Date: 401 to 6110 un s 2
Ora nch clrculU-me n
w,attctlon, 2
PName: or acetanion per panel:
�Add:c;sAFee for branch circuitswild purchase of
ity: service or feeder fa,each brurch circuit
State: ZIP: B. Pee for branch circuits widreul purchase 2
Phone: Fax: E-mail: r of service or ler der fee,Orsl branch circuit:Edell M111,11
th additinrrl br,nch circuit: 2
Ca
O�YFdwwfiogj
over 223 Misc.(serslrenr'eedernot Includedy
arapscamuereial O Health-care I1lcillty Cacti wnp cr irri irn circle
O ova 320 amps-mt[ad of I&2 O Hazardous ltrcador) �------E --- 2
Cath si r or uu I. I' uin
O Building over Itl,000 quare feet four or Signal cirec,t(s)a c!united:n 2
Cl System ova 6,70 volts nonittal non nshlentlel wilts in ore structure nay panel,
O Building over Ones stories alteratiar,err extension•
U Ooettpa II load ova"persons O Frrerbts,400 amps a mar 2
Mattu&chmW sum usis or RV pati •Uescri tion:
O EgnsNishting plan O O Other: Ertrb additional Inspection over the allowable In any ortheabovet
Submit _Ku of pleas with any of the above. Per ins ction
The above are not appHemble to temporary Irrvesli urian fee
conatrnMbn service. curer ._
Nn dl JrrladMlorrs wo"aWit urtts,plmm call ltriadktlon Ibr mote inaxmstbn.
O Visa O MasterCard Notice: This pemtit application Permit fee......................$ _
expires if a Plan review(at! a� S _
Glydh card number. " P parrttit is not obtaineo )
_ — ares within IAU days ager it has been State surcharge(8%).....S
ane o cardholder
It shown on credit card accepted as complete. TOTAL.
CardlwTdar s Harr S
Amount
4404613(&U )OM)
Are
161-u� jz
` PJ
0 0
ALL—
_ _ I
t'U f r� Lo►,/f �
r
ELECTRICAL_ PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
Compete Fee Schedule Below: Restricted Energy Fee............. $75.00
............................... .......
Number of Inspection*ear parmlt allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total Ohe.;k Type of Work Involved:
Residential.per unit
1000 sq.ft.or less $145 15 4 Audio and Stereo Systems'
Each additional 500 sq.n or
portion(hereof $33.40 1 ❑ Burglar Alarm
Limited Energy _- $75.00`
Each Manuf d Horne or Modular
Dwelling Sarvco or Feuder $80.90 _ 2 Garage Door Opener'
Services or Feeders Heating,VentllaWn and Air CondtOoning System'
Installation,alteration,or relocation
200 amps of loss $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 $6665 2
TYPE Of WORK INVOLVED -COMMERCIAL ONLY
Temporary Services or Feeders
Installation,alteration,or relocation Fee for each system.......................................................... $75.00
200 arnpe or less $66.85 2 (SEE OAR 918-280-260)
201 amps to 400 amps _ $100.30 2
401 amps to 600 amps _ $133.15 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
ass IV above Audio and Stereo Systems
Branch Circuits ❑ Boller Controls
Mew,alteration or extension per panel
a)The fee for branch circuit ❑
with purchase of ser0ce or Clock Systems
feeder fee.
Each branch circuit $6.65 Data Telecommunication Installation
b)The foe for branch circuits
wlfhout purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch arr_wt _ $46.85 v
Each additional branch circuit $6.65 HVAC❑
Miscellaneous Instrumentation
(Service or feeder riot indudud)
Each pump or irrigation cirds $53.40 Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s)or a limited energy
panel,alteration or extension $75.00 ____. ❑ Landscape Irrigation Control'
Minor Labels(10) _ $125.00_ O
Medical
Each additional Inspection over
the allowable In any of the above
I,er inspection _ $62.50 Nurse Calle❑
Per hour $62.50 _
In Plant _ $73.75 _ Outdoor Landscape Llghting'
Fees; ❑ Protective Signaling
Entw total of above fees $ _ ❑ Other
8%Stats Surcharge $ __— Number of Systems
25%Plan Review Foe No licenses are required. Licenses are required for all other installations
See'Plan Review'section on $
front of application. —.
Fees:
Total Balance Due $
Enter total of above foes
❑ Trust Account a ._ _ 0%State Surcharge f
Total Balance nue
All New Commercial Buildings require 2 sets of plans,
i:\d%u\forms\eIc•fces.doc 02/05/02
CITY OF TIOARD
Residential Certificate of Occupancy
0036 2 iagor) �GC _ 1-r���t
Permit No.:aCGi1Z2 Address: S w
Owner/Contractor:
Date of Final Inspection: ?S 0 _ Inspector: -7tn27N
This structure has been found to be in substantial compliance with the provisions of the State(/f Oregon One& Two Fa►nilp Dwelling
Specialty Code and is hereby approved for occupancy. _�