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11047 SW ESCHMAN WAY 1 0 L~ M, �F r i s L1047 SW ESCHMAN WAY - CITY Or TIGARD��,�+16.1,�ISPECTIOr1 DIVISION 24-Hour Inspccti me: 35-417 _ usiness Phone: 6394171 (c, .)ate Requested: A.M. _ P.M. MST: Location: Z16 q 7 BUP:+ Tenant: suite: Bldg: MEC: Contractor: `J '►�� Phone: �.� _ _ PLM: Owner: Phone: ELC: ELR: SIT: BUILDING BLDG(can't) PLUMBING MECHANICAL ELECTRICAL SITE Site Posl/I3eam Post/Beem PostMeaniCove/Service Sewer/Storm Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab Framing Top Out (ins Line Rough-In UG Sprinkler Foundation Insulation Sewer I:ood/Duct Reconnect Vault lismt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain[rain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/round Ir Heat Pump Low Volt Approved Approved Approved Approved Approved Appr/Sdwlk Not Approved Not/approved Not Approved Not Awroved Not Approved ` FINAL FINAL FINAL FINAL. C4 Aj 0 Call for reinspection Reinspection fee of S _required beton:next inspection O Unable to inspect Inspector- �� Date P of�_ CGU � CITY OF TIGARD BU' DING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-41, 1 B>J P _ Date Requested I-- AM__ PM BLD — LocationZlb q_Sc✓ ��j�r. u- Suite _ _ MEC Contact Person ^— Ph 3�/r•Gs ��- PI_M _— Contractor Ph SWR Tenant/Owner ELC _ R teining Wall -- ELIR Focting Access: Founuation FPS _ Ftg Drain SGN -� Crawl Drain Inspection Notes: — -- -- Slab ----------- - ---- - --- SIT Post&Beam ----- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nai ing Firewall ��- Fire Sp,inkle, -- -— — - ----- /`'� n .-. �/L✓ r ` C fir' C'- — Fire Alarm Susp'd Ceiling ---- -- - --- --- -_--- --.—_ Roof ASS PART FAIL. PIVMING Fost&Beam Under - Under Slab Top Out --------- - -- — Water Service ` Sanitary Sewer - Rain Drains Final P "PART- FAIL MECHANICAL --- - --- ----- -- t — Rough In Gas Line ----- --- — S%ok,Dampers ART FAIL (_ S [vice Rough In UG/Slab t-ow Vintage Fire arm Fin SS PART FAIL SITE Backfill/Grading — --- — -- - Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch(basin [ J Please call for reinspection RE: [ J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date ___ �_'__-11__�__._..__ Inspector_ _. — - --- - Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. O F 1 I G A R D - MASTER PERMIT CITY PERMIT#: MST2001-00505 DEVELOPMENT SERVICES DATE ISSUED: 10/10/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11047 SW ESCHMAN WA)' PARCEL: 1S133DB-06200 SUBDIVISION: CASTLES AT BRITTANY ZONING: R-25 BLOCK,: LOT:008 JURISDICTION: TIG REMARKS: Addition and remodel of approximately 256 square feet. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS _ REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: at BASEMENT: of LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 256 at GARAGE: If FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: If RIGHT: VALUE: $23,103.60 OCCUPANCY GRP: R3 13DRM: 1 BATH: TOTAL: 256.00 at REAR: PLUMBING i SINKS: WAT ER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAX•.TORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIUCMP<3HP: VENT FANS: CLOTI IES DRYER: FURN�•100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: ELECTRICAL REGIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 •200 amp: 0 200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPEC110N: EA ADO'L 500SF: 201 •400 amp: 201 400 amp: 1st W/O SVCIFDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENEPGY: 401 •600 amp: 401 600 amp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT: MANU HM/SVC/FDR: 601 • 1000 amp: 601 nmps•1000v: MINOR LABEL 1000.amp/volt: PLAN REVIEW SECTION Reconnect only: -4 RES UNITS: SVCIFDRx•225 A.: a 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 602.41 This permit Is subject to the regulations contained In the FORCUM, THEODORE L III FAHLMAN HOMES INC Tigard Municipal Code,State of OR. Specialty Codes and 11047 SW ESCHMAN WAY 31515 SE DIVISION DRIVE all other applicable laws. All work will be done In TIGARD,OR 97223 TROUTDALE,OR 97060 accordance with approved plans. This permit will expire B work is not started w'thin 100 days of issuance,or If the work is suspended for more than 180 days mi 1'ENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep N: LIC 5x630 forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies cf these rules or direct questions to C:'NC by calling(503)246-1987. REQUIRED INSPECTIONS Underfloor Insulation Low Voltage Mechanical Insp Rain drl:in Insp Electrical Service Electrical Final Electrical Rough In Mechanical Final Framing Insp Final Inspection Issued By J � Permittee Signatur Call (503) 639-4175 by 7:00 p.m. for an inspection needed th ext business day Building ('ej 1110, ,_,�)PU+cAOUAI City of Tig.-A.�..._.....,-_ ..._...,...._..�_.,..._.... P_Dro.!ercceivcd: > 'PB 0/ Permit no.:t-6fg(p SG Address: 13125 SW IF.ll Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: 'tPhone: (503) 639-4171 Date issued: By: I Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Addition/alteration/mpiaccment U Tenant improvement U Fire sprinkler/alarm U( ther: - Job address: 114 el 7 5 M 4 Bldg.no.: Suite no.: Lor. I Block: Subdivision: ( ,, . !, Fiax map/tax lot/account no.: 1)13 Project name: Description and location of work on premises/special conditions: /)FZD/ 7/r' -) �.'/ >f L r'F �2" /-2c,C,(11-h.)pdplain,%eptic capacity,solar,etc.). (MNI It I OR SPI I\1 1\1 0101 \1110141, 11-10 ( HUrkLI1SI Natne: Revr�l Mailing address: /6y7 ,rj,W. ifwm A4o ,o,+,f I&2 family dwelling: City: ¢0 State:ckj"LIP: 77-2 Valuation of work............... ......... .......... $ / IWO Phone: Fax: E-mail: No.of bedrooms/baths................................. I Owner's representative: ,;, f►r/c-m 00 Total number of floors.....................5. . .., z Phone:S0 6H Fax: IF.-mail: New dwelling area(sq.ft.) ......... .... ..... Garage/carport area(sq.ft.)......................... Name: AviG' F L Covered porch area(sq,ft.) ......................... Mailing address: / IS 3.,f- .L,6,1.-> Deck area(sq. ft.) ........................................ _ City: Tr2ou r ,4-f- State:r�. 7.tP: p 6 a Other structure area(sq. ft.)......................... Phone: p -D(�Q Fax: _ I nmol _ Commercial/industrialhnulti-family: Valuation of work........................................ Business name vents �p..,y FAr�alti Existing glare area(ft. ft.) .......... ............... New glare area(sq. ft.).... ...... .................. Address: 3/ r S •f• 10(_v, City: rjV 0?-,0 State:G� ZIP: �j_7G b Number of stories construction n............ ...................... - Type of construction........,...... ................... PhoneSo.3 663-C�L' Fnx: E-mail: - - ----- - Occupancy group(s): xisting: _ CCB no.: New: f'it�/nn lni lii n., 71icensed All contractors and subcontractors are required to ix with the Oregon Construction Contractors Board under Name: ,,,,�„� v e s of ORS 701 and may he required to be licensed in the Address: S,� ,, z on where work is being performed. If the applicant is Cit State: ZIP: exempt from licensing,the following reason applies: Contact person: ,W t. Plan no.: — — Phollu:- Fax: I E-mail: OLIN M 0 111 Name: Contact person: Fees due upon application ........................... $_ Address: Date received: _ City: State: ZIP: _ Amount received ....... ................................. $ Phone: Fax: I E-mail: Please refer to fee schedule. J 1 hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more infomiatitm. attached checklist. All pr visionsof I v. and ofjdinances governing this U Visa U MasterCard work will be complied wit"heherein or not. credit card number: _ __ _L /__ .�, F.cpires Authorized signature: % _ —Dale: p � _ Name ol cardholder as shown tin credit cmd Prim name:_� �_ —� CardMslder signature Amount Notice:Tltis permit application expires if's permit is not obtained within 180 days ager it has been accepted as complete. 410.161.1(6MCOM) One- artd Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: City oJ7igard CIt V of Tigard U Electrical U Plumbing U Mechanical Address. 13125 SW Hall Blvd,Tigard,UR 97223 UOther: Phone: (503) 639-4171 Fax: (503) 599-1960 I Land use actions completed.See jurisdicto m criteria for concurrent reviews. 2 Zoning.Flood plain, solar halaoee points,seismic soils designation,historic district,etc. 3 Verification of approved platilot. 4 hire 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-hasin protection,etc. 10 3 Complete sets of legible plans. Must he drawn to scale,showing co•rformance to applicable local and state building codes.Lateral design details and connections must he incorporated into the plans or on a separate full-sine sheet attached to the plans with cross references between plan location and details.Plan review cannot be completed if copyright violations exist. I I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 441.elevation(rifferential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator,lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolls,any hold-downs and reinforcing pads,connection details,vent size and location. _ I Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, lurnr,cc,ventilation fans, Ip utnbing fixtures,balconies and decks 30 inches above grade,etc, 1.1 Cross section(s)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. is k levation 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 arc acceptable. -_ I(, Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non prescriptive path analysis provide specifications and calr,ulations to engineering standards, _ 17 Moor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing locaUmis,Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engiueered systems,see item 22,"Engineer's calculations." _ 19 Beam calculations.Provide two sets of calculations using current coxae design values for all beams and multiple joists over 10 feet bong and/or any henm/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 mere appliances. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or architect licensed in()regun and shall he shown!o he applicable to the project under review. .11 HISDICIrIONALSPECII It 23 Five(5)site plans are required for Item 11 above. Site plans must be h-1/2" x 11"or 11"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. _ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 No"mirrored"building plans will he accepted. ILI 28 "Drawn to scale"indicates standard architect or engineer scale. I _ Checklist must he 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 4614 MAXW OMr Electrical Permit Applicat on — Palcreceived: 9 gfi of Permit no.: City of Tigard Project/appl.no.: Expire date: City u(%7gard Address: 13125 SW Ball Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U'renant improvement U New construction U Add ition/alterat ion/replace niuitI U Other: _ U Partial Joh address: / Gam,, 4 car/f/+ i l Bldg. nu. Suite no. Tax map/tax lot/account no.: Lo! Block: Subdivision: Project name: I Description and location of work on prcmises: Estimated date of complelion/inspection: EIALE Job no: I ev Max Business name: )� )t � Descriplion Qty. (ea.) Iotai no.insp -- Now residential-single or multi-famlly per Address: dwel ft unit.Includes attached garage. City: State: ZIP: Servicelnciudedc Phone: Fax: E-mail: 1000 sq.ft.or less t Each additional 500 sq.ft.or portio thereof CCB no.: Elec.hU6.liC.no: Li mited energy,residential 2 City/metro lic,no.: Limited energy,non•re.tdential 2 Each manufactured home or modular dwt I ling Signature of supervising electrician(required) Date Service and/nr feeder 2 Sup.elect.name(print) License no Services orfeeders–installallon, alteration or relocation: / 200 amps or less 2 Name(punt): 201 amps to 400 amps 2 Mailing address -- -- 401 amps to 600arnrs 2 –.--- 601 amps to I(M amps 2 City: Slate:Ct ZIP: 7 Over HWamps orvolts 2 Phone: Fax: E-mail: Reconnectonly 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,or relocation: ORS 447,455,479,670 701J 200 amps or less 2 1 S/t�r�/ � /�NS/�� 201 amps to 4W amps 2 Owner's signature: 401 to 600 amps 2 Branch circuits•new,alteration, or exlensinn per panel' Name: A. Fee for branch circuits with purchase of Address. _ service or feeder fee,each branch circuit 2 City: _ Slate: ZIP: 6. Fee for branch circuits without purchase Phone: I,tar Ii-notal: of service or feeder fee,fuel brench circuit: Each additional branch circuit: Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Healthcare facility Each pump or irrigation circle �_ 2 U Service over 320 Amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000square feet fouror Signal circuits)or a limited ene: panel. U System over 600 volts nominal more residential units in one structure alteration,or extension* 2 U Building over three stories U Feeders,400 amp.;or more "Description. _ U(kcupant load over 99 persons U Manufactured structures or RV park Each additional bupection over the allowable In any of the above: U Egress/lightingplan U Othet _ Perinspection ''ubmit kers of piano with stnv of the above. Investigation fee — I he alxrre are not applicable to temporary construction service, Other Not all jurisdictions weeps credit cads,pleme call jurisdiction for more informatlnn. Notice:This permit application Permit fee.....................$ U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit cad number _._ _ ___._ _ __L_1_ within 180 days after it has been State surcharge(8%)....$ Name _ Expires accepted as complete. TOTAL . Nae of c oI r u shown on cretin sad S _ Cardholder aisnature Amount 4404615(6i00tC'nM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: --- - _ TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee...................................................... $7 .00 Number of Inspections perpermit artowed (FOR ALL SYS'rEMS) Service included: Items Cost Total I Check Type of Work Involved: Residential-per unit 1000 sq ft.or less _ $145 15 4 -1Audio and Stereo Systems" Each additional 500 sq ft or portion thereof _ $33 40 1 ❑ Burglar Alarm L Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $9090 2 ❑ Garage Door Opener' Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $60.30 2 El201 amps to enO 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 $6685 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system............................................. ........... $75.00 200 amps or less $6685 __ 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps $133.75_ ___ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. ❑ Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel Boller Controls a)The fee for branch circuits with purchase of service or Clock Systems feeder fe-. Each branch circuit _ $6 65 L] Data Telecommunication Installation b)The fee for branch ci•cults without purchase of service Fire Alarm Installation or feeder fee. Firsi branch circuit $46.85 _ Each additional branch circuit $6,65 HVAC Miscellaneous ❑ Instrumetrtation (Service or febder not Included) Each pump or Irrigation circle $53.40 Each sign or outline lighting _ $53.40 _ ❑ Intercom and Paging Systems Signal circutt(s)or a limited energy panel,alteration or extension _ $75.00 _ ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 _ Medical Each additional Inspection over ❑ the allowable In any of the above Per inspection $62.50 ❑ Nurse Calls Per hour _ $62.50 __ In Plant _ $73.75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ Other 8%State Surcharge $ _ __Number of Systems 25%Plan Review Fee See"Plan Review"section on t ' No licenses are required Licenses are required for all other installations (rant of application _ — __ Fees: Total Balance Due $ - Enter total of above fees $__ El1 rust Account# 8%State Surcharge $._. Total Balance Due $ All New Commercial Buildings require 2 sets of plans. odsts\forrm\elc-fe-vdoc 08/30/01 Mechanical Permit Application Date received: Permit no,: City of Tigard Project/appl.no.: --- Fxpiredate: City(if Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Rcceiptno.: Phone: (503) 639-4171 ---- - Fax: (503) 598-1960 Case file no.: Payment type: Land use approval; Building permit no.: �^ , e U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvemen. U New construction U Additifm/altrration/rchl;u cru nt U Other: JOB SITE[NIZ611MATION Job address: Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suile no.: _ value of ali mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: Subdivisior: *See checklist for important application information and Project name: I jurisdiction's fee schedule for residential p.rmit fee. City/county: Description and location of work on premises: t e e t Prti•(ca.) Total Est.date of completion/inspec(ion: Description Qty. Re. only Res.on1) Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air r hhenandling unit CFM Airconditioning i tepla, system Is existingspace insulated?UYesU Ntt Iteratinof xistingACsyst em) Boiler/compressors Business name: State boiler permit no.: �� -. HP --Tons BTU/14 Address: _ _ _ _ Firelsmoke dampers/duct smoa detectors City: State: ZIP: I feat pump(site plan require ) — Phone: I ax: E-mail• Iitsta I I/replace furnac urner CCB no.: Including ductwork/vent liner U Yes U No Hata /rep ac re ocate teatcrs-suspended, City/metro lic.no.: _ wall,or floor mounted Name(please tint): Vent for appliance other than furnace t10 e gerat on: Absorption,units _ BTU/H Name: Chillers III, Address: _--- Com ressors _ I I.' — - :nv rontnenla ex aust an vent -hon: City: Statc: ZIP: Appliance vent _ Phone: Fax: E-inaiI: ryercx gust Hoods, ypc res. itc. c aznl mat nood fire suppression system Name: _ Exhaust fan with single duct(bath fans) Mailing address: Exhaust system a Qani from heating or AC City: State: 'LIP: Fuel piping an st ut on(up to 4 outlets) Type: LPG NO Oil Phone: Fax: 1 mail: ucli in eac 1 additional over outlets Process piping(sc ematic required) Mune. Number of outlets -- -. Ter RR appliance or equipment:— --- Address: Decorative fireplace _ City- Slate: LII': _ Insert-type Phone: Fax: E-mail- Woo stov pe et stove "her: Applicant's signature: Date: Other. Name(print): -— —Not all jurisdictions weep credit cards,pleme call jimOictirot fot nun Inrornaaan. Permit fee.....................$ U visa U MasterCard Notice:intra permit application Minin-.'.m fee................$ Credit card mnnher expires i1'a permit is not obtained Plan review(at _ %) $ _ -- -- -E��- within 190 days after it has beer _ p State surcharge(896)....$ Name of cardholder as shown on credit card accepted as complete. _ $ TOTAL .......................$ - - Cardholder signature Amouni 440-461;,NrXVCUMI MECHANICAL PERMIT FEES COMMERCIAL_ FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Tota P $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code _4tv (Ea) Amt $5,001.00 to$10,000.Ou $72.50 for the first$5,000,00 and 1) Fuma(e to 100,000 BTU $1.52 for each additional$100.00 or Includingducts&vents _x.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ $10,()00.00. 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 includingvent 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $25,000.00. or fluor mounted heater ta.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 6.80 fraction thereof,to and Including 6) Repair units $50,000.00, 12'15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7.11,see or Pump Cond fraction thereof. footnotes below. Comp* _ 7)<3HP;absorb unit Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14.00 _ 8)3-15 HP;absorb 8%State Surcharge $ unit 100k to 500k BTU 25.60 9)15-30 HP;absorb 25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU 35.00 Required for ALL commercial Permits only_ 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 5220 11)>•501-!P:absorb -- unit>1.75 mil BTU 87.zo _ __ 12)Air handling unit to 10,000 CFM ASSUMEDI_U _ VAATION_S PER APPLIANCE: 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description: Qt Ea Amount 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&vents 6.80 - Floor furnace Including vent 955 16)Ventilation system not Included in Suspended heater,wall heater or 955 appliance permit 10.00 floor mounted healer _ _ 17)Hood served by mechanical exhaust Vent not included In applicance 445 10.00 ermit _ 18)Domestic Incinerators Repair units 805 17.40 <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 101 k to 500k BTU 10.00 15-30 hp;absorb,unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.7TU1.00 >50 hp;absorb.unit, 5,725 F Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU Air handling unit to 10,000 cfm 656 8%State Surcharge $ Air handling unit>10,000 cfm 1,170 _ Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT f EE: $ Vent fan connected to a single duct 446 _ Vent system not included in 656 -- appliance permit Other Inspections and Fees: Hood served by mechanical exhaust 656 1 Inspections outside of normal business hours(minimum charge two hours) Domestic incinerator 1,170 $72 50 per hour. Commercial or industrial Incinerator 4,590 2 Inspections for which no fee is specifically indicated ;minimum chtrge-half hour) Other unit,Including wood stoves, 656 - 3 Additi per hour � Additional plan review required by changes,additions or revisions to plans(minimul inserts,etc. charge-one-half hour)$72.56 per hour Gas I n 1.4 outlets 360 _ Each additional outlet_ _ 63 'State Contractor Boller Certification required for units>200k BTU. _ "Residential AIC requires site plan showing placement of wilt TOTAL COMMERCIAL s VALUATION: _ I:\dsts\formsVnech-fees.doc 08/06/01 Permit#: 0Z--1X SO OF O � *rl e l Address: //D�!'7 SGc, &SC,yiM�c/ wH S� 4�. �1 Issued by: �TLEX_ _ Date: e 4 /d �- _ Statement: Information Notice to Property owners About Construction Responsibilities Note: Oregon Law, URS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential Building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be fled with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 313: 1. I own, reside in, or will reside in the completed structure. 2. 1 understand that I mum register as a construction contractor if the structure is sold or offered for sale before or upon comple*ion. L�I 3A. My general contractor is — L—I (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR R3B. 1 will be my oven general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify Q t the aho a information is correct and that i have read and do understand the Information Notice to Proper O Ar's about Construction Responsibilities on the reverse side of this form. -s 17 !' (Signature o permit applicant) (Date) (White copy to issuing agency permitfile, pink copy to applicant) tnformation Notice to Property Owners About Construction Responsibilities - i i i. - ' r'I!'„ �ir r.lr.�IYf tlr r 7i�:i•ri .; Ij I R -:..t i,t'rr! :,,Il, ;j l .iil,,J�•1: ,,. ,i ., ii_:'.`.'IIL.' 1a:'+�illll�l�:�IUila: .:1I711 dll`.r Jl �. 1:, . EMPL.Ulr EP RESPONSIBILITIES: i. ,. ,�. ,�,r i,�r4> :iu; Ilii ��< ;tr •.itl;. vo" (r v i l (t r• ll',• i' i r.. '.r-• h r' r I -m r `iA ill. :1 nti 111 itl 1{Irlli.11i 14 ��\(t(,T.tl,•i.. �•1 r} � .rr'' 1tni lr ,,�i{t('i'Sht'l1)c,,.� r .. r ,, �.Ii..•.a,P F'Cil!'1'alC'(11i}!'11C'11!f.11"-r)ft('({II1kILt•I{lr'lr(rr(kli l I.r �'r`tjl� {`illlrl'Prr• r�lfir;.,l• ;tt .hi, frl ('• •..ri.�,r tltpr•e iii t{k �' CTllt t��`ff•ttl'itr tlh' f�`CptilTt';{ Itl;,('tt'l.11lril5. �; tt' !I tlUi .iN•1, it II..' i r111:tiou wi)ttltai.'11i1}, Hit1r((({rt.) ;n<, i(.)(1, rt l(t 11l.(.)��ri'Zlli1 1. - ' I I h:• 1 ,, ,, NU "+itr.. ?(HI, In '�:alt•t1i CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC97--0524 PATE" ISGUED: 08/05/97 13125 SW Nall Blvd., Tigard, OR 97223 (503)639.4171 PnRC('t : I.S133T)B 06200 T(- ( DTI i?F:!:"'i. : 1 1 0/47 kiln 1: r.:I IM(1N WAY Br;I Y II TC)N. . , :CAt3TI._E.., AT BR1TTANY 7.0W1 i( .; R- 1;:'. .:Ir !OCK. . . . . . . . , . . I_.QT , . . . . . . , . . ;6 JURTSn)[)TCTION: TIG o•j e c 1, D e s c:r i.p t i o r; : ADD THREE (3) BRANCH CIRCUITS. - RC5 T DL.NT I AL_ UN T T .-- TCMP v R VC/FEEDER M I SCELLANE:OU"i 00 SF OR LEST. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/I RR I CAT ION. . . . : 0 CH ADD' I-. 5005F. , . -. 0 r-.01 - 4l*Z)0 amp. . . . . . . : 0 F31('_,N/OI..)•T LINE LTG. . : 0 MITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 G1(3NAL/PANEL. . . . . . . : 0 I'JF. HM/ V(.'/FDF?. . 171 6014-amps 1040 vult:s. : 0 MT110R LABEL ( 10} , . : 0 -.i("RVT_CaE/FC..FDFR_._.__..._. _... __BRANCH CIRCUITS--____ _...-._-ADD' L INSPECTIONS--._— ;::,00 altlr_), . „ . . . : 0 W -7F'RV'(rT' OR I"-I-EDER. 0 PEF? INGPECTIQN. , . . . : 0 .'1 400 amp. . . . . . . 0 1. �,t W/O SRVC OR FDR. . I PFP HOUR. . . . . . . . , . . , 0 1 600 aIII P. . . . . . 0 EA ADD' L SRr1CI1 CIRC- 2 111 PLnN1.. . . . . . . . . 1 - 1000 'Amp. . . . . : 0 __.. ____-._._._...---.____.___.__PLAN REVTEW V10+ ainp/vrrl.11. . . . . .. 0 > :.4 REG) UNITS. . , .. . . . . : > GOO VOLT NOMINAL.. . : c.-onnert Drily. . . . . : 0 SVC/FDR > - 225 IAMPIS. . : C'I._A55 AREA/SPEC OCC, 17 R TIA FORCUM type amot.Int t)y date recpt, 047 13W ESCHMAN WAY PRMT t 4'-. 00 ' E'Q1 011/05/97 97 .'r:1'37'.? GARD OR 97F 9`3 5PCT t 2. ,-:' GEO 08/0 5/97 97-297944 ,one #t: (, EL.t"C LR'I!:r�i.. GE RVICr; I1.11- 4'7. . :5 7()TAL_. 20 GE I NTrRNAT I ONAL.. WY E A - 107 RE DLII RCD INSPECTIONS LWAUKIF OR 97222: Ro1agF1--.in Elect' 1 Servi : one 4I : G 5 4 3 3 i2t3 Undf rcgt-ol.rnrl Cove Elect' 1 L-'ina .g #. . 097,,774 s permit is issued sub:ect to the regulations contained i�l the Tigard Municipal Code, State of Oregon Specialty Codes and all oth licable laws, All work will be done it accordance with approved plans. This permit will expil•e if work is not started within lee ,s of issuance, or if work is suspended for more than 188 days. ATTENTION: Oregon law requires you to follow the ruses adopted by Oregon Utility Notificat7on Center. Those rules forth in OAR 952-MI-0010 throug� npa W-401-1987. YOU may obtain a cop `hese rules or direct questions to Ol1HC by calli, L.6-1987, is r, �(� Issued _..._ _ R T NFiTAI_LA`rI ON ONI.. , "i;y I own V01 if r'aTT"�J '`1h,i( Y Dn1 �" 5 " C7--2-7- + +++ 1. f .1.i 1 A Y..1 1._f_. .4.y.+..+ 1 .4_.f..+...4 -1 4 4...{-1 1.-1 -4 +++.4+++++++•++++•+4•44-1 + 4 1 .1.,1.4 1-++-F+44 F+ ++ ++{4 +-i '.1 41 !1; f': :t'+0 p m. r,rr -i,,1 inspection needed thr next bi_Isi.ness 0 TUE 1 R : n 1 J F• 1_: • U$ Ilfi Qi Ill' I3 ?5503 694 7297 CITY OF TIGARI1 �C1002 (.1 o." cii Y of 'rIGARr) Electrical Permit Application 131 SW HALL BLVD, PI;�nChock _ TIW OR 97223 Rsr'd sy------- - --- Phc a (503) 639 4171, X304 Date Rac'tl— Date to Intrl. ct pn X503) 639-4175 Print or Type Data to DST -� Fa. ; 4.7297 Incomplete or illegible will not be accepted Permit I. Job Address - -- -� Caua.i— -- _ ------- Name Of Di:velopm@nt,. 4. Complete Fee Schedule Below. ._ �T �--- Nuinruer of Inspecyona per permit allow,?,, Name(or name of business)_! e�.` r CL_ rc.4 m A;iclregg Service included;IItems Cost Sum 4a. Residential.per unit Ci'� State/7.ip_ -TfrCl (?2" q�� 100U Sq.h,or les. Silo --- Each addilio'&1500 sq,'!, ur 00 _ _ 4 I Crunmercial 13 Residential� portion thereof ____ 5,00 Limited Energy $7$25.40 w -- -----. 1 Each Manul'd Homo or Moll lar 2,1. Contractor Installation only: Dwefling Service ur F.odor ,Ankh S68 co py Of all current lice, e) 4b.Services or Feeders E �:tr;c31 Contractor C t; <" 4 i frac U 1 f L�, Installation,alferallon,or refuca;-un 200 amps or loss 560.00 C tv State. 201 amps to 400 amps ----Zip- -I - 401 amps to Goo amps $80•� 2 �—_ $t70.00 J,,t. NO _ _-� q 801 amps to 1000 amps $12000 2 —'^', _ _ Over 1000 ampb or veils $100 00 _ 2 Elec.Cont, ��e, No. � .Exp.Date Roconnoct only -- - 2 ICR State CCB Reg. No_ pc - P Date d �� Esc oo -_ - 2 I.GT Suc;nlrrg rex or fviEttro No. k,Temporary services or Feeders l _Exp. _ Installation,alteration,orre!ocatlon I : ,nature of Supr, Elec'n _ 200 amps or lees __ $ 201 an,f,s to 400 amps $5ro 0 2 --? 401 amps to Soo amps 00 00 ~— -— 2 t'CAII$e No,- g - ----_Exp.Dete Over 600 amps to 1000 v.,it6, $100.00 2 IPhone No,,!_._...-- --- - - ase.,b..above. - - ?b, Forowner Insfq/latlons: - 4d.Branch Circuits New,aiferai!on or exi.noion pAr panel a)The fee for bunch%;irt;wts with r' n1t Owner's f148rra purcheseofgot vicnor reactor Ise. - Z777-- Each branch circuit S500 l" We IY-a -- state_State zi - b)The fee for tnanch circuits ! N,. - P_- -- -- without purchaso of __ - - - servlae or reader tce. -he instalidlion Is being made on property I own which Is not First branch c!rcuil $35.00 ��5 (jb �rtded for sale, lease or rant, Each atldltlonal branch eircUlf $5,00 T - z C.vnei"s Signdlure4e.Misoallanevus (Service or teeamr not irr;luejW) Each pump or Irrigation circrc $40.00 2 3. Plan Review sectlon(if required):' T-sch sign of oulline fighting $40.00 Signal circull(s) s limited ene,gy, g Please she: a panni,alteration or ortn•,Slon $40.00 k pproprlate item and enter fee In sactlon 5B. Mlno►I abels(+,1) -- 910000 S 4r"WOrE91C6 ltlai units in one structure - I _Si mce and fowler 225 amps Or more 41.Each addlilonal lnspoctlen over 9y5lerr-Over 60C volts n;,minal the allowable In any of the above Class IF40 arae Or Stru:furo containing speciai occupancy Per ection _ 535.00 a:d oscrlbed in N E C C: dpte'S Per hour355.00 in Planl �� $55,p0 - gubmit 2,;via of pl ms with application where any of the above apply. 5, FeCs: _ Nut required for temporary.on*uctlot%Services.i 54.Enter tufa!at above'dap TIC 6%Suichar;e(.08 x late:fees) $ ^ubtutal $ s •_ �'EFlbtO& 9F(!Ok'E VO D IF WORK OR CONSTRUCTION AUTHORIZED IS fib.Plan Enter vl line SA for $ NOT ChlklEMCED WI'H;N 180 DAYS,OR IF CONSTRUCTION OR WORKt'r�fSoc.9) i i SUSp;NDt D OR AuAN:)ONFO FOR A PERIOD OF 1B0 OAYS AT ANY Subtotal S - Trust Acc,.unt a - `r.