11420 SW ESAU PLACE N
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1420 SW Esau Place
CITY OF TIGAR _ MASTER PERMIT
TIGARD #: MST2003-00127
DEVELOPMENT SERVICES DATE ISSUED: 4/21/03
13125 SW Hall Blvd., Tigard, OR 97223 (50'!) 639-4171
SITE ADDRESS: 11420 SW ESAU PL PARCEL: 1S135CA-EE003
SUBDIVISION: ESAU ESTATES ZONING: R-12.
BLOCK: LOT: 003 JURISDICTION: TIG
REMARKS: New SF detached dwelling.
BUILDING
REISSUE: A039 STORIES: 2 FLOOR AREAS _ REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 20 FIRST: 768 of BASEMENT: of LETT: 5` SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD; 40 SECOND: 194 of GARAGE: 280 sf FRONT: 15 PARKING SPACES
TYPE C.C'1NST: 5N DWELLING UNITS: 1 TMPD of RIGHT: 5
OCCUPANCY GRP: R3 BDRM: T BATH; 2 TOTAL: 1,562 of VALUE; 1�1 1 1'Ho REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 1 TRAPS:
LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 1 SF RAIN DRAINS: CATCH BASINS:
TUSISHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1 8CKFL.W PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: 0 BOILICMP c 3HP: VENT FANS: 3 CLOTHES DRYER: 1
ELE FURN�-BOOK: UNIT HEATERS: HOODS: t OTHER UNITS:
MAX INP: btu FLOOR FURNANCES VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEUI18 ADD'L INSPECTIONS
100,1SF OR LESS 1 0 -200 snip: 0 -200 amp W18VC OR FOR: PUMPIIRRIGATKIN: PER INSPECTION:
EA ADD'L 500SF: 2 201 400 srnp: 201 - 400 amp: 1 at W/O 8VC/FDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 500 amp: 401 !00 snip: EAADDL SR CIR: SIGNAL/PANEL IN PLANT:
MANU HMISVCIFDR: 801 1000 amp: 001+ampa•t00ov: MINOR LABEL,
1000+amp/volt:
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVCIFDRN-225 A.: 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO R STEREO. FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEtIRRIG. PROTECTIVE 81GNL:
GARAGE OPENER: CLOCK, INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELF.COMM: NURSE CALLS: TOTAL N SYSTEMS.
Owner: Contractor: TOTAL FEES: $ 6,831.30
This permit Is subject to the regulations contained in the
WERNER JUNGKIND ADAIR HOMES Tigard Municipal Code,State of OR. Specialty Codes and
8105 SW 66TH PL 1111 SW 170TH AVE all other applicable laws. All work will be done in
PORTLAND,OR 97223 BEAVERTON,OR 97006 accordance with approved plans. This permit will expire If
work Is no' started within 180 days of Issuance,or if the
work Is suspended for more than 180 days. ATTENTION:
Oregon law regL.res you to follow rules adopted by the
Phone•. 501-245-8577 Phone: S03-645-1156 Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through 952-001-0080. You
Rao K: j I( 591 may obtain copies of these rules or direct questluns to
OUNC by calling(503)246-1987.
REQUIRED INSPEC TIONS
Etoslon Control Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Inst Water Service Insp Building Final
Sewer Inspection Underfloor Insulation Electrical Service Low Voltage Appr/Sdwfk Insp
Fouling Insp .trawl Drain/Backwater Electrical Rough In Insulation Insp Electrical Final
Foundation Insp PLM/Underfloor Framing Insp Rain drain Insp Mochah'ital Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Water Line Insp Plumb Fina 1 I
Issued By �"�L-4_1 _ Permittee Signature
Call (803) 639-4175 by 7:00 p.m.for an inspection needed the next busi ess day
CITYOF TI GARD __SEWER CONNECTION PERMIT
DEVI LOPMENT SERVICES PERMIT#: SWP2003-00101
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4-it! DATE ISSLIED: 4/21,103
SITE ADr;<ESS; 11420 SW ESAU P'. PARCEL: 1S135CA-EE003
SUBDIVISION: I'SAIJ FSTA'II.S ZONING: R-12
BLOCK: LOT: 003 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NFW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL_ TYPE: LTPSWR IMPFRV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner: -- — -
- -- FEES
WERNER JUNGKIND — -
8105 SW 38TH PL Description Date —Amcunt
PORT[ AND, OR 97223 JS W USA I Swr Connect 4/21/03 $2,300.00
ISWUSA]Swr Connect 4/21/03 $0.00
none: 503-245-8577 ISWINSP]Swr Inspect 4/21/03 $35.00
ISWINSP] Swr Inspect 4/21/03 $0.00
C. ntractor: --
- --- --- 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 accw acy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: "1L �i , L Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next bus"dayy
3 J_wRsZooS_ �
Building Permit Application
Date reccived49��.� 03 Permit no&S7.�DO /et
City of Tigard
Address: 13125 SMI Ilail Blvd,Ti and1 R 97E3
ProjecVappl.no.: Expire date:
City ofTigard Phone: (503) 639-4171 MA 'T 20
r) Date issued: BY: �.eipt no.:
CITY Fax: (503) 598-1960 Y OF TIGARLT -- Case file no.: Payment type:
Land use approval: '11"111-DINGO DIVISION 1&2 family:Simple Complex:
1
XXI &2 family dwelling or accessory 0 Commercial/industrial U Multi-family M New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler/alarm 0 Other:
Job SITE 1NFQRMAt10N
Job address: //yad Esau Place ] i,,,A l OR.97223 Bldg.no.: Suite no.:
Lot: 3 J Block: Subdivision: cSo9ic- E7- .S Tax map/tax lot/account no.: 1 S IW351402 140
Project name: fi-/ 31/ J'ci A'6 K/At i� /S/_?-Sc of- &M On
Description and location of work on premises/special conditions: Ne-_, I x r 9 Ra S'va A'./ATT rar _
Name: Werner Jun kind solar,(Floodplairsseptle capacity,
Mailing address. 8105 SW 68th P1. _ I &2 family dwelling:
City:Portland State.:OR ZIP: 97223 Valuation of work...........................•............ $t!
y(�
Phone:2 5. 8577 Fax: E-mail: No.of bedrooms/baths.................................
Owner's representative: _,bE/V/SE' AO,6 E/P-TS Total number of floors................................. a—
Phone: S- r& Fax y,rid.s Pf, E-mail: New dwelling area(sq. ft,) .......... ............... J !p _,
191 Garage/carport area(sq.ft.)
Name: Werner Jun kind
Covered porch area(sq. ft.) .........................
-
'—
Mailing address: As Above neck area(sq, ft.)_ '•'•"""'.•".......••.•..•.••••••••••
City: _ State: ZIP: Other structure area(s . ft.).........................
fhc,nt F❑s Email: ContmerciaUindustrial/multi-family:
tt Valuation of work........................................ $—
Existing bldg.area(sq. ft,) ....................... ..
Business name: ',d.ti r Humus, lac . New bldg.area(sq.ft.)............................ .. _
Address: 1 111 SW 170th Number of stories
City:Beaverton State:OR ZIP:97006 Type of consttuction....................................
Phone: .5- 56 1 Fax: 645-5986 E-mail: Occupancy group(s): Existing:
CCB no.: N-w:
City/metro lic.no.: Notice:All contractors and subconuartots re required to be
licensed with the Oregon Constnlstion Cr.,mmetors Board under
Name. Adair Hoemes, Inc provisions of ORS 701 and may be required t i be licensed in the
Address _ jurisdiction where.work;s being performed.I;the applicant is
exempt from licensing,the following reason applies:
Cit : State: Z:P:
Contact person: Chuck Day or Plan no.:3--15 62 A):G,1 C
Phon;Penise Ro er x: E-mail:
NameAdair Hotnes, Inc. Contact person: Denise Fees due upon application ........................... $
Address: As Above Date received:
City: State: ZIP: Amount received ................................... ..... S
Phone: Fax: I E-mail: Please refer to fee schedule.
hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more inrormation.
attached checklist. All provisions of laws and ordinances governing this ❑Visa U MasterCard
or�will be co I' d with whet ier specified herein or not. Credit card number: _//-
f {,� `t t Expires
l2f:a' na urs: bate: t U-3 Name or cardholder as shown on credit card
n�tnar' �s f ✓+�'�a.��r�-rte i.�� �/�tJG K/til r7 s —
me: ��� —.. CardholderslRnature _ Amount
Notice:
Notice:This permit application expires it a penury is not obtained within 180 days ager it has been accepted as complete. 4404613 ttsavcobt,
One- and Two-Family Dwelling
Building Permit application Checklist Reference no.:
City q/TrgardCllty of Tigard><• v--� Associated permits:Address: 13125 SW Hall Blvd,Tigard,OR 97223 O Electrical U plumbing Q MechanicalO Other:
Phone: (503) 639.4171 -
Fax: (503) 598.1960
t t 4tj PresIn 4
I Land use cctions completed.See jurisdiction criteria for concurrent reviews.
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc.
3 Verification rf approved plat/lot. -- —
4 Fire district approval required.
- ---------------------------------------
Septic system permit or authorization for remodel. Existing system rapacity _-
6 Sewer permit. -
7 Water district approval.
s report.Must carry original applicable stamp and signature on file or with application.
9 tooliloncontrol U plan LI permit required.Include drainage-way protection,silt feria:design and location of
,aftch-basin protection,etc.
10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
Wilding codes. Lateral design details and connections must he incorporated into the plans or on it separate full-sine
sheet attached to the plans with cross references between plan location and detai,s, Plan review cnnnot be completed
copyright violations exist.
11 a/plot plan drairn to scale.The plan must show lot and building sethark dinuasions;_par rt comer elevations(if
fere is nrm than a 4•R.elevation differential,plan must show contour lines at 2-11.fnterva s); cx anon o eusemen s:ncT
driveway;footprint of structure(including decks);location of wells/septic systems;utility loca tons; r on rn len or,lot
arca;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor bolts,any hold-dmwns and reinforcing pads,connection dew.:I%vent
sire and location. �f
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater,
furnace, ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. J
14 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. _
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual greac if the change in grade is gre•uer than four fort 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 assen)blic;,indicating member sizing,spacing,and bearing
locations.Shoe attic ventilation._
IS Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems,see item 22,"Engineer's calculations."
119 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joist.;
over 10 Iect long and/or any be:un/joist carrying it 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 required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review
.
23 Five(5)site plans are required for Item I 1 above. Site plans must he , /2" w 11"or 1 1 i '
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 plans must meet criteria outlined in the Permit&System Development Fees document.
raven to scale"indicates standard architect or engineer scale.
28 Sij plan to include tree size,type&location per approved prrjea_t street tree plan(if applicable),and COT Sirat Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plar s may be in blue or black ink.
Red ink is reserved for department use only. 443.4614(&MCOM)
Plumbing Permit Application
Lam"' Date received: Permit no _-00-1.4Z
City Ot � 1�111Cf���j�� E Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97221
city(/f ngard phone: (503) 639-4171Project/appl.no.: Expire date:
Fax: (503) 598-1960 MAR 3 1 NO3 Date issued: By' keceipt no
Land use approval. 611 OF TIGARD Cascrjlena.: Paymenttypc:
TYPE 0FRIERMIT
41 &2 family dwelling or accessory E'Commercial/industrial 0 Multi-family U Tenant improvement
aNew construction U Add iunn/altoration/replace metit ❑food service J Other:
3011 SITE 1 t Information
Job address: Esau Place ilcscriirtion Qty.I Fee Iea.) I Total
New I-and 2-family dwellings only:
Bldg.no.: Suite no.:
(includes 100111.foreach utility connection)
Tax mar/tax lot/account no.•1S W3 02-1 03 _ SFR(1)bath
Lol:3 Block Suhtlivision: SFR(2)bath
Project name: 4-139 SFR (3)hath u
City/county: Tigard, OR. ZIP: 97223 Each additional hath/kitchen
Description find location of work on premises: Siteutilities: y'
New 3 Br 2 Ba SFR w/at t 1 Car Ca r Catch basin/arca drain
Est.date of completion/inspeclioi, Drywells/leach line/trench drairPLUMBING ��
t Footing drain(nor. lin. fl.)Cron
Manufactured home utilities j
Business name: 3 'T Plumbing Manholes 11
Address: 1890 Lana Ave, w Rain drain connector
City:Salem St ile OR 7.IP:91303 Sanitary sewer(no. lin. Il.)
Phone: 71-4693 I Fax: 588-2233113-mail: Storm sewer(no,lin.ft,)
CCB no.: 1470 g. no: 24-379PB Witter service(no.lin. ft.)
City/metro tic.no.: Fixture or item:
Contractor's representative signor Absorption valve
Back flow preventer
Print name; r' Q - fl1L c'i I Backwater valve
Basins/lavatory
Name: Terry Ferrando Clothes was1
Address: 6,s Above _ ishwashcr
Drinkin fountain(s)
City: ____ State: ZIP:
Ejectors/sump
Phone: Fax: E-mail: Expansion tank
= 1131011111 Fixture/sewer ca _
Name(print): Werner Jungkind Floor drains/floor sinks/hubGTib— _
Mailing address: 8105 SW 68th Place — — Hosc bibb
a bis>osal 1
Cit
y ort an State:OR ZIp:97223 1Ce m-a-Ve
Phone: - Fax: E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation F'rimer(s)
will he 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) i
Owner's signature: _ Date: Sump
Tu s/shower/shower pan
Urin, _
Name: Adair Homes. Inc`_ _ Water closet
Address: 1111 SW 170th Water heater
City:_Beaverton Statc:pR ZIP:97006 Other:
Phone: 645-1156 1 Fax: 645-5986 E-mail: ota
Nut all jurisdictions accept credit cards,please call jurisdiction for more inromurlunNotice: I his permi
Minimum fee................$
t application plan review(al �,
U vi __visa ❑MasterCard expires if a permit is not obtained ) $ —
Credit card numberwithin 180 days after it has been State surcharge(8%)....S
pepires
Name of cardholFer u shown on credit card
accepted as complete. TOTAL, .......................$ _
_ S
Cardholder Nsnature Amount W-41,16(IMCOM)
PLUMBING PERMIT FEES:
u PRICE TOTAL New 1 and 2-famlly dwellings only: -
FIXTURES (individual) _ QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection
One 1)bath _ T $249.20
Tub or Tub/Showur Comb 16.60 Two(2)bath 3350.00
Show, Only 16.60 Three 3 bath $399.00
Water Closet 16.60 - SUBTOTAL
Urinal 16.60 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 1660 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 PLEASE COMPLETE:
A" 16.60
Water Heater 0 conversion O like kind 16.60 - Quantity b Work Performed _
Gas piping requires a separate mechanical Fixture Type: Now Moved Replaced Removedl
permit Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 L avatory
Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Showe;Only - _
Drinking Fountain r 1660 Water Closet
Other Fixtures(Specify) - 1660 Urinal
_ Dishwasher
Garbage Disposal _
Laundry Room Tra
Washing Machine
Floor Drain/Sink: 2"
Sewer-1st 100' 55.00 3"
Sewer-each additional 100' 4640 4"
Water Service-1st 100' 55.00 Water Healer
Water Service-each additional 200' 46.40 Other Fixtures
_
Storm 6 Rain Drain-1st 100' 55.00 (Specify)
Storm d Rain Drain-each additional 100' 46.40
Cominercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55 - ---
Catch Basin 16.60 �-
inspection of Existing Plumbing or Specialty 62.50 -
Requested lits ectionsper/hr COMMENTS REGARDING ABOVE
Rain Drain,single family dwelling 65.25
Grease Traps 1660
QUANTITY TOTAL -
Isometric or r:jer diagram Is required If - -
Quantity Totpi'- >p - --- -
*SUBTOTAL --
-8%STATE SURCHAPGE ---
"PLAN REVIEW 25%OF SUBTOTAL
_-Re uired on.y if fixture qty total Is a
TOTAL $
'Minimum permit tee is$72 50•8%state surcharge,except Residential Backflow
Prevention Device,which is$35.25"a%state surcharge.
"All New Commercial Bultdings squirt 2 sets of plans with Isometric or riser
diagram for plan re dew.
is\dsts\forms\plm-fees.doc 12/26/01
Electrical Permit Application
KLUMED Datereceived: Permit n9 cHS%i1A03-O��e�
City of Tigard Project/appl,no,: Expiredatc:
f ifyn/Tigard Address: 13125 SW Hall Blvd,TigaOff �7FN03 Date;ssued: By: Receipt no.:
Phone: (503) 639-4171 rMINK L
Fax: (503) 598-1960 (;ITY OF'TIUARU Case file no.: Payment type:
Land use approval: _ BUILDING DIVISION
1
T�] &2 family dwelling or accessory U Commercial/industria! U Multi-family J Tenant Improvement
IJ New construction U Add ition/alteration/replw-cmeni J Other: J Partial
Job address: Beau Place Bldg. no.: I Suite no.: ITax map/tax lot/account no.: 1 S I W35 1 4C 2
Lot: 3 Block: Subdivision:
Project name: I Description and Iucation of work on premises: New 3 Br 2 Ba SFR W/att 1Car Car
Estimated date of completionhrspection:
CONTRACTOR 1SCHEDULE
Job no: -/ / i Fee Max
Business name: Interstate Electric Description Qty. (ea.) Total no.imp
Address: PO BOX 7342 New residential-single ormuld-family per —�
dwelling unit.Includes stfaclKdgarage.
City:Salem State: OR ZIP97303 Senicelncluded: I
1000 sq.ft,or less 1 1
Phone: - Fax: 393-972JE-mail: _._
CCB no.: Elec,bus. Iic.no: — Each additional 500 aq.ft.or Drano thereof y
Limited energy,residential 2
Cil ftpttrclic.no,. Limited energy,non-residential r2 i
L.9 lrlz) Each manufactured home or modular dwelling
Si 5 nature of su rvising ec rician(re uired) Da',* I Service and/or feeder
Ltcenseno.
Sup.elect name(pont): (. n I Services or feeders-installation,alteration or relocation:
OWNER 200 amps or less
Nl I amps to 400 amps - Ll
Name(print): Werner Jun Lind - 1
g — 401 amps to 600 amps
Mailing address: 8105 SW 68th Place 601 amps to 1000 amps I
City: Portland St:acOR -5P: 9_7223 Over lf000amps;orvolts
Phone: 245-85%7 Fax: I E-mail: Reconnectonl {
Owner installat;on:The installation is being made on property I own Temporary services or feeders- i
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocatlon:
ORS 447,455,479,670,701, 200 amps or less 2
201 amps to 400 amps 2
Owner's sl nature: Date: 401 to 600 amps 2
Branch circuits-new,alteration,
Name: Ad
extension per panel:
Ad a i r Homes. J.it c. _ A Fee for branch circuits with purchase of
Address: 1111 SW 170th service or feeder fee,each branch circwt 2
CitAeaverton state:OR I ZIP:97006 B. Feeforhranchcircuits without purchase
Phone:645-1156 Faxb45-5986 E-mail: _ of service or feeder fee,first branch circuit:
Each additional branch cu.uit•.
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U Health-care facility Each pump or irrigation rtrcle
U Service over 320 amns-rating of I dt2 U Hazardous)nation Each signor outline lighting
i
fanulydwcllings U Building over to.(=square feet four or Signal cirruit(s)or a limited energy panel, i
U System over 600 volts nominal more residential units in nnc structure alteration,or extension* _—
U Building over three stories U Feeders,400 amps or more '11--.. tion:_
U Occupant load over 99 persons U Manufactured structures or RV nark F,ach additional Inspection over tire allowable in any of the alcove:
U Egress/hghtingplan U Other: _ — Perinspection _
Submit-___sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. other
Not all jun%dictions accept credit cards,please cntl purtulicnon(omrot
r more tn6eatiNolle):This gents))application Permit fee..................... _
U Visa U MasterCard expires if n permit is not obtained Plan review(at _ %) $ NA
Credit card number _ __ within 180 days after it has been State surcharge(8%) ....$ _ _^
accepted as complete.
Nerve of cardholder wshown on credit card
_ S
Cardholder aignstiue — Amount 440"4615(M(YC Okii
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
I TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
l
B
l
d
h
S
F
Complete Fee Schedule Below: - ---
P Restricted Energy Fee...................................................... $75.00
Number of Inspections eer pem-It allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work Involved:
Residential-per unit
1000 sq ft.or less $145.15 T 4 ❑ Audio and Stereo Systems'
Each additional 500 sq.ft.or
portion thereof _ $33.40_ 1
Limited Energy $75.00 Burglar Alarm
Each Manurd Hc.me or Modular
Dwelling Service or Foeder �_— $90.90 —`--_ 2 ❑ Garage Door Opener'
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or reloration
200:mps or less _ $80.30 ? r 1 Vacuum Systems*
201 amps to 400 amps $106.85 _ _ 2 0 y
401 amps to 600 amps $160.60 2
601 anips to 1000 amps $240.60 2 Other
Over 1000 amps or volts $45465 2
Reconnect only — $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Insta;lation,alteration,or relocalio!i Fee for each system......... ............................................... $75.00
200 amps or less $66.85 (SEE OAR 918-260-260)
201 amps to 400 amps $100.90 2
401 amps to 600 amps _ .$133.115_ Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. ❑1 Audio and Stereo Systems
Branch Circuits i
New,alteration or extension per panel L—I i3oiier Controls
a)The fee for branch circuits
with purchase of service or L� Clock Systems
feeder fee.
Each bunch circuit — $6 65 _ _ ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service
or feeder fee. �❑ Flie Alarm Installation
First branch circuit _ $46.85__ ❑
Each additional branch circuit $6.65 HVAC
Miscellaneous ❑
(Service or feeder not included) Instrwnenlation
Each pump or irrigation circle _ $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s)or a limited energy
panel,alteration or extension v— $75.00 ❑ Landscape Irrigation Control'
Minor Labels('10) $125.00
Each additional Inspection over ^` _ ❑ Medical
the allowable In any of the above
Per inspection _ $62.50 n Nurse('ails
Per hour _ $62,50
In Plant _ $7375 ❑ Outdoor Landscape Lighting'
Fees:
�❑ Protective Signaling
Enter total of above fees $ _ Ll Other
811.State Surcharge $
-------- ._Number of Systems
25%Plan Review Fee
Sea"Play Revlaw"section on 6 No 5censes are required Licenses ere required for all other Installations
front of application.
Fees:
Tota/Balance Due $
Enter total of above fees S
❑ Trust Account
--- ---�-- 8'/.State Surcharge
All New Commercial Buildings require 2 sets of plans, Total Balance Due $
i ldstslfomss\elc-fees.doc 08/30.01
Mechanical Permit Application
Dale received: Perrnn no,l��,? �•(,�/oj7
City Of Tigard t"' Project/appl.no.: r Expire date:
City of Tigard Address: 13125 SW Hall Blvd'"Tigard,OR h7223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 MAR 4 1 1001 Case file no.: Payment type: i
Land use approval: _ Building permit no.:
eliy l
XS I &2 family dwelling or accessory 0 Commercial/industrial 0 Multi-family L7 Tenant improvement
XQ2 Ncw construction. 0 Addition/alteration/replacement EI Other:
Jolt SITE,INFORMAT16N COMMERCIAL VALUATION SCIIEDULE
Job address: Esau Place Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: I Suite no.: value of atl mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: 1S IW351402-•1403 profit.Value$
Lot: J JBIock:_ Subdivision: *Sec checklist for important application information and
Project name--.,A-/3/ rr�+r, iN I _ iurisdicticm's 1cc schedulr fur residential permit fee.
City/county: Tigard OR ZIP: 97123 t 1
Description and location of work on premises: _-_ i t 11161 ci F.1TQty.
New 3 Br 2 Ba SFRw/A� Car Gar (en.) Total
Est.date of completion/inspection: Descri tion .ont Res.on]
Tenant improvement or change of use: Air ha.'
Air handling unit CFM _
Is existing space heated or conditioned?0 Yes 0 No Air conditioning site plan required)
Is existing space insulated?0 Yes 0 No Alteration of existing A system
MEQIANICAL CON t o ler compressors
State boiler permit no.:
Business name: Arlair Htirnpq. t„p- HP Tons BTU/H
Address: 1111 SW 170th Fire/smoke dampers/duct smoke-detectors
CityBeaverton5tate: OR ZIP: 970 6eatpump(stepanrequired)
Phone:645-1156 Fax:645-5986 I E-mail nsta rep ace furnace/burner—
Including ductwork/vent liner O Yes O No
CCS no.: 593 nsta Vreplacc rc ocate7iieaters-suspende ,
City/metro tic.no.: wall,or floor mounted
Name(please print): enc for n ionFe of err an furnticc
Refrigeration:
Absorption units_ 11T11/11
Name: Denise Rc-erts or Chuck Day 'hitters ___
Cum ressors IIP
Address: AS Ab nv ronmentnrez oust an ventilation:
City: State: ZIP: 777 Appliuncevcnt — 1
Phone: 645-1156 Faz C:-mail: )rycreT�ust
oo s,Type l�ws.kitchen atinat 1
hood fire suppressiod system 2
Name: Werner Jungki nd Exhaust fan with single duct(bath fans)
Mailing address: 8105 SW 68th Place .xhausts stemm��a a�rt nomhcatin or AC
'
Portland State: ZIP: are p p rig andd>strl ut on(up to outlets)'
City: _ .__ _ Ty LPC; NO Oil
Picone: Z4 5-8 5
Fax: Email: arc ! iii cacTa3ditiona over outlets
Process piping(sc ematicrequire )
Number of outlets
Name: Adair Homes, inn . Otherlistc app Vance orequpment-
Address: As Above ')ecorativefireplace
a City: State:- ZIP: -� -nsert-type _
Phone: ax; E-mail: oo stove pe et stove
t er: —
Applicant's signature: �rLL 1 Date` 1a ter:
Name (print <;L�)yy_r�i, - jf—
Noi all
Juridic nt rccept credit cords,pleair call;unxtiction for more inf rination PCrntll fee..................... f _
Notice lltis permit application Minimum fee................$
O visa 0 MasterCard —L r expires if a permit is not obtained Plan review(at _ 6 r ) $
Credit card number__ — within ISO days after it has been _
er � State surcharge(896) ....$
---- as cont tete.
Nanx of cardholder a shown on credit cud accepted$ p
TOTAL .......................$
Cardholder Denature `Amount .inn-4r,17IWYCO ti
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMIP( DWELUNIG FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description; Price Total
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001,00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU `
$1.52 for each additional$100.00 or including ducts&vents I 14.00
fraction thereof,to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts&vents 17.40
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or Including vent 14.00
fraction thereof,to and including 4) Suspended heater,wall heater
$25,000.00. or floor mounted heater 14.J0
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Ven'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 file 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 ••
Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<3HP;absorb unit
to 100K BTU 14.00
8%State Surcharge $ 8)3.15 HP;absorb
unit 100k to 500k BTU 25_.60
25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb
Required for ALL commercial permits only unit.5-1 mil BTU 35.00
TOTAL COMMERCIAL PERMIT FEE: $ 10)30.50 HP;absorb
unit 1-1.75 mil BTU 52.20
11)>50HP;absorb
unit>1.75 mil BTU 1 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM
Value Total 10.00
Description: 13)Air handling unit 10,000 CFM+
�� Qt Ea Amount
Furnace to 100,000 B 17.20
Including 955
ducts&vents 14)Non-portable evaporate cooler
Furnace>100,000 BTU including 1,170 10.00
ducts&vents 15)Vent fan connected to a single duct
Floor furnace Including vent gg5 - - 6.80
Suspended heater,wall heater or 955 16)Ventilation system not included In
floor mounted heater appliance Permit 10.00
Vent not Included in appliance 445 17)Hood served by mechanical exhaust
permit 10.00
Repair units 805 18)Domestic Incinerators
<3 hp; ibsorb.unit, 855 17.40
to 100k BTU 19)Commercial or Industrial type incinerator
355 hp;absorb.unit, V 1,700 69.95
101k to 500k BTU 20)Other units,Including wood stoves
15-30 hp;absorb.unit,501k to 1 2,310 10.00
mil.BTU 21)Gas piping one to four outlets
30-50 hp;absorb.un.., 3,400 5.40
1-1.75 mil.BTU 22)More than 4-per outlet(each)
>50 hp;absorb.unit, 5,725 1.00
>1.75 mil.BTU Minimum Permit Fee$72.50 SUBTOTAL: $
Air handling unit to 10,000 cfm 656
Air handlingunit>`!,J00 cfm 1,170 - 8%State Surcharge $
Non-portable evaporate cooler 656
Vent fan connected to a single duct _ 446 TOTAL RESIDENTIAL PERMIT FEE: $
Vent system not Included in 8S8
:reliance permit
Hood served by mechanical exhaust 658 Other Inspections and Fees:
Domestic Incine_rctor 1 170 t Inspections outside of normal business hours(minimum charge-two hours)
$62.50 per hour
Commercial or industrial Incinerator _ 4,590 2 Inspections for whi-no fee is specifically indicated (minimum charge-half hour)
Other unit,Including wood stoves, 656 $62 50 per hour
inserts etc. 3 Addihcnal ni+r,review required by changes,additions or revisions to plans(minimum
Gas piping 1-4 outlets 360 _ charge-one-half hour)$62 50 per hour
Each additional outlet 63
'Slate Contractor Boller Certification required for units>YOOk BTU.
TOTAL COMMERCIAL a **Residential A/C requires site plan showing placement of unit
VALUATION: _ All New Commercial Buildings require 2 sets of plans.
isldstaVormsvnech-ft es.doc 02/11/02
PLOT PLAN
Name 61U1 E2'vE/z
Property Locations S GU• ESA u P l O�e 1,72-2,E?
Legal Address 4'f L7,
ESQ L+ e.5"774 TES
7f. Y s / R• -� �.J. S c c Q S THE L'•JFORMATIO 'ON THIS PLOT PIAN HAS BEEN PKVIDILD ANU
REVIEWED BY THE PROPERTY OWNER WHO.BY SIGNING BELOW:1.)
ACKNOWLEDGES AND ACCEPTS FULL RESPONSIBILITY FOR ITS ACCURACY
3 _ AND COMPLETENESS:2.)IS RESPONSIBLE TO ENSUCE THAT THE
1 h IMPROVEMENTS TO THE SITE TAKE PLACE IN CONFORMANCE WITH THIS
N PIAN.3.)WILL ESTABLISH All THE CORNER IRONS,LOT LINES AND CODETHIS
I�E V E 12-5 E h REQUIRED SETBACKS REQJIRED OF THIS PROPERTY.Aid`(CHAT L
KAM
S E PRE•APPROVED BY THE GOVERNMENJAL AGENCIES WITH
101,THE mDRTGALE NDER AND THE TRACTOR AND
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0420 s .w . s.9 r� p 4 /9 cE-. RECEIVED
MAR � 1 2003
OTY OF T IGARD
RVIDING DIVISION
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST 0 3 "V b Pa I
INSPECTION DIVISION Business Line: (503)639-4171 — -
_ (BUP
Received , Date RequestedAW—__ PM __ BUP _
Location __ ---Suite---------- MEC -_
Contact Person - ` —_... Ph( ) PLM _
Contractor
-- Ph( .�) J 3 Z 2 3 SWR _
BUILDING Tenant/Owner
Foot'ng _ n ELC
Ft u'Drain dation Access: 24V-YL
ELR
Crawl Drain
Drain
Slab Inspection Notes: 1 SIT
Post&Beam ------- _-_ _.-----__-_---_---
Shcar Anchors ---- - ---- -.-_._ - -_
Ext Sheath/Shear
Int Sheath/Shear
Taming -- -
- - - -
Insulation
Drywall Nailing
firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - - - - --- - - -
Root
Other: - - -- -
Final
PASS PART FAIL
PLUMBING _,—
Post&Haam --
Under Slab ---- -- - —
Rough-In
Water Service --- - ----. ---- -- --
Sanitary Sewer
Rain Drains _�-
Catch Basin/Manhole
Storm Drain -- - - - -----
Shower Pan
Othur: ---
Final
PASS PART FAIL A
MECHANICAL
Post&Beam
Rough-In ---
Gas Line
Smoke Dampers
Final
PASS- FAIL - --
�C
vice
Roug�i In
U ` ---- - -
ow V --
F' R
�i ASS PART FAIL E] Reinspection fee of$___._—� required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S (_] Please call for reinspection RE:_ - [] Unable to inspect- no access
Fire Supply Line
ADA
Approach/Sid3walk Date _ �� inspector_ _ ""`~ Ext
Other:
Final DD NOT REMOVE this Inspection record from the JA site.
PASS PART FAIL
24-Hour
CITY OF TIGARD
BUILDING Inspection Line: (503) 639-4175 ; ?
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Received _-.___— _ __-Date Requested -/_� � 2 S_ AM------ PM ___ BLIP
Location �11�C ��_ -/ Suite `/ MEC _
Contact Person — ,Qi _L — -_-, Ph(—) �Q -t'Z &
. - PLhI -_-----_--_ -----_
Contractor _- rely a-�%'�-� r _.� Ph(� —) - -- SWR ------------- _--_.___
BUILD1Nf Tenant/OwnerELC
o mg ELC
Foundation Access: dl1 � „/ ----.__-_---------_.---
Fog Drain �' ELR
Crawl Drain —._--
Slab Inspection Nates: SIT
Post d, Beam
Shear Anchors -- - ---- ----
Ext Sheath/Shear
Int Shoath/Shear
Framing 1, �. 1 -- -----------
Insulation
Drywall Nailing -- ----------- -— —Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -— -'t_1���o� _►�Q•�t�T_.�T"�— --- --__—
Root `
9be—r —
SS- ART FAIL ----
PL BIND - -- ---- -— --- -----
Under Slab
Rough-In �-- - ---- --
Water Service
Sanitary Sewer
Rain Drains -- -
Catch Basin/Manhole
Storm Drain -- -
Shower Pan
--
PA_RT FAIL
MECHANICAL
Post 8 Beam _ _-�----
Rough-In
Gas Line
Smoke Dampers -- -
na
33 ART FAIL ---- - — ----------- —-- -
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final [� Reinspection fee of s_. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE_ Please call for reinspection RE:_. _ _ n Unable to inspect--no access
Fire Supply Line
ADA C -21 -AP __ Inspector �� f- Ext.
Approach/Sidewalk Date.-_ T— r
Other
Find DO NO` REMOVE this Inspection record from the job sbte.
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__9F__..z 41"- AM PM BUIP
Location MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner .._.._--
Footing
...Footing ELC
Foundation Access:
Ftg Drain 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
Roof
Other:
Final —
PASS. T FAIL
UMBO W_
rist�Beam
(snder Slab
Hough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
[!_PAS PART_ FAIL
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
tC_ d_Tff1dA_L
Service
Rough-In
LIG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
Please call for reinspection RE: Ll unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date U-�' Vispector wcz L Zi Ext
Other
Final DO NOT REMOVE this Inspection recoiol from the job site.
PASS PART FAIL