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9533 SW ELROSE STREET 1-11JOTPLAN IAV t` ill,l.tilt III 111.111t, 11110. I'( ) 11OX 2.511 151) •I I( *#ARl ) OR 9728 1 I'll: ()i: 543 FAX: 684 O(►7I ` Lot S�ibdlvislo►n f t Jl� . L___ 9- 5 W LJ_ __Address � JLt-LAN Y4Y4LL]�i/'��]l n )Q !��qiJ €� .►I�vA4. r qlr r �.., ,1,�___€w 1 �r _ _ f r Iv w L� �____._.__� p'o t� '. . vc r VV 11 Ir k,;V,\ �` ;lVN ' C� ve��s Fti S �f /L f 11466 v r _ o 3 , 66 q \ 1 6 160 09 A'j; Ir SW 11 NOTICE: IF THE PRINT OR TYPE ON ANY � I � l � l � � ll � i � ' � IlIIIII IIIIIII IlIIIIlllllllli Ilillll � � ll-f"rT` ( lllill IIIiIII I � I � ilil � ! 111 � I11111111 Ilf 1111111 III. .`p III TI.T _r 11fill1I1 1111111 111 111 IIIIII ! III Ill � lli � lll IMAGE IS NOT AS CLEAR AS THISI + r I I NOTICE, 8 - 10 IT IS DUE TO THE QUALITY OF THENo 36 - - -------- ---- / ORIGINAL DOCUMENTE 63 8 Z L Z 9 Z Q Z Z �; Z Z I Z O Z 6 t t G T 91 L 4 I i E i Z T T T 6 8 9 4 E Z i Illlllllllllllllllllllllllllllllilllllllilll �l�llllll�lllllllllll(IIIIILIIIIilllllllllllllllllilllll Ilillllllllilill .illllillliilllllllllllll II I T �ai�w i II IIII I II (111111 1111111 1111 IIII IJl 111.1 1ll111l��1I , i 4 1 W W SN m N ell fD 9533 SW Elrose Street CITY OF TIGARD BUILDING INSPECTION DIVISION MCT 24-Hour Inspection Line: 639-411,75 Business Line: 639-4171 BLIP _ _(P�4il _Date Requested _AM_ _PM BLD Location— �.� �G/r�t.Q,[ — Suite —_ MEC Contact Person _ Ph —7�� q 2— PLM _ _— Contractor — — Ph -- SWR -- —_ BUILDING _ Tenant/OwnerELC Retaining Nall _ - ELR Footing - -' Accessi Foundation l��• FPS _ Fig Drain lV` `�`` `` G Crawl Drain Inspection Notes SGN Slab --_ _ SIT Post&Beam l(� �► ` _ _ Ext Sheath/Shear Int Sheath/Shear 1 ,(,/ Framing �!tJe _�r'L. �c 7 �?�-4 +c r c: / �vS w_ �, 1 A [ Insulation Drywall Nailing _ __�Gf - �f �, ., i •� /o � � . , LJi t�.L� Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling '�-�-/a V c� V�► �' A - �'� _ G► c Ter �, C;� T Roof Mir.c: — - ----- ---- - Finol ---------- PA PART FAIL — -- --- — Under Slab Top Out Water Service Aon. Sanitary Sewer Rain D ains PART FAI?- hNICAL _ — - - - -- --_--'- Post&Beam _ — - -- --- _.- --- ---- Rough In Gas Lnie Smoke Dampers Final ------ - --- - P FAIL Sn1ab Rou ULe F PASS PART FAIL _-_--SITE Backfill/Grading -- ---- - -` — Sanitary Sewer Storm Drain I j Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ 1 Please call for reinspection RE' _ _ - __ ( J Unable to inspect no access ADA Approach/Sidewalk `� ff , Other Datef_ Inspector /'n Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST �rwo G o.�G 3� 24-Hour Inspek.tion Line: 639-4175 Business Line: 639-4171 BUP _ Date Requested Z AMPM BLD Location 3 3 S� S r _ Suite MEC Contact Person Ph PLM — Contractor Ph SWR BU _ Tenant/Owner ELC _ e a ing Wall FLR Footing Access FPS Foundation Ftg Drain SGN Crawl Drain Inspection Notes. ---- -- Slab __. — SIT Post&Beam -�- '--— Ext Sheath/Shear Int Sheath/Shear r, Framing __. / �uw�ia, n / nM e" p' l v✓r ev - Insulation Drywall Nailing e c I Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc. _ ZFin SS PART FAIL BING Post&Beam Under Slab Top out Water Service Sanitary Sewer Rain Drains Final -- - PASS PART FAIL Post& Beam ---- Rough In c;as Line -- smoke Dampers I PASS PART FAIL EL CTRICAL `iervlce Rough In UG/Slab _ I.ow Voltage Fire Alarm Final PASS_ PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain ( Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line speci )Please call for reinspection RE [ ]Unable to Inspect-no access - ADA Approach/Sidewalk Date ate I G '� nspector Tum✓ ti•*� ___. Ext 36 0 Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPEC;TIO'a DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ----- / BUP _Date Requested C�% ' 2'L' _ —AM-----PM _ BLD — Location 3 S `'' f/�'' Suite MEC _ Contact Person _ Ph ?YL - 0 y 4 Z PLM Contractor Ph SWR BUILDING Tenant/Owner El_C Retaining Wall ELR Footing Access: FoundationGr FPS Ftg Drain SGN Crawl Drain I In�� ,n Nnt,:g --------- Slab _-� _ ---- — SIT Post&Beam "----T- Ext Sheath/Shear Int Sheath/Shear — Framing Insulation Drywall Nailing Firewall /7 Fire Sprinkler / / - Fire Alarm 7` Susp'd Ceiling Roof Misc: -- -- Final PASS PART FAIL ---------- PLUMBING Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final -- PASS PART FAIL MECHANICAL Post&Beam - - -- - - --- Rough In Gas Line -- --- -- Smoke Dampers Final --- ----- -- ----- PASS PART FAIL Service Rough In UG/Slab -- Low Voltage Fire Alarm na ART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain I j Reinspection fee of$ required beforeDate nes action. P t City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I J Please call for reinspection RE:^ Unable to inspect-no access ADA Approach/Sidewalk / Other „L Inspector r- — _-_ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the lob site. �_.AAAA, AAAAAAAAAAAAAAAAAAAAAAAAAAAAAYIAAAAAI►AA F A o d Io. rri d ► rTl F"3 ► poll pol- a. M ► ► CL ° ► q C' rr ► d d CD ` ► r i ► r O °, ► as ► 44 ► 41 y rriJ� 0-1 44 C� p j poll- o 01. A 010, 44 110. �-] o a I ® � ► i ► Cl A rA Q � 5 H M cr o �. r Fr Olt � a o f M O \ 3 O , a �0 F C � Q i' d � x 3 CITY OF TIGARD 13125 S.W. HALL BLVD, TIGARD, OR 97222 IMPORTANT PERMIT NOTICE INTERSTATE ELECTRIC INC PO BOX 7342 SALEM, OR 97303-0068 Electrical Signature Form Permit #: MST2000-00565 Date issued: Oii29i2001 Parcel: 2S111 BA-11000 Site Address: 09533 SW ELROSE ST Subdivision: LAUTT'S TERRACE Block: Lot: 004 Jurisdiction: TIG Zoning: R-4.5 Remarks: Construction of new single farnily detached residence. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: NEWCASTLE HOMES INC INTERSTATE ELECTRIC INC PO BOX 230459 PO BOX 7342 TIGAFr'D, OR 972^ SALEM, OR 97303-0n68 Phone #: 503-684-7543 Phone #: MBL 393-2223 Req #: LIC 117121 SUP 1479S ELE 24-354C AN INK SIGNATURE IS REQUIRED CSN THIS FO Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE NORTHWEST PREMIER PLUMBING P.O. BOX 23338 TIGARD, OR 97281 Plumbing Signature Form Permit #: MST2000-00565 Date !ssued: 01/29/2001 Parcel: 2S,i 11 BA-11000 Site Address: 09533 SW ELROSE ST Subdivision: LAUTT'S TERRACE Block: Lot: 004 Jurisdiction: TIG Zoning: R-4.5 Remarks: Construction of new single family detached resiuence. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No pluinbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR. NEWCASTLE HOMES INC NORTHWEST" PREMIER PLUMBING PO BOX 230459 P.O. BOX 23338 TIGARD, OR 97281 TIGARD, OR 91281 Phone q: 503-684-7343 Phone #: 503-624-0582 Reg #: 1 Ir 135022 PI M 34-348PB AN INK SIGNATURE IS REQUIRED ON THIS FORM 4//'/1 Z 11_ 1A liz Signature of Authorized Plumber If you have an, questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD MASTER PERMIT PERMIT M MST2000-00565 DEVELOPMENT SERVICES DATE ISSUED: 01/29/2001 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 09533 SW ELROSE ST PARCEL: 2S111 BA-11000 SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCK: LOT:004 JURISDICTION: TIG REMARKS: Construction of new single family(etached residence. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 2,248 at BASEMENT: at LEFTG SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,132 at GARAGE: 580 of FRONT. 2n PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS. 1 FINBSMENT: of RIGHT- B VALUF. $307,340.00 OCCUPANCY GRP. R3 BDRM: 4 BATH: 4 TOTAL: 3,380.00 at REAR: i6 PLUMBING SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: t CATCH BASINS: TUBISHOWERS: 6 GARBAGE OISP: 1 WATER HEATERS: t WATER LINES: t0G BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: 6 CLOTHES DRYER: 1 GAS FURN)-•i00K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: I MAX INP: blu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL _ RLSIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCEL,-ANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPnRRIGATION: PER INSPECTION: EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 19t WIO SVCIFDR: 00 SIGN',OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT: MANU HM/SVCIFDR: 601 • 1000 Amp: 601+8mpa•1000v: MINOR LABEL: 1000+amplvolt PLAN REVIEW SECTION Reconnect only: >•4 RES UNITS: 9VCIFDR>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&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 6 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,709.40 NEWCASTLE HOMES INC NEWCASTLE HOMES This permit is subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and PO BOX 230459 PO BOX 230459 all other applicable laws. All work will be done in TIGARD,OR 97281 TIGARD,OR 97281 accordance with approved plans This permit will expire If work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Reg 6: 11(' 59667 forth in OAR 952-001 0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1187 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Fireplace Appr/Sdwlk Insp Sewer Inspection Post/Beam Mechanica Mechanical Insp Framing Insp Insulation Insp Electrical Final Footing Insp Underfloor insulation Mechanical Insp Shear Wall Insp Gyp Board Insp Mechanical Final Foundation Insp Crawl Drain/Backwater Plumb Top Out Low Voltage Rain drain Insp Plumb Final Wtr Proofing Bsm't Wa Footing/Foundation Dr; Electrical Service Gas Line Insp Water Line Insp Final Inspection Issued By : Permittee Signaturr?!L -y Call ( 03) 639-4175 by 7:00 p.m.for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00384 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 01/29/2001 PARCEL: 2S111 BA-11000 SITE ADDRESS; 09533 SW ELROSE ST SUBDIVISION: LAUTT'S TERRACE ZONING: R-4.5 BLOCKS LOT: 004 _ JURISDICTION: TIG — TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDING& 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new single family residence. Owner: — FEES _ NEWCASTLE HOMES INC Type By Date Amount Receipt OX B PO 230459 PO BOX, 30 97281 PRMT CTR 01/29/2001 $2,300.00 27200100000 TIGARDINSP CTR 01/29/2001 $35.00 27200100000 Phone: 503-684-7543 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued The total amount paid will be forfeited if the permit expires The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance given 1f not so located, u e installer shall purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: Permittee Signatur�a Call 03) 639-4175 by 7:00 P.M. for an inspection needed the next business day Vol i,. / _Ju i olrtad t�j tl Buildhii,g Permit Application City of Tigard Datereceived: 1ol'/t-erg Permit no.: H5rai�--ee,� Address: 131 ZS S W Hall Blvd,Tigard,OR 97 Project/Opp).no.: Expire date: City ofTigard g Phone: (503) 639-417! f. Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ 1&2 famuy:Simple Complex: t 7Add ly dwelling or accessory U Commercial/industrial U Multi-family 2 New construction U Demolition lte ratio n/repiacement U Tenant improvement U Fire sprinkler/alarm U Other: 1%1 IL t Job address: jyy = It us Q, L7, Bldg.no.: Suite no.: Lot: Block: Subdivision: L-q,t/ 's TL//4.0 - Tax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: sina U�1,1bir Name: He-W C rLS tl[.- }}U rnA s In L Mailing address: Po Cie x 2-364,59 � I & 2 famlly dwelling: City: 7-i 4f cl State:QtQ 7.1 P: q 7 Z 8/ Vuluadon of work........................................ $ 13 y U. ` Phone: &Rq. T5 x{33 Fax:(o8V&P 71 E-mail: No.of bedrooms/baths................................. 't Owner's representative: TQ y M i II e I Total number of flags................................. 01.. Phone: (:>,'ro\x Faxt F.•mail: New dwelling area(sq.R.) .......................... 3. 80Garage/carport area(sq.ft.).......................Name: of t�h i ft(Cl c fu Covered porch area(sq.R.) .........................Mailing address: ,anti Deck area(sq.ft.) .......................................City: ate: ZIP: Other structure area(sq.ft.)......................... Phone: Fax: E-mail: CommereiaUint;ustrial/multi-family: Valuation of work........................................ $` Existing bldg.area(sq. ft.) ........... ............ Business name: /Vt_iNGQStIt tftSmA-•.S , Zn G New bldg,area(sq.ft.) —_ -- Address: r'Yttr ) - Number of stories --- try: _ State: ZIP: Type of construction...... _ Phone: Fax: E-mail CCB no.: - 4� Occupancy gmup(s): Existing: _ r'�-- — - - -- --- City/metro lie.no.: New: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of URS 701 and may be required to he licensed in the Address: jurisdiction where work is being performed.If the applicant is City.. Srate: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: — — -- - Phone: Fax: I F.-mail: - — -- Name: ,'ILA( et.jq Inik r j',-, Contact person: t4 vj, Fees due upon application $ ........................... Address: Date received: City: State: 7,IP: Amount received ......................................... $ Phone: Fax: E-mail: Please refer to fee schedule. hereby certify I have read and examined this application and the Nd all jurisdictions rceM credit cards.please call jurisdiction for moxe information. attached checklist. All provisions of laws and ordinances governing this U visa U MasterCard work will be complied wi ,wether specified herein or not. Credit card number Authorized si nate: .— Date: /I?_ t k M - Expires 4 g YName o f c"tolder as shown on credit card Print name: K -f f ( — -- $ -- Cardholder N6nature Amount Notice:11his permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. WA tlboatcoMt One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: CitycUyq/Tigard of Ti Tigard ❑Electrical U Plumbing ❑Mechanical Address: 13125 SW Nall Blvd,Tigard,OR 97223 UOther: Phone: (503) 639-4171 Fax: (503) 598-1960 1 Land use actions completed.See jurisdiction criteria fur CUnCUITem reviews. 2 'Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. 4 Fire district—.__approval required. 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewer permit. _ 7 Water district approval. 8 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,ctc. 10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details.Plan review cannet b•-completed if co yright violations exist. _ 1 I Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if there is more than a 44 elevation differential,plan must show contour lines at 24 intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility Iocafions;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 bolts,any hold-downs and reinforcing pads,cont ection details,vent size and location. 13 Floor plana.Show all dimensions,room identification,window size,locatior,of smoke detectors,water heater, furnace, ventilation fans,plumbing fixtures,balconies and decks 30 inches alh ve-rade,etc. 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 grade if die change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. _ 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all floorstroof assemblies,indicating member sizing,spacing,and bearing locations.Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered systems,sec item 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current c.,de design values for all beams and multiple joists over 10 feet long and/or any beamijoist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more appliances. _ 22 Engineer's calculations.When requires:or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the project under review. 23 Five(5)site plans are required for Item above. 11 ab , 24 .. ._._ 25 26 27 28 — — Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black irk. Red ink is reserved for department use only. 4164614 try WOMt Plumbing Permit Application Date received:/% /t G'G> Petmitno.: STS- %I Z City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 CaY of I i,t;rrr`I Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: >4 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement X New construction U Addition/alteration/replacemcnt U Food servicc U Other: Job address: r� Sw C-Ito5-e- 5t Description Qtv. Iec(cr.) 'Iota! , Bldg.no.: Suite no.: --- New I-and 2-family dwellings only: Tax map/tax lot/account no.: ---- — (includes 100 It.for each utility connection) SFR(1)bath Lot: Block: Subdivision: (.,U 'S Ttxothee.. SFR(2)bath- -- -- -- �- Project name: SFR(3)hath City/county:Ti 0-fd Was k • ZIP: 7 Z7,1Each additional bath/kitchen Description and location of work on premises: _ Siteutilitles: 1 _ Catch hasin/area drain Est.date of completion/inspection: Dry%c2s/leach line/trench drain -� Footing drain(no.lin.ft.) Manufactured home utilities Business name: ND✓�-h west f✓`C in;R i jVLjmbMj Manholes _ Address: P D 86 X 2-333 3 Rain drain connector C ity: 7 *9 CL e d Stated re I ZIP: q 7 2 7/ Sanitary sewer(no.lin.ft.) - — -� Phone: 793.7 9 Z 3 1 Fax: I E-mail: Stonn sewer(no.lin.ft.) CCB no.: /3 5 t)Z,2- Plumb.bus.reg.no: Water service(no.lin.ft. City/metro lic.no.: Fixture or Item: Contractor's representative signature: Absorption valve Print name: Date: Back flow preventer — Backwater valve Basins lavatory _ Name: /�,p:i'1 WC.e F= Clothes washer Address: / r, Dishwasher _ �u Drinking fountain(s) City: _ State: ZIP: Ejectors/sump — —� Phone: Fax: I E-mail: I Expansion tank Fixture/sewer cap _ Name(print): Floor dm ns/floor sinks/hub Marling address: Garbage disposal _ Hose bibb _ City: State: ZIP: Ice maker Phone: _ Fax: E-mail Interceptor/grease trap Owner instal lation/residential maintenance only: 'The actual ir:,lallation Primers) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) _ Owner's signature: Date: Sum _ Tubs/shower/shower pan Name: Urinal - - — Water closet Address: _ _ Water heater City: State: 7,IP: Other: V — ---- Phone: _ Fax: Gmail: Tot Not all Judadicdons accept credit cods,pleas call jurisdiction for mote inf nuation. Notice:This permit application Minimum fee..... ..........$ -- - �- O Visa U MasterCard expires if a permit is not obtained Plan review(at __ %) $ Credit card numbet. _ —/ / - within Igo days after it has been State surcharge(8%)....$ Marne of cardholder as shown on credit card Expires -- --- accepted as complete. TOTAL .......................$ _ _ S _ cardholder signature nmoum 440 4616(6AXWOA11 PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family 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 for each utili connectlon) 16.60 _ Lavatory V _ One(1)bath $249.20 Tub or Tub/Shower Comb 16.60 Two(2)bath—_ $350.00 _– Shower Only _ 16,60 Three 13 bath $399,00 Water Closet ^– 16.60 —� SUBTU2'AI _ ^— Urinal 16.60 8%STATE SURCHARGE _ — Dishwasher 16.60 -PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 __ _ TOTAL- Laundry Tray 16.60 Washing Machine Floor Diain/Floor Sink 2" 16.60 _- PLEASE COMPLETE: 3" 16,67 uantity b Work Perfo Water Heater O conversion -OT-like kind 16.60 _ Qrmed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed! ermit. Capped MFG Home New Water Service 46.40— Sink MFG Home New San/Storm Sewer — 46.40 Lavatory_ _-- Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains — 16.60 Shower Only Drinking Fountain 16.60 Water Closet— _ -- Urinal _ Other Fixtures(Specify) 16.60 Dishwasher _ __—,- - Garba a Dis osal Laundry Room Tray _ -- Washing Machine — _- __ —- Floor Drain/Sink 2" _ Sewer-1 st 100' 1 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater _ Other Fixtures Water Service-each additional 200' 46-40 (Specify) _ Storm&Gain Drain- 1st 100' 55.00 btorm&Rain Drain-each additional 100' 46.40 — —._ -- --- Commercial Back Flow Prevention Device 46.40 i - — --- Residential Backflow Prevention Device" 27.5` — Catch Fasin 1630 Insperlion of Existing Plumbing or Specially 72,50 Re uested Inspections —` er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family d-velling 65.25 Grease Traps 16 60 —_- _ -- ---------- ----- QUANTITY TOTAL __— Isometric or riser diagram is required If Quantity Total is >9 -- -------------__.--_��—._-- "SUBTOTAL – ---- --- -- — 8%e STATE SURCHARGE --- ---- — - "'PLAN REVIEW 25%OF SUBTOTAL ^ Required only If fixture city total is>9 TOTAL a *Minimum permit fee Is$72 50+8%state surcharge,except Residential Backflow Prevention D^,vice,which Is$3e 25+8%stale surrhargn "All New Commercial o•dldings require plans wit# isometric or riser diagram and plan re"iew 1:ldstslfc-mslplm-fees.doc 10/10/00 l lectrieal Permit Application ---� bate received:/;'-/y r,cl Permit no,. /�>/�c,r� f City of �1t9-_ Project/appl.no.: Expire date: 0(v lts,/IIgaid Address: 13125 SW liall Blvd,Tigard,OR 97223 Date issued: By: Receipt no, Phone: (503) 639-4171 71 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: ,$1 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement eNew construction U Addition/al(eration/replacerncnt U Other:_ U Partial MI fIVE MO Job address: S �/ St _ Bldg. no.: Suite nu.: Tax map/tax lotlaccount no,: Lot: $lock: _ Subdivision: 1-"ft S 74-e rq�(t� Project name: Description and location of work on remises: Estimated date of completion/ins ection: ---- Job no: F're Ma•t _ 't Business name: -Lraft(5ta LA� -✓1 C —� Description Qlv• (ca.) 'folal tw insp - New residential-single ortnotti-fandlyper Address: aQ -73 dtvellingunil.Includes allachedRnrage. City: sctum jState:oXK, ZIP: 7,36 Seri ice Inc luded: Phone: -:%93,z?-z,3 Fax: I E-mail: Ilxx)sq.ft.or less _ 4 - Each additional 500 sq.fl.or onion thereof CCB no.: / Z Elec.bus.Itc.no: Limited energy,residential - 2 City/metro lic.no.: _ Limited energy,non-residential _ 2 _ Each manufactured home or modular dwelling Signature of supervising elxtrlcian( wired) l r,,,, Service and/or feeder 2 Sup.elect.name(print): Liccnscnu Services or feeders-installation, PROPERTY OWN111 alteration or relocation: 200 amps or less 2 Name(pf7nt): A/P_W(_(-LI,r LQ. Yb(Yu 6 ,�c. 201 amps to 4W amps Mailing address: -P 0 a �3b 4( amps to 600 amps 2 6- amps to i 000amps 2 City: C el,/d Slale:C)fQ ZIP: 9722'/ Over 1000 amps or volts 2 Phone:6$ 5 V 3 Wax!6$' -UP71E-mail: Reconneclonly I owner installation:The installation is bein-made on property 1 own Telnponryservices orfeedeu- which is not intended for sale,lease,rent,..r exchange according to Installation,alteration,or relocation: ORS 447 455,479,670,701. 200 amps or less 2 201 amps to 400 amps _ 2 Owner's Signature: _ Dale: 401 to 600 ams 2 Ranch circuits-nen,alteration, or extension per panel: Name: Al i 1 -4 (14/_�' )/1 t Q r i n A. Fee for branch circuits with purchase of Address: _ service or feeder fee,tach branch circuit 2 city: o(+I ctn d State:be, I 71P: 9 7 N. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: Misc.(.Service or feeder not Inc•luded): U Service over 225 amps-commercial U Health-care facility Each pump ar irrigation circle 2 U Service over 320 amps-rating of 1&t2 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000 square feel fouror Sigaal civ ait(s)or a limited energy pmtel. U System over 600 volts nominal more residential units in one structure allen tics,orextension• I 12 •Building over three stories U Feeders.400 amps or more •Descrition. U Occupant loot]over 99 persons U Manufactured structures or RV park Each additional inspection over the allowable in any of the above: U EgressAighting plan U Other — Perinspecunn) Submit`__sets of plane with any of the above. investigation fee The above are not appllcaLle to temporary construction service. Other Nrtt all Jurisdictions accent credit rants,pleau call jurisdi,tion far more inform tion Notice:This permit application Permit fee.....................$ U Visa U Mastercard expires if a permit is not obtained Plan review(a; _ %) $ Credit cud mother / / within ISO days after it has been State surcharge(8%)....$ _ Expires accepted as complete. TOTAL --- $ Nems of cardholder u shown on credit card --- _ S Cardholder signature Amount 410-4615 16+UCOM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK !NVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost _Total Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less $145 15 _ ,. Audio and Stereo Sy�'cros Fach additional 500 sq ft or portion thereof $3340 1 Burglar Alarm I imi-3d Ene,gy _ $7500` I ach Manuf d Home or Modular Garage Door Opener' Dwelling Service or Feeder 890 90�^ _ 2 Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $8030_ _ 2 Vacuum Systems' 201 amps to 400 amps $106.85 2. 401 amps to 600 amps _ $160.60 601 amps to 1000 amps _ $240.60 2 Other Over 1000 amps or volts $454.65_ 2 Reconnect only $65.85— 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 $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps __ $100.30 2 401 amps to 600 amps $133 75 2 Chc,k Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch dicults with purchase of service or Clock Systems feeder fee. Fach branch circuit — $665 _ 2 Data Telecommunication Installation b)1 he fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. First branch circuit $46 85 _ ❑ Each additional branch circuit $665 HVAC Miscellaneous Instrumentation (Service or feeder not included) Each pump or irrigation circle _ _ $5340 _ Intercom and Paging Systems Each sign or outline lighting $53 40 Signal circuit(s)or a limited energy panel,alteration or extension M_ $75.00 _ ^ Landscape Irrigation Control' Minor Labels(10) $125.00 _ Medical Each additional inspection over C� the allowable In any of the above Nurse Calls Per inspection $6250 Per hour $62.50 In Plant $73 75 Outdoor Landscape Lighting' Fees: n Protective Signaling Enter total of above fees $ Other 8%State Surcharge $ ------ _ _Number of Systems 25%Plan Review Fee See"Plan Review"sectio,on $ No licenses are required Licenses are required for all other installations `runt of application -- — — - Fees: Total Balance Due $ El-� Enter total of,hove fees E l Trust Account k 8%State Surcharge s_ Total Balance Due S - 0dststformskic-fees doe 10/09'00 Mechanical Permit Application „ — patereceived:;;-/G�-ltd Permitno.: City O� TigardProject/appl.no.: Expire date: f'u>nl7i);r,rol Address: 13125 SW Hall Blvd,Tigard,OR 97223 pate issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 5911-1960 Case file no.: Payment type: Land use approval: Building permit no.: I &71amily dwelling or accessory U Commercial/industrial U Multi-family J Tenant improvement J6 Newruction U Addition/alleration/replacement iJ t)lhor:_ COMM11,316AL VALUATIONSCHEDULE Job address: ivCz I/Os S- Sf _ Indicate equipment quantities in boxes b0ow. Indicate the dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead. Tax map/tax lot/account no.: profit.Value$ — Lot: 81ock: Subdivision:Lavt)}s Tr r/q c� 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: wish ins ZIP: 7 z0 Mum Description and location of work on premises: tI Illi 11111 PEI MIMI I It Ll 11 KIIEE= 7RRrm.s.onIj Total Est.date of completion/inspection: Desch Ion QI 1Res.only Tenant improvement or change of use: ' Is existing space heated or conditioned?U Yes U No Air handling unit ^CFId M_ - v conditioning(site plan require Is existing space insulated?U Yes U No Alteration o existing m AC syste — -- OI er/compressors State boiler permit no. Business name: rp v/ S2ASo nS NCGtf7/7 I{P tons i.—.BTU/H Address: P p fjCX (o 40Fire/smoke dampers/duct smoke detectors City: p/t /aAcl Statep R- ZIP: `77-196 eat ump(site plan rtquire ) --- nsta rep ace urnace/uurner Phone: 7 -S / rax: E-mail: Including ductwork/vent liner U Yes U No CCD no.: $ 2, $3 fists I/rep ace re ovate caters-suspende , City/metro lic,no.: wall,or floor mounted Name(please print): Vent fora lance of er than urnace e gest Absorption units BTU/II Name: M M Q h Ct+7 Chillers— _—_ Hf-- ---- Compressors_ HP Address: - --- :nv rontnenla ex ust an •ent at on: City: _ State: 7.IP: Appliancevent Phone: I a e [_ 111;111 oyer ex aunt _ 1 s, ype U I I resTit h-e-R6azmal hood fire suppression system Name: Exhaust fan with single.duct(bath fans) Mailing address: Exhaust system a art from heating or AC i - fie p ping an st bl on(up to 4 outlets) City: --- 15tai. 1711' Type: _ LPG _` NG __ Oil Phone: I,i E road. uel i in ench additions over 4outets roceccpiping(schematicrequire ) _ Name: Number of outlets t - Address: - -• rerlicte app fence orequ equipment: _ _ Decorative firepla-c Cil): Slate: ZIP: nsT ert=type x - - _ --- Fax: E-mail: Wr > stove/pe e—�Istrne- Phone: ^- (h 1cr: Applicant's signature: Date: Name (print): -- Not all Juduliciione accept credit cants,pleax call jurisdiction I'm more informatioPermit fee.....................$n. Notice:This permit application U\9sn U MasterCard Minimum fee............ ...$ Credit cud number17, `1� expires if a permit is not obtained Plan review(at ' t $ . _—.—_— /r— Expires within 180 days after it has been State surcharge(8%)....$ rse Nuof cardholder at shown on c ii cad— accepted as complete. -- — —— _ s TOTAL .......................$ --- — Cadhotdet signature Ammnt 4104617(&WCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: _ Descripbon: Price Total Table 1A Mechanica;rode vb (Ea) Amt $1,0012-$5,090.00 Minimum fee$72.50 1) Furnace to 100,000 3TU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and Including ducts&von; 1400 $1.52 for earn additional$100.00 or �) Furnace 100,000 BTU fraction thereof,to and Including including ducts&vents 17.40 _ $10,000.00- --- - $10,001.00 t 75, $$ 000.00 - $148 56 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or inr�;- vent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater _ _$25,000.00 or floor mounted heater 14.00 5,001.00 t0$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit $2 $1.45 for each additional$100.00 or _ 6.80 fraction thereof,to and including 6) Repair units 12.15 $50,000.00. $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 (lump Cond fraction thereof. footnotes below. Com --- --�- 7)<3HP;absorb unit _ --- -- - to 100K BTU _ ?a.00 ASSUMED VALUATIONS PER APPLIANCE: _ __ 8)3-15 HP;absorb - - - Value� Total unit 100k to 500k.BTU 25 60 [IlescOt (Ea) Amount 9) 15-30 HP;absorb Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU _- 35.00 ducts&vents 10)30-50 HP;absorb Furnace> 100,000 BTU including `1,170 _unit 1-1.15 mil BTU 52.20 ducts&vents 11)>50HP:absorb Floor vent 955 __-__- unit>1.75 mil BTU 87.20 Suspended heater,wall healer or 955 12)Air handling unit to 10,000 CFM floor mounted heater _-__. __ ___1000 Vent not included in appiicance 445 13)Air handling unit 10,050 CFM+ 17 20 Repair units -$05 --- 14)Non-portable evaporate cooler <3 hp:absorb.unit, 955 10.00 to 100k BTU _ _^ 15)Vent fan connected to a single duct 3-15 hp;absorb.unit 1,700 6.80 101k to 500k BTU --- 16)Ventilation cistern not included in 15-30 hp;absorb.unit,501k to 1- 2,310 appliance permit 10.00 _ mil.BTU __ _ 17)Hood served by mechanical exhaust 30-50 hp;absoru.unit, 3,400 10,00---- 1-1.75 0.00 - 1 1.75 mil.BTU - 18)Domestic,incinerators >50 hp;absorb.unit, 5,725 17.40 >1.75 mil.BTU 19)Commercial or industrial type Incinerator 69 9J Air handlingunit to 10,000 cfm Air handling At>10,000 cfm --::11170 20)Other units,including wood stoves Non ortable evaporate cooler 656 10.00 Vent fan connected to a sin le duct -446 _ 21)Gas piping one to four outlets Vent system not Included in 656 5.40 agppance permit 22)More than 4-per outlet(each) Hood served by mechanlcal exhaust 656 1.00 Domestic Incinerator 1,170 Minimum Permit Fee$72.50 SUBTOTAL: $ Commercial or Industrial Incinerator 4,590 Other unit,Including wood stoves, 656 8%State Surcharge $ Inserts,etc_ __ C;as I inq 1-4 outlets _ -360 -- 25%Plan Review Fee(of subtotal) $ Each additional outlet- _ _ -_ Required for ALL commercial permits only TOTAL COMMERCIAL TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: _ _ __-__. ---- --- - _ Other Inttpectlons and Fee><: 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour 2. Inspections for which no fee is specifically indicated (minimum charge-half iviur) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum rharge one-half hour)$72 50 per hour .State Contractor Boiler Certification required for units>200k BTU. "Residential A1C requires site plan 4howing placement of unit. i:ldsN\formsknech-fees.doc 10/11/00 SEE 35MM ROLL# 22 FOR LARGE DOCUMENT