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11830 SW GREENBURG ROAD .o., a� LO 0 c� 0 , i S 1 I i' I I i Q 21 91IMMIM MS OCOTT CITY OF TIIGARD 24-Hour ��yy BUILDING Inspection Line: (503)639-4175 MSTL �_d�� INSPECTION! DIVISION Busine Lin : (503) 639-4171 7/ BJP �___------------------- Received —_ Date RequesjRd v _ 3 AM PM -- - BUP Location l��/I) L MEC _ __.—_------- - Contact Person � 'F__C-6x Ph(.�E _ �v-3- L_'_- �,7�PLM ---- -.._-- Contractor __ - Ph ( - ) _ _ - -- - SWR _----- BUILDING Tenant/Owner - ____- - - --_- --_ -__ ELC _- ----_--_--__-� Footing ELL - — --- ---- Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes. SIT _. Post&Beam _ Shear Anchors Ext Sheath/Shear Int Shaath/Shear Framing - -_ Insulation Drywall Nailing Firewall L.'7- Fire Sprinkler - - ��t y P,�M G�V� K \ Fire Alarm - usp'd Ceiling R ✓ �� Roof ��1�1L�._ Other: -_ f Final dez. PASS PART FAIL PLUMBING Post Beamwk� Under Slab ,-�-� Rough-In Water Service -- - Sanitary Sewer Rain Drains - --- -- - - - ---- -_ - --- --- Catch Basin/Manhole Storm Drain Shower Pan Other: -- - - - Final PASS PART FAIL --- - MECHANICAL Post&Beam Rough-In - Gas Line Smoke Dampers --- ---in ASS ART FAIL - - -- -- -- ELECTRICA — Rough-In :�-�` CA`kI, �' -- ►� UG/Slab �- Low Voltage _ PART_ FAIL F] Reinspection fee of$�_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please cell for rein ection RE: Unable to inspect-no access Fire Supply Line ADA C�` -Ext - Approach/Sidewalk Date! __ ._ Inspector -_ Other: O NOT REMOVEthisInspection record fr nt the Job alte. PASS PART FAIL CITY OF T'IGARD __^MASTER PERMIT PERMIT#: IViST2003-00106 DEVELOPMENT SERVICES DATE ISSUED: 3/25/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 SITE ADDRESS: 11830 SW GREENBURG RD PARCEL: 1S135DD-04200 SUBDIVISION: ZONING: k-12 BLOCK: LOT: JURISDICTION: 116 i REMARKS: garage conversion to living space. BUILDING REISSUE. STORIES: I FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: At T HEIGHT FIRST sf BASEMENT, el LEFT- 5 SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD 4" SECOND. al GARAGL of FRONT: 19 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS 1 T1*Rp $f RIGHT. 0 U0 . OCCUPANCY GRP: R3 BORM. BATH. TOTAL: i� sl VALUE1 00REAR. I`, PLUMBING SINKS WATER CLOSETS: WASHING MACH. LAUNDRY TRAYS: RAIN DRAIN TRAPS. LAVATORIES: DISHWASHERS. FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS. GARBAGE DISP WATER HEATERS. WATER LINES. BCKFI W PREVNTR. GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN c I00K: BOIL/CMP c 3HP: VENT FANS: Ct OTHES DRYER. FURN—100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP- btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS. ELECTRICAL RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVCIFEEDERR BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS. 0 - 200 anp. 0 200 amp: WISVC OR FDR, PUMP!IRRIGATION. PER INSPECTION: EA ADD'L 5005F'. 201 - 400 amp 201 400 vnp 1st WIO SVC/FOR: 1.ei SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY 401 BOO anlp 401 000 amp EAAODI.RR CIRSIGNAL/PANEL: IN PLANT. MANU HM/SVC/FOR. 601 1000 8111 601.am ps 1000V MINOR LABEL 1n00.,moivolt: PLAN REVIEW SECTKIN Reconnect only: —4 RES UNITS: SVC/FDR-225 A >600 V NOMINAL: CLS AREAISPC OCC. ELECTRICAL-RESTRICTED ENERGY _ A.SF RESIDENTIAL _ B.COMMERCIAL AUDIO&STEREO VAG'IUM SYSTEM: AUDIO&STEREO. FIRE ALARM. INTEF,COMIPAGING OUTDOOR LNDSC LT: BURGLAR At ARM OTH: BOILER HVAC: LANDSCAPE/IRRIG PROTECTIVE SIGNL GARAGE OPENER CLOCK. INSTRUMENTATION MEDICAL: OTHR, HVAC. DATAITELE COMM: NURSE CALLS' TOTAL 0 SYST°MS. Owner: Contractor: TOTAL FEES: $ 182.69 This permit is subject to the regulations contained in the SMITH& JORDAN LLC HOME CONSTRUCTION Tigard Municipal Code,State of OR, Specialty Codes and 630 NE 365TH 330 NE 365 all other applicable laws. All work,will be done in CORBETT,OR 97019 CORBETT,OR 97019 accordance with approved plans. This pennit will expired work is not started within 180 days of issuance,or If the work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Phone: 503 649-6208 Ph,no 503-649.620K Oregon Utility Notification Center. Those rules are set for`- in OAR 952.001-0010 through 952-001.0080. You Req LIC t 5292 may ubtain copies of these rules or direct questions to OUNC by calling(503)246-1987 l REQUIRED INSPECTIONS Framing Insp Insulation Insp Electrical Final Final inspection Issued By : �_� : �..4 Lee r< _ _�.�� ( _ Permitiee Signature : • � ��'�� Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next busine s day I C Building Termit Application OFFICE y�_____._-_ Received Building Date/8 :3- 5 ••C) �� Permit Noft jl 7C 3^or)10 1h' of' t r a t'O Planning Approval Other �, Date/By: Permit No. 13125 SW Niall Blvd, Plan Review Other Tigard,Oregon 97223 Date/By. Permit No.: Phone: 503-639-4171 Fax: 503-59811960 Post-Review land Use Datc/ByInternet: www.ci.tigard.or.us Contac : Case No. g Contact Juris.: See Page 1 for 24-hour Inspection Request: 503-639-4175 Name/Method: Sa lemental Information TYPE OF WORK REQUIRED DATA: New construction _ Demolition I&2 FAMILY DWELLING Addition/alteration/replacement _Other: CATEGORY OF CONST_RUCTIUN Note: Permit fees'are based on the total value of the work performed. Indicate \ 1 &2-Family dwelling I F I Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials.labor, overhead and profit for the work indicated on this application. Accessory Building Multi-Family o - Master Builder _4H_ Other: Valuation......................................................... S Q-Q-- JOB SITE INFORMATION and LOCATION No.of bedrooms:_J_ No.of baths: Job site address: —.JL( Total number of floors.............................:....... _ New dwelling area(sq.ft.)............................. -- Suite #: _ Bld ./A t.#:J Garage/carport area(sq.ft.)............................ Project Name: _ Covered porch area(sq.ft.)............................. Cross street/Directions to job site: Deck area(sq. ft,)............................................ Other structure area(sq.ft.)............................ REQUIRED DATA: COMMERCIAL-USE CIIECKI JI f tl Subdivision: Lot#: rax ma / arcaI #: Note: Permit fees'are based on the total value otthe work perl'urmed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dolinr)of all equipment,materials,labor, c overhead and profit for the work indicated on this application. — Valuation......................................................... S w — — Existing building area(sq.ft.)......................... New building area(sq. ft.)......... ..................... — �) Number of stories............................................ =PROPERTY OWNER TENANT Type of construction....................................... Name:. Occupancy group(s): Existing; h — - -- -- New: Address: _<--- City/State/Zip: V Plione: Fax' NOTICE: All contractors and subcontractors are required to be t CA T NTA T PERSON licensed with the Oregon Construction Contractors Board under n► _ -- provisions of ORS 701 and may be required to be licensed in the It Business _ .S"y�t7� �/�1/1( �/� r u jt-risdiction where work is being performed. If the applicant is exempt r� Contact Name: from licensing,the following reason applies: .�, -I Address: Cit /State/Zi ��'G'f n Dk- 97OJ 9 — -- Phone-: Y9" Fax: z -- BUILDING PERMIT FEES* —E--mai 1: Please refer to fee schedule. CO TRACTOR - --- Business Name: A ' - - Fees due upon application.............................. S_ _P Address: ' ' � � 3 City/State/Zi f ^��'/ Amount received..... ... ............. ......_.. ..... 5 Phone: - �' Fax: `J ' Date received -- - — -- J CCB Lic. #: ---- --- - - 1 1 Authorized Notice: phis per ill application expires Ifs permit Is not obtained within Signature: 180 doss arty-it has been accepted as complete. *Fee me(hodoloo set by TNd'ounty Building Industry Service Board. ` IN se print name) - �� i:',Dsts\Permit Pore\BldgPetmnrtApp t78e-_(QUJA13 One- and Two-Tamily Dwelling Building Permit Application Checklist Reference^°.: -- Associated permits: Cl vofrigard Cit of Tigard Y g U Electrical iJ{'lambing U Mechanical Address: 13125 SW Nall Blvd,TigarJ,OR 97223 U Other: Phone: (503) 639-4171 rax: (501) 599-19611 THE FOLLOWING ITEMS ARE REQUJIREID FOR PLAN RIEVftW Yes No NfA I land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.flood plain,solar balance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. 4 lire 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 conformance to applicable local and state building codes, Lateral design details and connections must he incorporated into the plans or on it separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if' there is more than a 4-11.elevation differential,plan must show contour lines at 241,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 bolts,tiny hold-downs and reinforcing pads,connection details,vent size and location. I I Floor plans.Show all dimensions,room identification,window sire,location of smoke detectors.water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor. I _wall construction,roof construction.More than one cross section may he required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding miderial,footings and t'oundation,stairs, fireplace construction, diermal insulation,etc. 15 Elevation views. Provide elevations for new construction;tninimum 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 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/root'assemblies,indicating member sizing,spacing,and bene ng 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 Bepm calculations.Provide two sets of calculations using current code design values for all beams and multiple jt,ists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer ur architect licensed in Oregon and shall he shown to he applicahle to the project tinder review. 23 Five(5)site plans are required for Item I i above. Site plans must he 14-1/2"x I I"or 1 I"x 17". 24 Two(2)sets each are required for Items 16, 11t,20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building flans will be not accepted. 26 "Reversed" building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List. Checklist must 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 uvcx►rotio Mar 19 03 06: 29a GRW Electric Inc. 5032176236 P. 1 FOR OFFICE USE ONLY Electrical Permit A pp "cats u i.cccivctil t{Ixtrice! Uatemy: _. . --- PertnilNu.:�S .� Oo�O , Ci of T� and Planning Appruval Sign DRIC/R --- permit No.; 13125 SW 11all Blvd. Plan Review ("AlbaTigard,Oregon 97223 Ihtc/li : PcrnnitNo. Phone 503.639.4171 lax: host-Review tattd Uwe Intelnct: www,ci.ti gardLionise Case No.: _ b .orms20 Contact � luNs.; �,5oc Page 2 for 24-hour Inspection Request; 503-639-4175 Ntutta/Mclhgd: Surf► Icmen d Information. TYPE OF WORK PLAN REVIEW(Plea9c check all that apply) f New construction I)cmt,lition Servict:over 22,1 amps- Health-care facility l cumnwnsial ❑Hazardous location Addition/alteration/re lacememt Othcr: 0 Service over 320 amps-rating of ❑Building ovcr 10,1100 squire feet, - C;ATEURrY OF CONSTRUCTION 1 dt 2 family dwellings tbur or more residential units,n l &2-F�nmily dwelling []Cominercial/Industrial ❑'yuan over 600 vults nominal one stmtcotrc Q tiuilding ovcr thrcc st(wics ❑Pucdurw,401)amps of mure ACCO-SorY Buildin Multi-Fami!y - 0 Occupant load ever 9q peroona ❑Manufactured%tructurca tw RV p;uk Meister Builder Other: Cl Cgressnightinp plan ❑MCI% J(?it SITR NFORMA'PION and LOCATION Subinit^seta of plan%with any of the above. The above are not applicable to temporary,construction service. Job site address: O ,S 4 ——� - lel✓ .�.._�.�.�. _ k'�F'C�•$CItaDL1LK. Suite#: � F31d ./A Apt.#' - _Nuntbcr of Ins cctlans cr crntit allowed Project Name: l>catri,firm Qty Pre(Pa.) Twin er Cross street/Dircetions to job site, New residcnt.Incl Ede tar attantuched itm a . dwclliutt unit.Includes attschcd Cnrxkc. I ervice Included: I(1011 sq,IL ar leas 145.15 4 I-Ach additional 500 sq.(1 tar Iwn/inn tharonf 33.40 1 t Limited ener• rcaidcndal 7$.00 _ 2 Subdivision. _ L Jmitcd cncrlly,r unrosidenual —745,00 J Tax Ina / arccl #: Fsch manufactured home tar modular dwelling DBSG'AIPTION OF WU service and/or forder 110,90 ' Services or feeder%.installation, altcnltar rotocationt -"""rrr "�►.-'.'-7""-- 200 amp m.less An.3o 2 201 amps to 400 arnitig 106.85 2 401 Unf>R to 600 amp _ 160.60 2 a J� -NANT f>tl I a to 1000 01111" 140,60 2 PROP TY U TF, ---•-• n_ct 1000 amts or vents _ 454.05 7 Hanle: S,.////1 H l /J I`7/ / 4-4- ICccunnect only 66.115 2 AddrCSS: tc 3V /✓t s Temporary servlet-e(if(ceder%-Installation, rl(crollon•or,elocation: Cit /Sy tate/z1 Cdlf L" /P 97(1 f!, Z00 am r. nr ler . Phone:_5�.3 '1X: 201 oimps tt;4dnannns 4tt1 tn6tN!arn . i3,:7s � z APPLICANT CONTACT PERSON Branch circuits.new,attendee,or Name: extension per panel: " A.For for branch circuits with purchase of Address: i _ service or feeder fes,each branch circuit _-6.63 _2 ('It /St3tC/Zl tt,Fee for branch circuits withuut ptut:hase of wrvice or feeder fee,first branch circuit 46.95 2 Phone: rax: ._ _ Bach otkl:Jonal Manch cuwtl _- 6.65 E-Mail: M,se.(5vrv;cc or feeder not tncludmi); — CONTIZAC�11R Tach pwnp or hriastwn c)m•Ir 2 y 53.40 U_ch xiLn,IN VIA lino Ll htinr 53.40 2 Job No: Signal circuit(s)tar a limited energy panel � �� alteration,dr extension P o 2 Business Name: x%eriH[s .�,.X• Ton, Address: - �T�' _ — Fsch additional inspection over the allnw_ able In an of the above' City/State/Ltp: j`,,, _Q AK f cr tnsprctiunptK hour_rmin.I brut 6, +� •' Inveeu anon fcc. Pholle.�� rax: -- - ---- CCA Lic. #: Q Lic. #: '1 t r Electrical Permit Vacs• Supervisrnsv cicctrit:tan� 4 - Subtotal t Signature re Uirctl: _ Plan KcviGw 2.5'Yn of Permit Nccl S — t —` State Surchargc_(8%of Pcrmit Fc- S i'ritzt Namc: < Lic. ii: -- TOTAL PERMIT FEF S Authofized Notice: ThLs permit application expires if a permit ii not obtained withltt Signawre: _ Uate I 8 days after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service hoard. (rleate print namc) -. \Osis\Permit rormslFlePrrtnitApp,doe 01/03 ..s? 3 9 s D6 k� 1 ,, I LIABILITY ! � CITY OF TKiARD � l The Cit olITigard and its Approv-3d.,:.............................. employees sh no H CondiNont�l►yAppmved ! ............. ): I responsible for scrG' �.Ir S h�K� �'QT«'�✓ For only�ihwnr�,nadenrtibedin 1 which may pear herein. Seo�e'nert� renc+W........................ ..... Akftlh . ( ) Jolt'Address $�?— --CA t et, .aS Ah ok 1 ! .5„ yo►S �./ � l`jn � 5 r�o w� W r�eTn�7;a.J S r Final inspection approval is Approved plans t required prior to occupancy. ,Shall be on job 1 Address shall be posted and visible from F,treet. 1 / t 0 ( 6 Friday, April l l . 2003 CFS OF TIGARQ FILE Copy OREGON Jeremy Jordan Smith & Jordan Properties PUB 5311 Beaverton, OR 97006 `J RT; 11830 SW Greenburg Rd.. Tigard This confirms that Permit No. MST2003-00106, covering the conversion of a garage to living space, has passed the electrical final and building final inspections and that all work under the permit is complete and is accepted by the City of Tigard. As you know, this conversion of living space was actually done by a previous owner, as was various electrical work in the house including the installation of electric baseboard heaters, all without permit. The City of Tigard had cited this property and the then owner for multiple violations of the Building and Housing Codes and we had prohibited re-occupancy until the violations were corrected under permit and the permits received final inspection approval. Although you and your associates did not create those violations, you did, immediately upon becoming aware of thern, take out a permit to cover the work as we requested and effected all necessary corrections promptly and in a cooperative and highly professional manner. The City of Tigard finds that all of the previously noted code violations have been corrected, finds the property to he in compliance as a single family residence, and herewith withdraws the previously issued prohibition on re-occupancy. By copy of this letter I am advising Barbara Sellers, your purchasers' realtor, of the same. If anyone else needs to be advised of the City's acceptance of this property please pass this letter on to them. Anyone with questions may contact me at the City of Tigard, 503-718-2426. It has been a pleasure to work with you, Ms. Sellers, and Randy Mailey in bringing this property back into compliance. I appreciate the professionalism and integrity that each of you has dem strated. Th for your cooperation. G Albert Shie ds (lousing Inspector, Building Codes Enforcement Officer cc: Barbara Severs, Property file. 13125 SW Hall Blvd., Tigard J17 97223 (503)b39-4171 TDD (5'13)684-2772 -- CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 2IV3- �V INSPECTION DIVISION Business Line: x(503) 639-4171 MST --, BU P ------ --- Received - ____-_- -_ Date Requested AM...Y__— PM BLIP Location -- _ ___.__--------- ----_- _ (� ( - tulteMEC Contact Person . ----._ - - -- Ph( ) PLM _-- Contractor_ _-- - - - - -- ---- - Ph(— ) SWR --- ------ --- BUILDING Tenant/Owner _ ELC __- Footirig Foundation Access: / ELC - ---- -.. _-_ FtgDrain y �Urt / /C�/ t'=cY EI_R ---- - ---- -- Crawl Drain _ Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- Insulation �- Drywall Nailing Firewall Fire Sprinkl/jr ---- --„ —--- Fire Alarrr ? Susp'd Ceiling - ---- --- -- - Root Other; Final PASS FART FAIL - P_LUMBIN_G Post 8 Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin i Manhole Storm Drain - Shower Pan Other - - --- ----- Finai PASS PART FA,L MECHANICAL r i Post& Beam Rough-in - I Gas Line --i-Y Smoke Dampers Final r PASS PART FAIL _ - - - ------- -- ELECTRICAL Service Rough-In --- UG/Slab -- --------- ----_-- - Low Voltage Fire Alarm -- ---- - - -�`- Final Reinspection fee of$ requ-red before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection rfE: -� jJ Unable to inspect- no access Fire Supply Line / ADA Approach/Sidewalk Date _ Inspector . - IF-xt Other. Final DO NOT REMOVE itnls IntrNaction record from the Job site. PASS PART FAIL CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2001-00403 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/9/01 PARCEL: 1 S135DD-04200 SITE ADDRESS: 11830 SW GREENBURG RD SUBDIVISION: ZONING: R-12 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: AI_T v FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS- VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: COMES. INCIN: 3 - 15 HP: COMML INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS _ CTHER UNITS: 2 FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 3 > 10000 cfm: Remarks: Installation of gas line to fireplace logs, furnace and water heater, kitchen stove and backyard bar-b-clue. Stub for future furnace. Owner: — PEES —� KITCHEN, WARREN TAYLOR + Type By Date Amount Receipt KATHIE ELLEN PRMT CTR+ 11/9/01 $72 50 272001000C 18211 STREETOP DR 5PCT CIR 11/9/01 $5.80 2720010000 OREGON CITY, OR 97045 -- — Total $78.30 Phone: – - – Contractor: ALINE INC. 4221 SE 113TH REQUIRED INSPECTIONS Gas Line Insp Phone: 503-760-8433 Final Inspection Reg#:LIC 138272 This pep-mit is issued subject to the regulations contained in the Tig.�rc, Iviunicipal Code, State of Ore. Specialty Codes and all other applicable laws. Ail work will be done in accordance with approved plans. 1-his permit will expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 througo OAR 952-001-0080. You may obtain copies of these rules or direct w1tions to Q1U �t��eeetting /r;fl'217dR_p1 Issue By: –. G, Permittee Signatur Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application ^ .. 1 l7 IDatere-ceived: 1 Ca i� / Permilno.: /L�Gt' •(, City of Tigard Pro;eevappl.no: Expire date: ' ('ityof Iigu,d Address: 13125 SVV Ball Blvd,Tigard,OR 9722; Phone: (503) 639-4171 lute issued: By Receipt no.: Fax: (503) 598-1960 Case file no.. Payment type: Land use approval: -- ---- -- Buildiny,permit no.: 7Ncw ly dwellingor accesscry U Commercial/indusinal U Multi-family UTenant improvement ruction Ll Addition/;dteration/replacement U Other: 308 SJ I F INFORMATION COMMERCIAL VALUATION, SCIII'DULE Job address: 1 U Z!7777774 v Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suilc no.: value of all meet I�naterials,equipment,labor,overhead, Tax map/lax loUaccount no.: profit. Value$ — . Lot: Block: Subdivision: *See checklist for important application information and Project name: jurisdiction's lee schedule lbr residential I)ermit fec. City/county: 1 ZIP: q 71-L-3SCHEDULE scripti n and alt of ork or IV 'er(ea.) Total Est.date of completion/inspection: 11kicription Qfr. Res.only Res.only Tenant improvement or change of use: Is existing space heated or conditioned'?U Yes U No Air handling unit —('FM---- Air t Pi Air conditioning(site plan require ) Is existing space. insulated?U Yes U No -- --- ----- A tcration of existing IVAC systeZBTU/14 Y 6 111511 W= Boiler/compressors - -- - Business name: State hoiler permit no.: HP Tons Address: 7-7 SC- — Fire/sma a amper. uctsmo a e — City: P0VUaA IS(ale' ZIP: licat pump(site p an icyuir�c�j Phone'71,C) Fax: Gtttail: Insta I/replace furnace/burner_„ i Including ductwork/vent liner U Yes U No CCB no.: Z Z l; >`; ,',� Install/rcp ace relocateheaters-suspended, City/metro lic.no.: wall,or floor mounted Name(please print): for a Aiance tither than furnace et gest on: - Absorption units_ _ BTU/H Name J � L - Chillers� �, _ HP Address: V Com ressors _ IIP ronmenta ex Aust and ventU ventilation: City: _-- Slrlle: ZIP: o _ Appliance vent Phone.'&!i --p 7q I I Drycrexhaust —Hoods.Type hes.kite en laznuli hood fire suppression system Name: Exhaust fan with single duct(bath fans) Mailing address: Exhaust system a)art from heating or AC —— ue piping an str tut on(up to outlets) City: _ State: 7.1 P: _ type --LP(; � NG Oil Phone: Fax: E-mail: Fuel piningeach ad onal over-4 outlets rocecsp p ng(schematic requir-R) _ Numhcr of outlets "— Name: _ ter$sten appliance or equipment: - Address: Decorative fireplace City: State Insert-type �- Phone*, tax: E-mailoo stove/ ctstove er• _Applicant's signature: _ Date: C>t1 1111 CName(print): Not all)udulictions reel%credit cud%,please cell)uriufiction for nnxe infw—Inallon Permit fee.....................$ U Visa ❑MasterCard Notice:This permit application Minimum fee................$ expires if a permit is not obtained ��[—_ Plan 1'CVICW(at _ Rh) $ , F.xpliea within 180 days after it has been 896 State surcharge Name of cardholder as shown on credit card accepted as complete. g (8%)....$$ —��— s TOTAL ..... ................. Cardholder signalum— Amount 4W4617(WWOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00Minimum fed$72.50 - Table 1A Mechanical Code Oty (Ea) Amt 0 $5,001.00 to$10,000.0 - $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 1400 ` fraction thereof,to and Including 2) Furnace 100,000 BTU+ $10,000.00. Including ducts&vents 1740 $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 _ 14.00 $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 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 n. Pump Cond _ fraction thereof. footnotes below. Comp Minimum Permit Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit a to 100K BTU 14.00 6'/.State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU 25.60 26'/.Plan Review Fee(of subtotal] S 9)15-30 HP;absorb Required for ALL commercial permits only unit.5-1 mil BTU 35.00 TOTAL'COMMERCIAL PERMIT FEE: s unit 3-1.7 mi absorb unit 1-1.75 mil BTU 52.20 --_._ 11)>50HP;absorb ~ unit>1.75 mil BTU 1 87.20 ASSW IED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM Value Total 10.00 Description: O (Ea) Amount 13)Air handling unit 10,000 CFM+ 17.20 Furnace ti. 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTI I Including 1.170 15)Vent fan connected to a single duct ducts&vents 6.80 Floor fuma2 Induding vent 955 --- Suspended heater,wall heater or 955 16)Ventilation system not included In floor mounted boater appliance permit 10.00 Vent not Included In appiicance 445 171 Hood served by mechanical exhaust permit10.00 - Repair units 805 18)Domestic incinerators 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 101k to 500k BTU _ 15-30 hp;absorb.unit,501k to 1 2,310 10.00 mil.BTU 21}has piping one to four outi ets 5.40 30-50 hp;absort.unit, 3,400 1-1.75 mil.BTU 22)More than 4-per outlet(each) 1.00 >50 hp;absorb.unit, 5,725 >1.75 mill.BTU Minimum Permit Fee$72.50 SUBTOTAL: $ Air handling unit to 10,000 dmi 656 1 - --- - - Air handling unit>10,000 cfm 1,170 8%State Surcharge $ Non-portable evaporate cooler 658 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 448 Vent system not Included In 656 appliance permit Hood served by mechanical exhaust 656 other lnaections an Foes: Domestic Incinerator _ 1,170 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee Is spe0 icaily indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 $72 5o per hour Inserts,etc. 3 Additional plan review required by charas,additions or revisions to plans(minimum Gas piping 1-4 outlets 360 charge-one-half hour)$72 50 per hour Each additional outlet 63 -- ---- *State Contrarfor Holler certification requfrel for units 2110k 8 i U TOTAL COMMERCIAL $ "Residential AIC,requires site plan sho'Ning placement or iinit VALUATION: All New Commercial Buildings require 2 sets of plans. I:Wsts\forrns\mech-fees.doc 08/29/01