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12991 SW GALLIN COURT N UC G d 0 O C 12991 SW rallin COurt R CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE NORTH STAR PLUMBING 1445 SE OREGON ST SHERWOOD, OR 97140 Plumbing Signature Form Parmit 11: MS-r2nn1-nnn71 Date Issued: 3/13/01 Parcel: 2S104DA-03600 Site Address: 12191 SW GALLIN CT Subdivi:;ion: QUAIL HOLLOW - WEST Block: Lot: 022 Jurisdiction- TIG Zoning: R-4.5 Remarks. New SF detached. FOOTINGS TO BE SURVEYED - SEE SITE PLAN Your company has been indicated as th,� plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate in(JOCIual from your -,ompany sign below and return this Plumbing Signature Form prior to the start of the work to the address above. ATTN. Building Dept. No plumbing inspections will be authorized until thic rornpleted form is received OWNER: PLUMBING CONTRACTOR. LIEN HONG NORTH STAR PLUMBING 8900 SW SWEEK DR #1226 1445 SE OREGON ST T UALATIN., OR 97062 SHERWOOD. OR 97140 Phone #: 503-885-0577 Phone #: 62!i-2679 Reg #- I Ir. 00090697 Pf M 34-255PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Sig ature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD � MASTERt'ERMIT PERMIT#: MST2001-00071 DEVELOPMENT SERVICES DATE ISSUES ' 3/13101 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12991 SIN GALL IN CT PARCEL: 2S104UA-03(300 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R•4 5 BLOCK: LOT: 022 JURISDICTION: TIG REMARKS: New SF detached. FOOTINGS TO BE SURVEYED - SEE SITE PLAN BUILDING REISSUE: STORIES: 2 FLOOR AREAS RFOUIRED SETBACKS REQUIRED CLASS OF WORK: NF:N HFIGH1. 21 FIRST: 1,396 at BASEMENT: et LEFT'. 2 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD 4r, SECOND: 1.312 at GARAGE: 540 at FRONT. 20 PARKING SPACES: 2 TYPF OF CONST: 5N DWELLING UNITS. 1 FINBSMENT: al RIGHT: 10 VALUE: $245,950.00 OCCUPANCY GRP: R3 BORM: I BATH: ! TOTAL: 2,703.00 of REAR. 25 PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: , DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DPAINS: 1 CATCH BASINS: TJB/SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: i WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIUCMP<3HP: VENT FANS: 5 t:LOTHnS DRYER: 1 GAS FURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: OAS UUTLETS: I ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER _ TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF-UR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 50OBF: 5 201 400 amp: 201 400 amp: tat WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL SR CIR: SIGNALIPANEL IN PLANT, MANU HMISVCIFDR 601 • 1000 amo: 601+2mp5•1000r MINOR LABI-L 1000•amplvolt PLAN REVIEW 95C PION Reconnect only: >600 V NOMINAL: CLS AREAISPC OCC: aa4 RES UNITS: SVClF('R>m226 A.: _ ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ B.COMMERCIAL AUDIO S STEREO: VACUUM SYSTEM: AUDIO&;3 TEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER. IJVAC. LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: 07HR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL#SYSTEMS: Owner: Contractor: TOTAL F=EES: $ 4,37.04 This permit is subject to the regulations contained in the LIEN HONG ECK CONSTRUCTION INC Tigard Municipal Code,State of OR Specialty Codes and 8900 SW SWEEK DR 41226 PO BOX 2:14 all other applicable laws. All work will be done in TUALATIN,OR 97062 SHERWOOD,OR 97140 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 Rep N: LIC 114755 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)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Filial Sewer Inspection Underfloor fisulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final Footing Insp Crawl Draln/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing/Foundation Dr Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Building Final Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final Issued By : —L-61-19 _ _ Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARL _SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2001 OUOS£3 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/13/01 SITE ADDRESS; 12991 SW GALLIN CT PARCEL: 2S104DA-03600 SUBDIVISION: QUAIL HOLLOW- 'JVEST ZONING: R-4.5 BLOCK: _ LOT: 022 _ _ JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: I_TPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner: -- - - — FEES LIEN HONG 8900 SW SWEEK DR #1226 Type By Date Amount Receipt TUA.LATIN, OR 97062 PR IT CTR 3/13/01 $2,300.00 27200100000 INSP CTR 3!13/01 $15.00 27200100000 Phone: 503-885-0577 Total $2,.135.00 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. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to foll w rules adopted by the Orepon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain app;*s of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: , Permittee Signature: Call (50 ) 639-4175 by 7.00 P.M. for an inspection needed the next business day '��_ Building Pt ved:.Z 0 0/ Permit no.:i+ltf.?OO1-0007/ City of '1'igar Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: City o.f hgard phone: (503) 639-4171 Date issued: l3 Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: C , t U I &2 family dwelling or accessory U Commercial/industrial U Multi-family New construction U Demolition U Addition/alteration/replacement 1_11'en•mt improvenu',u U Fire sprinkler/alarm U Other: EM ENF.ORMA11ON Job address: Bldg.no.: Suite no.: _ Lot. Block: Subdivision: 2, _ m.tp/_tax loyaccount no.: /d 176 Project name: Description and location of work on premises/special conditions: Name: r , r Mailing address: fq f jr, 1 &2 fandly dwelling: _ r ;;W' �y p City. rCiA/ o Slat ZIP:qJ�,e Valuation of work......wt..�1.:�... ..... .......... $ Phone: .r -e) - " •ax: ---- E-mail; No.of bedrooms/baths................................. Owner's representative: Total number of floors................................. New dwelling area(sq.f.) ..........................Phonc: Garage/carport area(sq.ft.) Name: _4 � --c_ Covered porch area(sq, ft.) ....................... _.-.. Mailing address: rDeck area(sq. ft.) ........................................ City: � I State; ZIP: Other structure area(sq.ft.)......................... Phone Fax j!- : mail: ('ommereiaUindustrieUmultl-family: Valuation of work........................................ CONTRA( I OR Existing bldg.area(sq, ft.) .... ..... ...,t - Business name: = kr. %L�l'• New bldg.arca(sq.ft.) ................{/............ Address: - - - - City: State: ZIP: / Number of stories...................................... 12 Phone Or' Faxi iPA-- mail: Type of construction................ . _ ... . Occupancy group(s): Existing: fl. -- ------- -- New: City/metro lic. no.: Notice:All contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under Ivzme: f provisions of ORS 701 and may he required to he licensed in the Address: � c: c-� jurisdiction where work is being performed. If the applicant is Cit Stat• ZIP: 4- �� exempt from licensing,the following reason applies: Contact person: Plan no.• ;/ > . Phone �inail: Fax: ,i •i Name: Contact person: Fees due upon application ........................... $ Address. Date received: _ City: ', State: LIP: 7 Amount received ......................................... $_ Phos . - •ax: E-mail: Please refer to fee schedule. hereby certify I have read and exnmined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for troae in(cwtnalion attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard work will he complied with,whether specified herein or not. Credit cad number Expires Authorized signrture;C— — 'C Date: Nene of cardholder as shown on credit card Print name: S'r�Z'`i C ,f-� -- Cardholder signature - $ Amount Notice:This permit application expires if a permit is not obtained within 1110 days oiler it has been accepted as complete. W 4613(6MCOM) One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: r'itr /"I'i�un� City of Tigard i Associatedpert:i;ts Address; 13125 SW Hall Blvd,Tigard,OR 97221 U Electrical U 1 lurnhing U Mechanical Phone: (503) 639-4171 U Other- Fax: (503) 598-1960 1 Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. -- T 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 Watcr district approval ----' _T_S0_1_1.1 report. Must carry original applicable stamp and signature on file or with appin:ation. 9 Eror;lon control U plan U permit required.Include drainage-way protection,silt fence resign and location of catch-basin protection,etc. 10 __ 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 fell-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed jf copyright violations exist. 1 I Site/plot plan down to stale.The plan must show Ice and building setback dimensions;property comer elevations(if there is more than a 44 elevation differential,plan must show contour lines at 241.intervals);location of easements and driveway;footprint of structure(including decks);lavation 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,any hold-downs and reinforcing pads,connection details,v%nt size and location. _ 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. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-Moor, wall construction,rou.construction. More ti�an one cross section may he.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,ew. 15 Elevation views.Provide elevations for neva construction;minimum of two elevations for additions and mnurdcls. Exterior elevations must reflect the actual grade if the change in grade ;• greater than four foot at building envelope. Full-size sheet addendurns 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 Floorlroof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing localions.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 code design values for all beams and multiple joists over 10 feet long and/or any Learn/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 enpincer or architect licensed in Oregon and shall he shown to be applicable to the project under review. 23 hive(5)site plans are required for Item I 1 above. 24 -- 25 26 -- 27 28 — --- Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink. Red ink is reserved for department use only. 4404614(&tarcoM) Electrical Permit Application Date received: Permit no.: City of Tigard ProjecUappl.no.:_ Expirc date: CifyofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Cee,pt no. Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type- Land use approval: all W U 1 &2 family dwelling or accessory O Commercial/industrial U Multi-family U Tenant improvement U New construction U AddiliorUalteration/replacemcui U Other: U Partial JJJEM3i111r4ATION Job address: IBldg.no.: I Suite no.: Tax map/tax lot/account no,: Lot: Block: Subdivision: _ -- Project name: Description and location of work on premises: Estimated date of completion/inspection: -- - Job no: FCC ntax Business name: �- rC A.-,�� • hrscri Torr (try. (ea.) lural 110.111~11 Address: NewresMenthd-sbrgk-ortmdli-fanilh per dwelling unh.Inelud"altached garage. City: Slate: ZIP: Servicelncluded: Phone:?2a, Fax: E mai I: 1000$4.fl.or leas 4 CCB no.: Each additional 500!q.ft.or onion thereof 6 / Elec,bus.lie.no: Limited energy,residential 2 City/metro tic.no.: Ornitedenergy,non-residential 2 _ Each manufactured home or modular dwelling Signs ure of sit rvising electrician(re uired) pale Service and/or feeder 2 Sup.elrct.name(print): License no: �� J' Services or feeders-Installation, 00ROPERTV OWNER , alteration or relocation: 200 amps or less 2 Nance(print): 201 amps to 400 amps — Mailing address: 401 snips to 600 amps - -- 601 amps to 1000 amps — 2 — City: Stale: ZIP. --- Over 1000 amps or volts 2 -" Phone: Fax: E-mail: rte„0nnecr0nk, — Owner installation:The installation is king made on property I own Temporary services or feeders- — which is not intended for sale,lease,rent,or exchange according to hrstallatlon,aneratlon,orrelocallun: ORS 447,455,479,670,701. 200 amps or less 2 201 amps to 400 amps - 2 Owner's sI nature: -- --- Date.: 401 to 600 ant rs —� -- 2 mp Branch circuits-new,alteration, Name: or extension per panel: _— A. Fee for branch circuits with purchase of Address: _ _ service or feeder fee,each branch circuit City: Stale: 7.1P: B. Fee for branch circuits without purchase I'hoTic a I{_mail of service or feeder fee,first branch circuit. 2 Each additional branch circuit: Mbc.(Serv: . rrfeeder not Included)- JSeim.cuvri 225aml,�conunercial UHeal;llcarefacilily Each pump• rigation circle 2 U Service over 320 amps-rating of 1A2 U Hazardous location Each sign or outline lighting 2 familydwellings U Building over 10,000 square feet four or Signal circuil(s)or a limited energy panel, U System over6on volts nominal mom residential units in one structure alteration,or extension* 2 U Building over three stories U Feedera,400 amps or more *Description: _ U(kcupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: U ligress/lightingplan U(Rher: Per inspection _ Submit sets of plant with any of the above. Investigation fee 71re above are not applicable to temporary construction service. Other Not all Jurisdictions wcefa credit cards,please call Iurlu*ljon for more inrrxou ion Notice:This permit application Permit fee.....................$ _ ❑visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit card number within Igo days after it has been State surcharge(8'Yc,)....$ -- --- 0ipife” accepted as complete. TOTAL . $ Name of cardholder as"town on c it c """" _ s Cardholder Ngnature Amount 4404613(1iJ00rCOM) Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Bebw: TYPE OF WORK INVOLVED -kESIUENTIAL ONLY ---- — - Restric Number ted Energy Foe.................... of Inspections per permit allowed ••••••••••••.•••••.... 575.OU FEachadditictial rvice includ sd: Items Cost Total �. (FOR ALL SYSTEMS) idential-per unit Check Type of Work Involved: 0 sq.I cr less _ $145 15 q ❑ 500 sy ft.or -'- -- -- Audio and Stereo Systems portion thereof $3340 I imilod Energ✓ $15 00 - 1 ❑ Burglar Alarm Each Manufd Home or Modular Dwelling Service r r Feeder $9090 _ _ 2 Garage Door Opener' Services or Feeclou; Installation,a'!.,ation,or relocation ❑ Heating,Venti alion and Air Conditioning System* 200 arnps or less ___ $80.30 2 201 amps to 400 amps $10685-�-- 2 ❑ Vacuum Systems* 401 amps to 600 amps $160.60 2 601 amps to 1000 amps __ $24060_ 2 ❑ Other Over 1000 amps or volts $454.65 2 - Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alleralion,or relocation I Foe for each system... .................... 200 amps or less $66 85 $75.0n 2 (SEE OAR 918-260-260) 201 amps to 400 amps -�- $100.30 401 amps to 600 amps $133 75 --- --- 2 Check 1 ype of Work Involved: Over 900 amps to 1000 volts, see"b"above. Branch Circtdts ❑� Audio and Stereo Systems New,alteration or extension per panel ❑ Boiler Controls a)The fee for branch circwls with purchasa of servicr or feeder fee. ❑ Clock Systems Each branch circuit $6 65 2 E]bl The foo for branch circuits Data Telecommunication Installation without purchase of service orfs°der fee• F-'] Fire Alarm Installation First branch circuit $46 85 Each additional branch circuit N $6.65 T_ ❑ HVAC Misceilaneous (Service or feeder not included) ❑ Instrumentation Each pump or irrigation circle $5340 _ _ Each sign or ou"line ligh!ing $53.40 ❑ Imercom and Paging Systems Signal circuit(s):it a Ilm�ted energy — oanel,alteration or extension $75.00 ❑ Landscape Irrigation Control* Minor Labels(10) $125.00 Each additional Inspectinn over ❑ Medical the allowable in any of the above Per inspection __ $62.50 __ Nurse Calls Per hour — _ $62.50 In Plant $73.75 v_ Fees.: F1O,jtdoor Landscape Lighting' ❑ Protective Signaling Enter total of above fees $ _ ❑ 8%Stale Surcharge $ Other .-------.--_._----_-_--.,--_.��_- ---�-- 25%Plan Review Fee - - --.____Number of Systems See"Pl.n Review"section on $ " No licenses are required Licenses are required for all other installations front of application Total Balance DueJ-PeS' $ ❑ Trust Account p Enter total of above fees $ -.-- 8%State Surcharge $ Total Balance Due $ i:Wst5lf1nns\r'Ic-fec.doe 1910w00 Mechanical Permit Application Date received: Permit no.: 11 L City of 'Tigard Project/appl.no.: Expire date: Cil)„/IlKilId Address: 13125 SW lull lilvd,Tigard,OR 97223 Phone: (503) 639-4171 bate issuul: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: J I & 2 family dwelling or accessory U Co,nnicrcial/i-idustrial U Multi-family U Tenant improvement JWNew constructiim U ^.�i(hnon/itla_ratiort/replacernent U Other: VAL11A110N-k'I1EDftE Job address: Grp 7L- Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ i Lor. .2Z IBlock: I Subdivision: ' )*See checklist for important application information and Proj ci name: /rp / ,ice jurisdiction's fee schedule for residential permit fc,,. Clly/county: T'/�►�f.�� ZIP: Description and location of work on premises: I ev(ea.) Total l,st.date of completion/inspection: _ Description 4,My. Res.only Res.mdy 1'enant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air handling unit _CFM Air con monwg(site plan required) Is existing space insulated?U Yes U No Iteration u existing HVACsystrm _ o er compressors - — — Business name: ,�rj�T!t_ �i �n State boiler permit no.: HP Tons BTU/H Address: Fire/smoke dampers/duct smoke detectors City: _ State: ZIP: mat pump(site pan required) ax: I E-mail: nsta rep ace furnacelburner-`_MUM Including ductworWvent liner U Yes U No CCB no.: nstu rcT pTace rem heaters-suspen ed, City/metro lic.no.: wall,or floor mounted Name(please print): --- col l rra �.ianceothert an umace efr Rest on: Absorption uni!s �_ BTU/I I Name: Chillers_ _ _ HP Address: �— ("1111pressors HP _ Environmental exhaust and ventilation: City: - State: _ IIP: F,ppliance vent Phone: ! ,r I nl.til 1Jryerex altist tl400ds,Type /Wires. itc ie iazmat hood fire suppression system Name: Exhar .an with single duct(bath fans) Mailing address: Ex.au�si s stem a cart nose eating or AC Fuel piping an r sli tut on(up to outlets _city: -_ ��: I :_��I►' _ Tyly UIG _ NG oil Phone: Fax: E-mail: Net I n cac t additional ever 4 outlets is rocesspiping(sc emaucrequirec) Name: Nunihrr of outlets -- -- — ter sl—tea appliance or equipment: - Address: _-_ Decorative fireplace city: State: ZIP: nseT n type Phone: I.r E-mail: oo stove/pe e1 stove Applicant's signature: Date: ler: - Name(pont): —! _ t -- —-- Not all junrdictions accept credit carats,please call jurisdiction fore more information. Notice: Permit fee...... ... .....$ UVisa UMusterCnrd lifa permit application Minimum fee........... ...$ _ Credit card numher__� / / expires if a permit is not obtained Plan review(at _ %) $ Expires within IRO days atter it has been State surcharge(8%)....$ Name of c-irdho! r ex shmvn on credit c $ accepted as complete. TOTAL $ -- �—- Cardholder signatureAmount 4104617(VOKOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 &2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION FEE: Description: Price Total Mechanical Code City (Ea) Aml $1.00 to$5,000.00 Minimum fee$'2,50 Table $5,001.00 to$10,000.00 $72.50 for the Fret$5,000.00 and 1) Furnace ce to 100,000 BTU $1.52 for each additional$100.00 or Including 14.00 ducts&vents _ fraction thereof,to and including 2) Furnace 100,000 BTU+ including ducts&vents 17.40 $10,001.00 to$2.5,000.00 v$148.50 for the first 1,110,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 14.00 fraction thereof,to Grid inNuding 4) Suspended heater,wall heater _ $25,000.00. or floor mounted heater 14 Ou $25,001.00 to$50,000.00 $379.50 for the first$2!i,000.00 and 5) Vent not included in appliance:permit $1.45 for each additional$100.00 or 6.60 - fractior,thereof,to and including 6) Repair units $50,000.00. 12.15 $50 001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. footnotes below. comp* 7)<3HP;absorb unit ASSUMED VALIDATIONS PER APPLIANCE: to took BTU _ 1400 _ 8)3-15 HP;absorb Value Total i)nit 100k to 500k BTU _ 25.60 Descri don: Q Ea Amount 9)15-30 HP;absorb Furnace to 100,000 BTU,including 955 unit.5-1 mil UTI/ 35.00 ducts&vents 10)30-50 HP,absorb s Furnace> 100,000 BTU including 1,170 unit 1-1.75 mil BTU _ _ 52.20 ducts&vents 11)>50HP:absorb Floor furnace including vent 9% unit>1.75 Trill BTU 1 87.20 Suspended heater,tvall heater or 955 12)Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not Included in appllcance 445 13)Air handling unit 10,000 CFM+ permit 17.20 _ Repair units 805 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 system not included In 15-3U hp;absorb.unit,501k to 1 2,310 appliance permit 10.00 mil.BTU 17)Hood served by mechanical exhaust 30-50 hp;absorb.unit, 3,400 _ 1000 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,ncInJitor Air handling unit to 10,000 cfm- _ 1156 _ 69.95 Air hindlIng unit>10,000 cfm 1,170 _ 20)Other units,including wood stoves e Non- ortabie va orate cooler 658 _ 10.00 Vent fan connected to a single duct 446 21)Gas piping one to four outlets Vent system not Included In 656 5.40 appliance ermit _ 22)More than 4-per outlet(each) Hood served by mechanical 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. _ Gas piping 1.4 outlets 360 25%Plan Review Fee(of subtotal) a Each additional outlet i 63 Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: S VALUATION: I i Other Inspections onj Fees: 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 hour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum charge-one-half hour)$72.50 per hour "State Cor".zior Boller Co.tificallon required for units>200k BTU. "Resid i AIC raqulres site plan showing placement of unit. I:ldsts\form9\mech-fees.doc 10/11/00 Plumbing Permit Application City Of Tigard Date received: Permit no.:Address: 13125 SW Hall Blvd,Tij;Aid,OR 97223 Sewer permit no.: Building permit no.: Cir v q/Tigard Phone: (503) 639-4171 ProjecUappl.no. Expire date: Fax: (503) 598-1960 Da:eissued: rjy: Recciptno.: Land use approval: __— _- -- Case file no.: Payment type: U I &2 family dwelling or accessory U Commercial/industrial L I Multi-family LJ'renant improvement �t(New constnlction U Adclition/alleration/rcplacentrnl U Food service U Olhrr t Job address:/,,I 5; / C�✓//,, G-�j.��• r/9dtii Descri llon Qty. Fee(ea.) TONT Bldg.no.: Suite no.: Nen 1-and 2-Tamil}'dwcllinr�s nnl�: Tax map/tax lot/account no.: (Includes 109 n.foreachulirilvconuecliunl sl:lt (1)bath Lot: Block: subdivision: — -- - -- - T O SFFt(2)bath Project name: �, as�' ^— SFR(3)bath —^- — --- City/county: =�•�G ZIP_ Each additional bath/kitchen ---- ---- D;.scription and loc tO8[ n of work on premises: Site utilities: Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain Footin drain(no.lin.ft.) Business name: Manufactured home utilities — — ---��a �'�' /� Manholes Address: e— o; Rain drain connector — City:.�i, �iYt�Ola Stat ZIP: / p Sanitary sewer(no.lin.ft.) Phone Fax: E-mail: Sturm sewer(no.lin.ft.) CCB no.: �j� - I Plumb.bus.reg.no: �� Water service(no. in. ft.) City/metra lic.no.: Fixture or Item: Contractot's representative signature: Absorption valve Print name: Back flow reventer -- F1atr: Backwater valve — Basins/lavatory Name: �jif� Clothes washer Address: Dishwasher — __ — - -- ---- - -- -- Drinking fountains) -- City: _ State I'��': -- Ejector-sump Phone:+ I ;ix — I[ m,ul Expansion tank Fixture/sewer cap Name(print): Floor drains/floor sinks/hub Mailing address: Garbage disposal Ilose Bibb City: i _ State: ZIP: Ice maker Phone: Fax: E-mail: interce for/grease trap Owner installation/res dential maintenance only: The actual installation Primer(s) will be made by me of the mair&niance and repair made by my regular Roof drain(commercial) employee on the prope•ty 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date: I Sump Tubs/shower/shower pan Name: Urinal — Water closet Address: Walcr heater City: State: ZIP: Other: Phone: - Fax: E-mail: Tota Not all jurisdictions accept credit cards,please call jurisdiction for meas Inrormaaon. Minimum fee................$ Notice:This permit application O Win D MasterCard expires if a penuit is not obtained Plan review(at _ %) $ Crsdit card number:-- _ E/ within IRO days after it has been Slate surcharge(8%)....$ __• Expires TOTA1, accepted tete. .......................$ _ Name of cardholder a shown on credo card p P _ S Cardholder signature Amount— 440.4616(VOCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 24amily dwellings only: FIXTUf!ES (individual) QTY ea) _AMOUNT (includes all plumbing fixtures in PRICE TOTAL Silts; 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT for each utility connections Lavatory 16.60 One 1 bath 5249.20 Tub or Tub/Shower Comb �- 18.80 -��--_ - - - -- -_ -- - -_ Two 2 bath _ - $350.00 Shower Only 16.60 Three 3 bath - - $399.00 _ Water Closet 16.60 ---- --- - -- JUBTOTAL _ Urinal 16.60 8%STATE SURCHARGE � - Dishwasher 16.60 PLAN REVIEW 25%OF Sum 8TAL -� Garbage Disposal 16.60 _____ - ___ TOTAL Laundry xray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" _ 16.60 PLEASE COMPLETE: 4- 16.60 Water Heater O conversion O like kind 16.60 Y - Uuantit b I Work Performed_ Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. MFG Home New Water Service 4640 Sink MFG Home New San/Storm Sewer 46.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Onlv -� Drinking Fountain 16.60- Water Closet Wither Fixtures(Specify) 16.50 Urinal _- Dishwasher Garbage Disposal _ Laundry Room Tray -- Washing Machine_ Floor Drain/Sink: 2" Sewer-1 st 100' 55.00 33" - Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater _ -- Water Service-each additional 200' 46.40 Other Fixture.: _ Storm&Rain Drain-1st 100' 55.00 (Specify) - Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 48.40 -- - Residential Backflow Prevenllun Devica" - 27.55 - Catch Basin 16.60 -- Inspection of Existing Plumbing or Specially - 72.50 Requested Inspections perthr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometrlc or rlser diagram Is required If - QuantityTotalls >9 "SUBTOTAL8%STATE STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL _ Required only it fixture t total is>9 TOTAL E "Minimum permit fee is$72 50+e%,slate surcharge,except Residential packnnw Prevention Device,which Is$36 25+8%state surchargo `"All New Commercial Buildings require plans with Isometric or riser diagram and plan review Is\dsts\forms\plm-fees.doc 10110/00 o v 17 E0 6'O.s©��r I „e ,, :37VJS '10 AII77VD AS 1,44 r/ ,LSM 10770H 71YIl b n Qhs T my n/� ' • r6G IVU �/rVCis00 J \ \ 1 1 � 1 � r � u.�r [r1 o m til •O 101-�/LN\Cf) 1 11 rig Oct r rn 1 � �.. ►�, � r 305 � -- $ �4�r l�° f Z/ � Q, /1 h �1/ rr 1 Ln w� 0 V, V 1