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10500 SW NAEVE STREET - " ECCG S. W. LAD YMARION DR L=:= .3�E82.01 ' 0/ 5.0'Ld 27.2' 6.8' an �-- Q 3 7--7 r Cl w o 19.0' 4.0 v! cn y �Li 23.7' 3 76 z Ln Vil &1*'j CN • N � '�'t1k u, 51 N� (� o A0 Q� aJ�q ... 1.0' 0 20.0' , ell 89-57'06:"� �, N W 100.00' SCALE DRAWING LOT 179 ERICKS'ON HEIGHTS S.E. 1 /4 SEC. 10, T.2S., R.1 W., W.M, --A 2.5 FOOT LANDSCAPE EASEMENT CITY OF TIGARD SHALL EXIST ALONG ALL STREET FRONTAGE. WASHINGTON COUNTY, OREGON its --A 7.5 FOOT PUBLIC UTILITY EASEMENT FEBRUARY 4 2002 SHALL EXIST ALONG THE LANDSCAPE EASEMENT ' Centerline Concepts Inc . DRAWN BY: MSG CHECKED BY: WGDIII SCALE 1 "=20' ACCOUNT # 115 EMAIL CCI EMAI LdPA0L. COM 640 82nd Drive Gladstone, Oregon 97027 EM: \MLI\L17ERICK 503 650-0188 fax 503 650-0189 NOT�ICE: IFTHE PRINT ORTYPE ONANY -rl-►-� + ( � + I + + + IIIiIIIiII Illill Illllli illi r�r`r1T T�T� rTr111r �.li ► I � ili ilt llt ili � I � � � i ' � I � I� r ili ili Ili � I � i i < < I ! I I f l ! I I t I III I I I D IMAGE IS NOT AS CLEAR AS THIS NOTICE, Z 2 3 ! ! I _--__ __ -- 5 _ _ 6 _ 7 S 9 10 11 _ _ 12 /,Cz ITIS DUE TO THE QUALITY OF T�� — -- ----- ---- -�-- E - No .36 ORIGINAL DOCUMENT -- --�-�-- - -- - � - -- - _ — — — ---- i . E .. ., 8Z LZ 9Z � Z fi� Z �Z ZZ zjlZ O7 6T SI LI 8 � 9I � I � T ZT IT T _ -- I , IIII IIII►IIll�llil 1111 IIII llll,Illl IIII IIII IIII IIIL 1111 I I+II IIII iI�I IIIL lilllllll IIII ' 1111 IIII IIII IIII IIII IIII IlIii(i1�.1lIIIIII►IiII IIII IIII IIII IIIIlIIIIIIIIilll.l ll.11lil. Illl�llllILIII-1111(.1.1 111 . ll 1IJ1111��►�11 i a 0 to 0 0 Z m CD Cr 10500 SW Naeve Street ��a CITY OF TIGAIRD 24-Hour BUILDING Inspection Line: (503)639-417 6�;� INSPECTION DIVISION Business Line: (503) 639-4111 MST a Q BJP -- Received Date Requested 3 AM----- PM _ _____ BLIP Location - 5 � _.SUite , I - - MEC ---—----- ----- Cuntact Person � �-_.._._ Ph(--._) `t C1—`31 0 PLM Contractor __— _ _ ___ -_ Ph(—) SWR BUILDING Tenant/Owner -_ _ — _ _— ELC Footing — ELC _ Foundation Access: �- Ftg Drain ELR -_- _- Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchnrs I f Ext Sheath/Shear Int Sheath/Shear Framing --- -- --- -- -— Insulation Drywall Nailing — -- --- -- ---- _. --- Firewall Fire Sprinkler —� - - -- - Fire Alarm Susp'd Ceiling ------- ---- - _ -�_._. _. Roof Other: _ --- --- _ Final PASS PART FAIL PLUMBING-- ---- - - - Post& Beam — Under Slab - ----- - -- - - --- ----... ---.._ - -- Rough-In Water Service — -- - -- ---- ---- - - -- Sanitary Sewer Rain Grains -- -- —! ----- -- -- - Catch Basin/Manhole Storm Drain --— - --- — -- "— ------ - Shower Pan Other: -- ------------- - --------- Final PASS PART FAIL -- MECHANICAL ---__-- _ -- _ --- --__-. ------ Post&Beam Rough-In -- ----- — - - ---- -- ---� ...._ Gas Line Smoke Dampers - Final PASS PART FAIL - - ELECTRICAL Service ----- - -- - - Rough-In _ -- — - - --- — - UG/Slab Low Voltage -- -- ---- - --- - - - Fire Alarm Reinspection fee of$-_ _required before next Inspection. Pay at City Hall, 19125 SW Hall Blvd. 111'M PART FAIL SITE Pipase call for reinspection RE: - - Unable to inspect-no access Fire Supply Line ADA ' A roach/Sidewalk Date _ �_ Insp�ot -'����"'`� Ext PP Other:,--- Final ther:-_--Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP _.. Received __- Date Requested_ .3 AM _ -_ PM - BLIP Location .._Z_0-5_,210 �.� liLCtyy! Suite---_ MEC Contact Person ._ - --. Ph ( �) . 3/_6) PLM ---- Contractor -_ Ph ( —) -- SWR Tenant/Owner - E L C Footing - Foundation Access: ELC Ftg Drain ELR Crawl Drain _ - - Slab Inspection Notes._ SIT Post&Beam Shear Anchors - - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing ---- Firewall -------- �_-� Fire Sprinkler - -------- -- --_ Fire Alarm Su:o'd Ceiling --- Rooi Other: --- i ASS PArtT FAIL - < - - -+-- P BING Post& Beam Under Slab _ f Rough-In Water Service _ Sanitary Sewer Rain Drains - -- — --- Catch Basin/Manhole - Storm Drain Shower Pan Other.jM - --- F i PART FAIL - --- ,---- rL Post& Beam Rough-In _ Gas Line - Smoke Dampers Fin PART FAIL AL Service RICA Rough-In UG/Slab Low Voltage Fire Alarm Final �J Reinspection ice of$ required before next inspection. Pay at City Hall, 13125 SW Hal!Blvd. PASS PART FAIL SITE _- Please call for reinspection RF Unable to inspect-no access Fire Supply Line ADA ` y� Approach/Sidewalk Data +/i/ Inspector Ext—...-.-- Other: Finril DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL i CITY OF TIGARD MASTER PERMIT _ PERMIT#: MST2002-00163 DEVELOPMENT SERVICES DATE ISSUED: 3'14/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10500 SW NAEVE ST PARCEL: 2S110DA-05600 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 017 JURISDICTION: TIG REMARKS: New SF detached residence. Path 1 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK NLW HEIGHT ,'S FIRST: 1,833 st BASEMENT. s1 LEFT: 15 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: ao SECOND: 11,034 st GARAGE. `- 81 FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: st RIGHT: 9 VALUE OCCUPANCY GRP: R3 ODRM: a BATH. f TOTAL: 2 957-1 sl REAR: 23 PLUMBING SINKS: 1 WATER CLOSETS. 3 WASHING MACH, I LAUNDRY TRAYS: RAIN DRAIN, 10n TRAPS: LAVATORIES: 5 DISHWASHERS. 1 FLOOR DRAINS. SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS 3 GARBAGE DISP. ! WATER HEATERS: 1 WATER LINES: 100 6CKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: ti CLOTHES DRYER: 1 As FURN>=100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS 1 WOODSTOVES. GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER_ TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 400 amp 201 400 amp: 1st WIO sVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 800 amp: 401 800 amp: EA ADDL OR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 501 • 1000 amp: 001+ampe•1000V: MINOR LABEL: 1000.amp/volt PLAN REWEW SECTION Reconnect only: >-4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO FIRE ALARM: INTERCOMIPAOING: OUTDOOR LNDSC LT: BURGLAR ALARM. OTH: BOILER HVAC: LANDSCAPEARRIO PROTECTIVE SIGNL: GARAGE OPENER, CLOCK: INSTRUMENTATION: MEDICAL OTHR: HVAC: DATA/TELE COMM: NURSE CALLS TOTAL a SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,714.55 RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES This permit Is subject to the regulations contained in the 1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR Tigardother Municipal Code,State o k wOR.ill Specialty Codes and o all other applicable laws. All work will be done.n WEST LINN,OR 97068 WEST LINN,OR 97068 acoordance with approved plans. This permit will expire if wo,k Is not started within 180 days of Issuance,or If the work is suspended for more than 180 days. ATTENTION: Phone. Phoria: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg 0: LIC 049955 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.nsp& Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insf Rain drain Insp Plumb Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Ins Footing/Foundation Drl Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Post/ Structural ptM/Underfloor Framing Insp Gas Fireplace Electrical Fi at I -4111 Issu d By : Permittee Signature Call (503) 639 4 75 by 7:00 p.m. for an inspection needed the next business dayv----/ CITYOF TIGARD __ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00114 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/14/02 SITE ADDRESS; 10500 SW NAEVE ST PARCEL: 2S110DA-05600 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 017 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new SF detached residence. Owner: _ FEES RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt 1672 SW WILLAMETTE FALLS DR — WEST I-INN, OR 97063 PRMT CTR 3/14/02 $2,300.00 27200200000 INSP CTR 3!14/02 $35.00 27200200000 Phone: 557-8000 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 riot guarantee the accuracy of the side sewer laterals If the sewer is not located at the rne2surement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located,the installer shall purchase a "Tap and Side Sewer''Perm Issued b : Permittee Signature: ' _�- L Call (503)639-4175 by 7:00 P.M. for an inspection needed the next business day / az /27— - Building Permit Application rProject/appl. 7Expire::d�ate�: Permit n City of Tigard Address: 13125 S W Hall Blvd,'Tigard,OR 9722,3- Phone: 722 _ CiryojTigard phone: (503) 639-4171 y'_ Receipt Date issued: B t nu.; Fax: (503) 598-1960 Case file no.: Payment type: Land use appr( �.d: I&2 family:Simple Complex 1 )(1 &2 family dwelling or accessory U Commercial/industrial U Multi-family )(New construction U Demolition U Addition/alteratiotVreplacement U Tenant improvement lJ Fire sprinkler/alarm U Other: .1011 SUI E'INFORMATION Job address: 1 - O 'J CC, \ u:t- `_ _ Bldg.no.: I Suite no.: Lot: /' I Block: Subdivision: Epr4 leSTax map/tax Iot/account no.:� Project name: E'-ie Iles-✓r *4&6 _ - /. _ 7 Description and location of work on premises/special conditions: �� �► - __- !��� ��/ _ __ /� tt /, 1 1 go. Name: &M AU Sa14cr CkJ7LcW^ Hdy"C! t MENt Mailing address: /672 Sl,/ t,///��•+ r /-�,i/s ,d,�1e 1 &2 family dwelling: City: �6! 1.4 State: ZIP: Valuation of work 22�14�� Phone:5P11778'mtfl0 Fax:So-V_WL E-mail: No,of bedrooms/baths................................. _ Ai— Owner's i—Owner's representative: �;at„s H Ps io o rs Total number of floors................................. Phone: tare Fax: E-mail: New dwelling area(sq.ft.) .......................... Garage/carport area(sq. ft.)......................... SvJ� Name: Xo^t Covered porch area(sq.ft.) ......................... Mailing address: Deck area(sq. ft.) ........................................ _-• _City: I St:t 1 i l I' Other structure area(sq. ft.)......................... Phone: Fax: I nuns CommerciaUlndustrial/multi-family: Valuation of work......... .............................. $- Existing bldg.area(sq. ft.) .......... .......... ... — Business name: fRi•+e V _ _ _. - New bldg.area(sq. ft.)..................... . ........ Address: -- City State: ZIP: Number of stories......................... ...... ..... _-- �rYPe of construction............... ................ ----- --- Phone: Fax: E-mail: Occupancy group(s): Existing: CCB no.: 13(1y X 7_16 mz New: _ City/metro lic.no.: �, �; /Z mb Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed.If the applicant is City: State: 7.11': exempt from licensing,the following reason applies: Contact prrsun Plan no.: -- Phone: Fax: I E-mail: Name; _ Contact person: Fees due upon application ........................... $ Address: Date received: City: — State: 7JP: Amount received ......................................... $_ Phone: TF_ax I E-mail: Please refer to fe,; schedule. 1 heret-;certify I have read and examined this application and the Not all juridi dotu accept credit cards,please call junsdiction for more infornurtion attached checklist. All provisions of laws and ordinances governing this U Visa U MasterCard work will he complied with,whether specified herein or not. ct«tu e.rd number _ —EA ae% �d on p Authorized signature:____. Ste: Name of cardholder as shown on credit card Print name:_ Tra✓il ----T— Cardholder signature -- S Amount ' Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 440-M13(6a10rCOM) 0roe- and Two-Family Dwelling Building Permit Applileation Checklist Referencent - _ — Associated permits: city of Tigard city of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW Hall Blvd,'Tigard,OR 97223 U Other: Phone: (503) 639-4171 Fax: (503) 599-1960 THE FOLLOWING 1 I Land use actions completed.See jurisdiction,r u, n.i l a concurrent reviews. 2 Zoning.Flood plain,solar balance points,setsnuc soils designation,historic district,etc.. _ 3 Verification of approved platllot. 4 Fire district_ approval required. _ 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. 9 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,etc, 10 3 Complete sets of legible plans.Must be drawn to scaic,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-site sheet attached to the plans witi cross references between plan location and details. Plan review cannot be completed if copyright violations exist. I I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including deck::);location of wells/sepdc 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,vent 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-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. I S Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remoaels. 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 w,d calculations to engineering standards. 17 Floor/roof framing.Provide plans for all flours/roof assemblies,indicating member sizing,spacing,and bearing locutions.Show attic ventilation. 19 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered systems,see icem 22,"Engineer's calculations." 19 Veam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists over !0 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 calc,rl•itions. A gas-piping schematic is required for font or more appliances. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDIC1110NAL SPECIFICS 23 Five(5)site plans are required for Item 1 I above. Site pians must be 8-1/2" x 1 I"Ur I I x.1 7". _ 24 Two(2)sets each are required for items 16, 19,20&22 above. 25 building plans shall not contain red lines or tope-ons. 26 "Reversed" building plans must meet criteria outlined in the Permit&System De-elopment Fees document. 27 No"mirrored"building plans will be accepted. 29 "Drawn to scale" indicates standard architect or engineer scale. _ --- Checklist must be 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(eniacoM) Plumbing Permit Application 7received Pcrmia no.:1 c.j;�yC.a_„ -DDI City of Tigard Bwlding permit no.: Address: 13125 SW Hall Blvd,'I'igard,OR 97223Ct ,�of hgurd Phone: (503) 639-417) . . Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: _ case file no. Papment type: OF I &2 Gamily dwelling or accessory U Commercial/industrial J Multi-family U'I•enant improvement New construction J Addilion/alleration/replacelnent J Food service U Other: JOR SITE INFORMATION FEE �,CIIEDULE(for special iqorrnalion use checklist) Job address: Description Qty.I Fce(ea.) Total Bldg. no.: - Suite no.: - New 1-an/17.-fGunily d»ellings nul}: ----- --- (includes 106 fl.for carhIII Hit IUnnnt•coon) Tax map/tax lot/account no.: SFR(1)hath Lot: Block: Subdivision: / , SFR(2)bath --- - Project name: /.' t/ •,, , 14,., /, SFR(3)bath --- City/county:i c 4 LIS ,rr,•• • ZIP: Each additional hath/kitchen Description and location of work on premises: /y_ Sileutililies: �/ Catch basin/area drain Est.date of completion/inspection: _ -- Drywells/leach line/trench drain _ Footing drain(no. lin. ft.) PLUMBING CONT t Manufactured home utilities Business name: _ f f /< /0/,,,,,,4,N� v Manholes Address: �irr Rain drain connector R City: /j,., ,,,,►,,, State: 'fig ZIP:: 7— D Sanitary sewer(no. lin. 11.) -- - Phone: Fax: E-mail: Storm sewer(nu.lin. ft.) CCB no.: 79CC Plumb.bus.reg.no: 10_ -v b Water service(no. lin. Il.) City/metro lie.no.: Fixture or Item: Absorption valve Contractor's representative signature: - Print name: r><e �!,//� Date: Back flow preventer Backwater valve CONTACT Basins/lavatory Name: Clothes washer Address: - - — -- Dishwasher Drinking fountain(s) City: State: 7,IP: Ejectors/sutnp _ Phone: E-mail: Expansion tank _ Fixture/sewer cap Name(print): /�r,��,fj� i. Anm 1,fi­"&t Floor drains/floor sinks/hub -v_ --- Mailing address: /6 7Z Se✓ a r I/s Garbo a bis usal Hose bibh ' City: (,/.�i� ,,�,1 State: .yt' ZIP_ 7 :y' Ice maker Phone: 077n^C Fax: E-mail: Interceptor/grease trap _ Owner instal lation/residential maintenance only: The actual installation Primer(s), _ will be made by nae or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date: Sump Tubs/shower/shower pan Urinal Name: _ _ Water closet Address: Water heater _ City: _ State: ZIP: __ Other: — - — -- Phone: Fax: �E-mail: 'Total Not all jurisdictions accept credit cards,please call jurisdiction for mote information Notice:This permit application Minimum fee................$ _ ❑Visa ❑MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit card numfxr. —L1� within 180 days afler it has been Slate surcharge(8%)....$ Expires ted as complete. TOTAL .......................$ None of cardholder u shown on credo cad accepted p - _ S Cardholder signature Amount 44446151 ULYCOM1 PLUMBING PERMIT FEES: -- - L New 1 and 2-family dwellings only: FIXTURESPRICE TOTA _iiridividual) (includes all plumbing fixtures in v PRICE TOTAL OTY (ea) AMOUNT the dwelling and the ftrst1ft 00 . OTY (c a) AMOUNT Sink 16 _ for each utility connection) Lavatory 16.60 - One 1 bath -_ $249.20 Tub or TublShower Comb 16.60 Two 2 bath _ $350.00 - Shower Only 16.60 - Three 3Jbath $399.00 Water Closet 16,60 SUBTOTAL Urinal 16.60 A 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25'/.OF SUBTOTAL - 16.60 - - -TOTAL Garbage Disposal ` Laundry Tray 16.60 Washing Machine 16.60 Floor DralnlFloorSink 2° 16.60 _ PLEASE COMPLETE: 3" 16.60 4" 16.60 ------_---- _ Quantity b Work Performed _ Water Heater O comarsion O like kind 16.60 Fixture Type: New Moved Replaced Removed/ Gas piping requires a separate mechanical Capped ermit. Sink MFG Home New Water Service 46.40 ---- Lavatory MFG Home New San/Storm Sewer 46.40 Tub or Tub/Shower Hose Bibs 1650 __ Combination _ _ _- Roof Drains 16.60 ,:hower 16.60 Water Closet Drinking Fountain Urinal _ Other Fixtures(Specify) 16,60 - Dishwasher Garba a Disposal_ _ _- LaundryRoorn Tray- _ _ _ -• Washing Machine _ Floor Drain/Sink: 2" _ Sewer•1 at 100' 55.00 Sewer-each additional 100' 46.40 4' _- - 55.00 Water Heater Water Service•1st 100' Other Fixtures Water Service-each additional 200' 46.40 - S eciU _ _- ----. Storm 8 Rain Drain-1st 100' 55.00 Storm 8 Rain Drain-each addltlonal 100' 46.40 -- - ---- Commercial Back Flow PrevenllonDevice Residential Backflow Prevention Device' 27.55 _ Catch Basin 16.60 Inspection of Existing Plumbing or Specially perchr COMMENTS REGARDING ABOVE: Requested Inspections erm - Rain Drain,single family dwelling 65.25 16.60 ------ - - -- - Grease Traps QUANTITY TOTAL - _ --.----- - Isometric or riser diagram is required it ---- Quantity Total Is >9 - "SUBTOTAL 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL - RegWre_d only -- -- TOTAL S 'Minimum permit fee is$72.50+6%state surcharge,except Residential 6ack1low Prevention Device,which is$36 2.5-a%state surcharge "All New Commercial Buildings require plans with isometric or riser&kig,am and plan review I:ldsts\forms\plm-fees,doc 10/10/00 Mechanical Permit Application Date received: Permit no City of 'Tigard IIroject/appl.no.: Expire date city n(Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 ` Phone: (503) 639-4171 Date issued By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ Building permit no 1 F PERMIT I &2 family dwelling or accessory U Commercial/industnal U r.lulti-family U Tenant improvement New construction J %(Itlilioil/alteration/replacement J(Wire _ AW41E INFORMATIONCOMMERCIAL VALUATION SCHEDULE Job address_- Indicate equipment quantities in boxes beluti. Indicate the dollar Bldg.no.: -- _ Suile no,:_ value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ _ Lot: Block: Subdivision: C- A/, ,i ��,, l� *See checklist for important application information and Project name: �/� / ,• r jurisdiction's fee schedule for residential permit fer City/county:'rW s I✓a,l,, .� ,, 'l.I P: SCHEDULE Description and location of work on premises: t t rVJie✓hftct/ IeY(ca.) Ictal Est.date of completion/inspection: Ueuription Qty. Kes.ord Res.only Tenant improvement or change of use: Ci Is existingspace heated or conditioned?U Yes U No Air handling unit CFM •p Air conditioning(siie plan required) Is existing space insula) d?U Yes U No _Alteration of existing AL system poi er compressors - Busincss name: State boiler permit no.: C a`'", /'/e"f'"'`� HP --Tons BTU/H Address: Z7 ,11 s� , 3'?'� 1 �irc/smokedampers/ductsmokedetectors C'ity: /fir Or __ State: oy' ZIP: 9 7/73 Heat pump(site plan require-d) E-mail: -Ma rep ace urnace/ umer / -- Including ductwork/vent liner U Yes U No CCB no.: ©/ Z�r73 e,.., yfLtjfn�>/ nsta rep ace re oceteheaters-suspended, City/metro tic.no.: .18 S6" wall,or floor mounted me— Natelease print): (G,-�/, - Z'vnt 1't,r a, iance of ter than furnace_- tefrigera►on: Absorption units �sv»e Chillers_____._- HI' : Cum ressors Environinentmi ex aunt and venIllation: City: - _ -� State: 7.1P: Appliancevent Phone: i.,ax: E-mail Dryerc.Fiaust--_ _` --� Hoods,Type T/TT/res. i-tcFe__n7/fi azmat �r hood fire suppression system Name: /r r.l�i,ssp�re C Cu f7/s H /Uaa.rs Exhaust fan with single duct(bath fans) — Mailing address: /(; 7Z Exhaust system apart from heating or AC --- Cit - Fuelpiping an str rut on(up to outlets) Y i✓+, r t'. +,+ Stnte: n Q ZIP: Ty I-116 NG oil I'Itone:j:r SS J g�r r Fax: ;cry isG iL f-tnail: Fuel pipingeach additional over 4 out t.ts rocesspiping(schematic requirc ) Number of outlets Name:_ ter appliance or equipment: - Address: __ Decorative fireplace. City: - - 1 ,I,llr 7.IP: nsert-type ----__ -- `— Phone: Fax. E matt oo stov pe et stove Applicant's signature: i ' �� Date: Ot—hu - -- --_ Name (print): Not all judscliclions accept credit cards,plena call iunsdiciion for nacre information Permit fee.................•...$ _ U visa U MasterCard Notice:This permit application Minimum fee................$ Credit card number_ expires if it permit is not obtained Plan review(at _ %) $ Expires within ISO days after it has been State surcharge(8%) ....$ None of cardholdei as shown on ciR char accepted a5 complete. ----- _ s TOTAL .......................$ - — Cudholder signature Amowi 1444617(&WCOM) MECHANICAL PERMIT FETES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: _ Description: — — -- Pnce Total $1.00 to$5,000.00 Minimum fee$72,50 Table 1A Mechanical Coop Oh, (Ea) Amt $5,001.0-0t o$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 ETU $1.52 for each additional$100.00 or including ducts&vents 14 00 fraction thereof,to and including 2) Furnace 100,000 BTU+ -- $10,000.00. Including ducts&vents 17 40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace — $1.54 for each additional$100.00 or including vent 1400 fraction thereof,to and including 4) Suspended healer,wall heater _ _ $25,000.00. or floor mounted heater 1400 $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,U0 fraction thereof,to and Including 6) Repair units _ $50,000,00, 12 15_r $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 •• Minimum Permit Fee$72.50 SUBTOTAL: a 7)<31-IP;absorb unit to 100K BTU 14 00 8%State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU _ 25 60 Fe 25%Plan Review e(of subtotal) $ 9)15-30 HP;absorb Required for ALL commercial permits only unit.5-1 mil BTU 3500 TOTAL COMMERCIAL PERMIT FEE: $ 10)30-50 HP;absorb unit 1-1.75 roll BTU 5220 — - 11)>50HP;absorb unit>1.75 mil BTU __8720 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM — t o 00 Description; Qt Value Amount 13)Air handling unit 10,000 CFM+ --- Furnace to 100,000 BTU,including 955 1720 ducts&vents_ 14)Non-portable evaporate cooler Furnace> 100,000 BTU Including 1,170 10 00 ducts&vents 15)Vent fan connected to a single dura Floor furnace including vent _ a445 -- _ 680 Suspended heater,wall heater or 16)Ventilation system not included in floor mounted heater appliance permit 1000 Vent not Included In applicance '17)Hood served by mechanical exhaust ermit 1000 18)Domestic Incinerators <3 hp;absorb.unit, 955 17 40 to 100k BTU 19)Commercial or industrial type incinerator 3-15 hp;absorb.unit, 1,700 — 69_95 101k to 500k BTU 20)Other units,including wood stoves 15-30 hp;absorb.unit,501k to 1 2,310 1000 _ it.BTU 21)Gas piping one to four outlets 30-50 hp;absorb.unit, 3,400 _ 5.40 1-1.75 mil.BTU 22)More than 4-per outlet(each) >50 hp;absorb.unit, 5,725 — 1 00 >1 75 mil.BTU Minimum Permit Fee$72.80 SUBTOTAL: ?, Air handling unit to 10,000 cfm 656 Air handling unit>10,000 cfm 1,170 8%State Surcharge b Non-portable evaporate cooler 656 Vent fan connected to a single duct 446 TOTAL RESIDENTIAL PERMIT FEE: $ Vent system not included in 656 — ap Ilance permit -- Hood served by mechanical exhaust 656 Other Inspections and Fees: Domestic Incinerator 1,170 ----" 1 Inspections outside of normal business hours(minimum charge-two hours) Commercial or Industrial Incinerator 4,590 $72 50 per hour 2 Inspections for which no fee is specifically Indicated minimum char a-half hour $72.50 per Hour Other unit,Including wood stoves, 656 p Y ( 9 inserts,etc. _ _ 3 Additional plan review required tis manges,additions or revisions to plans(minimum Gas piping 1-4 outlets 360 charge-one-half hr-,,)$72 50 per hour _Each additional outlet 63 Slate Contractor Boller Cerllflcatlon required for units>200k BTU. TOTAL COMMERCIAL $ "Residential AIC requires site plan showing r, zement of unit VALUATION: _� _ All New Commercial Buildings require 2 sets of plans. I'%dsts\forms\mech-fees.doc 08/29/01 F;lectrical 1'ernilit Application — -- - Date rct:crscd: Pcnt,!tnu.:/1; 1 City of Tigard Pro,jecl/appl.no.: Expire date: C1ryr,("l7frrrrl Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no. Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TYPE OF PERM11 I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement 'vew construction U Addition/alteration/replacement J Other. U Partial Joh address: Bldg.no.: Suite no,: Tax map/tux lot/account no.: _ Lot: Block:_ Subdivision: �,.,r/c r+,, r, tri Project name: Description and location of wort•.on premises: - ---- Estimated date of completiott/inspection: CO1 ' APPLICATION, SCHEDULE Job no: ree Max Business name: V C- Description pry. Ira.) Total no.Ins �r3 /s'` fir' Nesvresidential-%Ingleormulti-fandivper Address: pr ,� - -0 _ dorllingunlr.lncludesattaclwdgarage. City: IState: C3Q I ZIP: !70/5' Serviceincluded: Phone:y,,- ,-7 ir;y2 Fax: E-mail: IO(K)sq rt.or less — --- a- CCB no.: i Syr/ Elec.bus.tic.no: J / F.ach additional 500 sq.ft.or portion thereof _ Lunnedenergy,residential City/metro lic.no.: Z 3 _- _ Limited energy,non-residential 2 1 Each manufactured hom^or modular dwelling Signature of supervising electrician(requited) _ Dale Service and/or feeder _ Sup elect.name(pnnt): C.4 61" a License no: GjT_$ Servirmorfeeders-Installation. ahcratlon or relocation: 200 amps or less 2 Name(print): L / 201 amps to 400 amps 2 P C✓.'1 cs /it.4e a j.Ovvs Mailing address: (` 7"_ S� �./ //�,,,�HR /Ga// r, 40�ffmps sto600amps 2 60to 1000 amps 2 City: "4 G,,,+ State:ra? ZIP: j7 off Over IWOantpsorvolts _ 2 Phone: s., S , irlciT I Fax: s" 6-sC11® F-mail: Recumnectonly I owner installation:The installation is being made on property 1 own Temporary services or feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alterauon,orrelocation: ORS 447,455,479,670,701. 200 amps or less 2 201 amps to 400 amps 2 Owner's si gnaturC: Date: r 401 to 600 ams 2 Branch circuits new,alteration, or extension per panel: 7Phon'e*. A. Fee for hr h circuits with purchase of service or iceder fee,each branch circuit -'ZIP: B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: I nr Email: Each additional branch circuit: PLAN 114FIVIVIV(Please check all flint applyT M(sc.(service or feeder not included): J Service over 225 amps•commerct&I U Health-care facility Each pump nr irrigation t rcle U Service over 120 amps-rating of 1&2 U Hazardous location Each sign or outline lighting '- family dwellings J Building over 10000 square feet four or Signal circuit(s)or a hunted energy panel. O System over 600 volts normnal more residential units in one structure alteration,or extension - 1 2 U Building over three stories U Feeders,400 amps or more *Description U Occupant load over 99 persons U Manefactured structures or RV park Vach additional Inspection user the Allowable In any of the above: U Egressilighting plan U Other - Pertnspecuon Submit___sets of plan with any of the above. Investigation 11te above are not applicable to temporary construction service. Other �_ Permit tee... .............$ mn Not all jurisdictions accept credit cards,please L211 jurisdiction for more mfowan Notice:This permit application -- J visa J Mastercard expires if a permit is not obtained Plan review(at Credit card number _-_ __-LT_L_ within 180 days after it has been State surcharge(8%) ....$ _ Esphes accepted as complete. TOTAL $ _ Name of cardholckr as Shawn on credit curd S Cardholder si6nature — Amount 4.10-4615 t6d00,t'OMt ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: ------ /� Restricted Energy Fee.............................................. . ... $75.00 Number of Inspections per perrnit allowed (FOR ALL SYSTEMS) 1,ervice included: Iterns Cost Total Checl, Type of Woik Involved. Residential-per unit 1000 eq ftor less —_ _ $145 15 - 11 El Audio and taereo Systems' Each additional 500 sq ft.or portion thereof $33.40 _ 1 Burglar Alarm Limited Energy _ $75.00 Each Manufd Home or Modular Garage Door Opener Dwelling Service or Feeder $90.90 _ 2 Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 Vacuum Systems' 201 amps to 400 amps $106.85 _ 2 El 401 amps to 600 amps $160.60 , _ 2 601 amps to 1000 amps $24060 _ 2 F 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,alteration,or relocation Fee for each system................................ .................... ... $75 00 200 amps or less $66.85 2 (SEE OAR 918-260.261)) 201 amps to 400 amps $10030 2 401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts. ❑ see"b"above. Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service or Clock Systems Feeder fee. Each branch circuit $6.65 a Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. First brancli circuit $46.85 Each additional branch circuit $665 _ HVAC Mi,cellaneous ❑ instrumentation (Service or feeder not Included) Each pump or irrigation circle $53.40 intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s)or a limited energy panel,alteration or extension $75.00 _— Landscape irrigation Control' Minor Labels(10) $125.00 Each additional inspection over E] Medical the allowable in any of the above Nurse Calla Per inspection $62.50 Per hour $62.50 In Plant $r3 75 Outdoor Landscape Lighting' Fees: Protectbe Signaling Enter total of above fees $ Other -- 8%State Surcharge $ Number of Systems 25%Plan Review Fee ' Na licenses are required Licenses are required for all other Ostallations Sse"Plan Review"section on $ front of application. —. -- ------ "-- ---- Fees: Total Balance Due $ Enter total of above fees $—____ -- ❑ Trust Account# _� 8°o State Surcharge $ .J Total Balance Due $--- - i:Wsts\forms\elc-fees.doc 06/07/01 SEE 35MM- ROLL #20 FOR OVERSIZED DOCUMENT 2 � �• O O ? ° c o c. a o � �0 CIO) It L: n w a ^ � n y � � N I OQ \ v C 3 I S x I