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10504 SW NAEVE STREET 00 o 1 l - - MOVED HOUSE TO 15' SETBACK PER CLIENT, 4/3/02 MSG. • -- FLIPPED HOUSE TO GAR. LEFT PER CLIENT, 4/11/02 MSG. S 89'57'06" E 103.16' 3 2o36� I� . 0 f �. PAM�� 0 r 40.00' _'.. O C o NI"C1�1 C��- '< ifr►-�-�. r to w 00 4 � � 36 �- 3 �./ 00' 3.50' - 40.2' R N 26.4o 1 r4 0 �. - 9.50 p Ln tj 0 0 N N 6 ,N . S 896M5 '514" 117.67 SCALD DRAWING LOT 15, ERICKSON HEIGHTS S.E. 1 /4 SEC. 10, T.2S., R.1 W., W.M. CITY OF TI GAR D WASHINGTON COUNTY, OREGON APRIL 2, 2002 Centerline Con cep is Inc . --A 2.5' LANDSCAPE EASEMENT SHALL. EXIST DRAWN BY: MPT CHECKED BY: WGDIII ALONG ALL STREET FRONTAGE. N � EMAIL CCIEMAIL�AOL. COM ---A 7.5' PU©IC UTILITY EASEMENT SHALL. SCALE 1 =20 ACCOUNT 115 640 82nd Drive Gladstone, Oregon 97027 EXIST ALONG THE LANDSCAPE EASEMENT M: \MLI\L15ER1(:K 503 650-0188 fax 503 650-0189 NOTICE: IF THE PRINT ORTYPE ONANY -rl-I- Ili Illi 111 Illllll li , � lll llI ill Ill it r�_r .��.r ,�. rf-�- � �� � iiliii iii iii tit tip .il � � i' I -iii i�lr iii ii < < I < < < < < �- �...i r i i r i i I i i i i i Jill i IMAGEI I I I I j l l C l l l � i i I l , 1 2 3 I ( II S NOT AS CLEAR AS THIS NOTICE, I // ) /J _ __�_ _____ �_� ____- . 7 8 __ 9 -_ i 14 ___-- 11 12 ITIS DUE T O THE QUALITY OF THE -_ _.__.__..- ._.___- _�__-____-- __-- _- _ -- 36 ORIGINAL DUCUMENT - _. ---- ----- -- - --- ---- ------- -- ------ -- --_---_ -__- ----- - --- --- ___ ---- I . E 6Z 8Z LZ 9Z ZZ IZ OZ 6T 8I L i 8T 9I fiT ET ZT TT a 9 - �~ E Z II�Iilllilllll!l �IIIIIIIIiIII,iIIIIIIII� iIIi �IlilliiLllIIIllillilLll,Illi. llllilllllllllliil�li�lil�iii�li ll I Il IIII fill Illi ilii ill 1111 Ilii lilt Ilii Ilii ilii Ilii Ili lll Illi .(.Ill Illi Illi Llll l.11.l ll 1� llllll�ll 0 n Ob cn Z D m m Cl) --q M m m 10504 SW NAEVE STREET CITY O F T'G A R D - MASTER PERMIT PERMIT#: MST2002-00204 DEVELOPMENT SERVICES DATE ISSUED- 4/22/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10504 SW NAEVE ST PARCEL: 2S110DA-05400 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 015 JURISDICTION: TIG REMARKS: Construction of new SF detached residence.Path 1 euILDINu REISSUE. STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1447 at BASEMENT of LEFT. SMOKE DETECTORS. r TYPE OF USE: SF FLOOR LOAD •ui SECOND. 1 55" at GARAGE "N if FRONT: l0 PARKING SPACES. TYPE OF CONST 5N DWELLING UNITS: I FINBSMENT: of RIGHT. 5 VALUE: b:9r.INa tS OCCUPAN0 GRP: R3 BDRM. 3 BATH. A TOTAL: 3._'000 if REAR: 4,, PLUMBING SINKS I WATER CLOSETS. 1 WASHING MACH. I LAUNDRY TRAYS: 1 RAIN DRAIN: TRAPS LAVATORIES 11 DISHWASHERS I FLOOR DRAINS. SEWER LINES 1— SF RAIN DRAINS. I CATCH BASINS TUBISHOWERS. 1 GARBAGE DISP I WATER HEATERS: I WATER LINES I"^ BCKFLW PREVNTR. GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN-10OK: BOILICMP<3HP. VENT FANS 5 CLOTHES DRYER I ,AS FURN-100K: I UNIT HEATERS HOODS OTHER UNITS I MAX INP. blu FLOOR FURNANCES. VENTS. WOODSTOVES: GAS OUTLETS: _ ELECTRICAL RESIDENTIAL UNIT_ SERVICE FEEDER v TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 200 Amp W/SVC OR FDR. I PUMPIIRRIGATION: PER INSPECTION. EA ADD'L 5009F. 5 201 400 amp: 201 400 amp. 1st WIO SVCIFDRSIGWOUT LIN LT: PER HOUR. LIMITED ENERGY 401 600 amp: 401 - 600 amu'. EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIF DR. 601 1000 arnp: 601-amps-1000V MINOR LABEL: 1000+amulvolt: PLAN REVIEW SECTION Reconnect only: '"— > 4 RES UNITS: SVCrFDR> 225 A >600 V NOMINAL.. CLS ARFAISPC OCC`. ELECTRICAL•RESTRICTED ENERGY �y A.SF RESIDENTIAL B COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO&STEREO. FIRE ALARM: INTERCOWPAGING: OUTDOOR LNDSC LT BURGLAR ALARM: OTH: BOILER HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL. GARAGE OPENER. CLOCK, INSTRUMENTATION: MEDICAL: OTHR' HVAC. DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS Owner: Contractor: TOTAL FEES: $ 7,917.13 This permit is Subiect to the regulations contained in the RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Code.State of OR. Specialty Codes and 1672 SW WILLAME17E FALLS DR 1672 WILLAMETTE FALLS DR all other applicable laws All work will be done in WFST LINN,OR 97068 WEST LINN,OR 97068 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 tollow rules adopted by the Oregon Utility Notification Center Those riles are set Reg N: 11C 131449 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, PosGBeann Structural PLM/Underfloor Framing Insp Gas Fireplace Mechanical Final Grading Inspection flostlBeam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Plumb Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Ins; Rain drain Insp Final inspect),)n Footing Insp Crawl Drain/Backwater Ele.trical Service Low Voltage Water Line Insp Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp I ^� Issued By : J✓ f �' `r` �'� Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business dat CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00143 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/22/02 SITE ADDRESS; 10504 SW NAEVE ST PARCEL: 2S110DA-0540 SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5 BLOCK: LOT: 015 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 _ RENP.ISSANCE CUSTOM HOMES 'f e B Date Amount Receipt 1672 SW WILLAMETTE FALLS DR _yp y p WEST LINN, OR 97068 PRMT CTR 4/22/02 $2,300.00 27200200000 INSP CTR 4/22102 $35.00 27200200000 Phk-ne: 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 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 riot so located, the installer shall purchase a "Tap and Side Sewer" P m Issued 4: , ✓f�< < �� (��cf-f Permittee Signature: Call (503) 635-4175 by 7:00 P.M. for an Inspection needed the next business day j i. ��5�,�,���� Z- 1��J �SOJ� Building Permit Application • Datc received: Perms:n,. ) 7 '>Itv of Tigard _ ---- Address 13125 SW Hall Blvd,Tigard,OR 97223 i'rojccUappl.no.: Expire date. City n�Tignrrt — Phone: (503) 639-4171 Date issued: By--4,t I Recciptno.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: — "1,. I&2 family:Simple Complex: , 1 &2 family dwelling or accessory ❑Commercial/industrial U Multi-family AeNew construction U Demolition U Addition/alteration/replacement U Tenant improvement U Firr pumk1cr/alarni U Other: INFORMATION-110111 SITE Job address: c'"p t;J —qL7—^ Bldg.no.: Suite ria.: Lot: I Block: Subdivision: E�iz./,as,,, /� (�� Tax map/tax lot/account no.: — Project name: _- Description and location of work on premises/special conditions: Ltmg Name: �vt ct rIa t C Mailing address: /4 7Z 5'l✓ !,///r, a// . I &2 family dwelling: City: t /.J!- �,,.�,� State: ZIP: Valuation of work........................................ $ Z& Irv,/� Phone: -;--r (0 IFax: •SG /Eu'+/ E-mail: No.of bedrooms/baths................................. 3 �� _Owner's representative: i-'0-t --e Nu.�- Total number of floors................................. �• Phone 6 7.r ,?050 Fax:C70 ?663 E-mail: New dwelling area(sq, ft. Garage/carport area(sq.fl.)......................... 6 T Name: c.,..� Covered porch:trea(sq.ft.) ......................... Deck area(s ft. _ Mailing address: q. ) ................./........ ............ �4 City: State: ZIP: Ofher stnn lure area(,, ft.)slD/!' Phone: Fax: E-mail: Commercial/industrial/multi-fanuly: Valuation of work............................ ... . ..... $ Business name: s1et,�„r Existing bldg.area(sq.ft.) ................. ---—._ New bldg.area(sq. ft.) ............ ....... . . Address: •••• ------ -� ........................... City: State: ZIP: Number of stories - -- - Type of construction.................. ................ I hone: Fax: E-mail: Occupancy group(s): Existing: CCB no.: r3 - -- New: City/metro lic.no.: /,, Z of ' Notice:All contractors and subcontractors are required to be R11 11jRjWJjJ961U1 licensed with the Oregon Construction Contractors Board under Namu 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: ZIP: -' exempt from licensing,the following reason applies: contact person- Plan no.: _ Phone: Fax F. mail: ---- Name: i contact person: Fees due upon application ........................... $_— Address: Date received: City: State: ZIP: _ Amount received ......................................... $ Phone: Fax: _ Email: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Na all iunWictions accept credit cards,plane tail Jurisdiction for tnm information attached checklist. All provisions of laws find ordinances governing this U Visa J Mastercard work will be complied with, whether specified herein or not. credit cmd natnher ____ Fspnes Authorized signature: Date: —Nana or cardholder as shown on credit card Print name: S f��• i�rw.r Cardholder n6mrure s Amount Notice:This permit application expires if a permit is not obtained%%Whin 190 days after it has been accepted as complete. 4404611 tnaxvcor.t, One- aijd'I ivo-Family Dwelling Building Permit Application Checklist Reference no,: Cityu/Tigardilr(I Associated permits: City of Tigard 13 Electrical 'J f lumhinp J Mechanical Address: 13125 SW Hall Blvd,'Ilganf,OR 97221 Li Other Phone: (503) 639-4171 Fax: (503) 598-1960 THE IkOLLOWING ITEMS ARE REQUIRED1 1 Land use actions completed.See jurisdiction criteria for, )ncurrent reviews. 2 'Zoning.Flood plain,solar balance points.seismic soils designation,historic district,etc. 3 Verification of approved plat/lot, 4 Hire 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 onginal applicable stamp and signature on file or with application. 9 Erosion control ❑plan U permit required.Include drainage-way protection,silt fence design and location of catch-hasin protection,etc. 10 3 Complett sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if copyright violations exist. I 1 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations tit there is more than a 441.elevation differential,plan must show contour lines at 2-11.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,any hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor plans,Show all dimensions,room identification,window sire,location of smokt 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,mof construction. More than one cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if 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/roof assemblies,indicating member sizing,spacing,and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems,see 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 heam/joist carrying a non-uniform load. 20 Manufactured noor/roof truss design details. 21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or architect licensed in()regon and shall lie shown to he applicable to the project under review. JURISDICTIONAL 23 Five(5)site plans are required for Item I i above. Site plans must he.8.1/2' x I I"or 11' x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 No"mirrored"building plans will he accepted. 28 "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(6MCOM) Mechanical Permit Application Date received: Permit no.:YL,,i G0� U✓ a City of Tigard Project/appl.no.: Expire date: City gfTigard 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: _- Building permit ro 1 U 1 &2 family dwelling or accessory U Cumnicrcial/industnal U Multi-family J"I rnant improvement U New construction U Addition/alteration/replacement U Other:.109 SITE INFORMATION1SC"EDULE Job address: za,51_0 if 55 La /U f.,SG Indi.ate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax mapltax lot/account no.: profit. Value$ _ Lot: Block: Subdivision: Frtx/r s«+ r, .,r 'See checklist for important application information and Project name: ��<<z ., ,., "isdiction'stee schedule for residential permit fee. City/county: Wa �,, �,N ZIP: EM Description andlocation of work on premises: 1v:r.r r 1� Mt /;�, Est.date of completion/inspection: _ tkuripdI Oty. Res.only Re;.onl Tenant improvement or change of use: Is existing space heated or conditioned?O Yes U No Air hhanandling unit _CFM Air conditioning(site plan required) Is existing spare insulated'!U Yes U No A terinonofexisting HVAU system Boiler/compressors State boiler permit no.: Business name: State HP 'Pons _BTU/H Address: 6 47 .45._ Al Fire/smoke dampers/duct smo a etectors City: ,t,f(e State:Oe ZIP:_ 9 70/1 ieat pump(site plan rcyu—ir-7e 1 Phone: '2 G6 Z Fax: 24( 7 l 9 1 E-mail: nsta T J/replace furnacAu�ne� B - Including ductworlu'vent liner U Yes U No CCB no.: 9 e 15 Install/replace/relocate heaters-suspen e City/metro lic.no.: wall,or floor mounted Name(please l , e� oce other than furnace e gerat on:e Absorption units _ BTU/11 Name: Chillers HP S•c,«e -- ------- - -- Cum ressors _ HF' Address: —_ Environmental exhaust and ventilation: City: Slate: ZIP: Appliance vent Phone: Fax: E-mail .yer_ haust Hoods,Type res.kitchell/haamat _ / hood fire suppression system - Name: gr✓o, oAt �w /fir,«vJ Exhaust fan with single duct(bath fans) Mailing address: fL 7 2 Sw L/t 11,L«r'�P F-//,- Exhaust system a art frnm heating or AC Fuelpiping andistribution(up to outlets) City: in/rJ''- 0.1 State: , ZIP: 7m6 i7 Type: 1_11G NG __ Oil Phone: S s J toe T Fax: b s` t( r, 1 F mail Fuel piCing eichadditional over 4 o%t etT .s rocas piping(schematic required) Number of outlets Nome: _ _. Other&IR appliance or equipment: Address: Decorative fireplace City: State: ZIP: Insert-type -- — oo stove/pel et stove _ Phone: Fax: E moil: ON— Name Applicant's signature: Date: Name (print): S t+✓ u - Not all Jurisdictions accept credit cards,please call jurisdiction for near mtnnnanm Permit fee.....................$ _ — Notice:This permit application Minimum fee................$ _ J Visa O MasterCard expires if a permit is not obtained rreducad number._ — -��-- --� 1-. within 180 days aPlan review(at _ %) $ ^_--- after it has been State surcharge(896)....$ _ --- _- accepted as complete.Name of c older u shown at credit card P P � TOTAL .......................$ Cradholder signature Amount 440-4617(OW-01M) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: -Price Total rrable 1A Mechanical Code Oty (Ea) Amt $1.00 to$5,000.00 Minimum fee$72.50 1) Furnace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vents 1400 $1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+ traction thereof,to and including including ducts&vents 17.40 $10,000.00. Floor Furnace $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Including vent 14.00 $1.54 for each additional$100.00 or 4) Suspended heater,wall heater fraction thereof,to and including $25 000.00. 379.50 or floor mounted heater 14.00 $25,001.00 to$50,000.00 $ for the 00 first$25, 0.00 and 5) Vent not included in appliance permit 680 $1.45 for each additional$100.00 or fraction thereof,to and including 6) Repair units 12.115 $50,000.00. $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Booiler eat Air ond $1.20 for each additional$100.00 or For Items 7-11,see Comp _ fro.;rion thereof. footnotes below. _ $ 7)<3HP;absorb unit - 14.00 Minimum Permit Fee$72.50 SUBTOTAL: to 100K BTU -- 8)3-15 HP,absorb 25.60 8%State Surcharge $ unit 100k to 500k BTU 9)15-30 HP;absorb 35.00 25%Plan Review Fee tof subtotal) unit.5-1 mil BTU Required for ALL commercial ermits only10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20 11)>50HP;absorb 87.20 unit>1.75 mil BTU I i 12)Air handling unit to 10,000 CFM 10.00 �ASSUMED VALUATIONS PER APPLIANCE: �� Value Total 13)Air handling unit 10,000 CFM+ Descrl i tion Qt Eat- Amount 17.20 Furnace to 100,000 BTU,including 955 14)Non-portable evaporate cooler 10.00 ducts&vents _ Furnace>100,000 BTU Including 1,170 15)Vent tan connected to a single duct Goo ducts&vents _ Floor furnace including vent - 955 16)Ventilation system not included in Suspended heater,wall heater or 955 appliance permit 10.00 floor mountbd heater _ -- i7)Hood served by mechanical exhaust Vent not included in appllcance 445 10.00 permit -- 805 18)Domestic Incinerators 17.40 Repair units - ---- <I hp;absorb.unit, 955 19)Commercial or industrial type incinerator 69.95 to 100k BTU 3-15 hp;absorb.unit, 1,700 20)Other units,including wood stuves 101k to 500k BTU 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets 5.40 mil.BTU 30-50 hp;ebsorb.unit, 3,400 22)More than 4-per outlet(each) 1 00 1-1.75 mil.BTU>50 hp;absorb,unit, 5,725 Mlnlmum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil,BTU _ - Air handling unit to 100000 cfm 656 8%State Surcharge $ Air handlin_ ug nit>10,000cfm 1,170Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not inciuded in 656 -- - a liance armit Other Insoectlons and Fesa: 656 Hood served b mechanical exhaust 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic incinerator - _1,170 $72 50 per hour Commercial or industrial Incinerator 4,590 _ 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour) $72.50 per hour Other unit,Including wood stoves, 856 3 Additional plan review required by changes,additions or revisions to plans(minimum inserts,etc. _ 380 charge-one-half hour)$72 50 per hour Gas piping 1-4 outlets _ - Each additlonil outlet 83 -- - 'State Contractor Boller Certification reyaired for units>200k BTU ---1 "Residential A/C requires site plan showing placement of unit. TOTAL COMMER..tAL S VALUATION: ____.__� All New Commercial Buildings require 2 sets of plans iAdsts\forms"ech-fees.doc 08/29/01 A Electrical Permit Application -- Uatereceived: Permitno.: �- City of Tigard Projecl/appl.no.: Expire date: City af,rigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 pate issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U Addition/alteration/rrpLlcement U Other: U Partial JOR SITE INFORMATION Job address: o Q %J 1314. no.: Suite n L: Tax map/tax lot/account no.: Lot: I Block: Subdivision: , < 7Ij,!g _ Project name: of work on premises: — -- _ -- -- -- - ------.____.------ Estimated(late of completion/inspection: CONTRWFOR APPLICATION FEE SCIfEbULE Job no: 1(Y' Max Iteurfpriort ph. (ea.) local no.fits[, Business name: a � Elac ri,G New residential singk�ut mahi family Ix-r Address: I +• Z dwellingrudLIncludes atlathedga"ge. City: C1 4u State:pjQ ZIF 17015- Servlcelneluded: Phone:S<," .'S 1 fr;y2 Fax: E-mail: 1000 sq.ft,or less CCB no.: t 3 Syt/ Elec,bus. lie.no: 3-• / Each additional 500 Nq.ft.or portion thereof — Limitedenergy,residential 2 City/metro lic. no.: zly3 Limited energy,non-residential _ // WL � Each manufactured home or modular dwelling Signature of supervising ectr eian(rcyuncd) Date Service and/or feeder — —j• Services or feeders--Installation, Sup.elect.nnnte(punt) C (rs r I iccnse no; �/�3 alteration or relocation: PROPFR-iry OWNER 200 amps or less 2 Name(print): 201 amps to 400 nmps 2 p (r.1 cs 'r Gas earl !"' 401 amps to 600 amps _ Mailing address: 14 7 Z S',/ w //Q,w,f><a 60 /- 4 ✓ 601 amps to 1000 amps City: L,t,, I State: W ZIP: 1-7 CY Over 1000ampsorvolts 2 Phone: S., 5 , Tocip I Fax:S^1 O F-mail: Reconnectonly 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,alteration,or relocation: 200 amps less ORS 447,455,479,670,701. to 201 amps to 400 amps 2 _ Owner's signature: _ Date: 401 to 600 ams 2— Branch circuits-new,alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: State: ZIP: B Fee for branch circuits without purchase --- — — of service or feeder fee,first branch circuit: _ 2 Phone: — I ,t F until: Each additional branch circuit: Misc.(Service or feeder not Included)- LJ Sci-Nice over 22ti anips-comineicial ncluded):JSe;-rceover22tiamps-commercial Jlleatih-care facility Each pump orirrigation circle U Service over 320 amps-rating of 1&2 U Hazardous location Each signor outline lighting — familydwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,or extension* U Building over three stories U Feeders,400 amps or more "Description: U occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable in any of the above: U Egress/lightingplan U Other -- Per inspection Submit_—_sets of plans with anv of the above. Investigation fee The above are not applicable to temporary construction servt,•e, other 1 Not all Jurisdictions accept credit cards.please call jurisdiction for more ininnnauon. (Notice: This permit application Permit fee.....................$ -------— U visa U MasterCard expires if a peri:,is not obtained Plan review(at _ %) $ Credit card number. -�_ / / within 180 days after it has been Slate surcharge(8%) ....$ Expires accepted as complete. TOTAL .... $ Name of c— ar t�older es shown on credit cord Cardholdet signature Amount 440-4611(&MIC'OMI ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: _TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fce Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed tFOR ALL SYSTEMS) Service included: Iterns Cost Total Check Type of Work Involved. Residential-per unit f 1000 sq ft or less $145 15 4 Il Audio and Stereo Systems' Each additional 500 sq ft.or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00_ Each Manufd Home or Modular Dwelling Service or Feeder $90.90 7 Garage Door Opener` Services or Feeders ❑ Healing,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 201 amps to 400 amps _ $106.85_ 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,alteration,or relocation Fee for each system................................... $75,00 200 amps or less $6685 2 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Typo of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits New,alteration or extension per panel ❑ Boiler Controls a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. Each branch circuit $6(55 2 ❑ Data Telecommunication Installation b)i'he fee for branch circuits wifheut purchase of service ❑ or feeder fee. Fire Alarm Installation First branch circuit _ $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentau o (Service or feeder not included) Each pump or Irrigation circle $53.40 _ Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems Signal circuit(s)or a limited enemy panel,alteration or extension $75 00 _ ElLandscape Irrigation Control' Miror Labels(10) $12500 _ Each additional inspection over ❑ Medical the allowable in any of the above ❑ Per irispection $6250 Nurse Calls Per hour _ $62 50 In Plant _ $73.75 ! �❑ Outdoor Landscape Lighting' Fees: ❑ Protective Slgnarn i Enter total of above fees $ Other 8%State Surcharge $ T _ Number of Systems 25° Plan ReFee SReview" See"Plan Review"section on $ rd, i(eases are required Licenses are required for all other installations S front of application -- Fees: Total Balance Due $ r, Enter total of above fees $ LJ Trust Account# 8".State Surcharge $____� _ Total Balance Clue $ i:\dsts\fommsklc-tecs.doc Oh'07'01 1. Plumbing Permit Application Date received: Permit no.b i City of Tigard - y Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 - C'iryu('l•tgard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no.. Land use approval: Case file no.: Payment type: TYPE OF PERMIT I &2 family dwelling or accessory J Commercial/industrial U Multi-family J Tenant improvement New c(utaruetion J Addition/alteration/replacement J Food service J Other: -- JOB SITE INFORMATION t Job address: IQS' �(,J �('Z_.S�' __ Description (py.I Fee(ea.) 1 TOta) Bldg, no.: Suite no.: ;Neer 1 and 2-tantili d"ellings unl}: (include,10011.fill.each utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot: I Block: Subdivision: % o r �� h SFR(2)bath Project name: / s•,,, ,_ le,14 _ SFR(3)bath City/county:-„ L,/,��,,4, ZIP: Each additional hath/kitchen Description and location of work on premises: H, a , Site utilities: _ __ _ ,•tJi�/rN�;a/ Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no. lin. ft.) PLUMBING CON,irRA(-]'OR Manufactured home utilities Business name: G..,:f'f �/< /�/f,,,r,urN9 _ Manholes Address: 77,14 sf i ti Rain drain connector City: „ r,.r.„ Sate: ZIP: 9700 Sanitary sewer(no. lin. ft.) Fax: E-mail: Storm sewer(no. lin. ft.) Phone:spy-6 -?' 9 CCB no.: 7q 'LG rD Plumb.bus.reg.no: -Z _ q (, Water service(no. lin. ft.) City/metro lic,no.: Z 5,f/ Fixture or Item: Absorption valve Contractor's representative signature: AlerBack flow preventer _ Print name: r < C',/ Date: Backwater valve Basins/lavatory _ Name: ya,.,e _ Clothes washer -- - Dishwasher Address: - Drinking fountain(s) City: State: ZIP: _ Ejectors/su np _ — Phone: Fax: E-mail: Expansion.ank Fixture/sewer cap _ Name( riot): l/ Floor drains/floor sinks/hub P ffeolar�romce Cus am nMrf Garbage disposal Mailing address: J6 7 S / a • //s— Hose bibb City: i�- /,". State: nX I ZIP: 7 ; �' Ice maker _ Phone: E-mail: Interceptor/grease trap _ owner installation/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the pranerty I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) _ Owner's signature: Date: _ Sump 'Pubs/shower/shower pan_ _^ Urinal - Name: Water Address: Water heater City: State: '!_IP: [lther: -- -� Phone: Fax: Email: T&W - Minimum fee................$ Not all jurisdictions accept credit earls,please call jurisdiction tot more information Notice:This permit application ❑visa U MasterCard expires if a permit is not obtained Plan review(at _ 96) $ Credit card number. _ — —L s within 180 days after it has been State surcharge(896) ....$ Expires Name of cardholder u shown on credit card accepted as complete. TOTAL ....................... Cardholder signature Amount 440-461616000/COMI PLUMBING PERMIT FEES: - _ PkrCE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) QTY _ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL -- � - - 16.60 the dwelling and the first100 it. QTY (ea) AMOUNT Sink _ _ - for each utility connection) - 16.60 $249.20 Lavatory _ Ones bath ___. Tub or TUb/ShoWWr Comb 16,60 Two 2 bath $350.00 - Shower Only 1660 Three;3�bath $399.00 Water Closet 16.60 — SUBTOTA_L Urinal 16.60 _ - 8%STATE SURCHARGE Dishwasher 16 60 PLAN REVIEW 25%OF SUBTOTAL --- —- TOTAI- Garoago Disposal 1660 -- --- La.indry Tray 1G.60 Washing Machine 1660 Floor DramlFloor 5lnk r'� -� 16.60 -- PLEASE COMPLETE: 3„ 16.60 4^ 16.60 - Quantity bFRe rk Performed _ Water Heater O conversion O like kind 16.60 Fixture Type: New Moved placed Removed/ Gas piping requires a separate mechanical __— Capped ermit -- Sink MFG Home Now Water Service 4640 _ -- --4640Lavatory — -- MFG Home Now San/Storm Sewer Tub or Tub/Shower Hose Blbs - 1660 Combination Roof Drains 1660 Shower On.l — 16 60 Water Closet _ Drinking Fountain _ — Urinal_ Othe. Fixtures(Specify) 16,60 Dishwasher Garbage Disposal Laundry Poom Tray _- Washing Machine_ _. Floor Drain/Sink: 7' -ewer. Ist 101)' - -- 9500 3 Sewer-each additional 100' -- 45 40 - 4 5500 Waaler Heater Wator Service-1st 10U' _- Other Fixtures Water Service-each additional 200' 46 40 _ S ecif Storm 8 Rain Drain-1st 1U0' — 55,00 Storm 8 Rain Drain-each additional 100' 46 40 -_ - --- Commercial Back Flow Prevention Device 46.40 -- Residenllal Backflow Prevention Device' 21 55 Catch Basin 16.60 — - lnspeclian of Existing Plumbing or Specialty 7250 COMMENTS REGARDING ABOVE: Requested Inspections — — Rain Drain,single family dwelling 6525 Grease Traps 1660 --- - QUANTITY TOTAL — ls,metric or riser diagram is required if Ouai fit,Total is >8 'SUBTOTAL - _ -- 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only if fixture qty total is 0 _ TOTAL E 'Minimum permit fee i S72 50+a slate surcharge,except Residential Backflow Prevention Device.which,s$36 25-6%state surcharge All New commercial Buildings renuire plans writ .metric or riser diagram and plan review i\dsts\forms\plm fees.doc 10/10'00 SSE 35MM ROLA, #20 FOR OVERSIZED DOCUMENT CITY OF TI''.ARD 24-Hour BUILDINU Inspe-tion Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received _ - _ Date Requested -2.3 AM - - - PM - -- BLIP - -- Location _ __Suite _ _ MEC _ Contaci Person Ph( ) `7 >1 D i_ PLM - ----_ - Contractor- Ph( ) SWR --- -_- BUILDING TenanVOwner --- ELC -_- - Footing Foundation ELC Access: Ftg Jrain ELF! Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing -- Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling -- - - Roof Other._ -- —- FF1 a-) PASS PART FAIL _ BIN_G _ Port&Beam Under Slab Rough-In Water Service Sanitary Sower Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other Final _PASS PART FAIL MECHANICAL -- Post F, Beam Rough-In Gas Line Smoke Dampers a SS PART FAIL _gECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm Final (� Reinspection fee of$. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd PASS PART FAIL _ $ITE Please call for reinspection RE:_ __ L7 Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk nate D�` _ Inspectcr ._ __ Ext Giller. Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL AAAAAAAAAAAI►AA.AAAAAAAAAAAAAAAAAAAAAAAAAAAAA rri i i C4 I )I ' CN ` a rD Q. rD v i y ► a. rD N (A "i i 4 < ro ► n v- ► e i ► 'I I ► ' � � I " 1 � a rW+ � � ► �I > ► i t?7 p p ► ► pool •� � N � _ � ISI ► 44414 1b ► Fill V. 1 loll i w i 44 I ► i s �V, G O ~ fb rb - a w o d y a� a n A 0 h o � � o � � h o � A d �e It CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BUP -- - - Received -- Date Requested Z AM PM BUP _ Location �0s y —�iCL.PJrt Suite _ MEC Contact Person _ .d����P . - Ph ( _-) — � �'j ✓31 A Z- PLM -- Contractor --__ _-- Ph ( _) SWR BUILDING _ Tenant/Owner _ ELC Footing Foundation Access: ELC Fig Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam - ---- - - Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing — —_ Firewall Fire Sprinkler - - - -------- Fire Alarm Susp'd Ceiling Roof Other: Final _ ART FAIL _MBI - --- Post& Beam - Under Slab ---- Rough-in Water Service - — Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan AS PART FAIL M ANICAL Post 8, Beam --- ------.—._ ----- -- Rough-In Gas Line Smoke Dampers Final RT FAIL — —-- — -- — CLECTPJCPL' Se — Rough-In UG/Slab Low Voltage — Fire Alarm ASS PART FAIL Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE:_ — Unable to inspect-no access Fire Supply Line ADA c Approach/Sidewalk Date Inspector �_— Ext -- Other:_ Final DO NOT REMOVE this Inspection record from the Job site. PASS PAST FAIL.