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10514 SW NAEVE STREET IS 3AHVN MS v'i50l E� a � W � z m 0 lot W .� 10514 SW NAEVE ST ELECTRICAL PERMIT- CITY OF TI GARD RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT ELR2005-0002 9 13125 SW Hall Blvd.. Tipard. OR 97223 (503)639-4171 DATE ISSUED: 2/15/2005 SITE ADDRESS: 10514 SW NAEVE ST PARCEL: 2.S110DA-02500 SUBDIVISION: RENAISSANCE SUMMIT ZONING: R-3.5 BLOCK: LOT: 016 JURISDICTION: TIG Prosect Description: Stereo and Data Cabling. A.RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: X V AUDIO&STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT- GARAGE.OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COM14: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM, OUTDOOR LANDSC LITE: OTHER: DATA CABL : X HVAC: PROTECTIVE SIGNAL.: INSTRUMENTATION: OTHER: _ TTAL# SUMMI Owner: Contractor: DOUG FORST TELEPHONE CONNECTION SERVICE 10514 SW NAE=VE ST PO BOX 2075 TIGARD, OR 97224 BEAVERTON,OR 97075 Phone: 503-598-9206 Phone: 642-7374 Reg*: LIC 50013 1`111 34-142CLE FEES SUP 458LEA Description Date Amount REQUIRED ITEMS AND REPORTS ELPRMTj ELR Permit 2/15/2005 $75.00 F TAXI 9%State Surcharl 2/15/2005 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be,done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for rnore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 IL through OAR 952-001-0100. You may obtain copies of these rules or direct questio.is to OUN at(503)248 t3699. Issued by `� , Z` , `1'�, � Permittee Signatura�(� OWNER INSTALLATION ONLY m The Installation is being made on property I own which is not Intended for sale, lease, or rent. t:7 uu OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N _ DATE:--- LICENSE NO: �� Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day 145V- E EYial Permit Aur ttmc 1v ED City of Tigard Date/By a Received ! PenmtNo: I W5 SW Flail Blvd.,Ti ard,OR 97223 nae/B /7 Q J �joS-DDp B Plan Revtcv/ Other Pen.tit: Pnunt. 503.639.4171 Fax: 503.599.1960 [_ Date/By _ Inspection Line: 503.639.4175 Date Ready'By: rut ® See Pa=e t for Internet: www.ci.tigard or.us CITY OF TIG N Notiffed/Method. �/6� Supplemental Information Ott %'``` New cot,struetion 2 Addition/altersdon*106lo6nt Please check all that apply: F1 Demolition ❑Other: []Service over 225 amps,comm') ❑Hazardous location []Service over 320 amps-rating ❑Buildng over 10,000 sq.fl., of 1-and 2-family dwellings 4 or more new residential 1-and 2-family dwelling ❑CommerciPVindustrial ❑Accessory building []system over 600 volts nominal units in one struc ure ❑ Multi-family ❑Master builder ❑Other: ❑Building over three stories [ Feeders,400&trips tat more []occupant load over 99 persons []Manufactured structures or ❑Egress/lighting plan RV park Job no.: Job site address: Q ! y /�l� Q [11 -care facility ❑Other:— 1 (- r� Submit_j sets of plans with any of the above. City/State/ZIP: �/ I[� The above are not applicable to temporary construction service. Suite/bldg./apt.no.: Project-tame: ' .. _ DaserlpeMa Qty. lee. Toed Cross street/riirections to job site: New residentirf single-or multi-family dwelling unit. -- - Includes attached garage. 1,000 sq.ft.or less 145.15 4 Subdivision: !� Lot no.: Ea.add'l 500 sq.ft.or portion 33.40 1 Tax nap/parcel no.: Limited energy,residential 75.00 2 Limited energy,non-residential 75.00 2 Each manufactured or modular �)� �/�N f dwelling,service and/or feeder 90.90 _ 2 Services or feeders installation,alteration,and/or relocation 200 amps or less _ 8030 _ 2 201 mpt to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 / Name: DUG �[!� _ 601 amps to 1,000 arms 240.60 2 Address: Over 1,000D amps or volts 454.65 2 Reconnect only _ 66.85 2 City/State/ZIP: Temporary services or feeders Installation,alteration,and/or relPhone:(0'3 ) �g -1 200 Fax: a( ) ps _ _ 20_0 strips or teas _ 66.85 Owner Installation:This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale,lease,rent,or exchange,accordi•ag to ORS 447,449,670,and 701. '01 amps to 600 amps 133.75 2 Owner signature: _ Date: n:anch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with service or feeder fee,each 6.65 2 Business name: branch circuit B.Fee for branch circuit Co,,tact name: without service or feeder fee, 46.85 2 Address: each branch circuit Each add')branch circuit 6.65 2 City/State/ZIP: Miscellaneous(service or feeder not Included) d Phone.( ) Fax::( ) Pump or irrigation circle _53.40 2 _._. Sign or outline lighting _ 53.40 2 E-mail: Signal circuit(s)or limited- energy panel,alterntiou,or (C' Business name Q�je,�' �1jL, �aN C'�Ceor extension.Describe: Page 2 2 m Address: a�t /j0 l7KJ'7 5 Each additional Inspection over allowable In any of the above Per inspection 62.50 _ J City/State/ZIP:�j A� pe. q/��S Investigation pet hour(t hr ndn) 62.50 Phone:(SM) �- 7 -7 Fax:(y3 ) 4r a, �S'q� Industrial plant per hour 73.75 CCB Lic.:5001.3 1Electrical Lic.:Lfs$ � Suprv.Lic.: Subtotal �Jse�d Suprv.Electrician sigl lature,required: Plan review(25%of permit fee) --- State surcharge(8%of permit fee) �!,(J a Print name: �� Date: 5 O S -- — t. TOTAL PERMIT FEF, r Authorized signature: This permit soplication aspires If a permit is not obtained within 130 days sner It has been accepted a complete Print name: Date: Fee methodoloily set by Tri-County Building Industry Service Board •�Number of inwetions trer permit allowed. i•1Buildintvermlb\BLC-PamdtApp.doc t2/oll 440-4e15T(t0/WCOM/W89 Electrical Permit Application - City of Tigard Page z - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Bt lar Alarm ❑ Gara Door Opener* ❑ Heatin ,Ventilation and Air Conditioning System* ❑ Vacuu. ystems* ❑ Other: Fee for each comm cial system.....•................. $75.00 (SEE OAR 918-26 -260) Check Type of Work volved: ❑ Audio and Stereo stems F1 Boiler Controls ❑ Clock Systems e ❑ Data Telecommunication Installatio ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Inte/Landscape ng S tems a Landscape ' Control* N ❑ Me ❑ Nur W [1 Oute Lighting* ❑ Prong ❑ Other Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations \R 1din&ennftAet.c-PennmApp nr 04103 CITY OF TIQAHD BUILDING DIVISION PERMIT#: ELR200&00029 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/102005 Phone (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-41 1'5 INSPECTION WORKSHEET =0R DATE: 4/6/2005 TIME: 7:10AM PAGE: 0 SITE ADDRESS: 10514 SW NAEVE ST CLASS OF WORK: SUBDIVISION: RENAISSANCE SUMMIT LOT#: 016 TYPE OF USE: PROJECT NAME: FORST DESCRIPTION: Sttgpo and Data Cv*.Aing. OWNER: FORST, DOUG PHONE: #: 503598-9208 CONTRACTOR: TELEPHONE CONNECTION SERVICE PHONE #: 643-7374 Inspection Request Scheduled For: Date: 4/8/7005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Elediir..al final 00417601 503-4f 1-5625 N v Corrections/Comments/Instructions: CLs w a - ---- ------ - - ----- _------- - [PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ��— pate: _ Phone #: (503) 718- CITY OF TIGARD MASTER PERMIT DEVELOPMENT SERVICES DATE ISSUIED: 8/5/2004 4-002!5 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 SITE ADDRESS: 10514 SW NAEVE ST PARCEL: 2S110DA-02500 SUBDIVISION: RENAISSANCE SUMMIT ZONING: R-3.5 BLOCK: LOT: 016 JURISDICTION: TIG REMARKS: Convert crawl space to habitable. BUILDING REISSUE: CUSTOM STORIES: _ FLOJR AREAS _REQUIRED SETSAC_K_S-_ --.REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: 1,127 of BASEMENT: 1,127 of 4 LEFT: 0 SMOKE DETECTORS: Y TYPE OF JSE: Sr FLOOR LOAD: 40 SECOND: If GARAGE: 6f FRONT: PARKING SPACES: 2 1 YPE OF CONST: 5N DWEL LINO UNITS: 0 THRO a/ RIGHT: 0 OCCUPANCY GRP: R7 BDRM: 1 BATH: t TOTAL: 1.127 a1 VALUE: 4000 00 REAR: PLUMBING SINKS: 1 WATER CLOSETS: i WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS. FLOOR DRAINS: SEWER LINES: SF PAIN DRAINS: CATCH BASINrf: TUBISHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PRFVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: i CLOTHES DRYER: FURN•-100K- UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL.UNIT SERVICE FEEDER - TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ,ADD'L INSPECTIONS 1000 sr OR LESS: 0 - 200 amp: 0 - 200 amp: W/SMJ OR RIR: PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 6003F: 201 - 400 amp: 201 •400 amp: 19t wo svoFDR: 00 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amn: 401 •600 amp: EA ADOL fR CIR: 2 m SIGNAIJPANEL• IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp: 601+ampa•t000v: MINOR LABEL: 1000+amptvolt: PLANREVIEWSEGTION Reconnect only: _ —4 RES UNITS: SVr.IFOR?•72S A.: i•600 V NOMINAL CLS AFEAISPC OCC: ELECTRICAL-RESTRICTED ENERGY _ A.SF RESIDENTIAL B.COMMERCIAL _ AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO S STEREO: FIRE ALARM: INTERCOM MAGING: OUTDOOR L HUSC LI: BURGLAR.ALARM: OTH: BOILER: HVAC: LANnSCAPFARRIG: PROTECTIVE SIONL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR- HVAC DATA7TFLE COMM: NURSE CALLS: TOTAL#SYSTEMS: Owner: Contractor: TOTAL FEES: $ 958.19 This perrnit is subject to the regulations contained in the DOUG FORST NORTHWEST PREMIER CONTRACTTigard Municipal Code,State of OR.Specialty Codes 10514 SW NAEVE ST INC and all other applirat le laws. All work will be done in TIGARD,OR 97224 PO BOX 33121 acoordance with approved plans This permit will expire IL PORTLAND, OR 97292-3121 If work is not started within 180 days of Issuance,or If the R work is suspended for more than 180 days. I"" Plan: 503-598-9206 Phone: 503-810-1822 ATTENTION: Oregon law requires you to follow rules U) adopted by the Oregon Utility Nutificatbn Center. Those Rea R' LIC 157731 rules are set forth In OAR 952-001-0010 through 952-101-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-1987 CD REQUIRED INSPECTIONS C) W Footing Insp Crawl Drain/Backwater Framing Insp Electrical Final J Foundation Insp PLM/Underfloor Shear Wall Insp Mechanical Final Post/Beam Structural Mechanical Insp Exterior Sheathing Ins; Plumb Final Post/Beam Mechanical Plumb Top Out Special Insp.required Final Inspection Underfloor Insulation Electrical Rough In Insulation Insp Issued By : za fit, �i '� Permittee Signature Call (503) 639-4175 by 7:00 p.m.for an Inspection needed the next business day BuildingPermit Ayirfca�FoAV F City of Tigard nn� "Date/B2 p Pernut No 13125 SW Hall Blvd.,Tigard,OR 977.23 200 i Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By _— er Permit Inspection Line: 503 639.4175 Date Ready/By ® See Attached Check Hit for �Internet " 'w"w'w.ci tigard.or.us Notified/Method: Supplemental Information *ND tilr, AMILY DWELLING ❑New constriction ❑Demolition Permit fees*are baud on the value of the work performed. - — Indicate the value(rounded to the nearest dollar)of all Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the vt r,'t� work indicated on this application. .� � i e�ae.,J r a.,,:.. .. .,.ort,• r Valuation. s r oco and 2-family dwelling ❑Commercial/industrial t of bedrooms: -- ❑Accessory building E]Multi-family _ ❑Master builder ❑Other: Number cf bathrooms: e SI fL K!it+bilm .'ET61V hPl XIQN Total number of floors [� Job site address: 1051y 5o A*e ae..L j# New dwelling area: square feet City/State/ZIP: Tt' It'V 0'. 47 Z .2.,/ Garage/carport area: square feet Suite.'bldg./apt.no.: Project name: Covered porch area: square feet Cross street/directions to job site: Desk area: —square feet -- -- t+ Other structure area: tLJ±) square feet �Z `6-WSX CHECKLIST SubdivTion: Lot no.: Permit fees'are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the work indicated on this application. _ Valuation: S N 1 /r+ur Existing building area: square feet New building area: square feet Number of stories: Name: —� tH� Gr-+,>�i Fers r _ Type of construction: — Address: 10ft4 !&-J �t..tit ` q� Occupancy groups: City/State/zIp. Tyw.� t'�r 9-7 2 2 y _ Existing: Phone:(F63 $9 9206 Fax:( ) New: HL All L i am Business name: All contractors and subcontractors are required to be M Contact nan•e: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed.If the N City/State/ZQ': applcant is exempt from licensing,the following reasons apply: Phone: — _J E-mail: rul :. ,' . W Business name: V W Pre-%t C C4.1 f P-[u 1,"2 _— J Q -- Address: e► Plane refs to fee schedule City/State/ZIP. Q 79,7;)a : '3/ Fees due upon application Phone:(' ) r. Fax:( ) - --- Amount received CCB lic.: /57 ") VLJ1 0 S _ — Date received: Authorized signature: ---� � This permit application expires If a permit Is not obtained within 180 days after it has been accepted as complete. Print name: 0/1644kv !�,♦a-1 �y�� • Fee methodology set by Tn-Cour ilding Industry Service Board. i\BuilAinalPemrdU dnlBUP-Penppdoe 12103 440-1e111(II102/COAVWt3D) One- and Two-Family Dwelling Building Permit Application Checklist City of Tigard Received Penmt No 13125 SW Hall Blvd,Tigard,OR 97223 Phone: 503 639,4171 Fax: 503.598.1960 lec U Electrical ted permip 24-Hour Inspection Line: 503.639.4175 l7 cal l7 Plumbing O Mechanical Internet: www.ci.tigard.or us O Other -- 1 Land use actions completed. Seeul risdiction criteria for concurrent reviews. _ 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. El 1:1 3 Verification of approved plat/lot. 4 Fire district proval required. Name of district: 5 Septicstem ermit or authorization for remodel. Existing system capacity 6 _Sewer permit.k 7 Water district ilipproval. _ :1 CE33 8 Soils re ort. M t carry original applicable stamp and signature on file or with application. 11 9 Erosion controlplan Llpermit required. Include drainage-way protection,silt fence design and location of catch- U basin protection,et 10 _L Complete sets o\1ele plans. Must be drawn to scale,showing conformance to applicable local and state 0 11 building codes. Lateign details and connections must be incorporated into the plans or on a separate full-size sheet attached to the with cross references between plan location and daai{s. Pion review cannot be completed if copyrt ht violations _ I 1 Site/plot plan drawn to sce. The plan must show lot and building setback dimensions;property corner elevations if there is more than a 4-fl.elev ion differential,plan must show contour lines at 24 intervals);location of easements and driveway;footprint of stru ore(including decks);location of wells/septic systems;utility locations;direction indicat4 r;lot area;building covea area;percentage of coverage;impervious area;existing structures on site;and surface dt xi�e. _ 12 Foundation plan. Show dimen:-+on.,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 El and location. 13 Floor plans. Show all dimensions,roo dcntification,window size,location of smoke detectors,water heat , furnace,ventilation fans,Plumbing fixtures, alconies and decks 30 inches abovgrade,etcY 14 Cross section(s)and details. Show all fram1 -member sizes and spacing such as floor beams,headers,' ists,sub 11 Li - floor,wall construction,roof construction. Mo than one cross section may be require3 to clearly po y construction. Show details of all wall and roof sh thing,roofing,roof slope,ceiling height,siding terial,footings and foundation,stairs,fireplace construction,therm insulation,etc. 15 Elevation views. Provide elevation,G,r new construe n;minimum of two elevations for add ons and remodels. Exterior elevations must reflect the actual grade if the ch a in grade is greater than(bur fo at building envelope. Full-size sheet addendurns showing foundation elevations cross references are accept le. 16 Will bracing(prescriptive path)and/or laterr.l analysis r�� ., Must indicate details ld!,.)---.ions:for non- prescriptiveasp h analis provid�ecifcations and calculi wn_, en ineerin stan ds. _ 17 Floor/roof framing. Provide plans for all floors/roof assernblie,,i icating mem r sizing,spacing,and bearing Cl locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and do shows cement of rebar. For engineered systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current cod esign lues for all beams and multiple joists over 14 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 71118e calculations. A gas- i ing schematic is required 13 a for four or more appliances. __ 22 Engineer's calculations. When required or provided,(i.e/shear wall,roof truss)shall be stampe an engineer or ~ architect licensed in Oregon and shall be shown to be a icable to the project under review. MURGINIM rn 23 Five 5 site plans are required far Item I I a_bov Site plans must be 8-1/2"x I I"or 11"x 17". m 24 Two(2)sets each are required for items 16, ,20 and 22 above. 25 Building plans shall not contain red linec4r tape-ons. "Mirrored"building plans will not be accepted. W 26 "Reversed"biti[ding plans must mist criteria outlined in the Permit&System Development Fees document. -J 27 "Drawn to scale"indicates stapftd architect or engineer scale. 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard Street Tree List. j 29 Site plan to include tree protection measures as required by conditions of approval. J 11 El 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approvedprior to September 9,1995. i:\Building\Permits\One-Two-FamilyChecklist.doc 12/03 Bgilding Fixtures �� Plumbing Permit ApplIeWi nFIVEC City of Tigard JULReceived Pertrdt No.: 13125 SW�.ill Blvd.,Tigard,OR 97223 U2004 PlanDateRe: _--_ Phone: 503.639 4171 Fix: 503.598.1960 DaW`B vich Other Permit No 24-Hour Inspection Line: 503.639.4175 a -- - - CITY OF TIG , Date Ready/By San' 0 See Palo 2 for Internet: wwwei.tigard.or.W !11111 Dipir. Notirkd/Method: Supplemental Information ❑New construction []DOn70lit10<s For special information use checklist_ Descnpt on _ i Qty. Fa. Total Addition/alteration/replaccment ❑Other: New I-2-family dwellings(includes 100 fl.for each utility connection) rAccessory SFR(1)bath 249.20 y dwelling ❑Com nercial/industrial SFR(2)bath 350.00 lding ;]Multi-family' SFR(3)bath 399.00 Each additional both/kitchen 45.00 ❑Other: Fire sprinkler( sq.ft.) Page 2 f. Site utilities lob site address: Catch basin or area drain v 16.60 -�-8�u2 5 F _ City/Stale/ZIP: Tit; o, 972 Z y Drywell,leach line,or trench drain 16.60 Stute/bldg./apt.no.: Project name: Footing drain(no.linear fl.: Page 2 - Manufactured home utilities 11000 Cross strecVdirections to job site: -- Manholes 16.60 Rain drain connector 16.60 _ Sanitary sewer(no.linear It.: Page 2 - !' Storm sewer(no.linear It.:i) Page 2 Subdivision: Lot no.: Water service(no.linear fl.: Page 2 -- l--- Fixture or Item Tax map/parcel no.: • Absorption valve 16.60 Backflow preventer Page 2 Coat,k r3 1,944 i ruk* Sac cc t0 �'oi�ii-S ps 4 Backwater valve _ 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 Ejectors/sump 16.60 Name _V.2 e.�}�e fe r Expansion Unk 16.60 Address: Fixture/sewer cap 16.60 City/StatelZip: i Flom drain/floor sink/hub 16.60 Phone:( ) Fax:( ) Garbage disposal 16.60 Hose bib 16.60 Ice maker 16.60 Business tome: - Interceptor/grease trap 16.60 Contact name: Medical gas(value:S ) Page 2 Address: Furrier 16,60 N City/Stale/ZIP: Roof drain(c iel) 16.60 Phone:( ) Fax::( ) Sink/basi avatory16.60 Tub/shower/s ower pan 16.60 E-mail: Urinal 16.60 (; r h-I 8( * Water closet 16.60 JBusiness name: �s�e+-6 �eti /��s Water heater 16.60 Address: Y- Other: City/State/ZIP: _____- Subtotal Minimum permit fee: 572.50 Phone:( ) Fax:( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: --- Plumbi 3.: Plan review (25%of permit fee) - _ State surcharge(8%of permit fee) rizexl signature: �. _ - - _ TOTAL PERMIT FEE Print name: �.ft�<</ N Date: /t !,�! This permit application expires If a permit It not obtained within ��- ISO days after It has been accepted as complete. "Fee methodology set by Tri-County Building Industry Service Snard. i\Hui ldins\Prrmin\PLMF-PermitApp doe 12/13 410-4616T(I(VQ2/C'0M/WHB) Plumbing Per.:.it Application_ - City of Tigard , Page 2 - Suppiemental Information Fee Schedule: Residential Fire Suppression Systems: Footing drain-I"100' 55.00 0 to 2,000 $115.00 ---�—_ Footing drain-each additional 100' 46.40 2,001 to 3,600 S 160 00 _ ^� Sewer-Ism 100' 55.00 3,601 to 7,200 $220.00- - ----- 5309.00 Sewer-each 7,201 and greater Water additional 100' 46.40 � — Water Service-1st 100' 5500Medical Gas S Stems• Water Service-each additional 1 . 46.40 Storm&Rain Drain-1st 100' 55.00 $1.00 to$5,010.00 Minimum fee$72~50 Storm&Rain Drain-each additi 100' 46.40 $5,001.00 to 510,000.00 $72.50 for the first 55,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and including 510,000.00 Commercial Back Flow Prevention DevXce 46.40 510.001.00 to 525,000.00 5148.50 for the first$10,000.00 and S1 54 for Residential Backflow Prevention Device each additional 5100.00 or fraction thereof,to minimum permit fee S36.25) 27.55 and includinit 525,000.00. Rain Thain,single family dwelling 65.25 S25,001.00 to$50,000.00 $379.50 for the first 525,000.00 and S1 45 for Inspection of existing plumbing or each additional$100.00 or fraction thereof,to specially3pecially requested inspections-per hour 72.50 and includin 550,000.00. --- Subtotal: 550,001.00 and up S742.00 for the first 550,000.00 and$1,20 for each additional$100.00 or fraction thereof Fixture Work: Are you capping,moving or replacing existing tures? If "yes",please indicate work performed by fixture. Failure to accurate) report fixtures could result in increased wer fees*. r: Comments garding fixture work: Ba tis /Font Bath -Tub/Shower - -- -lacurzi/Whirl Car Wash -Each Stall — Drive Thru -- - -- Cu idor/Water Aspirator Dishwasher -Carnmercial - -Domestic Drinking Fountain Eye Wash Floor Drain/sink -2" - 3" 4" - - Car Wash Drain - - Garbage -Domestic — F. Disposal -Commercial *Note: If the ure work under this ermit results in an -Industrial F �• Ice Mach./Refri .Drains increase of sewer Us,a sewer permit will be issued and L OilSeparator Gas Statim fees assessed for the ewer Increase must be paid before the Rec.Vehicle Dunn(Station plumbing permit can issued. mShower -Gang -Stall _ JSink -Bar/Lavatory Quantity Total -Bradley -Commercial Isometric or riser diagram is required if fixture quantity -Service total is>9. Swimming Pool Filter Washer-Clothes Water Extractor Plan Review Water Closet-Toilet _ Plan review is required if fixture quantity total is>9. Urinal Othcr Fixtures. i\Bui1din9\PmniWPLM-Por,nitApp doc 3103 RECF Electrical Permit AnmTica. on Received Macellow JJL ZOO Planning Approval Sign City of Tigard t>rtdBy __- Permit No.: 13125 SW Hell Blvd. t'I TY r " clan Review Other Tigar4 Om pla 97223 - –-----►ern i�yo _�___ Phone. 503-6394171 Fax: 503-1,98-1960 Poet•Rav:w Land U&* e Internet: wway.ei.tgard or,us t7ot tact lode, sea L &V 3 for 24-hour Inspection Request: 503-639A175 Tiantelli6ethod; _ _ Oo lrracatallaUsrmettae. —'�a�,*,'.-'h�, •F""".�_"`-_—_=� c-�-' .;;.�•-; ::.. ...•;'i"Y.,•L1°fRBYI�W�IM' tE�shtria'tiDtll,. , ',. - �. El 1'Y1R��O 1VOA'�C New constmetlon I Demolition Snvtcc ovcr 725 amps- Lj Health-catc facility eornrrtercial H mndcwe Imation Additiorda'<]terationheplaceintnt I Lj Other: [1 Service over 320 tune:-hung of Building ovn 10,000 nl`src fed, �It\'OFC lY5.1RUCTlt1 k 2 family dweilinp four or more nuidatial units in I &2-Fanuly dwellul ComrnereiaUtndustrial C)system over Goo v�,tt nominal one etrvcn e Q Building over tbtee aWtics FeMcni,400 amps rn mom Aeees,9ar�r ltuildin Multi-Family'� [j Occupant lad over 99 penons MenufavhJred sbuchm&P\•1�rk Matta Builder Other' ❑f4mi itbting p4n other:_` __.. Submit cyto of plane With awl of the alsere <r. R i it ON` 71e a are nota irAble to tr ra ansa eiia-Vict. Job site address: 103 Jt! fw Suite*: ll ftJ pt.#: 111lud er d to it allowed ProltCCt Name: ._ � Neaerl sea - Qtr ane •reset ---- Nttw r w Wdll"aaaar Par C ms atreet/Direetions to job site: dwswall waft tetttldu We"$.rants. Service brkAw. 1(100%It(a 14 ,13 h fl.er OQi110tt thereof _ .AO 1 �suwvision: _ .00 - Taus!till / 1 M yip Each rr�afst tme4 htr.to of moMi dwellitt - �4+R. 'i�_ ., on attdrer feeft _- 90.90 - ---�— 3eryk"or itrim-iastalletlee, 1er robeatl0o: E0000 UM"-r lots 401 atm dslm -• Over 1000 asp ar vehe 4- 5 Nwn& 4.,; G F.- Rece,tt.etewly --- ,ls Address: to ti y j.0 ,.�•�.�+ s. Temporary aeries or twders-InAdInNem alhratiea,or rdneaNeo. Ci /3tate/ZiP. TJ y�_,0 �+ f 'Z 2 y - zoo k•r_ — 66.ts PhoneSTS +tote Fax: lotto60otorte. liar - -41 "—A -_... Branch cheats new.alterstlea.er Name: asreesMe per pael: Address: --- -, ---- A.Fbrn+ch e.wit�pehnof 6.65 Cl /StatclZl _ — R.Fer hrw+elt eieuftr tNtheut ptaaMe of I 4b t! FeX. — wrvke lhtitwwitjhg_ Phone: — d' E-Mail Vim(quAce nr feeder not incl Fxh hrl cimle 43. -0 a 53.40 rn Job No: wal circ , art ettargy panel. Duailness Nmne: IeCr � o �,°` z J Adds m: Obtr mer DO rdtoNenol layeeden ever the ollow"le In of the*bm Cid tate/Z11: _ D� rer p r rtr�rnin,l Acer _ 5 Phone: ,U ax: e _ �__ _ Uj -u CCs 1Lic.#: 1 kc 1 I Lic.# 3 a ee-- '� ,. .• ::n :i.. F _ F Supervusing electrician subtaw S si ature r red• J P*Review %of Permit Feed S __o-- �"---'-- Stale s a 8%of Pcrnut Fee S L— —– Print Name: l Lic.#: „� _1 ^I i_ TOTAL PERMT FZZ s Authorized Notice: IU PKUH tlpplicatlow egttree It a parte t k net awwd w.tidd Siptlatttfe' - _ Date: i N slays ttAer lthw baa arcaptatl a emptett. •Fen melheMlap ut by Tri-Cmtaty WallttbglNlartry Service Berard. —(Plese Print fame) i:lM%\Perrrdt Fom 1VJcPertrtitApp.dcc 01103 Too(n IVi n2:90 Poog'10;90 Mirba:iicai Permit ApglLeAft Cit ok Ti and Received y g Date/By Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone. 503.639.4171 Fax: 503.548 1960 201'1 DateBy Other Permit: Inspection Line: 503.639.4175 Date ReadyBy runt 0 7,SecPage 2 for Intemrt: www.ci.tigard.or.us CITY OF TIGARD Notillad/Method Supplemental Information ii""'`'� �'SCRHL►riUL$ — 03E CRECiQ 1ST ❑New construction Addition/aiteration/replace,,ieI t Mechanical permit fees'are based on the value of the work performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,ons profit ' t Value:S ti�. . :� f �: ,ice,' •. .:i,�..� ,. �,,, _..-. 1-and 2-family dwelling CommCommercial/industrial *X$iD) NTUL EQI)IPMENT/SYSTEMS FEES* — ❑Accessory building -- ❑Multi-family ❑Master builder ❑Other: For spacial information use checklist. Descnption QE Ea Total Heating/cooling _ Job slag address: Air Air conditioning or heat pump St (requires site plan showing placement) 14.00 City/State/Z[P: a r dr- 972 Z Furnace 100,000 BTU ducts/lents _ 14.00 Furnace 100,000+BTU(ducts/venu 17.90 Suite/bldg./apt.no.: Project name: — Gas heat Pump 14.00 Cross street/directions to job site: Duct work _ _ 14.00 Hydronic hot watersystem 14.00 Residential boiler(radiator or h dronic) _ 14.00 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 10.00 Subdivision: I Lnt no.:� Flue/vent for any of above 10.06 --- Other: 10.00 Tax map/parcel no.: Other fuel appliances Water heater 10.00 p Gas fireplace 10.00 GAnrt d.t o e ria a/ pact_ •c. Jpa c^ Flue vent for water heater or gas fireplace 10.00 — — Log lighter as 10.00 Wood/pellet stove 10.00 Wood ft Iace/insect 10.0c Chime/liner/flue/vent 10.00 Other: 10_00 Name: —D' (f ,t Environmental exhaust and ventilation _ Address: Range hood/other kitchen ui ment 10.00 City/State/ZIP: Clothes dryer exhaust _ 10.00 Phone:( ) — Single-duct exhaust(bathroo Fes; trq, ( ) toilet compartments,utili roorns _6.80 77 Attic/crawls ace fans 10.00 Business name: Other: 10.00 — Puel piping IL Contact name: S5.0%for first four;111.00 for each additional Address: Furnace,etc. (— Gas heat pump N City/State/ZIP: _ WalVsuspmded/unit hater _ Phone:( ) _ Fax: :( ) Water heater Fireplace E-mail: / Rm ge Barbecue LU -- .J Business name: J -"epel Nil J Clothessr a—swL Other Address: t. City/State/ZIP: _ Subtotal Phone:( ) ( ) — Min �Fgximum permit fee(572,50) — Plan review(25%of permit fee) CCH lic.: _ _State surcharge(9%of permit fee) TOTAL PErMIT FEE This permit application expires If a permit is not obtained Millin Iso UIIfOtIZed signature: _ dare after It hat been acreptr 1 as complete. Print name �ei�et /�/ti� Date: ' ' Fee methodology,set by Tri-County Building Industry Service Board itBuildingtPetmiulh9C•Pe"Appdoe 12103 "'1 6I7T(IIM2/COM/WrtH) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Ape Schedule: $1.00 to$2,000.00 Minimum fee$72.50/1 $2,001.00 to$5,000. 0 $72.50 for the first 2,000.00 and$2.30 for each additio $100.00 or fraction _ thereof,to and i ludin $5,000.00. $5,001.00 to$10,000.00 $141.50 for th�f, rst$5,000.00 and $1.80 for eac ditional$100.00 or fraction there o and including 00. 10,000. 810,001.00 to$50,000.00 1.50 for a first$10,000.:0 and $1. fore h additional$100.00 or fracti th eof,to and including _ $50, _ $50,001.00 to$100,000.00 $771.50 f the first$50,000.00 and $1.25 for ac dditional$100.00 or fr.tction ereo , and including $100 0 .00. $100,000.01 and up $1,396 0 for the firs 100,000.00 and $1.10 reach additiona 100.00 or fract' n thereof. Note: All new commercia buildings require 2 sets of plans. a ac U) M 5 W a iABuilding\Permits\M .-PamitApp doc 12103 2 X12 05 09: 38a GRW Electric Inc. 5032176236 P. 1 CITY O GARD 13125 911 N.MALL BLVD. TIGARI OR 97223 IMPORTANT PERMIT OTICE GAw E.WMC INC PA.K 13C 314 TUALA1 Vi,OR 87062 EIOCWal Sign*Wrm Form Parmit* M 16 Date Ise xmt >slttl2 Parol: 2611 2000 Site Address: 10614 NAEVE ST Subdivision: RE SUMMIT Block: Lot: 010 Jurisdiction: TIO Zoning: R-3.6 Remarks- Cone r t crawl space to habitable. your company has beenrw4 as tP,e eWrioa i contmcfor for the perno!idicated above. In order for the e?eotricad permit io be signature of the supervising�el8cmeian Is required. Please h"the appropriate hdlvldusi frompany sign bekm,and retum this Electrical 8lgnsaure Form prior to the start aF the work to the aove, ATTN: Building Division. No electrical Insp�1 aulhvritrd until this compts*d farm Is gwmlvwd OWNER: ELECTRICAL CONTRACTOR: DOUG CAW ELECTRIC INC 10514 SW MAI WE gr P.O. BOX 6414 TK#ARD,OR 224 TUALATIN,an 97062 Phone 4: d03 S-9206 Phone 4 003-412.3"0 Rei : Ur- 1s"" FLE 34-OW sur 3"" IL AlINK SIGNATURE IS RF-QUIRED ON THIS FORM in Signature of Superoh*V E m w if you have any queetb Is, p*Awe cal 503.719.2433. t8/t8 3J!!d 14M 9NIQlIIa MV911 189EVZ9E8S 99:9I 99OZ/let/ZB CITY OF TIGARD 0 BUILDING DIVISION PERMIT#: MST2004-00215 13125 SW Hall Blvd.,Tigard, OR 97223 DATr- ISSUED: 8/5/2004 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/22/2006 TIME: 7:12AM PAGE: 19 SITE ADDRESS: 105114 SW NAEVE ST CLASS OF WORK: SUBDIVISION: RENAISSANCE:SUMMIT LOT 1e: 016 TYPE OF USE: PROJECT NAME: FORST DESCRIPTION: Cunvert crawl space to habitable. OWNER: FORST, DOUG PHONE k: 5035989206 CONTRACTOR: NORTHWFEST PREMIER CONTRACTING INC PHONE M: W1810.1822 Inspection Request Scheduled For: Date: 4/22/M Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 006181-01 36t}904-6367 N Corrections/Comments/Instructions o� _m L9 --- — — W J ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED VIL� f� Inspector: D06: L�/�SPhone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT if: M�=16 j 13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 81 Phone: (503) 639-4171 Inspection Requests (24 HrR.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/2?171'10S TIME: 7:12AM PAGE: 18 SITE ADDRESS: 10514 SW N&F-W ST CLASS OF WORK: SUBDIVISION: RENAISSANCE St1MMIT LOT#: 016 TYPE OF USE: PROJECT NAME: FORST DESCRIPTION: Convert crawl space to habitable. OWNER: FORST, DOUG PHONE #: 503598-9206 CONTRACTOR: NORTHIVWS'T PREMIER CONTRACTING INC PHONE #: 5038111822 Inspection Request Scheduled For: Date: 417112006 Pour Time: ,O Code # Inspection Description Confirm # Contact # Message 399 Plumbinq final 0051181-02 360.904-6367 N Cor /Comments/Instructions: 'O p n-) _ �-,-` -- 2- IL -- N - m W ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL [ ] CALL FOR INSPECTION J_] ADDITIONAL. FEt"S ASSESSED --- Inspector: Inspector: _ Date: Phone : (503) 71e- CITY OF TIGARD o • BUILDING DIVISION PERMIT#: MS1200400215 13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: �y20Q4 Rhone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/13/2005 TIME: 7:12AM PAGE: 91 SITE ADDRESS: 10514 SW NAEVE ST CLASS OF WORK: SUBDIVISION: RENAISSANCE SUMMIT LOT#: 016 TYPE OF USE: PROJECT NAME: FORST DESCRIFTION: Convert cuawl space to habitable. OWNER: FORST, DOUG PHONE #: 503.%. &9206 CONTRACTOR: NORTHWEST PREMIER CONTRACTING INC PHONE#: 603810.1822 Inspection Request Scheduled For: Date: 6113/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message U 199 Electrical final 006787-01 3G4904-6367 N Corrections/Comments/Instructions: a _ Uj a XPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL U CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector Date: _ Phone M (608) 718• _� CITY OF TIGARD BUILDING DIVISION PERMIT#: MST2004-00215 13125 SW Hall Blvd.,Tigard, OR 97223 DATE ISSUED: 916200,4 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5113/2005 TIME: 7:12AM PAGE: 90 SITE ADDRESS: 10514 SW NAeVE ST CLASS OF WORK: SUBDIVISION: RENAISSANCE SUMMIT LOT#: 016 TYPE OF USE: PROJECT NAME: FORST DESCRIPTION: Convert crawl space to habitable. OWNER: FORST, DOUG PHONE#: ;►035919.9206 CONTRACTOR: NORTHWEST PREMIER CONTRACTING INC PHONE#: 503810.1822 Inspection Request Scheduled For: Date: 5113/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message l M. Final inspection 006787-02 360.904-6367 N Corrections/Comments/Instructions: a W PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r� Inspector: ,&- - Dete.S 3' Phone #: (503) 718-