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6912 SW TAYLORS FERRY ROAD t 6,412 SW Taylors Ferry Road CITY OF TIiGARD 24-Hour BUILDING Inspection Line: (503)639-4175 02/ INSPECTION DIVISION Business Line: (503)639-41171 t'•ST BUP _ Received Date Requested__— q— _3 AM_ ._ PM�_�__ BUP _— Location _T- Suite__ ME$, Contact Person ._— �� Ph(_ ) �{� —739 PLM Contractor_._ — _ — Ph( ) _ SWR BUILDING `— _ Tenantfl-caner ELC Footing --- Foundation Access: ELC -- Fto Drain ELF! Crawl Drain Slab Inspection Notes: SIT Post&Beam -- Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall --- ---- ---....--- - - Fire Sprinkler Fire Alarm --- �- Susp'd Ceiling Roof -- rFinal PART FAIL -` -- ---- - Be - -- _ -- _ Post 8 am --- Under Slab Rough-In ----- Water Service Sanitary Sewer --- -- Rain Drains _�_ - - ----- - --------- -- Catch Basin/Manhole — Storm Drain — -- - - - __----- Shower Pan �~-- -----�-- Other: - - — ------- ------ - - ------ Final PASS PART FAIL -- _— --- MECHANICAL Post 8 -- Rough-In Gas Line -- --- Smoke Damper: ---- -_-- -_--- - Final PASS PART FAIL --- _ -_ _-----___-- ...-----_- - ELECTRICAL__ -------------- ervice - Rough-In UG/Slab - -------- - — Low Voltage Fire Alarm ------ ---- Final Reinspection fee of$__-- required before next inspe;tion. Pay at City Hail, 131?5 SW Hall Blvd. _PASS PART FAIL SITE — - d Please call for reinspection RE._ _—_,- - _ Unable to Inspect-Po access Fire Supply LineADA ��_ ,� Approach/Sidewalk Date e2_51 Other: Finel _ — T DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL �� A fir.,/ s A D MASTER PERMIT PERMIT #: MST2002-00213 DEVELOPMENT SERVICES DATE ISSUED: 5/6/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDREOS: 06912 SVV TAYLORS FERRY RD PARCEL: 1S125DA-08200 SUBDIVISION: KINGS VIEW ZONING: R-4.5 BLOCK: LOT:070 JURISDICTION: TIG RE=MARKS: changing roof line adding approx 408 sq ft BUILDING _ REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS LIF YIORK: ALT HEIGHT: 20 FIRST: at BASEMENT: of LEFT: SMOKE DETEL ORS: 'f TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 406 of GARAGE: at FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: of RIGHT: VALUE: E 20,000 00 OCCUPANCY GRP: i:1 BDRI* BATH: I TOTAL: 40000 of REAR: _ PLUMBING - SINKS: WATER CLOSETS: I WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: I DISHWASHERS. FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: I CATCH BASINS: TUBISHOWERS: I GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN It t00K: BOIL/CMP<3HP: VENT FANS: CLOTHES DRYER: GAS FURN�-100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FI IRNANCES: VENTS: 0 WOODS-,JVES: GAS OUTLETS: ELECTRICAL _AFSIOENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 200 snip: 0 200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 5008F: 201 •400 amp: 201 400 amp: IA W/O SVC/FDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 4111 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR, 601 • 1000.mp: 60141mos•1000v: MINOR LABEL: 1000•omplvolt: PLAN REVIEW SECTION Reconnoct only: >.4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMME'ICIAL AUDIO b STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM. INTERCOWPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: 1301LER: HVAC, LANDSCAPEIIRRIG PROTECTIVE SIGNL GARAGE OPENER CLOCK: INSTRUMENTATION. MEDICAL: 01 HR: HVAC: DATAITELE COMM: NURSE CALLS: 10TAL 0 SY4TEbl3: TOi AL FEES: $ 737.97 Owner: Contractor: This permit Is subject to the regulations c-)ntained in the RASMUSSEN,TERRY J+ EVELYN A c?1►J,+lEfi Tigard Municipal Code,State of OR. Specialty Codes and 6912 SIV IAYLORS FERRY RD ��� ZK� at��all other applicable laws. All work will be done In TIGARD,OR 97223 �-c2�t C �^�� �—� cDordance with approved plans. This permit will expire H e)'l S work is not started within 180 days of Issuance,or if the `1 work is suspende:l for more than 180 days. ATTENTION: Phone Phe .: " �� r7 '.1 Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through 952-001-0080. You may obtain Copies of these rules or direct questions to OUNC by calling 1503)246-1987. REQUIRED INSPECTIONS PLM/Underfloor Framing Insp Rain drain Insp Mechanical Insp Shear Wall Insp Electrievi Final Plumb Top Out Exterior Sheathing Insl Mechanical Final Electrical Service Low Voltage Plumb Final Electrical Rough In Insulation Insp Final Inspection Issued By : I r�� ,� l�-tint d )I-<ILI,L� -_ Permittee SiLinahjre Gall (503) 639-4175 by 7:00 p.m. for an inspection n, iced the next business day Building Permit Application Date received: �� G :1- Permit �' _UU /� City of Tigard � �J Project/appl.no.: Exp. o date: VA w 1 uv n("/ignrd Address: 13115 SW IlalI Iil (l, 11 d,OR i1 V3 �tk1 Phone: (503) 639-4171 t�' Date issued: By:'�j Reccipt no.: _ Fax: (503) 598-1960 Case file no.: Payment type: a "` '� 1&2 family:Simple Co nplex: Land use approval- ._ ________.. 6F PERMIT' U 1 &2 family dwelling or accessory U Commercial/indusdfr:tI J MilliI-fanuly U New construction U Demolition 7 -1 C Additi,.dalt ration/replaccment U Tenant impr1wenrrni U Firr aprinklet;alarm U Other:- )H SITE INFORMATION •o +r • 5 . Bldg.no.: Suit•no. Job adrtress: ' a ,z �.CS I,ot: _Plock- - T0division: K i ragay t IG W Vest' '7c.� Tax map/tax lot/account no.: 1-5 1 Q••5 Pia• Project name: "r•%" Description and location of work on prcmises/special conditions: ty PO vt--T .L.l�.w-__�/'�'�-moi. 1tt�✓1, Name:'T IL IL 1LY Mailing address: (:o9 I?— 5•w. T^`-(t F—ILYCI-- I & 2 family d�%elliug: �J _City: �'1(a�p.lL� Slatc:C7 ZIP:Cj-122 3 Valuation of work........................................ $_2 Dov Phone: 14 Fax: EE-mail: No.of bedrooms/baths................................. Owner's representative: Total number of floors............................... Phone: Fax: Gmtill: New dwelling arca(sq.ft.) ...........•..•........... Garage/carport area(sq. R.)...................•..... - Name: Covered porch area(sq.ft.) ...............•......... - Deck area(sq.ft.) ..............................•......... Mailing address: - - -. -ng - Other structure area(st. ft.)......................... City: State: ZIP: -- ----- - phone: Fax: -mail: CommerciaUindustrial/multi-family: Valuation of work•...................... ............... --- Existing bldg.area(s ft.) ....... ........I......... 7B ,ess name: �� j^ )/1 C1 n 61 New bldg.area(sq.ft.) ...ress: Number of stories............._ Statc: ZIP: Type of construction........ ........ ..�...... Phone: Fax: E-mail fh cu ane group(s):(s): Existin . - Occupancy R P g --- CCB no.: _ New: City/metro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name:.JCV M fy _ /-N, provisions of ORS 701 and may be required to be licensed in the Address: 6 Z(ob S.W N1.5r b Z'1 K_W_IT— rurisdiction where work is being performed. If the applicant is Cit : /-%ft. Slaw IP: ,� - exempt from licensing,the following reason applies: Contact person:.l©NtJAwlt lAr lan no.. Phonc&2O 8(atoEj Fax:La 1_0 v iai :-- — ---- Name: Contart person: Fees due upon application .. Address: i Date received: City: _ State: ZIP: Am unt received ......................................... $ Phone: Ta_: E-mail: Please refer to fee schedule. _ 1 hereby certify I have rep.f rnd examined this application and the Not all jurisdiction%accept credit cards.please call jurisdiction for row infortnalkm. attached checklist. All provisions of laws arA ordinances governing this U Visa U MmterCard work will be complied with,whether specified he%.gin or not. Credllcard numhct _ ---- _ 1-1-- — spires Authorized siggj ore: Date: Name o cardholder a+%hnwn nn cmdii card Print name: c `"'��r KN-J� --�-- Cardholder signature �— --- -s Amount Notice-This permit application expires if n permit is not obtained within 180 days after it has been accepted as complete. ""AIA(6fflwoM) t One- and'l'wo-Family Dwelling Building Permit Application Checklist Rcferenceno.: ------ Associated permits: C it),n/Tigard City of Tigard U Electrical U Vumhing U Mechanical Address: 13125 SW i fall Blvd,Tigard,OR 97223 U Ocher: Phone: (503) 639-4171 Fax: (503) 598-1960 1 1 r 1 I 1 Land use actions completed.See jurisdiction crueiia cur com:urrent reviews. _ 2 Zoning.Flood plain,solar halance points,seismic soils designation,historic district,etc. 3 Verification of approved plat/lot. 4 Fire district approval required. _ 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. 8 Solis report. Must carry original applicable stamp and signature on file or with application. 9 Zroslon control U Faun 0 permit required. Incivae drainage-way protection,silt fence design and location of' catch-hasin protection,etc. _ 10 3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and detu•is. Plan review cannot be completed if copyright violations exist. --- 1 i Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if there i ,pore Dian a 4-It.elevation differential,plan must show contour lines at 2-ft.intervals);local ion of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations.direction indicator;lot area;building coverage aria;percentage of cowxage;impervious arca;existin structures on site;arc:surface drainage 12 Foundation plan.Show dimensions,im-hor polls,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,wale-hcalc furnace,ventilation fans,plumbing fixtures,balconies and decks 3')inches above grade,etc. 14 Cross s rtlon(s)and details.Show all framing-member sues and spacing such as floor lx ams,headers,joists,sub-fluor. wall construction,roof construction.More than one cross section may he required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footingN arc foindation,stairs, — Fireplace construction, thermal insulation,etc, _ I5 Elevation views.11-1vide elevations for new construction:minimum of two elevations for additions and remodels. Exterior elevation.,,.rust reflect the actual grade if the change in grade is greater than four loot at building envelope. Full-size sheet addendums showing foundation_elevations with cross references arc ecce table 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 slandards. 17 floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. _ 18 Basement and retaining walls.Provide cross sections and details shim ing placement of rchar.For engineered systems,see item 22,"Engineer's i,alculations." 19 Beam calculations.Provide two!.ets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. _ 21 Energy(%)de compliam:e.Identify the prescriptive path or provide calculations A pits piping schemati•-is required for foi,r or more afpliar.es. 22 Ftiglneer's calculations.When required or provided,(i.e.,shear wall,roof uu•• 1, 11 he stamped by an engineer or architect licensed in Oregon and shall bz si,own to be applicabl,•t.,flit,la,lioct iii,,' i review. 13 Five(5)site plans are required for item I I above. Site plans must he 8-1/2":t 1 I"or I V x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Puilding plans shall not contain red lines or tape-ons. "Mirrored"building pians will he not accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit &Syste n Development Fees document. 27 "Drawn to scale" indicates standard an.hitect or engineer scale. 28 Site plan to include tree size,type&location per approved project skeet tree plan(if applicable),and COT Street Trec List. Checklist must he completed before plar review start date, Minor clianf,es or notes on submitted plans may be in blue or black ink. Red ink is reserved for derartme'tt use only. 440-4+14(6ADCOM) _ _ _ _ M - - - Mechanical Permit Application -y-- - Datereceived: Permit no.: City of Tigard Project/oppi.no.: Expire date: City of Figard Address: 13125 SSW Hall Blvd,Tigard,OR 97223Uate issued: 9y: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no: Payment type: Land use approval: Building permit no.: 1 U I &2 family dwelling or accessory U Commercial;indus',rial J Multi luau) U Tenant improvement U New construction U A(Iditiotdalteration/replacement J,liber:.,Oil Sir uF 1 1 Job address: S W TCL X&I, Aer Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: osis r.v.: value of all mechanical materials,equipment,labor,overhead. profit.Value$ Tax map/tax lot/account no.: —_ Tax Subdivision: ► *See checklist For i-mrortant applicat on information and LA; IProject name: jurisdiction's fee schedule for residential permit fee. City/county: _ I Description and location of work on premises: !ee(ea.) lural Est.date of completion/inspection; — - _ Wsclipllfm dry. Res.only Res.omlr Tenant improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?U Yes U No Air con itionmg(site plan require ) Is existing space insulated?U Yes U No tern[on n existing E, .system 0 er compressor., State boil.nr p%rmit no,: Business name: Ali—'�"—�. n cs"�`�f" HP Tons__BTU/H Address: tr smo c amper �uctsmoTce etectors City: Stair: ZIP: cat pump(site_pn required) Fax E-mail: nsta replace urnoce urner__ "I U1H Phone: Including duetwork/vent liner U Yes U No CCB no.. _ _ nstn1Vteplace re ocate heaters-suspended, City/metro Ile.no.: wall,or floor mounted Ntfine(please print): vent fora;,iauce other than furnace rf gent on: Absorption,units BTU/H Chillers _.. HP Name: - Com ressors lip Address: Environmental exhaust livent ton: City: State: ZIP: Appliance vent Phone: Fax: E-mail: )rycrcx must 7hood S. ype res. tc c aamat fire suppression system Name: ust fan with single duct(bath fans) ust system apart rum real ng or ACMailing address: p p ngan st ut on(up to 4 out ets) City: Stale: LIPS LPG __ NC Oil Phone: Fax: E-mail: t Inmac a itional overout ets Process piping(sc ematicrequire ) Number of outlets Name: terst appUt—nee or equ pmemt: Address: Decorative ftre Ince City: - State: ZIP: nscrt-type — Fax: E-mail: oo stov pc et stove _ Phone: her: Applicant's signatureDale:: �:� Name(print): PrL .rC-fl-zj - _ Permit fee.. Not ail Jurisdictions accept credit cards,please can Jurisdiction for mare InfnMauan. Notice:'this permit application Minimum fee................$ U Visa a MasterCard expire-ire p^rntit is not obtained plan review(at _ %) $ _ Credit card number. -- --- -- —L— within ISO days after It has been — splrcs y Siete surcharge(896)....$ Man*of carMoldef ass own on crich,cud accepted as cot,iplete. tt TOTAL .......................$ -- Cvdhuldcr d�naune -- Amount 40-617(fs0aiCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: 1 TOTAL VALUATION: PERMIT FEE: Description: Price Total $1.00 to$5,000.00 Minimum fee$72.5J Table 1A Mechanical Code Oty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 DTU $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 addltional$100.00 or including vent 14.00 fraction thereof,to and including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater 14.(10 $26,001.00 to$50,000.00 $379,50 for the first$25,000,00 and 5) Vent not included In appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and Including 6) Nepal -rnits $50,000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 an•t Check all that apply: Boller Heat Air $1.20 for each additional$100.00 or For itorns 7-11,see or Pump Cond fraction thereof. footnote:Below. C6Tp Minimum Permit Fee$72.50 sus,rOTAL: 7) absorb unit $ to 1100K00K BTU _ 14.00 °/.State Surcharge 8)3-15 HP;absorb 8 $ unit 100k to 500k BTU 25.50 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb 35.00 _ Required for ALL commercial permits onl unit.5-1 mil BTI( TOTAL COMMERCIAL PERMIT FEE: $ 10)30-50 HP;absorb unit 1-1.75„til BTU _ 52.20 11)>50HP;absorb _ A unit>1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00 Value Total 13)Air handling unit 10,000 CFM+ Descri tion: Ott Ea Amount_ 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct ousts&vents _ 6.80 Floor furnace Including vent ! _ 955 16)Ventilation system not Included in Suspended heater,wall hea.er or 955 appliance ermil _ 10.00 floor mounted heater 17)Hood serve, by mechanical exhaust Vent not included In appliance 445 1Q,00 oetmit - 18)Domestic In-Inerators Repair units 605 17.40 <3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator to 100k BTU 69.95 3-15 hp;absorb.unit, 1,700 _u1 Other units,Including wood stoves 101k to 500k BTU __ 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU _._ 5.40 _ 30-50 hp;absurb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU _ 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mill.BTU Air handli�unit to 10,000 cfm 656 8%State surcharge $ Air hal.dlinp unit>10,000 dm 1 170 Non-port:31)le evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not Included.t 656 _appliance permit Hood served by mechanical exhaust _ 658 _ Other Insoectlone and Fees: Domestic Incinerator 1,170 1 Inspections outside of normal business hours(minimum charge-two hours) $02 50 per hour Commercial or Industrial incinerator 4 590 2 Inspections for which no fee is specifically Indicated (minimum charge half hour) Other unit,Including wood stoves, 656 $62 50 per hour Inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(mi,imum Gag piping 1-4 outlets 360 charge-one-half hour)$82.50 per hour Each additional Outlet v, 83 "State Contractor Boller Certification required for units>200k BTU. TOTAL COMMERCIAL v $ - `Residential A/C requires site plan showing placement of unit. VALUATION: _ _ All New Commercial rwildings require 2 sets of plans. l:\dsts\forms\rnech-fees.doc 02/11/02 Plumbing Permit Application --+ ~ Date received: I Permit no.: J., Cityof Tigard --- 9, .-, Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 — Cityc�(Ti,gord phone: (503) 639-4171 Project/eppl.na: Expire date: Fax: (503) 598-1960 Date issued: By: Teceipt no.: Land use approval: Case,deno.: Payment type: U I k 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement (_J New construction )4 Addition/alteration/replacement `a Fend service U Other: 11 1 Joh address: `'`•" ` I 'c._ 4.1. Dcscriptiou Qt Fee(ea.) "Total Bldg.no.: Suite no.: —^ Nen 1-and 2-Tamil)dweilings only: P , 't2S aA t't. $Z (includes 100 ft.for eochutilitvconnec•tion) Tax ma /tax lot/account no.: G� SFR(1)hath Lot: 0 Block: Subdivision:Klw>t � v t tE_W --- ""� SFR(2)bath Project name: _ SFR(3)bath - City/county ZIP: Each additional bath/kitchen Description and location of work en premises:_ Siteutllitles: _ Ce(ch basin/area drain Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin.ft.)I'Ll AI III NGVON1'ftACj.OR Manufactured home utilities Business name: (0 U f NQ 11 _ __ _ Mauholes Address: _ Rain drain connector City: State: "LIP: Sanitary sewer(no.lin.ft.) _ Phone: Fax: IE-mail: Storm sewer(r.n.lin. ft.) CCD no.: Plumb.bus.reg.no: - Water service(it!). lin. It.) City/metro lic.no.: _ Fixture or Item: Contractor's representative signature: Absorption valve t _ _ Back flow preventer _ Print name: Date: Backwater valve Basins/lavatory Name: Clothes washer Address: Dishwasher Drinking fountain(s) City: State: V LIP__ Ejectors/sum Phone: Fax: E-mail: Expansion tank �MXIT ® Fix.turr/scwer cap _ Name(print): T IL-7IC.`E R-�./�` H V L N Floor drains(tloor sinks/twb Garbage disposal Mailingaddress: o°I 1 Z r--IE Flow bibb _ City:'r-I p:,_r> I State:OZlp: Ice makrr Plione:24 5='132 Fax: Email: nterce tar/ reasjLmy Owner instal lation/residential maintenance only: The actual installation Primer(s) will he made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the propet}y I o as per ORS Chapter 447. Sin (s),basin(s),lays(s) Owner's si nature:'�� w Date: �.2 Z U Suing- Tubs/shower/shower pait _ Name: Urinal —�— --_ -- Water closet )Address: Water heater City:i State: ZIP: Other: -- Phone: Fax: I E-mail: Total Not ell jurisdictions accept credit cants,ptsase call) rioction ror more IMnrtnsllonNlinimom fee................$ Notice:'17us permit application plan review(at _ %) $ U Visa U MasterCard expires if a permit i3 not obtained Credit cord t,umhet: _�_--_ within 180 days after it has been State surcharge(8%)....$ _ .rtp ros -- Nano M cerdhal r u shown on cnida cert accepted a.;complete. TOTAL ....................... -- _ S Cardholder signature - -- Amount 4404616(uA) OMi PLUMBING PERMIT FEES: PRICE TOTAL Wew 1 and 2.4amily dwellings only: FIXTURES Individual QTY ea AMOUNT_ (incl,;:r?s all plumbing fixtures In PRICE TOTA_ ----� ---- 16.60-7- the dwelling and the first100 ft. QTY (ea) AMOUNT Sink X6.60 - for each utllit rLconnectlon Lavatory One 1 bath $249.20 _- Tub or Tub/Shower Comb J.60 Two 2 bath _ $350.00 _ Shower Only - 16.60 Three 3 bath $399.00 _ Water Closet 16.60 SUBTOTAL Urinal - 16.60 8"/e STATE SURCHARGE _ Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL ]-qT6-,60 - TOTAL Garbage Disposal Laundry Tray Washing Machine - FloorDrain/Floorlink 2" - R66 PLEASE COMPLETE: 3„ q" uantit b Work PerformedWater Heater Oconverson O like kind Fixture Type: New Moved Replaced Removad/ Gas piping requires a separate mechanical Capped permit. - Slnk MFG Home New Water Service 46.40 - ­­;i6.40 Lavato MFG Home New Sar./Storm 8uwer Tub or Tub/Shower Hose Biba 16.60 Combination - Roof Drains 18.60 Shower Only Drinking Fountain 16.60 Water Closet - - - Urinal - Other Fixtures(Specify; 18.60 Dishwasher -- Garbage Dispose --- - Laundry Room Tra r_ Washin Mg achine Floor Drain/Sink: 2" Sewer-1st 100' 55.00 3" Sewer-each adi 46.40 4" Water Service- 55.00 Water Heater Other Fixtures Water Service each additional 200' 48.40 (Specify) Storm 8 Raln Drain-1st 100' 55.00 - Storm 8 Reln Uraln-each additional 100' 46.x0 Commercial Back Flow Preventlol,Device 46.40 Resldential Backflow Preventlon Device' 27.55 -� Catch Babnt 16.60 Inspection of Existing Plumbing or Zpecially 62.50 Re nested Inspections err COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 --- _ Grease Traps 16.60 - _-- �- QUANTITY TOTAL ---- Isometric or rlsor diagram Is r,.lulred If Quantity Totalis >9 -- _ "SUBT'JTAL --- 8%STATE SURCr-IARGE - _ •'PLAN REVIEW 25%OF SUBTOTAL Required only If acture I Intal is>9 -. TOrAL l *Minimum permit fee is$72.50+e%state surcharge,except Residenn:.i eackflow Prevention Uovice,which Is$36.25+a%state surcharge. "All New commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. I:\dsts\forms\plm-rees.doc 12/26/01 Electrical Permit Application Dale received: Permit no.: City Ot ig and Project/appl.no.: Expiredrte: Cllr"t l igard Address: 13125 SV. Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Paymenttype: Land use approval: OF.-PERMIT U I &2 famiiy dwctiing or accessory U Commercial/industrial U Mulli-family U Tenant improvement U New construction Add ition/alterttion/replacenfent J()Ihot A Partial Joh address: (vq 12 `p.ver(. TA b L'� Bldg. no.: Suite no.: Tux rnaphax lot/account no.:(�125 p Lot: TBlcx k: _ Subdivision. Project name: -- I Descriptitm and location of work on premises: Estimated date of corn letion/inspecI i,rlt: ON 11 RU'i OR APPLK�ATIOA SCHEDULE Job no: (1)Vv! (VL U' Fee Max Business name: - Descripron Qty. (ea.) Total no.ins — — Nen-residetdial sinkkorroulti-farrrih ier 1 Address: dwellhtaunu.Includes angflMYl k.0 at;.•. City: Sla(e: ZIP: service Included: Phone: Fax: I E-mail: lax)sq.It.nr less 4 CCB no.: Elec.bus.Iic,no: Each additional 5(N)sq.ft.or portion thereof Limited energy,residential 2 City/metro Ilc.no.: Limited energy,non-icsidenual 2 Hach manufactured hrmne or modular dwelling Signature of supervising electrician(required) Date Service and/or feeder 2 Sup elect namre(prino l 11.111. IPI Services or feeders-Instalbdion. alteration or relocation: OWNER 2W amps or less 2 Namc(print):'T ter.IL K--f IZ- �"'�``�►—t v`� fit.! zit 1 apps to 400 amps 2 401 amps to 600 amps ! Mailing address: L ail M S W. TAY Lo ILS r-IL It.� 601 arnpr to IOW amps z City: T l za f�t�-P Stater 7.IP: Q 1 ?2^ over l WO caps or v.hr-- __— 2 Phone: Fax: E-mail: Recnnnectrnily --- I 'temporary r Owner installation:The insttdlr,l.ion is being made on property 1 own pr' '�'�services or feeders- which is not intended for sale,lease,rent,of exchange according to installation.alteration,ort?location: 2W amps of less ' ORS 447,455,479,670,7( amps to amps 1. -� 201 4 ' -2;-- owner's si nature•, /_�,>,..z-1:-- D 'Al-ale: Z C) 401 u,6llnam s Branch circuits-nen,alteration. orextenslnn per panel: Name: - - A. tee for branch circuits with purchase of Address: _ _ _ service or feeder fee,each branch circuit_ State: zip: H. Fee for branch circuits without purchase ---- --- —-- — — — of service or feeder fee,first branch circuit: 2 Phrinr I'ns E-mail: Bach additional branch circuit: r =I j oil I RIVI WMisc.(Service or feeder not Inclutkd): U Service 41%VI"S Imps-aumnWu ral U Health-care fa,ihty Each pump or irrigation circle 2 U Service over t'0arrips-rating of 1&2 U Ha7.ardoulilocation Each sign or outline lighting 2 family dwellurgs U Building over KIM square feet four or Signal circuit(s)or a limited energy panel, USyctemover6Wvolts nondnal nxire residential units intitle structure atteratinn.(it extension" 2 U Building over three stories U Feedenr,4(x1 amps or naxe •1 k.. r ruim Ll Occupant loud over 99 persons U Manufactured structures or RV park Each additional Mspectlon over the allowable In any of the above: U F.grrss/lightingplan U Other. - [letInspecuom — Submit—sets of plans with any of the above. Investigation fee The above are not applicab'e to temporary construction service. Other Not nil jurisdictions accept credit canis,please call juriadicuon lox more info maurxi Notice:This permit application Permit fee......... ...........$ __ U visa U Mastercard expires if a permit is not obtained Plan review(at _ %) Credit card number: within 190 days after it has been State surcharge(8%) .... Flipires accepted as complete. TOTAL ........ $ Name of carAoldet u ahmvn on credit card _ S _ Cardholder sleure—-- —�Amount 440-4615(ty WOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL Y ComP Restricted Energy Fee...................................................... `--$75.00 Number of Inspections per perrnit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total _ Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less _ $145.15_ ,1 ❑ Audio and Stereo Systems' Each additional 500 sq.".or portion thams $33.40_ _ t ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or ModularGarage Door Opener' Dwelling Service or Feeder _ $90.90 2 Ej Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 El amps to 400 amps $106.85 _ 2 Vacuum Systems 401 amps to 600 amps _ $160.60_ 2 601 amps to 1000 amps $240.60 2 ❑ Other— Over 1000 amps or volts $454.65 2 Reconnect only _ $63.85 _ 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 918-260-260) 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 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 65 _ 2 ❑ Data Telecommunication Installation b)l he fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder too. First branch circuit $46.85 Each additional branch circuit $665 r).14- ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder riot included) Each purrp 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 Irrige-lon Control' Minor Labels(10) _— $125.00 Each additional Inspectl-ten over ❑ Mac:al the allowable in any of tt;e above F-1Per Inspection _ _ $62 50 — Nurse Calls Per hour $6250 In Plant _ $73.75 - ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ _-- ❑ Other 8°i State Surcharge $ Number of Systems 25%Plan Review Fee See'Plan RevIeW section c $ " No licenses are required Licensee are required for all other Inslallatlore, front of application - Fees. Total Balance Due $ Enter total of above fees S ❑ Trust Account#— - 8%State Surcharge $_ Total Bafance Due A!! New Commercial Buildings requiro 2 sats of plans. 0dats\formrMlc-fees.doc 08/30/01 Permit#: Vh 5l dde.J d (>t�•�-L Address: (fit 12 _ SW '�1°rfLDi2S f�Q� N .t. issued b}r-- - Date: �2 -�'"Y Statement: Information Notice to Property owners About Construction Responsibilities Note: Oregon Law, URS 701.055(4), requires residential construction permit appli- lants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, nnechcnical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will he filed with the permit. Fil l in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: 1 own, reside in, or will reside in the completed structure. 2. 1 understand that I must register as a construction contrtrctor if the structure is sold or offered for sale before or upon completion. (� 3A. My general contractor is_ O W- 2-el- (Name) Contractor regis. # I will instruct my general contractor teat all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. I will be my own general contractor. It'I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. It' I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. 1 hereby certify that the above information is correct and that I have read and do uni lerstand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. �y -2-2. -02- (Signature of permit applicant) (Date) (White cope to issuing agency permit file, pink copy to applicant) x information Notice to (Property Owners About Const'i lli tion Responsibilities J.. 1 �� � Vt�l�i<' !�� �irfltJPY"t1'(rl�'YIt''1"1il�1Ul!( t !Nr!'i''lU"/;�1fi Re,apoiislhtliYrc's ,� ;fi �tt� 7t' Lli , J! PIF'V op" R , ( 'f rtCt!'11�(`trr�)i �" �..0 � ?�/1J'Y �1(and!n r,!, (rl„�(�:7!7i t' 41.1fiC7,ORS 701.0'�If F if If tiolt are acting as yol.tr (.114'!1,,imtrji.t.(1r o Cl'nmrllf.'t :.i 1;1vNV h0tlk' 01 IlUdk. ,t hi1,11:rt:.lrill 11 Illtl'li'C)WC'r1lf:iil to an�Xl,ting I`wMPLOYEA RESPaONWBILITI! j: It YI'•il furl' �� r,�i i r1,r! Ir, ,•i, "f �i f k I-ii, .,I t I 'ILit'1!I VI i., '•I III , t'1'+11=•{i`i{Cltl_l'. ( 1�r iii ,' �� ii) !i � l'C :I��, .i 11f' ;i11 CitYl)I„„'I l 't(I Ehi , , �' � r VOI,1 hlri91V1)6 i�;rrl„ �'� Uit1l11V' `t'I'tll Ihti` f, Oregon,.;%1111111t,10411, i.)- yi, "Yrrtf' �i � �i,i t ! , � �, �r1".•,ti qtr w:", r r t tF � 1t1C1;l1 lt'i rl Irt: 911:u_'ri� , I; llr,, p'lihl Yi�, l iit 1, 1� y1, i.,. 11� ' ,x 1'�I.1111'llk t 1o,q i ,Oi1 Ooll�f I� '1:'11, n Ill), Ili lilt- x` lt'tr 11 ol1 rI`i ,f� t 1..d �� '1 �) \ r i 1, 1 � 111 int't1r111ilt.igl'i, .:�il tlr� l iria)�(t,wi, tl, l'1i, tJ'176�W� tS�t�)d�:!'tl"�1'l QJtt4�rM11Alt1'rl'1G.rEl ll!"31id"Ul114'A ld' it "111111firt'r. , ,I i'�htt3 �C]11M.'.l Ili i'i r'y Cll" ah ; Id171C; C.'l`!•. Flo "0 11"�riluy Irli:rii IhviSlm)at(lie Mpitil.lictii") 1;tit Ipill I kt i'-11'44;' 1 ill IT4.152.4. w119"I�CP$�Cf1r1111K'1YW8t11111 M'4S`•tlrLf,rll.l'1: :�' iilt 1. Vt.tl aro ^,til'�Pr' !, I�r I�ti '� ) ti ,rril Wolt,t" o llltrll .'!\rtJ. etilll ltlr.l9t llflti,1111"1Mt`'[i!aiy.,�l::1,t�114115ti11 it '11y4t1 ,.. )hl ,"{Eit ��Il�li)XIL1�1 I� 'urafflllf. rIoUi�l11;'�ytl�i"r`� I:Uilll't�;ll`;r111t�',Iltl``llt,illk".1��1 <<�1.{ Iii:It Tit w ifl hl' ,11111 ttti'�111rn;�irtticiiltlr,ililis; (i,.11llk�fi'rt�t1 .1:1''i ' ,��,1;4t ctittrlil w�i;ul�tllil�l,l�, i1�,;111u1i��lnnih.� li'd1`9 1' �1:iq infel�,��111i "ll ,_;Ill the f,tl 't.i' (,"flttllll;r)` ..!(lii I)7,.'hill alt 'lho M= ,. ` i'�'�, 1 "V1 iII(Cr11u1 Reven Ile ScI Ikdk.: l.tII C.1111.)1t1'vt'I', YUUI11u9i00th1,6It1'vdtC 1 M)lwo!1;0 LAX llhill!'lv.l ofl,'1t�1{lt� ���,�, ,'fl�k�f, lialArfill>t,h+,'tllkPAVM.`ilit111didn'1tlK i „riililr� 9111+.rlti.11irri.� htrrtt;llt _ ,'lrlr ti'I'i"'1` o l iER Fi E aPG1NSIBILITIES AND AREAS OF CONCERN: ("odreompi:inse,A,._,thepe!t,"ifhol,iicrf'rlrli'Ii<l11 jt t.y't�italr't", thl, 1''Iit," lt111,!,11 . l'tilur ir, i9dcr4�t11ai�: 1n'rllt, that mfty he hllll+ht Ill your Iutonlitlll 11 11 it s,lc'_llrirl,s. t l.iu1)ilit% and pni,pLrty f1ultul;;,4;imus 1tim. i,tiilt':'t t SVILtx,tll tJ111111t'.,IrS !,l to l t.,v II 'oli iljslllallvt't.'ill t'r1ige rill' l ! It ,'Iii allU,l t�itil`.:l�Jl'IA "Ul l7 1:� !�tlltilka tt%111 ., 1!;,11111 (".lj'.l)t114, o.111wt 'IUtllll,,I_ Itoo l irt., lltttli,101L: , lift', vi U1,k illiv 1111..19t ht, It tl!r w,, t Time Ill lm1wrOse enipluyli's. 1�9,+'�� �r�� "�11i Il,i'.�� 11iilli.1vill ilme to Sulu yokil elrip"4lyt"i �, ViperWx A.i,�1 , .nr �,,�1 hr'1'",f�a�pl1'a l l' 1Eglft+iaiTl+1.l�t�l,ll�`1''ll+l'a� tiwrSllrrtrlf(Iiilltti`dhrt,'rlrkr,�i'tlli�tll-ilillllti1111iF1t trade%. ;oi 1.+ iwli', 1,10flol" rtlti!`ink ,it the ;lrwrTol,lrtilty IIrvliC"!Cit ihi'1` cm, h,`11ilrm ill,- re(purecl til Il1t"Ctli41+:, 11 )uil Iit'uit!l uidoitilwtlnl w 11�..of Call 1111 ( lm.,tructiun t 'olill°i"I'll, 1111oal(1''(;11 R(M:14t,10,Salt'n1, t)h ')71,09.1,09.5052. X031178-,W'1) The Bollrtl i,. 1,lcowtt a! 700 Sownict St, NF `dile 3M, in Salem. o UO .v I 1 e John D Armand, II NCARB Architect 8260 S W Hunaiker St Tigard, OR 97223 1s L-7 T-IL aT I C ►J N Co GZ E.'1 d It.�•1 G �.. Vc IN4w?s L 0 T -7o 2 51> 0 a a C) ? 1 ___ MECHANICAL PERMIT CITY OF TIGAR® DEVEI-OPMENT SERVICES PERMIT#: MEC2000 00322 DATE ISSUED: 8/10/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S125DA-08200 SITE ADDRESS: 06912 SW TAYLORS FERRY RD SUBDIVISION: KINGS VIEW ZONING: IG BLOCK: LOT: 070 JURISDICTION: TIG TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT CYSTEMS: STORIES: BOILERS/COMPRESSORS HUODF- _ FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: 1 GAS PRESSURE: 50 4• HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= -10000 cfm:�! GAS OUTLETS: > 10000 cfm: Remarks: Installation of gas fireplace Owner: — __ — FEES RASMUSSEN, TERRY J + EVELYN A `Type By Date Amount Receipt 6912 SW TAYL.ORS FERRY RD PRMT DLH 8/10/00 $50.00 0004389 TIGARD, OR 97223 5PCT DI_H 8/10/00 $4.00 0004389 Total $54.00 Contractor: _. LUDEMAN'S FIREPLACE + PATIO 12675 SW BEAVERDAM RQ BEAVERTON, OR 97005-2129 REQUIRED INSPECTIONS Mechanical Insp Phone:646-6409 Final Inspection Reg# LIC 51469 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of dire. 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 more than 180 days. ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001(' through OAR 952-001-0080. You n,ay obtain copies of these rules or direct questions to OUNC by calling (503)246-9189. Issue By: c ,�I- Permittee Signature- Call ignatureCall (503) 639-4175 by 7:00 P.M. for inspections needed the next business day 1 Plan Cheo 0 CITY OF TIGARD Mechanical Permit Application RerdBy _ 13125 SW MALL BLVD. Commercial and Residential /I(� Date Rec'e TIGARD, OR 97223 Dale In P.E. (503) 639-4171, x304Date UST Print or Type \}� c' A 70 Permd p ,�l ECodoao ro �2 Galled Incomplete or illegible a plications w not b ��tedi Name ofDOV@kOrr MW.Mpa Description ���th\1 l �AS k k ,- �.�� Table to Md*tlt 91 Code Ot Price Amt I A) Perm4 Fee ! r 16 00 Job TS1fe1 k:VT;"t p n 1) Furnace to 100,000 BTII Addrc_ludn ducts 8 vents "a lootnoto 1,2 9.65 r i)e� n tJ r, 0- ^ ,� 2) furnace 1 O,000 vents rl 1�J d-,� inducing duds 8 vents ace footnote 1,2 12.00 -- Name(or Items*Ilaii"Wa) 3) Floor Furnace y res, me ndudi_n v9 ent see footnote 1,2 9.65 Owner 6t d) ous•p ended heater,wall heater IIAerMailing A nr floor mounted heater see footnote 1,2 9.65 5) Vent nol included in apphince pennd 475 Cty�sure Phone Check all that apply. 'Boder Heat An q.S 13,)V For Items 6.10,sae or Pump Cund oty Price Amt --- -- - wine la name ar tnrrwaq footnotes 1,2 Com 6)<3HP;sbsorb unit to . Occupant Wiling --- )3-15 HP;absorb unit --- - - `- - 1100k to 600k BTU t-' GS crYisia+e nP ptwna 8)15-30 HP:absorb unit.6-1 mil BTU =4 1_ _ 9)30-60 HP;absorb - Contractor r"TO �l unit 1-1.75 mil 9 FU _ 1� /-it &f YH A�•) > 10)>50HP;absorb utut V� Prior to permit �_ +0 " r " "''L >1.75 mil BTU Issuance.a rnpy M• Adds` �� 11 Air handling unit to 10,000 CFM -- of all Itornse•_ l:1Yrt3 >7o P 0 0 — - - CFM- am required N (J /t 1/ (� r 40'&''&qV 12)Ah handling unit 10,000 CFM+ expired in COY' 7 t Cants.Cant Lie. �.tete t 1 65 dSe J /ir/ G 13)Non-portable evaporate cooler 7 on Archltect Name ---- — - 14)Vent fan connected to a single dud d 7[ or plaiut9 Address- - - - -! 151 Ventilation system not rndudlerl in a Bance nn,t �00 Enolneer cny sone —--�- �—Zp t'rone +6)Hood served by mechanical exhaust DD _ _ ---_- -_. ___ 17)Domestic Incinaalors - -- — Describe work to be done _ 12.OU New IS( Repair O Replace wrlh like kind Yes O No O 18)Commercial or industrial type incinerator 48.25 Residential C Gornmerdal O "- 19)Repan units - --------- 8.40 Additional lniormahon cr deacnotron of work fir„ �, .r �P.rD n►Ity nN�IrIMM Aw,Ml��r 7.00 �az NOTE. For Commercial proleds only;Unds over 400 lba requirr 21)Gas pining one!o four outlets Structural gas calks. See footnote 1 _ 3.75 Type of fuel otl O nolural qas O LPG O electric O 22)More than 4 per outlet(each) 75 _Minimum Permit Fee$50.00 SUBTOTAL `� I hereby acknowledge that I have read this applk0ion,that the information 81/.SURCHARGE rrrr gran is coned,that I am the owner or authorized agent of PIAN REVIEW 25°�OF SUBTOTAL Required for ALL commercial permits only ►. �✓� the owner,that plans submitted are In compliance with Oregon Slate laws TOT Dia SI r!01 l?vy 1 Other Inspections and Fees: r• V����«% �� 1. Inspections autsldr!of normal business hours(mininurn charae-two ttAhlaat rxt Phone hours) $60.00 per hour 2. Inspections for which no lea is sraclrlcally Indicated (minimum charge-halfnpan hour) !ew re per hob Foor►otes for comrnarctal protects only: 3 Additional plan review required by changes,addlilons or revisions to plans(minimum charge-ono-half hour)$50.00 per hour t Provide full schematic of existing and proposed gas line and pressure 2 Provide drawings to scale showing existing and proposed mechanical _ i� ':,tate C,ontra,'!ai dmler Cerldd icatlnr•rr•qurre units --- "RrsKt►pleat AC %rte man show-q Wa-1,W)t I Vnechpenm doc rev 7119199 CIT` OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 �' MST INSPECTION DIVISION Business Line; (503)639-4171 BLIP Received —__- - Date Requested__-1__ _ AM __— PM__ 1 - - BUP Location >- _ TL - Suite ---- EC D- 00 - 00 ZZ-- - Contact Parson -- Ph(-----) ---.. - _-- - PLM ----- Contractor -- - --- - - - Ph SWR ---- BUILDING Tenant/Owner - ELC - Footing ELC Fcundation Access: Ftg Drain ELR - Crawl Drain - Slab Inspection Notes: SIT -- Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- -- Insulation Drywall Nailing - - - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: - _ - - --- -- Final PASS PART FAIL Post& Beam ider Slab --- - ----- -- ------- -- Rough-In Water Service -- -------------- -___..__ __ - Sanitary Sewer Rain Drains - ----- -- -- - - -_ _. Catch Basin/Manhole Storm Drain -- �- ��-- Shower Pen Other: --- - ------------- — -- - — - - - Final PASS '- FAIL - -- CHANIC — v-_ .--- ----- -- Post& Beam 'T ` Rough-in -- -- - - Gas Line ` Smo Dampers - - r"5_CS-t`R PART FAIL ICAL _- Service -- Rough-In UG/Slab Low Voltage ---- Fire Alarm Final 1 Reinspection fee of$_— _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SITE Please call for reinspection RE: _ - _ -_ Unable to inspect-no access Fire Supply Line / 17- DAoach/Sidewalk Date► � __— Inspector v �.�^ Ext A PP Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL