9615 SW VENTURA COURT c
r
9615 SW Ventura Court
MASTER
CITY OF TIGARD
/ PERMIT#: MS12001-00,166
DEVELOPMENT SERVICES DATE ISSU -D: 9'11/01
13125 SW Hall Blvd.,Tigard, OR 911223 (503) 639-4171
SITE ADDRESS- 09615 SW VENTURA CT PARCEL: 1 S125DD-017100
SUBDIVISION: WASHINGTON SQUARE ESTATES NO 3 ZONING: R-4.5
BLOCK: LOT: 079 JURISDICTION: TIG
REMARKS: Residential addit;.•,i of family room.
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 11 FIRST: 15 of BASEMENT: of LEFr• SMOKE DETECTORS: Y
TYPE.OF USE: SF FLOOR LOAD: 40 SECOND of GARAGE: of FRONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: FIN3SMENT. of RIGHT: 6
VALUE: 6 28,817.60
OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 29601) st REAR: 61
PLUMBING
RINKS: WATER CLOSETS: WASHING MACH. LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LIN:4: SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS; GARBA13E DISP: WATER HEATERS: WATER 1.14.5: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN c 100K: BOIUCMP c 3HP: VENT FANS: CLOTHES DRYER:
GAS FURN"100K: UNI7 HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS:
ELECTRICAL
_RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: u' 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 -400 amp: 201 400 amp: tat W/O SVC/FDR: SIGNIGUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 $00 amp: 401 600 amp: EA ADDL SR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM1SVCIFDR: 601 - 1000 amp: (101+amps•1000v: MINOR LABEL:
1000+amplvolt
PLAN REVIEW SECTION
Reconnect only:
�-•4 RES UNITS: 9VCIFDR>•228 A.: >800 V NOMINAL: CLS AREA/SPC OCC
_ ELGCTRICAL-RESTRICTED ENERGY
A sr RLSIDENIIAL .� B.COMMERCIAL.
AUDIO 6 STEREO: VACUUM SYSTEM AUDIO&STERE'): FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0114 BOILEf: HVAC: LANDSCAPEIIRRIO: PROTECTIVE SIGNL.
GARAGE OPENER: CLOCK: INSTRIIMENTA710N: MEDICAL: OTHW
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 770.44
KATSAVOPOI ILC S,ATHANASIOS +SO WOOD CONSTRUCTION INC This permit!s subjectCode,
to the regulations contained in the
9615 SW VENTURA CT 17855 NE LEANDER DR Tigard Municipal Code,State o k wR. Specialty Codes and
TIGARD,OR 97224 SHERWOOD,OR 97140 all other ce with a laws. p work will be done it
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:
Phona, Phone: Oregon law requires you it.foibwrules adopted by the
Oregon Utility Notification Center. Those rules are set
Rep Il: LIC 82941 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
Footing Insp Crawl Droln/Backwater Framing Insp Electrical Final
I Foundallon Insp Footing/Foundation Dn Shear Wall Insp Mechanical Final
Post/Beam Shuctural Mechanical Insp Exterior Sheathing Inst Plumb Final
Post/Beam Mechanica Electrical Service Insulation Insp Final inspection
UndWf rf�Insulation Electrical Ruugh In Rain drain Insp
Issued By : _� �-� Permittee Signature : , A L;5'�
Call (5J3) 639-4175 by 7:00 p.m. for an inspection needed the next business day
7 � �� � ; pi
�T
Building Per_mitAppiiption
' City of Tigard � �� Uatcrecei - t 1/ Q Permit no.
iip,olTItiurd Acldress: 13125 SW Ilall131vd,'I'i�;ird,OR 97223 Prnlcct/appl.no.. Expire date:
Phone- (503) 639-4171 Date issue(:
Fax: (503)598-1960 _ HY' eceiptno.:
Case file no.: Payment type:
1Xc2 f
Land use approval. -- --- '�
nmilv_tiiml,t,— Complex:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Addition/alteration/replacement U Tenaiit improvement 'J fire ,prinkler/alarm U Other:
t .
Job address: I Gi) C r -;
Lot: Block: SubdIV _ Bldg.no.: Suite no.:
isl,m
_
-- Tax map/tax IoUaccaunt no.:
Project name: _ _
Description and location of work on premises/special conditions: of w , ,�, y. .,,,• , _ J
140
Name:
Mailing addreks (�, � '5 W , • .. -►Hnlp2i
1 &2 family dwelling:
City: 1. ,�, State/ IP:~rr Valuation ofwork.,...... .Phone: = I ' Fax: E $
Owner's representative:
No.of bedrooms/baths.............. .. ..
Total number of floors, I
Phone: � ,'i Fax: E .
-mail: New dwelling area(sq.ft.) _
Caragc/carlwrt arca(sq. ft.)......................... --
.........................
Name: -----
Covered porch area(sq. ft,) .........................
Mailing addr•�s: - - --
_ beck area(sq.
f.) ............................. ..........
Slate:
-- -----
ZIP: Other structure area(sq. 1't.)........................
Phone
Fax 1: mail ('ommercial/industrial/malit-family:
Valuation of work........................................ _
Existing bldg.area(sq. f.) $ -
..........................
Address: , Now bldg.area(sq. ft.).............................. --
City: r+r State: ZIP: 7 4 Numtxx of stories........................................ ` -
Phone: G 15! Ed's Fax:�, E-mail: Type of construction.......•.........•...•....•....•....
CCB no.: 1 - Occupancy group(s): Existing: `---
City/metro lic.no.: New: _
Notice:All contractors and subcontractors are required to be
licensed with the Oregon Constniction Contractors Board under
Name: provisions of ORS 701 and may be required to he 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: li retail:
Name: _ Contnct person: Fees due upon application
_ ................•.....•..•.
Address:
_ Date received:
City: _ State: ZIP: Amount received .,...phone: — — .....................I.............. $
Fax: E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and theNM all Jud�tictlona accept cmlit cards•please call Jurisdiction Jnr more iufonnation.
attached checklist. All provisions of laws and ordinances governing this v visa a tifaaierCard
work Nell he complied with whether specified herein or not, crcdu card numhet:
Authorized signature:_�� !` bate:_fj!/vim - Fspims
7�` Namrh
e or c"ol r as own on reedit card
Print name:— - - ----- S
— --— Car&tiolder sipulure Amount
Notice'lliis permit application expires if a permit is not ohtain-d within 190 days after it has been accepted as complete.
410I61 1(wpOK'oM)
Ear��'�Ai
One- and Two-Family Dwelling
Building Permit Application Checklist Referclice no.
--- - --- Associatedpernits:
City n(Tigard City of Tigard U F.lectriral i 11'Iumbin J Mechanical
Address: 13125 SW I lalI Blvd,Tigard,OR 97223 U Other:
Phone: (503) 639-4171
Fax: (503) 599-1960
1 1 ( ' NIA
I Land use actions corupleted.Sre jurisdiction crV ria for concurrent wviews.
2 Zoning.Flood plain,solar balance points,seismic soils designation.insioric district,etc _
3 Verification of approved plotllot. _
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 curry original applicable stamp and signature ou,file or with application.
9 Erosion control U plan U permit required.Include drainage-way protet iinn,silt fence design and location of
catch basin protection,etc. _
10 3 Complete sets of leg Ible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must he 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 be completed
if copyright violation,exist.
I I Site/plot plan drann to Neale.The plan must show lot and building setback dimensions;property corner elevations(it'
there is num+than a 4 It.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot
area:building coverage am 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
sire and location. -
13 Floor plans.Show all dimensions.room identification,window size,location of smoke detectors,water heater.
furnace,ventilation_fans, plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists.sub-floor,
wall construction,root'construction.More than one cross section may he required to clearly portray construction.Show
details of all wall and roof sheathing,rxofing,roof slope,ceiling height,siding material,footings and foundation,stairs,
fireplace construction, thennal 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.
1�i Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations:for
non-prescriptive path analysis provide specifications and calculations to engineeriry standards.
17 Floor/roof framing.Provide plant for all floor~/r:xof assemblies,indicating member sizing,spacing,aEheaLfinnglocations.Show attic ventilation.I8 Ifnsement and retalring walls.Provide cross sections and details showing placement ofrebar.For en
systems,see item 22,"Engineer's calcmations." _
19 Beam calculations.Provide two sets of calculations using current code design values for 1111 txams at d multiple joists
over 10 lecl long and/or tiny hcam/joist carrying a non-uniform load.
20 Manufactured floortroof truss design details.
21 Energy Code compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required
for four t.r more appliances. _
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or
architect li ensed in Oregon and shall be shown to he applicable Io rhe p101, i muder review.
.11 l(ISUK71I0NALS1Pl:( 11 If
23 Five(5)site plans are required for Item I I above, Site plans must be 8-1/2" x 1
34 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 No rolled,reversed or mirrored building plans will be accepted.
27
28 —
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink,
Red ink is reserved for department use only. 4404614 aenrcvcoMI
Mechanical Permit Application
— Uate re e;ived: _ Permit no.:Mfzxj_ c
�~¢ City Of Tigard ProjerUappl.rick Expire date:
City ofT'igard Address: 13125 SW flail Blvd,Tigard,OR 97221 pate issued: ---- By: Receipt no,:
Phone: (503) 639-4171 —- —
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
U I rot 2 family dweii ne or accessory U Commercial/industrial U Multi f:nnily U Tenant improvenu:nt
❑New construction AAddition/alteration/replacement U Otht i -
li
MillINATION 4 U0MMERUIAL.V.%I V XTION'-,SUIiI-'I)11
Job address: (� �) ( u•. . L+ Indicate equipment quanuti,.-s in loxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax neap/tax lot/account no.: profit.Value$
Lot: Block: Subdivision: 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit l'ec.
City/county: _ 'LIP:
Description and location of work on premises: FA
Uee(ea.) lolal
Est.date of coin plction/inspection: ,��! r 1)eseriMion _ Qt . Res.only Rev.only
Tenant improvement or change of use:
Air handling unit __CFM_
Is existing space heated or conditioned'?�Yes U No _
it con uioning(site plan required)
Is existing space insulated?Id Yes U Noterationofexrst ng system
1Boiler/compressors
Business name: I,t.' t•f O State boiler permit no.:
— _ HP Tons BTU/H
Address: I ' / i. �.E,. .A 4. , i smo ke dampers/duct smoc detectors
City: p,,. O Statc:Q ZIP: f Heat pump(site plan require
Phone: Pax rr� E-mail: nota rep ace urnac urner —BTU/H
Including ductwork/vent liner CI Yes U No
nsta repTacr rite heaters-suspends ,
City/melm lie.no.: I•� J ` _ wall,or floor mounted
Name(pleaseprint): ,�j. 14 t U
0 -- —— Vent for a p i' ref ce otiicr than turnare•
Refrigeration;
Absorption units— BTU/H
Name: Chillers_T_ HP
Address: Compressors HP
a ronmenta ex usl an vent a on:
City: State: IZIP. — Appliance vent
Phone: Fax: E-mail: I )rycrex cwst _
Hoods,Type res. tc en azi
hood fire suppression system
Name: Y 140 Lia le Exhaust fan with single duct(bath fans)
--
Mailing address:Q y. Exhaust system art from heating or AC
�_ ; • aoe,piping an trt on up to 4 outlets)
City_ ,ry ,• State:0, I ZIP: q ) r4 Type: __LPG NO Oil _
Phone: Al Fax: E-mail: Fuel pipingeac n tt-«7i conal over 4 outlets
rocesspiping(sc ematicrequ rc )
Name: Number�f outlets -
t er st sed-pnVniFte or equipment:
Address: Decorative fireplace
City: State: ZIP: Insert-type
Phone: Fax: E-mail: oo stovPhone: Fax: E-mail: pe5tove
Other:
Applicant's signature: _ Date: 1
Name (print):
Nol all jurisdictions accept credit cards,please call jurisdiction for more l"Form llon. Permit fee. ...................
U visa U Mastercard Notice:This permit application Minimum fee........... ....
t'redil cord number: — �_� expires if a permit is not obtained Plan review(at _ %') $ _
.__ -- Expires within 180 days after it has been
p State surcharge(896) ....$ ------_
Name of cars holder as shown on credit card accepted ea complete.
— —��Cadholder signature Amoum 410-4617(~'OM)
MECHANICAL PERMIT FEES
COMMERCIAL. FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
VALUATION:: PERMIT FEE: Description: Price Total
$1.00 to$5,000.00 _ Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU
$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. includin ducts&vents 17.40 _
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or Including vent 14.00
fraction thereof,to and Including 4) Suspended heater,wall heater
$25,000.00._ _ _ or floor mounted heater 14.00
$25,001 00 to$50,000.00 $379.50 for the first$25,000.00 and_ 5) Vent not included In appliance permit
31.45 for each additional$100.00 or 6.80
frar%on thereof,to anc includlnq 6) Repair units
$50,000.00. 12,15
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air
$1.20 for each additional$100.00 or For Items 7.11,see or Pump Cond
frcctfon thereof. footnotes below. Com '
7)<3HP;absorb unit
Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14.00
8)3-15 HP;absorb
8%4t.aa Surcharge $ unit 100k to 500k BTU 25.60
_ 9)15-301;P;absorb
25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU 35.00
Rc quired for ALL commercial permits only 10)30-50 HP;abscrb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU 52.20 _
11)>50HP:absorb
87.20
unit>1.75 rail BTU
12)Air handling unit to 10,000 CFM
ASSUMED VALUATIONS PER APPLIANCE: 10.00
Value Total 13)Air handling unit 10,000 CFM+
Descrl tion: City 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
ducts&vents 6.80
Floor furnace includin vent 95.0 _ 16)Ventilation system not included In
Suspended heater,wall healer or 955 appliance permit 10.00
floor mounted heater _ 17)Hood served by mechanical exhaust
Vent not included In applicance 445 10.00
permit _ 18)Domestic Incinerators
Repair units 805 17.40
<3 hp;absorb.unit, 955 19)Commercial or industrial type inUnerator
to 100k BTU _ _ 69.95
3.15 hp;aUsorb.unit, 1,700 20)Other units,including wood stoves
101k to 500k BT.1 _ 10.00
15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
mil.BTU 5.0
30-50 hp;absorb.Unit_ 3,400 22)More than 4-per outlet(each)
1-1.75 mll.BTU _ 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mill.BTU _ __
Air handling unit to 10,000 cfm 658 _ �� 8%State Surcharge $
Air handling uiA>10,000 cfm _ 1,170 _ _
Non-portable evaporate cooler 656 - -
TOTAL RESIDENTIAL PERMIT FEE: $
Vent fan connected to a single duct 446 _
Vent system not included in 658 -- - - - -
appitance permit Other Inspections and Fees:
Hood served by mechanical exhaust 656 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`or which no fee is specifically indicated (minimum charge-half hour)
$72.5Other unit,including wood stoves, 658 Addlti per Hour
InsertsetC. 3 Additions:plan review required by changes,additions or revisions to plans(rninimun
chsrgeaone-half hour)$72 50 per hour
Gas piping 14 outlets 380
Each additional outlet 63 'State Contractor Boiler Certification required for units>200k BTU.
'"Residential A/C requires site plan showing placement of unit.
TOTAL COMMERCIAL
VALUATION:
I:\dsts\forms\meth-fees.dor. 08/06/01
Electrical Permit Application
- ------ - I rntc rconved Permit no.: Snw/'DO`S
City of Tigard I'roject/appl.no.: Expire date:
Citygffigard 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: _
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction All(llll')n/ahcr:dirnt/r plarrt,n 111U O)thrr: - U Partial
Job address: :. �r jN , c Islelg. nu.: tiuitr no.: ITax map/tax lot/account no.:
Lot: I)IrnckSubdivision:
Project name: _ Description and location of work on premises: rl
lislimated date of completion/inspection: 1-: ? �
Job no: fee Nta.
Business name: -Ty-l (QUA, -�u 1s�A,,t C, De%,ription spy. (CA.) Total no.ins
New residential-single or mull I-fnmlly per
Address: 10 dwelling unit.Includes attached garage.
City: 4 =Slat. LIP: `t Service Included:
Phone: �61 L0 I b Fax: r,,.� �� E-mail: l(HH)sq It r r lcsN --- 4 --
CCB no.: tl'0 J Elec.bus. tic,no: Each additional 500 sq.ft,or portion thereof
Limited energy,residential 2
Ciiy/metro lie.no. Limited energy,non-residential _ 2
Each manufactured home or modular dwelling
Signature of supervis,n�electrician(required) Urate _ Service and/or feeder _ 2
Sup.elect.name(print): License no: Servledorfeeders-Installation,
alteration or relocation:
20O naps or Icss 2
Name(print): 201 amps to 400 amps Z
Mailing addless: - 401 amps to 600 amps _ 2
601 amps to 1000 amps 2
City: Slate. LI1'� Over I(HH)amps or volts _ 2
Phone: Fux: E-mail' Reconnect only I
Owner installation:The installation is being made on property I own Temporary services or feeden-
which is not intended for sale,lease,rent,or exchange according to 2Installation.psor lessaltelon,orrelocallon:
ORS 447,455,479,670,701. 201 amps to X) 2
2(11 amps to 4tH)amps 2
Owner's si nature: Date: 401 to 6W am:s 2
branch circuits-nen,ohers(ion,
Name- or extension per panel:
A. Fee for branch circutts with purchase of
Address: service or feeder fee,each branch circuit 2
City: Slate: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee,first branch chcuit: 2• 2
Phone: I ;n E-mail! -
Each additional brooch circuit.
Misc.(Service or feeder not Inc'uded):
U Service aver 225 rmq .unnm;ictal U Health-care facility Each pump or imgation circle 2
❑Service over 320 amps-rating of 1&2 U Hazarduuslocatioln Foch sign oroulline lighting2
family dwellings U Building over 100H)square feet four or Signal circuit(s)or a limited energy panel,
U System over Glx)volts nominal more residential units in one structure alteration,or extension* 2
•Building over Il.ree stories U Feeders,400 amps or more *Description:
U Occupant load aver 91)persons U Manufactured structures or RV park Each add81om4 Inspection over the allowable In any of the above:
U Egress/tightingplan U Other: -- Perinseection r
Submit sere of plans with any of the above. Investigation tee --
77te alwye are not applicable to temporary construction set-Hee. other
Not all jurisdh eons accept credh camp.pleasecall jurisdiction for more infarrt;iinn Notice:Phis permit application Permit fee.....................$
U visa >Mastercard expires if a permit is not obtained Plan review(at — %) $
Credit card number: _-..�_ - within 180 days after it has been State surcharge(8%)....$ _
"fir`" accepted as complete. TOTAL ... $
Name of cudholder u shown on credit card
_ S
---
Cardholder eipature Amount 440-4615(60MCOM) '
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75 00
Number of Inspections per permit 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
Lach additional 500 sq.ft.or
portion thereof _ $33.40 _ 1 ❑ Burglar Alarm
Limited Energy _ $75.00
Each Manufd Home or Modular Garage Door Opener'
Dwelling Service or Feeder _ $90.90 r
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or reloc:atirni
200 amps or less _ $8030 2
201 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 $66.85 2
Temporary Services or Feeders v TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installaticn,alteration,or relocation Fee for eachsystem.................. . .......... ......... .. ...... __ . $75.00
200 amps or less _ $66.85 2 ,SEE OAR 918-260-260)
201 amps to 400 amps $100.30__ 2
401 amps to 600 amps _ - $133 75 - 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, I�
see"b"above. lJ Audio and Stereo Systems
•anch Circuits
W,alteration or extension per panel Boller Controls
?The fee for branch circuits
with purchase of service or Clock Systems
feeder fee.
Each branch circuit _ $6 65 ❑ Data Telecommunication installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
.st branch circuit $46.85 _ ❑
Each additional branch clrcul' $665 HVAC
Miscellaneous ❑ Instrumentation
(Service or feedcr not Included)
Each pump or Irrigation circle $53.40 _ _ ❑ Intercom and Paging Systems
Each sign or outline lighting $534o
Signal clrcult(s)or a limited energy
panel,alteration or extension $7500 Landscape Irrigation Control
Minor Labels(10) $125.00
Medical
Each additional Inspection over `�� ❑
the allowable In any of the^bove Nurse Calls
Per inspection _ $62.50 ❑
Per hour $62.50 _
In Plant _ $7375 ❑ Outdor!r Landscape Lighting'
Fees: Protective Signaling
Enter total of above fees $ -_ r� Other—_-
8%
ther—___8%State Surcharge $ _ Number of Systems
[5%Plan Review Fee
See"Plan Review"section on $ No licenses are required. Licenses are required for all other installations
front of application _ -
Fees:
Total Balance Due $
- Enter total of shove fees
❑ Tit st Account H 8%State Surcharge $
Total Balance Due
i:\dsts\forms\etc-fees.doc 10/09100
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CITY OF TIGARD
13125 S.W. HALL BLVD.
"rGARD, OR 97223
IMPORTANT PERMIT NOTICE
TRI-COUNTY ELECTRIC
PO BOX 40
SANDY, OR 97055
Electrical Signature Form
Permit #: MST2001-00466
nate Issued: 9/11/01
Parcel: 1 S125DD-07100
Site Address: 09615 SW VENTURA CT
Subdivision: WASHINGTON SQUARE ESTATES NO.3
Block: Lot: 079
Jurisdiction: TIG ,_ cP 2
Zoning: R-4.5 CEIV -
Remarks: Residential addition of family room.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and reirarn this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form i_- received
OWNER. ELECTRICAL CONTRACTOR:
KATSAVOPOULOS, A HANASiOS + SO TRI-COUNTY ELECTRIC
9615 SW VENTURA CT PO BOX 40
i iGARD, OR 97224 3 C, 1', OR 970:1.5
Phone #: Phone #: 503-668-5016
Req #: arc 16462
EI.E 3-91(�
'-SUP 32755 '
AN INK SIGNATURE IS REQUIRED ON THIS FORM
L
Signature :)f Supervising Electrician
If you have any questions, please call (503) 639-4171. ext. # 310
CITY OF TIGA►RD BUILDING INSPECTION DIVISION
24-1-lour Inspection Line: 639-4175 Business Line: 639.4171
BLIP
Date Requested_ /-e, /_ �AM PM _ � BLD
Location ��.�� lee— _ Suite MEC
Contact Person Ph �Z �r- fi PLM
Contractor _ _ Ph 574- -sem_ SWR
UILDINTenant/Owner _ ELC _
tngi/t a E L R
Footing Access:
Foundation FPS
Fig Drain
Crawl Drain I Inspection Notes: SGN
Slab I _ 51T
----
Post& Beam _
Ext Sheath/Shear
Int Sheath/Shear
Framing _
Insulation
Drywall Nailing
Firewall / ----- ---_.__
Fire Sprinkler l
Fire Alarm /
Susp'd Ceiling
Roof
Misc:
Fin .- - -
ASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Top Out — - -
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
•CHIN AL
�-Post& Beam -
Rough In
Gas Line
Smoke Dampers
na - - -
ASS) PART ;AIL
MECT-RICAL ---—
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAO,
SITE
Backfill/Grading --�--- - - - —
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ]Please call for reinspertion RE:
Fire Supply Line -- ( ]Unable to inspect no access
ADA
ApprOtheoach/Sidewalk Date [ _ IrrspPct�r _ Ext _
Final
PASS PART FAIL DCT NOT REMOVE this inspection record from the job site.
II
1
CITY OF TIGARD BUILDING INSPECTION DIVISION j
MST ZOO,/—,24, 5/j:;�)6
24-Flour Inspection Line: 6:: 175 Business Line: 639-4
BLIP
_Date: Requested AM` <' AMPM BLD
Locations / /�� $-w (J�nfiu y<� Suite MEC
Contact Person — Ph �2= _ PI-M
Contractor_rT ,Iii L_.r Y�� �Dyrs'fr�x i Ph �5—3 f'iP SWR
BUILDING Tenant/Owner �� ELC i v
Retaining Wad ELR _
Footing ,access _
Foundation FPS
Fig Dra'n SGN
Crawl Drain Inspection Notes: - - -
Slab — - _--- SIT
Post&Beam ----
Ext Sheath/Shear
Int Sheath/Shear —
Framing
Insulation
Drywall Nailing -
Firewall -. -- <-
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof
Misc — --
Final
PASS PART FAIL r -
PLUMBING � r
Post&Beam
Under Slab 2
Top Out OF f
Water Service _
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post&Beam --- -��
Rough In
Gas Line -
Smoke Dampers
Final -- --- --- - -
ART FAIL
ervia -- -- --- - ----------- ----------
Rough In
UG/Slab
Low Voltage
Fire Alarm —
in
PART FAIL ----
Backfill/Grading
Sanitary Sewer
Storm Drain I ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd
Catch Basin
Fire Supply Line ( )Please call for reinspection RE: _ I ]Unable to Inspect-no Fucess
ADA _
Approach/Sidewalk
Other Date _a!10 Inspector "'4 C41 --Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.