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14395 SW 128TH PLACE 1 14395 SW 128`" Avenue CITY OF TIGA.RD 2.1-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECT'ON DIVISION Business ine: (503) 639-4171 — BUP Received __ ----.Date Requested__.__ AM___ _ PM BUP Location `-- l �,�-_' ,Suite. --- --- MEC _-_ -- ------ — Contact Person Ph(_--) ..��—-��' PLM Contractor—_— _ Ph (_ ) _ SWR - BUILDING Tenant/Owner — - ELC - - _� � � Footing �`/� /�t?/t,/y r' ELC I Foundation Access: Fig Drain - ELR - Crawl Drain - Slab Inspection Note!. Post&Pearn ----- - --- - -- Shear Ancho, f Ext Sheath/Shear _ ------ Int Sheath/Shear Craming 4;L . . .-- - InsulationC519 7 S Drywall Nailing Firewall Fire Sprinkler - -- Fire Alarm Susp'd Ceiling Other: the Other_ finales ASS PART QFAIL � PLUMBING Post&Beam -- Under Slab -- ------ - Rough-In Water Service — Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain _—_— Shower Pan / -PASS PART IL _MECHANICAL -- Post& Beam Rough-In - — -- Gas Line i Smoke Dampers PAS ` PART FAIL _RICAL_ Service Rough-In UG/Slab Low Voltage -.— ___--_ -- -- - Fire Alarm PART FAIL Reinspection fee of$_- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. A -- _— E] Please call for reinspection RE:—_ — -- F-1 Unable to inspect-no access Fire Supply LineADA Approach/Sidewalk Dib— C lei Z- -- Inspector �{ _ _ Ext Other: Final QO NOT REMOVE this Inspection record from the job site. PASS PART FAIL ILAA IF- 41— ► 4 o41 b a 4 ► r 4 J4 CL ! 4 � �� ► 4 N tz) ► 4 a ° ► r ell 4 y d C� ► o o 4 1 � �, ► rJ .. ... ► 4 u� ► P- d ' d j d d oo ► 4I9 > 0 0 ► M o ► 4 CD inrt 0 ► `5 rb 51111 4 o• I► 4 p ► t o ► / ► A too. 4 e ► 4 ► d , ► rvvvvv7vv♦♦vvvvvv7vvvvvvvvvvvv♦vvvvvvvvvvvvvI n � m p � n S CD f C1. ry 7 11}�'J w Q 1" n O w� Cl ry UP) v, 0 c o sU n Q b s t,'6TY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 --�0 Ov INSPECTION DIVISION Business Line: (503)639-4171 MST /� /o?o BUP _ Received �[�Date Requested—_ AM PM _ SUP Location — ��1 —1 P`"�— P L.- Suite ,__� pL MEC Contact Person _ _ — Ph(—) ! `=�� DJC PLM Contractor Ph( _) SWR — BUILDING Tenant/Owner — ELC _ Footing ELC — Foundation Access: Ftg Drain ELR — Crawl Drain -- 31ab Inspection Notes: SIT Post&Beam -- — Shear Anchors Ext Sheath/Shear --- Int Sheath/Shear Framing Insulation Drywall Nailing -- -- Firewall Fire Sprinkler — Fire Alarm ? _— Susp'd Ceiliny � — Roof Other:. _ - ma — L_& 2 — S A FAIL Pos Beam Under Slab - — Rough-In Water Service --- — Sanitary Sewer Rain Drains - _-- Catch Basin/Manhole Storm Drain Shower Pan Other: --- Final PASS PART FAIL ---� - - ---------- MECHANICAL -- Post&Beam — Rough-In -- ------ ------- Gas Line Smoke Dampers — — -- -- VLT—R PART FAILICA_L_ Service Rough-In --. UG/Slab Low Voltage __ __ —•-- ------ Fire Alarm Final [� Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: — _ [] Unable to inspect-no access Fire Supply Line ADA Dateut Approach/Sidewalk _1 L —AIL �`- Spor— -- ---- Other: Final DO NOT REMOVE this Inspection record from the fob site. PASS PART FAIL CITYOF TIGAR® MASTER PERMIT PERMIT#: MST2002-00007 DEVELOPMENT SERVICES DATE ISSUED: 1129/02 13125 SW Hall Blvd., Tigard, OR 972.23 (503) 639-4171 SITE ADDRESS: 14395 SW 128TH AVE PARCEL: 2S109AA-04300 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 009 JURISDICTION: TIG REMARKS: Construction of ne-,v SF residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS_ REQUInED CLASS OF WORK: NEW HEIGHT: J0 FIRST: 1,745 of BASEMENT: 90.00 at LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,546 of GARAGE: 1,000 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNIT'S: 1 r INSSMENT: of RIGHT: 5 OCCUPANCY ORP: R3 BDRM: 3 BA1 H: 3 TOTAL: 3,291 00 of VALUE: S 334,959.70 REAR: 50 PLUMBING SINKS: I WAI ER CLOSETS: .7 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS 1 Cf..CH BASINS: TUBISHOWERS: 4 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNI R: GREASE TRAPS: MECHANICAL UTHLR FIXTURES: FUEL TYPES FUNN<100K: BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER: I GAS FURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: blu FLOOR FURNANCES: VENTS: I WOODSTOVES. GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT_ SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'I.INSPECTIONS 1000 SF OR LESS: 1 f 200 amp: 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 7 201 400 amp: 201 400 amp: tot WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 •600 amp: EA ADDL SR CIR: SIGNAUPP.NEL: IN PLANT: MANU HM/SVC/FDR: 601 1000 4mo: 6014ampo•100ov: MINOR U BEL: 10004 amolvolt: Reconnect only: PLAN REVIEW SECTION —4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREAISPC Out:: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO d STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATARZLE COMM: NURSE CALLS: TOTAL N SYSTEMS: Owner Contractor: TOTAL FEES: $ 8,256.71 PAUL CARNEY PAUL R CARNEY,INC. This permit is subject to the rcqulations contained In the 1480 NW 102ND. 1480 NW 102NC AVE Tigard Municipal Code,State of OR. Specialty Codes and PORTLAND,OR 97229 PORTLAND,OR 97229 all other appii^able laws. All work will be done In accordance w lh approved plans. This permit will expire if work is not started within 180 days of Issuance,or If the work is suspended for more than 180 days. ATTENTION: Phone: Phone: OrPgon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep 0, LIC 50652 forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Wtr Proofing Bsm't Wa Footing/Foundation DI; Electrical Service Low Voltage Water Line Insp Grading Inspection Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Sewer Inspectior Post/Beam Mechanlca Ftng Drain Bsm't Walls Framing Insp Gas Fireplace Electrical Final Footing Insp Underfloor Insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechaniral Final Foundation Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final E / Issued By Permittee Signatur�: '"� Call (503) 639-4175 by 7:00 p.m. for an Inspection neededihe next business day CITYOF TIGARD SEWER CONNECTION PERMrr ;-n DEVELOPMENT SERVICES PERMIT#: SWR2002-00005 13-125 SW Hall Blvd., Tigard, OR 923 (503) 639-4171 DATE ISSUED: 1/29/02 7 SITE ADDRESS; 14395 SW 128TH AVE PARCEL.: 2S109AA-04300 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 009 JURISDICTION: TSG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK. NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF residence. Ownvr: ---- -- -- PAUL CARNEY = — - - —� -- 1480 NW 102ND. Type By Date FEES Amount Receipt PORTLAND, OR 97229 INSP CTR 1/29/02 $35.00 27200200000 PRMT CTR 1/29/02 $2,300-00 27200200000 Phone: 503-297-9406 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer Is not located at the measurement given, the installer shall prospect 3 feet In all directions fmm the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm � �" Issued by: G rt.t-Cr--, Permittee Signature:. Call (503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day -CG�L7U,5 Building Permit Application ,l 1 Citypate received: I-- /d—�y Permit no.: � of Tigard T I C� 1 Address: 13125 SW Ilan 131vd.'I'ig OR 97223 I'roject/appl.no_ Expire date: f'uvu(Tigard - Date issued: B Phone: (SU3) 639-41' i ( Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: O Ts Land use approval: 1&2 family:Simple Complex: o U 1 &2 family dwelling or accessory U Commercial/industrial J hlulu tauuly J N(,v, construcuon J Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: Joh address: 1 G Ff.H l!' Bldg.no.: Suite no.: Lot: Bloc' :_ Subdivision: fit. K ;.-, Tax map/tax lot/account no.: Project tame: 2'S I LX'1 AA 14 :1 CE; � Description and location of work on premises/special conditions: Name: •- C,ilr.t r -,,� Mailing address: 010. /1.10 I &2 family dwelling: City: / rf Stale: ZIP: KZ _ Valuatiop c work...........:.�,1..�..f.'. Ph,..e;,$' 5-2?Z-95446 Fax:,-S+79'6 ftd E-mail: No,of bedrooms/haths................................. Owner's representative: P14 ----- 'Total number of floors................................. 2 Phone: N Fax: E-mail: New dwelling area(sq. 11t.) .......................... Garage/carport area(sq.ft.)....... Name: .r, Covered porch area(sq.ft.) ..........11.1..... Mailing address: - -- Deck area(sq.ft.)........................................ �sy City: - — — State: 7.IP: Other structure area(sq. I't.) !! °' Phone: Fax E-mail: Commercial/industrialhnulti-family: t Valuation of work................................ Business name: Existing bldg.area(sq.ft.).. ................ b►v —� _— Address: _ New bldg.area(sq. ft)............... ............ City: - State: ZIP: Number of stories.................. ............. - - Type of construction........ .......................... - Phone: Fax: E-mail -�- Occupancy group(s): Existing: CCB no.: s"G $S'2 _. _ New: _ City/metro lie.no.: Notice:All contractors and subcontractors are required to he I with the Oregon Construction Contractors Board under Name: "� �� ,/��,,at 7- " 9jo ar J:,e provisions of ORS 701 and may he required to be licensed in the. Address: i 2 w St"41^ ,1 .jurisdiction where work is being performed. If the applicant is City: ,, , Stated I.IP: pZ Z exempt from licensing,the following reason applies: Contact person: /77,rC Plan no.: _ ----- ------ Phone:rt-,WS—ir?71 rax "7 v l E-mai -- - Name: _ Contact Ix rs_on. Fees due upon application ........................... $ Address: Date received: City: _ state: ZIP: Amount received ............ . .......................... $-- - Plume: _ I Fax: I E-mail: Please refer to fee schedule. _ hereby certify I have read and examined this application and the Nd di juddiction+accept credit carde,plemw call jurisdiction fa mine inintmation, attached checklist. All provisions f laws and ordinances governing this U VW axle rCa d wo, t will to compli• w •th r cilied heref .or not. Credit card oumhe, � G Z a c► A�J7 �yy7 /et >Z— C - t=.pirel Authorized signatu - _ ale: l - S wrirrt nldr thownon-�od_�> $ Print name:►• rt r-�e - . t m at. _ute �.-- "Amotmt Notice:This permit application expires if a permit is 404butined within 190 days after it has hren accepted as complete. 110-4613(fiMroht) One- and Two-Family Dwellhig Building Permit Application Checklist Reference no.: –�— -- Associated permits: /Tigard Cit of Tigard City U Electrical U Plumbing O Mechanical Address: 13125 SW Ii;1L' Blvd,Tigard,OR 97223 U Other: Phone: (503) 639-4171 Fax: (503) 598-1960 THE "1 1W]ING ITEMS ARE REQUIlItEDFOlt I Land use actions completed.See jurisdici wn criteria,for concurrent reviews. 2 'Zoning.Flood plain,solar balance points,seismic soils designation,historic distn,i 3 Verification of approved plat/lot. 4 Fire district--approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sew,.,r permit. 7 Water district approval. 8 5olls report.Must carry original applicable stamp and signature on file or with application. S7 t 07eyo ti 9 Erosion control U r;an U permit required.Include drainago-way protection,silt fencee designocation of catch-hasin protection,etc._ _ D w r/� Al__ 10 3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state huil(ling codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size V sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale.nie plan must show lot and building sethack dimensions;property corner elevations(if then:is more dean a 44t.elevation differential,plan must show contour lines at 24t.intervals);Ir-.ation of easements and driveway;footprint of structure(including decks);location of wclls/septfc systems;utility locations;direction indicator;lot _ area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent u size.and location, 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,wnh!r h.ater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc, 1.1 (Toss section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub•floor, wall cons(mction,root construction.More than one cross section may he required to clearly portray construction.Show details of all wall anti roof slicathing,rx)frng,neat'slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, aherrnal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations trust reflect the actual grade if the change in grade is greater than four foot at building envelope. v Full-size sheet addendums showing foundation elevations with cross references are acceptable. jl 16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for �j r1or1_rresicriptive.path analysis provide speciflcstions and Calculations to engineering standards. �ci ir(7— T 17 Floor/roof framing.Provide,plans for all Iloom/roof assemblies,indicating member sizing,spacing,and hearing x locations.Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details shot;•^,t placement of rehar. For engineered systems.see item 22,"Engincer s calculati.ons." 19 Beam calculations. Provide two sets of calculations using current axle design values for all heams and multiple joists over 10 leet long and/or any hearn/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. _ 21 Energy Code compliance.Identify the prescriptive path or provide calculation.;.A gas-piping schematic is required for lour or more appliances. _ 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or architect licensed in Orcgon and shall he shown to he applicable to the project under review. 1 23 Five(5)site plans are required for Item I I above. Sae plans must he h-1/2"x I I"or I I"x 17". 24 Two(2)sets each are required for Items ftr}�I' �Yc above, 25 titidding plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accepted. 26 "Reversed" building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "Drawn to side" indicates standard architect or engineer scale. 28 Site plan must include street tree size,type&location per City of Tigard Street Tree List booklet. Checl.list must he completed hefory plan review start date. Minor changes or notes on submitted clans may b_ in hfue or black ink. Red ink is reserved for department use only. 4404614(WWOM) Mechanical Permit Application t ino.' c Date received: perm _ ��� ' City of Tigard ProjecUappl.no.: Expiredate: _ Address: 13125 SW Hall Blvd,Tigard,OP, 97223 Date issued: By: Receipt no.: Clfv n(Tigard _ Phone: (503) 639-4171 Case file n 11 o.: Payment type: Fax: (503) 598-1960 Buildingperrnit no.: Land use approval: U Multi-family U Tenant improvement U I &2 family dwelling or accessory U Commercial/indtn utial _—_ 0 New construction U A(ldition/alteration/rcplacement U Other: 7 we C indicate equipment 41,111111160 in boxes below. Indicate the dol iaf Job address: value of all mechanical materials,equipment,labor,overhead. Bldg.no.: Suite no.: profit.Value$ Tax map/tax lot/account no.: See checklist for important application information and fit: Block: Subdivision:l/� s•A ����y- ' - jurisdiction's fee schedule for residential permit fee. Project name: _ City/county: ZIP: Description and locati n of work on premises: 1'ee(ea.)I Total lleacti Q(y. Res-oniv Res-only Est.date of completion/inspection: — p •...ng unit CFM._ Tenant improvement or change of use: requi - Is existing space heated or conditioned?U Yes U No Atr coniuoning(s to p nnAlteration of ex sun system te Is existing space insulated?U Yes U No oiler compressors State boiler permit no.: 4 L �f a NP Tons BTUlN _ Business name: —J :it amo e amper, uct amo c_ electors Address: eat pump(site p an requ reT — --- City: State: "LIP: nsta rep ace urnac timer Phone: Fax: E-mail: Including ductwork/vent liner U Yes U No CCB no.: __ Insta rep ac•re ocateherssuspe eat - n e . wall,or fluor mounted City/metro lic.no.: nt or In -c of ler t an urnace Name(please print): a Bret on: BTU/H Absorption units III' t'hillcra_ Name: Com mssors ---- Address: C5 State: UZ �' ar ronmenta ea ust an vent at on: i Slate: ZIP: Q7.2.7 Apl)W;llce vff:' — City: 7, 'R" ' Tryt:rcx aust - - Phone:Z - f1 u hax:2 t6-96 Email: oype I res. tc a azmat hood fire suppression system C• Exhaust fan with single duct(bath fans) Name: l '` :x aunt a stem a err rom eaun or Mailing address: `� tie p p ng a st tit on(up to out els) St • ZiP: TLPG NO Oil _ City: — Type: Fax: E-mail: ue pipin ea I t a c ttiona over out eta Phone: ess p p ag(so emat c requ r ) Number of outlets I er app ance or equ pmeutt Name: -- Decorativefire lace — Address: --� nwrt- type City: _ _lS ale' ZiP. o It pe et stove Phone: E-mail: Other. Date:/ Applicant s signs rd. --- _ Name (print): ✓ C.r •" — Permit fee.....................$ . Nd ill jurttdlcUoru r«p a��cLy,ptcmc call jurixfktlon for n s«nwt�+ Notice:This permit application Minimum fee................$ �- U vise ,t'l�IaaterCar(1 G Z esa 9�j3"% q3-� n expires if a Permit is not obtained Plan review(at ` ) S ere&crd�rrybe!e and within 190 days after it has been State surcharge(8%)....$ y� accepted as complete. TOTAL ••.••••S — .............. . — N till u cwt ca1O = MO-4617(WMM) h d _ Amoual "_J7r:l G./v•�C /v�r� MECHANICAL. PERMIT FEES 1 & 2 FAMILY DWELLING FEE SCHEDULE: COMMERCIAL_ FEE SCHEDULE: price -Total Description: Qty (Ea) Amt TOTAL VALUATION: PERMIT T FEE: Table 1A Mechanical Code $1.00 to$5-0 Minimum fee$72.50 1) Furnace to 100,000 BTU 14.00 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vents ,_--- $1.52 for each additional 5100.00 or 2) Furnace 100,000 BTU+ 17.40 fraction thereof,to and including indudin ducts&vents - -- $10,000.00. 3) Floor Furnace 1400 S'10,001.00 to$25,000.00 $148.50 for the first$10,000.0 and indudin vent $1.54 for each additional$1o0,00 or 4) Suspended heater,wall heater 14.00 fraction thereof,to and including or floor mounted heater -� $25,000.O_0_;___ 666.66 and 5) Vent not included in appliance winit 6,80 $25,001.00 l0$50,000.00 $379.50 for$-1 45 for each additional$100.00 or units u 12 15 fraction thereof,to and Including 6) Repair -_ $50 000.00. Boiler Heat Air 550,001.00 and up $742.00 for the first$50,000.00 and Check all that apply, or Primp Cond $1.20 for each additional$100.00 or footnotes Ile es below 9e Comp fraction thereof. 7)<3HP;absorL,unit 14.00 T_ Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 8)3-15 HP;absorb 25.60 --- 8a/-State Surcharge $ unit 100k to 500k BTU 9)15-30 HP;absorb 35.00 25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU - Required for ALL commercialermits onl 10)30-50 HP;absorb 52.20 TOTAL COMMERCIAL PERMIT FEE: $ 11lll BTU )> 50HP absorb 87.20 unit>1.75 mil BTU _ - - 12)Air handling unit to 10,000 CFM 10.00 ASSUMED`/ALUATIUNS PER APPLI ANC E� Total 13)Alr handling unit 10,000 17.20 Qt Ea Amount Descrl tion: 955 14)Non-portable evaporate cooler 10,00 FurnaceTO-_j_0_0,000 BTU,Including ducts&vents 1,170 15)Venl fan connected to a single duct 6 80 Furnace>100,000 BTU including -- ducts&venls ___ 955 16)Ventilation not included In Floor furnace Including vent 10,00 iance per 955 applmit Suspended heater,wall heater or 17)Hood served by mechanical exhaust 10.00 floor mounted heater Y 445 Vent not Included In applicance 18)pomestic Indnerators 17.40 rmit 805 Repair unite959 19)Commercial or in,:ustrial type Indnerator 69.95 <3 h nit, to I 00 BTU 1 X00 20)Other units,Including wood stoves 10.00 3-15 hp;absorb.unit, _ 101k to 500k BT11 2,310 21)Gas piping one to four outlets 5.40 15-30 hp;absorb.unit,501k to 1 mil.BTU 3,400 22)More than 4-per outlet(each) 1.00 30-50 hp;absorb.unit, _ _-- 1-1.'75 mil.B_TU5. >50 hp;absorb.unit, 725 Minimum Permit Fee$72.50 SUBTOTAL: >1.75 mil.BTU - 656 B%St-ate Surcharge i Alr handling unit to 10,000 cfm 1170 s Alr handlin unit>1 _ 0,000 cfm 858 Non Rortable evaporate cooler 448 TOTAL RESIG ed to a sin le duct ENTIA PERMIT MIT FEE: Vent fan connect656 -- Vent system not Included In and F s a Llance ep I� 656 - other Ingo speed l4���- Hood served by medlanlC81 exhaust 1 Inspections outside of normal uusiness hours(minimum charge Hood hours) 1 170 $62 50 per i,our Domestic incinerator 4 590 z inspections for which no lee is specifically indicated (minimum charge-hell hour -Comm_ e_ ru__ _I or industrial-Incinerator 656 $62.50 per hour Other unit,induding wood stoves, 3 Additional pian review required by changes.additions or revisions to plans U7° Inserts - chergoone-hell hour)$02 50 per hour 380 des I In 1-4 outlets 63 Ead1 addlUanal outlet 'State Contractor Boller certification required for units>200k B TU **Residential AIC requires site plan showing placement of unit. TOTAL COMMER CIL ^ 1u ' `` S All New Commercial Buildings require 2 seta or plans. VALUATION: T. I:\dsts\forms\mech-lees.doc WJ26/01 Electrical Permit Application Date received: Permitno.: L" project/appl.no.: Expire date: City of Tigard B Receipt no.: Address: 13125 SW Nall Blvd,Tigard,OR 97223 Date issued: _ y Cirv( Tigard Phone: (503) 639-4171 Case file no.: Payment type: Fax: (503) 598-1960 Land use approval: - U Multi-family J Tenant improvement 7LJNcw amily dwelling or accessory U Commercial/industrial U Partial onstruction U Add iIi(m/alterat ion/repl-ice nu•nt U Otter: S w �4 Bldg.no.: Suite no.: Tax map/tax lot/account na_� Job address: 1 �� _ Lot:::: Block: Subdivision: f / 1r n' Project name: iv E �--^+ Description and location of w rk on premises: ?--"-1. Estimated date of completion/inspectiow L- ) 11111111 11111M 1 I I1'ec Ma+ Job no: Ile+cnp(ion I U(s. (ea.) 1'utal aro.111%11 . _� �'�^ / c New residential-%ingk of multi-farnih lK r Business name Address: dwelling unit.Inclntk%aW claval Rarnf;c. State: ZIP: tiwrvicclncluded: 4 City: ION)sq.ftf.i_ r_less —__-- -_--- _ - - Phonu: Fax: E-mail: Each additional 566 sq.ft.or portion thereof _ 2 CCB no.: Elec.bus.lic.no: q ./U r✓ Limited energy,residential 2 1G a /V /—O7L- Limited energy,non-residential Each man2 ufactured home or modular dwelling -- Date Service and/or feeder _ tiignu(ure of supervising electrician(required) Ser�lresorfeeden-Insldlatlon, I i u c no Zj"'f alteration or relocation: Sup.Acct name(print i 2 1 t 2(Ml amps or less _ 2 201 amps to 4W amps 2 C "r ` ` 401 amps to 6W amps Name(print): .�— —t— J 2 Mailing address: 10 t� 601 amts to 10(10 amps - 2 Stale: ZIP: �� Over IOW ramps or volts 1 Clly:� T of— Rcaonueclonl Phone: ,^r o Fax:Z 9 ''6 s? E-ntuil: Temporary aervlre%or kreden- Owner installation: 1'hc installation is being made on property I own Installation,ahention,orrelocatlon: 2 which is not intended for sale,Iease,rent,or cx(h�nge according to 2tMt rrinp%or les% — 2 ORS 447,455,479,h7(1,7(11. 20I nm s to 4(10 amps 2 Date: 4(11 to 6tM)am s Owner's si nalurC. Branch circuits-new,alteration, or extension per panel: Name: A Fee for branch circuits with purchase of service or feeder fee,each branch circuit Address: _ B. Fee for hrnchacircuits wfthrr�h�e 2 City: Stale: ZIP: or service or feeder fee,first branch circuit: � --- — Pholi I •i L'.-mail: Each additional branch circuit Mbc.(!Servlrx or reader not Included): 2 Each pump or irrigation circle 7) U Service over 225 coops-commercial Each Will'11 cwrlucrlity Each sign or outline If hint U Service over 32o amps-rating of 1&2 U lWardous location Signal circuit(,)or a limited energy panel, 2 family dwellings U Building over lo,000sycare(rel four or Sign, oreslerufan• U System over 6(M)volts nominal mon:residential units in one structure � ^_—--_� U Building over three stories U Feeders,4111)amps or marc •I kscn unn _ J i kcupant load over 99 Persons U Manufactured structures or RV park FAch additional Iturpection over the dlorrable In any of the above: U I.presdlightingplall Uother ---- —. __._ Perin, •coon Submit ___sets ol'plans with any of the above. Investlgationtee __---- 7'he above are not applicable to temporary construction service. Other Permit fee..................... Nd an►utixlicuun,accept ciedli crad,,piew call jurisdiction foi marc informa6m Notice:'this permit application Plan review(at 96) $ _ f(/,T- expires if a permit is not obtained Slate surcharge(8%) ....$ U Visa asleaC.arl♦t./ SZ ot, cryr7 " within 180 days after it has been ('relit umtri- __+/ -- — spires 'TOTAL .................... ..S _ �--!� , accepted as complete. Cot der u shown am c n e $ 44n4615(iLrl WOMi � Amount - ('ardNNJ—et s —"-- ELECTRICAL PERMIT FEES: LIMI-t i.© ENERGY PERMIT FEES: --� _r--- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Bel jw: - —�.-_— 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 4 Audio and Stereo Systems' Each additional 500 sq.ft.or portion thereof $33.40 _ 1 ❑ Burglar Alarm Limited Energy $75.00 Each Munufd Home or Modular ❑ Garage D=Opener' Dwelling Service or Feeder $90.90 Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 2 ❑ Vacuum Systems' 201 amps to 400 amps $106.85 2 401 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 TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $66.85 7 (SEE OAR 918-260-260) 201 amps to 400 amps $100.30 __ 1 401 amps to 600 amps $13375 1 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems Branch Circuits ❑ Boller Controls New.alteration or extension per panel a)The fee for branch circuits with purchase of service or ❑ Clock Systems feeder lee. Each branch circuit _ $6 65 2 ❑ Data Telecommunication Installation b)The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 _-_- ❑ HVAC Each additional branch circuit -' $665 _ Miscellaneous ❑ instrumenw in (Service or feeder not Included) Each pump or Irrigation circle $5340 _ _._ ❑ Intercom and Paging Systems Each sign or outline lighting _ $5340 _ Signal circull(s)or a limited energy panel,alteration or extension _ $7500 _ _ ❑ Landscape Irrigation Control' Minor Labels(10) $12500 Medical Each additional inspection over ❑ the allowable in any of the above Per inspection $62.50 ❑ Nurse Calls 11er hour _ _ $62.50 _ In Plant $73.75 ❑ Outdoor Landscape Lighting' Fees; ❑ Protective Signaling Enter total of above fees $ ❑ Other 8%State Surcharge $ Number of Systems 25%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 above fees ❑ local Account q 8%State Surcharge Total Balance Due : All New Commercial Buildings require 2 sets of plans. I\dsu\frrrms\elc-fees.doc 08/30/01 Plumbing Permit Application Date received: Permit no.: }<figt�a -d City of Tigard -- Address: 13125 SW liall Blvd,Tigard,OR )',223 Sewer pennitno.. Building permitco.: Ciryu(Tigard phone: (503) 639-4171 Proj_ct/appl.no.: Expire date: Fax: (503)598-1960 Date issued:- --� By: Receipt no.: Land use appro\r�l: se til_r _ Caio. Payment type: &2 family dwelling or accessory U Conuucrcial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/rept icemenr U Food sery;cc U Other: Job address: ��3 9s s�" z r'v 1�a^<< Description Fce(ea.) Total Bldg.no.: Suite no.: New 1-And 7,-family dwellings only: Tax map/tax lot/account no.: (includes ib0ft.for each utility connection) : , SFR(1)bathlot: BlockSubdSFR (2) -- Project name: SFR(3)bath City/coun►y: �- �� ZIP. _ Each additio-n-i bath/kitchea Description and fc,caH6n of work on p miser:_ r Slteutillties: Cat�Fonting h basin/area drain Est.date of completion/inspection: ellstleach line/trench drain drain(no.lin.ft.) - Busines�name: Manutactured home utilities - - -- Manholes Address: t Rain drain connector - - City: State: I ZIP: —Sanitary (no,lin. ft.) --- - - -- Phone: Fax; E-mail: Storm sewer(no.lin. ft.) — CCB no.: Plumb,bus.reg.no: Water service(no. tin. City/metro lic.no.: - - Fixture or Item: Contractor's representative signature: — Absorption valve Print Warne: — - - Back flow pro-venter - - - Backwater valve Basins/14vatory - Name ,�.r Clothes washer---- n� - - Addss—: '-/�g'ca �� �--i��_1�----� Uishiashcr - Drinking fountains) --- - City:- Stat_:C1r2 ZIP: 9�2 Ejectors/sum Phone: -- z - y y Fax: E-mail: Expansion tank _ 1 --sewer cap Name(print): _ �� Flcxrr drdins/Iloor sinks hub - — — — Mailing aJdress: A_�w �� �, Garha a dis oral (lose bibb City; � — State: ZIP: ep 7.2 7>e -- _- -- �. Ice mak_r Phone: 2 e6 Fax: Email Intcrce tor/ reasc trap — Owner installation/residential maintemuice only: The actual installation Primer(s) will he made by me or the maintenance d repair made by my regular Roof drain(commercial) - .nhploycr on the prylrrrty as ,,ORS'Chapter 447. Sink(s),basin(s), lays(s) r)wner's signatt re:`_ `�`�I`iale:� Z Sum 1'ubs/shower/shover.r pan Name: Urinal — Address: - - - Wate:closet - _-- Water heater City: - -- - State: �Z—IP•:- ( Other: - J___ Phone: ` -- -- fax: E-mail: Nd VI JudSdicUmS Scttp4 credit cnida,pleme coil JudSrlktlo':,x mme informalivn. Minimum fee................$ U Vitta �'�1aeterC Notice: Ibis pennit application - --- e expires if a permit is not obtained Plan review(at 9F) $ t'-tit card number 6z — State surcharge 8% ..... -- - Expires within I RO days en_r it has here R ( ) - Nome of_card�holde�r uShown on I c 11 - accepted as complete. TOTAL .......................$ �,1bldeTit — W4616(tiUWOM) PLUMBING PERMIT FEES: PRICET TOTAL New 1 ant,.-family dwellings only: FIXTURES individual QTY ea' _ AMOLNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the filst100 ft. QTY (ea) AMOUNT 16.60 for each utllit connection) ___ Lavatory One 1 bath _ ^-- $249.20 - Tub or TubtShower Comb, 16.60 Two 2 bath _ _ - _ $350.00_ -- Three 3 Shower Only 16.60 - Z bath $399.00- _--- -- - --- ---- Water Closet— 1660 --" -- SUBTOTAL Urinal 16.60 - 8%STATE_SURCHARGE shwasher 16 60 PLAN REVIEW 25%OF SUBTOTAL Di TOTAL Garbago Disposal 16.60 - - I.tsndry Tray - 16.60 �'!-h.ng Machine 16.60 Floor Drain/Floor Sink 2" 1660 PLEASE COMPLETE: � 16.60 4'• - -- 16.60 Quantit b Work Performed Water Heater O conversion O like kind 16.60 Fixtlare Type: New Moved Replaced Removed/ Gas piping requires a separate mechanical Capped permit, - MFG Home New Water Service 46.40 MFG Home Now San/StormSewer 46,40 Laval_ -- _ _ ---- Tub or Tub/Shower Hose Bibs 16.60 Combination -_ Ro Drains 16.60 Shower Only, Drinking Fountain 16.60 Water Closet _ Urinal Other Fixtures(Specify) 16.60 _— Dishwasher _ -Garbage Disposal _ -- Laundry Room Tray_ Washin Machine - - Floor Dralr'Slnk: 2" _--� Sewer-1 st 100' -- - 5500 - 3° Sower a:,�h additional 100' 46.40 _ 4„ --- Water Service-tst 100' 55,00 Water Heater Other Fixtures Water Service-each additional 200'- 46.40 - _LSpecif Storm R Rain Drain-1s1 100' 55.00 --- Storm R Rain Drain-each additional 100' 46.40 - - -- Commercial Back Flow Prevent' n Device 46.40 - -- - -- - Residential Backflow Prevention Device' 27.55 !- -- --_ - -- Catch Basin 16.60 Inspection of Existing Plumbing or Specially 62.50 Requested Inse clionsper/hr -_ COMMENTS REGARDING ABOVE: Rain Drain,sing) lamOv dwelling - 55.25 -- Grease Traps - - 16,60 - --- --- ---- v- -_ QUANTITY TOTAL Isometrlc or riser diagram Is required it Quantity Total is ,9 *SUBTOTAL -- ---"---� 8%STATE SURCHARGE. _ ---- -- --___ "PLAN REVIEW 25%OF SUBTOTAL _Requi,c,l unly II flxturesy tutal Is> -� TOTAL 'Uinlmum permit ha Is$72 50•o%slate surcharge,except Residential SaOflow Pmvenlion Device.which is$39 25•9%state surcharge ssAll New Commercial Buildings requir.:sets of plans with Isometric or riser diagram for plan revlsw. I\dsts\formslplm-fees.dot. 12J28/01 A CITY OF TIGARD OREGON INTENT TO HAUL EXCAVATION (LOTS STEEPER THAN 20%) I, (print name), hereby certify that ALL excavation material on the subject property will be removed from the si'--1 and not be placed as fill, except for that amount necessary to back-fill the foundation ONLY. I understand that failure to remove the excavation material will result in the requirement to remove the material or obtain a grading permit by submitting grading plans prepared by a licensed engineer accompanied by a geo-technical report regarding the placement of the excavation material as fill. I further understand that my footing inspection will be denied if that inspection reveals that excavated material has not been hauled, and that work will be stopped and no further inspections conducted until the City has received and approved a plan and report from a geo-technical engineer regarding placement of the fill material. Signature Date Permit -f+- Job Address: I 7J�J uL) Subdivision: L .IJ-VkO I haul clot(DST)7/98 13125 SUFI Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD (503)684-2772 -- - RttE-iau::.. .,. ,s.. .r.„..,uu +gut•+ s:a�•.At,N4 ,a����,, ,_-�....-.��H�:d. Y.A9jwdv.:al—i:X#.. .. Nd:Yrc'•5»-i.firF*::IA9:.e waw.,..r...,:...i.w.�unMi��.�Yrwwex�o:ra aMYb►wY�+•r+•- / r u a Jr LL � . ry 7• r I �,` I r --- f s Pi O f t 71 - c q.5 Li n r� CITY OF TIGARD .���C�V 13125 S.W. HALL BLVD. ����I V �� tf TIGARD, OR 97223 r(7 Qi IMPORTANT PERMIT NOTICE { �f��? CIL F1 � LYI-y OF '14jA1W gpINGD FRANKLIN ELECTRIC INC BUILDIN43 D11MON 2889 SE 18TH CIRCLE GRESHAM, OR 97080 Electrical Signature Form Permit #: MST2002-00007 nV•Mtllc,, Ic-uec:': 1,23102 ' J Parcel: 2S109AA-04300 Site Address: 14395 SW 128TH AVE Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 009 Jurisdiction: TIG Zoning: R-7 Remarks: Construction of new SF residence. Path 1 Your company has been indicated as the electrical contractor or the electrician it indicated above.ease have In order for the electrical permit to be valid, the signature of the supervising he appropriate individual from your company sign below and rturn this Electrical Signature Form prior to the start of the work to the address above, ATI N: BuildingDept. No electrical inspections will be authorized until this completed form is received OWNE=F:: ELECTRICAL CONTRACTOR: PAUL CARNEY FRANKLIN ELECTRIC INC 1480 14W 102ND. 2889 SE 18TH CIRCLE PORTLANn. OR 9727.9 GRESHAM, OR 9708G Phone #: 503-297-9406 Phone #: 492-4651 Reg #: LIC 140170 ELE 26-1041 C SUP 22605 AN INF( SIGNATURE IS REQUIRED ON THIS FORM Signature(fS—upervising Electrician If you have any questions, please call (503) 639-4171 , ext. # 310 FROM RMH PLUMBING CONTRACTORS MC J FAX NO. 503 632sef;G Feb. 21 2002 03:40PN P1 e CITY OF TIGARQ �. 13125 S.W. HIAI.I BLVD. T1t3ARD, OR 57223 IMPORTANT PERMIT NOTICE RMH PLUMBING CONTRACTORS INC 21964 S LARKSPUR AVE OREGON C", OR 97045 Plumbing Signature Form Permit#: MST2002-00007 Date Issued: 1129/02 Parcel: 2$109AA4)4300 Site Address. 14395 SW 128TH AVE Subdivision: EI-K HORN RIDGE ESTATES Bieck: Lot: 000 Jurisdiction: TIG Zoning: R-7 Remarks: Construction of new OF residence. Path 1 Your company has been indicated as the plumbing contractor for the permit Indicated above. In order for the plumbing poi-, it to be vaild, please have 09 approplate Individual from your company son below and return this Plumbing Signature Form prior to the start of the work;o the adrimss above, AT'TN: Budding Dept No plumbing Inspections will by authorIzed until this completed form Is received OWNER: PLUMBING CONTRACTOR; PAUL CARNEY RhIN PLUMBIN43 CONTRACTORS INC 1480 MW 102ND. 21064 S LARKSP?IR AVE PORTLAND, OR•-97228- r T OREGON CITY, C 1 97043 Phone#: 803-2974)406 Phone#: 503.632-8861 Reg#: LIC 140416 RUM 34362PS AN INK SIGNATURE IS REQUIRED ON THIS FORM 1-T 0 Signature of Autho~ rizedlu bor If you have any questions, please call (503) 6144-4171, ext. # 110 wjT' :-« cy?:J_' UNIUWIld H148 TEN -Ek4H�Tw! Ln� I r