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11387 SW FONNER STREET -- FIREPLACE WAS CUT 9Y 6 INCHES SO THAT IT UID NOT ENCROACH INTO THE ACCESS EASEMENT. AND THIS WAS CONFIRMED WITH THE CLIENT, 11/12/02 MSG. 7 N 89'04'23" W 99.96 ,� � 3 LSANITARY SEWER EASEMENT s s � ice. o— — n d0- Z ACCESS AND STORM EASEMENT � t0 IN- CD C1 X17 :n `� 0 O21 p o 4 5.50'� , +5.50' W( Inz cf) N � V 2 4 I cV cJ v Q I O r 9 19 o 7.00 9.00 UR O 6.50' 11 NCD a 17 co � 36.5 I . o' ,►' -----129 5.00 ( In I � i � i i s W o i O 04 30 • wLn M , N O I in 20 - 20.0' O p --� 15.0' d 4-0.00' _ N O in — e SETBACK UNE z O 4 w S 87'47'36" W 100.13' PARCEL 1 STAKE® UT PARTITION PLAT NO. 2002-084 N.E. 1 /3 SEC. 3, T.2S., R.1 W., W.M. tt: CITY OF TIGARD .w+ WASHINGTON COUNTY, OREGON T+: NOVEMBER 12, 2002 Centerline Concepts Inc . DRAWN BY: MSG CHECKED BY: WGDIII SCALE in=20' ACCOUNT # -2972 640 82nd Drive Gladstone, Oregon 97027 M: MLI P10284 503 650-0188 fax 503 650-0189 NOTICE: IF THE PRINT OR TYPE ON ANY rl_� T► � r l � ll ► (� i � l � i � i I � ilr1l .r� ilrlr i � ili �r ( � 11.41111-f ill ill 11 11111.( 11 Ilil ( II I � ( � I � f .( � ( � (.� ( ( i_( 1_ r � l1r � I t-� (�� r � � �r1 ( lTr� l � l ( � I � r1T, I1 ( � I- 011111 I �T� l � ( ISI I � I � i t I III I I 11111 IMAGE.IS NOT AS CLEAR AS THIS NOTICE 1 _ Z _ 3 _� rJ 8 9 - 10 11 1 -� IT IS DUE TO THE QUALITY OF THENo.36 ORIGINAL DOCUMENT � — E 6Z 8Z LZ 8Z Z � � Z EZ ZZ TZ OZ 6ISI LT 9T 91 � Z ET ZZ TT T 6 8 L 9 9 T► E Z T ��i�w ill, �� ►�� lllllal�� 11� �� « �� 111 �1�1 �� 1� �� u�� ►� �� ►� �1�� l� ��r �� i 11387 SW l=ancer Street CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST _Z3 INSPECTION DIVISION Business Line: (503)639-4171 BLIP Received q _.Date Requested�� AM—_ PM � B4P — _�_ Location _�_ c� —Suite — MEC --- -- � -�-� Contact Person _ --- — Ph ( _) PLM Contractor Ph---- ----- -- Ph( _) — SWR --------- -- BUILDING _ Tenant/Owner ____._ —_ _r_ ELC ____�--..------ Footing— ELC — Foundation Access: ELR ____— --------— Ftg Drain Crawl Drain SIT — Slab Inspection Notes: Post&Beam - -- -' Shear Anchors Ext Sheath/Shear Int Sheath/Shear -- --- Framing — Insulation ---- Drywall Nailinq - Fi reveal I -.Z _ 1 S ----- Fire Sprinkler - - -- —` Fire Alarm J� Susp'd Ceiling --h — Roof —Other- Final -- Final �- -- Pol P S RT _FAIL LUMBIN Un earn Under Slab --�^�- - Hough-In — Water Service Sanitary Sewer --r— Rain Drains Catch Basin I Manhole �rj Storm Drain r4.� Shower Pan el — -- --� Other- -in ther--m �,/ -. ----- P PAT FAIL RANI L / - Pos eam "i -�,� i- /Q L --------- — Rough-In —�--- Gas Line -----.--_--- -- — S.r-n�yke Dampers — rlFW I _ — --- S_ PAr..T FAIL ECTRICAL Service — Rough-In _ — U(,/Slab --- Low Voltage — - -—`—Fire Alarm Alarm required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Final n Reinspection fee of$ PASS PART FAIL Please call for reinspection RE: Unable to inspect-no access SITE —_ — L J Fire Supply Litre n� ADA Inspector ` Ext--_._— Approach/Sidewalk Date Other: DO NOT REMOVE this Inspection record from the job site. Final PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received ---- Date Re nested S'�S _ AM___._. PM BUP Location __ _ _ ✓ —__Suite— —_ MEC Contact Person _ _ _ Ph( ) �U ��3� PLM Contractor Ph SWR BUILDING Tenant/Owner --____ _—__ ___ ___._._�____._ ELC F;,oirig ELC Founda,wn Access: Ftg Drain ELR Crawl Drain ---- Slab Inspection Notes: SIT Post&&Beam --- --- -- - -- ---- --- -- _ bhear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - -- ---------- -- ---- - -- - ------ ---------- - Insulation Drywall Nailing ----- -- - -- -- ---- - --- - -- - Firewall Fire Sprinkler — - - -- - - __--------_-.____-- Fire Alarm Susp'd Ceiling - - -- Root Other: - Final PASS PART FAIL PLUMBING - -Post& 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 -- -- -- -_ Final PASS T FAIL ---- TRICAL vice ,Low Voltam — — Fir alarm "P"' PART FAIL L_ Reinspection fee of$ required before next inspection. Pay of City Hall, 13125 SW Hall Blvd - -- P!ease call for reinspection RE:_ ,__. F] Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date __ �_3 -- Inspector _ Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST h _—�---. INSPECTION DIVISION Business Line: (503)639-4171 BUP Received ------ Date Requested__ �� AM-- _PM __ BUP -- Location Suite_�� _ MEC --- - - -- �� 3 Contact Person ------ ..------...-- - Ph PLM ------- Contractor — -- --- --------- -- _ ._ Ph(—_--) ___ SWR BUILDING Tenant/Owner ELC -- Footing ELC Fourdation Access: Ftg Drain ELR _ ---------------- Crawl Drain SIT -- Slab inspection Notes: --- --- Fost& Beam ----- --- - ------ Shear --Shear Anchors Ext Sheath/Shear - - --- - int Sheath/Shear Framing -- -- Insulation Drywall Nailing Firewall - Fire Sprinkler Fire Alarm Susp'd Ceiling - — ---�- Roof VAIAL PART FAIL PEUMBING - -- Post&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 Final -_ PASS PART FAIL - - ELECTRICAL - 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 FAILL --- ___ �� Unable to inspect--no access SITE Please call for reinspection RE:_—___--_ Fire Supply Line /A ADA Ext Approach/Sii�walk Date Inspector _ Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL n y � 7 ao o a ° Im ^y N yCA N g c� c O Re 0 d s a' x CITY OF TIGARD _ MASTER PERMIT PERMIT#: MST2002-00423 DEVELOPMENT SERVICES DATE ISSUED: 11/22/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11387 SW FONNER ST. PARCEL: 2S103AC-ESP01 SUBDIVISION: ERVIN/STARK PART/MIS2001-00022 ZONING: R-4.5 BLOCK: LOT: nu; JUR SDICTION: I IGI REMARKS: Const. of new SF detached residence.Patn 1 BUILDING REISSUL STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NLW HEIGHT: 19 rIRsr 951 Ef BASEMENT: If LEFT: 20 SMOKE DETECTORS. TYPE OF USE: SF FLOOR LOAD. 40 SECOND: 1,001 at GARAGE. 703 If FRONT: 40 PARKING SPACES. TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: If RIGHT: 10 OCCUPANCY GRP: R1 eDRM4BATH. + TOTAL: 1.951 VALUE: 197,441.70 sl REAR: 20 PLUMBING SINKS. I WATER CLOSETS: + WASHING MACH: 1 LAUNDRY TRAYS. RAIN DRAIN 100 'r RAPS: LAVATORIES: 4 DISHWASHERS. i FLOOR DRAINS: SEWER LINESloci SF RAIN DRAINS. I CATCH BASINS: TUSISHOWERS 4 GARBAGE DISP. 1 WATER HEATERS. 1 WATER LINES: BCKFLW PREVNTR: I GREASE TRAPS. OTHER FIXTURES. MECHANICAL FUEL TYPES FURN-100K ROILICMP<OHP. VENT FANS: CLOTHES DRYER: 1 .AS FURN>-1001K: I UNIT HEATERS: HOODS: 1 OTHER UNITS. I MAX INP: blu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS. 1 ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp. W/SVC,OR FDR: 1 PUMPIIRRIGATION. PER INSPECTION. EA ADD'L 500SF. •1 201 400 amp 201 400 amu' 1st WIO SVCIFDR: On SIGNIOUT LIN LT. PER HOUR LIMITED ENERGY. 401 600 amp: 401 600 amp EA ADDL OR CIR: SIGNAI(PANEL: IN PLANT MANU HMISVCIFDR: 601 1000 amp: 601+amps-10110v MINOR LABEL: 1000-amplvolt PLAN REVIEW SECTION _ Reconnect only: —4 RES UNITS: ...+oR:=225 A.. 600 V NOMINAL. CLS AREAISPC OCC. ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO VACUUM SYSTEM. AUDIO&STEREO. FIRE ALARM. INTERCOMIPAGING OUTDOOR LNDSC LT BURGLAR ALARM: OTH BOILER: HVAC. LANDSCAPEIIRRIG. PROTECTIVE SIGNI,. GARAGE OPENER: CLOCK INSTRUMENTATION: MEDICAL OTHR HVAC: DATA/TELE COMM. NURSE CALLS TOTAL 0 SYSTEMS Owner: Contractor: TOTAL FEES: $ 7,496.51 This permit is subject to the regulations contained in the SERGEI KRAVCHENKO SERGEI KRAVCHENKO Tigard Municipal Code,State of OR. Specialty Codes and 8364 SW PFAFFLE ST 9364 SW PFAFFLE ST. all ulher applicable laws. All work will be done in 0210 #210 accordance with approved plans. This permit will expire If TIGARD,OR 97223 TIGARD,OR 97223 work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION. Oregon law requires you to followrules adopted by the Phone. 503-810-6438 Phone: 503-810-6436 Oregon Utility Notification Center. Those nlles are set forth in OAR 952-001-0010 through 952-001-0080. You Rap M: LIC 152358 may obtain copies of these rules or direct questions to UUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8' Post/Beam Mechanica Mechanical Insp Shear Wall Insp Rain drain Insp Plumb Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Water Line Insp Final inspection Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Appr/Sdwlk Insp Foundation Insp Footing/Foundation Dr Electrical Rough In Gas Fireplace Electrical Final Post/Beam Structural PLM/Underfloor Framing Insp firewall Insp Mechanical Final ,r Issued By , �,_ �" :'%=C ci Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day SEWER CONNECTION PERMIT CITY OF TIGARD PERMIT#: SWR2002-00279 DEVELOPMENT SERVICES DATE ISSUED: 11122102 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AC-ESP01 SITE ADDRESS; 11387 SW FONNER ST. ZONING: SUBDIVISION: JURISDICTION: — BLOCK: LOT: TENANT NAME: FIXTURE UNITS: Lk USA NO: DWELLING UNITS: 1 CLASS OF WORK: NEW NO. OF BUILDINGS: TYPE O� USE: SF IMPERV SURFACE: INSTALL TYPE: LTPSWR Remarks: Sewer connection for new SF detached residence. --i Owner: _ FEES SERGEI KRAVCHENKO Description D`te _ Amount 8364 SW PFAFFLE ST -- 1 �22102 $2,300.00 #210 IS\VUSAI S�� -t ol"W t $35.00 TIGARD, OR 97223 �ti\1'INSI'� tier Imhcct 11122102 Phone: 503-Xlu-0438 Total _ $2,335.00 Contractor: Phone: Reg#: Required Inspections _ Pxpires 180 This Applicant agrees to comple with total amohuntules anregulations of the Clean atet Srvices. Th-pa d will be forfeited f the permit expirres.e days from the date issued. ThasuremeThe Ayency does'not guarantee ocate ewe the accuracy of the side sewer lateraliftheS f nottso loclated thetinlstallPer shall purnchatse a Tap a dllSide Sewer' Perm ce 3 feet in all directions from the di given. Permittee Signature: Issued by: Call (503) 039-4175 by 7:00 P.M. for an inspection needed the next business day �s 1'l0- 7'r7 2- Building Building Permit Application Date received: City of Tigard Project/appl.no.: Expire date: Address: 13125 SW Flail Blvd,Tigard,OR 97223 gy ,k Receipt no.: Ciry t,/I ig«rd Phone: (503) 6319-4171 c - Date issued: Fax: (503) 598- OU06 Case file no.: Payment type: 1&2 family:Simple Complex: Land use approva4:,r-,-- ----_--- I &2 fa,nily dwelling or accessory U Commerciat/industrial U Multi-1;11110Y New construction LJ Demolition -- U dd,,i.,:J:.Iteration/replacement U'fenant improvement U Fire sprinkler/alartn U Other: _-__-_- r '�irfir_ -- �r_ :Lt��!'/Z Bldg.no,: Suite no.: Job address: / 1 Tax map/tax lot/account no.: Lot: ,Z Block: Subdivision: Project name: - Description and location of work on premises/special conditions: -- - -- - Name: r d'� 1 &t family,dNclliag: Mailing address: tl 7i Cit --�? State:G' ZIP: < �t� Valuation of work.....L7.�. � ................. Phone: I/G Fax: E- it: No.of bedrooms/baths................... .....y Total number of floors.............................. Owner's representative: _ -1 __ d''f�s .�,. Phone: I ax: E-mail: New dwelling area(sq. ft.) .......................... Garage/carport arra(sq.ft.)........................ Covered porch area(sq.ft.) ---,�� Name: — Deck area(sq. ft.) ........................................ Mailing address: - - Other structure arra(sq.ft.)......................... City: State: ZI" Phone: Fax: E-mail: Commerclallindustrial/multi-famll Valuation of work.................. .... ...... - Existing bldg.area(sq.ft.) •......•••• -- Business name: ' �' !C ' New bldg.area(sq.ft.) ............. -_ — Address: Chi ` C'�' Number of stories.................. ..... ..... _ -- City: - ' `tom. State:C, ZIP: Type of construction Phone: ax: Occupancy group(s): E-mail: Existin i'L' '�CCB no.: /. � 3S �_- �_ City/metro tic.no.: (?�' Notice:All contractors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under �x 7ti ��<` provisions of ORS 701 and may be required to he licensed in the Name: jurisdiction where work is being performed.if the applicant is Adss: �� exempt from licensing,the following reason applies: dre Cit 11 State:,K ' ZIP: Contact person: /fir - *9t Plan no.: Phone:r�'�` '/.%v •ax:�, '�(``S -mail:/!1�-+[r-_? ! --�--�-- nel lot 10 Dees clue aIxrn application ...............__�� Name: u lee Contact person: a{1 Date received: Address: --- -- State: ZIP: Amount received ......................................... City: Please refer to fee schedule. Phone: Fax: Email: Not all Jurisdictions accent credit co ,pleaar,cell)urimoreMliction fcx e infcxnwthxt. I hereby certify 1 have read and ex trained this application and the Visa O MuterCard attached checklist. All provisions of laws and ordinances governing this cora somber _ - 'Expires' / work will he complied with,. hether spe fie herein or not. Credit — � of cudho —Warne idtt d s hown txt credit cud S Authorized signature: _ - �� ? . � �/V — Cudholder dguturc Amount Print name: 4-fOJ61 t IM10/t'UMI Notice:This permit eppticatiou expires if a permit is not obtained within 180 days after it has peen accepted as complete. One-and Two-Family Dwelling Building Permit Application Checklist Reference no.: 7 Associated permits: CifyojTignrel City of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW liall Blvd,Tigard,OR 97223 U Other: Phone: (503) 639-4171 Fax: (503) 595-1960 1111111" FOLLOWING ITEMS ARE' 111F,Q11111111FID FOR PLAN REVII'm Ve% No NIA Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designatiom,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 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control U plan U permit required. Include drainage-way protection,sill fence design and location of icli"basin protection,etc. 10 V 3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state huildfng codes. Lateral design details and connections must he incorporated info the plans or on a separate full-size sheet attached to the plans with cross rel'srences between plan location;aid details. Plan review cannot he completed if copyright violations exist. I I Site/plot plan drawn to scale.'rhe plan must show lot and building setback dimensions;property corner elevations(if there is more than it 4-I1.elevation differential,plan trust show contour lines at 2-11.intervals);location of easements and drivewav;footprint of structure(including(leeks);location o1'wells/septn sN stemfs:utility kx;tions:direction indicator;lot area;building coverage area;percentage ol'coverage;impervious area;existing structures on site;and s Mace drainage. 12 Foundation plait. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater, furnace,ventilation fans,plumbing fixtures,balconies find decks 30 inches above grade,etc. I a f'ross seetion(s)and details.Show all framing-member sizes and spacing such as floor teams,headers,joists,sub-floor, a all construction,roof construction. More than one cross section may he required to clearly portray construction. ~how details of all wall and rool'sheathing,roofinn rool'slope,ceiling height,siding material,footings and foundation,stairs, fire placc construatin, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable _ 16 Wall bracing(prescriptive path)and/or Iaferal analysis plans. Must indicate details and locations:for non-prescriptive path analysis provide specifications and calculations to engineering standards. 1T Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. 18 Basement and retaining Nulls. Provide cross sections acid details showing placement of rebar. For engineered systems,see iteni 22,"Engineer's calculations." 19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any leant/joist carrying it non-uniforn load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more appliances. _ 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof'triss)shall he stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to th• lroject under review. 23 Fve(5)side plans are required for Item i I above. Site plans must he 8-1/2"x 11"or I i" x 17". 24 Two(2)sets each are required for items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will be not accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List. Checklist must be 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. 4444614(e0WOM) Mechanical Per-nit Application Date received: Permit no.: City of Tigard — Address: 13125 SW Hall Blvd,Ti ,OR 97223 ProjecUappl.no.: Expire date: City nard (Tigard g -- Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no,: &2 family dw0fing or accessory U Commercial/industrial U Multi-family U Tenant improvement L ew construction U Addition/alteration/replacement U Other: Ul Job address: �C � F at . _, Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax trap/tax lot/account no.: profit. Value$ Block: suhdivision: -- 'See checklist for important application information and Project name: juri•dictiun's Ice schedule for residential permit fee. City/county DC3enption and IcKation of work on premizs: G e� _ tx I fit Est,date of completion/inspection: Cx (My. Total !"U�� _ Ilkscrifrtlou y. Re�s.only Res.onh Tenant improvement or change of use: Is existing space heated or conditioned?U YesNo handlingunit CFM Is existing space intiulate(r,U Ye, W Nu Air conditioning(sitep anrequirc ) teration o exisling UIVAC s stem o er compressors Business Hume _ ,�' - ?�� State boiler permit no.: Address: /� -- _ _ HP Tons BT(I/H _ sir smo c dampers/duct smoke electors City: 7 .- Stale: [� 'LIP: �� ' Tleat pump(site p an rcqu rc ) ---- — -- Phone: i Fax: C'+ f''!� Email: nsta rep nee furnnc utter AT CCB no.; 4 � 6 (� Including ductwork/vent liner U Yes U No City/metro tic. no.: C nsla rep ac re ocate heaters--suspe.n ed, - wall,or floor mounted Name(please print): E , / T �Ci �i cnl for a t lance o1her than furnace e ger at ass. Absorption units WHIM fl IM Name: ----- C:hillers__-��_ III - Addrcss: — Com ressinti _-� I'I, — City: State:--Fz—lp. at exhaust zn rent at on: Appliance veal Phone: Fax: E-mail: ::ycrex roust 0o % Type res, tc a azmat Name: � '.a- -��L�C hood fire suppression system a Exhaust fan with single duct(bath fans) Mailing address: 5`! f" �/'/� r, x oust system anan 'tom isatin or C -- City: ,c Y7 Slate: ZIP: ,��t� ue tat p ng andistribution iup to out etsl Phone: ;' " Fax; ,� E-mail: Tyres NG Oil FuelWIN tin cac t a (IThoma over out ets rocessp p ng(sc ematicrcgaire ) Name:741,-) /:'�c_SYc�" Numb-,,r of outlets - 1 er lisle app-tlince or equ pmenl: Address: / n{ -!{ Ee, Decorative fireplace City: ,A 7' -9t Stale: nsrT ri type_ 1'ltone: 1 Fax: o0 stove/pcletstovl—'e Applicant's signature: Name (print): - L :��±—--------- t twin cud nU Ma M ) expires If 8 Permit fee.....................$ Not all jurisdictions ecce credit cardi, ease call uriadicaon for mire inf w lon. Notice:This permit application _-- -- UVisa U Masrett'nrrl Minimum fee................$ _ ex 1 permit is not obtained plan review(at _ %) $ within 180 days after it has been -Name of c"Older as ahown on credit cam - accepted as complete. State surcharge $ TOTAL .......................$ `— crdhol,kr sit nature — Antounl 4404617(6000UOM, MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL 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 includinaducts&vents _ V 00 fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000. 0. including ducts&vents _ 17 40 $10,001.00 to$25,000.00 $148.50 for tha first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent t4 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 $1.45 for each additional$100.00 or 6 e0 fraction thereof,to and Including 6) Repair units _ $50,000.00. 1215 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof, footnotes below. Comp Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<3HP;absorb unit to 100K BTU 14 00 f '/.State Surcharge 8)3-15 HP;absorb 8 a unit 100k to 500k BTU 25.60----- 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb 35.00 Required for ALL commercial permits ony i iit.5-1 mil BTU _ TOTAL COMMERCIAL PERMIT FEE: $� unit 301.7 mi absorb 52.20 unit 1-1.75 mil BTU _ _ �.-__ - --- _--- 11)>50HP;absorb unit>1.75 mil BTU 87.20 _ --- - ---- - 12)Air handling unit to 10,000 CFM ASSUMED VALUA_TIO_NS PER APPLIANCE: 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description'-_ Q Ea Amount 17.20 Furnace to 100,000 BTU,Including 555 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 Including vent 955 16)Ventilation system not Included in Suspended heater,wall heater or 955 appliance permit 10.00 floor mo,,ted heater 17)Hood served by mechanical exhaust Vent not Included In appliance 445 10.00 ermlt 80� 18)Domestic Incinerators 17.40 Repair units <3 hp;absorb.unit, 955 19)Commercial or Industrial type incinerator to 100k BTU 69.95 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 500k BTU 1000 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU 5.40 _ 30-50 hp;absorb.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 572.50 SUBTOTAL: $ >1.75 mil.BTU Air handling unit to 10,000 cfm 656 -- 8%State Surcharge a Air handling unit>10,000 chn 1 170 Non- ortable evaporate cooler - 656 TOTAL RESIDENTIAL PERMIT FEE: $ _ Vent fan connecle'to a single duct 446 Vent system not included In 656 appliance permit Hood served by mechanical exhaust 656 other Inspections and Fees: Domestic Incinerator 1 170 1 Inspections outside of normal business hours(minimum charge-two hours) _ $62 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 $62 50 per hour Inserts,etc. 3 Additional plan review required by Granges,additions or revisions to plans(minimum Gas piping 1-4 outlets _ 360 charge-one-half hour)$C2 50 per hour Each additional outlet 63 _ 'State Contractor Boller Certification required for units>200k BTU. TOTAL COMMERCIAL "Residential XC requires site plan showing placement of unit. T_ VALUATION: All New Commercial Buildings require 2 sets of plans. i:\dsts\forms\mech-lees.doc 02/11/02 Plumbing,Permit Application Date received: Permit no.: C;q of Tigard_ Sewer permit no.: -- Building pe;rnit no.: _. Address: 13125 SW I lall Blvd,Tigard,OR 97223 City of7'igard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fa):: 003) 598-1960 Date issued: By: Receipt no.: Land use approval' _ Case file no.: Payment type: &2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement New construction U Addition/alteration/replacement U food service U()dwr Joh address: Description Qty.I Fe (ea.) Total Bldg, no.: Suite no.: Ne" I-and Z-family dnellings only: --- (Includes 100 ft.for eachutilitsconnection) Tax map/tax lot/account no.: — Sl-R(1)bath Lot: I Block: Subdivision: ---- SFR(2)hath Project name: SFR(3)bath _ City/co 1'.1y: ZIP: Each additional bath/kilchcii fD sc rip.ion-.,ild locat' n of work on pre t.ses: �L f Siteutllities: c'�t.it�c`iE' C_�-�'Sc" c> ,, __ Catch htsin/arca drain Est.date ol'compleliun/inspection: rywells/each line/trench drain Footing drain(no.lin. 11.) Milli 11 r=110 I 11AN I Manufactured home utilities Business name: anholes Address: 17") - 5"7- Rain drain connector _City: Slate:(,L ZIP: fWe,-y,,2 Sanitary sewer(no.lin. ft.) Phone: SJez. Fax: � ' �'� Storm sewer(no. lin.ft.) CC$noE-mail:Plumb•bus.reg.no:jT• Water service(no. lin. fl.) City/metro lic.no.: e�ve,Cj mss/ Fixture or Item: Contractor's representative signature: _,ems Absorption valve Print name �:�, ^ - ate: X ( r ') Back flow preventer i— — - Backwater valve Basins/lavatory _ Name: RCZ C«-Q Clothes washer - Address: Dishwasher _ Drinkin fountain(s) - - City: state: l.II': Ejectors/sump _ -- Phone: fax: E-mail: Expansion tank Fixture/sewer cap _ Name(print): -1:6A Floor drains/floor sinksthub Mailing address: :F:-!sa§ 5Y `�'(l �� arbage disp2sal City: e- O -- late, Hose bibb '> ZIP: ,�'� = ce maker --- Phone: interceptor/grease trap - owner installation/resident;,' maintenance only: The actual installation Primer(s) will be made by me or the t)aintenance and ar made by my regular Roof drain(commercial) employee on the property 19wll as per UR ter 447. Sink(s),basin(s), ays(s) _- owner's si nature: _ Date: Sum _ Tubs/shower/shower pan Urinal Name: e-7 sC.. ��' �"G e Water closet Address: _ �' �/ �� Water heater } City: `E t-._..1 State: ZIP: �L Other: -- -- Phone:,''' V I Fax: �'�' f -3 mail: Total Not all puisdictims mete"credit cards,pleaw call Juddkilar rix mac inram flora Notice:This permit application Minimum fee................$ U Visa U MasteWard expires if a p--mit is not obtained Plan review(at _ %) $ credit card number _— --i within 180 days atter it has toren State surcharge(8%)....$ Fapilr'e Name of cardholder o shown on credit card accepted as complete. TOTAL .......................$ S Crdholder alp ature Amoun, 440-4616 MWCOMI PLUMBING PERMIT FEES: PRICE TOTAL � New 1 and 2damlly dwellings only: FIXTURES (individual) _QTY !!)_ AMOUNT (Includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 18,80 for each utilit connection) _ One 1 bath $249.20 Tub or Tub/Shower Comb, 1660 Two(2)bath $350.00 Shower Only 16.60 Three(3)bath $399.00 Water Closet 16.90 SUBTOTAL Urinal 16.60 _ _ 8%STATE SURCHARGE_ Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16,60 - TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16'60 PLEASE COMPLETE: 3~ 16.60 4^ 16.60 — Water Heater O conversion O like kind 16.60 Quantity b Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Horne New San/Storm Sewer 46.40 Lavatory _ Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain (16.60 Water Closet Other Fixtures(Specify) 1660 Urinal y Dishwasher Garbage Disposal _ LaundryRoom Tray Washina Machine Floor Drain/Sink: 2" Sewer-1st 100' 55.00 3^ _ Sewer-each additional 100' 48.40 4" Water Service-1st 100' 55.00 Water Heater _ Other Fixtures Water Service-each additional 200' 46.40 (Specify) — Storm 8 Rain Drain-1 st 100' 55.00 Storm 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing car Specially 62.50 Requested Ina ectionaer/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 - Grease Traps 16.80 QUANTITY TOTAL Isometric at riser diagram Is required if ^_ Quanth Total Is >9 _ "SUBTOTAL — — 6s/e STATE SURCHARGE - -- "PLAN REVIEW 25%OF SUBTO rAL _ Ro aired only If 8dure qty.total is�_9 TOTAL f "Minimum permit tee is$72 50•a%state surcharge,except Residential Backflow Prevention Device,whl,h Is$38 25.8%state surcharge "All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. L\dsts\forms\plm-fees doc 12/26/01 :33 R:1LT\12PE.dwg MRR C _--- - okSq -aaOd LOr COVERAGE 4MPERVIOUS HOUSE 1,739 SO. Fr. HOUSE 1.739 SO Fr Lor AREA 8,000 SO. Fr. CRIVEWAY 193 SO Fr PERCENIAGE 21.7 X WALKWAY 66 SO Fr r0 rAl AREA 2,098 SO Fr Lor AREA 8.000 So. F r PERCEIN NAGE 261 X 0 5 - X - - - - 8000' X - - — � 10 �. IX I X . 0 o Ix f yXc r- --——--—————————----———————— 20' --1 I I v x, 1 -0" X I I MAIN FLOOR o I I� +''••, I i I To — ------ d AA E E143 51 �? x 1\ I I J x �0 0' l.a- X It / X 4" CONC X DRIVEWAY (3500 P.S.1,I \ '\ — 3'SANITARY X 1 I L ——— — RAIN DRAIN X p —— X I I — X i I a TO SIN FONNER SL_O_ �V ---------- -- IX --------- i -1--.--_ L----- ---I- --- -- 3 ATE �, S ---_ --- _ -- ------ 80 00' - -7 w 5' LANDSCAPE 25' PRIVATE ACCESS, BUFFER UTILITY, AND STORM DRAIN EASEMENT 08/01!02 MRP _ S C A L E 1 2 0 0 ALAN NA9CDRD OF91DN ASSOCIATES INC ro NDT CITY OF TIOARp 219 9 LIABLE FLIP iNF ACCURAc OF iNF IOPODRAPNr EioR11A'"n I$tNF$aF RF9PowselEn.a iNE PARISH ESTATES r INA E IC rEREr All 511E CDNdiIDN9,w lF71Na ANY Flt RACEp oN tNF 5tE AND NOtir'NE PARCEL 2 UNNIFR$OF ANY PU:FNTIAI FIELD YDDN'ICATION$ ALM IIA�COFED alas Af/OCMrIt11,we. 1'365 S.W FONNER STREE 1 By SERGEI KRAVCHENKO MLP 2002-0002 PH (503) 910 6436 . :.. qua'�aI► wr.�.wr,�� ,,n��+�lil'�Iw9�iI�YW�Ii�:�.:._�.i�__��.v DOCUM NT Electrical Permit Application - ' Date received: d/� Perm,�lt�• f - 00 �---- IrrojecUappl.no.: Expire date: city Of Tigard By; Receipt no.: Cilyul77f;unl Address 13125 SW 11x11 Blvd, I•i)�ard,(w 07223 Date issued: Payment type: PI one: 1303) 639-4171 Case file no.: Fax: (503) 598-1960 Land use approval: - - - - U Muld-family U Tenant improvement y U Commercial/industrial U Partial rNew family amily dwellingor accessot U Addition/alteration/rcplam cccnt U Ot,ec: Q I Bldg.no.: ISUite no.: Tax map/tax lot/account no.: Lot: 2 Block: Subdivision: C - Description and loc:ltion of work on premises: ---- Project name: - �od_a �.f, Estimated date of completion/insliccl...- MAN Fir fh+criplion Ob• (ea.) lo(al no-Imp ,lob no: _ � Nen rrsirkHttlal-single nr multi-fondly Ix•r Business name: ' dviellingunit.Inclmksadnclrrdgarage. 1. . dQ Address. Z 0 S�' state:D zip:( 00 Scnicelnch(detl: 4 City: P �' 1000 sq.ft.or less -6 Fax v --/ PE-mail: Each additional 500 s .ft.or portion thereof Phone' ai l - D�' Limitedenergy,residential 2 CCB no.: �Y7(!�'7 El.-C.pus.tic,no: Limited energy,non-residential City/metro lie.no.: 1 S�, p2 Each manufactured home or modular dwelling 2 Set%-ice and/or feeder H Date Services or feeders-Installation, Signature of su rvisin electrician Vuired) `f i lCenseno: S d(erallonorrelocation: Sup.elect.nnn,c(print)' 200 amps or less 2 C � 201 amps to 400 amps - 2 r p 401 ams to 600 amps 2 Name(print): r' .` - f�"L� S 601 amps to 100)amps 2 - Mailing address: over►000 amps nr volts -- — l State: ZIP: e� City: Reconoectonl _ Fax: [ Email: Temporary services or feeders- Phone: p pt y lnstallatlon,dtcralIon,orrelocal nn: Owner installation:The installation is being i a lr on ru r awn 2[x)ampr or less z- which is not intended for sale,lease,rent,u ex ange according to 201 amps to less amps , —- ORS 447,455,479,G70,7 ate: �V/�` nl to 6[x)am s - owner's sl-:ttnrv- '-- '/ Branch circuits•nevv,alteration, or extension per panel: l' ';C G'�<- A. Fee for brunch circuits with purchase Ot 1 service or feeder fee,each branch circuit Add~eas: _ ZIP. 7�'C� B. Fee for branch circuits without purchase -- Slate: of service or feeder fee,first branch circuit: City: :-tttall: kiach adctitiOnal branch circuit: Fax: �'P S c s'� Mlsc.(Service or feeder not Included): Each pump Or irrigation circle 2 p U Fealth carcfacil,ty Eachsignoroutlineligl=_ U Service over 225 amp,.Commercial R resat U Hazardous location Signal circuits)or n limited el gy panel. 2 U Service over 12(1 am -rating Of I Jct U Building over 10,(X))square feet four or a1 c-atior extension• - family dwellings more residential units in one structure _ - U System over(0)volts nominal • --- _-` -of Ilx drove: U Building over three stories U ManufaFeederctured tur amps or res O F aci�ddltional Ins ction o•er the diorable in any V Mmwfactured structures or RV park M' U Occupant load over 99 persons U other. _- per,nspeclion U Egress/llghtingplaa lwith any of the above, Investigatiunfee Submit—sels 6f Pana other tar co Service. permit fee.... .. ----- The%hove are not applicable to tempoY ............ . Plan review(at _9b) _------ - - hnt-Allisdi 11 accept ere.. cards,pleave call)urirdktia,fa more Infnnnauonl expires it cation at peermittis notobtained State surcharge(S�a)•••• -�--�- U Visa O Mas(erCard f _ I within 180 days alter it has h^ t TOTAL .......................S �-- l.redit card number -- ^ tore accepted as complete. Name of cardholder u shown on 646 credit car S 4115(61001COM) _ Amount i —�--Ciudhol r dgnarure—,----- ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY .............................. 575.00 Complete Fee Schedule Below: Re IFpR ALted L ergy Fee SYSTEMS) Number of Ins ctlons or ermit allowed Service Included: Items Cost Total Check Type of Work Involved: Residential per unit $145 15 4 At : ,nd Stereo Systems" 1000 sq fl.or less Each additional 500 sq.ft or $33.40 _ 1 Burglar Alarm portion thereof $75.00 Limited Energy ❑ Each Manuf d Home or Modular 2 Garage Door Opener' Dwelling Service or Feeder _ $90.90 -- Services or Feeders � Healing,Ventilation and Air Conditioning System' Installation,alteration,or relocation $80 30 _ 2 Vacuum Systems' 200 amps or less $106.85— 2 201 amps to 400 amps — -- $160.60 I— Other 1 401 amps to 600 amps -- 601 amps to 1000 amps $24060 _ 1—J_ Over 1000 amps or volts $454 65 2 __— Reconnect only $6685 2 TYPE OF WORK INVOLVED -COMMERCIAL ONLY 75.00 Temporary Services or Feeders Fee for each system............................................ . . Installation,alteration,or relocation $66.85 2 (SEE OAR 918-260-260) 200 amps or less $100.30 2 201 amps to 400 snips $133 75 2 Check Type of Work Involved. 401 amps to 600 amps — Over 600 amps to 1000 volts, Audio and Stereo Systems see"b"above. Branch Circuits L_J Boiler Controls New,alteration or extension per panel a)The foe for branch circuits Clock Systems wilt,purchase of service or feeder fee. $6 65 2 Data Telecommunication Insiallation Each branch circuit _ b)The fee for branch circuits ❑ Fire Alarm Installation without purchase of service or feeder fee. $46.85 rl First branch circuit — L�l HVAC Each additional branch circuit _ $6.65 _ Instrumentation Miscellaneous (Service or feedor not Included) 40 Each pump or inigation circle $53. _, Intercom and Paging Systems Each sign or outline lighting $53.40— ❑ Signal circuits)or a limited energy $75.00 Landscape Irrigation Control" panel,alteration or extension _ $12500 _� Minor Labels(10) — EJ Medical Each additional Inspection over Nurse Calls the allowable in any of the above $6250 Per Inspection $62 50 Per hour $73 75 .-- Outdoor Landscape Lighting' In Plant — Prolective Signaling Fees: Enter total of above fees $ _ � Other._ _�._�-__ --------- $ J __-Number of Systems 11%State Surcharge ----�� -- 25%Plan Review Fro $ No licenses are required Licenses are required for all other installations See"Plan Revied'section on _ __—._--------- — front of application Fees: Total Balance Due ------ Enter total of above fees El Trust Account#— --- 8%State Surcharge s -- --- ----�—" `� ---- - Total Balance Due s_ All New Commercial Buildings require 2 sets of plans. odsts'J rms\eta%ft.4 C 0 /30101