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11389 SW FONNER STREET s w 00 ca V. n 0 9 V) my m 11389 ,AVN Fonner Street CLTY OF TIGARD 24-Hour BUILDING Inspection Linc: (503) 639-075 MST _ INSPECTION DIVISION Business Line: (5031639-1171 BUP _ Received pDate Requested -� _ AM _. PM - �'. __ BLIP Location - -__ �� :3o J -__J�� ,Xjt. _Suite MEC Contact Person __ _ Ph(__ _ _) PLM Contractor - ,_. ---- --- Ph( —) SWR - BUILDING TenandOwner ELC Footing -- _-- ELC - - Foundation KCCBSS: Ftg Drain ELR Crawl Drrin "—-'- SIT Slab Inspection Notes: - Post&Beam Shear Anchors Ext Shaath/Shear Int She&th/S,iear Framing Insulnlion Drywall N iiiing - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: - -- - Final Y 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 PART FAIL ------_-.------- -- . _- ---- - --- - - ------- -- _ ----- ELECTRICAL.---- Service Rough-In -- --- ----- � UG/Slab -- ------- -- -- Low VOltage _— _ ------- --------- -- - dire Alarm SS PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. — :::] EJ Please call for reinspection RE: ❑ Unable to inspect--no access Fire Supply Line Appr.,ech/sidewalk Date r -��—_-� Inspe^tor '� dv� . Eltt- Other: Final DO NOT REMOVE thls inspaction ricord Prem the Job site. PASS PART FAIL MASTER PERMIT CITY OF TIGt'il► /� RD PERMIT#: MST2002-00424 DEVELOPMENT SERVICES DATE ISSUED: '11122102 !3125 SW Hd',i Blvd., Tigard, OR 97223 (50) 639 4171 PARCEL: 2S103AC-ESP02 SITE ADDRESS: 11389 SW FONNER ST 00022 ZONING: R-4.5 SUBDIVISION: ERVIN/STF'ARK PART/MIS2001"LOT: 002 JURISDICTION: TIG BLOCK: REMARKS: Construction of new SF detached resideDnce. Path 1BUILNG _ REQUIRED SETBACKS REQUIRED REISSUE: STORIES: 2 FLOOR AREAS _ CLASS OF WORK: NEW HEIGHT': 23 FIRST: +ry of PASEMENT of LEFT SMOKE DETECTORS: Y TYPF OF USE: SF FLOOR LOAD: 40 SECOND: "17 of GARAGE 436 At FRONT. 4'l PARKING SPACES: 2 RIGHT. �+ TYPE OF CONST: 5N DWELLING UNITS: t FINSSMEN': of VALUE 190 312170 PrHR. OCCUPANCY ORP: R7 BDRM: A BATH: 3 TOTAL: 1.945 e1 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH I LAUNDRY TRAYS. RAW DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS. SrWER LINES: 100 SF RAIN URAINS: 1 CATCH BASINS: GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 SCKFL W PREVNI W I GREASE TRAPS: TUB/SHOWERS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN c 100K: t BOIUCMP c]HP: VENT FANS: 4 CLOTHES nRYER: 1 GAS FURN a.100K: UNIT HEATERS: HOODS: OTHER UNITS: 2 btu FLOOR FURNANCES: VENTS: WOODSTOVES: OAS OUTLETS: 7 MAX INP: ELECTRICAL BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDER3 PER INSPECTION: 0 200 Amp: 0 - 200 imp: WISVC OR FOR: I PUMPIIRRIOATION: 1000 9F OR LESS: t PER HOUR: 201 400 Amp: 201 400 Amp: jet WIO SVCIFDR: 00 SIGNIOUT LIN LT: EA ADO'L SOOSF: SIGNALIPANEL: IN PLANT: 4D1 800 amp: 401 600 Amp: EA ADDL OR CtR: LIMITED ENERGY: MINOR LABEL. MANU HMISVCIFDR: 801 1000 Amp: 601+empe-1000v: 1000+Amplvolt: PLAN_REVIEW SECTION Reconnect only: a.4 RES UN'.TS: SVCIFDRa-225 A.: a 600 V NOMINAI.. CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY S.COMMERCIAL A.SF kESID ___ ENTIAL AUDIO 6 STEREO: FIRE ALA'M INTERCON,PAGING: OL TDrIOR LNDSC L AUDIO&STEREO: VACUUM SYSTEM: BOILER: HVA,';: LANDSJAPEIIRRIG: P1.7TECTIVE 91GNL: BURGLAR ALARM: OTH: CLOCK: INSTRUMENTATION: MEDICAL: DTHR: GARAGE OPENER: NURSE CALLS: TOTAL 0 SYSTEMS: HVAC: DATAlrELE COMM: TOTAL FEES: $ 7,412.99 Owner: Contractor: This permit is subjea to the regulations contained in the SERGEI KRAVCHENKO SERGEI KRAVCHENKO Tigard Municipal Code.State of OR Specialty Codes and 8384 SW PFAFFLE 8364 SW PFAFFLE ST. all other applicable laws. All work will be done In #210 #210 accordance with approved plans. This permit will expire N TIGARD,OR 97223 TIGARD,OR 97223 Work Is suspended forork is not started nin more0das of then 180 days ATor it the TENTION' Oregon law requires you to follow rules adopted by the Phone: g03.g10.6436 Oregon Utility Notification Center. Those rules are set Phone' 503-810-G93G forth In OAR 952-001-0010 through 952-001-0080 You M06: I.IC 152358 OUNobtain C by calling(503)246-1987rules direct questions to REQUIRED INSPECTIONSExterior -- Plumb Final Erosion Control Insp 8, +•.I n;Bfhocr Insulatlen Plumb'I OV Out Low Voltage Sheathing Insl Watery Line Rain drain lln n Final Inspection Footing Insp Crawl Drain/Beckwr-ler Electrical Service Gas VoLine Insp Appr/Sdwlk insp Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Framing Insp Gas Fireplace Electrical Final Posl/Beam Structural PLM/Linderfloor Insulation Insp Mecha^ical Final Post/Beanl Mechanica Mechanical Insp Shear Wall Insp —. Permittee Signature 1 Issued By : Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00278 13125 SW Hall BIN-d., Tigard, OR 97223 (503) 6.3,9 4171 DATE ISSUED: 11/22/02 PARCEL: 2S103AC-ESP02 SI-i E ADDRESS; 11389 SW FONNER ST SUBDIVISION: ZONING: BLOCK: LOT: _ — JURISDICTION: TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection permit for new SF detached residence. Owner: _ FEES SERGEI KRAVCHENKC: Description Date Arriount 8364 SW PFAFFLE #210 JSWUSAJ S\�r connect 11/22/02 $2,300.00 TIGARD, OR 97223 1SWINS111 Swr Inspect 11/22/02 $35.00 Phone; 503-8 10-6936 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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 from the distance given. If riot so located, the installer shall purchase a"Tap and Side Sewer' Pemiit and the Agency will install a lateral ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules cr direct questions to OUNC by calling (503) 246-6699. toe C- Issued b -r�a"C �� - Permittee SicJnaturr,: --- Call (503) 639-4175 by 7:00 P.M. for an i ;pection needed the next business day Building Pern>!it application City Of Tigard Address: � �,'�- Permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: City ofTign►d ' Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 ,� Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: &2 family dwelling or accessory LI Commercial/industrial U Multi-family New construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/a arm U Other: JOB SITE INFORMA'I ION Job address: `�-4M Bldg.no.: Suite no.: Lot: Block: Subdivision: rTax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: OWNER FOR SPECIAL INFORMATIdN, USE CIIECKLI.W. solar, Mailing address: f2-56 T- I &2 family dwelling: City: � I State: ZIP: c' 7�>�a� Valuation of work........................................ $ Phone: No.of bedrooms/haths................................. Owner's representative: Total number of floors................................. Phone: Fax: I:-mail: New dwelling area(sq.ft.) Garage/carport area(sq. ft.)......................... Name.: _ �cr�ce-� Covered porch area(sq, ft.) .. ...................... _ Mailing address: Deck arca(sq. ft.) ........................................ _ City: State: 7_IP! Other structure area(sq. 11.)......................... Phone: 1- E-mail: Commereiallindustrlal/multi-family: Valuation of work........................................ $ Business name.: �- t Existing bldg.area(sq.ft.) .......................... -- -i �' �-f.L �t Address: New bldg.area(sq. ft.)................................ _ City: e jU — State: G% ZIP E 1ra�� Number of stories........................................ _ ' Fax: Type of construction.................................... Monti: mail: CCB no.: �',l � Occupancy group(s): Existing: --=-- ._�-- -- -- - ---- New: City/metro lie. no.: — Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board und,.r Name: provisions of ORS 701 and may he required to he licensed in t!he Address: '-tC�<" ,�{ jurisdiction where work is being performed. If the applicant is Cit : �1 -' State: IP: j�r—1 exempt from licensing,the following reason applies: Contact person: Plan no.: 2/ _ Phone: rj/ Fuse: - Gmai IL, ,,, Name: ��<<<'E__ _ Contact person: Fees due upon application ........................... $ Address: Date received: City: State: ZIP: Amount received .............. .......................... $ Phone: I E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more Information attached checklist. All provisions of laws and Firdinances governing this ❑Visa O MasterCard work will he complied with., ether specija'ed I rein or not. Credit card number _____ �1__. �� ____ p lms Atithori?ed signature: :_ Name of cardholder u shown on c it card Print name: = ,d2i4'L�.' �E.�C T r� — - z CadhnlderiiRnaturc Amount Notice:nis permit application expires if a pemrit is not obtained within 190 days after it has been accepted as complete. 440-4613(WWOM) One-and Two-Family Dwelling Building Permit Application Checklist '�e'Cfe°Ce° ---- -- ---- - Associated rrnuts: CityofTigard Lit of Tigard U Electrical ❑Plumbing ❑Mechanical Address: 13125 SW Hall Blvd,'figard,OR 97223 JOther Phone: (5031 639-4171 Rix: (503) 598-1960 THE, FOLLOWING UFF.MS ARE REQUIRED FOR I Land use actions completed.Scejurtsdicti(m truism lot tilncuncnt rrvtc%k�. 2 Zoning.Flood plain,solar balance points,,(-I� m . nl,dL'�IVI,ttion,historic 3 Veri0cation of approved plotllot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel. I ixisling system capacity _ 6 Sewer permit. 7 Water district approval. 8 Soils report.Must carry original applicable stamp and signature on file or with apple a1 1(,11 9 Frosion control U plan U permit required. Include drainage-way protection,silt fence dcstgn and locatr ai III catch-hasin protection,etc 0 ._L Complete sets of legible plans.Must he drawn to settle,showing conformance to applicable local and stair building codes. Lateral design details and connections must he incorporated mill the plans or on a separate full-si/e sheet attached to the plans with cross references between plan location and details, flan review cannot he completed if copyright violations exist. 1 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(it — -- there is mole Iltan a 4-I.elevation differential,pian must show contour lines al 2-11.intervals);Vocation of easements and driveway;foolprinl of structure(including decks);location of wells/wptc',"Menu:wiloy Iitcations;direction indicator;lot area;building coverage area;percentage of coverage;impervious are:.:c suunl sno.unrs on site:and surface drainage. 12 Foundation plan.Show dimensiom,.anchor holts,any hold-doww,and rerrdorcing pads,connection details, vent size and location. ---_ - ----_-_ - -- - 13 Floor plans.Show all dmirn,•wn�, wore idrntlicaliott,wirtdu',s stir, location of snn,kr detectors,writer heater, furnace, ventilation halls,plumhtnl!fixtures,hadcontes and decks 30 inches above grade,etc, _ 14 Crocs section(s)and details.Show all framing-member sizes and spacing such as floor seams,Realtors,joists,sub-Iluor, wall construction,roof construction, More than one cross section may he rrquircd to clrarly poitu(t rI Instruction.Shosv details of all wall and roof sheathing,nothing,roof slope,ceiling height,siding matcnal,footings and foundation,stairs, fireplace construction, 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'tilt-chance in grade is greater than four fool at building envelope. Full-size sheet addendums showing foundation elevations with cross references ore acceptable. 16 W.Al bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing.Provide plans for all (lours/rool assemblies,indicating member sizing,spacing,and hearing locations.Show attic ventilation. 18 ilasement and retaining walls. Provide cross sections and details showing placement of rehar. For engineered systems,We item 22 "Engineer's calculations.,, J19'Ream Calculations. Provide two sets of calculations usm�L urrrin Lode design values for all heams and multiple joists over 10 fee: long and/or any beam/joist carrying a nun-unifo nn 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 Fnglneer's calculations.When required or provided,0.e.,shear wall,ruol'truss)shall be stamped by an engineer or architect licensed in Oregon and shall be shown to he applicable to the pro.jecl under review. 23 Five(5)site plans are required for Item I 1 above. Site plans must be 8-1/2"x I I"or 11" x 17". 24 Two(2)sets each are required for Items 16, 19,10&22 above. 25 Building plans shall not contain red lines or lupe-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 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. "04614(rratnvM) Mechanical Permit Application Date received: Permit no. ,, — City Of Tigard �r'"��, Project/appl.no.: Expire date: Cm ,//,,,,,,,/ Address: 13125 SW Hall Blvd,Tigairw — Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 �j�. - ?O�)1 Case file no: Payment type: Land use approval: Building permit no.: I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U AdditiolUalterati(utitc lil.0(nig III J (Wwr: J013 SITE INFORMATION COMMERCIAL VALUATION S�'IIFD�JLIE Job address: indicate U.•�iC— ' � � � Indicate cyuipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax snap/lax lot/accuunt no.: profit.Value$ Lot: BIock: Subdivision: 'See checklist for important application information and Project name: ,jurisdiction's fee schedule for residential permit fec City/county: ZIP: _ 91,11 W I I 1 Description and locaflon of work on premises: _ PJAIKI W I W IWAJ F1 I i 111111%11113 Iee(ea.) 701al Est,date of completion/inspection: --- Description . Res 1anl Rla,otU Tenant improvement or change of use: Air handlfn unit __ CFM Is existing space heated or conditioned'?U Yes U No irconditioning(enc plan required) is existing space insuiated?U Yee U No teration o existing�l T system _ Wo er compressors LL Business name: i/(/'. l9 -� State boiler permit no.: HP Tons BTU/II Address: / 7/2 Sfi lVe. c'iET` ir•smo carnpers/ uctsmo a detectors City: �C}_�_c Slatc:�//'I ZIP; 7 e;.4 . eat pump(site p an required) Phone: /. c, �S` Pax: tfO E-mail: nits repose furnace/burner / CCB no.: Including ductwork/vent liner U Yes U No itsta rcp a •cre ocate eat.rs-suspcn c City/metro lic.no,: wall,or fluor mounted Name(please print): - 7�1r�, ent for appliance of er than furnace e gerat on: Absorption units_ __ BTU/H Name: Y?L!_Cc _ _ Chillers_ HP Address; Compressors HP City: State: IP: nr ronmenta exhaust■n ventilation: Appliance vcnt Phone: Fax: E-mail. )ryerex aust o s, ype /11/res.kite en/hazntnt hood fire suppression system _ Name: Exhaust fan with single duct!hath fans) Mailing address: ( Exhaust system a art from heating or AU Fuelpiping andistribution(up to outlets) City: i n� '� State:l' ZIP: ?<< ' ;' iype LPO NO _ Oil Phone: C ' Fax:. � "-c`,�r(i E-mail: s— - ue ,i to�eat additional over outlets Process piping(sc erratic required) _ Number of outlets Name: 7,,�� i,c� .'vr t er app an—ii nce or eq-u pment: Address: Decorative fireplace ('fly: : f , Slate: ZIP: assn-ty Phone: <' a Fax: 6=2ustoveipellet stove Applicant's signature: Date: r' ter: Name (prinq: `X ,fit l✓!' �r'r'avc 4.w,�ir Nd all Jmirdictione accent credit catdr,please call furidiction for more infor moon. ion Permit fee....................$ L1Visn U MacteWnrd Notice:This permit expires if a permit is not notapplobtained Minimum fee................1s rredu ears nnmtxr Lipires/ - within I8U days ager it hes lien Plan review(at —96) $ State surcharge(8%)....$ Name of cardholder u shown on credit c $ accepted as complete. TOTAL .......................$ Cardholder silluture Amount 4104817(tltOIMCOM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: - -�----- Price Total _ Description: Qty (Ea) Amt TOTAL VALUATICIN: PERMIT FEE: Table 1A Mechanical Code _._ $1.00 to$5 000.OU Minimum fee$72.50 1) Furnace to 100,000 BTU 14.00 x5,001.00,�$10,000.00 $72.50 for the first$5,000.00 and Indudin ducts 8 vents $1.52 for each additional 3100.00 or 2) Furnace 100,000 BTU+ 17.40 fraction thereof,to and Including Including ducts&vents $10000. 3) Floor Furnace 14.00 $10,001.00 to 525,000.00 $148.50 for the first 510,000.00 and includln vent $1.54 for each additional$100.00 or 4 Suspended healer,wall heater fractlon thereof,to and including ) or floor mounted heater 14.00 $25000-00. 5) Vent not Included in appliance permit $25,001.00 to 550,000.00 $379.50 for the first 525,000.00 end 6.80 $1.45 for each additional$100.00 or 6) Repair units fraction thereof,to and Including 12.15 $50000-00. Ooller heat T-Air $50,001.00 end up $742.00 for the first$50,000.00 and Check all that or pump Cond $1.20 for each additional$100.00 or ootiItems 7-1111'notes below.ee Comp fraction thereof. 7)<3HP;absorb unit 14.00 SUBTOTAL-: Minimum Permit Fae 72.50 to 100K BTU 8)3-15 HP;absorh 15.60 8•/.State Surcharge $ unit 100k to 500k BTU -- _ _ 9)15-3014P;absorb 35.00 25Y.Plan Review Fee(af subtotal) $ unit.5-1 mil BTU Required for ALL commercial permits onl 10)30-50 HP;absorb 52.20 TOTAL COMMERCIAL PERMIT FEE: s �� mil BTU )>50HP a 81.20 --- -- unit>1.75 mil BTU _ 12)Air handling unit to 10,000 CFM 10,00 ASSUMED VALUAt10NS PER APPLI al a E. Total 13)Air handling unit 10,000 CFM+ Descrl tion: Qt Ea Amount 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler 10.00 ducts a vents 1 170 Furnace>100,000 BTU including 15)Vent fan connected to a single duct t3 80 _ ducts&vents - Floor furnace Ind955 udin vent 16)Ventilation system not Included In 10.00 Suspended heater,wall heater or 955 a Ilance ermlt floor mounted heater _ 17)Hood served by mechanical exhaust 10.00 Vent not Included In appliance 445 _ 18)Domestic Incinerators 17 40 permit Re airir unite 805 _ <3 aabsorb.unit, 955 19)Commerclal or industrial type indnerator 69.95 to 100k BTU 1 700 3-15 hp;absorb.unit, 20)Other units,including wood stoves 10.D0 101k to 500k BTU 15-30 hp;absorb,unit,501k to 1 2,310 21)Gas piping one to four outlets 5.40 mil.BTU 400 3, 30.50 hp;absorb.unit, 22)More than 4•por outlet(each) 1.00 1-1.75 mil.BTU 725 SUBTOTAL: 5, >50 hp;absorb.unit, Minimum Permit Fee 572.90 >1.75 mil.B7 656 - g•/.State Surcharge $ Air handlin unit to 10 000 dm 1 170 Air handlin unit>1U 000 cfm 656 $ Non ortable eva rate copier 446 TOTAL RESIDENTIAL PERMIT FEE: Vent fan connected to a sin le duct 856 Vent system not Included In a Ilance errnit 658 Other Insaectlono and Fees: Hood served by mecharllcal exhaust _ 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic incinerator 1 170 - $s2.50 per hour. Commercial or Indusfrlal ind� neva r _4590 _ 2 inspections for which no fee Is specifically Indicated (minimum charge-heft hour) Other unit,Including wood Stoves, $82.50 per hour I Additional plan review required by changes,ad dltiona or revisions to plans(minimum Inserts etc. 360 charge•one-hell hour)582.50 per hour Gas I Ing1-4 outlets 63 Each additional outlet ..___ __--- State cont.actor Boller Certification required for units>200k B Residential AIC t equires site plan showing placement of unit. TOTAL COMMERCIAL- All New Commercial Buildings require 2 sets of plans. VALUATION: I:\dstslforms\moch•fees,doc 02/11/02 Plumbing Permit Application – --�— Date received: Per City Of Tigard and -.- �"'' Sewer permit no.: Building permit no.: Address: 1 1125 W Nall 1314�n ,DR'97221 Project/appl.no.: Expire date: City of Tigard Phone: (503) 639-4171 - Fax: (503) 598-1960 I Date issued: By: Receipt no.: Case file no.: Payment typeapproval:Land use approval: ---- 71 7ewconstruction y dwelling or accessory U Commercial/industrial U Multi-Family J Tenant improvement U Addition/alteration/replacement U F16-1 �NAM it txxl service J Ocher: t J / 6" -) Description Qt . Fee(ea.) Total Job address: G IG New 11-and 2-(s+mily dwellings only: Bldg.no.: Suite no.: (includes 100 ft.for cacti utility connection) Tax map/tax lot/account no.: SFR(1)hath Lot: z Block: Suhdivision: SFR(2)bath Project name: SFR(3)bath City/county: �- ZIP: Each additional bath/kitchen Descript on and to tion of work on r mist' __ �� Slteutllitld: C.'.��" /j�re _ Catch basin/arca drain ----- -----� — D wells, sac line/tri,nc drain _ Est.date of completion/inspection: Footin drain(no.lin.ft.) anufactured home utilities Business name: �/ L l �-cc4t [a i Man oles Address: /TCi•�} C /V C'T Rain drain connector City: C� G C� state: zip: Q6 y�2 Sanitary sewer(no.lin. ft.) Storm sewer(no,lin.ft.) Phone: Fax: �'7 tJ -mail: Water service(no, in.ft. CCB no.: - //7 Plumb.bus.reg.no:j Fixture or item: City/metro lie.no.: Aliso tion valve Contractor's representative signature: ti tt°_ Back flow preventer Print name: �' �' DaBackwater valve -- CON'll AU 1 PERSONasins/lavatory Clothes washer Name: Dishwasher Address: Drinking fountain(s) City: State: ZIP: Ejectors%sump Phone: F:m E-mail: Ex ansion tank _ t -fixture/sewer cap ,��a Floor dralh</floor sinks/hub Name(print): _ _ - garhage dispus- at Mailing address: ?�' SCG f f f Zt- r'1 How bibb City: ;' ':k State: r 'LIP: 7 ).7 Ice m .cr Phone: - Fax: C • ,t. , .-mail: Interce tor/ rcase trap Owner installation/residential maintenance only: The actual installation Primer(s) will he made by me or the maintenance and repair made by my regular Roof drain(commercial) _ — employee on the propeli�kown as per F)RS Chapter 447. Sink(s),basin(s), ays(s) _ Owner's signature: = ';t .r - ate: Sum Tubs/shower/s ower an Urinal Name: is .ti 7�z S� �. _. attar sweet Address: er City: y�j , State:�; , Other: Phone: S y/ei Fax: To Minimum fee................$ — Not dt Jurisdictions accept credit ceras,please call Jurisdiction for more infomtMlon. Notice:'Mis permit application Plan review(at `16) $ U visa U Mastercard expires if a permit is not obtained State surcharge(8%)....$ Credit card numbet Expires within 190 days alter it has been TOTAL .......................$ accepted as complete. •— None of cardholder 440-4616 rhown on credit card S Cardholder ei uttrc 44rF461b(64tYCoN1 i Amount PLUMBING PERMIT FEES: PRICE TOTAL Now 1 and 2-family dwellings only: FIXTURES (individual) QTY ea AMOUNT iincludes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. CITY (ea) AMOUNT Lavatory 16.60 for each utility conn_ectlon One 1 bath $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath $3550.00 Shower Only 16.60 Three 3 bath $399.00 _ Water Closet 16.60 SUBTOTAL Urinal 16.60 8%STATE SURCHARGE - Dishwasher 16.60 PLAN REVIEW 2_5%OF SUBTOTAL Garbage Disposal 16.60 _ -,�___�TOTAL - Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" 16.60 PLEASE COMPLETE: 4" 16.60 Water Healer O conversion O like kind 16.60 v Quantity u j Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ ermit. Capped MFG Home New Water Service 46.40 Sink _ MFG Home New San/Storm Sewer 46.40 Lavatory Hose Bibs 16.60 Tub or Tub/Shower Combination Roof Drains 16.60 Shower Only Drinking Fountain :16.60 Water Closet .ether Fixtures(Specify) 18.60 Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Sewer-1st 100' 55.00 Floor Drain/Sink: 2" _ Sewer-each additional 100' 46.40 4^ Water Service-1 st 100' 55 Ou Water Heater Water Service-each additional 200' 46.40 Other Fixtures (Specify Storm&Rain Drain-1st 100' 55.00 Storm&Rain Drain-each additional 100' 46A0 Commercial Back Flow Prevention Device 46.40 -- Residsntial Backflow Prevention Device' 27.55 Catch Basin 16.80 Inspe,11on of Existing Plumbing or Specially 62.50 Request d Inspections I per/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 Grease Traps 16.60 Y _ QUANTITY TOTAL Isometric or riser diagram Is fired i1 Quantity Total Is >9 - - *SUBTOTAL --- 8%STATE SURCHARGE _ --- "PLAN REVIEW 25%OF SUB T OTAL Required only if flxlure qty.total Is>9 TOTAL 5 *MI, .-am permit its Is$72 50+6%state surcharge,except Resklentlal Backflow Prevertion Device,which Is$36 25+8%state surcharge "All New Commercial Buildings require 2 tett of plane with Isometric or titer diagram for plan review. lAdsts\forrn9\plm-fee9.doc 12/26/01 Electrical Permit Application Permit as -o14 ---- oatereceived: 10 cUappl,no.: Expire date: Proje city of Tigard i}atect/appBy: Receiptno.: _ City of Tigard Address: 13125 SW I lall Blvd,Tigard,OR 97223 _issued: Payment type: Phone: (503) 639-41'11 ('axe file no.: Fax'. (503) 598-1960 Land use approvill: --- - -- - NEFMI Ll Multi la 1111y U Tenant improvement essory V Commercial/industrial __ -- U Partial A4 &2 family dwelling or ace U Addition/alteration/replacement U Other: New construction j N 1'ax map/tax lot/account no.: Bldg.no.: Suite no.: Job address: #40k �� Lot: Block; Subdivision: G i Project name: pescriplion and cx anon of work on premises: - Estimated date of completion/inspection: C"X�` 1 ' Fee Max I1Mscri lion _ QIY• (ca.) lbtal nu.imp Job no: Business(lame: S Newrcsidcntial-slnRkurmuhbfamllypc•r ) k dwellhtgunil.IncludesallaclterlRnra{le. Address: Z State: ZIP: 1"16 erviceincluded: q City: `T'O�f 1000 sq.ft.or less — — F-mail: tach additional.5(x)s .ft.or portion thereof 2 Phone: ��o Dy- Irl Fax SOS Y - 6 6/0 C CCB no.: y VIec,bus.lie.no: 3 t/ ' Limited energy,residential Z Limited enet gy,non-residential City/metro lie.no.: - 0 s 02 Tach manufactured home or modular dwelling 2 � b Service and/or feeder Date Berrices or feeders-installation, Signature off sit ,rvising electrician(required) I icenseno: alteration or relocation: Sup,elect.ranine(print). u t ,"' 66 - 2 � 200 amps or Icss 2 201 amps to 400 amps 2 pint): I t G G? 401 amps to 600 amps 2 Name(p S� 7yc �_� r 601 snips l0 1000 amps 2 Mailing address: Stale: ZIP: �'S�' Over 1000 amps or volts l City: --, "rte Iteconnectonl: 1 Fax: FSG 1:-nlail: Temporaryservicesorfeeder%- Phone: Owner installation:The installation is being made on property 1 own Installation,aherallon,or relocation: 2 + • which if:not amps or less not intended for sale,lease,rent,or exchange according to ,01 ant s Io 4tH)amps J— — ORS 447,455,479,670,701. batt.. __ 401 to Glx)amps Owner's si mature: - - Branch clrculls-new,alleration, or extension per panel: A. Fee for branch circuits with purchase of 2 / Name: <<� service or feeder fee,each branch circuit Address; ��f� l� /� B. Fee for branch circuits without purchase 2 �� . Stale: C.� fzl P: li'l of service or feeder fee,first branch circuit: City: — 1?-ttlltil: Each additional branch circuit: Phone: �' 114 Fax: ' 0 Alse.(9er"Aceorfeedernot included): 2 F.nch amp or irri noon circle 2— U I lealth care facility Each signor outline lighOn�_�_ U Service ver 325 amps•commcrelocation U Service over 320 amps•rnlhtg of I 1&2 U IlatnrdousSignal circuit(e)or a limited energy panel. 2 familudwellings [l Building overIO.000squarefeetfouror alteration,or U System over 6W volts nominal more residential units in am structure _ -'-_ U Feeders,4tx)amps or nmre •Ikscri lion: _ — the— U Buildingover three stories Fach additional Mspeclfon over the allowable In any any ofr : U Ckcupant load over q4 persons U Manufactured structures or RV park U Other- __� Per ins coon U Egressllightingplan Invest illation 5ubmh sets of plan+with am of the alNtve. Other Ile shore are not applicable to temporary construction service• cation permit fee.....................$ _----- Plan review(at _ %) $ _------ Not all tudsdicoons rccept credit cant,pleaee call judedlction fix more inGxmarNro expires i a permitt is nottobtained State surcharge(8%)....$ — U Visa U MasterCard _ within ISO days after it has been (-redu cud number ------ xp re: accepted as complete. TOTAL .......................$ ._------ arae of card o i r as shown on cre it c s 440461 t(6Ir V'uMI Cardholder signature i mountA ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: __ -- —� TYPE OF V!ORK INVOLVED -RESIDENTIAL -NLY _ --.-.-..-. $75.00 Complete Fee Schedule Below: ResF ted Energy Fee................... ...................... Number of Inspections ermlt allowed (FUR ALL SYSTEMS) S=Vi - Residential ded: Items Cost Total Check Type of Work Involved: -per unit — W 145 15 4 D Audio and Siereo Systems' 1000 sq ft or less Each additional 500 sq.(t or 1 C� burglar Alarm portion thereof $33.40 _ $75.00 _,__ _ Limited Energy Garage Door Opener Each Manurd Home or M(xiular $90 80 _ Dwelling Service or Feeder _— ❑ tem' Heating,Ventilation and Air Conditioning Sy.� Services or Feeders Installation,alteration,or relocation $80.30 _ — f �] Vacuum Systems* 200 amps or less - $106.85 201 amps to 400 amps ------- $160.80 2 Other 401 - 401 amps to 600 amps __--— 2 601 amps to 1000 amps _` —_ $240.80—�_ 2 Over 1000 amps or volts $66 ___ $ .65 Reconnect only $88.85___ 2 L ONLY TYPE OF WORK INVOLVED -COMMERCIA $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 V.01 amps to 400 amps - $133.75 _ t Check Type of Work Involved: 401 amps to 600 amps Over 600 amps to 1000 volts, Audio and Stereo Systems see"b"abovd. Branch Circuits Boller Controls Now,alteration or extension per panel a)T he too for branch circuits Clock Systems with purchase of service or feeder fee. $6.65 __ __ 2 Data Telecommunication Installation Each branch circuit b)The fee for branch circuits Fire Alarm Installation without purchase of service of feeder tee. $4685 HVAC First branch circuit $6,65 Each additional branch circui — Instrumentation Miscellaneous (Service or feeder not included) $53.40 _- Intercom and Paging Systems Each pump or Irrigation circle $53.40 Each sign or outline lighting ❑ $75.00 _ Landscape Irrigation Control' Signal circult(s)or a limited energy panel,alteration or extension — 5145.00 _. Minor Labels(10) -- Medical Each additional Inspection over Nurse Calls the allowable in any of the above $62.50 _._ Per inspection - — $6250 Per hour -- $73 75 -_—_ Outdoor Landscape Lighting' In Plant ------ Protective Signaling Fees: Enter total of above fees $ � Other� r Number of Systems 8%State SurcL..rge ' No licenses are required. Licenses are required for all other installations 25%Flan Review Fee $ __---- See"Plan Review'section on front of appl"Iien ---- Fees: Total Balance Due ------ Enter total of above fees El Trust Account q 8%State Surcharge $-------"" - Total Balance Due All New Commercial Buildings require 2 sets of plans. 0dstslforms\elc-fccs.doc 08/30/01 02 Aug 01 15:43:54 R:\LT\P3PE.dvvg MAR 70- Lor covERAGE WRYOW HOUSE 1,589 SO Fr. HOUSE 1,589 SO. Fr LOr AREA towo sa FT DRIVEWAY 1,385 SO, Fr PERCENTAGE 14.7 x WALKWAY 220 SO. Fr. rOrAt AREA 3,191 SO. F r. LOT AREA 10,800 SO Fr PERCENTAGE 29.6 X 'j- W- 100,00' --————————————--———— )30 C;) 5' LANDSCAPE BUFFER 9 I XxXX-X ............ MAIN FLOOR titin I fit: EL :233 0' m I I I 1` CONC I ' iGARAGE IVEWAY I 13500 PSI I t,1. :2315' -J, 2 cl R;b III E 10000' I IIS ———————— X-X X-X- 2 t frAtt STONE RETAINING WAt I PROPOSED rRF[ ID KEEP PIYOPOSFO mr rt) wmOff 25' PRIVATE ACCESS, UTILITY, AND STORM DRAIN EASEMENT ,08101102 MRR C A L E 1 0 ALAN WASCORD DISM ASROCIA�Elllwmc Is NOT LAKE FOR THE ACCURACY'N T41 cjAWY CITY OF TIGARD =,*N It Is llsott,Rlspamsft I (* ESTATES ,,CtU0;mwl PARISH nutafn to KNIT AL of C"too'' PARCEL 3 Z152C ANY FILL PLACED ON THE SM AND NOTIFY THE 00MI49 or ANY OfflMlAt M0 e"WICA104 11385 SW. PONNER STREET BY SERGEIKRAVCHENKO LAOS MASCOM WSM ASSOMATIS.94. MLP 2002.0002 PH 15031 810-6436 y � C7 0 y � d � �"�1 1 �. n � c � � � � ..� � � 4� � � � .� c. � � � � o � 0 !�► �• co �. � � �. o � � � ro R � � � o °i �� < � � y � �� co F �+ � � ..� cti � ti � � � n g' ''� � o � C� s 0 o n 5 ,ZS a � a� o `� ._ Vl s IF CITU' OF TIGARD 24-Hour on Line: (503)639-4175 MST � - oo BtJ:LDING INSPECTION DIVISION Business Line: (503)639-41'1 BUP - - 3 - % AM7 PM __ BUP —.-- - Received __--Date Requested -- - _ ' Suite ____.--------- MEC - �i- Location —�1-3�1----- - - �D__�(v �.�5i PLM ( ) Contact Person ____._---- - - - Ph SWR - __ Ph(_ ) ---- ---- Contractor -- -- -- _ ___ ELC BUILDING Tenant/Owner — --- - ____— - - - ------ ELC F_ooting Foundation ACCeSs: 1 Z� ELR -_.-_-- Fog Drain Crawl Drain —- SIT - Slab Inspection Notes: Post&Beam _-- - - - Shear Anchors — Ext Sheath/Shear � Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm _ Susp'd Ceiling - cloot Other: ----- - — )PART FAIL Post&Bearn Under Slab -- - - Rough-In -- Water Service Sanitary Sewer -- Rain Drains _— Catch Basin/Manhole -�— Storm Drain - - — ----__— Shower Pan _- --- ---- in — ASS• FART FAIL -- ANICAL _ Post&Beam Rough-In - Gas Line - - --.-- Smoke Dampers Final --- - - - PASS PART FAIL Service --- - _—. Rough-In _ UG/Slab Low Voltage - - Fire Alarm Final Reinspection tee of$_. required before next in��ctfon. Pay at City Hall, 13125 SW Hell Blvd. _PASS PART FAIL Unable to inspect-no access SITE [� Please call for reinspection RE'. Fire Supply Line j ` /J \V ADA Inspector / Ext Date Approach/Sidewalk _.---._ - --- 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 Requested r AM_- _PM BUP Location - ! 3g /Y��t� --=s --Suite MEC --- Contact Person _ _-- l�__-_ Ph( ) 7 O PLM --._--_- Contractor ----------------- - --- Ph( ---) - --- ------ _-------- BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT __- Post& Beam ---- -- - ----- ------ Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing A.,,�� 1='•.ti.a}L X71 O S i aiv C3.�.[ .�c. [�%!i�i�� - - - Insulation Drywall Nailing IVl5i� - ''...iK Jul., `"'S'•'"S ��ovV� Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - Roof Other: - -ma _'PASS PART FAI - - --- - -- _ _�- _P_LUMBING_ _ — Post& Beam - Under Slab Hough-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 Linn Smoke Dampers na PART FAIL - RICAL Service Rough-In UG/Slab Low Voltage _-._- Fire Alarm Final u 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 ADAExt Approach/Sidewalk Data "� Inspector _4_14z. 06 ler:__ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL