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14450 SW FERN STREET J cn G { m z cn m m } I i ii , 14450 SW FERN STREET CITY OF TIGARO 24.Hour BUILDING MST Line: 1,503)09-4175 3 —�� 73 MST - --- INSPECTION DIVISION Business Line: (503)639-1171 BUP Received .--.----Date Requested_— ` —� AM— _ PM __ __ BLIP — Location — / �-157(DL-T- ` Suite �_... MEC Contact Person Z- — Ph( _) — — PLM -.---------__-_-- Contractor _---.-___ _— Ph( ) _ SWR BUILDING --1 Tenant/Owner — >> ELC Footing_ 5 � ' - U 6 �' - J ELC _ Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes -i — SIT --__-_----- ---- Post&Beam Shear Anchors Ext Sheath/Shaar ---- - - Int Sheath/Shear Fuming - -- - - Insulatiun Drywall Nailing - - -- - - cirewall Fire Sprinkler - - --- -- - -- Fire Alarm Susp'd Ceiling - - - Roof Other. - - _ in, _ -- PASS PART FAIL -PLUMING - - 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 [:l 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 fu inspect - no access Fire Supply Line ADA Approach/Sidewalk Date _ 1 _��3 ____ Inlp�ctor Ext Other Final DO NOT REMOVE thin Inspection record from the job site. PASS PART FAIL. l i�"FNCE ONLY Electrical Permit Ap Re " .ation CE1VCd Electrical) Date/By: Permit al City of Tigard Planning Approval Sign y g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use -� Internet: www.ci.tigard.or.us Date/By: Case No,: Contact Juris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information. —4r+L, . �' `I-�1A Ili V17±Wim,st.cileC{c all_t at 1. ew construction ❑ Demolition n-s�ervice over 225 amps- Health-care facility Addition/alteration/re lac crnent Other - commercial U Hazardous!ocation 0 [J____._____ Service over 320 amps-rating of [�Building over 10,000 square feet, „` ;;'.. CQNSTRUTIOJYI` ,a... . ? 1&2 family dwellings four or more residential units in & 2-Family dwelling ❑ Commercial/Ind_u_s_trial ❑System over 600 volts nominal one structure [I Building over three stories ❑Feeders,400 amps or more Accessory Building ❑ Multi-Family ` _ _ _ ❑Occupant load over 99 persons Manufactured structures or RV park Master Builder F1 Other: ❑Egressllightingplan Other: i7B SITE INFOR Aft AjTIb�i I t Submit-__sets of plans with any of the above. "—'�- -'--=-------`— �. The above ate out a 1 7IICable to temporaly c(n 9tructlon service. -Job site address 1 Z S w F e�'ri..tom i�;.+ ` '.C1U>L�E��; ,, ai:.. �.;... Suite#: Bld ./A t.#: Number of Ins ect ons per permit allowed Project Name: Description -- Ory I Fee(ea.) Total Cross street/Directions to Ob ore: New residential-single or multi-family per dwelllm--snit.Includes attached garage. Servict -eluded: 1000 sq.it.or less 145.15 4 Each additional X00 sq.ft.or portion thereof 33.40 1 Subdivision: Limited energy,residential 75.00 2 Limited energy,nonresidential 75.00 2 _Tax map/ arcel #: Each manufactured home or modular dwelling service and/or feeder Y 90.90 2 Services or feeders-Installation, alteration or relocation: Cie 200 ams or less 80.30 2 -- ---- — 291 amps to 400 ams _ 106.85 2 401 ams to 600 ams 160.60 1 2 PPEl IV oWtviari3 --r,d t ftk'N --�— 601 ams to 1000 ams =�. 240.60 1 -��--RO- --- - -----_ Over 1000 amps or volts 454.65 2 Name: __ Reconnect only 66.85 2 Address: Tempo, services or feeders-Installation, - --- - ---- alteration,or relocation: Cqy State/Zip: 200 ams or less 66.85 1 Phonc lax 201 ams to 400 ami _ 100.30 2 401 to 600 ams 133.75 1 'I._1 -.�.-_ — CYIMAC T PER.: - - _—�_..:.._..-_ ':� _----`�.=:-'----_-' Branch circuits-new,alteration,or Name: extension per panel: Address: A.Fee for branch circuits with purchase of 6.65 2 service or feeder fee,each branch circuit City/State/Zip: B.Fe-for branch circuits without purchase of ----- -- ---- -- --- -- -- service or feeder tee first branch circuit 46.85 2 Phone: _�F:Ir __ Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): Each um or irri ation ci..le 53.40 2 Each sin or outline li !ting 53.40 2 JOU No: Signal circuit(i)or a lirrited energy panel, alteration,or extension Pae 2 2 Business Nellie: _ - / Description: Address: O E_ Cit iState/Zi Each additional inspection over the allowable In an of the above: Per inspection per hour Lmin. I hour) 62.50 Phone F X: Investigation fee: -- CCB Lic. #: ? Lia #: -_S -C� Ot1ir Supervising electricia subtotal S signature Ce u d: ce t ' Plan Review 259%of Permit Fee S Print 16,11-1 c.#: -2_2 _ State Surcharge(8%of Permit Fee) S -- TOTAL PERMIT Authorized Notice: This permit application expires if it permit is not obtained within Signature: Dater-_ -- 180 days after it hits been accepted as complete. .Fee methodology set by Tri-County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forrns\ElcPermitApp.doc 01/03 Electrical Permit Aaalication-Ct of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems....................................................... $75.00 Check Type of Work Involved: Audio and Stereo Systems* Burglar Alarm Dgarage Door Opener* Heating,Ventilation and Air Conditioning System* 0 Vacuum Systems* 0 Other COMMERCIAL WORK ONLY: Fee for each system.......................................................... $75.00 (SEE OAR 918-260-260) Check Type or Work Involved: Audio and Stereo Systems Boiler Controls Fj Clock Systems Data Telecommunication Installation Fire Alarm Installation HVAC Instrumentation Intercom and Paging Systams Landscape Irrigation Control* Medical Nurse Calls Outdoor Landscape Lighting* Protective Signaling Other Number of Systems * No licenses are required. Licenses are required for all other installations t CustsTermit Forms\ElcPcrmit/',ppPg2.doc 01/03 + CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST 3 L INSPECTION DIVISION Business Line: (503)639-4171 77 BLIP Received /__,------ Date Requested_ ..L-.-- AM PM _ BLIP Location -L_ _ ---- -Suite_ _ MEC Contact Person _ � �-�=�Z- Ph (---) S 7-7 0 PLM Contractor ._..- --- -- -- --- -- Ph SWR BUILDING Tenant/Owner ___. —__— _ ELC �. Footing------- -- ELC - Foundation Access: — Ftg Drain ELR Crawl Drain — Slab Inspection Notes: SIT Post& Beam ----- - Shear Anchors Ext Sheath/Shear --- --- — Int Sheath/Shear � Framing _-- Insulation Drywall Nailing u " Firewall .r�,�-�y /LS c.,,, ,may/ QTe"� , - Fire Sprinkler Fire Alai mL�rTiS� OF /,ICC �PT7�3.ACLg ! nom_/� Susp'd Ceiling Roof -- -�-'D L✓u,�.��.. i��A�T /-c r�A�iQt��dural\ Other: _ PASS PART CfAidl� PLUMBING — Post& Beam - Under Slab --� Allies_ >`r` -r�t�' (�• ✓I�`�� Ut _,s C Acv . Rough-In Water Service - — Sanitary Sewer Rain Drains ---- Catch Basin/Manhole Storm Drain - - Shower Pan Other: - - - - - Final PASS PART FAIL MECHANICAL_ --- --- - -- — --- - Post&Beam Rough-In Gas Line Smoke Dampers -- -- _ i A PART FAIL ----------- ELECTRICAL Service Rough-In - — — UG/Slab Low Voltage - - - - - --— -- --- Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE F] Please call for reinspection HE -- ___-_-... L] Unable to inspect no access Fire Supply Line ADA Approach/Sidewalk Date C t Inspect Ext _ Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING I Inspection Line: (503)539-4175 MS �� 7 INSPECTION DIVISION Business Line: (503)639-4171 _ BUN Received Date Requested - AM PM BUP Location ��- Suite �� MEC ¢-__1 Contact Person _ Ph(_ ) >' 2:Z PLM Contractor Ph( ) SWR 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 - — Insulation _n Drywall Nailing — Firewall Fire Sprinkler \J Fire Alarm Susp'd Ceiling Roof Other: Final PA-,SS- RT FAIL - ----- LU IN n11391—m— Under Slab --- Rough-In Water Service ------ — Sanitary Sewer Rain Drains -- -- ---- Catch Basin/Manhole Storm Drain �- — — Shower Pan OthaL I PAS _PART _FALL - — NICAL _ Post& Beam Rough-In - - ----- Gas Line Smoke Dampers -- -- --- ---- Final PASS RT FAIL -- -- - ECT AL Service --- — - -- — - Rough-tri ---- UG/Slab Low Voltage Fire Alarm WASPART FAIL Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. SI [ Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA �� /�'�� Approach/Side-Valk Date 3 InspostOr- -__—_--Bxt - Other: Final DO NOT REMOVE thls Inspection record from the fob oft*. PASS PART FAIL /�— Thi s 1 does not nuthorize the violation of any V rights ho rs of private easements. The up - u 4, surge to contact any such parties and �,.;MI Curr thio app vat before commencing work. n FHy6KPczy aad Eaztl $cicatcs r April 4, 2003 Mark Britcliffe CITY OF TIGARD 27485 SW Zanthus Street Approved........................... ..... Sherwood, Oregon 97140 Conditionally Approved......................f >: For only the woLk as described in: PERMIT N0, S ZZ 200 3 WO�g Re: Slope Block Retaining Wall Design, 14450 and 144 tSrt�`t r obe tr el'-Ti ardi , ..•J%p ( 1 ..S. Oregon D Jub Ad'r s: RECEIVEBy _ � Date - Dear Mark: OF1'ICF. COPY MAf u a 1003 At your request Willamette Engineering and Earth Sciences (Willamette) ha:; completed the cross section design for a maximuT>'� taining wall system constructed from Slope-BlockTM modular concre I� f I�'units, at the above referenced site. Based on our discussions, WillamF•tte. understands the project will involve constructing the wall against a cut slope created to allow placement of the structures approximately as shown on Figure 1. The retaining wall section used in the design was considered the critical section for the entire installation, as it was the maximum height. Willamette understands the base of the wall will be founded in compacted aggregate fill. The wall will retain aggregate fill and . residual native silts and clays. RETAINING WALL DESIGN Willamette utilized the design and stability analysis methodology outlined'in the Slope Block Design Manual (Willamette, May 1997) to design the retaining V'Ut ccctio-i Jamc assumptions for the modular block wall stability analysis are as follows: • 1�J+J+ r r 1. Wall backfill material is a free draining well-graded crushed stunt or vggrPrv3te ". mixture. The material will be considered cohesionless. t 2. The interface friction angle between the backfill and wall is qtml to or greater than 2/3 the internal friction angle of the backfill material 1 3. Active earth pressures on the wall are determined b tsed on modified Coulomb theory. The Coulomb earth pressure coefficient, Ka, is increased by 20 percent to account for uncertainty in design. Cohesion in the retained soil is accounted for by methods presented in Foundation Analysis and Design(Bowles, 1982) 4. The block-on-block interface frictional coefficient is 0.70 based on data published in Naval Facilities Design Manual (NAVFAC DM) 7.1. i i P.O. Box 1139, Dallas,OR 97338 _ (303)623-0304 Retaining Wall Drsign, 14450 SW rern.VUS i �t Mark Britcliffe MBR-001.001 April 4,2003 Page 2 5. Adequate drainage is provided to reduce hydrostatic pressure build-up behind • +}�� wall. 0. n 01' 1 9-inches of compacted backfill is placed behind the wall. 7. Stability ol'the excavated slope is the responsibility of the contractor. Analysis methodology was developed firr the most critical installation option, which is constructed with the smooth block face out. I'he internal stability (local overturning and sliding) of the exposed split block face wall is greater than with the smooth face. External stability (global overturning) is the same. Design calculations therefore consider the less conservative case. The design wall cross section is presented in figure 2. The maximum wall height above the finished ground surface in front of the wall is 13-feet. The wall is inclined 28-degrees into the slope and is backed by an average of 2.0-feet of compacted angular aggregate. The wall was analyzed with a surcharge loading of 50-psf to accommodate light traffic loading. Soil parameters for the retaining wall stability analysis were based on presumptive soil values and data provided. Willamette analyzed the retaining wall for the stability of the compacted, cehesionless, aggregate backfill, and for the cohesive soil. A friction angle,gl;:• • •• IF aegrees was used to model the cohesionless aggregate fill. Based on our experience Arra,, the data provided, a cohesion intercept of 250-psf and an angle of internal friction of 29,••• degrees were selected to model the cohesive retained soil. The mi-iimum factor of safety calculated for the wall is 1.9 against overturning a.id greater" than 5 against sliding along the base, or shear failure in the wall for the roh.ssiv,? r-wined � soil, for the, static case. The minimum factor of safety calculated for the wail is 2.2 cgainst overturning and gteater than 5 against sliding along the base, or shear failt-re in the %rill For the cohesionless aggregate fill, for the static case. The factor of sa.2) red►wed .o a minimum of 1.6 for the quasi-dynamic earthquake loading of 0.2 gravities. Bearing pressures for the wall footing are a resultant of the forces acting pare Ilel to '.*he w-Ill axis. The bearing pressures are computed to be on the order of 1,000 pa:. The allowable bearing pressure anticipated for the soil conditions is on the order of 1,500-psf. A summary of the design calculations is presented in Attachment A. Willamette has included spreadsheet analysis for both static and quasi-dynamic, analysis of the wall for each of the cohesionless and cohesive backfill conditions. Willamette also included output from SRWall, Version 3.22, from the National Concrete Masory Association. ?V alts tctee Retaining\\all 0019n. 144iO S\� I:ein\nes CK�f-qcc utg and c;azrk ,� sgeed Mark Britcliffe MR 001.001 April 4, 2003 Page 3 CONCLUSIONS Willamette believes that the design wall system is stable for worst case static loading conditions. The analysis assumptions are detailed above. The wall construction will require careful control of wall inclination, as variation in the wall angle will cause significant changes in the factor of safety. The mini1rr11m factor of safety for the analysis of the cohesive backfill case is 1.9, however, the analysis does not consider the strength of the aggregate wall backfill which will significantly increase shear and overturing resistance. Analysis of seismic loading conditions for both cases yielded a factor of safety greater than 1.0. , The dawings provided in this report are included to provide design detail regarding wall inclination and construction requirements. Physical wall location on the project site and setbacks from property lines are not included in this report and should be provided by the engineer responsible for civil aspects and site grading. 'lo• •• • • . 1.„ • ••�!!J • J 9 �t'�ClcrlC�c Retaining Wall Design, 14430 SW FemA qs L'Hgi.reeuag ,..c( Gctatlr ,ccincet 1 1 1 Mark 13ritcliffe MBR-001.001 April 4, 2003 Page 4 Willamette appreciates the opportunity to assist you with this design. If you have any questions, please call me at (503)623-0304. Sincerely, V?Uafe&C 5-94-'�" Emd s D PROpe 0.ED PRO ' t�G I NSF p AGIF � 9 170 3 17 3 � REG , 9a -Cr 9, FRT J EXPIRES 06130/04 , Robert J. Slyh, P.E. Principal Engineer Attachments: Figures 1 and 2 • Limitations .•^ ' ' A: Wall Stability Analysis •' r.w ui t1.di i4,iLn, I J 0.1)%% 1 cin 11)a GNSutCCti.f3 Q�e>j G�=!k ,�CtCrtGtd �wrr.rr moo, 4'trVj rORNIRAIM rmm M a We OF OMT.ML FIRAP ry OeMILTER FAaRX. GORMT TO V M 5D. Jr AW Sw Wt.K44 nAPS I SM6.MR.ADM IPO. Kw4flw? soar V7 %w T. 611 it I' I I LIV Ito I 1 1, 1 lt 11,011 1 1 , iB r GAR 1 C , J Man =exmw M //, /I#01 .0 VIC!, % I cc p"LHTS f ,1� .' \ 1,1;1 x\11`111\ � C I`GAR�MQ I ( +/ ., I%'� ( ,��_.. v Lh/ EXMV 5.'.To EA UNIT(KM r F ICIAM Prue.NOTALL M%UPC f ? i CAR It IS.7 /�� .,, ! jAR 110 z_zz*_" LIV OKA= FXTfNT (0- 1 1 Fm"9wmA= PR 81w cr rto or LM(4 PLCW TU MT11t EAMI'M To 10 to.Mr.3 1" ij\MI*F49eRwr NJ 1917 Man WRAP M400-ftWIR FMM 4 y II M WATER MIENS 0 MPALL FOR VrL(i� A OUTY PLAN SITE ev o p le, ri ri I o (.1ocictd-rd seni, v to I-J) CI IN (tF TIGArID - SITE PLANNING DIVISION: Reyliired Sethacl;s: I9R,--,'(rprvvcd ❑ Not Apprmed `yule. J S!n•:'I -Ilie. /J I low. !11:i�irnun E�ttil )in•� H�'i�:�lt �- Ir '► ff \k`. sClv ICc I'fo\ IIiCC I,rltef KcUtUfc'(: .,eyes `...i li.: 1•I ,�oJ __ _! Actual ')lupv: Lr—% J!rApprovud ❑ No' .Apprk--J Site Pian: (Approved Nrt ;1(,nrr ed [is. M•Mtapo*0 Date: Noiv,, I u.m Bob To Mark Hnudlfle Date 1115!2003 Time.7.5948 Alin Paye 2 of 4 V&IMCM .5.rg4atea1(aq rtad Sdit4 .5dencea November 4, 2003 Mark 13ritclifte 27485 SW lanthus Street Sherwood,Oregon:7140 Re: Slope Block Retaining Wall Constnlction Observation, 14450 and 14458 SW Dern Street:'Tigard,Oregon Dear Mark: At your request Willamette Engineering !111(1 Earth Sciences(Willamette) has completed two site visits and observations of the Slope Block retaining .vali oonstntcted at the above referenced site. 'Elie design called for a maximum 13-foot high retaining wall system as described in Willamette's retaining wall design report dated April 4,2003. The maximum as-built wall height above the finished ground surfitce in front of the wall is 13- 1iet. The wall is inclined at approximately 28-degrees into the slope. 'llte wall is reportedly hacked by an average of 2.0-1eet of compacted angular aggregate, although aggregate thickness at the top of the wall is significantly less. Willamette completed two dynamic cone penetrometer(DCP)tests to depths ofgreater than 2- 12 tet in the wall backfill to test compaction. Penetration resistance was measured at approximately 2 blows per inch over the depth of the test. The aggregate appeared to he a '., open graded cntshed rock which should he relatively free draining. CONCLUSIONS Willanletle believes that the wall system is stable as constnicted, and also believes that the wall constntctuction meets the design intent. The relatively titin backfill zone at the crest of the wall should he acceptable provided the average backfill thickness meets the design specifications as reported. DCP testing indicates the aggregate tested is compacted to approzitnately 95 percent of standard proctor which should he adequate Ibr the wall stability. P O Box 1139, Dallas,OR 97338 (503)623-0304 IICIIIIIIIIIk 1YIIII CoII'II11C1.ml Vi'Il. 1.1110 MV rem Hl'; Udid. I'IIbILUU3 I IMS,/.bY Q1 AM Page 3 o1 4 Mark RritcliM IMBR-001.002 November 4, 2003 Page 2 Willamette appreciates the opportunity to assist you with this project. If ,,oil have an' questions. ,!lease call me at(503)623-0304. Sincerely. a �a S PROA4 Z131,R r� 1 ,pt,�ch�,, w a „ A EXPIRtc!�01513c)•j4 Roberi J. Sl'h. 1'.I;. Principal Fngincer ;Attachments: Limitation �✓IY,�QHYC1�1 P Ndennil�l�'ell:'xlynlnuul Visil.144511 SW rmn\its u.rgi«cru.ro rt.rd ga,r, Smewrd CITYOF TIGARD SITE WORK PERMIT DEVELOPMENT SERVICES PERMIT # : 2 00028 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED : 110/0/22//00 3 PARCEL : 2S104BC-05000 SITE ADDRESS: 14450 SW FERN ST SUBDIVISION: MLP96-0011 JEFFRF ' ZONING : R-7 BLOCK: _ LOT: 00_2 JURISDICTION : TIG GLASS OF WORK: OTR � PAVING ?: RESO. NO: TYPE OF USE: SFA GRADING ?: VALUE: 2,000.00 EXCV VOLUME: cy LANDSCAPING?: FILL VOLUME: cy SITE PREP ?: ENG FILL?: STORM DRAINS?: SOILS RPT READ?: IMPERV SURFACE: sf Remarks: Retaining wall Owr or: FEES MARK R DARLA BRITCI_IFFE Description v Date Amount 27485 SW XANTHUS CT. — SHERWOOD, OR 97140 1I1-I)l I'rmr Fee-Valu 10/22/03 $62.50 [BUPPLhII'InC'k-Valu 10/22/03 $40.63 Phone: 503-925-8387 ITAX1 8 tit Tax-Valu 10/22/03 10/`22/03 $5.00 Total $108.13 Contr,ctor: M & D INSTALLATION INC. 27485 SW XPANTHUS CT. SHERWOOD, OR 97140 Phone: 503-925-8387 Reg#: LIC 91116 Required Inspections Final Inspection 1-1lis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work iF- suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR J52-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: .`y,�16r K►t a �� `� Permittee Signature: Call (503) 639-4175 by 7-00 P.M. for an In6pectlon needed the next business day Site Work Building Permit Application Received7 Building DBte/B : Permit No S C -' y „�, r Planning PFro al Other Cit of TI.gand � ED Date/By; Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Perri►No.: n Post-RevPhone: 503-639-4171 Fax: 503-595-1960 Datc/B y: Land Ilse ate/ Case No. Internet: www.ci.tigard.or.us Contact Juri�.: 19 See Page 2 for 24-hour Inspection Request: 503 639-4175 Name/Method: — _ Supplemental Inm foration TYPE OF WORK REQUIRED DATA: El New construction Demolition1 &2 FAMILY DWELLING Addition/alteration/re laccment Other: CATEGORY OF CONSTRUCTION Note: Permit fees'are based on the total value of the work performed. Indicate 1 &2- amily dwelling ommercial/Industrial the value(rounded to it.,:nearest dollar)of all equipment,materials,labor, overhead and profit for the work indicated on this application �� Accessory Building — Multi-Family Master Builder ❑_Other: Valuation........................................................._s+ - JOA SITE 1NFORMA'f Nand LOCATION of 17 bedroom No.of baths — ` To number f floors..................................... _ Job site address: (4450 l Z- �1� 2 New II g area(sq.ft.).............................. Suite#: Bld ./A t.1l' --- — Garage/ rt area(sq.ft.)............................ -—_ _ Project Name: _ '73RJ 7-eA t- — Cover pore ea(sq. R.)......................... Cross street/Directions to job site: De arca(sq. ft.)ea(s................................. ... _. O cr structure area(s (t.)........................... REQUIRED DATA: ` S' COMMERCIAL-USE CHECKLIST Subdivision: _ Lot#: -- Tax ma / arcel#: .1�5 /D 113_e-`O S 9O O Xc ,de.'d rmit tees•arc base n the total value of the work performed. Indicate K DESCRIPTION OF WORK — (rounded to the rest dollar)of all equipment,materials,labor, --- end profit for a work indicated on this application. __ — ---- n.. ..... ..............................................bui g area(sq.ft.).........................ld g a(sq. R)..........................7- 2-� — storic ......................................... PROPERTY OWNER TENANT constructio ...................................cy group(s): Existing: N e: New: Address:27`t�S_ �' •-v w C Cit /State/Zi NOTICE: All contractors and subcontractors are required to be Phone: S ( Fax: 1`? S licensed with the Oregon Construction Contractors Board under APPLICANT CONTACT PER ON provisions of ORS 701 and may be required to be licensed in the Business Name: jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing,the following reason applies _Address: ---- -- -. - - ---- City/State/Zip: _-- — -- - -- ------- - Phone: Fax' - —_ --� BUILDING PERMIT FEES* E-mail: _ Please refer to fee schedule. CONTRACTO --- _Business Name: � )-may � �� lees due upon application.............................. S Addresi7z L S cel i -- � Amount received............................................. S Cit /State/Zi : % _ Phone:S-/ - v J Fax: Date rcoetved:, - Authorized Notice: This permit application expires if a permit is not obtained within Signature: _��.. _ l Date:_ IAO docs after it has been accepted as comrlete. 'Fee methodolop set h� 1 rl-( ouot% liulwmg Industry Service Board. t t ►�� t ,�.t . r � , (Please print name) � I:\Dsts\Permit Forms\BldgpermitApp doc 01/03 SITE WORK PERMIT CHECK LIST Commercial, Multi-Family (R-1 occupancy) and Residential: Please complete all items below, unless otherwise noted. -- - -------- -- Excavation Volume: _ -__ _ cu• yds. Grading Volume: tSoils report required for >5,000 cu. yds.) cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum densit cu. yds. Retaining structure? (Check one) U Rock U CMU LJ Concrete LJ Other U *Total new impervious area including all buildings, sidewalks, and paving _ -_ sq. ft. --- — --------_ _ - ._---.--------- Site Utilities Plumbing Work: Complete the "TAN" Plumbing Permit Application for site utilities plumbing work. Plans Required: See "Site Work Permit Application - Plan Submittal Requirements" attached. The following mus.accomany this application: _ Site Plan with Vicinity Map showing *Parking (including ADA) and ADA compli, .ice _ Lighting Plan TGrading Plan and details — *Landscaping Plan Erosion Control Plan and details Soils Report (if required) Retaining Structures *Does not apply to 1 and 2-family dwellings. F— # of Plaris TYPE OF SUBMITTAL Required at (Includes New, Additions or Alterations) Sub Ittal Commercial Multi-Family R-1 Occupancy One-- & Two-Family Dwelling NOTE: Plan review Is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). i\dsts\forms�sitechecklist.doc 09/24/01 Tuesday, September 30, 2003 CITY OF TIGARD Robert M. Slyh, F.E. OREGON Willamette Engineering and Earth Sciences P.C. Box 1 139 Dallas, OR 97338 Re: SIT2003-00028 and SIT2003-00029 Dear Mr. Slyh: Please include reference to the following items in your final structural observation report for the above retaining wall projects located respectively at 14A50 & 14452 and 14456 & 14458 SW Fern St. in Tigard Oregon. 1. Adequacy of the placemznt and compaction of the crushed aggregate leveling pad for the base course of"Slope-Block" retaining wall blocks. 2. Adequacy of the placemQnt and compaction of the crushed aggregate backfill behind the wall. 3. Adequacy of the provided drainage. 4. An explicit affirmation that the wall as constructed will adequately stabilize and retain the cut slope. 5. Final acceptance of wall construction. Thank you for your cooperation. Sincerely, Mark VanDomelen Plans Examiner cc: Applicant mark Britcliffe, 27485 SW Xanthus Ct., Sherwood, OR 97140 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 TDD (503)684-2772 — p►RD — MASTER PERMIT CIT , OF TIG PERMIT#: MST2003-00173 DEVELOPMENT SERVICES DATE ISSUED: 6/18/03 �- 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 SI'i E ADDRESS: 14450 SW FERN ST PARCEL: 2S1048C-05900 SUBDIVISION: MLP96-0011 JEFFREY ZONING: IZ BLOCK: LOT: 002 JURISDICTION: I It i REMARKS: SF (Duplex) 14450 and 14452 SW Fern. BUILDING REISSUE: STORIES: FLOOR ARE^Q REQUIRED SETBACKS _ REQUIRED _ CLASS OF WORK: NEW HEIGHT 25 FIRST 950 of BASEMENT: sf LEFT 11 SMOKE DETECTORS. r TYPE OF USE: SFA FLOOR LOAD: 40 SECOND: 2,130 of GARAGE: 0ftif sf FRONT "I, PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: THR) 0 of RIGHT: , n TOTAL: 3.080 of VALUE: 308,551 do REAR OCCUPANCY GRP: R3 BDRM: BATH !`• PLUMBING SINKS: e' WATER CLOSETSWASHING MACH: < LAUNDRY TRAYS: RAIN DRAIN: lou TRAPS: LAVATORIES: 6 DISHWASHERS . FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS. _ CATCH BASINS: TUBISHOWERS. 4 GARBAGE DISP : WATER HEATERS: WATER LINES: 100 BCKFLW PREVNTR GREASE TRAPS: OTHER FIXTURES. MECHANICAL _ rUEL TYPES FURN<TOOK: 0 BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER. FURN>-TOOK: 0 UNIT HEATERS: HOODS OTHER UNITS. MAX INP. blit FLOOR FURNANCES: VENTS: WOODSTOVES GAS OUTLCTS: 0 _ ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS t INCH CIRCUITS MISCELLANEOUS _ADD'L INSPECTIONS WOO SF OR LESS: 1 0 - 200 anip 0 2r 'arnp WISVC OR FDR PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500fIF. 7 201 - 400 arnp 201 ..OD arnp. 1st WIO SVCIF DR. SIGNIOUT LIN LT PER HOUR: LIMITED ENERGY: 401 - 600 amp. 401 - 600 amp: EAADDL RR CIR SIGNAL/PANEL: IN PLANT. MANU HMISVC/FDR 601 - 1000 ainn BUT-amps-1000x. MINOR LABEL: 10004 ampivolt. PLAN REVIEW SECTION _ Reconnect onl:•. >-4 RES UNITS: SVCIFDR>-225 A.. >600 V NOMINAL. CLS AREA,SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL At IDIO 8 STEREO. VACUUM SYSTEM. AUDIU 3 STEREO: FIRE ALARM, INTERCOMIPAGING: OUTDOOR LNDSC LT DURGLAR ALARM. OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL GAPA 3E OPENER. CLOCK INSTRUMENTATION: MEDICAL. OTHR HVAC, DATAITELE COMM: NURSE CALLS. TOTAL"SYSTEMS , Owner: Contractor: TOTAL FEES: $ 13,549.83 MARK &DARI_A BRITCHIFF M& l7 INSTALLATION INC. This permit is subject to the regulations contained in the ARK SW RLA BRI CT 2!485 NS XA INSTALLATION THUS..^.IN Tigard Municipal Code,State of OR. Specialty Codes and 11�11855HLRINOOD,OR 97140 SHERWOOD,OR 97140 all other applicable Taws. All work will be done i accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or it the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503-925-8387 Phone: 503-925-8187 Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You RSD"' LIC 91110 may obtain copes of these rules or direct questions to OUNC by calling(503)246-1987, C 4 C1 cU �/ REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Ins{ Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Lew Voltage Roof Nailing Mechanical Fin71 Footing Insp Crawl Drain/8arkwater Electrical Rough In Gas Line Insp Water Line Insp Plumo,-'^..;i Foundation Insp PLM/Underfloor Framing Insp Insulation Insp Water Service Insp Building Final Post/Beam Structural Mechanical Insp Shear Wall Insp Firewall Insp Appr/Sdwlk Iris Issued By : jet - Permittee Signature Call (508) 1;39-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TdGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00163 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 6/18/03 SITE ADDRESS; 14450 SW FERN ST PARCEL: 2S10413C-05900 SUBDIVISION: MLI'96-0011 .IE'FFRI-Y ZONING: It-7 BLOCK: LOT: 002 JURISDICTION: TI(Ii TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 2 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new Duplex. 14450 & 14452 SVV Fern St. Owner: — - FEES BRITCLIFFE, MARK & DARLA Description Date Amount 27.185 SW XANTHUS CT, SHERWOOD, OR 97140 ISWUSAI Swr Connect 6/18/03 24,600.00 S W USA I Swr Connect 6/18/03 $0.00 Phone: 503-925-8387 1SWINSP] Swr Inshco 6/18/03 $35.00 Contractor: ISWINSPI Swr Inshct 5/18/03 $0.00 Total $4,635.00 Phone: Reg#: Required Inspections chis 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 riot guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the instal'r shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm .7 f t j L� lt�e 1114.-4,�01, Issued by: Permittee Signature,_ / Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next buss day r Building Permit Afflicatio>I>t ' IZeceivea � Building �L Date/By: /-05 t Permit No.:f vti/aCy;, -00/ii r City of Tigard Planning Approval Other -- E C E��/C P P a n g Permit No.: �J 13125 SW Hell Blvd. �/ I••- Plan Review other Tigard,Oregon 97223 Date/By. Permit No.: r Phone: 503-639-4171 Fax: 50_19103 Post-Review Land Use �? e ')ate/By: Case No. —_ V Internet: www.ci.tigard.or.us Contact Juris. See Page 2 for 24-hour Inspection Request:CKNOf-AMARD Name/Method: _ Supplemental Informallon (Y' \\) AUILDING DIVISION TYPE OF WORK ] REQUIRED DATA: '0 -, New construction Demolition _ I&2 FAMILY DWELLING ❑ Addition/alteration replacem _ ent Other: CATEGORY OF CONSTRUCTION the Permit fees*are based on the total value of the work perhormed. Indicate 1` I &2-Family dwelling � Commercial/Industrial the value(rounded w the nearest dollar)of all equipment,materials,labor, � — — — - overhead and profit for the work indicated on this application. -Accessory Building ❑ Multi-Family ti Master Builder _ ❑Other: Valuation.... JOB SITE INFORMATION and-10CATIO No.of bedroomsNo.of baths:-3-Total number of floors.........,.. o - - New dwelling area(sq.R.)...7G'. ........ Suite#: / �'� Bid JA t.#: Garage/carport area(sq.R.).... q ........ Project Natnc. Covered porch area(sq. ft ......... Cross street/Directions to job site: Deck area(sq. If)........ ..•.....I.......... Other structure aret (sq. R.).. ........................ '-- - REQUIRED DATA: COMMERCIAL-USE CHECKLIST Subdivision: Lot#: --- —�� Tax ma / areal �!: . I-) J Note: Permit fccs•are hosed on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollrr)of all equipment,materials,labor, -- - overhead and profit for the work indicated on this application. Valuation.................................. ...................... $ -- - Ex;sting building area(sq.R.)......................... -- - --- -- ---- New building area(sq. R.)..•............................ Number of stories............................................ Ll PROPERTY OWNER 7'ENAN ' Type of construction....................................... _ Name ( - Occupancy group(s): Existing: New: Address'. Cit /State/Zi tate/Zi - x71 i 9 NOTICE: All contractors and subcontractors are required to be Phon O� a �� 9� licensed with the Oregon Construction Contractors Board under 1:2-APPLICANTONTA T PERSON provisions of ORS 701 and may be required to be licensed in the Business Name- O l _�L 7,'l4 ej,-- ff, jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing,the following reason.applies: Address: Jo Phor - � F > �7 - � BUILDING PERMIT FEES* E-ma11: Please refer to fee schedule. CONTRACTOR ---- - -- --- -- Business Name: /� „Jt1s_ G �1L_400 eFccs due upon application..._ Address: 7y Cil /State/Zi : 7/yam Amount received ...._. ... . Phots - TJD Fa Z Date received:___ CCB Ic. ZZ * _— - --- Authorized Notice: Th' permit application expires Ira permit is not obtained s0thin Signature: _--i— -- — Dater D 3 I8(1 da%� after it hrs heels acuyited as complete. _ *Fee oicomdolop -.et 1» 1 ri-( ount) Building Industry Service Hoard. - (Please print name) I\ustsq,enttit I;omts\IlldgPcrowApp.doc 01/03 Commercial Plan Submittal Requirement Matrix City of Tigard TYPE OF SUBMITTAL #of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Building 1* Fire Protection System 3** Mechanical 2 Plumbing - 130ding Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plar, review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plans. **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i\dsts\forms\CUM-matrix,doc 9/24/01 i Mechanical Permit Application Received Mechanical Date/BL. Permit No.:�l 1� •` '✓- /// City of Tigard Planning Approval Building Date/By Permit _ Permit No.: 13125 SW Ball Blvd. Pian Review Other Tigard,Oregon 97223 Dateiny: Permit No.: -- Phone: 503-639-4171 Fax: 503-598-1960 Post-Review e Datc/B3 Internet: www.ci.tigard.orms contact Juns. See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method _Su Icmenlal Information. TYPE OF WORK COMMERCIAL *S F.CIIECKLIST New construction Demolition Mechanical permit fe II�dFlsli�hluc of the work Addition/alteration/replacement r Ulher: J performed. indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materiels,equipment,labor,overhead and profit. E] 1 &2-F3mi1 dwellin C'onurlercial/Industrial Value: S See Page 2 for Fee Schedule `r�� y — ------ - RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE Accesso Buildin ' Multi-Family ---- -- Description Qty Fee(ea.) 'rolal _❑ Master Builder Other: ----- Henn cooun _ JOB SITE INFORMATION and LOCATION Furnace-add-on air conditioning**. 14.00 Gas heat um 14.00 Job site address: ' ,-�� '� &F— L? �/-/I L. // ' ,� Suite#: Bld ./A t.#: Duct work 14.00 �- FI dronic hot water system 14.00 Project Name: ' Residential boiler Cross street/Directions to job site: for radiator or h dronic system) 14.00 Unit heaters(fuel,not electric) in wall,in-duct,suspended,etc.) 14.00 Flue/vent for any of above 10.0 I Subdivision: Repair units — 12.15 Lot#: T Other Fuel Appliances _ Tax map/parcel #: atcr heater _ 10.00 — 4 _ RSCRIPTIQN OF WORK Gas fire lace_ 10.00 Flue vent(water heater/ as fireplace) 10.00 - ---------- Log lighter as _ 10.00 -- Wood/Pellet stove 10.00 _ Wood fireplace/insert 10.00 _ Chimney/liner/flue/vent 10.00 PROPERTY OWNER TENA T Other: — 10.00 Name— _ Environmental Exhaust do Ventilation Range heod/oth..r kitchen equipment 10.00 Address: c-,'/' Clothes dryer exhaust 10.00 City/State/Zip:5//fir r 1W Single duct exhaust Ph( (bathrooms,toilet compartments, APPLICANT I El CONTACT PERSON utility rooms) 6.80 -- NameAttic/crawl space fans I O.OU afilii/lam/. i�� /Sri yl/.• )' +�- - other: ----� — 10.00 Address:2 Jzl 1 ef ri /ry f e"f _ Fuel Piping _ Cit /Sy tate/Zl f%' ?�7� 71 C "05.40 for first 4,51.00 each additional -� Furnace etc. one' •• Ph " , � - 5 3 Fax?,<,--,? ,Z� Fax5 3I L Gas heat pump '• __ E-mail: Wall/suspended/unit heater '• _ CONTRACTO_Rn Water heater __ •• _ Business Name: lew,t3 t'e .LA6101-1Fireplace -- Range -- •. Address: '�q ► ► r BB •• City/State/Zip: .C, (_)VL ?-/0(r( Clothes dryer(gas) Phone: 9.fj-9n " 5b 7! I Fax: ether:_ — •• CCB Lic. #: [09-)15-71 _ �._-. Total: _ __ Mechanical Permit Fees* Authorized _ Subtotal: S _ Signature. Date:----- _ ----_Minimum Permit Fee'4'72.50 S _ Plan Review Fee 25%of Permit Fee S (Please print name) State Surcharge 8%of Permit Fee S TOTAL PERMIT FEE S Nntice: This perrnit application expires If a permit Is not obtained Nithln *Fee methodology set by TN-County Building Industry Service Board. 180 dm's after it has been accepted as complete. **Site plan required for exterior A/C units. I"PstsU'ermit Fnrms\MccPemutApp doc 01'03 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuations I Permit ee: $1.00 to$5,000.00 Minimum fee$72.50 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thc;�of taandincludin $10,000.00. $10,001.00 to$25,000.00 $148 M for the first$10,000.00 and $1.54 for each additional$100.00 or fraction thereof,to and including $25,000.00. $25,001.00 tc c` ,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,001.00 and up $742.00 for the first$50,000.00 and $1.20 for each additional$100.00 or fraction thereof'. Assumed Valuations Per Ap lienee: ----- --- Value Total Descnption: tL _f(a_ Amount Furnace to 100,000 BTU,including 955 ducts&vents Furnace>100,000 BTU including ducts 1,170 &vents __— Floor furnace including vent 955 Suspended heater,well heater or floor 955 mounted heater Vent not included in appliance rmil 445 Repair units 805 <3 hp;absorb.unit, 955 to 100k BTU 3-15 hp;absorb.unit, 1,700 101 k to 500k BTU 15.30 hp;absorb.unit,501 k to 1 mil. 2,310 BTU — .f0-50 hp;absorb.unit, 3,400 1-1.75 mil.BTU _ >50 hp;absorb.unit, 5,725 >1.75 mil.BTU Air handling unit to 10,666 cfm 656 Air handling unit>10,000 cfm 1 170 Non- ortablc evaporate cooler 656 Vent fan connected to asin Ig a duct 446 Vent system not included in appliance 656 rmit _ flood served by mechanical exhaust 656 Domestic incinerator 1,170 Commercial or industrial incinerator 4,590 other unit,including wood stoves, 656 inserts,etc. Gas piping 14 outlets 300 Each additional outlet _ 63 TOTAL COMMERCIAL VALUATION: i i i i\Usts\Pcrmit Fomcs\MccilerrnitAppl'g2 doc 01;113 Building Fixtures Plumbing Permit Application Received Plumbing Date/thy: Permit No.: 1 CityCit Or Tigard Planning Approval Sewer Date/ny Permit No.: 13125 SW Hall 131vd. Plan Review Othrr Tigard,Oregon 97223 Date% Pen-nit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Datc/Dy: case No.: Internet: www.ci.tigard.or.us contact Juris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: _ Supplemental emental Information. TYPE OF WORK FEE*SCHEDULE(for special Information use checklist New construction Demolition Description Qty. Fe (ea.) Total _Addition/alteration/replacement ❑Othel New 1-&2-farnlly dwellings — CATEGORY OF CONSTRUCTION Flt(I bath includes 100 ft.for each utllit conne249) 20 1 &2-Famil dwellingCommercial/Industrial_ SFR 2)bath 350.00 Accessory Building Multi-Family — SFR 3 bath 399.00 Master Builder Other: Each additional bath/kitchen _ 45.00 _ JOB SITE INFORMA'CION and LOCATION Firesprinkler-sq. n.: Pae 2 Jab site address: Yy SpJ�, ;/ site Utilities Suite M Bld ./A t.#: Catch basin/area drain _ 16.60 Dr ell/leach line/trench drain _16.60 Project Name:4-',' / ' 7 Foolingdrain(no. linear Il. Page 2 o Cross street/Directions to b site: ---�- — .) Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector _ Ili 60 Sanitary sewer no. linear al. Pa gc 2 Subdivision: WY— _ Lot#: Storm sewer(no. linem ftp- Pa e 2 Water service no. linear n. Pu e 2 Tax ma /parcel #: I �' �CFixture or Item DESCRIPTION OF WOl t' Absorption valve IG.6O _ V Backnow preventer Papc 2 _ Ha-kwater valve _ ..60 -�-- —------ - --- - -- - Clothes washer 16.60 V ----- ----- ---- - - - -- Dishwasher 16.60 _._ Drinking fountain _ 16.60 PRD? RTY OWNER -=TENANT F cctors/sum _ 16.60 Name: L -Ll /� k1-/ / «_Z,l/, � Expansion tank 16.60 _— Address:� Fixture/sewer ca 16.60 � 7�f�5 �c.[J .1/�.iii rc —�--- City/State/Zip: Fluor drain/(lour sink/hub 16.60 Garbage disposal 16.60 Phonr.<.- �,) y 71a, 7 FCO'� ' iZS Flnse bib_ --- 16.60 �AAPPLICANT _ —NfA�T PERSON Icc maker _ 16.60 — N_amPjY�jl,�/�_ ;y',(,� n i /� f — Interceptor/grease trap 16.60 Address: Mcr'ical�Lds• clue: $ Page 2 Primer 16.60 Cit /State/Zi . , . �� 9,71 �, _ �- c Roofdran; cornmcrcial) I6.60 Phon e 4g --'(5- Sink/basin/lavatory 16.60 E-mail: I ub'shower/shower pan __- 16.60 CONTRAIO Urinal — 16.60 _ Business Name: LCV 50 1ti k,.N 1),40, Water closet 16.60 Water heater 16.60 Address: �{ a c3L.: 5*� Lfi Other - Cit /State/Zi ''T v- .. b U(Z- 7--WL; Other: -- -- Phone: ` $ g'i i Fax: Flumbing Permit Fees* CCB Lic. #: -11 Plumb. subtotal $ - Minimum I'cnnit Fee$72.5(1 $ Authorized Residential Backflow Minimum Fee$36.25 Signature: -- Date:_- Plan Review(25%of Permit Fee) $ State Surcharge(80o of Permit Fee) $ (Please print name) TOTAL PERMIT FEE,$ Notice: This pernill application expire,If a permit Is not ohlained within All new commercial buildings require 2 sets of plans with Isometric or 1110 days after It has been accepted as complete. riser diagram for plan review. 'Fee methodology set by Tri-Counts Building Industry Servicc Hoard. 013stsTermil PwmS Vlnhl'ernul4l,V,10C ,ll Iii Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: _ Permit Fee: Footing drain- I" 100' 55.00 0 to 2,000 — $115.00 _ Footing drain-each additional 100' 4040 7,001 to 3,600 $160.00 3,601 to 7,200 _ $220.00 _ Sewer- Ist 100' 5500 7,201 and greater _ '309.00 Sewer-each additional 100' 46.40 Water Service- Ist 100' 55.00 Medical Gas SystCmS: Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain Drain- Ist 100' 55.00 $1.00 to$5,000.00 _Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and Fixture or Item Qty. Fee(ea) Total including$10,000.00. Commcicial Hack I low Prevention Dedra 46 40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permil ice$36.25 27.55 and including$25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to Inspection of exisling plumbing or _ and including$50,000.00. specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are wtu capping, moving or replacing existing fixtures'! It' "ves 11,please indicate work performed by fixture. Failure to accur-at� report fixtures could result in increased sewer fees*. uantit•by(Fixture)Work Performed ('ounnt'ntc regarding fixture work: Fixture Type: Replace New Moved Eilstinit Capped -- BapUslr — Hath -Tub/Shower _ -Jacuzzi/WhiqLool _ -- ------------ Car Wash -Fach Stall -Drive Thru _ Cuspidor/Water Aspirator Dishwasher -Commercial -Domestic — Drinking Fountain Eye Wash --- -- ------- --- --- Floor Drain/sink 2" V' -- ----4" Car Wash Dram Domestic — 'Note: If the fixture work muter this permit results in an Garbage - Disposal -Dorn esticial — _— increase of Sewer ED11s,a sewer permit will be issued an(] Industrial fees assessr d for the sewer increase must he paid befor,r the Ice Mach./Refri .Drains _ plumbing permit can he Issued. Oil Separator Gas Station)) Rec.Vehicle Dump Station Shower -Clang -- -- _J -Stall Sink -liar/Lavatory -Ilradley -Commercial _ -Service Swimming Pool Filter _ 14'ashcr-Clothes _ Water Extractor —_ Water Closet-Ioilet Urinal Other Fixtures iADsts\Permit Fornis\PlntPernutAppPg2 doc 01%111 Electrical Permit Application Received Electrical �~ Date/By: Permit No.: CityLit Of 'i Bed Planning Approval Sign Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other -- "Tigard,Oregon 97223 Date/fly: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date/ljy: Case No.: Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for 24-hour Inspection Request: 503-639-4175 Narnc/Method: Sopnlementa!)nformalinn. TYPE OF WORK PLAN REVIEW ase check all that kTR!y) New co_nstructio_n_ _ I El Demolition _ Service over 225 amps- Hcalth-care facility commercial ❑Hazardous location Addition/alteration/rc lacement Other: ❑Service over 320 amps-rating of ❑Building over 10,000 square,feet, CATEGORY OF CONSTRUCTION I&2 fsmily dwellings four or more residential units in I &2-Family dwelling Commercial/Industrial (]System over 600 volts nominal one structure - — ❑Building over three stories ❑Feeders,400 amps or more Accessory Building ❑ Multi-Family [❑�Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder Other: O Egress/lighting plan ❑Other: _ JOB SiTE INFORMATION and LOCATIONSubmit_._sets of plans with any of the above. Jeb site address: The above are not applicable to lem rorary construction service. y�/ �� (_ J /�r� rrrr/ _ � FEE*SCHEDULE Suite#: Bld ./.4 t.#: Number of i_tts ections per pcrtn_it alluwed Project Name: - Description Qty Fee(ea.) 7'oul CCOSS Streel/I)IrectiOflS to iOb sltP.: New resldential-single or multi-f lmlly per dwelling unit.Includes attached garage. Service Included: 1000 sq.ft.or less _ 145.15 4 Each additional 500 sq.It.or portion thereof 33.40 i Subdivision: Lot#: Limited ener ,residential 75.00 2 _- limited energy,non residential 75.00_ 2 Tax map/parcel #: �' / C�� Each manufactured home or modular dwelling DESCRIPTION OF WORK service and/or feeder 90.90 2 —----- -- Services or feeders-installation, Q alteration or relocation: 2lN)am s or less 80.30 ? 201 amps to 400 amps _ 106.85 2 ",x. IR401 amps to G00 amps _ 160.60 _ 2 (�PROPERTY( " R TENANT 601 amps to 1000 amps — 240.60 _ 2 Over I(N)O amps or volts 454,65 2 Name: I-le 611 Reconnect only66.85 —� 2 Address:2 !L4 Ll� ,/ .�/�r//f�1G'j [,11 Temporary services or feeders-ins(allation, alteration,or relocation: City/State/Lf oc-,i /,(r r- 7/ 200 amps or less 66.85 1 Pho e f -b 3,97 Fa eC I) fZS_b y 20l ami to 400 amps Ita.]o z A PLI 'A T CONTACT PERSON 401 to 600 s 133.75 2 Nrarch circuits-Baty.alteration.or Name: e �' 4 G /'. e— ti. extension per panel: A.Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 6.65 2 City/State/Zip: 5/ B.Fee for branch circuits wahout purchase of service or feeder fee,first branch circuit 46.85 _ 2 Pho 4 .J" Z Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder no;included): CONTRACTOR Bach pump or irrigation circle — 53.40 2_ ----------- [ach signor outline liphung 53.40 _ 2 Job No: Signal circuit(s)oi a limited energy panel, Business Name: tr � �� alteration,or extension Pae 2 2 (. f Description —' — — Address: 1 b d €6e, �= Cit /State/Zl `t2Y.g G 'C3 Each additional Inspection over the allowable In any of the above: _ H tq Nt 709 Per inspection r hour min. I hour 62.50 Phone: 3" ';-I I Fax: Investigation fee: CCB Lic.#: I q 017C I Lic.#: Other: _ Electrical Perntlt Fees" Supervising electrician Subtotal S _ s gn ature required: f_ __ _Plan Review(25%of Permit Fee) S _ Print Name: Lic.#: State Surcharge(8%of Permit Fee) S _ "fOTAI,PERMIT i'EE S Authorized Notice: This perm.l appllcPlinn expires if a permit Is not obtained rsilhhl Signature: — Date:_ ___ IRO days after it has been accepted as complete. 'Fee methodolups set by I rIA aunts Building Indnslry Sery ice Board. - - — — (Please print name) --�-- i\f)sls\Pcntnit Forms\FlcPrrmitApp.doc 01103 Electrical Permit Application - City of'Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Feefor all systents............................................................ $75.00 Check'1'ype of Work Invohcd: ElAudio mal Stereo Svstemis* Ilurgho Alarm (iarage I)unrOpencr* l J I leafing,Ventilation and Air conditioning System* C1Vacuum Systems* C7 -- COMMERCIAL WORK ONLY: Feefor each system.......................................................... $75.00 (SEE OAR 918-260-20(1) Check'I' pe of Work Involved: An(ho and Stereo Systems nailer Controls Clock Systems Data Telecommunication Installation EJI ire Alarm Installation IIVA(- Instrumentation Intercom and Paging Systems I andscape Irrigation Control* Medical Nurse Calls El Outdoor Landscape Lighting* Protective signaling Othcr Number of Systems * No licenses are required. Licenses are required for all other installations i\DstsU'emrit forms\FlcPcrnntAppPg2 doc u1,03 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE FRANKLIN ELECTRIC INC 1031 SE 23RD COURT GRESHAM, OR 97080 Electrical Signature Form Permit #: MST2003-00173 Date Issued: 6/18/03 Pa►cel: 2S104BC-05900 Site Address: 14450 SW FERN ST Subdivision: MLP96-0011 JEFFREY Block: Lot: 002 Jurisdiction: TIG Zoning: R-7 Remarks: SF (Duplex) 14450 and 14452 SW Fern. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MARK & DARLA BRITCHIFF FRANKLIN ELECTRIC INC 27485 SW XANTHUS CT. 1031 SE 23RD COURT SHERWOOD, OR 97140 GRESHAM, OR 97080 Phone #: 503-925-8387 Phone #: 4924651 Req #: Lit 140170 SUP 22605 AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature o Su ervising Electrician If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE RONALD HUDSON PLUMBING 942 SW 15TH CT TROUTDALE, OR 97060 Plumbing Signature Form Permit #: MST2003-00173 Date Issued: 6118103 Parcel: 2S104BC-05900 Site Address: 14450 SW FERN ST Subdivision: MLP96-0011 JEFFREY Block: Lot: 002 Jurisdiction: TIG Zoning: R-7 Remarks: SF (Duplex) 14450 and 14452 SW Fern. Y-ur company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: MARK & DARLA BRITCHIFF RONALD HUDSON PLUMBING 11)c 27485 SW XANTHUS CT. 942 SW 15TH CT SHERWOOD, OR 97140 TROUTDALE, OR 97060 Phone #: 503-925-8387 Phone #: 503-998-5871 Reg #: LIC 103571 PLM 3-30;PB AN INK SIGNATURE IS REQUIRED ON THIS F'JRM Signature of Authorized Plumber If you have ony questions, please call 503.718.2433. i CITY OF TIOARD Residential Certificate Of Occupancy Permit No.: Address: Owner/Contractor: .� Date of Final Inspection: ��—03 Inspector: 1 'Phis structure has been found to be in substantial compliance with the provision. of the State of Oregon One& Two Family Dwelling S ec iaU Code and is hereby approved for occupancy.