8563 SW HAMLET STREET 00
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8563 SVV Hamlet St. ,et
n� CITY O F T I G,r4 R D MASTER PERMIT
PERMIT#: MST2001-00093
DEVELOPMEwr SERVICES DATE ISSUED: 3/12/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRE--q: 00563 SW HAh1LET S1 PARCEL: 2S111DD-17100
SUBDIVISION: MILLMONT PARK ZONING: R-7
BLOCv: LOT: 048 JURISDICTION: TIG
REMARKS: Garage into habitable space
BUILDING
RF.ISStIE. STORIES: 1 FLOOR AREAS i_ REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: 441 el BASEMENT. of LEFT: SMOKE DETECTORS: 0
TYPE OF USE: SF FLOOR LOAD: 4(1 SECOND: sf GARAGE: of FRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: FINSSMENT: sr RIGHT:
VALUE: $28 AR On
OCCUPANCY GRP: R3 RDRM: 2 BATH: 2 TOTAL: 441.00 at REAR:
PLUMBING
SINKS: WATER CLOSETS WASHING VACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIL'DRAINS: CATCH BASINS:
TUB/SHOWLRS: I GARBAGE DISP: WATER HEATERS: WA)ER LINES: BCKFI.W PREVNTR: GREASE TRAPS:
OTHER FIXTUREr
MECHANICAL
FUEL TYPES FURN<100K, BOILICMP<311P: VENT FANS: 2 CLOTHES DRYER:
GAS FURN>-100K. UNIT HEATERS: HOODS. OTHER UNITS:
MAX INP: btu FLOOR FURNANCES, VENTS: 2 WOODSTOVES. GAS OUTLETS:
ELECTRICAL _
RESIDENTIAL UNIT _SERVICE FEEDER TF!AP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADVL INSPEC1IONS
1000 SF OR LESS: 0 200 amp 0 200 amp: WISVC OR FDR: PUMPIIRRIGAI'ION: PER INSPECTION:
EA ADD'L 540SF: 201 400 amp: 201 400 amp: 1st W/O S CIFDR: SIGNIOU'LIN LT: PER HOUR:
LIMITED ENERGY: 401 800 amp 401 Boo amp: EA ADDL BR CIR: SIGNAIJPANEL: IN PLANT:
MANU HMISVCIFDR: 601 - 1000 amp 601+8mps•100ov: MINOR LABEL:
1000+amplvolt.
PLAN REVIEW SECTION
Reconnect only.
>•4 RES UNITS: SVCIFDR>•225 A.: 800 V NOMINAL: :LS,.iEAISPC UCC:
ELECTRICAL•RESTRICTED ENERGY _
A.SF RESIDENTIAL B.COMMERCIAL
0UDIO d STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: MVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAUE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: OATAITELE COMM: NURSE CALLS TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 775.61
PATRU EUGEN B 3 V CONSTRUCTION This permit is subject to the regulations contained in the
8563 U HAMLET St 1 1847 SE ALDER STREET Tigard Municipal Code,State of OR Specialty Codes and
TIGARD,OR 97224 PORTLAND,OR 97216 all other applicable laws. All work will be done i
accordance with approved plans. This permit will expired
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION.
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rep 0: t IC 121.16 forth in OAR 952-001.0010 through 952-?01-0080 You
-nay obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Post/Beam Structural Plumb Top Out Electrical Final
Post/Beam Mechanica Electrical Service Mechanical Final
Underfloor insulation Electrical Rough In Plumb Final
PLM/Underfloor Framing Insp Final Inspection
Mechanical Insp Insulation Insp Building Final
Issued By : -Ti�ry�,�_'�_ _ Permittee Signature
Call (563) 639-4175 by 7:00 p.m. for an inspection needed the next business day
! (4 s t 7 cr/ /r r T
Building Permit Application
Date received:?: _ Permit no.y)1;7�co!-(f�
City of Tigard 5
Address: 13125 SW Hall Blvd,"Tigard,OR 97223 ProjectiappLno.: Expire date:
City(4 Tigard [hone: (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:
U 1 &2 fwnily dwelling or accessory U Contntercial/industrial U Multi-family U New construction U Demolition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm 0 Other:
Job address: r. ' -,_ o u- Bldg.no.: r'suiteno.:
Lot: block- _Subdivision: fax map/tax lot/account no.:
Project name:
Description and location of work on prpmises/special conditions:
Name:
(Floodollilln,%eptictslilgelly,solar,etc.)
Mailing address: �'' 3 �t V ��> Y k 2 family dwelling:
City: T/6 X R6 State: ZIP: <<'y Valuation of work....................................... E v
Phone Spa d"^ •/ li' Fax 5a1 -/Al E-mail: No.of bedrooms/baths.................................
Owner's repmsentative: Total number of floors.................................
Phone: Fax: E-mail: New dwelling area(sq.ft.) ..........................
Garage/carport area(sq.ft).........................
Nance: t7�/cI Eu Lt! Covarcd porch area(sq.ft.) .........................
Mailing address: J� SW1• f �Alr 4 EJ 5 T De k area(sq. ft.)........................................
City: -_16 _ State:e"4 ZIP: ��� Other structure area(sq.ft.)......................... _
Phone:
Bus'iess name:
Address:
Faxa !fl'j ' E-mail' CommereloUluditstriallinuiti-family:
Valuation of work....................................... $ -_
- .- Existing bldg.area(sq.ft.) ..........................
New bldg.arca(sq. ft.)
— --- --
Slate: ZIP: — Number of stories........................................
City: Type of construction
Fa
Phone: x: E-mail: Occupancy group(s): Existing:
CCB no.: _ _ New:
"aiiio
Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
--- jurisdiction where work is being perforr.ed.If the applicant is
Address: _
City: State: ZIP: exempt from licensing,the fallowing reason applies:
Contact person: Plan no.:
Phone: Fax: E-mail:
hy
Name: Contact person: Fees due upon application ........................... $
Address; Date received: —.
City: _ TState: Z!P_, Amount received •....•. $
Mkone: Fax: F-mail: Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all ludsdictium a ccep credit cards,please call luriuhction for more infattmtim
attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard
work will be complied with,whether specified herein or not. credit card number: -- — _— F.-
Authorized signature:�f sv G' _ Dale: /� / N�tne of car&+oldrr ata rMrwn at end witard
s
Print name:_� � _�.'�� �� -- —Cardholder sidnarure ��— Amount
Nouse:This permit application expires its permit is not obtained within 180 days after it has been accepted as complete. 440�4613(ISMPCOM)
One- and Tv-,,a-11_P tidy Dwelling
Building Pe rmit Application Checklist Referenceno.:
Associated permits:
City of Tigard U Electrical U Plumbing U Mechanical
Address: 13125 SW Nall Blvd,Tigard,OR 97223 U Other:
Phone: (503) 639-4171
Fax: (503) 598-1960
1 1 �=k=RE REQUIRED Wit
I Land use act loin completed. '. . Jun X11" 111)11 a i I , f 1)r concurrent reviews.
2 Zoning.Flood plain,solar balance point~,scisnm soils designation,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 J permit required.Include drainage-way protection,silt fence design and location of
catch-hasin protection,etc. _ W
10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building cozies. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist.
i I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if
there is more Ulan a 4-11.elevation differential,plan must show contour lines at 2-ft.intervals);lavation of easements and
driveway;footprint of structure(including decks);location of wells/septic systems',utility locations;direction indicator;lot
area;building coverage arca;percentage of coverage;impervious area;existing structures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
sire and location. _
13 Floor plana.Show all dimensions,room identification,window size,location of smoke detectors,water henter.
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross sectlon(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor,
wall construction,roof construction.More than one cross section may be required to clearly portray construction.Show
details of all wall and roof sheathing,rooting,roof slope,ceiling height,siding material,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 the change in grade is greater than four fat at building envelope.
Full-size sheet addcndums showing foundation elevations with cross,cferences are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
nun-prescriptive path analysis provide speo.itications and calculations to engineering standards. _
17 Floorlroof framing.Provide plans for all tloors/roof assemblies,indicating member siring,spacing,and bearing
locations.Show attic ventilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rebar.For engineered
systems,see item 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 beam/joist carrying a non-unifomi 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. , shear v all,roof truss)shall he stamped by an engineer or
architect licensed in t)regoii and shall be shown to hr :ipplj,silt,t(,the project under wN iew.
23 Five(5)site plans are required for Item I I above. tiuc plans must he 8 V_' s I I"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.
26 No rolled,reversed or mirrored building plans will he u:cepted.
27
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. W-4614(Mi(WOW
Plumbing Permit Application
Tigard d
of Ti
City IDate receive ./ � Pcttnit no.:
g
`J b
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.:
----
Cirvoffigard phone: (503) 639-4171 Project/appl.no.: E:xpiiedate:
Fax: (503)598-1960 Date issued: By: Receipt no.:
Land use approval: _ Case file no.: Payment type:
LI I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Food service U(Rhea-:
1
T 7 i)Mscri lion Qt Fce(en.) Total
Job address: t�'�E_
Bldg.no.: —��Saite no.: --�� New 1•end 2-family dwellings only:—
(includeR 100 fl.for each utility cat mectIon)
Tax map/tax lot/account no.: —_ SFR(1)bath _
l rut: Block: Subdivision: SFR(2)bath — — _ -- -
Project name: _— SFR(3)bath --� - --
_City/county: ZIP: Each additional hatlt%kitchen
Description and location of work n premises: _—_ _— SiteutWties:
67 _c�;�1 _Catch basin/area drain
contplrtinn/instu coon -- Drywells/leach line/trench drain
Est.daa of _—
+ Footing drain(no.lin.ft.)
Manufactured home utilities
Business name: __ Manholes
Address: Rain drain connector
City: _ _tate_ ZIP: Sanitary sewer(no.lin.ft.)
Phone: Fax: _ Email Storm sewer(no.lin. f_l.)
CCB no.: A Plumb.bus, reg.no: Water service(no. lin.ft.)
City/metro lic.no.: Fixture or item:
Contractor's representative signature: Absorption valve �—
_ -- Back flowreventer _
Print name: Date. Backwater valve
Basins/lavatory —
Name: _washer
--- — Dishwas'her
Address' Drinking founlilin(s)
City: State: 7.1P: E'ectors/sum!
Phone: Fax: E-mail: Ex ansion tank -
Fixture/sewer cap _Name(print): l fi�Tl�C/ C/CCS Flo'r dtains/floar sinks/hub
Mailing addresa: '' Garbage dis sal _
g >b' �' a gW C T r_ Hose hibb _ _
City , /( ' Statc:&' LIP:, ,' ' ice maker _
Phon t Fax p t lir; Email: Interceptor/grease trap -�
Owner instal lotion/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s).basin(s),lays(s)
Owner's signature: Date: Sump —
Tubs/shower/shower part
Urinal
Name: _ Water closet
Address: Water heater — —
City �� State: _ ZIP: _ Other. —
Phone: Fax: —_ rE�mail: _— Total
NM nil'uriedicUons acre creetit cards.paau rail'uris<ticlinn`or marc infer Minimum fee................$
1 M ) Notice:'Ibis tettnit application
U Visa U MasterCard expires if a p�rrnit is not obtained Plan review(at
Credit card number within IRO days alter it has been State surcharge(8%)....
$ _ _
Espiers
------ card — accepted as complete. TOTAL .......................$
Naw Naof cudholder as Shawn on ctedi,cod �—
S
— ---('ardhoher signature —~ Amount 440-4616(6111COM)
PLUMBING PERMIT FEES:
^� PRICE 1 OTAL New 1 and 24amlly dwellings only: �-
FIXTLRES Individual)
_ QTY ea AMOUNT (Includes all plumbing fixtures In PRICE TOTAL
Sink r 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory _ 16.60 for each utllltv connection)-
One jbath 49
$2 .20
Tub or Tub/Shower Comb_ - 16.60 - Two(2)bath $350.00
Shower Only 1660 Three 3 bath _ $399.00
Water Closet _ 16.60- _SUBTOTAL
Urinal 16.60 _ 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60 TOTAL __L"-
Laundry Tray - 1650
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 PLEASE COMPLETE:
4" 16.60
Water Neater O conversion O like kind 16.60 T uantity 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 '�- Lavelorry _
Hosa Bibs - 16.60 -- Tub or TublShower
Combinatic i
Roof Drains 16.60 Shower Only
Drinking Fountain - 16.60 Water Closet -�-,
Other Fixtures(Specify) 16,60 Urinal
Dirhwasher _
Garba a Dispocal e
Laun�Room Tray _
Machine
--•-- Floor Drain/Sink: 2"
Sewer-1 st 100' 55.00 - 3„
Sewer-each additional 100' 46.40 q"
Water Service-1st 100' 55.00 Water Heater _
Water Service-each additional 200' s 46.40 Other Fixtures V
Specify)
Storm&Rain Drain-1st 100' 55.00
Storm&Rain Drain-each additioncl 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.5E -- - -
Catch Basin 16.60 -
Inspection of Fxisling Plumbing or Specially 72.50
Requested Inspections COMMENTS REGARDING ABOVE-
Rain Drain,single family dwelling 6525
Grease Traps 16.60
QUANTITY TOTAL - -` --'- �- -
Isometric or rliei diagram is reribired It ----'-
Quant Total is >9 _ _ - --- -----..
'SUBTOTAL -- -- - -
�- 8%STATE SURCHARGE
"PLAN REVIEW 25%OF SUBTOTAL
Re3uired only If fixture qty total Is>9
TVTAI.. $
*Minimum permit lee is 512.50-8%stale surcharge,except Residential Backflow
Prevention Dp ice,which Is$36 25+8%state surcharge
"All New commercial Buildings require plans with isometric or riser oiapram and
plan review
lAdsts\forms\plm-fees doc 10110/00
Mechanical Permit.Application
Datereceived: Permit no.:
City of Tigard Project/appl.no.: Expire date:
C'iiyofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Date issued. _ By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: D ayipent type:
Land use approval" Building permit no.:
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New consiniction U Addition/alteration/replacement U Other: _
1
Job address: << / , �/'�/�/�L % _ Indicate equipment quantities in boxes below. Ind
,^,j6 icate the dollar
Bldg.no.: _ Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule fbr residential permit fee.
City/county: ZIP: DWELLING
Description and location of work on premises:_ t
Fe+e(ea.) 'total 1
Est.date of completion/inspection: Uescri on Q(y. Res.only Res.only
Tenant improvement or change of use. Air handling unit ___CFM
_
Is existing space heated or conditioned?U Yes U No it con itioning(site p an required)
Is existing space insulated?U Yes U N(j Alteration of exisung HVAC system _
of
ler/compressors
_
FBusiness name: State boiler permit nc.:
Hf --Tons BTLIM
Address: Fir smoke dampers/duct smoke detectors _
City; _ State! ZI:': eat pump(sue p an required)
Phone: Fax: E-mail: nsta rep nce furnace/burner— B FUTIT
CCB no.: Including ductwork/vent liner U Yes U No
_ lnsta t/rep ac re ocate heaters-suspen e
City/metro lie,no.: wall,or floor mounted
Name(pleaseprint): cot ora lance other than furnace
CONTAUF PERSON Refrigeration:
Ahsorption units RTU/H _
Name: Chillers__ lip
Address: Com rressors _ Hp
_-.- nv ronmenta exhaust an vent ati n:
City; �o Slate: LIP: Appliance vent
Phone: i u E-mail: )ryerex aunt
111"k Aim Hoods,Type res. itc cRT zmal
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
Mailing ad.!:-.-;s- Exhaust system apart in heaun or AC
Cily: Y Slate: ZIP: Fuelpiping andistribution tip to outlets)
_-----.-_ _-- _-_ Type: __LPC; NG Oil _
Pho rio: l',i� E-mail: ucl pipini each adUltional over 4 outlets
Oman rocess piping(schematic requireJ—)
Number of outlets
Name: ter llsiti4 app ance or equipment:
Adti-ess: Decorative fireplace
City: State: ZIP: Inscil-type
Phone: Fax: E;-mail' Woodstove/pellet stove
Other:
Applicant's signature: Date: Other.
Name(print):
Nd all juriatartions accept credit cards,please call jurisdiction For mom infunnation Permit fee.....................$ _.
❑Ytsa U MasterCard expires
This permit application Minimum fee................$
expires if a permit is not obtained plan review(at _. 96) $
Credit card number _._ __
Expires within 180 days after it has been State surcharge(13%)....$
--- — accepted as complete. '—
NatrK of carNtolder a atrown oa crcdir card p p
$ TOTAL .......................$ _
-Cw1holder sl`aature Amann 440-4617(&%VOW
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
esptio: Price Total
---- - ----_ Dcri
TOTAL VALUATION: FEE: - Table 1A Mechanical Code _ Qty (Ea) _ Amt
$1.00 to$51000.00 -____ Minimum fee$72.50 - 1) Furnace to 100,000 BTU -
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and including ducts&vents14.00
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
fraction thereof,to and including including ducts&vents 17.40
$10,000.00.
$ 3) Floor Furnace
10,001.00 to 525,000.00 $146.50 For the first 510,000.00 and includin vent 14.00
4
$1.54 for each additional$100.00 or
fraction thereof,to and Including ) Suspended heater,wall heater - 14.00
$25,000-00. or floor mounted heater
-- - 5) Vent not Included In appliance pemllt
$25,001.00 to$50,000.00 - $379.50 for the first$25,000.00 and 6.80
$1.45 for each additional$100.00 or ----•- - -
fraction thereof,to and including 6) Repair units
1215
$50,000.00. _ _
$50,001.00 and up $742.00 for the first$50,000.00 and check SII that apply: BoPer Heat Air
$1.20 for each additional$100.00 or For Items' '1,see or Pump Cond
fraction thereof. footnotes below. Comp*
-- 7)<3HF;absorb unit -�
_ to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb
Value Total unit 100k to 500k BTU 2560 _
Description: O Ea Amount g)15-30 HP;absorb
Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU v 35_00 -�
ducts&vents __ - _ 10)30-50 HP;absorb
Furnace>100,000 BTU Including .unit 1-1.75 mil BTU 52.20
ducts&vents 11)>50HP:absorb
Floor furnace Including vent 955 unit>1.75 mii BTU _- 87.20
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater - 10.00
Vent not Included in applicance 445 13)Air handling unit 10,000 CFM+
permit 17 20 -
Repair units 805 _ 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 - 10.00
to 100k BTU_ 15)Vent fen connected to a single duct
3-15 hp;absorb.unit, 1,700 6.80
101k to 50Uk BTU 16)Ventilation system not included In
15-30 hp;absorb.unit,501k to 1 2,310 appliance rmit 10.00 _
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 _ 10000 _
1-1.75 mil.BTU 18)Domestic Incinerator
>50 hp;absorb.unit, 5,725 17.40
>1.75 mil.BTU 19)Commercial or incustrial type Incinerator
Air handlingunit to 10,000 dm 656 69.85
_
Alr handling una>10,000 cant _ 1,1;0 - 20)Other Non- ortunits,Including wood stoves
able evaporate cooler 656 10.00 _
Vent fan connected to a single duct _ 446 21)Gas piping one to four outlets
Vent system not Included In 656 5.40
appliance permit 22)More than 4-per outlet(each)
Hood served by mechanical exhaust 656 1.00
Domestic Incinerator _ 1 170 Minimum Permit Fee$72.50 SUBTOTAL: $
Commercial or industrial Incinerator 4,590
Other unit,Including wood stoves, 656 8%State Surcharge $
Insertsl etc.
-Gas piping 14 cutlets 360 - 25%Plan Review Fee(of subtotni) $
Each additional outlet_ 63 Required for ALL commercial permits only
TOTAL COMMERCIAL ( $ TOTAL RESIDENTIAL PERMIT FEE-
VALUATION:VALUATION: _� -----. ---- -- J:2'
-
Other In-pections and Fees:
1 Inspections outside of normal husiness hours(minimum chnrge•two hours)
$72 50 per hour
2 Inspections for which no fee Is spec:irically indicated (minimum charge-half tau-)
$72 50 per hour
3 Additional plan review required by changes,additions or revisions to rdans(minimuc,
charge-one-half hour)$72 50 per hour
'State Contractor Boiler Certification required for units 3,2ook BTU.
"Residential AIC requires site plan showing placement of unit.
1:ldatsVormalrrlech-fees.doc 10/11/00
Electrical Permit Application
Datereceived: 311&1 Permit no.:
City of Tigard Project/appl.no.: Expire date:
Cit yn(Tigard Address: 13125 SW flail Blvd.Tigard,OR 97223 Date issued: By: Receipt no,: -
Phone: (503) 639-4171 ---
Fax: (503)598-1960 Cas• file no.: Payment type:
Land use approval:
=New
dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
ction U Additiolt/alteration/replacement U Other: U Partial
Joh address: 57, Bldg.no.: Suite no.: ITax map/tux lot/account no.:
Lot: Block: Subdivision:
Project name: �,4{ ?�,�,o rpt Description and location of work on premises:
Estimated date oi•completion/inspection:
CONTRAU7OR APPIACATION I 1 1. SOIEOCLIE
Job no:
Business name: I)cscription QtV. (ea.) rolal no.insp
-- New rrsirkntial-sinKk or mut:i famhr)ter ^�
Address: dwcllina unit.Includes attached parat e.
City: SIaIC: ZIP: Se"lechrcluded:
Phone: Fax: Email: 1000 sq.ft.or less
Each additional 5(N)sq.ft.or portion thereof I
CCB no.: Elec.bus.lic.no: Limited energy,residential 2
City/motto lic.no.: LA mi led energy,non•residential 2
fiach manufactured home or modular dwelling
tii(.natun of supervising electrician(requited) Date� Serviceand/orfeeder 2
Sup elver nanre(print): License no. Ateraeaorreetlon or relocation:lo
n–tnslallalion,
alteraration:
200 amps or less 2
Name(print): / 7 /' 201 amps to 400 amps 2
� ---
_ 401 amps to 600 amps 2
Mailing address: fj ' f 44 S 601 amps to 1000 anrps 2
City_ Stale:e) 'LIP: ��S over I(NH)amps or volts _ � _ 2
Plmne -/ Fax: E mail: Reconnect only I
Owner installation:'rhe installation is being made on property I own Temporaryserviresorfeeders-
which is not intended for sale, lease,rent or exchange according to installation,alteration,or relocation:
ORS 447,455,479,670,701. 2(x)amps or less 2
201 amps to 400 amps 2
Owner's si nature: Dale: 401 to t,00 amps 2
Branch circuits-new,alteratlon,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each bunch circuit 2-
City: State: ZIP: B Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: 2
Phone: - Fax: E-mail
Each additional branch circuit
' IWISIMIRM Misc.(Service or feeder not included):
J Service over 225 mnps•con.mercial U Health-care facility Each ptnnp tiArrigation circle 2
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2
family dwellings U Building over 10.000 square feet four(ir Signal circuit(s)or a limited energy pmrel.
U'System over 6Wvolts nominal more residential units in one structure alteration,or extension" 2
U Building civet three stories U Feedr,t.4tx)amps or more "Description:
U Occupam load over 99 persons U Manufactured structures or RV park Elteh ad hhnral inspect inn mer the allowable in any of the above: _
U I'Fres0ightingplan U other _--___ Perinspection _
Submit^sets of plans with anF of the above. Investigation Ice
The above are not applicable to temporary construction service. other
application Permit fee.....................$ _
Nor all jurisdictions weept credit cents•please call iurisdrction for ovar nrfonruttion Notice:Tills permit pp'
U visa U Mastercard expires if a permit is not obtained Plan review(at 9F) $
Credit card attmber: within 180 days after it has been State surcharge(8%)....$ _
accepted as complete. TOTAL . $
Name-of er-u shown on credit card
S _
___—, Cardholdef silmoure Amount 411M615(6MWOM)
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: - -� `--"—
Restricted Energy Fee........................ ............................. $75.00
Number of Inspections per permit allowad (FOR ALL SYSTEMS)
Service Included: Items Cost Total Check Type of Work Involved:
Residential-per unit
1000 sq.It.or less —_ _ $145.15 q ❑ Audio and Stereo Systems
Each additional 500 sq.It.or
portion thereof $33.40 1 Burglar Alarm
Limited Energy $75.U0
Each Manufd Home or Modular Garage Door Opener'
Dwelling Service or Feeder _ $90.90 2
Services or Feeders C] Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 Vacuum Systems'
201 amps to 400 amps f $106.85 2
401 amps to 600 amps $160.60 2Olh
601 amps to 1000 amps $240.60 2 ❑ er
- --
Over 1000 amps or volts $454.65 2
Reconnect only � $68.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Fee for each system.......__.............................................. $75.00
Installation,alteration,or relocation
200 snips or less $66.85 2 (SFE OAR 918-260-260)
201 amps to 400 amps _ $100.30 2 Check Type of Work Involved:
401 amps to 600 amps $133.75 2
Over f30 amps to 1000 volts, Audio and Stereo Systems
see"b"above.
Branch Circuits Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits ❑
with purchase of service or Clock Systems
feeder fee.
Each branch circuit $6 65 __ ❑ Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 ❑ HVAC
Each odditionsf branch circuit $6.65
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or Irrigation circle $53.40 —__ ❑ Intercom and Paging Systems
Each sign or outline lighting $5340 _
Signal circuit(s)or a limited energy Landscape Irrigation Control'
panel,alteration or extension $75.00
Minor I abels(10) _ ^ $12500 _ ❑
Medical
Each additional Inspection over
the allowable in any of the above Nurse Calls
Per inspection $62 50
^er hour $62.50
In Plant $73.75 Outdoor Landscape Lighting'
Fees; Protective Signaling
Enter total of above fees $ _�. ❑ Other ----
8%State Surcharge $ _ --_Number of Systems
25%Plan Review Fee No licenses are required Licenses are required for all other installations
See"Plan Review"section on $
front of application. __._ --
Fees:
Total Balance due $
-- ---- Enter total of above fees $
Trust Account#__,_— 8%State Surcharge f
Total Balance Due $
i Asu\fnrms\cic•fecs doc 10/(19100
Permit# -
Address:
Issued by: _ Dat.e:31jGl.___�
Statement: Information Notice to Property/ owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
IM1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractar if the structure is sold or offered for sale
before or upon completion. �--
3A. My general contractor is�� L/ YL t/�(�—t�it�' _ 2---�—AJA�Q
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If i change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibibitic% .m file reverse side of this form.
gWn— permi appi , 1) (Date)
(White copy w i.c.criin,s ilf'r►nit file,
pink copy-to applicant)
information Notice to Property Owners
About Consiruction Resporisibilitties
, I%r:• l,i(, 'rn+lion„� 'V',1(1(t; !U ;'r,lf�tN1�' !,1}P l �')',S�i�?f�ii! 1 +�f9V�'I11+ 1'!+'� �i�r',y;lrn lY'11 71�If!!”
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tlallPLUYt..F' RESPONStf'.oUTIfti:.
' • . ,. . 1. ��glHiw?f.fV I.II�'•. '� �tis`i•rtrlr. _ n., its,lv,L. -. . .
th
, i i 'i •1'�rt'� l tt,�rli , I
rk
S. Internal VV1,11tiv
;, ,hli for flit 1•1" 11It truth
OTHER W-.SPONSIBII_.ITIES ,AND AREAS OF CO1rdl.:l::RN
( 'rr/Iq't'Yltlil,lOY.`Ic l''.
111.0 Iml% I' I,i iii hI
t�.� itlr;ltt:. :111�J �ntn>�ir1n ,ul It 4S lallklg t00k,jld m v,.atcl damopfroth fue. o
r+.` t1c11:e.
IIlllk` tl1 Iro111t'l't 4'1+.r xnerrl-�re.�.<,. 0.,q.t.. .+t.. � �.�, L,•+.,. „11�„ ..�1 r,rfi„� to tinrv•t'�-.c,• ,r,ou
��.'�ij►E"YNISC', A�:Ik,g•�ti .r1:Is1 .�.,.,i�k .�`\I:c.';t. .. ,. .i„t., .}: ;i, iiy .. ,. .
Cr,u1��. :ulll �r'r rn�tily htliltlirt r tri;th,At the rl(r�rlMr!” iIV 0171t1� err tH!w r�r1r r,*rinn`n the rrgnireti irt9 c:�tu.>rl�.
Itl hat v adtliti41wil r`ue,,tions.�+6w or c;lll '010 t'Otlsfmoion Contnkcf,rr, Board(f f ) Box 14140,Safem.
51� i?IR-�1C,'i ”(he 13oarll i lnc�it<�RI ut 7 o Stammer`tit. NI tiuttc .31N1 in Salrnl.
I Jsl-t7
CITY OF TIGA,RD BUILDING INSPECTION DIVISION MST _Uvo�•G
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
Date Requested__;7— _ AMPM f31_D
Location G 3 IL4k �� t .f _ Suite MEC
Contact Person Ph PLM
Contractor _ Ph SWR
Tenant/Owner ELC _ — —
Retaining Wall ELR
Footing ACC@SS: - ___---_—�--
Foundation FPS
Fig Drain SG
Crawl Drain Inspection Notes ------- ---
Slab _----- - SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ----_._., — ...--- ---- - --- ----------- -- - I
Firewall
Fire Sprinkler ___.-.- -------_----__..-
Fire Alarm
Susp'd Ceiling -----___---.__-------------- _—._-------
R oof , r-_---
ASS , PART FAIL -_._. — --------.---- ---- ---
PL BING
I ost& Beam
Under Stab
TopOut - --_ ----__--- -.._--- -�-- ------------ -
"JNater Service
Sanitary Sewer
Rain Drains
Final
PASS PART JAIL
MECHANICAL
Post& Beam � - --- - — ..-- _._ --- --- --- --- ----- _--- --------- -
Rough In
Gas Line ---
---
SmoKe Dampers
Final -- ----- ._.. - — --- -- -- ---- — ----- ---
PASS PART FAIL
ELECTRICAL -- --_-----------_-_ _--_ ------ - --------
Service
Rough In _--
UG/Slap
Low Voltage
Fire Alarm ------ ---
F
__-----.__---
Final
PASS PART FAIL-
S11
Backfill/Grading �.__ --Y_—, --- ----- -__----------------- -- _.-^.
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
I-ire Supply Line ( ]Please rail for reinspection RE: _ _ ( ]Unable to inspect-no access
ADA
Approach/Sidewalk --- � - --
Other Date I Inspector _ _— Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION , �,f �in�,;�r-�4_�✓GU�'
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
_^Date Requested_ L _ AM _PM BLD
Location�i1�e A S Suite — MEC
Contact Person Ph ���-�/ zJ_,zr PLM
Contractor Ph SWk
rbRiiLDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access'
Foundation 4=PS
Ftg Drai^ -- SGN - —�—
Crawl Drain Inspection Notes: ----
Slab SIT
Post&Beam 17
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc
Final
ALS T FAILM81N
n, am
Under Slab
T On Out
Water Service
Sanitary Sewer
Rain Drains
-int JM&'I
PART FAIL
Post& Beam ---- ---- --- - ---
Rough In
Cas Line
---
Smcke Dampers
PART FAIL
E ECTRICAL - — . - -- _ ----- -
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final --------------
PASS PART FAIL
SITE _
Backfill/Grading
Sanitary Sewer
Storm Drain I j Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ )Please call for reinspection RE _T [ j Unable to inspect-no access
ADA
-7 Inspector t t
Approach/sidewalk Date � !i' �
Other ` --
_ `. _Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY Com'' TIGARD BUILDING INSPECTION DIVISION MST
24 ..-,.ar Inspection Line: 639-4175 Business Line: 639-4171
BUP _
— _Date Requested—�' Z/ AM_ _—rm BLD _
Location s G-3 1. 6 r Suite MEC ,-
"ontact Person Fin PLM —
Contractor _ _a _ — Ph — SWR
Muir-- i. Tr?nant/Owner EI_C
Retaining V\r-i!! -- ELR _
Footing Access
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SIGN
Slab -- ----- ------- -- - _— --- -- SIT
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear -- -
Framing
Insulation
Drywall Nailing _---
Firewall
Fire Sprinkler -- ----.--__----------.-----_-_.._ _-- ----
Fire Alarm �-
Slisp'd Ceiling -- -- -----—------- ----- ---
Roof
Misc. - - - -- --
Final
PASS PART FAIL --- � `' - --._ -- --
PLUMBING
Post & Beam -- - ---- -- ---- -�---
Under Slab
Top Out
Water Service I -- -
Sanitary Sewer
Rain Drains
Final
PASSPART FAIL
MECHANICAL �~^ .—~--.�_--
Post& Beam
Rough
- - - - .. --- --- . - - --- -
Rough In
Gas Line - -- — --- ------- ----- ------
Smoke Dampers
Final
LRASS-2-A]LT FAIL
. �•rvrce
Rough In
UG/Slab ------- - -- ...---- ------
Low Vo;tage
PASS PART FAIL
Backfill/Grading - — — -
Sanitary Sewer
Storm Drain [ J Heinspection fee of$___ ,equired before next inspection Pay at(city Hall, 131.25 SVV Hall Blvd
Catch Basin
Fire Supply Line [ )Please call for reinsrection RE: [ J Unable to inspect-no access
ADA /
Approach/Sidewalk Date C� Inspector ' Ext
Other — -- -- -- ---
Final
PASS PART FA'_ DO NOT REFAOVE this inspection record from the job site,