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Permit (38) CITY OF TIGARDy MASTER PERMIT .7: . COMMUNITY DEVELOPMENT ',4,f',, Permit#: MST2018-00306 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2019 T t c u.T7 9 Parcel: 2S103BD10800 Jurisdiction: Tigard Site address: 11710 SW WALNUT ST Subdivision: 2003-045 PARTITION PLAT Lot: 1 Project: FURLOTT Project Description: Interior remodel:Adding(1)bedroom and(1)bathroom to the second story loft, and changing layout of master bathroom. 3/5/19: REPRINT to add(8)branch circuits and(4)bathroom exhaust BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $60,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 3 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 2 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 10 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: FURLOTT,RYAN C OSTERCRAFT HOMES Required Items and Reports(Conditions) KATO,ALYSHA C 15811 SE MONNER RD 11710 SW WALNUT ST HAPPY VALLEY,OR 97286 TIGARD,OR 97223 PHONE: PHONE: 503-658-7558 FAX: Total Fees: $2,078.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through AR 952-001 :190. You ma/•btain a copy the rules or direct questions to OUNC by calling 503.232. •87 or .•••132.2344. Issued By: ��4 > Z� Permittee Signature: i � _--� Call 503.639.4175 by 7:00 a.m.for the next available inspection i This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. CITY OF TIGARD MASTER PERMIT ' • COMMUNITY DEVELOPMENT Permit#: MST2018-00306 Date Issued: 01/10/2019 T f I.;A is C-7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103BD10800 Jurisdiction: Tigard Site address: 11710 SW WALNUT ST Subdivision: 2003-045 PARTITION PLAT Lot: 1 Project: FURLOTT Project Description: Interior remodel:Adding(1)bedroom and(1)bathroom to the second story loft, and changing layout of master bathroom. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Total: 0 sf Value: $60,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 2 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 3 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 2 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 1 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 2 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: FURLOTT,RYAN C OSTERCRAFT HOMES Required Items and Reports(Conditions) KATO,ALYSHA C 15811 SE MONNER RD 11710 SW WALNUT ST HAPPY VALLEY,OR 97286 TIGARD,OR 97223 PHONE: PHONE: 503-658-7558 FAX: Total Fees: $1,839.60 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00'0. You l obtain a co. of the rules or direct questions to OUNC by calling 503.232.1987 or 1. 2344. Issued By: i',/4/./i &1- ���5��ermittr=e Signature: '2 / Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential FOR OFFICE CSG OMEN si City of Tigard - DReceived Permit No.: e III13125 SW Hall Blvd.,Tigard,OR 97223 sPlan ,y� ✓�/� t: Reviewhone: 503.718.2439 Fax: 503.598.1960 ,, rz Date/By: 1 I � Other Permit : I-l A u D Inspection Line: 503.639.4175 'J\ t Date Ready/By: I Juris: 0 See Page 2 for Internet: www.tigard-or.gov Noti ed/Method: f t 7 / I Supplemental Information TYPE OF 1INCIIING DIVISION RE/UIRED DA A:1-AND 2-FAMILY DWELLING ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. �/ Indicate the value(rounded to the nearest dollar)of all ►�Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. �-,,{ Valuation: $ 5=-- -and 2-family dwelling 0 Commercial/industrial ti ocu L�1 . ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ill to $C ... W4-t.Nut 1 St New dwelling area: square feet City/State/ZIP: -i-t trkr><-o 04. Garage/carport area: 0 square feet Suite/bldg./apt.no.: Project name: rt,.,��vf T (ZE14.4.407 Et Covered porch area: 0 square feet Cross street/directions to job site: Deck area: 0 square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ R t.tauC l u-)/50-c ..teu- t N i a ki,v Uri/ s CANE-to'TO At,$)rl3Htx. - Ort.jet. Ey�1Cl_os E 2....0i> 517.30-1 Lori 1-4, AO 0 A- Sew-004A id- Existing building area: square feet Ck u- 13 h T FM.o obi * C.11-A,N Nr Lf'�o t►r OF Tilt Md3 r RA'Tf)n.o • New building area: square feet (.PROPERTY OWNER 0 TENANT Number of stories: Name: `, FK,L0 r r Type of construction: Address: H-110 6 w wB.,u„,UT Occupancy groups: City/State/ZIP: Ti h,vt„,t, 6✓L . Existing: Phone:(503) 481(0_60,s j Fax:( ) New: Q'APPLICANT ( CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: 0s Structural plan review fee(or deposit): Contact name: J E Kt-,„, ©S7'e�yo4c-� y FLS plan review fee(if applicable): Address: IS130 I S E A4...JArE-1, RD. Total fees due upon application' 5- J (1 t. City/State/ZIP: y�.p ft! V_*ey 2_ e17 v i3 6 Phone:(503) 81`t(g-1.4o Fax::( ) Amount receive E-mail: //�� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Jg/LE�"lylo/OS fLnl t o h cf I*v.z($ . GoM Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: // Submit two(2)sets of roof plan with connection details �S7t1L C rt kFt r3 (n/C. and fire department access,along with the 2010 Oregon Address: 1531 I XE MoNNek- 12 O Solar Installation Specialty Code checklist. City/State/ZIP: yo 01iceY On- Permit Fee(includes plan review $180.00 Y and administrative fees): Phone:(503) N, Ng2a Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 160/5-c� Total fee due upon application: $201.60 Authorized signatur Q ....& ( This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Print name: J\C,,„i OS,-,01 , Date: IIp_ q-/J Service Board. I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist e One- and Two-Family Dwelling FOR OFFICE t SE ONL1 Received City of Tigard Date/By: Permit No.: 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: II Phone: 503.718.2439 Fax: 503.598.1960 TIGARD 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1 e No y/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. ❑ ❑ 0 4 Fire district approval required. Name of district: . 0 0 0 5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 ❑ 6 Sewer permit. 0 0 ❑ 7 Water district approval. 0 0 ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ 0 9 E osion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0 bas protection,etc. 10 3 omplete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ ❑ 0 tlding codes. 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. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ 0 ❑ there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ❑ ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(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,roofing,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. 0 ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or 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 floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ ❑ 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 0 El ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured1Toor[roof truss design details. 0 ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ❑ 0 ❑ for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 ❑ architect licensed in Ore•on and shall be shown to be a..licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0 ❑ 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. H 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 ❑ ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLI' City of Tigard Received Permit No.: �— y r v 13125 SW Hall Blvd.,Tigard,OR 97223 `;S te/By. ' I 'Pl5n Review Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: [d See Page 2 for Internet: www.tigard-or.gov ,I; ; „a Notified/Method: Supplemental Information ' ..:'' 1 Y 'r ,, 4 COMMERCIAL FEE* SCHEDULE...7 USE C1!E CLIST Mechanical permit fees*are based on the value of the work ❑New construction aAddition/alterafl6nhreplatement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ CATEGORY CIF"CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* [`1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total '., JOB SITE INFORMATION AND LOC .�ON' „,,,=, Heating/cooling: �'` Air conditioning 46.75 Job site address: I I—„0 . (,3 Wfl u--A( 5r Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP: -1 ISYS- O� Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 _ Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 23.32 .;,•'''•' '41:i , 4 DESC 1.f t O�- :`N Gas fireplace/insert 33.39 k$'x' N'" ' ." Flue vent for water heater or gas Avp \ ve-yr-e vv fireplace 23.32 Ps ©O 1 tv F Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 'x1!RO"t. TY " .R i_ aS'ANT ........ Environmental exhaust and ventilation: Name: R.`psi F k tet-- t-c)T r Range hood/other kitchen equipment 33.39 Address: 11-1 I J $KW t t1A-t..N 1A.7 Clothes dryer exhaust ( 33.39 33.3`l Single-duct exhaust(bathrooms, City/State/ZIP: 1'l Ano toilet compartments,utility rooms) ( 23.32 2.3.3 2 Phone:(5'o3) ul b ....015-7 Fax:( ) Attic/crawlspace fans 23.32 `❑ ,APPLIC ❑"-C 1V[ GT PERSON- , 4 Other: 23.32 Business name: Fuel piping: Tt�CA-AV--r Y MFS NL $14.15 for first four;$4.03 for each additional Contact name: Jt�E.�y ( L� Furnace,etc. Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: Water heater Phone:( 53) et(-'1$Z 0 Fax::( ) Fireplace Range E-mail: J€ �.) 0srot..cK-kF7-14.a.tES.Gown Barbecue •.. '3 s • ACTOR., `' =:ate > > xx Clothe9 dryer(gas) ��e 0Other Business name: 57t'1tic"_Fr4-rt /Nr_ CA 1', ". t ,n Address: /51/i .SE MoNoVerl fZ J Seo-7/ Subtotal 'Q� City/State/ZIP: /4„ip y V k,Fy an, G37Ofe b Minimum permit fee($90.00) 33 •!�/ Phone: ,/r'° / Plan review(25%of permit fee) (,yi ) 51&_tigza Fax:( ) State surcharge(12%of permit fee) CCB lic.: /6 9 531 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: / * Fee methodology set by Tri-County Building Industry Service Board Print name. � a - /, Date: // i—(8 I:\Building\Permititss\\MEC_PermitApp_040113.doc / 440-4617T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information . Commercial& Multi-Family Fee Schedule: Total Valuation: Permit Fe . $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit Application FOR OFFICE: I si o'11.) City of TigardReceivedrEIMENPOI 13125 SW Hall Blvd.,Tigard,OR 9722f .x nate/B : ,� �, ''1 };Plan Review III Phone: 503.718.2439 Date/B : Related Permit#: Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: Juris: iZi See Page 2 for 1 I c,A R D Inspection Line: 503.639.4175 Internet: �6?yrttifard-or.goy, Notified/Method: Supplemental Information TYPE OF W9g1K,. PLAN REVIEW 0 New construction Addition/alteratidh1replacemen't+ Please check all that apply(submit 2 sets of plans w/items checked): q p: 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: , ;2, where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION "ilU'riexceeds 10,000 amps at 150 volts or 0 Floating buildings. E"1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amp0 Multi-family 0 Master builder 0 Other: Fire for all other installations. butngs. 0 Fire pump. Installation❑ of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived .-/ ❑Addition of new motor load of system. Job#: Job site address: ll ID l t) (A)A'LAI OT 100HP or more. ❑ A» E„ `1.2» `1.3» City/State/ZIP: Ti ttr ❑Six or more residential units. occupancy. 0►� Recreational vehicle parks. 0 Health-care facilities. 0 Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or lessN„4Y> Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) LoN✓€s..t Swim-v.11t3w. tt Lr1..&Np17-y Limited energy,multi-family / residential(with above sq.ft.) 75.00 2 �Nvc -'r 7v Dia-0.-k • 13A-'TI}lt.30(. 1 Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: �I r 200 amps or less 100.70 2 Rt—tir�t..orT Address: I l 0 s(J (A.m...wu 201 amps to 400 amps 133.561 2 401 amps to 600 amps 200.34 2 City/State/ZIP: inI tit d-r,o 02, 601 amps to 1,000 amps 301.04 2 Phone:(So3) ts((0_09 S) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 0APPLICANTBranch circuits—new,alteration,or extension,per panel 0CONTACT PERSON A.Fee for branch circuits with Business name: above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first I 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 1 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: / Sign or outline lighting 67.84 2 JJN IT( Liv a+Twl/.I GA ELEt_TM c.. Signal circuit(s)or limited-energy Address: 23 I b iia:2-c D panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: p '� Each additional inspection over allowable in any of the above `a11-krv0 on- 'I 1 21 0 Additional inspection(1 hr min) 66.25/hr Phone:(505 )11 3 Vp ci Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr WH;'(Et,lChN? 'fIJi+t9D ,G...Ai/1U-- C.t.wl Inspections for which no fee is CCB Lic.: 153%1 Electrical Lic.: 3'] 8I 7G Suprv.Lic.: L([ -75 5 specifically listed('h hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: t -7�j� IGB.sK Print name: �o g E,.,T T Tt ,,f�?l nd % Date: (` ,.g.�g 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signatu40 l TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: JY /rhSrec Mtrr Date:,/,9./I days after it has been accepted as complete. ewe-wkV * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: fps µ; FEE SCHEDULE �+SIDEN'IIAi,*�Rx:OI�.Y* �. �.�m� Fee for all residential systems combined: $75.00 Description Qty. Each I Total I * Renewable Renewwable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/hr min) CO [ ° ' VORI 0i'Y: T ELECTRICAL PERMIT FEES ,'-' Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PennitApp_ELR_ERE.doc Rev 10/26/2017 Plumbing Permit Application ' 'Building Fixtures ,; FOR OFFICE USE ONLY Cityof Tigard Received g Date/By: Permit No.: frry�-r-,�.jl,i , `3 116, II 13125 SW Hall Blvd.,Tigard,OR 97223 ,.., \ )a; plan Review ` / f i/� W = Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: la See Page 2 for Internet: www.tigard-or.gov „ � �,'''t s Notified/Method: Supplemental Information TYPE'OF$w41 TILMN J V Jp, 1jr +., FEE* t#EDULE ID New construction ID Demolition For special information use checklist Description Qty. Ea. I Total [.Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCT"# SFR(1)bath 312.70 I21-and 2-family dwelling IDCommercial/industrial SFR(2)bath 437.78 I=1 Accessory buildingSFR(3)bath 500.32 ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 Ja. „.mss, ,j130 SITE INFORMATION AND LOCATION: Site utilities: Job site address: 1 1-1 1 v Sl...) WfrLtsyur 6 r Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: I(.+.•q�n.. o Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: 1 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 3,:',.:16'..t.' DESCRIPTJ N OF WO '-e-047..",,p- , Backwater valve 12.51 .. ..�*. '''''w . �. ;-"6� Clothes washer 1 25.02 2S. 62 °Ntl�1-r Tt...B To Cl.:atf'f3 -4-5 IJ;°'►` , 2e stoq E L I 5,117#441.,w1 Dishwasher 25.02 11.tip o 1•+e r--....L f3.4-j ei to nJ. Drinking fountain 25.02 Ejectors/sump 25.02 r Q Py " VNER ;;-,,d .., r. _ . ' NANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 l� APPLICANT vi g ACT Interceptor grease trap 25.02 Medical gas(value:$ ) Page 2 ry Business name: 0 Tte-tM1-l4 1=T H-eu.i.€5 /4L.)C Primer 12.51 Contact name: J E-11.,E .f D,T .t -61-4,., Roof drain(commercial) 12.51 Address: 1T(,( S C M ou jEh. 2D. Sink/basin/lavatory /�/.3 25.02 2S..U2 City/State/ZIP: (4 p„Q P y Ort....---e y ort.... 9-103j. Solar units(potable water) 62.54 Phone:( S ) Qj 16 tet{$-t , Fax::( ) Tub/shower/shower pan ,f j 12.51 1'Z.S I E-mailJ,o„lr,„`y��TEG1,1'LA-pi- 5 Lam Urinal 25.02 I-.. , f Water closet L 25.02 ZS,G2 ICTQR -1/ 3 . N .. •r - ,. ,. Water heater 37.52 Business name: MI. V t EL,/ ?/...‘A.w.31 IVti Water piping/DWV 56.29 Address: Pe 5crx 15 1 Other: 25.02 City/State/ZIP: L�Csq�tlJt+. tS(L 1,103 9 Subtotal 8 1.57 Phone:(5 o'S)Q,'-(y.I.-j Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: 19-7 01 g Plumbing Lic.no.: F i i q-1 State surcharge(12%of permit fee) Authorized sign .t=ka) TOTAL PERMIT FEE u �. Print name: Date: p This permit application expires if a permit is not obtained within 180 days J �I'� /• I en.,e 0"1 0STr)t.ta-wr after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Fee(ea) Total Permit:Fee: r Site Utilities Qry.,�.f. ���,�. . Sq>l���r, c��atage: .� -0w Footing drain-Pt 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit 11 ee: Storm&Rain Drain-1st 100' 62.54 '' $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for ry•r,i each additional$100.00 or fraction thereof,to b qty. Fee,eg) Total 4the speetiorFee� '' ;•:•. and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to M accurately report fixtures could result in increased sewer fees*. Plan R for "ftn$i bing a allatioi s. Quante by Fixture Type. Plan review is required for any of the following. Fixture Type for Replace! Please check all that apply. work Performed: Capped, Added Relocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engine -Jacuzzi/Whirlpool Car Wash: -Each Stall 0 New exxr. terior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thnt ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" ' "axle" to.t. s ttt 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 FOR OFFICE USE ONLY-SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT i 111 al lig Transmittal Letter i '(„\lin 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov / III 1 ll- 11111inI TO: .�` ��'S DATE RECEIVED: DEPT: BUILDING DIVISION AlUiSI/1 (1 JNlO1If1S aHv911 -AO ALIO FROM: J Or- rt-c;l..t► 8l OZ E t 3 a y COMPANY: (D11:---...:rs--0-,kr-r `.\-cw.,r I Ns c 3A133 • . PHONE: 563 -vlc - Lte2e) By: W RE: (\ 7J 0 £i.� WR-t.v.iu " 7 € 1 -°33O( (Site Ad ess) 0rmtt umber) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: 1 Description: Additional set(s) of plans. 3 Revisions: R;_u1sve F--i. 'Fk_ivv.5 Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: f\JE tAi LC A PLvgd.3s p v.._-s S E M A 1 t_ R G RTW E.MKA ' crz00-1 t1(isbe FOR OFFICE USE ONLY Routed to Permit T ician: Date: Initials: 6/14- Fees Due: Erfki 0 No Fee Description: Amount Due: $ an kf2- G,r� � t.e c.• $ 4$ $ $ Special Instructions: / Reprint Permit(per PE): ❑ Yes Nov ❑ Done joiL Applicant Notified: ,Le-- Date: / fi4r( Initials: I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 Mechanical Permit Application FOR OFFICE L SE ONE) N City of Tigard Received permit 13125 SW Hall Blvd.,Tigard,OR 9723; _ Date/By: �j /�]�, ga og`Qperj:ji Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: Date/By: I I c n R u Inspection Line: 503.639.4175 Date Read/B loris: 63 2for Internet: www.ti and-or. ov Ready/By: See Page l Information g g Notified/Methdd: _ � Supplemental Information *_7. ' ;w+ A I. TYPE OF WORK 71'r ' t/j' iMMERCIAL FEE* SCHEDULE - USE tDLCICLIST Mechanical permit fees*are based on the value of the work ❑New construction lEt'Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$ ATEGORY OF CONSTITerleN C RESIDENTIAL EQUIPMENT l STi MS FEES* 121-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total JOB SITE INMATION.AND LOC Heating/cooling: OR Air conditioning 1 46.75 q.(p." ' Job site address: 1 1^I `O 5w Lito,,t -cV Furnace 100,000 BTU(ducts/vents) 1 46.75 11.6:15- City/State/ZIP: 1.6'isCity/State/ZIP: T1 r_��� t b Furnace 100,000+BTU(ducts/vents) 54.91 "�I Heat pump 61.06 Suite/bldg./apt.no.: Project name: Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Other: 23.32 Subdivision: 1 Lot no.: Other fuel appliances: Tax map/parcel no.: Water heater 23.32 Fn DESCRIPTION OF'WORN tr Gas fireplace/insert 33.39 *s"1,--.,44' tei.:_ . Flue vent for water heater or gas A�v..�'f ItJ6n E)cvs-tl..lc., 1t�L.t1J►NIC..PcI_ 99,-A4t'T fireplace 23.32 /MS r.o2.0/? ' 603/( Log lighter(gas) 23.32 v(/ Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 0 PROPERTY N ti m ..,. . CI TENANT :, •ss Other: 23.32 4••�� OW° � a°'��" _ • Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment 33.39 Address: Clothes dryer exhaust 33.39 City/State/ZIP: Single-duct exhaust(bathrooms, t� toilet compartments,utility rooms) l 23.32 r Phone:( ) Fax:( ) Attic/crawlspace fans I 23.32 APPLICZ •' „ 7 ❑; ONTACT PERSON Other: 23.32 Business name: Fuuel piping: OSTeKc RAFT J I J4.tfn.CS I.IJ . $14.15 for first four;$4.03 for each additional Contact name: ci E Yl Nof ES-Pi t a1-.I A Furnace,etc. Gas heat pump Address: t5S�` 5� l' Nth R c) Wall/suspended/unit spended/unit heater City/State/ZIP: I\ feY VA`LE1Fax::( OK. 1108 C Water heater Phone:(50) 616_Li 12.2_0 ) Fireplace Range E-mail: JErI.=c iw�C•��.osT c-,tia.t�. �k1. CoM Barbecue CONTRACTOR' ' Clothes dryer(gas) Other: Business name: �0t_C 0 T.I. MECHANICAL PERMIT FEES* Address: Subtotal I • 3..2-8 City/State/ZIP: Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:( ) Fax:( ) State surcharge(12%of permit fee) 1 I• f<cl CCB lic.: i 2:25,0 TOTAL PERMIT FEE /all it j7 6 0,„../.. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. AuthOrized Sign•;.yam., / * Fee methodology set by Tri-County Building Industry Service Board Print name: JErt '%.y nSTL9t11Date/ /,7 I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T/(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial& Multi-Family Fee Schedule: -Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional$100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional$100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional$100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC_PermitApp_040113.doc 2 Electrical Permit Application FOR OFFICE USE Oy1.1 of TigardB Date/ : ( �/A Pl%ii //1 City P: /� lig • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review / C Phone: 503.718.2439 Date/By: Related Permit#: Email: TigardBuildingPermits@Tigard-or.gov Ready i 1, Juris: ® See Page 2 for I I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Not :,:./ :,-oSupplemental Information TYPE OF WORK 4��` N'' ;, �h PLAN REVIEW ❑New construction [2—Addition/alteration/replacement '• Please check all that apply(submit 2 sets of plans w/items checked): �,.' ` ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION / exceeds 10,000 amps at 150 volts or 0 Floating buildings. [Wand 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ' 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: I\—ri 10 St,_) Lop,t_PJ ti,4 100HP or more. ❑"A","E","l-2","1-s", City/State/ZIP: ❑Six or more residential units. occupancy. 1 C 4.p ❑Recreational vehicle parks. El facilities. Suite/bldg./apt.#: I Project name: ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 q ND...1 to ST- Ex)ST t so G, ELtc C^1 .t C.A L. PE►L.4.4 t T Limited energy,multi-family /14-57-,10residential(with above sq.ft.) 75.00 2 �� �O Renewable Energy ❑ See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 1 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Oc -EY' ac 4-t.M c5 1g L above service or feeder fee, 7.42 2 each branch circuit Contact name: DERE y -j-Eki{tt_w/\ B.Fee for branch circuits without / Address: \S-1301k �� n service or feeder fee,first 1 56.18 •Sto.i 5 2 1`, branch circuit Each add'l branch circuit 7.42 ¢ 2 City/State/ZIP: 1 (� Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: u3 W,tT1e Li f it+rsu 1.vG. ELE . Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy El See Page 2 2 Address: 2310 N g2tiv z panel,alteration,or extension. g 22 0 Each additional inspection over allowable in any of the above City/State/ZIP: �C7VLT A.)0 �.. G L-A - Additional inspection(1 hr min) 66.25/hr Phone:(s63) 712 - 2 ct)e1 Investigation(1 hr min) 90.00/hr 3 ` Industrial plant(1 hr min) 78.18/hr Email: (O4 ITE LA(.1 ti-TPJ 1 LAJ C.t ?D (Q.Cst,n t i)-I L•C..-1:50-1 Inspections for which no fee is CCB Lie.: jc3 gc"7 Electrical Lic.3'l8I I a Suprv.Lic.: i/LI-- 0 specifically listed('h hr min) 90.00/hr (1 / J` ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: J 22.9 6 Print name: —1-:,,t -T k a t 1,�J Date: i`s /, 0 Plan Review Required(25%of permit fee): ( < I!� State surcharge(12%of permit fee): Authorized Signai. /�J� L.---1 TOTAL PERMIT FEE: .4/ This permit application expires if a permit is not obtained within 180 Print name: Noe A r w 4. Date: 3/5—/./3 * days after it has been accepted as complete. l ( Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Fee for all residential systems combined: $75.00 EachTont 3' Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 (1 Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specificall listed('/z hr min) COMMERCIAL WORK ONLY: - EL) RICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11710 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00306 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Check possible leak right side master Lay, puddle under sink trap. All else ok. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11710 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00306 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Electrical contractor to connect whip for ac unit. Propane tank less than 125 gallon per homeowner and contractor. All permitted Mechanical appears ok. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11710 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00306 Inspection Type: Inspector: 299 Final inspection David Young Result: FA I L Comments: Provide approved electrical final. All else appears ok. Re schedule with electrical final inspection. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11710 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00306 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Ac whip not done. Missing smoke/ carbon detectors upper level. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11710 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00306 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Ac whip not done. Missing smoke/ carbon detectors upper level. Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11710 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00306 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11710 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Master Permit MST2018-00306 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - NoCofO Comments: Corrections complete. Violation Summary: Inspector Contractor