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Permit (2) CITY OF TIGARD MASTER PERMIT . ''' COMMUNITY DEVELOPMENT7, ° , _ 1Permit#: MST2019-00382 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 --r Date Issued: 10/09/2019 TIGARDParcel: 2S110AB01700 Jurisdiction: Tigard Site address: 14220 SW 114TH AVE Subdivision: COLE'S ACRES Lot: 4 Project: Ornelas Project Description: Adding (1)glulam bean support in living room. Repairing like for like subfloor, 2 ft foundation, and new load bearing wall and changing door locations. 11/18/19: REPRINT to add (1)200 amp BUILDING Floor Areas Required Setbacks Required Stories: Bedrooms: First: sf Basement: sf Left: Parking Spaces: Height: Bathrooms: Second: sf Garage: sf Front: Smoke Dwelling Units: Third: sf Right: Detectors: Total: sf Value: $10,000.00 Rear: PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain 0 Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Drains: 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: Clothes Dryers: Heat Pump: N Hoods: Other Units: Furn<100K: Vents: Woodstoves: Gas Outlets: Furn>=100K: ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 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: 6 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 Owner: Contractor: SAMSON CONSULTING LLC ISAIAH JOHN RITCHEY Required Items and Reports(Conditions) PO BOX 23966 31612 S PALMER RD PORTLAND,OR 97281 MOLALLA,OR 97038 PHONE: PHONE: 503-849-9671 FAX: 4 Total Fees: $1,338.37 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes an• . other . • able law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or work is :pended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Th. Id es are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain Tofthe-rules or direct questions to OUNC b_y coding-593332 •: ...i�frr 1 Y Issued By: %pis% -w _.J.P—�- Permittee Signature: Can 593t39.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 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' .. tt�.taa .: v: rl t-.; . w`rilsta14ir ► rrtw , �# Ann SCAN .,.. � i` A. *t +`�t'`anc11 i 'uttx+ +t ; Rosanna* cSr, C A) _ +A +`. , ot.youlmitros�. n , 4. •; 4 Contact n n ; � + w',U4 ss t 4 t Address; " +ak'r.:? "'', .....- -..._,...may,, a ° ` 4. Phone.I ) *, ^,. i.- t<at a to i +i' . nttllf' r €' + e ,, ; ' CON TRACI ON Adds s: / +�,f . "ice 1 ` t V —�._ �t w,._ 3 -�r c.rt._.,�;._..t.„,,..,- ,�, ..: �?e rtf9#�$*k ,# t`%ti"* 1'Q�0.t 1 • Cif S1:tte/IP. ,, ` z �,1'v, i t c t'tt'- i •• t` $' ."��„�, '•p..,..@?"9>x s'3 nf.:t .rn+tr ". � $ '�+GY t , (L. �$ ' .. yy¢ x [' rtitzt.-. f .., � A"E+, ,nµ r F_& ^ Jec i - " It �FR '"9 Yd 4 ,r i , tiY4R x i 1 -.',2 6 � :1sor u itot ' mm .. k a y k�;n .aa.-a ... .. ' 1tlt01 f t° ", — . It,e,I+t 1€tt{tt.tld ..,..... .a * '� St _. . - p� 4, i n b:a K ` 4 #s x-t '!, .g:;- ' se t*lt1'f1 4 14441 t*t*ota$t ld ig. ;•"� e.- .., ayy, e..t tt ti:fi 4 i a .tom &' Q'@ •. tf— f '4Aa"Ll Kt. y ,,@@}WW}��"" t 14414; ;4 t'- `>a�"i `TI j 5 ' ,,. +? .1 b�{"'x.a r ?t' t X CITY OF TIGARD MASTER PERMIT INla COMMUNITY DEVELOPMENT Permit#: MST2019-00382 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2019 Parcel: 2S 110AB01700 Jurisdiction: Tigard Site address: 14220 SW 114TH AVE Subdivision: COLE'S ACRES Lot: 4 Project: Ornelas Project Description: Adding (1) glulam bean support in living room. Repairing like for like subfloor, 2 ft foundation, and new load bearing wall and changing door locations. BUILDING Floor Areas Required Setbacks Required Stories: Bedrooms: First: sf Basement: sf Left: Parking Spaces: Height: Bathrooms: Second: sf Garage: of Front: Smoke Dwelling Units: Third: sf Right: Detectors: Total: sf Value: $10,000.00 Rear: PLUMBING Sinks: 1 Water Closets: 2 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 0 Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 1 Water Lines: 0 Drains: 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: Clothes Dryers: Heat Pump: N Hoods: Other Units: Furn<100K: Vents: Woodstoves: Gas Outlets: Furn>=100K: 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'500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 6 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+a m p/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 Owner: Contractor: SAMSON CONSULTING LLC ISAIAH JOHN RITCHEY Required Items and Reports(Conditions) PO BOX 23966 31612 S PALMER RD PORTLAND,OR 97281 MOLALLA,OR 97038 PHONE: PHONE: 503-849-9671 FAX: Total Fees: $1,124.78 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and .1 other -•plicable 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 .rk s spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T .-e r les are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop • - • - = •irect questions to OUNC by calling 503.2 .1987 or .:/i0.33 2344. Issued By: !–. l—�� •e •m•ture Cal 13:. • •.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. Buildium Permit Application Residential FOR OFFICE LSE ONEv Cityof Tigard Received �/ 1�]�// ��,/ g Date/By: �� P '7/OYi[ / V(/J�� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review S Phone: 503.718.2439 Fax: 503.598.1960 Date/By: i D7 i I ' z 6,". kac.l�(.(/6,?)-- T I O A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov .9 raorified/Me od G /, Supplemental Information TYPE OF WORK " REQUI D DATA: 1-AND 2-FAMILY DWELLING 0 New construction 0 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. El1-and 2-family dwelling 0 Commercial/industrial Valuation: $ 01- 0 Accessory building 111Multi-familyNumber of bedrooms: ❑ Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ‘9 saQ \Of\ New dwelling area: square feet City/State/ZIP: ` "` e,,,,� (3 9? k( Garage/carport area: square feet Suite/bldg./apt.no.: Project name: 0 r'h .'\ei,, Covered porch area: square feet Cross street/directions to job site: Deck area: square feet 1 Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST 1 Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the joeliar DESCRIPTION OF WORK work indicated on this application. Valuation: $ ozr vy\(_. G - �\t.‘_ .SV.l k1.51c 4 ,a8 c4 4k;{1 Existing building area: square feet W<W w cA\ 1 cr ca j _IVv1 G Z i- vv I Cc -Y New building area: square feet 0 PROPERTY OWNER 0 TENANT Number of stories: Name: j e V<„..,..f Ort e-)&5 Type of construction: Address: 7, p, Boy 2 3 9G L, Occupancy groups: City/State/ZIP: Par 4 )o kic-t 4228 ( Existing: Phone:(563 ) 840—)688 Fax:( ) New: 0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: G, �f h.Y S � GS i Structural plan review fee(or deposit): Contact name: FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: Phone:( ) Fax: :( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: ,� . \ ( y A ��� Submit two(2)sets of roof plan with connection details Sw�e� and fire department access,along with the 2010 Oregon Address: \G\ S cp m Solar Installation Specialty Code checklist. City/State/ZIP: VA Permit Fee(includes plan review $180.00 and administrative fees): Phone:(&01S.1il cIC7 I Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: Vic 14 Total fee due upon application: $201.60 Authorized signature: � o)2 ------ Voltai180 days after it has been accepted as complete. Print name: *Fee methodology set by Tri-County Building Industry � ti \Z Date: 'e ��C� Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Building Permit Application Checklist One— and Two—Family Dwelling l (11 1 i c l. I �1 (l\l 1 r I o City of Tigard Received `y Date/By: Permit No.: I 4 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits: Phone: 503.718.2439 Fax: 503.598.1960 T 1 G A K D 24-Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.tigard-or.gov ❑ Other: 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0 3 Verification of approved plat/lot. 4 Fire district approval required. Name of district: , ❑ ❑ 0 5 Septic system permit or authorization for remodel. Existing system capacity A . 0 0 6 Sewer permit. 0 0 7 Water district approval. ❑ ❑ 0 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0 9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ ❑ 0 basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0 building 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 0 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 0 ❑ 0 and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0 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- ❑ 0 0 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 0 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- 0 0 0 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 0 locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ 0 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 0 over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 0 , 0 0 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 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 0 architect licensed in Ore:on and shall be shown to be a..licable to the .ro'ect under review. .IURISDICTIONAL 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 0 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 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 0 Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 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 0 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) t. 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Bi19iPf .�S6&dtt8�` . :7, g �a�as „,,,k,..,,,,,k,,.�ai „ �...t�..W„° t)".1-4- 1�.�..U.F.. t, ,„.4 r Ytt,sl,,t ltz-q„ tsxtl; y f Atitl( 8: f -------- ;.�,:1 to , ,s �M "� pp Each addtt�tal lea ems Isar rtaa .ha #the a"i,ta+�� Cite St; 7 . r i( # - 92242 t ttitt� t a 3+rs t t} mar.) astr ., 4. �`f 4$31 2 t t l ei t ,t ltl nuts t ,t alt 0! 8,,, 3 T.`fab 5 q� � km in (� -C ' ,.r�;4,1 Ltt; ,., �d. °'.; ,, t ck ,,v4...,11.:.€ {Js 4 . s. � __. ..�� n. . Both. Ficoriciun' t u st bbrg;1: . - . St ti ft '11 st #,a . .444 ff, TOTAL it ' tilt `.3 e; ,- ..� t aet*wham ;'t#tf;Lamya Yate, 1st t1 tats at,t�tat srlste - 7 1 47 ii:70_ - = trtkas€s ititsw.st let.tINNItAet Electrical Permit Application FOR OFFICE LSE ONEI' City of Tigard Received Date/B Permit#: 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C Phone: 503.718.2439 Date/B : Related Permit 4: Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: Juris: Ea See Page 2 for T I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 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. ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION r� S G.1 AND LOCATION ❑Emergency system. larger separately derived l y ZG 0 !�y ,4ve ❑Addition of new motor load of system. Job#: Job site address: I00HP or more. ❑"A "E","1-2",`°1-3", Cl /State/ZIP' ❑Six or more residential units. occupancy. ty �/FQtA I O 1ti 97 Z Z 3 ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: les 0 Hazardous locations. 0 Supply voltage for more than O(.,„,z, N� "'—� ❑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 1 * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) Mpve. ?69g 4 S t.ii I e.,Lx,s t~-11f.A.ta- 6.14I I t5 cct••wt /GCA. Limited energy,multi-family L t� 11� t residential(with above sq.ft.) 75.00 2 lac,. Cor J rte., 1?1v4S a SW,ukes f tlyJ. (.1H S�Gt� C04n It 4.15 4 wa7 0 PROPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: J 2@c,,f Oe.oti&s 200 amps or less 100.70 2 Address: `. . 0.Be, 2 s ci 0( 201 amps to 400 amps 133.56 2 X 401 amps to 600 amps 200.34 2 City/State/ZIP: l` )ra-16v . oil 1728l 601 amps to 1,000 amps 301.04 2 Phone:(543)$yo-.0 g g Over 1,000 amps or volts 552.26 2 Li Temporary services or feeders installation,alteration,and/or Email: qrt 1M 0.��500.CO N S V 1 i to 9• G o r-% relocation Owner nstallatiod: s i .tallation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,``en', or change,according to ORS 447,449,670,and 7 1. 201 amps to 400 amps 125.08 2 0 Owner signatu 1_. - D 401 amps to 599 amps 168.54 2 0 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: 54- c A S skirt` above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 1 56.18 2 Address: branch circuit City/State/ZIP: Each add'l branch circuit 5 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: f �tJ ie,rak F- xIe ...1-c i G L.L.I.c Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address: 1 , 'L/ S C A I dqi C+ panel,alteration,or extension. (9� G 1 0 (� —1 1 Each additional inspection over allowable in any of the above City/State/ZIP: / ' N C` R. ?2 33 Additional inspection(1 hr min) 66.25/hr Phone:(6j3) 8(8l- 1 Sc 13 Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 225([2_. Electrical Lic.: Suprv.Lic.: specifically listed(%hr mi❑) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized si nature: TOTAL PERMIT FEE: e . / This permit application expires if a permit is not obtained within 180 Print name: (e_,/ C.. ( 1 a� i Date: /25'�,�f days after it has been accepted as complete. I r� e J * 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 Fee for all residential systems combined: $75.00 Description Qty. Raeh Total y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n 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 n Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ 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: n 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) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES $75.00 Subtotal(Enter on Page 1): Fee for each commercial system: * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls n 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_ELRERE.doc Rev 10/26/2017 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received Date/By: Permit No.: 141 III 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1960Date/By: Other Permit No.: TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris: Ea See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. - Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: /y22654.ki l/yf_I_° A ye.- Catch basin or area drain 18.76 ` r•A e 4722-� Drywell,leach line,or trench drain 18.76 City/State/ZIP: le / Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: ©r'AG 14s 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 1ktQ(ace__ 0 i pie MA? l•i• iii1Mttstlf b ..11,1fy► Dishwasher ( 25.02 3.e.e ...-c.t� (. A A . Por- /i ii,c_ L'.v J-Jres Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: 3,ce. ,....7 0rLAe,Ig5 Address: ( Floor drain/floor sink/hub 25.02 ?• 2 g Garbage disposal l 25.02 City/State/ZIP:RIkr4 14.4/ ah L, D& 9?Z 6( Hose bib 25.02 Phone:(93 ) 18'(O.-70gg Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 ___ ,ZJ e' '� Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory cli 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 1 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet Z 25.02 ... Water heater I 37.52 Business name: Vi tc t„et ' t vo„,b l Nq Water piping/DWV 56.29 Address: I(4 1O /51- L',) 11,6401.1 Other: 25.02 City/State/ZIP: ){4,p(2}01,„l OR Cr?y63 Subtotal Phone:(S' 7 JhZ1C) Minimum permit fee: $72.50 1�) 9��-. ' (74( Fax:( ) `� Plan review (25%of permit fee) CCB Lic.: 22.4. i(5` 4(1,(V L� Plumbing Lic.no.:1962,03/ State surcharge(12%of permit fee) Autho -• signatur- -A TOTAL PERMIT FEE K Kt�, /��// This permit application expires if a permit is not obtained within 180 days Print name: Date: after it has been a tcepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\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: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-1"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 Fee: 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 Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to 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 accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantity 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 Baptistry/Font El Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. 1:1Car Wash: Each Stall New exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ 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" 3" Isometric or Riser Diagram 4„ ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. 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