Permit ,
• tJ • ••
. , CIT OF TIGAR ®1 : '
.. .
DEVELOPMENT SERVICES ' • PLUMBING PE. RMI T ' .. •
i F'ER;►1ITk, ...... a F�I_M'7- -x+447
. '-- . 13 S W Hell Blvd., Tigard,OR 97.22 (503) 639.4171 ' DATE r r M
. DA,E ISSUED; 1.1/07!17•
. PARCEL. :,. 2311 EBD- 047000 - . • SITE ADDRESS : 15045 SW 79TH PiVE • , . ' '
3UBD T V I S I CI I; . 1�I'LP �1- fC�1G('JC Z ON' INiG;: • R-4 .
BLOCK - • - LOT.:, . . , . ... ,; e 00E '" ,JURISD.IC1 .t; ''TITS . • •
CLASS, OF WORK'..:OTR :' GARBAGE •D SPOSAI:_S„ : " ' Q( MOBILE HOME. SPACC�S. s ' 0 • . • ,'
TYPE OF USE :`SF , WASHI ' MACH.;...:.. e 0.. • BACK'FLGIW P,REVN7F:S..' 2 0
OCCUPANCY GRP.. `: R3 - FLOOR PRA INS ..... . 0. , TRAPS„ .... ......... . i '2: . , ■
• STORIES • • ^ ' 0 • '' - WATER HEATERS a 0 CATCH .: BASINS. '.... . 0' .. .
FIXTURES- - , F I X T U R E S - - - - - - - - - - - - - - - - -- L AUND'RY ' TRAYS... .. • 0 . SF P I•N D,RA INS •: • ,
SINKS , • ... 0' ' URINALS.." • .. 0' • ' GREASE' TRAPS'....'. : ., 0'
LAV ...
ATORIES.: 0 OTHER_ F A•TURE S.•. - ..• " :. 0 I •
TUB /SHOWERS. , .: ' 0': SEWER LINE ' (ft )•, .. ;; • 200 . ,, '
WATER CLOSETS.. 0 WATER LINE (ft, ... la • '' ' . • ' 1 '''' . . „ , .. '
DISHWA•Si- ICRS'... ..0•• RAIN DRAIN • (f;t i: " .. 0' "; • '
Remarks.:. 'Co,.rive.rsi,on of residence from se is -- v°o S-ewer.; Instal l.'at ion of 2 .0 ft 6, • ,
• -f - - - .
sewer, line from ho.use"to later'a'l :, ^P fill "'and inspect_ pump,, remo
ve and ,};
inspect abandoned septic sy.st
Owner; ----- - -•- - u `- . „-- - ' • -- - - -
. - - ,. -
,- FEES 4 __
-- .- = I -= ' •
TIMO'TH-Y •J SCAN-1
LtJ.. ' . • . - tyue amount • .by ,'da4'e ' _ r'ee • • • ■
1.5045 S W. ;79TH • AVENUE": " ' - • • : PRMT 1 - 5'5...00 D'RA, ' 11 /07197 97- 30079 , '
T I GARD OR ,.57224• . ,, ,. 3PCT .1i.: 75 DRA •1,1 r /6 /'97 97,-30679;:.:••
. .Ph on e• #:. 684- -0404. 81 •
'I
. Cont - - -- — • - - - - " -• - - - - -- . , . at
•
OLESON EXCAVATION . CO ' : . . - . • • ,
1.5405 SW PL.E'ASANT VALLEY, 'RL'i" „ . ^ , - • . ,
BEAVER �T ON OR 57007 ' _ _ -- - - ..,__.. _.___ - - - -- . _- _ • •
Ph one ''#:: 628- 563E' ' • ' . v 57.75; TOTAL "
Reg: #. `06866 • ' ', • , , ' ' , _ , • • . - .. • i , • • • ;
' '
• ' - -- , - -- - .REOUI RED.:: INSPECT TONS - --- ,
•This'peroitis issued subject to the regulations contained in the • Sewer Inspection'' • -_ -
'Tigard Flue ±i'cipal Code, State of pre. Specialty Cudes and. all other Mi.se: Inspection ' ' r _
applicably laws.. P1,1 work will be done in accordance: :nth - ' • insp exist in/ca .. ... , • . ^' ,
•
approved plans.: This rper�ait -will. expire if work -is, not started . .. • F l n n; I s ae r_•t i.a•n � ` ',
within 187 days of issuance; or if 'work is suspended foi oore — • ,
• than 18yi'•days. , - ATTENTION: 'Oregon'`l requires you to follow - ru'les•• _
' adopted' by the Oregon•llt,ilit,y Noi,iiicatiori Center.' Those, rules, are: ,••• ' • " _ ■
' set forth • in 04R 952- 6Or71- 016 threuah OAR• 952 -r o -Wso. • ,You. Iaa,+- • : r - :
obtain copies• of these rules ; :or direct q to '4LI C .by` call ing • '' , ___;,_ „ ' -'
• •
Issuer; 7 - '' • Permitt,ee Si,gn'at Lire s 0 _
' • - +' +•f +-4-. W.r-+"4 - + -'- 4.1.•-F-'r- + + ++- l-•1- +-F•+-I--F +-4 + +-F-,rt ++ + +y-t +- F•++.- F•- r•i-•f"4•+-t- ,-S--i••1-f; +-F•: -F 4 -F,+± +++i- -I- • F-4-4- 4- t +•f+
' : • ' 633_.•4175 bv' 7: 0 . o,. m. `for•' an inscect ;ne•eld'�ed tl siext' tb,-rs'i_ne.s,s. day ' . •.
• •i + ++4 +t - , 4.- -_t• t + + +i-•f +•:-* 4 + 4•• F•- F+ i-+- F•+++++ -F•+ +-i-- t=-F• +i4-1— •i_++F' + +-I + + + +-M-F•-:- ++' +4 1—+••- -- f- -1 - +, ++ .4.- + +4 -.4- -F. ,
e ,
: I . - -' -- _ _. - . - _ _ - ,
CITY OF TIGARD Plumbing Application Rec'd B
13125 SW HALL BLVD. Commercial and Residential Date Recd / - 7
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171 Date to DST
permit* M 9.) -c!vf
Print or Type Related SWR # 51.00.97 - pa
Incomplete or illegible applications will not be accepted Called
Name of Development/Project On back Indicate Work Performed by fixture.
Job .FIXTURES (Individual) . .. • _ QTY:. PRICE . AMT
Address Street Address �"' Suite Sink 9.00
/50 tt .S S w A
79 /t'4. Lavatory 9.00
Bldg # City/State Zip Tub or Tub/Shower Comb. 9.00
/ ;garid. am 9 ]y Shower On
Name
-7":,r, n Only 9.00
a- i ) 0..4 5 co-nn a.., Water Closet 9.00
Owner Mailing Address Suite Dishwasher
9.00
CityIsla a .. Zip Phone Garbage Disposal 9.00
Washing Machine 9.00
Name Floor Drain 2' 9.00
C- )Q .L 3' 9.00
Occupant Mailing Address Suite 4' 9.00
City/State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
Name 1 Urinal 9.00
Ole Sorg C •L CG�V C + -on CO Other Fixtures (Specify) 9.00
Contractor Mailing Address ' Suite
/ 59 o S 5(4.) Piers VG t1 9.00
Prior to permit City/State Zip Phone r, 9.00
issuance, a copy (3 e C,,,, �,., or 9 7 oo1 �p -7� 9.00
of all licenses are Oregon Cent. Board Licit Ex D to
v 49 j ��f 9.00
required if 1,/ Sewer - 1st 100' / 30.00 CJ®
expired in COT Plumbing Lic. # Exp. Date r�'
database Sewer - each additional 100' 25.00 Ll�i
Name Water Service - 1st 100' 30.00 �� Q) �
Architect Water Service - each additional 200' 25.00
or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 6--"".Addition 0 Alteration 0 Repair 0 Pollution Device
to be done: Residential 0-- Non-residential 0 Residential Backflow Prevention Device* 15.00
Additional description of work:
Any Trap or Waste Not Connected to a Fixture 9.00
S 2. Q `"J r'v ti'n' `lN' \ G` • iOrs * Catch Basin 9.00
\f ‘44, , ' ? Tel- . Insp. of Existing Plumbing 40.00
per/hr
Existing use of n Specially Requested Inspections 40.00
building or property 4k nirr . .5 ". LnuA.a _ per /hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information Isometric or user diagram is required if Quandy Total Is > 9 '
given is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL �C,D(�
that plans submitted are in compliance with Oregon State Laws. J - �
, I5ature of Owner /Agent Date 5% SURCHARGE A:15
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
Required only A fbdure qty. total is > 9
TOTAL 57,75
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
`,J}\1► Prevention Device, which is $15 + 5% surcharge
\" . ' , , \ :A
1 ldststplmapp doe 5197 R / tJ` )
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
Capped / Removed Moved Replaced
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I ldsts1pIrnapp doc 5/97
09/09/97 TUE 15:18 FAX 503 681 3993 WASH CO. BLDG SERVICES (1002
' Permits Live db Id: ACTP150 Keyword: UACT User: CHARP 09/09/97
Activity Maintenance - Inspection Processing Residential Electrical
Permit #: 05017821 Applicant: CANBY ELECTRIC
Status: APPROVED Address: 15045 SW 79TH AV TI
Item Description Item Description
402 Underground Electric 407 Pool
416 Electrical Sign 413 Wall Cover
403 A Cover & Service 414 Ceiling Cover
401 Temporary Service 418 Feeders
408 Hot Tub /Spa
499 Final Electrical
412 Special Inspection
30017 In -Plant (Use In -Plant Permit
404 Cover
405 Service
409 Low Voltage Cover
411 Low Voltage Final
410 Low Voltage Underground
Select Inspection Item: 402
(E= Entries A= Approved r= Required Inspection n= Additional Notations recorded)
F1 =Add item F2 =Next F3 =First F5= Requests F6= Notations ENTER = Select ESC =Exit
T..
. r.
09/09/97 TUE 15:18 FAX 503 681 3993 WASH CO. BLDG SERVICES Q003
•Permits Live db Id: ACTP125 Keyword: UACT User: CHARP 09/09/97
Activity Table Processing Residential Electrical
Permit #: 05017821 Applicant: CANBY ELECTRIC
Status: APPROVED Address: 15045 SW 79TH AV TI
Type: RESELEC Vers: 9003 Screen: 01
Base Screen Data
Status: APPROVED
Dates: Applied : 1/25/1991 Issued : 1/25/1991
Completed : / / To Expire : 7/29/1991 % Complete: 25
Job Title: SINGLE FAMILY RES - ELEC Valuation: .00
Descr: SINGLE FAMILY RES - ELEC
Type Const: 0TH
Address: 15045 SW 79TH AV TI
City Name:
Parcel: Owner:
Occupancy: R -3 Class Code: 900 # of Bldgs: 1 # of Units: 1
Public Own: N
Applicant: CANBY ELECTRIC
Insp Area: Val. By: CB
Entered: 01/25/1991 By: COUNTER
Enter Table Screen Number: 1 or ESC =Exit Table Processing F1 =List Screens
No more Table Screens
•
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13imtribution; ---
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested 7 -2'q / [,G AM e 'CV BLD
Location , C Suite MEC /i !'
Contact Person �� �� Ph 2.(00 - 7`780 PLM `7�7r `7 7
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access.
Foundation /'� � FPS
Ftg Drain 1S CJ SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation /
Drywall Nailing Ar
Firewall
Fire Sprinkler , �� i� . /�■
Fire Alarm I,,
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
MBl
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P 4- PART FAIL
' • CHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE ,
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] 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: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Inspector / � / %G ��� X
Other E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Go —W-19 Date Requested C' W - 19 AM PM BLD
Location 1 S OG S — ] 9 G � Suite MEC
Contact Person (T ' Ph 2-(40'-7g PLM c —Q)L/q 7
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall S cee T // � ^f ,
Fire Sprinkler OG S / l /uW
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS „BART FAIL
7 7 7
UMB
Post & Beam
Under Slab
Top Out
Water 'ce
nitary Sewe
ains
F,; >r
1,, 11: Y) FAIL
•
A L
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm "
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA /1I
Approach /Sidewalk Date 6 1/ Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site