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Permit C ITY OF TIGARD PLUMBING PERMIT A-N'r DEVELOPMENT SERVICES PERMIT #: PLM2001 -00379 '` I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/14/01 SITE ADDRESS: 11700 SW 98TH AVE PARCEL: 1S135CD-01900 SUBDIVISION: GREENBURG ZONING: R -4.5 BLOCK: LOT: 004 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of less than 100 len. ft of sewer line to connect existing house to sewer. FEES Owner: Type By Date Amount Receipt VISTA NORTHWEST PRMT CTR 8/14/01 $72.50 27200100000 P.O. BOX 91459 5PCT CTR 8/14/01 $5.80 27200100000 PORTLAND, OR 97291 Total $78.30 Phone 1: 503 - 531 -0505 Contractor: VISTA NORTHWEST P.O. BOX 91459 PORTLAND„ OR 97291 REQUIRED INSPECTIONS Phone 1: 503 - 531 -0505 Sewer Inspection Final Inspection Reg #: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By y�f // / Permittee Signature: (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day . c ' % - 64 - 00 _r L Plumbing Permit App ' ation Date received: ■ i AM Permit no.: i,G ai ' , � City Cit of Ti gar 1 1 h .44 . ' ; l •� g Sewer permit no.: Building permit no.: Address: 13125 SW H Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 ' - Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: EMI ` Receipt no.: Land use approval: Case file no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory LI Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: / " - : -tc) I''t' Description Qty. Fee(ea.) Total Bldg. no.: I Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: (Block: I Subdivision: SFR (2) bath Project name: SFR (3) bath City /county: I ZIP: Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Est. date of completion/inspection: Drywells/leach line /trench drain Footing drain (no. lin. ft.) PLUMBING CONTRACTOR Manufactured home utilities Business name: Z 11 � j /,( /cri=:. Manholes Address : lye Rain drain connector City: .e: j, I Stated ZIP ^I0 9/ Sanitary sewer (no. lin. ft.) 7 ma r 5 5,o v Phone, j3/ Fa l ,27/0 E -mail: Storm sewer (no. lin. ft.) CCB no.: /` ' �� ©7" IPP lumb. bus. reg. no: . Water service (no. lin. ft.) City /metro lic. no.: Fixture or item: Contractor's representative signature: Absorption valve Back flow preventer Print name: Date . Backwater valve CONTACT PERSON Basins/lavatory Name: � �' /--- ���c%S.ss.S/ Clothes washer Address: Dishwasher Drinking fountain(s) City: S''' "-- I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank OWNER Fixture /sewer cap Name (print): Floor drains/floor sinks/hub Garbage disposal Mailing address: Hose bibb City: I State: I ZIP: Ice maker Phone: I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maint- . ce only: The actual installation Primer(s) will be made by me or the m.�.4 - s ---- I repair made by my regular Roof drain (commercial) employee on the pro f • r ��,t ' %�, - 447. _ Sink(s), basin(s), lays(s) • Owner's signature: /�� / //Ifs■: :: . /_ Sump ENGINEER Tubs/shower /shower pan Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other: Phone: Fax: I E -mail: Total n Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $ 7 ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $ Credit card number: / / within 180 days State surcharge (8 %) .... $ S- CO Expires ays after it has been TOTAL $ 7 IC' , - 3 0 Name of cardholder as shown on credit card accepted as com Cardholder signature $ Amount 1 g 0, / y plete. 440-4616 (6/00 /COM) 3S. 0 7 € 3 A 7 PLUMBING PERMIT FEES: - PRICE TOTAL New 1 and 2- family dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 16.60 for each utility connection) Lavatory One (1) bath $249.20 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 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 Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE: 3" 16.60 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by 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 Home New San /Storm Sewer 46.40 Lavatory • Tub or Tub /Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fixtures (Specify) 16.60 Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Sink: 2" Sewer - 1st 100' 55.00 G„ef:' 3^ Sewer - each additional 100' 46.40 J 4" Water Service - 1st 100' 55.00 Water Heater Other Fixtures Water Service - each additional 200' 46.40 (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device* 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per /hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram is required if Quantity Total is > 9 *SUBTOTAL 8% STATE SURCHARGE * *PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total is > 9 TOTAL $ * Minimum permit tee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge. * * AII New Commercial Buildings require plans with isometric or riser diagram and plan review. is \dsts \forms \plm- fees.doc 10/10/00 c- tri A \ E- RI1E - 1r j ORVALL T. CADE 7DATE BYER'S SEPTIC TANK SERVICE, INC. 8 -6 -01 P.O. Box 549 NUMBER OREGON CITY, OREGON 97045 Job; 8 -3/ (503) 656 -3326 37 �} • Pi.Hdoot " �o Wayne Jeskey Const. Q' ' P.O. Box 1713 �p Clackamas , OR 97015 )176° ` • RECEIVED TERMS NET 10 DAYS AUG n 1 7 2Or� PLEASE DETACH AND RETURN WITH YOUR REMITTANCE $ (e - - COMMUNITY DEVELOPMENT DATE CHARGES AND CREDITS BALANCE 650 -8235 BALANCE FORWARD $190.00 8 -3 Tank pumping 190.00 Job: NACIRA SW 98th. St. trz(,c AUG 0 7 2C01 • WJC / 4 w.. pm NCM I MGM BACK K m sM v� 07CY I.C. ORVALL T. CADE PAY LAST AMOUNT IN THIS COLUMN BYER'S SEPTIC TANK SERVICE, INC. CITY OF TIGARD BUILDING IN §PEGTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Date Requested d �p AM ar PM BLD Location C 1 7 0 n ' Suite MEC Contact Person Ph — 24 � — 7 / f (J PLM DO 3 77 Contractor Ph SWR ,24n / - 6O 2 - 3C) BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access' Foundation FPS Ftg Drain r...12. � SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling �' a� u ru,rt'•4_ Roof , 9 C J41� a ,7 7'J , Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service ary ewer Rain Drains ■ el PART FAIL i _ ANICAL - 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 BackfillGrading 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 - - O Other Date Inspector �i j � f!IIJ� Ext 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 BUP Date Requested — I5 AM PM BLD Location 11700 3 ' Suite MEC Contact Person 0,)i9 Ph '2 - 7 / 9e) PLM Contractor Ph SWR c / - -ioQ3c BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Slab Crawl Drain Inspection Notes: / SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof -.J 4 e at. I Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out 04„ Sanitary Sewe • ins SS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final 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 1 /� Approach /Sidewalk Dat P- �'� 0 o Inspecto /I [ - �' �'e- E x t Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. I BUP - Building Permit ELC - Electrical Permit Inspection Description Date Passed By Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing I Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry/Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation - 4 Inspection Description Date Passed By Drywall nailing Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP — Fire Protection System Permit Plumbing underslab Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler fmal RP /backflow preventer Fire alarm fmal Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing fmal F— g,-", =� Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04 /17/01 C ITY OF TIGARD PLUMBING PERMIT A—vo DEVELOPMENT SERVICES PERMIT #: PLM2001 -00379 # !I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/14/01 PARCEL: 1S135CD-01900 SITE ADDRESS: 11700 SW 98TH AVE SUBDIVISION: GREENBURG ZONING: R -4.5 BLOCK: LOT: 004 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of less than 100 len. ft of sewer line to connect existing house to sewer. FEES Owner: Type By Date Amount Receipt VISTA NORTHWEST PRMT CTR 8/14/01 $72.50 27200100000 P.O. BOX 91459 5PCT CTR 8/14/01 $5.80 27200100000 PORTLAND, OR 97291 Total $78.30 Phone 1: 503 - 531 -0505 Contractor: VISTA NORTHWEST P.O. BOX 91459 PORTLAND„ OR 97291 REQUIRED INSPECTIONS Sewer Inspection Phone 1: 503 - 531 -0505 Final Inspection Reg #: N This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for morn than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. !� V Issued By: Permittee Signature: . / .. � �� . / Air/ - - - g Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day