Permit iDide0j-e 4 -1/2 '
CITY OF TIGARD
PLUMBING PERMIT
I4 DEVELOPMENT SERVICES PERMIT #: PLM2005 -00110
..�-� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/2/2006
PARCEL: 2S104AC -00200
SITE ADDRESS: 13280 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Installation of 900ft water service, 321' of storm sewer,1 catch basin and 2 manholes located in a
private street. These utilities are to be private, not public.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 1
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 900 ft
DISHWASHERS: RAIN DRAIN: 350 ft
Owner: FEES
J & S CONCRETE Description Date Amount
2800 NE WAGNER
MCMINNVILLE, OR 97128 [PLUMB] Permit Fee 2/2/2006 $476.00
[PLMPLN] Plan Review 2/2/2006 $119.00
Phone : 503- 538 -8615 [TAX] 8% State Surcharl 2/2/2006 $38.08
Total $633.08
Contractor:
SITE TECH INC.
15875 SE 114TH AVE, STE C REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
Contact # : FAX 503- 650 -7378
Reg #: LIC 102415
PLM 3 -563PB
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 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 -246 • _' "• or 1- 800 -332 -2 .
Issued By: , e:d.4 %Olt A Permittee Signature: dte
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit can 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 App , -- ���® FOR OFFICE USE ONLY
City of Tigard � Date /Bea Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960{0 C1' 1 0 2005 �h .' � Date /B : Other Permit.
Inspection Line: 503 639.4175 t"� Date Ready /By. runs: ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TIGARD
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ l- and 2- family dwelling ❑ Commercial /industrial Valuation: $
I=1 Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ® Other: 9 lot sub Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 13280 SW Walnut Street New dwelling area: square feet
City/State /ZIP: Tigard, OR Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Hillside Estates Covered porch area: square feet
Cross street/directions to job site: West of the 132 and Walnut intersection Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S104AC 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.
Installation of 4 separate 2" water services - Total 1188 L.F. Valuation: $
Installation of 321 L.F. of 10" Storm w/ 2 manholes and 1 catch basin, 4 wye's, and 5 lat's Existing building area: square feet
Installation of 335 L.F. of 8" Sanitary Sewer w/ 2 manholes, 7 wye's, and 8 laterals New building area: square feet
0 PROPERTY OWNER ❑ TENANT Number of stories:
Name: J & S Concrete Type of construction:
Address: PO Box 516 Occupancy groups:
City/State /ZIP: Dundee, OR 97115 Existing:
Phone: (503)307 -0235 Fax: (503)538 -1460 New:
0 APPLICANT 0 CONTACT PERSON NOTICE
Business name: Same as Above All contractors and subcontractors are required to be
Contact name: Jeff Conklin licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: (
E -mail: n/a
CONTRACTOR
Business name: Site Tech Inc
BUILDING PERMIT FEES*
Address: 15875 SE 114' Ave, Ste C
Please refer to fee schedule.
City/State /ZIP: Clackamas, OR 97015
Fees due upon application
Phone: (503) 650 -7377 Fax: (503) 650 -7378
Amount received
CCB lie.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Scott Hewett Rep. for J &S Concrete Date: 10/4/05 * Fee methodology set by Tri- County Building Industry
Service Board.
r\ Building \Penns \BUP- PcrmitApp doe 12/03 440- 4613T(1 I /02/COM/WEB)
r 'I / 1 3/2005 08:56 5036437905 SFA: PAGE 02
• ' r ,, l r_rr
Plumbing Permit AO l � L. ® _ - -. -
FOR OFFICE lUSE QONLY" _
City of Tigard � C. [ Received d 13125 S W Hall Blvd., Tigard, OR 97223 0 Dates PermitNo.: pc_ �2Q�i �, ; I,
8.1 ±T;, Plan R eview
Phone: 503.639.4171 Fax: 503.59
"..AF TIGAR 1J`WWI + �!` Datc/By: ftj j2/ Jot Other Permit
24 Hour Inspection Lino: 503. ��qq T{Y jq la See Page 2 for
U � � ',:.., Date Randy/13y; 1 Internet www,ci.tiganior.us 'WING DIVIS' - Notified/Method:
Filll i1 �{ r 1 rt { ;G� ; nz :,ms, r _ Supplemental Information
� t ; J< y ,�iii ��14 S�Iy!,I'(I�!�!j''��H1�``l �jf i��' j,'1�!'; f'{!4� i :i5'�{ �t �q • �, pt�n 1•�•ni i '9Gi{I A- t5/ ; �! ' �I'�!RS +1�, 5,��;�',i' h S i '4', � ,' l , * I � ■ { ; /�� ++ I w U,I! .kf AP IA n. u,,;a . e� �•� I,6 ,
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_ .,, l e Ifi n lyw{ ,. � tfu r�i, �I.�111s.., i . t�lfl, �l�t lilhglf r•,,< elmtrt^ is� tml f, rlk+, S��3� �. i �3J l� lI +J �� � JS {
® New construction ❑ Demolition For special Information are checklist.
El Addition/alteration/replacement ❑ Other Description qtya Ea, ! Total
ul n { New 1- 2- family dwellings (includes 100 R for each utility connection
l lifigg lltg 1€ m arar ' ,; ,, `0 1 � u 4r;�s�lI grit i SFR(I)bath '
�!r?Q� tl1'f n�'n. � „�l,I 249.20
❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350
0 Accessory building ❑ Multi- family SFR (3) bath 399 00
ID Master builder El w ®Other 91ot sub
Each additional bath/lcitchen 45.00
'N :l�s S t! '+ 1 „ { {� �, Fire sprinkler(_ sq. R) Page 2
l
1 {`f ! ,! { i.; f+ l �i ei 1 i ' , PL; l, , d1 E ,,, `` .� �, .,. . - , +,� t + `>n'4 r4ir le; , �;
t ; 1� t 1, 1 JiRil<a41 p1n +If1 ' "!i� , �y '{ - Site atilitles
a wuf l
Job site address: 13280 SW Walnut Street Catch basin or area drain I 16.60 10,190
W
City /State/ZIP: Tigard, OR Drywcll, teach line, or trench drain 16.60
Suite/bldg. /apt. no.: i Project name: Hillside Estates Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: West of the 132" and Walnut Intersection Manufactured home utilities 110.00
Manholes Al 16,60 ? AO
Rain drain connector 16.60
Sanitary sewer (no. linear ft. Page 2
Storm sewer (no. linear ft.: '2.I) Page 2
Subdivision: - I Lot no.:
service (no. linear p0 , Pagc 2 /4.2L -2P
MO M map /parcel no.: 2S104A t } � � Fixture or item
+'' .1; � }} ' t;w '"alnrnl a�i ,�a s ;' IS ' ,, ti rn 1 ��r ^i (((� " {i1 ``' 1 ) ti , Absorption valve age 2
` ' Y 1"3I� UlL r
e'i'�,ii�, !, 1, tt sin •, l -„ ,1;4a1,t,1?!i!�{ , ;" � ! BaCk110WprevCrrtCr Page
installation of 4 separate 2" water services - Total 1,188 Lf. Backwater valve 16.60
Installation of 321 If of 10" Storm w/ 2 manholes, 1 CB, 4 Wye's, and 5 4" bats Clothes washer 16.60
-
Installation of 3351f of 8" Sanitary Sewer w/ 2 tutu's, 7 Wye's, and 8 4^ laterals Dishwasher 16,60
i 1- ' !f i !l;1 - 1 J'' < •.Y/o ,, ' a i� did„ ;bill; I ' }� I Drinkin fountain 1 -
h ;�� 6.60
' _ �. J "i� df 1010,1 :; l W A i!';C 1 Ejectors/sump 16.60
Name: J & S Concrete
Expansion tank 16.60
Address : 1'O Box 516 Fixtum/scwer cap 16.60
City/State/ZIP: Dundee, OR 97115 Floordrain/floorsink/hub 16.60
Phone: (503)307 -0235 Fax: (503)538 -1460 Garbage disposal 16.60
it t. T. 41 ix... T ' 4 ai a ,1 { I '; i'i ni!)){{{{ i ovt • ` " knic b '+r ,' . Hosc bib 16.60
Business name: Same as above [cc maker 16.60
Interceptor /grease trap 16,60
Contact name: Jeff Conklin Medical gas (value; $ ) Page 2
Address: g
Primer 16.60
City/State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: : ( ) Sink/hasin/Iavalory 16.60
E - mail: - Tub/shower /shower pan 16.60
'! i { '! I �tjin `'i'i�diil: {� v {J 5/ ! In0 1 l;h: Urinal 16.60
d. 1',�, � tri i'{u 4 M1 a ", ., {iiA ,}r. , fl - i ' ;., I, .a!' yt1 'r.,� r' Slw•'nciAl.?,, ,.,
i�1lr!n S { , . ,, �, ., i.,, ' „ . , .• „.,. „t,,. :'Ji 11{ I 1,11 i t , , .',. !'rii''i''.'�, i e,� ,. +
tl`tf,i .., J E'`,:ri Water closet 16.60
Business name: Site Tech Inc Water heater 16,60
Address: 15875 SE 114 Ave, Ste C Other: [��
City/State/ZIP: Clackamas, OR 97015 I I Subtotal L " `�'_.
Fax: (503) 650 -7378 Minimum
Phone: (503) 650 -7377 ( ) ''1 ' Residential b ackflow minimum permit fee: S36.25
CCB Lie.: 10- 0 27 Plumbing Lic, no.: ,1 . • Plan review (25% of permit fcc) / 00
Authorized signature: surcharge (8% of permit fee) 3 .
TOTAL PERMIT FEE . ( .5
Print name: Scott Hewett Date: 10/11 /05 This permit application expires if a permit is not obtainca vvenom _
-_0.0$a+/l 180 days after it has been accepted as complete.
'Fee methodology act by Tri -County Building Industry Service Board,
∎Attuadtamp its1PUN- pantilApp.dac 05/05 1404516T(10/07/COM/wfi8)
Plumbing I' z J..,. gE � 1),b ,�
FOR OFFICE USE ONLY
City of Tigard Lr/ C� 1�
Received /1 /a e O S vv
lo permit No. L�
13125 SW Hall Blvd., Ti �1 �� R � '
�"11'ti I ;. 32005 Plan Review
Phone: 503 639.4171 Fax. 5SS5550003.598.1960 Uy
24- Hour Inspection Line ,543. 4 j� A Date /By: 3 / 22) O 3 � Other Permit No..
Internet: www.Cl.ti� ja .t� � ��� t Date Ready /By. Supplemental See Page 2 for
/T T(�j�r Notified/Method: Supplemental Information
BUILDINtlY IOFIs FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: ire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Sit • tilities
Job site address: 13280 SW Walnut St. Catch .. sin or area drain I 16.60 ) ,
City/Sta • IP: Tigard, OR 97223 Drywell, - . ch line, or trench drain 16 60
E
Suite/bldg.lap . • ..: Project name: (side Estates Footing drat . (no. linear ft.: )
Manufactured h. e utilities n 0.00
Cross street/directions . •ob site: west o : 132 " and SW Walnut St. 2
Manholes V 16.60 33 az
Rain drain connector 16.60
Sanitary sewer (no. lines ; Page 2
Storm sewer (no. linear ft.: s 4 Page 2 , / 9H. ao
Subdivisio , . es Lot no.: 9
Water service (no. linear ft.: ;.`•4) Page 2 / 91/. AO
Fixture or item
Tax map /parcel no.: 2S1 04AC
Absorption valve 16 60
DESCRIPTION OF WORK Backflow prevente Page 2
Installation of +/- 350 feet of 6" water for fire purposes Backwater vale- 16.60
Installation of +/- 350 feet of 12" stom sewer with 1 catch basin and 2 manholes Clothes wash- 16.60
Dishwasher ..60 ■
Drinking fountain 16.. t
ROPERTY OWNER ❑TENANT -
J l . •ectors/sump • 16.60 � ,
Name: o1. ) 3 ► Exp... ion tank 16.60
Address: Fixture/s• er cap 16.60
City/State /ZIP: Floor drain/ • .r sink/hu • 16.60
Phone: 5j?' 6 %.. * 1 1 .? Garbage disposal 16.60
Phone: ( ) W Fax: ( )
❑ APPLIC• ❑ CONTACT PERSON
Hose bib 16.60
Ice maker 16.60
Business name: J &S Concrete Interceptor /: a trap 16.60
Contact name: Jeff Conklin
Medical 1 . s (value: $ ) Page 2
Address: 2800 NE Wagner Primer 16.60
City/State /ZIP: McMinnville, OR 971. 8 Roof drain (commercial) 16.60
Phone: (503) 538 -8615 I Fa • : ( ) Sink /basin/lavatory 16 60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
I NTRACTOR Water closet 16.60
Business name: Water heater 16.60
Address: Ot her: r u
City /State /ZIP:
Subtotal
Minimum permit fee: $72.50 4/3 g X
Phone: ( ) Fax: ( ) Residential backflow minimum pennit fee. $36.25 �/
CCB Lic.:
AP A ir 10 mbing Lic. do.: Plan review (25% of permit fee) / 69.5r
%.�VP� � State surcharge (8% of permit fee) 35 .Ob
Authorized signatur � � 5
.. TOTAL PERMIT FEE • a/ a
Print name: U) 7 LA r f I 411111. II Date:, . 18 , OS This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
c O W N' Ga„ 1 a5e .( five,) *Fee methodology set by Tri-County Building Industry Service Board.
l Building \ Permits \PLM- PermitApp doc 12/03 440- 4616T(10 /02 /COM/WEB)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
SITE TECH INC.
15875 SE 114TH AVE, STE C
CLACKAMAS, OR 97015
Plumbing Signature Form
Permit #: PLM2005 -00110
Date Issued: 2/2/2006
Parcel: 2S 104AC -00200
Site Address: 13280 SW WALNUT ST
Subdivision:
Block: Lot:
Jurisdiction: R -4.5
•
Zoning: TIG
Remarks: Installation of 900ft water service, 321' of storm sewer,1 catch basin and 2
manholes located in a private street. These utilities are to be private, not public.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for
the plumbing permit to be valid, please have the appropriate individual from your company sign below and
return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
J & S CONCRETE SITE TECH INC.
2800 NE WAGNER 15875 SE 114TH AVE, STE C
MCMINNVILLE, OR 97128 CLACKAMAS, OR 97015
Phone #:503 - 538 -8615 Phone #:
Reg #: L1C 102415
PLM 3 -563PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Si / oPlumber
If you have any questions, please call 503.718.2433.
10/13/2005 08:56 5036437905 SFA: PAGE 01
RECEIVED
SFA Design Group, L�
OCT 13 2005 FAX TRANSMITTAL
STRUCTURAL I CIVIL I LAND USE PLANNIN�(1 OF TIGARD
sf a 111 9020 SW Washington Square Dr • suite 350 • Portland, Drew 9 u3 I I IV G DIVISION
PHONE (50.3) 641 - 8311 FAX (503) M34434905
IA D' i 4i 11 L. ; ' .'��.',, , I i fi portY ( P) City of Tigard • 0 : • . i !fa, �,t 108-001
Scott Hewett
It 111. rt 1 Hillside Estates �4�' :::: , , . 1' li it t,; l i 1 1. rii ik J� ...... .
n i . ,a 2
r
., . 3 051 ! �9 , 'ii. 503- 598 -1960 � pTtin,>~; i : VA
•
WF ARF SFNI)INO YPU:
❑Urgent ❑ For Review ['Please Comment ❑Please Reply ❑ As Requested ❑Please Recycle
, f ul 1 1 1 � r , n v„ r , , ffYl1 , I
' I t r 1� iE 1 I 1t 8 t' t"�i r 1 , ,�
> } I l 1 1 P' y�l lr `�i:�1� r t l 1 q � � l;�p , ,
.ly,,,.t'.i„n, , „l. gi gi u ii< f F ;i ll �� Eg li t�� �' ' ll i ;f, . I�1�! �1 ri � ill i „11 ; tit
. Please find the plumbing permit attached for your use. It Is our understanding that the conversation between
Mike White and Luke Lappin in our office the plans were reviewed and approved by building ( ?) and that 3 sets
were supposed to be submitted to complete the fee's and obtain the permit.
Please let me know if there is any additional information that you need. .
Thank you,
•
Scott Hewett
I
CONFIDENTIALITY NOTICE: This message and/or any documents transmitted herewith Is Intended only for the use of the
IndiAdual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure
under applicable law. If the reader of this message is not the intended redolent, you are hereby notified that any dissemination,
distribution or copying of this communication is strictly prohibited. If you have received this communication in error please notify
us immediately by telephone and return the original message together with any documents attached.
•
;l !1 ; aii Me Scott Hewett
',' ' '(I
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+illy ?.si ItUi�,,t�(i i” Sf� , ; ' { ;,� +:r tli ,.
oiltexo tliS, ,4 1t :. S p'�� d.il �11 i+1!'• ?' 11�i .
I
CITY OF TIGARD , ' toc_K2-7
BUILDING DIVISION PERMIT #: 000-3 OD / / 2O
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ,
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: H I 4 5 ( t? ' 5� -1 CLASS OF WORK: •
SUBDIVISION: i LOT #: TYPE OF USE:
PROJECT NAME: 33 ).— -6 .
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: l 3 3 0 ..eit _1*---- PHONE #:
Inspection Request Scheduled For: Date: 3 - / - 0 1' Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 3 • 'id - 8'g7 -/Sltq
Cor ec i ns/ om ents /Instructions: W -
OA . I `tom. _ / _� - eK".
f err
O F / A // ice.
, / 7/74e r— /C
J / , -
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • .
Inspector: p b pi / PIA/ Date: /5i Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: !'l ltlt)5-t,;lt IO
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2D11006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
! I —
INSPECTION WORKSHEET FOR DATE: 2127/2006 TIME: , 7 , 01AM PAGE: 71
SITE ADDRESS: 13280 SW WALNUT ST' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HILT SIDE ESTATES SUBDIVISION
DESCRIPTION: Installation of 900ft water service, 321' of storm sewer,1 catch basin and 2 manholes located in a
private street. These utilities are to be private, not. public.
OWNER: J & S CONCRETE, PHONE #: 503.630 -0515
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date 2/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 027597 - 01 503 - 687 - 1549 N
Corrections /Comments /Instructions:
•
‘g
•
•
ASSARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ .CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - 7) G Date: Phone #: (503) 718-
.
CITY OF TIGARD.
BUILDING DIVISION c. A PERMIT #: NI-M2i 06.00 i10
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/.?/2.006
Phone: (503) 639 -4171 emu pp,
Inspection Requests (24 Hrs.): (503) 639 -4175 'IL
INSPECTION WORKSHEET FOR DATE:
21i6J2006 TIME: 7:07 Am PAGE: 48
. SITE ADDRESS: 13 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HILLSIDE .. ESTATES SUBDIVISION
DESCRIPTION: Installation of 900ft water service, 321' of storm sows -r,1 catch basin and 2 manholes located in a
private street. These utilities-are to be,piivate, not public.
OWNER: $, S CONCRETE, PHONE #: ,o53t .0616
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 2/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
0 Storm drain 027004 - 01 503 887 -'1549 N
Corrections /Comments /Instructions:
c,cr4(-, A s��- III c��L ( ��. -c _ - rte ,
•
•
•
•
❑ PASS IX PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: drt Date: 2, I 1 L 10(/ • Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200 00110
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2D/2006
Phone: (503) 639 - 4171 o � j � l
Inspection Requests (24 Hrs.): (503) 639 -4175 '_I_..
INSPECTION WORKSHEET FOR DATE: 2/10/2006 TIME: 7:(4AM - PAGE: 71
SITE ADDRESS: 13:600 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HILLSIDE F - •elh S ,SUBDIVISION
DESCRIPTION: installation f 900f water service, 32j'.of storm se•rrer,1 catch basin and 2 manholes located in .
private stick... .dit.se utilities are to be rivate, of public.
OWNER: ,J & S CONCRETE, PHONE #: 503 - 730 -8616
CONTRACTOR:!/ /0 PHONE #: .
Inspection Request Scheduled For: Date: 2/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 026628-01 503. 007 -1&i9 ' y
Corrections/Comments/Instructions:
d ir .. / _ A1L .. ✓. /lL1 /_ ii. k. ' /:,-,-/' � fd
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l j_PASS ❑ PARTIAL APPROVAL ❑ CANCEL , ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: % 1 Date: l d 0 f Phone #: (503) 718- Z