Loading...
Case File f I o0 k 00 N y 0 I t 3 i 08852 SW ASHFORD ST CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 JUL 2 ?000 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VALLEY HWY S ALOHA, OR 97006-1248 Electrical Signature Form Pormit #- PIST2000-00213 Date Issued: 7/18100 Parcel: 2S111 DA-16600 Site Aadress: 08852 SW ASHFORD ST Subdivision: APPLEWOOD PARK NO. 3 Block: Lot. 159 Jurisdiction: TIG Zoning- R-7 Rema rl,-,, S/F PATH I Your company has been indicated as the electrical co:itractor for the permit indicated above. In order for u,a Electrical permit to be valid, thF signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: building Dept. No electrical inspections will be authorized until this completed form is received OWNER- ELECTRICAL CONTRACTOR,- MATRIX ONTRACTOR:MATRIX DEVELOPMENT CORP GARNER ELECTRIC 6900 SW HAINES ST STE 200 21785 SW TUALATIN VALLEY HWY S TIGARD, OR 97224 ALOHA, OR 97006-1248 Phone #: Phone #: 591-1320 Req #: uc 121159 SUP 2707S ELE 34-305(, AN INK SIGNATURE IS REQUIRED ON THIS ORM 4 X Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY Y OF TIGARD "___MASTER PERMIT PERMIT#: MST2000-00213 DEVELOPMENT SERVICES DATE ISSUED: 7/18/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 08852 SW ASHFORD ST PARCEL: 2S111DA-16600 SUBDIVISION: APPLEWOOD PARK NO. 3 ,ZONING: R-7 BLOCK: LOT: 159 JURISDICTION: TIG REMARKS: S/F PATH I 131JILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT. 23 FIRST: P42 of BASEMENT: of LEFT: 4 SMOKE DETECTORS: Y TYPE OF UBE: Sr FLOOR LOAD: 40 SECOND: t.00.� of GAPAGE: 465 if FRONT: 20 PARKING SPACES TYPE Or c 1ST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT. 4 OCCUPAN 1Y GRP: R3 BURM: 3 BATH: 3 TOTAL: 1,844 00 of VALUE: E 139.554.86 REAR: 24 PLUMBING _ SINKS: I WATER CLOSETS: '1 WASHING MACH: t LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: 'TUBISHOWERS: 3 GARBAGE DISP. I WATER HEATERS. I WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS: MECHANICAL. OTHER FIXTURES. FUEL TYPES FURN<100K. BOILICMP<3HP: VENT FANS: 4 CLOTHES DRYER: I (SAS FURN>-100K: I UNIT HEATERS. HOODS' I OTHER UNITS. 1 MAX INP btu FLOOR FURNANCES& VENTS: WOODSTOVES GAS OUTLETS 1 ELECT;IICAL RESIDENTIAL UNIT SERVICE FEEDER _TEMP SRVCIFEEDERS BRANCH CIRCUITS _MISCELLANEOUS _ _AUD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp. 0 200 amp. WISVC OR FOR: I PUMPlIRRIGATIOW PER INSFcCTION: EA ADD'L 500SF: 3 201 400 amp 201 400 amp: let WIO SVC/FDR: cin SIGNIOUT LIN LT: PER HOUR LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 601 • 1000 amp: 601-amps-1000v. MINOR LABEL 1000-arnplvoll: Reconvert only: PIAN REVIEW SECTION � --- —_ >-4 RES UNITS: SVC/FDR> 225 A.. >600 V NOMINAL: CLS AREA/SPC OCC. ELECTRICAL RESTRICTED ENERGY A.SF RESIDENTIAL — _ 8.COMMERCIAL_ AUDIO B STERL:O: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMMAGING OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER: HVAC LANDSCAPEIIRRIG: PROTECTIVE SIGNL GARAGE OPENER CLOCK INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM. NURSE CALLS: TOTAL.N SYSTEMS Owner: Contractor: TOTAL FEES: $ 5,513.21 MATRIX DEVELOPMENT CORP LEGEND HOMES CORP This permit is subbed to the regulations contained in the 6900 SW HAINES ST STE 200 11130 SW BARBUR BLVD Tigard Municipal Code State of OR Specialty Codes and TIGARD,OR 97224 !'ORTLAND OR 97219 all other applicable laws All work will be done in accordance with approved plans This peirr It will expire if work is not started within 180 days of issuance,or if the Work is suspended for more than 180 days ATTENTION Phone Phone Oregon law reoulres you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Reg 11. 1 u: nn01;01A3 forth in OAR 952-001-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion 844-8444 Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp hlecnanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Inst Rain drain Insp Plumb Final Foundation Insp Fooling/Foundation Dr; Electrical Service Low Voltage Water Line Insp Final inspection Post/Beam Structural OLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Building Final PosUBgar6 Mechanical Mechanical Insp Framing Insp Gas Fireplace Electrical Final Ise d B ' Y � Permittee Signature all(503) 63)-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGA,RD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00173 13125 SW Hall Blvd., Tigard, OR 97223 (505) 639.4171 DATE ISSUED: 7/18/00 SITE ADDRESS; 08852 SW ASHFORD ST PARCEL: 2S111DA-16600 SUBDIVISION: APPLEWOOD PARK NO, 3 ZONING: R-7 BLOCK: LOT: 159_ JURISDICTION: 'FIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDING,-'- 1 114STALL TYPE: L.TPSWR IMPERV SURFACE: Remarks: S/F PATH I Owner: �— -• --- _— MATRIX DEVELOPMENT CORP — = tES — 6900 SW HAINES ST STE 200 Type By Date Amount Receipt TIGARD, OR 97224 PRMT DEB 7/18/00 $2,300.00 0003804 INSP DEB 7/18/00 $35.00 0003804 Phone: Total $2,335.00 Contracrnr: --- Pho ,d: Reg #: Required Inspections Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" PE'Mit and the Agency will install a lateral ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain 6pies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: — permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next busin ss day CITY OF TIGARD Residential Building Permit Application PlanG,eck# -�1 �� SW Recd By 131�.; �Vli HALL BLVD. New Construction TIGARD, OR 97223 Single Family Detached Date Date RFtecd c'd V 503-6394171 Date to DSTZ--2--0 0 F 503-684-7297 �� y Permit#1�51 ,",,o -u o 3( 3 Print or Type Called Incomplete or illegible applications will not be accepted P ,y v M JsvA Zva✓- U 17,3 Name of Project Name Job / L t !Y ."k--' Address Site dress v�+QS �� Architect MailingA dress - ---- City/State Zip Phone e l j / J C-""��C �71.,j� Z'49 - Owner Mailing/Address Name Ci tate Engineer linr,Addreb ZI Phon ' 6ys General Name City/Slate, Zi Phone Contractor Describe work New ML\ Addition O Alteration O Repair O Mailing Address -- — to be done: — Prior to permit / 1.7 3 j �-�lU G 9 � AG`r Additional Description of Work: Issuance,a copy Cittate Zip Phone of all licenses are required If Oregon Const.Cont Board Exp.Date PROJECT J expired in COT LIc.# VALUATION J l database 0(0 C95-6-f— _ Mechanical Name NE_1N_ CONSTRUCTION ONLY:_ Sub- ,-s Sq. Ft. House:—Y Sq. Ft. Garage-` Contractor Mailing Ad e s LY.� _ _����_ Prior to permit c7 ,� "r£ /��5 �c Indicate the res ricted energy installation by the Iectrical issuance, a copy C�'ty/Sts)e Zip Phone subcontractor In the followin areas of all licenses ft( 't le-z, J-5-2 7) Restricted Audio/Stereo are required If Oregon Const,Cont.Board Exp.Date Energy _ System Alarms expired in COT Lic.# �� A v s--3_CJc� Installations Vacuum �— Irrigation database U / Stem_ _Syst.em Plumbing Name (checc.all that Other: Sub- 41 ,/Cd14 / ' a PID I ---- Contractor 9 Number of Units in Builc�in Unit Number Designation Mallin Address g g w7 Has the Subdivision Plr,t recorded? N/A YFS NC) Prior to permit Clt /State Zip jape -_�'��� issuance,a copy l�(v 7-��tf -- - of all licenses are Oregon Const.Cont.Board Exp.Date required If Lic.# expired In COT 1 .D Cr off. 3 / ��I — — database Plumbing Lic.# ExQ�$Date I hearby acknowledge that I have read this application,that the �_� d 3/ _� information given is correct,that I am the owner or authorized agent 00 of the owner, and ;hat plans submitted are in compliance with I Name Ore on State laws. _ Electrical 0--191 -t "(2C,l Signatle of O ne gen Date Sub- Mailing Address L contacterson N g Phone) Contractor / & S 4eV 1C / A I F�,/ �,/�� bit-,- off' City/State Zip Phone Prior to permit issuance,a copy � 'G) FOR OFFICE USE ONLY: of all licenses are Oregon Const.Cont Board xp.Date -- ------ required If Lic.# Plat#: MapITL#• (� / expired In COT W ! , i' _ ' ' , 1 h r.; 3'7 database Electrical Lic.# Exp.DateSetbacks: It Zone: /7 !Lr -1-Q7 f? 7f` L �Ieclrical Supervisor Lic.# Ex .Date Engineering Approval: Planning Approval: T IF: I\dsts\forms\sfd-new dc.;11/20/98 l ® s ' FL Off' FLAN LOT #159, AFFL E WOOD f Af;RK R l 2 51 11 DA TAX LOT '016600 aa52 5W ASHFORD STREET 5.E. 1/4 OF SECTION 11, T.2, RJI-J, W.M. CITE' OF TIGARD W,45N INGTCN COUNT T , OREGON LEGEND HOME N 5UJ A514FORD STREET - D WATER METER CURB E , �J�-------- WATER LINE SIDEWALK ' N89'S4'25"E SANITARY" SEWER mpm SD— - - -- STORM DRAIN 8' UTILITY — - — 4 OF STREET EASEMENT 203 5' I 200.4' MANHOLE 1 ® CATCH BASIN 40' Y�31d' PROPOSEDj 4•0' STREET TREES -3 - STREET LIGHT ►� ,LOT 15g FIRE HYDRANT �� - 4, 216 SQ. FT. / _ 1 RON,IOOD 8 61 FIN. FLR. 2©5.6' o� GARAGE FLS. • 2045 PRO'✓IDE EROSION 4,0' •�� - CONTROL FENCE PER COMMUNITY X036' EROSION PLAN 104.4' J LOr 160 LOT 171 62.00' LOT 172 LCT' 1'71 Za;G CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONT. INC PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2000-00213 Date Issued: 7/18100 Parcel: 2S111 DA-16600 Site Address. 08852 SW ASHFORD ST Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 159 Jurisdiction: TIG Zoning: R-7 Remarks: S/F PATH Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the Plumbing permit to be valid, please hc.ve 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 Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR.- MATRIX ONTRACTOR:MATRIX DEVELOPMENT CORP WOLCOTT PLUMBING CONT. INC 6900 SW HAINES ST STE 200 PO BOX 2007 TIGARD, OR 97224 GRESHAM, OR 97030 0hone #: Phone #: 667-1781 Reg #: I Ir 00023847 PI M 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature c) Authorized Plumber If you have any questions, please call (503) 539-4171, exi. # 310 CITY OF TIGABD BUILDING INSPECTION DIVISION MST ��-Go .2 � 3 24-Hct,.r Inspection Line: 639-4175 Business Line: 639-4171 ��- BUP Date Requested_ l r/ —AM L/ PM RI C Locat� ,,;_� c✓ 5� Suite MEC Contact Person Ph -7U PLM _ — Contractor Ph SWR r ILDING„��--v Tenant/Owner _ ELC `-- e arning Wall ELR Footing -- ------- Foundation Access: FPS _ Ftg Drain Crawl Drain Inspection Notes �—' -' SGN —� Slab SIT Post& Beam ------- ----- - Ext Sheath/Shear Int Sheath/Shear -� -�--- -— Framing Insulation -- --- r-- -- Drywall Nailing Firewall - Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: ASS PART FAIL_ -- -- - -- -- --- --- PLUMBING Post&Beam - - _- Under Slab Top Out Water Service Sanitary Sewer i-- --- - - Rain Drains Final PASS PART FAIT_ _- - — a ost& Beam Rough In Gas Line — Smoke Dampers in AS PART FAIT ELECTRICAL _ - -- Service _ Rough In — UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading - - -- Sanitary Sewer Storm Drain ( ] Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Please call for reinspection RE: Fire Supply Line ( ] p — ( I Unable to Inspect-no access ADA Approach/Sidewalk Date t Other Inspector Ext Final PASS PART FAIL 00 NOT REMOVE this Inspectio record from the job sate. CITY OF TIGARD BUILDING INSPECTION DIVISION MST .�aGG'O�Z13 24-Hour Inspection Line: 639-41.75 Business Line: 639-4171 BUP --Date Requested � Z AM 4" PM BLD _ y Location Suite MEC Contact Person —, Ph �- �� 7U — PLM Contractor — Ph SWR BUILDING Tenant/Owner - ELC _ Retaining Wall ELR Fooling Ac ,s: FPS Foundation ------ --- Ftg Drain SGN Crawl Drain Inspection Notes. - -------- Slab ----_ ------ ---- --_— _—_ —_ SIT _�..------ Post&Beam Ext Sheath/Shear -- -- --- Int SheathiShear Framing Insulation Drywall Nailing —_- _-- _-- -- _ _ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- _—_--- -- -- - Roof Misc: — --- - Final PASS PART FAIL — "- PLUMBING Post&Beam Under Slab Top Out — ----�__ Water Service -- Sanitary Sewer Ra;. Drains -- Final PASS PART FAIL MECHANICAL Post& Beam ----- ------... - — --- - Rough In Gas Line —"- — --- ---- Smoke Dampers — Final ------ ---- - PASS PART FAIL Service — ------ --- -- ---_—. -----.— Rough in UG/Slab v Low Voltage F' larm in ART FAIL Backfill/Grading --- — Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next:nspectlon. Pay ei City Hall, 13125 SW Hal;Blvd Catch Basin Unable to Inspect-no access Fire Supply Line [ ]Please call for reinspection RE:—_ J p ADA Approach/Sidewalk Date � Inspector Exi Other Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITYOF TIGARD PLUMBING PERMIT PLM2DEVELOPMENT SERVICES PERMIT#: 6/5/01 1-00226 DATE ISSUED: 6/5/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111 DA-16600 SITE ADDRESS: 08852 SW ASHFORD ST SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 159— JURISDICTION: TIG _ oCLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ _FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHFR FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of back flow preventer valve. -- FEES _ Owner: -- Type By Date Amount Receipt PAUL VOSS PRMT CTR` 6/5/01 $36.25 27200100000 8852 SW ASHFORD ST 5PCT CTR 6/5/01 $2.90 27200100000 TIGARD, OR 97224 ---- -- Total $39.15 Phone 1: 670-0755 Contractor: AUTUMN LEAF LANDSCAPING LLC 1209 INDEPENDENCE CT. WOODBURN, OR 97071 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 503-982-1415 Final Inspection Reg #: PLM 7265 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: 1,fC�2 rc� Rr-��,(Cl_�f __ Permittee Signature: { Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application "Dater,e!!iveA4d�es Q Permi;no.: a City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97 City of Tigard phone: (503) 639-4171 ProjccJappl.no.: Expire date: Fax: (503) 598-1960 `C�� ; Date issued: By: Receipt no.: Land use approval: % Case file no.: Payment type; )� 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Adclition/alte ation/replacement U Food service Q Other: JOB SI I I� IN I FORMATION FFE, SUIIIAM 1,11(for sli"hil inforniatioll 11w Check is(). Job address: �/�� f}S�!, �'c,C S'f, — H tion Qt . Iee(es.) Total Bldg.no.: Suite no.: Ne" I-and 2-family dwellings only: g _ —- (includes 100 ft.for each utility connection) 'Tax map/tax lot/account no.: _J_ SFR(1)bath Lot: I Block: Subdivision: SFR(2)bath - Project name: _ SFR(3)bath City/county: c:✓ �— ZIP: Each additional bath/kitchen Desct;iption and I ation of work on emises:_ Slteutltities: I tr✓t�'Ct?r,.•, _ _ Catch basin/area drain Est.date of ompletion/inspection: 1171 6 I Drywclls/leach line/trench drain111[Un Ell I Footing drain(no.lin. ft.) Manufactured home utilities _ Business name: a r1 �` CC u 1 `(. Manholes _ Address: + t�/'�str Cil ✓ Rain drain connector City: State: ZIP:Q' Q ? / Sanitary sewer(no,lin.ft.) Phone:iU- il: Storm sewer(no.lin.11.) CCB no.: Plumb.bus.reg.no: Water service(no. lin.ft.) City/metro lic.no.: Fixture or I em: Absorption-alve _ Contractor's representative signature: �'f _ - back flow prevcnter Print name: Date: l; ' Backwater valve Basins/lavatory �' Clothes washer Name:��1-t x-`t r eta r --- Dishwasher Address: LC;-�00 rtes. Drinkingfountain(s) _ City; State: ZIP: Ejectors/sump Phone: Fa E-mail Expansion tank Fixture/scwcr cap Name(print): to v _ Floor drains/floor sii,ks/hub — Garbage dis,jsal Mailing address: , - �'' _ Hose bibb _ City; _ State: ZIP: Ice maker Phone: —(J76W Fax: I E-mail: Interceptor/grease trap _ Owner stallation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),hasin(s),lays(s) _ Owner's signature: Date: Sump Tubs/shower/shower pan Urinal Name: �_--- — Water closet Address: Water heater City: State: ZIP: Other: �— Phone: Total Minimum fee................$ Com- Not W jurirdi.tioru arcept credit ands,please call jurisdiction fat more hJotmMion. Notice:This permit application U visa U MasterCard expires if a permit is not obtained Plan review(at _ 96) $a(8%) ....$ ,t— r0 credit can+number: � — .�—�- within IRO days after it has been State surcharge Ntune of cardholder as shown on credit card accepted as complete. TOTAL .......................$ _ S CardholdK signature Amount 4441616(KOIC.'OM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: �FIXTUIRate ES individu — QTY ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT for each_utilit utility ccnnectlon _ 16.0 _ Lavatory — �- One(1)balti --_ _ $249.20 Tub or Tub/Shower Comb— 1660 Two2 ba] th _ __ $350.00 Shower Only 16.60 Three 3 b) ath _ $399.00 Water Closet 16.60 SUBTOTAL _ Urinal — 16.60 — 8%STATE SURCHARGE Dishwasher — 1660 PLAN REVIEW_25X/.OF SUBTOTAL -- i TOTAL - . Garbage Disposal 1660 f -- ---- - - Laundry Tray 16.60 Washing Machine 16.60 Floor Dr_'-iIFIoorSink 2' 1660 PLEASE COMPLEETE: 3" 16.60 Winer Heater O conversion O like kind Quantity b Work Performed 16,60 - Gas pining requires a separate mechanical Fixture Type: New Moved Replaced Removed/ Capped permit. 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 1660 Drinking Fountain 16.60 Water Closet —_ — Urinal Other Fixtures(Specify) 16 60^ DishwasherDi__ -- - Garbage s Laund,y Room T-T _ —_- -- - -- Washin Machine _ -00- — Floor Drain/Sink: 2" -- Sewer-1st 100' 5500 --- 3" Sewer-each additional 100' 46.40 4" --- ---- Water Service-1st 100' 55.00 Water Heater — 46 40 Other Fixtures S -- Water Service-each additional 200' eci Storm&—Rain Drain-1st 100' 55.00 _ Storm 8 Rain Drain-each additional 100' 4640 —-- — Commercial Back Flow Prevention Device 46.40 -- - Residenlial Backtiow Prevention Device' 27.55 - _ Catch Basin 1660 Irsoection of Existing Plumbing or Specially 72 50 Requested Inspections er/hr _ COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 - Grease Traps - 16,60 —.--- ----- — QUANTITY TOTALIsometric or or riser diagram Is required If Quantity Total iss9_ — 'SUBTOTAL ----- - 8%STATE SURCHARGE --- "PLAN REVIEW 25%OF SUBTOTAL — __ Required only if fixtu,e qty total is>9 TOTAL $ Minimum permit lee is$72 50 8%slate surcharge,except Residential BackIlow Prevention Device,which Is$36 25•8%slate surcharge "All Now Commorclal Buildings require plan;with isometric or riser diagram and plan ievie" I:\dsts\forms\plm-fees.doc 10/10/00 1 ITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST BLIP _ —Date Requested ;�C �j AM PM BLD Location Suite _ MEC L,ontact Person _ -L-`-L,1 _ Ph 716'._ C � PLM Co:ttractor— Ph SWR BUILDING TenantlOwner _ ELC Retaining Wall ELR Footing Access. - Foundati-)n FPS Ftg Drain _ ---— awl Drain Inspection Notes: —" SGN _ _— ab fbst&Beam -------------- ----- -- - --- SIT —. Ext Sh• ath/Shear - Int Sheath/Shear Framing --- - --_ Insulatioi �� --- --�- Drywall Nailing Firewall --_ --- ------------- --------- --- Fire Sprinkler Fire Alarm ----- -_---- -- Susp'd Ceiling _ Roof Misc: Final _-_-- PASS PART FA PLUMBING ----- --- -- - Post&Beam -- --- Under Slab Top Out ---- -------- Water Service Sanitary Sewer - --- Rain Drains B �44 PART FAIL NICAL — — Post& Beam -- Rough In Gas Line Smoke Dampers Final _ PASS PART FAIL ELECTRICAL - -- - - -- - Service Rough In - UG/Slab Low Voltage - - - Fire Alarm Final PASS PART FAIL SITE — -- 'ackfill/Grading - - Sanitary Sewer Storm Drain ( J Reinspection fee of$_ regrdred before nexi inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspecticn RE: _ [ ]Unable to Inspect-no access ADA Approach/Sidewalk Other Date AQ / Z V IC / Inspector LS� f ��� �V' !Ext Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. o � CD � yJ G rD O C r r � d � a ° � o .e y a \ J 140 ZZ a d ti p N s 1