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Case File s 0o CO .4 N ' D o CL U) eo i i� i 8874 SW Ashford Street CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-41 iS Business Line: 639-4171 —� / BLIP _ Date Requestedj G' _AM— —_PM BLD Location_— -5 S.?r - Suite MEC — Contact Person _ Ph 22-` 7 .3 �� PLM _ Contractor — _ Ph _ SWR —_ BUILDING Tenant/Owner ELC — — Retaining Wall ELR _ ----__— Footing Access: Foundatioi, FPS Ftg Drain -. SGN Crawl Drain Inspection Notes: -- — --- Slab -------- --------- -- -- SIT _ Post(i Beam — — -- Ext Sheath/3hear _ Int Sheath/Shear Framing — ---- --�------ ----------- Insulation Drywall Nailing -- — — --- \'-----—--- - - -- Firewall Fire Fprinkler — C -------------..-------- Fire Alarm ` Susp'd Ceiling Roof Mise: --- Final �— PASS PART FAIL --- --- -- — --- --- -- PLUMBING Post 8 Beam —_----------------- -- - -- — -- Under;lab Tap Out ------------ ----------- -- Water Service Sanitary Sewer Drains Fin SS PART FAIL Post& Beam ---- --— ----- ------ --- Rough In GasLine ---- ----- ---------- --- — — Smoke Dampers F i n al - ---- —- ------ -- — --- - -- PA PART FAIL Rough In UG/S!ab — -------- ------ — _ - -- ------ Low Voltage FXAJS Atrm F PART FAIL —___-- Backfill/Gradiny ---------- — — -- — Sanitary Sewer Stone Drain [ ]Reinspection fee oI , — required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE:_— — [ J Unable to inspect no access ADA A roach/Sidewalk �-- Other Date /�; inspector_— )6,I'1— —Ext -- Final PASS PART FAIL DO NOT REMOVE this inspection record from thrJoh site. I CITY OF TIGARD BUILDING INSPECTION DIVISION MST-,4, 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ —_�LZX Date Requeste ' ' _ AM PM > �� BLD Location `. �< _ Suite MEC Contact Person � �,��Ir Ph 0 _ PLM - —_ — Contractor Ph SWR r T3 UILDING~` Tenant/Owner ELC Retaining Wall ELR _ Footing Access: Foundation FPS Flg Drain SGN Crawl Dmin Inspection Notes: - --- Slab _ SIT Post R.Beam -�— Ext heath/Shear _ Int Sheath/Shear --- -� Framing ---------- — - ---- --- ---- --- Insulation Drywall Nailing ----------------- Firewall ----�.__ -------------_--_--- ------- Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ------- Misc: --- -- ------ ---_._..... ..__ . _ ------ - AS PART FAIL - ---- --- --- ----- _ --- --- - -------.... - --- -- -, PLUMBING [lost& Beam Under Slab Top Out __----- Water Service Sanita,y Sewer - -"--- - Rain Orains Final PASS PART FAIL. [lost& Beam -- Rough In Gas Line Smoke Dampers E'C:�PA6S PART FAIL TRICAL ---- _.._. - -- -- - -- - Service Rough In UG/Slab Low Voltage ---- - --- ----- ------.—_---- Fire Alarm Final PASS PART FAIL $I Backfill/Grading - - ---- -- - -- ----- Sanitary Sewer Storm Drain ( Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin i ll f Please call reinspection RE: Fire Supply Line ( p ( Unable to Inspect no access ADA //'' Approach/Sidewalk Date I 7 - V ��111= eetor - Ext Other p --- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. n z o � \ I � � cam•+• ro n cp y .. n _ a o � F 7 uo r i i CITY OF TIGARD _ MASTER PERMIT PERMIT#: MST2000-00413 DEVELOPMENT SERVICES DATE ISSUED: 9/18/00 13125 SW Hail Blvd..Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 08874 SW ASHFORD ST PARCEL: 2S1 11 DA-16700 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 160 JURISDICTION: TIG REMARKS: S/F Path 1 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS_ REQUIRED CLASS OF WORK: NEW HEIGHT: ;.4 FIRST: 927 of BASEMENT: at LEFT: 4 SMOKE DF.TEc'rORS: TYPE Or USE: sF FLOOR LOAD: 40 SECOND: 1,227 of GARAGE: 479 of FRONT: 22 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: I -INBSMENT: of RIGHT: VALUE: $161,817 10 OCCUPANCY GRP: R3 13DRM: 3 BATH: 3 TOTAL: 2.154 00 of REAR: "I PLUMBING SINKS 1 WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS. RAIN DRAIN. 100 TRAPS. LAVATORIES 4 DISHWASHERS. I FLOOR DRAINS: SEWER LINEF, 1'p! SF RAIN DRAINS: I CATH BASINS'. TUB/SHOWERS, 1 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 13CKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL _ FUEL TYPES FURN<100W BOIL/CMP<7HP: VENT FANS: CLOTHES DRYER: I GAS FURN>=100K: 1 UNIT HEATERS: HOODS 1 OTHER UNITS: I MAX INP. btu FLOOR FURNANCES: VENTS. 1 WOODSTOVES: GAS OUYLETS: I ELECTRICAL. RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS- BRANCH CIRCUITS _ MISCELLANEOUS _ ADD'L INSPECTIONS 1000 SF OR LF-SS: 1 0 200 amp: 0 200 amp. WISVC OR FDR: I PUMPIIRRIGATION PER INSPECTION: EA ADD'L 500SF: 4 201 400 amp: 201 - 400 amp 1st WIO SVCIFDR. 00 SIGNIOUT LIN LT: PER HOUR LIMITED ENERGY: 401 800 amp: 401 600 amp- EA ADDL BR CIR. SIGNALIPANFL: IN PLANT: MANY HMISVCIFDR 801 - 1000 amp: 601-Amos-1000v: MINOR LABEL: 1000.amplvoll PLAN REVIEW SECTION Reconnect only: RES UNITS SVC/FDR-225 A.: >600 V NOMINAL: CLS AREAISPC OCC � ELECTRICAL•RESTRICTED ENERGY _..r A.3F RESIDENTIAL _ B._COMMERCIAL AUDIO&STEREO' VACUUM SYSTEM: AUDIO&STEREO. FIRE ALARM- BURGLAR OUTDOOR LNDSC LT: BURGLAR ALARM OTH: BOILER: MVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL OTHR: HVAC DATAITELE COMM: NURSE CALLS: TOTAL a SYSTEMS. TOTAL FEES- $ 3,384.83 Owner: Contractor: This permit is subject to the regulations contained in the MATRIX DEVELOPMENT CORP LEGEND HOMES CORP Tigard Municipal Code,State of OR Specialty Codes and 6900 SW HAINES ST STE 200 11130 SW BARBUR BLVD all other applicable laws All work will be none in TIC=ARD,On 97724 PORTLAND,OR 97219 accordance with approved plans This permit will expire if work is riot started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Phoner Phone, Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Rep N: I IC 00060551 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 Control Insp 8, Post/Beam Mechanica Mechanical Insp Framing Insp Gas Fireplace Electrical Final Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Ins{ Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dn Electrical Service Low Voltage Water Line Insp Final inspection Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/Sdwik Insp Building Final -1 G� i Issued By : ' -' ��–>,�_—� Permittee Signature Call (503) 639-4175 by 7:00 p.m.for an inspection needed the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00283 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/18/00 "'ARCEL: 2S111 DA-16700 SITE ADDRESS; 08874 SW ASHFORD ST SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 160 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for SF. Owner: _ —� �^ FEES MATRIX DEVELOPMENT CORP 6900 SW HAINES ST STE 200 Type By Date Amount Receipt nt ----- TIGARD, OR 97224 PRMT CTR 9/18/OC $2,300.00 27200000000 INSP CTR 9/18/00 $35.00 27200000000 Phone: Total $2,335.00 Contractor: Phone. Reg #: Required Inspection, Sewer Inspection 1-his Applicant agrees to comply with all the rules and regulations of Vie UnFied Sewage Agency. The permit expires 180 days from the date issued The total amount paid will be forfei!r!d if the pe,-rnit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer�s not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If nct cn!oratP✓, the installer shall purchase a"Tap and Side Sewer" Permit 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 copies of these rules or direct questions to OUNC by calling (503) 246-1987. < TJX Issued by: ' _ Permittee Signaturet �__M(' Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day �I l CiTY OF TIGARD Residential Building Permit Application PlanChec4 Sf- Recd By L 1�12fa SW HALL BLVD. New C,on,:tru(.► n Date Recd_f_J -/)n TIGARD, OR 97223 Single Family Attacned Date to P.E V 503-639-4171 Date to DST -'v F 503-684-7297 Permit#("iT Ct'i c ls„ Print or Type called - Incomplete or illegible applications will not be accepted AW)l �C?c ------�------ Name of Pro)ect Name / C J3 ,J ' _ Job Op�r 1 Architect Mailing AdofrP-s `y ? Address Site Adbifis CitylStnte Zip Phone Nam Name Owner Mallin ddross c-t:�GC.CI /—=- - lO� ��- En ineer Maiiin A dr ss s C�tylS�te Zip 7 7 Phone g r J h Cit /State / Zip Phcne General Na(he. _ ;� c !i _L'7� 3 GY�11 - Contractor �. Pr >2 Aal Describe work NewLC�/ Addition O Alteration U Repair O Mailing Adfiress to be done -- Prior to permit Additional Description of Work: issuance, a copy City/State Zip Phone — - of all licenses are required if Oregon Const.Cont. Board Exp.Date PROJECT 41 '/ • - expired in COT Lic,# / // //�� VALUATION database 0 ��(1J Li' -lJ� --- —.— —�- Mechanical Name - — _ NEWC014STRUCTION ONLY: _ Sub- \'I nrf �,cy� _ Sq. Ft. ous ' Sq.� Ga age Contractor Maili e - --- Pnor to permit _ (_71 ��/5r Indica e the restricted energy installation by the electrical issuance, a copy (; 'Slate Zip Phone 2 subcontractor in the following areas of all licenses 4regari�607 a 7) Restricted T Audio/Stereo are required if Cont Board Exp. Date Energy — System Alarms expired in COT Lic.# Installations Vacuum Irrigation _database_ ,J / 3 / 5 - y r System System TXn Plumbing Name check all that Other: Sub- > , ///y)�d1 apply) Contractor arllgg Addr ss Number of Units in Building Unit Number Designation ✓/�'� � �� Has the Subdivision Plat recorded? Prior to permit Gitylsta�e��y� Ph, 4�T>•.1n issuance, acopy of all licenses are Oregon Const Cont. Board Exp. Date —� required if Lic# — - — expired in COT o)), 3 e ,U —0 1 hearby acknowledge that I have read this application, that the database Plumbing Lic # Exp Date information gi%,ei is correct, that I am the owner or authorized agent / of the owner, and that plans submitted are .n compliance with �� (� � Oregon State laws Name Sig/r ture of Own r/Agen fla.e Electrical �� L— � - ✓ �/ Phon Sub- Mailing Address C ct Pers eC Contractor s 81 Cityistate Zip Phone Prior toermit issuance pa copy FOR OFFICE USE ONLY: of all licenses are Oregon Const Cont.Board Exp.Date Plat# M r A 7 required if Lic# L q' / �t✓tf ' C, `� expired in COT Z � r / database Electrical,L � �CT Exp Date( Setbacks Zone: ) i7 U0 Electrical Supervisor Lic.K Exp Date Engineering,Approval Planning Approva: TIF: i.Wslslforrnsbfa-new doc 11Ro/9A May-10-00 10: 21A Wolcott Plumbing 503 667 9391 P.02 WOLCOTTreet Ad urns Mailing ox 20 7 Y11�/lIY/ l!l L 7.050 N W,Burnside P O Boz 2007 Gresham,Oregon Gresham.OR 97030 PLUMBING (603)667-1781 Fax(505)667-9891 C.� Cco 027647 GNTRACTORS, INC. May 10, 2000 Building Department City of Tigard 13125 SW Hull Blvd. �� / r Tigard,OR 97223 Wcilcott Plumbing Contracuus, Inc. docs hereby authorize a representative of Legend Humes to represent this firm when applying for plumbing permits inside theJurisdiction of The City of Tigard. Wolcott Plumbing Contractors, Inc. realize that should the agreement with Legend Homes terminate, we have the right to withdraw our consent. game Title eattire Date 26-208PB 4281 State Plumbing License City License LOT PLAN LOT *1160, AFF E1 OOD FARK RIPD 251 11 DA TAX LOT 01&(oOO aal4 5W Al" 4FORD STREET LEGEND S.E. 1/4 CSF SECTION 11, T.2, R.iW, W.M. _ 117M qWeOME OM S W !II emcs Inoal sso-mm 71GA". oa. u7.s., CITY OF T IGARD . (�3) ccol eoaea W,45;4INGTON COUNTY, OREGON N SUJ A,S1-I C�?�RD 5TFREET -- - -- - __ I I' 20'-0, ---------�- ---- -W---------------i- -- - --w----------- �- N CURB �' ; _ N89 54'25''E ----- ---- 6M WATER METER w► 62.00 I SIDEWALK >A W– -- - WATER LINE 8' UTILITY X04 2' SS———— SANITARY SEWER - I I EASEMENT SC-- - - — STORM DRAIN • — — — 1� OF STREET 5.0' MANHOLE 2ra4�' l 204.3' /� / — + / ® CATCH BASIN =1 4.67' PROPOSED m - �4 STREET TREES LOr STREET LIGHT / 4, 216 SCS. FT. FIRE HYDRANT 0 p �; PARGOURr 11A FIN. FLR. • 205.6'�/l Q z 4.b1' GA"E FLR. = 20425'// z J PROVIDE EROSION Zmb.l' 2ld 4.6_J CONTROL FENCE _ PER COMMUNITY ` EROSION PLAN Lor 1h1 N89'54'25"E 4042 62.0 0' LOT 17,0 LOT 171 - LOT 172 1m� OL CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE GARNER ELECTRIC 21785 SW TUALATIN VALLEY HWY S ALOHA, OR 97006-1248 Electrical Signature Form Permit #: MST?000-0041 Date Issued: 9118100 Parcel: 2S111 DA-16700 Site Address: 08874 SW ASHFORD ST Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 160 Jurisdiction: TIG Zoning: R-7 Remarks: S/F Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the 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: T FLEC RICAL CONTRACTOR: MATRIX DEVELOPMENT CORP GARNER ELECTRIC 6900 SW HAINES ST STE 200 21785 SW TUALATIN VALLEY HWY S TIGARD, OR 97224 ALOHA, OR 9700E-1248 Phone #: Phone #: 591-1320 Req #: LIC 121159 SUP 3707S ELE 14-305C AN INK SIGNATURE IS REQUIRED q THI FORM XL, .r Signatur o Supervising Electrician If you have any questions, please call (503) 639-4 171, ext. # 310 CITYOF T'IGARD PLUMBING PERMIT _-- DEVELOPMENT SERVICES PERMIT#: PLM2002-00294 1',125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/26/02 SITE ADDRES; : 08874 SW ASHFORD ST PARCEL: 2S11'DA-16700 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 160 JURISDICTION: TIG CLASS 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: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow preventer device. FEES Owner: -- Type By Date Amount Receipt TRACY ANDREWS 5PCT CTR 7;26/02 $2.90 27200200000 8874 SW ASHFORD ST. PRM7 CTR 7/26/02 $36.25 27200200000 TIGARD, OR 97224 �� Total $39.15 Phone 1: 503-620.1945 Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS Phone 1: 682.-6076 RP/Backflow Preventer Reg #: LIC 6136 Final Inspection PI-M 11558 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. SP Y PP Fp 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: -t.� L---- Permittee Signature: — r Call (503) 639-4175 by 7:00 P.M. fur an inspection needed the next business day Plumbing Permit Application / Date received: Q V Permit na.: ` �V `0 City of Tigar ::k W&IV Sewcr permit no.: Building permit no.: Address: 13125 SV/H C1ryofTtgard phone: (503) 639-4:71 �G I'rojecUappl.no.: Expircdate: Fax: (503) 598-1960 Date issued: By: VV'I 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 Addition/alteration/replacement U Food service J Otllel: 1 1 1903CMIMM=Iatr= Job address: ,S-(,U 44h /ime eyt- Description Qty. Fec(ea.) Total Bldg. Suite no.: New 1-and 2-family dwellings only: no.: (includes 100 ft.for each utility connection) Tax map/tax lot/account no.: & 55 E 7 SFR(1)bath _ J _----- Lot: _Lot: Block: Subdivision: SFR(2)bath _ Project name: 7yAC / !rei-VSSFR(3)bath _ City/county: A. 7TP 1 � 40?- ach additional battt/kitchen — Descrjption and4 ation of work on premises:—_ ___ Siteutilltles: dQ.U[Ck, _ Catch basin/area drain D wellsAeach lineltrench drain _ Est.date of completion/inspection: 0 Footing drain(no.lin.ft.) yl1111 NIHING.CONTRA(I*ORManufactured home utilities — Business name: rr0&fz,(S ( C2Manholes —_ �l Addres&;X/ Q Z S911041 Rain drain connector ^_ City: t (jYl Ul I t StateO►'L ZIP. ?G7 V Sanitary sewer(no.lin. ft.) JPhone: &� W? Fax(p mail: Storm sewer(no.lin.ft.) Plumb.bus.re no: Water service(no.lin.ft.) CCB no.: /3 g' - Fixture or Item: City/metro lic.no.: GG 3 Absorption valve — Contractor's representative Signa _ �, Back ow preventer Print name: GIl }r Y('�.L [)ate: Backwater valve CONTACT PPRSON Basins/lavatory _ Pa'l (t,r 1'�J'lt`) Clotnes washer Name: Dishwasher Address: Drinking fountain(s) City: 1.e State:01PLIZilylluEjectors/sump _ Phone Fax: E-mail: Expansion tank Fixture/sewer cap _ Floor drains/floor sinks/hub _ Name(print): i-I R7YU-2!W S Garbage disposal Mailing address: J Hose bibb __ City'T j (.1-4 CC- StatQQ ZIP:9 7,),4 Ice maker Phone:(p�- y4 Fax: as E-mail: Interco tor/ ree tram _- Owner installation/residential maintenance on:y: The actual installation Ptimer(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),basin(s),lays(s) Omvner's signature: _ Date: Sump _ Tubs/shower/shower an _ Urinal Name: �. Water closet _ _ Address _ _ _ Water heater _ City: State: ZIP: i_ Other. Phone: Fax: I E-mail: Total Minimum fee................$ a - Not all jurisdictions accept credit cud+,please call jurisdiction for more information Notice:This permit application plan review(at — %) $ U visa o MasterCard expires if a permit is not obtained State surcharge(896) ....$ credit cud number —✓!—�-- within 190 daTOTAL .......................$ days after it has been 9 /S Nune of cardholder u drown on credit c $ ExpiresExpiresaccepted as complete. CrdboWn slputure Amount 440-4616 I6A,VCOMt J PLUABING PERMIT FEES: ---- -- �PRICETOTAL New 1 and 2-family dwellings only: FIXTURES individual) QTYUNT (includes all plumbing fixtures In PRICE TOTAL Sink the dwelling and the firs, QTY ft. QTY (ea) AMOUNT 16.60 for each utility_connection) '.;;story One 1 bath _ _ 5249.20 __ 1 ub or Tub/Shower Comb. 16.60 Two 2 b) ath _ 5350.uU -- Shower only 18.60 Three 3 bath $399.00 _ -- - Weir Closet J 16.60 SUBTOTAL Jrinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL v TOTAL Garbage Disposal 16,60 - Laundry Tray 16.60 Washing Machine 16.60 FloorDrein/Floor Sink 2" lsso PLEASE COMPLETE: 3" 16.60 4" 16.60 _ Quantity by Work Performed_ Water Heater O conversion O like kind 16.60 Gas r;H'ng requires a separate mechanical Fixture Type: New Moved Replaced Removed/ Gapped ennit. - - MFG Hc;me New Water Servic 4640 SinkMFG1-oma New SeNStorm Sewer 46.40 Lavatory Tub or Tut'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 3" _ Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater 48.40 Other Fixtures Water Gervlce-each additional 200' (Specify - Storm&Rain Drain-1st 100' 55.00 Storm&Rairi 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 Reguested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.80 QUANTITY TOTAL I -- Isometric or ilser 9lagram is required if Quantity Total is >9 -- 'SUBTOTAI I c�7 �' S 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only if fixture qty total., 9 TOTAL *Minimum permit fee is 572.50+s%state surcharge,except Residential Backlfow Prevention.Device,which Is$36.25+6%lisle surchboge "All New Commercial Buildings require plans with isometric or riser diagram and plan review i Wsts\forms\plm-fees.doc 10110/00 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)638-4175 MST INSPECTION DIVISION Business Line: (51d)639-4171 BUP Received _ _r__ - Dd,,c R/e�uested ___ _ AM___��._PM BUP Location -_V_-___� $ Li 5. 1. _ Suite_-_._ MEC Contact Person Ph PLM ?� Contractor __.__ —�___�__________-__ Ph SWR BUILDING Tenant/Owner _ ___ ELC rooting — ELC Foundation Access: Ftq Drain ELR Crawl Drain _ Slab Inspection Notes: SIT Post&Beam Shear An;hors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler ----- --- -- - _ —_ — - -- - ------- --- Fire Alarm Susp'd Ceiling Roof Other: F anal 5 RT FAIL -- - -- PLUMBI ---- _ — Under Slab _ ---*- ---- — - Rough-In Water Service Sanitanr Sewer j Rain Drains --- - 1 Catch Ba;-,in/Manhole Storm Drain - Shower Pan Other: �t S PART FAIL MIFF ANICAL Post&Beam Hough-In As Line smoke Dampers -- Hnal PASS PART FAIL — ELECTRICAL--Service Rough-In UG/Slab I.ow Voltage Fire Alarm Final PASS PART FAIL lieinspection tee ct$ _- required before next inspection. Pay at City Hall, 13125 SW 001 Blvd. _ Siff___— Please call for reinspection RE:_ Unable to inspect-no access Fire Supply Line ADA `'�-- Data ___ SL�J Inspector \ ;'__� Ext - Approach/Sidewalk ----- Other Final _ DO NOT (REMOVE this Inspection record from the job site. PASS PART FAIL