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CITYOF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00213
13125 SW Hall Blvd., Tigard, OR 87223 (503) 639-4171 DATE ISSUED: 4/25/03
PARCEL: 2S104CC-07200
SITE ADDRESS: 13515 SW ASCENSION DR
SUBDIVISION: HILLSHIRE WOODS ZONING: R-7
FLOCK: LOT 916 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 Hr: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS?: _0 - 50 HP: REPAIR UNITS:
woou TovEs:
GAS PRr:_SSUKE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfnr. GAS OUTLETS.
> 10000 cfm:
Remarks: Installation of a r unit.
Owner: FEES
PAYNE, BRYAN D +CHERYL J Description Date Amount
13515 SW ASCENSION DR --
TIGARD, OR 97223 1MFUIII Permit Pee 4/25/03 $72.50
11 AXI 8"6 StateTax 4/25/03 $5.80
li
Phone: Tonal $78.30
Contractor:
GAROK EN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 PEQUIRED INSPECTIONS
Phone: 03-848-3838 Cooling Unt InspFinal Inspection
Reg #: LIC 43124
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if wort, is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246^99-
Issued dy: W) Permittee Signature: � �
Call 503 639-4'i 75 h 7:00 P.M. for inspections needed thobusiness
in
1 ) Y p s ess day
04/24/2003 14:47 5033569002 GAROKEN PAGE 03
U3 21 01 "ED 12;58 F,t.0 503 598 1P80 CITY OF TIC,4RD
2004
Mechanical Permit,kpiplicattion
~-- �- _
City of Tigard Dateroceived: Qi Q s; Petmn na;`{fC � •�/
Address: 13125 SW Nall Blvd,Ti art.OR 97223 ProjecVappl,no.: Expircdate
C(r)of Tigard B ----�
Phone: (503) 639-4171 Dateissucd;� _ By Re(aptnu
Fax (303) 596-1960 Case file no.: I,.- �1Ptyment rype;
Land use approval; Building permit no:
6. 2 family dwelling or accessory U Comrn.:rciaUindustrial C1 Mulfi-farrill Q
0 New construction y Tenant improvement
Addit;c rJalteraGon/replacoment a Other:
T�� 15
Job addi lie _ _ __ Indicate equipment quantities in boxes below. Indicate the dollar
Bids. no.: Suite no.: value of all rnechanical materials,equipment, labor,overhead.
I
Tax 'nap./lax IoVAccount no., __ profit. Value$ ;
(^Lot black: Subdivision—_ 'See checklist for Important application information and
Pro)ect none: C�...� *A-- jurisdiction's fee schedule for residential pri-mil 1:c i
Descir w� zIP: q�f) —
I)escnFnnn a d anon f wort:op prcmisea: _
Yet to) Total
Est date of completion/ins ection: —�.-�, Descrl oa
_ _ F.a.oNy Res,oal�
"1erznt mprosement or change of use •
Is existing space heated or conditioned?Q Yei )id No Alt CFM
Is existing space insulated?❑Yes PAorton it to an require )
' ono cx n n system �'�'
0 or compressors
CP► % teboirpermuno.;Svsiness name ( tarceef) Er, HP
Tons THAddress: ' � a re mo e_6m uct amdetectors
;
etuseen requireit I
——.
Phan 1 —
CC8 603 B 3133$ Fex: E•ma,l: 1n11ud111Q ductwork/vont It nor Q Yes 0 No i
Citylm«tro lie. n X1555 nate D
rep ac re ate eaters-%aspen e ,
wall or float mounted `
Name(please print): 0 S'ej ant t c3rs
ora .nceorn urnsce
e tura ore
Abaurption uruts BTl!H
Chillers,_.______ HP `—rt
Address —`— Com re corsHr
r rotlm•M^`� ta4t an ren at o`n
Cur y State, 4:1P. Appiuncevent
Phone l;ax: E-mail: ere oust )
s o a, yres ezmet
hood fire suppression
system
systemm
Name_-_ r`!Z Exhaust fan with single duct(both fans) t
N1 lading;addre_ss: �— E6ausi 11—stern a an fTom healins or Ar
C:ny State: ;:IP: Fuel piping an r tit on up to 4 outlets)
phT LPO _ NO Oil
one w Fax' Email. Fuelin eacha ion
ita_over out alt
rocess p p n`(sc emstie require "
Name Numbor of outlets
--- er a app ante or equipment:
Address Decorative fireplace
City _ State :IP; nsert-type
Phone: Fax: T TE-mailo tov at stove —
I Applicant's si oat a [-bate! ji --
-�.�i?
P,a All JuM%&CuoM snap,cr{dir C"I,pltlafc t►rl 1uns&cdon(or nate Int muuon. Permit fee.....--....
7 V is Q MasterCard Notice-Tllls permit application Minimum fee................S
I CrW,cud nu'+ber
L� expires if a permit is not obtained Plan review(at 96) $
sr ter widtin 110 days after it his been State surcharge(896) S
I'— v�.rdno t o+n on cre +l,v f uceptcd as complete TOTAI, S
rdhodor rl avn Am,uni
W�ol�t0.g0<C�t
_ � Tl
04/24/2003 14:47 5033569002 GAROKEN PAGE 02
ID
J C Inc GAROKEN ENERGY CO . INC.
slHcc 1979
3065 SW 182Nd Avg • BEAVINTON, OR 97007 TEL (503) 1348.3838 FAX (50-I 366-9002 c:21a# 43124
I
� �`("�. ��/�n.� — 1351 S s w S�.P•�nS �
i cy -----
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CITY OF TIGAR _ELECTRICALPERMP
T PERMIT#: ELC2003 10278
DEVELOPMENT SERVICES DATE ISSUED: 5/15/03
13125 SW Hall B!vd.. Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104C -07200
SITE ADDRESS: 13515 SW ASCENSION DR ZONING: R-7
SUBDIVISION: HILLSHIRE WOODS
BLOCK: LOT : 016 JURISDICTION: TIG
Project Description: Installation of(1)branch circuit for A/C unit.
RESIDENTIAL U'!IT TEMP SRVC/FEEDERS _ MISCELLAN__E_OUS
�—
1000 SF OR LESS: 0 200 arnp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/ FDR: 601+amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ _PLAN REVIEW SECTION
1000+amptvolt: _ >=4 RES UNITS: —> 600 VOLT NOMINAL:
Reconnect only: SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PAYNE,BRYAN D+CHERYL J HEBERLE ELECTRIC
13515 SW ASCENSION DR 19680 SW NELIGEBAUER RD
TIGARD,OR 97223 HILLSBORO,OR 97123
Phone: Phos,e: 503-628-2095
R #: SUP 30535
----- ---- LIC 152342
_ FEES r.Le 34-160(
Description Date Amount
Required Inspections
IELPRM"fj ELC Permit 5/15103 $46.85
I ,%X >;°°State Tax 5115/03 $3.75 Rough-in
Elect'I Final
Total $50.60
L._
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 952-001-0010 through OAR 952-001-0100. You may obtain copies er these rules or direct questions to OUNC at(503)246-6699 or
1-800-332-2344. /
Issued By: Z' Sa/�__ _ Permit Signature: '"
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S S,MATURE: _ _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N• DATE:
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
05/14/2003 07:57 5036283076 HEBERLE ELECTRIC FAM 01
� 6, r z
l . '
Electrical Permit Application
Untereccived:s Pcrm4no.:&ze z6 9
City of Tigard ProkcUappl.no.: sxplr�dalo:
CllyofTigard Address: 13125 SW Hall Blvd,Tigard,09 97223 pptotaauetl; sytm Receipt no.: _
Phone: (503) 639-4171
Pax: (503) 598.1960 Case filo no.: Paynllnt type:
Land use approval: - �G
;JNe
;hnillj dwelling or accessory U Commercial/industrial 0 Multi-family O Tc6nt Improvement
lcliem dtlilionlaUerali�n/rchaccmctu ❑Cltller: U Patriot�a J CS►/�/yZ Bld . no.: Suite nu.: Tax inn r/lax IotYaccount era:
7-7.-
Lot; Block: Subtlivixiion::� -'C.�f�-•V(r -n �yZ
Pro oct amnia; _ - I Description and location of work on remisop: -
Wmaled dwa of coni ricdon/ins cellon:
fir Mnx
Inh Irol - -1 aE�B -� -. � b' � NcStrIp11MI Qom{. (rn. 1 Dial no,lus r
Illl9llles�I1a111C: 19G80Sw u Ne"WIllenllal %Ingkormtdll•fmm�y per
Address: __._klWshafO _Qp( kpn 97123.94467 dwellingunit.loclttk+attachcdgnrnge.
Cil : Mate; Z1P: or— Servlrelnrill".
Photlo; 8 -2 0 9 5 Fax:
2 1 Dot"^ n•or Iwo 4 _
F. Atli d�fl Dant S(1U sq,ll.or portion tTEreof
CCB no.: 4 2 8 41Elce.bus_,lio.no: 34-16_0C Umhed rner ,tClitlelllial 1
Cil
/n e.no.: 0 Limiiedenergy,notrroaidenlia z
% Vich rnenufnctured home or modular dweillop
cion rcqu
Dat Service nnd/of feeder 2
► lura 0 e C 1a —'
r BertTenor !l+aria-M.allannn, i
Su .elect.nn Int): e f f C 2 T— roams nn:3 0 J 3-S aherntlon or relecodont
z0o.mps or less 2
Name : 2 amps l0 400 e_=�
401 amps 10 600 amps 2
Will ad a % 601 AmpA to IOOU nntpa
City: Stale: 7-1 P: Over low Amps or volts 2
1i-malt:
Itceonncctonl t
1'clap0twry$Mica or feeden• I
Uwnor Installation:'1'he Installation is being made on property l own k►elallatloa,dlerrllot,orreleeallun: I
which is not inionded for sale,lease,rent,or exchange according to 20U amps or leas 2
ORS 447,455,479,670,701. 1010mrstoiluoil 1 2
gwncr's sl IlalurC; pale: 401 to 600 nm s 1
branch circ 1s•sew,allerallen,
or exteo•lon per panels
rNattte: A. Fee far branch circuiti with pnrchnxe of
service or feeder fee,each hratch circull
SIAIC; yIP: n. Pec err Inns s sires Is without purchnee 8 2
Chy: of Acrvlce of feeder fee,Oret lxancb Urcuit:
Pliom - Fax: E-mail: Co.. stlefloinnAhlandleirealt
se.(serr sear ederoellnc tide+)s 2
O service over 225 nmpx•cormxroiAl U l lealth ease ractlily Bach Rum tx Irtigallig Circle
❑oerviee over 12n orops•tailttg of M U Nnrnrdous localion ash sign of oat ins 11 l n
fatally dwchings O Ruilding over IU,txq lqumc feet four or Si(tnnl circnit(a)of a flmUed energy panel,
O 9yatttn over ri00 votes nominal twig nwe;Eollsi units in one stntCture aherntlon,orcalensiolt' _
Z
U 8011canr,over three stories ❑Feeders.400 amps or more •[kscri un: �-
❑oecmptnd load over 99".no tl Manaraelnred dluelures or AV pork Ew,h ndditlnnal Inspection ore►rhe MlowaUk In say of lift slate.
J Fptcedl pluht{plan U Otho. PC,
Inspection
90110011—eels of plane w11h wry of the above. nvclttl orlon fee
the above are not appllatble to temporary cold ruelks serrlee. 011ier
�_ Plamit fee.....................$
NrA nut hailped�ea.Creep sada Cards,prase call)nrladrten he more larmm im. Notice:71t1s permit application Plan review(at
EJ w.• „"'J'Uxterc tut expires if a permit Is tint obtained
...eau Card number: �y within Igo days allet It has been Stale surchiirpe(8%)..,,f
J'aF�ti __rte�l 'TOTAL ....................... k.
-'—"1G-' n'xadn�c—dw --'- accepted as complete.
(, .t afiare Amount (see— eL 7~ ++wsls(soa�vMl
`ter
�. E X PERMIT #/RECEIPT TO 503-62B- '407A A-Ar . TPAMWVntt.
CITY OF TIG,ARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received __ __— Data Re ested__—S�` __ Af� — PM _ _ BUW —
Location _ 1 J s Suite _ MEC —
Contact Person — Ph( ) _ _ PLM SWR
Contractor ___ Ph( ) q-1
BUILDING Tenant/Owner _ e�y� �� ELC
Footing ELC
Foundation Access:
Ftg Drain ELR -- --- - -- --
Crawl Drain
Slab Inspection Notes: SIT
Post&Benm ---
Shear Anchors --
Ext Sheath/Shear
Int Sheath/Shear
Framing - - --- - - -- -
Insulation
Drywall Nailing -- - -- - - -
Firewall
Fire Sprinkler - - -__-- --.----
Fire Alarm
Susp'd Ceiling -- ----
Roof
Other: —
Final
PASS PART FAIL - --- _ ------ ---- -----
PLUMBING -- -.
Post&Beam
Under Slab --
Rough-In
Water Service
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain --
Shooter Pan
Other_ --
Final
P L FAI -- - --- - - --_ ---- - --- --- --
F L
FIECHANICAA
Post _
Rough-In
41
Gas Line � —
Smoke Dampers
Final
JOKS'S PART FAIL -
RICAL
---- --------------
_.----_._......._—_ _...-----------
Service
Rough-In - --- --— --- _ — -
UG/Slab
Low Voltage —_----
Fire Alarm _ --------------------------
Final L7 Reinspection fee of$—� —required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASSPART FAIL
SITE _ -- Please call for reinspection RE:_ ❑ Unable to Inspect-no access
Fire Supf;y Line
ADA
Approach/Sidewalk Qsto / - �- - Inspector _---- `-_ --- - _ Ext -
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Lin,,: (503)639-4171 MST _
BUP _
Received - -Date Req sted ✓- 9 M PM BUp
Location —_ �' s�5 _ uite.
MEC --
Contact Person _ ..J Ph(_—�) -7 —to '?
PLM
Contractor_--__- Ph( ) _ SWR
BUILDING- Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam _ _ --
Shear Anchors - --
Ext Sheath/Shear
Int Sheath/Shear -
Framing
Insulation - -"— -
Drywall Nailing ---.-
Firewall
Fire Sprinkler
Fire Alarm �—
Susp'd Ceiling ----- - __ _
Roof -
Other: - - - -- -----
Final -- -------- - - ------
PASS PART FAIL -- -- ------ - -- -_-__ _--
PLUMBING
Pest& Besm
----- --- ---------_------------ ----- —
Under Slab __-- ---_- -- ---
Rough-In --
Water Service
Sanitary Sewer -
Rain Drains
Catch Basin/Manhole
Storm Drain ------ ------ -- _— - _
Shower Pan
Other: - -------- ----
Final -- --------_-
PASS PART FAIL --- ---- ------------- — -
MECHANICAL _
Post&Beam --- --� -- ---- - --
Rough-In
Gas Line ----- - _ -- ---
Smoke Dampers
Final -- ---'-
P FAIL
ECTRICAL
Se - -- _ — -- - -- -
Rough-In
UG/Slab --- -- - --
Low Voltage
F' Alarm -- - — - --- -----
*inReinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
�� Please call for reinspection RE: - Unable to inspect-no access
Fire Supply Line
ADA �
Approach/Sidewalk pato -- y In8P0Gt0lr _-
Other:
Final _---- -- DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
MASTER PERMIT
CITY OF TIGARD PERMIT #. . . . . . .
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223-8199 (503)629-4171 PARCEL: LS104.CC--HW0i6
KmlarmPATH l �
--------------------------—----------------------------------- WILDING -----------------------------------------------------—---------
�
R$I6SUE. STORIES.......1 2 Fl0]H AREAS----- BASEMENT.... N sf REQUIRED "ACxS--- REQUIRED------------
CLAM OF WORK.AEW KEIGHT...,...,/ 27 FIRST....' 1995 if GARAGE...../ 615 sy L[pT.,..,..... 5 90K[ 0C7ECTRg: Y
TYPE OFUSE../6F FLOOR LOAD.... ' 40 ,,[COND...: 693 s FRONT....... 21 PARKING SPACES: )
TYPE OF CUN8T iSN DWELLING UNITS: I FlN8SPEM : 0 sf RIGHT ....... 5 �
OLLUP*CY GRP./G BAN: 3 [ATH: 3 TOTAL'---: W sf VALLE.A/ 183640 REAR........ : 60 �
| -------------------------------—------------------------------— PLUMBING ' ------
/ SlNKS ...../ I WATER CLOSETS.: 3 WWSHNGMA[H .- l LAUNDRY TRAYS. ; 1 RAIN DRAIN ft: 0 TDAPS ...... @
1AVA70RlBl..: 5 U1SHNA5HE89 .x I FLOOR DRAINS.. SEWER LINE ft. N SF RAIN DRAINS' l CATCH WINS.. 0 |
TUB/SHOWERS...: 3 OARWE DlSP..' I WATER HEATERS. i WATER LINE ft: ]00 ACKF\W mKEVhT : l GREASE lW5 .- 0 /
OTHER FIXTURES: Z
WLL n,Ev—' rUm ` i Om w no/ 'w= ` 3HP/ v mm. rwno : . CLO= "".==^ ^ �
PWX 1%.: 0 BTU FLOOR FURNACES: 0 VENTS......... 0 WOODSTOVES....: I GAS OUTLETS...; I
--RES;DENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMr- SRK/FEEDERS-- ---BRANCH CIRCUIT'S--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS—
IM SF OR LESS. I e - 200 alp..: a @ .- 200 alp.. : 0 W/SVC OR FDR,.: 0 PUMP/IRRIGATION: 0 PER INSPECTION: e
� 00mpHMVSVC/Fm N Got UNN alp.. m kw\ /010 w omNOmLmE). on n
/www^ nwp sz : w pLmp ,E,/cn SECTION ------' --------
�
i
_ I
PERMIT
CITY OF TIGARD DATE I ISSUED:• 02/2716-7—sr-
COMMUNITY
2/2:16 9
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SVV Hall Blvd,Tigard,Oregon 97223.8199 (503)830-4171 PARCEL.: 2S 104CC—HWO 16
i I L. kAdbR :aa. . . : 1 ya 1'J !:W kSLLN-510N DR
3U13DI V i SION. . . . : ZONING: R-•'7 PLI
?.LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
-------------
TE;N(4N! NAME. . . . . .
j5p NCI. . . . . . . . . . s FIXTURE. UNITS. . . : 0
I Aa a
OF WORK. . . :NEW DWEL-LING UNITS. . 1
YPE OF UIBE. . . . . :GF NO. OF BUILDINGS: 1
i114a7A1.L TYPL. . . . :LkUSWFc 111F=,C:RV SURt=ACC : 0 Sf
iemalr ka : VIAT'H I
]wner. _....._._.._._ .___....______._...._..___._._._.____..__.__.._ .________.___ ___._•___.---. - F[ ES —_..___...
,HEL.SURNL DEV type .amol.lnt by date r•ecpt
1008 SW NYBERG RD PRMT f 2L-00. 00 JMH 02/26/96 96-2762? i
I N G P 1. 35!5. ON JMI-1 OJI/c_fa/96 96- c 7La3_7'
TIJALAT I N OR 97062
:'hone #: 692--6383
_,untr°a,c:tor : --__—_.--_______—______._____--._
'.;UNTRACTQR NOT' ON PILE
r,urle # : ._x.135. 00 T(jT(�1-
Rey #. . .
-- - -- -- R!=QU I RED INSPECTIONS
—
'his Applicant agrees to comply i,i h all the rules and regulations Sewer 111spe t ic,n
of the Unifiea Sewage Agency. Thl permit expires 180 days f+-om
the date issued. The total amoant paid will be forfeited if the
Permit expires, The Agency does not guarantee the accuracy of the
,ide sewer, laterals. If the sewer is not locatea at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, thesta11 r all purchase
a "Tap and Side Sewer" Germit and the nr will i _ al' a lateral.
e nit, le� IL)a{tLlrw :
-----------
call fore inspection 639--4175
r
_v
R�. _idential Building Permit AwAication p
c,;cv of �;r;:vt^�f Ctrl
'/3125 Sl 1,J?;l Blvd.
,!"i lard, OR 97 —
1'503) 6:�9-41T.'
'obui°q ,i tdress: 1
+hdlvleio +:
-hQp Lot# 1AC Office Use-Only
��. Contact Date _ / / Initials
Viluatiorr � ( `4', _ Result
New Co. ,tructio + Only: (Square Footage) Planck/Rec #
6� Permit # qi �_U�(/ 17
House Garage. _ Reissue of_
Map & TL # .5/O V.CC /it,)0/
Corner Lot? Y �� Flay Lot? Y Zone
Plat #�
Owner: - —
Address -700 /�j/,�T Z� ,1��_ Appovais Re wired
Planning Setbacks �'�� r� Solar
Engineering
PhoneOther
- � � � .��+?��
Contractor: �-
Items Required
_�`������/� ����,/. _
Subcontractors
Address AjOU _ Truss Details — -- _
Other ^�
Phone. ( ) Notes --___-- --
Contractor's License # _V2 3 9,T -
(attach dopy of current dregon license)
:ontact Name: -
a
Contact Phone l)� ) �_Yz— A; 3J?3
Subcontractors: I 0c Architect/Engineer:
Plumbing —� I�i. Address
Mechanical: �/LfrG 0��l c'LD MFO,e
(attach copy of current OR Contractor'.- License)
JOB DIPTION: O �Q�/�T" +, ;�e._ ml C ge -- . —
7^
�—
Appy nt Sign jre Aonl cant Phone number
Received by _6C - Date Received:
Permit 9 Account Description Amount Amt. Pd. Bal. Due
rh
ly y - Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
J
Mach. Permit (MECH) 5
State Tax (TAX) /
Bldg: _ _!
Plumb: /l ?
Meuh:
CA2 0�
Plan Check (PLANCK) � �� �'�• ��,�
Bldg: .
Plumb:
Much:
.S«R1)-0 S Z Sewer Connection (SWUSA) L)
Sewer Inspection (SWINSP) 3 )/
Parh;s Dev Charge (PKSDC)
Residential TIF (TIF-R) _l_L_L_= '7(
Mass Transit TIF (TIF-MT) 2' e
,
Commercial TIF (TIF-C)
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS)
Office TIF (TIF-0) r�_
Water Quality (WQUAL)
Water Quantity (WQUANT) v _ d
Fire Life Safety (FLS) Y/'! 'I,
Erosion Cntrl Permit (ERPRMT) !'� to •cam
Erosion Planck/USA !ERPLAN) c
Erosion Planck]COT (EROSN) P, �1
_ _ 1
PLUMBING FERMI'T 1,.
CITY OF TIGARD PERMIDATEI5SUED. . . . :P/99 4
6-02
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 972230199 (503)639.4171 PARCEL: 2S 104CC—HWO 16
SITE ADDRESS. . . : 13513 SW ASCENSION DR
SUBDIVISION. . . . : HIL.LSHIRE WOODS ZONINGs R--7 FD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :016
CLASS OF WORK. . :OTR GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE, OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . s i
OCCUPANCY GRF.. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . 1 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES-------- LAUNDRY TRAYS. . . . . : 1'� SF RAIN DRAINS. . . . . : 0
0 URINALS. . . . . . . . . . . : 0 GREASE T'RAPS. . . . . . . s 0
LAVATORIES. . . . . : 0 OTHER FIXTURES. . . . : 0
T'UB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. . : 0 WATER LINE (ft ) . . . : I'll
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 4'1
Remarks: Installiny residential backflow device
Uwner. ---- ------- --_._________________________.------____-- FEES ---------------
3HELBURNE ui7VELOPMENT type amount by date rerpt
700H !,W NYBERG RD PRMT $ 15. 00 B 08/28/96 96-283342
5PCT $ 0. 75 B 08/28/96 96-28334e
IUHLHTIN OR 97062
phone #:
Contractor: --_.______.._____.__________•_-___-__
MASTER' S TOUCH SERVICES INC
DONALD BURTON
,2202 SW MICHAEL DR
WEST LINN OR 97068
Phone #: 655-6436 $ 19. 75 TOTAL
Req #. . : 11509
—-- ---- REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All Mork will be done in accordance with
approved plans. This permit will expire if Mork is not started
within IN days of issuance, or/�uspende for
than lAi days.
Per,mittaI_i r ature:
Issued By: _
Call for inspection - 639-•4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/eRec.rrTi it #
1 31 25 SW Hall Blvd.
Tigard, OR 97223 2 - 3 D v 6 P P P L(-
(503) 639-4171 S- j- 'I�NTMUM $25.00 PERMIT FEE + ST. SURCHARGE
New Single Family Residences Only
` ❑ 2 BATH HOUSE$195.00
/^ �, ❑ 1 BATH HOUSE$140.00
Job /5 5��� /At-015/trlt l/ ` Q 3 BATH HOUSE$225.00
Address cM,lBu,e nu Fee includes all plumbing fixtures in the dwelling and the first 100 feet
�< < of water service, sanitary sewer and storm sewer. See fees below.
Nem.is n.me.1 Bue,nq FIXTURES QTY PRICE AMT
>uiti✓(' A�,je Sink
9.00
M.Ynp A"... Lavatory
�n 9.00
��1� Tub or Tub/Shower Comb. 9.00
Owner - 9.00
0,"131.,. nv Shower Only
r
J Water Closet 9.00
9.00
Nem.Iw n.m.of t,nne..l Dishwasher
Garbage Disposal 9.00
OccupantPh- Washing Machine 9.00
Metllnp Pddrn.
Flocr Drain 9.00
rwpstele
m Water Heater 9 00
Laundry Room Tray 9.00
Urinal 9.00
Other Fixtures (Specify) 9.00
m.rnu ns cis aua .,
,Td
7�wa 9.00
Contractor 2202 S.W.Michael 9011
ZipWad 1 Inn C1fi --- ^.00
ralrmlae
Sewer 1 st 100' 30.00
Pepelrennn N- .r N. Sewer-ea. Addit. 100' 25.00
�I.le -�
Water Service 1st 100' 30.00
25.00_
1 hereby acknowledge that I have read this application, that the Water Service ea. Addit 200'
information given is correct, that I am the owner or authorized agent of Storni &Rain Drain 1st 100' 30.00
the owner, that plans submitter, are in compliance with State laws, that 7.5.60
I am registered with the Construction Contractor's Board, that the Sio Til •3 Rain Drain Addit. 100' -
number given is correct. (If exempt from State registration, please Mobile Home Space 25.00
give reason below) - -
Back Flow Prevention
Device or Anti-Pollution -,avice 9.00
9.00
oae Any Trap or Waste Not
:,1pn.ttne teener or.penal
(,onnected to a Fixture
r' repair O Catch Basin 9.00
Describe work new Q addition �) alteration (� -- 40.00/hr
to be done residential O non-residentia (� Insp of Exist. F lumbin9 40.00/hr
-- Specially Requested Inspections
Existing use of Rain Drain, single family dwelling 30.00
building or property _ _ - Residential backflow prevention
devices 15.00
Proposed use of
building or property ._ �- - '(Except residential backflow
prevention devices) _
NOTICE •Minimu:n Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 51/p SURCHARGE
AUTHORIZED IS NOT COMMENCED WITH114 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PIJ,N REVIEW 25% OF SUBTOTAL
COMMENCED - -
TOTAL I -`-
Special Conditions --
Date issued by
r
CITY OF TIGARD CEROCCKATE OF
Or_cuGAnlr_Y
F'E Fthl I T� +I►. » . . . . ,
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 013/a7/96
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)830.4171
VIARCEL t 23104LC- 1IW016
} IL WUWtLa.�. . 1,3515 SW (aSCGNSILIIJ DR Z(.)NING', R -1 I-'D
,I iLq)1 V 191 LIN. . . . : H 1 LL.SH I RE WOODb
t01
;LASS OF WORK. -NEW
I YPE OF USE.
OCCUPANCY GRP. :''iN'IN
ICCUPANCY L OA!?w:'
mai kst PA111 I
�314ELDIJRNF DCV
700-8 SW NYBE:RG RE)
TUALAT IN OR 97062
r.)hone 01 69i?-6383
Contractors
'-;I 1ELBURNF DEVELOPMENT
""08 5W NysE RG RD
I LINT...0 . IN OR 97062
Phawo 141: 692-61,383
Req it. . 4238E1
This "ef-tificate grants ur.c:upancy of the at?ave reterentFcl buildingc,r portion
11.erecf and confirms that the bi.,i l(jiny has beer•► insperted fc r c ompl. i.ance with
,e Stste of Ot-ryon Sperialty C:odt's for tl,e 9`0"P occuPan'=Y, anrJ use l(nC1E'r
rich the w- f renced hermit
.FILMING INSPECTOR SU.iLNG OFFICIAL
POST IN CONSPICUOUS PLACE
I
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone. 639-4171
Footing Rain Drcin Cover/Service FINAL:
Foundation Water Line Ceiling -P�ib.
Post/Beam Mach. Shear/Sheath Framing
Plbg.lJnd/Fir/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. cm
San. Sewer Gas Line Appr/Sdwlk $�
Other:
Date: _ �� _ A.M. __P.M. _ Entry: .77
Address: 13 J 15 0.�Lr _�y ?� G/
Tenant: — Ste:___._ MST: 1s7
Con/Own: .Z -q _ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRU�- ELR:
Inspector: _. _i Date:�-
APPROVED DISAPPROVED/CALL FOR REINSP. CF CO