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c. PROVIDE & MAINTAIN SOIL SEDIMENT
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SCALE DRAWING LOT 92 EAGLE POINTE A
N.W. 1 /4 SEC". 10,T.2S,R.1 'W, W.M.
CITY OF TIGARD ' '�
K.
WASHINGTON COUNTY, OREGON
APRIL 29, 1997 Cen terl in e Concepts Inc: .
--AN EIGHT FOOT PUBLIC UTILITY EASEMENT DRAWN BY: MSG CHECKED BY: WGDIII
SHALL EXIST ALONG ALL STREET FRONTAGE. SCALE 1"=20' ACCOUNT 115
640 82nd Drive Gladstone, Oregon 97027
M: \MLI\PLAT EAGLEPO\L32EP—A 503 650-0188 fax 503 650-0189
NOTICE. IF THE PRINT OR TYPE ON ANY [Ij1 1IIII ( III
IMAGE IS NOT AS CLEAR AS THIS1 !
NOTI�.E, 4 6 (
IT IS DUE TO THE QUALITY OF THE ---- - - __. - --L__..-- _-- w___-�-_-- No
36� � ,� �--- ----�
� . . _ . -- --- 1 : T11191111111,11111111
Ilk ORIGINAL DOCUMENT E 91
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13586 SW AERIE DRIVE
�t
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4111
CERTIFICATE: 1Jf'
OCCUPANCY
PERMIT M. . . . . . . s MST97-•0164
DATE: I SSUED I 01/30/98
Pf-IRC;E'Ls 2SI04DD-04100
ITE ADDRESS. . . s 1J,586 5W AERIE DR
,USDIVISION. . . . s EAGLE POINTE ZONING%R--4. 5 PL)
,{LOCK. . . . . . . . . . I LOT. . . . . . . . . . . . . 10.3? JURISDICTIONsTIG
;LASS OF WORK. s NEW
I YPEF OF' USE. . . s SF
"YPE OF CONSTRs5N
)CCUPANCY ORP. a R3
)CCUPANCY LOAD a 2
emarkss s Nevi9FD PATH I
owners
?E"NA I SSANCE
1.6/2 WILLAMETTE FALLS OR
"JFST LINN OR 97069
"i nne #: 557--8000
.1aratr,act or-a
RENAISSANCE: DEVELOPMENT
167P 'SW WILLAMEI'7E f'AL.I_S DR
�4(--')T L INN OR 97068
Phone #s 557--8000
Pep #. . t 000499
Phis Certificate Grants oc:rupancy of the itbove referenced building tar pian# ,
thereof and confirms that the bmilding has beer! intriec:ted for, compliance with
she State of Oregtan Specialty Codes for, the Gr^ouP, occupinry, and usp i.knder
which the refer cencead permit way issilled.
��1!11.I)1NLy I F�E(:TO ��clt []iwr . ,tcaL/ I F..CTI,(1 9UF-ERVi1?c)k
POST IN CONSPICUOUS PLAUE
i
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 6394175 Business Phone- 6394171 p
Date Requested: 1 �-> . �� __ _ _--.-__� A.M. P.M._ MST:
Location: --.--
Tenant: Suite:_ Bldg: _ MEC:
Contractor-.. t.21.9.1 d�- Phone: PLM:
Ownrr: Phone: __—_. ELC:
ELR:
BUILDING! BLDG fig wPL �Ri'N w lyl�t SITE
Site Pos exam PosVTkmn Post/Itcam Cover/Sermt.- Sewer/Storm
FooVag Roof UndFUSlab Rough-In Ceiling Water Lineam
Sl,.o Framing Top Out Gas Linc Rough.-In �TinT c '
foundation Insulation Sewer 10od/Dua Reconnect
11smt Damp Drywall Slottn Ftunace Temp Service MISC.
Masonry Ceiling Rain limn A/C: UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found lr Heat Pump Low Volt _
t proves Approv � ?v > > r< p rovcT
Appr/Sdwlk o roved )roved U4A.4. pr ed Not ved Not Approved
INAL �EI�IAL--7 _k�N�L--� FIN FINAL
C7 Call I'm win+pection El Reinspection fee of S_ required before next inspection r7 Unable to inspect
Inspector-.-----_ � late: �.�C=) ` ! " Page—__—^of --
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Datc Requested: C / �� q / — A.M. P.M.--- MST: ---
Location: �.�J &\.A .( IUP: ------
Tenant:_ —_ � Suite:_ YOU
ME(�:
�C-'�...�
Contractor: �� / PCZ•C-:1 til,(� 1t �� — Phone: �•5 1- 0 PLM:,
ZZR
Omicr: Phone: ELC:— --�—
fiLR:
srr:
BUILDING BLDG(con"t) PLUMBING MECHANICAL ELECTRICAL SITE
Site Postflicam Isi)st/ncam Post/ficam Cover/Service Sewer/`itonn
Footing Roof Undl-I/Slab Rough-In Ceding Water 4.ine
Slab Framing Top Out Gas Linc Rough-In HG Sprinkler
foundation Insulation Sewer I hod/Duct Reconnect Vault
Iistnt Damp Drvw3ll Stonn Furnace temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab v
Shear/Sheath Fite SIA-Ir/Alm Crawl/I ound Dr Iteat Pump Low Volt !�-�v- 7(�-
\pproved Approved Approved Appro%ed r
Appr/Sdwlk Not Appiovr 1 Not Approved Not Approved Not Approved Not Approved
FINAL "`FINAL FINAL, FINAL FINAL
O Call for reinspection C3 Reinspection fee of$ required before next inslkction l7 Unable to inspect
Inspector:__------e'er; -- — Date:._ Q ------ Page of
CITY OF TIGARD
PFRMIT
DEVELOPMENT SERVICES PERMIT MASTFP #. . . . . . . .. MST97-0164
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATF ISSUED: 06/ 11/97
PARCEL: 2S104DD-04100
ITE ADDRESS. . . : 13586- SW AERIE DR
'J
SI;BDIVISTON. . . . :EAGLF POINTE ZONING: R-4. 5 PD
BI-OCK. . . . . . . . . . LOT. . . . . . . . . . . . . .N3,=' JURISDICTION:
Remarks: New SFD PATH I
------------------------------------------------------------------- BUILDING ----------------------
REISSUE:
---------------------RFISSUE: STORIES........ 2 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- RE.GUIRED----L-------'---
F1 ASS OF WORK. :NEW HEIGHT........: 25 FIRST....: 1477 sf GARAGE.....: 670 sf LEFT.......... : 5 ME DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 1870 sf FRONT.........: 28 PARKING SPACES: 2
TYPE OF CONST.:5N DWELLING UNITS: I FINBSMENT: 0 sf RIGHT. ....... 5
OCCLPANCY GRP.:R3 BDRM: 4 BATH: 3 TOTAL------: 3347 sf VALUE.. 1: 235760 REAR..........: 39
---------------------------------------------------------------- PLUMBIM", ---------------
SINKS.........:
--------------SINKS......... I WATER CLOSETS.: 3 WASHING MACH.. : I LAUNDRY TRAYS.: I RAIN DRAIN ft: 100 TRAPS.......... 0
LAVATORIES....: 5 DISHWASHERS... I FLOOR DRAINS., : 0 SEWER LINE ft: 100 5F RAIN DRAINS: I CATCH BASINS..: 0
TUB/SHOWERS...: 3 GARBAGE DISP.. I WATER HEATERS.: I WATER LINE ft: 100 BCKFLW PREVNTR: I GREASE TRAPS..: 0
OTHER FIXTURES: 0
- ------------ ------- _----------------------_•------------ MECHANICAL -------------------------------------------
FUEL TYPES-- FURN 1100K 0 BOIL/CMP ( 3HP: 0 VENT FANS...,.: 5 CLOTHES DRYERS: I
GAS TURN )rIOW ! UNIT HEATERS,. 0 HOODS.........: I OTHER UNITS...: I
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: @ WOODSTOVES—.: 0 GAS OUTLETS...: I
---------------------------------------------------------------- ELECTRICAL ---------------------------------------------------------------------
-RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ---41SCELLAK-OLJS----- --ADDIL IN-PECTIONS--
ION SF OR LESS- 1 0 - 200 asp..: 0 0 - 200 amp..- 0 V/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
f A ADPL 5W. 6 201 - 400 asp..: 0 201 - 400 amp..: 0 1st WIO SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
i I r I TIP ENERGY.: 0 401 - 600 asp..: 0 401 - 600 amp..: 0 EP ADDL BR C:R: 0 SIGNAL/PANEL.. : 0 IN PLAT......: 0
MWF HM/SVC/FDP: 0 601 - ION asp.: 0 601+88ps-I000 v: 0 MINOR LABEL -10: 0
IW+ amp/volt.: 0 ------------------------------------ PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: S)C/F:DR)=225 A.: ) 600 V NOMINAL.: CLS AREA/SPC OCC:
------------ ELECTRICAL - RESTRICTED ENERGY ----------------- -----------
A. SF RESIDENTIAL---- B. ----------------------------------------------------------_--_— ---------
AUDIO I STEREO. VACtIUM SYSTEM.. AUDIO I STEREO. FIRE ALARM...... INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: X BOILER......... : HVAC........... : LANDSCAPE/IRRIG: PROTECTiVE SIDNL
'ARAGE OPENER..: CLOCK........... INSTRUMENTATION: MINCAL........ OTHR:
HVAC........... : DATA/TELE COMM.: NURSE CALLS.... : TOTAL # SYSTEMS: 0
Owner: ---------------------------------------Contractor: ---------- ------------- ----- TOTAL FEES:$ 5132.95
RENA I SSANCE RENPISSANCE DEVELOPMENT
1672 WILLAMETTE FR-Lr DR 1672 SW WILLAMETTE FALLS DR
WEST LINN OR 97068 WEST LINN OR 97068
Phone 0: 557-8W, Phon, #: 557--8000
Reg 0..: Wlyj
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 work is not started within 180
days of issuance, or if work is suspended for more than 180 days.
--------------------------------------------------- REQUIRED INSPECTIONS ----------------------------------------------------- -
Erosion Contal Post/Beam Meehan Electrical Servi Gas Line Insp Water Line Insp Building Final
Grading Inspecti Crawl Drain Electrical Rough Gas Fireplace Appr/Sdiolk Insp
Footing Insp PLM/Underfloor Framing Insp Insulation Insp Electrical Final
Foundation Insp Mechanical Insp Shear Wal InspAyp Board Insp Mechanical Final
Post/Beam Struct Plumb Top Out J40 t a Rain drain Insp Plumb Final
Flet-ni i t t e e S 1 gnAt Utle c;s 6ed By
'�ection 639-4175
a. I I f 0 i ro�
CITY OF TIGARD NEWER CONNECTION
DEVELOPMENT SERVICES PERMIT
13125 WWI Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : SW R97-0169
DATE ISSUED: L7-'--/11 /97
PARCEL. : 2S104DD-04100
SITE ADDRESS. . . : 13586 SW AERIE DR
SUBDIVISION. . . . :F_AGLE POINTE 70N I NG: R-4. 5 PD
BLOCK.. . . . . . . . . . LOT. . . . . . . . . . . . . :032 JURISDICTION:
---------------------------------------
TENANT NAME. . . . . : RENAISSANCE
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS OF' WORK,. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :B1.JSWR I MPE.RV SURFACE c 0 s f
Remarks : Nfw SFD
Owner: -- --__ _------------___ _____ - --- -------- -_---- FEES ----- -----_
RENIIISSlIN13F type amol-int by cl--ite recpt
1672 WILLAMETTE FALLS DR PRMT $ 21 '00. 00 JSD 97-295758
WEST LINN OR 97068 INSP $ 335. 00 ISD 06/11 /97 97-295758
Phone #:
OWNER
f 22'355. 00 TOTAL
------- REQUIRED INSPECTIONS -- -
This Applicant agrees to enmply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency, The permit expires 188 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 a--__--
Ade 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 iamtaller shall purchase
a 'Tap and Side Sewer" Permit andthe Ag n Mill,.tall a latm 1. _ _ I
- - - — -- -
1='er-mittee Signature : ____�
s-,,-(ed Byr=
Call for inspection - 639-4175
Plan Check 0
ITY OF TIGARD Residential Building Permit Application Recd By
3125 SW HALL BLVD. New Construction Additions or Alterations Date Recd Cr
iGARi-, OR '37223 Single Family Detached or Attached (Duplex) Date to P E. cam '77
' 503.639-4171 Date to
50:3-684••7297 Permit N Tr--C? -D1(.1cf
Print or Type called 3" eve-)
Incomplete or illegible applications will not be accepted / ;?-e
Name of Project n �..j Na"
Job
Architect Marling.Address
Address Site Address 1 ,r /k A� n
Name n City/StateZlp Phgrie
Name
Owner Mailing Address
/� ,>? /��.�/'.�1f� P,�,�f �' -v :✓coir - �.
CityrStata
Engineer Marling Address
Zi Pho a
lit I✓ p rfw? L;6e Sit t
Gty/,State Zip P n
Name , /�F'Tvf/�• (ZP
Y
General Describe work Now Addition O Alteration O Repair O
Contractor Marling Address to be done:
-1 003?. Additional Description of Work:
CityrState Zip Phgne
'rJ i 1"'x:✓ C ,��1�' J� �.q.r v�idlsd r� �f�rti.v,Y rnlF1'i�;y,,fr a
O on Const ConL Board Lic.M Exp.Awo.
Attach Copy of
Current COT Business Tax or Metro N / t/o
PROJECT
__Llcenses f.?r^�, -y VALUATION $ _79 --T
Name NEW CONSTRUCTION ONLY:
_
'Aechanir_al T�'/ C�'�r '•��'��' ,-T"/r1.�'«¢x�'A Sq. Fl. House: Sq. Ft. G�
S U b•• Mailing Address ..7
'ontractor /1'E,S/ _S.`� ,'/YI���'
Comer Lot-, YES Na. Flag Lot— YES Na.
citylstate Zip Phe
,fc (check one) _ � (check one)
Oregon Const Cont. Board Lie.# Exp.Date Restricted Audio/Stereo Burglar
tach Copy of r!�` ' c .1 ,�,N ��S Energy -- System_ _ (Alarm
Current COT Business Tax or Metro,• atd /- Installation Garage Door MVAC
Licenses ' ►"�
-. �-+' ' •' _� Opener _ .?,ystems
Norris (check all that Other-
0
r'lumbing Y>'7% i//!'i✓ .�'.0 e r,Nes apply)
Sub- Mailing Address — Will the electrical subcontractor wire for all YF� NO
' ontractor ?� rtc,{�I,�c/� /�!� restricted energy installations
Has the Suedivlsion Plat recorded? NIA YE NO
66
GtYrState Zip Ptlooe s�'
Oregon Can3L Cont.Board Lic.0 Exp.0 to Reissue of MST;*- y1� Solar Compliance i./
`'C
Attach Copy of (' r .3 ( 75 �
J r 7 -i
_ (Calculation Attached)
Current Plumbing L:c.Ir E4 D --- ---- — -- ----- —
Licenses /< < 10W �f ,Ie;' I hearby acknowledge that i have read this appircalion, that the
COT Business Tax w Metro a oats, Information given is correct, that I am the owner or authorizedC'I %'- .)2:z f I /�. /� agent of the owner, and that plans submitted are in compliance
Name r={ with Oregon State laws. -
Electrlcal Signature of 0"
r nt - Date
�.�+li" �"�;�� ' -rel �r -, �• /�i,-
Sub- Marling Address Contact P qn Nam , _ Phone 0
;ontractor r/�Cr' � "� IWC7 ,!� f' a✓r �, i y ,��,f
Cyt.1:e Zip Phgne FOR OFFICE USE JQINLYi
C-,r40CiC�m!'t i��t" �'/�' Plat W. /�'�_( » Map/TLN:
Orego i gpst.C nL Board Lic.tl Ex tD • �r-
~ach Copy of 7 S � �c if jF Setbacks: Zona'r Solar:
Current E:ectnc;ai L ic.
Licenses Engt9wrigApprqlall. Planning.Approval: TIF:
COT Business Tax or Metro N Ex .Oate
iAVapp.doC(dst) li97
1
Permit # AccQunt Description 6ingAmt. Pd.
di4-y
MST. Permit (BUILD)
Plumb. Permit (PLUMB) z c�
Mech. Permit (MECH) 4 4� a-v
ELC/ELR Permit (ELPRMT) 3uo,
State Tax (TAX) 6 7.
Bldg:
Plumb: ?
Mech: ? 4 0
ELC/ELR:
Plan Check
MST: (BUPPLN) 561.. t�C
Plumb: (PLMPLN)
Mech: PLN)
CDC Review
Sewer Connection (SWUSA) -
Reimf ursement District
Sewer Inspection (SWINSP) �J - _z
Parks Dev Charge (PKSDC) 1nSn, '
Re,idential TIF (TIF-R) JA
Mass Transit TIF (TIF-MT)
Water Quality (VVQUAL) l?0 g�
Water Quantity (V';QUANT) X66, /ov
Erosion Control Permit (ERPRMT)
Erosion Pidnck/USA (ERPLAN) Z 9.
Erosion Planck/COT (EROSN) 2 �,
Fire Life Safety (FLS)
TOTALS: 34 7
h8fopp.doc (dsq 1/97
Solar Balance Point Standard Worksheet
address / __S3K6 r` -4✓
Sox A calculations: North-South dimension for the lot_ Bos:A.
-tis dimension is determined by finding the midpoint of the North lot line and drawing
an intersecmng line ,xrpendicular to that point.
rust, determine which property lire is the North lot line. The Nort.h, lot !ine is the line
N1th the smallest angle from a line drawn east-west and intersecting the northern most
point of the lot.
I
1
ICE UNI t wo
N \ North-Scluth
Dimension for lot:
.Measure the distance from Ui a midpoint of the North lot line to the South lot line along
:he e descibed !ine. 7(� feet
1
N
w....oua a...v�
Bou B dculations: Shade point height for your residence. i3mc B.
Determine whed-er measurements will be based on the peak or eave of your
sauc=m The orientation of d-,e ridge is also important. Which descibes
your residence?
1 a: If the roof line runs North-South, measurements will i� (cirde one)
be cased on the peak of the roof. ICOUCJ
1A 1 1C
1 d: If t~e roof !ine tins cast-West ara the root pitch :s
less ;.;an 5i i 1, measuremencs wiil �--e :aseC4 cn ~e
eau P.
1 c- If 'Ue -ccf lire runs Ear .vest and tt a roof pitci :s
Sit Z cr sleeper, measurements wiil be lased an d e
peak. u ""r• I
Sox S. continued Box B:
vteasure c`tantje In eievauon from front procerre line to finished floor elevation. If
the 'oc slopes uo rrarn the (rant !cc line to the (oundation, the ngure Is positive. If r ft
the lot slopes down from c'1e front. !cc line to the foundation, the figure is negative.
i
3. measure discuxe fmm finished floor elevation to the affected peaWeave. �' � M
4. If the roof line runs vorth••South, deduce three feet If the root line runs East'-Wm ft
deduct nothing(
>. Subtract one foot for each foot of difference in elevation from the front property
line to the rear property line, if the lot slopes up from the front to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct nothing.
n. Total figure for box B: ft a
Sox: C. Distance to the shade reduction line- Box C-
I
t. Measurr- the distance frons the North property line to the foundation near the Yrs ft
arl;eC,ed peaWeave.
:'. Measure the distance from the foundation to the affected peak or eave, ft
-3. Total figure for box C: � - ft
I a Mna useful to draw a vertical fine m represent die appimpriaw ftum found in bmf'A'and a hw zonal fine to represent the
aprxopmui r Vim found in boot Z'. The intensityort of the verticW and horn rAital lines&mmmines dw value found in box'D'. The value
,n tA= 'D'should be ompared to the value in t ='8'; if the value in box'9'is lea than or equal to the value round in box 'LY, then
ries hu,idinS is us mmp4ancr with the solar baWom code. If you have any quer ons,pkme rmnaa us at 639-4171,2304 or at the
e-;mmurrty Oeveloprnent Counter.
MAximum Pte mffTo SHADt Pow HEIGHT (it, Ft")
Cisance to North-south lot dunenskn On feta
v%ade 1001- 95 90 85 So 7S ( :0 65 60 S3 SO 45 40
redumon line 1
ham norther
10 40 40 40 41 42 43
65 38 38 38 39 40 41 4 43
�U 36 36 36 37 2A 39at 22
3-t 3-t 34 ]5 36 3' 3 39 10 41
32 12 32 33 34 35 37 23 39 40
0;S t- 3o r0 30----34---32 ;J 3� 35 36 3: 38 39
:3 .3 .3 29 30 31 32 33 34 35 36 37 38
:5 :5 25 :5 27 '3 29 30 -3i 32 33 P 35 36
:, 21 :3 :4 :5 :5 27 23 :9 70 31 22 33 34
?7 J :s :5 :5 :7 :S :9 30 31 32
:7 0 :0 :0 :1 �7 23 ?j 25 .5 27 :3 29 30
5 18 a 18 79 :0 21_23 24 25 25 27 23
J 16 16 16 1; 13 19 =0 21 :2 _3 24 25 25
14 14 14 15 16 17 18 19 =0 21 2-1 23 2a
Sox D. ,Maximum ailowed s ,,ac?e point heighz: few
ti•' ��olar.rlo 1� v 1
i
i
SEE 35MM
ROLL# 22
FOR-
1---.A-R-GE
DOCUMENT
i
i
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Nall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . ; PLM97-0484DATE ISSUED: 11/20/97
PARCEL: 2S 1 C14DD--•04100
;ITE ADDRESS. . . : 13513E. SW AERIE DR
SUBDIVISION. . . . : EAGLE POINTE ZONING: R-4. 'S PD
BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . :032 JURISDICTION: TIG
CLASS OF WORK.. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASiHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . 0
TUB/SHOWERS. . . : 0 SEWER LINE ( ft ) . . . 0
WATER CLOSETS. . 0 WATER LINE (ft ) . . . 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Install r-esidential backflow prevention device
liwner•,: _____------_____.__._—____.._---____.___.._._ ______.______._—_. FEES
RENAISSANCE type amot_fnt by date recpt
1E,721 WILLAMETTE' FALLS DR PRMT $ 15. 00 TSD 11/18/97 97-301030
WEST L I NN OR 97068 5PCT $ 0. 75 JSD 11118197 '37—:301.030
Rhone #:
oil tact or'
MOODY ENTERPRISE INC
F'O BOX 98
ESTACADA OR 97023 Phone #: $ 15. 75 'TOTAL
Req #. . : 000059
— - ---- REQUIRED INSPECTIONS --- —
This permit is issued subject to the requlations contained in the RP/Backflow Prev
l f gard Municipal Code, State of Ore. Specialty Codes and all other Final T n s pest i on
applicable laws. All work will he done in accordance with
Approved plans. This permit will expire if work fz not started
within 180 days of issuance, or if work is suspended for morethan 18N days. AT—iENT1ON: Oregon law requires you to follow rules
adopted by the Oregon iR:Iity Notification Center, Those rules are
set forth in OAR 952-MI-010 through OAR 952--89A1•-@M. You may
obtain copies of these rules or direct questions to 01-W by calling
(503)246--1%7.
Tssi-fed By: ~_' t Permittee Si gnats-ire :`
+}+++++ V++++•4++4++++++++4 It++++++++++f i++++++++++++++-F++i ++++t+-h+++++++++++-1-
Cal l 639-4175 cry 7:00 p. m. for an inspection needed the next bi_isiness day
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++-�++-f-+++++++4
kATY OF YIGARD Plumbing Applic-at;r< !7 �AAIRec'd By... -
% / 1 `
'13125 SV'J HALL BLVD. Commercial ani' Pesidentl,rt Dale Recd
TIGARC, OR 97223 Date to P.E.�''� / Date to DST
(503) E139-4171 (�
L / Permlt•
Print -'r Type � Related SWR*_ .
Incompiete or illegible appl'cations will not be accepted Called _
Name of DevelopmenuProject On back Indicate Work Performed by fixture.
Job (� FIXTURES (Individual) QTY PRICE AMT
Address Street Addless SuiteSink 9.00
L ,SW !. _ Lavatory 9.00
Bldg i CitylState Zip -,-
a-•'� y 7}� Tub ar'ub/Shower Comb. 9.00Nam —� — Shower Only 9.00
Water Closet 9.00
Owner Mad ng Address Suite Dishwasher
9.:0
' Garbage Disposal 9.00
City/State Zip Phone
r 7- ao,, Washing Machine 9.00
'rzatjrName 7 0 Floor Drain 2" 9.00
3" 9.00
Occupant Mailing Address Suite 4" 9.00
`Z
Water Heater O conversion O like kind 9.00
CitylState ip Phone
Laundry Room Tray 9.00
-- i - -- _J
Plume / Urinal g,P1
bT• • Other FiAturea(Spicify) x.00
Contractor Mailing Ad ss (/ Suite
V Q.00
Prior to permit ity/S ale Zip Phone —_ 9.00
issuance,a copy V100 /11 9.00
of all licenses are Oregon Const.Cont.Board Lic.* Exp.Date 9.00
required if ""9j
L?/ Sewer- 1st'100" 1000
expired in COT Plumbing Lic 0 Exp,Odle
database Sewer.each additional IUD' 2500
Name —`— Water Service-1 st 100' 30.00
Architect Water Service-each additional 200' 25.00
Or Mailing Address Suite Storm&Rain Drain-1st 100' 30.00
Storm d Rain Drain-each additional 100' 25.00
Engineer City/State —Zip Phone Mobile Home Sp,,,-.e 25 00 �—
Commercial Back Flow Prevention Device or Anti- 25.00 -
he work New Anditioo O Alteration O Repair O Pollution Device
to be.done: Residential Qj Non-residential O Residential Backflow Prevention Device' 15.00
Additional description ofwork Any-.rap or Waste Not Connect-I' a Fixture 9 00
J Catch Basin - 900
Insp.of Existing Plumbing 4000
per/hr
Existing use of — — Specially Requested Inspections -- 40 00
budding or property_-_____-._ __— _ perrhr
Rain Drain,single family dwelling 30 00
Proposed use of - - --
budding or property Grease Traps 3 00
QUANTITY TOTAL
I hereby acknowledge that I have rea.:this application,that the information Isornet x or riser diagram s required A Quandy Total is >9
givens correct.Chet I am the owner or authorized agent of the owner,and -- 'SUBTOTAL
that olans submitted are in compliance with Oregon State Laws._
Sign re o O or/A ent Date ---- °,
��� 6% SURCHARGE 73
PLAN REVIEW 25°/,OF SUBTOTAL
Contact PrrsOn Name / Phone Y-4,
Required on d rixture qty total s>9
L TOTAL
'Minimum permit tee,s S25-5°4 surcharge.except Residential Backflow
Prevention Device,which is$15+5%surcharge
.••r...:+cc Inc°.9'
i
FILEASE CO LE -
Fixture Type Quantity by Work Performed
New Moved Replaced Reinoved/Capped
Sink
Lavatory
_Tub or Tub/Shower Combination
Shower Only -
Water Closet ---- -
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
411
Water Heater _
Laundry_ Room Tray _ —
Urina!
Other Fixtures (Specify)
COMIMENTS REGARDING ABOVE:
I�Csvl"imsm WC sig;