Loading...
13013 SW CADDY PLACE i r W O W UC C �7 Q. CL d 0 m t 13013) SW Caddy Place CITY OF TIGARD BUII DING INSPECTION DIVISION MST 24-Hour Inspection Line: 63: 175 Business Lint.: 639-4,% BUP — _Date Requested A'VI PM _ — - BLD Location _ _�C.' / eft �� Suite MEC _ Contact Person --�-`" _ Ph _ _ _ PLM Contractor '-�" y Ph SWR — gUILDING Tenant/Owns.- ELC _ Retaining Wa' - -- ELR ----_` Footing Access: Foundation FPS Ftg Drain SGN -'---^J Crawl Drain Inspection Notes. Slab SIT Post&Beam -- - Ext Sheath/Sheaf _ Int Sheath/Shea, Framing -- -�. e_-- -- - -- — Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiiung ------ -------- Roof Mfsc - -�_`----------. Final PASS PART FAIL ----- --- ------- PLUMBING Post 8 Beam - ----- --- -- — _ _---- ----- ----- - .--.` Under Slab Top Out -- - _ -- - Water Service Sanitary Sewer n Drains F` AS (PART FAIL - ------ MECHANICAL Post&Beam --- Rough In Gas Line - Smrke Dampers Final ----�- -- - PASS PART FAIL ELECTRICAL - - Service Rough In - UG/Slab Low Voltage -- Fire Alarm Final - PASS PART FAIL SITE Backfill/Grading — ---- -�i - Sanitary Sewer Storm Draio [ I Reinspection fee of$ _ required before neat inspection. Pay at City Hall. 13125 SW Hall Blvd BasiB Catch n Fire h Basi line ( j Please call for reinspection RE:—_- -_ [ j Unable to inspect-no access SupplyADA A roachlSidewalk n Otp her Date Inspector _ /1� pC��'c --Ext --- Final PASS PART FAIL DO NOT REMUVF_ this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 63 175 Business Line: 639-4 BLIP _Date Requested 2 -- 2- AM --PM — BLD Location /30 /--3 Cyw L Suite _- MEC Contact Person 11�cl Ae-e.�- _ _ Ph ��-_ PLM - Contractor Ph SWR BUILDING TenantiOwnerELC Retaining Wall - - ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes. SGN - --- Slab Post& Beam Ext Sheath/Shear Int Sheath/Shear ---- -_-- Framing ---- Insulation -�- -----__. -Drywall Nailing Nailing -----__----___ __-- ---___--- Firewall - - Fire Sprinkler Fire Alarm ------ --- - --- --- ------- Susp'd Ceiling _- Roof --- / --- ----- --- Mise - - --- Final --- --- ------ - - --------- -------- PASS PART FAIL_ - - - - - --- -- - - _ -- --._.__...------- PLUMBING; Post& Beam - - -------- --- Under Slab Top Out - ------- Water Service Sanitary Sewer Rain nrains Final ---- ------"— PASS PART FAIL MECHANICAL — -- Post& Beam -------- - --- Rough In Gas Line - ----- . __ Smoke Dampers - - Final -- - - -- - ----- PASS PART FAIL ELECTRICAL_ '— - - --- --- Service Rough In -- -- UG/Slab Low Voltage - ---�---- -- - ---"-- Fire Alarm ASa ART FAIL _— --_- Backfill/Grading - -- -- --- --- ---- Sanitary Sewer Storm Drain ( j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Bled Catch Basin ( ]Please call for reinspection RE: __ [ ] Unable to inspect no access Fire Supply Line / —_ -______ ADA Approach/Sidewalk Z v Other Date inspector ` - -"=q-- Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. i►AAAAAAAAAAAAAAAAA,AAAAAAAAAAAAAA�AAAAAAAAAAAA i � �' M d ► ► un ► 4 � � P 4 LIP, loo. 4 rD cnpoll Q. ► i d n ► 14 o 4 �- P � � P 4rTl r P c; P '14 � ► i �, ~� ll � ' ► rt o �i?}I Pil. 44 4 P f 4 I ; ( P 4 00.4 P %L _ P 7 O CIO l o r�S4 f) ✓ a o w h rD � n cat � J c r a CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE STREAMLINE ELECTRICAL 6017-B EAST 18TH STREET VANCOUVER, WA 98 Electrical Signature Form Permit #: MST2001-00218 Date Issued: 4/10/01 Parcel: 2S'I 04DA-13700 Site Address: 13013 SW CADDY PL Subdivision: QUAIL HOLLOW - WEST Block: Lot: 123 .Jurisdiction: TIG Zoning: R-4.5 Re, .arks: New SF detached rowhouse in Building #14. Setbacks as per A10.10 Plan B-S Your company has been indli�ated 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 turn this Electrical Signature Form prior to the start of the work to the address above, AT TN: Building DFpt. No electrical inspections will be authorized until this completed form is received OWNER: ELE ,TR!CAL CONTRACTOR: BROWNSTONE HOMES LLC STREAMLINE ELECTRICAL_ 12670 SW 68TH PKWY #200 6017-B EAST 18TH STREET PORTLAND, OR 97223 VANCOUVER, WA 98 Phone # 503-598-7565 Phone #: 360.993-5080 Req #: LIC 116514 ELE 34.4320 SUP i'49f AN INK SIGNATURE IS REQUIRED ON THIS FORM / r X Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARG 1312.5 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONT. INC PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2001-00218 Date Issued: 4/10101 Parcel: 2S104DA-13700 Site Address: 13013 SW CADDY PL Subdivision: QUAIL HOLLOW -WEST Block: Lot: 123 Jurisdiction: TIG Zoning: R-4.5 Remarks: New SF detached rowhouse in Bu:Iding #14. Setbacks as per A10.10 Plan B-S 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 addres4 above, ATTN. Building Dept. No plumbing inspections will be authorized until this completed form is received OWNC R: PLUMBING CONTRACTOR: EROWNSTONE HOMES LLC WOLCOTT PLUMBING CONT. INC 12670 SW 68TH PKWY #200 PO BOX 2007 PORTLAND, OR 97223 GRESHAM, OR 97030 Phone #: 503-598-7565 Phone #: 667-1781 Reg #: i ir. 23847 P1 M 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X7 3 Signatur f Alt orized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITYOF T I GA R D MASTER PERMIT PERMIT#: MST2001-00218 DEVELOPMENT SERVICES DATE ISSUED: 4110/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13013 SW CADDY PL PARCEL: 2S104DA-13700 SUBDIVISION: QUAIL HOLLOW-WEST ZONING: R-4.5 BLOCK: LOT: 123 JURISDICTION: TIG REMARKS: New SF detached rowhouse in Building#14. Setbacks as per A10.10 Plan B-S BUILDING REISSUE: STORIES: 3 FLOOR AREAS _ REQUIRED SETBACKS _ REQUIRED__ CLASS OF WORK: NEW HEIGHT: 31 FIRST: 173 sf BASE,AENT: of LEFT: SMOKE DETECTORS: *IPE OF USE: SF FLOOR LOAD: 50 SECOND: 735 sf GARAGE: 428 of FRONT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 580 of RIGHT: VALUE: S 138,630.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,48800 of REAR: PLUMBING SINKS: 1 WATER CLOSETS WASHING MACH. ' LAUNDRY TRAYS: RAIN DRAIN: lief TRAPS: L.n VATORIES: 4 DISHWASHERS: I FLOCK DRAINS: SEWER LINES: 100 SF RAIN DRAINS 2 CATCH BASINS: TUBISHOWERS. GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 RCKFLW PREVNTR GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN<100K: 1 BOIL/CMP<3HP: VENT FANS: CLOTHES DRYER: 1 GAS FURN>000W UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANLH CIRCUITS MISCELLANEOUS_ ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 ami: 0 200 amp: WISVC OR FDR: 2 PUMPIIRRIGATION: PER INSPECTION. EA ADD'L 500SF: 3 201 •400 amp: 201 400 amp: 1st W,'O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR, LIMITED ENERGY. 401 600 amp: 401 600 amp: EA ADDL BR CIR: 1 SIGNALIPANEL: IN PLANT MANU HMISVCIFDR. 601 1000 amp: 001-amps•1000v: MINOR LABEL: 1000.amp/volt: PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVCIFDR-225 A.: >600 V NOMINAL: CLS AREA SPC OCC: ELECTRICAL•RESTRICTED ENERGY SF RESIDENTIAL B.COMMERCIAL AUDIO d STLP(EO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: 0TH: ALL ENCOMB BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION, MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: r')ntractor: TOTAL FEES: $ 3,553.49 BROWNSTONE HOMES LLC BROWNSTONE HOMES, LLC This permit IS subject to !hE ragulations contained in the 12670 SW 68TH PKWY#200 12670 SW 68TH PKWY Tigard Municipal Code,State Specialty Codes and PORTLAND,OR 97223 PORTLAND,OR 97223 all other applicable laws All work will be done i accordance with approved plans. This permit will expire K work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION. Phone: Phone: Oregan law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep N: LIC 124621 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, Underfloor Insulation Electrical Service Low Voltage Firewall Insp appr/Sdwlk Insp Sewer Inspection Plm/undslab Insp Electrical Rough In Gas Line Insp Rain drain Insp Electrical Final Footing Insp PLM/Underficlor Framing Insp Gas Fireplace Roof Nailing echanl,if Final Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Water Line Insp � mb Final Slab Insp Plumb Top Oft Exterior Sheathing Insl Gyp Board Insp Wat6�,service Insp ' I Inspection Issued By : r�Z ��: _ Permittee Signature &A Call (503) 634-4175 by 7:00 D.m. for an inspection neededt)Te next uslness _ SEWER CONNECTION PERMiT CITY OF TIGAR® � DEVELOPMENT SERVICES PERMIT#: SWZ2001-00146 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/10/01 SITE ADDRESS; 13013 SW CADDY PL PARCEL: 2S104DA-13700 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4 5 _ BLOCK: LOT: 123 _ JURISDICTION: TIG 1 ENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: I_TPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached rowhouse Owner: - --- ---- - _ FEES___ _ BROWNSTONE HOMES LLC Typ. By � Date Amount Receipt 12670 SW 68TH PKWY #200 _ _ PORTLAND, OR 9722.3 PRMT— CTR 4/10/01 $2,300.00 27200100000 INSP CTR 4/10/01 — $35.00 27200100000 Phone: 503-598-7565 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections 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 he forfeited if the pen-nit 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 Pur .ase a"Tap and Side Sewer" Permit and the Agency will i,rstall a lateral ATTENTION. Oregon law requires you to jollo ,jles adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001/4'6i© throug R 5 001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503V246-1987 Issued by: �� _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the nex business day Builling Permit Application Date received: 0/i//n/ Prairul no.;?I City of Tigard Address: 13125 SW lull Blvd,Tigard,OR 97223 ProjecVapph o_ - Expire date: — City of%7�oral Phone: (503) 639A 171 Date issued: BY ! ("iptno.: Fax: (503) 598-1900 Case five no.: P'aymcnttype: Land use approval: _ 1&2 family:Simple U l &2 family dwelling or accessory U Conrrnci-cial/indcstrial U Multi-family Wl' cw construction U Demolition U Addition/altcratiott/n placctncnt U Tenant improvement ❑Fine sprinkler/alarm ❑Other. �— .1011 SITE INUORNIATION job address: v , A_ Bldg.no.: I[ Suite no.: Lot: I Block: Subdivision: 6?u A i% Ne It ,� T Tax map/tax l It/account no.: Project name: upi �. 1 Nu Ilorw Descripdon and location of work on premises/special conditions:— n)-60ML t tiltltil LDt'-tg'1z2lJLT i d Name• �1k �--� Mailing address: �y S*.t PA 2Q� 1 do 2 bmily dwelBrtg: City: r State:W ZIP: Valuation of work........................................ $ r---- Phone:°7 Cf F 7 5(r r� Fax: JJ ii fR oo 1 E-mail: No.of bedrooms/baths.............f. _ Owner's representative: 1 -0c'�- Total number of floors...............3 Phone: -1 -S?Ttl Fax:J7a"y 3942. 'F-mail: -- Ne.wdwelling area(sq.ft.) ........��:�.... - _-- Garage/carport arca(sq.ft.)..... .�?.4...... — Namc: SN A1�- Ain, A . a✓; Covered porch arca(sq.ft.) ..... .............. ------------- Deck area ft Mailing address: (sq. ) 5 A T City: State: ZIP: Other structure area(sq.ft.)...........".......... Phone: Fax: I E-mail: _ ('onmrerciaUiudus1rial/multi-family: Valuation of work........................................ $ --- Business name: Existing hldg.area(sq.ft.) .......................... Address: yitti� -- New bldg.sera(sq.ft.)................................ City: State: ZIP: -- Number of stories........................................ _. -,- - Type of construction.................................... Phone: Fax: I e-mail: OLcupancy gnmp(s): Existing: _CCB no.: -- New: _ City/metre lie.no.: - Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: Qta�(a r provisions of ORS 701 and may be required to be licensed in the Address: 1 `j .{l.�ti� A« jurisdiction where work.is tx:ing performed.if the applicant is �17T t k: State: w ra ZIP:City: �' exempt from licensing,the following reason applies: -29L4- Contact person: _vlf Plan no.: _ ---- -- — Mlone:Z'-('A,7511`1f: 1 Fax: 67-!'4,Z E mail: ---- Name: kj! N Contact person: Brp W 111 Fees due upon application ...........................$ Address: o , u Date received: City: , IStateur ZIP: Q7Z Amount received ............... ............$ _ Phone: W.,101!o' Fax: E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Nut all juridictiam accept credit cads,please call)�ntsdiction for more 6rarmaion. attached checklist. All provisions of laws d ordinances governing this U V,sa U MasterCard work will be complied%yJg r whether s i ed herein or not. o�tii cad^ate ---- - --L-L �,� Fspires Authorized signature:=� Date: _ Name d cmfioMcr a tl;owri on credit card Print:tame: -- _ — - c.;>�a��uwoR mot Notice:This permit application expires if a permit is not obtained within I Rt)days after it has Ix-en accepted as complete. 440A13(&%ICOM) Mechanical Permit Application _ Date received: Pcrrrlitno.:/y,r I�"1� Ci of Tigard�J g Projecdappl.no.: Expire date: City ofTieard Address: 13125 SW HaH Blvd.Tigard,OR 97223 Phone: (j03) 639-4171 Dateissucd: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: 71FU- 2family dwelling or accessory 0 Co:nmercial/industrial U Multi-family U Tenant improvement consttuction U Addition/altera(ion/re.placement U Other: Job address: Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overirad, Tax map/tax lot/account no.: -- profit. Value$ 2nfjf Lot: Bruck: _ Subdivision:a ud IL Mel1, trtc'3r 'See checklist for important application information and Project mine: ), ;t jurisdiction's fee schedule for residential permit fee. City/county: ZIP: AW 14WIMM2=11 INN Description and location of work on premises: _ 03 1 NwimiNt Fee(ea.) Total Est.date of completion/inspection: k.%Y. Rea.anh Rea.oaly Tenant improvement or change of use: Air handling unit _—CFM Is existing space heated or conditioned?U Yes U No Air condiuonwg(site plan regm ) Is existing spacot insulated?U Yes U No teration of existing system _---- or er compressors tjlc:Yl50" State boiler permit no.: Business name: nAw Address: 67(t O —-— HP __Tons BTU/H _ _ Fire/smoke dampers/duct smoke detectors City: •A T )lko) Stated ?IP:cy 7 Z eat pump(site p an iegwr�— Phone: r Cl I Fax:"7Inslallfreplace urnac urner__ -- Including ductwork/ven(liner U Yes U No (_CB no.: Z S nsta rep ac re ovate eater;--suspended, City/metro lic.no.:()DOD N()'LC _ wall,or floor mounted Name(please print): . 1 v- 114"�, � Vent for appliance other Utan futnacc e era n: Absorption units BTU/H Nance: i? A,t a-. A_, /�',C�✓t Chillers_�_�� FIP — LAddress: - — Corn ressors _ HP v rowenta xhau+t r�ffat�Ton: State: T.IP:_A Appliance vent Phare: T_ E-mail: F sres. itc tl enthalz at " � hood firession sy!itemName: r. G A �j/�py e r Exhauth single duct(bath fans) Mailing address: haitn apart mm tin orCity: State: ZIP: °c p ut up to out etsPhone: Fax: Email: Type: LIY3 __ NG Oil acT iTiadditiona ova4outIm a (schematic requi ) Name: J ' Numbelets terplli—e e- nt: Address: _ Decorative fireplace City: _ State: 7.IP: nscrt-type -- Phone:� Fax: E-mail: Woodstovelpellct stoveO _ -- - Applicant's signature: — Date: 4 v, We r: — — Name(print): Na all i.nivk iam wvept creAtt cods.plane call lurirNcti m fix nww lnImm ion i� Permit fee....... .............$ Notice:Ws permit application U visa L"]MaaterCerd Minimum fee................$ _ expires if a permit is not obtained -- rteait urd numlxx:_-- _--- _—L ._/ _ Plan review(at 96) a r.pir within 180 days after it hies been ,-�t- Stair,s:in:hargc(84'0)....$ -'-Nome d cwtih Id"as aw"on credit ctrd accepted as complete. $ TOTAL .......................$ '7 7 -- Cardholder signature i M null Iq�6t7(d001tA)Mq P?/A7,,2P01 11 =609939©8: STPEAMi_It'E ELECTP.0 FADE 0:/02 Electrical Permit Application 7_ _ M.d: tertnitee,:Nl �z City Of Tigstt pl.na. elt lots: I In al�lar•� Address: 11125 9W Hall Blvd,Trutt,OR 97223 d, Mcxrc: (SU1) 619 171 by Recc+pl tw Ria _ Plus:(501)995-19w ryare rtk ao. _—' Porne.t tom• band use npmval. O l ,2 trwttil7 dial or Iteoeat�ory M CCrttm#M1al,Hndr strw LJMulti-family C)Tenant improvartlonl Q New conwuoeton U AdditioWsltcmtlotVmplaconaenl L)Odt/r: G)t.rtid Job amreerTo,: 'Joie taco.. Tu me _Irx/acuowx IIO.: Ltx: Bhx k; bdiv V At l - No 11uv,► WtRP ?rt0lect atone: 1oa1 fJo I I dt.) Derr ttpion tlttd bcation of warn on pfrtmuee: New e00%TS*t'lw 1 �wdrtuted aCe of aarn edonlint tfott - -�� ler arts h tta■ N a Addre.a y J r, F= t.h fAwai�eerM rviltlaarrdlydMlrtre► Cttr: V a Il salter WA Zit: 913 6 61 ta.,+a.taelrraa -5 0 EA P: mrlll; 1000l 0 of inn .edt.dridaul WOR rxmmu"thcreel 34-432 '• C I��I.d�-��._. _. C'It !metro Ilt:,no: _ _ -__-- lawla.dener]r,nan-retuned �— 7 _ Bach mr"fol Ft v mo l r drKll►M uro�l t � �roquTrwl Sema urea tMdw Step,sins eases ll LraaMao orl i. r�iwiltrtl.n; atbr.IMr Mr'Na�rfi.a: 200 wl rtt Ida261 ] i Nanta rt): � ''�� � _1ZI1� .�.�:. _•o' `'° ._"�'..-------- - - � dling ad4trs.: .LalwlLW_�il .�- weoo'n" --- . C T tatC: Z,IP� Z �jwrjetpe n e 7 191,11oM: ` - Pan' b ak l n-tna Aeconna mi I Oil intltalltaden IT*Iartallatlett t in%mule property I own Tewr arysw.lr�off'- � ` Which I/it Irriended for We.I Liw enchor nxrordk is tr ORS 441,e 5.1.479,pi17�!t)1. ]oa.rla w ta. _ 2 O-A-1 d taus: Darts -461-10- oftwheksaw sell a N ttma ae a+da"W"Per teed: -- _ A Frill rw dre"Ih tvhb pwd,a.r M Addrt of: p%Sw or Mal IMl sl bnaph ciram t 71 P. 1, .hn hrtMa�ar.rla,ne r(+irw`py�tua el Wool or b.ea tn.Net branch circ.il' _ Ptiorar Ftrut: !a" 1: "��;u,�"-Ntacn Rrwit, Elvis M ( wader teatbt 1+ V farMe.s+ar jJ1 rorpwsarawrcld O 1teaW.carr AaM�ry 8aah r erlpltrm drala _ _� _ 1 Q IIMr ne ew 3]Cp+nhy M IA] O H+Iraadoo+loserolt a_r_o�ou�lrr a�h�um _ f /wdiydtlelllrye U9allalal/pwr10.010tgareall kdra tieher�Ifmledrnr+tYPN'1• U IlytMrN"M 4b7 Vol""Dill "W"nalOrrfY rnite le one etraafale O OaraAlty e.ar bre errrw U f'a.dwt.Oen W"Or mala Ll Owleprr lard&MITT mom C1 MoUbANard. "w"M RV/Ua 9 M)d Ik. U h^wA gdol1Man U Orta 4 Fill >lttseait__-..et.of phm Vil No of tlr 40"W". 1M raw on lues r s W is twell saw"! Mr wr"". w II MtlewtaNl en+r.�M.ew wtl trtrweeu-�w•a+-h iw� Na±u 11tie pern,:r.opltcatiael remit for.....................I Q via U t l~-*,rrl in ire.if a mrmN i."Oftined MR"�Wt�(.I %1 i cyawr aced wwnr _„__ __�_ t— I wi"110 days Ow R ha.bell 190.tm:harle ' aooq+rd ar mwtphete �....... - 0as..1111 Wal ll r Plumbing Permit Application City of Tigard Date received: P:rmitao.:r ( 1;20) Sewer permit no.: Building permit no.: Address: 13125 SW Nall Blvd,Tigard,OR 97223 -- - City of (503)639-4171 Project/appl.no.: Expire date: Fax: (503)598-1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Paymenttype: 8'rl 2 family dwelling or accessory U C ornmen-ial/industrial U Multifamily U Tenant improvement EY New construction U AdditiotJalteratiun/replacement U hood service U Other. INFORNIATION FrE SUILDULL(for.special Job address: f'>� `� � --� _ C��— Dcuripilon I Qkt . l ec(ca. Total Bldg.no.: j—�— Suite no.: New 1-and 2-family dwelling only: (includuq 100 It.for each ntllity connection) Tax map/tax lot/account no.: SFR(l)bath Lot: Bleck: I Subdivision: av A i to�t.w t,-!si SFR(2)bath - ---- Project name: �i uAi l Hd l l-t.-t SFR(3)bath City/county: TICIA4D W94A, I ZIP-- `[71Z Each additional bath kitchen Description and location of work on premises: <LA3J Siteatilities: _ CXX' ;lw0 _ Catch basirdarea drain --- Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin.ft.) Manufactured nome utilities Business name: t�)Q\ Sj ��Mn�t•X� _ Manholes --- Address: Rain drain connector City: IState: ZIP: Sanitary sewer(no.lin.ft.) — - Phax:Wo7 9L9 l E-mail:— Storm sewer(no.lin.ft.) — CCB no.: _Plumb.bus.reg.no: Water service(no.lin.ft.) — City/metro tic.no.: Fixture or item: Contractors representative signature: Absorption valve Back flow reventer Print name: Date: Backwater valve--- ILIVI Basins/lavatory _ Name: Clothes washer - - Dishwasher Address: Drinking fountain(s) City: — - - State: 7.IP: Ejectors/sum Phone: I ax E-mail: I Expansion tank Frxlure/sewer cap _ Name.(print): Floor drains/floor sinks/hub Mailing address: —� —� �— Garbage disposal Hose bibb City: Mate: ZIP: Ice maker Phone: I E-mail: Interceptor/grease trap Owner instal lation/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 en the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owners signature: hate: Sum Tubs/shower/shower an Urinal _ Name: Water closet — _ Address: Water beater City: State: ZIP: — Outer. — Phone: Faxes E-mail: Total Nd VI iwisd.bow weeQt credit cards.plean call jurisdictian for mar idarnriar. Notice:This permit application Minimum fee................$ ----._-- t3viaa U MasterCard expires if a permit is not obtained Plan review(at —_ %) $ —_- credit caro num''er' within ISO days atter it has been State surcharge(8%)....$ Expires -- accepted as complete. !OTAL ......................$ Nie d carAnddr+u sbewo on txdit cans---- S Grr�oldet signature --- Amowit 110.1616(6A04 Ohi) Mar-06-01 03 :05P Wolcott Plumbing 503 667 9891 P .02 13,"06/01 I'L'L 14 41 I'A[ S03 .59A 19(o CIT) OF 003 PLUMBING PERMIT FEES: —--- — — RI TOTAL !:• J Ia�I+tNY�`d,V _1 g9 Silly,. FIXTILRfI{ 1(adtvldua ^�, bsl AMOUNT (' all,pumbinyy'ffelh��turefln P!�'Ck �I TOTAL -$irk 9 61 t ny el'd th#ArIR10t1 It., QT`r (►11j AMOUNT 1(hrqui iri,_gcllb Levatorr _—�,. _ C elfl �__ _ _ .e'20 �1 TuDor'ubrSnvwer omb Ili t69► �� 1 am $350 SI wtrOnly K•• 18.6) t`eth �_ 139=00 _ -1 - ^�LDTO_TT AL _ t C(ahwa.�er led? — - Vii' CVIf W4t/.OF SU8'OTAL C.'arhaga Ckpnlel 1 J _�.. l7t)lTl U�Idr/ r•y — talo WaiNnq Mach,no Flea pr'alflr our$hk 2' �—~ i6 tb ,. ----- -tea- Pi SE COMPLETE: �• -Talo _ "natr:,.e!ter Otunver9on Jk641nd 16(� "--_--- --, uAn Df Pa Ortnkd_ry 1 Ca10lp,np regvves■scoarrl4 rw.tlnrwcal I! �� C. yve: New Nlov d R c+d Rern6vdl GP ed r MFG ,orm4ow WM+n'Servlcw 403 0 F WO i-Wrne Now SarJSlormSewt' �•�--- Tr Lb/ShOwer �,_•1�--- P.acut ante t9dq S. mix t Crrinkn�Fa�nUn. J !� 1t3.I 0 1v "not _ Oh6t Fi4'�r•.ISpeciryi ��- 1!1110 `� G her "� -_.._- —'—• L:• , Room r jX ---- �- tc LMa e _ Sewer•1-_ at_1 0 � —`" '--._-_. 40 io C ,ower ue sddllio7a110•.- AS 10 d'- -- — _-.- V>,'alsr:r,:nco•rar —--- �5. C vVa'ar errc!•aec-h.ar�tior�J1a00 .... to 55,10 —. Or*IUre! toren 6 Raln Oralr• 'h 10n 1 — ! $lprm A 40TH fair_-4111c idrlt�111 100' Comme�r Back Flaw .�lbn Dei • 46 10 -- ---- - Re,bentlel Noc4Aew Pleventkxr wr 6' 27 66 _ Gakh B.�11n 1680 InspWivn of E■lallnq PMwoinq cr specoly 250 (t• u•a1W t edtoro -_ 2s,Jt CQ' F4T3 REGARDING ABOVE: aar t"min,tlng6�rr Ay dwet nq 99 25 -� QUANTITY TOTAL 4omtpnj tnc at is*,alpem is•6qucsd It f 'SUBTUTAL T A'/r/r S1ATE SURCHARGE ''PLAN REVIEW 25%OF SLRTOTAL I 1 TOTAL f 'Mir h+m pamll rat IS N:10•ea alaro prtl-ngr.suApr Re Ga 4410 96041`0- P,qvv,,,, Ocr ..wh r.ti a 114 15,lh.%31010 I'mho'at "A'A NOW coli lmLal•uild"a mr6me pUl1 W"Iaorn-1•r or es it}Iseram Ara /+Im -•Yw 1\�ats'Sonnatplm-Iceadoc 'CrtOl00