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8045 SW CHURCHILL COURT
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CITYOF 7 IGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLN11999-00255
- 13125 SW Hall Blvd., Tigard, OR 9722.3 (503) 639-4171 DATE ISSUED:
SITE ADDRESS: 08045 SW CHURCHILL CT
PARCEL: 2S112CC-02300
SUBDIVISION: BOND PARK NO. 3 ZONING: R-12
BLOCK: LOT: 051 JURISDICTION: TIG
CLASS OF WORK. OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS- I
OCCUPANCY G^P: k-' FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CA'rCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS- URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of residential backflow prevention device for irrigation system.
Owner: FEES
TRANK, MATTHEW R+ LAUREN K Type By Date Amount Receipt
PRMT DEB 8/10/99 $25.00 99-317537
TIGARD, OR 97224
8045 CHURCHILL CT 5PCT DEB 8/10/99 $1.75 99-31753/
Total $26.75
Phone 1:
Contractor:
TRYON CREEK LANDSCAPE INC
11400 SW NORTH DAKOTA ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 624-2174 RP/Backflow Preventer
Reg #: Li'. 00011525 Final Inspection
F i 629E
EXPIRED
1016-'l
This
016-
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable lacus. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
ISEU By: , \�-�� Permittee Signature: - - - _
Call (503) 639-4175 by 7:00 P.M for an inspection needed the next business day
.11
CITY OF TIGARD Plumbing Permit Apr11,1�ation
Plan heck A�
13125 SW HALL BLVD. Commercial and Residr,.Wdl Rec ey
TIGARD, OR 97223 Date t oc'd
Date to P.E. _
(503) 639-4171 Date to DST
Prin: or Type Permit:
Incomplete or illegible applications will not be accepted Rermit0 Pb;
_
WR
Celled
— Name of Development/Project FIXTURES (individual)
QTY PRICE AMT
r—
Job Y�— Oy> Sink 9.00
Street
Address suite Lavatory 6.00
Address Tub or Tub/Shower Comb. Q.00
Eli
lty/Stale Zip Shower Only 9.00
-L-L iWater Closet 9.00
Name 900
Ar�'—15C Dl:,hwasher
Owner Mailing Address .' 11 A_ Suite Garbage Disposal _ 9.00
C—`� t l C Washing Machine 9.00
City/Stele Zip Phone , Floor Drain/Floor Sink 2" 9.00
_ U �• 9.00
Name --
4" 9.00
Occupant Mailing Address Suite — Water Heater v conversion O like kind 900
_ _Gas iiin�requires a separate mechanlcs+l permit._
Clty/State Zip Phono Laundry Room Tray 9.00
Urinal 9.00
Name 'S r AC Q y ta.J P f Ne(• Other Fixtures(Specify) — 9.00
9.00
Contractor Meiling Address Suite ---
9.00
Prior to permit City/State Zip Phone Sewer-1 at 100' 30.00
Issuance,a copy Sewer-each additional 100' 25.00
of all licenses areL t.Cont.Board LlcA Exp.Date Water Service-1st 100' 30.00
required If U fof C� 25.D0
—
expired In COT Plumbing Lic.0 Exp.Date
Water Service-each additional 200'
datsbase Storm&Rain Drain-1st 100' 30.00
Name Storm&Rain U,aln-each additionel 100' 25.00
Architect -- Mobile Home Space 25.00
Or Mailing Address Suite Commercial Back.Flow Prevention Device or Anti- 25.00
Pollution Device
City/State Zip Phone Residential Backflow Prevention Device' 15.00
Engineer (Irrigation timing devices require a separate i
Drestricted energy permit.)
Describe work to be done _
Any
New O Repair O Replace with like kind: Yes O No O Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial O Catch Bann 9.00
Additional de�sccription of work: � /I Insp.of Existing Plumbing 40.00
1 7U'wn-C Ci�tx L'IL V'9'�04 t W f n,- 1 I — er/hr
Specially Requested Inspections 40.00
erRtr
Rein Drain,single family dwelling 30.00
Are you capping, moving or replacing any fixtures? Grease Traps — 9.00
Yes O Nom
If,yes,see back of form to Indicate work performed by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or dKr diagram is required M Ouantit 10911 is >s
WORK COULD RESULT IN INCREASED SEWER FEES. 'SUBTOTAL
I hereby acknowledge that 1 have read this application,that ittc Information _ -- ----
given Is correct,that I am the owner or authorized agent of the owner,and 6%SURCHARGE �
that plans submitted are In compliance with Oregon State Laws. _ —
Slgn tura of OwnerlAgent Date •'PLAN REVIEW 25%OF SUBTOTAL
I V r'1 R ulred only B ndure qty total Is>9
`�_ � TOTAL '
Contact Person Nams Phone
'Minimum permit fee is$25+5%surcharge,except Residential Backflow
-5(o . Ig7T- Prevention Device,which Is$15+5%surcharge
' ••ADI Now Commercial Buildings require plans with Isometric or riser diagram
and plan review
1:ldslslpk,mapp.doc 111/98
PLEASE COMPLETE:
by 1Alork Performed-----
New Moved Replaced Removed/Capped
Sink
Lavatory
Tub or Tub/Shower Combination
Shower
Water Closet
Dishwasher _
Garbage Disposal
Washing Machine —
Floor Drain/Floor Sink 2"
Water Neater �`----------- -- — — - -------
Laundry Room Tray ~� —
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I%datfN"app doc 717198
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80-/5 SW CHURCHILL LOUR`.['
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CITY OF TIGARD
DEVELOPMENT SERVICES
13125 51M Hall Blvd., Tigan',OR 97223 (503)639-4171 ELECTRICAL PERMIT -
RESTRICTED EIIERGY
PERMIT #: EL R97-0 .9
DATE ISSUED: 08/:0/97
SITE ADORESS. . . :08075 SW CHLJRCH 1.LI_ f_ 1 PARCEL: 2S 1 12,CC-02600
SURD 1 VI S I ON. . . . :BOND PARK NO. 3 ZONING:R--12
BLOCK. . . . . . . . . . .. LOT'. . . . . . . . . . . . . :54 JURISDICTN: TIG
Project Description: Add burglar alAre to existing SFU.
---------------- ---------- - ------------
A. RESIDENTIAL-- -__ --- B. COMMERClAL ---- ---- -- - ------------.____._______.___--
AUD T fl & STEREO. . _ AUDIO & S I E KEU. . INTERCOM & PAGING. . :
BURGLAR AL.ARM. . . . : r BOILER. . . . . . . . . . : LANDSCAPE/I RR i GAT. . :
GARAGE OPENER. . . . . CLOCK. . . . . . . . . . . . MEDICAL. . . . . , . . . •. .
HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . . NURSE CALLS. . . . . . . .
VACUUM SYSTEM. . . . : FIRE ALARM. . . . . . : OUTDOOR LANDSC LITE:
OTHER: : : HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL . :
INSTRUMENTATION. : �JTHER. . :
Owner. -------------------------------------------------- TOTAL # OF SYSTEMS: 0
__.--- V EES -----•---- --__-_
CHOI, WON & REBECCA type Amol_tnt by date reept
8075 SW ('HURCHJLI. COURT PRMT $ 40. 00 GEO O8/20/97 97-x'98467
TIGARD OR 97224 5PCT $ 2. O,h GEO 08/20/97 97-298467
Panne #.
HONEYWELL INC $ 42, 00 TOTAL
15455 SW SEQUOIA ��(r>tIRED --
STE 100 - -- _-- REQU I RED I NSPECT I ONS
PORTLAND OR 97224 ��- Ceiling CavFr Low Voltage Insp
Phore #: 9F,8-3333 `� /3/ Wall Cove- Elect' 1 Final
Reg #. . : 000578
This persit is issued suh,lect to the regulations contained in the Tigard Municipal Lode, State of Ore. Specialty Codes and all other
-ppli:able laws. All - ork will be done in accordance with approved plans. This persit will expire if work is not started within 180
days of issuance, dr if work i, suspended for Aa + than 180 days. ATTENTION: Oregon law regAres you to follow rule adopted by the
Oreycn Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-NI-O88. You say obtain copes of
these rules or direct questio Co at 15031246-1387.
IsC,.ied hv�-�► 1-'ermittee SignatLrr
10
-OWNER INSTALL.AT:iON UNl_Y---- ----- ----- ___----.-_-_---_-_
'The installation is being made on proper-ty I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: _ DATE:
INSTALLATION ONLY------ ---- ---------- ----- -
i
SIGNATURE OF SIIPR. ELEC' N: _ _ ___ DATE: y or
LICENSE NO:
++++++++++++++++++++++++++++++++++f-}++f++++++fi•.++++i•++++++++-F-f-++++f+++++++++++++
Call 639-4175 by 6:00 P. M. for-, an inspection needed the netct business day I
+++++•4.+++++++++++++++++i•+++++++++++•.++++++++++++i++++++++++++ h+i.+++++4•+4•++•!.+++++
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL_APPLICATION Recd by
13125 SW HALL BLVD Date Rec'd:_ d -
TIGARD OR 97223 PRINT OR TYPE
V- 503-639-4171 X304 Permit#: ,F-0-7-o;3c
F -503-664-7297 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED
Name of Development Project TYPE= OF WORK INVOLVED - RESIDENTIAL
---- - -- -- ---
f estricted Energy Fee........................................ $40.00
(FOR PLL SYSTEMS)
JOB Street Address Ste# Gheck Type of Work Involved.
ADDRESS 80755 Churchill Ce.
City/State Zip1 Phone# ❑ Audio and Lteren Systems
.2 S
Nathe !!�� I Burglar Alai m
WC n 4'R"O ec e'2 C!A i_1 ❑ Garage Uoor Opener'
OWNER Mailin Address
_pct a s ei 6 o ve- ❑ Heating,Ventilation and Air Conditioning System'
^' City/State Zip Phone#
Name ❑ Vacuum Systems'
❑ Other
CONTRACTOR Mailing Address .--
5 At
/00 TYPE OF WORK INVOLVED -COMMERCIAL
(Prior to issuance a ity/St to Phone 1111 Fee Tor earth systemWW................................ $40.00
copy of all licenses (SEE OAR 918-260-260)
are required If Oregon Contr.Bird Lic # Exp. Dat:,
expired in C.O.T. QJ 7 L2X / 1-31 y Check Type of Work Involved:
data base). Electrical Contr.Lic.# Exp.Date
.26 L02 • V 7 ❑ Audio and Stereo Systems
C.O.T.or Metro Lic.# Exp Date
N_ 1 L'17 Boiler Controls
Owner's Name
❑ Clock Systoms
OWNER - Mailing Address
APPLICANT ❑ Data Telecommunication Installation
CRY/State Zip Phone# ❑
Fire Alarm Installation
This permit is Issued under OAE 918.320-370. This applicant agrees to
��
make only restricted energy Installations(100 volt amps or less)under this ❑ HVAC
ED
permit and to do the following:
❑ instrumentation
1 Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licelising. ❑ Intercom and Paging Systems
These have asterisks(') All others need licensing;
❑
2. Cell for inspections when Installation under this permit are ready for Landscape Irrigetion Control*
inspection at 503.639.4175; ❑ Medical
3 Purchase separate permits for all installations that are not ready for an Nurse Calls
Inspection when the inspector is out to inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspec.tol are done,and;
❑ Prolective Signaling
5. Assume responsibility for calling for a final Inspection when all of the
corrections are completed. ❑ Other_
Permits are non•transferable and non-refundable and expire If work is not
started within 180 days of Issuance or i'work is suspended for 180 days Number of Systems
The person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other Installations
authorized to bind the applicant.
D / G y• ,-� FEES:
ENTER FEES :_ n• ,0
Signature
6%SURCHARGE(.05 X TOTAL ABOVE) :
a• o
Authority if other than Applicant TOTAL o
W�—
i Vesele doc 12/99 — --_