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APPLICANT- OUT
SITS PLANTOWNSHIP 7ATED IN T14E S.SOUTW, RANGE I WES, WILLLAAMETTETION 4MERIDIAN, DALTON GONSTRUGTWN 6TM1
MiRNM CRT OF TIGARD, WA6WINGTON COUNTY, OREGON 44"A 6,W. HEMLOCK STREET .0 RAT
T!GARD, OR 94!3
I DILA 6.W. EROADMOOR PLACE (b03) 020561
/1 TAX MAP 0251040B TAX LOT S A00
(� ZONING, R-4! SHEET
ET 12
NOTICE: IF THE PRINT OR TYPE ON ANY T�- Ci � I ► III II ► ► � I ISI ISI I � III � I 111 11T -rf- rI-1 1jT" r_[ 11T T-11 _r 'J .j 1T 1'(T rll1.Lfl I ( I III I ( rrl � I I ! Irl � l 1-1.111 [IT I T11 111 1111
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IMAGE IS NOT AS CLEAR AS THIS NOTICE 1 2 3 4 5 6 7 _ _ _ 1.0_ __ 11
IT IS DUE TO THE QUALITY OF THE — Y �_ No.36
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13106 SW BROADMOOR PLACE
CITY MJF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171
CERTIFICATE OF'
OCCUPANCY
v.,ERmvr #. . . . .
' " " : MST97 -0241
DATE ISSUED: 04/17/98
PARCELS 251041)B-01900
IITE' ADDRESS. . . 1.3166 SW BROADMOOR Pl-
,UDDIVISION. . . . a AME SBURY HEIGHTS 7ONINGsR-4. 5
hl-Oci'l. . . . . . . . . .. e LOT. . . . . . . . . . . . . :019 JUPIGI)Ir-'TIUN- TIG
LASS OF WORK. %NEW
I YPE OF' USE:. . . SF
� YPC OF cnNSTRr5N
JGCUr-1ANCY GRP. j R:5
!-(.JJP0NCY LUAD-2
t4tw 9F0
I W F1 W t
,ALTON CONSTRUCTION INC
.�A65P SW HEMLOCK S1
; IGARD UP 972E3
, ,hone #i 45c-!.-0961)
f ontractoro
JONE CASTLE BUILDERS
V BOX 2130594
AGARD OR 97281
,hone it 45E-2554
'.'Pu #. . 1 001026
'his Certificate yr-Art � occupenc-y of the above reFeren-ed bUilding Or POV�ti0r)
ohereof and confit-ms that the b�.tildxrjg hos been inspected for compliance with
' he State of Oregon Specialty Codes For the qt'OUP, occupancy, And use, under
ohirh the referenced permit was issueo.
11-i-�Dl N ; SUPERVISOR
TNf-jPE(.TnR/
POW* IN Cr)NSPICUOUS r-ILACE
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: _ – 17 '^ M. 1C P.M. i MST:
Location: Ste- P.M.
_- AUR Tenant:-----.---- Suite n Hldccg: _ _ MEC: _
Contractor Phonr. '5-/ l.'So PLM:
(honer: -- ---- -- ---- Phone: .` ---------- ELC:— —
ELR:
__ __ _ ______ sff: _ _
BUILDING LD cnn'i) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Rearn Cover/Service Sewer/Storni
Footing Roof llndIA/Slah Rough-Li Ceiling Water Line
Slab Frarning 'I op Out (;as Line Rough-In l IG Sprinkler
Foundation Insulation Sewer I Lxxl/Dt'd Reconnect Vault
Bsmt Damp Drywall Storni Furnace 'temp Service MI5C.
Masonry Ceiling Rain Thain A/C 11G Slab
Slicar/Sheath Fire SIALYAlrn Crawl/Found Dr I lent Pinny Low Volt _
�ruve Approved Approved Approved Approved
App.•ISd%1I; Not Aproved Not Approved Not Approved Not Apptoved Not Approved
NA .) FINAL FINAL FINAL FINAL.
D Call for reinslxct'or f O Reinspection f'ee of S _requited before next inspection M linable to inspect
Inspector: __ Date:_. " /7 ' / Page- of
CITY OF TIGARD MASTER PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : casr97-0..41
-'G
13125 SW Hall Blvd., Tigard,OR 97223 ;503)639.4171 DATE ISSUED: 08/19/97
PARCEL: 2S104DB-01900
SITE ADDRESS. . . : 13166 SW BROADMOOR FII_
SUBDIVISION. . . . :AMESBURY HEIGHTS ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 19 JURISDICTION: TIG
Remarks: New SFD
- -----------------—------------------------------------------ BUILDING -----------------------------------------------------------
REISSUE: STORIFS.......: 2 FLOOR AREAS--------- BASEMENT.... 0 sf REQUIRED SETBACKS---- REQUIRED----_-____—
CLASS OF WORK.:NEW HEIGHT........: 30 FIRST....: 1935 sf GARAGE.....: 556 sf LEFT..........: 25 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 1990 sf FRONT.........: 20 PARKING SPACES: 2
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT.........: 25
OCCUPANCY GRP.:R3 BDRM: 3 BATH: 3 TOTAL-------: 3815 sf VALLE..1: 213662 REAR..........: 81
----------------------------__._-----.-------------------- PLUMBING --------—----—------------_--------
SINKS.........: 2 WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 188 TRAPS.........: 0
[AYATORIES....: 3 DISHWASHERS...: I FLUOR DRAINS..: 0 SEWER LINE ft: 188 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS...: 3 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW PhEVNTR: 1 GREASE TRAPS..: 8
GTHER FIXTURES: 0
---- ---------- ---- -- ------------------------------ MECHANICAL ------- - --- ---------------------- _--- .
FUEL. TYPES---------- FURN ( 100K ..: 0 BOIL/CMP ( 3HP: 0 VENT FAW3.....: 5 CLOTHES DRYERS: 1
GAS FURN )=I98K ..: I UNIT HEATERS..: 0 HOODS.........: 1 OTTER UNITS...: 2
MAX INV.: 0 BTU FLOOR FURVICES: 0 VENTS.........: 8 WOODSTOVES,...: 8 GAS OUTLETS...: 1
---------------- ----------------------- ------------------ ELECTRICAL ---- -----------------------------
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS-- --APD'L INSPECTIONS--
I898 SF OR LESS: I 9 - 288 amp..: 8 A - 288 alp..: 8 W/SVC OR FDR..: 0 PUMP/IRRIGATION! 0 PER INSPECTION: 8
EA ADD'L 509SF.: 6 281 - 488 amp..: 8 261 - 488 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 491 - 688 amp.,: 8 481 - 600 amp..: 8 EA ADDL BR CIR: 8 SIGNAL./PANEL...: 0 IN PLANT......: 8
MANE' HM/SVC/FDR: 0 681 - 1808 amp.: 0 601+amps-1888 v: 0 MINOR LABEL -10: 0
1808+ amp volt.: 8 ------------------------------------- PLAN REVIEW SECTION ------------------------------------
-- Reconnect only.: 0- ---)=4 RES UNITS..: SVC/FDR)=225 A.: ) 688 V NOMINAL: CLS AREA/SPC OCC:
----------------- -- ELECTRICAL - RESTRICTED ENERCY ---------------------------------------------
A. SF RESIDENTIAL--------------------------- B. COMMERCIAL--------------------..------- ------------------------------------------------
AUD10 t STEREO.: VACUUM SYSTEM..: AUDIO ✓< STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC I-T:
BURGLAR ALARM..: UTH- :: X BOILER.........: HVAC............ LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL......... OTHR: .
HVAC. .........: DATA/TELE LOW.: NURSE CALLS....: TOTAL 1 SYSTEMS: 8
Owner: -----------------------------------Contractor: ------------------------------ TOTAL ICES:/ 4620.11
DALTON CONSTRUCTION INC STONE CASTLE r'•.IILDERS This permit is subject to the regulations contained in the
P465A SW HEMLOCK, ST PO BOX 238594 Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 TIGARD OR 97281 other applicable laws. all work will be done in accordance
with approved plans. This permit will expiri if work is
Phone 1: 452-9`169 Phone 1: 452-2554 not started within 188 days of issuance, or if the work is
Reg C.: 001826 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 95?-801-9010 through OAR 952-081-8088. You may obtain copies of these rules or
direct questions to OUNC by calling 1583)246-1987.
----------------------------------------------------- ---- RERP RED INSPECTIONS ---- --------- ---------------..------------------------
Erosion Contol Post/Beam Meehan Electrical Servi Gas Line Insp Water Line Insp Building Final
Grading Inspecti Crawl Drain Electrical Rough Gas Fireplace Appr/Sdwlk Insp
Footing Insp PLM/Underfloor Framing Insp Insulation Insp Electrical Final
Foundation Insp Mechanical Insp Shear Wall Insp Gyp Board Insp Mechanical Final
Past/Beam Struct Plumb Top Out Low Voltage Rain drain Insp Plumb Final
I ssued By : �� 1. C l y �- _
bG�1-- Permittee Si nate-rre :�
*+++++++++ *++++++++++ +++++++++++++++++++++++++++++++++ ++++4+i +++++++++++++
Call 63-9--4175 by 6:00 p. m. for an inspection needed the next bi-is iness day
CITY OF T SEWER CONNECTION
ON
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : SWR97-0231
DATE ISSUED: 08/1x)/9'7
PARCEL: 2SIO4DB-01900
'LITE ADDRESS. . . : 13166 SW BROADMOOR PL
SUBDIVISION. . . . :AMESBURY HEIGHTS ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 19 JURISDICTION: TIG
TENANT NAME. . . . . :i',AL.TON CONSTRUCTION INC
IDSA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
LLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
JNSTALL TYPE. . . . :BUSWR IMPERV SURFACE: 0 sf
Remarks : New SFD
Owner: - ---------_____._-_____._______-__________-.-----___-_____ FEES _.____-------__--
DALTON CONSTRUCTION INC type amoLrnt by date recpt
8465A SW HEMLOCK ST PRMT E 2,200. 00 DST 08/19/97 97-298426
TIGARD OFT 97223 INSP f 35, tr1'a DST 08/19/97 97-298426
EROS $ 88. 40 DST 08/19/97 97-298426
Phone #: ERPU $ x.8. 60 DST 08/19/97 97-298426
ERPC f 28. 60 DST 08/19/97 97-298426
front Tactor: --------------------------------000L $ 210. 00 DST 08/19/97 97--298426
1IWNER PUN $ 290. 00 DST 08/19/97 97-298426
Phone #: E 2880. 20 TOTAL
------- REQUIRED INSPECTIONS ---------
This Applicant agrees to comply 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 _ �-
per-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 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
952-01--NIO through OAR x152-NNNIAM. you may obtain copies of Y
these rules or direct questions to OUNC by calling (583)246-1967.
Isst-red by :- 7.� 6 `-� l� Zl�� Flermittee Signature :_
i
f++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++*++++++++++++++++++
Call 639-4175 by 6:00 p. m. far an inspection needed the next business day
+++++++++++++++++++f+++++++f+++++++++++++++++++++++i+++++++++++++++.1-+++++- +++i-++
Solar Balance Point Standard Worksheet
,address t 5 k(,; ,; SPWk-t 'N\C iZ 1_A Le
Box A calculations: North-South dimension for the lot- Box.-
This dimension is determined by finding the midpoint of the North lot line and drawing
an intersecting line perpendicular to that point.
First, determine which property line is the North lot line. The North lot line is the line
with the smallest angle from a line drawn east-west and intersecting the northern most
point of the lot-
ace dw
t �
.a w N va w North-South
Dimension for Lot:
Measure the distance from the midpoint of the North lot line to the South lot line along
the described line. -7g,G' feet
t
N
non.aarn a►waon
I
Sox 8 calculations: Shade point height for your residence- Box B.
1. Determine whether measurements will be based on the peak or eave of your Which describes
structum- The orientation of the ridge is also important.
your residence.
1a: If the roof line runs North-South, measurements will (circle one)
be based on the peak of the roof. a o 0I
C
1 b,- If d-.e roof line runs Fast.-West and the roof pitch is
less ;ian 31'l?, measuremerts %gill cn :he
eav e. I�
1 c. If dre roof line n.rns East.-,Vest and the mof pitch is
or steeper, measurements will be based on the . :..--
peak.. ❑ _C:
Box B. continued Box 8:
'. .Measure change in elevation from front property line to finished floor elevation. If
the lot slopes up from the front lot line to the foundation, the Figure is positive. If
the lot slopes down from the front lot line to the foundation, the figure is negative. ft
3. Measure distance from finished floor elevation to the affected peak/eave. + 23.5 ft
4. If the roof line runs North-South, deduct three feet. If the roof line runs East-West, 3,n ft
deduct nothing.
3. SubLmct one foot for each Poor 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. ft
6. Total figure for box 8: 10,5 ft
Box G Distance to the shade reduction line. Box C.
1. Measure the distance from the North property line to the foundation near the ,3.0 ft
affected peak/eave.
2. Measure the distance from the foundation to the affected peak or eave. + 32. 0 It
3. Total figure for box C. 45,0 ft
It o molt useful to draw a v"dc21 fine to represent the appropriate fipm found in box'A'and a ho irontal line to represent the
apprvprim ngure found in box-C'.The intelsecbw of the vertical and horizons' .iotas detarmines the value h,und in box'D'. The value
in box 'O'should be compared to the value in boot'0'; if the value in box'9'is km than or equal to the value found in box'O', then
the building is;n compliance with the solar balance code. it you have any questions,please contact us at 639-4171, x304 or at the
Commuruty Development Counter.
MAXIMUM PERMITTED SHADE POINT HEIGHT (In feet)
Distance no North-south lot dsmen.*m an feet
shade 100+ 95 90 85 80 75 70 65 60 55 50 45 40
reduakm Gne
from northern
lot rine(110 feet
70 40 40 40 41 42 43 44
63 3A 38 38 39 40 Al 42 43
60 36 36 36 37 38 39 40 41 42
33 34 34 34 35 36 37 38 39 a0 41
50 32 32 32 33 34 35 36 37 38 39 40
*3 30 30 30 31 32 33 34 35 36 37 38 39
0 21 29 28 29 30 31 32 33 34 35 36 37 38
35 25 25 26 27 28 29 30 31 32 33 3.4 35 36
0 24 24 24 25 25 27 28 .9 30 31 32 33 34
25 22 21 22 23 24 25 25 27 28 29 30 31 32
27 20 =0 20 21 2-1 23 24 25 26 27 28 29 30
13 18 t8 18 19 20 21 22 23 24 25 26 27 28
'0 16 16 16 17 18 19 =0 21 22 23 24 25 26
14 14 14 15 16 17 18 19 20 21 22 23 24
Box D. .Maximum allowed shade point height_ 3 Z• D !feet
�+:`cioczvtar�ve+Tarn�.solar.e'io
Rented
Pian Cheat r X
ITY OF TIGARD Residential Building Permit Application Roe By h.
3125 SW HALL,BLVD. New Construction Additions or Alterations Date Recd -
,GARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P E.
503.439-4171 Date to DST
503-684-7297 Permit rV/
Print or Type called 4 ' '? L Z
Incomplete or illegible applications will not be accepted
Name of Project Name,
Job - v�� Pei t'j--r LJL_11jLL
Address site Ad Architect Marling Address
r u yt1 t'C f�
Name
C,b/S Zip Pttone
`7
a, nq Address N ^eOwner
t-
yr it:%r!'S
rY Zf1>
Phone Engineer Mailing Address 5
Cr ✓State
4
Name i / =i• Phone
General w' ,,r �_ L t C Describe work New 0 Addition O Attention O Repair O
Contractor Mill ling / /. to be done,
` r ` /' t Additional Descnpbon of Work:
cl)ystste Zip Phone
Oregoh Const.Cont,. aro Lie.* Exp
Attach Copy of
t., 1 Y ( t
Current COT Business Tax or Metro r Exp,D�is /PROJECT
Ucenses S ''VALUATION
N
ame
Mechanical l� �,J�� NEW CONSTRUCTION ONLY:
r •'-/ 4�
. . House-, rs e
Sub- Marling Address SqFtFt. Ga
� '�
Contractor <I-Aw'/�� ✓`� Comer Lot YES N9 Flag Lot YES N(�
CSP/Sia Zip Phoma S Z y i
(check one) - (check one _
Oregonnst.Cont Boaro Licr pp,Date C Restricted Audio/Stereo Burglar
•,
rtach Copy of Z ( D 7j ri' Energy System Alarm
(,urrent COT Bustnesat Tax or Metro K Exp Date Installation Garage Door ___FH
� HVAC
Licenses r ) y ? 1 _ Opener Systems
Name (check all that Other
Plumbing a ., , appiv)
Sub- Mailing Address Will the electrical subcontractor wire for all ' IES NO
:ontractor (Y c' SN) OS A)t restricted energy installations?
C. Te Zip Phone Has the Subdivision Plat recorded? N/A YES NO
C ,c-7 67-)e
regc.: onst.Cont. Board Lie 0 Exp.Date,.. Reissue of MST* Solar Compliance
tach copy of L l '5 (Calculation Attached)
Current Plumbing Lic. -
Licenses .. q i y ,71Z ��f p pate �� 1 hearby acknowledge that I have read this application. that the
C T Bu mess.Tax or Mptrq Exp. Date 1/ information given is correct, that I am the owner or authorized
--��j��t _ - `- agent of the owner, and that plans submitted are in compliance
f Namv with Oregon State laws -,
Inctrical ( r1� ��t't'_�f;r` ��C Signatyreofywner/Agent Date
Sub- Mailing Address I Coh a t Pe on Name Phone#
ontractor I f 7 (- , l a n 41'�
C.tyiS-ate Z.P 7, Prone, FOR OFFICE USE NL
Z Z Plat Z M8 L.ft: n
Oreg Const.Co Board Lie.ai E p, aM i f1
ach Copy of SetbacksZOnA: Solar-
Current E!ectneal L7# I Exp Date f V--
Licenses ( p`) - f '!'� gin Apj(t I: Planning Approval: TIF:
COT Bjsinesa tax or Metro a Exp Dare
I C a
:lsfap .doc Idst) 1197
Permi # Account Description 6moun Arnt. Pd. Bal. Due
p c/r
MST. Permit (BUILD)
Plumb. Permit (PLUMB) 2 2 5—, `"� 2 Z>.
Mech. Permit (MECH) 52, jz 1, s z
2.
ELC/ELR Permit (ELPRMT)
State Tax (TAX) 6-.y,
Bldg:
Plumb:
Mech:
ELC/ELR:
Plan Check
MST: IBUFPLN
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review �•�c (��s (LANDUS)
bZlewer Connection (SWUSA)
Reimbursement District ( )
Sewer Inspection (SWINSP) �
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R) /5 1a
Mass Transit TIF (TIF-MT) 1 2y
Water Quality (WQUAL)
r
Water Quantity (WQUANT)
Erosion Control Permit (ERPRMT) t w7
Erosion Planck/USA (ERPIAN) L�941 _ I
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS:
I 1:uMpp. rou)i�91
w
1
SEE3 5MM
ROLLf� 22
F' OR
LARGE
DOCUMENT
CITY O F T I G A R D I::'1 (.11.11*l l`I(1
DEVELOPMENT SERVICES V%�.'Rl*1l1'T It P1 1198 0 0 19
13125 SW Hall Blvd., Tigard,OR 97223 (503)6,39-4171 D()*,T[:, Ili.!:AJFJ):: 013/1.6/98
la: 71K ODD1'•iEKSE3.. .. .. ;: 1,31.66 1;;W DR(J(4D1v10()R 1:1
I -
.3LJ14D1V:[S3:0N. . . .. -. 1AE:T(*fl'S R 4
11,11 C)CA<. . . . . . . . . .. . 01'.. . .. . .. .. . ., . .. .. .. . C 0 1.9
...................................................................................................................... ........I.................................
C I AE-31E.3 (IF' WORK. » :(IDI) (3(aRBOGL D1E1A._.,013A1 C.; 0 IT101'.411-AHHOME: SVIACE..13. 0
OF, LKOK W(•193KENC) 11(11:3-1. . 0 I_.'(M'A/.F'L.0W 1::1RF:VKTR9. :1.
C)CCUPIANCY GRP.. -R3 FA C)OR DRAIM31, . 0 14MV,C).. .. .. 1. . 1. 1. .. .. .. .. . .. W
SIDRIES. (a WO*I*[*::R F1[:'()*T'F:RE). 0 (3:11'CA-4 DO1:iIAN03. .. .. . .. . 0
...........................................
I
I !:F' RO' Iq X)ROINS).. 0
1:71krUFOKE. M.J1qI),1':1Y 'TROYE). 0
1:NKS. . . . . . . . . .. 0 0 0
()VA'T*0RT1:--S.. 0 011A1:'R 1-1X*lLJR1::'.5., 0
W 13EWL R 1.. Th11::: (-f-t;) 0
W0TF_.R C1_J313F:J13). 0 W()'TV:J-; L.11*: (.f:A;) 0
1)*I:(,Ill.lw(11i,)I.i ::I:il),. 0 R011"I DR01M (-ft') 0
Renla-rksi.- Odd reV-J.deJ_Jt:i.j.-J*1. dc+Vi.c.,ce nc.-+W !:iJ.1-1q.1'e? I'Anlil'y dwo,1. 1-0-1
q_
Owne-ro ........................................................................................................................................
DAL'UM C01q9*1'RL1C,"1J0N 114' t.,y P allic)k.trit by date -rec.r)t
8465() 133W HE".111 CKAIN S7 PRI'll' $ 1.;`.'i»00 GED 03/1.6/98 98,,-,,304J.4rJ
11()PRI) OR 972213 11,5FIC17, $ (!7. '71,-5 C)F_':C) 03/16/98 98-3041.4t;
Phone 0.-
Cal 1".f'rieta-1................... ..........................
KOREY WINCHU.-L.
17465 NW C.)Rl C-T
PORTLFWDDR 97P29 ..................................................................I............................................
Phane 1#.- 61.4--081.4 $ 1.5. 75 1*01411
Rem 0— t 0001(26
......_......... RF.(4L)f RVI)
This permit is issued subject tr the regulations contained in the RP/14ackf1aw 1::1-reV ......................................................................
Tigard hiniripal Code, State of Ore. Specialty Codes and all other Fj.nal. 11-11ar)ec.,ti.cni .............................................................
Applicable laws. All work will be done in amrdanre with .......................I............................... .........................................................
Approved plans. This permit will expire if work is not started ................ ..............................
within IFA days of issuance, or if work is suspended for more ..........1.._...._...__-._...._..1..................... .............-.__..__....1..................I..........
than 180 days. ATTENTION: "on law requires you to follow rules ..................
adopted by the Oregon Utility Notification Center. Those rules are ................ ...............................................
Set forth in OAR 952-6661- 616through OAR 952-666I-9696. You may ........... ...'•m'_.._........_......._.._....._....._..._..............
obtain copies of these rules or direct questions to OUK, by calling ............... .....................
(563)246-1987. .......................................................... ... .........................
........................................... ..............I......................
........................................
t.tPe-rmi.ttee signatt.k.re".
Iiisvied By
- .../.I. .........................................
elo J?_-_ ....... .......... .......
+++4,++4-++4-+++++++++4-++++++4-+++++++4-+++4-4-++4-4-4-+4............
[,'.-A.1. (`,;39 41.7,`5 by 7aOO p.m. fo-r an inspeetion needed the next bUSilleiss day
{•++++++•F++4•4-++++++++++4-4-+++++4-++++4-+++4-++++++++++-4........4-+++++++-IF 4-++4-+4-+++++
CITY OF TIGARD Plumbing Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Fcz'd—
Date to P.E.
TIGARD, OR 97223 Date to DST
(503) 639-4171 Permit .�I 75-C)r Cy��
Priv It Or Type Related SWR#
Incomplete or 01--Mible applications will not be accepted Called_ _
Name of Development/Project On back Indicate Work Performed by fixture.
IF— Job A vie ., � `w r t r o Il'(`- FIXTURES (Individual) QTY PRICE AMT
Address Street Address Suite Sink 9.00
Lavatory 9.00
Bldg# Gly/Stai. Zip Tub or Tub/Shower Comb. 9.00
_ t lc> ,�,? o ?
Name Shower Only 9.00
A) C _L l r ����'S tY`� (C) , Water Closet 9.00
Owner Mailing Address Suite Dishwasher 9.00
HeA4U.xa-_ -1 _ Garbage Disposal 9.00
City/State Zip Phone Washing Machine 9.00
I 4 P C, ` 7ZZ3 l)c -o �c 9
Nami Floor Drain 2' 9.00
3' 9.00
Occupant Mailing Address Suite 4" 900
City/State Zip Phone
Water Heater O conversion O like kind 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
v .t l-A-- ti 61 C-L Other Fixtures(Specify) 9.00 I
Contractor Mailing Address Suite
9.00
714� C-4PJ61 9.00
Prior to permit City/State Zip Phone
issuance,a copy AA-. R _2,�! c(. r Z i 900
of all licenses are Oregon Const.Cont.Board Lic# Exp.Date 9.00
require) -Z if 6( �i �' Sewer-1st 100" 3000
expired in COT Plumbing Lic.# Exp.Date Sewer-each additional 100' 25.00
database
Water Service- 1st 100' 30.00
Name
Architect Water Service-each additional 200' 2.5.00
Mailing Address Suite Storm&Rain Drain-1st 100' 30.00
or
Storni d Rain Drain-each additional 100' 25.00
Engineer CitylState Zip Phone Mobile Horne Space 25.00
_ Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New O Addition O Alteration O Repair O Pollution Ckvice _
to be done: Residential O Non-residential O Residential Backflow Prevention Device* 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
Insp.of Existing Plumbing 40.00 I
per/hr
Existing use of Spey .Ily Requested Inspections 4000
building or property _ per/hr
Rain Drain,single family dwelling 30.00
Proposed use of
building or property.____ _ Grease Traps 9.00
QUANTITY TOTAL
I hereby acknowledge that I have read this application,that the information Isometric or nser diagram is required X Quantity Total is >9 '^ _
qiven is correct,that I am the owner or authorized agent of the oo.,er,and `- 'SUBTOTAL
that plans submitted are in compliance with Oregon,Slate Laws.
Signature of Owner/Agent Date -` e
5/eSURCHARGE
C nUet anon Nares Phone PLAN REVIEW 26%OF SUBTOTAL
Required ontlo A fixture qty total is>9
L ((f_"-J91L1 TOTAL
'Minimum permit fee is$25+5%surcharge,except Residential Backflow
Prevention Device,which is S15+5%surcharge
I tdsl24ftaop doc 5/97
FLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet —
Dishwasher
Garbage Disposal
Washing Machine _
Floor Drain 2"
A 11
Water Heater �}
Laundry Room Tray
Urinal
Oiher Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I W91s',pimapp doc 5197
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
G�
Date Requested: _ I A / P.M. MST:
BIJP:
Tenant: "Quite: E3ldg. _ W"C:
Contractor:` _ZIL/ C4 PLM: . �
Owner: _ _ _ Phone:
_ SIT: _
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/ficam PostAlearn Post/Ream Cover/Service Sewer/Storni
Fooling Roof llndl l/Slab Rough-In Ceiling Water Line
Slab I riming Top Out Cas Line Rough-In I JG Sprinkler
Foundation Insulation Sewer Ifood/Duct Reconnect Vault
Nsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Dram A/C UG Slab !ANOF-70-proved Shear/Sheath Ftre Spklr/Alm Crawl/Found Di I lent Pump 1,0%4,VoltApproved Approved Approved Approvedppro
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL
0 Call for reinspection O ReinspLction fee of S_ required before next inspection D Unable to inspect
Inspector: -�- l -� Date:�3 �� Pagc_—___--of