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13348 SW ESSEX DRIVE �1 ✓r I LO I W W^ lis ntM ,W VcI CS rMr^ V/ cn X a H i 1 r I I 1 I i i 1 ii 1 i I r I i 13340 6�i :,sSLx OR CITY QF TIGARD (_t. l �) SPAN �,L. accuANr..v COMMUNITY DEVELOPMENT DEPARTMENTPERMIT r#. . . . . . . : MST93- 037J i'J DATE I SUED 1 07/10/96 13125 SW Hall Blvd.Tigard,(Dragon 97223.8190 (503)839-4171 PARCEL: 21-S 104CA--0981210 1T1. 1-IUUFt�.;�y. . . s 1�,'.4H SW Ef�',�,E�7t DR �JBDIV191CIN. . . . s HILLGHIFRE' ZONINGsR--7 PD 1._aLK. . . . . . . . . . .. LOT. . . . . . . . . . . . . s e9a I..ASS OF WORK.. :NEW vF= OF USE. . . :SF ,CCUl=FANCY GRP.a'IN f23` ,1"C'UPANCY LOAD:' 'emalrks s PATH I owner~: ._._._._.._._._.._.__.__ _.______..._ ._......._.__.___.._.____.... ._._... ti4NYA EDUPUGANTI 3 �4fi C,W ESSEX TIGARD OR Phone fl: not rac:t or s I:ORGE Fi JOHNSON INC ) r-135 t,W '56TH PL_ 1'010 L AND OR ')7219 h'honez #1 245-•05181 Req R. . , ".35166 Ihrie; Certificate grenta acce.lF;anCt/ of the AboVp r-FferenceH building or portion thereof and confirms that the building has peen inspected for compliance with the State of Or, Specialty Codes for the gr^ouP, orrupancy, ,enc' use under which then refs ^enced permit was issued. ,J 7r._. BUILDING INSPECTOR r-.hUYLD G OF'F IL.._...IAL Pns;T IN CONSP I LUOUS PLACE I D1TYOF 7IGARD MECHANICAL PERMIT Cj lak fRPAl_#: MEC1999-00216 UEDEVELOPMENTMENT SERVICES OR13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SUED: 5/'19199 PARCEL: 25.04CA-09800 SITE ADDRESS: 13:..48 SW ESSEX DR SUBDIVISION: HILLSHIRE ZONING: R-7 BLOCK: LOT:098 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS• VENT FANS: OCCUPANCY GRP: R3 VENTS W!O APPL: VENT SYSTEMS: STORIES: BOILERS/CO".'iPR_ESSORS HOODS: _ FUEL TYPES_ 0 - 3 HP: 1 DOMES. INCIN: - T 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: OD GAS PRESSURE: 50 + HP: C FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: Install a new AIC unit. A/C units cannot be placed within the required setback areas. Owner: _ FEES RANYA EDUPUGANPI Type By Date Amount Receipt 11348 SW ESSEX OF' PRMT GEO 5/19/99 ^� $25.00 99-315512 TIGARD, OR 97223 5PCT GEO 19/99 $1.25 99-315512 -- _—~-Tota{ $26.25 nco ne: - — -- Coi,tractor: SUNSET FUEL_ CO PO BOX 42287 PORTLAND, OR 97242 REQUIRED INSPECTIONS—__— Cooling NSPECTIONS ___ _Cooling Unt Insp Phone:503-234-0611 Final Inspection Reg #: LIC 00002374 ELE 26-113C This permit is issued subject to the regulations contained in the Tigard Municipal Coda, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This )ermit 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 in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (50(3,)246-9189. Issue By: . _ �!, 1�/;'L" Permittee Signature: Call (50:f) 639-4175 by 7:00 P.M. for inspections needed the next business day Plan Check# CITY OF TIGARD . RECEIVMechanical Permit Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd TIGARD, OR 9722.3 MAY 19 1999 Date toP.E.�_ (503) 639-4171, x:'04 I Date to DST COMMUNITY DEVELOPMENT Print or Type Permit# Incorrlplete or illegible_applications_w_ill not be o.cepted caned Name of De .Iopment/Projecl Description Table 1A Mechanical Cade Ot ;,,e FAmt Street A) Permit Fee _ Job surer 10.00 Furnace to 1000 BTU Address y�j �tl �:,�Se l� 1) ,00including ducts&vents see footnote 1,2 6.00 eldegr# CNyr8lats Zip including Furnace 100,000 BTU+ including ducts&vents see footnote 1,2 7.50 Name(or name of business) 3) Floor Furnace -- Owner U x-11-f 7Ckr)i�7 I including vent see footnote 1,2 6.00 MaINngAddress °^ 4) Suspended heater,wall heater 1 -3 5 Z �� J` r or floor mounted heater _see footnote 1,2 6.00 L 5) Vent not included In appliance permit Cny/Stale `I Plane ___ _ 3,00 l I >y/ I �� S y fc'r r Check all that apply F.A( Heat Air or Namrunt o business) - For Item3 6-10,see e, Pump Ccnd Qty Price Amt d' footnotes 1,2 Com •• - Occupant Melling Address 6)<3HP;absorb unit to00K BTU 6.00 l 7)3-15 PP;absorb unit cry/State zip Prone 100k to 500k BTU _ _ _ 11.00 8)15-30 HP;absorb Contractor Name —.- unit.5-1 mil BTU_ 15.00 — K- - 9)30-50 HP;absorbl•1!/` / !/ / unit 1-1.75 mil BTU 22.50 Pior to permit Iln dross rr 10)>50HP;absorb unit — _^ Issuance,a copy ` L L,L _5 l r)( I r >1.75 mil BTU _ 37.50 ) of all licenses G y/Stat Zip Phone 11)Air handling unit to -CFM_ J - are required if , r �r-W G �C`l.- 1 / �(r�r 4.50 expired:.CCT Oregon Conn.Cont Board LI.r Exp.Date 12)Air handling unit 10,000 CFM+ database 1, __ 7.50 _ Architect Name 13)Non-portable evaporate cooler 4.50 or Mailing Address 14)Vent fen connected to a single duct _ 3.00 15)Ventilation system not included in EngineerE„y/State Zip Phone appliance permit 4,50 __ __ 1F)Hood served by mechanical exhaust C�scribe work to be done: 4.50 _ 17)Domestic Incinerators New Repair O Replace with like kind Yes O No O 7.5J Residbntial O Commercial O 18)Commercial or Industrial type Incinerator 30.00 Additional information or description of work 19)Repair units -- __ 4.50 _ 20)Wood stove NOTE: For Commercial projects only;Units over 400 lbs require 4.50 structural gas cabs. 21)Clothes dryer,etc Type of fuel: oll O natural gas O LPG O electric O 4.50 22)Other units — - _ I hereby acknowledge that I have read this application,that the information _4.50 given is correct,that I am the owner or authorized agent of 23)Gas piping o to to four outlets the owner,that plans submitted are in compliance with Oregon State laws. See footnot,j 1 _ 2.00 _ 24)More than 4 per outlet(each) _ Signature of Owner/Agent pate Y .50 «[t Minimum Perndt Fee$25.00 SUBTOTAL Contact Person Nime Phone ___ 5%SURCHARGE _ REVIEW 25%OF SUBTOTAL Foonotes for commercial pru)ects only: Required for ALL commercial permits only 1. Provide full schematic of existing and proposed gas line and pressure. TOTAL_ 1 y� 2 Provide drawings to scale showing existing and proposed mechanical CJ! units. 'State Contractor Boiler Certification required ..Residential A/C requires site plan showing placement of unk I\niechperm doc rev 02/4/99 su� se n 2944 S.E. POWELL BLVD. P.O. BOX 42287 PORTLAND,OR 97242-0287 TELEPHONE 234-0611 FAX# 503-234-0380 1 �toN�- 13 3y , SW C-1IT f° rn � _ 1 CITY OF 1`I G A R D ELECTRICAL PERMIT PERMIT M ELC1999-00327 DEVELOPMENT SERVICES DATE ISSUED: 6/'1/99 Wit 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104CA-09800 SITE ADDRESS: 13348 SW ESSEX DR SUBDIVISION: HILI_SHIRE 7.1NING: R-7 BLOCK: LOT : 098 JURI DICTION: TIG Nroiect Description: First branch circuit _ RESIDENTIAL UNIT _ _ TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: v �v EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: L;'AITED ENERGY: 401 - 600 amp: SIGNAL./PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): _____SERVIC'/FEEDER — BRANCHCIRCUITS _— ADD'L INS. ECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: )01 - 400 amp: 1st W/O SRVC OR FDR: '. PER HOUR: 401 - 600 amp: EA ADD'L. BRNCH CIRC: IN PLANT: 601 - 1000 amp: P_ LAN REVIEW SECTION 1000+ amp/volt: _ >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect anly_ _ SVC/FDR >= 225 AMPS: CLASS AREWSPEC OCC: Owner: Contractor: SRIRAM EDUPUGANTI WEST SIDE ELECTRIC CO INC 13348 SW ESSEX DR 1834 SE 8TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: Phone: Reg M U1-1 5006 SUP 1556s ELE 26-135c f_ _ FEES Required Inspections I Type By Date Amount Receipt I Elect'I Service PRMT BON 6`x/99 $35.00 99-3157(47 -- Elect'l Final SPCT BON – 6/1/95 $1.75 99-315797 ORIGINAL Total $36.75 This Permit is issued subject to the regulaticns contained in the Tigard Municipal Code.State of OR Specialty Codes and all other applicable laves 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 952-001-0080 You may obtain copies of th?se ries ordiract questions to OUNC at 1503) 246-1987 Permit Signature: Issued By: C�~ - t ?-V\ - Ivy �� OWNER INSTALLA7ION_ONLY The installation is being made on property I own which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE: _ DATE: CONTRACTOR INSTALLATION ONLY _ SIGNATURE OF SUPR. ELEC'N: TATE:_ LICENSE NO Call 639-4175 by 7:00pm for an Inspection the next business day RECEIVED CITY OF TIGARD EIectr'saal Permit Application Plan Check _ 13125 SW HALL BLVD.JUN o11999 Redd t,yLK Data Fiec'd_ � TIGARD OR 97223 COMMUNITY DEVELOPMEN1 Date to P.E. Phone (503)639-4171, x304 Date to DST_ Inspection (503)639-4175 Print or Type Permit a C� Fax (503)684-7297 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name(or name of business) Service Included: Items Cost Sum Address._133 9 S w b� 4a. Residential-per unit 1(M sq.It or less $110-00 4 City/Sten?/Zip T-1CAA-og , 60.• 1223 Each additional 500 sq.It.or portion thereof $25.00 Limited Energy Commercial ❑ Residential 1 $25.00 Each Manuf'd Home or Mudular Dwelling Service or Feeder � $88.00 2 2a. Contractor Installation only: (Attach copy of all current Ice ee 4b.Services or Feeders /, `�� Installation,alteration,or relocation Elect(-cal Cp t actor .3 200 amps or less $60.00 2 Addres ` - 201 amps to 400 amps _ $80.00 2 City C'."/ 2."C: State r Zip_ ��_ 401 amps to 600 amps $120.00 2 Phone No. 2 f 7 S VP 601 amps to 1000 amps $180.00 2 Job No. 1 O►� Over 1000 amps or volts $340.00 2 Reconnect only $50.00 Elec.Cont. Lice. No. 6", L Exp.Da'e OR State CCB Reg. No. /3106 Exp.[ate 4c.Temporary Services or Feeders COT Business Tax or Metro No. Exp.Date _ Installation,alteration,or relocation /r- 200 amps(ir less $50.00 2 Signature of Supr. Elec'n_ ( � 201 amps to 400 amps $75.00 2 401 amps l0 800 amps $100.0100.0 0 2 Over800 nmp9 to 1000 volts, License Nr S, S Exp.Date seeTb"b"above. Phone N �� 5 - 4d.Branch Circuits Now,alleralion or rxlunsion per panel 2b. For owner installations: a)the fee for branch circuits with purchase of service or Print Owner's Name - feeder for. Address _ Each branch circuit $5.00 2 b)The lee lot branch circuits City State Zip without purchase of Phone No. _ service or feeder lee. First branch circuit $35.00 •Go 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 2 Intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder riol Included) Owner's Signature_ Each pump or Irrigation circle $40.00 _ 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required):" Signal ato i or a limned energy panel1,,altlteration or eztenslon $40.00 Minor Labels(10) $100.00 Please check appropriate Item and enter fee In section 5B. 4 or more residen!tal units In one structure 4f.Each additional inspection over Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per Inspection $35.00 Classified area or structure containing special occupancy Per hour J_ $55.00 as described in N.E.C.Chapter 5 In Plant $55.00 Submit 2 sets of plans with application where any of'he above apply. 5. Fees: r Not required for temporary construct'.on services. So.Enter total of above fees $ 3 �- 5%Surcharge(.05 x total fees) $ 1 N9TIQ11 Subtotal $ - Sb.Enter 25%of line Ss for PE,1MITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review II required(Sec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ -__. IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS CnMMENCED. ElTrustAccount a_ 2i $ Total balance Due I DIUSIRC9f,APP nev W", CITY OF TIGARD BUILDING INSPECTION DIVISION MST 'L,1-Hour Inspection Line: 539-4175 Business Q a:.--Fi33 71 ---- r p a_ BUP _ Dat<� Requested Y1-N- ! A 'PiUf BLD 2 Location— �>S Q k r• Suite MEC Contact Person - ,�,Clylt�� . Ph `J ��( '� �i - . PL.M Contractor Ph SWR q BUILDING Tenant/Owner _— ELC Retaining Wall — ELR Footing Access: — Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: /' * ------- Slab _.� V SIT Post&Beam ----- Ext Sheath/Shear Int Sheath/Shear T Framing -- ---— ---- — — ----- --- Insulation Dryv,311 Nailing - -__— _ ----- -- —-� Firewell / Fire Sprinkles Fire Alarm Susp'd Cei;ing Roof - Misc: -- Final PASS PART FAIL PLUMBING Post&Beam - —_ - -- - ------ , ------ Under Slab Top Out -- ----------- - -- Water Service _ Sanitary Sewer -- Rain Drains Final PASS PART FAIL rHA U Post& beam ------— — Rough In Gas Line Smoke Dampers (-15A!2 PART FAIL FTF G TR I -- -- - — .�P_fVICe _ Rough In - UG/Slab Low Voltage - - -- '"ire Alarm 4ni A PART FAIL — Backfill/Grading — Sanitary Sewer Stone Drain [ J Reinspection feQ of$ - required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call fo reinspection RE ( ]Unable to inspect-no access ADA - -- - Approach/Sidewalk Other Date Inspector _ Ext �— Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 'rER ERI'vIt CITY OF TIGAR® PL.RMMA9IT #. . P . . . .. COMMUNITY DEVELOPMENT DEPARTMENT DOT L- fL-i',3LJED: G 13125 SW Hall Blvd.Tigard,OraWon 97223e8199 (503)819-4171 PARCrA.: 2S.1040v' f I.-L'0 11 W'_- ZONING, LAJ I — LAWILDING ............. .. I.W J, ! '"'.I." 'L B PE5 E M 17-:1\1 T. . . . . . . . :w BED 1-1119 D4(I If., ISARAGL. . . . . . . . . . :484 f FL(jtREQUIRED GETBA[2KS r 'W*! L.LF1. . 31 ft RIGW . 1,,/1 f F"R 0 N T. 2'0 ft REAR. . f RE UL)I RE"D- f 91,.DKL DETELTORS. :Y V Al- I + PARKING F.')PAGES. . : I SAGKIFLOW PREVNTRS. . T1 P TRAPS. . . . . . . . . . . . . . . CATC.'J-1 BOG INI'3. . . GREASE TRAPS. . . . . OTHER FIXTURE' WWI', 11f2WI\j ftp 1 . -ll m o un t by date VIL1,11 1460- 00 JH 07/ 1, 508. 00 JH 07 16 :'30. 20 JLH N 0 40 JH 1117 1f,/'' 000 F"UNI i L) f9o. 0 L71 i H 0'T/1C, 1500. ID0 JH 07/ 1" 45. 00 JH 07/1. 11. z".5 JH 07/ 1.1 2. 25 JH 07/16 1.62'. .`,3`0 JH 07/1 6. 13 JH 0*711, "D e regula'.ie timet in the REQUIRE 11 ji-c ftnicipall Code, State ci 1--j-, r4ecialty Codes e,nd all other out/f of-Ind Insp Flrpr ! ji -Able la"i. P.: w r. 14:1 be sore in acccrddree with approved Post/beam struct Geis Li":, s P 1-'Ost/Befam Meehan I n S u lat k o 1-1 tri lorlundslab Insp Gyp Poj.o f.ns,p 14 ,.-M/Un d e t-f 1.a c r Rain d, ' r•, ;F, __.Lg c h a r 1 r-a,I I n s 1-1 Water TI e I TI S F1 V lftmb Top Out Appr./5clk" '.k. I rI t. P P M 39 .417 H In CITY OF TIGARD PL RNI 1'T tt.... . _1.. . . . COMMUNITY DEVELOPMENT DEPARTMENT DArc ISSUED- Q-7/16/913.1 13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639.4171 PARCEL: 2SI04011144SO98 ,1 1*1.:' 0I)DRES!3. . . 13348 SW ESSEX DR UBDIVISION. . . . 'iILLSHIRE ZONING: R-7 r;. . . . . . . . LCT. . . . . . . . . . . :,098 I NOMF.. . . . . E-44 NO. FIXTURE UNITS. . . : L P6i 3 OF WCNRV,. NEW DWELL I NG UN I TS. . I I yt 9.. OF' LMJE. . . . . SF NO. Of BUILDINGS: 1 1 i41_J_ V . . r 13 U S W R IMPERV SURFAC'J". F'-'O TH I 014-3L 1.4 J(Jlil\[,(–'ON INC type amolint Oy dAte r-e(-p) PRMT $ 2c: 0 JH 07/16,193 I N 13 11, $ 37�. 00 J14 oi. k,l oLLL)) REQUIRED I NESPE CTI ONG is Applicant agrees to cooply with all the rules and regulations the Unified Sewage Agency, The perrit expires IN days fros -,,e date issued. Tme Total amount paid will be forfeited if the Bit expires. The Agency does not guarantee the accuracy of tne ide sewer laterals. If the sewer is not located at the measurevent iven, the installer shall prospect 3 feet in all directicris fris -it distance qivtn, If not so located, the —taller shall purchase "Tap and Side Sewer" Persit ane t,,? Ami ,stall a )Atpvpl, I'm I tt PP 5J grl-Ai I'A 311 -75 G� � (�� tI Y OF Z IGARD » uswtt�iinNi. PLNCK RCCT N COMMUNI`lTDENE.LOPMEN'TDETARTMENT npre,Orc" nu PERMIT N YS�U—'U 31/ � --- (503)639-4»1 DATE_ ISSUED JOB ADDRESS: /334Ye' 54t) F55ex L$r- TAX MA.'/LU T -Z SUB: LL�Sf�ip—& LOT: _ �1S� LAND USE: VALUATION: OWNER SPECIAL NOTES NAME: -- � � >� v�Ui�l�c/SalJ /�vc- . REISSUE OF: — ADDRESS: __ //53S SkJ LAST REISSUE: TL-*gt--�b 7oZl FLOOD PLAIN/ PHONE: SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED 5Nr3 90-CW l NAME: _----.__-- __-_- PLANNING: S�'/l5404" -OZ ADDRESS: ENGINEERING: _ FIRE DEPT: PHONE: OTHER: T/F CONTR. BOARD #: 5:5 / to EXP DATE: ITEMS REQUIRED SUBCONTRACTORS: PLUMB: RAY -S 00)--rntr3 LIST/SUBCONTRACTORS: MECH: 6-roq 146A c'iJV Cs. BUS TAX: ARCH/ENGINEER CALCULATIONS: NAME: �L-f9I ) TRUSS DETAILS: ---- ADDRESS: _ �' ��'�tJ 3 _ -- OTHER: PHONE: PROPOSED BLDG. USE: COMMENTS: G' SHE APPLICANT S IGNATURIE Received By: Date Received: PERM I T N ACCT # DESCRIPTION AP1'IUNT AMOUNT" PD. 13AL. DUE //►� � i7/ 10--432 00 Building Permit fees SOY,��' / 10-431 00 Plumbing Permit Feesl-.5�� 10-431 01 Mechanical Permit fees 10-2.30 01 State Building Tax (5%) _3 ` � __�_ .;�5 • 71s, Building u 111umbing b'./3 Mechznical ZI ' 10-433 00 Plans Check Fee - 93- Building 4ZBuilding .33U. '2- Plumbing 2Plumbing Mechanical _ 1 S 10-230 06 Fire,5c.,9 _v 32 3: - J2 00 Sewer Connection ovT uu 2 -- 30-444 00 Sewer Inspection 25-448-02 Commercial TIF Fees 25-448-04 Industrial TIF fees 25-448-06 Institutional TIF Fees 25-448-03 Office TIF Fees 25-443-01 Residential Traffic fees �,� u 's _L31 fl—. 25-448-05 Mass Transit TIF Fees 52.-449 00 Parks Sy-'em Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg ' (SSDC) 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL r nm/3587P.WPF CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.8190 (503)d39-4171 PLUMBING PERMIT PERMIT #. . . . . . . : PI-1195-0236 639-4171 DATE ISSUED: 08/28/95 PARCEL: 2S 104CA-•09800 SITE. ADDRESS. . . : 13";48 SW ESSEX DR SUBDIVISION. . . . : HII-I.ciHIRE ZONING: R----7 PD 9LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :098 CLASS OF WORK. . :ADD "ARBAGE DISPOSALS. -MOBILE HOME SPACES. TYPE OF USE. . . . :SF WASHING MACH. . . . . . . a BACKFLOW PREVNTRS. . s1 OCCUPANCY GRP. . :F,3 FLOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . . STORIES. . . . . . . . sc WATER HEATERS. . . . . . . CATCH BASINS. . . . . . . . FIXTURES----------------- LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . : SINKS. . . . . . . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . . LAVATORIES. . . . . : OTHER FIXTURES. . . . . : . 7118/SHOWERS. . . . : SEWER LINE (ft ) . . . . IJATf7R CLOSETS. . WATER LIHr-. (f): i . . . . „ DISHWASHERS. . . . : RAIN DRAIN (ft). . . . s Remarks : Installing backflow prevention device. Owner: -------------------------------------------------------- FEES --------------- RANYA EDUPUGANTI type a1noo.1nt by date recpt 13348 SW ESSEX DR. PRMT $ 15. 00 B 08/28/95 95-269635 5PCT t 0. 75 B 08/28/95 95-269835 TIGARD OR 97223 Phone #: Contractor : ..._..._._---_-_--___-.-_------------- !)Wl,ll R - -----_---..____._____.._ Phone #: f 15. 75 TOTAL Reg #. . : 000000 -------- REQUIRED INSPECTIONS ------- This permit is issued subject to the regulations contained in the Final Inspection Tigard Municipal Code, State of pre. 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 world is suspended for more _ than 180 da,s. --------__ PermittSi na eetures , Call for inspection 639-4175 City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 13125 SAN Hall Blvd. Permit # RM J -Oz3� Tigard, OR 97223 (503) 639-4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE of 0_.ft n"" - New Single Family Residences Only ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE$195.00 Job S49 nW L- S L X ❑ 3 BATH HOUSE$225.00 Address Wal•u "- zip Fee includes all plumbing fixtures in the dwelling and the first 100 feet d h, 9 "12-2-1 of water service, sanitrry sewer and s'onn sewer. See fees below. N.-`"le-e.1 fkioe°°°' FIXTURES QTY PRICE AMT RAN JA .SCIRAM =.DL?V06AmT L Sfik 9.00 M.&V'40i°° °"""° Lavatory 9.00 Owner L,SS(.X U R Tub or Tub/Shower Comb, 9.00 CAV,mm " Shower Only 9.00 Water Closet 9.00 Nome far"'T°e1°1°"„" Dishwasher 9.00 Garbage Disposal 9.00 Occupant kiedoo Washing Machine 9.00 Floor Ora ! 9.00 C"'B11 Z'" Water Heater 9.00 Laundry Room Tray 9.00 "'"" Urinal 9.00 Lam.) N k Other Fixtures (Specify) 9.00 u80,9�°'„. "°". 9.00 Contractor S (� -- 9.00 ulrrSn. II. 9.00 Sewer 1st 100' 30.00 •i.a•4.a.a� v up s.. T..Ne Sewer•ea. Addit. 100' 2500 _ Water Service tat 109' 30.00 1 hereby acknowledge that I have read this application, that the Water Service ea. Addlt. 200' 25.00 information given is correct, that I am the owner or authorized agent of the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00 1 am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00 number given is correct. Of exempt from Stare registration, please give reason below.) Mobile Home Space 25.00 J i- Back Flow Prevention Device or Anti-Pollution Devine 9.00 Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new O addition Q alteration repair Q Catch Basin 9.00 to be done residential ® non-residential O Insp. of Exist. Plumbing 40.00/hr Existing use of Specially Requested Inspections 40.00/hr building or property Rain Drain, single family owelling 3000 Residential backflow pr?vention devices 15.00 Proposed use of building or property '(Except residential backflow prevention devices) NOTICE 'Minimum Fee $25.00 SUBTOTAL 11 PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE CONSTRUCTION OR WO,-!K IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY--IME AFTER VVORK'S COMMENCED PLAN REVIEW 25°x. OF SUBTOTAL TOTAL Seec.al Conditions Date ssued 1 by