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13345 SW GENESIS LOOP P 13345 SW Genesis �.►►i►�, i CITY OF TIGARD --- PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00376 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/20/02 SITE ADDRESS: 13345 SW GENESIS LP PARCEL: 2S103DB-05800 SUBDIViSION: GENESIS NO. 2 ZONING: R-4.5 BLOCK: LOT: 028 ,JURISDICTION: TIG CL/',SS OF WORK: ALT GARBI\GE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: Si WASHING MACH. BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRAPS: SrORIES: WATER HEATERS: CATCH B4SINS: FIXTURES _ LAUNDRY TRAYS- SF RAIN DRAINS: �T SINKS: i URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Stack flow preventer ---- ---------- - - FEE; -...-- Owner: -- - ---- --- - Type By Date Arr.ount Receipt PROVENCHER, LEO G + SUSAN C i='i�M f CTR 9/20/02 $36.25 2720'200000 TIGARD, OR 97223 13345 GENESIS LOOP 5110 I CTR 9/20/02 $2 90 27200200000 To'.al $39.15 Phone 1: Contractor: EXSTREAM LANDSCAPING 6950 SE DEARDORFT ROAD PORTLAND, OR 972'36 REQUIRED INSPECTIONS Phone 1: 503-788.7906 RP/Backflow Prtventer Rej;#: PLM 7094 This permit is issued subject to the reculations contained in the Tigard Municipal Code. Stote of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approve•-1 1F3ns. This permit will expire if work is not started within 180 days of issuance, or if work is suspended nor more than 180 days. ATTENTION: Oregon law requires you to foll, w riiles adopted by the Oregon Utility Notificaticn Centc•i. Those rules are set forth in LIAR 9b2-0001-0010 through OAR 952-0001-0080. You may ob►:jm copies of these rules or direct questions to OUNC by calling 1503; 246-1987. Issued By: ,� y Permittee Signature: Call (563) 639-4175 by 7:00 P.M. for an, inspection needed the next business day Building Fixtures Plumbing Permit Application ' ' AMA`7Datceived: Permit nth/;; ;(,.. - � Cit of Tigard - y g ermit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigord,OR 97223 0n,°//tgard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: Payment type: NTIM 1111 U 1 &2 family dwelling or accessory U Commercial/industrial 0 Multi-family U Tenant improvement U New construction U Addition/afie rat ion/replacem-•,t Ll Food service U Other: 11 SITe INFORMATION Job address: ► LJ -P r Des•:ription Qty. �ee(ea.) 'Total - --- ''Jew 1-and 2-family dnellings only: Bldg. no.: Suite no.: -- (includes 1110 ft.for tach utility connection) Tax map/tax lot/account no.: - SIR(1)bath Lot: Block: _ Subdivision: S1-R(2)bath- Project name: SFR(3)bath City/county: ZIP: Each additional bath/kitchen Description andlocation of work on premises: _ W � o� Site utilities: Catch basin/area drain - ---- ISt.dale ol'conthlctttm`insperlionl lion ---` Dwells/leach line/trench drain ' -- 1 1 Footing drain(no.lin. fl.) NG CCT Manufactured home utilities Business name: (_�l`�1 r c rt cl �,• Manholes - Address: < !SCS �, t� t f _ _ Rain drain connector _ City: tl' State: R ZIP: 9'2j36 �,tniary sever(no.lin. fi.) Phone:)��79O Fax: 7 _ 1 S E-mail: Storm Sewer(no.lin.fl.)-- -- CCB no.: Qgb Plumb.bus,tcP.no: -7tAtj Water service no.lin.fl.) City/metro lic.no.: Mixture or lien rontractor's r,presental-e signature: /, Absorption valve Back flow reventcr Print name: t ; d, i Date: -d �� Backwater valve Dasins/1avatory :Addre_s _ me: Clothes washer _ set► 1 P IA I✓�t.m r.. ( r ll'G(1G Dishwasher s: Drinking to;'ntain(s) ty: ,State: LIP:one: Fax: E-mail: Expartson tank Fixture/sewer cap Name(print): a r,-, P+ Floor drains/floor sinks/hub 5L ='�f° Garbage disposal Mailing address: / -<<I; lose Bibb City: ZIP: Ice make:- _ Phone: 6.Ac -0 tj<<I Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Rocf drain(commercial employee on the property 1 own as per ORS Chapter 447, Sink(s),basin(s),lays(s) Owner's si nature: Date: Sum Ifni 110141 K a 11 Tubs/ehower/shower pan _ Urinal _ Name: Water closet _ Address: Water heater City: State: :'ll' _ Other: -- -- Phone Fax: E-mail ota Not all urisdiction%accept credit cards, lease call jurisdiction for more information. Plan ni review fee............ ) S 1 t h 1 Notice: This permit application plan review(at_ %) S U visa U MasterCard expires if a permit is not obtained ° Credit card number: within 180 days atter it has been State surcharge. ./o)....$ e Irea --— p accepted as complete. TOTAL......................S Name of car oder as shown on credit ural Cardholder signature _ Amountj 410-4616(&UVCOMI PLUMBING PERMIT FEES: -� - PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES indlvid tai QTY ea AMOUNT (includes all p:urnbing fixtures In PRICE TOTAL Sink 16.60 the dwelling and the tirst100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection- __ One 1 bath $249.20 Tub or Tub/Shower Comb. 16.60 Two 2 bath $350,00 Shower Only 16.60 Three 3 bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16,60 __ __ - ___TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 1660 - PLEASE COMPLETE: 3„ 16.60 a° 1660 Water Heater O conversion O like kind 16.60 I Quantlt h Work Performed Cas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit Capped MFG Home New water Service 46.40 Sink MFG Home New Sar/Storm Sewer 46.40 Lavatory — Tub or Tub/Shower Hose Bibs 1660 Combination Roof Drains 1660 Shower OnlyW, Drinking Fountain 16.6n Water Closet Other Fixtures(Specify) 16.60 Urinal Dishwasher Garbage Disposal _ — Laundry Room Tray Washing Machine Floor Drain/Sink. 2' _ Sewer-1 at 100' 55.00 `- 3„ - Sewer-each additional 100' 46.40 _ 4" Water Service-1st 100' 55.00 Water Heater Water Sdrvice-each additional 200' 48,40" Other S eG)I tures _ Storm&Rai,i Drain-1 at 100' 55.00 _ Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 - -- Residential BackOow Prevention Device' 27.55 ---- - Catch Basin 16.80 Inspection of Existing Plumbing or Specially 62.50 Requested Inspections perthr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 Grease"-aps 16.60 --- ----- QUANTITi TOTAL Isometric or riser diagram Is required If Quantity Total Is >9 -- — — *SUBTOTAL ----------- __-- 8%STATE SURCHARGE --- - "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture qty total Is>9 TOTAL S "Minimum permit fee Is$72 50+8%state surcharge,except Residential Backflow Prevention Device,which Is 536.25+8%state surcharge "All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. i:\dsts\forms\plm-fees.doc 12/28/01 CITY OF TIGAR17 24-Hour BUILDING Inspection Line: (503)635-4175 MST INFLL,7ION DIVISION Business Line: (503)639-4171 ; BUP -leceived --------Date Requested _ r'v Z3 AM -- PM BUP Location ___ moi Suite _. MEC _ Contact Person _�— _ Ph ) PLM 3 7 Contractor Ph(—) _ SWR BUILDING Tenant/WbELC Footing ELC Foundation Access: Fig Drain ELR Crawl P,airl _ Slab inspection Notes: ,C SIT _ Post&Bearn Shear Anchors Ext Sheath/She, Int Sheath/Shea. Framing - Ins,dation Drywall Nailing - - Firewall -� Fire Sprinkler - -- Fire Alarm Susp'd Ceiling - - Roof G� Other: ---- — — �— Final _PASS PART FAIL - - -- - --- -- -- - -- — PLUMBIN_G Pos;& Beam Under Slab Rough-in Water Service -- - -- - -- -- Sanitary Sewer Rain Drains Catch Basin/Manho' Storm Drain - Shower Pan - -- - - — Other: PASS PART FAIL - - - __ --- -- -- _ ANICAL Post&Raflm --- Rough-In -_ Gas Line Smoke Dampers -------- Final PASS PART __FAIL --- ELECTRICAL Service - - - Hough-In UG/Slab - - Low Voltage Fire 4arm Final Reinspection fee of$ requin.,,befor,a next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ [� Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA 1 Approach/Sidewalk Dito 12JI f Inspwctor t _. Ext—_._— Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITYOF TIGARD _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00646 13125 SW Hall Blvd., Tigard, OR 97223 (503) 539-4171 DATE ISSUED: 11/6/03 PARCEL: 2S 103DB-05800 SITE ADDRESS: 13345 SW GENESIS LP SUBDIVISION: GENESIS NO. 2 ZONING: R-4.5 BLOCK: LOT: U-'"i 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/COMPRESSORS HOODS: _ FUEL TYPES _ 0 3 HP- J DOMES. INCIN: 3 15 HP: COMML. INCIN: MAX INP'1T: BTU 15 - 30 HP: REPAIR UMTS: FIPc. DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO QR FURN >=100K BTU: <= 10000 cfm: — OTHER UNITS: GAS OUTLETS: > 10000 cfm: Remarks: Replace gas funwcac. Owner: FEES PROVENCHER, LEO G + SUSAN C Description Date Amount 13345 SW GENESIS LOOP 111 c I I I I'crnu� I rr 1116/03 $72.50 TIGARD, OR 97223 I x"„ tii,ur Surchart 11/6/03 $5.80 Phor�: �n i_r.` I- i►�a Total $78.30 Contractor: COLUMBIA HEATING + COOLING INC P.O. BOX 230397 8900 SW BURNHAM#E1190 REQUIRED INSPECTIONS _ TIGARD, OR 97223 Phone: 503-614-2704 Heating Final Inspection Reg#: LIC 76359 This permit is issued subject to the regulations containers in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted In the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued By: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day INIcchanical Permit Application "—'"��— Received Mechanical ate/$Y Permit NoY)IQ7.)C)/� ,i / L City of Tigard Planting Approval Building DateB Permit No 13125 SW Hall Blvd. Plan Review - — Other Tigard,Oregon 97223 Date/By: Perrnit No Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Internet: www,ci.tigard.or.us Date/By Case No.: 24-hour Inspection Request: 503-639-4175 Contact ;,iris.: See Page 1 for Name/Method: Supplemental information. ___,____ TYPE OF WORK COMMEKC'": FEE'SCHEDULE-USE CHECKLIST New construction I LJ Demolition Mechanical permit fees•are based on the total value of the work Add Ition/alteration/re lacement Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. ;1 & 2-Family dwelling Commercial/Industrial Value: s See Page 2 for Fee Schedule Accessory Buildin I Multi-Family RESIDENTIAL E UIPMENT/SYSTEMS FEE-SCHEDULE Master Builder Other: Description tv Fee ea. Total JOB SITE INFORMATION and LOCATION Heatin Kalli �-1 Job site address: / ��3 c r�,i Furia add-on air conditionin 14.00 L�? _ �.� C c v. eat um +• 14.00 Suite : Bld ./A t.#: Duct work 14,00 Project Name: H dronic hot waters stem 14.00 Cross street/Directions to job site: Residential boiler for radiator or h dronic s y item) 14 OU Unit heaters(fuel,not electric) in wall,in-duct,sus ended,etc.) 14.00 _ Flueivent for any of above I U,UU Subdivision: 1 Lot #; Repair units 12 15 Tax map/parcel #: Other Fuel A (lances DESCRIPTION OF WORK Water heater 1000 Gas U00Gas fire lace 1000 egn a Flut venl,,watr healer/gas fireplace) 1000 _... Lo li hter as 10.00 Wood/Pellet stove 1000 - -- -- Wood fireplace/insert 1000 Chimne !liner/fluelvent —10.00 ROPERTY OWNER FrIfENANT Other: 10.00 Name: I"U Environmental Exhaust&ventilation _ Address: Range hood/other kitchen equipment 1000 �kl_a-nd.0 LO` Clothes dryer exhaust 10 00 City/State/Zip: — Single duct exhaust Phone: C,2 y yt_ ,S t_ Fay: (bathrooms,toilet compartments, WO Name: PERSON utilityrooms 6.80 Name: _ Attic/crawls ace fans 10.00 Address: other: 10.00 Fuel PI In na City/State/Zip: ••55.40 for 11rs1 4,$1.00 exec additional Phone:,��y_ Fax; Furnace,etc. T•� E-mail: Gas heat pump Wall/sus endrdunitheater •• CONTRACTOR Water heater •• Business Name; Cpf Fireplace .. Address: p � 3 Rant •• Cit /State/Z.i : ge to T Q•8--�� Clothes dr er(Sas) •• Phon:Stj3 yo Fax: o,�XW p other .. CCB Lic. #:_ 7G,�� —i Total — _ Authorized � �� / Mechu_,,1 perndt Fees* _ Signature ,tom/ Date: Subtotal. S Minimum Permit Fee S72.50 S Plan Review Feu 25%of Pr,mit Fee S _ (Please pant name State Surcharge(89;Lf P:mut Fee) S TOTAL PERMIT FEE I S Notice: This permit application expires ifs permit i,not obtained within 'Fee methodoloRv set by Tri-County Building Industry Service Board. 180 days after it has beta accepted as complete. "Site plan required for exterior A C units. 1 Dsts`•.Pennit ForrmsAtecPermiLApp doc 01 o i CITY OF TICARD 24-Hour BUILDING Inspection Line: (503)639.4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP Received _/ z L 6- Date Requested L� _ Z 3 ~ �' 'AM_ PfA -__ BUP Location _ z) `� v j Suite MEC.✓ _'� ,Silo Contact Person Ph PLM _ Contractor Ph( ) SWR BUILDING Tenant/Owner __— ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Sheer Anchors — Ext 6heath/Shear Int Sheath,'Shear �- Framing --- Insulation Drywall Nailing Firewail Fire Sprinkler - - - Fire Alarm Susp'd Ceiling - - Root Other: Final ----------- PASS PART FAIL — PLUMBING _ Post&Beam Under Slab ---- ---------._-.__ - Rough-In , Water Service -- - -- --- - ��------- - Sanitary Sewer Rain Drains ------ -L- --- Catch Basin/Manhole Storm Drain - Shower Pan Other: _ __ 77-1 Final - PASS PART FAIL MECHANICAL Post&Beam Rough-In -- -- - Gas Line 5n3aiwDampers C Fi -- IART FAIL ------ - - ----- CTRICAL Service - �- -- ------- -- Rough-In —.— -- - -- -- UG/Slab Low Voltage Firo 'Alarm Final F-1 Reinspection fee of$_._ _required before next inspection. Pay at City Hail, 13125 SW Hail Blvd. PASS PART FAIL SITE 17Please call for reinspection RE:. - Unable to inspect-no access Fire Supply Line _7 --a 7 ADA Data L `Inspector. _ ` �' Ext _.-- Approach/Sidewalk --- -- Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL