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10198 SW INEZ STREET 1 N APPLICANT - TROY SCHMIDT 10190 S.W. INEZ STREET TIGARD, OR 97224 w — E 503.519.5420 REPRESENTATIVE - UP.BAN VISIONS 2123 SE 12TH AVENUE, #2 • PORTLAND, OR 97214 CONTACT: CORBIN SHAYS 50:3.797.9567 LOCATION - 10190 SW INEZ STREET, TIGARD, OR _ - - - - _ - .— _ . . . . . _ . . - • _ - - -- -- — TAX ID - R0502325 ZONE - R-3.5 (10,000 S.F. LOTS) . __ . -- . — . — • -- . __._ . _ . — . . _ . _ . — . — . — . — , _ , — . — . _ . . � . . _ , - 1 — . — . — . . — • -- S OVERALLSITEAREA - 22,548SQ. FT. S.W. INEZ STREET PROPOSAL - STORM DRAINAGE PLAN SANITARY - EXISTING DWELLING CONNECTED TO PUBLIC SANITARY. PUBLTrSANITARY AVATLABLETO - - SERVE NEW LOT. Lu - - 232.0 - - t5.�. 105.0 STORM - EXISTING DWELLING CONNECTED D TO DRYWELL. Z -►� PROPOSED DWELLING TO UTILrZE Lux ' STORM WATER PIPE SYSTEM. I IAj • WATER - EXISTING DWELLIN TO > WATER. E `O`,�U PUBLIC WATER A�;AILAL;.E TO SERVE Q !! Yv PROPOSED LOT. t cv� In u.; HOUSE In 0% all Oo - ; F-1 GARAGE LO CNo, °� PASzCFt__� ' • 00 105.0' El 10Iq I-, "00"� hIA60 `t If c�c•x� � v I r 71200- C I - 0 20 40 80 120 SCALE INFEET r) 1 = 40. SITE PLAN URBAN VISIONS SW INEEZZ STREEI� TROY T LAND DEVELOPMENT CONSULTING TR TIGARD, OREGON 2123 5E 12th .Avenue, #2 JANUARY/ 2001 Portland, OR 97214 DRAWN RY: JOD 503.797.9567 (Phone) CHECKED BY: JOD 503.797.9568 (Fax) jeSCALE: 1"=40' urbnnv@earthlink.net (E-Mail) rI I1 _ NOTICE: IF THE PRINT OR TYPE ON ANY ( i ( Ililllllll I { rlrlr I Ill � lll ilr � l � T � r-rT �TTrr � r � � 1i iii iii il � r � i iii iii r --r- Ali rl � l ► li r�-t_ .��7. 1.1� � ' � rl_r r� r- r �� � 1t -r-l-� ._rr�. �1-_ ��.rl-� li � lli � + I ilrl � � � ,. pR�-.�....�.. ����.. .� ��_.. t IMAGE IS NOT AS CLEAR AS THIS NOTICE, I I ( f 1 1 f l 1 2 '� 0 3 4 ( I ' - 6 8 _ 11 1 �• �?()G 41 IT IS DUE TO THE QUALITY OF THE _ __ _ _ No.38 ORIGINAL DOCUMENT .� E 6Z 8Z GZ 9Z Z fiZ EZ 7 TZ 0Z 61 81 GI 8I QI #' T ET ZT tt 1 6 8 L 9 2 0Vill# I till IIII IIII IIII IIII (III�IIiI IIII IIII IIII 11.1111 .11111 1LLf �l ll1LLl 1111. 11.1! 1111 ll�l Illi. Illi IIII IIlI IIII IIII IIII :III! III! 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Lill . llll��'�� A OD cN C 7 tD N �D .r i .�f 10198 SW Inez Street CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00196 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/3/02 SITE ADDRESS: 10198 SW INEZ ST PARCEL: 2S1 11 BC-04800 SUBDIVISION: SCHMIDT MLP2000-00005 ZONING: R-3.5 BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: 400 ft Remarks: Installation of approximately 400 feet of storm sewer line, through easement on neighboring property, to daylight onto SW 103rd Ave. FEES ^ Owner: — Type By Date Amount Receipt INTERCOASTAL DEVELOPMENT GROUP PRMT CTR 6/3102 $194.20 272002.00000 PORTLANDD,, OR 97291 PO BOX 95PCT CTR 6/3/02 $15.54 272.00200000 O _`. Total $209.74 Phone 1: 503-209-8940 Contractor: DITCH MASTERS SEWERS, INC. 8965 SE DIVISION PORTLAND, OR 97266 REQUIRED INSPECTIONS Phone 1: 503-777-8289 Storm Drain Insp Reg#: LIC 132.751 Final Inspection PLM 26-444PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 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. �j�� . i Issued By I Jc / -� i' r� Permittee Signature. Call (503) 639-4175 by 7:00 P.M. for an inspection needed the ne business day Plumbing Permit Application "Datereceived: (i 8 l Permit no. City of Tigard Sewer permit no,: Building permit nn. Address: 13125 SW Hall Blvd,Tigard,OR 971.23 - ChyqfTigard Phone: (S03} 639-4171 Project/appl.no.: 7—IN Fax: (503) 5911-1960 Date issued: B.4 Reccipt no.: Land use approval: — — — -- Case file no.: ayment typ­: U I &2 family dwelling or accessory U Commercial/industrial U Multi-IU Tenant improvement New construction U Addition/al teration/rcplacernent U I.o(xj service U Other: Job address: 'Ctl , f( ) IA)" :jig Descriptio; IQt .I Fee(ea.) Total Bldg.no.: Suite nu,: — i--- New 1-and 2-fam8y dwellings only: --- (includes 100 fl.for each utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot: Block: jSubdivision: SFR(2)bath _ — -- Project name: jltk;vy SFR(3)bath City/county: '-l4 ;A) ZIP: / 7 Z Each additional bath/kitchen Description and ltxafion of workon premises: r �. Siteutilllles: /i , Cpw-I _ Catch hasin/area drain Est.date of completion/inspection: Drywells/Ieach line/trench drain Footing drain(no,lin.ft.) Manufactured home utilities Business name: L1��°-�i f✓'�yl`- _. *rC Manholes Address: Rain drain connector City: 'Y ,i.1 II State: U ' ZIP: �G Sanitary sewer(no,lin.ft.) Phone: Fax: E-mail: Storm sewer(no.lin.ft.) CCB no.. - Plumb.bus.reg.no:• -�/ } Water service(no.lin.ft.) City/metro lie.no.: -- Fixture oe Item: Absorption valve. Contractor's representative signature: Back flow preventer Print name: Date: Backwater valve Basins/lavatory Name: �� f'1 fi ------IS t Clothes washer Address: G w Dishwasher _ /�' ldt.'k S r Drinking fountain(s) City: i �7, ►/� tale:oA- 'ZIP: X 71) Ejectors/stimp Phone: /r , ' Fax: E-mail: Expansion tank�i _ Fixture/sewer cap _ Floor drains/fla�r sinks/hub Name(print): OIL' tl{?rD)A( t •'ar'I .', �L Garbage disposal — Mailing ad as: Hose bibb — _ City: �'C ro State:jl ' ZIP: ! Ice maker Phone: b6 </ Fax: E-mail: Interceptor/grease trap _ Owner instailation/residential maintenance only: The actual installation Primer(s) will be mr:dc by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own,as per ORS Chapter 447. Sink(s),basin(s),lays(_s) _ Owner's signature: Date: _ Sump Tubs/shower/shower pan Urinal Name: _ Water closet _ Address: _ Water heater City: Stare: ZIP` Other: Phone: Fax ��E-mail: Total Not art jurisdictions accept crrdit cards,please call jurisdiction fnr mom infortna6on. Notice:Tris pelma application Minimum fee...... .........$ Plan review(at �) $ O Visa U MasterCard terCard expires if a pertnit is not obtained --- Credit rnru nntnM __ --�-- — within ISO days after it has been State surcharge(RTI ....$ __ F.tpires -- accepted as complete. TOTAL .......................$ x -- Nano(cardholAa as ahowu an credit card --- S --- — Cardholder sipature Atnottnl^ 4404616(~'OM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: I �I FIXTURES (Individual) QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16 50 the dwelling and the first100 ft. QTY lea) AMOUNT Lavatory 16.60 for each utility connection _ _ One(1).bath _ $249.20 Tub r-Tub/Shower Comb. 16.60 Two�?Lbath $350.00 Shower O;ly 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 __ _ Y _._ ____ TOTAL Laundry Tray 16,60 ^ Washi Ig Machine 1660 Floor Drain/Floor Sink 2" 1660 PLEASE COMPLETE: 1660 4" 16.60 Water Healer O conversion O like 4ind 16.60 uantity b Work Performed ^� Gas piping requires a separate mechanical Fixture Type: New Moved Replacer/ Removed/ permit. _ _ _ Capps MFG Home New water Service 46.40 Sink MFG Home New San/Storm Sewer 4640 Lavatory_— Tub or Tub/Shower Hose Bibs 16.60 Combination Root Drains 1660 Shower Only Drinking Fountain — — 16.60 —� Water Closet— Other Fixtures(Specify) 18 60 Urinal Dishwasher _ _Garbage Disposal Laun&y Room Tray -- -- Washing"4achine _ Floor Drain/Sink: 2" Sewer ls1100' 5500 1 3" -- Sewer-each additional 100' 4640 4" Water Service-1 sl 100' 55.00 Water Heater — Water Service-each additional 200' 46.40 Other Fixtures _ S eci Storm&Rain Drain-1st 100' 5500 Storm&Rain Drain-eech additional 100' 46.40 Commercial Back Flow Prevention Device 4640 — Residenlial Backflow Prevention Device' 27.55 Catch Basin 16.60 — inspection of Existing Plumbing or Specially 6250 _Requested Ins ecp lions —_ I peribi, COMMENTS REGARDING ABOVE: Rain Drain.single family dwelling 65.25 Grease Traps _ 1660 — _ QUANTITY TOTAL Isometric or riser diagram Is required If __QuanIrty Total is �9 - *SUBTOTAL - 8%STATE SURCHARGE •'PLAN REVIEW 26"/6 QESUBTOTAL —_ -- - Requieedam"7 fixture qty total Is a 9 TOTAL •Mhr6num permit fee Is$12.50+B%stale surcharge,except Residential Backflow Prevention Device.which Is$36.25+6%state eurr-harge ..All New Commercial Buildings require i sets of plans with Isometric or riser diagram for plan review. 1:%dstsiformslpim-fees.doc 12/26/01 Watthingto,.County,Oregon 20U2-�63'��� 0810312002 10:13:20 AM D-E CMai 8trM21 RECORDW. =16.00110.001111.00 -Total■1132.00 GRANTOR: IIIIIIII IIII ' Gary E. Fantz VIII � IIII II I I II VIII !IIII I II II IIII Gay Fantz 2200200631230030038 I,Jerry Henson,Director of Assessment and Taxation 14530 S.W. 103rd St. and EM-0RlcloCnuntyClark forWashingtonCounty, do hereby certirythat the within Instrument of oerttlna Tigard, Oregon 97224 me received and recorded In the bogs of records of i sal*county. sOh is R.Hanson,Director e^ent and Taxation, GRANTEE: Ex-Offldo County Cur,, Troy M. Schmidt 10198 S.W. Inez St. Tigard, Oregon 97224 AFTER RECORDING RETURN TO: Troy M. Schmidt 10190 S.W. Inez St. Tigard, Oregon 97224 UN'Tll,A C'IIANGE IS REQUESTED, AI.I,TAX STATEMENTS SHALL BE SENT TO TIIP. FOLLOWING ADDRESS: No Change EASEMENT GA RY E.FANi,z and GAY FAN,rz,Grantors,hereby grant a perpetual,nonexclusive easement to TROY M. SCHMIDT, Grantee, over the real property described as follows: BEGININING ut the SW corner of Parcel 2 of Partition Plat No. 2001-068, located in the 14W 1/4 of Section 11, T.2S., R.!W., WM, City of Tigard, Washington County, Oregon; said point also being the SE corner of that tract of land described in Document No.81-015073 Washington County Deed Records;th ince,on the south line of said Tract,N89°51'00"W 228.18 feet to the east right of wa} line of SW 103' Avenue; thence, on said right of way line, NO1°53'58" E 5.00 feet to a point when measured at right angles in 5.00 feet north of said south line; thence, 5.00 feet north of and parallel with said south line,S89°51'00" E 228.18 feet to,he west line of said Parcel 2; thence on said west line, SOI°53'58" W 5.0 feet to the POINT OF BEGINNING. Said are containing 1,141 square feet more or less. (the Easement Area") as shown on the diagram on C-xh+ht-LWattached hereto. Page 1 of 1 - EASEMENT C:\DATA\Clients\55069\EmementO2.wpd 4 2002-63123 The Easement Arca is a portion of the real property owned by Grantors described as follows: Lot 20 and the Northerly 10 feet of Lot 21, TIGARDVILLE HEIGHTS, in the County of Washington and State of Oregon. The casement granted hereby is for the benefit of Grantee's real property described as follows: Parccl 2, Partition Plat 2001-68 in the City of Tiga,I, County of Washington, and State. of Oregon. The terms of the casement areas follows: I. (;rantce shall use the L'asement Arca only for purposes of installing and maintaining a storm drain consisting of approximately 300 feet of five inch drainage pipe. 2. Grantee shall, at his own cost and expense, repair and retuni the Easement Arca to its condition prior to the installation of the drainage pipe and shall take reasonable care to avoid damage to trees, root systems and other vegetation. 3. Grantee shall have no obligation for the maintenance of, care of, or other cost of ( wncrship of the Easement Arca, including real property tax assessments. 4. This casement is granted subject to all prior casements and other matters of record. The true and actual consideration for this conveyance is $10.00, receipt of which is hereby acknowledged by Grantors. IN WITNESS WHEREOF, this easement has been executed the '31 day of May, 2002. GRANTORS: GRANTEE,: Gary EVant�, Grantor oy Schmidt, antes Gav ►nt . Grantor I'aEe 2 oft - I-;ASt'N11:1NI ('\UATA\('Iients\55069'kF,asement02wpd 2002-63123 STATE OF OREGON ) ss. County of Washington ) This instrument was acknowledged before me on the 31 day of May, 2002 by GARY E. FANTZ. )._.. .... _.. OFFICIAL SEAL SHARON M.BACON 1�}� NOTARY PUBLIC-OREGON COMMISSION NO.355899 Notary Public for Oregon r'°MMI`sl°N F7fPIRES MARCH 19,201My Commission Expires: i�-_�j-Zoo c. STATE OF OREGON ) ss. County of Washington ) This instrument was acknowledged before me on the 'BI day of May,2002 by GAY FANT%.. OrFICIAL SEAL SHARON M.BACON NOTARY PUBLIC-OREGON COMMISSION NO.355899 Notary Public for Oregon *my COMMISSION LXIVES MARCH 19,2006 My Commission Expires: 3 nA�00 6 STATE OF OREGON ) ) ss. County of Washington ) J MNt This instrument was acknowledged before me on the __3_ day of May, 2002 by TROY M. SCHMIDT. OFFICIAL SEAL pY A.BLAZE Nota�t�b'fi� 4reCoAn PEG NOTARYFUBLIC-OREGON My Commission Expires: COMMISSIm N04,333520 IL 102004 NIV COMMlSS10N EMIR Page 3 of 3 -EASEMENT i i��,� .;��,,I:��•„�,,,��, „�,,, SEE 35MM ROLL# 23 FOR LARGE DOCUM- ENT i Exhibit"A" (COUNTY ROAD NC. 76D) Ili 01'53'58" E _ -- - - 5-00' S.W. 103RD AVEWE r: nZ� r ,ti F Im � p • A7 IN ' r 5.00, N.M 1 4 SIA 11 or 710AM �SNiO'llll T jS 03 nof-+etAlif0te Cnncepte Ina.%MU 40' AMWT nil . _ \ltJWrp26p0d4/-G'itR-uQLL 6a 803 604 mas CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2000-00505 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/26100 PARCEL: 2S11113C 02200 SITE ADDRESS: 10190 SW INEZ ST SUBDIVISION: TIGARDVII_LE HEIGHTS ZONING: R-3.5 BLOCK: LOT: 020 JURISDICTION: 'TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERSICOMPRESSOR$ HOODS: _FEEL TYPES_ 0 - 3 HP: DOMES. INCIN: GAS 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 _ AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installation Of Gas Fumac, Owner: FEES SCH JIIDT TROY M + SUSAN L Type By Date Amount Receipt 101 )0 SW INEZ ST PRMT CTR 12/26/00 $72.50 272000000C TIGARD. OR 97224 5PCT CTR 12126/00 $5.80 972000000C Total $78.30 Phone: Contractor: JACOBS HEATING +A/C 4474 SE MILWAUKIE AVE PORTLAND, OR 97202 REQUIRED INSPECTIONS Mechanical Insp Phone:503-234-7331 Final Inspection Reg #:LIC 1441 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance. or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in 'DAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189. Issue By: ` �s __ Permittee Signature: Call 1503 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Date received: rmit no.:�,� City of Tigard Project/appl.no.: Expire date: Address: 1312.5 SW liall Blvd,'Tigard,OR +17221 --'— Phone: (503) 639-4171 Date issued: By Receipt no.; Fax: (503) 598-1960 Case file no.: Pavment type: Land use approval: Building permit no.: ` TI 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Add i tion/al teration/replacement Other: 1 Joh address: jC < < Co 1J Indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.; I Suite no,: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Iaot: Block: Subdivision: 'See checklist for important application information and Project name: 5c h Y,--) kcA jurisdiction's fee schedule for residential permit fee. City/county: T I C1 Ck LU I ZIP: 9 l --- Description and 16dation of work on premises:_ 1t%6 I.ILLL—_ 11 F f(✓WCA CLe Fec(ea.) Total Est.date of completion/inspection: Des rlpllon c?ty. Res.only Res.only Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Ait handling unit Ct M _— Air conditioning(site plan required) _ Is existing space insulated?J Ycs U No A tcratfotr of existing I AC system _ 3oi , compressors Business name: C State boiler permit no.: Ill' '!'ons BTU/!! Address: a t 3f_ ry1t ) fire/smo edamper. ductsmo c etectors City: _7 State: ZIP: 7 Hcat pump(site plan require ) Phone:��c�3 87 (o Fax: ) - E-mail: -7nsta I/rep ace furnar sumer_ I F U/I{ ! J InchlAng ductwork/vent liner U Yes U No CCB no.: IL)t-j nsta /r^p acGre ocatcheaters-suspended, City/metro lic.no.: L,e — wall,or floor mounted Name(please rint): Z FHTods, a fiance other than furnace rat on: ion units IFT'U/11 Name: ���= l t JHr�IJ J ____ lip Address; Compressors til' Environmental exhaust an vent at on: -City: �t 1 -- Slate: Z1 P:^ ce ventPhone: Fax: (&G E-mail: haustType I7IU'r—c. itr icPha mat — - — — -- 4 hood fire suppression system _ Name: U SCl t r, +Gt Exhaust fan with single duct(hath fans) Mailing uddre—ss x r �j exhausts stcm a art rom eaten or Ac' city:-T State:011 ZIP: 9 7jj T Fuel piping an st ul on(up to 4 oulllets) Type: LF'(7 _ N(; _ _ (hl Phone: ' 1 Fax: E-mail: ucl i i.n�.e,.a.cch�h n i iteral ovCr 4 outlets — roeesspiping(schematit,req uired) _ Name: Number o!outlets _ _ — t erlisted appliance or equipment- Address: qu pment-Address: Decorative fireplace_ City: State: ZIP: Insert- type Phone: I E-mail: Woodstovelpel let stove Other: Applicant's signature: Date: of er: Name (print): Not dl jurWictions ac"M credit ctudr,,pletue call jurisdiction for more infortmtion Notice:This permit application Permit fee.....................$ _ Minimum fee................$ U Visa O MasterCard expires if a permit is not obtained Credit cord numher:_. _--� Plan review(at -_,-,- %) $ within 180 days idler it has been State surcharge(8%)....$ S Rause or cir_&,ri1Nr u shown on credit card accepted as complete. Cardholdet signature Amoum _ 440-M,17(61a(kC•OM) MECHANICAL PERMIT FLEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWEDOW O 6)0CHEDULE: TOTAL VALUATION: FEE: Description: t,I Price Total $1.00 to_$5,000.00_ Minimum fee$72.50 Table 1A Mechanical Code Oty (Ea) Amt $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or including ducts&vents 14.00 traction thereof,to and including 2) Furnace 100,000 BTU+ _ $10,000.00. including ducts&vents _ 17.40 - $10,0_01.00_to_$25,_000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 1400 I fraction thereof,to and including 4) Suspended heater,wall heater _ _ or floor mounted heater 14 00 $25,001.00_to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit $1.45 for each additional$100.00 6r 6.80 fraction thereof,to and including 6) Repair units $50,000.00. 12,15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air $1.20 for eacr additional$100.00 or For Items 7-11,see or Pump Cand _ fractiun ihereuf. `_ footroteu below. Corip* r* 7)<3HP;absorb unit ASSUMED VALUATIONS PER_A_PPLIANCE: _�l l0 100K BT(1 _ 14.00 Value Total 1 8)3-15 HP;absorb VAmours unit 100k to 500k BTU _ 25.60 Description: __ Qt al 9)15-30 HP;absorb Furnace to 100,000 BTU,Including 955 ! unit.5-'I mil BTU - 35,00 ducts&vents Furnace> 100,000 BTU Including 1,170 I unit 301.7 mil absorb unit 1-1.75 mil BTU 52.20 ducts&vents 11)>50HP:absorb Floor furnace Including vent y55 _ unit>1.75 mil BTU _ 87.20 Suspended heater,wall heater or 955 12)Air handling unit to 10.000 CFM floor mounted heater 10.00 _ Vent not Included In applicance 445 13)Air handling unit 10,000 CFM+ ermit 17.20 _ Repair units _i 805 14)Non-portable evaporate cooler <3 hp;absorb.unit, 955 1000 to 100k BTU -- - 15)Vent fan connected to a single duct 3-15 hp;absorb.unit, 1,700 6.80 _ 101k to 500k BTU --- 16)Ventilation system not Includad in 15-30 hp;absor5.unit,501k to I 2,310 appliance permit 10.00 mil.BTU - 30.50 hp;absorb.unit, 3,400 1,')Hood served by mechanical exhaust 0.00 1-1.75 mil.BTU _ _ _ >50 hp;absorb.unit, 5,725 18)Domestic Incinerators 17 '0 >1.75 mil.BTU _19)Co - Air handling unit to 10,000 cfm 656 mmerclal or Industrial type incinerator yp69.95 Air handling unit>10,000 cfm 1,170 _ - Non-portable evaporate cooler 656 20)Other units,including wood stoves 10.00 Vent fan connected to a single duct 44 21)Gas p6 -ip-ing--one- ---5----- to four outlets Vent system not included In 656 _ 540 _ a Iianq�_permit 22)More than 4-per outlet(each) Hood served by mechanical exhaust 656 1.00 Uomestic Incinerator 1 170 Minimum Permit Fee$72.50 SUBTOTAL: a Commercial or Industrial incinerator _ _4,590 Other unit,including wood stoves, 656 y - 8%State Surcharge E inserts,etc. _Gas piping 1-4 outlets _ 360 T - 25%Plan Review Fee(of suhtotal) $ Each additional outlet 63 _ Required for ALL commercial permits only TOTAL COMMERCIAL -$ _ TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: Other Inspections and Fees: 1 Inspections outside of normal business hours(minimum charge-two hours) $72 50 per hour 2 Inspections for which no fee is specifically indicated (minimum cnarge-hall tour) $72 50 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum charge-one-half hour)$72 50 per hour State Contractor Boller Certification required for units>200k BTU. "Residential AJC requires site plan showing placement of unit. I:\dsts\formsUnech-fees.doc 10/11/00 CITY OF TIGARD 24-Hour BW DING Inspection Line: (503)639-4175 MST _ �'©U' 1Z INSPECTION DIVISION Business Line: (503)639-4171 BUP Received __ _.__ Date Requested AM_._______— PM_.______ BUP Location ___�/ C / z q _ _Suite ---__. MEC Contact Person ' ;_ 4 1:`__ Ph( ) ___ —__ PLM Contractor Ph(—) _ SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT — —_ Post& Ream Sriear Anchors - —__� - --'---- ---_---- Ext Sheath/Shear Int Sheath/Shear Framing --..__�- --- - --- ------ -------- Insulation Drywall Nailing - — ---- -- -- - - — ------- - _-------- -- ---Firewall Fire Sprinkler -------- --- -. -- - -- - - - -�._------ -- --- ----- -- hire Alarm Susp'd Ceiling ---- -- --- - --. ,_-— --- --- Roof Other: _ - - - --- — Final — PASS PART FAIL _ -----�----- --------- -- ---- — --__--�__. PLUMBING Post R Beam Under Slab - ---- - - - -- — - Hough-In Water Service -- ------ _-_ -- Sanitary Sewer Rain Drains ------- - - - -- - - --- -- --- -- r— - -- Catch Basin/Manhole Sto-m Drain ----- -- - ---- — ------ -- �— - --..—_. .------- Shower Pen Other: er: 5HANICAIIL PAflFAIL -- -- Post& Beam Rough-In - - -- - - - - ------- Gas Line lSmoke Dampers ---- --- - - I Final PASS PART FAIL --- - - - - ---- - --- ELECTRICAL - ------------------ Service Rough-In UG/Slab - -- -- -�- Low Voltage Fire Alarm Final [j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ L] Please call for reinspection RE: Unable to inspect-no accoss Fire Supply Line ADA Approach/Sidewalk Date_ 7 Inspector _-__� Ext Other Final DO OT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIG•ARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST '�221 ._ BUP _ Received _.__ Date Requested?— AM— __ PM_ — BUP _— Location 60 -- Suite — MEC ----- Contact Person —__ Ph(_ ) . ��� __. PLM Contractor -_ _ Ph( _ ) _ — SWR BUILDING _ TenandOwner ........ —, __,�_� _ — ELC Footing .^ ELC Foundation -- --- - - -- Ft ACC@SS: g Drain l� P dv'7 �'T� /1� �lrl ELR - - — - Crawl Drain Slab Inspection Notes: SIT Post& Beam Shear Anchors ---- --- - Ext Sheath/Shear Int Sheath/Shear Framing --- --- ---- - - ------ ---- ----- Insulation Drywall Nailing - ----.-. -------- . -. Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- ---- ---- -- -- Roof Other Final ---- PASS PART FAIL ----- _PLUMBING _ .._--------------- Post&Beam --- - �� - Under Slab ---- - - Rough-In Water Service - -- ------_ ._._-- -- — Sanitary Sewer Rain Drains ----- - --- - -- Catch Basin/Manhole Storm Drain - --- _-----__- -__ --__ Shower Pan other, ------ - - -- --- - -�_._ - - - Final - PASS PART FAIL_ MECHANICAL Post& Beam- -_ Rough-in Gas Line -- Smoke Dampers Firial PASS PAP.T FAIL ----- - --- -- ------- -- ----- -- ----- - E --- Service Rough-In _ UG/Slab Low Voltage Firg Alarm - -- - -- - -----__- rPA J.PART FAILReinspection fee of$ - _ - reauired bofore next inspection. Pay at City Hall, 13125 SW Hall Blvd. Cl Please call for reinspection RE: --V-_._- l__.l Unable to inspect-no access I ii e Supply Line ADA 2 Approach/Sidewalk Data_ �.1 �� Inspector _- - Ext Other: Final - DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST ZG�G/fJ INSPECTION DIVISION Business Line: (503)639-4171 BUP — Received _..__Date Requested�-- '-U 77� AM_ PM BUP Location _—Ln e Z 5f" ______, Suite__�___. MEC � Contact Person . —_— Ph( _._) _ PLM Contractor _ __. Ph( ) SWR LIIEDi� Tenant/Owner .—_ ELC Footing Foundation ELC Ftq Drain Access: ELR Crawl Drain -- Slab Inspection Notes: SIT Post&Beam Shear Anchors ~- Fxt Sheath/Shear Int Sheath/Sheaf Framing Ir-,sulation Drywall Naif ng --------------- r=firewall ---- ---� Fire Sprinkler ----_.. __-_- .-- -------- ---- Fire Alarm Susp'd Ceiling ----- -------- ----- - --- Roof Other: - PART FAIL - ------ ------ -- - --- --- BING__ _ Post& Beam UnderSlab ----_-- -. _-------- --___-_- _. _.__ ---------__---- Rough-In Water Service ---- - ------- --- --- _ _- - -- - ------ Sanitary Sewer Rain Drains --------- ------ --_ _ _ __ Catch Basin/Manhole Storm Drain -- Shower Pan Other- Final ther Final -- ---- — ------ - PASS PART FAIL - ------ Post& Beam -- Rough-In Gas line Spjoke Dampers ----- -- -- (Fitial_- TLECTPART FAIL1i - - - IR, ICAL Service Rough-In _ UG/Slab ----------- Low VoltageA-_.----- Fire Alarm Final L] Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE L] Please call for reinspection RE:_ ___--_-_ _ -__ �� Unable to inspect- no access Fire Supply Line _ ' ADA Approach/Sidewalk Date_! �__ -_ _ Inspector _ _ ---- _ _- - ---Ext - Other; Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL ` CITY ITY O F T I G A R D _ MASTER PERMIT \l DEVELOPMENT SERVICES DATE ES UIED: 2/8 0200 000la 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: '10198 SW INEZ ST PARCEL: 2S111BC-04800 SUBDIVISIO!' Qr' ;,`.",DT MLP2000-00005 ZONING: R-3.5 BLVv_ • LOT: 002 JURISDICTION: TIG REMARKS: S/F Path 1 BUILDING REISSUE. STORIES: FLOOR AREAS kFQUIkED SETBACKS REQUIRED CLASS OF WORK. NEW HEIGHT. 2a FIRST: t°41 sf BASEMENT. $l I FFT: 1; SMOKE DETECTORS v TYPE OF USE S1 FLOOR LOAD. au SECOND, 1.65.1 sf GARAGE: 734 sl FRONT: 4r, PARK-NG SPACES TYPE OF CONST: 'Al DWELLING UNITS: I FINBSMENT: sf RIGHT. 14 OCCUPANCY GRP: k BURM: a BATH. 7 TOTAL: f 195 VALUE: S 308,403 20 uo sl REAR: 15 PLUMBING SINKS: I WATER CI.OSETS: J WASHING MACH: I I nUNDRY TRAYS 1 RAIN DRAIN: ul(' TRAPS LAVATORIES DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES. ILq SF RAIN DRAINS: I CATCH BASINS: T UB;SHOWERS. _I GARBAGE DISP: I WATER HEATERS 1 WATER LINES 100 BCKFLW PREVNTR i GREASE TRAPS' MECHANICAL OTHER FIXTURES. FUEL TYPES FURN<TOOK. BOIL.'CMP<3HP. VENT FANS- 5 CLOTHES DRYER. 1 - FURN><100K. 1 UNIT HEATERS HOODS, 1 OTHER UNITS. 1 MAX INP. blu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OL:TLETS. 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADU'L C:SPECTIONS 1000 SF OR LESS: 1 O 200 amp: 1 0 200 amp I WISVC OR FDR: I PUMPIIRRIGATION' PER INSPECTION: EA ADD'L 500SF C 201 400 amp: 201 400 amp: 1s1WIO SVCIFDR: 1Ir SIGNIOLIT LIN LT. PER HOUR LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIR. SIGNALIPANEL: IN PLANT: MANU HWSVCIFDR 601 • 1000 amp: 601-amps-1000v MINOR LABEL. 1000•amplvolt: Reronnrcl only: PLAN REVIEW SECTION ­4 RES UNITS SVC/FDR> 225 A.: >600 V NOMINAL. CLS;,REA'SPC OCC. ..__._• ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO&STEREO. FIRE ALARM. INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM.: OTH: BOILER: I4VAC LANDSCAPE'S,RIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL: OTHR HVAC: DATAJTEI_F COMM NURSE CALLS. TOTAL.III SYSTEMS Owner: Contractor: TOTAL FEES: $ 8,419.83 INTERCOASTAL DEVELOPMENT GROUP JLS This permit is subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and PO BOX 917200 NW CORRIDOR CT.#110 all other applicable laws. All Hork will be done in PORTLANDD., O OR 97291 BEAVERTON,OR 97006 accordance with approved plans This permit will exptre if work is not stat led wi;nin 180 days of issuance,or if the work is suspenc 1(r,or more than 180 days. ATTENTION Phone. Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Certer Those rules are set Rey 0: TIC 1194~ 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, Post/Beam Mechanica Mechanical Insp Exterior Sheathing Inst Gyp Board Insp Mechanical Final Sewer Inspection Underfloor insulation Plumb Top Out Low Volt2ge Rain drain Insp Plumb Final Footing Insp Crawl Drain!Backwater Electrical Service Gas Line Insp Water Line Insp Final inspection Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Fireplace ApprlSdwlk I:,sp Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp `-lectrical'Final t,z Issued By: ,1L)L 4 L , 1( �� Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day SEWER CONNECTION PERMIT CITY OF TIGARD _ DEVELOPMENT SERVICES PERMIT#: SWR2002 00011 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 2/8/02 SITE ADDRESS; 10198 SW INEZ ST PARCEL: 2S111BC-04800 SUBDIVISION: SCHMIDT MLP2000-00005 ZONING: R-3.5 BLOCK:_ LOT: 002 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF residence. Owner: INTERCOASTAL DEVELOPMENT GROUP FEES PO BOX 91 185 Type By Date Amount Receipt PORTLAND, OR 97291 PRMT CTR 2/8/02 $2,300.00 27200200000 INSP CTR 2/8/02 $35.00 27200200000 Phone: 503-209-8940 Total $2,335.00 Contractor: Phone: Rei#t: Required Inspections 1 his 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 be forfeited if the permit expires. The Agency does not g jarantee the ac(;Tracy of the side sewer laterals. If the sewer is not located ac the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If riot so located, the installer shall purchase a "Tap and Side Sewer" Perm Issuc i by: �2li CZ-t-« !-'C., Purmittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Permit Application ,. Tigard �� Datereceived: City of � Address: 13125 SW Ifall Blvd,Tigard,OR 97223 Project/appl.no.: Expiredate: City of l'i!rard Phone: (503) 639-4171 Date issued: By: I fteceiptno.: Fax: (503) 599-1960s Case fife no.: Payment type: Land use approval: _ f�1�'C� r.(. 1&2 family:Simple Complex: elm W ottilli 111111c 4 U I & 2 family dwelling or accessory U O' mmicicial/indusuial U Multi-family XNew construction U Demolition U Addition/tilteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: Job addles" L,t �' - -r Bldg.no.: Suric no.. Lot: Block: Subdivision: i(t,}� �_�,1r ,, ,` Tax map/taxIollaccountno.: 4Slfl Project name: Description and location of work on prtimises/special conditions: l t " _ i t r., 1112 111IRS (�T;riling address:% �7' 1 & 2 family dwelling: O City: _• State rt,_ 7.11':c" Valuation of work...... �.0.�...�....... $ �ZL. Phone:.' x tax: :-mall: No.of bedrooms/baths................................. 7 a, Owner's r:presentativcF- - -1— 'Total number of floors.........................•.•..... _ Phone: f' - ax: I?-t ail: Ncw dwelling arca(sq.ft. — Garage/cmport area(sq.ft.)......................... Name: L C'ovemd porch area(sq. ff.) ......................... --- _ - - Deck area(sq.ft.) Mailing address: ........................................ - 011ier slnicture area(s ft.)............... .. City: _ State: ZIP: y. ....... ...— Phone: 17ax: E-mail: CommercInI/Ind ustrial/multi-famlly: Vaivat;on of work.............................. ........ $ _ Existing Ndg.area(sq. ft.) ............. ........... Business name: L ( , New bldg.ar!a(sq.ft.) -- Numbrr of stories.............•...... ................ — City: State: ZIP: Type of construction ........... ......... Phone:' ' - Fax ; < 1 I mail: Orcupanry group("): Eixt 'Neng: CCB no.: w: _ City/metro tic.no.: - Notice:All cmitractom and subcontractors are required to be lu 11 X3 Mm licensed with the Oregon Construction Contractors Board under provisions of OKS 701 and may he re•qu,red to he licensed in flit, Address: jurisdiction where work is being performed. 11"the applicant is ('ply � Slat E. ZIP` exempt front licensing,the following reason applies: Conlact person. )" Plan no.:, ' ---- - --- ----- Phon . * I t-t Name: t Contact person: tFees doe upon application ............ .............. R Address: I)ate received: —T City• 1 State• Z.IP:c Amount received .......... R --- I'lu,n �J Fa ... c:lr snail �� Please retcr to fee schedule. ^ I hereby certify I have read and examined this application and the Noi all jurisdictions accept credit cards,please call jurisdtcaon rex orae information attached checklist. AN pnwisionS>!rI laws and ordinances govenfing this U visa U Masier('ard work will he complied with r I specified herein or notq+,l credit card mnnlwf I:spites Authori/ed signature: Date: _ — - `c _ . Narne nr cnrdholrkt as shown un audit crudPrint name: Ctudholder signature T—i Amount Notice: This pennit appli ation expires if a pernii(is not obtained within 180 days alter it has been accepted as complete. a.a).u,�t i(AW t Al,„ One- and Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: City ,,/"/'igard City of Tigard U Electrical U Plumbing U Mechanical Address: 13125 SW Ifall Blvd,Tigard,OR 9722:3 UOther: Phone: (503) 639-4171 I'ax: (503) 598-1960 11-11F I 01110WING ITFNIS ARE 111FQ111111111 FOR PLAN REVIEW I es No N/A I hand use actions completed.tier luri.;diction criteria for concurrent review~. 2 ?,oning.I'I .d 14.11 n,solar balance points,seisrnic soils designation,historic district.rr - - - 3 Verification of approved plat/lot. 4 Fire district________.approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water district approval. -- -- 8 Solis report. Must carry original applicable stamp and signature on file or with application. _ 9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable final and state building codes. Lateral design details and connections must he incorporated into the plans or on it separate full-she sheet attached to the plans Willi cross references hetween plan location and details. Plan review cannot he completed if copylight violations exist. I I Site/plot plan drawn to scale.The plan must show Iot and huildine sethack dimensions;property comer elevations I ii rheic is more than a 4.11.elevation differential,plan must show contour lines at 2-11.intervals);location of easenxnts and driveway;footprint of structure(including decks);location of wells/septic systems;utility locatiorm direction indicator;lot _ area;building cov :age area;percentage ofcovcragc;impervious area;existing structures on site;and suri'ace drainage. 12 Foundation plan.Show diinensions.anchor bolts•any hold-downs and reinforcing pads,connection details, vent site and fixation. 13 Floor plans.Show all dimensions,room identiIll cat ion,window size,location of smoke detectors,water ,henter, furnace, ventilation tans,plumbing lixhacs,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-ntemht-l-sizes find spacing such as floor learns,headers,joists,sub-floor, Willi construction,roof construction. More than .nae cross section may he required to clearly pettray construction.Show details of all wall and root sheathing,riding,rxol'slope,ceiling height,siding nruerial,footingsand foundation,stairs. fireplace construction, (hernial insulation,etc. 15 Elevation views. Prcv.le elevations for new construction;minimum of two elevations for additions and remodels. li�.tru for elevations mus!reflect the actual grade if the change in grade is greater than four fool;u building u.Vclopc. Full-size sheet addendunts showing foundation elevations with cross references are acceptable. 10 Wall bracing(prescriptive path)andlor lateral analysis plans.Must indicate details and locations;for _nun-prescrptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,sp and hearing locations.Show attic ventilation. 118 Basement and retaining walls.Provide cross sections and details showing placement of rebar. N.. ngineered _ systems,see item 22,"Frigineer's calculations." 19 Ream calculations. Provide two sets of calculations using current code design values for all beams and mulliple.joists over 10 Iect long and/or any bearu/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance.Identify life prescriptive path or provide calculations. A gas-piping schematic is required I'm four or more appliances. 22 Engineer's calculallons.When required or provided.(i.e..shear wall,roof tiussl shall he stamped by an engineer or AIL hrlert hcenu•d un t)regon and.shall he'hown to he applit rhic r��III,- .�r(qc,r under review. ?; hive(5)site plans arc required for Ilent I I i1buve. Site plans must be 8-1/2"x 11 or I I"x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tale-ons. 26 No rolled,reversed or mirrored building plans will be accepted. - 27 �8 — - Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink Red ink is reserved for department use only. U).444 rrolm'oSt, FROM ROSS ELECTRIC PHONE NO. 5036422800 Aug. 07 2001. 08:37AM P2 i±;lectrical Permit Ap tication batereGelvetd: itirmltno, , / City of Tigard 1�)«u. Lno e.pUedau: Address: 13125 SW)fall Rlvd,119affl,Ctk 97271 thaleututd' Dy LReoaptne.: Phonn (50,1)639.4171 Cole file no, Pe5'moat lypc. I'ex:(im))YA•i960 Land use nppluvnl U 14k�.family dwelling or att'esMtry U Cornl1wrc1a induetrist 0 Multifamily U Teastt Improvernent ew oomlrticuon U Addltii,valt n rat U Other: _ _ (]Partial job sddmis:—, 'Ll i' ��( T 1 r` ' %fib "O.: Suits no. _Tar mep/tex lodaccowt Do.: f L .�� L - - 4oG--3Z- Rlnck: Subdivision, ...-� r- t _Y''y - -• - -~�----• P eet name; _ 17esoti tiw_t .J location of work on nnnioes: 6atlraserd date of cxtm ruoo/ins ' 'on: 44 t 'C !ee Mia IoM Not _. .— Ds 61 a Btpdnegs name: 5S ;c, IVaw dal• ear !Nr Address:?;3 RK r: _D r-'01Lrs— fu— Slat04 �7:IP: dwet7ty,lalt6oltelasl.aadsnl'r.la y 4 i Mot la! phone Inos_ltroof •� q�s. � j CC' no.: Elt'e: hew.tic,no: r Llmlledatejly,rs.waa;al --- - llnriledme 6Y.non•rnldenllal ._-. _•_ Cit ! tic.nv.: (�-- ----- f. h 0Iclurelhomecxl u vrctltna �1 -y 7 _l. �iUul) --- Date -_� oervtceavacrfeedv - t f tnQatvi.in electilclae(rctp_ - rwori; su .dere neem ): !e f)`�;, licaese o ao� aaeratlmalreleeMler" 100 Ynps of M _ 2 ..��100 sepe ►Jame(�t1nt)��-r C SOt urge m s00 atter - 2 -- Maflin addte+a: _ 601. so I�irnpi ucte�j ZIF• L... C' te0e or votu ' ' � •alt: &retail: -R«ettnectt� I trwn �"�erae�i a feerlgn C)wner Inmtllation: ftu I-11,tUon i.being made eft pry Y �a11Mka aWraebe,arrslentlem � f which tg not intended f(tr gala Ict)s A' 1111,or exchange a ding to 2 NM unp.u less ORS 447.455.419,1510-7 - •__ • ; ,1001 s-m-L-te ---- UN s Nre: / UstC: to m i tlruUb der t eew,■ ntsatsetsl.t Farpesb t i_pae for k t.neb dreune with purclusc of Nemo' — _ 4Addresll: > footer fee Beth bemdl mit+�� A Fe -i inchdmsit-awv�i p�L�r Lofrervia:afoo*ilia,fimut khcimzitfx: tom' &11ch Ctkle •ate R t eatfiwh r r rrtf Wee dmkaorecTldanps Winerrdsl -�.Tdkr mert20ereps•WOO1 of 1 s1 1et rat:Ylydnelllnst 0 Roildlnlover 10A0(1 arefeetinscr e 2 q gys"over C00 valts noyilnrJ nwee rc.ldoolial Unite( me evuClr,"e alfa WM.or nrrgNlUn f]Aulldlnloverthmt1l"e1 7Petden.40AOno or Or M •Det'> W 0 0,1pul IUad over o9 pertnn= 0 htamrfe,wrot aeUanrr Of RV pin) r �.,�.��don��r �e oe over tM a bl^my 61='29;v-n (3 F4tsu�ltehtlrytplut (Bleu: Porn '1�-- Sabenk—+eta of plea"Uh a.ry of the lmwd tion fes_ 'alts entre et'atnot bis to lent try tial sstnkx. i7�' Y - . - — Potmttfse.....................f G on lairsetlors�emir pb.,d�1) „-'��,,I expioa:ifs pemt i eppll;etian plall review(at -_%) - 0 v1.a O MasterCnd expitsa ifs pemtit b not u ti beend Stak sturchaege(11%) wkhin 160 days after It Fuu been "C"d u oomplek. TWAL...... -.......S -�. — �_ N.a.t Daae a awn atwl to sv C `' 2 . .... .........................................I................ . nus-7-2001 07:09rl FROlI:EDWARD M ILLEN PLUMBI 503 626 4633 TOt5035334306 P11/1 lr4V. tl YJ.L &U.II FAX P. 2 Plumbing Permft Ap lication Date recei+edr Permit no.: City of Tigard Sewer pelluil no.: Addre : 11125 SW Hall Dlvd.'flgnrd.0 97123 -- - BvIldlnppormUno.; Carrq/7/purd PMmc: 001)619.4171 11fo/ec1/appl.m: — tinptrodate: Fnx: (503) 598.1960 Dateimetl By. Rerelptno.; Land use.approval came file nu.: Payment": U I ate 2!eerily dwelling or accesitory U CommerclIndosWal U Muld-fandly OI Tenam Improvement lew caastrvLyltnl q/`ddltlorJal ratlnnlreplacement U RAM service O 011rar: Job addrooa: � Derrett tionFildFee ea. A'otal Tax no.: Suite no.: OmNdes dtm fl.fbreallitycoaardtoo) Taut mapJUu hn/munral hu.: 1 SFJ[ 1)bath :21: r Block: I.Subdivision: SFR slit' 1'tvJectmm�e: g --- (l) a& –+– CI1 lcount�:_ 71[' 9thaddiilue a ie eu brtlrcriplit In u lucalJantrek on Inrmiaea: -- nowtinti u _ _ a r�+r`>� _ Catch hasin/sies drain _ list."d date of n Ietion/inspecllon rywe–ii�eecii IL cit drain UNINIHIMOMMI" in. B_r>rirtesa name: 1 Panholes �enufacture me util es � — ACdress: i �. _ n d_naain connecwr State;bK ZIl'. /- $enT� sewerao_IIn.l�.) --- Pbme:(e� _ Pax: - &mall; 5hirmsewer(no.lin.TT CCB no.! r?a numb.bus.a8,no; eter errv:co Oh /nicau Le.no.: 15 4Sxtrnre or item[ z"�- —� "- Abulor time valve Oontracttx's m.preseotative slartel m: Pau ,7 law vomer TW flint name: L1e►e: O Backwater valve W calm prail Nome: Clcenwau � - -- At dmX a: L)13hwmher n J_onta n s Zip: n� u -""—" Phnne: Nas: f3 malL Upal M1 Uu-i cT----- - - • tt,orr sewer cap Nramc(print): i a -�7yK ttTninn Iota ei m t - Wdling nddteatl: fir; 121_�� I - -► ''- Unnrtntge s os--- -- �m b (J��i _ State•/' 7.1i. _=.1 _ Ptone -t f°ax: &mail: nterce or grease trap — O,vner InstallaicWrrsidentlal rain intoe only:lite act u imlalletltxt mer(s) -" will be trade by me or tits::_'et alnd repair made 11 my regaalra o f rain(cornmerr n) eerpioym to Or prvlrtat (lrspi r 447. i O wner's situres -_ _ Uat� -sum -.- ru-116111sholve ower pan _ Ntunc: uTn—ar—� A ddrw -----.—.— attx weler State: Phone: Fstt_— R mall: of al rart-0k—ip dine crap r.aI scab.Mew.eau 1.avantm ft ma+ htinimurn rex.................S . --- Notice:Tbia permit application — t]111e ❑MtrterGud Plan review(at %) t`rdh sad mn6e.: __.._ express it a permit is nm obtained State sumharse(8%)....1 ----- ti wfUain IBl►days eller it hu been —-- ane e w i�r n snaeptal a complete I(rl Ah......................f --- _ 44D 4616(6KVLVM1 By: Advanced Heating; 503 774 4391 ; Aug-7.01 "':"ti A'"; page 2,2 Hecolvod: d/ 1/01 A:01 AM; •> nuva nc eo Meatiny, F1ug. 01 02 07t UGa p• ' U(t!Otl/UI 110N 1R• lB FAX BU3 BUS IQBO CITY OF 1IGARD coz Mechx1ftd Permit Application /y /� _ .. . __�•...�... arirttoalvatt. Primtl�o: )1 /� a ,+ t'of IU&d rtolsau�pPl.00.. 9.ptreaKu city of11pord Addmu: 11123 SW Hdl Blvd,Tigud,OA 911x3 --- Phoaw (703)6394171 Decebrtrerl: Dr - Recvarptno,: Au: Nil)1".1960 C4"Die Co.: pryn,M�Y — Und use appmval: �� _ _ 8u11dlllRprarrgttnv. L3.1 Ik 2 family dwelbap rN acceerory :](;onun>rcirl/trdulutrl U mad-(Wady .1 (ctlaar ttnptvvenlenl New ooasuumloo J AddlttjnddmMlodtapiwA=ut O Other. - - Jab idd'°n_'_�GJ.�S�. i_A l t� 5 lrtdicak egtdprneot yutAtJtlm In bmte.Wow lnd c"+'e dwiRr )!ld ,re. �I sui z ao.; vdue Of all nw-hrnirml mWArIalr,rxlwpnUmt,Irhor,overitmad, 1'ytMWtax IOt WUMMt no, � .'X t ��.... prone vatm S Lot glacJc _ Sclbdlvtrtoo./.ILL?. .8m diwWLll for iMP01'ant epptiWiou Irabnzation tuul �PM)Mtmob: �--� IUlrlhrllott'r Me tt&uduir fbr midengal pumit fee, Laity/eowtt �ul : ._ Uulctiptitm and atlwork On pmmum: na r fte(oo;.) Tow _&t,dale of ledouAmpa•tl Qu. ■a Ree Terror impmvement or CbWW of use: Ak pYldlla ualt ,g ( 4 1 `� qL 11 eldadng rprcel hllaeed or ounditloaed t U Ye U No nT Ito r r u ""' - L eR[>airtg trpett InwlntM7 V Yet O r7p -XTtirti'oe rt c f rlrr,e,t - &1lfgTtvttiprecede Elvalnear name! Trace ballr perout ao. _ �dll�1_i�.�'D_... ING, _ . F{p Toru l3TU/f{ Add mrl )hone1�� __l ;.I��y��L�'mt1L _ nr lrrep e n -•)f,r'0A CCIi po, indadlodr6 A*wt/ved liner Q Yee U No OFT And— ~._ _.Qip>�2.�._. _.,_ ____..... 11>,r�lViep aur r�rw• eulNer+-and; - Citlleaatru he nr, -.tl,or floor veeuave Nanlc( none Intl:0711 Irp, + rIi i+oo ir"a"�urnaoa _ r- . 4M Ablorytloouhlu_ _ 6Ti It Nkme: Chiller_ T• kp Red yeanksIMMI city: _—. it" ZU' Uebtavurt llcooe: 1°aA. E Ma. pe u k3c�i ,.r�tul �_f hood Qu rumvenstoli 17rurn —1 6Utwct fwu«Im I dw jbilb har) marrmostim(up to 4 City t L�1 �-la_ n ZIF' T Lpo NJ ou � 1-It( l7totk::x r c n,t: E.tnatl: Tj" -- no anr ova �e1jul"—� q.im Nv!' tl�lD. �e�Il _ tvturbesol.ulteu _ I Addrase Sf__f [hG��trannatare ( /� (�-p ft A pllcvtt'c 11 Oure �- Dee: NwW(print) F4r,nit Orb _,•,�_ Na,.►.wr..+..�,..o�..s.N.....wwvwrTbe,..��...rw Netlte:ll��,rprvmit.pQ+Uortlan ,._..� O vin a memoK r t er ltn I t e Deemer to ec+ut teuled Minimtun The............... S _ CMera"ft'AA., ........... _ / � Plea rtvlrvv(rt ql,) : �..�r� %kithln 110 drys atter it has hetet State.lrrrtwRe ) 1 �rTfeilialirt Y 1�+�v.w rcerrtn4 w coot'la<• �_.. 3 rui'A L $ ----- i cJ LA LA Ikl m k CV- 71 IP B• - _ i i' 1 i Ln t n i 0; a � JYI r,o 6 c `t pQ0 F-' O 1� 1