11330 SW IRONWOOD LOOP J
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11330 SW IRONWOOD 1.11
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CITY OF TIGARD PLUMBING PERMIT
PLM{ DEVELOPMENT SERVICES PERMIT#: 8/8/00
/8/0 000-00291
DATE ISSUED: 8l8/00
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 1 S134AB-01000
SITE ADDRESS: 11330 SW IRONVVOOD LP
SUBDIVISION: ENGLEWOOD ZONING: TI 5
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT GARBA%. I ')'SPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: FLOOR DRAIN:. TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WAT`rI CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Inslailation of backflow prevention device. No electrical permit required for controller. _
_ FEE'S__
Owner: Type By Date Amount Receipt
SIMNITI , N KNOL + ANGELA S .1PRMT RCP 8/8100 $25.00
11330 SW IRONWOOD LOOP 5PCT RCP 8/8/00 $2.00
TIGARD, OR 97223 -- 71
Phone
Total $27.00
Phone 1:
Contractor:
REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone 1:
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. A!I work will be d )ne 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 follov& rules adopted by the Oregon Utility
Notification Ce,iter. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-008C.
You may nhf3ln copies of these rules or direct questions to OUNC by calling (503) 246-1987.
(/ 'LL
Permittee Signature:
Issued By: ----------��-�-- --— — �- -. 11 '. 1 v►...-�,�.L��L .
Call (563) 639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF'TIGARD Plumbing Permit Application Plan Check
13125 SW HALL BLVD. Commercial and Residential /' Rec'd By —_
TIGARD, OR 97223 i' \�17/ Date Recd
(503) 639-4171 /// Date to F.E. `—
Print or Type Date to DST
Incomplete or illegible applications will not he accepted Permit#__ ^_
Related SVvR#
Called— _
Name of Developrent/Project — FIXTURES (individual) -- QTY PRICE AMT
Job Sink — 1150
Address -Address Suite Lavatory 11.50
_
—
Tub or Tub/Shower Comb. 11.50
Fld >k City/Stale Zip Shower Only 11.50
_-"-— --� - -- Water Closet 1
Name 1.50
i Urinal 11.50
Owner Mailing Address Suite Dishwasher 11.50
I133� rrCt'NU-10 c -- ---
Garbage Disposal 11 50
CitylState ("ZPhone —� —
Laundry Tray 11.50
Name / Washing Machine/Laundry Tray 11.50
Floor Drain/Floor Sink 2. 11.50
Occupant Mailing Address Suite 3" 11.50
City/State Zip Phone 4" 11 50
Water Heater O conversion O like kind 11.50
Name —'— Gas piping requires a separate mechanical permit.
MFG Home New Water Service 32.00
Contractor Mailing Address Suite--- MFG Home New Sart/Storm Sewer 3200
Hose Bibs 11.50
Prior to permit City/State Zip Phone I Roof Drains 11.50
issuance,a copy _
Drinking Fountain 11.50
of all licenses are Oregon Const Cont.Board Lic# Exp.Date
required if Other Fixtures(Specify) 15.00
expired in COT Plumbing Lic # Exp.Dat —
database -- — -
- Name — -- -- —
Architect _ Sewer-Tst 100' --- 38.00
- or Mailing Address Suite — Sewer-each additional 160' 32.00
Phone — Water Service-1st 100' 38.00
Engineer City/State Zip
Water Service-each additional 2u6' 32.00
Describe work to be done Storm&Rain Drain- 1st 100' 38,00
New O Repair O Replace with like kind: Yes O No O Storm&Rain Drain-each additirnal 100 3200
Residential A Commercial O
Additional description of work: Commercial Back Flow Prevention Device 32.00
Residential Backflow Prevention Device' 19.00 )
Catch Basin — 11.50
Are you Capping,moving or replacinly'any fixtures? Insp.of Existing Plumbing or Specially Requested %00
Yes O No O Inspections _ er/hr
If yes, see back of form to indicate worl performed by Rain Drain,single family dwelling 4C.0�
fixture. FAILURE TO ACCURATELY P'iPORT FIXTURE Grense Traps -- +,.5
WORK COULD RESULT IN INCREASED SEWER FEES.
I hereby acknowledge that I have read this application,that the information QUANTITY TOTAL
given is correct,that I am the owner or authorized agent of the owner,and Isometric or riser diagram is required if Quantity Total is >9 —
t'iat plans submitted are in compliance with Oregon State laws, "SUBTOTAL
Signature of Owner/Agent nate -.---- -
---_ - _^ 8% SURCHARGE j
contact Person Name Phone _
"PLAN REVIEW 25%OF SUBTOTAL
1 BATH HOUSE y178.00 Required orly it fixture qty total is>9
2 BATH HOUSE$250.00 TOTAL
3 BATH HOUSE$2.85.00
(This fee Includes all plumbing fixtures In the dwelling and the first *Minimum permit fee i i$50 f 8%surcharge,except Residential Backflow Prevention
100 feet of sarltary, sewor storm sewer and water service) Device,which is$25+8%surcharge
"All New Commercial Buildings require plans with Isometric or riser diagram and
plan review
I\dsls\forms\plumapp doc 11118/1111
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved � eplaced Removed/Capped
Sink ___ � _ �--
Lavatory —v—
Tub or Tub/Shower Combination
Shower Only _—_ -- --- --
Water Closet
Urinal
Dishwasher_
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain/Floor Sink 2"
4„ - — —
���.;ter Heater—
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I Web\lormelplumopp doc 7 tl1 AM
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-hour Inspection Line: 639-4175 Business Line: 639-4171 - —
_ _
B U P
^Itf 1 Date Requested Z AM/do PM -_ RLD _
Location /%3 50 -'cu �8v1 cL Suite ME
,y
Contact Person _ /t-i'�� Ph
^;ontractor — _ _ Ph _—� SWB
BUILDING TenanJOvener ELC
Retaining Wall ELR —
Footing Access:
Foundation FPS —_-- —
Ftg Drain
Crawl Drain Inspection Notes, SGIN
Slab --- ---.,/� r t lr t c --- -- SIT --- --- --
Post&Beam
Ext Sheath,'Shear — - __—
Int Sheath/Shear
Framing — ----- - -------- _- ---- -- - - _ _—
Insulation
Drywall Nailing
Firewall I
Fire Sprinkler ___-_-- ---- _--_- _-- ----_—_— �-
Fire Alarm J ¢
Susp'd Ceiling - --------------------- - -
Roof
Mise _____ ------ - - - ------_-—
Final I
PA5 S PART FAIL — ------- - --- - -- - _. _-- - - --- - --
L MBIN
Post8 Beam -- --------- — ----------------------
Under Slab
Top Out -----
Water Service
Sanitary Sewer
Rai air.
F-• -------------- ---- - --- - --- -..--- -- - ---
i --
AS PART FAIT_
MECHANICAL
Post& Beafn
Rough In
Gas Line
Smoke Dampers
F inal
PASS PART FAIL
ELECTRICAL - - - - - - -
Service -
Rough In
UG/Slab __ -----._---------------_T.— -
Low Voltage
Fi,e Alarm - ---------...- -- -_ ------
Final
PASS PARI FAIL
SITE
E3ackfilllGrading _—
Sanitary Sewer
Storm Drain J ] Reinspection fee of$ required before next inspection. Pay at Cfty Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I J Please call for reinspection RE _ __. _ [ j Unable to inspect no access
ADA
Approach/Sidewalk 1 1
Date 2�� �� Inspector_ �' �`_ ��''�-- Ex� 9
t
Other _ �.
Final
PASS PART - FAIL_J 00 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP _
—_ Date Requested, AM-__ PM _ BLD
Location_ 11.x-30 2 1%/Od Suite �_ MEC
Contact Person �Lc �c'-r �11L �,� 'd� Ph PLM
Contractor S k IM v1 'i, t'17 Ph SWR
BUILDING -- Tenant/Owner ELC
Retaining Wali rELR� CSU=UGC
Footing Access.
Foundation / / FPS _
Ftg Drain i / ( 4 `?� r C._
Crawl Drain Inspection Notes: SGN --
Slab ---- --- L —�7, l-��"�'�' SIT _
Post& Beam
Ext Sheath/Shear
Int Sheath/Shear —
Framing --- --- ---- - ----- - --- - ------- --
Insulation
Drywall Nailing — �
------------------------ -- —Firewall �.-
Fire Sprinkler - ---- - - - --1 -_C__— -- ----- --------- ----- —
Fire Alarm
Susp'd Ceiling ---- — -------- ,.�� --- - --- -- --
Roof
Misc: —_-_---
Final
PASS PART FAIL —
PLUMBING
Post& Beam � -------- - ---�__.�__-_--------- -----------------------
Under Slab
TopOut ------ - --------... --------------- ____---_---- ---------
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post& Beam ------
Rough in
Gas Line --- --
Smoke Dampers
Final -- —
PASS PART FAIL
ELECTRIC L'
Service
Rough in rr1
UG/Slab
Iiwnr VOIfa�E ' e"t
F'
ASS J PART FAIL — --.- -----___-- --------------------
rm
Backfill/Giadmg -------- -- -----_-- ---__.—.---- ----
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hail, 13 125 SW Hall Blvd
Catch Basin
Fire Supply Line l )Please call for reinspection RE: [ J Unable to inspect-no access
ADA
Approach/Sidewalk pate / InsPector _— / �- Ext
Other __ —-- -- .
Final —
PASS PART FAII- DCS NOT REMOVE this inspection record from the job site.
CITY OF Ti^ARD BUILDING INSPECTION DIVISION MST
24-Hoar Inspection Line: 6:19-4175 Business Line: 639-4171 -- --
BLIP
�4 ,�Z ! Requested— BLD
Date b �� -��'�� AM i-M
BLD
Location > j (` J u ' ��,� WD�'%^� �z^ Suite — — MEC _ --
Contact Person — fir'-� Ph PLM
Contractor Ph SWR
BUILDING Terant/Owner ELC
Retaining Wall n ELR
Footing Access:
Foundation FPS
Ftg Drain _
Crawl Drain Inspection Notes: SGN _
Slab --- ------- - ---�..__---- SIT
Post& Beam --- --
Ext Sheath/Shear
Int Sheath/Shear -
Framing - -- ----------- -
,sulation
Drywall Nailing
Firewall
Fire Sprinkler
Firralarm /
S,sp'J Ceiling �
Roof L'�L7
Misc
Final
PASS PART FAIL --- -
Rr"G
Post&Beam - --
Under Slab '
Top Out - -- `" —
Water Service _
Sanitary Sewer -
Rain Drains
PASS PART
MECHANICAL
Post&Beam - - - - --
Rough In
Gas Line -- -
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL - _ —`--
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading -- --- -
Sanitary S3wer
Storm Drain [ J Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspL _ [ J Unable to inspect-no access
ADA _
Approach/Sidewalk r
Other Date C _Inspector= �, � r _ _Ext
Final '
PASS PART FAIL DO NOT REMOVE this inspectiot: record from the job site.
— _—ELECTRICAL PERMIT-
CITY OF TIGARD —
RESTRICTED ENERGY
- DEVELOPMENT SERVICES PERMIT#: ELR2000-00137
13125 SW Hall Blvd..Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 8/10/00
PARCEL: 13134AB-01000
SITE ADDRESS: 11330 SW IRONWOOD LP
SUBDIVISION: ENGLEWOOD ZONING: R-4.5
BLACK: LOT: 009 JURISDICTION: TIG
Proiect Description: Installation of irrigat on controller.
A.RESIDENTIAL _ B.COMMERCIAL
AUDIO & STEREO: AUDIO &STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRICAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: 'ONTROLLER X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
SIMNITT, N KNOL+ ANGELA S J OWNER
11330 SW IRONWOOD LOOP
TIGARD, OR 97223
Phone: Phone:
Reg #:
FEES —� _ Required Inspections _
_Type By Date — Amount Receipt Low Voltage Inspection
PRMT BLD 8/10/00 $60.00 0004413
5PCT BLD 8/10/00 $4.80 0004413
Total — $64.80
'rhis Permit is issued s.ibject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws All work wi l 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 ove set forth in OAR
952-001-00'10 through OAR 952-001-0080 You may obtain copies of these rules irect question to OUNC_.at (503)
246-1987. � � �
Issued by + Permittee Signature —,�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:`T—_---
CONTRACTOR INSTALLATION ONLY _ �—
SIGNATURE OF SUPR. ELEC'N _ —_ _^ DATE:_
LICENSE NO: -- — ------ -- ---- -----.._— _— �— _
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec'd by'
13125 ^"HALL BLVD Date Rec'd:. La��r _
TIGARD CR 97223 PRINT OR 1 YPE
V- 503-639-4171 X304 Permit#: E x-2000-0n/,?7
F - 503-598--1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:_
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED -RESIDENTIAL ONLY _
Restricted Energy Fee........................................ $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste#
ADDRESS Che(,,, 'ype of Work Involved
- -- Qy/State S � 1 Audio and Stereo Systems
Na (ICA
r. —_
/
-�- ❑ Burglar Alarm
Il► 6 _ `S I M (V f t ❑ Garage Door Opener'
OWNER ea
res
'r U��'���Lt �c Heating,Ventilation and Air Conditioning System'
Phone#
" yL Vacuum Systems'
add ,� OtherZlC(S�Q 1evfCONTRACTOR Mailin
TYPE OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to Issuance a City/State Zip Phone# Fee for each system.............................I................ $60.00
copy of all licenses _- _ (SEE OAR 918-260-2.60)
are required if Oregon ContiBrd L, # Exp D2te
expired in C 01 Check Type of Work Involved
data base). Electrical Contr.Lic # Exp Date
❑ Audio and Stereo Systems
G O T or Metro Lic.# -� Exp Date—
__ ❑ Boiler Controls
Offer's ame y
n7 7 ,�,n I I I _ C, Clock Systems
OWNER - Mailing Address
APPLICANT JIF 70 SR/ �rb/lyres [� ❑ Data Telecommunication Installation
/State Zz3 p one 0 r❑
gar — L .'-ire Alarm Installation
This permit is issued under AE 918-320-370.This applicant agrees to
make only restricted energy installations(100 volt amps or less)under this I—J HVAC
permit and to do the following
❑ instrumentation
1 Only use electrical licensed persons to do installations where required
Certain residential and other transactions are exempt from licensing ❑ Intercom and Paging Systems
These have asterisks(') All others need licensing;
❑
2 Call for inspections when installation under this permit are ready for Landscape Irrigation Control'
inspection at 503-639-4175; U Medical
3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector Is out to inspect under this permit,
4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspector are done,and; ❑
Protective Signaling
5 Assume responsibility for calling for a final inspection when all of the
corrections are completed ❑ Other
Permits are non-bansferable and non-refundable and expire if work is not
started within 180 days of issuance or if work is suspended for 180 days. `Number of Svstems
The person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other installations
authorized to bind th pplicant _
FEES:
Sidnatute -- ENTER FEES 3 )
8%SURCHARGE(.08X TOTAL ABOVE) $ . . �d
Authority if other than Applicant -- TOTAL $ !c e/ PQ
\dsts,formslresele doc 3/98