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10490 SW JOHNSON STREET � x i t r 1 5 10490 SW JOHNSON ST CITYOF fIvARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2004-00448 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/8/2004 PARCEL: 2S 103AA-01914 SITE ADDRESS: 10490 SW JOHNSON ST SUBDIVISION: COTTONWOOD PLACE ZONING: R-4.5 BLOCK: LOT: 015 JURISDICTION: TIG ,LASS OF WORK: ALT FLOOR FURN: EVAP COOLEPS: TYPE OF USE: 5F UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O ADPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML.. INC;IN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: r IRE DALIPERS?: 30 - 53 HP: WOODSTOVES: GAS PRESSURE: 50 + HP CLO DRYERS: FURN < 100K BTU: AIR HA14DLING UNITS OTHER UNITS: 1 FURN >=100K BTU: <= 10000 c:fr,: �— GAS OUTLETS: > 10000 cfm: Remarks: Install rxtctior A%C,do n��t Mace within ihr rr it, rcd setbacks Owner: --_-- FEEf3 DFP-RA L+AKER Descriffon Date Amount ^ 10490 SW JOHNSON ST 11,01) .'rniit I-cc 7/812004 $72.50 TIGARD, OR 9722:3 ITANI State Surchart 7/8-12004 $5.80 Total $78.30 Phone: ------------ Contractor: SPECIALTY HEATING &COOLING 1601 SE RIVER RD HIL.LSBORO, OR 97'123 _ REQUIRED INSPECTIONS Phone: 503-640-3607 Final inspection Rpg#: I IC 66576 t This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is Suspended for more thd,-t 180 days. ATTENTION. Oregon law requires you to follow rules adopted in the Oregon -Itility Notification Center hose rules are set fort`s it, OAFS 952-00'-0010 lhrcugh OAR 952-001-0100. You may obtain copiE 7 of these rules or direct questions to OUNC by calling (503)r246-6699 Issued By: _._ _ Permittee Signature: Call (501) 63Q-4175 by 7:0V P.M. for inspections needed the ness day Nlechanic,tl Permit Application. FOk0IFFA i1SE ONLY. Fit—Y ol'Tip rd SNOW 13 125 SW 1,ill Bli d..Tigard,OR 9727.3 Date/By: Permit No Phone: 503.639.4171 Fix: 503.598.1960 -Plan-ke-View impaction Une- 5113 639 4175 DaWBY. Other Permit Internet: wvrw.,;i r gard.or.us 4W,31��IL Date Ready/By: a Page I for Notifle"Iethod: -7 Supplemental Information Commihcrix.TEVSCHEDULE - UST CKECbIIST ❑New constrit(tion ❑ Addition/alteration/replacement Mechanical permit lecs*are based on the value of the work performed. Indicate the value(rounded-.a the nearest dollar)of All El Demolition ❑Other: mechanical materials,equipment,labp_r,overhead, ATOG(jRy 0V GWftRVCT1ON Value:$ C, ' RESIDENmi.xQUardENT/sYSTFivis rEEs- and'..-fitimly dwelling ❑Conimercial/industrial C]Accessory building For special information use checklist L3 Multi-firruly ❑Master builder ❑Other: Description Qty. Ell Total JOB SITZ*IFORNIATIOr4 AN" tj ON- Heaqngicoollng Job site address! Air conditioning ur heat pump (requital aIle plan 21 cement) City/state/22 Car Cj Furnace 100,00(B LU qL cts/van1400 _ _�ju Fumace-100,000+BTL du�Wveju I. 4 Suite/bIdg./apt.n(. Project name: Gas heat purnp j 4 0A, Cross street Idi rect.ons to job site; Duct work 1400 Hydronic but water system 14 00 Residtivi3i hailer(radiator or " or hydronici 14.00 (f I.tr - — Unit heaterti(fuel-FyTe.net elect,,.), in-wall,in-duct,suspended,etc 1000 if bo, Subdivlsiom Lot no.: Flucivent for an of above 1000 Other 100+0 Tax map/parcel n(.. Other fuel appliances DESCPJPT16N'OP 'WORK water heater 1000 _ Flue vent far water heater or gas 10.00 Los lighter(atis) 10.00 Woodipellet stove 1000 Wood fireplace/inserl, 10.00 �h PR( PYRTY O*Ak Chinarleviliner/nue/vent 1000 --------IL Other 10!0(1 Name: Lt �U, & Environmental exhaust and ventila Ion Address, Range hood/other kitchen _jjufpme_nt 1000 City/State/2 TP Clothes dryer extausr 10.00 single-duct exhaust(bathrooms, Phone; Pox: toilet compartments,utility Morrill APRLICANV, Ca CiDNXA,4Tr PEllikIN' Attic/craw,.,,acc Cans 1010 Auainess Hama: Other: 10,00 3'1.7,C C,C.-k- 41- 7 'Ll-, Fuel piping_._ Contact name in- nname55for first for four $1.00 for each additional , Address- —4 Furnaceetc, --Gas heat pun CityiState/2TP: Wall/suspanded/unit heater Phon Water heater iy !:(.S 11_.; ) itwo - F.•mail: T- Fire latae Range I Barbecue Business flame. Clothes dryer Other Address mECH.4mcAL PE"nT rEE.5* City'staWlip Subtotal Mimmum permfi-fee(-S,�, io) PhPhone: it Plan review(25%of n rmit feet CCB lie.: Ii State surcharge(8%ofoc;m,t11) TOTAL PER-N111 FEE Authorized lipotfire: i This permit ipplication expires it a permit is not obtained lays Attar It has been accepted as complete. L En.t!;me ILI 1--f Date: Fcc mettiodoiolly set by rn-courity,Swiding Industry Service Briard I tHU1l41nN\?WMjtMhC 'emitApp,loc IM3 -! .d t SILO see cog SUT%WGH R%t*T*049 dos : To *n so inr SITE FLAN _ n 5 PL PL G; • lr i S-,RLET ---�--- Specialty Heatzii,-r & Coolie, Inc. 9528 SW Tigard Street Ti hard, OR 97223 Phone 503 .620.504 3 Fax 503 .598 -0718 Hi11_sl:)oro Phone 503 .640-3607 Fax 50.3 .681 . 0793 E 'd SILO 86k7 EDS Su t zeeH 94 t e 1 vidg d6G : i D *n 90 1 mC / V ITv OF TIGARD _ ELECTRICAL PERMIT —_ PERMIT#: ELC2004-00417 DEVELOPMENT SERVICES DATE ISSUED: 7/12/2004 13125 SW Hall Blvd.,Tigard, OR 97223 1503) 639-4171 PARCEL: 2S103AA-01914 SITE ADDRESS: 10490 SW J'!ANSON ST SUBDIVISION: COTTONWOOD PLACE ZONING: R-4.5 BLOCK: LOT : 015 JURISDICTION: TIG f Project Description: 2 branch circuits for AC rind plug. RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 200 amp: PUMP,'IRRIGATION: EACH ADD'L- 500SF: 201 - 4on amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALWANEL: MANE HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 2.01 - 400 amp. 1st W/O SRVC OR FDR: ' PER HOUR: 401 - 600 amp: E4 ADD'L BRNCH CIRC: I IN PLANT: 601 - 1000 amp: _ _ PLAN REVIEW SECTION 1000+ amplvolt: -4 RES UNITS. > 600 VOLT NOMINAL: Reconnect only: GVC./FDR —225 AMPS: CLASS AREA/SPEC OCO: Jwner: Contractor: DEBRA BAKER SOHLER ELECTRICAL CONSTRUCTi0N 10490 SW JOHNSON ST 41131 SW BURGARSKY RD TIGARD,OR 97223 GASTON,OR 97119 Phone: Phone: 971-832-0807 Reg #: I.IC 158285 -- ----- III 34-667C FEES til 11 5945 Description Date Amount _ Required Inspections jELI'RM"ri ELU Permit 7'12 2004 $5350 — — [TAXI 8%State 1m chm i,c % 1-2 -004 $4.28 Rough-in Elect'I Final Total $57.78 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. ATTENTInN 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 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503) 246-0699 or 1.800-3 2-2.3 Issued By: ' , � -- Permi; Signature: g�_2�, _ OWNER INSTALLATION ONLY ``7t�`�� 1 he m Lillalion is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ DATE:—,– CONTRACTOR ATE: ._CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUFR. ELEC//'N: —_—_. _ DATE: LICENSE N O: ,, — —=~ 7 - ---–- --- -- ----- ------ Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit AppyRaliftu F04 OFFICE UIS W, Permit No... C- _7 City of Tigard 36 13125 SW Hall Blvd.,Tigard,OR 97223 Man lteitv Oder Permit: Phone: $03.639.4171 Fax: 503.598.1960 Inspection Une; 501,639A175 "glogM Dale Ready r writ. -TR-1 set rate 2 for Internet www.ci.tIZmd.or.us Notifie&Mrlhod- 111AN REVIEW riewc check all chit zpply-. New construction Addition/alteration/replacement []Seavict:over 225 amps.carrion') Iricaticin Demolition ❑Other. []service over 370 amps-rating (J-❑Buildng over 10,000 sq I ............. f 1-and 2-family dwc1lijigs 4 or noom new tesidennal OSystern over 600 volts norronal unit,in Me TU UCtUft mrd 2-Family dwelling [JComrrercial/industrial F-1 Act,smory building C]Building over thi r-z stai ics C]Feedem.,400 ams or mon Multi-family ❑Mester builder L1 Other []Occupant load over(y)pelsons Orlanufacrured structures c (6 a [:lEgressnighting plan I'V p2rk ORCSIth-cam fiacylity Job no.: 19 ILJob site adtimss: T0 k1_'SQV Subrrut sets of plans with any of the abom —J -j— The shove am not applicable to termc"ry construction service. City/State/ZIP: 77, .4 �- U Suite/bIdg./apt.no.: I QtY. Fr. I T T-1 T Cross street/directions to job site: New residential singlc--or multi-family dwelling unit. Includes attached garage. 1,000 sq.ft or less 145.15 Lot no.: Ea.add'!500 sq.ft or portion 3340 Subdivision: Limited energy,residential 75.00 2 Tax njap)`parml no.: Limited cnftg),.non-residential 75,00 2 ch manufacturedin.r',Wu ior modular serrim afKVor feeder 921.90 2 JServices or feeders installation,altwation,and/or reincation 200 amps or less 80.30 2 l06Ai--- 2 ..il Ar4T 201 amps to 400 amps EL 2 401 steps to 600 amps Narne: 6601 a.p-,-tn I LX amp to _240.60 2 5 Cd k,g Over 1.000 amps or vnl1s 454,65 -.2 Address: M '-19 v RcconneLt only - 2 5c) '-y— 66.85 cityfstateatm� 1-7 Temporary services Or hindars I'astmildLuarm,olterstion,vidlur 1-1-d 11 2-7221 relocation _ Phone,(_5-0 3 ) ( -r7o - 28SO I Fax PS 2!.-1— Owner installation:This installation is being made on rrroperty that I own which is not 201 amps to 400 arrps 100.30 ince ded for sale,lease,rent,or exclMge, 173-3775 according to ORS 447,449,670.and 701. 401 amps to 600 amps .2. Owner signature: Date.- panel A.Fee Mor branrJ%circuits wiM serviceree,each Ice rK feeder 6.65 2 Businnamess name branch circuit B Fee for branch cittuits Contact flame: S'n withnut scrvi�,-or feeder fee, I 46.85 2 each bench circuit Foch muld'I branch circuit 6.65 r,' 2 Address: I V it 57 Citv/State/ZM: r U rz or feeder not included) PurrV or irription&r� --F 5-1,40 2 U Phone: q 7f -33.40 2 . ?R 5 -1076 Sign or outline lighting C1 Fax' -63.9 S�- Signal circiiii(s)or limited cnrxgy panni -titration,or 7?NS f9ffi, Page 2 extension,fjescnbc� Business nwrw C4 in�-s�11 - F. additional IST!!tion over allowable In any of the above Address: Per inspection 62.50 City/State./ZIP: Investigation per hour(I Isr nd") 62.50 13.75 Phone:(1� 0 Fax.(5-0,J ?j5$-- I C) tridustrial plant per hour CCB Lic.: 15 6;28S slectrico q- Subtetal 7 Lie.: Plan review(25%of permit fee) Suprv.Electrician signature.coq State surcharge(8%of permit fee) '7 Print name_ Date: 7 c Y TOTAi,PERMIT kTU Authorized SignaMm: This pet-Mit 2PIAICStiOM expires 1fSpermit 12ant nbt1' dwithin 190 d.yi mittr It has 1peenmxeflltd 25.11W,ie oafF"P*thM,.1nry cel by TiWonnry f1milding Ind %n).scrwce B,%srd -teaPrint name: PA Nawb�.r of imorcuom m pernat xUry-1 Pm*AppAm 11103 our an inr CITY OF TIGARD 24-Hour BUILDING Inspection Line: (5 39-4175 MST INSPECTION DIVISION Business Line: 03)539-4171 BUP — Received �.__ / ._Date Requesled __ __ _____ AM— FM__—__ BUP Location _ /0`f qd �W— -------_ Suite — MEC Co itact Person — _. Ph PLM Contractor ._,—_—_----------____-- Ph(--,---.-) —_,_--__—_-- SWR .__-- BUILDING Tenantr'Owner _-- -__ _ ELC -Footing __--�— ELC Foundation Access: %.1A.L 4VT- ST,�_— -- - Ftg Drain Ib G TN DI!! Sc,tNt �bT= ELR Crawl Drain Slab Inspection Notes: �LL -- SIT Post& Beam Shear Anchors 1 /" O L f^ 00 -'1L Ext Sheath/Shear l.(� '1 V 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 op Rain Drains - - Catch Basin/Manhole S!orm Drain -.�_- ---- ------------------ - Shower Pan Other. Final _PASS- __P RT FAIL ( MECHANICA Rough-In - -- - Gas Line Smoke Damper - r�� PAS`= PART FAIL -- - -- -- -- -- ''" - Ssrwce .------- - - Rough-In UG/Slab Low Voltage Fire Alarm Final 11 Reinspection fee of$_ required before next inspection. Pay at City hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ___.-_ - ._- Unable to inspect--no access Fire Supply Line ADA Date _ C'l Inspector - 'L-'� - -- Ext -_---- Approach/Sidewalk Other Final DO NOT REMOVE this Inspection rec4ii rd frorn the job site- FASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-411"1 MST BLIP l Received -_-. Date Requested-_-�__� — e_ PM_--._ 8UP Location �d _Suite--__--- MEC --__ - Contact Person .--- ------- f A Ph( ) �" v� �� — PLM ----- - Contractor _____ --- _ Ph _—_ SWR BUILDING Tenant/Owner ........ _ —__ _ — L�s7 Y�7 Footing Foundation Access: ELC -- _--- Ftg Drain ELR Crawl Drain Slab Inspection Notes: y SIT _ Post& Beam ------- -- --L� ��t"��„�e-�e�Ct- A2 _ Shear Anchors e Ext Sheath/Shear Int Sheath/Shear Framing - - Insulation - Drywall Nailing -�— Firewall i Fire Sprinkler - — - Fire Alerm Susp'd Ceiling -- - Roof Other. Final PASS_PART FAIL -- - -- T---- PLUMBIING— Post&Beam Under Slab - - --- ---- ------------- Rough-In Water Service Sanitary Sewer `--- Rain Drains -- - -- ------ Catch Basin/Manhole Storm Drain Shower Pan Other - - -- - - - - -- --------- Final _PASS_ PART FAIL _ MECHANICAL Post&Bearn Rough-In ---_-_ Gas Line - - -- .-------- -- --- Smoke Dampers — Final PASS PART FAIL ---- ECTRICA�) Rough-In UG/Slab -------_--- Low Voltage - Fire Alarm Pin I PART FAIL Reinspection fee of$__ -__ required before next inspection. Pay a'City Hall, 13125 SW Hall Blvd. $I Please .all for reinspection RE:_ L� Unabia to inspectnc access Fire Supply Line ADA (� INPA L Approach/Sidewalk Dats Z� Inspector __v_ Ext Other: Final - DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITYOF TIGAR D _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR1999-00261 13125 SW Hall Blvd,, Ti, c, OR 97223 (503) 639-4171 DATE ISSUED: 12/9/99 SITE ADDRESS; 10490 SW JOHNSON ST PARCEL: 2S103AA-0191µ SUBDIVISION: COTTONWOOD PLACE ZONING: R-4.E _ BLOCK: _LOT: 015 JURISDICTION: TIG_ TENANT NAME: BADGER ` � USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF ®�► NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Connection to sewer lateral as part of Reimbursement District 412. Reimbursement fee of $5,597.82 paid on 12/9/99. Septic tank to be pumped, filled or removed and inspected. Owner: - '- FEES BADGER, QUENTIN J EUNICE —� 10490 SW JOHNSON ST Type By _ Date_—_ Amount Receipt TIGARD, OR 97223 PRh1T DEB 12/9.99 $2,300.00 99-3202.83 INSP DEB 12/9/99 $35.00 99-320283 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspection, Sewer Inspection Septic Tank Filled This Applicant agrees to comply with all the rules -,nd regulations of the Unified Sewage Agency The permit expires 190 days from the date issued. The total amount paid will be forfeited if the permit expires The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not locate6 it the measurement given, the installer shall prospect 3 feet in all directions frorn the distance given If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a I.a+eral. ATTENTION Oregon law requires you to follow rules adopter] 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 these rules or direct questions to OUNC by calling (503) 246-1981. Issu�d hy: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hou' Inspection Line: 639-4175 Business Line: 63q-4171 BUP —_— Date Requested �d 1 �`f ' _AM - l J)r M BLD _ Location 10`( YO 5� %'301 rl SJ-Y%- Suite 771 - 0G �folt1 Contact Person Ph 170 1 Contractor— _ Ph M _ SWR BUILDING -- Tenant/Owier ELC Retaining Wall —� E'R Footing Foundation Access: n,.�,,;�,�c �, �� t cam`, FPS — Fig Drain SGN Crawl Drain Inspection Notes: — Slab ---_—_-- -- -- SIT Post& Beam Ext Sheath/Shear Int Sheath/She,-.r Framing -- Insulation Drywall NaiPng — - —_--__-_--- - -_--- —_-- (Firewall Fire Sprinkler ---_--- _-_—_�- --- -_--� _-- Fire Alarm Susp'd Ceii ng ---- Roof Misc: _ �. ----------- -- — - - ----- -------- Final PASSPART FAIL —..___..__ _.----_._---_------_-----_--------__-- _-- LUMBIN Under Slab TopOut - �� ------------- -------- --- ------- --- ------ Water Service tz-lkaQ aniia Se — -- - -- ---- ---- Ram rains AS-1 PARI FAIL CHANICAL Post& Beam ----- ----------- Rough In " as Line - -.._. -- ------- ----— ---- - DamperssalASS PART FAIT. ELECTRICAL - - - - --- ------- - ---------------- Ser�ir.P Rough In --- - — -- ---- ----- -�_.___--_ LIG/Slab Low Voltage - -- - - FireAlarm - ---- --- — ------- - ---- ----------- ----------- Final PASSPART FAIL ---------.-----__.._._,.---_.-_ ---------..- __--_-.-__ -__— SITE Bac r ra rnq Sanitary Sewer Storm Drain ( ] Reinspection fee of$ _—� _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( 1 Please call for reinspection RE: _ [ [ Unable to inspect- no access ADA 5 Approach/Sidewalk i Z _` Other Date _ -- Inspector-- V..� Ext LFinal pASS PART....FNL_j DO NOT REMOVE this Inspection record from the job site. invoice G-1I1IF 'S SEWTIC' SERVICE, INC##A ,."1f Date. % 7f 2 AddressloZ i city �'� -- — _-.� ___ Initial I On Acd. I r� e ';te ._- Zi Code �_. --- --- — -- ----- -- -' i P1 Ice "Amount NOT RESPONSIBLE FOR LANDSCAPING A servicr. charge of 1.5%per month will be charged on all past due accounts. total; w Not responsible for attorney's fe, s. A fee of$29.00 will be charged on all returned checks. Approval ICustomer Slgnatur6 ?dank y)u PO. BOX 1244. • Canby,OR 97013 �� i (503) 263-2087 or-(503) 632-6138 CCBN 70548 f CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00429 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/13/1999 PARCEL: 2S 103AA-01914 SITE ADDRESS: 10490 SW JOHNSON ST SUBDIVISION: COTTONWOOD PLACE ZONING: R-4.5 BLOCK: LOT: 015 JURISDICTION: TIG CLASS OF WORK: ACS 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: LAVATOHi=S. OTHER FIXTURES: 1 TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATE R LINE: ft DISHWASHERS: RAIN DRAIN. ft Remarks: Re-routing plumbing Owner: __�—__ __ FEES —� Type By Date Amount Receipt BADGER, QUENTIN J EUNICE PRMT BON 12/13/199 $50.00 99-320391 10490 SW JOHNSON ST 5PCT BON 12/13/199 $4.00 99-320391 TIGARD, OR 97223 ---- Total $54.00 Phone 1: Contractor: LARRY CAMERON PLUMBING 1812 SE 158TH AVE PORTLAND, OR 97233 REQUIRED INSPECTIONS PLM/Underfloor Phone 1: 503-256-2705 Reg #: LIC 49792 Final Inspection PLM 26-366PB QR GIS A�� 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 w Kinin 180 clays 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. Issued By: 61 ___ _ Permittee Signature:/-, Call (503) 63t-4175 by 7:00 P.M. for an inspection needed the next b . ii .ss day CITY IGARD Plumbing Permit Application Plan Check, 13125 S` V HALL BLVD. Commercial and Residential Recd By TIG,z/2D; OR 97223 Date Recdiz-13 (501) 539-4171 Date lu P E Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit# r !n'liT=1 z`i Related SWR# Calied - Name of Development/Project FIXTURES (individual) - QTY PRICE AMT Job Sink 11.50 Address Street Address Suite Lavatory - 11.50 t!; ' TubId or Tub/Shower Comb. 11 50 Bi:i?! City/State Zip Shower Only - -- 11.50 Name Water Closet 11.50 Urinal 11.50 Owner Nfaiiing Address ` --fSL Suite Dishwasher 11.50 l C^ I S, Z) 'J ` Garbage Disposal - - 11.50 City/state Zip Phone --- - ��, Laundry Tray 11.50 Name- --' - - � Washing Machine/Laundry bray 11.50 Floor Drain/Floor Sink L4" 11.50 Occupant Mailing Address F-We 11.50 City/State Zip -'hone -- - ----- --11.54 Woter Heater O conversion O like kind 11.50 Name - - Gas piping requires a separate ntecham. 'permit. - MFG Hume N,ew Water Service 32.00 Contractor Mailing Addres§ Suite MFG Home New San/Storm Sewer _ _32.00 Hose Bibs 11.50 Prior to permit /stale Zip Phone Roof Drains 11.50 Issuance,a copy ;1 - Drinking Fountain 11.50 of all licenses are regon Cors. ont#l.lard Lic.# Exp.Date required If �� Ll - Other Fixtures(Specify) 1-00 expired in COT Plumhin Lic.# Exp.Date r t --� ytn{� database Name Architect _ Sewer-1st 100' 38.00 or Mailing Address Suite Sewer-each additional 100' 32.00 Cit (State Zi Phone Water Service-1st 100' 38.00 Engineer y� p --- -- _- �_ Water Service-each additional 200' _ -- 32.00 Describe work to be done: Storm&Rain Drain-1st 100' 38.00 New O Repair O Replace with like kind, Yes No O Storm R Rain Drain-each additional 100''- 32.00 Residential O Commercial O - Additonal description of work: ------ Commercial Back Flow Prevention Device 32.00 - Residential Backflow Prevention Device* 19.00 ��'�� -�_____ _ __ Catch Basin _ 11.50 re you cape ng, moving or replacing any fixtures? Insp.of Existing Plumbing or Specially Requested 50.00 Yes O No O Ins cellonsper/hr If yes,see back of form to indicate work performed by Rain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps �- --W 11.50 _WORK COULD RESULT IN INCREASED SEWER FEES. _ QUANTITY OTA(_ - I hereby acknowledge that I have read this application,that the information - Isometric or riser diagram Is required N Ouanaty Total,, 9 given is correct.that I am the owner or authorized agent of the owner,and - Ihat P ar1jifisubitlitled are in compliance with Oregon State Laws, "SUBTOTAL sl re of Owner/Age Date ---- - z� (-1 c1 /' •r c-c - ;/;;, / r K SURCHARGE 1. Dt7 ontact Person Phone - 1 r ,' 6 c�TC'J **PL.AN REVIEW 25% OF SUBTOTAL- 1 BATH HOUSE$178.00 Required only H fixtured total Is>9 - 2 BATH HOUSE$250.00 TOTAL 11 ;y 3 RATH HOUSE$285.00 - (This fee Includes all plumbing ilxtures In the dwelling and the fin.t Mlnlmum permit fee Is$50+8%surcharge,except Residential Backflow Prevention 100 feet of sanitary sewer stern sewer and water service) _ Device which Is$15+8%surcharge -All New Commercial Buildings require puns with isometric or riser diagram and plan review 11 dsisiformslplumapp doc 11118194 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink _ Lavatory Tub or Tub/Shower Combination Shower Only Water Closet _ Urinal _ Dishwasher _Garbage Disposal _ _Laundry Room Tray Washing Machine — C -- Floor Drain/Floor Sink 2" Water Heater _ -- Other Fixtures (Specify) -� - - COMMENTS REGARDING ABOVE: 1 ldelel oimMplumepp dor.11/18199 • CPLUMBING PERMIT CITY OF TIGARD DEVELOPMENT SERVICES PERMIT#: PLM1999 00420 DATE ISSUED: 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AA-01914 SITE ADDRESS: 10490 SW JOHNSON ST SUBDIVISION: COTTONWOOD PLACE ZONING: R 4.5 BLOC:: LOT: 015 JURISDICTION: TIG CLASS OF WORK: ALT 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: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Sewer line to connect _ --- FEFS Owner: Type By Date Amount Receipt BADGE=R, QUENTIN J EUNICE PRMT BON 12/10/199 $50.00 99-320338 10490 SW JOHNSON ST 5PCT BON 12/10/199£ $4.00 99-320338 TIGARD, OR 97223 — — Total $54.00 Phone 1: Contractor: TED MCBEE EXCAVATING INC, 11428 NE SCHUYLER PORTLAND, OR 972.20 REQUIRED INSPECTIONS Sewer Inspection Phone 1: 939-5246 Final Inspection Reg #: LIC 110314 ORIGINAL 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 yoi.1 to follow rules adopted by the Oregon Utility Notification Center. (hose 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 uUNC; by calling (503) 246-1987. Issued By: l �� ___ Permittee Signahire:-- Call (503) 639-4175 by 7:00 P.M. for an inspection nodded the next business day CITY OF TIGARD Plumbing Permit Application Plan Chec 13125 Ste/ I•iA.LL BLVD. Commercial and Residential Recd Byr�— TIGARD, OR 97223 Date Recd I D ! (503) 639-4171 Date to P.E. Print or Type Date to DST —j 7 L W�1 Incomplete or illegible applications will not be accepted Permit#. Related SR Called Name of Development/Project FIXTURES (individual) OTY PRICE AMT Job Sink 11 Fn Address Street Address Suite I Lavatory 11.50 -J 11) 0��] _ 1 ub or Tub/Shower Comb 11.50 Bldg If City/State `f^ Zip Shower Only 11.50 Water Closet/Urinal (Specify) 11_50 Dishwasher 11.50 Cr k- Owner Mailing Address Suite Urinal 11 50 -5 Garbage Disposal 11.50 City/State Zip Phone Laundry Tray 11.50 Name Washing Machine/1-aundry Tray (Specify) 11.50 Floor Drain/Floor Sink 2" 11,50 Occupant Mailing Address Suite 3" 11.50 4" 11.50 City/State Zip Phone Water Heater O conversion O like kind 1.50 Name Gas piping requires a separate mechanical permit.nyJ —_ I C ` MFG Home New Water Service -- 28.00 Contractor Mailing Address Suite MFG Home New San/Storm Sewer 28.00 % .2 -X Hose Bibs -- _ 11 50 Prior to permit City! tate Zip Phone Roof Drains 11.50 issuance,a copy .0� �0 -- --- -'. -" Zt)rinlriny Fountain 11.50 of all licenses are Oregon Corist.Cont.Board Lic.# Exp.Date — required if 1 N . 31 Othei Fixtures(Specify)_ - 15.00 expired in COT Plumbing Lic.# Exp.Date _ database '- -- --- Name -- __—-- — Architect Sewer-1st 100-' 38 00 or Mailing Address Suite Sewe•-each additional 100' 32.00 Water Service-1st 100' — 38.00 Engineer city/state Zip Phone _-- --- Water Service-each additional 200' 32.00 I)escribwork to be done Storm&Rain Drain 1st 100' 38.00 New Re air O Replace with like kind Yes O No O Storm&Rain Drain each additional 100' 32.00 — Res ential Commercial O �— — --_—� — Additional d scliptinn of wore i Commercial Back Flow Prevention Device _ — 32.00 Residential Backflow Prevention Devine' 1900, (� Q--0'0'IN L� ��osC40_ QC Sti LK),r Catch Ba — 11,50 Are you capping, moving or replacing any fi tures? Insp.of Existing Plumbing or Specially Requested — 50.00 Yes O No O Inspections per/fir If yes, see back of form to indicate work performed by Rain Drain.single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease fraps — 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. ereby acknowledge that I have read this application,that the information QUANTITY TOTAL I h Isometric or user diagram is required if Cluantity Total is >9 given is correct,that I am the owner or authorized agent of the owner,and that plans submitted are in compliance with Oregon State Laws. 'SUBTOTAL r " Signature of Ownur/Agent Date -- o - --� 8/o SURCHARGE J �; Co c Person Name Phone C. -- �/ ."PLAN REVIFW 25%OF SUBTOTAL I BATH HOUSE$17 .00 Required only l fixture q1Y fatal is>9 - TOTAL 2 ) 2 BATH HOUSE$250.00 3 BATH HOUSE$285.00 -- --- J (This fee Includes all plumbing fixtures In the dwelling and the flat •Mlnlmum permit fee is$50+8%surcharge,except Residential Backflow Prevention 100 feet of sanitary sewer stone sewer and water service) Device.which Is$25+8%surcharge **All New Commercial Buildings require plans with Isometric or riser diagram and plan review 1\dstsVormslpiumvpp doc 1011199 J PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink Lave tory Tub or Tub/Shower Combination _Shower Only Water Closet Dishwasher Urinal Garbage Disposal Law,dry Room Tray Washing Machine Floor Drain/Floor Sink 2" 311 Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I W%tetlormelplumapp doc 1011199