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9870 SW JOHNSON STREET-1 i 0 0 0 9871) SVV Johnson St / CITY OF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMITM PLM2001-00043 13125 SW Hall Blvd.,Tigard, OR 97223 1"503) 639-4 i 11 DATE ISSUED: 10/29/01 SITE ADDRESS: 09870 SW JOHNSON ST PPRCEL: 25102813-01600 SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND "ZONING: R-4.5 BLOCK: LOT: 019 JURISDIr.TION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE NOME SPACES: TYPE OF 'USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: UNK FLOOR DRAINS; TRAPS: S1 ORIES: WATER HEATERS: CATCH BASINS: 4 _FIXTURES LAUNDRY TRAYS: SF RAIN nRAINS: SINKS: URINALS: GREAS"'RAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 391 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Site utilities plumbing v irk for construction of u new parking lot. FEES Owner: Type Type By Date Amount Receipt ST ANTHONY PARISH PRMT CTR 10/29/01 $260.60 27200100000 9905 SW MCKENZIE ST 5PCT CTR 10/29/01 $20.85 27200100000 TIGARD, OR 97223 PLCK CTR 10/29/01 $65.15 27200100000 Phone 1: _ ___ Total $346.60 Contractor: FLOWLINE EXCAVATION & UNDE 12085 NW NEWELL PL i-OF:EST GROVE, OR 97116 REQUIRED INSPECTIONS ?hone 1: 503-992-7473 Storm Drain Insp , Reg #: LIC 87649 Misc. Inspection Final Inspection This permit is issued -subject to the regulations contained in the Tic and Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days Of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080 You may obtain cot-ies of tl,ese rules or direct questions to ')UNC, by calling (503) 246-1987. Issued By' Permittee Signature: Call (503)$ 4175 by 7:00 P.M. for an inspection needed the next business day i� Plumbing Permit Application City Of Tigard nate received Permit no.: ? Address: 13125 SW Hall Blvd,Tigard.OR 97223 Sewer permit no.: Building permit no.:c,- City`f Dgard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By:1A1.11Receipt no.: — 1 Land use appr aval: �' �'? �7 Case file no.: Payment type: U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-homily U•Tenant improvement U New construction LI Addition/alteration/replacement U Focal service U Other: .—__ .1011 SI-11:1:NFORNIATI& S661)ULL(for%peAd hi6rtnalion use checklist) Job addre s: ) Description . Fee ea. :otal 81de. •,o.: Suite no.: New I-and 2-family dwellings only: — (.ncluder1106fr.for each utility connecid �n) Tax wap/tax lot/account no.: �� SFR (1)bath Let: _ Block:__ Subdivision: 'FR(2)bath -- Project name: rF, SFR(3)bath -- City/county:-1 j['h�L_ fT Ay,94 _ ZIP_ -`Z.'?, _- Each additional bath/kitchen -W Description and location of work on n'cmises: Siteutilitiex: �( _rf- 4_0 �1_Ctt.( --_ Catch basin/area drain Est.date of coutpletion/inspection: - Drywells/Ieach ii.tciltench drain_ — Footing drain(no. lir,. ft.) PLUMBING CONTIM10iff- Manufactured bt.nte utilities - Business name: �;1� Manholes Address: _ Rain drain connector - _- ity: _ State: 7.11' Sanitary sewer(no. lin.ft.) _ "hone: Fax: C mail: Shorn sewer(no. lin. ft.)_ °1 C i CCB m Plumb.bus.reg.no: ---- ------- Water service(no, lin.Il.) _ City/metro lie.no.: — - Fixture or Item: ---- rContractor's representative signature: Absorl,.:•:d calve --.- - Back flow preventer _ Print name: Date: Backwater valve MwKIWI U=1 Basins/lavatory flame: !jrrr jz+ Crj`� t^�( A��1 Clothes waskher ----- --- _ _ (21 S J�J r!Lg�� 'I,', Dishwasher Ad,tress: Drinking fountain _-,City Ejectors/sump -- - - --- - Phone: --2 74`12 Fax:�2 3- '20� E-mail: Expansion tank -- -- - Fixture/sewer cap Name(pt:nt": Ai.)Vq_,N.`1 *H lnoor drainslfloor sinks/hub - Mailing a�tlnress^ rjw (y Garbage disposal — Cit State: Z1P: Hose bibb — - Y: r1L flf� _�(JQ �1213 Ice maker _ Phone: Fax: E-mail: lnlen:—a 1rtor/grease tra --- I Ottner instal lation/residenticl maintenance only: The actual installation Ptimer(s) will he made by me or the maintenance mid repair made by my regular I Roof drain(commercial) _- employee on the property 1 own as per ORS Chapter 447. r ;ink(s),basin(s),lays(s) Owner's signature: Dale: _ Sump _ Tubs/shower/shower pan Unnal Narne: k,)V( Water closet — Address: ?� j, vyrl ��. I.LS Water heater— City: � L Z State ( Other: -- Shone: Fax: .g E-mail: _ Total Not nil jutiedictiom accept etritt cud,,piers call Iwlydiction for mom information. Notice:This permit application minimum fee................ U Visa U MasterCard expires if a permit is not obtained Plan review(at - Credit hard number:--- ____ ___.L/___ within 180 days after it fins been State surcharge(896) ....$ Name of cnrdhnlder as shown on credit cardcomplete. C:xpirea as c - --- - accepted omplete. TOTAL ............... .......g -- S -�Cardholder signature --— -- Amnunt 440-4616(&WCOM) PLUMBING PERMIT FEES: PRICE TOTAL !dew and 24amily dwellings only - '- FIXTURES _ (individual) GTY ea AMOUNT (Includes all plumbing fixtures in PRICE TOTAL l Srnk 16.60 the dwelliag and the first100 ft. QTY (ea) AMOUNT Lavatory - fir each utility connection 16.60 __tY__�__-L-- _One 1 bash _ $249.20 _ Tub or Tub/Shower Comb. _ 16.60 Two 2 bath _ $350 00 _ Shower Only 16.60 Three q)bath - - $39_9.00 _ Water Closet - 16,60 -- - _ _ SUBTOTAL — -- Urinal 1660 _ 8%STATE SURCHARGE Dishwasher 16.60 PI AN REVIEW 25%OF SUBTOTAL Garbage Disposel -- - 16.60 — _.__ -`---TOTP'. - 'I I-at iry Tray - - 16.60 -- Washing Machine 1660 Floor Drain/Floor Sink 2" 16.60 3" --f6--Go- -- PLEASE COMPLETE: 4" - -_ 16.60 -- Water Heater O conversion O like kind 16.60 _ Q_uantity b(Work Performed _ Gba piping requires a separate mechanical Fixture Type: -F New Moved Replaced Removedl ermi, Capped MFG riome.N jw Water Service - 4640 Sink MFG Home New San/Storm Sewer — 46.40 I Lavatojj_ - - -- Nose Bibs i----- Y - --- ;6.60 _ Tub or Tub/Shower _ Combination Roof Drains _ 16.60 1 _ - Shower Only - - Drinking Fountain 16.60 Water Closet O'her Fixtures(_Specify) __-___ 18;60 Urinal - ------- - - - Dishwasher _ Garbage Disposal - I_aundry Room Tray - - --- Washing Mzchine ---- Sewer-1st 100' 5500 — Floor Dr-nin/Sink: 2" - -- Sewer-earth additional 100' 46.40 -` 4^ Water Service-1st 100' - 55.00 Wdter Heater _ - Water Service-each additional 200' 46,40 -- Other FbAtires - - Storm&Rain Drain-1st 100' (Specify) 55.00 -- -- - Storm&Rain Drain-each additional 100' 4640 Commercial Back Flow Prevention Device 4640 _- Residential Backflow Prevention r vice' 27.55 - Calch Basin­ _16( 1 ----- - ------ Inspection of Existing Plumbing or Specially 72.50 - -'-- Requested Inspections - per/hr _ GONMENTS REGARDING ABOVE: Rair Drain,Bingle family dwelling 65.25 Grease Traps 16.60 — - --- ------ -- -- -" ------ QUANTITY'TOTAL - - - ---- - — --- Isometric or riser diagram Is required It --— — -------._- _ Quar,�iotal Is >9 _ -- - ---_----_—� --—---- 'SUBT7TAL --- --- -- - ---- - �8%STATE SURCHARGE - '-°PLAN REVIEW 25%OF SUBTOTAL _ --- --�-- -i _--"--- -- -_ Re u'-ed only If fixture rity total Is>g — TOTAL S "M(nhnum permit fee Is$7250•8%state surcoxge,except Residential Backflow Prevention Device,which Is$35 25+8%state surcharge "All New Commercial Buildings require plans with Isomtrldr or riser diagram and pWi review 4F i:\dsts\formslplm-fees.doc 10/10/00 CITU OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP Received Date Requested AM - PM BLIP Location Suite MEC Contact Person Ph PLM Contractor SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Dain ELR CrawlrDiain �pe�ion � Slab No!es: SIT Post&Beam Shear Anchors Ext ShealhJShear Int SheatNShear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Calling Roof Other: Final PASS PART FAIL ro PLUMBJiNd____ Post& Beam Under Slab Rough-in Water Service Rain Drains Catch Basin/Manhole Storm Drain ---- ShowerPan Fina PART FAIL Post&Beam Rough-in Gas Line Smoke Dampers Final PASS PART FAIL ECEdfffidAL Service Rough-In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL Reinspectilon fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall qivri SITE Please call for rel-ispection HE: Unable to inspect—no access Fire Supply Line ADA Approach/Sidowalk D&W Inspector Uxt Other: Final DO NOT REMOVE ti,,iis Inspection record from the job site. PASS PART FAIL ; CITY OF TIGARD SITE WORK PERMIT yDEVELOPMENT SERVICES PERMIT# : SIT2001-00005 13125 SW hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED : 10/29/01 SITE ADDRESS: 09870 SW JOHNSON ST PARCEL : 2S1021312 01600 SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING : R-4.5 BLOCK: LCT: 019 JURISDICTION : TIG CLASS OF WORK: OTR PAVING ?: Y RESO. NO: TYPE OF USE: CUM GRADING ?: Y VALUE: $80,000.00 EXCV VOLUME: 72 cy LANDSCAPING?: Y FILL VOLUME: 900 cy SITE PREP ?: Y ENG FILL?: STORM DRAINS?: Y SOILS RPT REQD?: N IMPE.RV SUPFACE: 13,::00 of Remarks: Construction of a new parking lot. Owner_ -- - -- FEES ST ANTHONY PARISH 9905 SW M—KENZIE. ST Type By Date _ Amount Receipt TIGARD, OR 97223 PLCK r;TR 2/9/01 $412.69 27200100000 FIRE GTR 219/01 $253.96 27200100000 PRMT CTR 10/29/01 $634.90 272.00100000 Phone: 5PCT CTR 10/29/01 $50.79 272.00100000 Cor..ractor: Total T $1,352.34 FLr)WLINE EXCAVATION 12685 NW NEWELL PL FOREST GROVE, OR 97116 Phone: 503-992-7473 Reg #: LIC 87649 Required Inspections Erosion Control Insp 846-8444 --- Excavation Fill Grading Paving Insp Strm Drain Insp Culvert/Catch Basin Landscaping Insp Final rispectiorr This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work wili be done in accordance with approved plans. This perm*r will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies Gf these rules or direct questions to OUNC by calling (503) 246-1987. ' - J Permittee Signat re: Issue By: Call (503) 6394175 by 7:00 P.M. for an inGpr?ction needod the next business day • � u��,,v�-� r� oL S 1-� �(2c� t Building ra.civcd: /q ll Permit no.:$/rMI m6l)j City of Tr — Address: 13125 Svv Hari nrvu, rr ars,kim 7144-1 e%'rpPl.n°.: Expire date: Phonc: (503) 639-4171 Date issued: By: keccipt no.: Fax: (503) 598-1960 --f Case file no.: Payment type: Land use approval: L/ —7 —nnn^ / 1 U family:Simple Complex: OFTERMIT ❑ 1 &2 family dwelling or accessory ❑Commercial/industrial U Muhi-family U New consinictio t U Demolition U Addition/alteration/replacement O Tenant improvement U Dire sprinkler/alarm U t)lher: _ I { SITE INFORMATION Job address: -2t-) �� t t; _ Bldg.no.: Lot: I Block: Subdivision: I Tax map/tax lot/account1 — ^roject name:4r, k, —I Description and location of work on premises/special conditions: rLI- 1 1 Name: I ail;r r Mailing address: q'106 W I &2 family dwelling: City:15ARL2 IStatc:IDRZIP: Valuation of work........................................ $ Phone: Fax: E-mail: No.of bedrooms/baths................................. - -- - --Owner's representative:representative: _ _ Total number of floors................................. Phone: Fs:;. E-mail: New dwelling arca(sq.!t.) .......................... Garage/carport area(sq.ft.)......................... Name: Covered porch area(sq.ft.) ......................... -- - - Mailing address: fjf ` heck arca(sq.ft.) ........................................ City: I L � T StatespfZ ZIP: 2'L. Other structure area(sS. ft.)......................... Phone: Pax: -mail Commercial/industrial/multi-fan,"y: y CONTRACTOR Valuation of work........................................ $ 'i+� ! Business name: Existing bldg.area(sq.ft.) .......................... (D r L lt �' n►n L�.C. _ New bldg.area(sq.ft.)................................ �� ' C> Address: - C �- Number of stones 4 ........... ............................ State: 'LIP: I Type of construction................................... 1St Phone: c Fax: y E-mai!: CCR no.: 7� 4'a Occupancy group(s): Existing: — New: City/n,,!tro lic.no.: Notice:All contractors and subcontractors arc required to be licensed with the Oregon Construction Contractors Board under Name: r .,provisions of URS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: Statei ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: --- Phone: Fax'` _'!) I I Fi mail: -------- -- --- - - Name: Contact tvrson;C. . . Ltf s due upon application ........................... $— '' -- Addiess: ? 01 �. Date received: Cit State: ZIP: �L Amount received ... $_ Phone: - Fax!Z ,EjE-mail: Please refer to fee schedule. _ I hereby certify I have read and examined this application and the Not as jurisdictions accerR credit cards,please call jurisdiction for more infomunlon attached checklist. All provisions of laws#nd ordinances govemi g this O visa U Mastercard work will be complied writes whethe `'1f1W herein or not. credit card number: c/ sp rcs Authorized signature: Date: 2 T7 r/I Name of cardholder u shown on credit card Print name: _ $ Cardholder slgnaturc Amount No(ice:This permit application expires if a permit is not obtained within 190 days after it has been accepted its complete. 440.1613 tfrooN'oM) SITE WORK PERMIT CHECK LIST Commercial and Multi-Family: Complete ENTIRE form. Residential: Complete SHADED areas only. Excavation Volume: L cu. ds. Grading Volume: (Soils report required for >5,000 cu. yds _ Fill Volume: — (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) v cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete IJ Other ❑ Total new impervious area including all buildings, sidewalks, and paving: - `- I moi, 200 so ft. Site Utilities Plumbing Work: - - Complete the "TAN" Plumbing Permit Application for site utilities plunibing work. Plans Required: See "Site Work Permit Applicatir , - Plan Submittal Re uirements" attached. The followingmust acca�,,pany this application: Site Plan with Vicinity Map Parking (including ADA) and sl�owingADA compliance — Linc hti�nr Plan _ Grading Pian and_details _ Landscaping Plan — _ Erosion Control flan and details F2etaininStructures — _ Site Utility Plan and details Soils Report (if required) (showing connection to approved system) is\dstslforrnslsltectiecklist.doc 12/211100 ��VVDY WALKER / DI LORETO / YOU NIE , INC. CONSULTING S'1' I< t' (' I [IRA I. • CIVIL f. NGINIF. RS March 28, 2002 Principals Ceccacci Associates RoherlA. Walker 0215 SW Gibbs Do' J.DiLoreto Portland, OR 97201 Wade W. Younie Attn: Cd Ceccacci Cole G.Presrhus Vichuel Comnel RE: ST. ANTHONYS PARKING LOT ADDITION GRANT AVE AT JOHNSON, TIGARD, OREGON Gree G. hlun.cell "WATER QUALITY POND CERTIFICATION" Dear Mr. Ceccacci, At your request, WDY Inc has observed and field measured the as-built water quality pond constructed as part of the above project. We have found that its configuration and its associated appurtenances (onsite catch basin, diversion manhole, detention control manhole, overflow and outlet structures) have been constructed in accordance with the City of Tigard approved plans. If you have any questions regarding the above, please don't hesitate to contact our office. For you reference, we have included copies of our related field observation reports a,id field notes. Sincerely, WALKER/DILORETO/YOUNIE, INC. Flir Copy Z-S � D 0,,P Raleigh Itht /%recutiveHolding Cole G. Presthus, P.E. 6443 SW Beaverton- Hillsdale My. 43111 P:\97000++\97175.7 St Anthony's Park ing0ocuments\97175_7 Itr 01 doc Portland, OR 97221 Ain 503121.1-8127 1 fd r 5031103-8111 email:wdv(a'N'dvicom APR-09-2002 14:22 ST AhTHOM'S 503 624 2364 P.02i06 Y I , ?312 aw Ourtwa I111:4001' Fortw A Oregon 9M4 To(Swq SYe44" . Pax("s)3"Ales April 8,2002 GeoPacific Job No. 01 OR 7505 Cocci Associates 0215 SW Gibba Street Portlend,OR 97201 SOIL ENGINEER'S SUMMARY ST.ANTHONY'S PAIkKlNG LO CITY OF TIGARD,,OREGON G6oPaGfl1: Erpretr,ng, Inc. r. rductea on-cal 1pstinA services for Ihp above-vele. noW necking lot and associated sh7set Improvements. The tests sit: siamrmMosd it the aVacheo Based on our teen, the parking W MI and Use GoiursA met projec spedicattane sed our recommerdat arts The trench t3a Oil testing, bass course,and whaltic Concrete IN eralty met City cd Tigard reclui►amaits for;, lbik;Improveriwts. The base lift of asnhaitic rznorete on Grunt Streo t was slightly lower than tie typtel 91 percent of Rice density that is achievable for a bass lift;however,we do not believe that this will signifiganily affect the future o&Ierncnt life. We trust this information meets ydur needs If yol nave any questions, plemse call. Sincerely, I OeoRecfflc Engineering, l C. 1 00 PIR f !4743 ✓ OREGON t1 / FILE „„� , Copy James C. Imb G.E C Geotechnlca)Fnpineer Attachments: Test Perfixe-� Summary of Field Asphatic Concrete penalty Tents SummwV of Field Soil Field ben-qity Tests Site Plan with Lct;lumbers CC* St,Anthony Church-'r n Fax No, 60:'-621-7364 City of Tigard / 7 } \ \ - - / \ \ \ 2 2 � \ f \ \ ■ 00 $ / _ 00 _ © \ �' \ § § k ° / ¥ � C6 $ � 9 � 2 c / a cc u \ \ 2 2 a L c 00 n pp � M r G ,n U c n. w O v ,r o z � � � a g o. � R a $ a, a oa O M Q 8 N (> > Q fel (� r7 CL W v OD o� C] o fn R �y 0/ OG �i cC r i W apo o c � � o .y aQ Q S N G O A NC z z z Z Z z z 1 CJ VJ d Q ri C Ca O y ^1 O A � S Q a �* n C O 4 v cd vl lu 4. v b ate, a v o o > y > M N H E dl A I RJ LLA �i a 0. v K 6 w CL O aC a c U ce to oo LU ii V Oa _� �, � oO •_, In o� � o � NO o U U U U U 12 E f I •'Ti.�� � � y � V _ � = �' 2 W a 1 .a 3 °'�i � G• Q°CCS° �' cC D G pC � W aid e`a o H � J@CL o � � � c ] •e E r dCA CL _ 0.. 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