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12445 SW NORTH DAKOTA ST
77 CITY OF `T I G A R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT 0: PLM2002-00013
13125 SW Hr.ii Blvd.,Tigard, OR 97223 (503)6394171 DATE ISSUED: 1/16/02
SITE ADDRESS: 112445 SW NORTH DAKOTA ST PARCEL: 1S134CB-07000
SUBDIVISION: ANTON PARK ZONING: R••7
BLOCK: LOT: 032 JURISDICTFON: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HJME SPACES:
TYPE OF USt : SF WASHING MACH: BA.CY&LOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES i. LAUNDRY TRAYS: SF RAIN DRAINS:
F:NKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SVOWERS: 2 SEWER LINE: ft
WATER CLOSETS. WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remar�s: Installation of tub and shower.
O,,rner:
FEES
Type By Date Amount Receipt
LEE RICHARDSON PRMT CTR 1/16/02 $72.50 27200200000-
12445 SW NORTH DAKOTA 5PCT CTR 1/16/02 $5.80 27200200000
TIGARD, OR 97124 _
Total _$78.30
Phone 1:
Contractor:
REAMECH
893 NW 1 ST. PLACE
HIL.LSBORO, OF 17124 REQUIRED INSPECTIONS
Phone 1: 503-969-6252 Rough-in Insp
Top-out Insp
Reg#: Final Inspection
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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.
J 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.
r
Issued By: Permittee Signature`" 4
Call (503)639-4175 by 7:00 P.M.for an Inspection needed the next business day
Plumbing Permit Appli.
Date received: - ( - ')- Ptetrnit no.:—e1
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City n/Tigard phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 1110 Date issued: Bve Receiptno.:
Land use approval: Cage file ro.- Payment type:
1 U dt 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Food service U Other:
Job address: .12-4A S S N �,k C,4 c.. . Fee ea. Total
MaIg.no.-_-- Suite no.: — Nm i-and 2-f . �rT
y w
Tax map/tax lot/account no.: (iscladea109 ft.for each utility connection)
�--_ SFR(1)bath
Lot: Block: Subdivision: SFR(2)bath _
Project name: SFR(3)bath
City/county: Tt ;1i ZIP: Each additional bath/kitchen
Description and loeation of work on premises: 3heotllitlec
Catch basin/area drain
Est.date of completion/inspection: _ D wells/leach line/trench drain
Footin drain(no.lin.ft.)
Manufactured home utilities
Business names„,r�.(��ch Tt tC Manholes
Addres_ s: E�,7'3 Nw i�f�I ac Rain drain connector
City: , k\ .,<,: Stat e:r P- ZIP:4 7/24 Sanitary sewer(no.lin.ft.)_
Phone: .( ,:5 2 iFax: I E-mail: Storm sewer(no.lin.ft.)
CCB no.: v-1 7 7 Plumb.bus.reg.no: 39 _j P Water service(no.lin.R.)
City/metro lic.no.: j,•-)— - . Y Flxtare or hem:
Contractor's representative signature: i• Abso on valve
Back
now preventer
Print name: KP,,ctuiel Date: I 16 Backwater valve
Basins/lavatory_
Name: Clothes was
Dishwasher
Address: Drinking fountain(s)
City: __` State:_ ZIP: _ Ejectors/sump
Phone: Fax: E-mail: Ex ansion tank
Fixture/sewer cap
Name(print): (_,.e � ,�(s< �, Floor d►ains/tloor sinks/hub—
Garbage disposal
Mailing address: A S S�,•a N• C1cmt a+ Hose Nbb
City:; C'L r e lState:, ZIP:9 7 l 74 Ice maker
4 Phi-.e: T I ax: E-mail: _ Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
N will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Surn�_
J Tubs/shower/shower pan Z,
co
Unnal
Name: Water closet
Water heater
City: _ State: Z1P: Other:
Phone: Fax:--- E-mail: Total
,Not dhdi
l Jarcdan aaorxp axerbt rxdr,ptare au jarlretctlon bar marc tdarertm. Notice:This permit application Minimum fee................$
U Visa O MasterCard expires if a permit is not obtained Plan review(at _ %) $ -
Creat cwd mmt er:—. -- -- (8%)....$within 1 f10 days after it has been State surcharge
e TOTAL .......................$
Nttrrc d a rhown on accepted as oomPlete.
s
ds-t- "nasi 140 4 16(Gowx a/)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 And 24amity dwellings Only:
FIXTURES jindividual QTY sa AMf3UNT (Includes all plumbing fixtures In PRICE TOT/I
Sink 18.60 the dwelling and the f irstf00 ft. QTY Aea) AMOUNT
for each utility connection
Lavatory16.fio
_ _ One(1)bath _ _ $249.20
Tub of Tub/Shower Comb 16.60 TWo(2)bath — ._� $350.00
Shnwer Only 16.80 Three(3}bath $399.00
Water Closet 16.60 ------ SUBTOTAL
Urinal 16.60 11%STATE SURCHARGE _
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
laundry Tray 16.60
Washing Machine 16.60
Moor Drain/Floor Sink 2- -� 1s 60 PLEASE COMPLETE:
3^ 16.60
q^ 16.80
ork
Waler Heater O conversion O like kind 1660 Quant) Wept
Gas piping requires a separate mechanical Fixture Type: Now Moved Replaced Removed!
Capped
permit.
MFG Home New Water Service 4 40 Sink _
MFLavatory
G fiome New San/Sto Sewer qg 0 Tub
_ Tub or Tub/Shower
Hose Bibs 18 0 Combination
Roof Drains 16 0 Shower Only
Drinking Fountain 16 0 Water Closet
_ — Urinal
Other Fixtures(Specify) 1160 Dishwasher
Garbage D sposal
Laundry Room Tray
Washing Machine
Floor Drain/Sink: 2"
Sewer-1st 100' 5.00 3^
Sewer-each additional 100' 48.40 4"
Water Service-list 100' 55 00 Water Heater
_ Other Fixtures
VI iter Service-each additional 200' 48.40 Specify) _
Slum b Rain Drain-1st 100' 55.00 _
Storrs 6 Rain Drain-each additional 100' .40 —
Commercial Back Flow Prevention Device 46.
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Inspect)nn of Existing Plumbing or Specially 6250
Requested Inspections _ r/hr COMMENTS REGARDINQ ABOVE:
Rain Drain,single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL
IL Isometric or riser diagram Is required If
ouantq Total is >9
'SUBTOTA _
11%STATE SURCHARG G,,1
J "PLAN REVIEW 25%OF SUBTOT L Q/
m
Required only If fixture aty.total >9
WT AL
J
~Minimum permit%a Is$72.50•996 slate surcharge,except Residential Beckilow
Prevention Device,which Is$,219.25+8%state surcharge.
"An New commercial Buildings sequin 2 sols of plant with Isometric or riser
diagram for plan review.
I:%d9%V6m"4lm-fee9.doc 12/26/01
CITY OF TIGARD 24-Hour .
BUILDING Inspection Line: (503)6314175 •
INSPECTION DIVISION Business Line: (603)636-4171 MST
BUP
Received _ L'ate Re nested AM PM SUP
Location ___� -Sr r Suite. MEC _
Contact Person �,o Ph( ) PLM a� Z-Oct-, 3
Cont actor_� _. Ph( —) _ — SWR
BUILDING _ Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain 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 PARTF IL
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains ---
Catch Basin/Manhole
Storm Drain --
Shower Pan
Ofie`_r -
PART FAIL H_A_NiCAL
Post&Beam -�
Rough-In
Gas Line
Smoke Dampers
4. Final
PASS PART FAIL
m ELECTRICAL
Service - ---
Rough-In
m UG/Slab
Low Voltage
W Fire Alarm
-j Final r--1
PASS PART FAIL u Reinspection fee of Erequired before next inspection. Pay opt Cnj Hall, 1312F:W Hall Bpd.
SITE P!eese call for toincrg,;iiOn RE:__ :Mebie to inspect-n0 acme
Fire Supply Line
ADA _ ,.,, f
Approech'Sidewaik Date _��---SG-2
Other:
Final DO NOT REMOVE this Impootim noon tmm SIN fob!thio.
PASS PART FAIL
CITY OF TIGARD 24-Hour
• ' BUILDING 16 Inspection Line: (503)638.4175
INSPECTION DIVISION Business'Line: (503)6394171
MST
-0'w o 'PM ,�y BUP _ V
Received __7 _Date Requested_ — AM_ PM SUP
l-ocation l �- �,l`l 5 ���1.�Z7G ,Jnr+b Wits__ MEG _
Contact Person -- — — Ph( ) !;9A 90�-��p PLM
Contractor 6eF �� frt __� ,_ Ph(— ) SWR —
BUILDING Tenant/Owner _ — ELC 200A11010
Footing ELC
Ftg Drain Foundation
\ n'
ELR
Crawl Drain c - -
slab Inspection Notes: 81T _
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 _
st Ili 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 6 Beam
Rough-In
Gas Line
IL Smoke Dampers
Final
H PASS PART FAIL —
_ELECTRIC_AL
Service
-� Rough-In
m UG/Slab _
W
Low Voltage
a Fir larm
in Reinspection fee of$ pectic Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL ❑ P� required before next Inspection.
— r] Please call for reinspection RE: _ _ Unable to Inspect--no access
Fire Supply Line
ADA
Approach/Sidewalk Dib
Other:
Final DO NOT REMOVE lhb Ilet*oadM Meonl fteM go JO oft.
PASS PART FAIL
CITY OF T I GA,R� ELECTRICAL PERMIT
DEVELOPMENT' SERVICES DATE SSUIED: 1/16/02
/6/0202-00018
13125 SW Ha!I Blvd., Tigard,OR 97223 (503)639-4171 PARCEL: 1S134CB-07000
SITE ADDRESS: 1244E SW NORTH DAKOTA ST
SUBDIVISION: ANTON PARK ZONING: R-7
BLOCK: LOT : 032 JURISDICTION: TIG
Protect Description:
RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS _
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF• 201 - 40f amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 60(�amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601+amps-100f, volts: MINOR LABEL (10):
SERVICEIFEEDER BRANCE CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 arae: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
4n00+ampivolt: >-4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVC/FDR>=225 AMPS: CLASS AREAISPE OCC:
Owner: Contractor:
LEE RICHARDSON GENIE ELECTRIC CONSTRUCTION
12445 SW NORTH DAKOTA ST 8701 SE 156TH AVENUE
TIGARD, OR 9722' PORTLAND,OR 97236
Phone: Phone: 503-762-9296
Reg 0: LIC 56639
SUP 4536S
ELE 34-488C
FEES Required Inspections
Type By Date Amount Receipt Rough-in
PRMT CTR 1/16/02 $60.75 2720020000( Elect'I Final
5PCT CTR 1/16/02 $4.86 2720020000(
Total $65.61
L
This Permit is issued subject to the regulations contained in the Tigard Nkinicipal Code,State of OR. Specialty Codes and aN other applicable
laws. All work will be done in accordance with approved plans. This permit will e)pke if work Is not sterted 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 of these rules or direct questions to
0.a
Permit Signature: Issued By:
^
m 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ DATE-
LICENSE NO:
Call 639-4175 by 7:00pm for an Inspection the next business day
Ian 16 02 02: 02p GENIE ELECTRIC 503-762 9188 P. 1
Electrical PerokApplication
Uareruoaived:1-&-o permit no.: -'gA
City of 71gaTd ptvjec✓sppl.atr.: Eapireeaac:
1 Addrr.u: 13125 SW Hall Blvd,Tigard,OR 97223 -- -'_ _�___
(iq•nJTiOnrrf Phone: (503)639 4171 Dualsaued: $y Romipt
Fax: (503) 599-1960 C rue Gln ao.: payment type:
Land nAe approval: _.
IY 1 &2 fttmtly dwelling m acccuory 11 Comn tMialrindustrial L]Muhl frroay U Tenam improvement
❑New cons)ruction U Additioa/alteradon/repluement ❑Other:.-__ U partial
)obaddtess I 2445 SW North Dakota Tigard 11111d&no.: Suiteao: Ttumaphaxlotfaccountno.:
Lal. Dlack Subdivision: —_ _. —_-_
_— ----- —
Project name: _ _ —TDescriotiou oed location of work an pramitoe: 3 h rn n r h r
Estimated date:of completion/inspection: _ om
Job no: I iFiltt l►iast
Bu+ineat cam_:: f;en_ie �le�tricgcia r �t 1 1 rn w
t1.e.rveailcslVl-irjie.e..M4�tar
.mores•• 8701 S E 156th AveOwewiL ladat0ev nitaaha0 prge '
City: P .and SIWz: 'q SenlatadWk*
-Phone: 76:-9296 Felt: kk-3-1 •mall Qepe I& .n.mla.
CCB no.: t'� Eler,but. o:lic.n34-48QC lams n.or Portia"t waof - -_-
t,trnlred .tealb:ndN _1
City/tnetm tic.n0.: ,;�.•?��•; Wntibdeaeray,non•rulvlential -' ]
,-�V�- �1�_n7 l�dtmwafsetmadhumeornrAul.rAw•dliad
Sigma ue of n�r Wng elcorieian(regdwetl) Due SwvlceanNor reader 2
Sup.elect.name(prim) 1,cettaa no J+5W
keaNtad
a 2
Nfcme(prinQ: F 4{ 't 1 0 m h 1
`� - —-- 0 aatErMailing addrers: 00 r ]
City. State: LIP: liverloouinipt1% 2
Phone. _` Fax: Email^^ Recarmao -"- ---�- I
Owncr inrralhttion:The installation is being made or pmperty I own1 verilmen ac Mon-
which is not inlended ibr sale,lease,tent,or exchx4!e according to .1111hba''ltegook.oted"`"flags:
ORS 447,455,479,670.701. 200 ns at leo 2
201 WWI to 400 2
Owner's ' nature:: Due: 401 to Wo 2
Rnorl efret111s•�i� aretla�.
Name: araattradaaparperel:
A Pee rorbranch drt+tir with purchme of
Addn:ss: _ __ ,ervl!=a feedrt fry;ash 6rartclt dretdt 7
city: --- State: LII' aL Fee ror hraeeh enrnwa Mftwt paehre /
Phone: -_ Fax: Ismail of.entcealbaaertre,6rnbrartt2tctrwtt -?T-
Raeh addkiwg beech dmlt:
MW WTMOMM W k
C7Servineover22'Iamps-ooramerdd 0ilerhh-carefwillty Hae►pumporlid rteiede 2
JSemc=own 121)amp.-rating of 1&2 0Hasordaurlocndnt I?selt orondhteli,(htirt0 _ -
fsrrolydaepinf t O Building over 10 000 sgnre fees four or Slaeul chrnit(s)or s ilttrited emp panW, -
U Synmover60rlvaHsnornutat intim mWedial wdbinoaestrtcaas allendon,orexrexalon• _ T
Onnildngowsthraeanrim 13 Feeclas,4a0•mlaormrne �1>oaai on:
CL d OccepanrMsdever99petwn3 O MsmdacturnJsaueturesorRvpark +
O FlirrrJhphrio014an O thtcr_,_.T_—•_ rwitarpection - -- f
~ S I'b-I seta of pbrsts wilt#y of 11ar above. . nee --_-__ `L
U) Ma abov a are met litallik to t —�
_.T � tatpatary t»swrsttllata aattlots tMtcr
Krol a0)ett.auiea DIC40 mads calk,PROM CIM M iwhdk*M IN we fr Mame.. Notice This permit appliaauan Permit Poe.................... $
U Visa J Mar!rr rd expires if a permit is not oblainei l Ply'review(aI — %) S
(0 c•rak cord numbu �t ti- within IRO days after it has been Slate surcharge(11%)....S
W " -.rest t o s accaptedas mmirtlete. TMAL.......................S
7n, b -r dash= ._-- -`Arewed {4�als rMrrR,N)
I