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10905 SW TIGARD STREET-1 n ■ ADDRESS: 1 Ji:\records\microflm\targets\building.doc I�JI�nayi � 9 5 S L 'nOA 4uoy, iviol 1d1Q1 Ale -- ��3H lam. .�. I , I � I I ` � I I , � f f , I , f I I I , I I , I xvi e Imam 01JH 790W 10 IV N, •3D W43 no .Y. 0.13W SHOW I:1�V SS3Hnov •.�,Pfll IV . UZZ•809 (£OS) SLZZ•809 (COS) 51016 N09380 'N0183AV38 `31016 NO03N0 'NO183AV38 ZIS XOG '0'd 91 Si xa8 '0'd 'SNI SH3MOlH xNVO 'SNI SN3MOrlg ?I*dVg I i i W - a o u r4 I cn II I ► � W_ o � I cr `I I nl 41 w ut Rf• i i � I '� I C� i c W W 1H Q a w W I I ydl Q ,:1 �0 u " � a fn �D o If V E X i CITV OF TI GARD BUILDING INSPECTION DIVISION 24-1-lour Inspection Lina 6394175 Buziness,Phhonc: 6394171 Date Requested: tJ _ / /� A.M. f/ _ P.M. MST: Location: J�'���'-� �( t� �A aA St- _ BUP:-- Tenant: —__ Suite: Bldg: MEC: Contractor: I IZLA1 A, Phone: ['Q o� R ZPLM:9 7-OL1.1a Owner: — — Phone: ELC: _ ELR: p -7_ BUILDING BLDG(con't) PLUMBING. MECHANICAL EUXTRICAL iiTE Site Post/Beam Post/Beam Post/I3c un Covei'Service Sewer/Storm Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab Framing Top Out Lias Line Rough-Li UO Sprinkler Foundation Insulation r,weeerI lluod/Dut.t Rcconnext Vault Rsmt Damp Drywall Storm Furnace Temp`service MISC. Masonry Ceiling Rain Drain A/C UG SLib Shear/Sheath Fire Spklr/Alm Crawl/Found Ir Heat Pump Low Volt Approvedp�r itpproved Approved Approved Appr/Sdwlk Not Approved of A= roved _ Not Approved Not Approved Not Approved FINAL INAZ` FINAL FINAL FINAL L 0 Call for rains tion 13 Reinspection fee of S required before i„ext inspection C3 Unehle to inspect of Inspector: --—_-- Dater Page-.�— ��- CITY CF TIGARD � DEVELOPMENT SERVICES SEWF^ CONNECTION 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171F'E RM I T 1DE RM I T #. . . . . . . : SWR97-025 7 DATE ISSUED: 07/01/97 PARCEL-: 1 S 134DD--00800 SITE ADDRESS. . . : 10905 SW TIGARD S1" `SUBDIVISION. . . . : ZONING: R--4. BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG TENANT NAME. . . . . :EVANS i_.1SA NO. . . . . . . . . . . FIXTURE UNITS. . . . 0 (:I__ASS OF WORM. . . :ALT DWEL-L I NG UN I TS. . : 1. 1 YF'E OF USE. . . . . :SF NO. OF BUILDINGS: 1. INSTALL TYPE:. . . . :LTPSWR I MF'ERV SURFACE: 0 s f Remarks : Sewer connection for- r-esidence. RE: F'1—M97-0;�:32 (3wr,er: -- - -- — - _--.-------_______.__..._.._--.--._..__._____.____________-____._ FEES - - — ------ --- ROBE:RT EVANS type amol.knt by date recpt 1.0905 SW TIGARD ST (-'RMT $ 2200. 00 JSD 07/01/97 97--29663C, TIGARD OR 97223 TNSP, $ 35. 00 JSD 07/01 /97 97-296636 f'h o n e #: 624-••8597 Contractor: OWNER Phone #: $ 7'_`;3`.=. 00 TOTAL. Rey i(. . . -------- REQUIRED I NSPECT I ONS This Applicant ag-ees to comply with all the rales end regulations Fewer Inspec..:tion of the Unified Sewage Agencl, The permit expires 180 days from the date issued. The total ,.mount 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 located at the measurement given, the installer shall prospect ? feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in DAH 952-9014010 through OAP 952-0001-0888. You may obtain copies of these rule,.: or direct questions to OUNC by calling 15831246-1,987, i � J I s1_iefi by : F'ermi.ttee 5i )nature✓ s ++++++++++++++++++++++++++++++4-+++++++++++++i++4++++++++.++++++++++++ F+++;++++++ Ca). 1 639-4175 by 6:00 p. M. for an i nspect ion needed the next bi.rs i ne.:;r, d.ay +.+•+++++-f+++++++++++++++++++++++.+++++++++++++++++++++++++t++++++++++; f+++-4...+++++ Plan C7eck e_ ' OF TIGARD Residential Building Permit Application Recd By 5 SW HALI BLV ,. New Cunstruction Additions or Alterations Date Recd '.ARD. OR 97223 Single Family Detached or Attached (Duplex) Date ro P E. iO3-639-4171 Date to DS"i r. iO3-684-7297 Permit r Print or Type Called _ incomplete or illegible applications will not be accepted .lob Name of Project Name '� Address Site Address -- Architect Mailing A.ldress 776th : 7 city/state Zip Phone Name,/-- _ T-�(' �cr�1 C V Name Owner. Mallin , ress / 7/t, k,�j ,���� > 7 En meer Mailing Address C01549W Zip-171 Z3 Phone CC 9 ��d��� City/State Zip Phone Name General Describe work New O Addition O Alteration O Repair O Contractor Mailing Address to be done. Addibonal Description of Work: cay/state Zip Phone / Oregon Const.Cont, Board LIc.0 Exp Date Attach Copy of _ Current COT Business Tax or Metro for Exp. Date PROJECT Licenses VALUATION -ehanieal Namia NEW CONSTRUCTION ONLY: ---- --- Sub- Mailing Address - � Sq. Ft. House: Sq. Ft. Garage Contractor Comer Lot YES NO Flag Lot YES NO C,ty/State Zip Phone (check one) _ (check one) Oregon Const.Cont. Board L,c,O Exp Date Restricted Audio/Stereo Burglar Attach Copy of Energy System _ Alarm_ Current COT Business Tax or Metro M Exp Date Installation Garage Door HVAC censer _ Opener Systems Name (crthat eck all Other. Plurnbing � -�- - - Sub- Mailing Address Will the a ectnc:al subcontractor wire for all Y-_S NO :ontractor restricted energy Installations) City/State Zip Phone l-'as the Subdivision Plat recorded? TN/A YES NO Cregon Const.Cont. Board L.c# I Exp. Oa,e �elssue of MST solar Compliance Attach Copy of _ __ (Calculation Attached) _ Current Plumping Lc s Exp. Date I hr!aiay acknowledge that I have read this application, that the _ Licenses _ information given is correct. that I am the oamer or authorized COT Business Tax or Meire 1 i Exp agent I agent of the owner. and that plans submitted are ,n compliance Name — — with cn Slate taws. rS, n wre oi,:C r Date Electrical Sub- 'tailing address oat.fr.S Person Name Phone N Contractor I .. L- C,ry,State _ zip Phone I.OR OFFICE USE ONLY: Plat 1: Map/TLrt" Cregon Ccnst Cant Board L c 0 Exp Date I _ "—�__ _ Attach rent of _ Setbacks: I Zone —� Solar Current E:ec:ncai L.c # I Exp Date -- _ Licensee _ _ Frgineenng Aporoval: P!anning -pproval: TIF. CCT Business'aY ,r Metros t.p Date j -REMDLOOC (DST) 3)97 MST Permit (BUILD) (USUtLD) r PIumD Permit (PLUMB) (UPLUMB) Mech. Permit (MECH) (UMECH) —. ELC/ELR Permit (ELPRMT) (UELPMT) State Tax (TAX) (UTAX) BLDG. PLUMB: MECH: ~ ELC/ELR: Plan Check MST. (BI.JPPLN) (UBUPLN) Plumb: (PLUMB) (UPLUMB) Mech. (MECPLN) (UMEPLN) _ 1 Review (BUILD) (CDCBLD) (UCDC) OP CDC fleview,(PLN) (CDCPLN) N/A _ Sewer Connon (SWUSA) (USWUSA) Reimhur. District ( ) ( ) Sewer Inspection (SWINSP) (USWINS) Parks Oev Charge (PKSDC) N/A -- Residential TIF (TIF-R) (UTIF-R) Mass'Transit TIF (TIF-MT) (UTIF-M) Water Quality (WQUAL) (UWQUAL) _– Water Quantity (WQUANT) (UWQANT) Erosion Control Prmt (ERPRMT) (UERPMT) Erosion Planck/USA (ERPLN) (UERPLN) Erosion Planck/COT (EROSN) (UEROSN) `� J Fire Life Safety (FLS) (UFLS) TOTALS: _ I SFREMDL DCC (DST) 6r97 �1111[w�m JEJF� CITY OF TIGARD DEVELOPMENT SEHi!ICES PLUMBING PERMIT PERMIT #. . . . . . . : PLM9-/-023J., 13125 SW Hd1l Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 06/19/97 PARCEL.: IS134nD-`A0800 S IT[,' ADDRESS, 10905 SM T I GARD SUBD I V 15 1 01\1. . . . : ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: TIG CLASS (IF WORK. . :AL.T GARBAGE DISPOSALS. 0 MOB IL.E HOME SPACES. : 0 TYPE OF' USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . .. 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . 0 LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . . 0 L-AVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUE/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 1.00 WATER CLOSETS. : 0 WATER LINE. (ft ) _ . : 0 1)1 SHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remav­ks : L-ay sewer line only. Mo-tst obtain sewev• connection pet-mi.t to conneel, 1,(­; idence to line. Owner-•; ------------------------------------------------------ FEES ROBERT EMNS type amot-trit by da t e r-ecpt 10905 SW TIGARD ST FIRMT $ 30. 00 ,TSD 06/19/9'7 97-2'96206 TIGARD OR 97223 5PCT $ 1 . 50 JSD 06/19/97 97-296206 Phatip #: 624-8597 OWNER Phone #: $ 31. 50 TOTAL Reg REGILIJRED INSPECTIONS rhis permit is issued sub,lect to the regulations contained i^ the Sewer- Inspection Tigard Municipal rode, State of Ore. Specialty 1.'o6es and all other Final Inspection applicable laws. All worN will be done in accordance with approved plans. This permit will expire if work is not sta6�,d within 180 days of issuance, or if work is susp,!nded for more than 180 d,iys. ATTENT19N: Oregon law requires you to follow rules adopted b) the Oregon litility Notification Center. Those rules are set forth in PAR 952-03011-8010 thrnugh OAR You may obtain ccries of these pules or direct questions to RX by calling (503)246-1987. 5 +4+_-r4++#-++_.++++4-(�........F4......................1-+++++++-r+-',++++++-I............F++4 Call 6:?9- 4 175 by 6:00 p. m. for an inspection needed the next b�is iness day t-+.++++r++++++•1-++++............1-4.++-+-1..........#-+++4-+++-#.......f......4..........+++++++ I� �'lumbin A lication Recd By__�__��� CITY OF TIGARD y PP Date Recd 13125 SW HALL BLVD. Commercial and Residential Date tc 'F TIGARD, OR 97223 Date to DST_ (503) 639-4171 Permit 0�t f �- y4a b tN L �r�PQ,��y _ Np op Print or Type Related SWR 1— s I tM Incomplete or illegible applications w;ll not be accepted Called (A)IM t f'"A �� IV pp FIXTURES (Individual) QTY I PRICE AMT 1 Name of DevelopmentlProlect g 00 Sink _ JobLavatory 9.00 Address Street AAddress sU1fe— - 9 00 Tut)or TublShower Comb. _ 9.00 Bldg'! 1 C�i tate Zip -- Shower Only — //fifi> �)7LZ-� water Closet 9.00 -- Name ? r Dishwasher i-- — 900 — �M r i s -e Disposal 900 Mailing Address Suite 9.00 Owner _ Machine Ch,Stale Zip Phone (,,�� FF10- ..rain 2' _ 9.00 Z Z 6) r 3' 9.00 — Name 4• 9.00 !�.SME Water Heater 9.00 Suite Occupant Mailing Address — 9.00 Laundry Room Tray CitylState —Zip Phone Unnal 9'00 Other Fixtures(Specify) 9.00 9.00 JC --_� --- — 9.00 Contractor Mailing Address Sud, —_— — -- 900 Gty/State Zip Phone — — 9 00 ,- __ 9 00 Oregon Const.Cont.Board L.,0 Exp.Date -- — 9.00 Attach Copy of — — — Current Plu,nbtng Lic. Exp.Date Sewer-1st 100' —. -- f 30.00 Licenses ___ Sewer-each additional 100' 25,0 0 COT Business Tax or Metro X Exp. Date Water Seance-1st 100' 3000 ------ Water Service-each additional 200' 25.00 Name — — 30.00 Storm 3 Rain Dram- tat 100' Architect - Storm&Pain Drain-each additional 100 2500 Mailing Address Suite -- 2500 or Mobile Home Space _ rylState Zip Phone! Commercial Beck Flow Prevention Device or Anti- 25.00 Engineer Pocubr ri Device -- Resid ,ilial Backflow Prevention Devtae' 15 UO Describe work New O Adddton O Alteration O Rep3tr O _ to be done. Residential O Non-residential O Any ip or Waste Not Connected to a Fixtwe 900 Additional desrnption of work Ca' n Basin Insp of Existing Plumi inC 4000 per/hr — _ Specially Fequested Inspections 4000 -- --- petfhr Existing use of! 3000 budding or property_--_ --- Rain Drain,single family dwelling — Gtease Traps --V-Lu Proposed use of _ budding or property--__---__-__ ----- — QUANTITY TOTAL Isometric or riser diagram is required A Quanity Total is >9 Are you capping , moving cr replacing any fixWres? Yes❑ No O -- -- --_- 'SUBTOTAL (H yos see back of form) _ __ _ I hereby acknowledge that I have read this applicatirn.that the information --- 5% SURCHARGE givens correct.that I am the owner or authonzed agent of the owner.and J tha s ub tied are in ace with Oregon State Laws. PLAN REVIEW 25%OF SUBTOTAL gna a Of nail nt Date Rertuired only d nxture MYtotal.s>9 - � •(a') TOTAL r � 6LIf 1G-�J onto Person Name Phone •Minimum permit fea s S25-5%sur,urge except Residential Backflow Prevention Device,which is$15�5%surcharge t _ i 1rlydstplmapp doc 8196 ff ■ PLEASE COMPLETE AS APPROP ATE T -PROJE ` Fixtures to be capped, moven or replaced Qty Sink — --- — — Lavatory Tub or Tub/Shower C_c_ -nbir:ationi Shower Only__ Water Closet Dishwasher _ Garbage Disposal __—�_ Washing_Machine _ — Floor Drain 2" 4'r Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) p �^ COMMENTS REGARDING ABOVE: