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11,275 SUI/ Tigard Street
\ BUILDING PERMIT
CITY OF 1 IGA►RD - --
PERMIT#: BUP2002-00361
DEVELOPMENT SEMCES DATE ISSUED: 8/22/02
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S134DC-00200
SITE ADDRESS: 11275 SW TIUARD ST
SUBDIVISION: ZONING: R-4.5
BL0(,K: LOT: JURISDICTION: TIG
REISSUE: FLOOR_AREAS_ _ EXTERIOR_WALL CONSTRUCTION
CLASS OF WORK: DEM �J FIRSI: sf N: y S_ E: W:
TYPE OF USE: SF SECOND: sf PROJECT_OPENINGS? _
TYPE OF CONST: Sf N: S. E: W:
OCCUPANCY GRP: TOTAL AREA: 000 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: f AREA SEP. RATED:
OR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: ME7_.7?: REQD SETBACKS _ _ _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET.
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Remarks: Demo of 2,120 sq. ft. house and 2,400 sq. ft. shop building, all debris to be removed. Septic system to be pumped,
filled and inspected or removed. Deme credits may apply.
Owner: Contractor:
CASA TERRA, LLC RUTAN CONSTRUCTION
919300 SW OAK, SUITE 230 21515 NW CHERRY LAN
PORTLAND, OR 97223 HILLSBORO, OR 9721;
Phone: 503-452-8003 Phone: 643-3737
Reg#: LIC 00040085
FEES RE'1UIRED INSPECTIONS _
Type By Date Amount Receipt Erosion Control 'nsp 846-8 I
PRMT CTR 8/22/02 $62.50 27200200000 Pump/Fill Septic Tank Insp
Final Inspection
5PC1 CTR 8/22/02 $5.00 27200200000
EROS CTR 8/22/02 $26.00 27200200000
ERPC CTR 8122/02 $8.45 27200200000
(additional fees not listed here)
L�
Total $110.41.0
This permit is isstied subject to the regulatiot,3 contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all o:;.er applicable law. 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
requivas you to follow the rules adopted by the Oregon Utility Notification Center. Those ruies are set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-6699 or 1-�h800 32-2344.
Pe mi it tee
Signature:
Issued By: t -------- -- —
Call 639-4175 by 7 p.m. for an inspection the next business day
'�Aax Ut AL:'AA
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Building Permit Application
City of Tigard
A ddre6s; 13125-5W MAN Hl vd,Tigard.OR 97223
C':ty I'xits Pt aa.:
riplMi (SOS) 639-4171
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Land Use.approval: —�
MEWAIMER
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LU PAM—M 33
CITYO F T I A R® —___ PLUMBING PERMIT
PERMIT#: P24/02 00369
DEVELOPMENT SERVICES
DATE ISSUED: 9124/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134DC-00200
SITE ADDRESS: 11275 SW TIGARD ST ZONING: R-4.5
SUBDIVISION: JURISDICTION: TIG
BLOCK: LOT: --------- _-- ---- -
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTr'q:
FLOOR DRAINS: TRAPS:
OCCUPANCY GRP: R3
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRF
LAVATORIES: OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHW 45HERS: RAIN DRAIN: ft
Remarks: Private water service for 12 lot subdivision. _ - ----- --- -- --
FEES
Owner: — Type By ` Date Amount Receipt
CASA TERRA LLC PRMT CTR 9/24/02 $101.40 27200200000
C/O ALPHA ENGINEERING 5PCT CTR 9/24/02 $8.11 27200200000
9600 SW OAK STE 230 - Total $109.51
PORTLAND, OR 97223
Phone 1: 503-452-8003
Contractor:
TROY ELLIOTT PLUMBING
Pr) BOX 1958
NORM t' PLAINS, OR 97133 REQUIRED INSPECTIONS
Water Line Insp
Phone 1: 503-309-5750 Final Inspection
Reg#: PLM 34-402PB
LIC 152310
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 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.
f �
Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Plumbing Permit Application
-- — Date received: ;;,4- Permit no.:
City of Tigard Sewcr permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of figarr/ phone: (503) 639-4171 Project/appl.no.: Axore date:
Fax: (503) 598-1960 Date issued: BYF Receipt no.:
c•atic file no.. Payment type:
Land use approval: 51-1 ) _
r�
r,
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family _ Tenant improvement
New construction CJ Addition/alteration/replacement J I.,w]service U Other:,44I
�'T
Job address: /1^'lt W Slr- Description (1t;. Fee(ea.) "Total
Suite no.:
Nem 1-and 2-family drielling%only:
Bldg•no.: (includes 100 f1.for each tit fifty connection)
Tax map/tax lot/account no.: -S' G 2� " — SIR(1)hath
Lot; I Block: Subdivision: SFR(2)hath
Project name: r S e_D/A )dl a V SFR(3)bath
City/county: lf2D ZIP: 77y2, z7 Each additional bataitchen
Description and location or wo k�gpr�{�ryes: She utilities:
t . '.T'I vRT �� Cutch basin/area drain
D wells/leach line/trench drain
Lst date of amnmplctiun/inspection: Footing drain(no.lin. ft.)
Manufactured home utilities _
fiusumcss name: �t.V SLI I iT1 `F't��1S 1 — „ Manholes
Address: 0. �t1e?SJ Rain drain connector
City: t NS State:a ZIP: ( _ _ Sanitary sewer(no.lin.ft.)
Phone: �yU )0 ux: Email: Storm sewer(no.lin.ft.)
r7V - �D Q Water service m: in.ft.)
CCB no.: / 1 Z Plumb.bus.reg.no: �1/— Flxturc or Item:
City/metro lic.no.: 471 rl tion valve
Contractor's representative signature. _ Back flow preventcr _
Print nam .
Date: - Backwater valve _
Basinstlavatory
Clothes washer
Name: -
M Address: "�,y !VV �"/F - r rE v Drinkin fountain(s) _
City: r r'r( NA State:f c ZIP: 7Z ��Fgnansi(.n
•ctors/su
-Phone: S, S2, 2 Fax: �- Email: Ct tank
I Fixture sewer cap
C� A -7rrKVA LG G Floor:rains/floor sinks/hu
Name(print): !ffdrbage dis oral
C, • G ea r W r1A e, 1/ Pr Hose bihh
C� Mailing address: e, f -
City: State: G'1s' 'LIG - ce maker
Phone:- 00? Fax: 2 - E-mail: Interceptor/grease trap
Owner installation/residential nance only: The actual installation Primer(s)
will be made by me or the mai r -c rid repair made by my regular Roof drain(commercial) —
employee on the property 1 b hapter 447. Sink(s),basin(s),lays(s) __J I
Owner's signature: Date: Il DL Sump _
Tubs/shower/shower an
`•_ '� t c�i _Urinal
Narne: -lIM 1 l E 1�e Water closet
Address: 1'1 l'r Water heater
t to ra State: ZIP: ''Z?' Other:
City: 'ZT'T —
Phone: 5i1 y.� + Fnx: r'' •10 E-mail:-IiM t V E_. ota
ll
" Minimum fee................$ --
Nd all JuriedicNom accept credit code,please call Jurisdiction for mrxe infonnallun, Notice:This permit application Plan review(al — %) $ ---
,, U Visa U MaractCard expires if a permit is not obtained State surcharge(8%) ....$
Credit card numner _____— ---- ---1—— within 190 days after it has been
F.eplrcs TOTAL .......................$
accepted as complete.
Name or cardholder u drawn on credit card s
Cardholder slpwure Amount
440-46161 OM)
PLUMBING F ERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only: 1 '
FIXTURES (individual) - QTY ea AMOUNT (Includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY .(as) AMOUNT
Lavatory 16.60 for each utility connection)
One 1 bath $249.20
Tub or Tub/Shower Comb 16.60 Two 2 bath _ $350.00
Shower Only 16.60 Three 3 bath -
_ LL �. 5399.00
Water Closet 16.60
__
Urina _ 16.80 SUBTOTAL
STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
Laundry Tray 1660
Washing Machine 16.E0
Floor Drain/Floor Sink 2" 16.60
3" - 16.60 PLEASE COMPLETE:
4" 16.60
Water Heater 0 conversion 0 like kind 1660 _ (]uantit b Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit, _ Ca ped
MFG Home New Water Service 46.40 Sink —
MFG Home Now San/Storm Sewer _ 46.40 Lavattr
Hose Bibs 16.611 Tub or Tub/Shower -
_ Combination
Roof Drains 16.60 Shower Only _
Drinking Fot, 18,83 Water Closet
Other Fixtures(Specify) — W60 Urinal
— Dishwasher
_
_garbage Dls osal
Laundry Room Tray
-- —
Washing Machine
Sewer•1st 100' 55.00 Floor Drain/Sink: 2"— -
3"
Sewer-each additional 100' 440 -- 4"
Water Service-1st 100' / 55.00 54>ev Water Heater
Water Service-each additional 200' 46.40 O Other Fixtures
31onn&Rain Drain-1st 100' 55. 0 (Specify)
Storm 8 Rain Drain-each additional 100' 46.40 _
Commercial Back Flow Prevention Device 46.40 _
Residential Backflow Prevention Device- 27.55 --
Catch Basin 16.60 —-
Inspection of Existing Plumbing or Specially 62.50
Requested Inspections _ per./hr COMMENTS REGARDING ABOVE:
Rein Drain,single family dwelling 65.25
Grease Traps 16 'J
QUANTITY TOTAL / -
Isometric or risdr diagram Is required If - ---
Quanl Total Is >g
---._ .
'SUBTOTAL -
8%STATE SURCHARGE
"PLAN REVIEW 25%OF SUBTOTAL
Required only If 8xtwe qty total Is>g
TOTAL
"Minimum permit fee Is$72 50+8%state surcharge,except Residential Backflow
Prevention Devine,which Is$36 25 4 8%state surcharge
~All New Commercial Buildings require 2 sets of plans with Isometric or rifer
diagram for plan review.
is\dstsVorms\plm-fees.doc 12/26/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP V
Received Date Requested 'LL AM - PM BLIP
Location �,� _ _ Suite -
� _ -
-_- _-. _ MEC
Contact Person �..� Ph a —�L � PLM R- _
Contractor ,�//..,, SWR
BUILDING — Tenanvowner _ C LC - -
Footing
Foundation Access: "� ELC
Ftg Drain FLR
Crawl Drain -
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ---- - - - ----- -
Insulation
Drywall Nailing --- - - -
Firewall
Fire Sprinkler -
Fire Alarm .JL
Susp'd Ceiling
Roof
Other: ----
Final ----��-------
PASS PART FAIL - --
PLUMBING
Post 8 Beam
Under Slab -
Rou h-In -
a er e�rvic-e-s -- _.-_-
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
MECHANICAL
Post& Beam- - -------------__
Rough-In _.--.�---- -- --- - ---- - --
Gas Line
Smoke Dampers - -------- -- - --- ------ ----...-
Final
PASS PART FAIL ------- ------- ------ .-_..----------- -- --- ----��
ELECTRICAL
Service -
Rough-In
UG/Slab - -------__
Low Voltage
Fire Alarm
Final C1 Relnspeetion fee of$___._--_required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE -`� Please cal for reinspe tion RE: - _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dab - -�-- InspealOr Ext
Other:
I anal DO NOT REMOVE this Inspection record from the Job site.
PASS I ART FAIL