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13920 SW 87TH COURT J W u 00 7 0 A 1 ry 1 13920 SW 87"' Court CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00256 13125 SW Hall Bled., Tigard, OR 97223 1,50:,) 639-4171 DATE ISSUED: 9/5/02 SITE ADDRESS; 13920 SW 87TH CT PARCEL: 2S102DD-00810 SUBDIVISION: FILBERT PARK ZONING: R-4.5 BLOCK: LOT: 003 _ ,jURISDICTION: TIG TENANT NAME: USA NO: F"ITURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Connect existing residence to sewer. Septic tank rr,,st be pumiced, filled and inspected or removed. Owner: GLORIA KERR FEES 11615 SW CLOUD ST Type By Date Amount Receipt TIGARD, OR 97224 PRMT CTR 9/5/02 $2,300.00 27200200000 I JSP CTR 9/5/02 $35.00 27200200000 Phone: 503-620-1819 — _-- Total $2,335.00 Contractor: PENGUIN TRACTOR PENGUIN TRACTOR AND EXCAVATING 1 184 NE SUNRISE LN HA BO 681 CX3197124 Reg#: LIC 1 P4782 PLM 26-1116PB Required Inspections Sewer Inspection Septic Tank Filled This Applicant agmes to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 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 located at the measurement given, the Installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "1 ap and Side Sewer" Perm a Issued by: r yM . -; .,: , Permittee Signature: Call (503)639-4175 by 7:00 P.M.for an Inspection needed the next bur;iness day CITYOF TI GA R D — PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00352 13125 SW I-#all Blvd., Tigard, OF 97223 (503) 639-4171 DATE ISSUED: 9/5/02 SITE AriDR,-SS: 13920 SW 87TH CT PARCEL: 2S102DD-00810 SUBDIVISION: FILBERT P P..K ZONING: R-4.5 BLOCK: LOT: 003 JURISDICTION: TIG CLASS OF WORK: NEV'/ GARBAGIF DISPOSALS. MOBILE HOME SPACES: TYFE OF USE: SF WASHING MACH: 6ACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: GII4KS: URINALS: GREASE TRA.S: LAVATORIES: OTHER FIXTU?ES' TUB/SHOWERS: SEWER LINE: 300 ft WATER CLOSETS: WATER LINE: ft DISHWASHE"4S: RAIN DRAIN: ft Remarks: Installation of(2) Sanitary sewer lines for a tc,,al of 300'. One line is to connect existing house to sewer and the other line is for future development. Owner: - Type By Date FEESAmount Receipt GLORIA KERR PRMT CTR 9/5/02 $147.80 2720u2000001615 SW CLOUD ST 5PCT CTR 9/5/02 $11.82 27200200000 GARD, OR 97224 MISC CTR 9/5/02 $456.13 27200200000 Phone 1: 503-620-1819 1 Total $615.75 Contractor: PENGUIN TRACTOR PENGUIN TRACTOR AND EXCAVATING 1184 NE SUNRISE LN REQUIRED INSPECTIONS HILLSBORO, OR 97124 ----- -------- — Phone 1: C81-0319 Sewer Inspection Resj#: LIC 104782 Final Inspection PLM 26-31bP13 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 fallow 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) 245-1987. Issued By: / " %f Permittee Signature: '` 10 /X1 esl /L Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day Building Fixtures Plumbing Permit Application A Date received: Permit no.:f 6H;/jpQ-LYJ j City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 ;ewer permit no.: Building permit no.: City of Tigard Phone: (503) 6394171 Project/appl. no.: t.YRjre date: Fax: (503) 598-1960 Date issued: B Receipt no.: Land use approval: case file no. Payment type: TYPE OF PERMIT- U I & 2 fam1y dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: ._ 1 : SITE INFORMATION1 , Information use checklist) Job address: /, Q s, ({J, 8 7 r'` Cr Descripdcri Qty. Fee(ea.) Total Bldg, no.: Suite no.: New 1-and 2-family dwellings only: Tax map/tax lot/account no.: 8/0 (includes 1010 ft.for each utility connection) SFR(1)bath Lot: _7 IBlock: Subdivision: e5l,,6P t ArcA SFR(2)bath Project name: SFR(3)bath City/county: LIP; 7,2, z. Each additional hath/kitchen Description and ocation of work on premises; Siteutilities: es o V SC t�/ C r Catch basin/area(train - ^--- D wells/leach Iine/trench drain {st.dalc nfaxnplet ion/insperunn rY _ PLUMBING CONTRACTOR Footing drain(no.lin.ft.) Manufactured home utilities 7Aedrcqs: nt.s name: �Ch v� T�� � 4rx G�� Manholes p , tB $v/� "e L Rain drain connector s F 11CA b p-o State:(� ztr:q /L Sanitary sewer(no. lin. R.)e: / -8 >Pa Fax: p .�/ E-mail: Storm sewer(no.lin. It.) CCB no,: 0 _Z I'lumk,bus.reg,no; Water service(no.lin. R.t City/metrolic.no.: - Fixtureoritem: Contractor's representative signature: Absorption valve Back flow preventer Print name: bate: Backwater valve Basins/lavatory Name: 7' I'fl Clothes washer Address: /4/q0 mac' (,�,r / `-- Dishwasher Cy: "7" _�,.y State:Q�j 7_IP. Z— Drinking fountain(s) it — �_ �_— Ejectors/sump Phone: 3 _ 1 ax: E-mail; ' tan F xpansion k -- Fixlure/sc��crc.y;Name(print): �CrFloordrain` tl,wa "Ink"huh address: --- - Garbage disposal- Mailing — - �4 /S' S. 1✓. e 0tr Gt -Ilosebibh Cily:WfQ,.�lI Stale:0/Qr I ZIP: V 2.Z A Ice maker_v _- 1'h me: 9,Zo Fax: E-mail: Interceptot,grease trap Omicr installation/residential maintenance only: The actual installation Primer(s) will he made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature:_ Date: Sump — Tubs/s ower/s ower pan — Urin---�---- --- -- Name: W, LIVvt wf A A it r06, ZMGl__ — Watercloset Address: /I ✓of Water heater — -- City: 7-,"Or"d_ --- State:Ofj ZIP: x''7L tf Other- Phone: t er Phone. 01-9-34�� Fax: � E-mail: — _ •Total Not all jurisdiclions accept credit card+,please call p,Nadicunn for mme information. Minimum fee..... .......... S Notice: This permit application a U Viaa U Master('ard expires if a permit is not obtained Plan review(at _ /o) $ ('redo cud number r_ a res within IRO days after it has been State surcharge(8%)...I $ - p accepted as complete. _ TOTAL. $ /C- --�iameor`— emir�13"eru�Fnwnnncredircard�`— p P •���•••••�•����•�����•• - Ca older�fierr signature —— -- __.muni_- - '�, � 1, o r'r�/.(� �.. 440,46 It.t6f10/COMI PLUMBING PERMIT FEES: '- ?P.ICE I TOTAL New 1 and 2-family dwellings only: PRICE TOYAL FIXTURES individualL QTY (ea) _ AMOUNT (includes all p:umhing fixt,,res In AMOUNT 16.60 the dwelling and the first110 it. QTY (ea) Sink for each utilit connection $249.20 16.60 One'1 bath Lavatory -- $350.00 Tub or Tub/Shower Comb. 16.60 Two 2 bath $399.00 o- 16.60 Thre3 3�bath - Shower Only ------- 16.60 SUBTOTAL -� Water Closet _ Urinal _ 16.60 _ 8°!�-STATE SURCHARGE PLAN REVIEW 25%OF S_UBTOTAL 1 s.60 1--- 1_ Dishwasher AL _� 60 Garbage Disposal 16. _ 16.60 Laundry Tray 16.60 Washing Machine Floor Drain/Floor Sink 2" 10 PSE.-ASE COMPLETE: 3„ 16.60 4° 16.60 _ - Quantlt b Work Performed 16.60 Fixture Type: New Moved Replaced Remove df Water Healer O conversion O like kind Ca ed Gas piping requires a separate mechanwal _ permit. 46.40 Sink MFG Home New Water Service Lavato MFG Home New-San/Storn Sewer 46.40 Tub or Tub/Shower 16.60 Combination Hose Bibs 16.60 Shower 0 Roof Drains Water Closet Drinking Fountain 16.60 Urinal Other Fixtures(Specify) 16.60 Dishwasher Garba a Dis osal _ Laundr Room Tra Washin Machine Floor Drain/Sink: 2" 55.00 3- S3wer-1st 100' < �' 46.40 $G1 4- Sewer-each additional 100' _ Water Heater Water Service-1at 100 55.00 Other Fixtures Water Service each addllional 200' 46.40 S ecl - Storm&Rain Drain-1st 100' 55.00 Storm&Rain Drain-each additional 100' 46.40 Comniorcial Back Flow Prevention Device 46.40 Residential BaCkIlOW Prevbntion Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 62.50 COMMENTS REGARr)ING ABOVE: or/hr Re l.ested Inspections -..--- 65.25 -- Rain Drain,single family dwelliny i - 16.60 _._---- Grease Traps QUANTITY TOTAL - Isometric or riser diagram is required It Quantity Total Total Is >9 'SUBTOTAL "to - 8%STATE SURCHARCE "PLAN REVIEW 25%OF SUBTOTAL Req"rired only if fixture qty total is>9 _ TOTAL S,^ *Minimum permit fee is$72 50+8%stale surcharge,except Residential Backflow Prevention Device,which is$38 25 4 a%state surcharge "All New Commercial Buildings require 2 sets of plans with Isometric or riser , diagram for plan review. i i!\dststforms\plm-fees.doc 12/26/01 CITY OF TIGARD DUILDiNG INSPECTION DIVISION MST 24-Hour Inspection Line. 639-4175 Business tine: 639-4171 - -- BLIP —Date Requested /o�a�-/9% AM ---PM _ BLD Location.. 3c/��rLul��w� `` �J�'S ..74- Suite JI —— rEC Contact Person `LAY� F-Lc�GGy'' Ph l0.3 l _5�SS ] PLM Pq 9 Contractor Ph SWIRado C 3 3 BUILDING Tenant/OwnerELC Retaining Wall - ELR Footing Access: - Foundation F�11w_.L FPSFtg DrainXM SCiN Crawl Drain Inspection Notes: Slab SIT Post&Beam --- Ext Sheath/Shear C _ Int Sheath/Shear - -- Framing Insulation 1 Drywall Nailing Firewall yL Fire Sprinkler Fire AlarmC - Susp'd Ceiling Roof Misc._ Final PASS PART FAIL t3�NG Post R Beam Under SlabTop Out WateL,iy ice loe .- _ Rain Drains -- Fin ASS PART FAIL -MtnANICAL Post& Beam Rough In Gas Line --- — Smoke Dampers Z Final - f - - PASS PART FAIL � / �� 1 � �, 7 ,,. v � •� L� ELECTRICAL `y Service t ..- Rough In �- UG/Slab Low Voltage Fire Alarm Final __----- ----- --- ____, _ PASS PART FAIL SITE Backfill/Grading - -- -- -- Sanitary Sew, Storm Drain ( J Reinspection fee of$ required before next inspection Pay at City tall, 13125 SW Hall Blvd Catch Basin Flro Supply Line ( )Please call for reinspection RE: J A— ( J Unable to inspect •no access Ar'4 Other Approach/Sidewalk pate G Inspector ��) _- Ext 1` Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. m CL n o rn m rn �a � O T N 3 N .r � U oY LO .. ti o U 00 C:) O co M Q)O T LJ � O 0) T 0) O D r O Q O y 0) e 5 _ 16 [� m Q N NN 3 C) �O N T- N d) N c' E o 0 a� Boa a N R 4 vi �- Z 2 a N O rn ~ o CL 'C N i i 'L7 0 Z Z 10 d Q = 10 Z a) O il� 6 0 N in Y. C) 's 2 T T' M W 1 d CL 2. U 000 rn m am rn �a CL N N O � a o � o � 00 rn w o �a T Cl) T 000 0 (3) CD na) o � F- © No n. N �q U (n � � cn N ; E cn L) CL C:, y N � O 06 W V) 00) 0 (L 0 O E C7i ch L Z �- O N 0) fC O c v ro V) m � 4� � U C_ � U C = O M O x r z 41 m Q ^� Z z -7 ro am Ln _ > rn 0 o UI j Z S m CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE PENGUIN TRACTOR PENGUIN TRACTOR AND EXCAVATING p 1184 NE SUNR+SF LN-_ 10418, n1 LYc�-71�;�'✓/�n�o���J� HILLSBORO_, OR -97-424-- f GVe6rr -We, Lo/Z Plumbing Signature Form Permit #: PLM2002.00352 Cate Issued. g,'5102 Parcel: 2S102DD-00810 Site Address: 13920 SW 87TH CT Subdivision: FILBERT PARK Block: Lot: 003 Jur',,Fdiction TIG Zoning: rR-4.5 Remarks: Installation of (2) sanitary sewer lines for a total of 300'. One line is to connect existing house to sewer and the other line is for future development. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid; please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work . No plumbing inspections will be authorized until this completed form is received OVVNt-lam: PLUMBING CONTRACTOR: GLORIA KERR PENGUIN TRACTOR 11615 SW CLOUD ST" PENGUIN TRACTOR AND EXCAVATIN( TIGAF '), OR 97224 1184 NE SUNRISE LN HILLSBORO OR 97124 Phone #: 503-620-1819 Phone ##: 681-0 19 Req #: LIC 104782 PLM 26-316PB AN INK SIGNATURE IS REQUIRED OW HI F R X (J natur f Auth ized-IM#a have an questions, lease call 503 -4171 ext. # 243 If you a e v q , p ( ) 639 3 -_--� CITE' OF T'IGARD 24-Hr BUILDING Inspection Line: (503) 639-4175 N INSPECTION DIVISION Business Line: (5031 G39-4171 MST --_- -_ _- ��/� BLIP - - --- - - Received ____ -- Date Requested —1-t�_ -_AN! — PM --_ BLIP Location _ _ .__/39a6 E7 Or- _Suite MEC - Contact Person _ C44 0 _ -__ Ph(—) - � PLM o� L C�? 4c�� Contractor -_ Ph( ) SWR BUILDING Tenant/Owner _ _ ELC - Footing ELC Foundation - Fig Drain Access: ELR Crawl Drain Slab Inspection Notes: ~--- SIT Post&Beam Shear Anchors - --- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Dr/wall Nailing Firewall Fire Sprinkler Fire Alarm ousp'd Ceiling -- I- Roof Other: - — - - ---- ' Final PASS PART FAIL — LU Post& Beam - Under Slab -_— Rough-In Water SewicQ.___ - an tary Sew.-F Rain Catch Basin/Manhole Stogy m Drain - - Shower Pan Other: - -- - - Fi --_ A _PART -FAIL - -A--- MEC_H_ANICAL Post 8 Beam __- Rough-In --__ __----•----___-- _ Gas lire Smoke Dampers -- ----- - ___ Final PASS PARI FAII_ -- ---- ---- - -• -�____�__.__ ELECTRICAL Service - - - - Rough-In UC/Slab _---- -- —�—�- - Low Voltage Fire Alarm --- Final Reinspection fee of s _ required before ned inspection. Pa at CI Hall, 13125 SW Hall Blvd. PASS PART FAIL l--] P q P Y City SITE — [ Please II for reinspection RF:__- _ _-- F-1 Unable to inspect•-no access Fire Supply Line � s ADA Dawt� - Approach/Sidewalk `' �- -_.r-. Inali1c•ct0► - Other. Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL w�_ r CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ,,,,,.,%d L. PENGUIN TRACTOR SEP 1 2002 PENGUIN TRACTOR AND EXCAVATING 1104 NE SUNRISE LN HILLSBORO, OR 97124 Plumbing Signature Form Permit #: PLM2002-00352 Date issued 9i5102 Parcel: 2S102DD-00810 Site Address: 13920 SW 87TH CT Subdivision: FILBERT PARK Block: Lot. 003 Jurisdiction: TIG Zoning: R-4.5 Remarks: Installation of to sewer and the olther li�ne�is for future, (2) sanitary redeOvelopmentne line is to Gonne, existing ho oi Your comoanyhas been indicated as the plumbing contran�ivduar for hfrompermit your company above. gn beloworder andf relthn plumbing permit to be valid, please have the appropriate this Plumbing Signature Form prior to the start of the work . No plumbing inspections will be authorized until this completed form is received OWNER t'I.UMBING CONTRACTOR: GLORIA KERR PENGUIN TRACTOR 11615 SW CLOUD ST PENGUIN TRACTOR AND EXCAVATIN( TIGARD, OR 97224 1164 NE SUNRISE Liv HILLSBORO OR 97124 Phone #: 503-620-1819 Phone #: 681-0M9 Rett #: sic 104782 PLM 26-316PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Authorized Plumber If you have any Questions, please call (503) 639-4171 , ext. # 2433