11790 SW 92ND AVENUE anNSAV nN76 MS 05/.TT
BARD
PLUMBING PER1,11-r`1TY OF T 1 PERMIT #. . . . . . . : PLM43----0357
DA' TE ISEJED: 12/07/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall 51vd.Tigard,Oregon 9722398199 (503)639-4171 P,A P.C El-, IS135DC-05600
SITE (41)DREGS. . . : I i /')III S W 1)'-N D A V F-
SUBDIVISIGN. . . . : BARBEE COURT ZONING: R--'
T. . . . . . . . . . . . .
CLASS OF WORK. REP GORBOGE DI'SPOSAL117. 171 MOBILE HOME SPACI.'.5.
TYPE OF jSK'. . . . :SF WA311ING Mi')CH. . . . . . . 0 BACKFLOW PREVNTRS. . 0
O(,,'CUPAN-*,Y 5RP. P3 FLCOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . 0
STORIES lzi WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . 171
LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINES. . . . . . . . . . . 1 URINALS. . . . . . . . . . . . 0 GREASE TRAPF 0
LM,'ATORILS. . . . . 2 OTHER FIXTURES,. . . . : 0
TUB/F.IHOWERS. . . . 2 SEWER -INE (ft ) . . . : 0
WATER C-OSETS. . WATER LINE (ft) . . . : lil
DIGHWASKIRS. . . . 0 RAIN DRAIN (ft ) . . . : 0
------- FFE-Er-)
LORENTZ BRL.JUI\l CO INC tvOe AM 0 Unt by date ii,-ecpt
3636 SE 20 AVE P,RMT f~ 63. 00 .TSD 12/07/95 95-273670
SPCT 1 3. 15 JSD 12107/95 ')5-,='7
PORTLAND OR 97242
Phone #: 232-7106
Contract or.:
[ROWLAND PLUMPING
4524 N LOMBARD
PORTLAND OR 97:*-'033
PI-iorie r-1,85-2:586 (,6. 15 TOTAL
Reg 0. 005628
REUUIRED INSPEuIONS
Piis permit is issued subiect to the regulations contained in the RuLtqh-iri Ins
TiSard Municipal Code. State of Ore. Specialty Codes and all other, FILM/Underfloor
applicable laws. All work will be dope in accordance with Top-clut Irlsp
approved plans. This permit will expire if work is not started Final liir,pec,tir)ri
within IN days of issuance, or, if work is suspended for more
than 100 days.
P e r-in i v' I qnA t I..1 v-P -
Ca I I for- i ri s,r)ect i a n 39--4175
City of Tigard PLUMBING PERMIT APPLICATIO': Planck/Rec. #
13125 S'J,J Hall Blvd. Permit # �Ito% `j5 0 3(;7
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ;'T. SURCHARGE
` wm.w o.. 0-1 New Single Family Residenais Only
M*- :1 1 BATH HOUSE $140.00 C 2 BATH HOUSE$195.00
Job �,r (� `- 2►Jo ❑ 3 BATH HOUSE$225.00
Address Fee includes all plumbing fixtures in the dwelling and the first 100 feet
� ) VF C") -
Dof water service, sanitary sewer and storm sewer. Sen fees below.
wm• .,.•„•,,�R,n.,...r FIXTURES CITY PRICE AMT
Sink 9.00 '
M-1 kM.•u' �'��• Lavatory Z 9.00 f
Owner Tub or TubiShower Comb 900 O
n-:.• cc Shower Only 9.00
Water Closet ? 900 C_t:
-` �.m+,n„•m•, .....• Dishwashc: 900
Garbage Disposal 900
Occupant M��M• �• Washing Machine 9.00
Floor Dram 900
Water Heater 900
Laundry Roy n Tray 9.00
m• r Urnal 9.00 I
��OI,OCAYJ-1_ �L1aawU'3O Other Fixtures (Specify)`--- - 9.00 -�--
M.Iny Ad&- Ph.•• 900
Contractor 2�S - --
56 _ _ 900
Z0 900
--w'T f ti o V Sewer 1st 100' 00 __—
`bM.Reyrb.WNo 'n cm Bus T..N. Sewer -ea. Addit 100' 25 00
T•wo Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea Addit 200' 25 00
information given s correct, that I am the owner or authorized agent of - -
Storm & Rain Drain 1st 100' 3000
the owner, that plans submitted are in compliance with State laws, that
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit 100 ?'+00
number given is correct. (If exempt from State registration, plea-,e —
give reason below) Mobile Home Space _-
( Back Flow Prevention
Device or 4nti-Pollution Device 900 -_
w. ,•�• �•o•^ ��1---==--- •^ Any Trap or Waste Not —
Connected to a G' :�e 900
Describe work new addition Q alteration (_l repair Catch Basin 900
to be done residential non-residential n Insp of Exist Plumbing 40.00/hr
Specially Requested Inspections 40 00/hr
Existing use of -�jC Rain Drain, single family dwelling 3000
L,jilding or property _
Residential backflow prevention
devices 1500
Proposed use of .�-�--
budding or property - _ --'--
'(Except residential backflow
prevention devices)
U
NOTICE 'Minimum Fee $25.00 SUBTOTAL („J
PERMITS BECOME VOID IF WORK OR CONSTRUCTION I15
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5°'. YURC4ARGE 3-
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED -
FOR A PEPrOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED PLAN REVIEW 25% 0' SUBTOTAL
TOTAL C 'I rf0
Suecial Conditions _
Date issued Cv
MASTER PERMIT
ERMIT #. . . . . . . : MST95---0412
1TY OF TIGARD PERMITDATE ISSUED: 11/29/95
COMMUNITY DEVELOPMENT DEPARTMENT
131,'!5 SW Hall Blvd,Tigard,Oregon 97223*8199 (503)539.4171 PIAPCEl-- 1 S 1 35DC-0560Qi
si ru SW ''- 1D AVE
SUED I V I S 1 ON. COURT ZONTNIG: R7
. . . . . .. . . . . . . . . . . . . . . . . ..zl.
Remarks: fire damage repair
--------------------------- ----------------------------------- --------------------------------------------------------------
RE'SSUE:
STORIES....... P FLOOR AREAS---------- ;ASEMENT... of REOLTRED SETBACKS---- REQUIRED-------------
CLASS OF •WORK.AEP HEISHT........ 0 FIRST.... 0 sf GARAGE..... sf LEFT.......... @ SMOKE DETECTRS: Y
TYPE -,,F USE...:SF FLOOR LOAD....: 0 SECOND...: 0 Sf FROM......... 0 PARKING SPACES: 0
1YPL I CD\-3T.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT.........: 0
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL------:---: 0 sr VALUE..f: 30000 REAR..,.......: 0
----------------------------------------------------------------- PLUMBING --------------------------------——----------------------- -
5INKS......... I WATER CLOSETS.: 2 WASHING MACH.. e. LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: ri
..AVATORIES.... 2 DISHWASHERS...: @ PLOOR DRAINS.. 0 SEWER LINE ft: @ 9F RAIN DRAINS: 0 CATCH BASINS—: 0
TUB/SHOWERS...: 2 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: @ GREASE TRAPS..: 0
_-------------------------------- - MECHANICAL —-------------------_--------- 07HER FIXTURES: 0
'UEL TYPES----------- FURN ( IW @ SOIL/CM0 ( 3HP: 0 VENT FANS.....: CLOTHES DRYERS: 0--------------------------
,'GAS/ / / rlwft )-low 0 UNIT HEATERS.. 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.. @ BTU FLOOR FURNACES: 0 VENTS.........; @ WOODSTOVES.... 0 GAS OUTLETS...: 0
-------------------------------- --------------------------- ELECTRICAL --------------------------------------------------------------
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS--- -ADD'L INSPECTIONS-
ION SF OR LESS: @ 0 200 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
'q ADDL 50015F.: 0 201 400 ago.. : 0 201 - 400 amp..: 0 1st W1 SVC/FDR: 0 SIGN/OUT LIN LT: @ PER HOUR...... : 0
: ;MITER ENERGY.: 0 401 600 610L..: @ 401 - 60P amp.. : 0 EA ADDL BR CIR: 0 SIGNAL/PANEL—. : 0 IN PLANT......; @
MANF HM/SVC/FDR: 0 601 1000 a
op.: @ 601+alps-1000 v: 0 MINOR LABEL -10: 0
IW+ amp/volt.: 0 ----------------------------------- kAN REVIEW SECTION ----------------------------
Reconnect only.: 0 )24 RES UNITS..: SVC/FDR)=22'j A., ) 600 V NOMINAL: CLS AREA/SPC OCC:
---------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY
:------- -----------------------------------l,, SF RESIDENTIAL--—------------------------ B. COMMERCIAL------------------------- ------------------------------—--------------
AUDIO I STEREO.: VACUUM SYSTEM...- AUDIO 4 STEREO.: FIRE ALARM..... INTERCOM/PAGiNG: OUTDOOR LNDSC LTi
BURGLAR ALARM..: OTH: BOILER.........: HVAC...........: LANDSCAPE/IRAIG: PROTECTIVE SIGNL:
GARAGE OPENER..., CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEII�:
Owner: ---------------------- ----------------------------- TOTAL FEES:1 423.00
LORENTZ BRULIN CO INC LORENTZ BRUUN CO., INC.
3636 SE 20 AVE 3636 SE 20TH AVENUE
PORTLAND OR 97242 PORTLAND OR 9724E
Phone #: 232-7106 Phone #: (503)232-7106
Reg #..s OW33
This permit is issued subject to the regulations :ontain@d in the Tigard Municipal Code, Sta # of Ore. Specialty Codes and all other
applicable lawi. All work will be dve in accordance with &0Voyfd plans. This permit will axoire if work is not Started within IFP
days of issuance, or if work is suspended for more than IN, days.
------------------------------------------------------ ACQUIRED INSPECTIONS ------------------------------------------------------------
Mechanical Insp Insulation Insp Buildina Final
Plumb Top Out Gyp Board Insp
Electrical Seryi Electrical Final
Pt-aoing Insp Mechanical Final
Low Voltage Plumb Final
77.
rmit tee S i qnat ktr e C;S,t P(.1 S /4
Per. iarr 6:39-4175
CITY OF TIGARD MASTER P:, RMIT r
I-F"RM I T #.. . . . . . . M,�T9r-�_X41 c
D►ITE ISSUED: 12/01/95
COMMUNI'Vi DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.'Tigard,Oregon 97223.8199 (503)839-4171 PARCEL.: 1 S 1 35DC-05600
--)ITL PIDDRE:SS. . . : 111':40 .SW 92ND AVE:
-;UBOIVISZON., . . . : BARBE.E COURT :ZONING: R--7
61'..0CI•;. . . . . . . . . . . 1-01'. . * . .8 * . . . . .
-D1`. . . . . . . . . . . . .
Remarks: Fire damage W.air to include rvolacement of 8 light fixtures and 22 surface plugs, no wiring
----------------------------------------------------------- BUILDING --------------------------------------------------------
RE.ISaE: STORIES.......: 0 FLOOR AREA.--- ---- - BASEMENT.,.: @ sf REQUIRED SETBACKS---- REOUIRED-------------
CLASS OF WORK.-REP HEIGHT........: 0 IRST....: 0 sf GARAGE.....; 0 sf LEFT..........: 0 SMOKE DETECTP,S: Y
TYPE OF USE...:SF FLOOR LOAD....: 0 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT.........: 0
OCU"AiNCY GRP.:R3 BDRM: 0 BATH: @ TOTAL------: 0 sf VALUE..$: 300@O REAR..........: 0
----- PLUMBING ------------------------------------•---------------------------
INKS.........: 1 WATER CLOSETS.: 2 WASHING MACH..: 0 LAIMIDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 2 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: @ CATCH BASINS..: 0
TUB/514OWERS...: 2 GARBAGE DISP..; 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GR&I.SE TRAPS..: 0
OTHER FIXTURES: 0
------------------------------------------------------------ MECHANICAL ---_----_--------------------------------------------------
UEL TYPES----------- FJRN ( 10011 ..: @ BOIL/CMP ( 3HP: 0 VENT FANS...,.: 0 CLOTHES DRYERS: @
!GAS! I / FURN )zINK ..: 0 UNIT HEATERS.. : 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 YEN`S.........: 0 WOODSTOVES....s 0 GAS OUTLETS...: 0
-------------------------------------------------------------- ELECTRICAL. ---------------_--____--.--------------------------------
-RESIDENTIAL UNIT--- ---SE?VICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS-
10@0 SF OR LESS: 0 0 - 20@ asp..: 0 0 - 200 ago..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PIER INSPECTION: V
EA ADD'L 50@Sr-.: 0 211 - 400 amp..: 0 2@1 - 40@ ago.,: 0 1st W/O SVC/FDR; 0 SIGN!OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENFPEr.: 0 401 - 600 asp..: L1 401 - 6@@ am.: @ EA ADDL BR CIR: 0 SIGNALIP04EL... : 0 IN PLANT......; 0
MANE HM/SVC/FDR: 0 601 - 100@ amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: @
1000+ ago!volt.: 0 --------- - -------------------- PLAN REVIEW SECTION ---------------- ---------------
Reconnect only.: 0 )-4 RES UNITS..: SVC/FDR)-225 A.: ) 600 V NOMINAL: 1`19 AREA/SPC OCCs
--------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY -------------------------------------------..-----.
A. SF RESIDENTIAL--------------------------- B. COMMERCIAL---------------------------------------------------------------------------•-
ALICIO 6 STEREO.: VACUUM SYSTEM..: AUDIO I1 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: ;s BOILER.........: HVAC...........; LANDSCAPE/IRRIG: PROTECTIVE SIG*:
rARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL......... OTHR:
fIVAC...........s DATA/TELE COMM.: NURSE CALLS....: TOTAL M SYSTEMS: 0
Owners -----------------------------------Contractor: ----------------------------- TOTAL FEES:$ 4333.00
LORENTZ BRUUN CO INC LORENTI BRULIN CO., INC.
36336 SE 20 AVE 3636 5E 20TH AVEM.Z
PORTLAND OR 97242 PORTLAND P", 97242
Phone k: 232-7106 Phono 0: (503)232-•71@6
^eg C.: @@@633
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ore. Specialty Codes and all other
aaolicable laws. All work rill be done in accordance with aocroved plans. This permit will expire if work is not started within let
days of issue ce, or if wo- k is suspended for more than 180 days.
------- ----- ---.---------.-------------------- REQUIRED INSPECTIONS ---------------------.-----------------------------------
Mechanical Insp Insulation Irisp Building F►r,ol
Plumb Too Out Gyp Board I .sp _•___�_� �___ _.__._-_
Electrical Servi Electrical Final
rr•amino insp Mechanical Final
pow Voltage Plunb Final
,mittpe 5issnA+; . : a IsStawd I1y :
C;aa11 for inspection -- 639 4175
Re_ siciential Building Pe___ rmit_Ap�lication
City of Tigard
13125 SW Nall Blvd.
Tigard, OR 97223
(503) 639-4171 r,`
J;�bsite Address: 6W qX1 A, —
�r_R
Subdivision: T't�Jor, J G�2 9'�-2Z3
Lot # Office Use Oniy
Valuation: Contact Date / /
Initials
Fesur
New Construction Only: (Square Footage) �l`��
�G��U_� eyv t; Planck/Rec
House Garage: Permit # ►n
Reissue of
Corner Lot? y N Flag Lot? y N Map & TL
Zone
Owner Plat #� --
Address: Approvals Re wired
Planning Setbacks _ Solar
Engineering
Phone j Other --'—"----
Contractor: �QT��'�--�'� ��rJ V� ------
Items Required
i
Address: t Subcontractors
Truss [retails --
r - '2 Other
Phone: ok- Notes
7.
Contractor's License # � (y rr�' /_/ 1
(attach copy of current Oregon license)
Contact Name: id
Contact Phone. L 12 2---?1 r N
Subcontractors:
Architect/Engineer:
Plumbing: —
�--- I Address:
Mechanical:
(attach copy of current OR Contractors L-- rcense)
Phone:
1
JOB IPTION: �� ( � �(,�(� .�.G
Applicant Signature �U�
Received by:
Applicant Phone number
` � �.
�'+a►anva� — Date Received:
Permit # Account Description
Amount Amt. Pd. Bah Due
Bldg. Permit (BUILD;
Plumb. Permit (PLUMB) (� i
Mech. Permit (MECN)
State Tax (TAX) 46,
Bldg:
Plumb:
l K-US'
Mech: — f J--
Plan Check (PLANCK) �Z q ► _
Bldg: S y 3
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWiNSP)
Parks Dev Charge (PKSDC) _
Residential TIF
(TIF-R)
Mass Transit TIF (TIF-MT)
Comme-tial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0) W
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
1
. . . . . . . . . . . . . . . 5 �- � -Ti
. . . . . . . . . . . .
. . . . . . . . . . .
. . . . . . . . . .
. . . . . . . . . . . . . . . . .
. . . . . . . . . .
. . . . . . . . . .
P . .
NGINEER: _ORENTZ BRUUN CO.. INC. DAIS SHT OF
3838 9.E.20th Ave --
Q JOB NO.: Portland,Oregon 97202
(503)232.7116-FAX(503)2325809
DWG NUMBEi
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
LORENTZ BRUUN CO. , INC.
3636 SE 20TH AVENUE
PORTLAND OR 97242
Electrical, Signature Form
Permit # • . . . : MST95-0412
Date Issued. : 11/30/95 t'
Parcel . . . . . . : 1S135DC-05600
Site Address : 11790 SW 92ND AVE
SubdiviLion. : BARBEE COURT
Block. . . . . . . . I t 4
Zoning. . . . . . : R-7
Remarks :
fire damage repair
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrici:]n
is required.
Please have the appropriate individual from your company sign helow and return this Electrical
Signature Form prior to the start, of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
WNI R : ELECTRICAL CONTR11UT(1R :
LORENTZ BRUTJN CO INC
LORENTZ BRUUN CO. , INC.
3636 SE 20 AVE 3636 SE 20TH AVENUE
PORTLAND OR 97242 PORTLAND OR 97242
Phone # : 232-7106 Phone # :
Reg 000033
i
x ,
Sign urs oTSupervisrng ectr clan
Please return this completed form to the address above.
ATTN: Building Dept.
If yuj have any questions, please call 639-4171 , ext. #310
I
-- —
ION NOTICE
E
CITY OF TiGDUILDING INSPECT
Inspection Le B 639-4171
FINAL:
Rain Drain Co%,. - service
Footing ueiling -Plumb.
Foundation Water Line "Mach.
Shear/Sheath Framing
PosUBeam Mech. -Elect
Plbg.Und/Flr/Slab .
Plbg.Top Out Insulation BI
Bd
post/Beam Struct. Mech. Rolagh in Appr/Sdwlk Reins.
San. Sewer Gas Line
Other: ----' P.M. J Entry:__—----
Date: ���Q A.M.
Address: ---- Ste:— MST —. Q--
Tenant: _ ----- BUP:
A� ` 1_ 4 MEC:_—._-------
Con/Own:__ .L- - —"-----" PLM:
ELC: ._ _--
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
--- oe
-- r
- Date: _
_
Inspector. ,__.--- -- CF CO
ROVED _..DISAPPROVFD/CALL FOR REINSP.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg.Top Out Insulation -E/ lect.
Post/Beam Struct. Mech, Rough-in Gyp. Bd. ✓
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: -
Date: A.M. _P.M. Ent :_NQ
Address:
Tenant: —_ —_ Ste:___ MST: CL-,q —
i- ��
BLIP.
Con/Own:Sinn MEC:
--- -- PLM-
ELC - - -
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR
=ma -
-A5
• r
Inspector: I 1!�-V.L Date:
APPROVED _- DISAPPROVED/CALL FOR REINSP, r__
CO