InitiallyGood li
ADDRESS:
bA*
J-4A45 SW IDAAL
(y,
a
C1"
N
(.D
I:Vc-oondAmicrotim\targels\bui!ding.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 539-4975 Business Line: 639-4171
3UP
Date Re uested���� p R AM —PM BLD -
1 �.._�
Location��� y r 3 Suite MEC
Contact Person J� M (e--� _ Ph � �"�t ' _ PLM 33-3
Contactor Ph _ SWR
BUILDING Tenant/Owner ELC
Re:aining Wall ELR
Footing Acctss:
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes: —
Slab SIT
Post& Beam
Ext Sheath/Shear !f
Int Sheath/Shear
Framing ' — -------- - —
Insulation --
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Suso'd Ceiling
Roof
Misc:__— ------- --�
Final
PASS PART' FAIL = -- ---- — — --_-
P'-UMBING __ _ ---- - --- --- —
Po,t& Beam ------ ------.--_ — - —----—
Llmler Slab
Top ')ut -
Water Service
Sanitary Sewer -------___-—_—__
Rain Drair
Final --- -- - -------- ---------- -------- — _----
PASS PART FAIL_
MECHANICAL --
Post& Beam --
Rough In
Gas Line -- -- -
Smoke Dampers
Final --- ----- - ------
PASS PART FAIL
ELECTRICAL
Service
r Rough In --
`� UG/Slab
r Low Voltage
Fire Alarm -- ---�— — -------- -----
Final
PART FAIL ----- —_-- - -_--_--
�r
—
Sanitary Sdw7o r'i,t l
Slorrrrf a i r6),)h'Catch
J Rr inspection fee of$ _required before next inspection. Pay at City Hall, 12125 SW Hall Blvd
Catch Basin
Fire supply line [ J Please call fc. -inspection RF-___-- _ [ ) Unable to inspect- no access
ADA r
Approach/Sidewalk ete /�Qlw
!7L Inspector Ext
Other TTT --- —'
F'
'A PART FAIL DLJ NOT REMOVE this inspection record from the job site.
CITY UF' TI%.;ARD BUILDING INSPECTION DMISION
24-Hour Inspection Line: 639-4175 Business Lina: 639-4171 WT
BUP
Date Requested__/ v ' 7—_AM —PM BLD
n
Locat!on �i � L C�IJ F�'�) /9Uc Suite _ r-P;EC --
----�`
Contact Person Ph PLrM /G�, -66 33 3
Contractor Ph SWR
BUILDING Tenant/OwnerELC —
Retaining Wall — ELR
Footing
ACCCiSS:
Foundation ---_�! —_ FPS
Ftg Drain o — SGN
Crawl Drain inspection Notes:
Slab �.--- --—----. --- —� SIT
Post&Beam
Ext Sheathi5hear
Int Sheeih/Shear —
Framing ---- ---_ _--- ---- ---- —
Insulation
Drywall Nailing
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling
Roof /,c!Af
Final
PAS PAR-r FAIL —
P
_
Beam �- -- — --
Under Slab
�:o�-lop out
Water Servic
Rain Drains
_ PAR-r FAIL _
MECHANICAL.
Pc.'& Beam --
Rnugh In
Gas Line —
Smoke Dampers
Final -- --- — —
PASS PART FAIL
ELECTRICAL
Service
Rough :n --- - — --�— —
v~i UG/Slab
Low Voltage ----------r.W__.—_— -- - ----- --.._—
�" Fire Alarm
Final —_� __.--- •---- ------ ------� _..—_—
w PASS PART_r FAIL --____�_—__ .-- _—_ A _—
LO SITE
Backfill/Grading ---_— -�-- ---i-- —
Sanitary Sewer
Storm Drain [ ] Reinspection fev of$ — _—required before next inspection. Pay at City Hall, 13'125 SW Hall Blvd
Catch Wrsin
Fire Supply Line ( ] Please call for reinspection RE: ____— [ ]Unable to inspect - no access
ADA
Approach/Sidewalk Dete Inspector// t✓�
10ther
_Ext
Final
PASS PART FAIL DO NO7' REMOVE this inspection record from the job site.
CITYOF TIGARD PLUMB IVC PERMIT
• -00333
DEVELOPMENT SERVICES j� ` �NERMIT t'. PLi`�11999
11125 SW Hall Blvd., Tigard, OR 97223 (503) 639 A SSUEU: 10/15/99
SITE ADDRESS: 14245 SW 103RD AVE PARCEL- 2S111BB-01800
SUBDIVISION: TIGARDVI_LE HEIGHTS ZONING: R-3.5
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLO%V PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES_ _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Connect house to sewer and abandon existing septic system. Sewer work will not be withir 5'of house.
FEES
Owner_ ---
- — Type By Date Amount Receipt
HEISE, NANON L ESTATE Or —'
PJ
ONICA HEISE PRMT DEB 10/15/99 $50.00 9^-319100
BY
BY M NI 103RD 5PCT DEB 10/15/99 $4.00 99 319100
TIGARD, OR 97223 Total $5400
Phone 1:
Contractor:
MIKE MOORE & SONS EXCAVATING
2500 SW 178TH
ALOHA, OR 97006 REQUIRED INSPECTIONS
Phone 1: 692-3150 Sewer Inspection
Reg #: LIC 110863 Final Inspection
2
t--
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.
1:
-� This permit will expire if woi t: is not stagy ed within 180 days of issuance, or if work is -uspended for more
than 180 days. AT;ENTION: Oregon law rer,uires you to follow rules adopted by th( Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtaln copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Is ed By: Permittee Signature:
Call (503) 64-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TK7ARD Plumbing Permit Application Plan ChegN.
13125 32W HALL BLVD. Commercial and Residential Recd By
TIGARD, OR 97223 Date Recd '4�2 '
(503) 639-4171 Date to P.E. -
Print or Type Dit`'to 05T=--
Incomplete or iliegit►le applications will riot be accepted Permit#J 01(�) 31
Related SWR#�Gt.,Q-IQJ'� �
Called
-� Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Jab Sink 11.50
Address Street Adddress.,/� Suite Lavatory 11.50 _y
I, �St 9r Tub or Tub/Shower Comb. 11.50
Bldg# City/State d�ip rj_ Shower Only - - 11.50
(oA� 0fl /do _.
Water CloseNUrinal (Specify) 11 50
N �� y Dishwasher 11.50
Owner Malling Address it Urinal 11.50
// !ri f �� C�7 Garbage Disposal - 11.°0
City/ at tp Phone -
l /tr 7 _" ��'/n J Laundry Trey _ 11.50 _-
Name Washing Machine/Laundry Tray (Specify) 11.50 -
Floor Drain/Floor Sink 2" 11.50
Occupant Mailiny Address Suite 3" 11.50
r 4" 11.50
City/State Zip Phone - -- - -
Wa rater O conversion O like kind 11.50
- - Gas ping requires a separate mechanical permit. _
Name in ,MFG Home New Water Service 32.00
Contractor M Ilirtg Address r rC Suite MFG Home New San/Storm Sewer 3200
R' ��ril O - Hose Bibs 11.50
Prior to permit Clay/ tale /t /Zips, �Pne Roof Drains 11.50
issuance,a copy ; Ir C:'[ ��, / J / Drinking�'�G=' -- - -
of all licenses are Oregq o t Cart.Board Lic.# Exp.Date Fountain 1'- 11.50
required if /1( �/ / (n,1 Other Fixtures(Specify) t - 15.00
expired in COT P!
T Llc.# Exp.Date V
database
------ Namb
Architect Sewer-1st 100' - �� 38.00 ,G
or Mailing Address Suite Sewer-ear',additional 100' 32.00
City/State Zip Phone - Water Service-1st Ad �-- 38.00
Engineer Water Service-eachh addltle•mat 200' 32.90 I
Describe work 1 ire done: Storm i4 Rain Drain-1st 100' 38.00
New O Repair O Replace with like kind: Yes O No O Storm&Rain Drain-each.i'dllional 100' 32.00
Residential O Commercial O
Additional description of work&J Qi Q T- eu r t TO o LU f� esidBackflow
Commercial Back Flow Prevention . 32.00
LL Rential Bacow Prevention Device*
19.00
4 / A1Jiti1't�n&) ( rL!g/ d� T r �.>r Catch Basin 11.50
Are you capping,moving or repiscing any fixtures? Insp,of Existing Plumbing or Specially Requested 50.00
Yes O No O Int; ections er/hr
If yes, see back or form to indicate work performed by Rain Drain,single family dwelling 45,00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
-+ I hereby acknowledge that I have read this application,that the Information
j given Is correct,that I am the owner or authorfted agent of the owner,and Isometric or riser diagram Is required H Ouanuty Total is >9
that plans submitted are In compliance with Oregon Stale Laws. 'SUBTOTAL
wI nature of Ow,er/A ent Date -
g 7� g 8%SURCHARGE
ontact Person Name Phone 7
, "PLAN REVIEW 25% OF SUBTOTAL
1 BATH HOUSE$178-00
- -- Required only it fixture qty notal Is>9 _
2 BATH HOUSE$250.00 TOTAL D
3 BATH HOUSE$285.00
(This fee Includes all plumbing fixtures In the dwelling and the first *Minimum permit lee Is$50+B%surcharge.except Residential Backflow Prevention
90o feet of sanitary sewer storm sewer and water service) Devine,which is$25+B%surcharge
"All New Commercial Buildings require plans with isometric or riser diagram and
plan rev".
I\dsts\lorms\p1umaprdocl0lRM �u `/;,, �rf{/
CUD
a, d
PLEASE COMPLETE:
—Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink
Lavatory — ---- i — --- - --
Tub or Tub/Shower Combination_
Shower Only
Water Closet
Dishwasher
Urinal
garbage Disposal —
Laundry Room Tray
Washing Machine _
Floor Drain/Floor Sink 2"
411
Water Heater
Other Fixtu�es�Specify)
I
COMMENTS REGARDING kBOVE:
N
F-
J
LL1
I lilslallnrm Syl,lnnnl ]r_tr,/p/11
I
CITY �� �I��R� (,RO`Wkl�`NNE`?-`-`ERMIT
PERMIT#: SWR1999-00223
DEVtLUPMEIVT SERVICES DATE ISSUED: 10/15/99
13125 SW Hail Blvd.,Tigard, OR 97223 (503) X639-4171 PARCEL: 25111 BB-01800
�iTE ADDRESS; 14245 SW 103RD AVE -ZONING: R-3.5
SUBDIVISION: TIGARDVILLE HEIGI-ITS JURISDICTION: TIG
BLOCK: LOT: 002 —
TENANT NAME: FIXTURE UNIT`=
USA NO: DWELLING UNITS: 1
CLASS OF WORK: NEW NO, OF BUIL-ANGS:
TYPE OF USE: SF IMPERV SURFACE:
INSTALL TYPE: LTPSWR
Remarks: Connection of existing house to sewer Septic system mus! be pumped, filled or removed and
inspected. !�
HEISE, NANON l_ ESTATE OF ffTTyp:e: By pate Amount Receipt
c�Y MONICA HEISE EB 10/15/99 $2,300.00 99-319100
14245 SW 103RD INSP DEB 10/15/99 $35.00 99 19100
TIGARD, OR 97223 _ –— –
� Total! $2,335.00
Phone:
Contractor:
MIKE MOORE & SONS EXCAVATING
2500 SW 178TH
ALOHA, OR 97006
Phone: 692-3150
Fzeg #: LIC 110863
Required Inspections
Sewer Inspection
Septic Tank Filled
r..
N
I--
r-i
.J
ca
This Applicant agrees to ,orn! ,y with all the rules and regulations of the Unified Sewage Agency. The permit expires
- ued. The total amount paid will be fo-'1,ited if the permit expires. The Aga^r;� Foes no
180 days from the date iss
guarantee the accuracy ssthe side sewer laterals J the sewer i: . of located at the measurement given, the installer
shalt prospect 3 fee', in all directions from the distance given. 11 not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATT ENTION. Oregon law requires %,ou to follow rules adopted
by the OrcoQn Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080
Youy obtain ibpies of these rules or direct questions to OUNC by calling (503) 246-1987
` �'/ Permittee Signature:
Issu by: �
L� Call (503) 39-4175 by 7:00 P.M. for an inspection needed the next bUSi0ess day