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SITE PLAN SCALE 1 " - 20 '
FOR NEW GARAGE PIAN
AT 14700 SW 103 RD . AVE -."[ � 9 �w'�4- ( 2 ' �"�'"�5
TIGARD , OR . 97224 4D du,4-r or v�s4z-,-c �-� �
JAMES FRISWOLD LV,� l,Ay
�. I I �1I —_I_�I� � I_I I11tI1ITITr 11tNOTIGE: IFTHEPRINTORTYPEONANY 111
11 7 1 'l -
IMAGEIS NOT AS CLEAR A5 THIS NOTICE, 2 T' � � I � t II1 S__II IT � I ( III III Ilt SII I � IIC( I I �I I ( I III I � I SII ISI VIIII
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ORIGINAL DOCUMENT �09 6Z 8Z L Z 8 Z I SIS VE £ZZ 019 6IT i8lil
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14700 SW 103M Avenue
CITY OF TIGARD MASTER PERMIT
PERMIT#: MST2002-00448
DEVELOPMENT SERVICES DATE ISSUED: 11/21/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 14700 SW 103RD AVE PARCEL: 2S111BC-0^500
SUBDIVISION: MLP98-0004 GOTTERWILROY ZONING: R-1
BLOCK: LOT: 001 JURISDICTION: I I(]
REMARKS: Construct 528sf detached garage.
BUILDING
REISSUE: STORIES: 1 FLOUR AREAS REQUIRED SETBACKS_ REQUIRED
CLASS OF WORK: ACS HEIGHT: t I FIRST at BASEMENT: 5f LEFT 14 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 5o SECOND of GARAGE: Ste at FRONT20 PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT, at RIGH r 10
VALUE: 12.070 40
OCCUPANCY GRP: R3 BDRM BATH. TOTAL. 0 at REAR 22
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES' DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUBISHOWERS, GARBAGE DISP: WATER HEATERS WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL _
FUEL TYPES FURN<100K BOIL.GMP<3HP: VENT FANS: CLOTHES DRYER:
FURN>•100K: UNIT HEATERS: HOODS: OTHER UNITS
MAX INP: blu FLOOR FURNANCES: VENTS. WOODSTOVES: GAS OUTLETS.
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 5F OR LESS: 0 200 amp, 1 0 200,imp: WISVC OR FDR: PLIMPIIRRIGATION: PER INSPECTION:
EA AD01 500SF 201 400 amp: 201 400 amp: tat WIO SVCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 40, 600 amp: EA ADDL SR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIrDR: 601 • 1000 amp: 601*ampa•1000v: MINOR LABEL:
1000•amplvolt: PLAN REVIEW SECTION
Reconnect oniv: >000 V NOMINAL: CLS AREA/SPC OCC:
a.4 RES UNITS: 9VCIFDRa.225 A.:
ELECTRICAL•RESTRICTED ENERGY
_ A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH• BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATIC MEDICAL: OTHR
HVAC: DATAITELE COMM. NURSE CALLS TOTAL N SYSTEMS:
TOTAL FEES: $ 474.81
Owner: Contractor: This permit is subject to the regulations contained in the
JAMES FRISWOLD OWNER Tigard Municipal Code,State of OR Specialty Codes and
14700 SW 103RD AVE. SIGNED RESPONSIBILITY all other applicable laws. All work will be done in
TIGARD,OR 97224 FORM IN FILE accordance with approved i;lans. This permit will expire If
work Is not started within 180 days of issuance,or if the
work Is suspended for mote than 180 days. ATTENTION.
Oregon law requires you to follow rules adopted by the
Phone40�_f13q-I 158 Phone Oregon Utility Notification Center. Those rules are set
forth In OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Electrical Rough In Electrical Final
Footing Insp Framing Insp Final inspection
Foundation Insp Shear Wall Insp
Footing/Foundation Dn Exterior Sheathing Inst
Eler,rical Service Rain drain InspIssued By - I
—- l ! .. .1J Permittee Signature
Call (503) 639-4175 by 7:00 p nn for an inspection needed the next busine-s day
11cn„it 4:
�ddres --- -3— — - --
1 :
Issu d by: � � — Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701,055(4), requires residential construction permit appli-
cants who are not registered vvith the Construction C'ontractor•s Board to sign the
foltm+ging statement he/ore a building permit can he issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement ivill he filed ivith the permit.
Dill in the appropriate blanks anal initial boxes i and 2. and either box 3A or 35:
1. 1 own. reside in, or Nkill reside in the completed structure.
2. I understand that i must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
(�
3A. My general contractor is Contractor regis. #
l�l
(Name)
I \\ill instruct my gcncral contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
313. 1 will be my own general contractor.
\ ` e only subcontractors registered \\ith the Construction Contractors
IfI hire suhcont;actors. 1 \kill hi,
my mind and hire a general contractor. I will contract with a contractor who is
Board. If I change
registered\\ith the CCB and will immediately notif} the office issuing this building permit ofthe
name of the contractor.
1 hereh� certify that the abo%a information is correct and that I ha'a 1-earl and do t,title ;utd the I nformatii►n
Notice to Property om.ners about construction Responsibilities un the reN erre side ►►t this f"►rm.
(Signature of permit applicant)
(117tiie coj tv to issuing agent,'permit /ilc.
pink c•o/ty to apnlic•ant)
i
. r
Building Permit Application
Date received 4 ;L- Permit no.: DO�
City of Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 F'roject/appl.no.: Expire date:
City of Tigard Phone: (503) 639-4171 Date issued: By Receipt no.:
Fax: (503) 598-1960 !/ Case file no.: Payment type: ,l
Land use approval: K ` 1&2 family:Simple Complex: _=
0
❑ 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
ElAddition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm Other: f7 WA—A&
Job address: IWA QO SW \b J R 0 wv G 'T t 64xV Bldg.no.: Suite no.:
Lot: Gok Stthdivision:►A1 Tax map/tax lot/account no.: S I J
Project name:
Description and location of work on premises/special conditions:_� r.A o�a A v - 1-U 5`i}�
(M NI 11 1-OJJ Sill-A'11AL INFORNIA-11 ION, USE 117111M'KILUS-1-
Name: '�, ► W
Mailing address: M-l0o bvzi 03 Av/t; 1 &2 family duelling: �
City: '1-� Stale: ZIP: Valuation of work......... a.. •�
y' — �.�r r........... $�s�. Bf�PT_
Phon •Dp 1 Fax: E-mail: No,of hcdrooms/baths...............................
Owner's representative: Total number of floors..................... ..........
Phone: FuxIF-mail: New dwelling area(sq.ft.) .......................... — l
Garage/carport area(sq. ft.)...... ............ ..... �—
Name:'?p Covered porch area ftq. ft.) .........................
Mailing address: 1`"wSW %asL Deck area(sq. ft.) ................................. ......
City'T A, StnteQ R LIP:01J Ll. Other structure area(sq. ft.)................. ....... --
I'hon Cott t5 F. * i E mail:^'L�R�stn. t;J ,�• ('ummercinUindustrial/multi-family:
Valuation of work........................................ .
Existing bldg.area(sq. 1't.) ..........................
Business Warne; G _>�� Q. _ New bldg.area(sq.ft.)
.
Address: Number of stories.......................................
City: State: ZIP: Type of construction
Phone: Fax: E-moil: Occupancy group(s): Existing:
CCB no.: New: _
City/metm lic.no.: Notice:All contractors and subcontractors are required to he
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to he licensed in the
Address: L jurisdiction where work is being performed. If the applicant is
City: V 1- i State: ZIP: (I- I exempt from licensing,the following reason applies:
Contact person: Plan no.: )A —
Phon So'3 ` Pax: E-mail: --
Name: Contact person: Fees due upon application .......................... _
Address: Date received:
City: State: ZIP: Amount received ......................................... $_
Phone: I E-mail: Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all Juridkuoni accept credit cards.Mede call Jurisdiction rot mare inrutrutnon.
attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard
work will be com lied with,whether s ciQed herein or not. chdu cda number: _ __
p � I� \ Gspirei
Authorized signature:� ' — Date:t " z'i" 1' y --7�ar c d awn an credit c
(hint name:�A� -I is tZ��w�� _ car ate $ Amount
Notice:This permit application expires if a permit Is not obtained within 190 days after it has been accepted as complete. W-01.1(6MCOM)
One-and Two-Family Dwelling
Building Permit Application Check Iist Reference no.:
city'If Tigard City of Tigard Associated permits:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 LI Electrical 0 Plumhinp U Mechanical
Phone:Phone: (503) 639-4171
Fax: (503) 598-1960
1 1177.11 D111113 K111111IN all]!H III WA110111 A WAV I KI
i
1 Land use actions completed.See jurisdiction rateria for concurrent reviews.
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc. _
3 Verification of approved plat/lot. -- — -
4 Fire district_ approval required.
5 Septic system permit or authorization for remodel, Existing system capacity
6 Sewer permit.
7 Water district approval.
n Soils report. Must carry original applicable stamp and signature oro file or with application.
9 Erosian control U plan U permit required. Include drainage-way prrxection,silt tcnce design and location of
cat.:h-hasin protection,etc.
10 3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applil able local and state
building codes. Lateral design details and connections must he incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed
if copyright violations exist.
I I Site/plot plan drawn to scale.The plan"lust show lot and building setback dillk'IW His;property corner elevations(if
there is mons than a 4-I1.elevation differential,plan must show contour lines at 2-I1. intervals);location of•easenments and �.
driveway;fixolprint of stmcture(including decks);location of wells/septic systems;utility locations:direction indicator.lot
area;building coverage area;percentage of coverage:um1>-n ious area:existing structure's on site:and surface drainage.
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and location. y
13 Floor plans.Show all dimensions,room identification,window sire,location(of smoke detectors,water heater, X
furnace, ventilation fans,plumhing fixtures,balconies and decks to inches above grade,etc.
I a Cross section(s)and details.Show all framing-nu•muher sins and spacing such as fluor beams,headers,joists•sub-floor,
wall construction,roof construction.More(hall one moss',Ck tion may he required to clearly portray construction.Show
details of all wall and roof sheathing,nx)ffng,rx)I slope,ceilmp height,siding material,t'ootings and limundation,stairs,
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations mus(reflect the actual grade if the change in grade is greater than four foot at building envelope. X
Full-size shoo addendums showing foundation elevations with cross references arc acct tahle.
I o Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof from Provide plans for all floorsh•ouf assemblies,indicating nicnmher siring,spacing,and hearing
locations.Show attic ventilation.
I ti Basement and retaining walls. Provide cross sections and details showing placement of rehar. For engineered
systems,see item 22,"Engineer's calculations." �(
Ill Resin calculations. Provide two sets of calculations using current code design values I'or all heanus and multiple joists
over 10 feet long and/or any heam/joist carrying a non-uniform load. IV
20 Manufactured floor/roof truss design details. ><
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required
I'or four or ctmorc appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall•roof tnrss)shall he stamped by an engineer or
architect licensed in Oregon and shall he shown to he app!ic,"tile to the project under review.
23 Five(5)site plans are required for Item I I MIM c. time plans mmst he N 1/2 s 1 I"or 11" x 17".
24 Two(2)sets each are required for Items I ti, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accepted.
26 "Reversed"building plans must nice(criteria outlined in the Permit k System Development Fees document.
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT Street Tree List.
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserve,,' for department use only. 444614(6AWCnM)
Electrical Permit Application
Datereceived: Permit no.:
City of Tigard Project/appl.no.: Expire date.
City(V'igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type.
I` F�
Land use approval: _U
TYPE OF PERMIT_9P
U I &2 family dwelling or accessory U Commercial/industrial J N11.1111-lana ly U Tenant improvement
U New construction U Addition/alteration/replacement Other: U Partial
JOR SITE iNFORMATION
Job address: 3 Bldg. no.: Suite no.: ax map/tax lot/account no.:
Lot: Block: Sublivision:ML 6
Project name: I Description and location or work on premises: vo,
Estimated date of cot.ipletion/inspection: t"1
APPLICATIONSCHEDULE
Job no:
N�4 fZ _ Fee ntax
Business name: Descripliou tjry. (ca.) Itrtal no.iasp
Nets residernial-single or multi-ramliv per
Address: _ dnellingunit.Includetiattachedgaragr.
City: tate: ZIP: Service included:
Phone: Fax: E-mail: 1000 sq.A or less l
CCB no. Elec.bus.IIC,no: F.ach additional Slx)s .ft.or onion thereof
Limitedeuergy,residential
City/metro tic.no.: Limited energy,non-residential
Each manufaclumd home or modular dwelling
Signature of supervising electrician(required) Date Service and/or feeder
Sup elect.name(print): ,, Seri Ices or feeders--Installation,
alteration or relocation:
OWNERPROPERTV 2W amps or less 2
Name(print): jL Q 201 amps to 40 amps — 2
g 3 4Yfo 401 amps to 6W amps 2
Mailin address: 601 anipsto 1000 ams 2
City: l tba Stale: ZIP: over I(10oamps orvolts 2
Pho a ax: I E-mail: Reconnectonl I
Own •installation:The installation is being made on property I own Temporary servlees or feeder,
which is not intended for sale,lease,rent,or exchange according to installation,alteration,orrelocauon:
ORS 447,455,479,670.701. 1200 amps or less 2
201 amps to 4(x)amps 2
Owner's signature: Dale: 401 to 600 ams ,
Branch circuits-new,alteration.
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: Stale: ZIP.. B. Fee for branch circuits without purchase
Phone
of service or feeder fee,first branch circuit:
Each additional branch circuit:
Misc.(Service or feeder not Included►:
U Service over 225 amps-commercial U Ilculth-care facility Each pump or irrigation circle 2
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2
family dwellings UBuilding over lo,0(x)square feet four or Signal circuil(s)oralimited energy panel,
U System over 600 volts nominal more residential units in ane structure alteration.or extension" 2
U Building over three stories U Feeders,401 amps or more [FAch
Nscn'lion _
U Occupant load over 99 persons U Manufactured structures or Rv park addillonal Inspection over the allowable In any of the alcove:
U Egress/lighdngplan U r hher r hnspc•cSubmlt_-sets ofpbns with anv(if the above. estigmnan fee
The above are not applicable to temporary con+tructlon service. her -
Not all lurisdictionx accept credit cardx,please call Judvlicthto for nvae in6antanon Notice:This permi(application Permit fee.....................$
U visa U MasterCard expires if a permit is not obtained Plan review(sl _ %) $
Credo card number _ within 180 days alter it has been Slate surcharge(8%)....$
xMrc" accepted as-omplete. TOTAL $
Name of c to r u shown on credit er -------- —
Cardholder signature Amount
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed) (FOR ALL SYSTEMS)
Service Included: Items Cost Total `►' Check Type of Work irvolved:
Residential-per unit
1000 sq.h or less _ $145.15 4 Audio and Stereo Systems`
Each additional 500 sq.ft.or $33,40 1
portion thereof _- Burglar Alarm
Limited Energy _._ $75.00
Each Manuf d Hc"ne or Modular Gari le Door Opener'
Dwolling Service or Feeder $90.90 _ 2
Servieps or Feeders Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation $80 30 f'r� � � 2
200 amps or less 2 Vacuum Systems'
201 amps to 400 amps $106.85
401 amps to 600 amps $160.60 2
601 amps to 1000 amps
$240.60 _ 2 � Other__ -----__—_.--- ------ ---
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temftorary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Fee for each system.......................................................... $75.00
Installation,alteraliun,or relocation $66.85 2 (SEE OAR 918-260-260)
200 amps or less
201 amps to 400 amps $100.30 2
401 amps to 600 amps $13375 2 Check Type of Work Involved:
Over 600 amps to 1000 volts. Audio and Stereo Systems
see"b"above.
Branch Circuits Boiler Controls
New,alteration or extension nor panel
a)The fee for branch r_cuits Clock systems
with purchase of service or
leader rep.
Each branch circuit $665 J 2 Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 ❑ HVAC
Each additional branch circuit t- $6.65
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or Irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting $53.40 _
Signal circuits)or a limited energy Landscape Irrigation Control'
panel,alteration or extension — $75.00
Minor Labels(10) 5125.00
Medical
Each additional Inspection over
the allowable in any of the above Nurse Calls
Per Inspection
$62.50
Per hour $62.50
In Plant $73.75 Outdoor Landscape Lighting'
Fees: Protectl,re Signaling
Enter total of above foes $ �� Other
e%State Surcharge $ __ Number of Systems
1 25%Pian Review Fee $ ' No licenses are required Licenses are required for all other installations
See"Plan Review"section on —
front of applical!on.
Fees:
Total Balance Due
Enter total of above tees $
❑ Trust Account#_-- 8%State Surcharge s
-- Total Balance Due $All New Commercial Buildings require 2 sets of plans.
i:4ists\ronnaklc-fees Am 09130101
SEF, 35MM
ROLL # 21
FOR
OVERSIZED
DOCUMENT
CITY OF TIGARD 24-Hour rr��
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 - ----
D U P ..._---
Received ._ Date Requested— -_ �'( _ AM -_ PM BLIP
L.ocation -- q-70 U ��✓� �j�fr /4-U� Suite MEC -- -- -- ---
;ontact Person ph( ) � `f—// PLM
Contractc _ -- Ph( ) SWR
BUILDING Tenant/Owner __ k
Footilig - ELC - -.
Foundation Access: ELC - -- -
Ftg Drain
Crawl Drain ELR
Slab Inspection Notes: i SIT
------ - -----
Post&Beam ----
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear -- - -_
Framing
nsu atior, --
Drywall Nailing -_- --
Firewall
Fire Sprinkler
Fire Alarm
Susa'd Ceiling -— --
Roof
Other: _ _-__-
Final
PASS PART FAIL -- -
PLUMBING _
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Mannnlc,
Storm Drain
Shower Pan - -
Other:
Final
PASS _PART FAIL
_MECHANICAL
Post& Beam —
Rough-In _
Gas Line _
Smoke Dampers _.----r�--
Final -- -
PASS PART_ FAIL
ELECTRICAL -
Service ----- -- - ---- --
Rough-in
UG/Slab - - `-- ---- --- -
Low Voltage
Fire Alarm --��- ---- --- y-- —�
( I PART FAIL Reinspection fee of$_—_- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_ _ - Please call for reinspection RE:---_____ ❑ Unable to inspect-no access
Fire Supply Line -
ADA ��,
Approach/Sidewalk Date inspector
Other: -
Nxt
LFinal __ DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour ('
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 C!
BUP
Received7 ( Date Requez'-d / �r_ - AM_ PM _ BLIP
--.�
Location _. U / U 3 Suite--- -_ -- - MEC
Contact Person ___ C-J L"-- Ph( ) - PLM
Contractor-- _- ------ Ph(— ) SWR -
-ir
UILp Tenant/Owner - ELC
Footing - -
Foundation Access: ELC
Fig Drain
Crawl Drain ELR _-
Slab Inspection Notes SIT
- -- -
Post 8 Beam - - --
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear -- -- - --
Framing
Insulation --
Drywall Nailing r
Firewall
Fire Sprinkle
Fire Alarm
Susp'd Ceiling
Roof
Other: --- --
-in-a7"".
S PART FAIL
Post 8 Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer - —
Rain Drain3
Catch Basin/Manhole -
Storm Drain
Shower Pan -
Other:
Final
PASS PART FAIL -
MECHANICAL
Post 8 Beam __---..--.--
Hough-In -
Gas Line ---- --- -_ -
Smoke Dampers _-
Final ---
PASS PART FAIL -
Rough-In —
UG/Slab -
Low Voltage
Fire Alarm ------- - ----- - —
Final Reinspection
PAPART FAIL I� spection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE - [� Please call for reinspection RE: r� Unable to inspect-.no access
FI.: ,apply Line
ADA i
Approach/Sidewalk fa! _v —_ Inspector __ _ Ext
Other
Final DO NOT REMOVE this Inspectlon record from the Job site.
PASS PART FA!L
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 --
BLIP
_ Date Requested Z Z -- .' - 6/ AM PM BLD
Location /y 7 0 0 S. v , /0-3 � Suite MEC -
Contact Person _ Ph _ PLM ZOlg/ - j!�V 600
Contractor _ Ph SWR ZDG'/ ---0 a "-y 7
BUILDING— Tenan,/Owner ELC
Retaining Wall - ELR
Footing Access:
Foundation FPS _
Ftg Drain SGN -
Crawl Drain Inspection Notes: ----
Slab
Post&Beam --- -- -- �.. --- SIT ----..�_
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation F -
Drywall Nailing
Firewall -- �—
Fire Sprinkler _
Fire Alarm
Susp'd Ceiling
Roof /
Misc:
Final - - -
PASS PART FAIL
PLUMBING
'ost& Beam _-
-- -_
Under Slab
Top Out _-- - -
Water Service
Sanitary Sewer - -
Rain Drains
PART FAIL
MECHANICAL. --
Post&Beam
Rough In
Gas Line - --
Smoke Dampers
Final - _ ------ -- -
PASS PART FAIL
ELECTRICAL -"
Service
Rough In - - -
UG/Slab _
Low Voltage LL
Fire Alarm
Final -
PASS PART FAIL - -- -- -- _
SITE -- -----------
Backfill/Grading - -
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f J Please call for reinspection RE._ - ( J Unable to Inspect- no access
ADA
Approach/Sidewalk Date G� inspector rExt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
I
CITYOF T I GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2001-00600
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/13/01
SITE ADDRESS: 14700 SW 103RD AVE PARCEL: 2S1 11 BC-04500
SUBDIVISION: MLP98-0004 GOTTER/MILROY ZONING: k-3.5
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIZS: WATER HEATERS: CATCH BASINS:
_ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES. OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: 145 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Connect existing house to sewer lateral on neighbor's easement. _
FEES
Owner: -
Type By Date Amount Receipt
JAMES FRISWOLD PRMT CTR 11/13/01 $101.40 27200100000
14700 SW 103RD AVE bPCT CTR 11/13/01 $8.11 27200100000
Total $109.51
Phone 1: 503-639-1158
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone 1: Sewer Inspection
Reg #: Final Inspection
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 riot 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 052-0001-0080.
You may ob,ain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By `' Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the nett business day
iW
Plumbing Permit Application
:1atereceived: q1Permitno.:AH,*'-,
City of 'Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.:
City ofTigard Phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approval I Case file no.: Payment type:
t
U I &2 family dwelling or accessory U Commercial/industrial U Mul(i (;tinilfid•I'enaill nnl+i.,v c•nucnl
U New construction U Addition/alteration/repl,+cetnrnl U Fatal yen ILC' J()(Iter.
3OR,SITE INFORMATION
Job aadress: \`V�D w \V3►ZU Ali Description — Qty. Fcri'ea.) •Total
Bldg. no.: Suite no.: New I-and 2-family dwellings only:
- !includew100A.foreachutilityconnectim)
Tax map/tax lot/account no.: 11,3(1 U r,tJ U _- _ Sl It 111 hath
Lot: Block: Subdivision: SFR(2)bath - ---_ ---
Project name: SFR(3)bath
City/county: -Tt W q ZIP: e1 Z Z. Each additional hath/kitchen
Description and location of woe on premises: _ Siteutilitles:
1.1lt,�. A a, A o S*-k eL kom C.Za. rJ CY_�i_--__ Catch basin/area drain
---� - Dr wells/leach line/trench drain
Est.date of completion/inspection: y
11 till 111 1111111111 Footing drain(no.lin.ft.) _
Manufactured' me utilities
Business name: �Iv+»c o W V,'{ Manholes
Address: Rain drain connector
City: State: ZIP: Sanitary sewer(no.li•i.ft.)
Phone: Fax: E-mail: Storm sewer(no.lin. ft.)
CCB no.: Plumb.bus.reg,no:
Water service(no.lin.ft.)
City/metro lic.no.: - Fixture or Item:
Contractor's representative signature: Absorption valve
- -- - - ---- -- Back flowivventer
Print name: Date: Backwater valve
Basins/lavatory
Name: Clothes washer
Address:
Dishwasher
\i'' ,_ Drinking fountain(s)
City: - - -- Stntc i[I' —�— - F'cctors/sum
Phone Fx ansion tank
Fixture/sewer cap
Floor drains/floor sinks/hub
Name(pr...,,: t W 0 f;arhagc disposal
Mailing address: \`t-�s��� `,��; t U•3 Rte Ail E
bb
City: �v c: StaiI ZIP: V"� L-Z Hose akar
c
Ice maker
Phone:SU3 ;�'rtty� F :t,U' ti E-mail:
Interceptor/grease tea
(Avner 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 p tperty I owu I V's per URS(chapter 447. Sink(s),basin(s),Iays(s) --
Owner's ei nuture: Date: Sum
Tubs/shower/shower pan _
Name: Urinal
-- ----- -- idler closet _
Address: Water cater
City: State: ZIP: Other: - — —
Phone: Fax: E-mail: Total
Nd all juriulictions accept credit tarda.please cull Jurisdiction for ntrnm
e information Notice:'fldis permit application Minimum fee................$
U Visa U Mestertard expires if a pennit is not obtained 1 Ian review(al r %) $
Credit card number: _. -- —L— within 180 days atter it has been State surcharge(8%)....$
TOTAL $ /89,� /
-Name of cardholderushown oncrrdUcard -- s accepted as complete. •••••••••••••••••••••••
CudholderdEnaltre - Amount -. 40.416(6IOalCOM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only: PRICE TOTAL
FIXTURES individual) QTY AMOUNT the the and theincludes all nfi srxtures t100 ft.in QTY (ea) AMOUNT
Sink i 16.66.6 0 for each utilityconnection
16.60 One 1 bath $249.20
Lavatory $350.00
Tub or Tub/Shower Comb. 16.60 — Two(2).bath _ — $399,00
16.60 Three 3 bath
Shower Only -
Water Closet 16.60 SUBTOTAL
Urinal r 16.60 8%STATE SURCHARGE _
16.60 PLAN REVIEW 2_5%OF SUBTOTAL
Dishwasher ---- TOTAL
Garbage Disposal 16.60
Laundry Tray 16.60
Washing Machine 16,60
Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE:
3•• 16.00
4" 16,60 — — --du—antity b Work Performed
Water Heater O conversion O Iike kind 16.60 t-iYture Type: New Moved Replaced Removed/
Gas piping requires a separate mechanical _ — Ca ed
ermit 46 40 Sink —
MFG Home New Water Service Lavatory -
MFG Home Now San/Storm Sewer 46.40 Tub or Tub/Shower
Hose Bibs 16.60 Combination —
Roof Drains 1660
Shower Only —
16.60 Water Closet
Drinking Fountain --- Urinal —
Other Fixtures(Specify) 16.60 Dishwasher
Garba a Dis osa! — —
_- Laund Room Tra -
__ - Washing Machine
Floor Drain/Sink: 2"
Sewer-1 st 100 3-
Sewer-oath addlLonal 100 46.00 4"
Water Heater —
Waler Service-1st 100' 55.00 Other Fixtures
Water Service-each additional 200' 46.40 S ed
Storm
--
Storm 8 Rein Drain-1st 100 55.00
SOW-&Raln Drain-each additional 100' 46.40 — — —
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55 —
Catch Basin 1660r- 72,50 of Existing Plumbing or Specially '2
_ erlt+r COMMENTS REGARDING ABOVE:
Requested Inspections
Rain Drain,single family dwelling 65.25
Grease Traps 16.60 _
QUANTITY TOTAL -
Isomen,c or riser diagram is required If —
Quantity Total Is 1 g
'SUBTOTAL -
STATE SURCHARGE
"PLAN REVIEW 25°/a OF SUBTOTAL
Required only Il Ilxturo r .total is�9
TOTAL S
*Minimum permit fee Is$72 50 4 8%stale surcharge,except Residential Backflow
Prevention Device,which is$3e 25•s%stale surcharge
"All New Commarclal Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
lAdsts\forms\plm-lees.doc 08/29/01
S
I.. 0 T 2 1
TIGARDVII EE I IEIGIITS
PARTITION PLAT 110
ON LINE NO. 1992--077 \�4X,�,°
FD 5/8" IR rD 5/8" IR PARCEL 3
} NO CAP W/YPC SCRIBED 1{
HELD EAST—WEST S 0075'17" E "LS 80R" r
0.11' iN 2.4366
N 01'14 59 E SN 1011,85 N
0111'
ORIGIN UNKNOWN N 89'31'4.1)" E ( (N 89'35'09" F 76,7.24'(51;) 767.2x' _ 5
Fb BY SN 11100 7q 7,07' I "B" TO "C" (747.00'(S2)) _
380.08' zo.00'
116.1;0' 1
3' (N 89'3500 E 27.0.OJ(D7)) NI �� 155.05 (N 89'35'00" E 155.0!i'(S.')(bl))'""�
N R.00' WIDE S1�►J�r►�ctY
SEWER EASEMENT
PARCEL 1 i' " 2 FOR THE BENEFIT n
.0.00' WIDE ARRA 2:,, O78 S.F. I •n .0 OF PARCEL I v X
ACCESS EASEMENT
-OR THE BENEFIT
7r PARCEL 2 N r7�'4G OO' W pq I r
- - -- - - -Z�+5.7�-. - - _ 71.00'V
- Qlr,, �,� �' PARCEL 2
— - - — 0 r.' '�
17 4.`74' — �. - z �rn c AREA 18,628 S.I I ,n ;
1
.04 r- 0 N O
b,
'r. I „ 0 r
N N r47 1!1 f r
_ N C7
rt S 0114'59” W /r I 7.. vt,
01 174.76' 33.01' 45.25' 1
76"00" W 22.0.01' ,I (5 8!3'",4'3x' W 155.03'(S3)(D1))01
1
( N 89.46'00" W 220.00'(D2)) N 01'14'59" E- i � G '.i9�J 5;�" W 154.93' (�
10.73' _-- UJSN
IIELft rl
!1 11100
av
rt fi
!gyp � � ♦�°
r JUG�,\pl
lit dt
�
rn
ut v
ct ' I
7 n
y
v
1I
N 89'46'00" w (74a.oU'(52p 14
243.08' (245.00'(S3)(01)) _ —1 ' — _ 154.7n' (155.00'(93))
BASIS OF BEARINGS h 89'46'00" W (N 89'46'00" w 7a1;.40'(S1)) (N MP'49'On' W (^3))
S.W. MURDOCK STF
CITYOF TIGARD _ SEWER CONNECTION PERMIT _
DEVELOPMENT SERVICES PERMIT#: SN'R2.001-00299
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED• 11/13/01
SITE ADDRESS; 14700 SW 103RD AVE PARCEL: 2S111BC-04500
SUBDIVISION: MLP98-0004 G' 'TER/MILROY ZONING: R-3.5
r3LOCK: _ LOT: 001 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for ey.isting house. Septic tank is to be pumped, filled and inspected.
Owner:
JAMES FRISWOLD FEES —
14700 SW 103RD AVE Type By Date Amount Receipt
PRMT CTR r 1/13/01 $21300.00 27260100000
IN SP CTR 11/13/01 $35.00 27200100000
503-63: 1-1158 Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
Sewer Inspection
Septic Tank Filled
This Applicant agrees 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 P,gency 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 purdiase a "Tap and Side Sewer" Perm
is ued by: /`'l ri �/�,) Permittee Si nature: -
- Call (503)6539-4175 by 7:00 P.M. for an inspection needed the next'6ysiness day
WALTER LAWSON
-4 - Aeaw
11055 S.W. Clay • Sherwor:d, OR 97140
Telephone: (503)682-0233
Date/�d,
Service for
Address
City 0178 ",0
For Cleaning Septic Tank
For Cleaning Drain Line
For Cleating Grease Trap _
For Extra Labor
Amount ald Balance Due
Due Date
Signature
Pleaas make check out to present driver
Three percPm per month interest charged on bills it not paid in 30 days.
Not responsihiP for septic tmtk,drain field,curbing or driveway damage.