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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd,Tigard,Oregon 97223.8199 (503)839-4171 PLUMBING PERMIT
F E RM I T 4. . . . . . . : P'1_M95-kij:tj
633-417: lexp,RT'E ISSUED: 08/1S/93
AU
PARCEL.: 1 S 133RD-1 1 AF1.l '�
L TE AtYI?RE.SS. . . : ]. 1847 SW ].2STF•i CT
JPD I V 19I ON. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING. R--4. C
,_OC,K. . . . . . . . . . ,. i_OT. . . . . . . . . . . . . . 153 1
_ASS OF WORE. . :i''." GARBAGE DISPOSALS— : Mn'aILE' HOME SPACES. :
VPE OF USE. . . . :S:- WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1
CUPANCY GRP. , : 0:3 FLOOR DRA i NG. . . . . . . . TRAPS. . . . . . . . . . . . . . ..
TORIES. . . . . . . . :L WATER HEATERS. . . . . . . CATCH BnSINS. . . . . . . .
w X'TURES . -_-___ ...- .. -._._ -- LAUNDRY TRAYS. . . . . . : SF RnIN DRAINS. . . . . .
INKS. . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
IVAT0IRIES). . . . . : OTHER FIXTURES. . . . . : .
JB/SHOWERG. . . . : SEWER LIME (ft) . . . .
i11 �R CLOSET15. . : WATER LINE: (ft ) . . . .
iWASHERS. . . . ; RAIN BRAIN (ft) . . . . :
)udr'kSA
4rter: __._._... __._.____._.._..______. ___...__._..____..._..____...._.__________.______.. FEES _..._.__._.__..
:IN MORISGETTE HDIIE:r: type anlot.int by d=LA te
-,b35 SW PANGY RD ##.'01 PRhIT $ 15. 00 8 08/15/95
P'CT f it)- 75 B 01,311' 15/1)r., 9C c43G`..
AKE OGWE.GG OR 9702 5
.,ane #: 620-7530
'MIS PLUMLA I N[-,
BUX 7160
_DHA OR 97007
lane #: [tire 40; '1 t, 15. 7a TOTAL
71860
REQUIRED I tNISPECTIONS
.s permit is issued subject to the regulations contained in the Fir1aI In1;Pet.tian
and 'Mi-nicipal Code, State of Dre. Specialty Codes and all other
licable laws. All world will Le done in accordance with
.:roved plans. This pet-sit will expire if work is not started
hie IU days of issuarce, or if work is suspended for more
F1 lays.
un
LO Call for inspection - 639-•4175)
.J
City of Tigard _PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # PL-/0 IiS -C !
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.04 PERMIT FEE + ST. SURCHARGE
"'^`•°'°-'°a^•^' New Single Family Residences Only
"d"••• `1 -L ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job i✓7 S W, a ❑ 3 BATH HOUSE $225.00
Address Fee includes all plumbing fixtures in the dwelling and the first 100 feet
1 L a kG c, of water service, sanitary sewer and storm sewer. See fees below.
"•`^° ^ •^`•^"'•°`°•• FIXTURES CITY PRICE AMT
Sink 9.00
""••a"d°°•• ""°^• Lavatory 9.00
Owner Tub or Tub/Shower Comb. 9.00
Ufyi31,1. Shower Only 9.00
Water Clcset 9.00
�°^^ •m•°"^•^°•• - Dishwasher 9.00
Garbage Disposal 9.00
Occupant u,+�•,,,, *�. Washing Machine 9.00
Floor Drain 9.00
"°ry°'• ^ Water Heater 9.00
Laundry Room Tray 9.00
•^• n Urinal 9.00
VPV ! V V,L,r C^��- Other Fixtures (Specify) 9.00
M.�a wa.. vnm. 9,00
Contractor n h
I,,C)r ?1 Lac' �Ilc��< LR Rltx'7 9.00
1:4nsw• zip 9.00
Sewer 1st 100' 30.00
9b1.P.pa.Mn N.-- Gly Bu..Tu Pb Sewer -ea. Addit. 100' 25.00
I l SS LO -?4-m grater Service 1st 100' 30.00
1 hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25,00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws. that Storm & Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00
number given is correct (If exempt from State registration, please -
give reason below) Mobile Home Space 25.00
Back Flow Prevention
t ^ `ZCA- $ 5 Device or Anti-Pollution Device 9.00
N. °^^«�•a•"" •• Any Trap or Waste Not
Connected to a Fixture 900
Describe work new addition alteration Q repair O Catch Basin 900
to be done residential P non-residential Insp of Exist. Plumbing 40 00/hr
Specially Requested Inspections 40.00/hr
Existing use of Rain Drain. single family dwelling 30.00
building or property
Residential backflow prevention
_ devices � ( 15.00
Proposed use of
"uildrng or property
L - '(Except residential backflow _
prevention devicesl
J NOTICE 'Minimum Few, $25.00 SUBTOTAL r
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE t )
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS Al ANY TIME AFTER WORK IS
COMMENCED PLAN REVIEW 2571, OF SUBTOTAL
TOTAL �1
Special Conditions -
Date issued
CITY CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171
CE P r I F I CA TL OF
OCCURANCY
PERMTT F4. . . . . . . . IVIST92 .0 i
039--4171
DATE ISSUED-, 05/06/93
1 T'r ADDRESS. . . i I 1.847 SW 1.1;25 T I-I C'T PARCEL : I S133DD-11.404:
IIJEADI V ISION. . . . t VILLAII.-JE A7 `aUMIIUR LAKE PARV 4 ZONING: R- A. 5
''A-OCK. . . . . . . . . . g LOT. . . . . . . . . .
I r6s or" WORK. -NEW
� YPE or' LJSF-.. . . t W
11-ICUPANCY Of4j. 3 FR5
CCUPANCY LOAD-&,2''"A 4
NANT
PATH I
!wner:
1�QN monIS'SETTE. HOMES
I.5555 SW SANGY PrI #201
AKE MWECAJ OR 970-'5
,hone #t 6P-0-7538
,ontractort
,',ON M(11?1S3F-1"1'E BUILDE7RS, INC.
-955!j SW UMMY RD.
221A I
OKE. OSWEGO OF? Pi 10;
,.eq 4t. . : 3!V?t33
lc-�C(ApiAflCy O.' the AbOVe V"ef et,eTicit,cl bul Ich np t 1.6 hereby given, and cert i f ies
he CoMpHance with the OtAtO Of ut-ouut, 15r)er-ialty Codes for the tV-,uupj
i'(".f.tpancy, and orit... undei, which the referenced permit was issued.
IL
FINE- N "PE' ICTOR
t\1 T'I C I AL
SUIL-rm 0 OF
Ln POST IN U0615PICUOUS PLAU.
uj
NSP6CT_Oit NOTICE
Ctty of Tigard Building Dvpartzient
v" ].3125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rea-O-Phone): 639-4175 Businene Phone: 639-4171
Inspection:
Footing Plbg. Underslab Rech. Rough-in Appr/Sdwlk
Found, Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Bo»m Mech. Rain Drain Insulation —Pi!=
Plbg. Underfloor Water Line Gyp. Rd.
Date Requested: _-� yTLmet AN kPH
Address: �S Permit
4
Builders
TBE FOLLOWING OORRECTIONS ARE REQUIRED:
ri
C!7
W ( L
110
Inspector• i Dates
APPkOVED __ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITYOF TIGARD
CrrY0FT1*W,AN1RWD
COMMUNITY DEVELOPMENT DEPARTMENT 02140" MASTER PERMIT
t3125 SW Hall Blvd. P.O.Box 23IQ7,rigaid,Oregon 9rM(603)&%�-4176 T-7 PERMIT #. . . . . . . : M'57'92-027/4
639-4171 DATE ISSUED'
1-21- 13
SITE ADDRESS. . . : 11847 SW 125TH CT PARCEL: IS133DD--11400
:3UBDIYISION. . . . .' VILLAGE AT SUMMER LAKE 14i"K 4 ZONING- R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 151
------------------------------------- BUILDING
REISSUEz DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :430 sf
IYPE OF USE. . . :SF FLOOR AREAS------------- REQUIRED SETBACKS-----------
TYRE OF CONST. :51\1 FIRST. . . . : 1611 sf LEFT. . .*5 ft RIGHT-58 ft
OCCUPANCY GRP. :R3 SECOND— : 1501 sf FRONT. -.20 ft REAR. . .-39 ft
STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED_________________._.........
HEIGHT
EQUIRED----------------------
HEIGHT. . . . . . . . t25 ft TOTAL------13112 sf SMOKE DETELTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . 150892 PARKING SPACFS. . : 1
Remarks: PATH I
--------------------------------- PLUMBING --------------------------------------- -
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREYNTRS. . :O
LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BAS114B. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE LISP. . . : 1 RAIN DRAIN (ft) . ;O
WASHING MACH. . . 11 SF RAIN DRAINS. . : 1
---------------- MECHANICAL ---------------------------------- FEES –_–_--______–__
FUEL 'TYPES------------ UNIT HTRS. . 30 type amoi-int by date reept
/GAS/ VENTS . . . . . :0 TIF $ 1460. 00 JH 02/01/93 –
MAX INPUT :0 BTU VENT' FANS. . P4 BPRF $ 560. 50 JH 02/01/93 –
FURN ( 100K . . -0 HOODS. . . . . . : 1 BPLL is 364. 33 JLH 11/17/92
FURN ) -100K . . : I WOODSTOVES. -O B5PC $ 28, 03 JH 02/01/93 –
FLOOR FURN. . . . :0 CLU DRYERS. ; I SSDC $ 2821. 00 JH 02/01/93 –
BOIL/CNP ( 3HP.-Q) OTHER UNIT'Sil MPRT $ 45. 00 JH 02/01/93 --
GAS
GAS OUTLETS: 1 MPLC s 11. 25 JH 02/01/93 --
Owner:
Owners $ 2. 25 JH 02/01/93 --
DUN
DUN MORISSETTE HOMES PPRJ $ 140. 00 JH 02/01/93 –
15555 SW RANGY RD #201 p5pl, t 7. 00 JH 02/01/93 –
PARK $ 2'50. 00 JH 0E/01/93
LAKE OSWEGO OR 970.35
Phone #s 620-7536
Contractor: --------------------------------
DON MORISSETTE BUILDERS, INC.
15555 SW SANDY RD.
#201
LAKE OSWEGO OR 97035
Phone #s 620-7538
V) Reg #. . : 35533
31413. 36 TOTAL
This permit is issued subject to the regulations contained in the ------- REQUIRED 1148FIECTIONS --------
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Struct Gas Line Insp
plans. This permit will expire if is t t Post/Beam lylectian Insulation Insp
I "I start within 188
days of issuance, or if work is spen ed for t an 0 days. Plm/Lindslab Insp Gyp Board Insp
PLIYI/Undet,f I oor Rain drain Insp
1 ,pr-mittee Signatl.ire -
Mechanical Insp Water Line Insp
Plumb Top Out Appr/Sdwlk Insp
I551.1ed By : Framing Insp Mechanical Final
Lail jut, irisLjgction 639-4175
CITYOFTIVARD
SEWER CONNLC f T OIV
COMMUNITY DEVELOPMENT DEPARTMENT dim�� PERMIT
7
13125 SW HWl Blvd. P.O.Boa 23307,Tlpvd,Oregon 97223(SM)839-e175 `'E RM I T #. . . . . . . :
639-4171 DATE ISSUED: :
SITE ADDRESS. . . : 11647 SW 125TH CT PARCEL: 1S133DD--11400
SUBD I V 19 I Oil. . . . : VILLAGE AT SUMMER LAKE. PARK 4 ZONING. R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 151
TENANT NAME. . . . . ..
USA NO. . . . . . . . . . : FIXTURE UNITS. . . :
CLASS OF WORN. . . :NEW DWELLING UNITS. . : 1
T YPE OF USE. . . . . :SF NO. OF BUILDINGS-. 1
INSTALL TYPE:. . . . :BUSWR I11PERV SURFACE. . : : f
Remarks : PATH I
Uwrier: — -------- ___________
------____._______._______-----._____ FEES
DON MORISSETTE HOMES type anroI.rnt by date recpt'
15555 SW PANG:;`/ RD #201 F'RMT $ L100- 00 JH 02/01/93 —
INSP $ 35. 00 JH 0".,/01/93 -
LAKE OSWEGO OR 97035
'none it: 620-7538
Contractor,: ----------------__------_----_.-.—
C:ONTRACTOR NOT' ON FILE:
I-'Irrjne It: 8 2135- 00 TOTAL __ •—__.__._.____...
Rey #. . :
RE DUI RED INSPECTIONS —_..--_.__ _.
This Applicant agrees to comply with all the rules and regulations Sewer, Inspection
of the Unified Sewage Agency. The permit expires 160 days from -- -
the date issued, he total amount paid will be forfeited if the
permit expires. me 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 riven. V not so loc d, a installer shall purchase
a "Tap and Side Sewer" Permit a the Age cy will install a lateral.
f e r m i l t e e 5 i y Ti 31 t�_r r -14,,,0 _�----
0
Call for inspection - 635-4175
v�
F-
s:
W
J
lues SW Ha B&,& PLNCK/RECT /
CIT' ..T OF TIGARD PO Box n397 PERMIT /
COMMUNITY DEVEI)OPMENT DEPARTMENT TwuA0-a°"97223
(m)639'-41-11 DATE ISSUED
JOB ADDRESS:
TAX MAP/LOT ZS/ Z 3 2 O /N"'
SUB: ..��l; m C�� L)W, Qlfy �. e 15i LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: 1—��rl S REISSUE OF:
ADDRESS: �S�� 15. `Ul LAST REISSUE:
FLOOD PLAIN/
PHONE: ���" _ SENSITIVE LAND: —
CONTRACTOR APPROVALS REQUIRED
NAME: ", '� \ ��' l�aC . r1GrYl � PLANNING: Of- Y`
ADDRESS: ) J`J� �" bU L`0 . UIENGINEERING:
L - Le- 16tis FIRE DEPT:
PHONE: I OTHER:
CONTR. BOARD 1: �J�J� J _ EXP DATE:
iTEMS RUVIRED
SUBCONTRACTORS: PLUMB: ] LIST/SUBCONTRACTORS:
MECH: � "1f1AUS TAX:
ARCH/ENGINEERo —�
CALCULATIONS:
NAME:
�1,�/�I (�.�/ ____� TRUSS DETAILS: —
ADDRESS: ne Ux OTHER:
- 2 nu 1 (9 E �PHONE:
PROPOSED SIOG. USE: ---
COMMENTS: �-
APPLICANT �IG MATURE
Received By: Date Received:
PERMIT ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL.. DUE
y� L 10-432 00 Building Permit Fees 5�0,
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees `" z
10-230 01 State Building Tax (5%) 3/-2-b' - ���.L cy
Building
Plumbing ? -"o
Mechanical
10-433 00 Plans Check Fee �>>>� / .l SU 1.2 S SY
Building
Plumbing
Mechanical
10-230 06 Fire
�.., is y:t(-r30-202 00 Sewer Connection u 6,11 U
30-444 00 Sewer Inspection �_� %' 3,>
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 nffice TIF Fees
25-448-01 Residential Traffic Fees _.j.S U
25-448-05 Mass Transit TIF Fees // U
52.-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
a (SSDC) 0
,`— 24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of) _
w
TOTAL ,r j,i(c -2 S
J ( )
V
nm/3581P.WPf