10765 SW FAIRHAVEN STREET i
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10765 SW EAIRHAVEF S'T'REET
CITV OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 639-4175 Business Photic: 6394171
Date Requested: � L���---� �_— A V P.M. MST:
IAx;ation: 10765 3UJ huup.+L1_��
Suite:_ Bldg: —_ MEC _
Contractor- �'`— � '�� Phone: ZRq_ _ PLM: _cl 7-030Owner �
—— Phone: p C� - ELC: _— -
ELK:
SIT: _
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Bemn Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slah Rough-In Ceiling Water bine
Slab Framing T (hit Gas Line Rough-In t IG Sprinklef
Foundation Insulation wet C��'h0.UrWtm
oouct Recoect Vault
Ilsmt Damp I)ywall Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Ahu Crawl/Fotmd IN Ileal Pump Low Volt
pprovcd <ZZj cued Approved Approved Approved
Appr/S!Wk Not Approved !WM-1tl+p Mt -d Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
O Call for r r►et i� O Rein. tion of required before next inq..-ection O Unable to inspect
Inspector: _ _._ Dater -- Page__of —
CITY OF TIGARD F
DEVELOPMENT SERVICES L1JPERMIT
4 PERMIT T ##.. .. .. .. . . . : PI__M97--0,07
13125 SW Hall Clvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 07,130/97
P1')RCCL: 2S10--DD--00405
SITE ADDRESS. . . c Iv.i G CW F- i;RI iA VF.N 1,11.
^l-IED IV ISI ON. . . . : FA I RI-If")G"N COURT ZONING: R- 3. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . , . . . : 1 JUPISDICTION: TT',7
CI_61SS OF WORK. . :ALT GARBAGF DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYFIE OF USC. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PRE'VNTRS. . : 0
OCCUPANCY GRP. . :R3 FLOOR DRA114S. . . . . . . 10 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
F-IXTURES- ...._.,_ -_-. ._.. LAUNDRY TRAYS. . . . . : V1 OF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIrS. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . a 0 SEWER LINE (ft) . . . : 100
lJf1TE:R CLOSETS. : 0 WATER LINE (ft ) . . . :
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Re: 5WR97-02 7G
Owner- : _....___._.___...--...___.... -------__._____.______..__..___._._____._. _-----..__..___.____ FEES
M(1RGARET THOMAS type '-Imol.mt by nate Sec pt
10765 SW FAIRHAVEN ST PRMT f 30. 00 JSD 07/30/97 97--2977SL
—IGARD OR 97223 5PCT 6 1. 50 JSD 07/30',97 '37 ;:'9775''
F'F•one #: G39--4350
Contract or._.....
r'OY--A EXCAVATION INC:
JACOUES POIRIC"R
19�_80 SF TIL _STROM
PnRING OR 97009
r'Irone #: 50.3 !rl>3 01�='9 $ 31 . 50 TOTAL.
Rog r#. . 118372
REDU I RED INSPECTIONS
This persit is issued subject to the regulations contained in the Sewer Inspection
Tigard yinic.pal Code, State of Ore. Specialty Codes and all other Final Inspection Y
applicable lows. All work will be done in accordance with
approves plays, This persit will ewpire if work is not star•tFd
within 198 days of issuance, or if work is suspended for sore
than 18t days. ATTENTION: Oregon law requires you to follow rules
ad9pted by the Oregon, Utility Notification Center. Those rules are
iet forth in OAR 952.8881--0010 through OAA 952-8881 NM. You say
abtain copies of these rules or direct questions to ON by calling
(503126-1987, _ _
5 i.1 e d B y : �-- : __. P e r m i t t F•e S i g n a t 11 r e s
++i...+++++++++•F•++i++ +.t ++++++++++++++++++.+++++++++•++++++++4 ++•F4+++++++++++-4
Call 639 -4175 by 00 P. M. for- ars inspection needed the n xt bi..5iness clay
!++++++++-L++i++++-E++t++++4-++•++++++++4.++++++•++++++•1 ++++++++ +++++++++++++++-r+•1-
V OF TIGARD Plumbing Application Recd 8y
125 SW,MALI. BLVD. Commercial and Residential o,t.Recd T" 3
.;ARD, OR 97223 Dace to P E-
0:) 639-4171 Oslo POMM s S /77 "-CtiTc;,-�
Print or Type Related SWR a / _ r_�
Incomplete or illegible applications will not be accepted called
Name of DevelowwUPropct .FIXTu"E ,Qf!d1v1dwQ Z;f Qty SCE.! 'AMT
Job d 7/1 S~ ��.✓ tC c''.t t r l Sink 9.00
Address Street Address Stute lavatory 9.00
Tub or TuGShower Comb. 900
Bldg a Ciry/Stars ZIP Shower Only - 900
Water Closet 9.00
Norrie
-i5W;W8-5—rW 9.00
Owner Me"Address � Swro C�'���+� 9.00
9.00
Cityrsute Zip Phone Floor Dram 2' 900
4 IQ r _
Name 3- 9.00
4. 9.00
)CCUpant Me".Ad]feaa Suite Water Hester 9.00
LAMCIry,Stader Room Tray 9.00
t97 L(p Phone
Urinal
9,00
N{rga _ Other F•oRut"(Specify) 9Ao
X r; V� t�.l--� j�rF 9.00
ontractor Ma&V Addceaa suite 900
'rfor to isxranc» Cky/Stace
9.00
must (< q Toe)7 666 6 3 S-"7 � 9.00
provide a9 oregon Cafte Curt.Board Uc o Exp.9?1
e 9.00
tr
conactors < 9.00
leene =�--+0 r ESxp.Date Seswr-tat 100' �-�
---
information '3 Z �� J `1 Cl�"
saw-each addi&mai tar
,or COT COT BkMfq;T or Mello S _ — 23.00
/ / Exp.Dan
latabasel. f'(1 Water Service-1st 10rY
Verne Water Serv+ca-ewe"additional 200' — 25.00
Architect Stone 6 Ram Oran•1st—100 ----"--
30,00
or Ma�rhg gess SudsSttxrn 6 Rain ikon-each sddidaral t00 20.00
Malde Home Space 25.00
Engineer Gtyrslats Zip- Phone CoMirnernal Back Flow Prsvesnnon Dewoe or Anti- 2500
PoaWlpn Device
.!Scribe work New O Addition O Alteration O Repair O Residential Backfbw Prevention Drerce' 15.00
x done: Residential O Non-residential O
;drt:onai desrnpoon o!work __ Any Trap or Wasra Not Connected to a Fixtures 9.00--
Catch Basin `-
9.00
Insp.of F�m[fng FMrmb+nq :� - Q -
_ per/ty
•Isting use al Spoaady Requested InapectMxts--- -- — 40.00
riling or property _
—Rim--5rrn,single family dwelling -- 30.00
onsed use of Grease Traps 9.00
Aing or p•openy
~ QUANTITY TOTAL *�
you cappry. moving or replagng any fbMuea7 Yes❑ No p laaneeia ar rim di19 in reaukea if Ouanxy Total is �9 �s•: .r :�.-
yes see back of form) 'SUBTOTAL
ereby acluKiwledge that I have read this application_that the information
sn is correct,that I am the owner or aulhonzed agent of the owner,and 5% SURCHARGE
at olans subnyded are m comoliance 4ith Oregon State Laws.
Mature at rrAgent Dab �PtJIN REVIEW 25% OF SUBTOTAL ,
Reduced onh f latum pry oral isis 9
f" { ��CJ TOTAL
rttact on me Phone
'Minimum perrnit tee is$25-5%surcharge.excxpt Residential 9ackfhow
w Prevention Device.which is$15- 5%sur,:harge
Llptmapp.doc 1196 (dst)
L! F�COMPLFTTE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
,-Water Heater
Laundry Room Tray
IJrinal _�__
Other Fixtures (Specify)
sOO.AMENTS REGARDING ABOVE:
I:`plmapp.doc 1196 (dst)
CITY OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
La
=21EM 13125 SW Hall Blvd., Tigard,OR 97223 (50.1)639-4171 PERMIT
PERMIT #. . . . . . . : SWR97-0276
DATE ISSUED: 07/17/97
PARCEL: 2S103DD-00405
SITE ADDRESS. . . : 10765 SW FAIRHAVEN ST
SUBDIVISION. — :FAIRHAVEN COURT ZONING: R--3. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 1 JURISDICTION! TIG
TENANT NAME. . . . . :TH011AS, MARGARET
USA NO. . . . . . . . . . . FIXTURE UNITS. . . : 1(-"
CLASS OF WORK. . . :AUD DWELLING UNITS. . : I
TYPE OF USE. . . . . :SF NO. OF BUILDINGS 0
INSTALL TYPE::. . . . :L.-rP TMP:,.�V SURFACE: 0 s
Remarks : Sewer connertion permit, reimbursement district #9- SF�1)1 if, 1:-Of
0
be pumped, filled or removed and inspected.
Owner: FEES ---------------
MARG91RET THOMAS type amount by date recpt
1.0765 SW FAIRHAVEN ST PRMT $ 2200. 00 DRA 07/17/97 97297269
TIGARD OR 97223 INSP $ 35. 00 DRA 07/17/97 97297269
MISC $ 4505. 88 DRA 07/1'7/97 97297269
Phone #: 639-4350
Contractor: ----________--_--_-----__.-----_
OWNER
--------------------------------------------------
Phu 1le it. $ 6740. 88 TOTAL
Req #. . :
------- PEDUIRED INSPECTIONS
This Applicant agrees to coopiy with all the rules and regulations Sewer- Inspection
of the Unified Sewage Agency. The permit expires 18e days from Septic Tank Fill
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does riot 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 "Tap and Side Sewer" Permit and the Agency will install a lateral.
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notifir-iiiiin Center, Those rules are set forth in OAR
952-0101-0010 through MR You may obtain copies of
these rules or direct uestions to OX by calling (503)246-1987.
I iti"Ied Permittee Signature :..
T
+4.4++++++++++++++++++++++++++.. .............................f-+4-f.................4+
Call 639-4175 by 6z00 p. m. foo an inspoction needed the next business day
4...............................4..........................4-4•.......1-4.............
CITY OF TIGARD L .
COMMUNITY CEYELOPMEN7, DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 9"2.9.8199 (503)539-4171
Y l .
I. l
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 S1M Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Now'Single Famifv Residences Only _
MOM ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job <?v -' P-*0t. 0A1--1 ❑ 3 BATH HOUSE$225.00
Address awsh" Fee includes all plumbing fbctums in the dwelling and the first 100 feet
i, ", U of water sarvke, sanitary sewer and storm sewer. Sae flees below.
i'"'"'Mai'"VAQ FIXTURES QTY PRICE AMT
�4,t Ctc�7ri�✓+�r4� - ' - v �__ Sink_ 9.00
Me" " ""'"' Lavatory 9.00
Owner 1704 f 'w f4, /* 77z 2 3 Tub or Tub/Shower Comb. 900
Willies' �' Shower Only 9.00 -
�Gn 2 u Water Closet 9.00
Dishwasher 9.00
Occupant Garbage Disposal _ 900
"""""'•` """ Washing Machine 9.00
Floor Drain 9.00
C&~ a' Water Heater 9.00
Laundry Room Tray 9.00
Urinal 9.00
Al s 74-77.1 !ti,! cNo�, +� -7"� , Other FatUres (Specify) 9.00
Cont;actor 9.00
6 e 9 5 r • •'' S T �^, 0"-v 9 7,1 Z 9.00
r� a _4.00
t �L7 �l Z� - X i 7,1 Sewer 1st 100' 30.00
ft" `AV sr_T.N& Sewer-ea. Addlt. 100' - - 25.00
Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Se vice as. Addit 200' 25.00
inkir oration 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
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addlt 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00 1
Baric Flow Prevention �J
L Device or Anti-Pollution Device 9.00
"move w-0 we Any Trap or Waste Not
Connected to a Fixture 9.00 j
Describe work new Q addition alteration Q repair Q Catch Basin
9.00
to be done residential Q non-residential O Insp. of Exist Plumbing 40.00/hr
Specialty Requested Inspections 40.00/hr
iling use of
building or property Rain Drain, single family dwelling 30.00
buddi _ _
Residential backflow prevention
devices / 15.00
Proposed use of -
building or property
--- '(Except residential backflow
prevention dev(ces)
NOTICE *Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION +~ i
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF' 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED -- --
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25`/. OF SUBTOTAL
TOTAL
Special Conditions
Dare issued by
I
CITYOF TIGARD
Ck.YOFTWARD
MECHANICAL
COMMUNITY DEVELOPMEMi DEPARTMENT oanawxe PERMIT
13126 SW HMI Blvd. P.O.Boo;23391.Tkjwd,Oregon W223 (603)6304176 � PERMIT #. . . . . . . a MEC92-0284
639-4171 DATE ISSUED: 10/27/92
SITE 'ADDRESS. . . r 10765 SW FAIRHAVEN ST PARCEL: 2S103DD--00405
SUBDIVISION. . . . FAIRHAVEN COURT ZONING: R-3. 5
BLOCK. . . . . . . . . . r LOT. . . . . . . . . . . . . e1
CLASS OF WORK. . s ADD FLOOR TURN. . . . a EVAP COOLERS a +
TYPE OF USE. . . . sSF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . :R3 VENTS W/O APPLs VENT SYSTEMSa
STORIES. . . . . . . . : 1 BOILERS/COMPRESSORS HOODS. . . . . . . :
FUEL TYPES------------- 0-3 HFA. . . . : DOMES. ?NC I N:
: /GAS/ / / 3•-15 IP. . . . : COMML. INCINs
MAX INPUT: PTU 15-30 HP. . . . : REPAIR UNITSr
FIRE DAMPERS?. . a 30-50 HP. . . . : WOODSTOVES. . a
GAS PRESSURE. . . a 50+ HP. . . . : CLO DRYERS. . e
NO. OF UNITS--------------- AIR HANDLING U14I TS OTHER UNITS. o
FURN ( 100K STUal <- 10000 cfm: GAS OUTLETS. al
FURN ) =100K BTU: > 10000 cfm :
Remarks : OIL. TO GAS CONVERSION
Owner: ----__.______.___...______._...._
------------ --- -------------- FEES -________.._.__-___-_
THOMAS type amount by date v-ei:pl;
10765 SW FAIRHAVEN PRMT f 25. 00 JH 10/27/92 -
5PCT f 1. 25 JH 10/27/92 -
TIGARD OR 97223
Phone #a
Cant Tact or e - -_____.___.___.__.---.---,___._-•_--__
COLUMBIA HEATING
8900 SW BURNHAM
SPACE E-110
TIGARD OR 97223 --___--__-___.---_-____- _--- -----__._-__---
Phone #: 624-2704 f 26. 25 TOTAL
Reg #. . : 76 359
RE:QUIREIT INSPECTIONS -------
This pewit is issued subject to the regulations contained in the Final Inspection _
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This perait will expire if work i, not started ^-
within 180 days of issuance, or if work is suspended for sorethan 180 days.
Permittee Signature: (1 ,L'
Iss�_led
By: � -� -
Call far inspection - 639-4175