10770 SW FAIRHAVEN STREET i
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10770 SW FAIRHAVEN ST
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : PLM97-0282
DATE ISSUED: 07/1.7/97
PARCEL: 2S103DD-00431
SITE ADDRESS. . . : 10770 SW FAIRHAVEN WAY
SUBDIVISION. . . . : FAIRHAVEN COURT ZONING: R-3. 5
BLOCK. . . . . . . . . . :# LOT. . . . . . . . . . . . . :7 JURI-IDICTION: TIG
I------------------------------------------------------------------------------
CLASS OF WORK. . ;NEW GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP.,. . :R3 r-LOOR DRAIN5. . . . . . .. 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES,. . . . . . . . : 0 WATER HEATERS. . . . . a 0 CATCH BASINS. . . . . . . : 0
FIXTURES-------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . 1 0 URINALS. . . . . . . . . . . 1 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 17, OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 40
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHIJASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Connecting to sewer,
Owner: FEES
ERWIN H SCHACHT type amount by date t,ecpt
10770 SW FAIRHAVEN WAY PRMT $ 30. 00 DS1 07/17/97 97-297266
'TIGARD OR 97223 5PCT $ 1. 50 DST 07/17/97 97-297266
Phone #:
POY—A EXCAVATION INC
JACQUES POIRIER
19280 SE TILLSTROM
BORING OR 97009 _---..._.-._---_------------------------_.
Phone #: 503-618-0129 f 31. 50 TOTAL
Reg #. . : 118372
REQUIRED INSPECTIONS
This peroit is issued subject to the regulations contained in the ;ewer Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final. Inspection
applicable laws. All work will be done in accordance with
approved plans. This pervit will expire if work is not started
within 180 days of issuance, or if work is suspended for iore
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 through OAR 952-0001-0080. You tay
obtain copies of these rules or direct questions to OLNC by calling
(903)246-1987,
Issued By : Permittee Signati-ir-e :
I+++++++++ +++++++++++++4•+++•F++4•++++++•+++++++++++++++++++. +++++++++++++++++++
. 1-+4............4
Call 639-4175 by 6:00 p. m. for an inspection needed thir/ne)/((t' biisiness day
.................................................4-+++++++++++*..............44
'ITY OF TIGARD Plumbing Application Recd By �-'
1125 SW HALL BLVD. Commercial and Residential Oats Rec'd f
-IGARD, OR 97223 D.te in P t_.
-03) 639-4171 Pam OST
Print or T
YpeRelated SWR a c -o�X]l(
Incomplete or illegible applications will not be accepted Caned
-�
Name Of l7411velopmentiProlect FIXTURIl;3,(hldMdli IrAw' ' i,
Job swt 9.00
Address Street Addtesasc✓ "'I Suite Lavatory 9.00
�' 7 1e r AA veil Tub or TuWShoww Comb, 9.00
Baps city/Statfa Zlp Shower only 0.00
l C� ✓Cf Wtla Cbsat
Name 9.00
Gc Obhwashar 9.00
Owner MatNrp Adams W 4y Swte Garbage 01.00,411 9.00
'`I f4 i.� N Waahw"V Maefhirme 9.00
citytState Zip Pharr --� Floor Oran Z-
9.00
Nanl! 9.00
{ V e S 4' 9.00
Occupant m"M AddM& Sulte Water Heater 900
Laundry Room Tray 9.00
Cutyfstats Zip Phone Urinal
9.00
y / O"M Fixttrn(Speafy) 9.00
T-u rJ LX_CQVG� T)a v 1 ✓v 9.00
'ontractor fNarlttq AddreuSuft9
r. S 6" 11 0✓kit 9.00
.00
'rior to issuence MM PhaN
applicant must . , ,..s /fir i�Uj 7 (P 60�Sf 9.00
provide
all
Oregon Const.Cont Board Uc.s Exp.Oat* 9.00
9.00
ken" Pl�mm"ljc.0 EXP_Date Sewer-1st 100'
30.00 'C. Q
information j 7 Z,7 .J%v S -9 iS sews-e.d,adtlNfon.l 1 ar '- 25.00
for COT COT Business ax or MO Exp, t•
__aabasa). ___) I q' water Service-1st too - 30.00
Name Water Sarvlce-each additional zoo -- 25.00 -
Architect storm a wit Drain-1u moo 30.00
or Mo+ng address - Suite storm A Ran Drain-each additional lar 25.00
---- mob"Home Spam 25.00
'ngineer Gtyrstaur Zip_
Phone - Commercial Bach Flow Prevention Devito_"or M- 25.00
_ Pollution()suite
()suite;;work New O Addition O Merabon O Repair O Residential Backflow Prevention Oe,.Kx* 15.00
e done: Residential O Non-residential O Any Trap or Waste Not Connected to a Fixture g 00
�ddrbonal desrnption of work - CIlch Basin --
_ 9.00
Insp.of E.=bM Plumbing 40.00
_ perft
%tiny use of -�� -� Specially Requested Inspections 40.00
cloy or property Ram Drain.single family dwelifny 30.00
nosed use of Grease Traps 9.00 '
'109 or prop"--
QUANTITY TOTAL
.you capping. movirg or replacing any tbktvres? Yes[J No C] tatrriasx or nsar Cu9nirn is rmMw"if Quana f Taal n >g
f n see beck of form
as%** i _ _ 'SUBT±.I_
-M-by admowiedge that T have read this application.that the information
n is correct,that I am the owner or authorized agent of the owner.and 5%SURCHARGE • -
Manu submitted are in compliance with Cregtxi State Laws. _ S
urr'qtu of Owner►A9ertt : bate ^PLAN REVIEW 25%OF SUBTOTAL
Raounid only r roma
>*1' '01011 b>9
cI - TOTAL 31
r ,57-)
!n M Nattte Phe
'Minimum permit fee is$25• 5%surcharge.except Residential t3acfkflow
Prevennon Device.which is S15• 5%surchan•ge
1:`plmapp.doc 12 96 (ds,)
'LEASE OMPL _TE AS APPROPRIATE TO PRQjEi:T:
ti
Fixtures to be capped, moved or replaced Qty .
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
Urinal
Other Fixtures (Specify)
:OMMENTS REGARDING ABOVE:
I:`plmapp.doc 13.96 (dst)
CITY OF TIGARD
DEVELOPMENT SERVICES SEWER C ONNEC f ION
l 13125 SIN Hall Bled.,Tigard,OR 97223 (503)639.4171 PERMIT #E E RMT r. : SWR 7 7-0`71;
DATE ISSUED: 07/16/97
PARCEL: 2S103DD--00431
SITE ADDRESS. . . : 1.0770 SW FA I RHAVE:N WAY
SUBI7IVISION. . . . :FAIRHAVE'N COURT ZONING: R 5-
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :7 JURISDICTION: TIG
TENANT NAME. . . . . :EH SCHACHT
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 0
INSTALL- TYPE. . . . :L.TP'SWR IMPERV SURFACE: 0 s
Remarks : Connecting to sewer,
Owner: __._----_____---•---...___.______--.--•--- --_____. _._._.__.___---..._._ FEES
F H SCHACHT type amar.int by date r-ecpt
10770 SW FAIRHAVEN WAY PRMT $ 2200. 00 B 07/16/97 97-29721.5
TIC;ARD OR 97c'c INSp' $ .T`�, �?i0 B 07/16/97 `37- 97"1`
MISC $ 4505. 88 B 07/16/97 97-297215
Phone #:
Cont r•actor:
OWNS R
Phone # $ 6740. 88 TOTAL
Reg #. . .
- - ----- REQUIRED INSPECTIONS ---- --
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 190 days frog __.
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee tho accura.y of the _-____.-
side sewer lateralk. If the sewer is not locattd at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance riven. If not so located, the installer shall purrhase
a "Tap and Side Sewer" Permit and the Agency will install a lateral, ________.._-._.___r_
ATTENTION. Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR
952-901.-0010 through CZAR 95<-N@1-0080. You may obtain copies of
these rules or direct questions to OK by calling (5831246-1987.
Permittee Signatrare :
+++++++++++++++-4-+++++++-h++++++-f+++++++•f++++++++t++++++++++++++ h+i+++++++++++++++
Call 639-4175 by .:x:00 p. m. far an inspection needed the next br.isin,rss day
+++++44 • •+++++++++4+4.+++++++++ /+++++++++++++i+++++4+++++++++++4••1-++++++++++++++++
CITY OF TIGARD BU-'q.DING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: A.M. P.M.
Location: Y-0 7 ZC7 BUR
Tenant:-_ Suite: _Bldg: Nfl"C:
Contra Phone: PLM:
ctor:—iL
Owner: Phone: FLC:
ELR.
BUILDING BLDG Fcon—'t) UMBIN§G__.�' MECHANICAL ELECTRICAL SITE
Site Post/13cam 110S cam Post/ficalil Cover/Service Sewcr/Stonn
Footing Roof UndFI/Slab Rough-in Ceiling Water Line
Slab Framing To Out Clog Lipc Rough-in TJG Sprinkler
Foundation Insulation r—l-rle-w—D I loo xul)tvt Reconnect Vault
Bsint Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Dram A/C U(;Slab
Shear/Sheath Fire Spklr/Alm Crawiflound Dr I leat Pump Low Volt
Approved Approved Approved Approved Approved
Appi/Sd%%,Ik Not Approved Not Approved Not Approved Not Approved
FINAL, FINAL FINAL FINAL FINAL
C1 call ir,?Wmsp!cwfi)n, � OrRe7on fee required before next inspection C3 Unable to inspect
Date: :7 Page or
CITY OF TIGARD
DEVELOPMENT SERVICES 5E=WFR CONNECTION
PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . :
DATE ISSUED: 07/23/97
PARCEL: 2S 103DD--0041.5
9TTE ADDRESS. „ . : 10770 SW FAIRHAVEN ST
J_IBDIVISION. . , . :FnIRHAVEN COURT TONING: R--•s. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . ..3 JURISDICTION: TIG
TENANT NAME. . . . . . JOHN ALEXANDER
USA NO. . . . . . . . . . . FIXTURE UNITS. . . : Qi
C 1.ASS OF WORK. . . :NEW DWELLING UNITS. . : 0
TYPE OF USE. . . . . :SF NO, mil` BUILDINGS: 0
I NSTnL.L_ TYPE. . . . :fat)SWR I MPERV SURFACE: 0 s f
Remai-ks : flay Sewer, SDC and Rei.mbr_ir,sement #9 fees
owner: _______-________._____.____.__.._____________..__---.---_.__.___._ FEES
JOHN ALEXANDER type Amor-int by date t ecpt
10770 SW FAIRHAVEN ST PRMT $ 2200. 00 JDA 07/23/97 97-297480
TIGARD OR 97223 TNSP t ? , 00 JDA 407/23/97 97297400
MTSC $ 4505. 88 JDA 07/23/97 97--297480
f=,hone #: 839--8303
L:ontractor: -.-_----------------_.._____-_-_-_
OWNER
1 6740. 88 TOTAL _ -
Re
- _- - - REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sr_l.,,ver Inspection _
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 Agency does not guarantee the accuracy of the
side sewer laterals. if the sewer is not located at the measurement
given, the instailer shall prospect 3 feet in all directions from
the distance given. If n6t 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 Notificaticn Center. Those rules are set forth in OAA
952-001-001? through OAR 952^.--0001-O80. You lay obtain copies of
these rules or direct questiors to OJNC by calling (503)246-1987.
Issr.ird by : - GL ____...__.... ._.._ Permittee Signati.ire: �� t f-7/ ,,I/�
c
r++{.++++++++++++++++++++++-+++++++++•+++++++++++E+++++++++++++++++++++++++++++-+ ++
Call 639-4175 by 6:00 p. m. for- an inspec_tior needed the next br.isiness day
+ ++++.++++++++++++++-F+++.++++++++++++++++++++a-+++4++++++++++++++++++.+++++++ r + I
1
CITY OF TIGARD
DEVELOPMENTSERVICESPLUMBING PERMIT
PERMIT #. . . . . . . : PLM97-0293
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 07/23/97
PARCEL: 2S103DD-00415
91 1 !. W)DRE 7. . . 10770 SW F AI RHAVE'N ST
SUBDIVISION. . . . : FAIRHAVEN COURT ZONING: R--3. 5
BLOCK. . . . . . . . . . . L0T. . . . . . . . . . . . . :3 JURISDICTION: TIG
----------------------------------------------------------------------------------
CLASS OF WORK. . :NEW GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES--------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . ,, 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 100
WATER CLOSET;. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN ( ft ) . . . : 0
Remar!,s : Connection of house to sewer-, r^eimbi.trsement district #9.
Owner-: _._.____..___._._...__...___._-_____. ._.___..._...----._.-___._____________ ._._ FEES —_—._--__------_.
JOHN ALEXANDER type amount by date recpt
10770 SW FAIRHAVEN ST PRMT $ 30. 00 DREG 07/23/97 97-297489
'TIGARD OR 97,222 ;PCT t 1. 50 DR() 07/23/97 97-297489
Phone #: 639--8303
Cont Tact _-
POY--A EXCAVATION INC
JACQUES POIRIER
19280 SE TILLSTROM
BORING OR 97009
r'hone #: 503-618-0129 ffi 31. 50 TOTAL.
Reg #. . : 11837P
------- REQUIRED INSPECTIONS -- -
This pereit is issued subject to the regulations contained in the Sewer- Inspection
Tigard Municipal, Code, State of Ore. Specialty Codes and all other Mi sc. Inspection
applicable laws. All work will be done in accordance with I n s p existing/ca
approved plans. This per'it will expire if work is not started Final Inspection _
within 196 days of issuance, or if work is suspended for sort _
than tA! days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-9991-991P, through OAR 952-M1-111/. You say w ��
obtain copies of these rules or direct questions to GUMC by calling
(593)246-1997.
I s s la e d _. __- Permittee Signature :
+++++++++++�4•++++++++++++++++++++++++++++++++++++++++++++++F+f+++4•++++++++i++++
Call 639-4175 by 6:00 p. m. for an inspection needed tHg next bl-:siness day
++++++++++++++++++++++++++++++++++++++++++++++4-+t+-4•+++++++++++++++++++++++++++
i
ITY OF TIGARD Plumbing Application Ras
Oatts
3125 SW HALL BLVD. Commercial and Residential Oat*
ed
Oats to P E.
IGARD, OR 97223 Date to DST
03) 639-4171 Pemut,
Print or Type Related SWR a , , v,,a
Incomplete or illegible applications will not be accepted Called
Name of Development/Project fIXjURES�(ktdlvldual) S yr';!« ; '..rl�
Job Sk* 9.00
lavaWy °'00
Address Street Address Scats
Tub of Tub/Shower Comb. 9.00
Bldg 0 City/State Zip Shower Only 9.00
Water Closet 9.00
Name Olsnwasher 9.00
Owner Ma"Address Suite Garbage mesal 9.00
wa& q Maowie 9.00
C1tylShite Zip Phone Floor Dram Y 9.017
3' 9.00
Name 4- 9.00
Occupant Maamq Address Suite Water blaster 9.00
laundry Roan Tray 9.00
City/Slate Zip Phone Urinal i 9.00
_. ----
Nantes Other Fixdxea(Spr►aty) 9.00
9.00
Contractor Marikh9 Address Surto 9.00
9.00
(Prior to issusnoI C Y(Stats ZIP Phone -
9.00
applicant mutt
provide all Oregon Const.Cont.Board Lrc.! Exp.Date _ 9X10
contractors 9.00
license Pkmmbahg Llc 0 Exp.Date Sewer-1lit 100' 30.00
Information _ Sawer-each additional 100• 23.00
for COT COT Business Tax of Metro S Exp.Oats water Service-1st 100' 30.00
database).
Name Water Serwce-each additional 200' 25.00
Architect Storm d Rain Oran-1st lar 30.00
or Mad^9 Address Surfs Storm A Rain Dram-each additional IW _ 25.00
Moble Hone Spada 25.00
Engineer City/State Zip Phone Comrnerual Back Flow Prawentwrh Dev+cs Of Anti- 25.00
ro kmon Deviee _
esrnbe wort, New O Addition O Alteration O Repair O Residential Backflow Prevention Dew A' 15.00
o be done: Residential O Non-residential O Arry Trap or waste Not Connected to a FLMrs 9.00
>Cditronal description of work Catch Bash �^ 9.00
Insp.of Existing Plumbing 40.00
per/hr
-.-- --
Specialty Requested Inspections 40.00
-ishng use of pefft
nlding or property Rain Dram,single family dwelling 30.00 -
mposed As of Grease Trips - 9.00
1)uAdinq or prop". -._________-_. - - ----
QUANTITY TOTAL -
Are you capping, mo-nng or repi,ang any flxtures 7 Yes Q-- No G Irwrrrrrrc a riser dbgnm o raouree a quarry total b >9 `t ..
Iles sN back of form) 'SUBTOTAL
hereby acknowledge hat I have road this application,that the rnformatron --- -
hien s correct.that I am the owner or akrthonzed agent of the owner.and 5% SURCHARGE
'hat plans submitted are in compliance with Orton Slate Laws.
;Ignature of OwnerfAgent pate PIAN REVIEW 25X OF SUBTOTAL A _
ReourtC akh/fttua4"n•9
-- -�
Tonal �• �� .
"ontact Person Mama Phone - ---
'Mlnlmum permit tee is S25 4 S%surcharge.except Residential Backflow
Prevention Device,which is S15+5%surcharge
I:Iplmapp.cioc: 1-'96 (dst)
'LEASE COMPLEIE- APPROPRIATE TO PROJECT:
Fixtures to be capped, moved o- replaced Qty .
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
Urinal
Other Fixtures (Specify)
OMMENTS REGARDING ABOVE:
L\pttnapp.doc 12.'96 (dst)
11