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10830 SW FAIRHAVEN WAY. �,
CITY OF TIGARD
DEVELOPMENT SEIIVIV`i:,'3; PLUMBING PERMIT
PERMIT #. . . . . . . . PL..M97-0252
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE I SSUET. : 07/08/97
PARCEL: 2S.03DD-0042'.
S11L- kDDH SS. . . : 10830 SW FAIRHAVEN WAY
SUBDIVISION. . . „ : FAIRHAVEN COURT ZONING: R-3. 5
BLOCK. . . . . . . . . . : LO'T. . . . . . . . . . . . . :9 JURISDICTION: TIG
CLASS OF WORK. . :ALT 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 BASTHS. . . . . . . : 0
FIXTURES---------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LF,k,'ATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER t_INE (ft ) . . . : 100
WATER CLOSETS. : 0 WATER LINE= (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Connection to Fairhaven Way sewer- line.
LAURENCE RICH type amount by date recpt
10830 SW FAIRHAVEN WAY PRMT f 30. 00 B 07/08/97 97-2296868
TIGARD OR 97223 SPCT $ 1. 50 B 07/08/97 97-296868
Phone #:
Cont Tact or----------•---•----•------------_.____._PO','--A EXCAVATION EXCAVATION INC
JACUAJES POIRIER
19280 SE T I L L_S1 ROM
BORING OR 97009 -_--------------__-_-_____-------------
Qhone #: 503-618-0129 $ 31. 50 TOTAL
Reg #. . : 118372
---- - - REDUIRED INSPECTIONS --___-
This permit is issued subject to the regulations contained in the Sewer 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 permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 188 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are _
set forth in OAR 952-8801-8810 through OAR 952-N81-M. You may
obtain copies of these rules or direct questions to OUNC by calling
1583!246-1987. -----��
Issued By''j, � - ��� Perm .ttee Signature :
I
++++++++++++i-++-•++++++++++++++++++++++++++++++++++++++ 4++++++++
Call 639-4175 by 6:00 p. m. for an inspection needed the , hext business day
++++++++++++++++F++++++++++++++++++++++++++++++++++++++++++++++++++4++++++++f �
t
tY OF TIGARD Plumbing Application Recd 9y
1[5 SW HALL BLVD. `'onim::rcial and Residential Date Reed -
3ARD, OR 97223 Date to P E-
)3) 6394171
-
1
13, fi3s-aa r1 note to GST� 1 Print
or Type Related SWR 0 _
Incomplete or Wegible applicatiorm will not be accepted caf d 7 1—"
r .a __ --- _ FlxNrts (kbt,►�wq ss3tgr aL]<ift '
Job us-rAcc. TSO,_ _ 9.00
Addresf C 7 d`tA) F►1 t"t �ena — 9.00
Tub or Tub(Shower C". 9.00
Bldg 0 CitylState Lp Shower Only
Tyra �� �172Z3 9.00
Water Grocer 9.00
Name L A v L"crUc t i c 1 Dishwasher
MA100-oaIe rC _ 9.00
Owner MOWN AdOnM FA f RN RV��, suite ba"CbPoew _ 9.00
10 93 0 9 1aaCtrne 900
C.ityfState Zip Phtine Fbw Dns — 2,
T-I"/-N t> �f'12Z"3 ��3 r) IZ�17 9.00
9.00
5 1 r1'1 F- 4- 9.00
Occupant mar''ti9 Address Suite Water amom — - 9.00
)...unary Room Troy — 9.Q0
Gly/Stat" 23P Phone tkvol — -- - 9.00
_-_ Name PC Y- ,e. Other Foam(Specfy) 9.00
SRc�UE,5 '�nl et'- .— — 9.00
Contractor msilng Awreaa suite _ _ 9.00
Prkw to tasuance CAyrstate ZIP Phone
applicant must 6ie C-!,! n VY 1 _ (v > to 4 6?1 _... _ _---- 9.00
pmme as Oregon Const.Cont.Board tic I Exp.Uato ! 9.00
contrectom
kens Fove"rrts Exp.Date � 1111 lor
ndo 30. 0
Seww-a"addaionei,W _ _ 25.00
database).COT tel. T Busrrross qx K%tro a Fes.Oats, -tq 100 '- J0.Q0� —
�,l l,� 1 1� L� 31-'1� -
water Seneca-caw additional 200' 23-00
Storm a twin tan-Ist 100T
Architec. 30-00
or ►waw Aec + suite — St"a Ren Drain-e"amdf- naf t o0 25.00
motirle Han.Span:_— `—— — Z&00
Engineer CityrStats — Zip Phone connwa.l Baer Flow Prevention Device or ant►- — 25.00
Paarrtion Devi=
esmbe waft New y Addition o Alteration O Row O Ram Bac dtow tir.rsrveon De%nu• ts.00
be done: Res,derrm O Non-residential O Any l rap a erases Not C wnected to s Fixture 900
dddia"desagbon of wont 9.00
.a^R AI t'-1 r1 P Y -3 1'C`I M B 050 Mr.-Aj �ii I- �� catch Bath
Insp.of Em"M PMrbrq 40.00 -
per/hr
-Sting rue of S'pomay ReirWomw Inepsctiona--- 40,00
dtnq or propem � perthr
Rain[rn
- Raa .single tarry dere" 30.00
)posed use of GreaseTraps -- - i 9.00
rduq or property rl-k
QUANTITY TOTAL
rs you cappnq. rnown or mptacinq any ftxrines7 Yes C] No❑ Ise rnrr or now reep am is rears"it tkrrry Tar is >9
l y,s tee beck of form) — 'SUBTOTAL
xreby adtnowledge that I have read tris appkation_mat me information _—__-- __ —d
.,en is correct that I am the owner or authortzed aqent of the owner.and 5%SURCHARGE ;_:•,
at olare9 submitted are in compliance with Omgon State taws. _ -
gnaWre of OwnerfAgeM-, ) Date PLAN REVIEW 15%OF SUBTOTAL
yjy��r.-�i-Te.e- 4 /c-�C —r/ Rtfaurrert eN/1 hrty� --
/�/n °'Y..-__.•_ ----_TOTAL - -,
intact Person fdnnre �- Phots
'Mlnunum permit fee is$25• S%surcharge.exrmpt Resrdenoal Bacxflow
Prevention Oear» which is S15•5%sunriarge �
Llptmapp.doc 12,96 (dst)
CITY CSF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
PERMIT
13125 SIN Hall Ellvd„ Tigard, OR 97223 (503)S39.4171 PERMIT #. . . . . . . : SWR97-0256
DATE ISSUED: 07/01/97
PARCEL: 2S103DD-00429 �
SITE ADDRESS. . . : 10830 SW FAIRHAVEN WAY
SUBDIVISION. . . . :FAIRHAVEN COURT ZONING: R--3. 5
BL.00K. . . . . . . . . . LO1.. . . . . . . . . . . . . :9 JURISDICTION: TIG
TENANT NAME. . . . . .- RICH, LAURENCE
USA NCI. . . . . . . . . . .. FIXTURE UNITS. . . : 1F,
CLASS OF WORE;. . . :ADD DWELLING UNITS. . : I
"TYPE OF USE:. . . . . :SF NO. OF BUILDINGS: 0
INSTALL. TYPE. . . . :LTF' IMPERV SURFACE: 0 sf
Remarks : Connection to Fairhaven Way sewer line.
Owner,. -------------------------------------------------------- FEES --___--__-.._
I_AURF_NCE: RICH type amount by date recpt
10830 SW FAIRHAVEN WAY PRMT $ 22200. 00 URA 07/01/97 97-096635
f TGARD OR 97223 INSP 8 35. 00 DPA 07/01/97 97-2:96635
MTSC $ 4505. 88 DRA 07/01/97 97-296635
F,hone #:
Contractor. ---------.---_-,--_-_-_--_.---_--
0WNER
--------------------------------------------
Phone #: $ 6740. 88 TOTAL
Reg #. . -
-------
. . ------- REQUIRED INSPECTIONS
-This Applicant agrees to comply Nish ail the rules and regulations Sewer Inspection w�
of the Unified Sewage Agency. The permit expires 188 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 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 Notification Center. Those rules are set forth in OAR
952-NI-Ml through OAR 952-(r I-00SO. You may obtain copies of
these rules or direct questions to ltk by calling (583)246-1987.
vV ��
Issued b ����C�-YL'�I,, A _ P e r m i.t t e e Signature
+++++++++++++++++++++.4.+4++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 6:00 p. m. for- an inspection needed the next business day,
+++++++++-f+++++t+++++++++++++++++++++++++++++++++++++++++++++++t+++++++++++++++•.
CITU OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 639-4175 Business Phone. 639-4171
Date Requested: �4 /`" A.M. P.M. P/ MST:
� /)c f'? ��CZcr�� BUR
a—
I"enant: Suite: Bldg: NEC:
Contractor_ C`/�� ` ']Phone: �t �t,n_��� ,�, PLM: y 7—D, 5
Owner: __ Phone: �' / ELC:
ELR:
STT:
BUILDING T BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Bearn Cover/Service Sewer/Storm
Footing Roof UndF)/Slab Rough-In Ceiling Water Line
Slab Framing �To OutOut Gas Line Rough-In UG Sprinkler
Foundation Insulation ,; w�, -.` llood/Duct Reconnect Vault
Bsmt Damp Drywall t$ori Furnace Temp Service 1VIISC.
Masonry Ceiling Rain Drain A/C tJG Slab
Shm/Sheath Fire Spklr/Alm Crawl1l'uund Dr Ileat Pump Low Volt
Approved Approved Approved Approved
EAppr/Sd,wlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL, FINAL FINAL FINAL
' Call fiir ' spection O Rein tion fees ofS required before next inspection L7 linable to inspect
►nspertorits—
Date:� � of