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10855 SW FAIRHAVEN WAY i , , a 1U855 SW FAIRHAVEN WAY CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-41711 . Date Requested: A.M. P.M. ✓ MST: Location: �l ;�� T dllf�1 �1/ 17 BLR': Tenant: Suite. Bldg: MF.C._ Contractor: hone: n PLM: Owner: '�.�%�.�t-Q.�, Phone EI.C; _ Elk BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTIU VAL SITE Site Post/Beam PostIlleam Post/Beam Cover/Service Sewer/Storm Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab Framing T (hit Gas bine Rough-In UG Sprinkler Foundation Insulation HoodMuct Reconnect Vault J Bsmt Damp Drywall r�' Furnace Temp Service MISC. Masonry Ceiling Rain train A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I seat Pump Low Volt Approved pp•ry Approved Approved Approved Appr/Sdwlk Not Approved o pproved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL C1 Call for rein tion C7 Reinspection fec of S. required before n xt inspe-tion C]IJnable to inspect Inspector_ - - — - - --- Date:/�f _� Page-_ —of-— — CIT` OF TIGARD SEWER CONNECTI3N DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : SWR97-026.3 DATE ISSUED: 07/12/97 PARCEL: 2S103DD-00421. F31TE ADDRESS. . . : 10855 .-"W FAIRHAVEN WAY SUBDIVISION. . . . :FAIRHAVEN COURT ZONING: R--3. 5 BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 1.2 IRISDICTION: TIG TENANT NAME. . . . . :L.EE KRAUSE: USA NO. . . . . . . . . . : FIXTURE UNITS. . . 0 r,I-ASS 017 WORK. . . :ALT DWELI-ING UNITS. . : I TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 0 INSTALL Tyr-.*. . . . :LTPSWR IMPERV SURFACE: 0 s Remat-ks : Installing sewer- line Owner-: FEES I EEI KRAUSE type akmoi.tnt by date r,e(-.Pt 1.0855 SW FAIRHAVEN WAY r.*jRMI' $ 22,00. 00 B 07/02/97 97-296719 TIGARD OR 97223 INSP $ 35. 00 B 07/02/97 97-296719 MISC $ 4505. 88 D 07/02/97 97-296719 Phone #: Contr-actor,: f1WNER !-,hone #: $ 6740. 88 TOTA1-- Peg #. . : REQUIRED INSPECTIONS This Applicant agrees to comply with all the rules and requ,ations Sewer- inspection of the Unified Sewage Agency. The permit expires 180 days from the date issued. The totel amount paid will he forfeited if the permit expires, The Agen.,y does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shill prospect 3 feet in all directions from ttp distance given. If ot so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law rquires you to follow rules adopted by the Oregon iltility Notification Center. Those rules are set forth in DAR 952-001-*11 through OAR You may obtain copies cf these rules or direct questions to DUN: by calling (503)246-1987. I s s tj e d b y Ppt,mittee EignatIAV'e : ........4++4........ ............4................4........... ..........4.+++-P.....4- Call 639-41-5 by 6:00 P. M. for, an inspection needed the next bi-isiriess day ......*..............4-++4-4....4.....4+.++++++4+++4.................#-++++++�.....4-4 CITY OF TIGA,Ra PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : PLM97-0;'Si' 13125 SW Hall Blvd., Tigard,OR 9722.7 (503)639-4171 DATE ISSUED: 07/02/97 PARCEL: 2SI03DD-00421 SITE ADDRESS. . . : 10855 SW FAIRHAVEN WAY SUBDIVISION. . . . : FAIRHAVEN COURT ZONING: R---2. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 12 JURISDICTION: TIG ----------------------------------------------- ------------------------------- CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOR II_E 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 5F RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . : 0 GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 100 WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Installing sewer iine Owner: ---------------------------------------------------- FEES -------------- LEE KRAUSE type amount by date recpt 10855 SW FAIRHAVEN WAY PRMT $ 30. 00 B 07/02/97 97-296719 TIGARD OR 97223 5PCT $ 1. 50 B 07/02/97 97-296719 Phone #: Cont ract HOLLENB()CH A HURD INC 3000 SW 174TH AVE ALOHA OR 97006 ------------------------------------ Phone #: 591-5987 $ 31. 50 TOTAL Reg #. . : 012180 ------- REQUIRED INSPECTIONS This persit is issued subject to the regulations contained in the Sewer Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection aiplicable laws. All work will be done in accordance with approved p4rs. This pervit will expire if work is not started within 18@ days of issuance, or if work is suspended for tore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are sit forth in MR 952-iWI-010 through DAR 952-MI-NN, You tat, obtain copies of these rules or direct questions to OLIC by calling (563)246-1987. TS;,;ued By :e1WJ1y1trL— Permittee Si gnat ure ...................4.............................. *+++,4...........4......... Call 639-4175 by 6:00 p. m. for an inspection needed the next business day ........4-4........... ..........4.......4........................................ :i'rY OF TIGARD Plumbing Application a,' 3125 SW.HALL BLVD. Commercial and Residential °"°''"" IGARD, OR 97223 Date to t,E- 503) 639-4171 Date to DST Pamnit ti L71 Print or Type Related SWR Incomplete or illegible applications will not be accepted canal Name of DevebprrrenvPrgecx .E1XTlJRE34()ndltridual) Job ;`P �. , ! Sink 9.00 �' ,� a/ � •� Jc ,._,.• a n- Lavatory 9.00 Atic,'ress Street Address Such Tub or TuWShower Comb. 9.00 Bldg a Ci ISlate ZIP Shover Only 9 /6 P wow Closet t 9.00 me" / /t i Q q G(S_� Dbhwaatter 9.00 Owner Mear9 Address � r1 Sude GarCepe Disposal9.00 'SAr /!/7 Y ./ i 9 Madrkre 9.00 Ci y/Slate Zip Phone Fbor Dram 2• 9.00 7$F y,I 3• 9.00 Name or*G. 4• 0.00 Occupant 11 " Address 3urte Water Heater - 9.00 Laun"boom Tray 9.00 Gty/State Zip Phone lhmar 900 Other Fixtures(Spec&j) 9.00 Contractor Willing Address r) Sults 9.00 ooh S 1 7y ..,,E 9.00 ,Prior to Issuance /State Zip Phone applicant must j-,AA• .*T.X `r' _ 9.00 provide ad Oregon Const.Cont-Board Lica Exp.Date 9.00 contractors /.2/- S! Y-//- �,r 9.00 Information Sewer Ur- Exp•Das Sewer-iat 10(r --_ - _ 30.0-0 Sewer-a"additional 107 25.00 for COT COT Tax or Metro 0 Exp.Date Water Servks-1st 100 30.00 database)- ,1(� /_ - Narne Water Service-eadr Wdltional 200' 25.00 Architect Storm d Ran Drain-1st 100' �- 30.00 _"- or M&*V Ade+ess Suite Stour+8 Rain Dram-each addAional 100' - 23.00 Mob+a tion Span• 25.00 Engineer City/State Zip Phone ionmrerLaal Baric Flow Prevention Deuce or Ano- 2s 00 _ Pofkrticrr Device -scnM wort New O Addition O Altersom O Repan O Residenbal Badcnow Prevention Devna,• --- 15.00 x dome Resrdortaf O Non-resrdendal O Any Trap Or Waste Not Connected to a Fwft" 9,00 .. nartronal desrxrptlon of worst latch Basin 9.00 P.of F�osbwmn Phxnb" - -- -40.00 petih( ing use o! -- Specialty Requested InspecDons 40.00 erg or pnOpe"y----.-_ - - - Fant Dram.angle family dweclny- 30.00 oosed use of Grosse Traps 9.00 cding or property_ - OUAN'nTY TOTAL ,ra you cappu-q. me" or replacing any fbMires7 yes(] Nop leorrw W ar new diagram s reou_rsa r Uuarray Total is es see beck of furan) - 'SUBTOTAL r� _ ereby acknowledge that I hive read this application,that the information _ ens correct.that I am Mvhen -rer or authonzed agent of the owner.and 5%SURCHARGE at Dians submitted are m co rW rice with Oregon State Laws. _ ynaturao A rtt Osa PLAN RE1/IFW 2576 OF SUBTOTAL , fired mw I-bmxe zy "u-s YE- �J� -, - k 3k ' r� I TOTAL C0 Person Phone l- -- i •IMlnknum permit fee is$25.5%surcharge.except Restdendaf Backflow Prevention Device.which is$15•5%surcharge L\plmapp.doc 1296 (dst) 'I EASE COMPLETE AS APPROPRIATE TO PROJECT: Fixtures to be capped, moved or replaced Qty Sink Lavatory 'rub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" 4„ ,t h"4 L2 0e)coo Water Heater4 Laundry Room Tray RPIlN6 vr.a wvtk.*)>4it? gEa5-gj Urinal Other Fixtures (Specify) ".OMMENTS REGARDING ABOVE: L\plmapp.doc I?.i% (dst) I I ALOHA SANITARY SERVICE P.O. Box 309, BAVKS, OREGON 97106 644-2797 648-6254 639-6188 NAME: /- ADDRESS: //1 n {i ..7, l,.l• �f J K/��a l-�' �l% _ -_ CITY: / E STATE: k ZIP: -_ HOME: WORK: CELL: JOB SITE: S/-,7r�7P�-- -_--- - - P.O.#: PAID BY CHARGE 71 CHECK 2 CASH 1 CREDIT CARD 1 _ DATE -1- .-;L I- ��DRIVER /�/TUE '7� flew/ _ AMOUNT__ PUMP SEPTIC TANK :1 o 71 LINE OPENING O INSPECTION FEE C in SERVICE CALL O LABOR, LOCATING, DIGGING & BACKFILL MATERIAL Jam' LC.!.t- e, W6:0 6:0►`- r - -- ---THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT �i 1 OTAI_ - - REMARKS - - TYPE - REMARKS - - TYPE OF TANK: STEEL rI CONCRETE 0 PLASTIC -I HOMEMADE HORIZONTAL 1 VERTICAL -1 RECTANGLE 9 OTHER SIZE OF TANK: 350 n 5001 750 O 1000 0 12501 1500 -1 20001 3000 71 LID LOCATION: INLET n OUTLET I MIDDLE 1 ENTIRE TOP 1 TANK CONDITION: GOOD ❑ FAIR 1 POOR 1 FITTINGS: BAFFLES 11 CONCRETE 1 CAST IRON 1 PLASTIC 11 NEEDS NEW LID? 1 YES SIZE GROUND COVER OVER TANK ,OMMENT ON CONDITION OF DRAINFIELD ETC. SIGNED BY DATE