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14115 SW FERN STREET 0 ,A Ln N X t� z x cn H Cb Cq H i. i I 9 I 0 1 14115 SW FERN STREET DEPARTMENT OF LAND USE &TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12 FIRST,155 NonTH LSBORO, OR 97124 COUNTY, PHONE: 50340-3470 / OREGON INSPECTION REQUESTS (24 hours). 503/681-3699 or 681-3697 Permit #: 05074006 Project # P0054762 Status: APPROVED PAGE 1 Applied: Issued . 11/01/1995 Fxpares 10/07/1996 02/13/97 06. 32 Cr,mpositn Tyr)e: ALTPERM i-:onstruction Type: ALT Permit Title: SFR - S\P\M\E Description: KITCHEN REMODEL Degun: 11/01/1995 Address: 14115 SW FERN ST TI Location: Location Detail : Region D Owner Name: BOHAN, THOMAS D Phone: Applicant Name: BOHAN, THOMAS Phone: 260•-7191 PLANS EXAM: JG Phone: Parcel : 2S1 04BC 00600 Occ : R3 approval#: APPR Valuation `fin roved � Inspector Comments: Rejected IVR-RESULT REQUEST ERRORI Inspected by. Date�- -- -------------------------- -- -- ---...------------- --------- Items requested to be Inspected . . Iten0t Inspection Description Requestor tNrea 00205 P Rough-In Plumbing KKP D AP DN IVR -7191 0030 Gas Line KKP D AP DN IVR + a -7191 .-------------------------------_-------------------------------------------- .---.---- Inspection History . 00199 S Firal Building AP DN IVR 00e99 P Final Plumbing AF DN IVR 00499 E Final Electrical AP DN IVR 00399 M Final Mechanical AP DN IVR DEPARTMENT OF LAND USE &TRANSPORTATION WASHINGTON 155 DEVELOPMENT SERVICES DIVISION #350-12 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, PHONE: 503/640-3470 OREGON INSPECTION REQUESTS(24 hours): 503/681.3699 or 681-3697 APPROVEU (,,ovv-,tvijc.tion It/pe p w til (,Ip q - C_ DEPARTMENT OF LAND USE &TRANSPORTATION WASHINGTON LAND DEVELOPMENT f;ERVICES DIVISION#350-12 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, PHONE: 503/640-3470 OREGON INSPECTION REOUESTS (24 hours): 503/681-3699 or 6811-3697 Permit. #: 05074006 Project #: P00543c. Status: APPROVED PAGE 1 Applied : Issued : 11/01/1995 Fx,i res 08/85/1997 02/28/97 06 00 Compositn Type: ALTPERM Construction Type: ALT Permit Title: SFR - S\P\M\E Description: KITCHEN REMODEL Begun: 1 .1/01/ 1995 Address. 14115 SW FERN ST TI Location: Location Detail : Region D Owner Name: BOHAN, THOMAS D Phone. Applicant Name: BOHAN, THOMAS Phone: 260"71.91 PLANS EXAM: JG Phone: Parcel : 251 04BC 00600 Approval# APPR Valuation: Approved Inspector Comments: Rejected IVR-RESULTS REQUEST ERROR ' Inspected byDate Items requested to be Inspected . . . . Item# Inspection Description Requestor Area 004 E C o v e r_ ..Jii�rwft�-� D AP ` UNC Comments : Requested thru IVR _.-� Inspection History . . . . . 00105 S Footing AP DN IVR 03/27/96 Inspector. Action: RI R11VR H7100 H 03/27/96 Inspector: MJ Action: AP APIVR I_UT12 I BS 00106 S Foundation AP DN IVR 04/02/96 Inspector: Action: RI RIIVR H7100 H 04/02/96 Inspector: MJ Action: AP APIVR LUT12 I BS DEPARTMENT OF LAND USE &TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, PHONE: 503/640-3470 OREGON INSPECTION REQUESTS (24 hours): 503/681-3699 or 601-3697 Permit #. 050i4006 Project ib: P00543bP Status APPROVED PAGE 1 � Applied , lsc. ued : 11/01/1995 Expires: 10/07/ 1996 OgI20196 06: 00 t:c,mpositn Type : �1LTPERIh Construction Type ALT Permit Title SFR -- S\P\M\F.: Desr_ription. KITCHEN RE111IDE.L. Begun: 11/01/1995 Ad(Ires5 . 14115 SW FERN zvr TI 1 ,-oca t i.on . 1 !.-acation Detail Region D Owner Name? BOHAN, THOMAS U Phone: Applicant Name BOHAN, THOMAS PFione: 260-71.91 FLANS EXAM JG PF ane. Parcel. 2S1 04BC 00600 Approva l#: APPR Valuation: ingpr,ct.ur Cc�mn,erits. Re jected,_��___... R I VR-•R;95ULT;" I REQUEST ERROR ' ' 1 i Jr c,I,e�ted by ,i L 1. 1 t ly.X'� Date. 3 I twrns requet,ted to be lnsprr:trd Itwrn# ion ' . Un Requestor Area ;)13 Exterior Sheathj ,of� SCS D AP UN IVR ;.111;pection History . J05 5 Footing AP DN IVR 0:3/27/96 Inspector. Action: RI RIIVR H7100 H 01/27/96 Inspector. MJ At.tion: AP AF'IVR LUT12 I PS ,1(.1106 S Foundation AP DN IVR 04/02/96 Inspector. Action: RI R1IVR F-:7100 H 04/02/96 inspector: 11J Ac tio- AP APIVR LUT12 I 39 03/29/96 Inspector. MJ Actic DN DNIVR LUT12 I 139 DEPARTMENT OF LAND USE &TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#3F3 12 155 NORTH FIRST, H;LLSBORO, OR 97124 COUNTY, PHONE: 503/640-347C OREGON INSPECTION REQUESTS (24 hours): 503/681-3699 or 681-3697 P: njec !. #1 P0054-3eic! lbtatus: APHROVEI) POA61= 'I Expires . 10/07/ 1996 07/24/96 06: 5 ! 11. � {7F14Ill Cows tructi.on T•Vpe. ALT I equri: 1 1 /01 / 1 t9 1WHAhI, f hicrrie: q{ i s rr:,nr !. Rlclnrr+ L1OHAN, 1HUMA''; Phone. c'&O-7'1`1. I{; Ph(ane: ::'S1 01 {"1r:r : R3 U S ce I if I nn Approved -. ,I' ERROR) 4fc Ar ea C-Ff1`,'IC:E 0 0 X AP DIS IVR AP DN IVR AF DN IVR ,P DN IVR W COUNTY Department of Land Use &Transportation E LE(,TR I CA L P E R i�t'1 IT Electrical Inspection Section APPLICATION 155 North First Avenue,/1350-12 Hillsboro,Oregon 97124 Information: (503) 640-3470 Fax: (503) 681-3993 / PRINTPLEASE Permit yy) 7 • • e • • • Number C'S�7ynn DatE xt/�/ 1. Location of installation. 4. Cornplete Fee Schedule below Address. /J 5 C'-% �� _ Number of inspections per permit allowed Building Service included Items Cost(ee ► SumV City -_ _ _ t f Suite No. Tenant Name A. Residential-per unit (if commercial) 1000 sq.ft.or less -- $110.00 1 Map No. —_ �_ Ts ix Let Each additional 500 sq.ft or purtion thereof $25.00 Limited Energy _— $25.00 — Thomas Map Book: Page: ___.______ Section: ._. Each Manuf'd Home or Modular Directions_. Dwelling Service or Feeder —_____ $66.00 Commercial U Residential In services or Feeders Installation,alterations or relocation 200 amps or less _ _$6000 ,_ 2 2a. Contractor installation only: 201 an ips to 400 amps —. $60.00 2 401 amps to 600 amps $12000 .. 2 Electrical Contractor_ _ Sol amps to 1000 amps _—_ $160.00 2 Address Over 1000 amps or volts _T $340.00 __ 2 City ._.. ___ State ZIP Reconnect only _- - $50.00 2 Date ..--._._-_.__ _ Job Number _ Property Owner C. Temporary Servlcea or Feeders Contractor's License No. Installation,alteration e•relocation Contractor's Board Reg. No. . _._ 200 amps or less __ $50.00 __—_ __ 2 201 amps to 4vu amps $75.00 2 Signature of Su r. tlec'n — 401 amps to 600 amps _____ $10000 g p Over 600 amps to 1000 volts see"B"above License No. Phone No. FAX No. D. Branch Circuits F New,alteration or extension per panel 2b. r' owner installations: 2 4 0 –7/ f/ ni The fee for branch circuits with �{ p a purchase of service or feeder tee. lJ/iAN Jy l PFTrii D re's Name -FFone o. Each branch circuit _— $5.00 ki�i�! b) The fee for branch circuits without A8 resspurchase of service or feeder fee, t .yam 4 ee e/ C -7 Z First branch circuit __[____ $35.00 �e'.��'—�-� 2 �{y 1 {ate zip Each ndd'nl branch circuit $S.00 �Z/`&U 2 E. Miscellaneous(Service or Feeder not includrd) The installation is being made on property I own Each pump or irrigation circle $40.00 ____._... _____ 2 which is not intendeo for sale, lease orrent. Each sign or outline lighting _ _ $40.00 2 Signal circulus)or a limited Owner's Signature t/'_"} e _ energy panel,alteration or extension __—. $40,00 3. Plan Review section if required) F. Each additional itispertion over the allowable Please check appropriate item arid enter fee in section 5B in any of the above 4 or more residential units in one structure Per inspection $3500 Per hour $55.00 ___Service and feeder,800 amps or more In Plant $55.00 I System over 600 volts nominal _.Classified area or structure containing special 5. Fees E occupancy as described in N.E.C. Chapter 50 A. Enter total of above fees $ __ 1 Submit 2 sets of plans wt0i application where any of the above 501, Surcharge (.05 X total fees) $ __ I apply. Not required for temporary construction servk:es. Subtotal $ . _ This Parma becomes null and void it the work authorized by the permit Is not B. Enter 25% of line A for commenced within 180 days from data of Issuance of such permit or If the Plan Review if required (Section 3) $ work authorized is suspended or abandoned at any time after work Is Subtotal $ commenced for a period of ISo days. Electrical Permits are non-refundable $ and non-transferable. � Trust Account »_.�_.... For Inspections call Balance Due $ 681-3699 or 681-3698 24-hour recorder, one working day in advance of need eL2e • 8,195 WASHINGTON COUNTY RESIDENTIAL Department of Land Use &Transportation it!�tmbing Inspection Section PLUMBING P E IT 155 Nnrth First Avenue,#350-12 Hillsboro, Oregon 97124 Project/ Information: (503)64:5-j47n Fax: (503) 6934412 Permit Number _4-f-?V Date Inspection Request!.: (503)681-3699 of-681-3698 permit Fee Schedule . . . omplete all Sections. DESCRIPTION OTY. COST(Ea.) AMOUNT _ RESIDENTIAL- SFR (1) PATH $210.00 Narre of Development NEW - SFR(2) BATF 275.00 Job - _ -SFR 3 BATH 325,00 --- --- Address /it//,/ ,� t,-) SINK(KITCHENL 9.00 Map No. Tax Lot WATER HEATER 9.00 DISHWASHER 9.00 Thomas Page Section DISPOSAL 9.00 Map Book WATER CLOSET 9.00 _ Directions to Site BASINS 9.00 or Cross Street - -- TUBS 9.00 SHOWERS 9.00 NanlL T CLOTHES WASHER _ 9.00 LAUNDRY TRAY 9.00 Mailing Address MISC, 9_._00 Owner f / S {� - REMODEL EACH FIXTURE City/state Zip (minimum fee-$25.00) 12.50 •2 i2e":n r ' ,ZZ Phone FLOOR DRAINS 9.00 ?.t/ ZL/'0 7 RAIN DRAIN/DOWNSPOUT 9.00 - Name DRY WELULEACH LINE 10.00 '�---� WATER SERVICE first 100' 30.00 Mailing Address WATER each addnl 100' 25.00 Contractor City/State s Zip - REPLACING in building water supply lines Phone FIRST FLOOR _ _ 30.00 ADDN'L FLOOR -each _ 1.2.00 _ State Registration No. i Plumbing Lic. No. SAN. CONNECTION _�- SEWER first 100' 30 00 I hereby acknowledge that I have read this application,that the each addnl 100' 25.00 information given Is correct. that I am the owner or authorized agent of the owner,that plans submitted are in compliance i Ath separate perm to preven Stale laws,that I am registered with the State Builders'Board. that two contractors from working the registration number given Is correct. (if exempt from State re trauon,please give reason here.) tiff same permit 40.00 -8VCKFLOW PREVENTER 9.00 STORM up to 4"diameter-per 100' 10.00 `- SEWER over 4"diameter-per 100' 15.00 0 '6 for ea, addnl 100' 30.00 Fr tit CATCH BASINS/AREA DRAIN _ 10.00 MOBILE HOME UTILITIES 60.00 T►utho zs gnatura - ate INSP. OF EXISTING PLUMBING Describe work per hour_ 40.00 to be done ❑ new Jddkfon ❑ alteration ❑repair SOLAR-MINIMUM 30.00 HEAT EXCHANGE 9.00 COLLECTOR/PANEL 9.00 F _ TANK 9.00 NOTICE: MINIMUM FEE 25.00 This permit becomes null and void if the work or construction authorized is not commenced SUBTOTAL within 180 days, or if constriction or work 6%of subtotal for State Surcharge authorized is suspended or abandoned at any 0 TRUST ACCOUNT TOTAL FEE DUE time after work is commenced. BL26-3'95 WASHINGTON COUNTY Depart RESIDENTIAL Department of Land Use &Transportation Mechanical Inspection #35 MECHANICAL PERMIT 155 North First Avenue,, #350-1-1 2 Hillsboro. 7regon 97124 Information: (503)640-3470 Fax: (503)681-3993 Project/ Inspz,ction Requests: (503)681-3699 or 681-3698 Permit NumberCU� Date PRINTPLEASE anct cox1vt6 PERMIT FEE SCHEDULE Narne of Development PERMIT ISSUANCE FEE l 1000 Addres DESCRIPTION QTY. COST(Ea.) AMOUNT � —��� FURNACES Map No. Tax Lot upto 100,000BTU 600 Job including _-- _-- — ductwork over 100,000 BTU 7.50 Address Thomas Page Section end vents - Map Doo, FLOOR 6.00 Directions to Site HEATERS suspended,wall or floor-mounted 6.00 or Crors Stree`. AIR HANDLING _ UNIT u to 10,000 CFM 4.50 AIR CONDITIONER over 10,000 CFM 750 Name (or Name of Business) HEAT PUMP 7,50 s .17 —J u ,A1 --- ailing Address ALTER EXISTING SYSTEM 4,50 () Owner /////^ S/�/ f N -- REPAIR OF EQUIPMENT LISTED ABOVE 6,00 City/State Zip Non-portable EVAPORATIVE COOLER 4.50 e4, 7 2 7- Phond VENT FAN connected to single unit 3,00 2' VENT not included in Appliance Pam 3.00 Name — — S VENTILATION SYSTEM not Incl.App.Pmt. 4,J0 Mailing Address HOOD served by mach.exl�sust` Contractor City/State Zip DOWN DRAFT FOR RANGE 3.00 _ WATER HEATER VENT_ 4.50 Phone INCINERATORS ddmetitype 7.50 State - WOOD STOVES FIREPLACE 4.50 Registration No. SOLAR SYSTEM 4.50 I hereby acknowledge that I have read this application, CLOTHES DRYER 4.50 _ flint the Information given is correct, that I am the owner or authorized agent of the owner, that plans submitted GAS PIPING 1 to 4 outlets 2.00 are In compliance with State laws, that I am registered each additional .50 with the State Builders'Board, flint the registration number given is correct. (If exempt from State re_gistra- OTHER _ tion, please give reason here.) OTHER SUBTOTAL 5%of subtotal for State Surcharge -- � �, J ❑ TRUST ACCOUNT _ ��"'✓i' _ _`_��"�^L��- / V—Datle- Describe Receipt No TOTAL FEE DUE Authorized Signature work ❑ new []addition ❑ alteration (]repair to be done Date Date Submitted Issued NOTICE: This permit becomes null and void if the work or construction authorized is not commenced within 180 days, or if construction or work authorized is suspended or abandoned at any time after wort, is commenced. BL27 •RMS DEPARTMENT OF LAND USE&TRANSPORTATION WASHINGTON LAI-1 DEVELOPMENT SERVICES DIVISION 155 NORTH FIRST,HILLSBORO,OR 97124 COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415 OREGON xx� xxxxx--: Paae : 1 c. t Date : 11/01/95 Time 12 : 06 Permit Type Add. /Alt.er Combination Perin Permit # 05074UU6 Permit Status -AF+ftetl'EDTIIuzq Applied 11/01/95 Situs Address 14115 SW FERN 5" TI Issued 11/01/95 Permit Title SFR - S\P\O\E Completed Permit Descr . KITCHEN REMODEL To Expire : 04/29/96 Project Title SFR - S\P\O\E Proiect # P0054362 Project Descr . : KITCHEN REMODEL * EROSION Parcel Number : 2S104BC-U0600 Land Use District LOW Valuation 24 ,840 Leqal Descr . HANDY ACRES , LOT 10 , ACRES 1 . 45 ( FROM A&T, 04/U8/94 ) Owner BOHAN, THOMAS D Construction : ALT Applicant Name BOHAN, THOMAS Classification 434 Applicant Addr . : 14115 SW FERN Occupancy R3 TIGARD, OR 97223 Validated by PH Applicant Phone : 260-7191 Inspector Area Buildinq Val . Data #1 : 07-T5-WF ! Fee description Units Fee/Unit Ext fee Data r ---------------------------------------------------------------------------- Buildinq Fee : 196 . 55 Plans Review Fee : 127 . 76 Remodel Fixture: Minimum $25 . 00 25 . Ou Plumbina Fee : 25 . 00 Electrical Fee: 40 . OU State Surcharqe of 5t : 13 . 08 Development Compliance LY-Yesi 36 . 00 Y TIF Amount to TIF Fund: t TIF Amount to TRANSIT Account : Total Permit Fees : 436 . 39 ** * Fees Required *** * ** Fees Collected & Credits *** ---------------------------- ------------------ ------------------------------ Method Check # Receipt No , Date Payment CK 9077 11/01/95 376 . 14 CK 9078 11/01/95 62 . 25 TOTAL THIS DATE: 438 . 39 Fees : 438 . 39 Adjustments : . uU Total Credits : Ou Total Fees : 438 . 39 Total Payments : 438 . 39 Balance Due: . 00 NOTICE This permit becomes null al if the work or construction for which it Is asued Is not commenced within 180 days. Once construction has started, the permit becomes nuil and void II construction is Interrupted for a period .if 180 days. I certify that the Information presented by the applicant and his agent or agents In support of this permit Is true i correct to the best if our knowledge. I acknowledge that the Building Department'&reliance upon false and misleading Information may Invalidate this permit. All pro%Isions of applicable laws and ordinances governing the construction and use of this bu4cling or structure will be compiled with whether or not specified on the plans or noted on the plans correction sheets I acknowledge that the granting of a permit does not grant authority to access private property or to i..e easements. i further acknowledge that the use or occupancy of the structure or oullding permitted depends upon my calling for inspections at various times during the process of construction and the building Inspection staff verifying compliance w"h the varlous codes. Use or occupancy of the building or structure-permitted prior to approval by the Building Department Is solely at the risk of the a..uplicnnt and such use Of occupancy Is revocable until all Inspection requirements are satisfied and approval is given by the Building Official. I further acknowledge that s her may be placed on the title of the property upon which the permit is issued specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements. r APPUCANT'S SIGNATURE Permit#: �©ze1 d. Address: Issued by: Date: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement, This statement will be filed with the permit. t Fill in the aPP appropriate riate blanks and initial boxes 1 and 2, and either box 3A or 313: E�I. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. F13A. My general contractor is (Name) Contractor regis. # 1 will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR �313. 1 will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Boated. If 1 change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCE ll immediately notify the office issuing this building permit of the name of the contractor, I hereby certify that the above information is correct and that I hacv read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. xy /�J (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) Info"dtion Notice to Property {owners Ak,)r,-)ut C-onstruf:Zion Responsibilities ,'��.rL• drll . jl.l ,,. ��,•�-,jl; r � ��, .-1. 1'�1, .. (' ,i(. trINI hi' ,`Utt'.tly;I�fl'.; ,III II!.. '+,.,I), .I1.111t '1111'!, ill. � _ �. ,�W�t!i.. U� !.71'.. il'l��J+!111(, ,,.r.�,•�,if1.u'.,il,. .tilU ,tlC.t .Yl ��i1. .lil • EMPLOYER RESPONSlE31 TIF.;✓. ,i �! ,Iail'{'1„' , li!� I , I � `.(i IIS. 111' ,•.li 1. 11. ISI Ili , i{fr" 1 �l' !1Y' .`.i{ 1;11'!1.. 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OTHE=R I' P"' ONS1BIUTIES AND AREAS OF C:014CERN ! ;n.,'. ;' I'I '!!•: 1.' �!Iy!(I 111'-17t'Cllt'll�, , 1 LhlYllil '�II111 })I�il(/1:11.1 r�+.1111;71 l' �ll`,ihl r'+ll. {. U111.1,.( }t7i11 UItilJT8T1idi1�Ci71 lU t':C !I +J 1.+li lTill'Glk11l'1I11AG� ll�i:1'f 1'I�'. ' I I it I:;l p"'I 't1' `,ti+. I• I'• '. ,. 1, (,'''I" 1',4111( X17'C'i�1L111. 1\i111:1'1Ii111&1�',. 111'11111111 111111Clllft�ti„1U'I. l?I W'Ur (11;11 (YY 111411'I''tkq, II dt011Y '•. ,, '7 i+'' 11.1`+' t1111R'fl'iII IIII11' 1 ' �'ll '!Ir t'1111A1hV't',” 1 r.. rtlr,Y•• \( I , I I, .. .,717r„rr.{.;..�Irr•t11;OCt Br+\f11t1'(11VIT tIf`Iltrl'i11 C' Ilt! 1,'1,,t Y;`(!lf1("r'1111'!t�`fh,'\Vf't'I.'Y��"I'ifl'17111.111..Y I-rnr ' I+ I 1 1.,, I 1„' 7nh1'n1�ti;3tr time*� St1 lhl v s�;Y,Y 1.!•rFrYn;1110 tenlnrrrl in<rp, tio!w I,,1_ I 0tjw4t)i,- 11(,10 tltl) Rw, W,U), 11; I , Road 91 ' i 12n ' 24'4" 24' 2713" 62 Garage 2414" House 44'9" 46' Septic Tank 15' -- 1101 50' f� J4117 5' RESIDENTIAL PERMIT APPLICATION PROJECT NO. � � � .��� WASHINGTON COUNTY BUILDING SERVICES DEPT. OF LAND USE AND TRANSPORTATION PERMIT NO. 155 N. IST, #350-12, HILLSBORO, OR 97124 (503) 640.3470 FAX (503)681-3993 r- �' r l T rl r l ( v V N Please print the information clearly or fast and acc. rate computer entry. DEVELOPMENT, u 0 LOT N ADDRESS FEE: (YES)=(NO) ADDRESS: 11*r d W Fe-AAl CITU: Zifigj j TAX MAP AND TAX LOT N � DIRECTIONS TO S17'E:_ {` r ~0" I l , THOMAS MAI' PAGE. NO. SI:CTI(IN: —�— RFSIDF?N"A1. PROJECT D SCRIPTION: CAST: FII.I- N(). (Please circle appropriate categorylies) I I'LAN TO: Ae Ah0 -r– " <;,ti"I'lMAT612 VALUATION: (build) (add in) (remodel) (demolish) a (new) (existing) (neressory)((arm) huilding at the atwore site. AREA OF SQUARE ROOTAGE IN: IST FLOOR: C)0 � 2ND FLOOR: Z � ,1R1/ FL(le I(1R: CARPORT: GARAGE:: BASEMENT: IlONUS RO(M1: MANUFACTURED IIOME: (check whether) NO. OF BEDROOMS: NO. OF BATHROOMS: SINGLE DOUBLE 1.R11-14- QUAD. NfrCIIANICAL WORK (YES) (N(1) N(1. OF FURNACES: AIR CONDITIONER O'l-.S) (NO) PLUMBING WORK (1'F:S) NI1) ELECITICAL WORK 'ES (NO) PROVERTYOWNF.R: /'7Q Aj/1/ 1'II(INI:: LLO '7/4f ADDRESS: 7.IP CODE: 'Z F:NEIN[:ER/ARl lll'fEC'flUF.SI(�N'1;R: !'HONE: ADDRESS: 'LII' C01)El: DESIGN NO: RF,-ISSUE: 111,I1,DrRICONTRACTOR: SerL PHONE: ADDRESS: ZIP CODE: BUILDERS BOARD NO: �EXPIRATI(lN DATE: N N(YI'ES: To obtain pour permit you will nted the following: I) Approval for ,your septic system from the Health Department or approval to install your sewer from Unified Sewer;--i Agency (USA), 2) (*) Electrical Fermil appliuetion (filled nut hs your electrical contractor, 3) (*) Plumhing permit tilled oul by your plurnhing contractor. (* Unless State law allows sou to takeout these permits.) 1 his application, together with the plans, Npecifications, and evhihits, comprise the application. False or misleading nfornation may he grounds rf�r incalid;rting a permit. The applicant is responsible t•or compliance to all applicahle codes. Land Deselopmei Services, checking the plans for compliance to huilding codes and coordinating with other departments, dues not relieve the applicant of this responsihility. --�--� NANtE OF APPLICANT:__/ RI-PRESENTING:--I have read and agree with these cordili:rns. , 'OGNATURE: _ �r?� ' �t -- �'r� .z^''r�_ DATE: ---- WASHINGTON COUNTY FFFFCTII'E 141` Septemher 8, 1992 FROM: Joe Crillo, Land Ut,vrkopmrot Serie" Ntimager Suhuct: BOULEVARD TREE REQUIREMENT- FINANCIAL GUARANTEE ALTF:RNATIVK At the Board of County Comumissio->•rs's meeting of August 4, 1992, the Board gave direrlioo to flit, Department of Land Ust• and Transportation to create a financial guvrantee allernative for thr CDC reepuirrmenf of planting INotlecard trrrls)(CDC 407-9). This, alternative is designed to be in lieu of planting the lNnlevard tree(s)prior to final in.spro•tion rrofuesf. It should hr noted the huibler Hill%fill lir responsible for lite planting. At such,this alternative is broken into Iwo subjects fit reflect builders and developrrs. A. For a developer request: 1. In lieu of planting,file INrulevard Irrr(s)for an approved devriopmeW,flit developer umy either,(a)post flit-financial security t' a With the County for lite appropriate amount per fres defermitted by file County, or (it,) assign flit Coonty mppropriale financial anloont set aside throogb privale mgrevinenls (such as escrow set asides as part of home/lot clo%ings). It. For a builder request: I. In lieu of planting lilt, lnwleiard trod%) for an approved plol plan nod huildiog permit, the hoildrr mat post the financial cer•orily wilh Ihr County for the appropriate amount as determined by Ihr Coonly. C. Method of Financial Sevoril.% Calcolalioli 1. For it developer,the total number of boulevard tree•(%) per appro%ed developoo•mf little% $200 per tree tgoml lite amount to he postr(1 %villi the hoilding services- Land Development Services, Divi%ioo. 2. F•)r a hoildrr,the total soother of INrulevard tree(s)per approved plot plan lime%$2011 lies-free equal the amount to he pwsled vloh flit building servicer - bind Development Services Division. I1. Administration of Finanriai Secorily I. For it developer, Ihr financial %morily shall hr in form of cash, m• check, Ietlrr of credit• or it Coonl% approv,Y) financial surely. Ani financi of sows-- sn% financial curet) mo%I hr valid for is minion m of 1%%che (12) month% from final plat approval. The financial sort-IN mmi ht• uo%Ie(I_%%ills lite Count% prim^Irl final Ishii am roval. 2. For it builder,flit-financial %ecuritshall hem forst of cash,m•check,letter of credit,or it County approved financial surety. Am financial sores%. Thr financial%orety%%ill he held for four (4) monllt%after final impeclion. 'lite financial soreh must hr ImMed %%ith the—Cpoint N most hr mmud it, uarl of flit• hnildin_ uermil i%st o ve. F,. Iloule•%ard "fret, Planting Re-spoo%ihilities: I. A hoildrr or (ie%eloptr shall ns-rerpon%ihls-for planting tilt• hnulciard beets) pur( 000t� rrgoiremenl%e%en if'the party has pals(e•d a finani iiil %morit) %rilh Ihr Counl.N. 2. If a dr%rloprr ha% INrslt•d tilt'%erurit%, livAhe is r"Itomihle for plmliog %uch INrolv%;ard !rev(q) %%ilhi11 four(41 naontlis aflei H hoildrr ha, recri%rd final imperlion. I ailore to plant %%ithin this tinlrlint• %%ill require %ii.t6inglon Count% to utilise financial secorit) In plant houlr%ard Ire-t,(%). No refoo(1s%hall occur its the dt-%eloper it the Count.%draw-, Morn fire financial srrurilc. ,l. It is hoildrr ha% posted thu %erasil'N, heAhe is responsible for plooiog Such hoolv%ar•d lre•r(%) %%ilhin lour (4) month% alter a builder has recirked final inspection, I ailore tar plant %%ilhin this linirlioe%%ill re-quire N'a%hioglou County% to otilire financial see•orif% to plot )Nrule%ar(tret-W. Ni- refund%shrill occur to Ile•deirloper if the Counts dr;m%,upon lite financial iKuril). 4. If a hoildrr or dr%eloper plaots Iht•appropriale NmIt-lard It e4•(%1 %%ilhio the four month period in an arta%%herr flit Count% has rer•ei%ed frnamrial Net orifi, the Coon% %hall, Aller sift, iusllrclioo, retract, (hs- financial %e•corit% ler% %511.10 per tree to apprupriale hoilderhls-%eloper, l he$50-00 retained h.i lite Comil% shall corer flit-r(m of %ill-inspection io d admioistrali%r o%erhead. I . In the e%ent a Iruilderlde%rloper fail% to plant flit, appropriate INmlr%arl Irt•r(sl :out Ihr%ohwtiti w loud imne•r refuses In permit lilt, houlr%ard Irec(s)to hr phut(rd on lhuir properl% %%ilhio t Ire•1 of Ihr proprrt% line•, Ow financial se•corty shrill he placed into %t•parate re%enue account in LUT- Lod Ile%elopoo•nt Ss-nices, Io hr o%e•d Ior planting liers'%hruhhe•r'N in allernali%r pohlic %pate%m%ne•d hs Washington Count%. Thr Land Dr%ulopmrnt Ser%ice% Manager%bill rvi onm uod Irom lino•to lioic•In flit-Director of DI.11T potenlial landscape project% to ulilin• s11­11 11111(%. I lir diretlor %hall appro%t•Such projevh will inlurni tilt, Roar( of Count,% Cnmmis%ionrrs of such preyject%. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone. 6394171 Date Requested: A.M. __ P M. MST: L � Q Location: 13[1P: -- ! Suite: _ [_13ldg: __ MEC: — O atrao tor:�,na,� T �' (� Phone: 5 Z � ,14q 3� P1,M: _— Phone: 7 // ELC:— f ---- — - --- - --- — ELR:_ --- ------- -- ----- - -- Sri,. _ BUILDING BLDG(coni) PLUMBING MECHANICAL TRICAL SITE Site Post/Beam Post/Beam PosUlleam Cover/Service Sewer/Storni Footing Roof UndFl/Slah Rough-In Ceiling Nater Linc Slab Framing rop Out Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer Ilood/Duct Reconnect Vault Iismt Damp Ihywall Stonn Furnace Temp Service MISC. Masonry Ceiling Rain Thain A/C ll(i Slab Shear/Sheath I ire Spklr/Alm Crawl/Found Dr I leaf Pump olt Approved Approved ApprovedApproved Approved Appr/Sdwlk Not Approved Not Approwd Not Approved o proved Not Approved FINAL FINAL FINAL A FINAL f7 Call for reinspection tcinspection fee of S_ required before next in tion 0 Unable to in.4pect Inspector:—__--_ Date 1�t� Page_ of CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 639-4171 Date Requested: _ A.M. 1\ _ P.M. _ MST': 6 Location: 1 LI I J AV LeA. EV _ BIJP:^ Tenant: _ Suite: Bldg: p MIiC: Contractor. ��1�,Q Y11Q.Q fUa IIiQ/� Phone: Owner:`- -- _-- Phone: `fG �tD(..' Sr!': BUILDING BLDG(coni) LUMBING_ MECHANICAL ELECTRICAL SITE Site Post/Ream os cam PosUlleam Cover/Service: Sewer/Storni footing Roof 1lndFl/Slab Rough-In Ceiling Wate Line ~1111) Framing Top(int (ills Line Rough-In 1IG Sprinkler Foundation Insulation Sewer Ilood/Duct Recomtect Vault Ilstnl Damp I"all Slonn Furnacc Temp Service MISC. Masonry Ceiling Rain Thain IVC IJG Slab Shear/Sheath Fire Spklr/Alm Crawl/bound Dr I Ieal 1'1"1111 I,ow Volt Approvedoved Approved Approved Approved Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approve,; FINAL INA FINAL FINAL FINAL CI Call for reit C7 Reinspection Ice of Suir r e ne\t inspection [7 Unable to inspect Instor� PC L __ nate .�! Page --- of y� SCI CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Linc: 61' 1175 Business Phone: 639-4171 Date Requested: / A.M. _AP.M. MST: 00 7 —400 v Location: p.� _ _— BUP: Tenant._ _ Suite:.' / _ Bldg: -�J_ MEC: Contractor:� fS 2—I� — Phone: /rT—_ PI,M: Owner. J/ "hone: / ELC: Sri,: BUILDING BLDG(ron't) �PI,UMBINGCWICAL J` ELECTRICAL SITE Site Post/Beam Post/lieam Post/Beam Cover/Service Sewer/Storni Footing Roof Undl'I/Slab Rough-In Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UG Sprinkler I'oumiation Insulation Sewer Ilood/Duct Reconnect Vault Bsmt l hunp Drywall Stonn Furnace Temp Service MISC. Masonry Ceiling Rain Thain A/C UG Slab Shcar/Sheath Fire Spklr/Alm Crawl/Found Ihcat Pump Low Volt Approved Approved C1XvAp rov� Approved Approved Appr/Sdwlk Not Approved Not Approved Almaved Not Approved Not Approved FINAL FINAL FINAL, FINAL FINAL C1 Call fol reinspection rl Itrmslxrucm ice of X tey med trtere next inspection C7 1 fiuble to msputt Inspector: i Date e,-1 �O B __ Page ___.__ of CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 --�+ �IuP -- �_ Date Requested ���' 3 AM PM BLD Location y s--, Suite MEC Contact Person _r Ph 5 2 k/ PLM _ Contractor Ph G / �f/ SWR UILJII�NG�� Tenant/Owner ELC _ Retaining Wall ELR _ Footing Access: Foundation FPS Fig Drain SGN Crawl Drain Inspection Notes: - - Slab a SIT Post&Beam - Ext Sheath/Shear _ Int Sheath/Shear -- ---�-"- Framing77 A-, _ Insulation - ---- Drywall Nailing A�4S Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ ------ - ------- Roof __�----- ---___._.--,___-- Misc. in SS PART FAIL ---- . — - -_.�W-_- -- ------- - - -.-.� LUMBING Post& Beam Under Slab Top Out -- ----- .- ------- - Water Service _ Sanitary Sewer Rain Drains Final PASS PART FAIL _ MECHANICAL Post & Ream --------- Rough to Gas I ui -- 6mnke t)anq,ers PASS PART FAIL ELECTRICAL Service Rough In --- - -- ------ i UG/Slab Low Voltage J Fire Alarm _ Final PASS PART FAIL _ SITE Backfill/Grading Sanitary Sewer i Storm Drain [ J Reinspection fee of$_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin l Please cal for reinspection RE: Fire Supply Line ( J p �-_ ( J Unable to inspect no access ADA Approach/Sidewalk Date Other 3'� ___ Inspector _ Ext _ Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. 1 DEPARTMENT OF LAND USE 6 TRANSPORTATION WASHINGTON 55 NORTH FIRST,HILLSBORO,OR 9ND DFVELOPMENT SERVICES 70 124 COON 1 i/, INSPECTION REQUESTS: 503/640-3561/693-4415 OREGON CbNO eennit # Wj0740PI J NOTICE This permit becomes null and void If the work or construction for which 1'Is Issued Is not commenced within 180 days Once construction has started, the permit becomes dull and void If construction Is interrupted for a period of 180 days, I certify that the Inlormation presented ny the applicant and his agent or agents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance upon false and misleading Information may Invalidate this permit. All provisions of applicable laws a•Id ordinances governing the construction and use of this building or struct-rre will be compller,with wh^ther or not specified on the plans or noted on the planm correction sheets. I acknowledge that the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the bu;lding Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by it e Building Department Is solely et the risk of the applicant and such use or occupancy is revocable until all Inspection requirements are satiefitd and approvr,l Is given by the Building Official. I further acknowledge that a lien may be placed on the title of the property upon which the permit Is iasued specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all inspection requirements APPUCANT'S SIGNATURE 44ft. 9 In ht. Nate, furance stove 12 ft. I I i i CITY OF TI GARD PLUMBING PERMI r DEVELOPMENT SERVICES PERMIT#: PLM2004-00191 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 4/28/04 PARCEL: 2S 104 BC-00600 SITE ADDRESS: 14115 SW FERN ST SUBDIVISION: HANDY ACRES ZONING: R-7 BLOCK: LOT: 010 JURISDICTION: TIC CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 90 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: 90' of sanitary sewer service to connect to sewer. Septic tank to be pumped, filled and inspected. Sewer connection fee paid on 9/1/95 to CWS, permit#108942. FEES Owner: Description Date Amount BOHAN, THOMAS L & DIANE E 14115 SW FERN I I'LUMiiI Pcrniil Fee 4!28/04 $72.50 TIfGARD, OR 97223 I'i'AX] 8°/o State Surchari 4/28/04 $5.80 Total $78.30 Phone : Contractor: OWNER REQUIRED INSPECTIONS Sewer Inspection Phone : Insp existing,capped fixtures Reg#: Final Inspection 'This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: �C Permittee Signature: Call (503) 639/-4175 by 7:00 P.M. for an inspection needed the next business day Build4 Fixtures Plumbing Permit Anolication FOR OFFICE USE ONLV City of Tigard Received Date/By Pcmut N, 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review —` Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No 24-Flour Inspection Line: 503.639.4175 Date Ready/By: m 0 See Page 2 I'ar Internet: www.ci.tigard.or.us Noti6ed'Method Supplementallnfonnatiun TYPE OF WORK FEE* SCHEDULE ❑New construction ❑Demolition For special Information use checklist. — --- Description Qty. I Ea. Total ❑ Addition/alteradorr/replacement ❑Other: _ New 1.2-family dwellings(includes 100 ftfor each utility connection) CATEGORY, OF CON$ PJCT�ON',, SFR(I)bath 249.20 ❑ I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00 SFR(3)bath 399.00 ❑ Accessory building - - _-- C1 Multi-family -^ ❑Master builder _ ❑Other: Each additional bath/kitchen E]]45.00 - - T * Fire sprinkler C—sq.fl.) Page 2 JOB SITE 1NFp�tMATION ANh LOCATION Site utilities Job site address: / /J J 6f/ /-�,2 /V Catch basin or area drain 16.60 City/State/zlp: - Drywell,leach line,or trench drain 16.60 Suitc/bldg./apt.no.: Project name: ti's n�.G L!/N Footing drain(nolinear ft.:_) Page 2 Manufactured home utilities 1 10.00 Cross street/directions to job site: ,i -- -- Manholes 1660 - _- Rain drain connector 16.60 -- Sanitary sewer(no.linear It.: Page 2 jim Storm sewer ono.linear R.: ) Page 2 Subdivision: Lot no.: Water service(no linear fl.: ) Page 2 'fax map/parcel no.: Fixture or Item Absorption valve 1660 • � Backflow preventer Page 2 $�Ly Cwt Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 04 Drinking fountain 16.60 i.. ' 27 Name: es Ejectors/sump 16.60 ,��// ' /1` =` !141.�& 04 Z of/' Expansion tank 16.60 Address: Fixture/scwercap 16.60 City/State/ZIP: Floor drain/floor sink/hub 16.60 Phone:03 ) d -2- � ( ) I Garbage disposal 16.60 r Hose bib 16.60 ]_,APPLICANT ❑ CONTACT I' i50N - -— = ----- Ice maker 16.60 Business name: — Interceptor/grease trap 16.60 Contact name: Medical gas(value S ) Page 2 Address: Primer 16.60 ---------------- City/State/ZLP: Roof drain(commercial) 16.60 Phone:( ) Fax: ( ) Sink/basin/litvatory 16.60 - -- E-mail: Tub/shower/shower pan 1660 Unnal 16.60 Water closet _ 16.60 Business name: h o n.r` N�2_ Water heater 16.60 _Address: ` '� IJ1` _rW lc e/ 4 _ Other City/StateiZIP: 2 Subtotal f -- Minimum permit fee $72.50 �^. Phone:(f'p3 ) Ll7l.-Yt'y� m Fax.( ) Residential backfluw mimum permit fee $36.25 d CCB Lic.: Plumbing Lic,no.. Pian review (2511/o of permit fee) �- State surcharge(8%of permit fee) Authorized signature: TOTAL.PERMIT FEE �7 en, -T /J• Date: 'i ��66t his permit application expires 11'a permit is not obtaine within -y / 180 days after It has been accepted as complete. "Fee methodology set by Tri-County Building Industry Ser,ice Board i,euddmg,PenmbtPLMFPe Mppdoc 1201 4404616T(10/6]lC0"TH) Plumbinp- Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Supp ession Svstems: Site Utli ties. Qty. Fee(ea) r°tai Square Footage: Permit Fee: Footing drain-1" I Oo, - _ 55 00 0 to 2,000 $11500 Footing drain-each additional 100' 46.40 2,001 to 3,600 $16000 Sewer• lst 100' 55.00 3,601 to 7,200 $22000 7,201 and greater_ $309.00 Sewer-each additional 100' 46.40 — Water Service- I st 100' - - 55.00 Medical Gas S stems' Water Service-each additional IOO' 4640 �ala`at ou: Permit Fee: Sturm&Rain Drain- Ist 100' 55 00 $1 00 to$5,000.00 Minimum fee$72 50 Storm&Rain Dram-each additional 100' 4640 $5,001.00 to$10,000 00 $7250 for the first$5,000 00 and$1.52 for each Fi7Ctlhl'C.OratCm Qty. „ Fee(ea) Total additional$100 00 or fraction thereof,to and including$10,000.00 Commercial Hack Flu« Prevention Device 46.40 $10,001.00 to$25,000 00 $149 50 for the first$10,00000 and Si 54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to (minimum permit fee$36.25) 27.55 and including$25,000.00 Rain Drain,single family dwelling 65 25 $25,001 00 to$50,000.00 5379.50 for the first$25,000 00 and$1 45 for Inspection of existing plumbing or each additional$100.00 or fraction thereof,to specially requested inspections-per hour 72 50 _ ___ __ and including$50,00000. Subtotal: — $50.001 00 and up $742 00 for the first$50,000.00 and$1.20 for each additional$10000 or fraction thereof Fixture Work: Are you capping, moving or replacing existing fixtures? If ".es",please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. f uaut{t b Ixtur16rk P, i formed Fixture Type: New Moved Bappea Comments regarding fixture work: hath Jub/Shower — — '— •lacuui/Whirlpool Car Wash -Each Stall _ -Drive Thou �— Cus idur'Water As valor __—_- Dishwasher -Commercial R -Domestic - -- -� Drinking Fountain _ - — F•a Wash Floor Drain sink 2" .Y 4" Car Wash Drain t.arhage -Domestic -- Disposal -Conunercial _ *Note: If the fixture work under this permit results in an _ Ig Draws e fn ,a er Ice Mach RcDraws p'increase of ser EDUssexvpermit %%ill be issued and ()tl Separator(Gas Station fees assessed for the serer increase must he paid before the Rec.vehicle Dump Station plumbing permit can he issued. Shower -Gang _ ---- _ -Stall `ink -Har/lavatory Quantile Total -Bradley Isometric or riser diagram is required iffixture tivantil% -Commercial -Service total is A. Swimming fool Filter Washei -Clothes Water Extractol' _ Plan Review Water Closet-Toilet —_ Plan review is required if fixture quantity total is I!nnal ` uthet Fixtures — 9uddiaekramn0LM PermaApp doc 3103 sewerage SANITARY* a a Uf155 ng� SURFACE WATER N. First AVc., Suite 270, Hillsboro, Or.,57124 503 648-8621 I. ONNILG T I ON I'L KN I 1 ' 'iGUC LLAT' 090195 E:XP RoT I ON DATE 02.2896 FERMI I 1'894 TPUCTURE ADDRESS 1.411.5 PROJECT ?991 I'RUCTURE STREET SW FERN ST 1-01' BLOCK YPE CONNECT IUN - EXIST OF YF''E INSTALLATION- ( 1 ) NUILDTNG SEWER ONLY rF'E 0CCUF'ANCY- ( 1. ) STNCTI.0 FAM [L.Y PARCEL 2S1 4 SIC 600 nTR (,F.0 MH 90004 fJWNE:R THOMAS BUHAN �tD11RES3 141 15 SW F'F'E RN r;T TREATMENT F'LnNT ril.ICtHr1t1 TICARD OR T7223 i'HONE 524 -4282 WATER DISTRICT TIGARD I IXTURE E UIJIVAL.E:.N1 DWELLING RE 10 1 VENT I(10L. IINT, TS SEPVICE UNIT 0IItd1 IS 1 "ERVICE. UNIT CONNE:CTiON FE'E.S UF'T'"AC'L: WATER (r!'')I" I 0r`MF-NT FEES SEWER CONNECTtotl WATER QUALITY 0.00 LESS CREDIT t 0 ,00). WATER QUANTITY 0.00 00, qr /� d2� o y �'/�c 1-11—, 6A4ZCt1A lav V rVT ''F L. NAME:. DIANE F'F•1gNC .��.� . .�... ... .. r' 11-1.IAT ION OWNER ,. HARKS SFJ? CONNECT TO C T UAkll r f IFINATl1Rr _ � rrC:fr. _ ._ (. _ :. _.'� . . ' '` "_ -- -� I'',� I.IE n ry rFPf'fq Permit Conditions. The applicant aglMs to comply with all rules and regulations of the Unified Sewerage Agency "lien calling for an inspection please refer to the Penni) Number The Per" expires one hundred eighty (180) days born the date of issuance the Agency does not quarantee the accnra r of the location of side sewer laterals 7/93 WHITE - USA, BLUE - Accounting, GREEN -Inspection, YELLOW - Customer CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP _—.— Received ,� Z Date Requested— .JU �Z� AM--—. PM BUP Location -757 _ --_Suite MEC )— Contact Person PLM� 1L Contractor— - ------- ------- Ph —) ------ SWR BUILDING Tenant/Owner -_- -_——.-- _.----- _-- ELC — Footing ELC Foundation Access: Ftg Drain ELR --__---_�—_ Crawl Drain Slab Inspection Notes: SIT Post& Beam Shear Anchors - - Ext Sheath/Shear Int Sheath/Shear Framing - --- --- - -------- --- Insulation Drywall Nailing � — -----"-"---- — FirewallZLS� Fire Sprinkler -- ----�� Fire Alarm _ Susp'd Ceiling — _---- Roof _- Other:_ - — Final u PASS PART FAIL_ - PLUMBING Post&Beam Under Slab - ---- Rough-In Water Servic — banitary Sewer Catch Basin/Manhole Storm Drain - - -- -- Shower Pan Other: - -.. --- _. - - ---.-..---- - Fir 'P RT FAIL m.. - -------- _---- -- -- _ H _CAL — Post&Beam Rough-In - ---- - Gas Line Smoke Dampers --- - --- --- -- --- ---- __. Final PASS PART _FAIL ----- -- -- ----- ---- - - --- — ELECTRICAL Service -- - -- ------------ Rough-In UG/Slab Low Voltage - -- - -- - -- -- ---- -- --- Fire Alarm Final L-I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL __ __ Unabe to inspect-no access SITE [l Please call for reinspection RE ___-_..._. -- I P Fire Supply Line y ADA Date Inspector Approach/Sidewalk - - Ext --- — Other:_ Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL ALOHA SANI'T'ARY SERVICE INVOICE NO. 8600 SW Hillsboro Hwy., Hillsboro, OR 97123 8494 503-644-2797 0 503-648-6254 503-639-5188 r NAME: M.1tr.-,t-1 v -- ADDRESS: an CITY:— �_ STATE: — ZIP: ("n Y C HOME: _ Z'� --— WORK: CEI�U-)1)DING DIV)S+ON JOB SITE: J P.G.#: PaID By CHARGE ❑ CHECK t'o! CASH ❑ CREDIT CARD ❑ DATE DRIVER 7(Q,f� AMOUNT PUMP SEPTIC TANK �? ❑ LINE OPENING ❑ INSPECTION FEE ` ❑ SERVICE CALL — ❑ LABOR, LOCATING, DIGGING, BACKFILL ❑ MATERIAL Q� THIS IS NOT A SEPTI TOTAL $ Z 0113SYSTEM INSPECTION REPORT - - 44- - - REMARKS -,- TYPE n - . REMARKS - -TYPE OF TANK: S EEL LJ (;0fjC\RETE LJ PLASTIC, ] HOMEMADE ❑ ORIZONTAL LJ VERTICAL LJTA RECNGLE LJ LJ OTHER SIZE OF TANK: 350 ❑ 500 ] 750 1090❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑ LID LOCATION: INLET ❑ OUTLET ❑ MIDDLE ❑ ENTIRE TOP ❑ TANK CONDITION: GOOD ❑ FAIR ❑ \POOR L)FITTINGS: BAFFLES LJCONCRE7 LJ CAST IRON LJ PLASTIC LJ NEEDS NEw LID? YES LJSIZE // GROUND COVER OVER TANK _ COMMENTS ON CONDITION OF DRAINFIE ETC. SIGNED BY -- --�—_—._ — — -- DATE �Q// '.ITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST — INSPECTION DIVISION Business Line: (503)639-4171 BUP l leceived Date Requested AM PM BUP ocation __ Suite MEC ;ontact Person PLM �. -ontractor -- Ph( ) — SWR BUILDING' Tenant/Owner —__ _ —_ E$A[._C1 V AlG Cl Footing ELC Foundation 4 2004 Ftg Drain ELR Crawl DrainI T Y OF TIGARL) Slab Inspection Notes: INS SI UIUTN(i DTV191017-- Post&Beam _ Si oar Anchors Ext Sheath/Shear _ Int Sheath/Shear Framing — Insulation -� Drywall Nailing 7-V Firewall Fire Sprinkler Fire Alarm ,r Susp'd Ceiling - - — Roof Other: -- Final --- - PASS PART FAIL _PLUMBING — -- _— Post& Beam Under Slab --- -- Rough-In Water Service -- Sanitary Sewer Rain Dins — — -- - -- Catch Basin/Manhole. Storm Drain — ShowerPen Other: '► -- ---- — -- PAS 'P RT FAIL WIEUWCAL Post& Beam Rough-In — ------ ----- — -- —_� Gas Line Smoke Dampers --- ---- — ---- — Final PASS PART FAIL -- - -- ----- ---�— —�-- ELECTRICAL Service _ - - _i -- --- — - -_— Rough-In — UG/Slab Low Voltage __-- Fire Alarm Final E] Reinspection tee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL F] Please call for reinspection RE: U Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Data_� r - �Lf _ Inspector ,;%� Ext Other: Final - DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL