10225 SW MCKENNA PLACE 0
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10225 SW McKenna Place
�'�� �� ������ MASTER PERMIT
/ PERMIT#: MST2001-00318
�L7
DEVELOPMENT SERVICES DATE ISSUED: 6/13/01
13125 SW liall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 1027.5 SW MCKENNA PI. PARCEL: 1S136AA-09800
SUBDIVISIONS VEN'fURA ESTATES ZONING: R-4.5
BLOCK: LOT: 020 JURISDICTION: TIG
t:EMARKS: Construction ol nerr :iingle f; luiy aetached residence. Path 1
BUILDING
�wREISSU': STORIES _ FLOOR AREAS REQUIRED JET BACKS REQUIRED
CLASS Of WukK: NEW HEIGHT: 25 FIRST: 1,293 9f BASEMENT: al LL T: 9 SMOKE DETECTORS
TYPE OF USE: IF FLOOR LOAD: 40 6ECOND: 1.217 of GARAGE: 552 sr FRONT: 41 PARKING SPACES.
TYPE OF CONST: 'N DWELLING UNITS: 1 FINBSMENT: 61 RIGHT: 5
VALUE: $230,46090
OCCUPANCYGRr. A3 BDRM: " BATH: 3 TOTAL <_Stii��7 of REAR: 28
PLUMBING
SINKS: 1 WATER CLOSETS: I WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
I-AvA,DRIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER I INES: 100 SF RAIN DRAINS: 1 CATCH 4SINS:
TUSISHOWERS: I GARBAGE UISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS hURN>000K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
_ ELECTRI"AL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS —MISCELLANEOUS _ ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 100 imp: 0 - 20D amp: WISVC OR FDR: 1 PUMPIIRRIGATIOW PER INSPECTION-
EA ADD'L 500SF: 4 201 - 400 amp: 201 400 amp: let W/O SVC/FOR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 800 amp: 401 600 amp: EA ADDL SR CIR: SIGNAI.IPANEL IN PLANT
MANII HMISVCIFDR: 601 • 1000 amp: aDl.ampl 300v: MINOR LABEL:
1000•amplvolt
PLAN REVIEW SECTION
Reconnect only:
—4 RES UNITS: SVCIFOR>=225 A.: >800 V NOMINAL: CLS AREAiSPC OCC
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B,COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR.4LAAM OTN BOILER: •,DAC: LANDSCAPEARRIG: PROTECTIVESIGNL:
GARAGE OPENER CLOCK: INSTRUMEN rAT104: MEDICAL: OTHR.
HVAC DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTD I_ FEES: $ 7,459.76
WINGATE CORP WINGAtE CORPORATION This permit is subject to the regulations contained In the
Tigard Municipal Code,Sta.e of OR Specialty Codes and
15840 S POPE 1,>NE 15840 S POPE LANE all other applicable laws. All work will be done in
OREGON CITY, OR 97045 OREGON CITY, OR 97045 accordance with approved piens. This permit will expire t►
work is not started within 180 days of issuance,or if the
wo•k is suspended for more flan 180 days. ATTENTION
Phone, Phone: Oregon law requires you to fellow rules adopted by the
Oregon Utility Notification Gunter Those rules arF set
Reg e: I. 94680 forth in OAP 952-001-0010 through 952-001-OOFO You
may obtain copies of these rules or direct questions to
OUNC by Calling(503):46-1987
REQUIRED INSPECTIONS
Erosion Control Insp 81 Post/Beam Mechanical PLM/Underfloor Framing Insp Gas Fireplace Appr/Sdw k Insp
Sewer Inspection Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final
Footing Insp Underfloor Insulation Plumb top Out Exterior Sheathing Inst Rain drain Insp Mechanical Final
Foundation Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Plumb Final
Post/Beam Structural Footing/Foul dation On Electrical Rough In Gas Line Insp Water Line Insp Final inspection
Issued By Permittee Signature :�• --
Call (503) 639-4175 by 7:0(1 p.m for an inspection needed the-o"tbusin-'es day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICESPERMIT #: S -00179
13125 SW Hall Blvd., Ti( ,rd, OR 97223 (503) 639-4''-1 DATE ISSUED: 61113/013/01
PARCEL: 1 S 136AA-09800
SITE ADDRESS; 10225 SW MCKENNA PL.
SUBDIVISION: VENTURA '_STATES ZONING: R-4.5
BLOCK: LOT: 020 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new single family residence.
Owner: --
FEES__
WINGATE CORP Type By Date Amount Receipt
S
15840 POPE LA JE —
15840 SCITY, Old 97045 PRMT CTR 6/13/01 $2,300.00 27200100000
OREGON INSP CTR 6/13/01 $35.00 27200100000
Phone: 503-657-3300 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
i
This Applicant agrees to comply with all the rules and regulations 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 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 tc follow rules arJopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987.
r9 Permittee Signature: ` _ \ 9.J��`✓
Issued by: , �r T ' �' (� ___�L_- --
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the nee a day
Building Permit Application
Datereceived: S r/
City of Tigard � Penn;t no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 ProjecUappl.no.: Expire date:
Cuy of"l"i�.n d kec ei Date issued: B t no.:
Phone: (503) 639-4171 Y� p
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: 1&2 family:Simple Complex: G'
I
0 I &2 family dwelling or accessory U Cornmer-cial/industrial Cl Multi-famiiy New construction C _)ernolition
U Addition.ialteratioNreplacernent L)Tenant improvement U Fire sprinkler/alarm U Other:
Job address: Ii 'E _ I Bldg. no.: 1,.Suite no.:
Lot: Z ) I Block: ,Subdivision: r_�TUa-A S.&-y Tax map/tax lot/account no.: IS t 3i�.th,�\
Project name: '71,
Description and location of work on premises/special conditions: .��=R 1119A64(Floodplain,septic capacity,solar,etc.)
__-
Name:
Mailing address J tiQ f:. L A I & 2 family dwell' 4g:
City: L1 State ZIP: Valuation of work........................................ E .:3b >/
Phone: (05'}-'',,300 Fax: E-mail: No.ofbedrooms/baths................................. Zrft
Owner's representative: `S�tom_b�-SBVLNS Total number of floors................................. Z-
Phone: ;- C Fax: E-mail: New dwelling areas ft ZSID
Garage/carport arca(sq.ft.).........................
Name: cwL Covered porch area(sq.ft.) ......................... _
Mailing address Deck area(sq.ft.) ........................................
City: _ _ State: ZIP: Other structure area(sq.ft.).........................
Phone: Fax E-mail: Commerc"industt•iai/multi-family:
Valuation of work.....................I....... ...... 3
Business name:
Existing bldg.area(sq.ft.) .........................
— New bldg.area(sq. fL) .................
Address:
City: State: ZIP: Number of stories........................................ _
Phone: Fax: E-mail: Type of construction....................................
CCB no.: Occupancy group(s): Existing,:
NeN:
City/metro lie.no.: 7Notice: contractors and subcontractor are required toh the Oregon Conswction Contractors Board under
Nan,e: jj�F� i�v5 nt�tL f ORS 701 and may be required to be licensed in the
Address: where work is being performed.If the applicant is
Cit -� State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.:
Phone: Fax: E-mail: - —�—
Name: Contact person: Fees due upon application ........................... $
Address: Date received: ,__
City: State: ZIP: Amount received ......................................... $_
Phone: Fax: E-mail: _ Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not Wt iundictlur accept peau cards.tW cai iuriediclfon fua ane mr«msion
attached checklist. AU provisions of laws and ordinances governing this U visa U MasterCard
work will be compiled with,whether s reed herein or n Cmd11 cant number: P �
1pim
Authorized signature t +L� Date: `'7 Nam of cand larda u ab;wn on Twin crd
S
Print name:. cAnowwa aawaR —� Amoua
Notice:This permit application expires if a permit is not obtained within 18o days atter it has been accepted as complete. 40(► 1116RDICOM1
Electrical Permit.Application
Date received:JF ?G �PermrWtit .:
City of Tigard Project/appl.no.: 4 Expire date:
em ML
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: ltuceiptno.:
Phone: (503) 6394171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
e
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U'Tenant improvement
)�New construction U/rddition/alteration/replaaement ❑Other: U Partial
JOB SITE 1 '
Job address: 2.:x.5 K, ,r„I [ildg. no.: Suite no.: Tax map/tax lot/account no.: 5, i P A
Lot: Zp Block: _ Subdivision: ��_ E.6T*T-ES -_
Project name: Inscription and location of work on premises: SE& Nom)
Estimated date of cern letion/inspection:
Job no: n I ee Max
Business name: MG` EL_1LL3-9-1 C Descriplion (P). (ea.) 'loin] fit) ins
New residential.single or could-family per
Address: Qb3q �� t rJ - dweltingruril.Includes attached garage.
City: +xNt� Serviceircludcrl:
Phone: -p % Fax: E-mail: 1000 sq It.or less 4
CCB no.: qs I Elec.bus.lic.no: Each additional 500 sq.ft.or portion thereof
_31 I — �-- Lirniledenergy,residential 2
City/metro lie,no.: _ l.imiiedenergy,non-residential 2
JMI-ach manufactured horn or modular dwelling
Signature of suLr;vf§i1lg electrician(required) tate s-y 7i Service and/or feeder 2
Sup.elect.name(prino: 0p4vt ktL.te_rrsG0-- License nil Services or feeders-installation,
alleraliou or relocation:
21x1 amps oWLUJWr less 2
Name(print): 201 amps to 401 amps 2
Malting address' -- 401 anamps to 61x1 amps 2
601 amps to I(xx)amps 2
City: v Slate: ?IP: _ Over I1x10 amps or volts 2
Phone: I E-mail: We`conncci only I
Owner installation:The installation is heing made on property I own Iemporaryservice orfeelers-
Y Iiich is not intended for sale,lease,rent,or exchange according to im allation,alleralion,orrelocalion:
ORS 447,455,479,670,701. 2110 amps or less 2
201 amps to 400 amps 2
Owner's signature:_ Date. 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: SIaIH C: iT L!I' Fee branch circuits without purchase
Jof sefurrvice or feeder fee,first branch circuit: '
Phone: Fax: E-mail: I ach additional branch circuit. - -
Mlsc.(Service or feeder not Included):
U Service over 225 amps-cxmmsenial U Health-care facility Each pump or irrigation circle 2
U Service over 310anips-rating of 1&2 U Hazardous location Euch sign or outline lighting 2
flintily dwellings U Building over 10,000 square feet four or Signal circuit(s)or a linined energy panel,
U System over 6W vols nominal rnore residential units in one structure alteration,orextension• 2
U Building over three stories U Feeders,40U amps or nxnrc •Description:
U(tccwpant load over"persons U Manufactured structures or RV pari; Foch additional Inspection user the allowable In any of the above:
U Egre Aightingplan U Other. pnnnspection
Submit`.rets of pis my with any of the above. Investigation
'fire above are Dot applicable to temporary construction service. Other
Not all jurisdictions accept credit catch,please call,,uriwficuon Gx nxre od xnm
ram Notice:This permit application eRnll fee..................... _
U visa U MasterCard expires if a permit is not obtained Plan review(at __ %) $ _ ^
Credit card numtar: -1.__ within 180 days atter it has been State surcharge(8%)....$ -�
Apires accepted as complete. TOTAL .......................$
Naar of cardholdeo at gMwn onnoncredit card
_ s
Ca±d der !Lmwe Amount 4404615(6WCOM)
\ Mechanical Permit Application
Datereceived:!; !!/ Permit no.: ps/
City Of Tigard Project/appl.no.: Expire date:
Cit o , urAddress: 13125 SW Flail Blvd,Tigard,OR 97223
J IT8d [)ate issued: By: Receiptno.:
Phone: (503) 639-4171
Fax: (503)598-1960 Case file no.: Payment type: !_
Land use approval: _ __ Building permit no.:
t
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi family U Tenant improvement
,idNew cowitruction U Addition/alteration/replacement 0 Other:
Job address: t 1` - PLACE. —` Indicate equipment quantities in boxes below, Indicate the dollar
Bldg.no.: Shite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: IS° 6 profit.Value$
Lot: Block: Sutxivision: &-Mev _ Ezra See checklist for important application information and
Project name: jurisdiction's fec schedule for residential permit fee.
171111 Ewa 11%11
City/county Mk-Stl LIP: Z3 _- °
Description and locati of work o, :miles: -_ ° a �-: -
Est.date of•completion/inspection: ilk,*ilitturr - may' Res.onl es oni`
Tenant improvement or change of use: Air handling unit CFM._
Is existing space heated or conditioned?U Yes U No rr con iuom (site plan required) !_
Is existing space insulated?U Yes U No A tsrauon o existing _s stem _
ofler/co
mpressors
State boiler permit no.:
Business name: (7 CAO L-d r-41!23 _ HP Tons BTU/H
Address: (pp 00 Sr,- FirOsmoke damyter uct amo a etectors
City: C�.A AMflS State:tSQ_ ZIP: _ -Ti—catpum(a ie plan required)
Phone:(D5b p Fax: E-mail: ista rep ace urnac urner
Including ductwor dvent liner D Yes U No
CCB no.: nits rep ac re o tate. eaters-suspended-
Cily/metro lic.no.: wall,or(loot mounted
Name(please print): r=P--t 14-0 S . ��1 C-D R °C entora lance oSer than furnace
e ger at on:
Absorption units W. _ BTU/H
Slc�ml�
Name: Chillers HP
t -_ -_--- _ Com ressors___._ -- HP
A.;.iressc _ nmeota a uat M111131111011: w
City: State:T ZIP: Ath
liancevent _
Phone: I ax F-mail: Bust
pe res. itc a azmat
uppression system -
Name: r n with sin le duct(bath fans)
Mailing address: stem aart rom eatin or AC
tie pp oll up to outlets)
City: State: ZIP: Ty LPC NO Oil --
Phone: Fax: E-mail: —4tic i m��Miuona over 4 outlets
(totals p (sc emauc required)
Number of outlets
Name: Ot Fier app a or equipment:
Address: Decorative fireplace _
City: Stale: ZIP: Insert-ty — _
pe etstove
Phone: Fax: E-mail: srov Other:
Applicant's signature: Datc: .S Za O I _
Name(print): _ --
Na all imidlcteau mmo cme cards,please tail jmidkaoa fa mae inrarmaaon. Permit fee.....................
Notice:This permit application Minimum fee................$
D Yw D MasterCard expires if a permit is not obtained _
P Pe Plan review(at u %) S
etarit card numhr7 -,-- - - E,piRa within 190 days atter it has been
_ State surcharge(896)....$
Named�&-,s-,i own oa cmdit c� $ accepted as complete.
TOTAL .......................$ ___-----
Ctadholder sip9ture Asowa 440.4617 W We 1)14,
Plumbing Permit Application
Datereceived:< D permit no.;
City of Tigard Sever permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of Tigard Fnone: (503) 639-4171 Projectosppl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: IReceipt no.:
Land use approval: Case file no.: Payment type:
U 1 &2 family dwelling or accessory U CommerciaYind r.m,il U Multi-lamily U Tenant improvement
14New constriction U Addition/alu;ratiutdreplaccment U Focal service U Other:
Job address: C) 25 5 ctrlrJ Uescrf tion Qty. Fee ea. Total
Bldg.no.: Suite no.: 4New an 1- d 2-family dw%IUngs only:
Tax map/tax lot/account no.: Jnciudesloon.forewbutllityconnection)
FR(1)bathLot: Block: Subdivision: FR(2)bath
Project name: FR(3)bath
City/county:?' 7LAi A I ZIP: ZX— Each additional badi/kitchen
Description and location of work or,premises: ZfQ– til _ Site utilities:
_
Catch basin/area drain
Est.date of completion/inspection: Dt wells/leach line/tmnch drain
Footing drain(no. lin. ft.)
Manufactured home utilities _
Business name ' Afj���(� _ Manholes
Address: I �, " Rain drain connector
City: e.pJyI State.-QA T ZIP:9 Sanitary sewer(no.lin.ft.)
' Phone: -i&j3-.G2/ Fax: I E-mail: Storni sewer(no.lin.ft.)
CCB no.: I 13 Z,/o Z I Plumb.bus.reg.no:3��7��� Water service(no.lin.ft.
City/metro hc.no.: Flxture or Item:
Contractor's representative signature: �, – Absorption valve
...e t Date: 5 t)j Back flow reverter
Print name: c
Backwater valve
Basins/lavatory
Name: Clothes washer
- -- Dishwasher __
Address: Dunkin (ountain(s)
City: _ State: LIP: Ejectors/sump
Phone: Fax: E-mail:+ Extiansion tank
Fixturi'lsewer ca
Name(print): Floor drains/floor sinks/hub
Mailing address: Garbage disposal
Huse bibb
City: tate: ZIP: Ice maker _
Phone: Fax: E-mail Inteice tor/ rase trap
Owner Installafion/residential maintenance only: The actual installation Primer(s) _
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), asin(s), ays(s)
Owner's signature: Date: Sum
Tubs/shower/shower pan
Naine: Urinal
Water closet
Address: Water heater
`State, ZIP: Other:
Phone. --- Fax: 1--mail: olal
Na an juri6&cd0W WcW kT"I card&,rteaao calf Jwib&cua,r«mere information Notice.This permit application Minimum fee................
O Yw O MasterCard expires if a permit is not obtained Plan review(al _ %) $
Cmdtt card numba _ i— J / within 180 days after it has been State surcharge(8%)....$
expire. TOTAL .......................$
Name d cardkider u mown on c+rdl�c.�e accepted as complete.
g
si – Amouof 4"16(60000M)
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4 IIVA STREET
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66.00,
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WINGAIL CURPURATION w s
15840 S POI-)E LANE
OREGON CITY OR 97045 IS
WINGATE CORPORATION PIAN
15840 S. HOPE LANE SCAU: i'
OREGON CITY, OREGON 97045
503-657-3300 QZ2.5 5"1 (n� KC�nIn1A P►-Ac
N
COMPASS ENGINEERING LOT 20
wE FNG NI EERING• SURVEYING+ PLANNING VENTURA ESTATES
�7 ow0a LAA"°'O (MM anlox.A.r+ TIGARD, OREGON 1
WLWAU1°E.Mw"ww (0071��olwu
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE RECEf�F�,
M PLUMBING JUN '`
411 HARNEY WAY 000*hlry uEvf�v►•N►,y
VANCOUVER. WA 98661
Plumbing Signature Form
Permit #: MST2001-00318
Date Issued: 6113101
Parcel: 1 S136AA-09800
Site Address: 10225 SW MCKENNA PL
Subdivision: VENTURA ESTATES
Block: Lot: 020
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Construction of new single family detached residence. Path 1
Your company has been indicated as the plumbing conte actoi for the permit indicated above. In order for the
PIUM bing permit to be valid, please have the appropriate inaividual from your company sign below and return
this Plun,hing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumb;ng inspections will be authorized until this completed form is received
OWNFI?: PLUMBING CONTRACTOR:
WINGATE CORP I M PLUMBING
15840 S POPE LANE 411 HARNEY WAY
OREGON CITY, OR 97045 VANCOUVER, WA 98661
Phone #. 503.657-3300 Phone #: 310-2083
Reg #: I Ir: 115262
P1 M 37.35'/qb
AN INK C IGNATURE iS REQUIRED ON THIS FORM
X
Signature of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
JUL-27-'01 11:09 ID:CSA CONSULTING ENG TEL N0'503-22e-0475 4073 P02
RPM CUMMINGS,SENKEL&ASSOCIATES
CONSULTING ENGINEERS
27 July, 2001
Barry Defbiens
Wingate Corporation
15810 S. Pope Lane
Oregon City,OR 97045 is�a p 01
Re: Garage wing walls; Lots 3 k20 -'Ventura Estates; CSA Job# 2619a
CSA Consulting F'ngineers has reviewed the Pollard-Hosmar Plans 2152A and 2152BR
for shear wall requirements at the garage wing walls. It is our understanding that the
concrete stemwall below these walls was built approximately 4" lower than specified by
Detail 2/1_2. Adequate strength can be provided by sheathing both sides of the wing walls
(inside and outside)according to the specifications given for only one side.
We trust that this will provide the information you need at this tinie. If we can be of
further help please do not hesitate to call,
Cordially,
I CSA Con c ing Engine rs
I
f (:,ary U. Fa P.E.
� CITY Of: TIGANiJ
Approved......................
+' Conditionally Approved...... ..............( ):
1 • ++ ++ For only the work as doscibed in:
.1...` PERMIT NO.
i ! •• See I_ellof to:Follow......... . ._ ..... .... .....A Y
Attach..... l I
•s •! Job Addr
.. !L.' _��_ U>i� k ate.► �
.!..!. •• '.K ,' s ` Fly:._.__ _. Date: �1-"j 10i
•! I I I s l i
/
i •J I If •/I! 1!1 1; G
I •1111 • • •
• • • ,.! I COPY
i
321 S.W. 4th, 4th Floor• Portland, Oregon 97204
(.503)223-3048 FAX (503)229-0475
CITY OF
T'C A R D —_—__ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2001-00661
1315 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/20/01
SITE ADDRESS: 10225 SW MCKENNA PL PARCEL: 1 S136AA-09800
SUBDIVISION: VENTURA ESTATES ZONING: R-4.5
BLOCK: LOT: 020 JURISDICTION: TIG
CLASS OF WORK: AL f GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH. BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: A URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINT: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks- Installation of back flow preventer device.
-- ---- — FEES
Owner: —— —--- — --
- Type By Date Amount Receipt
W INGATE CORP PRMT CTR 12/20/01 $36.25 27200100000-
15840 S POPE LANE 5PCT CTR 12/20/01 $2.90 272001000on
OREGON CITY, OR 97045 _
Total $39.15
Phone 1: 503-657-3300 —
Contractor:
I M PLUMBING
411 F'ARNEY WAY
VANCOUVER, WA 98661
REQUIRED INSPECTIONS
Phone 1: 310-2083 RP/Backflow Preventer
Reg #: LIC 115262 Final Inspection
1'L M 37-357pb
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 Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: d ". ,_61-li c. �� 4 �' Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the neness day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - --
HUP
_—__— Date Requested ( _AMPM —_ BLD
Location /G' S _ j�yL�NL uite MEC —
Contact Person Ph — J �/ c�r� [� PLM
Contractor Ph SWR
BUILDING_ --� Tenant/Owner FLC
Retaining Wall
Footing --a---- ELR
Access:
Foundation
FPS
Ftg Drain —
Crawl Drain Inspection Notes: S G N
Slab -- - -- - - SIT
Post&Beam --_
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation - --- ----- ----
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc ----
Final
PASS PART FAIL -
PLUMBING
Post&Beam -- - _� --- ...-----—--
Under Slab
Top Out ------ ----- _ -----
Water Service
Sanitary Sew --.- ---.----_-
Rain rains
S PART FAIL
-------- ----
ANICAL ....__...._...--
Post&Beare __--________�--_-__-- _-__ _�-_.__-•
Rough In
Gas Line ---- ----------- -----
Smoke Dampers
Final - -- - ---- -_ ---_._..------- ---- --- - ----
PASS PART FAIL
ELECTRICAL
Service
Rough In _. _ .,----- •- -
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL.
SITE - �..--------- _---
Backfill/Grading
Sanitary Sewer
Slone Drain ( J Reinspection fee of$- -A required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspection RE _ ( J Unable to inspect-no access
ADA
,Approicl/Sidewalk
Other Date /Z-S Q1 _ Inspector 11 A✓t, Ext
Final
PASS PART FAIL 00 NOT REMOVE this inspect;.on record from the job site.
Plumbing Permit Application
Datereceived: Permit no-Tuil2aD(Ir
City of Tigard �-
g Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of Tigard phone: (503) 639-4171 ProjecUappl.no.: Expire date:
Fax: (503)598-1960 ` " Date issued: Byj Receiptno.:
Land use approval: -_ Case file no.: Payment type:
U I &2 family dwelling or accessory U C'ouunenaal/lu-lustrral U Multi-family lJ Tenant improvement
%(New construction U Addltion/alteratiorUreplaccment U Food service U(Mice
Job address: O �ZS ,J .r r{(�, .PL `►esc j! L1on " Fee ea. 'I otal
Bldg.no.: Suite no.: New l-and 24junily dwellings only:
Tax ma tax lot/account no.: (includcw 100 ft.lot cacti utility connection)
p/ SFR(1)bath
Lot: Block: Subdivision: FR(2)bath — - -� - --- _
Project name: SFR(3)bath
City/county: ZIP: Each additional bath/kitchen
Description and location o work on premises: .S1"Q- r% Sitesli tles:
Catch basin/area drain _
Est.date of completion/inspection: D wells/leach line/trench drain
Footingdrain(no.lin. ft.)
Manufactured home utilities
Business name: , ? M tit N 1„ Manholes
Address: v.JAq Rain drain connector `
City: J _ I Statc, A 'LIP:q 9616 1 Sanitary sewer(no.lin.It.)
Phone: ::, 2 Fax: I E-mail: Storm sewer(no.lin.ft.)
CCB no.: I I g 2.(0"Z. 1 Plumb.bus.reg.no: :35,2 e6 Water service(no. lin.ft.
Cit /metro lic.no.: Fixture or Item:
Absorption valve
Contractor's iepresentati%.;signature:
-. Bach ; -venter
Print name: Tca 1 Date: Bar wi!xr"dl,
Bas." llavitu�ry
Nance: Clothe-e -
--- -- Dishwasher
Address: Drinking fountain(s)
City: State: ZIP: Electors/sump
i
one: I ax E-mail: Expansion tank
Fixture/sewer cap _
Name(pript): Floor drains/floor sinks/hub
Mailingaddress: Garbage dis sal
Hose bibb
City: lee maker _ --
Phone: Fax: _ Email Interceptor/grease trap
Owner installatiol>/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature:" _ _ Date: Sum
Tubs/shower/shower pan
Urinal
Name: _ _ Water closet
Address: _ Water heater
City: --�-"— 1State: ZIP: Other.
Phone: �Fax:�- — Gmail: Total
--- ---- --
Nr all}riadicliam rxW cm&t cards,plem call)rirliction rm mat idwri
oron Notice:This permMinimum fee................Sit application -
U Visa U MuterCard expires if a permit is not obtained Plan review(at __ %) S
Credit cid camber:_� ___ �- within 180 days atter it has heen State surcharge(8%) ....SExpim _
Nae d card6oNler r dawn m c"'cid
accepted as complete. TOTAL .......................$ _
Crdpdder sipwvre AowW 4/04616(601K OM)
CITY OF TIGARD BUILDING INSPECT"ON DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- --
1 B'JP
-- Date Requested__ / _ ��- AM _pm Bl p
Location--.- -� L � _Pyi c rVr4a-_ Suite �C MEC —
G
Contact Person Ph �`� 3 ��'a �` PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC —__—
Retaining Wall ELR
Footing Access: -------- - —---
Foundation FPS
Fig Drain ---�r-- SIGN
----- .. ---
Crawl Drain Inspection Notes. �� ---------- ----
Slab r4_` SIT
�
Post&Beam — ----- ----
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof __--
Misc - - --
PART FAIL --
PLUMBING
Post&Beam - - - - - -----
Under Slab
Top Out _.—_- ---- --- -- -- -----
Water Service
Sanitary Sewer +—
Rain Drains
Final -
-4kkRJ FAIL
MECHANICAL —�
Post& Beam -- __------ -- — --- --
Rough In
G is Line -- — ------ — ---- --- —
Sm a Dampers
A PART FAIL
ELECTRICAL _ �—
Service
Rough In —"--"-- --__—_ _
UG/Slab
Low Voltage
Fire Alarm — _.—
Final
PASS PART FAILSITE
[DA
Grading
Sewer
rain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
asin [ ]Please call for reinspection RE:— --_— [ ]Unable to inspect •no access
pply Line
ch/Sidewalk Date _ _ / , (` - _-. Ext
1 � Inspector PART FAIL ! DO NOT RENJOVE this inspection record frrsm the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
� BUP
Date Requested / r AM _ PM — BLD _
Location /G L % ) C 'l�.Ci. Suited 'L- p�3 MEC
Contact Person — Ph / / 3 �� /.� PLM
Contractor Ph SWR
BUILDING -- Tenant/Owner _ ELC
Retaining Wall ELR
Footing
Foundation CBS (�� / - --^-. _ - -----
Fig Drain ' FPS
Crawl Drain Inspection Notes , SGN
Slab SIT
Post& Beam — , _.__..-------
Ext Sheath/Shear '
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall - -
Fire Sprinkler
Fire Alam
Susp'd Ceiling
Roof • —.._�-
FinalPASS PART PART FAIL
PLUMBING
Post&Beam
Under Slab "— —
Top Out __—
Water Service
Sanitary Sewer —
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post& Beam ---- — - - —_—
Rough In
Gas Line -- ---- —__ —_ _---
Smoke Dampers
Final --_ --- ---- — - --
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
PART FAIT_ _--------
SITE
Rackfili/Grading - - --- --
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$_ required b-fore next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE:_ ( J Unable to inspect-no access
ADA
Approach/Sidewalk C
Other Data Inspector __ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the Joh site.
CITY OF TIGARD BUII1 DING iNSPECTION DIVISION S 2tiol
24-Hour Inspection Line: 63, 175 Business Line: 639-4, O—C-51I
BUP _ -
-Date Requested _— —AM___PM — BLD
Location 10 125 1`�� Kt >t.li�� _ "�_ Suite _ _ MEC
Contact Person _ �f:C1,1'T Ph --)q3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner _ ELC - ----------_
Re'aining Wall --- a EL R
Footing Access: -----..__
Foundation FPS
Ftg Drain -�� _a)C� L_-�i ` + F�
Crawl Drain Inspection Notes $GN
Slab SIT
Post&Beam
Ext Sheath/Shear Cd-L `3c-O''IT Vt(2`�%n Tq _
Int Sheath/Shear
Framing W C�`.\r` _-
Insulation
Drywall Nailing Jcv 61 W-14- c2 'Ile
Firewall 1.11'•,!'., /�.a,�."� "k.� V � �
Firewall
Fire Sprinkler -2• N S _- �o-`'-----Q -- �ti�� Ze 6 Dr—, 1,
Fire
Fire Alarm
Susp'd Ceiling
Roof
Final
PART FAIL ------ --- ----- --
pLUMB1N
[lost& Beam -
Under Slab
Top Out — _ -
Water Service
Sanitary Sewer - - -
n Drains
Fin - -
)AS PART FAIL_
CHANICAL
Post&Beam --
Rough In
Gas Line - -- - - - -- ---------._
Smoke Dampers
Final - -- - ---- --------- --- --- - ----
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL _
SITE
Backfill/Gra_ ng ---'--- —" ---
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE: [ J Unable to inspect-no access
ADA
ApproFt.h/Sidewalk pater
Inspector l L-e!w r. Ext
other _
Ficial
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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