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10230 SW MCKENNA PLACE .a CD N W O En n ro D1 d n ro 10230 SW McKenna Place CITY OF T'GARD BUILDING ASrECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ------- - BUP - _ _Date RequestedAM _PM BLD Location G Sy �"h bjq,-Y(� f.--, Suite MEC r Contact Person _ Ph .7 �1 .3 J'S�5 PLM Contre t:for Ph 3WR BUILDING Tenant/Owner ELC Retaining WL I! ELR Footing Access: FoundationFPS Ftg Drain I Co C, ks - SIGN Crawl Drain In ction Notes: - Slab SIT Post&Beam -'— Ext Sheaf;i/Shear Int Sheath/Shear - Framing _ Insulation Drywall Nailing Fi•ewall ffT: Fire Sprinkler - Fire Fire Alarm Susp'd Ceiling Roof Misc Final PASS PART FAIL PLUMBING Post B Beam Under Slab Top Out Water Service Sanitary Sewer Rin Drains , PART FAIL MECHANI(-,AL Post& Beane -- - -- --- ------ -- Rough In Gas line -- -- -- ------- - Smoke Clampers Final PASS PART FAIL ELECTRICAL _ __—_.--._---------_— �;ervice Rough In — UG/Slab Low Voltage rire Alarm Final PASS PART FAIL SITE Backfill/Grading - - ------ --- _---._..--_- ----_ __ Sanitary Sewer Storm Drain i Reii spection fee of$--- required before next inspection Pay at City Hall, 13125 SW Hali F110 Catch Basin Fire Si.rpply Line ( J F'leose call for reinspectior RE:a �_-- __- _- _ J Unable to inspect-no arses,, ADA A roach/Sidewalk PP Bate 2 �_ __.. Inspector . �� G _-�d�. Ext ---- Other _ Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. M I - _ CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 13UP _ .---Date Requested i AM_—_—PM BLD Location C) Z ,) 5 w * G1(o�nG /lC Su��e —__ —_._ MEC Contact Person Ph PLM PLM Contractor Ph SWR --- BUILDING Tenant/Owner hLC_ - - -- -- -- Retaining Wall ELR _ - Footing Access: Foundation I Q FPS Ftg Drain t " Gey` /N /� Crawl Drain Inspection Notes: SGN Slab -- -� __T_ �__ SIT Post&Beam - F_xt Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm /,�G CJ /!.� S•f7�`/i✓�p�5tU Susp'd Ceiling _ ----- Roof Misc Final - P RT FAIL �_-- ------ --�-� -T ----- st& Beam Under Sleb 'Top Out —.._-- TL Water Sentice --r - -- - -- _ San"aiy Sewer BAga-Diains PART FAIL NICAL Post& Beam --- - ----- -- - Rough In Gas Line _--- Smoke Dampers Final ---- S P T FAI'_ ECTRI \ Rough In G/Slab -- - ---------- - ----- Low Voltage Fire Alarm - Fi SS PART FAIL Backfill/Grading ------------ ----------- -__-_ _ Sanitary Sewer Storm Drain ( J Reinspection fee of$ T-requiied before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ j Please call for reinspection RE: - [ )Unable to inspect-no access Fire Supply Line - - --��--- ADA �"r.--�---1Ext Ci " '' -`. Approach/Sidewalk Date ��,� (� [- Inspector Other ----- Final f PASS PART FAIL 00 NOT REMOVE this inspeeztiom record from the job site. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST -ra:JO/ O03U INSPECTION DIVISION Business Line: (503) 639-4171 BUP - Received Date Requested__3 r�S� AM PM — _. BLIP Location .__.___ /,Q Z 3U _ `� yyy�- / Suite MEC Contact Person ------__ _ _.-_ Ph( ) Z�K3 - 5' -.S PLM _-- Contiactor, _ --.____ Ph( ) -. __—___ SWR BUILDING Tenant/Owner _ ELC Footing ELC _ Foundation Access: Fig Drain ELF! Crawl Drain Slab Inspection Notes: SIT -- -- - Post&Beam r __ Shear Anchors / Ext Sheath/Shear G-• Int Sheath/Shear Framing -- "C' Q�.0 t"p�! Insulation Drywall Nailing Firewall Fire Sprinkler Fire elarming f�►y '��aC�.-I _W L�� C�N � "x t Q�w -- Roof Other:n PART - PLUMBINGL----;, �� Post&Beam Under Slab _— ��----- ------ -- —_.. - - -- Rough-In Water Service --- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain ----- ----- — - _ Shower Pan - A Other:_ _ __ — ---------------_—� --- Final — PASS PART FAIL HANIc _ __—_ _-----_---- ----- ----- -ft Post&Beam Rough-In ------ -- ------- -- —_ . —_ Gas Line Smoke Dampers -- -- _-- —.-----�.__-.._ `__-- PART FAIL ELTRICAL _—-- _— a_. - --- --- --- ------ Service Rough-In _--.____ -- — -- -- -— — ------ UG/Slab Low Voltage -----_—_--- Fire Alarm Final Reinspection fee of$ required before next inspection. Pay t City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE F-1 Please call Mr reinspection RE:__—__._...-_._.______-- Unable to inspect-no access Fire Supply Line _ ADA Approach/Sidewalk Dat* 1 J Inspector -`�,� _ __Ext —___— Other: —_ Final Do NOT REMOVE this inspection record from the jab site. PASS PART FAIL r o \ Cot c W R � w Q ti n a � w Iy n rDG ct', r Q rt ic ro a e Jo s 1 C. 3 I v Y e� CITY O F T I d�A R® ---- MASTER PERMIT _v PERMIT#: MST2001-00301 DEVELOPMENT SERVICES DATE ISSUED: 5/30/01 1125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10230 SW MCK'ENNA PL PARCEL: 1 S136AA-09700 SUBDIVISION. VENTURA ESTATES ZONING: R-4.5 BLOCK: LOT:019 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1.201 et BASEMENT: of LEFT: 5 SMOKE DETECTORS v TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,705 sf GARAGE: 849 sf FRONT: 25 PARKING SPACES: 2 TYPE OF CONST: 6N DWELLING UNITS: 1 FINBSMENT: sl RIGHT: 6 VALUE: $272,38510 OCCUPANCY GRP: R3 BGRM: 4 BATH: 3 TOTAL: 2,906.00 of REAR: 19 PLUMBING SINKS: 1 WATER CL OSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER i INES: 100 SF RAIN DRAINS: I CATCH BASINS: TUOISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS 1 WATER LIN-S: 100 BCKFLW PREVNTR: 1 GREASE TRAPS. OTHER FIXTURES: MECHANICAL FUELrYPES FURN<100W BOIL/CMP<AHP: VENT FANS: CLOTHES DRYER: 1 GAS FURN>-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS. 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 -200 amp:i 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 400 amp: 201 400 amp: 1st W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 500 amp: 401 •600 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT: MANU HM/SVC/FDR: 501 1000 amp: 601+amps-100ov: MINOR LABEL: 1000+amplvolt PLAN REV EW SECTION Reconnect only: >=4 RES UNITS: 9VC;FDR>a225 A.: >860 V NOMINAL: CLS AREA'iPC OCC ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: X VACUUM SYSTEM x AUDIO&STEREO: FIRE ALARM: INTERCOMWAGING OUTDOOR LNGSC LT: BURGLAR ALARM: X OTH: BOILER: HVAC: LANDSCAPURRIG: PROTECTIVE SIGNL: GAf'.3E OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC: x DATAITELE COMM: NURSE CALLS. TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,359.43 This permit is subject to the regulations contained In the WINGATE CORP WINGATE CORPORATION Tigard Municipal Code,State of OR. Specialty Codes and 15840 S POPE LANs 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 plans. This permi!will expire if work is not started within 180 days of Issuance,or if the work is suspended for more than 180 days ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep N: t C 91661' forth in OAR 952-001-0010 through 952-001-0080, You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Appr/Sdwlk Insp Grading Inspection Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Mechanical Final Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Rain drain Insp Plumb Final Foundation Insp Footing/Foundation Dr; Electrical Rough In Gac Line Insp Water Line Insp al Inspection Issued By: ''.L , { 1� Flermittee Signature // Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next t lness day V PRIVATE STREET :,.�� J �e,,� c' v 'Aix 6 . 1 .0 VW4'e I 6�) Aa -T I T, 322' A fJ 61 SV + co 58.W L ———— ------—— co < 87.99' N co WINGATE CORPORATION 15840 S POPE LANE s WINGATF CORPORATION 15840 S HOPE LANE OREGON crry OR 97045 PLAN OREGON CITY,OREGON 97045 i- 503-657-3300 023 o S /Y)c COMPASS ENGINEERING LOT 19 ENGINEERING* SURVEYING a PLANNING VEN TURA ESTATES 4—%Lw4p aA."t,UumoffM"w am om FAX " TIGARD, OREGONa9f, No_v VSSM ..0—p— J SEWER CONNECTION CITY OF TIGARD ® ® DEVELOPMENT SERVICES PERMIT#: S30/01 -00171 13125 SW Nall Blvd.,Tigard, OR 97223 (503) 639 4171 DATE ISSUED: 5/30/01 PARCEL: 1 S 136AA-09700 SITE ADDRESS; 10230 SW MCKENNA PL SUBDIVISION: VENTURA ESTATES ZONING: R-4.5 BLOCK: , LOT: 019 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: F_E E 5_-----------.—. WINGATECORP Type By Date Amount Receipt 15840 S POPE LANE OREGON CITY, OR 97045 PRM,f CTR 5/30101 $2,300.00 27200100000 INSP CTR 5/30/01 $35.00 27200100000 Phone: 503-793-8895 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The per.nit 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 Fo 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 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: :�LY ` Wi t". __,_ Pei mittee Signature: J -u- Call (503) 639.4175 by 7:00 P.M. for an inspection needed the reit bu4lness day Building Permit Application 4 City of Tigard Date received: - Permit no.: Address: 13125 SIX Hall Blvd,Tigard,OR 97223 Noject/appl.no.. Expire date: Ciryoj77gurd �-- - Phone: (503) 6394171 1 Date issued: By: Receipt no.: Fax: (503) 598-1960 //It �J// Case file no.: Paymcnt type: Land use approval: r — 1&2 ran►i:y:Simple Complex: �. U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family 14 New construction U Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkles/alann U Other. Job address: c' UJ IA L_k.C.Ij r'i I1, Bldg.no.: Suite no.: Lot: I Block: Subdivision: qetAjgTax ma tax lot/account no. ; %( 4,4i Project name: t Description and location of work on premises/special condilions:'SER ,_-4 Name: W I t4 MC. _- -- -- Mailing address� i�_ rG L�4 I &2 family dvtelling: - •-- J L City: QP-4E�kQ A C I _ Stsue2l 7.I P: - �,� Valuation of work...................... ................ $ 2`s� Phone: �5�33ot, Fax: E-mail: No.ol'be,:r(x)ms/baths........... . Owner's representative: Lo r E.'<> t Total number of floors................................ L_ N one: 3- Fax: E-mail: Q$ New dwellinv,area(sq.ft.) .......................... 'v}bt{ Garagecarport area(sq.ft.)......................... _G Z.G Nam;:_ _— Covered porch area(sq.ft.) ......................... /SU Mailing address: — -- Ihck area(sq. ft.) ....................................... "! '---"-_ Other structure area(s .ft.)................. City: _ State. ZIP: _ •••••••• — Meone: Fax: E-mail: - CommerciaUlnduslrlal/muld-family: toValuation of woik........................................ $ Business name: SAry%F Existing bldg.area(sq. ft.) ..\...... ............ Address: New bldg.area(sq.ft.) ........... .......... --- y. Number of stories................ ;.......... City: State: ZIP: ... . - Phone: Fax: lt;mail: Type of construction.................. ....... CCB no.: — - Occupancy group(s): Existing: _ New: _ City/metro lie.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be:zyuited to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: Scate: LIP: — exempt from licensing,the following reason applies: Contact person: _ Plan no.:: --- - ---- --" Phone: ^ Fax E-mail Name: " '_C-;L L-"-, lContact person: Fees due upon application ..................... ..... 'S Address: _ Date received: City: State: LIP: Amount received $_ Phone: Fax: E-mail: i i Please refer to fee •-hedule. J I hereby certify I have read and examined this application and the Nut all phadictian KAxpt credit cant,pkne can jundKuon ter mare intartnawn attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard work will be complied with,whether W-ifted herein or not. Creat cud wart n'--- _ -_L_._L.__.. E.rirr Authorized signature: `t LL `l` Date: �') blamed cwdhoWu as blown on credit cad-- Print name: rT- )� �,_ Tf'rtlboider olpv,:urc Artrwot .J Notice:This permit application expires if a permit is not obtained within 180 days atter it has been auepted as complete. 443-aaii(69M UM) Electrical Permit Application — Date received: --//�, Permit no.: City of Tigard Project/appl.no,: Expire date: City of7igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: U I &2 family dwelling or accessory U Commercial/industrial U Mulu-family U Tenant improvement New construction U Addilirm/nit rnitm/rchlncrtn nl L)Other-_- -- U Partial 1 T Job address: rp ,� lild�. nu.. Surrr.no. _ Tax map/tax lot/account no.: Lot, Bltxk: Sulxlivision: - � - _ _ — Project name: —� escription and location of work on prcmisos: - I1stimated date of completion/inspection: CONTRACTOR i Job no: F'er M1tax Business name: pe-X 14E.1 ( (� Description Vly. (ea.) "total no.MY- Mf rr,%kkntW-single or mulli-family per Address: b t dtelling wait.Includes attached gai-age. Statc:Q ZIP: L3'4 Z 5erviceincluded: Phone: p Fax: E-mail: I(MX)sq 0 or less d Each additional 500 sq ft.or portion thereof CCB no.: S Elec.bUs.lic.no: ZAPS 2, Limitedenergy,residential /' _ 2 City/metro lic.no.: Limited energy,non-resideruialtL 2 - Fach manufactured home or mo lar dwelling T -- - Service and/or feeder 2 Si nature of su rv_ilfg electrician(re uired) Uatr Sup.elect.name(prim) no(v/G 13"E-us4�rN Llcenseno, 3216, Services or feeders--Installation, alteration or relocalion: WMIA 200 amps or less _ 2 Name(print): 201 amps to AIM amps 2 - - 401 amps to 600 amps Mailing address: 601 amps to 10(x1 amps 2 City: — State: ZIP: Over IWOamps orvolts�-- 2 Phone: Fax: E-mail: Reconmcctonl I Owner installation:The installation is being made on property 1 own Temporaryservicesorfeeders- which is not intended for sale.lease,rent,or exchange according to installation,r less tlon,orrcloation: 200 amps or less 2 ORS 447,455,479,670,701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to mit)ams 2 Branch circs-new,attention, or esrension poiter panel: Name: _ _ A. Fee for branch circuits with purchase of Address: — service or feeder fee,each branch circuit 2 City: Stale: ZIP: B. Fee for branch circuits without purchase --- - of service or feeder fee,first branch circuit 2 Phone. I'a t' E-mail: Each additional branch circuit. Misc.(Service or feeder not included): U Service over 225 amps-cmnnrcm�t,d U Hath-care facility Each pump or imgatior.circle 2 U Service over 3 Damps-rating of 1&2 U Harnrdouslocation Fach signor outline lighting 2 familydwellingr U Building over IO,M)square feet four or Signal circuits)of a limited energy panel, U System over 6volts nominal more residential units in one structure alteration.or extension* 2 (IO U Building over three stones U Feeders.41x1 amps or more •ikscn non: — U Occupant load over 99 persotu U Manufactured structures or RV putt "ch additional inspedlon over the allowable In any of the above: U Egressnightingplan U Other -- -----. Per inspection Submit--sets of pbuu witb any of The above. Investigation fee The above are not applicable to temporary ronrttruction service. Otter —_--- — Permit fee.....................$ No alljurn-W -ons accept credit cards,pleaw call jurisdiction fix note infomisor r Notice:This permit application U Vila U MasterCard expires II u Perini,is not obtained Plan review(at r ) Credit cad number. ._ within 180 days after it has been State surcharge(11%)....$ _ Expires accepted as complete. TOTAL .......................$ Nur;t,r carrrholdrr a shown on c its-- S nanllwtder srroature Arnow 440x615(&McoM) Plumbing Permit Application Date received: t crtrtit no.: i City Of TigardSewertrait no.: Huddin !e 8 permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 �`ry°f7i8°r`l Phone. (503) 639-4171 F'rojecUappl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: Receipt no, Land use approval: _ Case file no.: Payment type: 1 _l 1 h ' lanoly 1J,v1 llulj;ui accessory U(',vnnterctal/nidusu-1al U Multifamily U Tenant improvement U<New constim tion U Addition/alterationlreplacement U Food service U Other: Job address: ' ,,•y �C fN P I►%Writion Fee(a.) Total Bldg.no.: Scute no.: New 1-and 2-hunilly dwelliings only: Tax map/tax lot/account no.: (includes 100 R.for each utitit v connection) Lot: Block: Subdivision: SFR(1)bath 1p'Q1 'FR(2)bath ----- Projec name: SFR(3)bath -- - City/county: ZIP: -+Tz Each additional bath/kitchen Description apd location or work on premises: .SF2.. I.lE�- SiteutiUties: Catch basin/area drain _ Est.date of completion/inspectimi: Drywells/leachline/trench drain Footing drain(no.lin. ft.) Manufactured home utilities Business name: �. [3�1 N Manholes Address: I Rain drain connector City: ►LpJu rI stateiAFA ZIP:419(, Sani sewer(no. lin. ft.) ' Phone: :! - Fax: I E-mail: Storm sewer(no. lin. ft.) CCB no.; (o Z Z„ Plumb.bus.reg.no: _ Water service(no. lin. ft.) City/metro lic.no.: Fixture or Item: Conti actor's representative signature ^-,, Abso tion valve Print dame: , Lo - t Date: Back flow proventer Backwater valve 3asins/lavatory Name: Clothes washer Address: Dishwasher Drinking foutitain(s) City:_ _ State:_ ZIP: __ Ejectors/sum Phone: Fax E m.ul: Expansion tank Fixtunlsewer cap Name(print): Floor drains/floor sinks/hub _ Mailing address: _--- - Garbage disposal City: _ State: ZHuse bibbIP^_ Ice maw Phone: Fax: E-mail: Interce ptor/grease trap Owner installation/residential maintenance only: The actual installation Primers) 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 URS Chapter 447. Sink(s),ba—sin(s),lays(s) Owner's signature:., Date. _ Sum Tubslshower/shower Iran Narne: Urinal Water closet Address: Water heater City: ZIP: Other: -- Phone: Fax: E-mail: oW No all hrbdictlatr wcept cm&t girds.pkw call juriadkUon la mese lnfamtation Minimum fee................$ Notice:Thies permit application plan review(at %) $ U Ws Q MuterCttrd expirca If a permit Isnot obtained CteWt cart ttmmbe: --u.-- within I80 days after it has been State surcharge(8%) ....$ Hxpltea Nn of codholdes w down on c edit cod --- 7 accepted as complete. TOTAL .......................$ S Cantholdw alpawe Anwtnt 44046161641f MKI) �A Mechanical Permit Application Dale received: ' , "!�"i Permitno.:/ � - City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: By: Receipt no.: Fux: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: 61 U 1 lJ I cit 2 faintly dwelling or accessory U Conro,ctcial/industrial U Multi-lanuly U Tenant improvement XNew construction U Addition/alteration/replacement U Other: 1 Job address: �, Indicate equipment quantifies in boxes below.Indicate the dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ Lot: C Block: Subdivision: e;td-rUF_b See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county. t A ZIP: Description and locatioff of work on premises:iNF9, Fee(ea.) 'total Est.date of completion/inspection: Destripdon ReLonly ReLoal Tenant improvement or change of use: Is existing space heated or conditioned?U Yes U No Air handling unit __ CFM Air conditioning(site plan reg ) Is existing space insulated?U Yes U No Alteration ofxisting sys1em I III I L1011 of er compressors Business name: (1 CDC u rJ State boiler permit no.: � HP Tons_ BTU/H Address: 6000 S F Q:4 F_ nl it smo a ampers/ uctstooks detectors City: Stater- ZIP: heat pump(site plan required) Phone:651t. p Fax: E-mail; nsw rep ace urnac ,,,nems CCB no.: Including duchvor!.;vent liner U Yes U No nsta replaci7relocate heaters-suspended, City/metro lic.no.: __ wall,or floor mounted Name(please print): k=(Z s �'(� R t L, —� Vent ora Lance other an furnace e era Absotption units BTU/H Name: Sgry��_ Chillers _ HP - - -__---- -- ---- - Address: Compressors HP _ vlarenasental ei&iuirt and 4Ol t OA: City: State: ZIP: Appliancevent _ Phone: Fax E-mail: )ryf eiexhaust cxx s, y� restc a. tazmat herd fire suppression system Name: _ Exhaust fan with single duct(bath fans) Mailing address: .x aust s stem a art from heating or AC City: _ State: ZIP: Fuelpiping and dUtribuUon up to 4 outlets) Type: LPC NO Oil Phone: Fax: E-mail: I Fuelpiping each additional over 4 outlets rocess pipling(sc emauc requir ) Name: Number of outlets t er 1 sl ap a or eq pment: Address: Decorative fireplace City: State: ZIP: rise rt-ty Phone: Fax: E-mail: stov et stove __ Other: Applicant's signature: - Date: c' O Wiwi Name (print): Na as}u KIkUmn wczp crew,cwdr,rteaw call pvi@&ctkm for mile infomWton Permit fee ................$ -- OVisa O MutetCud Notice:This permit application Minimum feeee................$ rer Credit card numbers.. —6i � expires a permit not obtained Plan review(at _. %) $ — p.pwithin 180 days suer it has been State surcharge(8%)....$ ams of a rhowo 0o e,cdi,— ems, -- accepted as complete. f TOTAL ...................... $ _ Aoeast 4"17(GWMM) CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE I M PLUMBING 411 HARNEY WAY VANCOUVER, WA 98661 Plumbing Signature Form Permit #: MST2001-00301 Date Issued: 5/30/01 Parccl: 1 S136 AA-09700 Site Address: 10230 SW MCKENNA PL Subdivision: VENTURA ESTATES Block: L.ot: 019 Jurisdiction: TIG Zoning: R-4.5 Remarks: Construction of new single fami;y detached residence. Path 'i Your company has been indicated as the alumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above. ATTN: Building Dept. No plumbing inspections will be authorized until this c :j;. , 'ed form is received OWNI R: PLUMBING CONTRACTOR: WINGATE CORP I M PLUMBING 15840 S POPE LANE 411 HA.RNEiY WAY OREGON CITY, OR 97045 VANCOUVER, WA 98661 Phone #: 503-793-8895 Phone #: 310-2083 Reg #: 1 it 115267. PI FA 37-357ab AN INK SIGNATURE IS REQUIRED ON THIS FORM X Sign atur, o A u4Korized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 7 CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: P,M2001-00660 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4'71 DATE ISSUED: 12120/01 PARCEL: 1 S136AA-09700 SITE L.ODRESS: 10230 SW MCKENNA PL SUBDIVISION: VENTURA ESTATES ZONING: R-4.5 BLOCK: LOT: 019 _ JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: P.3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GPEASE TRAPS: LAVATORIES: OTHFR FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLPSETS: WATER LINE ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install backflow preventer device Owner: __— _ _ _FEES — Type By u Date Amount Receipt WINGATE CORP 5PCT GTR 12/20101 $2.90 27200100000 15840 S POPE LANE PRMT CTR 12/20/01 $36.25 27200100000 OREGON CITY, OR 97045 -- Total $39.15 Phone 1: 503-793-8895 Contractor: _ I M PLI, MBING 411 HARNEY WAY VANCOUVER, WA 98661 REQUIRED INSPECTIONS RP/Backflow Pr inter Phone 1: 310-2083 Final Inspectic Reg#: LIC 115262 PLM 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. ATTENTIONS 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: L- ,. Permittee Signature: Call (503) 639-4175 by 7:00 P.M.for an Inspection neededl4 -t°axt 6csein�s day Plumblug Permit Application Date received: Permitno.:� 1 City of Tigard Sewerrmit no.: Building g permit no.: Address: 13125 SW Mall Blvd,"Tigard OR 97,223 - CityujTigarrl Phone: (503) 6394171 Pno)ccrlappl.uo.: Lxpircdate: Fax: (501) 598-1960 /� Date issued By: Neceipt no.: \ Land use approval: --_-_ Cu:,c file no.: Payment.lyntent type: U I &2 family dwelling or accessury U Conimerciai,)ndustrial O Multi family U Tenant improvement V,New construction U Ad(iition/alteiationjreplacemcnt U Food service U Other - !ob_address: I1U,J tC Ss� Description Qt Mee eA. Total Bldg,no.: Suite no.: �- New 1-and)-family dwellings only: Tax map/nu lot/account no.: - (Includes 100 fl.for each utilityeounec•tioo) __ SVP i I)bath Lot: I'tBlcxk:-- Subdivision: 'Fk(2)bddi -- — -- -_ Project name: SIR(3)bath City/county: _— ZIP: tll-L23 Each additional batlt/kitchen -� Dcscnption and location o work on premises: S>^"R- }� Site utilities: _ Catch hasin/area drain -- - ---- Est.date of completion/inspectionD v cllti/leach line/trench drain --_ - : Fcxotir� el drain(nu. lin. ncft.) _ Manufactured home utilities - Business name: Manholes -- Address: ( -tlJt?^/ _ Rain drain connector City: �J� [Stag-A I ZIP:-q Sanitary sewer(no.lin. ft.)_ - Phone: {, - 1Iax: _ Email: Storm sewer(no. lin. ft.) CCB no.: ria OR Water service(no lin. R.) — 2.fo 2 _-�Plumb.bus.reg.____ =�L�-L�_ Fixture or item: City/metro lic.no.: _ Contractor's representative signature: Absorption valve - -Back flow preventer Print name: C-0 I C Date: Backwater valve ---_ inwa-__- M U 0 146111100 _Basins/lavatory — Name: Clothes washer - -- - Dishwasher _ Address: City: ---... SStaa(c: ZIP: Drinking founWil(s) _ -"--� Ejectors/sump Phone: I ax E-mail. Expansion tank FixturtJscwcr cap - Name(print): Floor drains/floor sinks/hub Mailing address: -�- - - ---- --- Garbage disposal --Y -- ----- -- --- - Hose Bibb City: State: _ LIP: Ice maker -- Phone. I-ax rl:-mail: Inlerk.eptor/Sre.w trap --- -- - Owner installation/residential maintenance only: The actual installation Primer(s) will be m:tcle by me or Ute 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) - Ownees si nature: Bate: ._-__.--- Suillp -- Tubs/shower/shower pan Urinal Nairn- -- - ---_--_�- Water closet Address: _ Water heater City: __ State: ZIP: Other: --- Phone: Fax E-mail: _- Total Na dl)undietlar aoapr credN cards,please call)uridiction run Ince informationNotice' lltts permit application Minimum fee................$ U Visa U MancrCard / expires if a permit is not obtained Flan review(at — `Ib) $ _ --1.- /— �yilt.,i:: :��lla)5 eller It(' 'S bl'l'n State surcharge(8%) ....$ ri .—.--.- Aprer __--- -----_-. accepted as complete. TOTAL .......................S _ Name d catdM�lde:a drown m claxlil card _ S _ —Cardhnldu±pi;W Amami 4104616(610DOCUM)