12785 SW MARIE COURT-1 J.3 31HVW MS 58126 -
W_
Q
co
I,-
C4
r
12785 SW MARIE CT
� A
CITY OF TIGARD _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2004-00108
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 1/17/04
SITE ADDRESS: 12785 SW MARIE CT PARCEL: 2S104AD-00200
SUBDIVISION: BELLWOOD ZONING: R-4.5
BLOCK: LOT: 013 JURISDICTION: TIG
CLASS OF WORK: OTR GANI31 GE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WAST:ING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water heater with like kind
FEES
Owner: --
Description Date Amount
ABEL, GARY B WENDY -
12785 SW MARIE COURT IPI,UMB1 Permit Fee 3/17/04 $72.50
TIGARD, OR 97223 [TAX) R°/ State Surcharl 3117/04 $5.80
Total $78.30
Phone
Contractor:
OWNED
REQUIRED INSPECTIONS
Phone : Final Inspection
Reg#:
a
�c
U)
-� 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
Jplans. 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: _ �T: fPermltte
` e Signature:
Call (503) 639-0175 by 7:00 P.M.for an inspection needed the ay
Fpile.ng Fixtures
Plumbing Permit Anplicatian
City of'Tigard pa«;By / Permit No
13125 SW Hall B:vd.,Tigard,OR 97223 'Ian Review
Phone: 503.639.4171 Fox: 503 598.1960 )ate/By Other Pemut No
24-Hour Inspection Line: 503.639.4175 )a,e Ready/By. aur ® See Page 2 for
Internet: wwv.ci tigard or its Notified/Method. d'21 Supplemental Information
El New construction L1Demolition Fors ectal in ormatlon use cn.5...,+st
-- — Description Ea _Tr'
❑Additionlalteration'teplacement ❑Other: New I-24►r.dly dwellings(includes 100 R.for each utility cr nection)
'A I r SFR(1)bath2920T
—
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath _ 350.00
❑Accessory building _ ❑Multi-fpmily SFR(3)bath _ 399.00
-- -- Each additional bath/kitchen 45.00
❑Master builder El Other:
Fire sprinkler L_sq.ft.) Page 2
P Site utilities
e address: Cat
Job site basin or area drain 16.60
_ f� c ... 1atec� � i _ _
City/State/ZIP: _ Drywell,leach line,or trench drain 16.60
Suite bldg.'apt.no.: Project name: — Footing drain(no.linear R _� Page 2
Manufactured home utilities 1 10,00
Cross streeVdirecrions to job site:
-- �—. -- Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no.linear ft. �) Page 2
Storm sewer(no.linear R.: — Page 2
Subdivision: Lot no.: Water service(no linear fl.:
— Fixture or Item
Tax map/parcel no.: - —
Absorption valve 16.60
Backflow preventer Page 2
C Backwater valve 16.60
Clothes washer 1660
Dishwasher — 1660
Drinking fountain 16.60
S
Ejectors/sump 16.60
Name:
Expansion rank 16.60
Address:'it&—, Fixture/sewer cap 16.60
City/StatelZlP: Floor drain/floor sink hub 16 60
Phone:( ) ���_ v Fax:( ) Garbage disposal16.60 —
4 Hose bib -- 16.60
Ice maker 16.60
Business name:
Interceptor/grease trap 15.60
Contact name: Medical gas(value:S ) Page 2
0- Address: Primer 16.60
Roof drain(commercial) 16.60
N City/State/ZIP: _ —
Phone:( ) Fax: :( ) Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E-mail: Urinal 1660
Water closet 16.60
WBusiness name: KI-L, Water heater 16.60
Address: Other: `-
---- — Subtotal
City/State/ZIP: — -
- Minimum permit fee: $72 50 S
Phone:( ) Fax:( ) Resid_ntial backflow minimum permit fee: $36 25
CCB Lic.: APlumbing Lic.no.: _ Plan review (25%of permit fee)
�I State surcharge(11%of permit fee)
Authorized signature: _ _ •%[moi' �f/ _ _
TO"fAL PERMIT FEE
LPrint name: Date: _1/':2e�� This permit application expires;(a permit 13 not obtained within
180 days after It has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Servict Board
i\Building\Pemiits\PLMFPrrmttAppdoc 12/03 ta0-4616T(10,02/C0M/WEE)
�r
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sum) ession Systems:
FA IK
Qty. Ile �l� S4,, y
Footing drain- 1"100' 5300 0 to 2,000 --- $11500
Footing drain-each additional 100' 46,40 2,001 to 3,600 $160.00
Sewer-Ist 100' 55 00 3,601 to 7,200 5220.00
7,201 and greater 5309.00
Sewer-each additional 100' 46.40
Water Service-I st 100' 55.00 Medical Gas S stems:
Water Scrvice-each additional 100' 4640
Storm&Rain Drain-1st 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.30 _
Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 far the first$5,000.00 and 51 52 for each
additional$100 00 or fraction thereof,to and
including$10,000.00-
Commercial Back Flow Prevention Ikvice n46.40 $10,001.00 to 525,000 00 $148.50 for the first$10,000.00 and 51 54 for
Residential Backflow Prevention Device each additional$100 00 or fraction thereof,to
minimum permit fee$36.25) 27.55 and including 525,000.00
Rain[rain,single family dwelling 65,25 $25,001.00 to$50,000.00 $379.50 for the first 525,000 00 and$1 45 for
each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or and including$50,000.00.
specially recuested infections-per hour 72.50 550,001.00 and up $742 00 for the first$50,000.00 and$1 20 for
Subtotal: each additional$100.00 or fraction thereof
Fixture Work:
Are you capping,moving or replacing existing fixtures? It'
"yes",please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
y D
Comments regarding fixture work:
F.ttistr !Font _
Bath -Tub/Shower _
-Jacuzzi/Whirlpool _
Car Wash Each Stall
_ -Drive Thru
Cuspidor/Water Aspirator
Dishwasher -Commercial
-Domestic
Drinking Fountain
-Eye Wash _
Floor Drain/sink 2" _
3' -- _
4"
a
Car Wash Drain _
Garbage -Domestic
U) Disposal -Commercial *Note: If the fixture work under this permit results in an
_ Industrial increase of sewer FDIJs,a sewer permit will be issued and
Ice Mach./Refri .Drains
J oil Separator Gas Station fees assessed for the sewer increase must he paid before the
CO Rec.Vehicle Dump Station _ plumbing permit can be issued.
Shower -Gang
W -Stall
Sink -Bar/D.avatoty _ nanlity Total
-Bradley
-Commercial Isometric or riser diagram is required if fixture quantity
-Service total is>9.
Swimming Pool Filter
Washer-Clothes
Water Extractor Plan Review
water Closct-Toilet Plan review is required if fixture quantity total is>9.
Urinal —
Other Fixtures:
i\nuildinitTermiu\Pt M PermitArp doc 3103
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: M00121
Al 4� 13'!25 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/1171047/04
PARCEL: 2S 104AD-00200
SITE ADDRESS: 12785 SW MARIE CT
SUBDIVISION: B;-:.LWOOD ZONING: R-4.5
BLOCK: LOT:013 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: CLO DRYEI',S:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLET:
> 10000 cfm:
Remarks: Replace furnace with like kind.
Owner: _ _ FEES
ABEL, GARY B WENDY Description Date Amount
12785 SW MARIE COURT INIFC 111 Permit Fee 3117/04 $72.50
TIGARD, OR 97223 ITAX) 81%State Surchart 3/17/04 $5.80
Total $78.30
Phone: —�
Contractor:
OWNER
REQUIRED INSPECTIONS
Rhone: Final Inspection
Reg#:
L
2
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Li
Specialty Codes and a!I 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 iSSU 11•.:e, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questi+ to OUNC by calling
(50346-6699.
Issued By: PPermittee Signature:
Call (503) 6 9 4175 by 7:00 P.M. for Inspections needed the ne day
Mechanical Permit Apiplication
Received
City of TVAr DatuBy 7 Permit No ^ 1
13125 SW ball Blvd,Tigard,OR 97223 Plan Review YL!J
Phone 503.639.4171 Fax 503.598.1960 Date By Other Permit:
Inspection Line: 503.639.4175 Date Ready/3y0 See Page Z for
Internet: www.ci.tigatd.orUs Notified/Method Supp,
amental
,y-,p �G ,1119 - U!►✓(3HECKI.IST
❑New construction ❑Addition/atteration/replaceinent Mechanicil ptrmit fees'are based f the value of the work
performed.Indicate the value(roun A to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,la •,overhead,and profit.
wI .. e..... �.
N'l�'AIL 19QUIPIKINT iYSTEMS FEES"I-and 2-family dwelling ❑Commercial/industrial El building --- --1
-For special information to check:ist _
❑Mules-family ❑ Master builder E]Other- Description ---LI Ea Total
Heating/cooling
Job site address: /j ,r Air conditioning or heat pump
4
fg-cc--) C- (requires site plan showing placement) 14.00
City/State/Z1P: O/`'� Furnace 100,000 BTU(ducts vents) AL 14.00
---IFurnace 100,000+BTU ducts/vents
� l 17
Suite/bldg./apt.no.: Project name: lies heat pump _ 1400
Cross street/directions tojob site: Duct work 14.00
H dronic hot water system 14.00
Residential boiler(radiator or
N h dronic 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above lo.00
Other:_ 10.00 _
Tax map/parcel no.: Other fuel appliances
Water heater 10.00
Gas fire lace 10.00
0;__1Z1A1e 41v Flue vent for water heater or gas
fireplace 10.00
Log lighter(gas) 10.00
_ Wood/pellet stove 10.00
Wood fiteplace/insert 1000
.f
Chi mne /liner/flue_/vent 10.00
Ai r t Other: 10.00_
Name: Environmental exhaust and ventilation
Address: % ���� Range hood/other kitchen
equipment 10.00
City/CtateJZIP: �+ 0,�-Q—� Clothes dryer exhaust _ 10.00
All
� U Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet corn urtments,utili rooms 6.80
Attic/crawlspacc fans 10.00
.._ .. , PI l�_.�" y. �.. ,.
-— "`�-u" Other: 10.00
Business name: -
^__ _ Fuel piping _
Contact name: S5.40 for first four;$1.00 for each additional _
Furnace etc. _
Address: Gas heat pump
U) City/State/ZIP: Wall/suspended/unit heater
Phone:( ) Fax: :( ) `Y Water heater
J
Fireplace
E-mail: Range110 _
Barbecue
JBusiness name: Clothes dryer(gas) _
Other.
Address:
City/State/ZIP: _ _ Subtotal
Phone:( ) Fax:( ) ,_ Minimum permit fee
Plan review(25%of perr fit fee) _
CCA lic.: State surcharge(8%of per nit fee)
TOTAL PERMI','FEE
This pt;.nit application expires If a permit Is o,t obtained Athin 180
Authorized signature: days after It has been accepted as c fmalete.
Print name: Date: -Q Fee methodolog set by Tri-County Building 1.,ust.v Service Board
i\Budding\Permin\MF.0-?e. i;Appd 12/03 44"617T(I 1(02/C0MMM1s)
Mech aakal Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
r, r
$1.00 to$2,000.00 Minimum fee$72.50 _
$2,001.00 to$5,000.00 $72.50 for the first$2,000.00 and$2.30
for each additional$100.00 or fraction
_ thereof,to and including$5,000.00.
$5,001.00 to$10,000.00 $141.50 for the fast$5,000.00 and
$1.BO for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,001.00 to$50,000.00 $231.50 for the first$10,000.00 and
$1.35 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,OOL00 to$100,000.00 $771.50 for the first$50,000.00 and
$1.25 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first$100,000.00 and
$1.10 for each additional$100.00 or
fiaction thereof.
Note: All new commerelil 'ouildings require 2 sets of plans.
CL
ot;
N
N
W
i:\Building\Pemits\MEC-PrrmitApp.doc 12/03 2
CITY OF TIGARD 24-Hour
BUILDING , Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
4 BUP
Received J_//-2 1009' Date Requested Q_-5/ AM BUP
Location PM _
—[_�__- s 2/fLLA e At Suite MEC
Contact Person - -- — Ph( 0?-
2?Z---A PLM
Contractor ____ -_.__ Ph(_ ) - _ SWR
BUILDING Tenant/Owner _-v_- ELC
Footing
Foundation ELC
Ftg Drain Access: ELF! _
Crawl Drain
Slab InspectiO UtQS: SIT
Post 8 Beam _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -- — —
Firewall
Fire Sprinkler - -
Fire Alarm
Susp'd Ceiling -- --
Roof
Other: _-
Final
PASS PART FAIL
PLUMBING
Post 8 Beem----- -- -�-^
Under Slab
Rough-In
Water Service ---
Sanitary Sewer
Rain Drains - - -
Catch Basin/Manhole
Storm Drain --- --
Shower Pan
Other:
Final
FAIL -` -`--
Post F:Beam
Rough-In -
Gas Line
C
e Dampers - -- --
;EUE
PART FAIL
CTRICAL
J Service
0 Rough-In
9 UG/Slab
j Low Voltage
Fire Alarm
Final FIReinspection tee of$_� required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE J� -� u Please call for reinspection RE:e ____ _ L Unable to Ins"-no access
Fire Supply Line
ADA {�
Approach/Sidewalk ��� � -- Inspector_ ? 11F —(i[x�
Other: _
Final NOT REMOVE this Inspection record from the fob sits,
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503163%"175
INSPECTION DIVISION Business Line: (503)639-4171 MST —__`----
p Q�� BUP
Received��-_0�'_� � Date Request d, -1_4—" AM ___PM_ _ BUP
Suite------. MEC _
/ .
Contact Person 9-/44 Ph(,r� v� sh�—4r[) Lis_LT_)l --
Contractor Ph(—) _ SWR
BUILDING Tenant/Owner __...__ __—� ELC �.
Footing ELC
Foundation Access: a—
Ftg Qrain �- � � Q ELR
Crawl Drain �—
slat, Inspection s: SIT
Post a Beam _------_---_
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing --- - -------- - -
Insulation
Drywall Nailing --- -- - -- ---
Firewall
Fire Sprinkler — -- — -
Fire Alarm `
Susp'd Ceiling ---
Roo' --
Other: --
Final
PASS PART FAIL
PLUMBING
Post&Beam --
Under Slab - -- - --- ----- - —
Rough-In
Waiter Service — - -
Sanitary Sewer
Rain Drains --- --
Catch Basin/Manho
Storm Drain --
Showe Pan —
Other: -'— — —
VS
PART FAIL
_ NICAL
Post&Beam
Rough-In —
Gas Line
d. Smoke Dampers
Final
F� I PASS PART FAIL
N ELECTRICAL _
Service +^
-� Rough-In
LO UG/Slab
W Low Voltage ---- -- -----------
W Fire Alarm —�-
Final FIReinspection fee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS_ PART FAIL
31TE __ F1 Please call for reinspection RE: ___ _ L]UnFble to Inspect-no access
Fire Supply Line �j 1J
ADA IIIspeClOr '/% /✓ ^- ------ —
Approach/Sidewalk
Other:
Final _ - DO NOT REMOVE thls Inspection record from the job sib.
PASS PART FAIL