8910 SW MCDONALD STREET-1 1S OIVNOa3W NQS 0169
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8910 SW MCDONALD ST
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CITY OF T I G A R D BUILDING PERMIT
PERMIT#: BUP2003-00519
DEVELOPMENT SERVICES DATE ISSUED: 9/3/03
131251 SW Hall Blvd.,Tigard. OR 97223 (503) 639-4171 PARCEL: 2S111AA-01000
SITE ADDRESS: 08910 SW MCDONALD ST
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS_ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TY"!: -F CONST: sf N: S: E: W:
OCCUPAW;Y GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
w BSMT?: MEZZ?: _ READ SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HHDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Remarks: Deino existing house. NO SEWER CREDIT FOR THIS HOUSE.
All debris to be removed. Septic tank to be pumped, filled and inspected.
Owner: Contractor:
FOUR D DEVELOPMENT FOUR D DEVELOPMENT
PO BOX 1577 PO BOX 1577
BEAVERTON, OR 97075 BEAVERTON, OR 97075
Phone: 503-590-0805
Phone: 503-590-0805
Reg#: 603-590-08mM37
_ FEES REQUIRED INSPECTIONS
Description Date Amount Purnp/Fill Septic Tank Insp
[BUILD] Permit Fee 9/3/03 $62.50 Final Inspection
[TAX] 8%State"Tax 9/3/03 $5.00
[ERPRMT] Erosion 9/3/03 $26.00
1 FRPLN] Ero Plck-1 ISA 9/3/03 $8.45
(additional fees riot listed here)
Total $110.40
IL
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
N and all other applicable law. 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 tha, 180 days. ATTENTION: Oregon law
-� requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rubs are set forth in OAR
m 952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct quc—tions to OUNC by
W
calling (503)246-6699 or 1-800-332-2.344.
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Issued By: t L�et f. ei .
Permittee
Signature:
Call 6394/445 by 7 p.m. for an Inspection the next business day
Buildiii Prr it K1111 till]M&
—r �- —
Receive
Building
-- Date/B : _-- Pemnt No.W E 3 -Ge)5/9
Cit of Tigard / Planning p oval Other
�' g SEP 0 3 2UO3 Date/By- _ Permit No:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: —_ Permit No.:
Phone: 503-639-4171 Fax: 56X15 gjf9WAl i Post-Review Land Use
Internet- www.ci.tigard.or.us I IUILUING DIVI'' Done CaseJurisNo See Page 2 for
24-hour Inspection Request: 503-639-4175 NameRvlethod 7/(7 Supplement4lntormation _
New construction Demolition
Addition/alteration/re lacement Other:
Note: Permit fees'are based on the total value of the vork perfo Indicate
the value(rounded to the nepre:'dollar)of all equipment, als,labor,
1 &2-Family dwelling Commercial/Industrial I overhead and profit for the woi indicated on this a ation.
Accessi► BuildingMulti-Family
ElMaster Builder Other: Valuation................. �\................. ............ S __
No.of bedrooms: o. aths: —
Job site address: ► Total number of(loot's..... ..... ..................... _
New dwelling area )............... ... ........
Suite#: _ Bldg./Apt.#: - _ Garage'c
carport (sq.ft.)..................... .
Pro'ect Name: �,''R64.as Ws ej- s�3 Covered po area(sq.ft.).............................
Cross street/Directions to job site: Deck ar sq.ft.)............................................ _
Other s cture area(sq.ft.)............................
Subdivision. Lot#:
Tax map/parcel #: 7Note: Pees•are.based on the total value of the Mwork pert d. Indicateded to the nearest dollar)of all equipment,ma als.labor,
it for the work indicated on this applica
'7 N a.w
-- Valuation................ ..................................... $
Existing building area ft.).................. .....
_ —
New building area(sq.ft. ................ .......... -- �—
Number of stories................... ...... .. ............ --
Type of construction.................. .................
Name:
_
Occupancy group(s): xisting: _
Address: D, _
City/State/Zip: 07.5
Phone 3-S v-per Fax. .503^ O-/ / NOTIC/nR
tors and subcontractors are re ed to be
licensedon Construction Contractors Boar der
provisiand may bP required to be licensed in eBusiness Name: S'R,., _Ahi jurisdick is being performed. ]r the applicant is xempt
Contact Name: from liclowing reason applies:
o. Address: —
QC
-City/state/zip: _
0 Phone: _ Fax:
E-mail:
a
to Business Name: Fees duc upon application.............................. S_
F3
w Address: --
J City/State/zip: Amount received............................................. S
Phone: Fax: Date received:_
CCB Lic. #: D / 1-o — -- —
Authorized Notice: This permit application explres If a permit is not obtained within
Signature: / _ Date: 3— 180 days after It has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
(Please print name) r
i'\DstsTermit Formc\B1dgPermitApp.doc 01/03
C t^f A1 �(s) feogien� Cc J L
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)63A-4171
BUP
I
Received q_—Date Requested_ � ��` AM_— PM ---_ BUP _--
Location C Suite —_ MEC —
Contact Person --__— Ph(�l-�?2 ) — 04 3a PLM —_— —_
Contractor _ _ Ph( ) SWR �.
BUILDING Tenant/Owner .—.__ _— ELC —_—
Footing
Foundation Access: ELC --
Ftg Drain ELR ---_—
Crawl Drain
Slab Inspection Notes: SIT — —
Post&Beam ---
Shear Anchors —'- —
Ext Sheath/Shear
Int Sheath/Shear —
Framing ------- -- ---- --
Insulation
Drywall Nailing — -- — ---
Firewall
Fire Sprinkler
FireAlarm
Sus —�
Susp'd Ceiling -- --
Roof, '
ofr: - ---- __
ASS PART FAIL
Post R Beam
Under Slab LIZ _Rough-In
Water
Water Service —
Sanitary Sewer
Rain Drains ----- - -
Catch Basin/Manhole
Storm Drain — -- — —
Shower Pan
Other:fiWS-S/ PART FAIL — —
ANICAL ----- —--- — -- —
Post&Beam
Rough-In
Gas Line
IL Smoke Dampers -- -- - -- --- -- -
Final
PASS PART FAIL --- —-�
} ELECTRICAL —
F- Service
J Rough-In
m UG/Slab
Low Voltage
_j Fire Alarm
Final Reinspection fee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reins p ctIon RE:_ — Unable to inspect- no access
Fire Supply Line
ADA
Approach/Sidewalk Date "� Inspector _ Bxt—
Other:
Final DO NOT REMOVE this InspectiollV. cord from the job site.
PASS PART FAIL
Al CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00628
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 12/18/03
PARCEL: 2S 111 AA-01000
SITE ADDRESS: 08910 SW MCDONALD ST
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
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: ft
WATER CLOSETS: WATER LINE: 930 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of 930' of private water service for lots 2, 22, 23, 24, 25, 26 &27.
FEES
Owner:
Description Date Amou�t
FOUR D DEVELOPMENT iPLUN1131 Permit Fee 12/18/03 7472.60
PO BOX 1577
BEAVEP.TON, OR 97075 IPLMPLN] Plan Review 12/18/03 $118.15
[TAX] 89%State Surcharl 12/18/03 $37.81
Phone : 503-720-7445 __ Total $628.56
Contractor:
BUMBLE BEE PLUMBING
PO BOX 373
TROUTDALE, OR 97060 REQUIRED INSPECTICNS
Water Service Insp
Phone : 50361R-R97R Final Inspection
Reg#: LIC 113297
PLM 26-5001113
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m This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
0 Specialty Codes and all other applicable laws. All work will be done 'n accordance with approved
LU
-J plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more pan 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Is ed By: Permittee Signature:
Call (503) 9-4175 by 7:00 P.M.for an inspection needed the next 4siness day
Building Fixtures
Plumy ming Permit Application- ueLtiyed Plumbing (�
/;� Permit No Al tl;x 15 p
City of Tigard Planning, pro%al I Sewer
Date/By: Permit No
13125 SW Hall Blvd. Plan Reviev other
Tigard,Oregon 97223 Date/By _ _ Permit No _
Phone: 503-639-4171 Fax: 503-598-191:0 Post-Review land Use
Internet: www.ci.tigard.or.us Date/By: Case No.
Ju s.: See Nile 2 for
24-hour Inspection Request: 503-639-4!75 Name/Method: Supplemental Information.
TYPE OF WORK FEE•SEH!..)ULE(for special Information use cbecklbt
New construction 1 0 Demolition Desc.lption I Qty. I Fee(ea.)_T Total
Addition/alteration/replacement Other: New 1-&2-family dwellings
CATEGORY OF CONSTRUC rION Qucludes 100 R.for teach is Ility connection)
I & 2-Family dwelling Commercial/Industrial SFR I bath _ 249.20
_
Accessory Building Multi-Family SFR 2)bath 350.(X)
SFR(3)bath _ 399.00
Master Builder 1�710thcr: Each additional bath/kitchen45.00
JOB SITE INFORMATION and LOCATION Firesprinkler-sq. fl.: Pae 2
Job site address: `�/n v i�� `7 .q[_D Site Utilities
Suite #: Bldg./Apt.#: Catch basin/arca drain 16.60
Project Name: Dry-well/leach line/trench drain 16.60 _
Cross street/Directions to job site: Q -- Footing drain no.linear ft.) Pae 2
Manufact
Sr W. MC Doll 14 t_D �' C) / 11Vc Manholesuredhome utilities 110.00
16.60
�kE�NSt�A�� Pn� �� �r�v/U/ Rain drain connector _-
.S/6 Sanitaryft
sewer(no. linear . Page
e 2 2
Subdivision: _ Lot#: Stomi sewer(no. linear fl.)
Tax map/parcel #: — Water service no. linear R.) 9 P2 D
DESCRIPTION OF WORK AbsorptionFixture or Item
valve 16.60
c ,5�JU✓/C C 1-,yr-c- /e Backflow prevcnter Pae 2
7 Backwater 16.60
^T Clothes washer _ 16.60
-- Dishwasher 16.60
Drinkin
PROPERTY OWNER TENANT DAV o d fountain 16.60
E cctors/sum 16.60
Name: U E1�E4P '� � �_ _
Expansion lank 16.60
Address: (�,�t JA,X ISI-7 Fixture/sewer cap 16.60
City/State/Zip: Ae--AyC127vtj CIF_ Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone:,5.; 7 U - 7Y 4S I Faxs"U ,590--o 17 S/ Hose bib — — 16.60
171 APPLICANT I Ll CONTACT PERSON Ice maker 1660 _
Name:le_l, M 5C �cyus7 . Mt K- JZ%Nwi Interce tor/ reale trap16.60
Address: r,o , Fj,:,X Medical pu-va!oe: S Page Z
City/State/Zip:
Primer 16.60
L U V4 �7 �`' Roof drain(commercial) 16.61'
r Phone: St.,3 - 7C;(r, -� (� Fax:g2 ,3�s_-2137 Sink/basin/lavatory 16.60
1) E-mail: Tub/shower/shower pan 16.60
CONTRACTOR Urinal _ 16.60
Business Name: F LU Water closet 16.60
Water heater
p Address: S'(') ,5,E. pcv�C� 16.60
Other:
City/State/Zip: "17 ?Z--3 -Other:
Phone: c:.3 -,33c - .5637 Fax: Plumbing Permit Fees*
CCB Lic. #: /L3 Z cl Plumb. Lic.#:26 -Sip Subtotal 5
Minimum Permit Fee$72.50 S �7� C
Authorized O -� Residential Backflow Minimum Fee$36.25
Signature. _ ���G-._T_ Date:�, 'A-0 Plan Review 251%of Permit Fee S ag,
State Surcharge(8%of Permit Fee) S 7.
Please print name) TOTAL PERMIT FEE S .S
Notice: This permit application expires If a permit Is not obtained within All new commercial bulldings require 2 sets of plans with Isometric or
Igo days after It has been accepted as complete. riser diagram for plan rtivlew.
'Fee methodology set by Tri-County Building Industry Service Board.
i.\Dsts\Permit Forrm\PlmPermitApp doc 01103
Plumbing Permit Application - City of Tigard v
Page 2 - Supplemental Information
Fee Schedule: _ _ Residential Fire Su ression Systems:
_ Site Utilities _ Qty. Pee(ea) Total Square Footage: — Permit Fee:
Fooling drain- I" I(NY 55(x) 0 to 2,000 _ $115.00 _Footing drain-each additional 100' 4640 2,001 to 3,600 $160.00
Sewer- I st I(x)' 5500 3,601 to 7,200 5220.00
7,201 and eater S309.00
Sewer-each additional I IN)' 46.40 —
Water Service- I%I I(N)' 55.00 Medical Gas Systems:
Water Service-each additional 100' 46.40 Valuation: Permit Fee:
Storm&Rain Drain- I st 100' 55.00 V 00 to 55,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional I(N)' 4640 $5,001 00 to$10,000 00 $72.50 for the first$5,000.00 and$1.52 for each
F:Iture or Item Qty. Pee(ea) Total additional$100.00 or fraction therof,to and
including$10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to$25,000.00 It148.50 for the first 510,000.00 and 51.54 for
Residential Backflow Prevention Device each additional 5100.00 or fraction thereof,to
(minimum permit tee$36 25! 27 55 and including 525,00000.
Rain Drain,single family dwelling 65.25 $25,001.00 to S50,000.00 S379 50 for the first$25,000.00 and 51.45 for
Inspection of existing plumbing or each additional S100.00 or faction thereof,to
-pccially rc ucsted inspections- and including$50,000.00.r hour 71 50 550,001 00 and up $742.00 for the first S50,04 r.00 and 51.20 for
Subtotal: each additional 5100.00 of fraction thereof.
Fixture Work:
Are you caping,moving or replacing existing fixtures? If
"yes please indicate work performed by fixture. Failure to
accurate) l report fixtures could result in increased sewer fees*.
anti re)Work Performed Comments regarding fixture work.:
Fixture Type: Roptaee
New Mored Miles Cappoil Baptistry/Font
Bath -Tub/Shower
-Jacuzzi/Whirlpool —
Car Wash -Tach Stall
-Drive Thru —
Cus idor;Water Aspirator
Dishwasher -Commercial
-Domestic
Drinking Fountain ---- —
Eye Wash _
Floor Drain/sink •2"
4" _
('at Wash Drain *Note: If the fixture work under this permit results in an
Garbage -Domestic increase of sewer FDUs,a sewer permit will he issued and
Disposal -Commercial
-Dndustnal_ fees assessed for the sewer increase must be paid before the
1 Ice Mach.iRefn .Drains _ plumbing permit can be issued.
Oil Separator Gas Station)
Rec.Vehicle Dump Station
Shower -Gang
-Stall _
Sink -Bar/Lavatory
-Bradley
-Commercial
-Service
Swimming Pool Filter
Washer-Clothes
Water Extractor
Water Closet-Toilet
Urinal
Other Fixture.
i\DststPermit Forms\PlmPcrmitAppPg2.doc 01103
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)63941175
INSPECTION DIVISION Buslnesstine: (503)639-4171 MST
BLIP _
Received —_ Date Requested_a�JF --- AM —PM BUP _...
Location — g�ll7_�1 C 9.1n, Suite o MEC
Contact Person _ Ph(���) 7�" ��o Z PLM __.° G�
Contractor Ph(_--) — — SWR
BUILDING Tenant/Owner __ ELC
Footing
Foundation ELL
Ftg Drain
Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post A 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&Beam
Under Slab
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain -
Shower Pan
PASS PART FAIL
MECHANICAL
Post& Beam
Rough-In
Gas Lina
Smoke Dampers
Final
PASS PART FAIL -- ---
ELECTRICAL
Service -- � -
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$- r uircd before next ins
PASS PART FAIL F] Reins p - inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE _ Please call for reinspection RE: __ -_ _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dab InsprCtor —Ext
Other: _
Final DO NOT REMOVE this Inspection record hom the Job aft.
PASS PART FAIL