The URL can be used to link to this page

11680 SW SHEFFIELD CIRCLE 11680 SW Sheffield Circle �� I�� _ ELECTRICAL PERMIT PERMIT#: ELC2002-00067 DEVELOPMENT SERVICES DATE ISSUED: 2/20/02. 13125 S4 Hall Blvd . Tigard. OR 97223 (503) 6�3-4171 PARCEL: 1S133DC-06000 317E ADDRESS: 11680 SW SHEFFIELD CIR 13UBDIVISION: BRITTANY S©UAiPE NC'. 1 ZONING. R-12 BLOCK: LOT : 018 JURISDICTION: TIG Proiect Description: Lay underground power supply for cable TV. RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS —T__ __ MISt-_-LANEOUS 1000 SF OR LESS: _ 0 - 200 amp: _ PUMP/IRRIGATION: EACH ADD'L 5003F: 201 400 arnp: SIGN/01-111 LINE i-TG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: .AANF HMI SVC/ FDR: 601¢amps - 1000 vols: MINOR LABEL (10): _ SE_RVICE/FEEDER BRANCH CIRCUITS __ ADD'L INSPECTIONS_ 0 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION: 201 400 amp: 1st W/O SRVC OR FDR: SFR HOUR- 401 600 arrrp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION _ L1000* amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: . Recc,rinect only: SVC/FDR>= 225 AMPS: _ CLASS AREA'SPF OCC: ._ Owner: Contr::;,tor: HOAIJG. LAN P POWER TECHNOLOGY 20504 SW VENICE CT PO BOX 1766 V0 ALOI•(A, OR 97007 OREGON CITY, OR 97045 ` Phone: Phone: 503-657-0315 Reg #: LIC 129287 ELE 3-511C SUP 3575S FEES Required Inspections Type By Date —Amount Receipt Underground Cover PRPr1T CTR 2/20/02 $80.30 2720020000( Elect'/ Service Elect'/ Final 5PC T CTR 2/20/02 $6.42 2720020000( Total $86.72 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code,State of OR. Specialty Codes and all other applicable laws All avow,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 suspen0ed 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 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at(503) 246-6899 or 1-800-332-2344. Permit Signature: ! Issued By: t,,. L L ----- -- _ _ OWNER INSTALLATION ONLY The installation is being made on prope,ly I own which is not intended for sale, 1"ase, or rent. OWNER'S SIGNATURE: -- DATE: __---------- .__- CONTRACTOR INSTALLATION ONLY SIGNATURE. OF SUPR. ELEC'N: �� J �' ' / _ DATE: _ LICENSE P40: -----�� `---- Call 639-4175 by 7:00pm for an Inspection the next business day h4a tlancM lnni- 503 657-0942 P. 3 i F,lectrical Permit Applicatioa Permit no.:e-r_a(x�a �r Datetcceived% BEGEMM- Pro)ect/appl.no.: Gxpiredate: City of 'Piga -- —-- Address: 19125 5W I IoU ISlvd,Tigard,OR 97223 Uate issued: Ry Receipt na: - tuvn)7ignrd ment pa a Phone: (503) 639-4171 Case file no.: Y Ype Nax: (503) 598-1960 C111 Uk 11UAKU Land use•l,+X0v4§tJJL "T--— O Multi-family O'1'enanr improvement U 1 &2 family dwellitip or accessory i4commerctaU(ndustrial l] enrol Ncw canstrucuon U AddMmIhIltr.faltir ,,,epli cement D Other*_ tub address: f r` - bldg.no... Suite no.: JTax map/tax lot/account no.: Lot: Block: _ Sulxiivleion: Project name: r, ' �•5 Description anJ I anon of work on premises:Estimated date of c TI1111rnurJin.pecIi( Far 111Ax Job no: -- Ikseriptum - Qly. (m) "iutd no.lm Business name: U,) pY]QC -V1. n.l "A Iti t pre Address: Il _ dwcltlngtrth.Inclw ' t Ser City: rC ly ( 3Gtle: - Zi P: -t� S 1()(x)%4.(t or less__ — — — -- I'fwnc cl E-mail: _. �- S' 1 l3nch odditionul 500 u.h.ur Ilion Ihereof 2 •�1cj t I Elec.bus,lie.no: � Urni(—" eden`eIPY-resid"Lisl Z /��y-�rc-��-��h LlrnUed eucrgy,nun•rcaidentisl _ — city/ elro tic no.: V IJIJ�J Vliv Each manufacnrrcd homo or rnodulor dwelling V - Service and/or feeder - Signalure of supervising CI I inn required -- nolo 3e►vlede tiorfcen-Ilnullatlon, _ r- IC� utxu.eno. sheratlonorrelocation: Sup elect.name(prim). l 2 200 amps or less_ 201 stops to 400 amps 2—' e(print); -- _ - 401 arapeto60oampz _-- Z �. - .— _ Mauling address: �_ 601 am s to IoW Amps City. �`-- SG' � ZIP: - Over I(KKI%raps of volts Fax ,e-mail: Rccannccton+ 1�y Phone: L - — fewpurary ser rices or reedees- Uwner installution:,111c installation is hcing made on property I own installdlaa allersti"n,Or1*10"tbn: s which is not intended for sale,lease,nenl,or exchanq,r ncconling In 2110 amps vt leas �_,_. _ - 2 ORS 447,455,479,670,701. 20 I naps to 400 snips 2 Dale: 401 to 600 ata OwnU'S signature: Brehcireahs-me",oilers," aa , or extrtsslon per panel: Manic: _ A Fee(of btwtch circuits with put'llase of 2 service or feeder fee,each branch circuit Addretiti: __ - - n. Fee for hranrh circuits wit"ul purchase 2 City: - state: ZI-P _ of service or feeler fee.First branch circuit: Phone: l'H-A F' il' Tach additional branch circuil Misc.(Sertlee or feeder Sot lacladed): [ach pump ut IitillAtiou circle 2 13.1 vixover225srnpo-rorrunercisl f3Hr4atfirldo care(sctity Each.sip,noroutlinelighting _ D Scrvic�uvrx720antps-raungnf Ik2 (]Hatsrttturslncation signal circuu(s)nl alnnitedenetpypwtel, 2 family dwellings U Building over IO,txxl square feel(bur or t _ - - —__ sheroUun,or c a Ic nti ton' U Sys, III ever 600 votes nominal man•13,400 err unit'in txtr.,Inteuue _ _ — — — --— — —T ❑uildingnverthreestultes UManun,gured tpsulrrnae •Ilescn non ___ - U Occupwtl land over+l9 peruuls O Manufactured rtructures nr RV I„t4. rash rdditbtul Insper•llon over the dlowtMe In any of the atrorp: _ U E.I;ressAi)thi..,,..wt O Other _ .— - Penns ecutnt 4uMrit _cels of pbuM"many of the shove. InvaUgrrivnfu - eolanraction service. — The aboire are not applleaMe to le�lrpalllr) — _ - - Pemtit fee... ..... ..... --- HM.n Sunrlteaom auept�,r.ul math,ntaAu l+rtt.dlctlOn 1a 1 1°Itdnrnutton Nourx. fhis permit appl: arra Plan review(ret O Visa jtiAss Ward expires if a permit i51101 obtained State surcharge(R'!") .. t�7_.v_I VlLI X�•- y , within ISO days atler it Ines been TOTAL ............. $ - cl°'_tit;J�g1./j�"°'"°r� accepted as complete. -�yy44L �- 4MW41S(6A(Yt:UMI LAITY OF TIGARD _—YELECTRICAI_PERMIT - PERMIT#: ELC2003-00510 DEVELOPMENT SERVICES DATE ISSUED: 9/12/03 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 1S133DC-06000 SITE ADDRESS: 11680 SW SHEFFIELD CIR ZONING: R-1= SU'3DIVISION: BRITTANY SQUARE NO. 1 BLOCK: LOT : 018 JURISDICTION: TIG Project Description: Install (2)branch circuits to AC and furnace. _ RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 31np: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: b'WISERVICE Ori FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT- 601 - 1000 amp: ___ REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: J SVC/FDR>=225 AMPS: — CLASS AREA/SPEC OCC: Owner: Contractor: SANDRASANDAHL DAY ELECTRIC LLC 11680 c IN SHEFFIELD CIR 10130 SE 134TH TIGARD,OR 97224 PORTLAND,OR 97236 Phone: Phone: 203-997-1454 Reg#: I.IC 153273 Ll I 3-552C FEES Description Date -� — Amount Renuired Inspections I:I.I'ItM l J IiLC I'cnnu I �� $53.50 1) 1103 1 , u t $4.28 Rough-in I!\ J K "StateTax Elect'I 'incl Total $57.78 This Permit is issued subject to the rogulatlons eontaired in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordance with approved plana. This permit will expire if work Is not started within 180 days of issuance r If work is suspended for more than 180 days. ATTEN—ON: Oregon low requires you to follow rules adcoted by the Oregon Utility tification C ter. Those rules are set forth in OAR 952-001-0010 througi OAF 952-001.0100. You may obta in copies of these rules or direct que s to OU 41'(503)246.6699 or 1-800-332-2344. - 4:Z4 -� Issued Byu�–* _CJ Signa'ure: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: __ —_ DATE-_ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: __�—__—_.__- ____._ _ - DATE:___ LICENSE NO: --- Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application Irate receive . d Permit no.: City UY igard Projecttappl'. no.: Expire date: Ciia o/1'iAwrtl Address: 13175 SW Hall Blvd,Tigard,OR 97223 pate issued: B Receipt no.: Phone: (503) 639-4171 ------ Fax: (503) 598-1960 1 Case file no.: IPaymenttype Land use approval: -W-1 &2 family dwelling or accessory UCommercial/industrial U Multi-family U Tenant improvement U New construction U \ddiiioniiiiieratinnircplacenient J Other ___U Partial Job address- _0 4 4IiIJg, 11o.: tinlic m, 'fax map/tax lot/account no.: --- Lot: Block: Subdivision: _ __ _ Project name: Description and location of work on premises: At.L- Estimated date of c•om letion/inspection: -C Job no: (02, Fee Mon -- --— Business name: Dea�Ibe ply. (ea.) l oil no.lnsp Q S��,L Q.L.L. Ne«trerdderklal•trNrRletxtrtttaNl-6�Ily per Address: e) S L k 3y')-ary�J d«dtlrrRraeNIrtcNMeaonaclredtoraNe. City dl State 'LIP:Q")23 t9ee.kehclded: Phot. -!4 Fax: E-mail: l(N)a, A.or less 4 CC B no.: 1 5 3 27 3 I sec.bus.tic.no: C Each additional 51N1 . fl.or portion thereof ^_ Limited enet y, residential 2 C'e}Y/4tiptro lic,no.: 2 ,• Limited energy. non-residential Each manufactured home or mothilar dwelling Signatury of snpenisur electrician (require'lf bntc ,! Service and/or feeder 2 Sup elect name Iprnul a1�J'C� r Z J+ I,ccarc nn (✓-- Servlcesorfeeders-inmaltalloo, alter�Ilon or re Irnatlon: 200 amps or tess 2 Nactc(print): 201 amps in 4(NI amps 2 Mailing address: —— 401 ams in 601)amps 2 601 amps m) 1Won imps 2 City: _— State: ZIP: _ over IWon maps or volts 2 Phone: Fax: E-mail: Reconnect only I Owner instal lalion The installation is being made or,property I own Itraporan wrvice%orfeeder% - which is not intended for sale,lease,rent,or exchange according to Irnfallallon.sheralion.lir reloraliun: ORS 447,455,479,670.7111. _'IMI amps of Icss 2201 sial,%to 4iNI amps - —_ 2— Owner's sit natio:_ _tate: 401 to boo amps 2 Sraach circolla-mus,allerelles, or exteualoo per panel: Name: — A. Fee rot hmth:h circuit!;with purchase of Address: service or feeder fee.each hranch circuit 2 City: ZIP: —-- -H Fee for hranch circuits without purchase Phone: Faux: F.-moil: yrg� of service or reciter fee,first branch coca, I 2 — Gach adtlitinnal branch circuit Mlw.(4ervice or feeder not Included): U Service over 225 anipscornmen•ial U Ilealdremc Imilmy Goch pump or irrigation cavic U Service over 120 runt.,-mimp of I A 2 U ehvardom h,calion Each sign to outline lighting family dwelling. U Nodding over 10,1NNI syurtc lett four or Signal circuit(%)or a limited energy panel, U Systrhm over 6941 voles aminal more resulrntral units In one stntclare alterathm, fit eslensinn• ___--- _ L_ -- L_2 U Building liver thrrc shriek U feeders,4(NI amps or nt"rc •t)cscn mon U(locupnnt load over,w persons U Manul'nrlun•d Onirntnv lir R v park E aeN addNlonal Impeclloa neer IMr atbo%able loan)of rhe aMrre: — U Fgtens hghlinu plan U(Ido per ire pechon_ _. Snbrnil wl%til plain with%env tit the those. Ime.ti alg ion fee 1 he above are not applicable to lemporar) construction wrvire. Othe, Not all jurisdiction%accept credit card%.please rail jurisdiction for more inronnsrnn, Notice: This prntlil application Pearm it n review(at _.. ..%) S U Vise U Mastercard expires if a permit is not ohtained credit card number --_ l . i within 190 days after it has peen State surcharge 18%).....S Z _ f.%pre% accepted as complete 'TOTAL.........................S Name of ca Ider s+.hown,a,,rcdn,nal S Ca iu,Id .,hnalme Amorist 440.46111MIC/U010 CITY OF TIGARD 24-Hour E-911-DING Inspection Line: (583) 639-4175 MST --- --------- INSPECTION DIVISION Business Line: (F j) 39-4171 12-� 6UP — Received _ 511 _Date Requested _ AM- ___-- _ PM _ BLIP Location �L1_c',� � J 4�J � SuiteG_� —_ _ MEC 1 �� Contact Pers(,.i r Ph(`Z �) 3" Y Y PLM - Contractor - — Ph( —) _-- SWHI -- Tenant/Owner ELC BUILDING / — - - - _ -_ _ - Footing le SS ap ELC: - Foundation Access: Ftg Drain ELF Crawl Drain Slab Inspection Notes: GG I S SIT Post&Beam SI leer Anchors Ext Sheath/Phear Int Sheath/Shear Framing - Insulation Drywall Nailing Firewall Fire Sprinkler - - - - - - --- --- Fire Alarm Susp'd Ceiling Roof Other: — Fina' PASS PART FAIL — PLUMBING — — Post&Beam Under Slab _ -- Rough-in Water Service !Q,nitary Sewer Pain Drains Catch Basin/Manhole _ Storm Diain Shower!"an Other:_ — Final - PASS PART FAIL HANK --- Post&13 am Rough-In — ^__ —_- _- -- ---- - Gas Line Smoke Dampers —------ ---- - - — �. m PASS PART FAIL - --�- --�"- -- -- �-ELECTRICAL Service _—_—.-_— Service — Rough-In -- UG/Slab Low Voltage - Fire Alarm Final nalPART FAIL F-] Reinspectionfee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASSSITE _ _ Please call for reinspe tion RE:_ �— Unable to inspect-no access Fire Supply LineJ 01 Approach/Sidewalk Dart __ADAQ _. Ins o Ext---•-- Other: . LFinal DO NOT REMOVE this Inspection record ram the to. PASS! PART FAIL / CITY Old-- Ti GA R� � MECHANICAL PERMIT DEVELOPMENT SERViGES PERMIT#: ME32003-00544 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/5/03 PARCEL: 1 S133DC-06000 SITE ADDRESS: 11680 SW SHEFFIELD CIR SUBDIVISION: BRITTANY SQUARE NO. 1 ZOWNG: R-12 L'LJCK: LOT: 018 JURISDICTION: TIC CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS. OCCUPANCY GRP: R3 VENTS WIO APPI.: VENT SYSTEMS: STORIES: _BOtLF_RSICO_MPRE_SSORS _ HOODS: _ FUEL TYPES 0 - 3 HP: DOMES. INCIN: LFA; 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 • 30 HP- REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP WOODSTOVES: GAS PRESSURE: 50 + HP CLO DRYERS: FURN < 100K BTU: 1 --.AIR HANDLING .UNITS C'rHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 (;fm: Remarks: Install gas new furnace and AC, _Owner: _ _ FEES_ SANDRA SANDAHL Descriptic:i D. _ Amount 11680 SW SHEFFIELD CIR 1 Pr i I YJ 9/51 Q,72.50 TIGARD, OR 97224 8",, S(ML'1A 9/5/03 $5.80 -- Y— Total � $78.30 Phone: Contractor: ASSURED AIR COMFORT INC 2.0170S. MAY ST. OREGON CITY,OR 97045 REQUIRED INSPECTIONS Heating Unt Insp Phone: 503-880-8434 Cooling Unt Insp Reg #: LIC 00106403 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or If we-k is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules a�e set forth in OAR 952-001-00 Z el Issued By: ��,�� Permittee Signature: Call (543) C-39-4175 by 7:00 P.M. for inspections needed the next business day 09.0:, 2003 09 51 FAX 5035981960 CITY OF TIGARD (Pool Mechanical Permit .Application l carved Mechanical �r v� �, atemy Petttnt City of Tigard Piacmm Building 13125 SW Hall Blvd. � rt Re[hte/SY ma MetPermit No,: Met — — Tigwd,Oregon 97223 S1.,_� I I ! atc/8 : Permit No. �4L Pott.Review Phone. 503639`4171 Fax: 303-59 - Land vac --- LN td_B _ harnet: www,Gl.tlgatl�� ntact Ants.: See Page 2 for 24-hour Inspecdon R N txn��awd- _Z/ Supplemental tofotmado•. New consaw i0t1 _ Detnoliti0>; Me,:hanical Permit fees•are based on the total value of to work AddltYot:Jelt%retionhe lactartent Other: performed Indicate the value(rounded to the nearest dullaz)of all mechanical m?um.ls,equipment,labor,overhead and profit 1 &2-Family dweliwg C1�,onurrerctnL'I1nduStrtal V%rye: S_ Ste Page 2(or Fee Schedule — — ----------------- - Accesso Bttildin Na Multi-Pam _M I � �e teat u, royal Master Builder Other: Flrrr►ace•add-on aft contlitionmg•• T , 14.00 Job site address: //6 ..$'G•� .S .; , •-L c_r heurPuny 14,00 - --- Suite# _ Bld ./A t.tl: ihra work - / 1400 Project Nelne: ionic hot Waters stem 14.0.0 ,Zana nodal boiler -- -- CtOSS s ct/DIre.4 QfIS to site: aur radiator or bydmrdc system) 14.00 U.tit beetets(fuel,not elecinc) — -- wall.La-duct,su nded etc i41 00 _ Fl;Wyout foian- of above _7 10.00 Subdivision: Lot#: — Re tau sputa 12 l s Tax ma / creel A: Watrr beater 10.00 Gay V plate,__ — 10.00 ---- - - -- -— - _ Flue vent water hate,/Us foil low 10.00 to lighter 10.00 Wood/Pellet stove _ 10.00 -- Wood fir lace'inan 10.00 chimneynmeritluelvent_ 10.00 (Ater. - 10.00 Name: �s�r� X5'4 d� 4r �. ARange hoodlother kitchen equipment 10.00 ddress:/ © ,. , _Cit�►/State/Z� ,,.. ��TZ2cl "fin Clothes •° 1000 Phone Z r Fax; Sing a duct exhaust— (Isatltrooma,Wilat carmarrn_.s, Utihty rooms 6.80 4 Name. Artie/crawl space fens 10.00 Address: tither 10.00 Ct : p/State/Zt ___ •• s.robrf6ret-� t.00. 111110 Phone: Furnace,etc •• _-- Fax. _. Gae Deal At1IDp-- ---- E-mail waiusu edlunit hntw — •• Water hewn •• Business Name: .- — _ ••-- _�_ Address:R 0/"? t s i'1 ESRan as r Q --- at •• - --� l:lothN ar Y Phone' _48� .�r'f' — Other, — •• CCD LIc. /aG �3 —_--- Toad: ed � . s ugo. su>ytotal MwJtn tm Parrot Fee 571.50 S >; Plar,tteview Fee(25%of Pertrdt Nee) S (Plew pant name) State SurrIwIe ! of Perron Fee S Modet: Tbis pernsh appl tadoe isplres if a permit Is not obtataed wkblr • N t iWbW4•Iep art—bye-Ecru Sulking t•drpry Senleiaa IAO days affer it hu been accepted as complete. "Mabe plan ng•i,•ed for arterler APC r.tlb• cU)sr:lemut PinrroUNccYundtni>t�dcH. nl•h� �l € r� n' -- -- CITYY O C T'GAR D __PLUMBING PERMIT DEVELOPMENT SEPVICES PERMIT #: PLM2003 00468 13125 SW Hall Blvd , Tigard, O . 7223 (503) 639-4171 DATE ISSUED: 9/5/03 PARCEL: 1 S133DC-06000 SIT.E ADDRESS: 11630 5W SHEFFIELD CIR SUBDIVISION: BRITTANY SQUARE NO. 1 ZONING: R-12 BLOCK: LOT: 018 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: S` WASHING 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: 01 HER FIXTURES: TUB/SHOWERS: 1 SEWER LINE: ft WATEK CLOSETS: l"L;TER UNE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Convert water heater to gas, replace tub with new. _ _ FEES _ Owner: Description Date Amount SANDRA SANDAHI_ 11680 SW SHEFFIELD CIR I'I.t J Mlil Permit Fee 9/5/03 $72.50 TIGARn, OR 97224 i I'AXI x"„State'l'ax 9/5/03 $5.80 Total $78.30 Phone Contractor: PLEASANT VALLEY PLUMBING INC 13540 SE MT VIEW LANE CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Rough-in Insp Phone : 503-380-8124 Final Inspection Reg#: LIC 1242(15 III M 3-35411B 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: Oreqon low requires v-,-j to follow rules adopted by the Oregon Pe:mittee Signai�!re: � Is3ued BY: Call (503) 639•4175 by 7:0(1 P.M. for an Inspection needed the next business day Building Fixtures R OF WE USE'ONLY Plumbinp. Permit Application Received �, „mh!ng Dam'B : Petmrt No.: t OQd Gt0 Cit of Tigard Planning Approval Sewer City g Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 DateB : - Perrnit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Internet: www.ci.tigard.or.us Date/By: Cas o.: Contact 1 S. See Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: / Su Icmental Informat{un. iE or s eciahinfgrnnatiold'nfise; Lrcklist New consmfction _ DemolitionDescription Oh F'ccica.) Total Additton,'alteration,,re lacemen ❑t Others SFR 1 bath _ 249.20 - I &2-Family d elling Commercial/Industrial SFR 2 bath 350.00 Accessory Building Multi-Family SFR 3 bath J 399.00 Master Builder Other: Each additional bath/kitchen 45.00 ' AW�N" F!rc s nnHer-s .ft.: - -- Page 2 Job site address: �O S,ItJ, S/SFr',, ,Ul 'i' +Sitautilities Suite#: Bld ./A _t.,4: Catch basin/area drain 16.00 _ Project Name: Dr ell/leach line/trench drain 16.60 Cross street/Directions to job site: n{ ' S(c� ' C�i-._ -Footing drain(no, linear ft. Pae 2 Manufactured home utilities 110.00 Manholes _ 16.60 _ Fain drain connector 16.60 Sanitary sewer(no, linear ft.{ P e 2 Subdivision: Lot 4: Storm sewer(no. Itnear tl ) Pa e 2 Water service no. linear ft 1 Pae 2 Tax ina / arcel #: {� r 17rR t~ . RL �iX_t1fr 'Ur'Itefn R-r Abso tion valve 16.60 Backflow preventer _ Pae 2 < 0101 u J h 14 0 h r__J Backwater valve a i6.60 Clothes washer _ 16.60 Dishwasher - 16.60 Drinking fountain 16.60 -- E'ectors/sum 16.60 Name: Expansion tank 16.60 _ Address: _ _ Fixture/sewer cap 16.60 City/State/Zip: Floor drain/floor sink/hub 16.60 -- - - Garbage disposal 16.60 _ Phone: Fax: Hose bib 16.60 _.-.�, Ice maker 16.60 Name: Interceptor/grease trap 16.60 r r Medical as-value: S Pae 2 Address: 1 Primer 166. City/State/Zip: -------- -- --- --- --- - Roof drain commercial 16.60 Phone: Fax: Sink/basin/lavatory 16.60 L-mail: Tub/shower/shower pan 16.60 _C_O1111'TJ,2AC'I'f i3,, ,. Urinal _ 16.60 Business Name; ,�ifc 15 yWater closet 16.60 t /.^. Address:/.,,-, 'ir.� Water heater 16.60 ? � '! a t0" Other: City/State/Zip: C It k tt l 5 Other: Phone:r,,:)-1 3 12.'-+ Fax: t r�': #' Subtotal S CCB Lic.#; 1 .4 ; Plumb. L1C. Minimum Permit Fee$72.50 $ 7a �- Authorize _ S ��1 Residential Backflow Minimum l ee$36.25 Signature: �� u Date. Plan Review(25116 of Permit Fee) S 4, !Z'y t _ t77 �/ 5,ate Surcharge L"of Permit Feel S 5. _(Pitase print name) _ __ TOTAL PERMIT FEF S r . Notice: Tnls permit application expires if o permit Is not obtolned within All new corn rm c{al buildings require 2 sets of plans with isometric or 180 days after it has been accepted as complete. riser diagram for plan review. "Fee methodology set by Tri-County Building Industry Service Board. i:lDstslPetmit FormslPtmPerm!tApp.doc 01103 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: _Residential Fire Suppression Systems: S uuarree f4gota e: _ Permit_Feel F17_ooting drain-1"100' 55.00 0 tr' �2,000 -- - Footing drain-each additional 100' 46.40 2,001 to 3.600 _ $I tn0 00 - - 3,601 to 7,100 ___ $220.00 _ Sewer-I st 100' 55.00 7,201 and greater $309.00 Sewer-each additional 100' 46.40 Water Service-Ist 100' 55.00 Medica; Gas_Syst_Ms: Water Service-each additional 100' 46.40 w �R1 — Storm&Rain Drain- Ist 100' 5500 $1.00 to$5,000.00 Minimum fee$72 5u Storm&Rain Drain-each additional I ui' _ 46 40 $5,00100 to$10,000.00 $77..50 for the first$5,000.011 and$I 52 for cacti additional$100.00 or fraction thereof,to and r N Ft including$10,00000. Commercial Back Flow Prevention Device 4 40 $10,001.00 to$25,000.00 $148 50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to miniraum permit fee V-6.25) 27_ ,55 and includin $25,000 00. Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 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 iuclud'n $SC 000.00. Subt�•al: $50,001 00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. Fixture %Fork: Are you cappi till, mo�Ing or replacing existing fixtures". If "yes",please indicate work performed by fixture. Failure to acc,.ratel re ort fixtures could result in increased sevver fees*. t p }vor~h e'rforrnedt t f olnmcnts rcl ar•ding fixture work: Baptistry/Font Both -1'ub/Shower - --- - - --- -Jacuzzi/Whirl ool -- ('or Wash -Each Stall _ -Drive T'hru Cuspidor/Water Aspirator ----- Dishwasher -Commercial -Domestic Drinking Fountain Eye Wash ---- ----- — Fluor Drain/sink 2" -4" - - Car Wash Drain *Note: If the fixture work under,this permit results in an Garbage -Domtstic Disposal -commercial _ Increase of sewer EDC1s,a sewer permit will be issued and -Industrial fees assessed for the sewer increase must be paid before the Ice Mash./Refri .Drains plumbing permit can he issued. (.til Separator(Oas Station Rec.Vehicle Dump Station Showa -Bang _ -Stall oink -Bar/Lavatory -Bradley -C mmercial -Service _ - Swimming Pool Filter _ Washer-Clothes Water Extractor Water Closet-Toilet Urinal Other Fixtures: — i:\DsU\Permit Forms\P1mPermitAppPg2.doc 01/0.