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12210 SW SUMMER CREST DRIVE N N O I• I_ 12210 SW SUMMER CREST DRIVE CITY OF TIGARD 24-Hour BUILDING Inspection Lire: (503) 639-417F MST INSPECTION DIVISION Business Line: (503; F,39-4171 BUP Received _ _— _—_ Date Nequested--�" AM_-- PM��_. _ BUP Location Z Z la � __L1 Suite L^— _— MEC Contact Person 4/ —_ Pt,1 ) 10 'Lt—v o 7_'Z _ PLM 3 — 00 oZy Contractor — _ _— _ Ph( _) . _ SWI BUILDING TenanUOwne. � '__� y 3 / _ __ E.LC Footing �'-"- Foondgl,on __.�.. ELC - Ftg Drain Access: ELR Crawl Dra'n Slab Inspection Nates. -_ — -- Si7- 0o.:t&Beam - Shea. Anchors - --- - -- - - - Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing — -- - - - - �' -- - -- - -- --- - Firewall Fire Sprinkler --- -- - --- ------- Fire/alarm SuspdCeiling ----- - -- C�"' -- -- -- Roc.f Other: _ --- - - Final PASS PAR r FAIL PLUMBING -� !"vst&Beam Under Slab ---- -- -- Rough-Ir --- -- ----- ------�- _ Water Service --- - -.----- --- Sanitary Sewer Rain Drains - -- -- --------- ------------------ Catrh Basin/Manhole & ,n Drain — _ ------ ---- - --._----- - ----- - S',ower Pan Other: _- ,------._.-------- ----- - ---�--- PART FAIL -- - ------ _- - --- ----- MECHANICAL Post R f3easn _— ----•-------------_-__-.--------_.._. Rough-In __ ------ ------ -- ---- -- Gas Line Srroke Dampers -- -- ---- ---- Final PASS PART FAIL -- ------ ----__ -- ----- -- -- - ELECTRICAL Service -"— ----- --- ----------------- - -------------- Rough-In -- - ---- --- - --- UG/Slab Low Voltage -- -- - -- - - - - ---- - ---- --- ----- Fire Alarm Final r J Reinspection tee,if$—__-._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd, PASS PART FAIL SITE Please call for reinspection RE:----- --_ - Unable to inspect-no access Fire Supply Line ADA Approach/Sidewslk Daft—___ -_-- Inspealstlsr Othet: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIOARD 24-Hour BUILDING Inspection Lire: (503) 639.4173 INSPECTION DIVISION Business Line: (503) 639-4171 MST Blip Receil,ed Date Req, ted— - // _ AM__ PM -- BLIP Location _- LZ0 29 Suite MEC Contact Person _-_ Com- Ph(—) PLM Contractor_ " — Ph( ) SWR _ BViLDING Tenant/Owner — —_ _ ELC Footing ELC Foundation Access: Ftg Drain i Cn ELR Crawl Drain Slab :nspection Notes: SIT Post&Boam �� . A C.>;3 1 Shear Anchors Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywall Nailing -- - Firewall - Fire Sprinkler --- -- - -- - --- ---- ---- -- Fire Alarm G Susp'd Ceiling -- — -- Roof Other:- ---- ---- --�7 Final PASS PART FAIL --- ------ PLUMBINGi Post& Beam ------"_- Unuer Slab _-- - _. -------____-- - --. - — Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: Final PASS PART_ FAIL -— `-- -"— -- MEC_HANICAL Post& Beam --- "-- ---- --- - -- —.-v Rough-In -— - --- --- - - - Gas Line Smoke Dampers - ------ _ — Finaf" ASS P)lRT_ FAIL - - — --- _CTRICAL n Service -- - L 9� ------ ------- Rough-In �_ UG/Slab Low Voltage Fire Alarm - Final Reinspection fee of$ required before next inspection. Pay at City Ha!I, 13125 SW Hall Blvd, PASS PART FAIL SITE _ Please call for reins coon RE:— Unable to inspect-no access Fire Supply Line ADA / Approach/Sidewalk Hato '0~ It1* 0r Other: Final PAR71" FAIL DO NOT REM OVE this inspection record f om the J slte. PASS CITYOF TIGARD C� PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00234 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/30103 PARCEL: 1 S134CI3-02800 SITE ADDRESS: 12210 SW oUMMER CREST DR SUBDIVISION: SUMMER HILLS PARK. ZONING: R-4,5 BLOCK: LOT_ 026 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: `aF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; T RAPS: STORIES: WATER HEATERS: 1 CATCH BASINS. FIXTURES LAUNDRY TRAYS: SF RAIN DkAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 50 ft DISHWASHERS: RAIN DRAIN: ft Remarks. Replace electric with gas water heater. Revised 6/17/03 for addition of 50'of water service and (3)hose bibs. _ FEES_ Owner: -- Description Date Amount DUFF, DON W + MARTHA S I'LUMBI Permit Fee 5/30/03 $72.50 12210 SW SIJMMCRCREST DR I FAXI KIN,State Tux 5/30/03 $5.80 PORTLAND, OR 97223 II'LUMRI Permit fee 6/17/03 $48.90 (TAXI 9",/n State Tax 6/17/03 $3.92 Phone : 503-590-8431 Total $131.12 Contractor: _ COLUMBIA PLUMBING 6e26 SE HARNEY STREET PORTLAND, OR 97206 REQUIRED INSPECTIONS Final Inspection Phone : 503-775-8487 Reg#: I.IC 117709 I'[ \1 26-603Pt] This permit is issued subject to the regulations contained in the Tigard Municipal Code State of OR. Specialty Ccdes and all ether 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 Permittec Signature Issu a BY: s "� Call (503) 394175 by 7:00 P.M. for an inspection needed the next business day Kuifitiing I,lixtures Ph—ti;,ini! Permit Application Received�� Plumbing r Jate/B l� Permit No.�� Q�1 City of Tigard Planning Appr nl Sewer —7 Date/By: Permit No.: 13125 SW Ball Blvd. Plan Review — - Other - Tigard,Oregon 97223 Da Permit No- Phone: 503-639-4171 Fax: 503-598-1960 Post-review land Use Internet: www.ci.tigard.or.tts Date/By: I Case 24-hour Inspection Request: 503-6394175 Contact See Page 2 for Name/Method: _ uPplemental Information. _ TYPE OF WORK FEE*SC11EDtILE for s�cclal Information use checklist ❑New construction _ Demolition Descri ptiut ►t _— OIy. I Fec(ca,l Total Addition/alteration_re lacenienl Other New I-&2-family dwellings CATEGORY OF CONSTRUCTION (includes 100 ft.for each utllitv connection 1 &2-Family dwelling Commercial/Industrial SFRLIJbath 249.20 SFR 2 bath _ 350.00 Accessory Building Multi-Family_ �- SFR(3)bath 4399.00 Master Guilder Other: — _ _ Each additional barhukitchen 45.00 JOB SITE INFORMATION and L_OCATION -Fire sprinkler �sq. ft.: Pa c 2 Job site address: (,) d L �,, �"7 ft ,7 Site Utilities Suite#: _ Bldg./Apt.#: Catch basin/area drain _ 1�,60 Project Nat?te: _ Dr ell/leach line/trench drain 16.60 Footing drain(no.linear R.) Pa�e 2 Cross street/Directions to job site: age Manufactured home utilities _ 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer no. linear ft. Pae 2 Subdivision: _ _ -I T,ot#; Storm sewer(no.linear ft.) Pae 2 Tax map/parcel #: Watcr service(no. linear ft.) _ Pa c 2 _ DESCRIPTION OF WORK AbsorptionFixture or Item valve 16.60 Backflow preventcr _ Pae 2 Backwater valve 16.60 Clothes washer _ 16.60 Dishwasher I6.60 _ �PIZOPF.RTY OWNER ___ TENANT ^-- Drinkil. fountain 16.60 - — - — jectors/sump 16,60 Name: OL-,-i �_/'/ Expansion tank 16.60 Address: �, �,1 �� Fixture/sewer cap 16.60 City/State/Zip: Floor drain/floor sinVhub 16.60 Garbage disposal 16.60 Phone: Fay: Hose bib 16.60 WICAN'T CONTACT PERSON - -- ------ Ice maker 16.60 _ Name: -_ - _ Interceptor/grease trRp 16.60 Address: Medical gas-value: $ page 2 ------------ Ctt /State/Zi : rimer 16.60 --- Roof drain commercial 16.60 Phone: FaX: Sink/basin/lavato 16.60 E-mail:` _ Tub/shower/shower an 16.60 CONTRACTOR Urinal -16.60 Business Name: �. h I t..�h.'r, S Water closet 16.60 Address: (, Water hcatcr 1 16.60 Other: City/State/zip: f' /-7-. 0;4 e 6 Other: --- — Phone: Fax: ]] `a'1 _ Plumbing Permit Fees* CCB Lic_#: ( I 7 70�" Plumb. Lic.#: ��'-F�_P/ _ subtotal $ Authorized �D Minimum Permit Fee$72.50 $ Signature 1� �--- - Date: Residential Backflow Minimum Fee$36.25 Plan Review(25%of Permit Fee $ —_-_ - State Surcharge 8%of Permit Fee) $ (Please print name) — -- TOTAL PERMIT FEE $ �d^ Notice: This permll npplicallon expires If a permit Is not obtained'Altham All new cmmerclal buildings regr.;re 2 sets of plans with Isometric or Igo days after It has been accepted as complete. riser diagoram for plan review. *Fee methodology set by Trl-County Building Industry Service Board. i\Dsts\Permit Fomv\PlmPcrmitApp.doc O!103 Pidmbing Permit Application - City of Tigard Page 2 - Supplemental Informati,m Fee Schedule: Residential Fire Suppression Systems: _ Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- I" I(HY 55(x) 0 to 7000 $115.00 Footing drain-each additional 100' 46.40 2,001 to 3,600 — $160.00 -- 3,601 to 7,200 _ $220.00 — --- Sewer-Is(Ioi), 55.00 _ 7,201 and greater_ $309,00 - Sewer-each additional I W' 46.40 - WaterService-Ist I(V -_- 55.00 Medical Gas S 'stems' Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain Drain•Ist 100' 55.00 $1.00 to$5,000,00 Minimum fee$72.50 Storm&Rain Drain-each additional IA' 40 40 $5,001.00 to 510,000.00 $72.50 for the first$5,000.00 and$1.52 lir eac[, additional$100.00 or fraction thereof,to and F'Ixtureorltcm Qty. Fee(ea) Total including$10000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to 525,000.(x1 $148.50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee$36.25 27.55 _ and including$25,000,00. Rain Drain,single family dwelling 65.25 $25;701.00 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 srx,:ially requested inspections•per hour 72.50 __ and including$50,000.00. Subtohl: - $50,00,00 and up $742.00 for the first$50,000.00 and$1.20 for each additional$100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing lixtures:' If "yes",please indicate work performed Sy fixture. Failure to accurately report fixtures could result in Increased sewer fees*. _Qu■ntlt by Fixtt re Work Performed Comments regarding fixture work: Fixture Type: Replace _ New Moved Pllsting Capped -- Ba tis( /Font Bath -Tub/Shower -� -- - •Jacuzzi/Whirl �I - Car Wash -Duch Stall -Drive Thru Cuspidor/Water Aspirator -- - Dishwasher -Commercial -Domestic Drinking Fountain — — --Eye Wash Floor Drain/sink -2" -3 Car Wash Drain *Note: If the fixture work under this permit results in an Garbage -Domestic Disposal -Com-,ercial increase of sewer EDUs,a sewer permit will he Issued and -Industrial fees assessed for the sewer increase must fie paid before the Ice Mach./Refri .Drains_ plumbing permit can he issued. Oil Separator Gas Station Rec._Vehicle Dump Station _ Shower -Gang -Stan Sink -Bar/Lavatory -Bradley -Commercial _ -Service _ Swimming Pool Filter _ Washer-Clothes _ Water Extractor _ Water Closet-Toilet _ Urinal Other Fixtures: i:\DsLc\Petmitromu\PlmPermitAppilg2.dm 01/01 l CITY O F TIGARD __MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00269 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/27/03 SITE ADDRESS: 12210 SW SUMMER CREST DR PARCEL: 1 S 134 C B-02800 SUBDIVISION: SUMMER HILLS PARK ZONING: R-4.5 BLOCK: LOT: 026 JURISDICTION: TIG CLASS OF WORK- ALT, FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: t STORIES: — BOILERS/COMPRESSORS HOODS: FUEL TYPES0 3 HP: !� _ DOMES. INCIN: t ; _ 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: _AIR HANDLING UNITS CLO DRYERS: FURN >=100K BTU: <- 10000 cfm: OTHER UNI I"S. > 10000 cfm: GAS OU1 LEI S: 017) Remarks: 1�cplacc furnace and AC unit. AC cannui he pLiced in the required cibacks. 6/10/03 Add gas and venting for water heater. Owner: _ FEES DUFF, DON W + MARTHA S Description Date Amount 12210 SW SUMMERCREST DR PORTLAND, OR 97223 [MECH] Permit Fcc 5i27'03 $72.50 [TAX]90%,StateTar 5/27103 $5.80 Phone: 503-590-8431 _ Total $7830 Contractor: WESTERN HEATING + A/C 14314 SW ALLEN BLVD STE 220 REQUIRED INSPECTIONS BEAVERTON, OR 97005 -- -- ---� Phone: 618-5808 Heating Unt Insp Cooling Unt Insp Reg #: LIC 76978 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 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those ru'3s are set forth in OAR 952-001-00 Issued By. ; cLsg _ / Permittee Signature: _ Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business clay cation Me b_ Aml Permit Aun Datc/B d Permit io: . Date/B :�'��'�' L PcrrnitNo.: '�'.. 'C`C's; �- Planning Approval Building City of Tigard Data fay: _ Permit No.: 13125 SW Hall Blvd. Plan Review other Dete/B : Permit No.: Tigard,Oregon 97223 Post-Review Land Use Phcne: 503-639-4171 Fax: 503-598-1"60 Date/B _ Case No.: Interne±' www.ci.tigard.or.us Contact J_u_ris.: See Page 2 for 24-hour 1,,spection Request: 503-639-4175 A Namc/Method: I Su lemental Information. TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST i� JeW cons J Detnolition Mechanical permit fees*arc based on the total value of the work 4cw con/alteration/re lacement ❑Other: performed. Indicate the value(rounded to the nearest dollar)of all mechanical materials,equipment,labor,overhead and profit. CATEGORY OF CONSTRUCTION Value: $ See Page 2 for Fee Schedule pJobsitcaddrcss: 2-Famil dwelling r Commercial/Industrial RF.StDENTIAL E UIPMENT/SYSTEMS FEE*SCHEDULE essory Building Multi-Family Descri tion t Fee(ea. Total ter Builder Other _ In Looting_ JOS SITE INFORMATION and LOCATION urna - add-on a' conditionin • �' 14.00 Gas heat Pump --_�_ 14.00 U Lv SN4w-22 14.00 11ite .. Bl •/Apt•#: Duct work H dronic hot water system 14.00 j'ect Name: -. Residential boiler .xoss street/Directions to job site: for radiator or h dronic s stem 14.00 Unit heaters(fuel,not electric) in wall,in-duct sus ended etc. _ 14.00 Flue/vent for any of above 10.00 Repair units 12.15 Subdivision: Other Fuel A (lances Tax map/parcel # Water heater _ ___ _ _ 10.00 DESCRIPTION tOFWORIKGas fire lace 10.00 Flue vent(water heater/ as fire laceIo.UO 1.u.�''-1-�1:�.--�--•`f Lo li iter(Bas) 10.00 10.00 _ -- Wood/Pellet stove Wood fire lace/insert 1000 -- - Chimne /liner/flue/vent 10.00 TENANT Other: 10.00 PROPERTY OWNER __-� - Environmental Exhaust&Ventilation Name f)� _� j f�- Range hood/other kitchen equipment 10.00 Address: f f�� '1r/ �x�''��Ott �J/ ST ni1�` Clothes dryer exhaust 10.00 City/State/Zip: c7 ' Single duct exhaust Fax: (bathrooms,toilet compartmems, CONTACT PERSON _ utility rooms 6.80 Attic/crawls ace fans — 10.00 Name: w — other: 10.00 —- Address: _______—___— Fuel Piping, Cid/State/lip: —_ ___ **AX.40 for first 4.$1.00 each additional Fumace,ctc. Phone: _ ` ` ' Fax.— Gas heat pump ** — 1Wall/sus ended/unit heater E-mail: _ .. CONTRACTOR Water heater _ -- _Fire lace ±� Business Name' Ly ;r&,,7,flZe Ran c _ �j Clothes drver�a� ** cit /State/ 1�f:_ `� — ♦* Phone: $��= Pax:_ Other: - Total: �� Mechanlesi Permit Fees* _ ccB I'ie. #: Authorized r _ Subtotal: 5 /� /y -� Signature: �G 'J' r�.--- Date= Minimum Permit Fee$72.50 S _ Plan Review Fee 25°/.of Permit Fec S State Surchar a 8%of Petmit Fee S _ (Please print name) TOTAL PERMIT FEF. S Notice: This permit application expires If a permit is not obtained within •Fee methodology set by Tri-Cunt)Bullding Industry Service Board. —site plan required for exterior AK'units. Igo days after It has been accepted as complete. _ is\Dsts\Permit Forms\MccPcrmitApp.doc 01103 Mechanical Permit App icatiop - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: _ Pern,�it Fee: $1.00 to$5,000.00 Minicnum fee 572.50 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction _ theroof,to and including$10,000,00._ $10,001.00 to$25,000.00 $1411.50 for the first$10,000.00 and $1.!4 for each additional$100.00 or fraction thereof,to and including $25,000.00. $25,(N11.00 to$50,000.00 $3'19.50 for the first$25,000.00 and V 45 for each additional$100.00 or t'rection thereof,to and including $°0,000.00. $50,001.00 and up $742.00 for the first$50,000,00.and $1.20 for each additional$100.00 or fraction thereof. Assumed Valuations Per Ap Mance: _ —_—`� Value Total Description: _ t Ea Amount Furnace to 100,000 BTU,including 955 ducts&vents -- Furnace> 100,000 BTU including dlet9 1,170 &vents Floor furnace including vent 955 Suspended heater,wall heater or floor 955 mounted heater Vent not included in appliance permit _445 Ke air unite _ 805 3 hp;absorb.unit, 955 to I00 HTU 3-15 hp;absorb.unit, 1,700 101 k to 500k.BTU 15-30 hp;absorb.unit,5ol k to 1 mil. 2,310 BTU _. 30-50 hp;absorb.unit, 3,400 1-1.75 mil.BTU >50 hp;absorb unit, 5,725 >1.75 mil.HTIJ — Air handlin ug_nit to 10,000 cfm 656 Air handlinpunft>10,000 c1'm _ 1 1170 Non-portable evaporate cooler 656 Vent fan connected to a single duct_ 446 Vent system not included in appliance 656 rmit _ Hood served by mechanical exhaust 656 Domestic incinerator 1,170 Commercial or industrial incinerator 4,590 vcs _ Other unit,including wood ato656 inserts,etc. _ Oas piping I-4 Wallets _ 350 _ Each additional outlet 63 TOTAL COMMERCIAL VALUATION: is\Dsts\Permit Forms\McePermitAppPg2.do': 01103 y 1 J 3''�lll Rgil