9732 SW LONDON COURT 9732 SW London Court
�\ CITY OF
TIGARD _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00124
DATE ISSUED: 4/3/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 1 S 135CD-08000
SITE ADDRESS: 09732 SW LONDON CT
SUBDIVISION: LONDON SQUARE NO.2 ZONING: R-25
BLOCK: LOT: 032 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: 5( WASHING MACH: BACKFLOW PF,-VNTRS:
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/SHOWEr<S: SEWER LINE: ft
WATER CLOSET S: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install water heater. _ __ ---I
F:t-- --- --- FEES
Owner: --- Description Date Amount
MARCIE BROWNI I'I \lltl Permit FCC 4/3103 ` :,72 50
9732 SW LONDON CT
TIGARD, OR 97223ti�,itr"lax 4/3/03 $5.80
Total $78.30
Phone : 503-267-9,199
Contractor:
r>U,INER
REQUIRED INSPECTIONS
Final Inspection
Phone
Reg 't:
This permit is issued subject tc 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 160 days. ATTrNTION; Oregon law requires you to follow rules adopted by the Oregon
Is'ue.i By: �f �f,1' Malt C� Permittee Signature: ,-
Call (.503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Fiixtt'"s I , ,
l�lu�lj�? 7_L (')I-)(���t A���)fli�'illll�)�ll Received Plumbing
Date/D !�3 �+B Permit No?_#1-Z&-) -'d01-Z
Planning Appruval Sewer
City Of Tigard Date/B : PermitNo•: _
13125 SW Hall Blvd. Plan Review Other
Datc/D : Permit No.: _
Tigard,Oregon 97223 Post-Review land Use
Phone: 503-639-4171 Fax: 503-598-1960 DatciD : Case No.:
Internet: www.ci.tigard.or.us Contact Juris.' See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: _ Supplemental Information.
�,E OF WORK— FEE*SCHEDULE(for special Information use checklist
ENew construction Demolition
Desert tLn v Qty. Fce(es.) Total
New I-&2-f:untly dwellings
Additio //alteratign/replacement Other: Includes 100 ft.fol each utilit connection
CATEGORY or CUINs I'RUCTION SFR(I bath 249.20
&2-Family dwellings Comtnercial/Industrial SFR 2 bath 350.00
p Multi-Fatnil 5FR 3 bath 399.00
pAcccsso wilding as.0u
Master f3uildt'r Other: Each additional bath/kItchen
Fir,s 'inkier Pae 2
JOEL SITE INFORMATION and LOCATION Site Utilities
Job site address: Catch basin/area drain 16.6(1
Suite#: Bld ./A t.#: — pr ell/leach lin,/trench drain 16.60
Pro'ect Name: !� — Footing drain no.linear ft. Pae 2
Cross street/Directions to job site: Manufactured home utilities i IO.Oo
Manholes 1 G.GO
Rain drain connector I G.GO
Sanitar sewer n,. linear ft. Pae 2
-- —T� Storm sewer no.linear fly_ Pa e 2
Subdivision: _ ____�.—L_ot # — Pae 2
Water service no.linear ft.
Tax map/parcel 4 Fixture or Item
nESCRIPTION OF WORK Abso tion valve _ 16.60
Backflow reventer Pae 2
A1�Q r p�L--- Backwater valve 16.60
--- Clothes washer IG.GO
_ --- Dishwasher I6.Go
Drinkin fountain 16.60
RO:'CRTY OWNER — TENANT E'ectors/sum _ 16.60
ame: _ (�L(t t_L- 7:5CD_tAZY�._ _ Ex ansion tank 16.60
Fixture/sewer ca 16.60 _
Address: - � i Fluor drain/floor sink/hub 16.60
C1tV/StUte/Ll : _ A7aa_ Garba a dis osal _ 16.60
Phone:501....Iax: Hose bib 16.60
TI—_ tAPPLICANT CONTACT PERSON Ice maker 16.60
Interce tor/ rease tra 16.60
Name: _ _ ----- — Pae 2
-- — Medical as-value: S
Address: _ --.-- — Primer __ 16.60
City/State/Zip: ___—__._ Roofdrain commercial 16.60 —
FaX: Sink/basin/lavatory16.60
Phone: -- Tub/shower/shower niin 16.60
E-mail: — Urinal 16.60
CONTRAC►nit water closet 16.60
Business Name: Mia r_C a p " p l t„� NVjtcr heater 16.60
Address: �� _ Other:
City/State/Zi : 0& q 2 as Other. _.
_._— � Plumbin>;Pcrmlt Fees*
Phone: 503 a6--g Pax- — Subtotal s
CCB 1.tC. #: Plumb. LIC.#: M.mimum Permit Fee$72.50 S
Authorized Residential Backflow•Minimum Fee$36.25 _
Signature: bate'--9-3-1 -'3' Plan Review t,5°o of PCI mit Fee S
�— �� State Surcharge L 6 of PermiRr.At Fee S -
-- (Please print n�l T OTAL PERMIT'FEE. S
Notice: This permit application explres if a permit is not obtained N ithio Allen diagram o facial buildings require 2 sets of plans with isometric or
Igo days after U has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board.
i:\Dsts\Permit Fomu\PImPermitApp.doc 01/03
Plumbinp Permit Application -City of Tigard ,
Page 2 - Supplemental Information `
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ca) Total Square Foote e: Permit Fee:
Footing drain- I" 100' 55 0 to 2,000 5115.00
M
45.40
2,001 to 3,600 $160.00
Footing drain-each additional 100' 3,00, to 7,200 $220.00
Sewer• I st 100' 5500 7,201 and 1greater $309,00 _
Sewer•each additional 100' 46.40
Water Service-Ist I(V 55.00 Medical Cas S stems'
Water Service-each additional 100' 46.40 Valuation: Periait Fee:
Storm&Rain Drain-I st 100' 55.00 $1 00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-cacti additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 fur each
additional 5100.00 or fraction thereof',to and
Fixture or Item Qty. Per (ea) Total including$10,000-00.
C'o iai back Flow Prevention Device 45.4(1 "10,001 00 to 525,000.(10 $14!,.50 for the first 510,000.00 and 51.54 for
ke Biro .I IiackflOW Prevention DC1'ICe eac,additional$100.(x)or fraction thereof,to
27.55 __ and including$25,(M.00.
..;ino n. ,permit fee$35.25) 0(11.0
525, 0 to$50,00(1.00 $379,50 for the first$25,000.00 and$1.45 for
Rain Drain.single family dwelling 55.25
each additional(100.00 or fraction thereof,to
Inspection of existing plumbing or end includin $50,000.00.
specialty requested ins ctions-per hour 72.50 $50,001.00 and up 5742.00 for the first$50,000.00 and$1.20 for
Subtotal: each additional$100.00 or fraction thereof.
Fixture Work.
Are you camping,11loving or replacing existing fixtures? If
"yes",phase Indicate work performed by fixture. Failure to
accurately report fixtures could result 'n Increased sewer fees*. Comments regarding lixulre work:
uanlit b PlxUtrc Work 1`crformed
Fixlurm T-pe: Replace
_ New Moved Fxlslln Ca )cd
Baptistry/Font - --- --
Bath -Tub/Slower _
-Jacuzzi/Whirl sol
Car Wash -Each Sall --- — -- --
-Drive Thru _ __—
Cus idor/Water A.
Dishwasher -Commercial
-Domestic
Drin ing Fountain _
Lj ec Wash
Floor Drain/sink -2" _-Y
.4"
Car Wash Drain *Note: If the fixture work under this permit results In an
Garbage -Domestic increase of sewer EDUs,a sewer permit will Ile issued and
Dispe3ai -Commercial fees assessed for the sewer increase must be paid before the
-industrial
Ice Much./Refer .Drains plumbing permit can be issued.
Gil Separator Gas Station
Rcc.Vehicle Dump Station
Shower -Gang
-Stall
tiink -Bar/i.avutory
-Bradley _
-Commercial
-Service
swi Ming Pool Filter
Washer-Clothes
Water Extractor
Water Closct.1 ollet
Urinal
Other Fixtures:
0139tsTcm•Mit Fomjs\plmPcrrnitAppPg7.doc 01103
/ "�"'P1. /� �� �_ MECHANICAL PERMIT
CITY
ITY O e
DEVELOPMENT SERVICES PERSUE #: 4/3/03MEC23-00170
13125 SW Hall Blvd., Tigard, OR 97223 (503) 630-4171 DATE ISSUED:
PARCEL: 1 1513 S135CD-08000
SITE ADDRESS: 09732 SW LONDON CT
SUBDIVISION: LONDON SQUARE NO.2 ZONING: R-25
BLOCK: LOT: 032 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: VEN"r SYSTEMS:
STORIES: BOILERSICOMPRESSORS 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 DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: !
> 10000 cfm:
Remarks: Install(2)gas liipin,e outlets lM fireplace an(l kcatcr heater.
Owner: FEES
MARCIE BROWN Description Date V Amount
9732 SW LONDON CT �ti11.('I I 1 Permit 1-cc 4/3/03 $72.50
TIGARD, OR 97223 I'I AX 1 Kit;,5tatc'I'as 4/3/03 $5.80
Total $78.30
Phone: 50-207-9499 —
Contractor:
NW GAS LINES
ANTHONY M YOUNG
16731 NE WASCO ST REQUIRED INSPECTIONS_____
PORTLAND, OR 97230 Gas Line Insp _
Phone: 503-250-2430 Mechanical Insp
Reg #: LIC 131136
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 rules are set forth in OAR 952-001-00
Issued By: �X'[h .Q,,�.�� t_ Permittee Signaturely/ /mL D ..'.=A.'.'Vu11-1 _
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanic.al Permit Application m ct,anfcal
Datc/B : '� _G. Permit No.>lCICd-003 -UQ/1D
Planning Approval Building
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use
Datc/B : Case No.:
Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for
24-hour Inspection Request: 503-6394175 Name/Method: Supplemental Information.
_ TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
New construction _ Demolition Mechanical permit fees*arc based on the total value of the work
Addition/alteratiott/re-place __ Other: performed. Indicate the value(rounded to the nearest dollar)of all
CA]EGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit.
I & 2-Family dwellingCommercial/industrial Value: S See Pate 2 for Fee Schedule
Accesso Buildin Multi-Family RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCHEDULE
Description QtY T FeRea-7 _Total
Master Builder LJ_Other: _ Heatin Cooun
JOB SITE INFORMATION and LOCATION Furnace-add-on air conditioning" 14.00
Job site address_�7 a Lznlnn�� Gas heat pump 14.00
Suite#: Bld ./A t.#: Duct work 14.00
Project Name: H drodic hot waters stem 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters(fuel,not elcctris)
in wall,in-duct suspended,etc. 14.00
Fluc/vent for any or above) 10,00
Subdivision:— Lot#: Repair units _ 12.15
Other Fuel Apt iliances
Tax map/parcel #: _ Water heater �(G _ 10.00
DESCRIPTION OF WORK Gas fireplace 10.00 10,bt
Fiue vent(water heater/gas fire lace) 10.00
Log lighter(Bas) — 10.00
A Wood/Pellet stove _ 10.00
Wood fireplace/inscrt 10.00
_ Chimne /liner/flue/vent 10.00
PROPERTY OWNER TENANT _ Other: 10.00
ame: ' Environmental Exhaust&V_entilatlon` g � Range hood/other
kitchen equipment 10.00
Address: 1?3;�,�� _ Clothes dryer exhaust 10.00
Cit /State/ZlpL. �LSingle duct exhaust
Phone: 503 Fax: (bathrooms,toilet compartments,
APPLICANT CONTACT PERSON utility rooms _ 6.80
Name: Attic/crawls ace fans 10.00
Address: _ Other: _ haat Pi In 1000
Cit /State/Zi : I "05.40 for first 4,$1.00 each additional
furnace,etc. _ ••
Phone: I rax: --��—_ Gas heat pump '•
E-mail: _ Wall/suspended/unit heater '•
CONTRACTOR Wete_r heater ••
Business Nang;: �as�� he S f Ire a face — — •�
Range ••
Address: BB
Cit /Stair;/Zip: Clothes dryer as *'
Phone: 503 Other: ••
CCB Lie. #: 1 13 Lo _ _ Total.
Mechanics!Permit Fees* _
Authorized O _ Subtotal: S _
Signature: Date:�I-.3- 3 -- Minimum Pennit Fee$72.50 S _
T Plan Rcvicw Fee(25%of Permit Fee) S
(Pie a print name) State Surcharge(8%of Permit Fee S _
--- TOTAL PERMIT FEE S _
Notice: This perndt application expires its permll Is not obtained Aitlihi "Fee"let lindol)gy set by Tri-County Building Industry Service Roard.
180 days after It has been accepted as complete. **site pian required for extirlor A/C unfts.
013sts\Permit Dorms\MecPermitApp.doe 01/03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule: _
Total Valuation: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
$5,001.00 to$10,000.00 $72.50 for the first 55,000.00 and$1.52
for each additional$100.00 or fraction
thereof,to and including$10,000 00,
S 10,001.00 to$25,000 00 S 148.50 for the first S 10,000.00 and
$1.54 for each additional$100.00 or
fraction thereof,to and including
$252000.W
$25,001.00 to$50,000.00 $379.50 for the first$25,000.x1 and
$1.45 for each additional$100.00 or
fraction thereof,to and including
$50,()00.00.
$50,001.00 end up $742.00 for the first$50,000.00 and
$1.20 for each additional$100.00 or
fraction thereof.
Assumt d Valuations Per Appliance:
Value 'total
Description: Qty (Ca) Amount
Fumace to 100,000 1311),including 955
ducts&vents
Furnace>100.000 BTU including ducts 1,170
&vents _
Floor furnace includin vent _ 955
Suspended heater,wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
<3 hp;absorb.unit, 955
to 100k BTU
3-15 hp;absorb.unit, 1,700
101 k to 500k BTU
15-30 hp;absorb.unit,501 k to 1 mil. 2,310
BTU
30-50 hp;absorb.unit, 3,400
1.1.75 mil.B'ru
>50 hp;absorb.unit, 5,725
>1.75 mil.BTU
Air handling unit to 10,000 cfm 656
Air handling unit>10,000 cfm 1,170
Non-portable evaporate cooler 656 _
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
I loud served by mechanical exhaust
Domestic incinerator 1,170
Commercial or industrial incinerator 4t590
Other unit,including wood stoves, 656
inserts,etc.
Gas piping 1-4 outlets _ 360
Fach additional outlet 63
TOTAL COMMERCIAL
VALUATION:
iADstsV'ermR FnrmsNMecl'ermi1AppPg2.doc 01103
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 5
MST _
INSPECTION DIVISION Business Line: (503)
-.� BUP
Received — Date Reques d_ 11 - AM PM BUP
Location Suite — MEC 'd O U
Contact Person —1_ Ph( ) Sa - 35 3 PLMContractor_ _ -__-_. Ph(. ) -_-_ SWR _
BUILDING Tpnant/Owner __ - _ ELC -
Footing ELC
Foundation Access:
Ftg Drain ELR --_-
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam --_Shear Anchors 3;36
� --
Ext Sheath/Shear
Int Sheath/Shear
Framing --
Insulation �"�� 44
Drywall Nailing -- --- �—— --
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -- -- --------- ---- --
Roof — ------ — _— —-- -------�
Ocher:
Final
_PASS PART FAIL -- --- -- -- -�-- --- —
PLUMBING - ----- --- ----- -- - ---
Post& Beam •
Under Slab ---- -- --- -- -- — —
Hough-In
Water Service —------ ----- -—
Sanitary Sewer
Rain Drains -- -- --- -- — --
Catch Basin/Manhole
Storm Drain ------ ---_— _-. — — — ---
Shower Pan
Other: _ -------- ---------- --
Final
P T FAIL -- — -�-- �� --- —
ECHANI L -------- -- ----- — -- -
Pos eam
Rough-In (,l%�'����� --- ---- - — ----- -------- -
Gas Line
SC e Dampers --
ASS_ PART FAIL -----
.CTRICAL
Service -- --_.-.� _--- — — —------------ ----
Rough-In — ---- -- ------------ ------ _—
UG/Slab
Low Voltage
Fire Alarm
Final
lPART FAIL F-1Reinspectionfee of s. required before next inspection. Pay at City Hall, 13125"."W Hall Blvd.
PASSSITE n Please call for reinspection RE: _— —_ -- Unable to inspect—no access
Fire Supply LineADA '''��
Approach/Sidewalk Date -_ �—G _ Inas-Gator__— % - -- ut---
Other.
Final DO NOT REMOVE this Inspeatlon record hom the job sko.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: d175 INSPECTION DIVISION Business Line: 71 MST _.
BUP
Received ._ Date Requested__ A — AM PM�'� BUP
Location — 01111 �, �si�.R,� —Suite MEC
Contact Person — — — __ Ph(—) 3 S^�3PLM __ �1�0 /_d_l
Contractor Ph(_—___) SWR
BUILDING Tenant/Owner _—.__—__—__ --. ELC
Footing W!
Foundation Access:
Fig 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 ----- _ ----__-.-- -- _--_—.
Fire Alarm
Susp'd Ceiling ------ - -- -- -----
Roof
Other:------- - --- _ ------- -
Final
PA �PART FAIL --
--- -
LUMBIRO -- --- --
Post& Beam
Under Slab
Rough-In
Water Service --- --- -- ---
Sanitary Sewer
Rain Drains ----- --- - -- - --- ----
Catch Basin/Manhole
Storm Drain --- --- - - - -- ---------
Shower Pan
VPPA'Sgi) PART_ FAIL
IHANICAL _ _—
Post&Beam
Hough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage —_---
Fire Alarm
Final Reinspection fee of$- required before next inspection. Fay at City Hall, 13125 SW Hall Blvd
_PASS PART FAIL r_�
SITE [� Please call for reinspection RE:_ u Unable to inspect no access
Fire Supply LineADA
(�
Approach/SidewalkDeft A+/\, -_--�--- Inspoder-- � — F-r f
Other:-
Final DO NOT REMOVE this Inspection record from the job shoo
PASS PART FAIL