Report (99) g4c p;20/7-- De/53 - -- --- __
STATE OF OREGON
WATER SUPPLY WELL REPORT ff1q SW i l Sir C'rl�. . WELL ID#L None. .___ _
(as required by ORS 537.765) f i LES DRILLING, INC. START CARD# W1037846 -
Instructions for completing this report are on the last page of this orm •
CO OWNER: Wet Number. gL_ (9)LO A`ON OF WELL by legal description:
Name_Unitas' EXt-.aV1 •F r +., County Washington Latitude Longitude
Township 2SOUTH N or S. Range 1 WEST _ E or W.of W M.
Address 4804 NW Bethany Blvd,Ste 1-2 PMB 3 Section-IlSCB NW 114 SW 114
City Portland state OR nP 97229 — Tax lot 00200 Lot Block Subdivision
(2)TYPE OF WORK: Street Address of Wet(or nearest address) 15149 SW 161st Ave,
Er:New Well ❑Deepening !iAlteration(repair/recondition) 5C]Abendonment Tigard,OR
DRILL METHOD: (10)STATIC WATER LEVEL:
(3) 280 ft.below land surface. Date 2L1.512010_
X:Rotary Alr j Rotary Mud J Cable ❑Auger Artesian pressure_ lb.per square inch. Date
Other _—__ (11)WATER BEARING ZONES:
(4)PROPOSED USE: Depth at which water was fi �` �"`
'XIDomestic L'Community ❑Industrial ❑Irrigation
El Thermal ❑Injection `±Livestock Li Otter L dram i To _EstimateFlow Rate _SWL-_-,
(5)BORE HOLE CONSTRUCTION: _ — — -DEC 1 B -11)1
- -- CITY v�-1.161\1101\1188N
Special ConsWciion approval DYes NNo Depth of Completed Wall 0 ft.;:_
Explosives used Yes E ]No Type Amount
HOLE SEAL Amount
�UICDINC =- -
Diameter From To Material From To sacks or pounds (12)WELL LOG:
A ! 'CO MOM Wi51® 340 Ground elevation
bentonite 14 100 Sacks — -.
i Material ! From To ' EWL
I Sentonite___ 14, 0.7 Sacks-____. Ab- --
l afldQnrn�n_Only —
I !Calculated 1 85 Sacks
How was seal placed: Method DA i J B ❑C ❑D ❑E
(-Other Lumped at bottom;Poured_bentJnite — —
Backfill placed from ft.to ft. Material
Gravel placed from ft.to ft. Size of gravel —
(6)CASING/LINER: r.- iTsicietz �I -ma � ___.. - -
Diameter From To Gauge Steel Plastic Welded Threaded
Casing: 8 i 0 451 .250 [[ ii [ ❑ --5034546-2483-
Existng I I El -- ElEl n—
w: El ❑ —
None! i F; ❑ ❑
Liner.
0 ❑ ❑
Drive Shoe used ❑Inside ❑Outside ❑None
Final location of shoe(s)N/A __._ _...___ _—_ l
(7)PERFORATIONS/SCREENS:
—
— -------_--__--
:XlPerforetions Method AIr-P_@Ifer?tor --- --
❑Screens Type Material . . —
—
Slot Tele/pipe _
From To size Number Diameter size Casing Liner
0 - 45 `1!8x1 I_. .650_ _ i ,r --— -- -._ --------
.-_. __yt-
_ Date started Com feted
17 ❑ 2/15/201$ P 2116t2o18-
_ ❑' ❑ (unbonderiJ Water Well Constructor Certification:
_... , i{ Cl I certify that the work I performed on the construction,alteration,or abandon-
ment of this well is In compliance with Oregon water supply well construction
(8)WELL TESTS:Minimum testing time is 1 hour standards.Materials used and information reported above are true to the best of my
Pump i,-Bailer `Air ❑Flowing Artesian knowledge and belief.
WWC Number uS4____
Yield gavmin Drawdown Drill stem at Time Signed - ---- Date 2/19/2918
----- -----
N/A I Skyles Drilling,Inc.
I. (bonded)Water Well Constructor Certification:
II accept responsibility for the construction, alteration, or abandonment work
I performed on this well during the construction dales reported above. All work
-
Temperature of Water Depth Artesian Flow found performed during this time is In compliance with Oregon water supply well
Was a water analysis done? ❑Yes By whom _ _ construction standards. This report is true to the best of my knowledge and belief.
Did any strata contain water not suitable for intended use? ❑Too tittle ` WWC Number 1998
__Salty Muddy ❑Odor ❑,Colored ~Other Signed
' ' !." �`" 11812018 _
Depth of strata: Skyies Drilling,Inc.
ORIGINAL-WATER RESOURCES DEPARTMENT FIRST COPY-CONSTRUCTOR SECOND COPY-CUSTOMER
•
CITY OF TIGARD SITE COPY BUILDING PERMIT
III _ COMMUNITY DEVELOPMENT Permit#: BUP2017-00153
RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/13/2017
T<<'`� g Parcel: 2S108CB00200
Jurisdiction: Tigard
Site address: 15149 SW 161ST AVE
Project: River Terrace Park Subdivision: None Lot: None
Project Description: Demo(1)3,516 sf dwelling on septic and(1)2,349 sf accessory structure and(1) 105 sf accessory structure.
UPON FINAL INSPECTION, DEMO CREDITS FOR SDC FEES MAY APPLY.
Contractor: NORTHWEST EARTHMOVERS INC Owner: STANLEY,JEAN A TRUST
PO BOX 1609 BY STANLEY, JEAN A GAVIN D CO-TRS
SHERWOOD, OR 97140 15025 SW 161ST AVE
TIGARD, OR 97224
PHONE: 503-625-3100 PHONE:
FAX: 503-625-3108
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 07/13/2017 $464.97
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 07/13/2017 $0.50
Dwelling Units: 1 11x17)
Stories: Height: ft Erosion Control w/Development 07/13/2017 $107.60
Bedrooms: Bathrooms:
Value: $25,350
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $573.07
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344.
Issued By: le' `/ Permittee Signature: V/Gtk75�/_
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Inspections Required for mit No.: /341/61,20/7 7i ;3
IVR Code Type Permit Description WR Code Type Permit Description
01 BUP Building—structural 07 SIT Site Work
02 ELC Electrical 08 SWR Sewer Connection
03 ELR Restricted Energy 09 FPS Fire Protection
04 MEC Mechanical 10 RER Re-Roof
05 MST Master—residential combination 11 CMS Commercial Manufact.Structure
06 PLM Plumbing 12 SFM Single-Family Manufact.Structure
J Req'd Code Inspection Description ✓ Req'd Code Inspection Description
Building(structural)Inspections Electrical Inspections
205 Footing 105 Underground/slab cover
210 Foundation walls 110 Temporary electrical service
215 Footing drain 115 Electrical service
220 Slab 120 Electrical rough-in
225 Post/beam structural 125 Wall cover
230 Underfloor insulation 130 Ceiling cover
240 Exterior shearwall 135 Low voltage rough-in
242 Interior shearwall 140 Sign installation
245 Firewall 145 A/C or heating unit circuit
250 Roof nailing 150 Hot tub/spa/pool
255 Wtr proofing basement walls 195 Misc. inspection
260 Tilt-up panel 198 Low voltage final
265 Masonry 199 Electrical final
270 Reinforcing steel(rebar)
275 Framing Mechanical Inspections
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 _ Suspended ceiling _ 615 Mechanical rough-in
289 Approach/sidewalk 620 Hydropic piping
295 Misc. inspection 625 Duct work
299 Final inspection 630 Fire damper
635 Smoke detector shutdown
Fire Protection System Inspections 640 Exhaust hood
901 Sprinlder supply lines 645 Grease duct test
905 Sprinlder underfloor/slab 695 Misc. inspection
906 _Flush test 699 Mechanical final
907 Sprinkler hydro test
910 Sprinkler rough-in/test Plumbing Inspections
915 Fire alarm rough-in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc.inspection 312 Backwater valve
998 Alarm final 315 Post/beam plumbing
999 Sprinlder final 320 Plumbing rough-in
322 Shower pan
Site Work Inspections 330 Water service
405 Excavation 335 Rain drain
410 Fill 340 Storm sewer
415 Grading _ 345 Culvert/catch basin
495 Misc Inspection 350 Septic tank
499 Final Inspection 395 Misc.inspection
399 Plumbing final
Sanitary Sewer Inspections
505 Sanitary sewer
Erosion Control Inspections 585 Misc. inspection
750 Initial erosion control 599 Final inspection
752 LIDA on-site facility inspection
755 Regular erosion control Manufactured Structure Inspections
797 Final LIDA inspection 810 MFG-Structure set-up
798 Final erosion control 899 MFG-Structure fmal
I:\Building\Forms\Inspection Cards\AOP Insp Card By Case\InspCard_All_031816.docx