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Permit A CITY OF TIGARD PLUMBING PERMIT I II DEVELOPMENT SERVICES PERMIT #: PLM2001 -00351 ll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/15/2001 SITE ADDRESS: 15088 SW 107TH TERR PARCEL: 2S110DA 07200 SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5 BLOCK: LOT: 033 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 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: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. FEES Owner: Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT CTR 08/15/2001 $36.25 27200100000 1672 SW WILLAMETTE FALLS DR. SPOT CTR 08/15/2001 $2.90 27200100000 WEST LINN, OR 97068 Total $39.15 Phone 1: 503- 557 -8000 Contractor: MOODY ENTERPRISES INC PO BOX 713 ESTACADA, OR 97023 REQUIRED INSPECTIONS Phone 1: 503 - 630 -5532 Final Inspection Reg #: LIC 5973 PLM 11717 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: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: 4,1 � �� L Permittee Signature: c, l) Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day rfsTaoo / -00037 Plumbing Permit Application Date received: ( /';',./0/ Permit no. ;PLilzaD / -z3 o25/ 'Pill C Td ,. City of igar Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: 1366 Receipt no.: Land use approval: Case file no.: Payment type: TYPE OF PERMIT ❑ ) & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family 0 Tenant improvement c'eNew construction O Addition/alteration /replacement U Food service U Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: / J cT _ f S, t u i /'77-// T Description Qty. Fee (ea.) Total Bldg. no.: I Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: 3 3 I Block: I Subdivision: SFR (2) bath Project name: f1 , e /`10 f ./r -,'l jib' SFR (3) bath City /county: T ,, a t I ZIP: rj- 7 2 Each additional bath/kitchen Description and location of work on premises: ,f',"J.c'X /P4C Siteutilities: Catch basin/area drain Est. date of completion/inspection: Drywells/leach line/trench drain PLUMBING CONTRACTOR Footing drain (no. lin ft.) Manufactured home utilities Business name: 0 d ii rti ey,, ,s,',' rti' c'. Manholes Address: RC; /g,t 7 /3 / Rain drain connector City: FSlgta I State:() / I ZIP: 7 70 2,3 Sanitary sewer (no. lin. ft.) Phone:&,y -6 /t) 5 5 2. I Fax:$ 4 1 1 E -mail: Storm sewer (no. lin. ft.) CCB no.: /17/7 I Plumb. bus. reg. no: 6'V 73 Water service (no. lin. ft.) City /metro lic. no.: Fixture or item: /l Absorption valve Contractor's representative signature: La, e , ""./7 4 ,1 . 07.17.7/7' Back flow preventer r Print name: , 4 , ;✓ e ,4 f J Date: 7 51 o/ Backwater valve • ('ONTAC PERSON Basins/lavatory Name: 18 a ,; V Clothes washer Address: e, 8r 7 47 Dishwasher City: rS'7'ty'c•« I StateO2 I ZIP: 9-702Y Drinking fountain(s) Cf Ejectors/sump Phone: co 3 -C 2 4 S"7Z Fax: Set,.//t' E -mail: Expansion tank OWNER Fixture/sewer cap Name ( print): C, JP (a5,*J(J► tv/l V! Floor drains/floor sinks/hub Mailin g address: 1012 wan, BLS Ito Garbage disposal Hose bibb City: 't' �.i �/ jJ I State: e t , I ZI Ice maker Phone] • Woo I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me o e / : •ntenance and repair made by my regular Roof drain (commercial) _ employee on the p r 1 , wn as per ORS Chapter 447 Sink(s), basin(s), lays(s) _ Owner's signature: a Date: 19 i O / Sump Tubs/shower /shower pan Name: Urinal Address: Water closet Water heater City: I State: I ZIP: Other: Phone: I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction f o r more information. Minimum fee $ —3 6 , ZS Notice: This permit application D Visa 0 MasterCard expires if a permit is not obtained Plan rev (at %) $ ` 9d Credit card number: / ir/ within 180 days after it has been State surcharge (8 %) $ p TOTAL $ 39 , i5 Name of cardholder as shown on credit card a ccepted as complete. $ Cardholder signature Amount 440-4616 (6/00/COM) /o//6 a / .eawnsz__ j 57 .,...• • ., rn� i. . Subject: Erickson Heights �'��v��e . a / - � 2 ' �� Following is a list of the plumbing permits issued for irrigation backflow devices that are being voided and 80% of the permit fee will be refunded to the plumbing contractor, Moody Enterprises Inc. Refund calculations: 1) $36.25 @ 80% = $29.00 refunded to applicant 2) $36.25 @ 20% = $7.25 retained by City of Tigard for administrative costs 3) $2.90 state surcharge is non - refundable. L 0 Site Address Permit # $ Refunded $ Non- refundable 10888 SW Kable St. PLM2001 -00389 $29.00 $10.15 No F1S7 10856 SW Kable St. PLM2001 -00337 29.00 10.15 0 200 '3"/ #' 3 10832 SW Kable St. PLM2001-00338 29.00 10.15 tJ /t >' 4 10810 SW Kable St. PLM2001 -00339 29.00 10.15 5/2- f /. 8 10652 SW Kable St. PLM2001 -00340 29.00 10.15 gaol /3 ' 10630 SW Kable St. PLM2001 -00341 29.00 10.15 /t f 10600 SW Kable St. PLM2001 -00330 29.00 10.15 00-53 f 10559 SW Kable St. PLM2001 -00388 29.00 10.15 NO /ISM CIO 10510 SW Hoodview Dr. PLM2001 -00342 29.00 10.15 , o0/ cliff Z 1 10501 SW Naeve St. PLM2001 -00343 29.00 10.15 2aoo -It ' 20 10503 SW Naeve St. ' PLM2001 -00344 29.00 10.15 000 %r • / 10505 SW Naeve Stb PLM2001 -00345 29.00 10.15 .1 -,758' T 2 1050 W Naeve St. PLM2001 -00346 29.00 10.15 .2a00--.566 P 28 15210 107` Tern. PLM2001 -00347 29.00 10.15 /69 V 29 1510SW 107 Terr. PLM2001 -00348 29.00 10.15 aeoj... �¢ 3 15156 SW 107` Ten. PLM2001 -00349 29.00 10.15 76 Z 15100 SW 107 Terr. PLM2001 -00350 29.00 10.15 2001 -3“ I 1508$ SW.107` Ten. PLM2001 -00351 29.00 10.15 39 34 1066`6 SW Lad Marion Dr. PLM2001 -00352 29.00 10.15 0 00 o -/I7 f , 35 10654 SW Lady Marion Dr. PLM2001 -00353 29.00 10.15 ,2yo / 36 10537 SW Lady Marion Dr. PLM2001 -00354 29.00 10.15 aoOm- (o F o rife 10555 SW Lady Marion Dr. PLM2001 -00355 29.00 10.15 y/y T 8 10599 SW Lady Marion Dr. PLM2001 -00356 29.00 10.15 Z000 -77 P 39 10635 SW Lady Marion Dr. PLM2001 -00357 29.00 10.15 958 P 40 10651 SW Lady Marion Dr. PLM2001 -00358 29.00 10.15 20 / -// 3 Z 41 10669 SW Lady Marion Dr. PLM2001 -00359 29.00 10.15 "4 G 42 10677 SW Lady Marion Dr. PLM2001 -00360 29.00 10.15 Moo - /I5 F 43 10693 SW Lady Marion Dr. PLM2001 -00361 29.00 10.15 , ol -/ /y Z 44 10733 SW Lady Marion Dr. PLM2001 -00362 29.00 10.15 02001-1y i A • 7 15101 SW 107 Terr. PLM2001 -00363 29.00 10.15 a000 -155 1 48 15125 SW 107 Ten. PLM2001 -00364 29.00 10.15 a000 -7r, 2 r 49 15159 W 107 Ten. PLM2001 -00366 29.00 10.15 3 7 f 1528 107 Ten. PLM2001 -00367 29.00 10.15 .a9 f 158 SW Kable St. PLM2001 -00387 ' 29.00 10.15 aool- yy2 2 56 10859 SW Kable St. PLM2001 -00368 29.00 10.15 ‘ 9,00 /7/ G '$ 10889 SW Kable St. PLM2001 -00386 29.00 10.15 NO / Yy - ar) 36,5.y, d,,GS \ERi C /u o,,,�-/E ( Pu-i • d oc_ f _ .2 2. /\)oT.� /Jc -7: 3 O ITS n/ v n Al , r rrA 1 n,Cit:>,- .a._- A C ?i l BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By 4 Inspection Description Date Passed By I Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation 4 Inspection Description Date Passed By Drywall nailing Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final Final inspection PLM - Plumbing Permit Inspection Description Date Passed By BUP — Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank -�) Foundation walls Plumbing final /U /1.- y /"4/ / (r Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils Inspection Description Date Passed By • Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04 /17/01 • CITY OF TIGARD PLUMBING PERMIT 1 61 : DEVELOPMENT SERVICES PERMIT #: PL /15/20 -00351 — ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/15/2001 SITE ADDRESS: 15088 SW 107TH TERR PARCEL: 2S110DA -07200 SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5 BLOCK: LOT: 033 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 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: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. FEES Owner: -- Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT CTR 08/15/2001 $36.25 27200100000 1672 SW WILLAMETTE FALLS DR. SPOT CTR 08/15/2001 $2.90 27200100000 WEST LINN, OR 97068 Total $39.15 Phone 1: 503- 557 -8000 Contractor: MOODY ENTERPRISES INC PO BOX 713 ESTACADA, OR 97023 REQUIRED INSPECTIONS Phone 1: 503 - 630 -5532 Final Inspection Reg #: LIC 5973 PLM 11717 41 4 6.1. 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 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 mo 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 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. 114 Issued By: , _ / _ � _ Permittee Signature: Cj Call (503) 639 -4175 by 7 :00 P.M. for an inspection needed the next business day