Permit . CITY OF TIGARD PLUMBING PERMIT
i rI ,x DEVELOPMENT SERVICES PERMIT #: PLM2001 -00200
'VIII DATE ISSUED: 5/16/01
13125 SW Hall Blvd., Tigard, OR 9 7223 (503) 639 -4171
SITE ADDRESS: 12025 SW ROSE VISTA DR PARCEL: 2S103CC -01100
SUBDIVISION: COLONIAL VIEW ZONING: R -4.5
BLOCK: LOT: 006 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
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: 20 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Connect existing house to newly installed sewer lateral.
FEES
Owner:
Type By Date Amount Receipt
HUFFMAN, DAVID S +
CRYSTAL F PRMT CTR 5/16/01 $72.50 27200100000
12025 SW ROSE VISTA DR 5PCT CTR 5/16/01 $5.80 27200100000
TIGARD, OR 97223 Total $78.30
Phone 1:
Contractor:
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 503 - 639 -5296 Sewer Inspection
Reg #: LIC 2439 Final Inspection
PLM 34 -29PB
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 y: j ; i 4 _ i " Permittee Signature: ! / l1j '
Call (50 ) 639 -4175 by 7:00 P.M. for an inspection needed the next I Isirreg
May 16 01 11:08a western plumbing 1 503 684 9015 p.2
05/16/01 WED 11:44 FAX 503 598 1960 CITY OF TIGARD VI 002
� U -eel 7 -
Plumbing Permit Application
Date received: c >" /'` Permitno.J t oel /'Qd'v
,, � �; Cit y Tigard
Ti and
.411 Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: 1503) 639 -4171 PrOject/appl. Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receipt. no.:
Land use approval: . Case file no. Payment type:
r TN'PE OF PERMIT
2 family dwelling or accessory 0 Comm :rcial /industrial 0 Multi- family 0 Tenant improvement
construction ❑ Addition/alteration/replacement 0 Food service ❑ Other:
JO I SITE INFORMIAI'ION FEE SCHEDULE (for special information use checklist)
B Description Qty. Fce(ea.) Total
Job ld address: , , . i_ e n S A. �/'. New I- and 2- family dwellings only:
ldg• no.: Suite no.: (i 100 R. for each utility connection)
Tax map/tax lot/account no.: ___ SFR (1) bath —_
Lot: I Block: 1 Subdivision: • SFR (2) bath
Project name: SFR (3) bath
City/county: 1
ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain y ,
Dry wells/leach line/trench drain
EsL date of completion/inspection: Footing drain (no. lin. ft.)
\IBING CON1'R.ACTOR Manufactured home utilities
Business name: �y e //7 ru /% '7 ff Manholes
Address: Rain drain connector _
City: 17 orebr al State: ?IP: Sanitary sewer (no. lin. ft.)
�! a tc /. '4":!.--le mail: Storm sewer (no. lin. ft.)
one /• ` Fax: Water service (no. lin. IL)
CCB no.: Plumb, bus. ■ . o
� � / ' Fixture or item: tic, no.: �/' .: a /�/ - Absorption valve
Contractor's re ntativa � /` - Back flow preventer
PEE g am. '�i:1Jp,�
Print nauae: �1L ;�.rlj Cate: - Backwater
valve
CONTACT PERSON MIIIIIIIIr Basins/lavatory
Clothes washer
Name: - Dishwasher
Address: .
Drinking fountain(s)
City: State: ZIP: Ejectors/sump •
Phone: Fax: E -mail. Expansion tank
OWNCH Fixture/sewer cap .
Floor drains/floor sinks/hub
Name (Mint): -
Garbage disposal
Mailing address: Hose bibb
City: 1 State: 1 ZIP: Ice maker
Phone; Fax: 1E-mail : Interceptor/grease trap
Owner installation/residential maintenance only: Tht: actual installation
Roof drain (commercial}
will be made by Inc or t he maintenance and repair nude by my regular -
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Sump - •
Owner's signature: Late: Tubs/shower/shower pan
EN GINEER Urinal .
Name: Water closet
Address: Water heater .
City: State: ZIP: Other.
Phone: Fax: E -mai : 1- Total _
Minimum fee S 7 2 • c)
Nat ,u jurisdictiau wcePt csadi cards, please oaa imisIc000 roe mote m!orntattoo. Notice: This permit application Plan review (at %) S
la Visa 4 MasterCard expires if a permit is not obtained State surcharge (8%) •••• $ _____,5_—(E-0_
Coedit cod wombat within 180 days alter it has been TOTAL ' 3-_ f_)
accepted as complete.
Nama or csrdhddse as shown m aedlt cad :
410.4616 (6t10fCOM)
Ctidboldcr iiseaflen we wuar
t 1 P
12015 SW Rose Vista Dr
FF EI =314' Approx.
11975 SW Rose Vista Dr 1
'-
FF EI =308' Approx. �CO # 1
I b /I Sto 16 +90.00
o�Gau
CONSTRUCTION NOTES UTILITY NOTES sta ,s +ao.oa po VI?
.'ziz 10 % II
O Remove Approx. 20 LF Concrete Curb & Gutter and Construct Proposed Off - street Manholes per Detail Drawing 110 -SA, Sht SS6 : .J
I
120 SF Sidewalk. Reconstruct some per Restoration. _.- Top of Off- street Manholes 3 Ft From Rim to Ground Cover.
O 2 Install 4" PVC Lateral per Detail Drawing 170 -SA, Sht 556 Construct Proposed Manholes in Street Section per Detail Drawing 010, Sht SS6 - aD - : I
O Remove Approx. 20 LF Concrete Curb and 160 SF Contractor Shall Restore Ground Cover to Topsoil in off- street Easement Areas a I��_ = _
Sidewalk. Reconstruct some per Restoration. . ! n t I
to ,
a)
cn
0 lol
Sta 16 +15
LIZ
N 12005 SW Rose Vista Dr
FF El=302' Approx. \ / 0 , O / '
FF EI =288' Approx. \` /
el■ MH #7 ,•; ,7 15 +93.58
Scale: 1"=20' MH # � ...f, o p \
Sto 14 +06 < r Q �, 1 I ; 11 0 SW Rose Vista Dr
>✓ Sto 15 +14.49 i • 1 ; . `� FF =317' Approx.
Install 4" PVC Lateral Per Detail � i� � 1 <,
0 \ per Detail Drawing Sht SS3 (Typ. % •. i j` is \
() 170 -SA, Sht SS6 411 x
1.0. �
-----1 -f.,0\ / 12015 SW Rose Vista Dr II *oft w / ,
FF EI =281. Approx. ..f ' , / )
�✓
(n PL pal -r au / i / ✓� �� ,- Remov 21 LF
Rem ove MH #5 �/ g • II, � ^ Q \
\ « Concrete Curb and 160 SF
1 1 Existing Tree Sto 13 +8 `y _ _ y, A g9 Driveway apron. Construct \
\ A MH 3 \ (Typ.) 4 Each a �. �P curb and driveway apron.
egf \
7 1- -. .q. / /
�` I'1 Sto 11+ 4 Per De tail J 12000 SW Rose Vista Dr
Sht SS3 (Typ.)
See Note o �� FF E I =315' Approx.
pal p : xxu rn Abandon Exist. — y PP ,, Droinfield
,, x a " \ - ' ...Cr z .., /A i.�Du
1 , ----- 8 ,
,, . , : 4 / z . _..„...--;,---->,._/e., i ,r
k
4
MH #2 '6.:!' SA,2� t - ry !?; ° 1�4i� ,'0 Py __ _ __ ,,---
.V`� 10' 4w e �W = h i / / o Sto 10 IE (10" Storm) =273± __../-'4' PL w ,. a P — _ __ �? __ _ i \ )r o -Dl+. Sum �ieTt� a• di r 0
IE 8" Son = 265.20 uw j 1 � /' /ppp i .t Sa. tic ✓' ° , j Drain Field _ _ Line gs_ -, ` .0 O • ,, � Ili,-• 5' Utility op ` ;' — =` . ,-,' : /� �♦ / Easement I ti -i C 1 ,. 4° 3 '...ti / . .„,1 12020 SW Rose Vista Dr •
MH # (Exist) I v(p. i V G3 - MEO M . 35 L • • ► V o PP
L ine SS -1 15' Utili E. - ent �� / / FF EI =305' Approx.
Sta 10 +00 / 1 � � 4� 00.0 Y J 4 �/ � MH #4 8
E I (N) 78 3.48 / / � Maintain Tree ZOIZ Distrib ..n Box
Sta 10 +00
10' Temporary C.O. #2 12025 SW Rose eta Dr Remove 10 L.F.Cur
�
c", / Line / Construction F`F El=286' Ap• ox. I® / Construct 10 L.F. Curb
i 1 ∎. � / Easement Lateral Connection l @ I 0 W
"
1 iii
aI
i MH #
,.d t ri
Sta 10 +57
EP / y -004,1.6, 00 R emove 40 LF 411 S0 Z . SS
Concrete Curb and ,
�
I
200 SF Sidewalk. ��
-- — iik,_
r ■ / / Construct curb and sidewalk. t. tt 1 Match /ine STA 10 +80
45 PR
VANNIE T. NGUYEN, P.E. A F.Y. 2000 -2001 SANITARY SEWER REIMBURSEMENT PROGRAM
4, 4comatI PRO,ECT MANAGER ROSE VISTA DRIVE
PRELIMINARY DRAWING PLOTTED A 'r °Illllli"'
A6(Cr /0 REVIEW ANa CaOlENTS ORRGON . t,l 'I LINE SS -1B PLAN
DO NOT USE FOR Ga4S7RU`TION HALF THE NOTED SCALE '• I.• , L. SANDERSON
December Z 2000 CITY OF TIGARD ENGINEERING DEPARTMENT SHEET
ER0NEERW 1MO
G 1EO1AN OREGON ,JI. it ,,.4 610 FILE N0. DWG NAME: MOM I mam Ilowoo I sy GIP-DO-SS-05D N: \ENG\2001 \ROSEVISTA SS •
1
FAX 1 -rnT
- CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Ins Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5'_ ( AM PM BLD
Location / 20 2) Sw vs-to 's h- Dv' Suite MEC
Contact Person Ph AS - G oJ OL• z � PLM AG / -60 20 U
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear � (�
Framing W COQ
Insulation 1
Drywall Nailing r 2 �r�Z t r).. 2 .er4.,___ ?) •
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Cy6 t ( v ri ir
Water Service
a e
ain Dram
Fin
• PART FAIL
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk /J ' l
Other Date /7-" 1 a Inspector v Ext� t/
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
+ •
V I I I 12015 SW Rose Vista Dr
. ! FF EI =314' Approx.
11975 SW Ross Vita
Appr, Dr 1 I
FF EI =308' ' CO /1
1 I ` ' Sta 18+90.00
NOTES: Sta-46+80.00 ' . � � i I
l�
1 i
1. Frame and Cover for Manhole No. 3 shall be per Detail Drawing 110 -SA j
Suburban type cover, Sht. SS6. Expose Top of Manhole 3 Ft from --\
Rim to Ground Cover. I I .> a .-1.... -. 1�Jk.,
2. All other manhole frames and covers shill be per Detail Drawing 110 -SA, , ; ` °D 3 ` J< J.h_��. J��
Standard type cover, Sht. SS6. : 0 — — — —
3. Curbs may be removed and replaced as necessary for construction of i I -2 o
tend 9 a) . ~ > 1
service laterals, or contractor may choose to use method of pipe boring `• �` • i 5 D +°„ Ir '
at
co
1' . to avoid impacts. T, I \ •
/ l' cr' I
N
Sta 16 +15 V
12005 SW Rose Vista Dr,/ \ ' 9. 3 + 0
FF EI =302' Approx / I (J) / o ir , •
FF EI = 288' Approx.
StA 15+93.58
Scale: ~ =2�� MH /8 /1;.://s.,', G iii
\ `�_ \\
11960 SW Rose Vista Dr
Sta 14+06 Sta 15+14.49 �} • Q, �� ` ' ° ° \
p Install
€ Per Deta \\ FF 317 Approx.
Sht SS3 (Typ. w 1 � ^ / ° \\\ J .
/ - - -{ L (T)P•) + s �
/ aDl °� 12015 SW Rose Vista Dr /�` .
■
/ / IF EI =288' * y 3 �P 1 i
Remo i 21 LF
(n PL � .
/ / Remove / MH /5 F P t -.2.7.-., I Concrete Curb and 160 SF
/ / , Existing Tree y Sta 13+8 . 64 5 ` g� ` Drivswa Construct
�' \ ■ " MH (bp.) 4 Each h a. �3/� a ,33,2 Y won
/ / `, a + • I +; it 5 61 �,- i " f curb and driveway apron.
/ /l Per Detail i ^�'`�
Sht SS3 (Typ.) w . 12000 SW Rose Vista Dr
/ / / \\ See Note y i 5 ; Abandon Exist. . \ ��; FF EI =315' ApproApprox. / F , / Dralnfield � . •
/ / / I `' = • "''' vy 4, , % � ,��, LEGEND & ABBREVIATIONS .
/ / / ; . I i S P SG E -' •3 .63 L.F - ' u' �.
/ / / I NH 1 `' ^ ?' �F ''` 8" PV C ^ -r' F r � \ Q ' N. ' r . % c EXIS7,JNG • / Sta 1 r 81 i ., x 8 o � t2 �7 '' t 53 28 i• � line -, ;" 6 • .. • . j+ Gaq /or Water Vdve Fence
/ IE 10" St. =273f f % f , n ° a w� _ 1 - �. : � �' t 1� s y 4 Water Meter Gas Line
IE 8 San.365.20 j ! ,,G � / ±� ' - r r.-' - / Catch Eosin Water Une
// �r „ _ 1 '%
Utility Manholes Electric Une
111 .,:, --- -- `k_ -----PL
5' Utility "—�- w = \ t 12020 SW Rose Meta 4r y
/ / 0 •6 Ai!: Easement y � ,nY _ � ,� � �';�� •� ' �
_� : Fire Hyd Telephone Une
--MH /1 (Exist) • F �;1' 7 g ' Approk.
-- \/ . /, �y`. Line SS-1 15' UtAlty Edgernent FF EI =305 Mailbox Sanitary Sewer Une
Sta 10+00
IE In =283. Maintain Tree ��
l ,, ,�, / Sta 10+00 Power Pole Storm Drain Line
Rim EI =2Z8 `� j /• `� �
( t / rivate light
/ ' !' 10 Temporary C.O. C 0 1 SSW Rose Vista Dr / „ Remove 10 LF.Curb
/ :. / Une SS -1 ? / ;won EI ■288' Appi ox \' , l ° r L F. Curb aeon Out (CO)
NEW
� ' ? / / Easement + Lot- C onnection + 1 ` d r . ! Construct 10 Guy Wire (anchor) -Sanitary-Sewer (NH) Une
I
\ / / } € l . e + r' . r Manhole (NH) •
\ a f .._1.1 — _ ` ; I Trofflc Sign
, t Tree ABBREVIATIONS
/
\, / EP � f . �� Ste 10+57 Shrube/Hsdge CO Cleanout
/ / ,. Remove 40 LF i ' � Right of Way/PL —j — MH Manhole
/ Concrete Curb and ,. l ; Curb PL Property Une
200 SF Sidewalk. �+ n ��
- 1 — - °` ST Storm Line
/ Construct cu4+ and sidewalk ^�,('
SAN S
- o , Alotch!!ne STA 10+80
w _ See Sht SS4 Sanitary Une
' ','� r�^ l tr —
f(?)'1 ? V A .- C .b v` ff , ii VrwwE T. Mouror. P.E. FY 2000-2001 SANRARY SEWER RENBt1R8E1rENT PROGRAM
°"O."T """"°°` II , ROSE VISTA DRIVE
k •-° 0 ) 7
V DRAWING PLOTTED AT •••• r Li E 88-1 PLAN
(A HALF THE NOTED SCALE ` , o avn+a o cm' OF TIGARD DEPART/ENT
NT
` \\\\ �;t ` � a+oNma+a i[o�o,w OREGON was NW. IMO. F'R.E NO. MSG NAPE: SHEET
•
1 °'M! "^"'" •`w O ..) r'"' OP-SS -01-01 II: \ENO\2oo1 \RasEhsTA SS 1
VOIM INt M4-7717