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13740 ,SW Ash Avenue
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection. Line: 639-4175 Business Lir e: 639.4171 --- --
BDP
I Z'O►�� —Date Requested--- - A1lIPM 9LD --
Location Suite MEC
Contact Person _ Ph .�7-�7 �f� _ PLM 'L ?�_ �
Contractor __. _ —� Ph SWR — —_
,BUILDING Tenant/Owner ELC —_
Retaining Wall M ELR
Footing Access:
Foundation FPS
Fig Drain 'GN
Crawl Drain Inspection Notes' ----- - —
Slab _-_ _ .---- T-,-_-- SIT
Post&Beam -- - --
Ext Sheath/Shear
int Sheath/Shear -_- -
Framing _T_
Insulation � ---- ------ -- ----- -------------- -
Drywall Nailing —_----
Firewall �% -�
Fire Sprinkler
Fire Alarm �\ �
Susp'd Ceiling —`
Roof F
Misc: -
Final
PASS -PART FAIL -
in
Post R Be2m
Under Slab
fop Ovt
Water odc
SeweF- — - - --
jigi Drains
PAR T FAIL
iw"AWCAL - -- -
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 ( J Reinspection fee of$ r _ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ )Please call for reinspection RE: _ [ J Unable to inspect-no access
Fire Supply tine — -- ---
ADA
(Appruach/Slde walk
Other Date _� Inspector_ �� Ext
anal
LPASS PART FAIL. 00 NOT REMOVE 01s inspection record from the job site.
PLUMBING PERMIT
CITY OF T I GA R D
DEVELOPMENT SERVICES PERMIT#: PLM2001-00016
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/23/01
SITE ADDRESS: 13740 SW ASH AVE PARCEL: 2S102CD-03001
SUBDWISION: FREWINGS ORCHARD TRACTS ZONING: R-4.5
BLOCK:— LOT: 030 _ JURISDICTION: TIG
CLASS OF WORK: A.l_T GARBAGE DISPOSALS: IWOBILE BIOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUP�,NCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURFS_ LAUNDRY TRAYS: SF RAIN DRAINS-
SINKS: URINALS: GREASE TRAPS:
L-AVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: 130 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of sewer line for new sewer connection. Septic tank to be eitl !r pumped, filled and inspected, or
removed.
Owner: FEES ----_.—_
KAHUT, JAMES J + SUSAN D Type By Date Amount Receipt
13470 SW ASH AVE PRMT CTR 1/23/01 $101.40 27200100000
TIGARD, OR 97223 5''CT CTR 1/23/01 $8.11 27200100000
Total $109.51
Phone 1: — -- - ---- -
Contractor:
MINUTE FENCING
10422 NE KILLINGSWORTH
PORTLAND, OR 97220
REQUIRED INSPECTIONS
Phone 1: 503-251-7446 Sewer Inspection Y -
Reg #: LIC 107391
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of f✓R.
Specialty Codes and all other applicable laws All work will be done in accordance with approved plans.
This permit will expire if work is riot 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 thm,.jgh OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: r" _ - Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed t e ext business day
CITYOF TIGARD — SEWER CON NEC TION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-00019
1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/23/01
SITE ADDRESS; 13740 SW ASH AVE PARCEL: 2S102CD-03001
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: R45
BLOCK: LOT: 030 _ JURISDICTION: TIG__
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPIF OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit. Septir. tank must be properly abandoned by either pump, fill grid
inspection, or by removal.
Owner: _
KAHUT, JAMES J + SUSAN D - FEES _
13470 SW ASH AVE Type By Date Amount Receipt��
TIGARD, OR 9722.3 PRMT CTR 1/23/01 $500.00 2.7200100000
INSP CTR 1/23/01 $35 00 27200100000
Phone: — _
Total $2,335.00
Conti ctor: "--
MINUTE FENCING
10422 NE KILLINGSWORTH
PORTLAND, OR 972.20
Phone- 503-251-7446
Regi: LIC 107391
Required Inspections_
Sewer Inspection —
Septic Tank Filled
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires
180 days from the date issued The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given If not so located. the installer shall purchase a"Tap and
Side Sewer' Permit and the Agency will install a lateral Al'ENTION Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center Those rules are set forte in OAR 952-001-0010 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987
Issued by: "d" —_ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M for an inspection needed th ext business day
Plumbing Permit Application
Date received: �/^3 D / Permit no,•q�,j��/��JpJ/
City of Tigard Sewerrmit no.
pe g�V1-D(,rJ/,7 Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of Tigard Phone: (503) 639-4171 ProjecUappl.no.: Expire date:
Fax: (503) 598-1960 Date issued: B • Reccipt no.:
Land use approval: _ Case file no.: Payment type:
LJ I &2 family dwelling or accessory 0 Commercial/industrial U Multi-family ❑Tenant improvement
U New construction U Addition/alteration/replacement U Food servii e U Other.
FORMATIONJOI)SITE IN
Job address: / 3 JU .S llescription (ply. I ee(ea.) Total .
Bldg.no.: New I and 2-fancily dwellings only:
(InTludes 1001t.for each utility connection)
Tax map/tax lot/account no.: SFR(1)bath
Lot: Block: Subdivision: SFR(2)bath
Project name: - SFR(3)bath
City/county: 7 ZIP: Each additional bath/kitchen
Description and I17tion of wo •on premises: Site utilities:
Catch basin/arca drain
Est.dale of completion/inspc ctian: D wclls/leach line/trench drain
1 Footing drain(no.lin.ft.)
MENEM Manufactured home utilities
Business name: ,,Z/ �' M:nholcs
Address: ® L- -J lGL/. a,7 _ Rn- drain connector
City: _ State: ZIP: 7pi,l� Sanitary sewer(no.lin.ft.) i_'o /D/ Y /oi
Phone.: Fax: li nrtil Storm sewer(no.lin.ft.)
CCB no.:�D�� y/ Plumb.bus.reg.no: Water service(no.lin.ft.)
Fixture or item:
City/metro lie.no.: ''-
Absorption valve
Contractor's representative signature: Back flow preventer
Print name: /� Datc: Backwater valve Rob's MINE M014611��
Basins/lavatory _
,J � Clothes washer
Name:
Dishwasher
Address: _
-- I LL/ � Drinking fountain(s)
City: 5tate�v Z1P: �� Ejectors/sump —
Phone: /• Fax: E-mail: Expansion tank
Fixture/sewer cap
Name(print): 9A-Y kr Floor drains/floor sinks/hub
Garbage disposal
Mailing address: -$ wc? 4&j Hose bibb
City: T A-—A-4 State. jVEJ ZIP: ;3 Ice makcf
Phone: Fax: I E-mail: Interceptor/grease trap
Owner installatiotl/resi dential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: _ Date: Sump
LL Tubs/shower/shower pan
Urinal _
Name: Water
---- closet _
Address: Water heater__
City: State: ZIP: _ Other: - -
Phone: Fax Email: Total
-
Minimum fee................$
Not all)uritfictiorn acceq credit code,l4eaae call jutim iction for more infornutlon. Notice:*his permit application ,
❑visa ❑MasterCard Ilan review(el ,_. 91+) $ _
expires if a permit is not obtained /
Credit card numb. ______— — — 1 within 1 SO days after it has been State surcharge(896)....$ _2 1�_
t:xvlre� TOTAL . $ /U
Name of cardholder we-shown oncredit cud
accepted as complete.
_ s _ , X35 DO
--- Cudhdder dpWure Amount oC 4/0.4616 16010170M)
10170M)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES (IndivlduaD-_.- QTY ea AMOUNT (Includes all plumbing fixtures in PR!CE TOTAL
Sink 16.60 the dwelling and the ftrst100 ft. QTY (ea) AMOUNT
for each utility connectlonl
Lavatory ---- - 16.60 - _-- pne(1)bath _ - $249.2_0 -
Tub or Tub/Shower Comb. 16.60 Two(2)bath _ $3_50.00
Shower Only 16.60 Three 3 bath - $399.00
Water Closet - 16.60 -- - _ SUBTOTAL _
Urinal 16.60 _ 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL.
TOTAL
Garbage Disposal 16.60 -- - -_--
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" - 16.60 PLEASE COMPLETE:
3" 16.60
4^ 16.60 -_ - - -- - -
Water Heater O conversion O like kind 16.60 Quantic b Work Peliormed__
Gas piping requires a separate mechanical Fixt• a Type: New Moved Replaced Cappemoedl
permit - Ca ed
MFG Home NewWater Service 46.40 Sink
Tub
or
MFG Home New Sart/Storm Sewer 46.40 T _
Tub or Tub/Shower
Hose Bibs 16.60 Combination _
Roof DraI s! 16.60 Shower Only -._
Drinking Fountain 16.60 Water Closet
---•- Urinal
Other Fixtures(Specify) 16.60 Dishwasher_ _
Garbage Disposal _ - -
-Laundry Roorn Tray _
Washing Machine
_ Floor Drain/Sink: 2" _
Sewer-1st 100' / 55.00 �Z) 3"
Sewer-each additional 100' 46.40 y� c 4" -_-
Water Service-1st 100' 55.00 Water Heater _
Other Fixtures
Water Service-each additional 200' 46.40 S eci -
Storm&Rain Drain-1 st 100' 55.00 _
Storm 8 Rein Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40 - - - ----
R esidential Backflow Prevention Device' 27,55 -�
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections perthr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 ---
Grease Traps 16.60 - --- -- -----
QUANTITY TOTAL
Isometric or riser diagram is required It
Ouantity Total is >9
"SUBTOTAL ---- --
8%STATE SURCHARGE ----
"PLAN REVIEW 25%OF SUBTOTAL
Required only it fixture qty total is>9
�- TOTAL
*Minimum permit fit Is$72 50+8%state surcharge,except Residential Backllow
Prevention Device,which is$36 25•8%state surcharge
"All New Commercial Buildings require plans with Isometric or riser diagram and
plan review
lldsts\fonns\plm-fees.dof� 10/10/00