DashNumberEnd `tom' 1 CALIPER TRIDENT MAPLES i
r .
LOT 1 •
k , ..
LOCATION OF EXISTING SEPTIC TANK AND
- I ► D AND =`
DRAIN HELD TO BE V`R FE
ABANDONED IF LOCATED ON FUTURE LOTS
AND EXISTING HO,E CONNECTED TO T `IE
EV TING SEWER SERVICE PROVIDED.
�9
- ---ION I O.-BAGS
/ _
(T�RICAQ
�■.�.��� .1�.■d.. L......6 .■.■1_ ..... �Q' =_ EXISTING PAVEMENT
TO REMAIN
Liz
SEDIMENT' FENCE - —
1EXPIREL)
i
EXISTING PWV�MENT AND
ZAPPROXIMATE LOCATION _ - - GRAVEL DRIVE SHALL BE
_ _
OF EXISTING- SEPTIC _ REMOVED AND REPLACED _
- .. . WITH TO SOI L
LINE AND DRAIN FIELD
__ .._--. ._- __--- ___-- . . .�. � ,�, �/ EXISTING TREES TO BE
REMOVED (APPROX. 8
LOT 2 - - -LOT �3 �
_ ` TREES)
WHERE EXISTING TREES ARE
REMOVED SHALL HAVE A 6'
TALL SIGHT OBSCURING
_ - NEW -15'-- PUBLIC / / FENCE ALONG PROPERTY LINE
STORM AND SANITA Y _ \'
. EASEMErVT \ - EXISTING PAVEMENT
SEWER L ` SHALL BE REMOVED
GRAVEL
i - - CON
,, NEAREST EXISTING STREET LIGHT
NEAREST EXISTING STREET LIGHT - - CON NCESTRUCTIO�� , IS AT INTERSECTION WITH 116TH PL.
IS AT INTERSECTION WITH 119TH AVE., �' `�� ,' - APPROXIMATELY 280' FROM
APPROXIMATELY 640 FROM -
•\� �:� '��,/ ��. / i �=' SE PROPERTY CORNER.
SW PROPERTY CORNER.
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- - TRIANGLE
- _ - 1 NON ACCESS VISION CLEARANCE
RESERVATION - �� ' ' . - . ` . .`: :' .� EXISTING 15' PUBLIC STORM EASEMENT
R.O.W. LINE -.— -.- - R.O.W. LINE
_ _ 5' P.U.E. _. - -- - - - -- - - - - - -- - - — �" ,
— .�
.!• • • �� • • i • • -� • • - mm • • imam • • -7 - •-T -1 � .i
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1 .0'
2
.._
EXISTING 5' CON RETE SIDEWALK - 32.0'
on EXISTING CONCRETE CIJRB - EXISTING CONCRETE CURB -/
STREET TREES TO BE 21 .0' EXISTING MAILBOX LOCA110N TO EXISTING DRIVEWAY APRON TO
TRIDENT MAPLES BE UTILIZED FOR THIS PRL .'-CT BE REPLACED WITH NEW APRON
STREET TREE I PER CITY DETAIL 142
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IT IS DUE TO THE QUALITY OF THE
No. a, *- .•.
ORIGINAL DOCUMENT E 6Z 111; — Z 9 Z 5 Z v Z E 7 Z Z T Z O Z 6 i 81 L T 9 i �' T fi t E T 91 I [ T _ 6 S L 9 fy E Z 1 ��tli3w
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11695 SW Beef Bend Road
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2001-00648
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/2/02
SITE ADDRESS: 11695 SW BEEF BEND RD PARCEL: 2S110BD-02000
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: U WASHING MACH: BACKFLOW PREVNTRS: 2
OCCUPANCY GRP: LINK FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 4
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: WATER LINE: 10 ft
DISHWASHERS: RAIN DRAIN: 200 ft
Remarks: Site Utilites serving (3) lots involving water meters, backflow,storm sewer, and sanitary sewer.
FEES
Owner: —
Type By Date Amount Receipt
EDWARDS, BARRY A& MONA R PRMT CTR 1/2/02 $277.90 27200200000
11695 SW BEEF BEND ROAD
TIGARD, OP, 97224 PLCK CTR 1/2/02 $69.48 27200200000
SPCT CTR 1/2/02 $22.23 27200200000
Phone 1: 503-684-0432 Total _$369_61
Contractor:
RAYBORN'S PLUMBING INC
PO BOX 69
TUAL.ATIN, OR 97062 REQUIRED INSPECTIONS
Phone 1: 503-692-4139 Sewer Inspection
Water Service Insp
Reg#: ' IC 87852 Storm Drain Insp
I'LM 34166P6 RP/Backfl(- Preventer
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and --ill other applicable laws. All work will be done in accordance with approved plants.
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 ruies are set forth in OAR 952-0001-03,10 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: /��1 LCLi, GfJf'% Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needelf6e next but) es s day
I L I Tl
Plumbing Permit.Application
Datcreceived � 1 Permit no.: r�LAl," I JI
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Ilall Blvd,Tigard,OR 97223
CitygjTigard phone: (503) 639-4171 P�6W—Gt�t��0 Project/appl,no.: Expire date:
Fax: (503)598-1960 Date issued: B,� Receipt no.:
-'gyp
Land use approval: Case file no.: Payment type:
U 1 & 2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement
❑ New Lonstruction U Addition/alteration/replacement ❑Food service U Other:
,y
Job address: 11695 Be e f Bend Road _ I)cscriptionQty. Fee(ea.) Total
Bldg,no.: I Suite no.: New A-and 2-farnily dwellings only:
(includes 100 ft.for each utility connection)
Tax map/tax lot/nccount no.: 2 S 1 J O B D 12000 SFR(1)bath
Lot: 113lock. Subdivision: _ - - -
SFR(2)bath _
Project name: Edward Partition SFR(3)bath
City/coun�(WTf%s .Lb. I Zip: 97224 Each additional bath/kitchen
Description and location of work on premises: Siteutilitles: \�
Catch basin/area drain
Est.date of completion/inspection: t.tork to begin in 56Tinq Drywells/leach line/trench drain
Footing drain(no.lin.ft.)
Manufactured home utilities
Business name: Manholes
Address: _ Rain drain connector
!1y: State: 7.IP: Sanitary sewer(no.lin.ft.) ,t\
P one: Fax: E-ma:l• Storm sewer(no.lin.ft.)
CCB no__ Zg 5.y 1 Plumb.bus.reg.no: ig,4 -Qef4P Water service no.lin,ft.
City/metro lic.no.: _ Fixture or Item:
Abso tion valve
Contractor's representative—Signature: Back flow preventer
Print name: Date: Backwater valve _
1101 (A a Basins/lavatory
Name: Sistrl Enqineering / Joseph EgnerClothes washer _
Address: 75 fbrtland AtrnlA Dishwasher
Drinking fountain(s)
city: adstor State: OR I ZIP: 97027 hjectors/sum
Phone: 503-057--WOR Fax: E-mail:nsi sulal4or-.stet Mansion tank _
Fixlure/sewer cap _
Name(print): Barry f rliords Floor drains/floor sinks/hub
—T16 SW Reef Bund /iload Garbage disposal _
Mailing address: Nose bibb —
City: Tigard State: OR ZIP: 97224 Ice maker
Phone:503-54 --I Fax:620-x,97 Email: Interceptor/grease trap _
Owner installation/residential maintenance only: The actual instalhltion 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. Sinks),basm(s),lays(s) _
Owner's signature: Date: _ Sump _
Tubs/shower/shower pan _
Urinal
Name: Sistll Lnginmring / Joseph /rpw-r — Water closet _
Address: 375 Portland Aven _ Water heater
City: Gladstone State: OR I ZIP: 1177027 Other: _
Phone:503.657-0188 Fax: 657-5779-FE-mail: _ total
Nol all Jurisdiction accertr credit cards.pieta call jurisdiction for mare information. Minimum fee................$
Notice:This permit application plan review(at _ 96) $
U visa O MasterCard expires if a permit is not obtained
Credit card number, _-- _LL.— within 180 days after it has been State surcharge(8%) ....$
Eapir»a
_ -- accepted as complete. TOTAL .......................
Name of cardholder as shown on creat card
S
Cardholder signature Amomn — 2 W-4616(6R)0I170Mr
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only: �V
FIXTURES (individual) QTY ea AMOUNT (Includes all plumbing fixtures In PRICE 1 OTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 1660 - for each utility connectloTL_ �_
- One(1)bath _ $49.20 _ _
1 uh or Tub/Shower Comb - 16.60 Two 2 bath $35_0,00
Shower Only --- 16.60 Three(3)bath $399.00 --
Water Closet_- - 16.60 -`u- SUBTOTAL —
Urinal 1660 _ ^- 8%STATE SURCHARGE _
Dishwasher t6.1i0 PLAN REVIEW 25'/.OF SUBTOTAL _
Garbage Disposal - 16(i0 TOTAL
Laundry Tray -- 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" - 16.60 -- PLEASE COMPLETE:
4" - 16.60
Water Heater O conversion O like kind 16.60 - _ Quantity b I Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit -- - --- - Capered
MFG Home New Water Service 46.40 Sink _
MFG Home New San/Storm Sewer 4640 — Lavatory - -
-- Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drains 1660 Shower
Drinking Fountain 16.60 Water Closet -
Other Fixtures(Specify) 16.60 - Urinal -
__ Dishwasher _ _
_ Garbage Disposal _
-- LaundryRoom l r
--�- - ---- ---- Washing Machine
Floor Drain/Sink: 2"
Sewer-1st 100' I 55.00
Sewer-each additional 100' 46.40 4"
Water Service-1st 100' 55.01 Water Healer
Water Service-each additional 200' 46.40 Other Fixtures
Storm 8 Rain Drain-1st 100' / 5500 s (Specify)
-- - _
Storm d Rain Drain-each additional 100' ( 46,40
Commercial Back Flow Prevention Device 46.40 - —
Residential Backflow Prevention Device' _ 27.55 --
Catch Basin p 16.60 -
Inspection of Existing Plumbing rn Specially 72.50
_Requested Inspect iolrs — er/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 6525Grease Traps 16.60 --
QUANTITY TOTAL --- — --
Isometric or riser diagram Is required If — --
Ouanl_y Total Is >fl _ ---------------- — — ---
'SUBTOTAL
Z '77, //q0
8%STATE SURCHARGE - - -- ---- _.
`"PLAN REVIEW 25%OF SUBTOTAL 'y
— — Re�uiretd
only II fixturo� total Is>g
TOTAL
- - G9�
Minimum permit fee is S72 50 4 8%state surcharge,except Residential Back Bow
Prevention Device,which Is$38 25+8%state surcharge
""All New Commercial Bulldlnps inquire plans with Isometric or riser diagram and
plan review
i:Wsts\forms\plm-fees,doc 10/10/00
Jan-04-02 09:21A Rayborn' s Plumbing, Inc . 15036912328 P.01
CITY OF Ti NRD
13125 S.W.'HALL BLVD. _-
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN, OR 97062
Plumbing Signature Form
Permit#: PLM2001-00648
Date Issued: 1/2102
Parcel: 2311013D-V 000
-;it*Address: 11695 SW BEEF BEND RD
Subdivision:
Block: Lot:
Jurisdiction: 11 G
Zoning,: R-4.5
Remai''As: Site Utilltes serving (3) lots involving water meters, backfiow,storm sewer, and
sanitary sewer.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Forrn prior to the start of the work .
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CON TRACTOR:
EDWARDS, BARRY & MONA R RAYBOIZN'S PLUMBING INC
11695 SW BEEF BEND ROAD PO BG)(69
TIGARD, OR 97224 TUALA,TIN, OR 97062
Phoney#: 903-684-0432 Phone #: 503.692-4139
Req #: LIC 97952
PLM 34-166PR
AN INK SIGNAL URE IS REQUIRED ON PHIS FORM
X Co. _ rI(
Sicinatur of Authorized Plumber
If you have anv Questions, please call (503)639-4171, ext. # 310
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT#: ELC2002-00244
DEVELOPMENT SERVICES DATE ISSUED: 5/31/02
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S110BD-02000
SITE ADDRESS: 11695 SW BEEF BEND RD
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT : JURISDICTION TIG
Proiect Description: Change from overhead to 200amp service
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISC;:L_LANEOUS
71000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W/SERVICE OR FEEDER: PER INSPECTION
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EDWARDS, BARRY A AND MONA R OWNER
11695 SW BEEF BEND ROAD
TIGARD, OR 97224
Phone: Phone:
Reg #:
FEES _ Required Inspections__
Type By Date Amount Receipt Elect'I Service
PRMT CTR 5/31/02 $6u.85 2720020000( Elect'I Final
5PCT CTR 5/31/02 $5.35 272002000tH
---- Total _ $72.20v —
This Permit is issued subjec!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 approve-d 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 Notificatir n
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct quests'-,to
Permit Signature: ` Isst-ed By: r ,
OWNER INSTALLATION ONLY _
The installation is being mads on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ _ _ SATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ DATE:_ _
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next bcsiness day
Electrical Permit Applicati®n
Date reccived: 'E� 31 0 2_ Permit nqFj�,_.a� • q V
City of Tigard Project/appl.ri . Expire date:2, k ---
—
CitvofTigard Address: 13125 SW Pall Blvd,Tigard,OR 97223 Date issued: —_ By: Receiptno._
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _.. _---_ —__-
611
1
I &2 fancily dwelling or accessory U Commercial/industrial U Multi-family U'renant improvement
U n New constructioU Addition/alteration/replacement U Other: 0 Partial I
1
Joh address: c Bldg.no.: Suit:no.: Tax map/tax lot/account no.:
Lot: — Block: Su ivisi n: —
Project nance: _ Description and location of work on premises:
Estimated date of completion/inspection:
Ma%
Job no: Desciiplion Qty. (ea.) 1'olnl oo.insp
BUSineSS flame: — Newrrsidential-sins kormuhi-family per
AddCe55: --- - dwellingunit.Includesaltaclrerigaralm.
City. �Ltate: z1P: Semiceincluded:
I(MY)sq.ft.or less
Phone: Fax: l
E-mail: —_
Each additional 5110 s .ft or portion(hereof
CCB no.: Elec.bus.11c.no: _ Limited energy.residential 2
City/metro lie.no.: Limited energy,non-residential 2
Each manufactured home or modular dwelling
Date _ — Service and/or feeder _
Signature or su .rvising electrician(required) 5etwlcaorfeeden–Installation,
Sup,elect.name(print) License no: alteration or relocation:
200 amps or less 2
201 amps to 400 amps 2
Name(print): /' 401 amps to 600 amps 2
Mailing address: r _ �l0 601 amps to 10amps 2
Cit Slate: 2 ZIP:• �.2 Over 1000 amps or volts-----
2
L 00 — I
Phone: Fax: E-snail: Reconnect only
Tempotary iersices or feeders-
Owner installation:The installation is being made on property I ownInstallation,alteration,orrelocation:
which is not intended for sale,lease, • L or exchange according to 21x)amps or less —
ORS 447,455,479,67 I. ti11 amps In 400 amps —_
// _ �,
Own signature: C �` Date: 9 / 401 w 600 am ---
Br inch circuits-new,alteration
or extension per panel:
7N� A Fee forbranch circuits with purchase ofservice or seeder fee,each branch circuit =Stile: T: B. Fee for branch circuits without purchase
of service of feeder fee,first branch circuitone: Fax:
E-mail: Each additional branch circuit:
Mise.(Service or feeder not Included):
Each pump cr irrigation circle _ 2
U Service over 225 amps-comniercini U Health-care facility Each slgn or outline lighting 2
U Service over 320 amps-rating of 1&2 U Hazardous locati.m Signal circuit(s)or a limited energy panel,
family dwellings U Building over 10,000 square feet four or g
U System over 600 volts nominal more reside-tial units in one structure alteration,orextensions
U Building over three stories U Feeders,400 amps or more •I)escri tion: --- --
U tkcupant load over 97 persons U Manufactured structures or RV park Fjch addNional Inspection over the allowable In say of the above:
U Egress/lightngplan U(hlher — perinspection L-- ---
Subt ill setc of plan+with any of the above. investigation fee
l� The above are not applicable to temporary construction service, Othcr
Permit fee.....................
;JM all iuri+dictions sever credil canii.please cidl lV.natiction fcK inme hnformali0a Nol.ce:11his permit application Plan revicW(al _, %) -.
U Visn U MasterCard expires if a permit is not obtained
/ / within 180 days atter it has been State surcharge(87f)....1,
('redil card numfrr: -_--._—_-- Expire
accepted as complete TOTAL ................ ...... _
Nnthe of canlho er a++hown hm ci card s
—---- Cardholder tiputure Amount 44G-461 i(WWOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED RESIDENTIAL ONLY
Complete Fee Schedule Below: Rastricter:f_W:9v—Fee... ........................
ee..................................................... $75.00
Number of Inspections per permit allowed
I (FOR ALL S 'S"_MS)
Service included: !temps Cost Total F Check Type of Work Involved:
Residential-per unit
1000 sq.ft or less $145 15 4 1 Audio and Stereo Systems'
El
Each additional 500 sq.it or
portion thereof $33'10 _-_ 1 El Burglar Alam
Limited Energy $7500
Each Manuf d Home or Modular1-1Garcge Door Opener'
Dwelling Service or Feeder $9090 —_ 2
Services or Feeders ❑ Healing,Ventilation and Air Conditioning System'
Installation,alteration,or relocation --
200 amps or less $8030 2 F1Vacuum Systems'
201 amps to 400 amps __ $106.85^ 2
401 amps to 600 amps _ $16060 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $45465 _ 2
Reconnect only $66.85 2
Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary Services or Fee
Installation,alteration,or tele der Fee for each system......................................................... $73.00
tio200 amps or less _1_ $66.85 _ 2 (SEE OAR 918-260-260)
201 amps to 400 amps $10030 _ _ 2
401 amps to 600 amps _`_ . $133.75 _ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts.
see"b"above. �] Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
Now,alteration or extension per panel
a)The fee for branch circuits ❑
with purchase of service or Clork Systems
feeder lee.
Each branch circuit $665 2 ❑ Data Telecommunication Installation
b)The fee for branch circuits
wlfhouf purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 -- ❑ HVAC
Each additional branch circuit $6.65
Miscellaneous Instrumentation
(Service or feeder not Included)
Each pump or irrigation circle _ $53.40 _ ❑ Intercom and Paging Systems
Each sign or outline lighting -- $53,40
Signal circuit(s)or a limited energy Irrigation Control'Irri
panel,alteration or extension — $75.00 Landscape_ ❑ p g
Minor Labels(10) $125.00
❑ Medical
Each additional Inspection over
the allowable In any of the above ❑ Nurse Calls
Per Inspection _ $62.50
Per hour $6250 ❑
In Plant $73.75 _ Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other __ --
8%State Surcharge $ �' �� --_Number of Systems
25%Plan Review Fee ' No licenses are required Licenses ere required for all other installations
See"Plan Review"section on $
front of application
Fees:
Total Balance Due $ 2 , Z ( )
Enter total of above fees
❑ Trust Account# _ 8%State Surcharge ---
---------- --- -------- —
Total Balance Due s— ---
All New Commercial Buildings roquire 2 sets of plans.
CI''Y OF TIGARD 24-Hour spection Line: (503)639-4175
BUILDING MST — —
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received _ Date Requested AM— PM __. BUP — - -
Location ��J �' r `'�' - Suite MEC
Conlact Person __--. ��' ( ) � -c � PLM
Contractor- ------_..__- ----- Ph(——) --- -.-- SWR
BUILDING _ Tenant/Owner _- -_ _-____- ELC __.-
Footing ELC
Foundation Access: ELR
Ftg Drain
Crawl Drain SIT -
Slab Inspection Notes: —
Post&Beam �._. - ---- - --- ------------
Shear Anchors
Ext Sheath/Shear --- - —-
Int Sheatfr/Shear -
Framing ------- - -- - -- —
Insulation
Drywall Nailing —
Firewall --- — _ --- _._---
Fire Sprinkler - - -- ---
Fire Alarm _ - - ---------__------_-
Susp d Coiling _
Roof —`--_-. --_
Other: - � -----�Final
PASS
----- ----_ -- - --- —-----_
PASS_PART FAIL
PLUMBING- -- - -- - ------- --------- --A.—_.__— _..._-_
Post& Beam -
Under Slab _— -.----- —__--.------------ ---
Rough-In --------- -- —.._-
Water Service - ---- --------- --
Sanitar Sewer -- __-- - ----- - ---__--_-
Rain Draft' - ------- --
Catch Basin/Manhole
Storm Drain --- ----- - ----- - ------__
Shower Pan
Ot
G
-------- ----_._-_ --- -- —.--.- -- ��
PART FAIT_
HANICAL -- -- -- �---
Post&Beam-------
Rough-In --- -- --__--
Gas Line
Smoke Dampers - - -
Final
PASS PART FAIL
_ELECTNICAL ---- -----_ - --- -- --
Service
Rough-In --- -- --- - - ------.-.
UG/Slab
Low Voltage
Voltage - -- ---------
Fire Alarm
Final n Reinspection fee of$- required hefore next inspection. Pay at City Hail, 13125 SW Hal°Blvd.
PASS PART FAIL
SITE n Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line L� /,.
ADA
IJot� � � C� �' tnnpactor!�_� --- ��" �'�" - - Ext - -
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITYOF TIGARD SITE WORK PERMIT
- DEVELOPMENT SERVICES PERMIT# : SIT2002-00003
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4971 DATE ISSUED : 2/6/02
SITE ADDRESS: 11695 SW BEEF BEND RD PARCEL : 2S110BD-02000
SUBDIVISION:
ZONING : R-4.5
BLOCK: LOT: JURISDICTION : TIG
CLASS OF WORK: OTR PAVING ?: RESO. NO:
TYPE OF USE: SF GRADING 7: VALUE: $6,000.00
EYCV VOLUME: cy LANDSCAPING?:
FILL VOLUME.: cy SITE PREP ?:
ENG FILL?: STORM DRAINS?.
SOILS RPT REQD?: IMPERV SURFACE: sf
Remarks: Erosion control permit (SR, no site vork)for WAC Street opening permit.
Owner: r--��— — -
—. _ FEE:S
EDWARDS, BARRY A & MONA R -_�...
11695 SW BEEF BEND ROAD Type By Date _ Amount Receipt
TIGARD, OR 97224 EROS CTR 2/6/02 $26.00 27200200000
ERPU CTR 2/6/02 $8.45 27200200000
Phone: 503-684-0432
ERPC C'f R 2;6/02 $8.45 27200200000-
Total $42.90
Contractor: r. � ___�_ —
Phone:
Reg #:
Required Inspections
Erosion Control Insp 846.8444
Final Inspection
PI D
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
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246-1987.
Permittee Signature:
Issued By: P'
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
(�kMto4 CON7PvL
Building Permit Application
IDatereceiview4d:City of Tigard / Dy Permitno.:SjT
City of Tigard
Address: 13125 SW Ball Blvd,Tigard,OR 97223 P)ojecthppl.no.: Expire date:
Phone: (503) 639-4171 pate issued: By: Receipt no.:
Fax: (503) 598-1960 rtVG ;)no' G)f- 'f.__1P Case file no.: Payment type:
Land use approval: �__ f&:family:Simple Complex:
U I &2 family dwelling or accessory O Commercial/industrial U Multi-family U New construction U Demolition
U Addition/allerationh-cplacement U Tenant improveni.ni LI Fire sprinkler/alann U Other:
Job address: _ _ Bldg.no.: Suite no.:
Lot: Block: Suhdivision: Tax map/tax lol/account no.:
Project name: —
Description and location of work ojm premises/special conditions:
I Nc� ^ }r
Name: I6 S
I Mailing address: 116 c - I &2 family dwelling: _
City: State: 'ZIP:! ?-2_ Valuation of work........................................
Phone: T / Fax: . ' E-mail: No of hcdrf>t=/baths.................................
Owner's representative: _ I'utal number of Moors.................................
Phone: Fax: E-mail: New dwelling area(sq.fl.) ..........................
mmmilGarage/carport area(sq. ft.).................... .
Name: Covered porch area(sq. ft.) .........................
Mailing address: Deck area(sq.ft.) ......... . ...... ................. ...
City: _ State: I ZIP: OUur structure area(sq. ft ). .......................
Phone Fax: E-mail: Commereiallinduatrlal/multi-family:
Valuation of work................................ ....... $
l-xisting bldg.area(sq.ft.) ..........................
Business name: -
Address:
New bldg.area(sq.ft.)................................
-- — - Numtwr of stories
( ity: State: ZIP: Type of construction
Phone:
....................................
Fax: E-nail: —----
---- ---- -- — ---- (h:cupancy group(s): Existing:
CCB no,:
-- -
-_ - — — New: --
City/metro tic.no.. Notice:All contra,ors and subcontractors mm'required to be
111111 ri 11 a 11 licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address, jurisdiction where work iF being performed.It the applicant is
— — --- _ --- exempt from lic.;nsing,the following reason applies:
Cit State: ZIP____
:
Contact person: Plan no.: --
Phone: Fax: E-mail: --
Name: Contact person: Pecs due upon application .. ......... ............ $_—
Address: Date received: —
City: — State: 1ZIP: Amount received ......................................... $--
Phonr. I E-mail: — — Please refer to fee sch^dule.
I hereby certify I have read and examined this application and the Nrt all jurisdictions accept credit ends,please call jurikiictim for r.,ore information
attached checklist. All provisions of is rsnd ordinances governing this U visa U htaslercard
work will be complied w' -whets ified rein or not. Ctedit tans nnmher.
Expires
.Authorized cIgnatt: .7 Date: r L Name of cardholdet as shown on credit cord
_._,.__ S
Print name:_�) Cardholder slgnarorevAmount
Notice:This permit application expires if a permit is not obtained within 180 dayser it has been accepted as complete. 4404613(dMCOM)
F;j't I�1 -T T 'D(r
sc
tt c
SITE WORK PERMIT CHECK LIST
Commercial, Multi-Family (R-1 occupancy) and Residential:
Please complete all items below, unless otherwise noted.
Excavation Volume:
Grading Volume:
Soils report required for >5,000 cuyds.) cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be compacted to 99% of
maximum dente-) - _ ____- -- - - _ cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other
*Total new impervious area including all buildings, _
sidewalks, and Daving__ _ _— __ eft.
Site Utilities Plumbing Work:
Complete the "TAN" Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements"
attached. The follo4ving must acccmrn — _this a lication:
Site Plan with Vicinity Map showing *Parking (including ADA) and
ADA complianceht
_ Li g ing Plan
Grading Plan and details - *Landscaping Plan
Erosion Control Plan and details Soils Report if required)
Retaining_Structures
*Does riot apply to 1 and 2-family dwellings.
— - # of Plans
TYPE OF SUBMITTAL ^� W�
Required at
(Includes Now, Additions or Alterations) Submittal
Commercial i 4
Multi-Family R-1 Occupancy 4
One- & Two-Family Dwelling 4
NOTE: Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
i Ai1s���from^�sih'rhe,�klis�dct, U514�111
J
r10,il
SEE 35MM
ROLL # 2U
FOR
OVERSIZED
DOCUMENT
CITYOF TI GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00062
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/25/02
SITE ADDRESS: 11695 SW BEEF BEND RD PARCEL: 2S110BD-02000
SUBDIVISION: ZONING: R-4.5
BLOCK: _ LOT: _ _ JURISDICTION: TIG
CLPASSOF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTrRS:
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: 150 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: 150 ft. line work and house connection. Septic to be removed, or pumped, filled and inspected.
Owner:
FEES _
I DWARDS, BARRY A & MONA R Type By _ Date Amount Receipt
11695 SW BEEF BEND ROAD PRMT CTR 2/25/02 $101.40 27200200000
1IGARD, OR 97224 5PC1 CTR 2/25/02 $8.12 27200200000
Total $109.52
Phone 1: 503-684-0432
Contractor:
1)WNER
REQUIRED INSPECTIONS
Phone 1: Final Inspection
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-000,1 .0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By.(T x_4.1, 6 a-tC1. -61 , Permittee Signature:
Call (503) 63$-4175 by 7:00 P.M. for an inspection needed the r1ext4:ttMrfes5 dt!y
Plumbing Permit Application
FVatercceived:: Permit ne.: 2-
CityCity
sof Tigi �( �` Sewer permit no.: Building permit no.:
Address: 13125 SW I (� (�
City of Tigard Phone: (503) 6394171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 F C_D 9 r7 jQQ �;' Date issued: B Receipt no.:
Land use approval: -04=uF [ Case file no.: Payment type:
ip I &2 family dwelling or accessory U('omtinercial/industrial U Multi-family U Tenant improvement
U Nvw construction U Addiliott/alteratiott/replacement U Food service Ll Other:
Descri tionQt '. Total
Job address: r f� ---- New I-and 2-family dwellings only:
Bldg.no.: Suite no.: (includes 100 It.for each utility connection)
Tax map/tax lot/accouni no.: — SFR(1)bath
Lot; Block: Subdivision:
Project name: arr cA -f SFR(3)bath _
City/county: -rZIP: 2L Each additional bath/kitchen
Description and loiKtion of work on premises:__ _ Siteuffities:
Catch basin/area drain
Est.date of completion/inspection: D wells/leach line/trench drain —
Footing drain(no.lin.ft.)
Manufactured home utilities
Business name: W A/<r Manholes
Address 9.9 Z, v Rain drain connector
City: - State: ZIP: Z Sanitary sewer(no.lin.ft.)
Phone: / Fax E-mail: Storm sewer(no.lin.ft..) ^_
Water service no.lin.ft.
CCB no.: ' Z Plumb.bus.reg.no:
Fixture or Item—
City/metro lie.no.: Absorption valve
Contractor's representative signature: Back flow preventer
Print name: Date: Backwater valve
Basins/lavatory _
Clothes washer _
Name: Dishwasher -
Address: GAJ Fre _ Drinking fountain(s)
City; �' State:Q 'LIP: �- E'ectors/sum
Phone: Fax: E-mail: Expansion tank
Fixture/sewer ca _
Floor drains/floor sinks/hub
Name(print): / crvv Garbage disposal
Mailing address: 11,4
Hose bibb
City: �%,T a.er0 Stat . ZIP: 22 Ice maker
Phone: 0 � Fax: o %f Email: Interceptor/grease trap _
Owner installationrresidential maintenance only: The actual installation P,imer(s)
will be made by me or the mainteniT d repair made by my regular Roof drain(commercial)
employee on the pmpe wn pe RS Ch ter 447. _ Sin (s),basin(s). ays(a)
Owner's signature: a _ Dale: ZS um _ —
Tubs/shower/shower pan
Urinal
Name.: _ — Water closet _
Address: Y Water heater
City: _- State: ZIP: _ Other:
-Phone. Fax: E-mail: Total
-' — Minimum fee................$
W.- dl jutirdiaiexu rcept txedit cadr,pleax cell jurirrlictkm for more dntarmetian. Notice:'Mis permit application Plan review(at %) $
LI visa U MasterCard expires if a permit is not obtained
Credit cad number.._ - --- 1 -1- within 180 days after it has tven State.surcharge(°9b)....$ 1
Expires TOTAL .......................$
accepted as complete. —
Nrtme o�carlwlder u rhowo on credit cad S
- t n1l+older�dsoettrre ------ Amown "0-4616(6MCOM)
PLUMBING PERMIT FEES:
PRICETTOTAL New 1 and 24amily dwellfngs only: -
FIXTURES (Individual) __ QTY' ea AMOUNT_ (Includes all plumbing fixtures In PRICE TOTAL
Sink �' - 16.60 the dwelling and the ffrst100 ft. QTY (ea) AMOUNT
for each utility connection)-_
Lavatory
16.60 -
Lavatory ___ One 1 bath $24920
Tub or Tub/Showor Comb. 16.60 Two 2 bath _ $350.00
-ho-w,;,-0 nly - 1ti.60- - - Three;31 bath_-_ - $399.00
Water Closet _ 1660 -` ---- SUBTOTAL
Urinal 16.60 STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25°/a OF SUBTOTAL
TOTAL
Garbage Disposal 16.60 - -- -� - -
Laundry Tray 16.60
Washing Machine 16.60
FloorDrainlFloorSink PLEASE COMPLETE:
3•• 16.60
4,.- 16.60 --- ---
__ - _ Quantity b Work Performed
Water Heater O conversion O like kind 1660
Gas piping requires a separate mechanical - Fixture Type: New Moved Replaced Remuvedl
-Capped
permit. -- - --- `--
MFG Home New Water Service 46 40 Si 1k
Lelvatory
MFG Home New San/Storm Sewer 46.40 - Tub or Tub/Shower
Hose Bibs - 16.60 Combination -
Roof Drains - 16.60 - Shower Cniy
-- - 16 ti0 - Water Closet -
Drinking Fountain _ Urinal _
Other Fixtures(Specify) 16 60 -__ Dishwasher
Garbage Disposal
-�` L3und Room Tra
Washing Machine _ -
Floor Drain/Sink: 2" --
Sewer-1st 100' - 5500 31'
Sewer-each additional 100' 46.40 / 4"_ --
Water Service-1st 100' 55.00 Water Heater
Other Fixtures
`Nater Service-each additional 200' 4640
Storm a Rain Drain-1s7t 100' 55.00
Storm&Rain Drain-each additional 10046.40 - --
Commerdal Back.Flow Prevention Device 46.40 -
Residential Back-ow Prevention Device' 27.55 -- - --
Catch Ba-sl n - 1660
Inspection of Existing Plumbing or Specially 62.50
CONIMENTS REGARDING ABOVE:
Requested Inspections _ -
Rain Drain,single family dwelling 65.25 -- __-_ ---- ---
Grease Traps 16.60 _--
QUANTITY TOTAL -
Isometric or riser dlagrarn is required it ----
r y.a icy Total Is ---
*SUBTOTAL - -_
8%STATE SURCHARGE -- --_--
"PLAN REVIEW 25%OF SUBTOTAL
R93y,tTd on�if fixture qtytotal is>0
- -`- TOTAL - 5
"Minimum permit fee Is$72 50+8%state surcharge.except Residential Backflow
Preventk,n Device,which Is$36 25+8%state surcharge
"All New Commercial Buildings requhe 2 sets of plans with Isometric or riser
diagram for plan review.
I:\dsts\fcums\plm-fees.doc 12/26/01
I
CITYOF TIGARD SEWER CONNECTION PERMIT
- DEVELOPMENT SERVICES PERMIT#: SWR2002-00107
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/25/02
SITE ADDRESS; 11695 SW BEEF BEND RD PARCEL: 2S110BD-02000
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT- JURISDICTIO_ W TIG _
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: I.TPSWR IMPERV SURFACE:
Remarks: Sewer connection.
Owner: � — —
--� - FEES
EDWARDS, BARRY A& MUNA R
11695 SW BEEF BEND ROAD Type By Date Amount Receipt
TIGARD, OR 97224 PRMT CTR 2/25/02 $2.,300.00 27200200000
INSP CTR 2/25/02 $35.00 27200200000
Phone: 503-684-0432 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspeclio
Septic Tank Filled
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agencv. The pencil expires 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does riot guarantee
the accuracy of the side sewer laterals, li the sewer is not located at the measurers int given, the install--r shall prospect
3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer' Perm
Issued by: Permittee/r� Permittee Signature:
Call (503) 639-4175 by 7:00 P M. for an inspection needed the next business day