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12722 SW BUGLE COURT .�s�NwwlMYws-4�wMN�.wrwru..u....,._.,.....�o,�1Yl�Y W+wY�w.a>��H+AwnIMy✓Yrwwxswwr�w+rw+i��.w...re.n�.�.:.......... W CD G c 12722 SW Bugle Court PAUL P.,J%W4iEY, mc.;; 503 298 9th; SEP-4 02 1 t :4AAM; PAGF ?;4 I / ■ 6trs.2Ysy 11*bMV Ameon an-9en�021c) CM 3 Cky of TIg &tr"a%,of ildings mad, OR i Attn: Found n Inspector 1 RE: nkel Re, pefrl irixa SWW8910t%alert.1rs l taa" 2W2- W3S2 gard,OR SIM*A&Lot 33 Elk Hom Ridge I►lava 09rocrnd IErvel 900tachnical luaGon rpt the above referwx*d addrep mi Ax�Migs ave been deepened into ,#wminfmurn f!iff native soils or rest daeCtty un enginee►bd Oil The ng width is 24 inch% W all engineemd fill. The s�1e yard has been retained with a r,Vxt dated anch fie+ Shm, and approval by ADaPT Engineering. inc (scw ADaPT With car 'm of the above am bsrsed on a final visual Waemfnation, it is m Current Gond of lut 33 E1N Hutt Rinse HMOs is in Y �G+nlai that the oft** 1E�7 ftn Wild' Coco. If fIefw*c.onformerxe With Apperrdiy,Chapter 33 +�9 yell haw9 I xVw-r questicme,please colt SiricerNyr y Paul la.Carr l� esirterR Qac;/� �` PA!K R R►NO GFS" I f CITY OF T I G A R D MASTER PERMIT (C PERMIT#: MST2002-00352 DEVELOPMENT SERVICES DATE ISSUED: 8/27/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 SITE .'rJDRESS: 12722 SW BUGLE CT PARCEL: 2S109AD-08900 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK LOT: 033 JURISDICTION: TIG REMARKS: New SF detached, Path 1. BUILDING _ REISSUE: STORIES: 2 FLOOR AREAS _ _REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,254 of BASEMENT: of LEFT: 15 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 967 of GARAGE: 456 of FRONT: 20 PARKING SPACES 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: at RIGHT: 5 VALUE: 5 216.301.20 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2.221 00 of REAR: 20 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: 1 USISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES. MECHANICAL _ FUEL TYPES FURN<100R: SOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>-100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: 0 VENTS: 1 WOODSTOVES: GAS OUTLErs: 1 ELECTRICAL RESII1ENTLAL UNIT SERVICE FEEDER _ EMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF UR LESS: 1 0 200 amp: 0 -200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 11008F: 4 201 400 amp: 2C1 400 amp: tel WIO SVC/FDR: '0 SIGN/OUT LIN LT: PER HOUR- LIMITED ENERGY: 401 600 amp: 401 • 600 amp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVC/FDR: 601 • 1000 amp: 601 amps•t000v: MINOR LABEL: 1000+ampfvolt PIAN REVIEW SECTION _ Reconnect only: >=4 RES UNITS: SVCIFDR>=226 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY _ A.OF RESIDENTIAL S.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: nTHR: HVAC: DATA'TELE COMM: NURSE CALLS TOTAL N SYSTEMS: Owner: rant-actor: TOTAL FEES: $ 7,435.70 This permit is subject to the regulations contained in the PAUL R CARNEY INC PAUL R CARNEY INC Tigard Municipal Code,State of OR. Specialty Codes and 1480 NW 102ND AVE 1480 NW 102ND AVENUE all other applicable laws. All wol k will be done in PORTLAND,OR 97229 PORTLAND,OR 97229 accordance with approved plans. This permit will expire If work Is not started within 180 days of Issuance,or if work Is suspended for mure than 180 days. ATT'JJII.N: Pho1e: Phone: Oregon law requires you to follow rules adopted ,y the Oregon Utility Notification Center. Those rules are yet Rep$: LIC 566x2 forth In OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions tr, OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion Control Insp 8, Post/Beam Structural Electrical Service Low Voltage Water Line Insp Final inspection Grading Inspection Ftng Drain Rsm't Walls Electrical Rough In Gas Line Insp Appr/Sdwik Insp SSWer Inspsctlon Ftng Drain BsITI't Walls Framing Insp Gas Fireplace Electrical Final Footing Insp Mechanical Inap Shear Wall Insp Insulation Insp Mechanical Final Foundation Insp Plumb Top Out Exterior Sheathing Inst Rain drain Insp Final - Issued By : �� �4��s. -� - —�` Permittee Signature,. Call (503)639-4175 by 7:00 p.m. for an inspection needed the next business day r ��� ®� �'t`���� SEWER CONNECTION PERMIT_ („�` PERMIT#: SWR2002-00233 -,l DEVELOPMENT SERVICES DATE ISSUED: 8/27/02 13125 SW Nall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S109AD-08900 SITE ADDRESS; 12722 SW BUGLE CT ZONING: R-7 SUBDIVISION: ELK HORN RIDGE LOT:ATE _JURISD!CTION: TIG BLOCK: _ — -- "-- TENANT NAME: FIXTURE UNITS: USA NO: DWELLING UNITS: 1 CLASS 0.=WORK: NEW NO. OF BUILDINGS: 'TYPE 0. USE: SF IMPERV SURFACE: INSTALL TYPE: LTPSWR Ramarks: Sewer connection for new SF. Owner:_ FEES — PAUL R CARNEY INC Tyra B„ _ Date Amount Receipt 1480 NW 102ND AVE PRMT CTR 8/27/02 $2,300.00 27200200000 PORTLAND,OR 97229 INSP CTR 8/27/02 $35.00 27200200000 Phone: 503-297-9406 Total $2,335.00 Contractor: Phone: Reg#: Required InsHQctions rules and regulations of the Unified Sewage Agency. The permit expires 180 This Applicant agrees to comply with all the days from the dete issued. Thetotal laterals. if the seouniwerlisbnot�ocateded iatthe meahe isurement gven,gheCnstollers�aglI prospect the accuracy of the side sewer 3 feet in all directions from the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer" Perm Permittep Signature: Issued by: _ �,,: ,L Call(503)639-0175 by 7:00 P.M.for an inspection needed the next business day r8- zz - GL 7 B oldingPermitApplication Cite of Tigard — Datereceived: ,� -�- Permit no.:NrrM,;?-,W;1s 2 City nffigord Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: date: Phone: (503) 639-4171 Date issued: By Receipt no.: Fax: (503) 598-1960 Case rile no.: Payment type: Land use approval: 1&2 family:Simple Complex: TYPt 01F 0ERM111 I:UAddi 2;amily dwelling or accessory LJCommercial/industrial U Multi-farnily ?S-w construction U Demolition tiotl/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: 0 M1 111 Elk]W1 I Job address:17. 72 s,w 7` Bldg.no.: Suite no.: Lot: " ' I Block: Subdivisi : z .r ti T 1 71 Tax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions:_— r 1 i lam•', {, . �- -- OWNFIt FOR SPECIAL INFORMATION, USE(flUCKLIST Name: 7� � %e••' G,��-r�/� � (Floodplain,septic capachl',so�lrl etc.) Mailing address: G--ti 's. -10 Z t 1&2 family dwelling: City- 7, Ti ,t. �- State: Z[P: ri Valuation of work........................................ $ ol, Phone: - r t a Fax:__24— `6 ' E-mail _. No.of bedrooms/baths................................. "Z Owner's representative: ',F C Total number of floors................................. Phone: : mat 6 Fax: E-mail: New dwelling area(sq.ft.) ..........................APPLICANT � T Oarage/caepctrt arca(sq.ft.)......................... -N-5 & Name: Ga Covered porch area(sq.ft.) ......................... Mailing addn;ss: J Deck area(sq.ft.)........................................ - - -- Cit State: ZIP: Other structure area(sq. ft.)......................... _------- E-mail:: ______ City. honi-: Fax: E-mail: Commercial/industrlallmulti-family: tValuation of work.................................... $ Existing bldg.area(sq.ft.) ........... ........ ... Business name: ° New bldg.area(sq.ft.) Address: -- Number of stories............................ ity: State: ZIP: Type of construction .................. Phone: Fax: E-mail: CCB no.: S`6 Occupancy group(s): Existing: 8S � City/metra tic.no.: New: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: I0q '.10 �- ,t = ' t provisions of ORS 701 and may be required to be licensed in the Address: / <� ,; /li fit. L - jurisdiction where work is being performed.If the applicant is City: T/ State:(,-)(,_ I 7.1P: 7,2 0 exempt from licensing,the following reason applies: Contactperson: Plan no.: Phone: S- Fax. ? • ��913 E-mail: — Name: Z .w ; / r,r=C6±J Contact person: Fees due upon application ........................... $ Address: t L oZ M S Date received: _ City: P -v�n.t State7.IP: Amount received Phone: y 6 Z c,,;IFax: E-mail: Please refer to fee schedule. I hereby certify 1 have read and examined this application and the Not all Jurisdictions accept credit cam,pteur can iudidtct+-n im fwwr inronn tion. attached checklist.All provisions of laws and ordinances governing this Xvisa U Mastercard work will be complied with,w er specified herein or not. Credtr cardnumn�r Authorized signature: - > �"� / / Fsspirca g Date: 3� O Name of carte er o shown on credo s Print name: ,�- ;,, t n V r f +- ::F 4mdit a nature Amount Notice:This permit application expires if a permit is not obtained within 180 clays after it has been ace ted as comp 4404613(60WoM) k d♦� One-and Two-Family Dweiling Buiiding Permit Application Checklist Referenceno.: -- — Associated permits: City of Ti;and City of Tigard ❑Electrical ❑Plumbing U Mechanical Address: 13125 SW Hall Blvd,'figard,OR 97223 ❑Other _ Phone: (503) 639-4171 Fax: (503) 598-1960 1 1MM1 1 1 Land use actions completed.See jurisdiction criteria for concurrent reviews. 2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district,etc_ _ 3 Verification of approved platflot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel.Existing system capacity 6 Sewer permit. -- 7 Water district approval. 8 Soils report.Must carry original applicable stamp and signature on file or with application. 9 Erosion control ❑plan ❑permit required.include drainage-way protection,silt fence design and location of catch-basin protection,etc. 10 L Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state building codes.Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if co right violations exist. – i 1 Sitelplot plan drawn to scale.The plan must show lot and building setback dimensions;property corner clevatic.n.s(if there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinfo%,mg Vads,connection details,vent size and location. 13 Floor plans.Show all dimensions,room identification,window size,location of smoke detcc tors,water heater, furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,sub-floor, wall construction,roof construction.More than v.ne cross section may be required to clearly portray construction.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs, fireplace construction, thermal insulation,etc. 15 Elevation views.Provide elevations for new construction;minimum ol'two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)andlor lateral analysis plans.Must indicate details and locations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. _ 17 Floor/roof framing.Provide plans for all floors/root'assemblies,indicating member Azing,spacing,and hearing locations.Show attic ventilation. 18 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered s stems,race item 22,"En ig neer,s calculations." 19 Beam calculations.Provide two sets of calculations using cun•ent code design values for all heanns and multiple joists over'10 feet long and/or any heam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. 21 Energy Code compliance.identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more applintices. 22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall he stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. 23 Five(5)site plans are required for Item I1 above. Site plans must he ti-1/2"x I I" u I I"x 17". 24 Two(2)sets each are required for Items 16, 19,20&22 above. 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accepted. 26 "Reversed"building plans must meet criteria outlined in the Permit&Syrem Development Fees document. 27 "Drawn to scale"indicates standard architect or engineer scale. 28 Site plan to include tree size,type&location per approved project street tree plan(if applicable),and COT 5trcet Tr-c List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red Ink is reserved for department use only. 440-461446ax>/conn Electrical PermitA.pplication Datereceived: I it Permit no,: ,,-). City of 'Tigard P,roject/appl.no.: Expire date: Cityoj7ligard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 --- Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: TVPE OF 0 ! &2 family dwelling or accessory O Commercial/industrial U Multi-family LI Tenant improvement 0 New construction l7 Addition/alteration/replacement 0 Other: ❑Partial JOB SITE INFORMATION Job address: /-2- 7.2 ! _ Bldg. nu.: 1 Suite uo.: ITax map/tax lot/account no.: Lot: Block: Subdivision: -7 { f STw r Project name: I Description and location of work on premises: _ Estimated date of completion/inspection: UONTRACI'011 AP CATJON FEE SCIIEWLE Job no: fee nla. Business name: k:V ' Description Qt (ea.) 'Total no.imp New residential-single or multi-family per Address: _ dwellingunit.Includes attachedgaroge. City: State: 'LIP: Service Included. Phone: Fax: I E-mail: lona sq.ft.or less 4 CCB no.: Elec.bus.lic.no: Each additional 500 sq.ft.or portion thereof Limited energy,residential 2 City/metro tic.no.: Limited energy,non-residential 2 Each manufactured home or modular dwelling Signature of supervising electrician(required) Date Service and/or feeder 2 Sup,elect.name(print). License no: Services or feeders-Installation, alteration or relocation: 200 amps or less 2 Name(print): r rr 201 amps to 400 amps 2 S! v �!-�. /v ..., 401 amps to 600 amps Mailing address: 2 601 amps l0 1000 amps _ 2_ City: )__), . State:CYC I ZIP: 7.2.1 Over 1000 snips or volts 2 Phone: -e IbL I Fax:Z 74-26 1 E-mail: Reconnect onlyI Owner installation:The installation is being made on property I own Temporary services orfeeders - which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,6717 2f)0 snips or less 2 201 amps to 400 amps 2 Owner's si nature: Date: -�/ - "Z 401 to 600 ams 2 Branch circuits-new,alteration, -(� or extension per r mel: Name: /�Y w T �� Vii. tit C-4r. A. Fee for branch circuits with purchase of Address: f „S£. /0 2 service or feeder fee,each branch circuit _ .� Slate' ZIP: B. Fee for branch circuitt without purchase City: ✓)7/� �• 7� of service or feeder fee•first branch circuit: Phone: 2s"tf Ka 97_ rax: J_l-061 E-mail: — Eachadditional branch circuit: .0m it 'A 1 aiwm"rmummromml—lrmlnm Mise,(Servlet,or feeder not Included): 0 Service over 225 amps-commercial O Health-care facility Each pump or irrigation circle 2 •Service over 320 amps-rating of1R2 U Hazardous location Each signor outlineligh6ng 2 family dwellings O Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. O System over600 volts nominal more residential units in one structure alteration,or extension' 2 0 Building over tlttee stories 0 Feeders,400 amps or store aDescrition _ 0 Occupant load over 99 persons U Manufactured structures or RV pork Fich addillonal Inspection over the allowable In any of the above: 0 Egress/lightingplan O Other. Penna ction r -7---1- 1 — Submit___sets of plans with any of the above. Investigation fee 'lite above are not applicable to temporary construction service. Other Not all jurisdictions accept credit card.,,please call lurisdictinn for more infurmalim. Notice:This permit application Permit fee..................... U visa O MasterCard expires if a permit is not obtained Plan review(at _ %,) $ . Credit card number:_ ___L_� within 180 days after it has been State surcharge(8%) ....$ Frpires accepted as complete. — --- TOTAL .......................$ Name�ioo t iishown on null c2V _ _ Z Ca tholder signature -- -- Amount 440.4615(6IOalCOM) Mechanical Permit Application - "Dateeceived: � Permitno,: Kha� City of Tigard Project/appl.no.: Expire date: City ofngard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: _ Building permit no.: 1 Mf&2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U Ad(liCon/alteration/replacement U Other: lob address: / 2 `^" ✓�_ __ Indicate equipment quantities in boxes below.Indic to the dollar no.:-- _ value of all mechanical materials,equipment,labor,overhead, Bldg.no.: Suite Tax map/tax lot/account no.: profit.Value$ Lot: Block: Subdivision: // �,, �, *See checklist for important application information and jurisdiction's fee schedule for residential permit lige. Project name: City/county: c/ ZIP: 7..,,: t �r Description and to tion of work on premises: � t 1 t 1 t s.. .A-. .-7 rr�e(ea,) rota) Est.date of completion/inspection: C: Desert tion Qt Res.only Res.only Tenant improvement or change of use: A,111- Air handling unit CFM _ Is existing space heated or conditioned?U Yes U Na it con it oning(site plan required) Is existing space insulated?U Yes U No Alteration of existing HVAU system of er compressors State Wilcr permit no.: Business name: L 1t w 7, r 'r f C IIP Tons BTU/H Address: z O /Z 5.w K-J Fire/smoke ampers/ uctsmo•e detectors City: /.� 1. Stale:a IP: / eat pump(site pan requ re ) e Fax:6?ts'• o68S� E-mail: nsta rep ace urnace Burner 3T UAl Phone: I?- S�+Z Including ductwork/vent liner U Yes U No CCB no.: _— nsta rep ac re ocate heaters-suspcnde , City/metro lic.no.: wall,or floor mounted Name(please tint): -Vent ore lance of ler l an furnace e erat on: CONTACT PURSON Absorption units BTU/11 Name: ,ats 7 Cil✓ ^- ' Chillers HP N L-, 0 y�--�J�—�,� Com ressors HP Address: a Z ,av ronmenta ex rut an vent at on: City; T A 1 doof jState:dr?- ZIP: :1 Appliancevent Phone:2 9 �- 9 Vd r, rax: 7f6-96y 11 E-mailrye sex au tres. itc c azmat hood fire suppression system Exhaust fan with single duct(bath fans) Mailing address: ` Exhaust s stem a art from healing (- or State: ZIP: ae P p ng an st ut on(up to outlets) Ty : _-LPO NO Oil Phone: 15rx E-mail: ue piping eac a ton over out els rocess p P ng(Be ematic required) - Number of outlets _ Name: a S. '� 'a -WhWer-Rilappliance or equipment: _ Address: _ 5�. . /Uti ,�(`` Decorative fire lace City: 7/,L. State:CL. I ZIP: ,Z/ nsett-type Tax: E-mail: stov•pellet stove Phone _ er: Applicant's signature. - Date: 7 1 o ter: Name(print): w P� Permit fee.....................$ -- P40.1 as iufl dkriunr-:cep credit cards•please call;odadicdon for more intmnailon. Notice:This Pe PP permit application Minimum fee................$ isa U MasterCard C 03 z 6a y�• v/'_- expires if a permit is not obtained plan review(at _ %) $ - Credit card num r: Expires within 180 days after it hes been V+ _�1t State surcharge(8%)....$ a Ider ae thowm oo. er TOTAL .......................$accepted as complete. Amount M0.4617(60rY'0M) Building Fixtures Plumbiag Permit Application Date received: 9 PetYrrt nn. ,"A 4 City of Tigard Address: 13125 SW I�iall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: City of Tigard Phone: (513) 639-4171 Project/appl.no.: Expire date: Fax: (503*, 598-1960 Date issued: i By: Receipt no.: Land use approval: __ Case file no.: Payment type: ;add 2 family dwelling or accessory ❑Commercial/industrial U Multi-family ❑Tenant improvement Nwconstr lction O Addition/alteration/replacement U Food service ❑Other.1 t i Description Qty- Fee(ca.)id ress: 2- New 1-and 2-family dwell ngs of y: Bldg.no.: Suite no.: (Includes 100 ft.for each utility connection) Tax map/tax lot/account no.: _ SFR(1)bath Lot: -1 Block: Subdivision: 1./K /4,, j t,d SFR(2)bath Project q- e: _SFR(3)bath City/county: -L"�3 _ Each additional bath/kitchen Description and lociation of work on premises: _ Site utilities: Catch basin/arca drain Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin. ft.) PLUMBING CON-1111ACT011 Manufactured home utilities Business name: s ��- D��M 'c Manholes Address: Rain drain connector _ City: State: ZIP: Sanitary sewer(no.lin. ft.) Phone: Fax: E-mail: Storm sewer(no.lin.R.) _ CCB no.: Plumb.bus.reg.no: — Water service(no.lin.ft.) City/metro lic.no.: Back Fixture or item: Contractor's representative signature: Btion valve Back flow preventer Print name: , /.a., f Date: d Backwater valve Basins/lavatory - -- Name: Clothes washer Dishwasher Address: q 0 A)k...../, /a --k - Drinking fountain(s) _ City: _ 74T State: ZIP: c ) 2 Ejectors/sump _ Phone: Z 1 Fax:2 E-mail: I Expansion tank Fixture/sewer cap Name(print): (y Floor drains/floor sinks/hub Mailing address: Garbage disposal Hose bibb City: State: ZIP: Ice maker Phone: Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installationFdrain — will be made by me or the main nce and repair made by my regular mmercialemployee on the propertyl ORS Chat s),lays(s)Owner's si atu2 Date: fcZhower pan _Urinal _ Name: oK, / ._ C Water closet Address: ,� 4 Z �^^ Water heater City_ 1_710` State:on_I ZIP: ef 7 other: Phone: ,zS q_ W 92_ Fax:., S40L. 476A E-mail: Tota Not I)uridldlons seep credit cards,please call jurisdiction for tore jw.nMmtlon Minimum fee................ S lass ❑MasterCard Notice: This permit application ,� i Pe PP plan review(at_ %) � ,)V h�0 7 expires if■permit is not obtained ° Credit c umber. N �G _ State surcharge(8%).... S e ' within 180 days after it has been 1 - s`— xp ros accepted as complete. TOTAL........................ S ame as r on credo acre P -- s de anatu ��mounl 1104616(WWCOM) J u u --- --- 490 i-. t m -�, NM 00n ' C,n s 't N co V'I N " --IL_ 3 V 2.0' 1�� Y r 0 ./ CITY OF TIGARD '13125 S.W. HALL BLVD. TIGARD, OR 97223 AECEI ED IMPORTANT PERMIT NOTICE SEP r) .1 20(1( FRANKLIN ELECTRIC INC Q:l.t i ve liw&:, 1031 SE 23RD COURT jewi GRESHAM, OR 97080 Electrical Signature Form Permit #: MST2002-00352 Date Issued: 8127102 Parcel: 2S109AD-08900 Site Address: 12722 SW BUGLE CT Subdivision: ELK HORN RIDGE ESTATES Block: Lot: 033 Jurisdiction: TIG Zoning: R-7 Remarks: New SF detached, Path 1. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical perrnit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signatui-� Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNE=R: ELECTRICAL CONTRACTOR: PAUL R. CARNEY INC FRANKLIN ELECTRIC INC 1480 NW 102ND AVE 1031 SE 23RD COURT PORTLAND, GR 37229 GRESHADA, OR 970813 Phone #: 503-297-9406 Phone #: 492-4651 Reg #: LSC 140170 ELE 26-1041C SUP 22605 AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature of Su ervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TICyARD, OR 97123 IMPORTANT PERMIT NOTICE MALMEDAL PLUMBING INC 111 318TH AVE ' n ' r•y ,; k . } CORNELIUS, OR 97113 Plumbing Signature Form Permit #: MST2002-00352 Date Issued: 8/27/02 Parcel: 2 S 109AD-08900 Site Address: 12722 SW BUGLE (:T Subdivision: EI K HORN RIDGE ESTATES Block: Lot: 033 Jurisdiction: T;G Zoning: R-7 ' Remarks: New SF detached, Path 1. 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 Form prior to the start of the work to the address above, A1'TN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONI RACTOR: PAUL R CARNEY 114C MALMEDAL PLUMBING INC 1480 NW 102ND AVE 111 S 18TH AVE ren-m-m.110" an 2-22' e0a►uct-11130, na n"4o Phone #: 503-297-9406 Phone #: 503-310-9795 Reg #: I it 102535 PI M 34-276PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X Sig ature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITYOF TIGARD PLUMBING "ERMIT DEVEI_C�PMENT SERVICES PERMIT P -00252 13125 SW Hall B,vd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/330103OiO3 SITE ADDRESS: 12722 SW BUGLE CT PARCEL 2S109^0-08900 I SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 033 _ — JURISDICTION: TIG CLASS OF WORK: AL-r G,'.RBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: i OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ _FIXTURES LAUNDRY rRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: `c WATER CLO -TS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential irrigation backflow prevention device_ FEES Owner: �_ -- — Description Date Amount PAUL R CARNET' INC �-- 1480 NW 102ND AVE 1 PI,UMt3l Permit fee 5/30/03 $36.25 PORTLAND, OR 91229 l'i., Y] 8"���Srrtr"1'ax 5/30/03 $2.90 Total $39.15 Phone : 503-297-9406 Contractor: GREENFIL LANDSCAPE IRRIGATION 21667 SW JAY ST ALOHA, OR 97006-7072 REQUIRED INSPECTIONS Phone : 99�. 57(18 RP/Backflow Preventer Final Inspection Reg#: PLM 7214 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 rujes adopted by the Oregon Issued By: ' Permittee Signature;' call(503)639-4175 by 7:00 P.M.for an Inspection needs a next business day w� I Bulicting r ixtures FOR OFFICE USF ONIA' Planibi g PerMgL4W11e n Received Plumbing n�� � 2 Dana Permit No." Planning proval Sewer City Of Tigard DateB : Permit No.: 13125 SW Hall Blvd. MAY 3 Q 2003 Plan Review Other Da Permit No.: _ Tigard,Oregon 97223 js� F9AGAI. Post-Review Land Use Phone: 503-639-4171 Fax: 16U" r Datc/g ; Case No.: Internet: www.ci.tigard.or.us UILDI. G DMS Contact lice Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: Sunp►emental Information. �— TYPE OF WORK FEE*SCHEDULE(Tor special Information use checklist Uescri ttion Qty, Fee(ea.) Total New construction — r Dc-molition __ --1------ -- New 1-&2-family dwellings Addition/alteration/replacement Other: _ includes loo ft.for each utiliconnection _ CATEGORY OF CONSTRUCTION _ SFR 1 bath 249.20 — 1 &2-Family dwell�� Commercial/Industrial SFR 2 bath 350.00 — Accesso Buildin I Multi-Farn SFR 3 bath _ 399.00 _ Other: Each additional bath/kitchen 45.00 Master Builder 2 JOB SIT7< iNPURMA'�ION and LOCATION Fire sprinkler- ft.: — — --3' Site Utilities Jot)site address: 11:-1 1 _ S W. Catch basin/area drain 16(i0 Suite#: Bld ./A t.#: utr Dr ell/leach line/trench drain 16.60 Pro'ect Name: lied ID46 Footin drain no.linear ft. Page 2 Cross street/'Directions to job site: Manufactured home utilities 116.60 Manholes 16.60 Rain drain connector 16.60 Sanita sewer no.linear ft. Pae 2 -- Storm sewer nolinear ft. Pae 2 _ Subdivision: — Lot#: Pae 2 _ Water service no.linear ft. Tax map/parcel #: _ —Fixture or item —•— - .--"'•-- �--.— 16.611 DESCRIP'T'ION_ OF WORK__ Absor tion valve --� Backflow reventer Pae 2 ----- - -- --- ^ — ----_— Backwater valve 16.60 --- _ ------— ------ - Clothes washer 16.60 Dishwasher 16.60 Drinkin fountain 16.60 — TENANT _ E'ectors/sum 16.60 �OItE Y O'W-N —--i-�— �.----. Name: I tk-r-- k,,^iL•,E't __--- Ex ureansise tank 16.60 Fixture/sewer cap 16.60 _ Address: H v N :�Z ��-- 9 Floor drain/floor sink/hub 16.60 City/State/Zip: 1 --- Garba a dis sal 16.60 Phone: -72Fax: __ Hose bib 16.60 A.PP _ LICANT CONTACT PERSON _.__ Ice maker 16.60 Interce tor/ case tran 16.60 Name' — Medical gas-value: S Pae 2 Address: - Primer 16.60 Cit /State/Zip: — Roof drain commercial 16.60 Fax: Sink/basin/lavato 16.60 _ Phone: Tub/shower/shower nan 16.60 E-mail: - 16.60 Urinal CON-_ TRACTOR —_ ��- 16.60 Water closet _ Business Name: Water heater — 16.60 Address: — __. -� Y J Other: - Cit /State/Zip: ,fie-o/�q ,E 9 D0� 706 a-- Other: �— Plumbing Permit Fees" Phone: 99�'"S7C� Fax' subtotal b _ CCB Lic. #: -7;L1 Plumb. Lie.#: _ Minimum Permit Fee$72.50 S Authorized i%3� 0 3 Residential Backflow Minimum Fee$36.25 3� Signature: /r _ Date:_ — Plan Review(25%of Permit Fee S State Surcharge 8%of Permit Fee S (Please print name) TOTAL PERMIT FEE S Notice: This permit applicotion expires it a permit is not obtained within All new commercial buildings require 2 seta of plans with isometric or ISO Jaya ager it hnc been accepted as complete. riser diagram for plan review. "Fee methodology set by Tr{-County Building industry Service Boar . i:\Dsts\Permit Fortns\PlmPetmitApp.doc 01/03 Plumbing Permit Application -City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Ite Utilities Qty. Fee(fa) Total _�- uare Footage: Permit Fee: Farting drain-1"100' 55.00 0 to?000 _7,000 $11500 Footing drain-each additional 100' 46.40 2,001 to 3,600 $160.00 Sewer-I st 100' 3,601 to 7,200 5220.00 35.00 7,201 and greatLr $309.00 Sewer-each additional 100' 46.40 -� Water Service-Ist 100' 55.00 Medical Gas SVS ms: Water Service-each additional 100' 46.40 Valuation: Permit Fee: Storm&Rain Drain-Ist 100' 55.00 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and S 1.32 for each _ i!lxtutre or Item Qty. Fee(ea) Total additional$100.00 or fraction thereof,to and Commercial Back Flow Prevention Device 46.40 — includina$10 000.OG. $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 51..54.or Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee$36.25 _ 27.55 and includin $25,000.00. Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for Inspection of existing plumbing or each additional$100.00 or fraction thereof,to specially requested ins ctions-per hour 72.5p and includinx$50 000.00. Subtotal: S50,001.00 and up $742.00 for the first 550,000.00 end 51.20 for each additional$100.00 rr fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures? If "yes",please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. uantltV b (Flat re)Work Performed Comments regarding fixture work: Aa tie /Font New Mowed 9112flng Cloned Bath -Tub/Showcr -- — Jacurti/Whirl I Car Wash -Each Stall _ _-Drive Thru --- C idor/Water Aspirator Dishwasher -Commercial -Domestic — Drinking Fountain Eye Wash -- Floor Drain/sink .2" _-- --- 4" -- Car Wash Drain Garbage -Domestic *Note: If the fixture work under this permit results in an Disposal -Commercial _ Increase of sewer EDUs,a sewer permit will be issued and -Industrial _ __ fees assessed for the sewer increase must be paid before the Ice Mach./Refri .Drains — _ plumbing permit can be issued. Oil Separator Gas Station Rec.Vehicle Dump Station _ Shower -rang -Stall Sink -Bari Lavatory _ -Bradley -Commercial _ -Service Swimming Pool Filter Washer-Clothes Water Extractor _ Water Closet-Toilet Urinal — Other Fixtures: i:1DsV\Permit Fonm\PlmPerrnitAppPg2.doc 01/03 CITY OF TIGARD 24-Hour BUILDING; Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BUP Received Date Requested__� /� AM PM BUP _ Location —_ ��_�-- �Pew�=-cSuite MEC Contact Person Ph( ) -93 c2 - 7 �SV PLM - -- Contractor _ Ph( , - _ -- _!. ) SWR -- _ BUILDING Tenant/Owner _ ELC - - - - Fuundation Access: ELC Fig Drain - - Crawl Drain ELR Slab Inspection Notes: SIT Post& Beam - - - Shear Anchors -- Ext Sheath/Shear --- Int Sheath/Shear -- - Framing ----- -- nsulatiun -_ - Drywall Mailing --__..- Firewall - Fire Sprinkler - - Fire Alarm - - Susp'd Ceiling - - Root Other: - na SFAIL - - P�-_- __ Post&Beam Under Slab _ Rough-In - Water Service - - Sanitary Sewer Rain Drains --- Catch Basin/Manhole Storm Drain -- Shower Pan Other: Final _ PASS PART FAIL MECHANICAL Post&Beam -- --— --- Rough-In - Gas Line -_ -- Smoke Dampers _ Final --- PASS PARTFAIL TR ELECICAL__ - Service ----- _. Rough-In --- _--- ---� UG/Slab Low Voltage — Fire Alarm Final Reins PASS PART_ FAIL pection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ] Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk nate -w' _-_ Inspector _ -- —— Other. Ext -- Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL lisase®AoAAAAAAAAAA AAAAAAAAAAAAAAAAAAA,kAAAAAA,Ar , o oil. i .. 7%J i rb ° s H ► a a ( n v ► a o - o (D ► a z r 0 a r• 0 ► a (D ► a a - o � ► a ° l ` a to ttT 'k , "allo o ► 0 � poll ► a ► a O i a ► a ► a ► a ► a �►♦vvvvvvvvvvsiivivvvvv��rsvvvvvvv♦ ---��` vvvvvvsvvv� 1 d ciu n � N �. .r O e`+• W M � � Q D � O O rJ N ` y Q O a O Q a Ix CITY OF TIGA,RD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 c� BUP Rereived ___-_-_.._..__ Date Requested___-__� _L— AM PM _ BUP _ - Location l L —Suite _ _ _ MEC Contact Person ------- _��?1a.><.•, Ph( -) Cf 9a EPLM -- -- Contractor _ __ ___ Ph( -) ___ _ SWR BUILDING Tenant/Owner __ __-___. ___- ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain - Slab Inspection Notes: SIT Post&Beam _---_ -. - - Shear Anchors - - - Ext Sheath/Shear -_ Int Sheath/Shear Framing ----- - --- - Insulation Drywall Nailing ------.--..-_ _ . -- - Firewall Fire Sprinkler ------ -- --- --- Fire Alarm Susp'd Ceiling -- - -------- - Roo! Other: --- - - Final - -- _ PASS_PART FAIL - Post&Beam Under Slab Rough- In Water Wafer In - ---- Sanitary Sewer Rain Drains -- -- --- --- Catch Basin/Manhole Storm Drain - _ — -- -- -" - Shower Pan Other: - Final PASS PART FAIL - --- - -- -- -- MECHANICAL Post&Beam Rough-In - - - - - Gas Line Smoke Dampers - - - Final PASS PART _FAIL - ELECTRICAL - Service Rough-In UG/Slab Low Voltage _ _ gn ' AlarmI PART FAIL Q Reinspection fee of$_-_ __ ___- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA DrMts ��"+�� ✓ 1 Approach/Sidewalk —�- --- -- --- Inspector �� J�. -- -Ext------ Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 a -�Cda MST INSPECTION DIVISION Business Line: (503)639-4171 — Q� BUP _- Received — Date Requested_ JAS` AM-----PM--. BUP -- Location Suitee MtC v Contact Person l —� Ph(_ _) _ L3� — _� PLM Contractor Ph( ) SWR BUILDING Terant/Owner ELC - --. Footing ELC - Foundation Access: Ftg Drain ELF! -- Crawl Drain SIT Slab Inspection Notes: -- - - Post&Beam --- — - - __ Shear Anchors Ext Sheath/Shear - - Int Sheath/Shear Framing - Insulation _ Drywall Nailing -- - Firewall Fire Sprinkler - - '- Fire Alarm ,�" �s;L ln�4Jc_J-IVIQ Susp'd Ceiling - Roof � "�a,>�_ - -- Other:_ Final PASS PART FAIL PLUMBIN_G__ — - - Post&Beam — Under Slab -- — — - - Rough-In Water Service - --- - ----— Sanitary Sewer ---_, Rain Drains ----�-'- - Catch Basin/Manhole _ Storm Drain - -- Shower Pan Other: -- Final - PASS PART FAIL u MECHANICAL -- - -- Post&Beam Rough-In — - `- (las Line Smoke Dampers -- ---- -- Final __- PASS PART FAIL — ELECTRICAL Service - Rough-In — -- ------ - --- --- UG/Slab Low Voltage !-_ -- -- -- --- - - Fire Alarm n El Reinspection fee of$` —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS PART FAtL SITE Please call for reinspection RE:__ _--. -_— Unable to inspect-no access Fire Supply Line ADA Ext Approach/Sidewalk Daft- Lam_._-_ Inspector -Lo _ -_._-.-----__--. 44 Other: vV Final _ DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL Z\ CITY OF TIGA, PLUMBING PERMIT 2�6& DEVELOPMENT SERVICES PERMIT#: PLM2001-00201 13,125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/16/01 SITE ADDRESS: 12722 SW BUGLE CT PARCEL: 2S109AD-08900 SUBDIVISION: ELK HORN RIDGE ESTATES BLC--K: LOT: 033 ZONING: R-7 _ JURISDICTION: TIG CLASS OF WORK: ALT -----`�-� GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PRFVNTRS: OCCUPANCY GRP: FLOOR DRAINS: STORIES: WATER HEATERS: TRAP S: FIXTURES _ LAUNDRY TRAYS: CATCH BASINS: SINKS: SF RAIN DRAINS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 100 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of 100'of water service. Owner: FEES O'BRIEN HOMES INC Type BY Date Amount Receipt 34444 SW IADD HILL RD PRMT CTR 5/16/01 $72.50 27200100000 WILSONVILLE, OR 97070 5PCT GTR 5/16/01 $5.80 27200100000 Total $78.30 Phone 1: 503-625-4400 ---_— Contractor: JIM'S PLUMBING PO BOX 7160 ALOHA, OR 97007 REQUIRED INSPECTIONS Phone 1: 649-4034 Water Line Insp Reg #: LIC 71860 PLM 34-186pb 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 9520001-0010 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 7 Permittee Signature: Call(503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application City of Tigard Date received: or­O/ Permit no.: ,2� -Q0.?0/ Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: City of'1'igard phone: (503) 639-4171 Pro'ect/a i.no.: J PP Expire date: Fax: (503)598-1960 Date issued: g Y eceipt no.: Land use approval: Case file no.: Payment type: U 1 &2 family dwelling or accessory U Commercial/industrial Cl Alulti famil ❑New construction Y improvement U Add J Ruud�cLI Other: 0 Other: 1 !oh address: , �,� s GIGC.E e. 11•cwcription r7��,ee(ea.) Total Bldg.no.: Suite no.: New 1-and 2-family dwellings only: Tax map/t•tx lotlaccounlno.: (Ineludml00t1.foreachutility connection) Lot: Block: Subdivision: / r7 SFR(1)bath -- (2) th -- ft Project name: SFR(3) adt ---- City/county: '15 ZIP: Each additional bath/kitchen Description and location of wok on premix s: _ Slteutilities: �'� �U� Catch basin/area drain I.st.date of completionhnspection: Drywells/leach lin trench drain Footing drain(no.lin.ft.) _ Business name: �94S Manufactured home utilities © Ade',ess: t Manholes _ Raw drain connector _City: (.th(�� State:Q Z.IP: p0 Sanitary sewer(no,lin.ft.) — Phone: 4� Fax: Z -mail: Storm sewer(no. CCB no.: '7/��O Plumb.bus,reg,no: ( Water service City/metro lie.no.: Flrture or item: Contractor's representative signature: Absorption valve Print name: ( / D Date: Back reverter Backwaatete r valve -- — Basins/lavatory -- -- Name: 1pj0 Clothes washer Address: fle(IK�Y-z(Z)�,p .e_ Dishwasher City: /CXlJ<L�t( — State, ZIP:�fj7C) Drinkin fountains) Phone ' �� Fax; E•ectors/sum - y E-mail: Expansion tank _ — Fixture/sewer cap Name(print): d �Q/�,r���/�,;y�� Floor drains/floor sinks/hub -- Mailing address: I/I/ / Garbage dis sal —� - — City _/LSUk'rjyG{.LS _ Stat�,� ZIP: ?d Hose bibb - -- Yhonr.: Ice maker Interceptor/grease trap - - Owner installation/residential maintenance only: The actual installation Primer(s) will he made by me or the maintenance and repair made by my regular hoof drain(commercial) -- employee on the property I own as per ORS Chapter 447. RoofSink( ), n(commercial) ercial — - Owner's si nature: Date: Sump in 1110lTrubstshowertshower pan —- Name: Urinal -- -- -- Water cicset Address: Other: Phone: -- C :1 — Water heater City: _ State:_ ZIP: — — --�-Fax: E-mail: _-- - Total No(Al juriufictlons accent cmiit code,phase calr iuritd;clion Inn rnw.Information. Minimum fee................$ UVisa Ll MasterCard Notice:This permit application CredN cmd number / expires if a permit is not obtained Plan review at _ %) $ _ E■pitee within 190 days after;t has been State surcharge(896)....$ _ . TOTAL, . N■me of crtrdltolder u-shown as credit card �--� accepted as complete. 4 ...................... ----- Cardhdder elRnature '� s_ Amami 4404616(WOCOM) PLUMBING PERMIT FEES: --- PRICE TOTAL New 1 and 2-family dwellings only: QTY ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL AMOI FIXTURES individual 1 ea the dwelling and the flrst100 ft. QTY (ea) Sink ---- for each utility connection)- - 16.60 One 1 bath -- _ 5249.20 Lavatory _ 5350.00 _ Tub or Tub/Shower Comb. 16.60 Two 2�bath $399.00 - -16.60 _Three(3)bath _-_____ - Shower Only __ SUBTOTAL Water Closet— 16.60 16.60 BY.STATE SURCHARGE - _-_ Urinal PLkN REVIEW 25'/.OF SUBTOTAL 16.60 - TOTAL Dishwasher _ - --- -- Garbage Disposal— 16,60 l-aundry Tray ____ _ Washing Machine 16.60 Floo Dr,Sink 3" - 1660 16.60 PLEASE COMPLETE: 3" `— 4" "--- 18.60 --Quantit b Work Performed Water Heater O conversion O lika kutd 13.60 Fixture Type: New Moved Replaced Removed/ Sas piping requires a separate mechanical _ Capped permit. 46.40 Sink_ -- MFG Hume New Water Service Lavalor _ - pAFG Home Now San/Storrs Sewer 46 40 --- Tub or Tub/Shower — 16.60 Combination ---- Hose Bibs --- -- 16.60 Shower Ong R oof Dralns _ Water Closet - 16.s0 Dtai rinking Founn Urinal _ - - Other Fixtures(Specify) 16.60 - Dishwasher - -- -' Garba a Dis osal -- -- Laundry Room Tra -_ - Washing Machine - Floor Drain/Sink: 2" — _ Sewer-each additional 100'- 46.40 _ -- Water Heater 4"_ -- Water Service 16t 100' 5500 -- Other Fixtures Waler Service ervice-each additional 200' 46.40 -- S eci --- -- Storm 8 Rain Drain-let 100'- - _ 55.00 - - Storm�Rain Drain-each:add46.40 itional 100' Comme*clal C+i_.f F'uw Pra "•r,Dev!re -45.40 - _ - 27.55 Residonlial Backflow Prevention Vavicu' — Catch BOsin 16.60 - ---- -- 72.50 Inspection of Exlslmg Plumbing or Specially 2.50 COMMENTS REGARDING ABOVE: Requested Ins ections _ - fir - _-__- ----- - Ratn Drain,single family ni;aiiing - ___-- 16.60 - ----- Grease Traps -,--- - --------- -QUANTITY TOTAL TOTAL Isometric or riser dlagram Is required if — �uaniky Total Is 1 9 _____--- ----_� --------- *SUBTOTAL 8%STATE SURCHARGE -`--------- ---------- "PLAN REVIEW 25°/a OF SUBTOTAL I Rayuired only II fixhue yly.total is>9 =—{ TOTAL *Minimum permit fee Is$72.50 6%state surrharge,excepl Residential Baekllow Prevention Device,which Is$36 25-R%slat"surcharge. '*All New Commercial Buildings require plans with Isometric or riser diagram and plan review I:\dsts\forms\pim-fees,doc 10/10/00 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- 8UP --Date Requcsted AM" `f PM _ BLD Location /?� 7Z Z Sw ��, — Suite MEC Contact Person —_ — Ph 7�� - 3 S� PLM Contra^tor Ph SWR BUILDING— 1•enant/Owner ELC Retaining Wall ELR Footing Access: -- ----------- Foundation FPS _ Ftg Drain -- Crawl Drain InsR ecfion Notes: i ,, SGN _ Slab --- — ��G�- � �� ��G� SIT Post 6 Beam -� Ext Sheath/Shear _ Int Sheath/Shear Framing 1•� -- `' /� Insulation I �" Drywall Nailing �-� i✓ C_.. _ Firewall _ - I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Ficial PASS PART FAIL Cr_ Post& Beam Under Slab Top Out Sanitary Sewer Rain Drains Fin AS_$) PART FAIL CHANICAL — Post&Beam ----- — z A,41 - 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 ---- --- - ---- ----- -- --- -_--___. Sanitery Sewer Storm Drr,in { )Reinspection fee of$_ requirr d before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ )Please call for reinspectior+RE. [ )Unable to Inspect-no access ADA /� Approach/Sidewalk pats 1/� U , `� - Ext ' Other _ � Inspector. —+--__.—�--.— Final v PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: P 00201 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5I1 6/01 6I01 PARCEL: 2S 109AD-08900 SITE.ADDRESS: 12722 SW BUGLE CT SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7 BLOCK: LOT: 033 —_— JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: 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: 100 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of 100' of water service. FEES _ Owner: � — --- -- - — Type By Date Amount Receipt O'BRIEN HOMES INC PRMT CTR 5/16/01 $72.50 27200100000 34444 SW LADD I1II1 RD 5PCT CTR 5/16/01 $5.80 27200100000 WILSONVILLE, OR 97070 _ _ —. — Total $78.30 Phone 1: 503-625-4400 Contractor: _— JIM'S PLUMBING PO BOX 7160 ALOI-A, OR 97007 REQUIRED INSPECTIONS Phone 1: 649-4034 Water Line Insp Reg #: LIC 71860 PLM 34-186pb 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 mored 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-0503) 246-1987. Issued By: L ''� Permittee Signature:� C�` _,ftr* Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day BUP- Building Permit ELC - Electrical Permit _ Inspection Description Date Passed By Inspection Description Date Passed By Footing/Setback _^ Underground cover Foundation walls _ Wall cover Footing drain — Ceiling cover Waterproof bsmt walls Electrical rough-in Slab Electrical service _ Craw, drain Electrical final — _ Underfloor insulation Post/t-arn structural _ — _ Shear walls/anchors ELR - Restricted Energy Permit Roof nailing Firewall ins ection Description Date Passed_ By Low voltage _ Tilt-uppanel Electrical final Masonr /Reinforcement Framing -- MFG-Structure set-up MEC - Mechanical Permit Insulation RCInspection Description Date Passed By Drywall nailing Post/beam mechanical Suspended ceiling — Engineered soils Gas line Welding Lab Final Mechanical rough-in Concrete Lab Final Fire damper -- Bolting Lab Final Duct work Structural observation Smoke detector Fireproofing Lab Final Mechanical final Final inspection,__ - -- - -- PLM - Plumbing Permit BUP— Fire Protection S stem Permit 4 Inspection Description Date Passed_ B Inspection Description Date Passed By Plumbing underslab Sprinkler underfloor/slab Crawl drain bi_ g SQrinkler rough-in Post/beam plum _ — Sprinkler final Plumbingt L--out Fire alarm final Rain reventer _ — — Rain drain _ — - Storm drain Water service SIT - Site Permit Sanitary sewer Ins_p_ection Description Date Passed By Culvert/catch basin Footings Pump/ 11 septic tank Foundation walls _ Plumbi_g finalZZA I S rinkler supply lines Sprinkler underfloor/slab — Catch basin/Manhole SWR - Sewer Permit Engineered soils Inspection Description Date Passed_ B Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits iAdsts\IbmugnspRecordBUP.doc 0417/01