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12658 SW GAARDE STREET N tJ1 OD U) G7 C) m 12658 SW GAARDE S7 C11 r I IGARD BUILDING INSPEC 0ON DIVISION MST 24-Hour Inspection Line: 639-4175 Busincss Line: 639-4171 BLIP — -Date Requested— Ze) _—_AM Z-ll` PM BLD Location l 2 (s'S S S �T4 G Y 6t sal`' Suite _ MEC Contact Person Ph 31f- / PLM _ — — Contractor Ph SWR B —~ Tenant/Owner — ELC Rw-iining Wall ELR Footing Access: Foundation FPS —_---- _-- Fog Drain SGN Crawl Drain Inspection Notes: -- - Slab ---- SIT Post&Beam Ext Sheath/Shear --- --- --- --- Int Sheath/Sheaf Framing L3 L' FC.fIyC�►-t j t _— Insulation — y� Drywall Nailing _ — ---- -- Firewall Fire Sprinkler -- Fire Alarm Susp'd Ceiling -- Roof Misc: _ — - -- -a aPART FAIL. BING _ Post& Beam Under Slab Top Out Water Service --- Sanitary Sewer Rain Drains ---- Final PASS PART FAIL _ - MECNAN L Post&Beam -- - Rou!7h In _ Gas Line -- moke Dampers ASS PART FAIL RICAL -- Service — Rough In UG/Slab — Low Voltage Fire Alarm _ -- Final PASS PART FAILSITE — Backfill/Grading — Sanitary Sewer Storm Drain [ )Reinspectlon fee of$ required before nest inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin )Please call for reinspection RE: [ )Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date /- ? �-` Inspector /2 Ext Other _ — ---- --- .... Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY O F T'G A R D � MASTER PERMIT PERMIT#: NIST1999-00178 DEVELOPMENT SERVICES DATE ISSUED: 6/16/99 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12658 SSV GAARDE ST PARCEL: 2S104DD-06400 SUBDIVISION: EAGLE POINTE ZON-JG: R-4.5 BLOCK: LOT: 060 JURISDICTION: TIG REMARKS: PATH I: New single family dwelling My/attached garage, covered porch and balcony. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUI,.ED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 2,055 of BASEMENT: if LEFT: 15 SMOKE DETECTORS: V TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,641 if GARAGE: 770 if FRONT: 20 PARKING SPACES: 7 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 19 'VALUE: S 273 418 94 OCCUPANCY GRP. R3 BDRM: 3 BATH: 3 TOTAL: Sf REAR: 53 PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH 1 LAUNJRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES. 100 SF RAIN DRAWS: 1 CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP: I WATER HEATERS: I WATER LINES: u)0 BCKFLW PP'VNTR: 1 GREASE TRAPS: 01 HER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOII iCMP,3HP. VENT FANS: 5 CLOTHES DRYER: I Hd; FI1RN-=100K: I UNIT HEATERS: HOODS. I OTHER UNITS: I MAX INP: bfu I LOOR FURNANCES- VENTS. WOUDSTOVES. GAS OUTLETS: I _ ELECTRICAL RESIDENTIAL UNIT _ SERVICE FEEDER 1_MIP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS 1 0 - 200 amp: 0 200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION. EA ADD'L 500SF , 201 400 amp 201 400 amp: 1St WIO SVCIFDR: 0'.7 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp. 401 600 ampEA ADDL BR CIR SIGNALIPANEL- IN PLANT: MANU HMISVCIFDR: 601 - 1000 amp. 601-amps-1000v! MINOR LABEL: 1000♦amvlvolf: PLAN REVIEW SECTION Reconnect only: 1=4 RES UNITS: SVCIFDR,=225 A.. >600 V NOMINAL CLS AREAISPC OCC: ELECTRICAL•RESTRICT-ED LNERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: X VACUUM SYSTEM: x AUDIO h STEREO: FIRL ALARM, INTERCOMMAGING: OUTDOOR LNDSC LT BURGLAR ALARM: X OTH: IRRIGA7IuN BOILER: HVAC, LANDSCAPEIIRRIG: PROTECTIVE SIGNI.. GARAGE OPENER: CLOCK: INS I RUMENTATIOW MEDICAL: OTHR: HVAC: DATA7TFLr COMM NURSE CALLS. TOTAL a SYSTEMS. Owner Contractor: TOTAL FEES: $ 3,838.85 This permit is subject to the regulations contained In the I IURRLE JOHN R I,EVELYN M OWNER Tigard Municipal Code. State of OR Specialty Codes and 5706 SE 20TH AVE SIGNED RESPONSIBILITY FORM all other applicable laws All work will be done In PORTLAND OR 97202 IN FILE accordance with approved plans This permit will expire If work is not started within 180 days of Issuance or if th,3 work Is suspended for more than 180 days ATTENTION Pnm,eI Oregon law requires you to follow rules adopted by the RINAL1(V-`� Oregon Utility Notification Center Those rules are set Repo forth in OAR 952-001-0010 through 952-001-0080 You may obtair copies of these rules OF direct questions to OUNC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion 844-8444 Post/Beam Mechanica Mechanical Insp Shear Wall Insp Rain drain Insp Plumb Final Grading Inspection Underfloor insulation Plumb Top Out Low Voltage Water Line Insp Final inspection Footing Insp CraNI Drain/Backwater Electrical Service Fireplace Insp Appr/Sdwlk Insp Building Final FOundation Insp Fo3ting'Foundalion Dr Electrical Rough In Gas Line Insp E ectrical Final PostiReanl Structural P_M/Underfloor Framing Insp Insulation Insp Mechanical final ISSUed By RJ L-Al _ Per nittee Signature ^ C Call (503) 639-4175 by 7:00 p.m. for an inspection needed thg ext business day CITYOF TIGARD SEWERCONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR1999-00102 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/16/99 PARCEL: 2S104DD-06400 SITE ADDRESS, 12653 SW GAARDE ST SUBDIVISION: EAGLE POINTE ZONING: R-4.5 BLOCK: LOT: 060 JURISDICTION: TIG TENANT NAME: HURRLE, JOHN R + EVELYN M USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: Sewer connection for a new single family dwelling. Owner: — _ FEES_ _ HURRLE, JOHN R + EVELYN M Type By Date Amount Receipt 5706 SE 20TH AVE — - —— PORTLAND, OR 97202 PRMT BON 6/16/99 $2,300.00 99-316144 INSP BON 6/16/99 $35.00 99-316144 Phone: Total $2,335.00 Contractor: BRIDGEVIEW PLUMBING INC 808 MOLLALA AVE OREGON CITY, OR 97045 Phone: Reg #: LIC 000459 PLM 3-140PB Required Inspections _ Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the :nified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect " `eet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Pe,.nit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. 1 hose rules are set forth in OAR 952-001-0010 throug AR 952- 01- 80. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-198. Issued by: Permittee Signature:/- x, f� C Call (503) 639-4175 by 7.00 P.M. for an inspection needed the rS t business day APR-11-97 FRf 7:30 RENAISSANCE FAX N0. 5036561601 P. 02 JOHN IL do EYZtYN M.HURRLE 1.OT N 60 EAGLE POIIV'I Z , I 1658 SW GAARDB ST. 9122`T THE PURCHASERS OF THE ABOVE MENTIONED PROPERTY WILL REPAY RENAISSANCE DEVELOPI TENT DIRECTLY F()A PR?PAID TRAFFIC IMPACT FEES(TIF's)IN THE AMOUNT OF$ 1,690.00.THESE FEES WILL BE COLLECTED IN THREE PAYMENTS AS SHOWN BELOW: ISTPAYmE'.NT:ArPn 14, 199 7 $ 100.00 2ND PAYMENT:MAY 14, 1997 $ 795.00 3RD PAYMENT:NNE 141997 TOTAL ORiMBURSEMENT OF TIF's $ 1,690.00 PURCHASERS: JOHN R.HURRLE DATE EVE LYN#tItURRL.E DATE? SELLER: K �ANCE DEVELOPMENT CORP. L�4�01 RAN AL S. . .BASTTAN DATE CITY OF TIGARD Residential Building Permit Application Plan Check 4- 'i13125 SW HALL BLVD. Additions or AlteraLQnE Recd By Date Recd ' TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E 5'7 V 503-639-4171 Date to DST 41- 9 `f F 503-684-7297 Permit Print or Type Called t" Incomplete or illegible applications will not be accepted _ -- 51�1/�lrfQQ'�IDoZ Name of Protect �co Gv�/� Name Job /�.1 ` "VV c (O0 Address Site Address Architect Mailin Address Ci /State Zlp Phone Nam .(i `1711`/ _ Owner ailing Address Na t � "' "� e Engineer M sting Address / Cloy/State Zip Phon "/(' /E City/Statq Zip Phone General Name ',// r Contractor �i[,✓ (",� Describe work New b: Addition O Alteration O Repair O Mailing Address to be done _ Prior to permit Additional Description of Work: issuance,a copy City,State Zip Phone of all licenses are required if eg—on Const.6o—n T Board Exp.Date PROJECT expired in Cor Lic# database VALUATION _ Mechanical Name --- / NEW CONSTRUCTION ONLY: Sub- " % 1 ,r 14 9 fin G Sq. Ft. House: _ — Sq. Ft. Garage Contractor Meiling Addrr;as' _� 31'W' �2E> ! •' '� ? Indicate the restricted energy installation by the electrical Prior to permit _ /.SC .9 ' subcontr,ctor in the fellowin areas issuance,a copy City/State Zip Phone --- -- _ of all licenses 1 .: c Restricted Audio/Stereo are required if Oregon Cons(.Cont Board Exp. Date Energy Systern Alarms expired in COT Lic.# Installations Vacuum Irrigation database - 1( 1 �r _astern --1_ System Plumbing Name (check all that Other: m Li Contractor Mailing dressy //�— Corner Lot YES NO Flag Lot YES NO (check one) (check one) Has the Subdivision Plat recorded? N/A YES NO Prior to permit City/State ZIP Phone i issuance,a copy .r Cr. ') / 10e.of all licenses are Oreon Const C6nt.Board Exp.Date requeed if Lic# -- expired it COT ��J j _� r /,/ I hearby acknowledge that I have read this application,that the databasa Plumbing Lic.# Exp Date information given is correct,that I am the owner or authorized agent of the owner,and that plans submitted are in compliance with _Orego_n $ipt aws. _ Name Signator' O er/ nt i Date Electrical ( t 1 SIt�J Mailing Address ^� -- Cont!WmePhone# Contractor vATT ►��__�.— __ f City/State Zip Phone Prior to permit issuance,a copy FOR OFFICE USE ONLY: of all licenses are Oregon Const.Cont Board Lxp Date V ctncPl t#: Ma /Tl.#: required if Lic# b _ / 7 p expired in COT _ ( database Eieal_L7c # Exp Date Set cks: Z t� Solar.T y� Electrical Supervisor Lic # _ Exp Data EngineMing App oval: Planning Approval TIF: 13% i\dots\formsWaddalLdoc 11120/99 I \� 1 � Ito NO 06 i:;wIt�- .- LnT' � �� �1►ST' Permit * O4V - Address:F / ,�� � ox / �... Issued by: _ Date: Statement: information (Notice to Property Owners About Construed n Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt,from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: 1. I own, reside in, or will reside in the completed structure. 2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is — (Name) Contractor regis. # 1� I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that tlWabove information is correct and that I have read and do understand the Information Notice to Proper vner about C str on Responsibilities on the reverse side of this form. �CY (Sig cure of permit applicant) (Date) (White cnp), to issuing agency permitfile, pink copy to applicant) Information Notice to Property Owners Abnut Construction Responsibilities ti i;/y1 �•'/4'i >•.y, r - IIt'! +lles 711 f t.... � . �Iili.:.`ti (ii., .. '. ill.;l llllhi(nc'llu'11111` ,I11�`al`dill^ '•Ill,, iill� . a,A; 11 Of ii) V% W ,JI 1.. u,. 711) �. �.,'fl: xv,l ,of 611111Cra EMPLOYER 1F„PC1N;3"E�IL.iY'hE:S: i riii '. A iiI rl.r r7 111 .. 'thtllu ii�la cif ii,',i i ltl; IIL' , i. , • :I I� fills � ..�{�`.. r1i1 ,'111Ii�� ,t.' 'i.� fI'i lI. - ''din t�-'1111 L?�:!'� I',11�.' L.'c.,f1,')1)nll•. .. ; It ,�,i911{ �tl�1;n'll('If`� `a•A"1l1';'t' I11hC Illill'�.'I il' ,, ,;{ fit' Irrylt{' l,ir f{ ` Ir�y [l,i`,11r,•, 1. ,'i,,.,l If � It t{(�11 t I,,'�lhlll� n,tltli: lil tllr'1:1V 1�I',1f11 kC`111't'111(1{",t,( { i n1�;1'I UI I t11,ion i.111l1U I)1„I,Li111111ew f)) Human {Z('b1�flCti lt'I' I.,I11. ,ti"� IYILI`il 10-11 Illblil,.11l'. .i 171$11 'vItli'l't{ ,. III'.'. I(,{1. Ut'l moll, IT1.111, Iti I.Cl, I 1 ,, i� 1.r< �1'tl '1 { � / '( 'c' 1(• (� ' v l r ni u ) I , ,( 1ti1� 1' II `,,;illl( lr '', Ilit'r "aF CONCERN' �!r.-I.;• i I , - , •.It41�ItY �i11lt1tt'fai Illl`t';l'1i{I,'Ia'4{II(It(il�'11;�. lil'11i,,ri'1.� (jal!`.'(;i:ill5!11':flll(. '-• t:.�.,.1 ,t :it Ilr.',II,G,_ ' .1,_.11 i, '..'1• !i 'till'; 1d 0111C.111hlo\t'('S. !L•'clll•I'1n1111vt'rv){1('i Nflf`t'li:" la�tnittrlt� Ill`,t`nCI':i{it.'Ifl`,1(IOr1("i('lyyMMin;1h'Illit" ol-kIIfrough itinndIini 0l i- I'l llOWY 1`1111{1wr f1 61(•114 :,11 1{lt' wriorr!illt' fllllf`l. cr,tlwv i't!II (.'�In1111��Iti ft't�lil�'l'"t�1115'�9C"C�I,OII�: 1 i {hl'. Boiird I• ! cill,d ill 11! 11111iCI `• .I IIIC {11{1, 111 Salem. r , i E� CITY Of TIOARD Residential Certificate of Occupancy 'ermit No. sir (7(��7 Address: 6, 5 � LeJ 6rA'V / U - 3 vner/Contractor: Q e of Final Inspection: - - Inspector: A *W strueaure has been found to be in suhstantial compliance with the provisions of the State q(Oregon One& Two Family bN,ellinR (144 ode and is hereby approved for occupant. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE BRIDGEVIEW PLUMBING INC 808 MOLLALA AVE OREGON CITY, OR 97045 Plumbing Signature Form Permit #: MST1999-00178 Date Issued: Pamel: 2S104DD-06400 Site Address: 12658 SW GAARDE ST Subdivision: EAGLE POINTE Block: Lot: 060 Jurisdiction: TIG Zoning: R-4.5 Remarks: PATH I: New single family dwelling wlattached garage, covered porch and balcony. Your company has been indicated as the plumbing contracto, 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, ATTN. Building Dept. No plumbing inspections will be authorized until this completed form is received G'JVNFR: PLUMBING CONTRACTOR: SHU�RgRILE, JOHN o, RE+ EVELYN M BRIDGEVIEW PLUMBING INC P7c�R I LANLT uKV3i tui Umckj% Lm ALA AVE V I U-to Phone 0 Phone #: Reg #: I Jr. 000459 PI M 3-140PB A INK SIGNATURE IS REQUIRED ON THIS FORM X ` . Signature of AutHorized Plumber If you Have any questions, please call (503) 639-4171, ext. # 10 ELECTRICAL PERMIT- CITY O F TI GARD RESTRICTED r':NERGY DEVELOPMENT SERVICES PERMIT#: ELR2000-00009 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 1/7100 SITESUBDIVISION:D SSEAGLE POINTERDE ST ORIGINAL ZONING: R 4 51[.D 06400 BLOCK: LOT: 060 JURISDICTION: TIG Proiect Description: Installation of an all encompassing restricted energy. A.RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: X AUDIO & STEREO: —INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: X CLOCK: MEDICAL: HVAC: X DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: OUTDOOR, LANDSC LITE: OTHER: X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: Owner: _ - Contractor: !� - HURRLE, JOHN R + EVELYN M GARY'S VACUFLO INC 5706 SE 20TH AVE 9015 SE FLAVEL PORTLAND, OR 97202 PORTLAND, OR 97266 Phone: Phone: 775-2042 Reg #: LSC 069047 ELE 26 728CLE _ FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT DEB 1/7/00 $60.00 00-320989 Elect'I Final 5PCT DEB 1/7/00 $4.80 00-320989 Total $64.80 J 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 copes of these rules or direct questions to OUNC at (503) 246-1987 Issued b� ( `>�� Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: — _ T DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: — LICENSE N O: -- --- - ----- —��--- -- — Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 1 CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APPLICATION Rec' by; 1 125 SW HALL BLVD Date 19C TIGARD OR 9722.3 PRINT OR TYPE q V- 503-639-4171 X304 Permit 0- 66ce F - 503 598 1960 INCOMPLETE OR ILLEGIBLE APPLICATIONS CUSt.CaII'd: WILL NOT BE ACCEPTED _ Name of Development Project TYPE OF W)RK INVOLVED -RESIDENTIAL ONLY Restr`05606 5 Energy Fee........................................ $60.00 S� �4 (FOR(FOR ALL SYSTEMS) JOB Street Address Slam ( � Check T pe of Work Involved ADDRESS C4 Q : CilylS T Zip Phone# Audio and Stereo Systems Name Burglar Alarm OWNER Mailing AdCress arage Ooor Opener' Cityl tem to Zip phone g Heating,Ventilation and nir Conditiumnp System' - -- - --- �17/ Name V UUm S stems' Ll �r f Other` ! f7 /y1�/`7`a-; — yT CONTRACTOR lig Cess — �`, TYPE OF WORK INVOLVED _COMMERCIAL ONLY IPrror to issuance..a /Sta oJne� Frere for each system.................................... ..... $60.00 copy of all licenses x- A. 1� (SFE OAR 418.260-260) L7__. are required if Oregon Godrd Lir-9 Ez Da e expired In C.O.T, nt Check Type of Work Involved. data base) LI I Contr.Lic.N S to L] Audio and Stereo Symams C.O T..rr Metro Ic.M — Et , Oke Z. - ,-.'i; ❑ Boiler Conhob Owners Name _ Crack Systems OWNER - Mailing Address APPLICANT Data Telecommunication Installation City/SlatePhone N ❑� -. Fire Alarm Installation This permit it;Issued under OAF 916 320-370. -Pillsapplicant agrees to make only restricted enerpy irstallations(100 volt amps or less)under this ❑ HVAC permit and to do the follcwtng ` r� Instrumentation 1 Only une elecincal licensed persons to do Irstallalions where required. Certain esideribiol and other transactions are exempt from licensing, L� Intercom and Paging Systems These have asterisks('1 All others neA-d licensing; Landscape Inlgatlon Control' 2. Call for inspections when installation under thispermR are ready for inspection at 503-6394175; ❑ Medical 3 Purchase separate perrnits for all installations that aro not ready for an ❑ Nurse Calls Inspection when the inspector is out to Insped under this permit: 4 Assume re-sponsiblllty,for assunnq that all corrections required by the ❑ Outdoor Landscape. I ighting' Insp"--tor are done.and, ❑ Protective Signaling Assuan-responsibility,for arlling Mr a Anal inspection whEn all of the corrections are cornpletrd ❑ Other Permits are non-transferable and non-refundable and expire if work is not ste-ted within 180 days of issuance or if work Is suspended for 190 days. Number of Systems 1 he person signing for this permit must be the applicant or a Person t' Nr)kxnerre,am"luired. Lluenses ern revuura l for all other insUaWrtions avthonred to bind the applicant - 0 - - - FFI $: f Signature - -- - --- FKTER FEES S LL X%SURC4'RGF(.08 X TOTAL ABOVE) S Authority if other than Applicant � 2 / TOfAr_ $��_©U I'\d*b;\fvrM9\re"10 dui.3189 2 v)U r -4t:'Lo 00OF-90-NItil CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00314 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/8/02 SITE ADDRESS: 12658 SW GAARDE ST PARCEL: 2S104DD-0640U SUBDIVISION: EAGLE I OINTE ZONING: R-4.5 BLOCK: LOT: 060 JURISDICTION: TIG ASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRi,PS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residertial backflow prevention device for irrigation system_. Owner: FEES - Type By Date Amount Receipt HURRLE, JOHN R + EVELYN M PRMT CTR 8/8/02 $36.25 27200200000 5706 SE 20TH AVE PORTLAND, OR 97202 5PCT CTR 8/8/02 $2.90 27200200000 _ Total $39.15 Phone 1: Contractor: MATT SANDERS LANDSCAPING INC 21785 SW TV HWY ALOHA, OR 97006 REQUIRED INSPECTIONS Phone 1: RP/Backflow Preventer Reg #: LIC 5703 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipa! 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 r,t!es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246,-1987. fy f Issued By: Permittee Signature:�_ � `C 'T•/Y,�l' �("_��(', 1,�.��,.. Call (503) 639-4175 by 7:00 P.M. for an inspection o�.eded the next business day Pluit bing Permit Application rRccc Plumbing) C Permit No. Arg' / Planning Approval Y Sewer City of Tigard 'Test Form Datc/ey: Permit No.: 13125 SW Hall Blvd. Plan Review Other 'figard,Oregon 97223 Da1e/ay: Permit No.: Phone: 503-639-4171 Fax: 503.598-1960 Post-Review Land Use Date/By: Case No.: Internet: www.ci.tigard.or.us Contact Juris.: Sec Page 2 for 24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information. TYPE OF NNORK _ FEE*SCIIEDUI_,E(forspecial Inform-a-ttiion use checklist) ` New construction IL-1 Demolition _ Description —I Ql.,• IFcc(eu) I ota1 Addition/alteration/replacement Other: New t-&2-family dwellings includes 100 ft.for each utili(V connection CATEGORY OF CONSTRUCTION SFR I bath _______249.20 _ 1 & 2-Family dwellin Commercial/Industrial SFR 2 bath — 350.00 ]Accessory Building Multi-Family SFR 3 bath 399.00 Master Builder Other: Each additional bath/kitchen _ 45.90 _LL JOB SITE INFORMATION and LOCATION Firesprinkler-sq.ft.: I'a c 2 � � Job site address: /,J 9k Site Utilities — Suite#: Bld ./A t.#: Catch basin/arca drain I6.G0 _ D ell!leach line/trench drain 16.60 Project Nam Footing drain Jno.linear R. Pae 2 Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes _ 16.60 Rain drain connector 16.60 Sanitarysewer no. linear n. Pae 2 Lot M Stomp sewer no.linear n.) Page 2 Subdiyi5lon� �— Water service no.linear ft ) V Not.2 Tax map/parcel#: Fixture or Item DEnCRIPTION OF WORK Absorption valve .6.60 -----rte—`—. �, � -- A /ice;� C ' Backflow preventer Page 2 Backwater valve 16.60 -- Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 PROPERTY OWNER TENANT Ejectors/sum 16.60 Name: , , ��/,c�� /��� KCL Expansion tank IG.GO �2v Address_I;&;e & G� - ��f!, Fixturc/sewer ca 16.60 —f Floor drain/floor sink/hub 16.60 City/State/Zip: it Garbage disposal 16.60 Phone: Fax: Hose bib 16.60 AI'I'LICANT' CONTACT PERSON Ice maker 16.60 Name:_ Int,.cc tor! rcase trap16.60 Address: �^ _ Medical as-value: S Pa e 2 �� --- -- Primer 16.60 Q City/State/ZiL_ _ — Roof drain commercial 16.60 Phone: Fax: Sink/basin/lavatory 16.60 C\ E-mail: Tub/shower/shower an 16.60 CONTRACTOR Urinal 16.60 — Water closet 16.60 p Business Name: 1---rA7T Lk / Water heater 16.60 Address: Other: ^Y Cit /State/Zi Other: (� Phone: SG '(Z -/ Fax: �C4 2- Plumbing Permit Fees* Subtotal S CCB L e. #; C 7 Plumb. LicA ti" Minimum Permit Fee$72.50 S Authorized ( - /. Residential Backnow Minimum Fee$36.25 i Date: Plan Review 25°b of Permit Fee) S Signature: State Surcharge k890 of Permit Fee) S ; TOTAL PERMIT' (Please print name) Notice: This permit application expires If a permit Is not obtained within IAO days after It has been accepted as complete. All ncss(onnme,cial building require 2 Geta of plans with Isometric or *Fee methodoiog� set t»'Tri-County Ilulldiag Industry Service Board. riser diagram fill plan resiesv. PlumhinE Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qly. Fee(ca) Total S uare Footage: Permit Fee: I'0oting drain-1" 100' 55.00 0 to 2,000 $115.00 2,001 to 3,6oo $160.00 Footing drain-each additional 100' 46.40 3,601 to 7,200 $220.00 Sewer-I st 100' 55.00 7,201 and greater $309.00 Sewer-each additional 100' 46.40 Wates Service-Ist 100' 55.00 — Medical Gas S stems' Water Service-each additional 100' 46.40 Valuation: Perm, fee: _ Storm!Rain Drain-IM 100' 55.00 $1.0010$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.:10 for the first$5,000.00 and$1.52 for each additional$10'1,00 or fraction thereof,to and Fixture or Item Qty Fc:(cal Total including_S10;0.00. C'omm>ercial[lack flow Prevention Device 46 40 $10,001.00 to$251000.00 $18.50 for the first$10,000.00 and$1.54 for each additions;$100.00 or fraction thereof,to Residential Backflow Prevention Device and including$25,000.00. minimum omit fee$36.25 tt27.55Rain Drain,single family dwelling $25,001.00 to$50,000.00 $379,50 for the first$25,000.00 end$1.45 fur each additional$100.00 or fraction thereof,to Inspection of existing plumbing or and includin $50,000.00. ur $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing fixtures? If ,,yes„,please indicate work performed by fixture. Failure to accurateh'report fixtures could resul. n increased sewer fees*. Commens retarding lixlure work: ( uanllty by Flriurc Work 1'crformed g Fixture Type: Replace New Dl.wed Eslstln Capped Baptist-Y/I:Ont — --— --— - Bath Tub/Shower _ -Jacuzzi/Whirlpool Car Wash -I:ach Stall -Drive'rhru C-us idor/Water As irator Dishwasher -Commercial -- -- - -Domestic Drinking Fountain Eye Wash -- Floor Drain/sink 2” --- _ — Y 4„ — Car Wash Drain If the fixture Isork under this permit results it, an (;arhage -Domestic - increase of sewer 1:b1 s,a server permit will be issued and Disposal -Commercial fees assessed for the seller increase must be paid before the -Industrialpl — Ice MachJRefri .Drains wlilling permit can be issued. Gil Se orator Gas Station Rcc.Vehicle Dump Station _ Shower -Gong -Stall Sink -[lar/Lavatory _ -Bradley -Commercial _ -Service _S_%%iniminp Pool Filter -- Washer-Clothes — Water Extractor Water Closet-Toilet Urinal Other fixtures: �tttw CITY OF TIGARD 24-Hour spe tion Line: (503)639-4175 BUILDING MST INSPECTION rjC1'- SON Business Line: (503)639-4171 BUP - Received ........ __- ------ Date Requested__-- '� - AM___ PM -_ BLIP Location __.-___. _� r�' �' > .---Suite_`—_-__-- MEC Contact Person -__-__..._ - Ph( ) PLM Contractor - ---- -_ � Ph(--- '4 SWR BUILDING Tenant/OwnerE.LC Footing E:LC Foundation Access: Ftg Drain ELR — Crawl Drain Slab Inspection Notes: SIT -- Post& Beam Shear Anchors Ext Sheatn/Shear ---------- - Int Sheath/Shear Framing --- . .. - ---- - - --._ --- —-- Insulation Drywall Nailing - -- ------ --- -...-_- -- -------------- - Firewall Fire Sprinkler --.Y-_.... __.----- -------- -__--- ----------- Fire Alarm Susp'd Ceiling -- - -- --------- - -- -- - Roof Other: --- _ - --- - - -_. .__ ----- - -- ----- - Final PASS PART FAIL PLUMB_IN_G ------ ---- --- -- Po,it& Beam Under Slab - - --- - -- _- -- -- -- Rough-In Water Service ------ Sanitary - --Sanitary Sewer Rain Drains - - --- --- — ---- - Catch Basin/Manhole Storm Drain ------ ------- — — Shower Pan Other. - - ----- .In� / — SS PART FAIL ---- --� -- —_ SSY. Beam- - ------ Rough-In ----- - -- ---- --- Gas Line Smoke Dampers - -- --- ----- ---- --- - Final _PASS PART FAIL - - --- ------ ELECTRICAL — Service - - ----- - ---- ----- - Rough-In - UG/Slab Low Vc l t e -----------_ _ - ------------- ------- -- Fire Alarm Final Reinspection fee of$ ._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE:__ _ _._- ___. Unable to inspect-no access Fire Supply Line ADA / Inspector Ext Apps ach/Sidewalk Date- _ - - --_-- - -__- - _- Other: Final DO NOI REMOVE this Inspection record from the job site. PASS PART FAIL