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10530 SW JOHNSON STREET CD Ul W �n O z z `I i 10530 SW JOHNSON ST. Invoice G"RIFF'S SEPTIC' SEARVIC13, INC 0 Name Date Addrp,is ZQ 513',e) 5 4) M-3/46-i!;-6 AJ Phone--� -<? City - / / I --- ---- Initial On Acct. 001- State, Zip Code Price Amount -� '- - -7 3 / -- ----- ---- -- NOT RESPONSIBLE FOR LANDSCAPING A service charge of 1.5%per mowh will he charged on all past due accounts. Total: Not responsible for attorney's fees. A fee of$25.00 will be charged on all returned checks, t .......... Appro al C By: Customer Signature qhank You PO PDX 1244. - Canby, OR 97n13 '503) 263-2087 or (503) 632-6138 CCB# 70548 nfi co Invoice # J, 13 SlINITnTION SUVICES, INC. Date: P.O. it P.O. Box 327 - Oregon City, OR 97045 11 Portland (503) 657-0219 * Vancouver (360) 695-1021 Fax (503) 656-6945 Name: kw_ J Address: 41J21z /1 AD City: ---- State: Zip Code: ._- City: State: Zip Code! Telephone: Area Code Mirnher Fax Number Ordered By: Frequency: 2 Wk 6 Wk I Mo 2 Mo 3 Mo 4 Mo 6 Mo Year Other Quantity Amount Unit Price Total SW WA Tip Sales Tax Total Due Must be notified 30 da7 in advancz- to cancel regular services. Serviced by: Rece i ved by �12 Please pay from this invoice. Finance Charge of 1'/P%rdr month, or annual rate of 18%is applied lo past due balance. "Thank you for your business." MY OF TIGARD BUILDING INSPECTION DIVISION 21. . our Inspection Line: 639-4175 Business Line: 639-4111 MST _ BUP _Date Requested ( 1 ZZQ2 _—AM_— —PM I,BLO Location- 1 7 ion sr- Suite ME_C Contact PersonPh < Contractor_ _ Ph (SWR BUILDING Tenant/Owner ELC 3 Retaining Wall ELR Footing Access: Foundation FPS Fig Drain Crawl Drain Inspection Notes: - SGN Slab --� Post t Beam _-_----___ -- _ SIT -------- Ext Sheath/Shear Int Sheath/Shear -- - Framing Insulation _-- - - --- Drywall Nailing Firewall - - -- ----%_ Fire Sprinkler Fire Alarm -- __ - -- Susp'd Ceiling Roof Final L��% -�L�L- t. PASS PART FAIL � �/r'�'ge UMBIRIS Past& Bearn - Under Slab P To Out Water Service Ril Drains q8 PART FAIL RMHANICAL Post&Beam -- ---- __ - Rough In Gas Line - --- _ Smoke Dampers $- Itrial PASS PART FAIL - - - ELECTRICAL - -- - -_ -_ Service Rough In - -- --- -- - - Low Voltage - --- Fire Alarm Final PASS PARI- FAIL- SITE Backfill/Grading -- -- Sanitary Sewer Storni Drain [ ) Reinspection fee of$_ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ )Please call for reinspection RF- _ [ J Unable to Inspect-no access ADA f n Approach/Sidewalk Date ` Other Ilrspector Ext Final PASS PPRT -FAIL` Do OT REMOVE this Inspection record from the job site. CITYOF TIGA,,RD _PLUMBiNGPERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00009 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: SITE ADDRESS: 10530 SW JOHNSON ST PARCEL: 2S 103AA-01915 SUBDIVISION: COTTONWOOD PLACE ZONING: R-4.5 BLOCK: LOT: 014 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTF S: OCCUPANCY GRP: R3 FLOOR DRAINS: TRANS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB/SHOWERS: SEWER LINE: ft WA I-E2 OLOSETS: WATER LINE: it DISHWASHERS: 01"N r)RAIN: ft RemarKS: Plumbing reversal from septic tank to sanitary sever. Owner: - -- FEES --- �_ ---_-� Type By Date Amount Receipt LAMBERT, ROBERT A 10530 SW JOHNSON ST PRMT BON 01/10/200C $50 00 00-321035 TIGARD, OR 9'223 5PCT BON 01/10/200[ $4.00 00-321035 Total — $54.00 Phone 1: --_--- ------ ----- Contractor: LARRti CAMERON PLUMBING 1812 SE 159TH AVE PORTLAND, OR 97233 REQUIRED INSPECTIONS Phone 1: 503-256-2705 Cc�,er Inspection Reg #: LIC 4979E PLM/Underfloor PLM26-366PB Final Inspection 0 R, I Gi IN A L This permit is Is,!ted subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Cedes 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 adopter] by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001 0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: �'� ( � ' Permittee Signature:) Z_ !�f� Call (503) 639-4175 icy 7:00 P.M. for an inspection needed the next b,A4144s day CITY OF T:CARD Plumbing Permit Application Kron Check 13175 SW }BALL BLVD. Commercial and Residential Rec'd By TIGARD, OR 97223 Date Recd I -tit a'G (503) 639-4171 Date to P.E. Print or Type Date to DST - Incomplete or illegible applications will not be accepted Permit#Fl-A1Z6XV) Cx>UV� Related SWR# Called Name of Developm?nt/Project FIXTURES (individual) QTY PRICE AMT Joh 1< i„, LA'-( Lc Sic:' 11.50 Address Street Address �L� Suite Lavatory 11.50 Tub or Tub/Shower Comb. 11.50 Bldg# City/State Zip Shower Only 11.50 Nam Water Closet 11.50 .i �1 yen2. Urinal 11.50 Owner Mailing Address Suite Dishwasher 11.60 --J0! Garbage Disposal 11.50 City/State Zip Phone Laundry Tray 11.60 Name - Washing Machlne/Laundry Tray 11.50 2A/1/I Floor Drain/Floor Sink 2" 11.50 Occupant Mailing Address Suite _ 3" 11.50 4" - 11.50 City/State Zip Phone _ Water Heater O conversion O like kind 11.60 ----- Gas piping requires a separate mechanical permit. L9me MFG Home New Water Service - 32.00 "rc tz.Y, COW 12 r c r�"� MFG Home New San'Slorm Sewer 32.00 Contractor Mailing Address suite - z -ci- cam- Hose Bibs 11.60 Prior to permit Col/State Phone Roof Drains 11.50 Issuance,a copy agahtLALVZ F Drinking Fountain 11.50 of all licenses are Oregon Const.Cont.Board L ic.# Exp.Date required if Z Other Fixtures(Specify) 15.00 expired In COT Plumbing LIc.# Exp.Date database Name Architect Sewer-1st 100' 38.00 or Mailing Address Suite Sewer-each additional 100' 32.00 ��teEn ineer Zip Phone Water Service-1st 100' _ 38.00 Engineer Water Service-each additional 200' 32.00 Describe work to be done Storm&Rain Drain-1st 100' 38.00 New O Repair O Replace with like kind: Yes No O Storm&Rein Drain-each additional 100' 32.00 Residential O Commercial O - Additional description of work: Commercial Beck Flow Prevention D(vla� - 32.00 r� Residential Backflow Prevention Devit e• 19.00 G 9c �G /c Lt UcS /4 Catch Basin 11.50 Are you capping,moving or replacing any fixtures? Insp,of Existing Plumbing or Speciall,r Requested 50.00 Yes O No O Inspectionsper/hr If yes,see back of form to Indicate work performed by Rain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. I hereby acknowledge that I have read this application,that the Information QUANTITY TOTAL Isometric or reser diagram Is requtred H ouantny Total Is >s given Is correct,that I am the owner or authorized agent of the owner,and that Ian submitted are in compliance with Oregon State Laws. "SUBTOTAL SI rtf Owner/ Date /C' _ Oc•f 8%SURCHARGE _ � l ontact Pers ame Phone �✓� /e �Z a ,J�� 5-� - ��� y. **PLAN REVIEW 26%OF SUBTOTAL 1 BATH HOUSE:1 18.00 Required only if fixture qty total is>9 TOTAL 2 BATH HOUSE$26u-00 BATH HOUSE$285.00 - --�`Ilrhlls fee Includes all t Ium5ing fixtures In the dwelling and the first *Minimum pelmll fee is$50♦B%surcharge,except Residential Backflow Prever,flon 100 test of sanitary ae ser storm sewer and water service) Device,which Is$25.9%surcharge **All New Commercial Buildings require plans with Isometric or riser diagram ano plan review I\dsts\formMplumapp doc 11/1 N99 4 PLEASE COMPLETE: -- Fixture Type — Quantity by Work Performed New Moved Replaced Removed/Capped Sink ------- - - — — — — Lavatorj Tub or Tub/Shower Combination Shower Only -------- - --Y-- - -- -- — Water Closet Urinal ---- ----- ---- --- --- -- - -Dishwasher Garbage Disposal Laundry Room Tray _— Washing Machine Floor Drain/Floor Sink 2" Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I AMOomtilplum BDP lm:11158199 - CITYOF T'IGARD PLUMBING PERMIT \ DEVEI.OPMENT SERVICES PERMIT#: PLM2000-00C 13125 SW Hali Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 01/06/2000 SITE ADDRESS: 10530 SW JOHNSON ST PARCEL: 2S103AA-01915 SUBDIVISION: COTTONWOOD PLACE ZONING: R-4.5 BLOCK: LOT: 014 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 'rug/SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks ..st 1 00'of sewer line Y� Owner: = - -- — FEES -- —�– Type By Date Amount Receipt LAMBERT, ROBERT A --- — AMBSCJ JOHNSON AT PRMT BON 01/06/200C $50.00 00-320951 10530 TIGARD, OR 97223 5PCT BON 01/06/200C $4.00 00-320951 Total $54.00 Phone 1: Contractor: TED MCBEE 'EXCAVATING INC 1 1428 NE SCHUYLER PORTLAND, OR 97220 REQUIRED INSPECTIONS Phone 1: 939-5246 Sewer Inspection Reg #: LIC 110314 I`1nIf� I ��,Il1 � This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtaiii copies oftheserules or direct questions to OUNC by calling (503) 246-1987. � 1 Issued By: Li��L Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CIT( OF T IGARD Plumbing Permit Application 'Ian Chock,# 13'i 25 SNIT HALL BLVD. Commercial and Residential Iiec't B (-%-��-- TIGARD, OR 97223 Dole Re'-.'—d - (l - 2-JU_2_ (503) 639-4171 Date to P E. _ Print or Type Date to DST Inromplete or illegible applications will not be accepted Permit# 0_^?/7V Related SWR# -_ Called Nam(.of De�elopment/Project FIXTURES (Individual) QTYI PAkICE- AMT Job Sin' 11.50 A(ldress Street Add ress ` Suite Lavatory - 11.50 - - �7(�_`' i Tub or Tub/Shower Comb, 11.50 Bldg# City/Slate ,^ Zip Shower Only - 11.50 _ y Nam. Water Closet 11.50 - ` Lalt2 Y Urinal -^- -- 11.51 Mailing Address Suite LLLIII Owner 9 Dishwasher 11,50 u Garbage Disposal 11.50 City/State Zip Phone -Laundry,IYaY 11.50 T Na -`- Washing Machine 11.50 _ Floor Drain/Floor Sink 2" •,1.50 Occupant Mailing Address Suite 3" 11.50 City/State - Zip Phone __ 4 11.50 — Water Heater O conve;ion O like kind 11.50 —�- Name - -- Ga, i ink r�uires a cepa ate mechanical permit _ -F _M t , ) �^t( 'V C• MFG H)me New Water Service - 32.00 ` Contractor Mailing Address Suite MFG Horne New San/Storm Sewer 3200 Hose Bibs ---v 11.50 Prior to permit City/State Zip Phone Root Drains— 11.50 issuance,a copy •'C' _ - - - of all licenses are Oregon Drinking Fountain 11.50 onst.Cent Board Lic# Exp.Date _ required if ` ` ^ %4 Other Fixtures(Specify) 15.00 expired in COT Plumhing Llc.# Exp.Dale database ----- - - Name -— ----— --- --- Architect Sewer-1st 100' 38.00 Or Mailing Address Suite Sewer-each additional 100' 32.00 Engineer Cdy/State Zip Phone Water Service-1st 100' -- 38.00 Water Service-each additional 200' 32.00 Describe work to be done V Storm&Rain Drain- list 100' 38.00 NewRepair O Replace with like kind Yes O No O Storm R Rain t main-each additional 100' 32.00 Resid ntial Commercial O - Additional description of work. Co,.rnerc:ial Hack Flow Prevention Device 32.00 11 0 Residential Backflow Prevention Device' 1900 L_Q i _- Catch Basin 11 50 Are you capping, moving or rep Ging any fixtures? Insp of Existing Plumbing or Specially Requested 50.00 — Yes O No O -inspections er!hr If 2s, see back of form to indicate work performed by vain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps — 11.60 WORK COULD RESULT IN INCREASED SEWER FEES. — I hereby acknowledge that I have read this application,that the information QUANTITY TOTAL given is correct,that I am the owner or authorized agent of the owner,and Isometric or riser dlogram Is rec uired it Quantity Total is >9 - Ihatbans submitted are in corroll3_nce with_Ore$oil State I.+ws `SUBTOTAL SliggIpture of OwneNAg nt Dale � -t t 8% SURCHARGE — I :_�_—�_— _ �t�r Conte arson Name Phone r'�f c ?-1 �1��' �'C -- c l'„ — — **PLAN REVIEW 25%OF SUBTOTAL ` '- -- Rr�red only H fixture q�lal is>9 1 BATH HOUSE$178.00 TOTAL ` 2 BATH HOUSE$250.00 r`L F BATH HOUSE$285.00 -------- �_-- - (This fee Includes all plumbing fixtures In the dwelling and the first *Minimum permit fee Is$50+a%surcharge,except Residential Backflow Prevention 100 feet of sanitary sewer ntoiTr1 sewer and water service) Device,which Is$25+a%surcharge "All Now Commercial Buildings require plans with Isometric or riser diagram and plan revlrw I ldslslformslplumapp doc 12/17199 1 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink — Lavatory Tub or Tub/Shower Combination Shower Only ---- — ---- -- -- Water Closet__ — Urinal Dishwasher --- Garbage Disposal Laundry Room Tray Washing Machine __— Floor Drain/Floor Sink 2" Vb'ater Heater___ Other Fixtures (Specify) COMMENTS REGARDING ABOVE: CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR1999-00263 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/15/1999 SITE ADDRESS; 10530 SW JOHNSON ST PARCEL: 2S103AA-01915 SUBDIVISION: COTTONWOOD PLACE ZONING: R-4.b BLOCK: LOT: 014 JURISDICTION: TIG _ TENANT NAME: LAMBERT, ROBERT& GEORGIA USA NO: FIXTURE UNITS: 1 CLASS OF WORK: NEW DV,;FLLING UNITS: 1 TYPE OF USE: SF NO. (.F BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFPCE: Remarks: Connection to sewer lateral as part of Reimbursement Uist,ict#12. Reimbursement fee of $5,597.82 paid on 12/15/99. Septic tank to pumped, filled :)r removed and inspected. Owner: -_----- FEER _ LAMBERT, ROBERT A 10530 SW JOHNSON ST Type Bl Date Amount Receipt _�-- -- -- TIGARD, OR 97223 PRMT GEO 12/15/199 $2,300.00 99-320425 INSP GEO 12/15/199 $35.00 99.320425 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections — Sewer Inspection Septic Tank Filled ORIGINAL this Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral. 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 O X952-001-0080 You may obtain copies of these rues or direct questions to OUNC by calling (503) ?AA 987 1 ,1 Issued by: .` �I� ��^c -- —� Permittee Signature:;+ Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day