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11455 SW JACKIE COURT J 5?1 CAc- 0 n I m n O c 'I i I JI 11455 SIN JACKIE COURT CITY OF TIGARD BUILDING IA PE:TIGN DIVISION 24-Hour Inspection Line: 639-44,75 Business Line: 639-4171 MST _------ BUP —._— Date Requested �`� — �� AM _PM _ BLD Location 4155 .� Suite ��- MtE- Contact Person Ph fju�!k��C`�Contractor (�C�� Ph . C / S BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: -- Foundation FPS Ftg Drain Crawl Drain Inspection Notes: / SGN Slab Post& BeamIT _ Ext Sheath/Shear �C � Int Sheath/Shear Framing Insulation / - --- Drywall Nailing ` Firewall -- Fire Sprinkler Fire Alarm - Susp'd Ceiling -- .�[//I ` ' �� •Le.�./� c�,�_rM �� `1 Roof Misc _ Final PASS PART FAILfly ?i!d�/ PIUMMG Post& Beam _ -- Under Slab Top Out — .. _a' ary Sewer - "----"- — — Rain Drains Fin -- — _ ASS ART FAIL MECHANICAL ---- --- --- Post& Beam Rough In _- Gas Line ---- .. ----- --- ------- Smoke Dampers - - Final ---- - -- - ---- - --- "---- _ PASS TART FAIL -- - - ELECTRICAL -------- -� Service Rough In -_- -- - -----------..___� UG/Slab Low Voltage ------ - -- — Fire Alarm Final ---_-. --__ ---------------------------- ------ PASS PART FAIL SITE ----------Backfill/Grading Sanitary ---- -- --- - --__._ _-- ---�-__-- Sanitary Sewer Storm Drain ( )Reinspection fee of$_ --_ -required before next inspection. Pay at City Hall, 13125 SW Flall Blvd Catch Basin Fire Supply Line Please call for reinspection RF -_—__-_ _- -i [ ]Unable to inspect- no access ADA Approach/Sidewalk �. q Other —` Date �' �' / — Inspector -- Ext — Final I _ PASS PART FAIL , DO NOT REMOVE this inspection record from the job site. CITY CF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd., Tigard, OR 97223(503)639.4171 PERMIT #. . . . . . . . MEC98-03C h DATE ISSUED: 08/25/98 PARCEL: 2S110AB—HM007 SITE ADDRESS. . . : 11455 SW JACK,I E f SUBDIVISION. . . . : HAWK MEADOWS ZONING: R-4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :007 JURISDICTION: TIG --------------------------------------------------------------------------------- CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 i30ILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES-------------- 0-3 HP. . . . s 0 DOMES. INCIN: 0 :GAS 3-15 HID__ : 0 COMML. INCIN: 0 MAX 'NPUT: 0 BTU 1c-330 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0 GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . . 0 NO. OF UN 1"f S— — -- --- - AIR HANDLING UNITS OTHER UNITS. : 0 TURN ( 100K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS. : 1 FURN ) =100K BTU: 0 > 10000 cfm : 0 Remarks : Owner: ______________-----____._.—•------.____----___.__.__--___—•- - FEES ---.----------- RIVERWOOD DEVELOPMENT LLC type amount by date recpt 4035 DOUGLAS WAY PRMT $ 25. 00 JSD 08/25/98 98-308584 I.-AKE OSWEGO OR 97035 `=JPCT $ 1.. 25 JSD 08/25/98 98—;328584 Phone #: Contractor: ---------------.—.----__---.----_.. ... SPECIALTY HEATIiVG & FABRICATIO 951'7:'g SW TIGARD Sp ___._.______._.._.--------------------.----_... 26. 25 TOTAL 1IGARD OR 97223 Phone #: 620-5643 Req #. . : 006657 ----- -- REQUIRED INSPECTIONS ---- -- This permit is issued subjer.t to the regulations rontatned in the Gas Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordarce with approved plans. This pprn t will expire if work is not started within 188 days of issuance, or if work is suspended fnr more than IN days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon I.Itility Notification Center. Those rules are set forth in OAR 952-001-90I0 through OAR 952-001-0080. You may obtain copies of these rules or, direct questions to OIINC by calling (503)246-9187. Issr_re By : _ _ Permittee Sigrratr+re: +••++•++++++++++++.++++t.+++++++++++++++++i•+++++++++++++++++-F++++++++++++++++++++++ Call 639-4175 by 7:00 p. m. for inspections needed the next br.+siness day .++++i-++++++++++++++-F++++++;•+•4•i-+++++++++++•E++++++++++++++++++++++++++++++++++++ CITY OF TIGARD Mechanical Permit application Plain Check# :ec'd By . ,13125 SW HALL BLVD. Cornrnercial and Residential Date Rec'd_�6 TIGARD, OR 97223 r Date to P.E. (503) 639-4171, x304 F��'^^�� a>1(d✓P�`' '4/ 3_, 1tJ flu tt: — `•, / / Date to DST � Print or Type / Permit# - Incomplete or illegible applications will not be accepted Called r Na o of O velopment/Pro(ed Description Table lA Mechanical Code Oty Price Amt Job Street Address ,uvea -A) Permit Fee — 10.(10 Address t 9 �(J �!�t?.kte- 1) Furnace to 100.000 BTU _ Bldga cilyrstate Zip including ducts&vents —_ 6.00 _ 2) Furnace 100,000 BTU F including ducts&vents 7.50 Na {or name of business) j 3) Floor Furnace Owner I including vent — 600 _ Mailing Address A 4) Suspenoed hea,er,w II heater ZID`.�� (''f� / u) J or floor mounted heat,r — 6.00 _ (/ a4 r) Vent riot included in appliance permit Cd /Slate Zip Phrne _ 3.00 0- G,35 .. �, CHECK ALL 'Boiler Neat Air Name(or name or husinets) —' —"- THAT APPLY-. or Pump Cond Oty Price Amt Comp Occupant Mailing Address — IOOKIunit to BTU 6 OU 7)3.15 HP;absorb unit I— Cny/SlateT- --� Zip Phone 1005 to 5 BTU 11.00 _ 8) 15-3)HP; absorb unit.5-1 mil BTU 15.00 Contractor Name 9)30-50 HP; absorb ('C 1'�. unit 1-1.75 mil BTU 27.5(1 Prior to permit Mailing Address r, 10)>50HP;absorb unit _ issuance,a copy t. r J >1 75 mil BTU— 37.50 of all lir,�nses /State Zip Phone 11)Air handling unit to 10,000 CFM are required if r' �� 4,50 expired in COT ore Const.Cont BoardLlr.a Exp pate 12)Air handling unit 10,000 CFM+ _ database —_ /1 �; — _7.50 Argy hitect Name 13)Non-portable evaporate cooler _ 4.50 or Mailing Address 1.4)Vent fan connected to a single duct 3.00 15)Ventilation system not included in � Zi Phone Engineer CftylStete --� _T __appliance permit 4.50 16)Flood served by mechanical exhaust Descritx�work to be done: �t I� tp�an of 7f0G'S I f n P- 4.50 L �r' / 17)DorTtestic incinerators New O Re it V/ Replace with like kind: Yes No O _ __ _ 750 Residential ommercial O 181 Commercial or industrial type incinerator — _ 62r►'l�T C_'Y _ __ --- -- 30.00 Additional information or description of work: 19)Repair units 4,50 _ 20)Wood stove 21)Clothes dryer,etc 4 50 _ Type of fuel oil O natural gas tDr LPG O electric O — 22)Other units —T— —Y 4 50 I hereby acknowledge that I have read this application,that the information 23)Gas piping one to four outlets given is corre(t,that I am the owner or authorized agent of _ 2-00 _ the owner,that plans submitted are in compliance with Oregon State laws 24)More than 4-per outlet(each) ---- -- — --- -- -- .50 Signature of Owner/Agent Date Minimum Permit Fee$25.00 SUBTOTAL_ 5%SURCHARGE `' Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL r Required for ALL commercial permits only State Contractor Boiler Certification required '•F.esidential A/C requires site plan showing placement of unit (:lmechperrn doc rev 07/20/99 CITY OF TIGARD PI.J..IMBING FIFRMIT - DEVELOPMENT SERVICES PERMIT #. . . . . . . . FL_M ��-a•--•, �,. 13125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 DATE I SSL1F=D: 09/t/,/98 1 TE ADDRE I-iS. . . : 1 i Ii 'tj :it~i -JfaCl�I F_: C ..F. PARCEL. ; 'S1. i V1AB--HM0V17 SIJ$D I V 151 ON. . . . : HAWi( MEADOWC ZONING: R-•4. S BI_.oCK. . . . . . . . . . .. LOT. . . . . . . . . . . . .007 JI-IRI S lI T CT I ON: T I(I CLASS OF- WORD;. . :NEW GARBAGE D T SF''O';A1_S. : 0 MOS I I E 1-111TmC.. .:PACF"S. : 0 TYPE OF USE. — :SF WASHTNG MACH. . . . . . : 0 AACKFI...OW PRE'VNTRS. . : 0 0CCI.JPANCY GRP. . : R: F-I_OOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . •, . , .. . . . 0 STORTES. . . . . . . . .. 0 WATFR HF'ATFRS. . . . . : 0 CATCH BASTIUS. . . . . . . : 0 rIXTLIRES_______.___._.__.._.._..-._ LAUNLrRY TRA`eS. . , . . : 0 SF Rr-i.(N DRAINS. . . . . . 0 SINKS. , „ . . . . . . . 0 UR I NA�_S. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0 LAVA'1 OR IF'41. . . . 0 OT1E f I XTI.JRE S. . „ . : 0 TLJB/SHOWFF•tS. . . 0 SFwt.R L TNF ( ft ) . . . : 0 WATER CLOSETS. : 0 WA-rr-R L I NF. (ft ) . . . : 0 DI HWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 80 Remarks : Installation of Approximately 130, of storm drain., Owner: -.. RI VE=RWOOD Df Vr-LOPMENT LLC type amol.tnt by date rer.pt 403 DOUGI._AS WPY PRMT 4 30. 00 DEEB 09/t4/98 98-30909.3 LAKI= OSWEGO OR 97030 ' PCT f, 1. 50 DEB 09/14/98 rj8--130':9ort3 Phone #: R B PI._IJMP I NG 0 BOX 12,69 TLI_SBORO OR 971C34_ 1=:69 (lone #; 640-..5770 31.. 50 TOTAL. 000001 ----- REPL1 T RFP T NSF'EC"T T Clr,le-; This ppreit is issued subject to the regulations contained in the Stnrm Drain Tnsp Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspertion apolicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 180 days of issuance, ur if work is suspended for sore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. These rules are set forth in OAR 952-00014010 through OAR 952••0001-0080. You say obtain ccpies cf these rules or direct questions to INK by calling (503)246-1981, __ --_._.-.-_____..__..- t`�` '' 1 Permittee Signatrtre : !�-f +� -4++++++++++++++++++++++++++++++++ f++++++•+++ H+++ t +++++++a ++++ f +--+•++++•+++++ Ctal 1 C a�3-.�+i7 by 7:00 p„ m. for an i.nspe(-tion needed the next bi_tsiness day { ++ 1 +++ l +++++ +++++•++++1 F+++ f F..h 1.++++++++++F+++++•+-h�•++++++++.4-4-+I•++++••+•++-+•++•++-r++ CITY OF TIGARD Plumbing Permit Application Plan Chok# _ 13125 SW HALL BLVD. Commercial and Residential Recd B TIGARD, OR 97223 Date Recd 4-/ (503) 639-4171 Date to P.E. Print or Type Date to DT Incomplete or illegible applications will not be accepted Permit# {qp�'�� Related SWR Called Name of DevetopmenuProject FIXTURES (Individual) QTY PRICEt AMT Job I-1 kk) -I -- 0',.0-S Sink Address Street Address S tie1/ 4 LS Lavatory - -9.00 t SIU `�•�� Tub or Tub/Shower Comb. 9.00 Bldg# C� ity%state Zip Shower Only �Y 9.00 NT a � Water Closet 9.00 tU F37� of) b 1 Dishwasher Owner Mailing Addre s uite Garbage Disposal 9.00 � -�- � �� Washing Machine 9.00 ' / tate 1p Phone _ Floor Drain/Floor Sink 2" 9.00 Name 3" --- -- 9.00 -- 4" -- 9.00 Addre Occupant Mailing ss Suite Water Heater O conversion O like kind 9.00 Gas iEng requires a separate mechanical permit, _ City/Slate Zip Phone Laundry Room Tray 9.00 -- -- _ Urinal 9.00 Name n ( � -_p/ G�I Other Fixtures(Specify)- g pp Contractor Mailing Address 1- Suite 9.00 • 6 17- -- 9.00 Prior to permit C y St to Zir Phone Sewer-1st 100' 30.00 issuance,a copy J } j' I U��►O oJ—;LzA 6< O — — ---- of all licenses are Oregon Const Cont Board l.lc.# Exp. atSewer-each additional 100— 2300 required if Watp,aervice-1st 100' 30.00 expired In COT Pturnbing Lia# Exp.Dale Water Service-each additional 200' 2500 database _'�y0 6 1 J �' Storm&Rain Drain-1st 100' 30.00 d Name Storm&Rain Drain-each additional 100' 25.00 Architect Mobile Home Space _ 25.00 or Mailing Address Suite Commercial Back Flow Preventlon Device or Anti- 25.00 _ _ Pollution Device /St _ Engineer Cityale Zip Phone Residential Backflow Prevention Devlce' 15.00 (Irrigation liming devices require a separate Describe work to be done — -- restricted energy permit) New Repair O Replace with Ilke kind Yes O No O Any Trap or Waste Not Connected to a Fixture__ 9.00 Resldrntial Commercial O — 9.00 --.- --_ Catch Basin Additional description of work — Insp.of Existing Plumbing 40.00 per/hr _ Specially Requested Inspections - 40.00 er/hr -- Rain Drain,single family dwelling 3000 Are you capping,moving or replacing any fixtures? _ Yes O No O Grease Traps 9,00 If yes,see back of form to indicate work performed by -- ---�--- QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram Is requlrea If Quanthy Totel Is _WORK COULD RESULT_IN_INCREA_SED SEWER FEES. _ — *SUBTOTAL ,� I herebv acknowledge that I have read this application,that the information _ given is correct,that I am the owner or authorized agent of the owner,and 6%SURCHARGE that plans submitted are in compliance with Ore on State Laws. Signature of Owner/Agent Date "•PLAN F:EVIEW 26%OF SUBTCTAI_ CrJt�� he lulred an t riutur!_qty total is>9 Contact Person Name Phone 7 Q TOTAL !�• a - IA/ D2 !C E-104 0 0(f), �7" ��l Z�� 'Minimum parr,-,',i fee is$25+5%surcharge,except Residential Backnow 1W Z `� Prevention Device,which Is$15+5%surcharge -All New Commerclal Buildings require plans with Isometric or riser diagram and plan review I\dot Opium app dor M198 PLEASE COMPLETE: Fixture Type Quantity by Work Perfor- {J _ New Moved Replaced Removed/C pa ped l Sink - Lavatory _ �— ---- - --- Tub or TL!b/Shower Combination — — Shower Only – ----- _Water Closet Di .hwasher_ - Garbage_Disposal — -- -- Washing Machine— --� -- Floor Drain/Floor Sink — Water Heater_ --- Laundry Room Urinal --- _Other Fixtures (Specify) - ----- COMMENTS REGARDING ABOVE: 1 WOMplumopp doc MMS CITY OF TIGARD DEVELOPMENT SERVICES SEWER CONNECTION 13125 SW Hall Blvd.,Tigard,OR 97223(503)639-4171 PE Rlyl I T PERMIT #. . . . .. . . : SWR98-021-�`10 DATE ISSUED: 09/0B/98 PARC,EL: 27'�il 1.0AB---HM007 5 1 TE ADDRESS. t 1455: 5W JACK I E CT SUBD I V I S I ON. . . . :HnWK MEADOWS ZONING: R--4. 5 BLOCK. . . . . . . . . . L.07. . . . . . . . . . . . . :007 JL.JRI5Dic'r,.ION: TIG TENANT NOME. . . . . . RIQFRWOOD DEVELOPMENT USA NO. . . . . . . . . . : FIXTURE UNITS. . . 0 C,'LASS OF WORK. . . :ALT DWELL.I NG UN I TS. . I 'TYPE OF USE. . . . . :SF NO. OF BUIl_DINGS.- I INSTALL. TYPE. . . . :L.TPSWR IMPERV SURFACE- 0 sf -Ap (at-, r,emove) (-,(?Ptit sYStein. Remar,��s - RE- PLM'980313 Mi-tst ptimp, fj, 11, and c--L Ownei-: FEES PIVERWOOD DEVELOPMENT LLC t y Pe amolAnt by date r-er--pt 4035 DOUGLAS WAY PRMT s �'_,300. 00 JSD 09/0-B/9B 98-308930 1 AVE 09WEGO OR 97035 IN9P $ 35. 00 JSD 09/08/98 98-..-308930 Phone #: Contrartat— OWNER Phone F�3313. 00 1 OTAI_ Reg #. . - REQUIRED I NSPE(,T*I ONS This Applicant agrees to comply with all thp rulps and regulations SewFv� Tnspec.,tior, of the Unified Sewage Agenvo. 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 sidp sewer laterals. If the sewer is not iaratpd at the measurement given, the installer ;hall prospect 3 feet in all directions from the distance given. If unt so lgcated, the inAaller shall purchase a "Tap and Side Semer" Permit and the Agency will install a lalpral. ATTENT!ON: Oregon law requires you to foll9w rul9s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952--001-0010 through OAR 952-Offl-WO. You may obtain copies of these rules or direct questions to OUNC by c 1hing (50-7)246-1987. d h —.7 C Pel-inittee Signati.it-e ". +4...........4-++4-++4......4................4++-++-++++4-++4-4.........#.+++++.+++++-1-4........ Ca 11 639--4175 by 7-00 p. at. f oi, an i ns ppt-t i on needed t he ne yt bl�is i tie S s day j ++4++++++4+++++++++4.-1..........r.................4-+++++++++4+++-+,++-++++++-4......+4+4-1 1 um Dy c c CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : P L M 9 8 0 3T 1. 13125 SW Hall Blvd., Tigard,OR 97223(503)639-41,1 DATE ISSUED: 09/08/138 PARCEL: 2S110ABHM00'7 SITE ADDRESS. . . : 11455 SW JACKIE' CT �J SUBDIVISION. . . . : HAWK MEADOWS ZONING.- R-4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :007 J'URISDICTION: TIG ---------------- CLASS Or WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 1?1 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . L 0 OCCUPANCY GRP.'. . - R3 FLOOR DRAINS. . ., . . . : 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . 0 WATER I.,:EATERS. . . . . : 0 CATCH BASINS— __ : 0 FIXTURES---- --. LAUNDRY TRAYS. . . .. . -, 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . 0 URINAI-S. . . . . . . . . .. . . 0 GREASE TRAPS� . . . . . . : 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . 100 WATER CLOSETS. : 0 WATER LINE (ft ) . . . 100 DISHWASHERS. . . . 0 RAIN DRAIN (ft ) . . . 0 Remarks : Reconnect water and hook--i.tp sewer Owner: --------- FEES RIVERWOOD DEVELOPMENT LLC t YPP amottnt by date recpt 4035 DOUGLAS WAY PRMI f 60- 00 JSD 09/08/98 98-308930 LAK%F OSWEGO OR 9701*35 5PCT $ 3. 00 J5D 09/08/98 98--308930 Phone #: Cant rart or--- G & B PLUMBING PO BOX 12,69 HI1_A_.5BORO OR 9712'3- 1269 Phone #: F,40--5770 63. 00 TOTAL Rey #. , : 000001 RFOUIRED T11SPECTIONS This permit is issued subject to the regulations contained in the Sewer Inspection Tigard Municipal Code, State of Ore, Specialty Codes and all other Water Line Insp applicable laws. All work will be done in accordance with Final. Inspection approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 18@ days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR W-NII-NIO throuh OAR 952-MI-M. You may obtain copies of these rules or direct questions to OUNC by calling I s-,t..i e d B y Permittee Signatl.lre :. 21?2!!!��- ............1-+4-++++++++4+4........+++4............................................... Cal I G."39--4175 by 7:00 p. m. for an inspect ion needed the next bl.1sinpss day ++++++4-4-4-4++4-++++++++++++.........4..................F4-4-4,+++4......++-+++++++++4++ 1 CITY OF TIGARD Plumbing Permit Application Plan Check_#__ ) 13125 SiiV HALL BLVD. Commercial and Residential Recd By`, - TIGARD, OR 97223 Date Recd (503) 639-4171 Dal to P.E. Print or Type Date to D33� Incomplete or illegible applications will not be accepted Permit#� 4-, Related SWR Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job tj 4W IR MD S Sink — -- — — 900 Address Street Addressllq Suite Lavatory 9.00 � S0�Ar�l _ Tub ur Tub/Shcwer Comb. 4 9.00 Bldg x City/Slain zip a7Z? 9.00 —�— _—_—_—.— Name — Water Closet i--— 9.00 V O- __MEW Dishwasher 9.00 Owner Mailing d re � W Suite Garbage Disposal — 9.00 w Weshing Machine 9.00 City/Slate Zip Phcge L AkE Ot +l"'11, 4"71 E3S-��6a Finer Drain/Floor Sink 2" _— 9,00 Name 3" 9.00 4" — — 9.00 Occupant klailing Addr@ Suite Water Neater O conversion O like kind 9.00 Gas i ing re Mies a separate mechanical permit. �P�_ —_ City/State Zip _F11—one _ Laundry Room Tray 9,00 Urinal --- Name 9 00 � �t,�{� Other Firlures(SFaGfy) 9,00 Contractor Mailing Address Suite 9.00 G 6c, 9.00 Prior to permit C�i,W/,;SIta'te Zip P nne Sewer-1st 100' 30.00 issuance,a copy n ��(�—__-� � �(- O —572 � 3� U JtSewer-each additional 100' 25.00 of all licer,-�;,are Oregon Const.Cont Board Lic.0 Ex D I. _ requi ed If 4 ? Z VO Water Service-1s1 100' W-00expired in COT Plumb ng Lie.# Exp Date Water Service-each additional 200' —f 25 00 database 'r & Storm&Rale Drain-1st 100' 30.00 Name Storm&Rain Drain-each additional 100' 2500 Architect Mobile Home Space --- — 2500 or Mailing Address Suite Commercial Back Flow Prevention Device or Antl- 25.00 Pollution Device Engineer City/State Zip Phone Residential Backflow Prevention Device' — 15.00 _ (Irrigation timing devices require a separate Describe work to be done. restricted energypermit.) New O Repair O Replace with like kind. Yes No O Any Trap or Waste Not Connected to a Fixture 9.00 Re,;identiai 0 Commercial U Catch BBasln — 9,00 Additional description of work ��,�, R-EGOA/I�17rC7 K.nrc/� 4— Insp of Existing Plumbing _—_ 40.00 'Se INW, pertfir Specially Requested Inspections 4090 _____ Rain Drain,single family dwelling 30,09 Are you capping, moving or replacing any fixtures, Yes O No 0 Grease Traps 900 If yes, see back of form to indicate work performed by QUANTITYTOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required If Quantity Total Is >9 WORK COULD RESULT IN INCREASED SEWER FEES. 'SUBTOTAL I hereby acknowledge that I have read this application,that the information 1 given Is correct.that I am the owner or authorized agent of the ow~ter,and ��— 5%SURCHARGE that plans submitted are in compliance with Ore on State Laws. Signs ure of Ownorl onf i Date **PLAN REVIEW 26%OF SUBTOTAL � � � Re ulred ordy If fidure qty total is,9_ —4 TOTAL � i Contact Person Name Phone 'Minimum permit fee is$25+5%surcharge,except Residential Back Prevention Device,which is$15 � 5%surcharge —All New Commercial Buildings require plans with isometric or riser diagram r and plan review 1ldslstplumapp dm 712198 PLEASE COMPLETE: Fixture Type - - Quantity by Work Performed__ Now Moved Replaced Removed/Capped Sink _ - Lavatory— -- - - Tub or Tub/Shower Combination - - Shower Only - ---- - Water C;oset -- Dishwasher _ -- -- - _- -- — -- - Garbage Disposal~ - 1 Dashing Machine_ -- --- -- --- Floor Drain/Floor Sink 2" i-- ----- -------- SII -- -------- - -- Water Heater - -- -- -- -- -- Laundry Room Tray - - - - UrinalOther v-- Other Fixtures (Specify) --- --- -- -- COMMENTS REGARDING ABOVE: I"J31S UMAPn dM 7/7199 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - ---- G, BUP ?�i 1�J _Date Request d_ 63 ' J AM— PM -` BLD - Location 5�? Suite MEC Contact Person 'lPh PLM �. - Contractor -_ ��Q � Ph ��" rJ�O��j - SWR BUILDING Tenant/Owner ELC _ Retaining Wall ELR Footing ------- Foundation ACCeSS: I,' ��M r' /� I (IN► trItKQ. t. FPS ------ Ftg Drain Crawl Drain Inspection Notes SGN �� -- Slab _ SIT Post&Beam {�� - - Ext Sheath/Shear lX L IIX l L S J� FraminInt g Framin Insulation �-- --Drywall Nailing Nailing --_ —_— — Firewall Fire Sprinkler --- ---- — — -- — — --------- ------- Fire Alarm Susp'd Ceiling ----___ — ------ ------ ------- Roof Misr: -- ---------—--- _ — ---- -- --._—. Final PASS PART FAIL PLUMBING -- Post& Beam _-- ------ — --- - -�- ____ Under Slab ) Top Out / Water Service Sanitary Sewer — -- _ Rain Drains 19 � - -- ---- Final --- ass—RAIU T FAIL ----_PASS- EGH ---- ------- -- Post& I eam --- ---- —_v— _ Ea!2h In Gas Line --- — -- --- — -- — — Smoke Dampers } PART FAIL Ell ECTRICAL _- Service Rough In UG/Slab Low Voltage Fire Alarm Final - — _^_.._----------------------- - PASS PART FAIL --- ---___ --------_----_`.—__-- SITE Backfill/Grading _._-- Sanitary Sewer Storm Drain [ ] Reinspection fee of$ --— 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 Approach/Sidewalk Date y 1- �,!�� Other ___ Inspector ��,L Q��Llpi.rt/ —_Ext -�--1 V Final PASS PART—FAIL DO NOT REMOVE this inspection record from the job site. CITYO F TI CSA R D _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00335 1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/19/03 PARCEL: 2S 110AB-05400 SITE ADDRESS: 11455 SW JACK E CT SUBDIVISION: HAWK MEAD(GWS ZONING: R-4.5 BLOCK: LOT: 007 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: — BOILERS/COMPRESSORS _ HOODS: _ FUEL TYPES _ 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 -4. HP: WOOLSTOV:S: FURN < 100K BTU: AIR HANDLING UNITS CLO GRYEC S: 1 FURN >=100K BTU: <= 10000 cfm: OTHER UNITS: 2 > 10000 cfm: GAS OUTLETS: 3 Remarks: Ing,tall gas piping to water heater,range and clOthc,, Ir,cr. Owner: FEES PASTER, BRIAN Description A� Date Amount 14155 SW JACKIE CT 'TIGARD, OR 97224 IMECH] Penuit I cc 6/19/03 $72.50 JT'1\l 8%)staid;r\ 6/19/03 $5.80 Phone: 503-708-7155 -- Total $78.30 --_-- Contractor: BABBITT PLUMBING INC. 7611 SW ALDEN ST. PORTLAND, OR 97223 REQUIRED INSPECTIONS Phone: 501-244-5279 Gas Line Insp Final Inspection Reg #: LIC 3086907/25/2004 This permit is is sued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 in the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-00 1 � y � 1 Issued By: ,{ t �c ,c, �' Permittee SignatuKe �(-� Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day ir. Mecha_r;ieal hermit Application Received ��)) Mechanical Date/By: ^ �lD Permit No.: CIS of Tigard d Planning Approval Building City g Dat /U : Permit No.: 13125 SW Hall tiled. Plan Review Other Tigard,Oregon 97223 Datc/B : Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 �,� Post-Revicw Land Usr Uate/By: Case No Internet:Inspection contact Jur s.: See Page—for —, 24-hour Inspection Request: 503-639-4175 Name/Method: �G Supplemental Information. TYPE OF WORK COMMERCIAL FEE"SCHEDULE-USE CHECKLIST__ New construction _ ❑ Demolition _ Mechanical permit fees"are based on the total value of the work 21 Add ition/alteration/replacement ❑Other: performed. Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. I & 2-Family dwelling _C_ommercial/Industrial Value: S See Page 2 for Fee Schedule _ RESIDENTIAL EQUIPMENT/SYSTEMS FEE*SCIIEDULF. Accessory Building__ _Multi-Family Master Builder _Other: Description � �ec(ea.) _ Total_ Heatln Conlin JOB SITE INFORMATION and LOCATION Furnace-add-on air conditionin " 14.00 Job site address: SS 15,W, U,—QCr,e =1 Gas heat pump 14.00 — Suite #: Bld -.//Apt-�#-- Duct work - Prt, ect Name: Pit-J A4r g sr v/0 h H dronic hot waters stem 14.00 Residential',oi!er Cross street/Directions to job site: for radiator w hydronic system _ 14.00 Unit heaters(fuel,not electric) 'f in wall,in-duct suspended,etc. 14.00 Flue/vent for any of above _ 10.00!1--'— Subdivision: Lot#: air units Other Fuel Appliances 12.15 _ - _ Tax map/parcel #: — fWater heater 10.00 DESCRIPTION OF WORK Gas fireplace _ _10.00 Flue vent(water heater/gas fireplace) I o --- - Log lighter(gas) 10.00 -- _ Wood/Pr 1.t stove 10.00 Wood fire lace/insert 10.00 Chimne /liner/flue/vent i 10.00 W PROPERTY ON_ER J C3 TENANT Jther: 1 10.00 —_ •� -- — Environmental Exhaust&Ventilation Name: /s7� Range hood/other kitchen equipment 10.00 Address: !I ,"5 iwacAir� � � ---- — C�/State/Zi : 'T' r J1� Clothes dryer exhaust _ 10.00 Singly duct exhaust Phone: 70,P- 7/:ft Fax: _ (bathrooms,toilet compartments, APPLICANT CONTACT PERSON utility rooms) 6.80 Name: Attic/crawls ace fans 10.00 ..- ------- _- - -- --— -- Other: 10.00 Address: Fuel Piping City/St'lte'/ZI **($5.40 for first 4,$1.00 each additionalL ---- ----.�'- --- - — - Furnace etc. Phone: Fax: --- —— --- - _ _.. Ges heat pump E-mail: _Wall/suspended/unit heater •" ___ CONTRACTOR Business Named Water heater •" _ - r• Water Fireplace _ •• �^ �� / Range Address: 1 ��PPP��N BBQ ." City/State/Zip: )" a,, 7A2 ___ Clothes dryer as •" _ _ Phone: 6V3—&y S'.17 FOther: __ •• _ CCB Lic. #: - Irc,L7 1 _ -Total: Authorized Mechanical Permit Fees" Signature: _�— Date: 41?-o-3 -_ Subtotal: $ Minimum Permit Fee$72.50 $ Plan Review Fee 250,5 of Permit Fee $ c State Surcharge 8%of Permit Fce $ -- (Please print name) TOTAL PERRiIT FEF. S v. 0 Notice: Tlds permll application expires If n permit Is not obtained within 'Fee methodology set by Tri-County Building Industry Service Board. 180 da.is after It has been accepted as complete. "•tilt,,plan r.q fired for exterior A/C units. ` hts Pcimil Forms\McePermitApp.doc 01103 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: __ Permit Fee: $1.(X)to$5,000.00 Minimum fee$72.50 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and including$10,000.00. $10,001.00 to$25,000.00 $149.50 for the first$10,000.00 and $1 54 for each additional$100.00 or fraction thereof,to and including $25,000.00. $25,001.00 to$50,000.00 $379,50 for the first$25,000 00 and $1.45 for each additional$100.00 or fraction thereof',to and including $50,000.0(). $50,001.00 and up $742.00 for the first$50,000.00 and —' -- fifor each additional$100 00 or fractiaction thereof: Assumed Valuations Per Appliance: Value 'Total Description. _ t Ea Amount Furnace to 100,000 BTU,including 955 ducts&vents Furnace> 100,000 BTU including ducts 11170 &vents _ Floor furnace including vent _ 955 Suspended heater,wall heater or floor 955 mounted heater Vent not included in appliance permit 445 Repair units 905 <3 hp;absorb.unit, 955 to 100k B W 3-15 hp;absorb.unit. 1,700 101It to 500k BTU 15-30 hp;absorb.uni',501k to I mil. 2,310 BTU 30-50 hp;absorb.unit. 3,400 1-1.75 mil.13111 >50 hp;absorb.unit, .`.,725 >1.75 mil.BTU _ Air handling unit to 10,000 cfm 656 Air handling unit>10,000 cfm _ 1,170 Non-portable evaporate cooler w 656 ` Vent fan connected to a single duct_ 446 Vent system not included in appliance 656 permit Ifood served by mechanical exhaust 656 Domestic incinerator 1,170 _ Commercial or industrial incinerator _ 4,590 Other unit,including wood stoves. 656 inserts,^.tc. Gas piping 1-4 outlets 360 Each additional outlet 63 TOTAL COMMERCIAL $ VALUATION: i•\Dsts\Permit Forma\MecPerntitAppPg2.doc 01/03 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 - -- BUR Received -_ Date Requested AM PM__--__ D,bP Location __.._ `_Z� `�c �� t _ -Suite MEC 2QQ� J 33- Contact Person _— Ph( _) __ PLMI Contractor -------- ----.�---- ._ -- - Ph( - ) - SWR BUILDING Tenant/Owner __ _ - ELC Footing ---- --- Foundation Access: ELC Ftg Drain ELR Crawl Drain -- -- -- Slab Inspection Notes: SIT _ Post& Beam --- Shear Anchors -- Ext Sheath/Shear I -- Int Sheath/Shear -- — Framing --- --- ----- — - -----_.--�_ Insulation -- Drywall Nailing Firewall T-1 ( -- Fire Sprinkler --- .✓ J _' _�_—__—_ _ - Fire Alarm Susp'd Ceiling --------_- - — _- ---- - -- Roof Other: ----- - -------- - Final -- _ ---- PASS PART__ FAIL PLUMBING [lost& Beam _-------- -- - -- Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole -- - Storm Drain Shower Pan — a Other: --- - - FAIL - ----- - —---------. MECHANICAL Posr�-a`m -- ------- R Eh In -------..`-- - _ Dampers -- -- --- Fin -- - -- -- �ART FAIL — -- -- - - - - _ ---- ELECTRICAL -- �— -- Service -_.-_ _ -- ----- --- -.. - ------ -- --- - - - Rough-In UG/Slab -- - - - --- --- --- ------ - Low Voltage — Fire Alarm -- -- ---- Final PASS PART NIL F1 Reinspection fee of$._-__- _. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE - _ CJ Please call for reinspection RE'__. _--_ _ - � � Unable to inspect-no access Fire Supply Line ADA .� �-o Apr,oach/Sidewalk Date " .-___-- - Inspector f._i ---- ---Ext -----_ Other: _ Final DO NOT REMOVE this Inspectlon record from the Job site. PASS PART FAIL CITY OF TIGARG 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST — J BLIP _ Received Date Requested- �/ AMPM BUP c Location � -� � "G--�-� - Suite MEC 0 633•s- Contact Pe►Son ^-------_-_— Ph PLM Contractor —_--_J_ —_ Ph( —) _ SWR — BUILDING- Tenant/Owner _ _ ELC Footing ELC Foundation Access: --�- - — Ftg Drain Crawl Drain C (��( _ ELR Slab Inspection Notes: SIT Post& Beam Shear Anchors -- - - Ext Sheath/Shear Int Sheath/Shear ---- Framiny _--___-- Insulation Drywall Nailing -- — ----..-.. - ----- - ----- Firewall Fire Sprinkler Fire Alarm Susp'd Coiling -- — - -- ------ — ----- ----- — Roof Other: --------- -- -- --_-.---- -- — - _- - Final --- --- - PASS PART FAIL --_ _- ---- —--- ----- - —---- --- I PLUMBING _ -------- -.._-- _ - _.-- ---.__-----...- ---------_..------ - Post& Beam UnderSlab ----__-_ _.__.--- --__-- --------_----_-_ —_ _._._.-._ Rough-In Water Service - ----- - ------ - -------- -------- - - Sanitary Sever Rain Drains Catch Basin/Manhole Slot m Drain --- ---- - -- - - -- — —- — Shower Pan Other. _�.. -- -- - -- --- - — - -------- - Final PASS PART FAIL _M_E_C_HANICAL Post& Beam ------ ----...------- _ ---- ------- ---------- ------.__--_--------- - Rough-In -- ---- - -------- -- ---- --�_ _.. --- Gas Line Smoke Dompers -- -- -- — - -- - ------- ------ -- ------ Final PASSPART -- ----------- - _ --_--- ------ -- - - _ELECTRICAL Service - -- ------ -.._-------_.-_ ------ ---- - -------- Rough-In UG/Slab ___-_ _ -- --_--- -._ _._-----__.__._---- -------- -- Low Voltage Fire Alarm Final C-� Reinspection fee of$ ---.__required before next inspection. Pay at City Hall, 13125 SW Hall BlvL' _PASS PART FAIL SITE _ Please call for reinspection RE: —.—_ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date _ - 7.._ Gla .- Inspector Otho• _ Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL