15143 SW KENTON DRIVE L?
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15143 SW KENTON DR
/ \ CITY V` TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: F,LM2003-00517
13125 SW Hall Blve., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/17/0-
SITE ADDRESS: 151.11._ _0 KENTON DR PARCEL: 2S 1 12CB-07700
SUBDIVISION: ASHFORD OAKS NO. 2 ZONI%G: R-7
FLOCK: LOT: 091 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HONE SPACES:
TYFE 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:
TUE/SHOWIERS: SEWEF LINE: ft
WATEP CLOSETS: WATER LINE: 76 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install 7G' of water service
Owner: `-- FEES !_
Description Date Amount
STEBNER, GRANT E/SUSAN K —
15143 SW KENTON DR I'LUNIBl PYsnut I•ee 10/17/03 $72.50
TIGARD, OR 97224 i rAXJ 8%State Tax 10/17/03 $5.80
Total _ $78.30
Phone �------
Cc ntractor:
ROTO ROOTLR-VVEST OFFICE
25599 SW 95T'A B
!NILSONVILLF_, OR 97223
REQUIRED INSPECTIONS
Phone : 503-227-3330 Water t_ir?P Inso -----
Final Inspection
Reg#: I Ic' 13989
III \1 37-761113
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialtv Codes and ao other applicable laws. All work will be done in accordance with approved
plans. This permit vvi,I expire if work is not started within 180 days of issuance. or if work is suspended
fo more than 180 days. ATTENTION: Oregon law requires YOU to follov, rules ad. ?ted by the Oregon
Issued By: �' t L-t _ Permittee Signature: elf
Call (503) 639-4175 :+y 7:00 P.M. for an inspection needed t e no sl s da
i
Bi ing Fixtures
Plfi.. ,ibina Pe lEOMWItntzon Received1 WWPlumbrr6
:Datc/B /�/7 7, rermit No.> lfZoo Z_Z 5-/7
of Tigard oG I Planning Approval Sewer
Cf
g (( -1 ! 1003 Date/BL___ Permit No,:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 CITY OF TYGA Date/By: _ Permit No.:_
F'ost-Review Land Use
Phone: 503-639-4171 AWII-104"11)'' N Date/By: _ Case No.:
Internet: www.ci.tigard.or.us Contact See Page z for
24-hour Inspection Request: 503-639-4175 Name/Method: _ u lemet+tal_Inlormation.
TYPE OF WORK FEE*SCIIEDULE for special information use cheeklkt)
New construction I ❑ Demolition Description _ Qty. I-Fee(ea.l I Total
gs
Additftmi en/rcplacement Other: New I-& or Vacily lily C ne
CATEGORY OF CONSTRUCTION New
loo fl.for cacti utiltt conneetlon
1 &2-Famil dwellin Commercial/Industrial SFR I bath 350.20
Y � SFR 2 bath 350A0
AccessoryBuilding ❑ Multi-Famii SFR 3 bath 399.00
Master Builder _❑Other: Each additional bath/kitchen 45.00
JOB SITE INFORMATION and LOCATION Firesprinkler-sq.It.: Page 2
Job site address: S/ r.. Site Utilities _
Suite#: Bldg./Hpt.#: Catch basin/area drain 16.60
Dr vcll/leach line/trench drain _ 16.60
Project Name: c'e C rte'/, 21e- U Footing drain n,).linear R,)--� _ Pag-.2
Cross street/L)ireetions to job site-_ / Manufactured home utilities 110.00
/-J,/-J, Y !!7
YF-Ilk i i-n /p,t o-S c 6ht ° Manholes --- 16.60
{. n pe r` c- _ � C�a4,tt,.l. Rain drain connector 16.60
c.'c C� 5 �olL a I Sanitary,sewer(no. linear Il.) Pae 2
Subdivision: ��Lot#: Storm sewer(no. linear fl.) Pae 2
Tax ma / areal i{: Water service(no.linear Il Page 2
DESCRIPTION OF WORK Fixture or Iteat
Absorption valve 16.60
(r Backflow prcvcnter Pae 2
Ba,kwater valve 16.60
Clothes washer _ 16.60
1 -- ---- -- ------� Dishwasher 16.60
ROPERTY OWNERDrinkingfountain 16.60
__=TENANT� T E'ectorr/sump _I6.60
Name: 7fi 21VC,k- Expansion tank 16.60
Address: Fixture/sewer cap 16.60 _
Clt /$tate/Zl r/('��/r. Ol/_._ `l e%a,^ Floor drain/floor sink/hub 16.60
Garbage disposal 16.60
Phone: 2 Fax: _ hose bib 16.60
A_PPLICA.NT __I LJ CONTACT PERSON Ice maker _ 16.60 _
Name: _ _ _ Interco tor' rease trap 16.60
Address: --- Medical gas-value: S Pae 2
City/State/Zip: i Primer -_ 16.60
_ ---- Roof drain(commercial) 16.60
Phone: FaX: Sink/basin/lavatory 16.60
E-mail: Tub/shower/shower pan 16.60
CONTRACTOR Urinal 16.60
E3usiness Name: i cn Tr Water closet 16.60
Water heater 16.60
Address: �� `�t1 .S 4, ,7� 1� /�v� Vit+ tc t3 Other: -- -.
City/State/Zip: 4.!;L. ;,+'))L Other: -
Phone: G, Z 7 1 `L- Fax• S Plunibing Permit Fees*
Subtc'al $ -5-
CCB Lie. #' 13`I " Plumb. L1C.#: .7 i 7lv P13 Minimum Pemlit Fee S-2.50 S
Authorized Residential Backflow Minimum Fee$36.25
Signature: L � � *_- Date:�4% /2 o
g ---�---- -- - _ Plan Review(25/o of Permit Fre S -
(Q r M+ - State Surcharge o%of Permit Fee $
7F I ase print nanx) TOTAL PERMIT FEF S
Notice: This permit application exp+^y If a permit is not obtained Nithin All new commercial buildings require 2 rets of plans with Isometric or
Igo days after It has been accepted.s complete. riser diagram for plan review.
*Fee methodology set by'I'ri-County Building Industry Service Board.
r\Usts\Permit For "'ImPermitApp dor 01/04
Plumbing Permit Application .-City of Tigard
Page 2 - Eupplemental Information
Fee Schedule: _ Residential Fire Su resion Systems:
Site Utilities Qty. Fee(ca) Total $ uare Footage: _ mit Fee:
Footing drain- I"100' `5.00 0 to 2,000 $115.00
201 to 3,600 $160.00
Footing drain-each additional 100' 46.40 6 _
3,601 to 7,200 $220.00
Sewer-Ist 100' 55.00 7,201 anteater $309.00 -__-
Sewer-cacti additional 100' 46.40
Water Service-Ist 100' -16 55.00 .jS Medical Gas S stCms:
Water Service-each additional 100' 46.40 Valuation: _ Pertnit Fee:
�iorm&Rain Drain-Ist 100' 55.00 $1.00 to S5,000.66 Minimum fee$72.50
Storm&Rain main-tach additional 100' 46.40 $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
Fixture or ItemQty. Fee(ca) Total including$10,000.00. _
Commercial Back Flow Prevention Device 46.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to
minimum permit fee$36.25 7.7.5' and including$25,000.00.
Rain Drain,single family dwelling 65.25 $251001.00 to$50,000-00 $379.50 for the first$25,000.00 and$1.45 for
each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or and including$50,000.00.
specially requested inspections-per hour 72.50 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
11
each additional$100.00 or fraction thereof.
Fixture Werk:
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 tees*.
usotlt b Fixture Work Performed ( onunents regarding fixture isork:
Fixture Type: Replace
New Moved Existing
Cam ed ---- -- - -- -- - -
Bath -Tub/Shower
-Jacuzzi/Whirl pool __ -- -- - -- ---
Car Wash -Each Stall ------------_.--
-Drive Thru
Cuspidor/Water Aspirator
Dishwasher -Commercial _ - -------- --- - - ----- ----
-Domestic -
Drinking Fountain
Fluor Drain/s;n'Drain/sin' -2" -- ----`�-- --
.T•
4"
Car Wash Drain "Note: If the fixture work under this permit results in an
(iarbagc -Domestic Increase of sewer EDtls,a sewer permit will be issued and
Disposal -Commercial _
-industrial _ fees assessed for the sewer increase must be paid before time
Ice Mach./Refri .Drains plumbing permit can he Issued.
Oil Separator Gas Station
Rec.Vehicle Dump Station -
Shower -Gang
-stall
Sink -Bar/Lavatory
-Bradley
-Commercial _
_-Service
-9-w-imming Pool Filter -
Washer-Clothes I
Water Extractor
Water Closet-Toilet
Urinal
Other Fixtures: _
c\Dsts\Permit Forms\PlmPcnnitAppPg2.doc 01103
CITY OF TIGARD 24-Hour
L' 'LDING Inspection Line: (503)639-4175
MST
IN:SPEC,ION DIVISION Business Line: (503)639-4171
t 71 BUP _
r
�/' UP _------
Received --.__.— —_Date Request B
_ .�--\—.�A� __ _—�pG�—___._
Location -Suite-- —_ MEC
Contact Person tel' L— —_ Ph ��
Contractor _�`,�— �`.' Ph(---) SWR _
BUILDING Tenant/Owner _- —__—_— �_ _-- ELC —_—
Footing ELC
Foundation Access:
Ftg Drain ELFT
Craw! D.--;n
Slab Inspection Notes:W4 CX SIT
Post I - --- _ -
Shear Anch., .
Ext Sheath/Sheer -
Int Sheath/Shear
Framing _.._.__ — -- ---- - - -- -- -
Insulation
Drywall Nailing - -- --- .._. - -- --..__-- �.----- - -
Fi�ewa!I
F ire Sprinkler - - - -- -- .. __ -- ------ -- - - -
Fnr 'larrn
Susp'd Ceiling
Roof
Final
PASS PART FAIL _--- - � - - ----_----- -- _ ___.
LUMBIN - 1j _.—___� ----
Post& Beam
Under Slab --- - - -. - ---------m--- -____._-
Sanitary Sewer
Rain Drains —.— - ------ ----- -----
Catch Basin/Manhole
Storm Drai i -- ---- - - --
Shower Pan
- ----
f
AS /PART FAIL
)PA
M HA_NICAL -
Post& Beam
Rough-In ---
Gas Line
Smokc Dampers - ---- -._ _- _—
Final
PASS_ PART FAIL - -- -_ -- _--
ELECTRICAL _
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE I I Please call for reinspection RE:.-___ _-__._- __—___ Unable to inspect- no access
Fire Supply Line
ADA
Approach/Sidewalk Date. - Inspector -- __ Ext - --.
Other:_
Final UO NOT REMOVE this Insk-9011orti record from the job site.
PASS PART FAIL
CITYOFT167ARD
PATILLAXING 1--1I:..'PM:LT
PEPMTT NO .
CMYOFMAND
COMMUNITY DEVELOPMENT DEPARTMENT D611K. ItiSUED : 0/29 69
13125 S.W.Hall Blvd.,P.O.Box 23397,Ticiard.Oregon 97223,(503)6394175 P 1:1 :M 11111
JOI-) ADDIIESS : SW Kk:-'NTON DP
TAX MAP/LOT Pin:1. JP SUB: ASHFOPI) OAK!:,) I T :91. 13K :
LAND USE: 14 !"110P1'.)
LOT 51VE . VALUAI'TON: SETBAG1<5
FRONT: 20 PEA14: 113
WORK GLASS : NEW DWELL,IJN'.I*.T!-i I LEFT : 5 RIGHT: 313
USE TYPE : 51NGLF-.: FAM1l Y NO . HEDPOOMS : 13 EXT .WALL CONST :
(N)NST . TYPE: VN NO. BATHS : 3 N: S : E: W :
OCXUi").OPP. : P3 PPO 1' .OPENINGS :
(NN"Ut- .LUA0 N: S : E: W:
TOTAI... AREA 20,70
NO. STONTES : P. 1.ST :1.02.28 1:40OF (:,ON!iT: C FIRE PET7
H I--'::r.G HT : R0 V.N D J.0,5 0 AREA SE PAR7 RATED :
13AS1--7M1:.:NT7 3810 : OC:(:UP SI--*1PAP7 RATED :
MEZZAN'.1*.NL.*? BASEM'T
FLUOP LOAU: '(110 GAPAGiE: 638 FIRE SPRKI—P7 Al—AAM7
FLOW(GPM) DE"T"LL11—e YE' ,
Hr:-.AT TYPE: (*.,A'3 HDC P. ACCESS?
P1 AN WY : 'T t
A1--:MARKS :
PETSSUE OF NO. 6806,eI3
LAST PEIISSUIii. 09 1-eJ5 7
W 0 M T.1-11 ER JTAY PERMI
N P . ri . DOX PLAN REVIEW tiie4 0 . 00
E TIGArw) 0 P 9*722*3 F:*:CRIT.". 0 r:::P,T
PHONE (503) 6841-75413 ':+TAIE TAX $21. . 05
OTHER
C '*.'VE1-(:IPMENT CHARGES .
0 MILLER JAY SIX-1(SI ORM) 11111I2150 . 00
N
T JAY MILLER DI-11:11A)EX4 Si DC( S TREF.."T) $600 . 00
R HOX (".3291 PDC(*2 11 $250 . 00
A
C t 3'.(3o A P D UP 97aP3 *A0 . 00>
T 1:-'-HONE (503) 604-75A3
0
R PF.-.-G'1SsTPATT0N NO. 301.09 TOTAL: ,e:j
t� e . 0!!,)
PEGE I PT NO.
This permit is issued subject to the regulations contained in Title,14
of the TMC. State of Oregon Spenialty Codes,zoning regulations4EQUIP11---D INSPECTIONS
and all other applicable codes and ordinances, and It Is hereby F 00 TT NG
Agreed that the work will be done in Accordance with the plans And BEWE'A
specifications and in compliance with All applicable codes and FOUNDATION WAI I PAIN DRAINS
ordinances The issuance of this permit docs not waive restrictive POST & SEAM WATI--'P LINE
covenants Contractor and subcontractors snail have current Ity 11-11-13 UNDERIA A H APPACH/SW
business tax permits This permit will expire End become null arid
void if work Is not started within 180 days,or If work Is suspenr ad or I NAL
abandoned for a piirlod of 180 days any time aft , work has PLA). 'I OPOUI
commenced It shall )a the responsibility of the permittee to assure F:RAM 3.N(*.,
all required inspections are requested and approved [!*T R E P I ACE
G A 5 i L. I N r-.*.
ENSULATION
(.',YP. BOARD
Permill gnature
Issued By 'T.014
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
M'�-*CHAN I CAL_
TYOF TIFARD ✓.
crvi C PERMIT
C .4UNITY DEVELOPMENT DEPARTMEID E*R M I T #, . , . . . . : MEC91-0143
W
13126 SW Hell Blvd. P.O.Box 23397,Tigard,Oregon 97223(503)6394175
�
---- , ��9 -i - "+.,i;i -fV*F-F- f 9.,4 d F 5 n 0 6 7' t t
SITE ADDRESS. . . : 15143 SW KENTON DR PARCEL. 2S 12
SUBD 1 V I S I ON. . . . : ZONING:
LALOCK. . . . . . . . . . : L.OT. . . . . . . . . . . . . i
CLASS OF WORK. . :NEW FLOOR FURN. . . , : EVAP COOLERS:
TYPE OF USE. . . . :SF uNIT HEATERS. . - VENT' F ANG. . . :
OCCUPANCY GRP. . .: R3 VENTS WIG APPL : VENT SYSTEMS:
STORIES. . . . . . . . . BOII.-.ERS/(.-OIYIP,IRE,�(:30R,,; HOODS. . . . . . .
FUEL 0-3 HP. . . : 1 DOIiE�. TNCIN:
: /C-*.L I'---1 3-15 HP. . . COMML. IN"IN.
MAX INPUT: BTU 15-30 HP. . . . REPAIR UNITS:
FIRE DAMPERS% ;30--50 HP. . . . WOODSTOVES. . :
GAS PRESSURE. . . 50+ HP. . . . CL.O DRYERS. . :
NO. OF AIR HANDLING UN I T5 OTHER UN TS. .
FURN ( 100K PTU: 10000 cfm : GAS OUTLETS. -
FUHN ) =100K 13TU: 1001110 f r."
F-'ernarks : INSTALL 3 TON AIR CONDITTONER
Owner. Fc EB
ED FIASL-EY type amount t)y date recpt
15143 SW KENTON DR PRMT $ 25. 00
5 P CT $ 25
TIGARD OR 972.24
Phone #-
Cuntractov,:
BELL HEATING INC
SE PIAllA AVE
CLACKMAS OR 97V 15 -------------
P11 0 T-1 e #: r-'4 3" 11.04 2C, 25 TOTAL
Re,
.4 #. . : 447
REOU I RED INSPECTIONS
This permit is issued subject to the regulations contained in the F j.r)a I I ri 1.5 Ij e c t i o Ti
Tagg d Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. N I work will be done in accordance with
approved plans. Thi- permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
P e ni i t t e e S i q n a t 1.trp
I!i-1-t e d Fly
Call for inspection 639-4175
CIWOFTIFARD (7!0MARD T NO SE0917!5Q
COMMUNITY DEVELOPMENT DEPARTMENT GON P1*4*1:11M.11'.
13125 S.W.Hill Blvd..P.O Box 23397.Tigard.Oregon 97223 (503)639-4175 1)0.1'T F.:-, 1.S Fit.)E,13 V/29 f39
PP I M . PM'T'.NO 13917.1.*2.15
JOR (-)I*)r)PE55 : 1-31W43 SW l-')P USA NUMDEP: 39043
VAX MAP/1 0 T' PS 1 12 SURAS SIF OAK!) L T : 9:1. 113 l<
I-AN13 USE: PA . 5PD
1-01' SIZE :
SECTION: 12. r w r, IIN(:; : 1.w
WORK (�LASS : NEW
USE TYPE.;
'1he LIF)P11C.AlLilt ii'.Lgrtecam til C'I:)Ml:)I.y With ukUl. r-titiniii rari(l c)-F thea Ul-lj.-V:ke(:l
Sc?wc.,�i-a9ca Agencaq . 'The iMXl:)iI--P'll1 120 chityls, fl-riln ti-le chiLtle
amuurit r.)aid wiIi bib fi:ir-Fe:L'twC1 i-V the j;)er,onJ.t Th',! Aqe)ri(::y c1c)rAs ricit gt.laI----
i:tnte-.4ot ti-le- (:l-F the-:,) 3.i3cmilt..cin ci+ tl-le i3i(JO? %ew0l' ]RILt-Ir"A-144 . 1-F
ricit Iclr-atecl pl.t Vile MeaMIL111"PIN0*111t g:[Vw?I-1 , ti-io J.nt4tia11*--.r 1:)ilt) t 3 +*'.?r.4t J.ri
iii dircoc.^Lii:lrl% +r-c)m 0.1to (Jii:Itvkl1c(4 (I.I.Voll . If nc)t inci lltclat,crci , thei inist4ii,]Joti-
PlLir-chw.iise at. ull-ld Side! Selwe!l" Por-in:1-t iarid -th*t Aqipric,y wil'l irimUkU. at
'�NSTALL . T 1-"1*-*. : 1811-111 DING SEWED IMPERVIOUSi APEA:
FIXTU11:41E UNTT:j : TENANT 3'MPR('1VLMF-..NT
DW1:::1-LING UNiTs : 1.
c.
0
W FEES :
N MILI E A JA PERMIT 11111 00
E
R P . O . 13 0 X 'r?3 2 9 1. caNblEcTION CHAA(.',I--* 111111,P50 . 00
Tff.,AAD ON 972p'.3 LINE TAP INSTALL .
1:)I--IUNI'--: (503) 6134-7513
(')THEIR
0
N
T M I L-I 11.i.P Jf)y
R JAY HUTLI)ER
A
C P ' (1 . BOX 23291.
T TIGA111) OR 97P23
0
R 1:1-4(a141liz: (!'503) 68A 7543
R1 me. 30109 TOTAL: 1111111 ,285. 00
This permit Is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes, zoning regulations REcrt:IP-T- NO. Mo ,�;Iy('�
and all other applicable codes and ordinances. and it is hereby
agreed that the work will be done In accordance with the plans and PEQUIlIED INSPE-C"T TONS
specifications and in compliance with all applicable codes and ROUGH.-IN
ordinances The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work Is not started within 180 days.or If work is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
- 7,
Perm
i g na t)�re
Issued By:
(FOR `1ikF
) -146ED ABOVE
SEPARATE PERMITS REQUIRED FO8hK-l'8" blES
CITY OF TIG4 RD
(CffYOF-TjW�A ORD I-:'F-PMT'T' NO . : PLA391.7,57
COMMUNITY DEVELOPMENT DEPARTMENT ONSGON
13125 SNI.Hall Blvd.,P.O.Box 23397,Tigard,Oegon 97222—;A3)639-4175
OATE. U i 29/89
PnT—m7F---Kr.NO 11:119 1*7 25
JOI-31 ADDRESS : 1-51413 SW KENTON 01:1
TAX MAP/1 01 251 3.2 SUB: AS1-IF*OQD OAKS LT : 91 DK :
LAND (.ISE: RAq.5PI)
LOT 51ZE ;
NO : NO:
WORK CLASS : NEW WA'T'F*R (A 0 S-i F-..T TRAP
USE TYPE: S:ENGLE F*AM:rLY UP11SIAL I-'IKi-:'L-OW I:-'I:'tVNTP
CONST .TYPE : VN L.AVONATOPY 4 PAF' Pl-.4T.MF*;1:4
TUB SHOWER TPAPS
D3.51--lWASHEP 1.
DV:iF'OSAI
NO. STOPlES : 2 WAr.)H:I'N(., MAUHTNE. 1.
DWELL.UNITS LAUNDRY TPAY Fil-DG - I)PAIN (1)1(1.
S1NK SEWF14 (FT
WA 14 5'1'(.'JRM/PA- TN (FT
OTHj..:P
PF:M(-)PK!;, :
W "Ir ES
N MlLLEA JAY PE PM11'
F 1.47 0
p . 43 BOX (123k191.
TT(-',ARD 1)1:4 97 P 2 3 FIXTURES
1:-'HONE (503) 634-75413 STATE TAX $7 .30
OT HE P
0
N
T WATTS KEN
R KEN WATTS PI-I.JMHTN(.*;
A
C BOX 230912115
T t:j.(4 a r•(i
0 rir- 91223
R PHONE (,503) 604-662.6
I-011 ESNP41H. 50114il`8 TOTAL : $1.5A .13(:)
This permit is issued subject to the regulations contained In Title 14 PE(-.EIPT' NO.
of the TMC. State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances, and it Is hereby
agreed that the work will be done in accordance with the plans and 4EWUTPED 1NSPECTTONS
specifications and in compliance with all applicable,codes and f."l—B .UNDERSI AD
ordinances The issuance of this permit does not waive restrictive POST k. BI;.:AM
covenants. Contractor and subcontractors shall have current cityWA'1'1..;.R.1
business tax permits This permit will expire and become null and I...CNE:
void If work Is not started within 180 days,or if work Is suspended or PLP. TOP( UT
abandoned for a period of 180 days any time after work has "A'LN DRAINS
commenced. It shall be the responsibility of the permittee to assure F 1:NAL
all required inspections are rec.jested and approved
Permittee lure ,
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
C17Y OF T117A RDMEC"HANIC:AL.4PERMIT /
CITY OFTIGARD 1ER:1IT NO. : MFri91758
COMMUNITY DEVELOPMENT DEPARTMENT OOIOON
13125 S W Hall Blvd.RO.Box 23397.Tigard.Oregon 97223.(503)6)9-4175 DA'T'E ISSUED: 8/29/89
— - --- — - PPJ:M. PM'T.N(]. 891725
.J(JP ADDRESS . 151141:.3 SW KI:::NTON UP
TAX MAP/l..C)'T' ;2S1 IP SUFI : ASHFORI) OAKS LT :91 E3K :
LAND (.)SF '. R-14. 1511)
LATT SIZE ;
ITEM: NO : NO:
WOPK C',LASS: NEW FURNACE:: <100K A1. 4 FIANIJI-N <:I.0
USE TYPI.: SINGLE FAMILY F-UPNACE: 1.00K+ 1, A:I.G, 110N1.)I-P 10K
CONSi'T . 'T'YPE : VN F1-000 FURNACE' 1:::VFrI, . (",011)LE P
OCCUP . GPP . : 8:3 1-IE:ATER Vl::.N T F*AN A
VF::N'T" t1F:N T . SYS T'E:M
BLP/COMP <:31•41'
NC). !:,'TC)R:1.E S : 2 F31...R/(::(:)MP 3--15H1)
DWELL . UNITS : 1 1:31...8/CUMP i-*-•:30HP (('..(.')M
I IJI: l_ 'TYPE: GASB 01-34/11UMP 30-•1101-11P PF:F)A:IP UNI15
MAX . INPUT E31...R/COMP 50.1•HI-` CtTFiF::I: P.
FIRE 1)MPR51 (;A!i 1-'.11'):CNI:: (al)T'I_I::a"!ii 1.
HIGH
11-111W PHESS ?
1�4F MARKS :
O
W FEES :
N MIL.I._E`.A .JAY PI-:RMI'T Ils1.0 . OU
R F) . Y.) . BOX 23P91 FLAN REVIEW tM:l.1 . i1'5
T'I(aAf11:) O8 972i'3 F'IX'TURES $31:5 . 00
1FIC)NF: (:503) 6844--71/•1:3 !�,TATE TAX >W2 . ab
C 0 lila:R
O
Ri
T
R E3E:L..1.. HEATING INC: .
A
C 1.311`.50Sk..i 1•)IAZZA AVE.:,
l (11 AC, AMASi OR 51701.5
R PHONE (150:3) 243 11.841
". . "• TOTAL: •"58. 50
This permit is ip.sued subject tu'he regulations contained In Title 14 RECEIPT NO.
of the TMC, State of Orbgon Spe�lalty Codes,zoning regulations ( / (J'_�j�y/)
and all other applicable codes an; ordinances, and it Is hereby
agreed that the work will be done in accordance with the plans and REQUIRED INSPECTIONS
specifications and it compliance with all applicable codes and GAS I-.INE
ordinances The issuance of this permit does not waive restrictive POST 1S lar AM
covenants. Contractor and subcontractors shall have current city ROIJf.;H :I:N
business tax permits. This permit will expire and become null and
void if work is not started within 180 da;s.or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the p,-rmittee to assure
all required Inspections are requested and approve•l
1
Perrntt ynature
issued BY
(-N—J., F'OP :I NSi'L:.l,f Ct7 639-411.75
SEPARATE PCRMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITYOF TIFARDPLAN CHECK APPLICATION —
Pi AN CHECK
lwgtiD�
" CI�YOFTPERMIT N � �1i1
COMMUNRY DEVELOPMENT DEPAM."ENT aero" DATE ISSUED
13125 8W Hd Blvd P.O.8=272x7,fl8rd,rk9gan W=736-4175 ( /
JOB ADDRESS: 15 1 L'S ) 1,
I''`) 1 Gn —� TAX MAP/LOT
SUB: _� a 3 LOT: LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: _ REISSUE OF:
ADDRESS: _ LAST REISSUE:
FLOOD PLAIN/
SENSITIVE LAND:
PHONE: --
APPROVALS REQUIRED•
CONTRACTOR PLANNING:
NAME: \/ �� )� ( h L ENGINEERING:
ADDRESS: FIRE OEPT _
OTHER
PHONE: - !�, , `/ ITEMS REQUIRED
r!I£''/S/SUBCONTRACTORS: _
ARCH/ENGINEER BUS TAX:
NAME: CALCULATIONS:
ADDRESS: TRUSS DETAILS: _
PARKING PLAN:
LANDSCAPE PLAN:
PHONE: OTHER: _
i
COMMENTS: p I f 5 k P
I
PERMIT k ACrl M DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-4.2 00 Building Permit Fees 4(�/ _ 401
—_� 10-431 00 Plumbing Permit Faes /� 7.5- ly•l,So
I .✓5 10-431 01 Mechanical Permit Fees .v L' SS•w�
10-230 01 State Building Tax (5%)
Building 9
Plumbing _ 7 ,39
Mach
10-433 00 Plans Check FFje 2�
Building yJ r
Plumbing
Mach
30-443 jO S2wer• Connection (20X) ' 0 _ /j"
30-202. 00 'ewer Connection (80X)
30-444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC)
52-449 01 Parks I System Dev Charge (PDC) _
52--449 02 Parks II System Dev Charge (PDC) .3 i� -150
31-450 00 Storm Drainage Syst Dev Chrg (SSDC)
10--230 09 1 RFD (45X)
10-435 00 TRFD (5%) _
10-230 06 Washington County Fire 01 (95X)
10-435 00 Washington County Fire 01 (5%) _
10-220 00 Amert/Wedgewood — —
�� TOTAL "- � ��..�— � '•�,3
! ; PEC N l
APPLICANT --� - -----
Received By: Dato Roroived: