Loading...
12060 SW TIEDEMAN AVENUE 12060 SW Tiedeman Ave CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 539-4175 Business Line: 639-4171 --- --- -- -- BUP Date Requested- -/__---AM-- -�1'M ESLD Location 1 U (� U^_ / �--vm.e� Suite ^� _ MEC - Contact Person Ph Ph / PLM C rac _ Ph SWR BUILDING — Tenant/Owner .i � _— _ ELC Retaining Wall ELIR _ Footing Access. Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes- Slab � -----_-- SIT Post&Beam -- -- -— Ext Sheath/Shear Int Sheath/Shear - Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- Roof Misc:_ - 1 ----- - - Final PASS PART FAIL -- PLUMBING Post&Beam -- Under Slab Tap Out /nl wySewe,r Ra' Drains PART FA& . '..CHANICAL Post&Beam - - - ---- -- Roughh In Gas Line -- ----- ----- Smoke Dampers Final PASS PART FAIL ELECTRICAL - - - -- - - - - -- - - Service Rough In UG/Slab _ --- ------- I ow Voltage I jrn Alarm ----------- --it final PASS PART FAIL - -----------_--- __.__ ___ Backfill/Grading _.— Sanitary Sewer Storm Drain ( I Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ Please cF.II for reinspection RE: [ )Unable to inspect-no access Fire Supply Line ADA /I L 't° , GLI�R., Approach/Sidewalk Date 7 _ ! Inspector _ Al Ext Other - Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job %lite. i CIT' OF TIGARD PL.UMEINGPERMIT DEVELOPMENT SERVICES PERMIT 4 PLM2002-00209 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/11/02 SI rE ADDRESS: 12060 SW TIEDEMAN AVE PARCEL: 2S103AA-00100 SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R-4.5 '3LOCK: LOT: 034 JUR!SDICTION: TIG CLASS OF WORK. ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPF OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN GRAINS: SINKS: URINALS: GREASE TRAPS: L AVATORIES: OTHER FIXTURES. TUB/SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: In;tall t tub/shower and 1 toilet in basement. Owner: -- ----- FEES —+- - -- _- - Type By Date Amount Receipt SWAN, ELIZABETH E PRMT CTR 6/11/02 . 72.50 27200200000 12060 SW TIEDEMAN 5PCT CTR 6/11/02 $5.80 27200200000 TIGARD, OR 97223 Total $78.30 Phone 1: Contractor: WATSON PLUMBING CO 7935 E BURNSii?E ST PORTLAND, OR 97215 REQUIRED INSPECTIONS Phone 1: 256-3720 Top-out Insp Reg #: LIC 111855 Final Inspection PLM 26-602PB This jermit is issued 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 adopted by the Oregon Utility Notification Center. Thoso 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 B Permittee Signature: _ Cali (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day 1 Plumbing Permit Application Datereccived , D'}-' Permit no.: UG. , lr City of Tigard Sewer permit no.: Building permit no.: 1 Address: 13125 SW liall Blvd.Tigard,OR 97223 City of7'igard phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 f Date issued: 3yReceipt no.: Land use approval: _ — Case file no.: Payment type. )11,1�&2 family dwelling or accessory U Commercial/industrial ❑Multi-family 0 Tenant improvement U New construction jiQ Mlthunn/allrrat, m/rrltLtrcmrnt U F(xxl service ;J(Wicr INI-00NIATION FIX &ul I I for speclsil liff6irmatlun Job address: U 3 VV 1 1 C-0 Description ec(ca.) Total Bldg.no.: I Suite no.: Nerk I-and 2-`amily dnrtlings only: (includes 1(111 A.for each utility connection) Tax map/tax lot/account no.: SI-R(1)bash Lot: Block: Subdivision: SFR(2)bath _ Project name: SFR(3)bath — City/county: ZIP: Each addition it badAitchen De sc ption and location of work on premises:-- — Siteudlities: p ATt+1�' Il Lt�f_ _ Catch basin/arca drain Est.date of completion/inspection: -- / - G Z welis/]each line/trench drain Footing drain(no.lin.ft.) 111111111101111 LLIManufactured home utilities — Business name:, l LtL 14 1 / Manholes v Address: S lA S / t< Rain dmin connector City: /ru ? I State:Q Zl .97O Sanitary sewer(no.lin.ft.) — Phon : `(„ 70 0 Fax:9 TfL.. 0/ ( E-mail: Storm sewer(no.lin.ft.) I d CCB no.: ( Plumh.bus.MR.no; - G� atcr service(no.lin.ft.) / City/metro lic.no.. l 0 y) .y fxture or Ilam: Contractor's representative signature: e_ - Back tion valve Back flow reverter Print n ! V 1 tic � Date(L) ` !-U 2 Backwater valve Basins/lavatory _ Name: Clothes washer _ Address: Dishwasher _ Drinkingfountain(s) _ City: ZIP: Ejectors/sump Phone: Fax: E-mail: Expansion tank Fixture/sewer ca Name(print): `)(� �-( Floor drains/floor sinks/hub - — --- Garbage disposal Mailing address: �) S LU C i'h - --- Hose hihh City: State: ZIP: -- c maker Phone:. Fax: E-mail: Trite. -e tor/ reale trap _ owner installation/residential maintenance only: The actual installation Prime,'s) will he made by me or the maintenance turd repair made by my regular Roof dr,in(commercial) - employee on the property I own as per ORS Chapter 447. Sink(s),b%sin(s),lays(s) Owner's si nature: Date: Sum --------- ---- -- - Tubs/sho,•—r/shower pan Name: Urinal ---- ---- ---- Wate,closet Address: —�_ W,^.er heater City: _ State: 7.111: (;cher: — Phone: _ Fax: E-mail: Total _ . Na all)uriatlieuera una pt credo cares,,please cart)urladkeon forrrrore irdornutMinimum fee................$ lon. Notice:This permit application - - U Visa U"AusterCard expires if a permit is not obtained Plan review(at _-_ %) $ aedlr card number __ _ —LL within 180 days after it has Leen State surcharge(8%) ....$ E.xpltet - as--- ecce ted complete. TOTAL .......................$ _ -- Name of cardhnld!r u shown on ee lrerp p --C;F"_ dm rlpuute Amount 4/04616(tZKIfMCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURESSIndividual1--- -- QTY AMOUNT (includes all plumbing fixtures in PRICE TOTAL - ---- -- eaL Sink 16.6[) the dwelling and the(irs2100 ft. QTY (ea) AMOUNT Lavatory A 16.60 �- for each utility connection) _ _ One 1 bath _ $249.20 Tub or Tub/Shower Comb. 16.60 _ Two 2 bath _ $350.00 Shower Only 16.60 Three 3)bath _ $399.00 Water Closet 16.60 - SUBTOTAL Urinal 16.60 6%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal - 16.60 - -_�� TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/FloorSnik 2° - 16.60 PLEASE COMPLETE: 3" 16.60 4" Water Heater O conversion O like kind 16.60 _ _ Quantity b Work Performed Gas piping requires a separate mechanical Fixture Type: View Moved Replaced Removed/ permit. _ Capped MFG Hume New Water Service 46.40 Sink - MFG Home New Sari/Storm Sewer 46.40 Lavatory Tub or Tub/Shower Hoso Bibs 16.60 Combination -_ Root Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fixtures(Specify) 16.60 -_ _ Dishwasher -_ Garbage Disposal -- -- Laundryra Room T WashingMachine Floor Drain/Sink: 2" Sewer-1 st 100' - 55.00 3" Sewer-each additional 100 46.40 _4" - Water Service-1st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 - Other Fixtures S ecl Storm&Rain Drain-list 100' 55.00 - Stonn&Rain Drain-each additional 100' 46.40 - - Commercial Back Flow Prevention Device 46.40 -- Residential Backflow Prevention Device' 21.55 - Catch Basin -- 16.60 _ Inspection of Existing Plumbing or Specially 62.50 Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 - ------ ---- -- QUANTITY TOTAL Isometric or riser diagram Is required If QuantitV Total Is >a - *SUBTOTAL _-- -_- - 8%STATE SURCHARGE I - - --- -- -- "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture qty total Is>0 TOTAL "Minimum permit fes Is$72.50+5%state surcharge,except Residential Backflow Prevention Device,which Is$30.25+5%state surcharge '"All New Commercial Buildings require 2 seta of plans with Isometric or riser diagram for plan review. I:\dsts\forms\plm-fees.doc 12/26101 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP _ Received —_.__ —_—.Date Requested '`/7 AM_ PM_ — BUP — Location __— 7 12 C, IU e/ '� Suite _ _ MEC Contact Person __ —_— L(b2�h( —) 7,;1,0PLM '43 -CSC' d`� Contractor__ --- _ __-----____-- Ph(--) • SWR — BUILDING Tenant/Owner _- _ ELC Footing — — ELC Foundation Access: Ftg Drain ELR Crawl Drain SIT Slab Inspection Notes: ----- — Post&Beam -.- --...---- ------ ----._.__. Shear Anchors Ext Sheath/Shear ---— Int Sheath/Shear Framing -- ------- - - - - ---- ------ ---- Insulation Drjnwall Nailing -- - - -- _---- Firewall , v Fire Sprinkler --- - — Fire Alarm Susp'd Ceiling -_ -- --� - Roof Other: _ -- Final _- P ART FAIL _ UMI -- eam Under Slab -- - - - - Rough-In Water Service --- - - Sanitary Sewer Rain Drains ---- - Catch Basin/Manhole _ Storm Drain " SART FAIL __ .-.--- ---------- -.. --- PICAL --- _----- --- ------ --_ Post&Beam — Rough-In - ----- --- ---- _ ---- -- Gas Line Smoke Dampers --------_ _._.. _-.-.-----____-- --- Final PASS PARTFAIL "-��--------- -----------�--- i_ ELECTRICAL_-- - _-__ --------- Service-- ----- ---- - ------ - Rough-In --- -- ---. -�- _- — - UG/Slab Low Voltage - Fire Alarm Final F-] Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SITE -- [� Please call for reinspecti)n RE: _- F] Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date InspectorExt - Other: Final — DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL. CITY OF TIGA,RD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION ENVISION Business Line: (503) 639-4171 J BUP Received __ Date Requested __ AM / S PM__ BLIP Location - _ � _� ` Suite MEC Contact Person — -- Ph( —) 24L(2 , - PLM Contractor Ph( ) __— SWR BUILDING Tenant/Owner _ —_ ELC _ Footing - - ELC Foundation Access: Ftg Drain ELR r— Crawl Drain Slab Inspection Notes: SIT Post&ream Shear Anchors Ext Sheath/Shear _ ' _�— Int Sheath/Shear Framing —. _ — _ ----- - --- —— Insulation Drywall Nailing - Firewall Fire Sprinkler ---- Fire Alarm Susp'd Roof 11 Other PART FAIL PtIDNISING - - Post&Beam - - Under Slab --- Rough-In Water Service — Sanitary Sewer Rain Drains -- — -- _ Catch Basin/Manhole Storm Drain -_— --� Shower Pan Other: -- -- — Final PASS PART FAIL MECHANICAL Post&Beam Rough-In Chas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service --_-- Rough-In -_ UG/Slab Low Voltage Fire Alarm Final L, Reinspection fee of$_ _ required bei.-1re 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 LineADA . J Approach/Sidewalk Date �e11 a v Inspector _—`•--�'���' Ext24�/T Other:_ Final W a DO NOT REMOVE this Inspection rocord from the Job site. PASS PART FAIL CITYOF T I G A R D __ PLUMBING PERMIT PERMIT tt: P 15/01 00390 DEVELOPMENT SERVICES DATE. ISSUED: 8!15/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AA-00100 SITE ADDRESS: 12060 SW TIEDEMAN AVE SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: 1C�11G _BLOCK: LOT: 034 _ JURISDICTION: 1 CLASS OF WORK. REP GARBAGE DISPOSALS: MOBILE HOME PREVNTES: TYPE Of- USE: SF WASHING MACH: BACKFLOW OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIX'rURE_S __ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URII`'ALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWL-R LINE: ft WATER CLOSETS: WATER LINE: 140 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replar-r, 1 " of water service -- FEES Owner: Type By Date Amount Receipt SWAN, ELIZABETH E PRMT CTR 8115101 $101.40 27200100000 12060 SW TIEDEMAN 5PCT CTR 8/15/01 $8.11 27200100000 TIGARD OR 97223 --- Total $109.51 Phone 1: Contractor: - ED'S CUSTOM PLUMBING 25480 BALD PEAK RD HIL.LSBORO, OR 97123 REQUIRED INSPECTIONS Water Service Insp Phone 1: 503-628-1810 Final Inspection Reg #: LIC 52900 PLM 34-338PB 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. direct questions to OUNC by callin 503) 2 - 87. You may obtain copies of these rules or Issued By: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application ----� Uatcreccivrd: l.5(Jf Permitno.: Crit of Tigard City � Sewer permit no.: Building permit no.: Address: 13125 SW hall Blvd,Tigard,OR 97223 Cityr�("Tigard Pr Phone: (503) b3^-41?I ojecUappl.no.: Expire daft: A Fax: (503) 598-1960 I)ate issued: By: Receipt no.: Land use approval: Case file no.: Payment type: I VPF UF PERM IT ❑ 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/aller:uion/replacelie lit U Food service r ltlu r Job address: (� ( _�/ Illescrl tion " I�ec(ea.) Total Bldg.no.: Suite no.: New I-and 2-family dwellings only: Taxn IoUl,cc�unt no.: (includes 100 fl.for each utility connection) map/tax -- SFR(1)hath Lot: Block: Subdivision: _ SFR(7)bath Project name: SFR(3)')ath City/county: — ZIP: Each additional bath/kitchen Descripl ion and location of work on premises:._ Siteudlitles: Catch basin/area drain _ Est.date of complei n nt/inspection: Drywells/leach line/trench drain PLUMBING CON I RA( I(MI Footing drain(no. lin.ft.) Manufactured home utilities Business name: Manholes Address:_2 < t Rain drain connector City: Stat . 'LI ':Cy'�� Sanitary sewer(no.lin.ft.) Phone: `ax: — E-mail: Storm sewer(no.lin.ft.) CCB no.: Plumb.bus.reg.no: ) +7ler service(no. lin. li.) City/metrou:. 1o.: ture or Item: Contractor's representative signature: v Absorption valve Back flow pre:cntcr Print name: / h e: ------_ �— Backwater valve Basins/lavatory �Narnee �i ��,j-t Clothes washer er Address: �y�y,ryr linking fo - Drinking fountains) City: State: ZIP: Ejectors/sump —� Phone:X eqtx: F. nt:lil: xpansion lank _-- fixture/sewer cap Name(print): Floor drains/floor sinks/hub Mailingaddress: Garbage disposal close Bibb _ City: State: ZIP: _ Ice maker Phone: J E-mail: Interceptor/grease trap C,vuer installation/residential maintenance only: The actual insth.11ation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on die p,nperty 1 own as per ORS Chapter 447. Sink(s),basin(s), ays(s) Owner's signature: _ Date: Sump Tubs/shoH�r/shower pan rin Name: - ater closet _ Address: Water heater City: _ State: ZIP: _ Other: Phone: Fax: _ E-mail: Tota Not all Jurisdictions Accept credit cattle,please cell Jurisdiction fat nm Inform ilon. Notice:This permit application Minitnum fee................$ 2-L y O Visa U Mastercard Plan review(at __ %) S expires If a permit is not obtained Credit card number / / within 180 days after it has been Slate surcharge(8%)....$ ' Eipires accepted as complete. TOTAL .......................$ _77777 7 Narne of cardholder u shown on Itlt c�— _ S Crdholder signature Amount 440.1616(tL WCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (Individual) QTY 0a AMOUNT (includes all plumhing fixtures In PRICE TO AL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 60 for each utilityconnection) 16 Lavatory — One 1)bath $249,20 Tub or Tub/Shower Comb. 16.60 Two(2)bath $350.00 16.60 Thr©e(3)bath _ _._ $399.00 Shower Only Water Closet 16.60 _ SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%11F SUBTOTAL TOTAL Garbage Disposal 16.60 Laundry Tray 16.60 _— Washing Mact ine 16.60 FloorDraln/Floor Sink 2" 1680 PLEASE COMPLETE: 3" 16.60 16.60 4• _ —___ — T Quantity b Work Perfonned Water Heater 0 conversion O like kind 16.80 Fixture Type: New Moved 'teplaced Remaved/ Gas piping requires a separate mechanical I Capped e.mit - Sink MFG Home New Water Service 46.40 — . MFG Home New San/Storm—Sewer 46-40 Lava!ory Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Onl — 16.60 Water Closet Drinking Fountain _ Urinal - Other Fixtures(Specify) 16.60_ Dishwasher _ "— Garbage Dis osai Laundry Room Tray _ WashIna Machine Floor Draln/Sink: 2" Sewer-1 st 100' 5500 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater _— 48.40 Other Fixtures Water Service-each additional 200' _ (Specify) Storm 8 Rain Drain-1st 100' 55.00 Storm 8 Raln Draln-each additional 100' 46.40 _ Commercial Back Flow Preventlon Device 46.40 Residential Backflow Preventlon Devlce' 27.55 —_ Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Ro nested Ing actions per/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram Is required If Quantity Total is >9 _ "SUBTOT.`.L 8%STATE SURCHARGE "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture qtY total Is>9 TOTAL S *Minimum permit fee Is$72.50 4 s%state surcharge,except Residential Backflow Prevention Device,which Is$36 25•a%state surcharge ~All New Commercial Buildings require plans with Isometric or riser diagram and plan review I\dsts\forms\plm-fees.doc 10/10/00 1 CITY O F T i GA R D --BUILDING PERMIT PERMIT#: BUP2002-00072 DEVELOPMENT SERVICES DATE ISSUED: 2/28/02 13125 SW Haig Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AA-00100 SITE ADDRESS: 12060 SW TIL--DEMAN AVE SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R-4.5 BLOCK: LOT: 034 JURISDICTION: TIG REISSUE:Y FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DEM FIRST: sf N: S. E: W: TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: sf N: S: `E: W: OCCUPANCY GRP: TOTAL.AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: GARAGE: sf OCCU SEP. RATED: STOR: HT: ft BSMT?: MEZZ.?: _ __REC]U SETBACKS _ _ REQUIRED FLOOR LOAD: sf LEFT ft RGHT: ft FIR SPKL, SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMF SURFACE: PRO CORR: PARKING: VALUE: Remarks: Demolition of 1558 square foot barn and (2)255 square foot sheds. All debris is to be removed from the site. Owner: Contractor: METRO DALE BRITTON INC 600 NE GRAND 4721 NE 148TH AVE PORTLAND,OR PORTLAND,OR 97230-3411 Phone: 503-797-1554 Phone: 503-760-3575 Reg #: LIC 32030 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Erosion Control Insp 846-8P4 pRMT CTR 2/28/02 $62.50 27200200000 Final Inspection 5PCT CTR 2/28/02 $5.00 27200200000 EROS CTR 2/2.8/02 $26.00 27200200000 ERPC CTR 2/28/02 $8.45 27200200000 (additional fees not listed here) Total $110.40 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-332-2344. Permittee Signature: ,L d n Isqued By: �� i — Call 639-4175 by 7 p.m. for an inspection the next business day Building Permit Application �� � Date received: /�g Oaj Pcrmitno.• ��•',�,ln� City of Tigard Addresbi(503) 639-4171 Y� P 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date: Phone: City of Tigard Date issued: B Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval; 1&2 family:Simple Complex: U I &2 family dwelling or accessory U Commercial/industrial U Multi-farnily U New construction Demolition U Addition/allerition/replacemenl J Tenant irnprovenu•nl U lire!,prinkler/alarm U Other: 1 ' 1 j Juh address: 1 L' �'�(� "`� —� Bldg.no.: _ Suite nu.: I,rtt: Blcxk: Subdivision: Tax map/tax lot/account no.: Project name: Description and location of work on premises/specda!conditions:-L,11 r1 OL < 5 C 55 - -- Name: 4 (Floodplaill,%eptic pachy,to Mailini nddress_f-�J l V� L' 1 &2 family dwelling: City: I Slate: ZIP: Valuation of work................. Phone:! 1 ' `T " ax: E-mail: No.of hedrooms/baths................................. Owner's tepresentative lit i t l.. Vi U 1,( Total number of flags................................. Phone:' IN Jr, mail: New dwelling arca(sq.ft.) .......................... NAPPLICANT Garage/carport area(sq. ft.)............. ........... Name: Covered porch area(sq.ft.) ......................... Mailing address: Deck arer ',q. ft.) ........................................ City: State: ZIP: Other structure area(sq. 1't.)......................... Phone: Fax: I E-mail: Commere al/industrial/multi-family: Valuation .if work........................................ $ ..— i Existing bldg.area(sq.ft.) .......................... Business name: Address: I ��',_ t � �' New bldg.area(sq.ft.) ............................... _ ., C. Number of stories...... ............................... City: State: C ZIP:(-,' _ Type.of construction.................................... Phone:r !,� -; 1- Fax:' , _ 1 ' 1 F-mail: -- - ( tr(fancy etoup(s): Existing: CCB no.: C New: _ City/metro lic.no.: (,'( � Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to he licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: — — Phone: I ak E-mail: — -` --� Name: Contact person: Fees due upon application ............ .............. $ —_ Address. _ _ Date received: _ City: — State: _ IIP: Amount received ......................................... $-- Phone: ^ --l-Fax: mail Please refer to fee schedule. —^ hereby certify 1 have Trod and examined this application and the Not all jurisdictions accept credit rards,please cell jurisdiction fix more inrormation attached checklist.AV provisions of laws and ordinances governing this U vtan U Mastercard ' work will be conlplie�lMul,w e C s cifitt ere n rat. Credit card number_,_—_—._ e +rc�f rAuthorized signature:� l` I `' �e: Y t Name of cardholder u shown an etcdlt card I l ri11LI" 1 L : 'I� i ,_. Print name: l��►tl� .1.1��_--- — cardnndeer ei6n.t.ue Am,uat Notice:This perwit application expires Ira permit is not obtainedwithin 180 days after it has;been accepted as complete. 440-4613( 'oM) A. t4. ebe, 5 �O I ; �5 Commercial Flan 1 luhnlittai Requirement Matrix Cite of Tigard TYPO: OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal Site Work 4 (must include location of all accessible parking) Plumbing - Site Utilities 2 Building 1* Fire Protection System 3** Mechanical 2 Plumbing - Building Fixtures 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. Afte; plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). *For over-the-counter commercial tenant improvements, submit 2 sets of plane. **"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. I:klsts\forms\COM-matrix.doc 9/24/01 FEB-28-2002 14:45 P.01i01 V w �. r•r 1,r•r���� 1.1.1.1•. G i �:r.;•r•1;r r�r;�tir �� f2�`r~r� tir{y C 4Fi C 1 'fti.y a Citi 44 ua] r \\\ :�;� fir•• � .r to CU ��rtirtir c a r•r.rr��., •x,1.1•,.,• 0. � �ti •f•Il• `� Qym"' G ''u1l \ 4 7 .C +7 �^ r•7.. z cn � CL. ro W'J � � zfs7G .:t?\%V:•rs'•' '!of,.s' hi `� L L7 a. Z m �l 0-10 100 TI'Ti L F.I-tI CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT M PLM2002-00364 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9127/02 SITE ADDRESS: 12060 SW TIEDEMAN AVE PARCEL: 2S103AA-00100 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: UNK FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of commercial backflow prevention device for Water Quality Facility#9. _FEES Owner: Description Date Amount CITY OF TIGARD LL BLVD I I'LUM131 11C111111Fee9/27!02 $72.50 13125 SW HA TIGARD, OR LL BL I I'LUMI31 Permit I�ee 9/27/02 $0.00 I AXI S%State Tax 9/27/02 $5.60 11'AX 19";' slag'lax 9/27/02 $0.00 Phone 1: -- — " Total $78.30 Contractor: TRYON CREEK LANDSCAPE INC 11400 SW NORTH DAKOTA ST TIGARD, OR 97223 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 024-2174 Final Inspection Reg #: MET 00003719 LIC 11525 PLM 0296 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 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued .� � ''� �'� _ Permittee Signature �. ��- �--t` - Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Building Fixtures Plumbing Permit Application a --- Date received q":PPz• Permit no. a"i%V 00 City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 — cYm /Tt);urd phone: (503) 639-4171 ProjecVappl no.: date: Fax: (503) 598-1960 Date issued: B Receipt no.: Land use approval: _ Case file no.: Payment type: TYPE OF PERMIT I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: _ IN 711 I lip inn, t n, ; t Descea ription Qty. Fec( .) "Dotal lob address: /�;. �: w: i i�, A. �k)t t' �- - NeN I-and 2-family drscllings only: Bldg. no.: Suite no.. (includes too ft.for each utility connec•lion) Tax map/tax lot/account no.:_A 5� -' /e.t. �T. SFR(1)bath Lot: Block: Subdivision: _ SFR(2)bath _ Project name: SPR(3)bath City/county: 7.1P__` Each additional bath/kitchen Description and location of work on premises: -_ _ Si(e utilities: Catch basin/area drain _ East.date of completion/inspection: Dl wells/leach line/trench drain PLUMBING CONTRACTOR I-ooting drain(no.lin.fl.) anufactured home utilities Business name: y 40,1\ j'eC IManholes Address: jl ,V _FU S ____ _ Rain drain connector _ City: `rl c IStated Zip: Sanitary sewer(no,lin. ft.) _ Phone: , l L Fa E-mail: Storm sewer(no.lin.ft.) CCB no.. I(, � r ( I I Plumb.bus.reg.no: Water Service no,tin.ft. City/metro tic.no.: b Fixture or Item: Abso tion valve _ Contractor's representatives nature: Back flow preventer _ Print name: 14V'V / Date: 'Backwater valve 15110111 Film 1111 0 rfi-.111Basins/lavatory Name: STAC Clothes washer ---- - - -- Dishwasher Address: Drinking fountain(s) Cit Stntr ZIP: Ejectors/sump _ Phone: S 17 Faz: I.-mail: Expansion tank —_ Fixture/sewer cap Name(print): 6 )T _ Floor drains/floor sinks/hub Garbage isposa _— Mailing address: _ — hose bibb _ City: —-_ — Stater ZIP: Ice maker — Phone: Fax: E-mail Interceptor/grease trap -_ Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Raof rain(commercial) employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature:---_-_-------.---—._—Date: Sump _ Urinashower/shl ower pan Urinal _ Name: _— Water closet Address: Water heater City; State: ZIP: Other: Phone: Fax: mail: _ ata --- Minimum fee................ Not all jurisdictions accept credit cards,please call jurisdiction for more mrorn stlnn. Notice: This permit application n Plan review(at _. /a) S _ U vise U MasterCard expires if a permit is not obtained State surcharge(80,10).... S credit card number,_____ ^__—� raphes within 190 days alter it has been Name of cat nider a shown on credit card accepted as Complete. TOTAL.,...................... S _. Ca older signature T� Amountj 4404616(&MCOM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES individual QTY ea AMOUNT (includos all plumbing fixtures in PRICE TOTAL Sink 1660 the dwelling and the first-100!t. QTY (ua) AMOUNT Lavatory 16.60 for each utility connection_)__ _ _ One(1)bath $249.20 Tub or Tub/Shower Comb _ 16.60 A— Two 2 bath $350.00 Shower only 16.60 Three 3 bath $399.00 Water Closet y y 16.60 —'--"----—— SUBTOTAL Urinal 16.60 _'8%STATE SURCHARGE_ Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 1660 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink ^" 16.60 3" 1660 PLEASE COMPLETE: 4" 16.60 Water Heater O conversion CO) IIke kind 16.60 uantit b Work Performed Gas piping requires a separate mechanical Fixture Type: Now Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory H — Tub or Tub/Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures(Specify) 16.6C Urinal _ _ Dishwasher Garbage Disposal _ _Laundry Room Tray Washing Machine _ Floor Drain/Sink: 2" Sewer-1 st 100' 55.00 '' 3" Sewer-each additional 100' 4640 4" Water Service-1st 100' 55.00 I _Water Heater Water Service-each additional 200' 46.40 Oiher Fixtures Storm&Rein Drain-list 100' 55.00 Storm 6 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 --- Residential Backfiow Prevention Device' 27.55 - — Catch Basin 16.60 _—__ _ 7-1 Inspection of Existing Plumbing or Specially 62.50 Requested Inspections er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.2.5 Grease Traps 1660 QUANTITY TOTAL ---_----- -_-_____ _— Isometric or riser diagram,s required it QuantityTotal Is >9 _ _ — `SUB'rOTAL — ---- _8%STATE SURCHARGE _ -- "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture qty total Is>9 _ TOTAL b "Minimum permit tee is$72,50•8%slate surcharge,except Residential Backflow Prevention Device,which Is$30 25+B%state surcharge "'All New Commercial Buildings require 2 sets of plans with Isometric or"Iser diagram for plan review. I:\dsts\forms\plm-fees.doc 12/26/01 CITY OF TIGARD 24-Hour BUILDINGInspection Line: (5"3)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Date Requested -1%�_ AM.____— PM BUP Location �` Ur'v G� I...1 a�G��✓1�-Y+-J __Suite_ MEC C� U Contact Person _ � Ph( —) �' �� PLM 42 Contractor ____ _ Ph( ) SWR _ BUILDING Tenant/Owner - —_-_--_ — - -- -- _ ELC Footing ELC Foundation Access: Ftg Drain ELR - - - Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling j Roof Other: - -- - - Final PASS PART FAIL PLUMBINt3 Post&Beam - Under Slab --- Rough-In Water Service - - - - --- - — _ Sanitary Sewer Rain Drains Catch Basin!Manhole Storm Drain Shower Pan Other. r S / PART FAIL WANICAL Post&Beam Rough-In - Gas Line Smoke Dampers - - ---'-- - Final PASS PART FAIL - -- ELECTRICAL Service Rough-In UG/Slab Low Voltage Fite Alarm Final F-1 Reinspection fee of$___ �__ 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 ADAroach/Sidewaa lk date pp - �- - InRnwrtcsr _. Ext Other: Final DO NOT REMOVE this Inspection record from the Joh site. PASS PART FAIL