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12665 SW 69TH AVENUE ADDRESS: a J5 SW GqT'4 AVE 1 w LL1 i\records\microflm\targetstuilding.doc �k k k \ E TE © 8 22 (§ ƒ % ƒ¥k f §\I £ § t o z e= @e@ § AE ° OD CO 7 ) d d d d d - - d d - ■ -M ) ƒ ) CL o 0 0 0 o e ' ® n o ® D _ $ )) co m a j k \ ( / § < < \ \ e x e c < e a e e � � £ d ( ƒ ƒ 7 % % 3 IL Go e c c e / R 2 c \ m \ 0 # \ § § § $ 2 § § @ 4-- § § § R § § ® ® § § § (n � � � § o q c � k \ k / E { § ; 2 \ E $ f k t 7 \ ) b / 2 2 ) CL f 7 f % $ / < (I / I k } \ / E § \ CN Lr) LO Qo o - w2 N@ 8 ° ƒ e U ) R § ) § IL2 = _ _D _ _ = a D Q m m m = m m cn m m o = m k 2 ) /f \ECL z ± ¥ ) m m m m m $ k @ @ ® @ Q = 4 x o o I c o \ \ K § g \ 5 � => ) \ � C) C) CD 00 co U , LU ) j k ( k _ @ O)o $ ) k U 16- $ m + m m 4— V)$ ./ 0 Q � A Cl. % / / 2 \ / § » . c 3 ƒ j \ \ } [ ƒ I � — � ) / \ \ ° \ } j u E o ~ :p ) 2 � ? \ \ + & A § \ \ \ § \ « g u m w 2 Q d 0 z a, rn s a L a �o d � v m - a 7 "0 m o x N J Q7 Q O n � � w � o a LO Q) T C m � v J z L1 o m N Q O t (n a" rn m cu U n- 4O 0 a N W N .ice a o V Q a� N Cl. C/) Y J FGA C' Q C CL v rn to a � C) CA Q LL N NLn 00 C I > Q co 0 a a Q p k a m m Q) a E a ami u o OL z 'U a' CL O O O O O 0 D b w a m U C7 C7 C7 _D y O y = J M M M ) n V) O " a � o n O LL C7 D m o � a" U, o N U 4 n I- 23 J rl aCN o in yp O 'p C N pj Q7 i� cc a n a CL a d7 u Um N N a V) (n U v CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: ELC98 --0003 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01/05/98 PARCEL: : S101AD-02800 SITE ADDRESS. . . : 1;_'F,6r SW 69TH AVF SUBDIVISION. . . . :WEST PORI-LAND HEIGHTS ZONING:MUE FLOCK. . . . . . . . . . . LOT. . . . . 031 JURISDICTION: TIG ProJect Descript ion : Morton Tree Serv . . . . . . . ng temp service. ---RESIDENTIAL UNIT----- -----TEMP SRVL./FEEDERS---- -----MISCELLANEOUS—-- 1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 1 PUMP/IRRIGATION. . . . : 0 FIaCH ADD' L 500SF. . . : 0 01 - 400 amp. . . . . : 0 SIGN/OUT LINE LTG. . : 0 LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . „ : 0 SIGNAL/PANEL.. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LAPEL ( 10) . . . : 0 -•--SERVICE/FEEDER----- -----BRANCH CIRCUITS---- -- ---ADD' L INSPECTIONS_-- 0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 c'01 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0 401 - 600 amp. . . . . . : 0 EA ADD' L_ FRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 ---•_.__.____________PL_AN REVIEW SECTION-•---------- ______ 1.000+ amp/volt. . . . . : 0 > =4 RES UNITS. . . . . . . . : > G00 VOLT NOMINAL. . Rpconnect only. . . . . : 0 SVC/FDR > - 225 AMPS. . : CLASS AREA/SPEC OCC. : Owner: ----------------------------------------------------- FEES DON MORTON type amoi.tnt by date recpt PO FOX 596 PRMT $ 50. 00 JSD 01 /05/98 98-30226t LAKE OSWEGO OR '37034 SPCT $ 2. 50 JSD 01 /05/98 98-302266 Phone #: Contractor: _______.___---------•--__._____---.--- OREGON ELECTRIC CONST/GROUP $ 52. 50 TC1TAl._ 1.010 SE 11TH AVE ------- REQUIRED INSPECTIONS -- - - - PORTL_AND OR 97214 Elect' 1 Service Phone #: 234-9900 Elect' 1 Final —_- R e g #. . : 203 This permit is issued subject to the regulations contained in the ligard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. All work will be. done in accordance with approved plans. This per3it 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 rulee adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-0017087. You may obtain a copy of these rules or direct questions to OLW by callinq (503)246-1987. Permittee 5 1 n a t i..i r e : l �s•_tpd By : -- - -- ---OWNER INSTALLATION ONLY------- The installation is beinq made on property I own which is not intended for Ln sale, lease, or rent. OWNER' S SIGNATURE: DATE: _____.___._---_---____--CONTRACTOR INSTAI_.L.ATION ONLI'-- --- ------ -------- S I BNATL.IRE OF SUPR. ELF_C' N r _ _ �._.._ _ DATE- LICENSE ATE:LICENSE NO: ++++++++++++++++++-1-++++.++++++++++F+++++++++++ ..-+++++++++++++++++++++++++++++++ Call 639--4175 by 7:00 p. m. for an inspPct i on npeded the npXt bi.tsi ness day +++++++++++++++++++++++.++++-{•++++++++.++++++++++++++++++++++++.+++++++++++++++a C+ Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # Permit # Phone (503) 639-4171 Date Issued CITY OF TIGARD FAX (503) 684-7297 Issued by TDD No. (503) 684-2772 Inspection (503) 639-4175 _ 1. Job Address: JOB No. 74592 4. Complete Fee Schedule Below: Name of Development Morton Tree Ser. and Lans Number or Inspections per permit allowed Address 12665 SW 69th Service included. Items Co.t(a;.i Sum City/State/Zip Tigard, OR 4a. Residential- per unit ^ 1000 w1 It or lase $11000 Name (or name of business) Morton Tree Ser, and and• Each addltwnal 500 sq it orportion thereof $2500 Commercial �; Residential❑ Each Energy $2500 Each Menul'd Home or Modular Dwelling Service or Feeder $6800 .2a. Contractor installation only: 4b.Services or Feeders Installation,alteration,or relocation ' Electrical Contractor Oregon Electric Group200 amps or less $6000 Address 1010 SE 11th Aye. 201 amps fu 400 ampe sae 00 401 amps to 60C amps <.120 00 City Portland State_ OR Zip 97214 801 amps to 1000 amps $18000 Phone No. 503/234-9y00 Over 1000 amps or volts —_— $34000 Contractor's License No.TNo. _ Reconnect only $5000 Contractor's Board Reg. _ 4c.Temporary Services or Feeders Installation,alteration or relocation Signature of Supr. EIeC'n ' �'� 200 amps or less 1 $5000 50.00 License No. 2841S Phone No. 234•-9900 201 amps to 0amps $ 000 _ — 401 amps l0 6 8000 amps $10000 Over 600 amps to 1000 voila 2b. For owner installations: see•b•Above 4d. Branch Circuits Print Owner's Name New Alteration or extension per panel Address a)The lee for branch circuits with City State_ Zi purchase of service or boder W. p Farb branch circuit $500 Phone No. b)The tea for branch circuits without The installation is being made on property I own which is purchase of service or Bede►fall Firsnot intended for sale lease or rent. Each branch circuit branch 635 00 1 Fach adddiorlal branch grcuil $500 Owner's Signature 4e Miscellaneous (Service or feeder not included) 3. Plan Review section (if required): Each pump or irrigation circle $4000 Each sign or outline lighting $4000 _ Signal circuil(s)or a lim4ed anergy Please check appropriate item and enter fee in section SB. panel,alteration or extension $4000 4 or more residential units in one structure Minor Lnbela(10) $10000 Serv'ce and feeder 225 amps or more System over 600 molts nominal 41. Foch additional inspection over o Classified area or structure contriining special occupancy the allowable in any of the above a as described in N E.C. Chapter 5 Per our on $3500 h _ � Per hour $55 00 N In Plant $5600 Ln Submit 2 sets of plans with application where any of the above l'- apply. Not required for temporary construction services. 5. Fees: J 5s. Enter tota!of above fees $ 50.00 NOTICE y- 5%Surcharge(.05 X total fees) $ 2_ in— PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 52.50 Sb.Enter 25%of line A for -� AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review if required(Sec 3) $ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $ A PERIOD OF 180 nAYS AT ANY TIME AFTER WORK IS - COMMENCED. ❑ Trust Accountill $ Balance Due $ 5(1 CITY OF TIGAR ® BUILDING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : BUP-97-0561i 1?125 S W Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 12/24/97 PARCEL: 2SIOIAD-02800 SITE ADDRESS. . . : 12665 SW 69TH AVE SUBDIVISION. . . . : WEST PORTLAND HEIGHTS Z ON I NG:MUE BLOCK,. . . . . . . . . . . LOT. . . . . . . . . . . . . :031 JURISDICTION:] IG REISSUE: FLOOR EXTERIOR WALL.. CONSTRUCTION- CLASS OF WORK. :A� FIRST. . . . : 320 s f N: S: E: W: TYPE OF USE. . . :COM(2 SECOND. . . : 0 s PROTECT OPENINGS?­­­­- TYPE OF CONST. :5N . . . . 0 sf N: S: E.- W: OCCUPANCY GRP. :B TOTAL------: 3.210 s ROOF CONST: FIRE RET? : OCCUPANCY I.-OAD: 0 BASEMENT. : 0 s AREA SEP. RATED: STOR. : 0 HT: 0 ft GARAGE. . . : 0 s OCCU SEP. RATED: BSMT? - MEZZ ? : REDD SETBACKS-------- REQU I FLOOR LOAD. . . . : 0 p s f LEFT- 0 ft RGHT: 0 ft FIR SPKL: S110K DEI . . : DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft: FIR ALRM: HNDICP ACC:Y BEDRMS: 0 BATHS- 0 IMF, SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ : 10000 R e m a r,1<s : Placement of modular trailer for temporary use due to burn-out of office. Owner-: FEES DON MORTON type amol.int by date reept P10 BOX 5':)6 FIRMT $ 80. 50 DRA 12/24/97 97--302051 LAKE OSWEGO OR 97034 5PCT $ 4. 03 DRA 12/24/97 97-302051 FILCK $ 52. 33 DRA 12/24/97 97-302051 F,hone #- 636-7902 FIRE $ 32. 20 DRA 1.2/24/97 97-3020551 Contractor: GENE CnNTRFI--I- 6860 SW NORSE HALL RD TUALATIN OR 970F,;:-' -------------------------------------- Phone $ 16`3. 06 'TOTAL Req #. . : 97005 REOUTRED INSPECTIONS ------ This permit is issued subject to the regulations contained in the Framinq Insp ....... Tigard Runicipal Code, State of Ore. Specially Codes and all other Appr/sdwli( Insp applicable laws. All work will be done in arcordance with Misc. Inspection ....... approved plans. This permit will expire if work is not started 1-, &JA L /At-0, within 180 days of issuance, or if work is suspended for warp than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are !.pt forth in OAR 952-00I-0010 through OAR 952-00101987. You many obtain a copy of these rules or direct questions to OUNC by calling (503)246-1987. Ln (J Si q n a t I ssited BY __�/�`>!1 /1 �/ — - ++++•t•+++++++++++•++++-; -+-+++4....+.++++++++++++++............4.................... Call 639-4173 by 7:00 p. m. for an inspection needed the next bi.isiness day ...............................................................&..............4.4 MEM CITY OF TIGARD Commercial Building Permit Recd Byu_'`` h- µ Date R" a _r� 13125 SW HALL BLVD. New Construction and Additions TIGARD, OR 97223 Date to P.E. �� ,�•/ `'z ,� (503) $39-4171 1 Date to DST /VPermit# ��li/ 17 -L Print or Type Related SWR# -- Incomplete or illegible applications will not be accepted Called Name of Development/Proiect Existing Building (] New Building Job , TT ��r� ,,n , r`�f r Address Street Address SOte Building tIZ� SW (e q�b Data Bldg# City/State Zip Existing Use of Building or Property Name Property �, Proposed Use of Building or Property: T s 5rr.� Owner mailing z'mac.v kinq Address - Suite � u u ')o -VV 5 No Of Stories: City/State Zip Phone Lot-ve 0a0etrp Sq. Ft. Of Project: Occupant Name 11 Occupancy Class(es) Name Contractor I Type(s)of Construction Prior to permit Mailing Address Suite J issuance,a copy (� W �f - r R Will this project have a Fire Suppression System? of all licenses t Yes ❑ No are required if City/State Zip Phone expired in C.O T Americans with Disabilities Act(ADA) database •i Valuation X 25% = $ Participation Oregon Const.Cont.Board Llc.s Exp.Date Complete Accessibility Form Project $ Name Valuation Architect -mading Addrf-;F, suite Plans Required See Mab ix for number of sets to submit cn back G ty State Zip Phone — I hereby acknowledge that I have read this application,that the mforrnation - - given is conect,that I am the owner or authorized agent of the owner,and Engineer N,•mr+ vthat plans submitted are In compliance with Oregon State Laws. � Mailing Address S;,,r Signature of Owner/Agent Date City i to Zip Phone Contact Person Name Phone til VIN .` ✓+>1.� �j (r- v e~n Indicate type of work: New O Addition O Demolition o FOR OFFICE USE ONLY Accessory Structure O Foundation Only O , Alteration O Map/'TL#� Land Use:Repair O Other � , _ /u/��7 e7OI� Description of work: ., 1,A, (r CSL O_e w-, Notes `, t LD TIF -� Parks: Estimated a of Employaos Note- Site Work Permit Application riust precede or accompany Building permit Application I\COMNEW DOC (DST) 8/97 COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST EXAMINERS (Note a.) TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE SITE 1 1 -- -- > (j,o,u) -- -- B (New or Add) 1 1 -- -- 3 O,o,w) -- -- F (New or Add or Alt.) 3 3 -- -- 3 O,o,f) M (New or Add. or Alt) l 1 - -- 20,o) -- -- B & M (New or Add) 1 -- -- 3 O,o,w) -- -- P (New, Add.or Alt) 2 2 -- -- 20,o) -- B & M & P (New or Add.) 2 1 1 -- 3 (j.o.w) 20.o) -- E (New, Add, or Alt) 2 -- -- 2 - -- 20,o) B & M & P & E (New, Add) 3 1 1 1 3 O,o,w) 20 o) 20,o) B or B &: M (Alt) 1 1 -- -- 20,o) -- B & -B & M & P(Alt) 3 1 2 -- 20,o) 2 O,o) -- B & N1 & P& E (Alt) 3 1 l 1 2 O,o) 2 O,o1 20,o) NOTE,g: KEY: a. Before returning to DST, Plans examiner gets appropriate j =Job B = BUP number of revised plans from applicant, stamps and completes, o=Office NI =MEC updates and adds actions. f= Fire P = PLM u= USA E = ELC b. Shaded areas designate ALT suLmittals only. w= Wash. County F = FPS c. FPS is a new permit category set -aside for fire sprinklers and fire alarms. d. Effective August 15, 1997,Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. J n vnatnc Doc OVER-THE-COUNTER (OTC) PERMIT COMMERCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST DESCRIPTION OF PROJECT: ef 2M P tv G7 b-1 GLASS OF WORK: AAle' FLOOR AREAS: . 2 y i EXTERIOR WALL CONSTRUCTION TYPE OF USE: �L' ��� FIRST SQ. FT. i N: S: E: W: TYPE OF CONSTR:__ / i SECOND SQ. FT. PROTECT OPENINGS?: OCCUPANCY GRP: _ THIRD SQ. FT. i N: S: E: W: OCCUPANCY LOAD:_Z�_ i TOTAL SQ. FT. i ROOF CONSTR: FIRE RET: STOR:i HT: FT: i BSMNT: SQ. FT. i AREA SEP. RATED: � I BSMNT?: MEZZ?: i GARAGE: SQ. FT. i OCCU.SEP.RATED: I I FIRE FIRE SMOKE HANDICAP SPRINKLER: ALARM: DETECTOR: ACCESS: COMMERCIAL INSPECTION ACTIONS FEE MENU Foot/Found Post/Beam $PfPermit Fee Masonry Framing V� " ,�" $ 3�Plan Review Insulation Shear Wall $ tl_L 5% State Surcharge 2 Firewall Gyp Board $�i�FLS Plan Review Suspended Ceiling Sprinkler Rough-in $. Add'I Permit Fee Sprinkler Final Fire Alarm $ Add'I FLS Pln Smoke Detector �i Approach/Sidewalk $ Inspection 71 _ MiscellaneousFinal $ MIS Fee �rK�hf 17 FOR OFFICE USE ONLY: ,1 TYPE OS USE OPTIONS(COM=commercial: CMS-commercial manufactured structure) CLASS OF WORK OPTIONS FOR ALL PERMITS(NEW=new;Add=addition;ALT=alteration; ACS=accessory;FND-foundation: OTR=other: DEM=demolition: REP=repair: FPS=Fre protection system, NOTE: USE OTR FOR FENCES, RETAINING WALLS. DETACHED DECKS. SIGNS. AWNINGS, CANOPIES) 1Aovrcntr2.doc (DST) 4197 12,,24 -97 11:43 FAA 2068544929 T KINNEY Ua :ULC9 OHV01 •35108 • 009 3I1nS '0U9t0iO S t G:L r lB9Z-SlC(90Z) s i a e SIM tot 7? le •��,•omm3mmoto somas SNOIZdW101 OMC ME1 mfl(low t�,. RrZ Pd.�x a Tgh r~ NJ 4 tJ p \ E $ien L o in �� � � •� � s 3 to.R bud• �vii ��`�. �n�v7'`/ � j... V is 9 - At-.A JIM s a M (\/+](1\J ,ri t 4-jj/t t-.9 ,r/t A-,t � �f �kE'� L :ry ag $ s 2 9 C v ¢ v O a � 43 0Cog Z of 15 O C4 Za j' T n € r a o n o w � > vi 31 '-j e 1.•'�� 97 11:49 FAX 20695.14929 MfEIN\EY 'has z � Q . u q ` w u Lu < w wr J U lu CL r � � z 4rLYt n � � tLL � � � UO 7 � a^ J 1 � N J •�v 1 7 t� .J C .. p I `•� yrs r � g r4 r1 ,tp R. (1' I— J � � J V�T Lv ANDY PARIS AND ASSOCIATES, INC. 15962 S.W. BOONES FERRY ROAD LAKE OSWEGO, OREGON 97035-4351 Ps. 2264' PH: 636-3341L. REOISTFJUD PROFESSIONAL NOTES: LAND SURVEYOR 1. ELEVATIONS ARE ON AN AS.',,'JMED DATUM. 2. THE PURPOSE OF THIS SURVEY WAS TO L, SHOW ELEVAT70NS FOR PLANNING PURPOS, ASSOCIATES, INC. ASSUMES NO LIABILITY i z OREGON HEREON FOR USES On4ER THAN INTENDEC �wNNer 13, M7I HAROLD P. SALO J. ANDY PARIS do ASSOCIATES, INC. ASSUME; ,r,AL T 2264 LOCATION OF ANY SUB—SURFACE S UCTi ` EXP JUNE 30, 1996 ui I t L.. I ♦I 1 1 I �/ W r so, BLOCK 31 Q BLDG COR. 0.2' NORTH OF PROP. LINE GRAVEL SHOULDER \VI f 106,fJEP N 87'28'22" W Xfof.u« D I EXISnNc 218.82' BUILDING X e.JJGRND T _.. I f I \I WEST PDGF iOF ASPHALT FMA X99.4,JGRND X00 _ �t ,-MAIL-BOX e � I CARAG!_' !ffOf,2�QR j GRA VEL DRI tl'—WA Y � I I R J� �9 \ 0 POINT ELEV--105 SURVEYOR's cot 9 _ ��5URVEYOR'S CONTROL \9 71.3 W I \ S f POINT ELEVg 98.55 I `— _ _ 1 10 �r T CAR--PORT i , , GU1"TER CLEM�-OUT I / EXISTING 0 i HOUSE \ \ z I 3 x9a.7acRND / I i I ORA VEL SHOULDER � S 87'28'24" E a 218.83' � _ - a ; 1� xfoo.e2aavD 1 ! OF" ASPHAL 7 X1of.744" � I TEIFPHONE' PEDESTAL I V,r^ ff6Af�P � CITY OF TIGA D BUILDING INSJPECTION NOTICE Inspection Line (Rec-O-Phone):639-4175 Business Phone: 639-4171 Inspection: ,� 2 Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mach. Rough-in Fireplace Post'Beam Struct. e5g. Top Out) Elea Rough-in FINAL: Post,'Beam Mach. San. Sewer Gas Line -Bldg. Plb(I. Underfloor Rain Drain Framing um . Alarm Water Line Insulation -Mach. Urn lerflr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: A Time: AM PM Address: Z �� r✓cL� / �"Q Builder: Permit #..4-Ir THE FOLLOWING CORRECTIONS ARE REQUIRED: o, v; f- J Ci C.7 .J I Inspector. Date: I140PROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE ___,Call For Relnsp. CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Lane (Rec-O-Phone): 639-4175 Business Phone: 41 i Inspection: Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation (---Mech._ Underflr. Insul. Shear Wall Gyp. Bd. � -Elect._ C> Date Requested:_ S Time: AM PM Address: c� �� j .moi_ 'rZLgj Builder: Permit #Ma THE FOLLOWING CORRECT IONS ARE REQUIRED: G_ n_ N J C� C7 11) J _ Inspector: Date: b2zt r PPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE _Call For Reinsp. CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-071 PLUMB'k NO PUE F 17'—ZRM17' t. . . . . . « Dn'117 ISS)U—U.D. i`(17,7j -U -TH i')VC "�TLAAND 70NING. C' Or-' �74 F,Ln 11 1 p 0 p M012 T LE '10ME CiF USE. r.- WA11'51-41NG MACH. . . . . . . SACKFrLow rrEVNTR9. IPANCY rL0017 ORIIINi. . . . . . . Trf--o"7. DRi 7— RIcj« WrITER HrPTCMS. . . ., . . . CATCH F.'13INS. . . . . . . . '."T1Jr.LES-- 1—MY-410PY TrMVS. . 7T' RAIN 1",RPTNG. . . XcS r . . . . . . . . . . . . . . . . . . CRCAST' 'RAF T" . . . . . SEWER LltiNlr W rYT E F, L T 11 1 r" t kP1 N D R A I l"! f 11; 'i'�TC114 Trr—E' i-AMOUWC 1�)V (2, , (.,t5 rRMT J':'7. 00 D 01:111 1'S i'30X jl'%"T'LANL) CIR 07309 Rf--P)L.!1REL) INSPECTION: t-sit issue f 4-bjF--A to t�,e t r"-M/ut�jov V1 uu1' !Qard ro(�E, tat� af (h.e. pe� al A .4, j i t'i 'AEt mrd 411 rther 'rop. out --piicatle laws. All Aurp. will be ccre -7 aLc.--dvcq iiit"i F i I EA I I n 5 0(-'G U T I clan-i 'h l'3 persit will pxpir; if work i; not started. ' !e'� of :-5:anca. oy if morl" is :' pqtJfj for sr-p City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # 13125-SW Hall Blvd. Permit # fl- Tigard, OR 97223 (503) 639-4171 MINIMUM $25.00 PERMIT FEE + !J. SURCHARGE New Single FamiN Residences Only Job +� G S �v , y i O 1 BATH HOUSE$140.00 O 2 BATH HOUSE$195.00 O 3 BATH HOUSE$225.00 Address a,.ar, a. _ Fee includes all plumbing fixtures in the dwelling and the first 100 met Z ai_U 7,7-,7- of water service, sanitary sewer and storm sewer. See fees below. « FIXTURES CITY PRICE AMr Sink 9.00 vO Ph- Lavatory 9.00 Owner Tub or TuWShower Comb. 9.00 Shower Only 9.00 412111110 Water Closet 9.00 (,r� Dishwasher 9.00 Occupant Garbage Disposal 9.00 Washing Machine 9.00 Floor Drain 9.00 "j°01i _► Water Heater 9.00 Laundry Room Tray 9.00 Urinal 9.00 Other Fixtums (Specify) 9.00 ""*4 Ad&. ^"" 9.00 Contractor � c ' ��1,5" 9.00 ZIP - 9.00 Sewer 1 st 100' 30.00 I, �t '0"'a'o""""` CRY°i� ''N. Sewer-ea. Addit. 100' 25.00 7 ; Water Service 1st 100' 30.00 1 hereby acknowledge that I have read this Application, that the Water Service ea. Addit. 200' 25.00 information given is correct, that I am the owner or authorized agent of the owner, that plans submitted are in compliance with State laws. that Storm &Rain Drain 1st 100' 30.00 1 am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00 number given is correct. (If exempt from State registration, please _ give reason below.) Mobile Home Space 25.00 �� � � Back Flow Prevention Q Device or Anti-Pollution Device 9.00 W Dow" Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new v addition Q alteration 0 repair 0 Catch Basin 9.00 to be done residential Q non-residential Insp. of Exist. Plumbing 40,00/h Specialty Reoluested Inspections 40.001hr Existing use of Rain Drain, single family dwelling 30.00 building or property 1/ Residential backflow prevention devices 15.00 Proposed use of 1 J building or property *(Except resldendal backflow prevention devices) NOTICE 'Minimum Fee $25.00 SUBTOTAL 1 �' PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS Ar ANY i CIE AFTER WORK IS COMMENCED, PLAN REVIEW 25% OF SUBTOTAL TOTAL Special Conditions y Date Issued 5- 115 b r- • CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 PERMIT PERMIT #. ,. . . . . . . SWR94•-03,V ., 639 i DATE ISSUED: 10/05/94 hPARCEL: `S 101 AD-02 '00 i T 1 E (ADDRESS. . . : 1.2665 SW 69TH AVE SUBDIVISION. . . . : WEST >=PORTLAND HEIGHTS ZONING. C--F' 13LUCK. . . . . . . . . . . LOT. .. . . .. . . . . . . . . : 31 TENANT NAME:. . . . . : USA NUJ. . . . . . . , . . FIXTURE UNITS. . . . CLVSS or WORK. . . :NEW DWELLING !JN I TS. . : 1 YRE OF USE- . . . . :SF NO. OF BUILDINGS: 1 T I\If3TAL.L. TYPE... , , . :BUSWR I MFPERV ,.AJFiF0C1.:7. . : : S f Rem.arks : CONNECTING TO SEWER Owner: — -- ---__ _.___.._.__._.._._._._____.._...________._..._...._._.___.__._____- FEES ,JOHN BE:LAND type zimol.rnt by r_iaty recpt 1,2301 SW MOFFITT' DR P'PRMT $ 2,200. 00 UES 10/05/ 34 .:5. 00 GES 10/05/94 iJll_SONVILLE OR y7070 Phone #: 682-2100 OWNER r-'fl on e tt: l 2235. 00 'TOTAL Key #. . . __...._._w_._ REGUUIRED INSFPECTIONS •--------_— This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit empires 18e days from t're date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side seder laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all drrect.ons from ,e distance given. If not sr, located, the installer shall purchase e "Tan and Side Sewer" Perrit and the Agency will install a lateral. initte,e f',ignc-it1..rrP Call for inspection - 639-4175 J Cu C7 11 _J City, of,Tigard PLUMBING PERMIT APPLICATION Plarick/Rec. # _ 1315 SW Hall Blvd. Permit Tigard, OR 97223 (503) 639-4111 i, 1�'r fG-1 ly, li r �'� MINIMUM $25.00 PERMIT FEE+ ST. SURCHARGE n...rawe�.r New Single Family Residences Only „hr. % :Mand "�••• ❑ 1 BATH HOUSE$140.00 G 2 BATH HOUSE$195.00 Job t}, ❑ 3 BATH HOUSE S2?5.00 Address war. Fee includes all plumbing fixtures in the dwelling and the first 100 feet (-n i of water service, sanitary sewer and storm sewer. See fees below. IMw xa iusr r aww•y FIXTURES QTY PRICE AMT Sink 9.00 " •"� awr Lavatory 9.00 I ' Owner ,1 Aci I f i t t lir 6F3?---'l )) Tub or Tub/Shower Comb. 9.00 CM*•'• sr Shcw,-er Only 9.00 nnvi lle, Cre r:n 117 )7) Water Closet 9.00 ""'"•�"^"^•r sr•r�r Dishwasher 9.00 „ ,• Garbage Disposal 9.00 Occupant ,,,+,a •mow ^,,,,, Washing Machine 9.00 Floor Drain 9.00 war• a► Water Heater 9.00 d, Grr ;on 122,2) Laundry Room Tray 9.00 "�"'• Unnai 9.00 dpla.nd Other Fixtures (Specify) 9.00 Contractor Rer... ph� 9'00 `!)1 "'d ;;o"fi.tt T?r 6q'_'1 9.00 wa�ra a 9.00 Sewer 1st 100' 30.00 R.9"~"` `ft"" Tu"" Sewer-ea. AddiL 100' 25.00 Water Service 1st 100' 30.00 1 hereby acknowledge that I have read this application, that the Water Service ea. Addit 200' 25.00 information given is correct, that I am the owner or authorized agent of the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00 1 am registered with the Construction Contractor's Board, that the Storm b Rain Drain Addit 100' 25.00 number given is correct. (If exempt from State registration, please give reason below.) Mobile Home Si,ace 25.00 Back Flow Prevention Device or Anti-Pollution Device 9.00 yo w•i.••�a � Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new O addition Q alteration Q repair Q Catch Basin 9.00 to be done residential Q non-residential O Insp. of Exist Plumbing 40.00/hr Specialty Requested Inspections 40.00/hr E,isting use of Rain Drain, single family dwelling 30.00 Z t• iilding or pror'erty Residential backflcw prevention devices 15.00 �. Proposed use of F- building or property �-, '(Except resldentlal bacJ)fow -r prevention devices) .. r w NOTICE 'Minimum Fen $25.00 SUBTOTAL PERMITS BECOME VOID IF'NORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PLAN REVIEW 251: OF SUBTOTAL TOTAL Special Conditions Date Issued t;v APPLICATION = STREET IMPROVEMENT/EXCAVATION J� l COPY TO: ORDINANCE NO. 74-14 // (WHITE)-FILE (YELLOW)-INSP. (INSTRUCTIONS ON SEPARATE SHEET) - --r (PINK),OT11612 AGENCY-bLCIC] (BLUE)-APPLICANT APPROVED APPLICATION NO.: NOT APPROVED E] CI I Y UI' I IGARD, ORLGON FEE AMT.: $ 832.00 PENDING FEE. PMT. ❑ CI I Y I{AI'll RECEIPT NO.: PENDING SECURITY ❑ PUBL IC WORKS DEPA R TMEN T BY _-�, - DATE I(' I I PENDING AGENCY ''OK" - ❑ \ppli(,Ition ;Ind Progress Record MAINTENANCE BOND # _ PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS RE Quo REU -- ANNUAI.. PENDING VARIANCE EXP IRATION �DATE: �__-.__�_ _ PERMIT NO. ..�4 _9`} DATE ISSUED: L -1-14 , BY: 1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL swaLa»y4Sewer Aide service and AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. APPLICANT John A. b,c[lAfld L413ul raw �1uLt i.tt Urlve .VLlS(.AlVLlI.U, uC. 97070 +"1£32•-2100 NAME ADDRESS CITU PHONE r ONTRACTOR (ganua) __ NAME R[ CITY PHONE FLANS BY ;)eC C.ity StandardS & Specificaj�ons NAME - ADDRESS -��-- CITY PHONE I_ST(MATED IMPROVEMENT TOTAL VALUATION ( COST): $ JUU-W DOLLARS '_';_EXCAVATION DATA: o on zFslc u, arr.00 : .32:� = MIN== STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY _ STREET PF.NED 3th Av?nue "''sp3 INSPEC- R TION E - --- Q U _ — ESTIMATED STREET OPENING DATE: E� __._�_ _ S ESTIMATED STREET CLOSING DATE: 1 � E STREET (3) SECURITY NO. SECURITY AMT.: $ 43W-(X) — - CLOSED SURETY CO,: _ em FINAL �R-HTyftfl cHE'.h W CASH ❑ BOND INSPEC. (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDITIONS FEATURES; EXCAVATION LOCATION AND EXTENT. _.qnf attached-- I I I 1 I _ 9W 69th Ave. _—_ I In i 1 r+Ork aces! ' 1 site: 12669 SW 69th Ave. I I jL; NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON. THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CIT., AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS APPLICANTS SIGNATURE: ' I 1 DATE „ /