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12645 SW 135TH AVENUE f rplAVAt' r -J- 1:lrecords\r111cro(hiVargeIslf)uilding.doc L w J \ z k m $ $ @ @ m # ( / a ® E ® E 0 \ \ \ c \ � D 0 j j } \ \ \ o ) )k )k ¥ � � a CL ) )/ )k o 0) Q§ § f § § a) � ( \ § \ \ W i \0 » 2 � k 0 4- � @ $ > v $ Q m k } 2 LL 2 un / 2 § / § § f § \ B § } j ( i & n :3 5 $ \ \ } w w E \ \ \ G G R m 8 8 a & ) \ \ \ \ \ \ « u w u w w w t k ) k d) - � { 2 � E/ /CL ; } ( = �§ §/ \¢ \ ) f 2 § ) (DM M - w w \ w \ S \ � ] > f f fƒ ƒf ƒ LC) k k k k k¥ p 0 04 CD 6 \ k/ \k § a) a) a / ° m = _ k § § § § § \ \� \ CD \ a ) $ $ f ) ) 0 0 E w w 4- 0 § i $ u Q k § 7 § 2 4 \ 2 % k / 2 g l ) . s { i - ` q $ S m/ - " ` , 2 , f p $ \ OL \ \ \ ƒ R ) 00 N /\ § ( } r- 0 c w r- \ } } } CITY OF T.CQ�tD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4.71 BUR _ Date Requested ��' J ""�� AM PM BLD Location ( 2-CO L/S I �21:�-tll ry� Suite q MEC Contact Person � ���? -_ Ph /_ PLMCI ' 2,� Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELF1 Footing Access: �.. Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes — — Slab �— _ --__ SIT Post& Beam -- Ext Sheath/Shear _ Int Sheath/Shear — Framing Insulation Drywall Nail'ng _— Firewall Fire Sprinkler Fire Alarm , Susp'd Ceiling — -- --- — Roof Misc --- -- — — ---- Final PASS PART FAIL -- L � Post&Bearn —— — -- Under Slab Top Out Water Service Sanitary Sewer Rain Drains PART FAIL NANICAL Post& Beam - --- ---- -- -- --- -- ---- Rough In Gas Line ---- --- ------- _----- ---------------- _-->>— Smoke Dampers Final ------- PASS PART FAIT_ ELECTRICAL —— -- ----- Service __—_— Rough In UG/Slab -- ---- -- — — -- -- _ -- — l.ow Voltage V) Fire Alarm _._-®_-- -- ------_—__�— —_ —_— --- �- Final ~ PASS PART FAIL SITE Backfill/Grading — — w Sanitary Sewer Storm Drain I I Reinspection fee of$ -—required before next inspectien. Pa),at City Hall, 1312.5 SW Hall Blvd Catch Basin Fire Supply Line l I Please call for reinspection RF ____—^ ____--_ [ J Unab'e to inspect-no access ADA Approach/Sidewalk U Other date 6 Insp ector _Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVILION FAST 24-Flour Inspection Line: 639-4175 Business Line: 639-4171 J� c7r, BUP — Date 1Requested �� / lAM PM „ BLD Location— rye Imo` `� v 'Z` _ Suilte, cam_cy MEC Contact Person Ph PLM Contractor _ Ph SWR BUILDING' Tenant/Owner ELC Retaining Wal! ELR Footing Access: +_ Foundation FPS Ftg Drain - Crawl Drain Inspection Notes: SVN Slab __--_ SIT Post&Beam - - - Ext Sheath/Shear _ Int Sheath/Shear Framing Insulation Drywal! Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling CC- Roof Misc _ --- - --- - --- - _ — Final - PASS PART FAIL PLUMBING Post&Beam --- — -^ - -- Under Slab Top Out ------- - -- -- --- Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& team - -- ---------- - ---- - ---- -- Rough In Gas Line - - - -- Smoke Dampers Final PASS PART FAIL. Service. Rough In CL UG/Slat - -- _ r Low Voltage �- Fire Alarm Ln - - r ASS PART FAIL -- J r Backfill/Grading Sanitary Sewer Storm Drain I ]Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin I I Please call for reinspection RE. „_- ( J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk _ Uate ` —! Inspector ���,� Ext Other Final PASS PAFT FAIL DO NOT REMOVE this Inspection record from the job site. CITYO F I I G A R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00205 13125 SW Hal! Blvd.,Tigard, OR 97223 (503) 1 1 DATE ISSUED: 7/6/99 SITE ADDRESS: 12645 SW 135TH AVE PARCEL: 2S104BD-01000 SUBDIVISION: HANDY ACRES ZONING: R-7 BLOCK: LOT: 1-2 JURISDICTION: URB CLASS OF WORK: GTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 150 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Connection of existing single family residence to sewer. Septic tank is to pumped, filled. and inspected or removed. ---- - — -- Owner_ FEES— — Type By Date Amount receipt ALEXANDER, MARION + DOMINIQUE PRMT DEB 7/6/99 $70.00 6004 12645 SW 135TH MISC DEB 7/6/99 $4.90 6004 TIGARD, OR 97223 i — Total $74.90 Phone 1: Contractor: PENGUIN TRACTOR PENGUIN TRACTOR AND EXCAVATING 1184 NE SUNRISE LN REQUIRED INSPECTIONS HILLSBORO, OR 97124 Phony 1: 681-0319 Sewer Inspection Reg #: LIC 104182 Insp existing/capped fixtures PLM 26-316PB Final Inspection a r� 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. L This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more UJ than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cente. . Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Isdued By: ) ! Permittee Signature: :'�;' !i(�(14� ICC A � Call(503) 639-4175 by 7:00 P.M. for an Inspection needed the next buslness day CITY OF TIGARD Plumbing Permit Application Planc ck#--}—��— 13125 SW HALL BLVD. Commercial and Residential Recd TIGARD, OR 97223 Date Recd (503) 639-4171 Date to P.E. ----- Print or Type Date to D'T=-- Incomplete or illegible applications will not be ce Permit# e.H i999_��S 1 Related SWR#_ Called Na e of Devefopment/Project L FIXTURES lindivldua QTY PRICE AMT / Job Sink — 11.50 Address Strreeett,A�ddre �T Suite Lavatory 11.50 Tub or Tub/Shower Comb. 11.50 Bldg# City/State Zip Shower Only 11.50 -- �i2� 1/2 X7222 Na Water Closet 11.50 le�D�xl,iufid lLr!_ Dishwasher — 11.50 1 Owner Mailing Address Suite Garbage Disposal 11.50 Washing Machine " 12 City/Slate Zip Phone C/ 4" 712 3 519e— Floor Drain/Floor Sink 2" 11.50 Name 3" 11.50 4" 11.50 Occupant Mailing Address Suite Water Heater O conversion O like kind 11 50 Gas piping requires a separate mechanical permit. City/Slate Zip A Phone Laundry Room Tray 11.50 N me Urinal 11.50 Other Fixtures(Specify) 15.00 Contractor Maili A d ess Suite /Y,1;7 _VZ WV - - Prior to permit Cl yIstaI Zip Phone Phone Sewer- 1st 100' 38.00 issuance,a copy f / l �Z G7 �/Q 7 ��" of all licenses are Oregon Const.Cont.Board Llc.# Exp Date Sewer-each additional 100' / 32.00 required if I O9 "]q r� A ari —p ( Water Service-1st 100' 38.00 expired in COT P r bing Ic.# Ex D to Water Service-each additional 200' 32.00 database .L,1-4 'A I to p �-?I_60 Storm 8 Rain Drain-1st 100' A 38.00 Name Storm&Rain Drain-each additional 100' 32.00 Architect Mobile Hong,Space 32.00 Or Mailing Address Suite Com-:_­!tal Back Flow Prevention Device or Anti- 32.00 _ Pollution Device _ Engineer City/Stale Zip Phone Residential Backflow Prevention Device' 19,00 _ (Irrigation timing devices require a separate Describe work to be done: restricted energy permit.) New O Repair O Replace with like kind: Yes O No O Any Trap or Wase Not Connected to a Fixture 11.50 Residential O Commercial O Catch Basin v 11.50 Additional description of work Insp of Existing Plumblr9 50.00 _ erRtt Specially Requested Inspections 50.00 Are you capping, moving or replacing any fixtures? Sp _ _ mer/hr Yea O No O Rain Gain,single family dwelling 4500 If yes, see back of form to indicate work performed by _ `3• fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11 50 l WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL I hereby acknowledge that I have read this application,trial the information Isometric or nser diagram Is required K Quentily total is >9 _ �. given is correct.that I am the ovrner or authorized agent of the owner,and 'SUBTOTAL �~ that plans submitted are in compliance with Oregon_ State Laws. �Q.A y ti %of OwnerlAgon ,6 c JDa!10! 7%SURCHARGE Co ct Pe n oName A -- Uj 11 .t C �� .Yl, , P G/eG ' PLAN REVIEW 26%OF SUBTOTAL J Required only if/lAure qty total Is>9 — 1 BATH HOUSE$178.00 TOTAL 2 BATH HOUSE$250.00 JL�•9 3 BATH HOUSE$285.00 'Minimum permit fee is$50*5%surcharge,except Residential Eackilow .(This fee Includes all plumbing firtures In the dwelling and the nrst Prevention Device,which Is$25+5%surcharge 100 feet of sanitary sewer storm sewer and water servlcs) "All New Commercial Buildings require plans with isometric or riser diagram and plan review 11dtltfVomoplumapp dx s/16mg PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink _ _— Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher I Garbage Disposal Washing Machine Floor Drain/Floor Sink 2" 3" -Water Heater Laundry_Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: r J 1' W 11dsbVormHpkm+a�+doc&t&vg 07/06/2019 11:02 5904166 GMBM PAGE 01 sewerage sSANITARY* IPE[ 955 ®wTetera � 8,t�"��' SURFACE WATER �N. First Ave.,4ve. Suits 270, Hillsboro, Or.,97124 503 648-8621 CONNECTION PFRM IT ISSUE DAH: 0701.99 E.XF'.ThATTf1N DATE 122999 FC 17XP ,'_TATE: PE-RM] T 1 17 13 6 STRUCTURE APDRE.SS I'16A i FIR0..11'C 1 11,99981'F,UCTI.IRE: 8'f FcE cr SW 135TH AVE 1.0 BL OCK. TYPE CONNECTION- EXIST OF TYPE INSTALLATION— ( i ) NUILDIN6 FWF'P ONL Y TYPE OCCUPANI'Y-- ( 1 ) 3INGI F FAMILY PARCEL 251 00 1000 QTR; SFC 4315 MH 17646 OWNER MARTON ALEXANDER ADDRESS 12645 SW 1337H AVE; TRF'ATMFNT PLANT DURHAM TITiAPP OR 97?23 PHONE. 90 --4063 WA1FR DISTkirT TIGARD FIXTURE EQUIVALEN'r DWF:1.1 I.HG RESIDFNTIAL Y ~ ONIIS SE*RV'ti E ('1411'S 0. 0 UNIT, 1 SERVICE UNITS CONNECT ;CON FEES '.i(IRFACE WATT R DFVFl 0Pm .N'f F v F3 SEWER CONNEt M)PI 2.300. 00 WATER I;JUALITY 0100 LESS CRE:'DIT t 10.00' WATER OUANTITY 0 .00 1..,k5S C R E LII1' 0 . 00 EPOS ION CONTROL ,UYTOTAl. 2300100 CSU PT0TAC 0 .00 TOTAL 2300.00 nPPI NAML: MARION PHONE _._,_....._. .._._ rr At=V I L L t A 1 ION UWNF_F' I EMAF+Kk3 HOOK UIQ EAI5T SFR J t'IGNATURE .ted: .;, t', r c %r:� '3S _. __..__. ... ......_.�w___.____ ... _.__ _._. � lat=e By uRassrr Permit Condmns, The awhearit agrees to comply with an rules and regutatforts of the Unified Sewerage Agency,including those regarding erosion controi. A 2a.hour notice Is required for erosinn control inspections.The Inspection request number II 8"9444,When telling for an Inspection,please rater to the permit.project and lot numbers. The permit expires ori;hundred eighty(180)days from the date of issuance.The Agency does not guarantee the accuracy of the location •f cida;1W;, ,t,,,,i 793 MNITS - USA. BLUR - Accounting, anaaN -inspection, YRLLON - Customer CITY OF TIGARD ELECTRICAL PERMIT PERMIT#: EI-C1999-00410 t DEVELOPMENT SERVICES DATE ISSUED: 7/9/99 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S104BD-01000 SITE ADDRESS: 12645 SW 135TH AVE SUBDIVISION: HANDY ACRES ZONING: R-7 BLOCK: LOT : 1-2 JURISDICTION: URB Proiect Description: Installation of two 200 amp or less services, one 201 to 400 arnp service and 1 branch circuit. RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS 1000 SF OP LESS: 0 - 2C0 amp: �PUMPPRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: A1ANF HMI SVC/FDR. 601-amps - 1000 volts: MINOR LABEL (10): SERVICE!FEEDER _BRANCH CIRCUITS ADD'L INSPECTIONS _ 0 200 amp: 2 W/SERVICE OR FEEDER: 1 PER INSPECTION: 201 400 amp: 1 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: FA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+a,mp/volt: _ >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: _ SVC/FDR >=.225 AMPS: CLASS AREA/SPEC OCC: Own*,-r: Contractor: ALEXANDER, N,ARION + DOMINIQUE MIKE'S ELECTRIC 12645 SW 135TH 17050 SW SHAW STREET TIGARD, OR 97223 BEAVERTON, OR 97007-1813 Phone: Phone: 649-6991 Reg #: LIC 00050209 SUP 4230S ELE 34-18c FEES — Required Inspections Type By Date Amount Receipt Elect'I Service PRMT DEB 7/9/99 $219.35 99-2-16737 Elect'I Final 5PCT DEB 7/9/99 $15.35 99-316737 Total $234.70 L ---- I -- —1 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, Stale 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 9 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 952-001-0010 through OAR 952-001-0080. You may obtain copies of these ales or direct questions to OUNC at(503) 0- 246-1987 it `r Ln Permit Signature: Issued y: ~ OWNER INSTALLATION ONLY —' The installation is being made on property I own which is not intended for sale, lease, or rent. L w OWNER'S SIGNATURE: DATE:__ J CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: / a� J� �C DATE:__ LICENSE NO: Call 639-4175 by 7:00pm for ao inspection the next business day P -(; E® CITY OF TIGARD Electrical Permit Application Plan Ch . 13125 SW HALL BLVD. " lgq�.i Rec'Dat dRec'd TIGARD OR 97223 Phone (503)639-4171, x304 GUlwinw++i ui Ivii.IVT pp Q� Date to P.E. Type N U Date to DST �- Inspection (503)639-4175 Print or T)pe Permit# e` > . Fax (503) 684 7297 Incomplete of illegible will not be ac ed Called _ F Job Address: 4. Complete Fee Schedule Belov: Name,of Development � � Number of Inspections per permit allowed Name(or name of business)_D o m i n i q u e A l e n a n d e r Service included: Items Cost Sum Address 12645 S W 135th --Ave . _ 4a. Residential-per unit City/State/Zip T1n g @ r d OR 1000 sq,ft.or less $110.00 4 �. Each additional 500 sq.ft,or Commercial ❑ Residential portion thereof $25.00 1 Limited Energy $25.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $66.00 2 (Attach copy of ail current If�enses) 4b.Services or Feeders `l'� g'S Electrical Contractor MI h l': S FLECTR IC Installation,alteration,or relocation to 2,0 �b 17 0 5 0 a W t . 200 amps or less $ e6 2 Address 201 amps to 400 amps �tlU,000 2 City Beaverton State Of Zip 97007 T 401 amps to 600 amps $120.00 _ 2 Phone No. 649-6991 601 amps to 1000 amps $160.00 _ 2 Job No. Over 1000 amps or volts $34000 _ 2 Elec.Cont. Lice. No. 3 4--119 Exp.Date^ Reconnect only $50.00 2 OR State CCB Reg. No. 050209 Exp.Date 3/18401 4c.Temporary Services or Feeders COT Business Tax or Metro No ' Exp.Date 0 Installation,alteration,or relocaticn ���� 200 amps or less $50.00 2 Signatwe of Supr. Etes--p'i� e/L 201 amps to 400 amps $75.00 - 2 401 amps to 600 amps $100.00 Over 600 amps to 1000 volts, Liconae Nr SExp.Date%lr� e'7 el see"b"above. Phone Nr ..-649 FAX - 9911 -7847 - 4d.Branch Circuits Now,alteration or oxtension per panel 2b. For owner installations: a)The fee for branch circuits with purchase of service or 5,3 Print Owner's Name feeder lee. 1 ��t 1 - = Address Each branch circuit _ - b)The fee for branch circuits City __. State Ztp without purchase of Phone No. ser0ce or feeder lee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 2 intended for sale,lease or rent. 4e.Miscellaneous !Servlcc.i meob,-M Included) Owner's Signature - Each pump or Irrigation circle $40.00 _ Each sign or outline lighting $40.00 3. Plan Review section (if required):* Signal circuit(s)or a limited energy panel,alteration or extension $40.00 _-_- _.. LL Please check appropriate item and enter fee In section 5B. Minor Labels(10) $100.00 .. _4 or more residential units in one structure 4f.Each additional Inspection over ~ Service and feeder 225 amps or more the allowable In any of the nbuve VSystem over 600 volts nominal Per inspection $35.00 _ > Classified area or structure containing special occupancy Per hour $55.00 F- as described In N E.C.t'.hapter 5 In Plant $55.00 L *Submit 2 sets of plans with application where any of the above apply. 5. Fees: I�. Not required for temporary construction services. 5e.Enter total above fees $ c� . LU c arge(.05 X total fees)7�0 $ ` -t NOTICE Subtotal $ 5b.Enter 25%of line$a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If reaulred(Sec.3) $ NOT COMMENCED WITHIN 160 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 160 DAYS AT ANY El mist a c e it M TIME AFTER WORK IS COMMENCED. Tota!balance Due � s �3�'7 U` I � O - ►9, s I0STsu=_Mas APP Rev WN