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12390 SW 106TH DRIVE N W CO C (n p A) s C m 12390 SW 1061' AVE. / PLUMBING CITY OF TIGARD DEVELOPMENT SERVICES PERMIT#: Pi.M2000 00065 DATE ISSUED: 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AA-01£16 SITE ADDRESS: 12390 SW 106TH AVE ZONING: R-4.5 SUBDIVISION: COTTOIJWOOD PLACE JURISDICTION: TIG BLOCK: LOT: 013 CLASS OF WORK: ALT GARBAGF DISPOSALS: BACKFLOW ILEHO E SPACES: TYPE OF USE: SF WASHING MACH: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUBISHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: 100'of sanitary sewer line. No re-routing of plumbing neccessary. Must pump, fill, and inspect septic tank. FEES Owner: — Type By Date Amount Receipt SANDERS, STEVEN W PRMT BON 03/02/2000 $50.00 0000406 12390 SW 106TH DR 5PCT BON 03/02/200C $4.00 0000406 TIGARD, OR 97223 Total $54.00 Phone 1: Contractor: OWNER REQUIRED INSPECTIONS Sewer Inspention Phone 1: Final Inspection Reg#: ORIGINAL 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 952-0001-3010 through OAR 952.-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-17.. Issued By: 2--&LfiVX'(-� Permittee SignatU�e� - _ &. `, -- Call (503)639-4175 by 7:00 P.M.for an Inspection nEa led the next business day LIT 1 OF TIGARD _ SEINER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00041 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03/02/2000 SITE ADDRESS; 12390 SW 106TH AVE PARCEL: 2S103AA-01916 SUBDIVISION: CO rTONWOOD PLACE ZONING: R-4.5 BLOCK: LOT: 013 JURISDICTION: TIG TENANT NAME: SANDERS, STEVEN VVl USA NO: FIXTURE UNITS: 0 :;LASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL. TYPE: LTP IMPERV SURFACE: Remarks: Connecting to sanitary sewer. Septic tank must be pumped, filled and inspected. RE'mbursement District#12 fees p-+id. ($5,597.82) Receipt#0000406 Owner: FEES SANDERS, STEVEN W Type By Date Amount Receipt 12390 SW 106TH DR TIGARD, OR 97223 PRMT BON 03/02/200C $2,300.00 0000406 INSP BON 03/02/2000 $35.00 0000406 Phone: Total $2,335.00 t;ontractor: Phone: Reg #: Required Inspections Sewer Inspection Septic Tank Filled ORIGINAL This Applicant agrees to comply with all the rules and regulations of the Unified Sews.ge Agency. The permit expires 180 & fs from the date issued The total amount paid will be forfeited if the perion expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon la'N requires you to follow rules adopted by the Oregon Utility Notification renter. Those rules are set forth in OAR 952-001-0010 through OA1 W-001-0080. You may obtail copies of these rules or direct questions to OUNC by calling Issued by: !'� lam. (_ `�'�i t/L _ _ Permittee Signature: Call (503) 639-4171 by 7-00 P.M. for an it spection neer+ed the next uusiness day CITY Or TIGARD Plumbing Permit Application Plan Check#__ 13125 SW HALL BLVD. Commercial and Residential Recd By TIGARD, OR 97223 Date Recd '7 (503) 639-4171 Date to P.E. Print or Type Date to DST - Incomplete or illegible applications will not be accepted Pern,ila(�1A7. y -CW Related SWR#Z 4V ( Jy Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job �jt�t..1�1�,25 Sink 11.50 Address Street Address Suite Lavatory 11.50 �_-3c1O Tub or Tub/Shower tomb 11.50 Bldg* Olt /State ZI Shower Only 11.50 Nee � �� Water Closet 11.50 �I•��st.��+L`� Urinal 11.50 Owner Mailing Address Suite Dishwasher 11.50 b4 _w��"' � \�' . Garbage Disposal 11.50 /Sts Z Phone Laundry tray 11.50 _ Vv"-\aZ -O�4 N Washing Machine 11.50 njf�� etJr1`j Flour Drain/Floor Sink 2" 11.50 Occupant Mailing Address Suite 3" 11.50 p 11?A0 r.L.J �C�c," be 4" 11.50 City/StateIp Phone "V gt12Z'� (n'�4 ryc,t5 Water Heater O conversion O like kind 11.50 e Gas piping requires a separate mechanical permit. MFG Home New Water Service 32.00 Contractor Mailing Address Suite MFG Home New San/Storm Sewer 32.00 Hose Bibs 11,50 Prior to permit City/Slate Zip Phone Roof Drains 11.50 Issuance,a copy Drinking Fountain 11.50 of all licenses are Oregon Const,Cont.Board Llc.# Exp.Date required If Other Fixtures(Specify) 15.00 expired In COT Plumbing Llc.# Exp Date database Name Architect _ Sewer-tat 100' 38.00 or Melling Address Sults Sewer-each additional 100' 32.00 Engineer City/State Zip Phone Water Service-1st 100' 38.00 9 Water Service-each additional 200' 32.00 Describe work to be done. Storm&Rein Drain-1st 100' 38.00 New O Repair O Replace with like kind: Yes O No O Storm d Rein Drain-each additional 100' 32.00 Residential Commercial O Commercial Back Flow Prevention Device 32.00 Additional description of work: Residential Backflow Prevention Device- 19.00 Catch Basin 11.50 Are you capping,moving or replacing any flxtures7 Insp of Existing Plumbing or Specially Requested 50.00 Yes O No O Inspectionsper/hr If yea,see back of form to indicate work performed by Rain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. I hereby acknowledge that I hove teau this application,that the information QUANTITY TOTAL given Is correct,that I am the owner or authorized 9gent of the owner,and Isometric or riser diagram is ruqulred ff Quantity Tot_Is-9 that plans submitt9d are In compliance with Oregon Stat;Laws "SUBTOTAL Signature of Ownur/Agent Date I 8%SURCHARGE CqAtt.1 Person N � Phone ?S\Ct -5'1�o "PLAN REVIEW 26% OF SUBTOTAL 1 HATH HOUSE$170-00 C Required only d h>ture qty lolal Is>9 _ 2 BATH HOUSE$250.00 TOTAL 7 BATH HOUSE$285.00 (This fee Includes all plumbing fixtures In the dwtdling and line first •Minimum permit lea is$5o.8%v rcharge except Residential Backflow Prevention 100 loot of sanitary smovor storm sews and wator service) q44 Oevice.which is$25+8%surcharge ""Ali New Commercial Buildings require plans with isometric or riser diagram and plan review 1%(10 rorme'plumapp doc 121 t,189 PLEASE COMPLETE: Fixture Type --- ---- Quantity by Work Performed New Moved_ Replaced Removed/Capped Sink _ Lavatory - -- - - ----- - - — ---- - -----� Tub or Tub/Shower Combination Shower Only -- — - - - -- --_— � _ Water Closet _Urinal ---- Dishwasher �_—_ �-- ----- -- ----- — Garbage Disposal------�---- _-- ------ ---------- -- _ Laundry Room Tray_ Washing Machine_ Floor Ura;n/Floor Sink 2" — - 411 Water Heater ---_-_—___-__—_---- Other Fixtures (Specify) — COMMENTS REGARDING ABOVE: ��j ALOHA SANITARy SE VICE RO. Box 309, BANKS, OREGON 97196 644-2797 648-6254 639-5188 _ 03645NAME: �� ADDRESS: ! � CIN: STATE: HOME: WORK: CELL: JOS 8 SITE: P.C .#:- - PAID BY CHARGE ❑ CHECK- -,/,• CASH ❑ CREDIT_CARD ❑ DATE - /. - �Q DRIVER AMOUNT PUMP SEPTIC TANK �! ❑ LINE OPENING ❑ INSPECTION FEE ❑ SERVICE CALL ❑ LA90R, LOCATING, DIGGING & BACKFILL ❑ MATERIAL L- HIS Is NOT A PT7C SYSTEM INSPECT10tvREPORT- TOTAL - - REMARKS - - TYPE - REMARKS - - TYPE OF TANK: STEEL O CONCRETE O PLASTIC71 HOMEMADE HORIZONTAL n VERTICAL 1 RE^TANGLE -1 OTHER SIZE OF TANK: 35011 500 7 750 1 1000 ❑ 1250 rl 1500 `l 2000 ❑ 3000 ❑ LID LOCATION: INLET 71 OUTLET 1 MIDDLE 1 ENTIRE TOP i71 TANK CONDITION: GOOD 71 FAIR 11 POOR 1- FITT:NGS: BAFFLES n CONCRETE ;1 CAST IRON -1 PLASTIC ❑ NEEDS NEw LID? -I YES SIZE GROUND COVER OVER TANK COMMENT ON CONDITION OF DRAINFIELn ETC. �, 7 SIGNED BY DATE CITY OF TI 3ARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - — ------ BUP kt) —Date Reauestecl_ AM PM _ BLD LocationC)l�' oy-, Suite _ MEC r Contact Person �' �� Ph PLM � � Contractor_— — Ph SWR BUILDING Tenant/OwnerELC Retaining Wall _ ELR _ Footing Access: Foundation FPS �i - Ftg Drain ;GN Crawl Drain Inspection Notes: Slab _ SIT Post Beam Ext Sheath/Shear Int`heath/Shear - Framing - -- -- -- Insulation Drywall Nailing Firewall Fire Sprinkler _ Fire Alarm Susp'd Ceiling Rocf Misc: _— Final - -- - --_ PASS PART FAIL - — - UMBIN �� v Ilost& Beam — Under Slab Top Out ------ ---- -- ---- Water Service Rain Drains Final -- ------- ---- -- --- PART FAIL MECHANICAL Post 8 Beam Rough In Gas Line ----_ ...... ----- _ _ Smoke Dampers — Final --— - ---. - _ — --------- PASS PART FAIL ELECTRICAL ------ -------- ---- Service Rough In --------_-_-------------- -- ---- - UG/Slab Low Voltage --.r-------- ------ - - ----- Fire Alarm Final PASS PART FAIL_ SITE Backfill/Gradii,g -— -- — Sanitary Sewer Storm Drain I I Reinspection,fee of$ -required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ 1 Please call for reinspection RE _- ( )Unable to inspect-no access ADA Approach/Sidewalk Other Date Inspector !— Ex 1. Final PA:;S PART Ft.& 4 SIO REMOVE this inspection record from the job site.