14425 SW 114TH AVENUE s
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14425 SW 114'' Avenue
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i0e INVOICE
ORVALL T. CADE
RYER'S SEPTIC TANK SERVICE, INC. Wants Early
PP.O. BOX 549
OREGON CITY, OREGON 91045 buSTOME*DE
02
(503) 656.3326
'raCe
_ ORDER TU A.M.
Gra—ce 3-
SILL.TO-'. 115
Hn ha Ezc•ADDRESS
CITY _AV WOWIOR NAME AND LOCATION14425 N 4 h. T EX-TRA CtUI WUfWEIRRA
DESCRIPTION OE MATERIAL USE O _
PRICE AMOUNT
UUANT.
-RUMizkq-r m!
I AHUII — - AMCNmt TOTAL
I IouRs ---- MATERIAL$
MECHANICS -
-
HELPERS --
hereby sckRorrktdp,lhn senaoctory TO AL LABOR TAX ---
comp~dMIsabovedwfbWwork- if .TED I
TOTAL
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,7
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fisasm, � re(,i747
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4.' ' r 1 a�t ❑NI'"alElIXi)�CI 442
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IIrA 7gp(il' ❑CoY:In�lAfb��1117 C Flrow Nlle(r<:i 1°c aov� IJ 6he,wga;S1}59242 t]AIV
JnI11�tai tT)3) 205 (5031tl�1101
_ q H rd�t91M6ti;)7d} _ ❑Luga a(1d,,589th)O ❑rmr htty!(503)397�Q_ L I Grnstram(.503)W 5577
—
MPP LOCAT£ IiAT H T,ME LFSVE PUWT ANPIYE JnR_ B`:41(J PCti.IF `-- r1NIS4 POl1R LEnVE•!33 ARRIVE PLANT
NATER ADDED A'r rFST CYL. � G MINUTE`S PEP YARD. CU4"TOMER AC,COI 1' t 140722"?i (CODE I�
TomrR'S REQUEST TAKEN; FREE UNLQADIIfG i�ir tl _ - BrD i
TIME ALLOWED ON
gals.to fu,l4oad L ; SES FULL LOADS.
�'"• Additional unloading ;iQl_C) ,4 aIL.N'ir I'`��x(-F-1Vta'f]a7M lit f'1_U'tEs.Lhll'3
.
—gals. to '-6 load ❑ YES - 1
� time charged at current
hourly truck rate. E'l(�hll' -. j
gals.to',5 load {� YF.S Y DELIVERY
---- -- _ -- POINT
ADDITIONAL WATER REASON FOh DELAY TIME:
ADDEDTOTHIS DATE "S/i?i.'/t);
SEWER PERMIT
A CITY OF TIC�ARD
PERMIT#: S 19/02 4 00126
DEVELOPMENT SERVICES
C�n DATE ISSUED: 3119/02
13125 SW Hall Blvd., Tigard, OR 97223 1503) 639-4171
PARCEL: 2S110AB-02600
SITE ADDRESS; 14425 SW 114TH AVE
SUBDIVISION: COLE'S ACRES ZONING: R-2
CLOCK: LOT: 012 _ JURISDICTION: TIC
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS. 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTP33WR IMPERV SURFACE:
Remark:-: Sewer connection. _
Owner: --------- _ _ FEES--
Type
EES _Type By Date Amount Receipt
PRMT CTR v 3/19/02 $2,300.00 27200200000
INSP CTR 3/19/02 $35.00 27200200000
Phone: Total $2,335.00 _
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
Septic Tank Filled
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The pen-nit expires 180
days from the date issued. The total amount paid will be for'eited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is riot 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" Perim
Issued by: Permittee SignatureAt A
:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
n CITY OF TIGARD ____ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00094
13125 SW Hall Blvd., Tigard, JR 97223 (503) 639-4171 DATE ISSUED: 3/19/02
SITE ADDRESS: 14425 SW 114TH AVE PARCEL: 2S110AB-02600
SUBDIVISION: COLE'S ACRES ZONING: R-2
BLOCK: LOT: 01'2 .JURISDICTION: TIG
CLASS OF WORK: ALT GARBAUE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING "ACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: -,RAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE- 100 ft
WATER. CLOSETS: WATER LINE: ft
DISHWASHERS: RAII. DRAIN: ft
Remarks: 100 I/f sewer line work for connection to lateral. Septic tank to be removed or pumped, filled and inspected.
Owner: FEES
Type By Date Amount Receipt
PRMT CTR 3/19/02 $72.50 27200200000
5PCT CTR 3/19/02 $5.80 27200200000
_ Total $78.30
Phone 1:
Contractor:
HUGH'S EXCAVATION + PLMBG
PO BOX 42276
PORTLANID, OR 97242
REQUIRED INSPECTIONS
Phone 1: 777-3116 Sewer Inspection
Reg#: LIC 32679 Final Inspection
PLM 3-178PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes ai id 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 fcr 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.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
F
Issued Et ' / Permittee Signature: \
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the Aext business day
Plumbing Permit Application
Datereceived: Permit no.:P -p0 D
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97221 Project/appl.no.: Expire date:
('j vol"f igar`f Phone: (503) 639-4171
Fax: (503) 598-1960 'v^ �/`/ Date issued:_ By: Receipt no.:
Case file no.: Payment type:
Land usr,approval: -- -- -
t '
Multi-family ❑Tenant impr �rrnrni
U I &2 family dwelling or accessory U Commercial/industrial y -
U New construction 0 Addition/alteration/replacement U Food service U Other:
/ Ilcscription QtY. Fee(ca.) Total
Job address: �� - New I and 2 family drrclhn}s only:
Bldg.no.: Suite no.. (Includes too fl.foreach wilityconnl coon)
Tax map/tax lot/account no.: — SFR(1)bath -- --
Lot: Block: Subdivision: _ SFR(2)bath __
Project name: _ _ SFR(3)bath
ZIP: Each additional bath/kilchcn
City/county: 5iteutlllllels:
Description and location of work on premises: -- Catch basin/area drain
_ rywells/leach linc/trench drain
Est,date of completion/inspection: Foto:-re drain(no.lin.ft.)
film Manufactured home utilities
Business name: J(v f ✓w Manholes
Address: ��, v' ` ZG Rain drain connector
City: iV Stat• Sanitary sewer(no.lin.ft.) f
Fax:T TT // E-mail: 3_ Storm sewer(no.lin.ft.!
r�� Phone: _ Wuttr service(no.11n.ft.)
7� _ CCB no.: ' A Plumb.bus.reg.no:
� Fixture or item:
'_ity/metro lic.no.: Z Abso lino valve
Contractor's representative signature: ck now prcl-.-cntcr
Print name: (, (s / Dat .: `� ckwater valve
Basins/lavatory
Clothes washer
Nnmc: C r✓t --� Dishwasher --
Address Drinking fountain(s)
City: -- State: LIP: E ectors/sump
Phone: ''ax: E mail: Expansion lank
Fixtu sewer cap
Floor drains/noor sinks/hub
Ntune(print): Gafi.ge disposal
Mailing address: ( Z J $ L ly Hose bibb
City: j> State: ZIP: cc mu er -
Phone: Fax: E-mail: Interec tor/ reale tra
owner instal lation/residential maintennnee only: The actual installation Primer(s)
will be made by me or the maintenance raid repair made by my regular Roof drain(commercial)
employee on the propcAv I own as per ORS Chapter 447. Sin (s),basin(s),lays(s)
Sum
owner's signature: Date: Tubs/shower/shower pan _
Urinal _ —
Name: Water close(
Address: __ — 'Nater heater —
City: 5tatc: ZIP: other:
Phone: r Fax: E-mail: _ TotalMinimum fee................ -
Not all Jurisdictions Kcepl credit cards.please cell}uriKUclic>n rix mere infonnaticm. Notice:111is permit application Plan review(at -_ %)
U Vlsa U MasterCard expires if•a permit is not obtained State surcharge(8%) ....
credit card nurntw: — Expires— within 180 days after it has bean TOTAL ................... _ —
accepted ns complete.
Name or t u shown on err ilk— _
mount — 44346I6(tllxlll.'OM)
PLUMBING PERMIT FEES:
-- PRICE 1'OTAL New 1 and 2-family dwellings only: I PRICE TOTAL
FIXTURES individual) --_ f1Tl' ea AMOUNT (includes all plumbing fixtures in
16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Sink for each utilit connection)___ -
16.60 One 1 bath J $249.20
Lavatory 16.60 Two(2)bath _ _ $350.00 ___,
Tub or Tub/SIiower Comb. - Three 3 bath $399.00 ___
16.60 -
Shower Only
Water Closet 16.60 SUBTOTAL _-_
Urinal 16.60 8°/.STATE SURCHARGE _-
16.60 PLAN REVIEW 25°/.OF SUBTOTAL
Dishwasher TOTAL _ -__
Garbage Disposal 16.60
60
Laundry Tray
- 16.
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE:
3" 16.60
4" 16.60 _ - T]uanti�b_Work Performed-
Water Heater O conversion O like kind 16.60 Fixture Type: New Moved Replaced Removed/
Gas piping requires a separate mechanical _ _ _^ Capered
ermit. 46.4 Sink ---
MFG Home New Water Service Lavato
MFG Home New San1St0rm Sower 46.4U Tub or Tub/Shower
Hose Bibs - 16.60 Combination -
16.60 Shower ON
Root Drains Water Closet
Drinking Fountain 16'60 Urinal -
Other Fixtures(Specify) 16.60 Dishwasher
Garba a DI s osal - -
Laund Room Tra ---
Washing MactiIne -
Floor Draln/Sink: z' -----
Sewer-1 at 100' 55.00 -_ 3" ----
Sewer-each addition46.40 4
al 100' - Water Heater --
Water Service-tat 100' 55.00 Other Fixtures
Water Service-each additional 200' 46.40 S eci
Storm&Rain Drain-1st 100' 55.00 -
Storm&Rain Drain-each additional 100' 46.40 _ '--
Commercial Back Flow Prevention Device 46.40
Realdeit al Backflow Prevention Devlce' 27.55
Catch Basin 18.80 - -
Inspection of Existing Plumbing or Specially 62.50
Re uesled Ins a^liana erRtt COMMENTS REGARDING ABOVE _
Rain Drain,single lamlly dwelling 65.25
80 .�
Gree3e Traps 19. - - -
QUANTITY TOTAL _-
Isometric of tiger diagram Is required If
ouentity Total Is >g_,_ '-
*SUBTOTAL
f9%STATE SURCHARGE - - -
"PLAN REVIEW 25%OF SUBTOTAL
Requlra_d only II fixture sty.total Is?8
'Minimum permit lee Is$72 5o.a%stale surcharge,except Reside Nial Backflow
Prevention Device,which Is$3925+e%stale surcharge
"All New Commercial Buildings require 2 sets of plans with Iso netric or riser
diagram lot plan revlew.
I:\dsts\lorms\plm-fees dor- 12/26/0l
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
FAST - ---
INSPECI ION DIVISION Business Line: (503)639-4171
BLIP
Received --_ _ Date Requested_, AM_—___ PM - BUP
Location __L 2 S - _ '� '"Ov't Suite MEC
Contact Person —_ - - ___ _— Ph( —) PLM ZOO z- 000 9y
Contractor- _---- --- - - - --- SWR ,, -j z.- 010 ZAP
BUILDING Tenant/Owner —__... ELC _—
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain ----
Slab Inspection Notos: Sfr
Post&Beam
Sficar Anchors
Ext Sheath/Shear --•-
Int Shoath/Shear _
Framing —
Insulation
Drywall Nailing --- - —
Firewall
Fire Sprinkler - -- --
Fire Alarm
Susp'd Ceiling --
Roof
Other:.---
Final
PASS PART FAIL_ -- - —
PLUMBING —
Post&Beam -
Under Slab - --- ---- --
Rough-In
Water Service -- --
Sanitary Sewer
Rain Drains ---
Catch Basin/Manhole _
Storm Drain --ShowerPan
-final
�- el FAIL — ------------�—..�----- — - —
MECHANICAL ----
Post&Beam
Rough-In - ---- - ------ - ---
Gas Line
Smoke Dampers — -- -- -_---
Final
PASS PART FAIL - -- — --- ---
ELECTHI_A -- _ — ---- ---- -----
Service
Rough-In _ - -- ---- — --
UG/Slab
Low Voltage --------
Fire Alarm
Final Reinspection fee of$A___ __- required before next inspection Pay at City Hall, 13125 SW Hall Blvd
PASS PART FAIL _
SITE _ H Please call for reinspection RE: --___-_ _ _-- -_-_._ Unable to inspect-no access
Fire Supply Line
ADA
Approach/SidewalkDelta S Inspector '�'Lii'-'?_ . _ _ Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL