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15380 SW 100"' Avenue
CITYOF TIGARD ?L'IMBINGPEt�MIT —
DEVELOPMENT SERVICES PERMIT#: PLM2002-00406
���•--� 13125 S'W Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/22/02
';TE ADDRESS: '15380 SW 100TH AVE PARCEL: 2S1'l ICA-09300
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
CLASS OF WORK: ALT GARBAGE 'DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF= WAS`iING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GR, : R3 FLOGR DRAINS: TRAPS:
STO17JES: WATER HEATERS: CATCH BASINS:
_FI'.TIIRFS _A LAUNDRY PRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 1
TUB/SHOWERS: t SEWER LINE: ft
WATER CLuSETS: 1 WATER LINE: ft
DiSHW!',SHERS: RAIN DRAIN: ft
Remarks: Remodel of upstairs bath. Other fixture is a hose bib.
Owner: _ __ FEES
Description Date Amount
VERDON, KEVIN W+ --
WASHABAUGH, MONA G I I'LUh1131 1'Crnut Ice 10/22102 $72.50
15380 SW 100TH AVE I I'LUMBI I'Crmit I-ce 10/22/02 $0.00
TIGARD, OR 97223 I TA x l 8 State'I a.x 10/22/02 $5.80
I I'AX 18"%State'l-ax 10/22/02 $0.00
Phone 1:
Total $78.30
Contractor: --- —
HALF MOON PLUMBING INC
11720 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 703-7449 Rough-in Insp _-- — �_- -- ---
Top•out Insp
Reg #: \11-'I' 5513 Final Inspection
I Ir' 128288
III M 34-31111113
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
Iss d By: %�� Permittee Signature: --'
— — — — —
Call (5031 39-4175 by 7:00 P.M. for an Inspection needed the ex business clay
Building Fixtures
Plumbing Permit Application WIVI
City of Tigard "Datereccived: /U lo?- Perrot n.--te N rery
Address: 13125 SW Mall Blvd,Tigard,m 9723 �- Sewer permit no.: Building permit no.:
City q/Tigard Phone: (503) 6394171 /� Project/appl, a.c.: a date:
FL/: (503) 598-1960 1 �I/�^ Date issued: B Receipt no.:
Land use approval; _ �I l� Case file no.: Payment type
Ciel &2 family dwelling or accessory U Commercial/industrial U Multi.-family U Tenant improvement
U New construction ❑Addition/alteration/replacement ❑Food service U Other:
-111 1
Job address: JL7 C60 —;;,W Go Description Qly. het(ta.) 'hotel
Bldg. no.: Suite no.: New 1-anu 1-family dwellings only:
Tax map/tax lot/account no,: (Includes 100 ft.for each utility connection)
Lot: BSFR(1)bathlock: Subdivision: _ SFR(2)bath _
Project name: SFR(3)bath _
Cit /county:— ZIP: ` Bach additional bath/kitchen
Descri tion tnJ I a ion 'work on premises: C01 utilities:
Card lmsin/a:eadrain
fast.date of completion/inspection: DrywelIs/leach line/trench drain
PLUMBING f Footingdrain(no, lin. fl.)
Business::ame: LEG= }N "1 Manufactured home utilities
�� '�:_t7 Manholes
Address: ! .., /r Rain drain connector
City: _ State: ,'LIP: Sanitary sewer(no. lin. ft.I
Phone: Fax: __� E-mail: Stonn sewcr
CCB no.: 12S '/ ;'/ Plumb.bus. reg•no: _�, j� Water service(no.F. R.
City/metro lic,no.: Fixture or item:
_Contractor's representative signature: �, Absorption valve
Print name. T , , - Back flow preventer `
e � Date: [3ackwater valve
1 PERSON Basins/lavatory f
Name. Clothes washer
A- re.zs• Dishwasher
Cit Drin ing t'oun,im(s)
Y _ State: ZIP: jectors/sum
Phone: f;tx E-mail: Expansion lank_ _
Fixture/sewer cap
Name(print): ` ^ Floor drains/floor sinks/hub
Mailing address: � � � / 7 Qarha e isposal
City:
Pose bib
— -- State: 7.IP•
-_— Ice maker
Phone: Fax: E-mail: nterceptor/grease trap
Owner installation/residential maintenance only: The actual installation primers)will be made by me or the maintannnre and repair made by my regular Roof drain commercin 1
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Sump —'
u s/s lower/shower pan ( 1
Name: rine �-
Address: eter closet — r
Ater heater _
City Slate-_ZIP: other:
Phone: Fax: -- E-mail: Total
Not dl fudedlconne ac
ep cr dll wde,please call JuNedlctlon for more into ii
hlir ittnnn fee............... S _
Notice This rnrit a lication
UVtac V Maaterc'ai�l expires if a pp Plaut t:vteH Itl _ °',) S _
Credit and number p hermit is not obtained
`_+ treg . within INO days after it has been State surcharge(8%).... Ste_
_ r
—dame of cardholder a ehown on c a ea -- accepted as complete. TOTAL.................... ... S
3
Ca ter sipumre Amount
-"-' 440.4616(&WCOM)
PLUMBING PERMIT FEE'S:
PRICE TOTAL New 1 and 2-fam1ly dwellings only:
FIXTURES individual _ QTY ea AMOUNT t,ncludes all plumbing fiy lures in PRICE TOTAL
Sink 16.60 the dwelling and the first 100 ft. QTY Lavato (ea) AMOUNT
ry 16.60 for each utility co_nne_ction
Tub or Tub/Show Comb. 16.60 hThree
1 bath $249.20
2 bath
Shower Only 16.60 �- - $350.00
3 bath $399.00
Water Closet 16.60Urinal 16.60 SUBTOTALDishwasher 8%STATE SURCHARGE
16.60 REVIEW 25%OF SUBTOTAL
Garbage Disposal 1660 _ _ TOTAL
Laundry Tray 16.60
Washing Machine .5 50
Floor Drain/Floor Sink 2" 16.60
3" 16.60 PLEASE COMPLETE:
4" 16.60
Water Heater O conversion 0 like kind
16.6J Quantic b Work Performed
Gas piping requires a aeparale mechanical Fixture Type:
New Moved Replaced Removed/
.
MFG Home New Water Service 46.40Ce ed
Sink
MFG He New San/Storm Sewer 46.40 Lavator --
Hose Bibs 16.60 Tub or Tub/Shower
Roof Drains _ Combination
.6.60 Shower On[
Drinking Fountain 16.60 Water Closet
Other Fixtures(Iloecify) 16.50 Urinal
Dishwasher
Garbage Disposal
Laund Room Tra
Washin Machine
Sewer-1st 100' 55.00 Floor Drain/Link: 2"
Sewer-each additional 100' 3"
46.40 4„
Ws!si Service-tsl 100' 55.00 Water Heater
Water Service-each additional 200' 46.40 Other Fixtures
Stone 6 Rain Draln-1st 100' 55.00 S eclf
Storm 8 Rain Drain•each addltlonel 100' 46.40
Commercial Back Flow Pre•r',dion Device 4640
Residential BacRow Pre, ,ntion-Device, 27.55'
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 62.50 -
Requested Inspections 5r/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 85.25
Grease Traps 1660
QUANTITY TOTAL - _-
Isometric or riser diagram Is requirer,it
Uunntity Total Is >0 _
'SUBTJTAL
8%STATE SURCHARGE
"PLAN REVIEW 25%OF sUa7UTAL
Req
TOTAL ;
Minimum permit fee is$72.50.9%aisle surcharge,except Residential Backflow
Prevention Device,which Is$39.25•B%state surcharge
"All New Comnrerelsr Bulldinge require 2 seta of plans with Isometric or riser
diagram for plan review.
1:ldstslforms\plm-fees.dnc 12/26!01
Cf OF 'IGARD BUILDING IP SPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Fomdation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg, Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation
-Mach.
Underflr. Insul. Shear Wall Gyp. Bd. ---Vl'ec-i-Ij
Date Requested;_ Time: AM M
Address: 5.3
Builder: L � �. ; (, - 04, Permit
THE FOLLOWING CORRECTIONS ARE REQUIRE[:
S r ��
r-
Inspector: �� :�
i Date:
APPROVED _DISAPPROVED __I,PPROVED SUBJECT TO ABOVE
`Call Fcr Reinsp. � f
CITY OF TIGARD FL-_RN1IT #. . . .PERMIT 5
COMMUNITY DEVELOPMENT DEPARTMENT T S' • ' • • • • : M/95� X43'7
DATE IS+cU,�D: 12!21/9
13125 SW Hall Blvd.Tigard,Oregon 07215.6109 (503)039.4111
SITE ADDRE35. . .. 1.".� iJ�QI all 1 VllZll'I i r tVL' Po RCEI_: a 1 1 1 CA--k��3,�•IZ 0
SUBDIVISION. . . . GULF= SIDE ESTATESN0. 2 ZONING: R-7
I31_OCJi. . . . . . . . . . . L..01'. • . . . . . . . . :37
Remarks: CREATE OPENING 'N WALL, RE'40VINb TWO SHORT NON-BEARING WALLS ADDING SKY LIGHT
REISSUE
--
---------- -••----------------------
--------------------- BUILDING -------------------------------------------------------------------
REISSUE: TORIES....,,,, 1 FLOOR AREAS---------- BASEMENT..,: 0 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS OF WORK.: HEIGHT...,.,,,; 0 FIRST.., 0 sf G•ARAGE... 0 sf LEFT„
TYPE OF USE...:`SF FLOOR LOAD....; 40 SECOND...: 0 sf 0 SMOKE G SPACES:
TYPE Or CONST.t% DWELLING UNITS: I FINBSNENT: 0 sr *RIGHT......... 0 PARKING SPACES: 0
OCCUPANCY GRP.:R3 Bn: 0 BATH: 0 TOTAL------ RIGH ...... .. 8
0 sf VALIhF..t: X00 REAR..........; 0
--....--------------------- PLUMBING -----------—---------SINKS.........; 0 WATER CLOSETS,: r WASHING MACH_ 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS..,....,,: 0
LAVATORIES....: 0 DISHWASHERS.,,: 0 FLOOR DRAINS,.: 0 SEWER LINE ft: 0 SF RAIN BRAINS: 0 CATCH BASINS..: 0
TUBiSHOWERS.... 0 GARBAGE ESP..- 0 WATER HEATERS, : 0 WATER LINE ft; 0 BCKFI.W PREVNTR: 0 GREASE TRAPS., : 0
---------
MECHANICAL OTHER FIXTURES: 0
FUEL TYPES----------- FURN ( 100K ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0
FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS.........: P OTHER UNITS..,: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS,........: 0 WOODSTOVES,...: 0 GAS OUTLETS...; 0
_�.___»--------------- -----------------------•---------------
-- SIDENTIHL MIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDS°S-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
'000 SF OR LESS: N 0 - 200 amp„: 0 0 - 200 amn..: 0 W/SVC OR FDR..: 0 PUINP/IPPIGATIOV: 0 PER INSPECTION: 0
EA ADD'L 500SF.: P 281 - 400 amp..: 0 201 - 400 dev.. : 0 lst W/O SVC/FDA; 0 SIGN/OUT LIN LT: 0 PER HOUR,,....: 0
A MITEC ENERGY.: 0 401 600 amp..: 0 401 - 600 aop.,: 0 EA ADDL BP CIP: 0 SIGNAL/PANFi.,,, : 0 IN Pte,, 0
NANF HM/3VC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0
MINOR (_ABCL -10; 0
1088+ ampivolt. 0 ---------------------------------- PLAN RE'.'IENSECTION -------
Reconnect only.: 0 )c4 RES JNITS..: SVC/FDr,I*e25 A., ) 600 V NOMINAL: CLS AREA/SPC OCC:
__--------------------------------------------- ELECTRICAL - RESTRICTED ENERGY
A. 5F RESIDEN'iAl.---------------------- ---- B. COMMERCE IAL-----------------------------------------------l. d STEREO..- VACUUM SYSTEM.,: AUDIO t STERFG,: FIRE ALARM,,,.... INIERCOM/PAGING: OUTDOOR LNDSL LT:
BURGLA5 ALARM..., 0TH: .OILER...,....,: HVAC..,..,.,...: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
.....,..
GARAGE OPENER,,: CLOCK.....,,...: INSTRUMENTATION: MEDICAL : OTHR:
HVAC....,.....,: DATA/1ELE COMM.:
NURSE CALLS...... TOTAL # SYSTEMS:
Owner; ---•--_--.•._.-------------Contracts : ...... ----......______ TOTAL FEEStt ,5.46
I(EVIN VERDON LET GEORGF DO IT _--_r
1538 SW 100TH G 0 BOX 513
TIGARD OR 9722.4-0000 LAKE OSWEGO OR 97034
Phone 4: 503-694-8256 Phone #; 452-6120
Reg #..: 037229
This permit is issued subiect. to the regulations Contained in th Tigard Municipal Code, State of Ore, Specialty Codes and all ethtr
applicable laws. All work will be done in accordance with approved plans. This permit viii eNnire if work is not started within of
days of issuance, or if work is suspended for sort than, 180 days.
Frasina lnsp ------------------------------ REQUIRED INSPECTIONS -----------------------__»-- _____........
.r_.__.._..
Gyp Board insp � _ --___---- _.._.
Building Final
r'tr^mit tew. Sigrrt1-tr^r, : Issci Env :
CAI I at, insc�ect ion 62,) 4175
Permit# Account Description Amount Amt. Pd. Bal. Due
% Bldg. Permit (BUILD) Z ,j , T,
Plumb. Permit (PLUMB) _
Mech. Permit (MECH)
State Tax (TAX) �.
Bldg:
Plumb.
Mech:
Plan Check (PLANCK)
a
Bldg:
Plumb:
Mech:
_ Sewer Connection 'SWJSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSOC)
Residential TIF (TIF-R)
is Transit TIF (TIF-MT)
bmercial TIF (TIF-C) _
ustrial TIF (TIF-1)
titutional TIF (TIF-IS) r
ice TIF (TIF-O) _
ter Quality (WQUAL)
ter Quantity (WQUANT)
e Life Safety (FLS) _
Tion Cntrl Permit (ERPRMT) _
n
r
bion Pianck.'USA (ERPLAN) j L
lion Planck/COT (EROSN) -\�
TOTALS:
' Residential Building Permit Application
City cf "Tigard
13125 SIN Hall Blvd.
Tigard, OR 97223
(503) 639-4171
site Address: /S ' Yo S tj /6 `"
Office Use Ong �''1��• l�l��
Subdivision: l�r�ld1 ira � b5 Lot
Contact Date.
Valuation: -�c9��' Result _
New Construction Only: (Square Footage) Planck/Rec #
Permit # /r'?5>l y y_o g 3
House. Garage. Reissue of
Map & TL#
Corner Lot? Y N Flag Lot? Y N Zone _! _ ..
Plat #
Owner: K E ✓ i 'U t'r°c�� �i.
Lot"
t�, Approvals Re u� fired
Address. I� 3 �U 5_�� r
Planning Setbacks Solar I
" ed 4"( wo-4 -7-1 z `- -- Engineering _ - -
Cther —_
Phone L1 y' ---
' b' �' � 1, i
/ Items Required
Contractor: L e- t �j��'e�J a f'�a 1 --
4 � Subcontractors
Address V'd� �°l ' �� _—. — Truss Details _
Other
Notes
Phone: ( ��� `.15 2 q1 Z U
Contractor's License #
(attach copy of current Oregon license)
Contact Name: f1c�r�. •
Contact Phone ( :,v 'S'S? l:a ure
Subcontractors: Architect/Engineer
Plumbing: Address
Mechanical: — -—
(attach copy of current OR Contractor's Licesise)
Phone:
JOB DESCRIPTION. �'Rt•. y /2- v,ria A4)A1 hrt ✓:+ Wa
/ SIJ
Applicant Signature r" Applicant Phone number
Received by: ` Date Received: G DSS
N ypall,hhYNOy
I
I
BEDROOM ( BEDROOM �
� II
CLOSET .
so Cut in approx. 80"x30" pass thru
BATF —UP opening with new 4x10 "ender
G 9
MV
LIVING AREA DEN
LIV -
316 sq ft II
Remove nen Remove non
_ bearing wall bearing wall
3�7— 11' -
Existing concrete pad
I I
ISkylight
Install Velux FS-156 fixed
KITCHEN FAMILY skylight in vaulted ceiling
between existing rafters
Verdon residence 12-04-95
15380 S.W. 100 th
Partial floor plan (1/4"= 1') Tigard, Oregon 97224 I
43 7 1 ivd cz
t
Existing 2x
floor joist Attic space \
2x6 ceiling joist.
FY
_. New 4x10 beam
Stair well Full Den
I - '
37
2x8 Mg and 112" � 4x8 beam (existing)
particle board 40 post (existing)
_ concrete pier pad (existing)
Verdon residence 12-04-95
Partial section (1/4" = 1') 15380 S.W. 100 th
Tigard, Oregon 97224