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10795 SW FAIRHAVEN STREET 1 r+ w 1C ►p w w to p M kl i r 1n c„ 10795 SW FAIRHAVEN WAY y,rivD CITY OF TIGARD BUILDING INSPECTIONtSlii MST 24-Hou: Inspection Line: 539-4175 Business �i.71 ---"— BLIP _ _Date Requested �" -AM ' BLD — — Location 1U7 7 S S� G LO- ''u, Gv — MEC —_ — Contact Person — Ph & / S-7;3 PLM Contractor _--_—_ Ph f G' o Z/ C SWR — __-- BUILDING Tenant/Owner —_____--- —�— — ELC - Retaining Wall ELR Footing Access Foundation FPS Ftg Drain — SGN Crawl Drain Inspection Notes Slab SIT _...------- ._.._ __------_-__-- ---- __-_._ - SIT - Post&Beam Ext Sheath/Shear ------ --- Int Sheath/Shear Framing -- -- ---- - ---- ----- - Insul2tion Drywall Nailing --- ------ -- --- -- ------ Firewall - Fire Sprinkler -- Fire Alarm Susp'd Ceiling -- -- - — --- Roof Mise: -- - _ - -- ---- Final --- -- --- � ' PASS PART FAIL ---- ----- - PLUMBING Ilost& Beam Under Slab ---------------- --- --- ---- ----- Top Out Water Service - - Sanitary Sewer Rain Drains Final PASS PART FAIT_ MECHANICAL Post&Beam _. - - ----- - - — - Rough In Gas Line - - - - - -- Smoke Dampers Fina! - - - - - - PAS ART FAIL ECTRI --- --- ---- - --- — -- ervice _T ---------- Rough In LIG/Slab —__ _ ----------_-_-- -- Low Voltage Fire Alarm --------- ---------- - - - — Fi A PART FAIL ---- SITE Backfill/Grading ------- -----.--._. .__-- -.-----_- -- — Sanitary Sewer Storm Drain [ ]Reinspection fee of$ -_required before next inspection. Pay at City Hall, 1312: SW Hall Blvd Catch Basin Fire Supply Line I 1 Please call for re'nspection RE: U able to inspr, .-no access ADA _ l --��' Approach/Sidewalk bete �1 �? Inspector Ext Other -- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CELECTRICAL PERMIT CITY OF TIGARD PERMIT#: ELC2001-00154 DEVELOPMENT SERVICES DATE ISSUED: 3/19/01 13125 SW Hall Blvd.,Ticlard, OR 97223 (503) 639-4171 PARCEL: 2S103DD-00419 SITE ADDRESS: 10795 SW FAIRHAVEN WY SUBDIVISION: FAIRHAVEN COURT ZONING: BLOCK: LOT : 014 JURISDICTION: TIG TIG Proiect Description: Installation of service. _ RESIDENTIAL UNIT _ TEMP SRVCIFEEDERS MISCELLANEOUS '1000 SF OR LESS: 0 - 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): _ SERVICE/FEEDERBRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: — 1 W/SERVICE OR FEEDER: PER INSPECTION: 201 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect 22!YL----—__ SVCIFDR >= 225 AMPS: _ CLASS AREA/SPEC OCC: Owner: Contractor: LUNDY, JACK M AND SADIE E OWNER 10795 S\A' FAIRHAVEN WAY TIGARD, OR 97223 Phone: Phone: Reg#: _ FEES Required Inspections Type By Date Amount Receipt _ Elect'I Service PRMT CTR 3/19/01 $80.30 2720010000( Elect'I Final 5PCT CTR 3/19/01 $6.42 2720010000( Total $86.72 This Permit is issued subject to the regulations contained in the Tgard Municipal Code. State of OR Specialty Codes and all othe-applicable laws All work will be done in accordance with approved plans This permit will expire if work is not started within 1180 days of issuance,or rf 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 952-0'91-0080 You may obtain oc)pies of these rules or direct questions to OUNC at(503) 246-1987 PEI2MITTE['S SIGNATIIa , -� /// �- ISSUED BY: r �� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: __—.__ �--- _ _ DATE:— CONTRACTOR ATE:CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: __..-- — __- DATE:------ LICENSE ATE:_ --- — LICENSE NO: — Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application ---- [)ate received: 2%ice/0 / Permit na.:,E(r� -�J�/S• , City of Tigard Project/appl no.: _ Expire date: C'ttyofTigard Address: 13125 SW Flail Blvd,Tigard,OR 9722 Date issued: t3y�- Itecciptno.: Phone: (503) 639-4171 U, Fax: (503)598-1960 Case file no.: Payment type. Land use approval: U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Additiott/alteration/replacement U Other: U I'ancd Job address: 79� f///Z r✓ N 131dg.no.: Suite.no.: Tax map/tax lot/account no.: Lot: Block: Subdivision: _- _ Project name: tDescription and location of work on premises: Estimated date of completion/inspection: CONTRACUOR Al"I'LIUM ION E SUM 01 111,.,/ Job no: Pee trot ndentiDescription - Qty. (ca.) Total no.insp BUSIneSS name: v/ New rxyial-singleor multi-family per Address: dwelling unit.Includes attached garage. Cily: Stale: ZIP: tierviceincluded: I WO sq.ft.or less 4___ Phone: _ Fax: E-mail: Each additional 500 sq.ft.or portion thereof CCB no.: Elec.bus.tic.no: Limi led energy,residential 2 City/metro lic.no,: _ Limited energy,non-residentiul 2 Bach manufactured hotne or modular dwelling Signature of supervising electrician(required) Date Service and/or trader _ 2 Sup.elect.name(print): License no: Services or feeders-Installation, ■'oration or relocation: f 200 amps or less ( _2_ 201 amps to 400 amps 2 Name(print): 401 amps to 600 amps _ 2 Mailing address: f' 6f11 amps w 1(100 amps _ 2 City: _ .N Slate: o L(P: c ' Over 1000 amps ut volts y 2 _ Phone: c - ' Fax: E-mail: Reconnect on I) 1 Owner installation:The installation is being made on property I own Temporary services or f^eders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:200 amps or less URS 447.455,479.670,701. — -- -- �_ ---_--� �•� 201 amps to 4011 amps Owner's si nature: Dale: 3 1�� r 401 to 6(x)amps Branch circuits-new,alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Addre%5: service or feeder fee,each branch circuit — Cll '--� T711': B. Fee for branch circuits without purchase City: - - - I.Sl,tlr 1�. - - - of service or feeder fee,first branch circuit. Phone: F'ax: I ttl'Itl Each additional branch circuit: III MITM Mise.(Service or feeder not Ip,huded): ❑Service over 225 emps•rnmntercial U Health carr lacdnFach pump or irrigation circle 2 y Z U Service over 320 amps rating of 1&2 U Hazardous location 1 ach sign or outline lighting __— family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,or extension' 2 U Building over three stones U Feeder,400 amps or more *Description: _ U Occupant load over 99 persons U Manufaclu�ed structures or RV park Each additional Inspection over the allowable In anv of the above: U F:gresAightingplan U other _ � Pct inspection - Submit_sets of plans with any of the above. Investigation fee The above are not applicable to temporary coastrncitlon service. other N(,i all jurisdictionsaccete credit cards,please call jurisdiction for more infomu ion Notice:This pe .......... rmit application Permit fee........... ex ire%if a permit is not obtained Plan review(al _ 9F,) $ U vise U MaatetCard P fre /. mdit card namber within ISO days after it has been State surcharge(8%) ....$ accepted as complete. TOTAL .......................$ -�Name�f card7lolder in shown on credit cad s - Crdlxdder signature Alsloanl 4404615(6MWMM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: --� — p Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft or less $145 15 4 Audio and Stereo Systems Each additional 500 sq.ft.or portion thereof - $33 40 - 1 C] Burglar Alarm Limited Energy $75.00 - _ Each Manufd Home or Modular Garage Door Opener' Dwelling Service or Feeder _ $9090 2 El, Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less _ $80.30 2 Vacuum Systems' 201 amps to 400 amps _ $106.85 — 2 401 amps to 600 ar,.ps $16060 2 --- �-�-� Other 601 amps to 1000 amps $240.60 2 - ---- -- - -- - Over 1000 amps or volts $45465 _ 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Foe for each system.......................................................... $75.00 200 amps or less —_ $66.85 _ 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $10030 2 401 amps to 600 amps —_� $133 75 — _— 2 Check Type of Work Involved. Over 600 amps to 1000 volta, see"b"above. Audio and Stereo Systems Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service orL j Clock Systems feeder lee. Each branch circuit _ $665 i 2 Data Telecommunication Installation b)The fee for branch circolts without purchasu of service Fire Aiann Instatlation or feeder fee. First branch circuit $46.85— Each additional branch circuit $6.65 HVAC Miscellaneous btsllumentation (Service or feeder not included) Each pump or irrigation circle $5340 _ ❑ Each sign or outline lighting _ $53.40 Intercom a�;raging Systems Signal circuit(s)or a limited energy panel,alteration or extension $7500 Landscape Irrigation Control' Minor Labels(10) _ $125.00 _ Medical Each additional inspection over ❑ the allowable in any of the above Nurse Calls Per inspection $62,50 —_ Per hour _ _ $6250 In Plant $73 75 — Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above flees $ C� Other 8%State Surcharge $ _ -----Number of Systems 25%Plan Review Fee ' No licenses are required Ucenses are required for all other installations See'Plan Review'section on $ front of application _-_— Fees: Total Balance Due $ Enter total of above tees S _ ❑ Trust Account# — - 8%State Surcharge S_ — Total Balance Due i\dsts\formsklc-fees doc 10/09/00 CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERMIT PERMIT #. . . . . . . : PLM9-'7-02,79 Arim"m 13125 SW Hall Blvd,, Tigard,OR 97223 (503)639-4171 DATE ISSUED: 07/16/97 PARCEL: 2SI03DD--.00419 SITE ADDRESS. . . : 10795 SW FAIRHAVEN WAY SUBDIVISION. . . . : FAIRHAVEN COURI ZONING: BL.LjCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 14 JURISDICTION: TIG CLASS OF' WORK. . :ADD GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 SACKFLOW V-*,RFVN7*RS. . 0 OCCUPANCY GRF,. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . 0 STORIES. . . . . . . . : 0 WATER HEATEFS. . . . . : 0 CATCH BASINS. . . . . . . : 0 F I XTLJRES------------- -- LAUNDRY 'TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . 0 SINKS. . . . . . . . . : 0 URINALS. . 0 GREASE TRAPS. . . . . . . 0 LAVATORIES— . : 0 OTHER FIXTURE * * RES0 TUB/SHOWERS. . . : 0 SEWER LINE (ft) . ,, . : 30 WATER CLOSETS. : 0 WATER LINE kft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN ( ft ) . . . : 0 Remarks : Pli-mbing per,mit to hook hoitse to sewev, lateral. Sewer connection and r,eimbi-tv-sement district fees paid on SWR97-0265. Owner-: FEES ,JACK M LUNDY type amol.int by date r,eept 10795 SW FAIRHAVEN WAY PRMT $ ,30. 00 DRA 07/16/97 97--2972t,-, 'TIGARD OR 97223 5PCT $ 1. 50 DRA 07/16/97 97-297212 FDhonp POYA EXCAVATION INC JACDUES 1:10TRIER 1'3,?80 !_iL ILLLSTRUM BORING OR 97009 Phone #: 503-618-0112,9 $ 31. 50 TOTAL Rey REQUIRED INSPECTIONS ------ This pervit is issued sub)ect to the regulations contained in the Sewer- Inspection Tigard Municipal Code, State of Ore, Specialty Codes and all other Misc. Inspection applicable laws. All work will be done in accordance with Final Inspect icti approved plans. This pernit will expire if work is not started within 180 days of issuance, or if work is suspended for sore than )BO days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are ...... set forth in OAR 952-8901-*I6 through DAR 9Y.-88814080. You say obtain copies of these rules or direct questions to 01W by calling (503)246-1987. s f..1 e P,y ci P F t-m j t t 5 i t ..........f++++-1......4......................... + e ............ Call 6,39-4175 by 6:00 p. m. for an inspect ion needed th next bi.tsiness day ..........4-++4•...........I........I....................4.............. ............... ;ITY OF TIGARD Plumbing Application Rodd v.. .�_ 3125 SW HALL BLVD. Commercial and Residential oat*R*CW-='"��^ '� 7 ]GARD, OR 97223 oats to P E. - -- ;03) 639-4171 oats to W - Pemw aJ _ Print or Type Reisted SYVR a Incomplete or illegible applications will not be accepted called_ Nams of Developm•nt/Profect .FU(TURES4(1n#iv ual) �f lT, «j Q !Tr Job sk,k Address Street Address wry Swto �a1s1pr�' 9.00 10'7115- / " r h.4 Ulu Tub or Tub/Shower Comb. 9 Bldg a city/ to ZIP Shaver Onty 9.00 r Y N __ J rmrwcloset 9.00 aG L NrT i Dtahwsensr 9.M Owner Ma*i Adfsss yspusN Suit Garbage Ol9.00 J J 7'1 5- f&I r u✓c ti WaarwqMacrMrw 9.00 C gState Zip Phone Flow pnn r 9.00 /r -- Name r 9.W _ 4' 9.00 Occupant MaWng Address suite Water Neater9 oto La ndry Ron, Tray 700 ClrytSrate Zip Phone UnnW _ 9.00 _ Other Fixtures(Spsrafy) 9.00 pp -r4 �jX t_ , Tri l._ 9.00 -ontractor ung Address sure. 9.00 iPrior to issuance Cllyr'Stst� 11p 9.00 applicant must rl ,. b °1-7 c3t> 4 Z , -- 9.00 provide ad Oregon Const.Cont.Board Uc.a EEotp.onto 9.tx1 contractors -3-1 ---- 9.00 lconse information PbAnbirq a E xP•D1te� Sower-1st 100' 30.00 - ' PV.� , 11 Sewer-0"additlonat lar fru(;0 T COT 8usness fax«Marro a ?5(>n database). �A•Dato Water Sam=-to 100'�- 30.00 Name Water S•rwce-each additional 200' - 25.00 -- Architect Stonn&Ran Dray,-tat 100• 30.00 or Mai ing Address Sude -- Storm 6 Rain Dram-each additional 1 ar -' 25.00 Mobde Morns Space 25.00 Engineer Gtyrstate Zip j Phone Carriormal Back Fbw Prevention Devote or Am- 25.00 �i__ P*Aldo Device xsrnba work New O Addition O Alte-abon O Repave O ReWential E9acktlow Prevention Device' 15.00 o be dorm: Residential O Non-residential O Any Tnp tori Waste`bt Connected to a Fixture 900 tltlrbonal description of work - Catch Basin 9.0'J Insp.of F paling Plumbing ` 40.00 � S�eavdy Rearrested Ins 40.DO .sang we of - Pedtons x0.00 nlding or property _ perthr _ Rain CXain,srrgb fain ty dwelling,-- -' 30.00 I 'noosed use of Grease Traps 9.00 J wilding«property_ _ QUANTITY TOTAL ) YOU upping. movwn or repisang any lIxtures7 Yes Q No❑ so weie or riser dt•g- a reoueed if Ounnoy row is >9 i., IfYes ass heck of rortnt 'SUBTOTAL. •• . :i lereby aryuiawbdge that I have read tha application,that the wnformabon -'en,3 oXted,that I am the owner or aut4nred agent of the owner.and S% SURCHARGE ,at ola lubmitted are in componce vero Oregon State Laws. igna rs;otOwner/Agent Dave PLAN RE=VIEW 25% OF SUBTOIAL , r Weaured ooh!'Fenn tory 'orale>9 _ TOTAL S F r,_ i r arson no Prho • 'Minimum p•rmvt t••is S25•5%suraiarge except Residential eaddlow, Plevenbon Device.which u S 15.5%surcharge Pptmapp doc 12.96 (dst) • E COMPLETE AS APPROPRI&TE TO PROJECT: Fixtures to be capped, moved or replaced Sink Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbag;: Disposal Washing Machine _ Floor Drain 2" 3" 4" Water Heater Laundry Room Tray _ Urinal Other Fixtures (Specify) :OMMENTS REGARDING ABOVE: Pplmapp.doc 11 96 (dst) CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-4171 Date Requested: -? - 17 r 7A.M. P.M. MST: Location: 72-5- BUP: Tenant: _ Suite: Bldg: _ MEC: 51—OwContractor: Phone: Sf�� 7'?:3 7 ` PLM:151— Owner: ner: 4I Phone: 2:L9_ ELC: ELK:_ M,IS pST _ SIT: .Sf v '77 C� J ILDING B (con't) MECHANICAL ELECTRICAL SITE Site Post/Beam Pos eam Post/Beam Cover/Service Sewer/Storm Footing Roof UndFI/Slab Rough-In Ceiling Water Line Slab Framing To Out Cas Line Rough-In UG Sprinkler Foundation Insulation ewer '�r IIood/Uuct Reconnect Vault Bacot Damp Ihywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Thain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Found ih Ileat Pump Low Volt Approved A rov Approved Approved Approved Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved FINAL _ `FiINAL FINAL FINAL FINAL Call foati O Reinspectio cs I'S� required before next inspection CI Unable to inspect Inspector: 17ate; — Pege`-�-of -- CITY OF TIGARD DEVELOPMENT SERVICES SEWER CONNECTION PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : SWR97-0265 DATE ISSUED: 07/02/97 FARCE.-: 2S103DD-00419 ITC. ADDRESS. 10795 SW FAIRHAVEN WAY SUBDIVISION. . . . :FAIRHAVEN COURT ZONING: R-3. 5 BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 14 JURISDICTION: TIG TENANT NAME. . . . . :LUNDY, JACK IDSA NO. . . . . . . . . . : FIXTURE UNITS. . . : 1.6 CI._ASF) OF WORK. . . :ADD DWEL...LING UNITS. . : 1 TYPIE OF USE. . . . . .SF NO. OF BUILDINGS: 0 INSTriLL TYPE. . . . :L'TP IMPERV SURFACE: 0 sf Remarks : Sewer connection permit to hook-i.ip to Fairhaven Way sewer, line, reimbi-rrsement district #9. Owner,: ---___..__.-•----____.__._.__.._._._- _-------- -._.__..__ ..----....---__._._._..-.--.-.----_-.--- FEES JACK M L_UNDY type amol.int by date r-ecpt 10795 SW FAIRHAVEN WAY PRMT $ C_200. 00 DRA 071132197 97-296740 TIGARD OR 97223 IN SP $ 35. 00 DRA 07/02/97 97-296740 M I SC $ 4505. 88 DRA 07/02_'/97 97-296740 Phone #: Contractor: --------- ____-.--- -------____._._ OWNER --------------------------- IIhcini- #: $ 6740. 88 TOTAL - - - - REQUIRED INSPECTIONS This Applicant agrees to comply with all the rules and regulations Sewer, Inspection of the Unified Sewage Agency. The permit expires 188 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracl 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 law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-881--8818 through OAR 9SS?-89@14880. You may obtain copies of these rules gr direct questions to OX by calling 15831246-1987. 1 � T isijedy :�"� __ _ P e r•m i t t,e e S i g n a t i_i r e : _ ►+++++++++++-r++++++++-►.+++•4+++++++++++++++++++++++++++++++++++++++++++++++++.+... Call 639-4175 by 6:00 p. m. for- an inspection needed the next business day 11 ++4+++++++4+++++4.++++++++++t++++++++++++++++++++++++++++++++++++.++++++++++i-44 I