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11370 SW FONNER STREET I� J n p r� I 1370 SNN FO1'NFR S CITY C7 F TIGARD ELECTRICAL PERMIT PERMIT#: ELC2002-0035.1 DEVELOPMENT SERVICES DATE ISSUED: 7/29/02 13125 SVI+ Hal; Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S103AC-07800 SITE ADDRESS: 11370 SW FCINNER `jT SUBDIVISION: PASSMORE PART/MLP2001-00014 ZONING: R-4.5 BLOCK: LOT ; 001 JURISDICTION: TIG Proiect Description: Replace 200 amp panel, Job No. 2!,57 RESIDENTIAL UNIT TEMP SRVC/r-EEDERS _ MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp- SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): _i SERVICErIrEEDER _ BRANCH CIRCUITS _ADD'L INSPECTIONS 0 - 200 amp: 1 WroERVICE OR FEEDER: PER INSPECTION: – 201 - 470 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: L ^—Recomioct only: SV:/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: LENNY GREC;O WILLAVETTE ELFCFRIC INC 11441 SW FONNER ST PO BO ! 230547 TIGARD. OR 9723 TIGARD, OR 97281 P:1one: Phone: 624-3631 Reg#: LIC 75059 SUP 1965S EI_E 3.1-283C FEES Regriired tn:apections Tyra By Date Amount Receipt` Elect'/ Service PRMT CTR 7/29/02 $80.30 27200200001, Elect'/ Final 5PCT CTR 7129102 $6 42 2 720020000( --�— - Total --- $86.72 ~� This Permit is issued subject to the regulations contained in the Tigard Mur�dFal Code,State of(JR Specialt j Codes and all other applicable laws. All wirk will be done in accordance with approved plans. his permit wi I expire If work is r of started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law require you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth it OAR 952-001-0010 through OAR 052-001}0080. Yc.0 may cbtain copies of these rules or direct questions tc Permit Signatum: ems— —`� —� _-��sve0 By OWNF.R INSTP LI_A.TION Of ILY The installation is being fnade on property I own which is not in'--ided for sai ' se, or rent. OWNEP'S SIGNATURE. DATE:_.. CONTRACTGt, ;NSTP ILLATION ONLY SIGNATURE OF SL PR El_F:C'N: DA E:__ LICENSE NO: —_,_— ------- -- --- -- Call 639-4175 by 7:00pm for an inspection tho next hisiness day Electrical PermitApplication Daterecelved: 7R4 D9--15 t'chmitno.:f'LCj,�•r�-���� City of Tigard Project/appl.no.: IJxplredate: City of Tigard Address: 13125 SW llall Blvd,Tigard,OR 97223 Dole issued: Iiy: Receipt no.: I'honc: (503) 639-4171 Pax: (503) 598-1960 Case file no.: Payn►ent type: !,slid use approval. 7N. 2 family dweihi)g or accessory O Commercinl/industrial U K1111 i-tantiiy U'Vellant iny,rovcmcnl cunsuuction U Addition/alteratioiVreplacemenl U()Direr. -__ v" U Pallial r Joh address: 13-70 *Bldg,no.: Suileno.: Tax map/lax lot/account no.: _ Subdivision:_ _A Pm'ecl) name: ,�{ cy -�Description and location of work(in premises: Com_ f Iistirnated date of rornpdcfion/ins rcctirm: '�Mnmrtitlrlll APPLICATION Job no: rte Max - - 11esc,ipt(on IJI (ea. ofal no.lns Rusine�s Warne; t(1, I I A Mi 1)1 U rr f ry Nen resMknNal dnr k or nadtl family pet Addrey, { /�� 2 To T4 T _ dnellinRmdl.lit(hol"nllmtied pn,wl!e. Cily: 1, f1,or less. p eZ U Stale:0, zlP: ?z-1 Servirelncruded- . 4 Phone: � hax: r;7 •t 7a- E-mail: _I poo 8_._4 Fach additional 5W sq.it.or purUon Iheoeof CCH no.: 71-0 S-1-r 1?Iec.bus.lic.no: 7 y_ zy-5 L _ Llndted energy,residential T 2 City/m Ivo 1c.no.: 1 l? Limited energy,tion residential - - _ 2 Fach manufactured home or modular dwelling --� Service andlor feeder 2 Slt lure of auhervish Iricla_n(ver u1 Iredj - � Ua1e _ Sup elrct nsmr(print) r).� /. I.Icensenn /96t1- alteration fier•lcaerfieden-Inslallalton, or reloca(lnn: P` 2W snips or les• d�. 2 201 amps Io 4(A)amps Name( rir,:): Lr ( 4O1 amps to GW amps - - 2 Maillnaddress: /11 �5 Gul amps to IOTA)atnps 2 City; il't state()^ ZIP: ji tOver IOW amps or volts 2 Phone I•ax: E-mail: Reconnectonly _ Owner installati(?t,.'Ilse installation is being made on property I own Temporary services or feeders- which is not intended for sale,lease,tent,or exchange according to M'ailallon+alletatlon,or reImstlon: ORS 447,455,479,670,701. 21t)amps or less _ 2 201 amps 10 400 still's 2 Oat.rt'% %i .inhnc: Date: _ 40IIn690an+s - Sranehelrcafb ne,v,sllevallor, or extensionl,e:panel: Name: _ A. Fre ror br•r: ; -ifcuits i+ d,purchase of Address: service tit feeder fee,each branch circuit 2 City: --�` �- )Slate: ZIP: H. Fee for branch circuits withoutputchsse - - -J— -- of service or feeder fee,fttsl lnmch circuit: 2 I'hone�-- -- I'ax: 1. r,tail: Eaehadcflllonalhrenchcircult: Mhe.(Service or feeder not Included): t:) Service over 225 strips-commercial U I leallh care facility Fach pump or ir'gslinn circle _ 2 U Service ever 510 vnps-rating of 1 R2 U I IA?At locatlon I'm ch signor outline lighting __ _ t fantilyevrellings U 1wilding over 11.1,000 square rert rout or Signa)circuit(%)or a limited energy panel, USystem over 6OUvolts nominal moteKsiden+alunits Inone stooclUK alteralinn,atestenslons U Building over tluee stoties U Feeders,406 strips or more I 'Description: _ U Occupant load over 99 persons U Manufactured suuclutes or RV park Fich additional Inspeellon over floe allowable In any is the atrnvr! U Fgtessllightingplm U UUw: per inspection r , Submit-_sets of plans with any of(he abort. Investigation fee _ 71te above are not applicable to temporary construction service. Other Nos all h priktirns accept cte6i cards.please can)udsdicllon For rnae hdanlallan. Notice:Ibis permit application I'enitit fee.... ................S ._ / � U Visa U MrsterCstd expires if a permit is not obtained flan review(at _-_- %) $ Credit erd somites: y _ within ISO days after it has been State surcharge(8%)....$ a11t: _ t t— _111oan accepted as complete. '1 OTAI. .......................$ Y�atnE tY�iolOef Ort t it ear �x Kr ( l t stnalure�_ ,� 'moats 4 110 4611(f: V(11+1) Electrical Permit Fees: Limited Energy Fees: ��-- TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: -- --- ------ -- — -- �' Restricted Energy Fee-................... ......... ...................... j7 i.00 Number of Inmpeclions per permlf all1wed (FOR ALL SYSTEMS) Service included: 11en1S Coit Tofat Check Type of Work Involved: Residential-per unit 1000 sq.11 o h'ss - _ $145 15 4 ❑ Audio and Slereo Systems Each addllkmal 500 sq 8 or portion thereof -_ $33.40_ 1 ❑ Burglar Alarm l.lmlled Energy _^ $15.00 Each Manufd Horror or Modular U Garage Docs Opener' DwelNr 41 Service or f eerier - $90.90 - 2 Services or Feeders lJ Ilealing,V,mtilaliun and Air Cnn(l,irunieil Sys( -nr' InsWallon,atleralkxn,or tela ation 200 imps or Mss _ $80302 2 1:1201 amps to 400 amps S 106.85 - 2 Vacuum Systems' 401 amps 10 600 amps S 160.60! 2 ------ -"-- Other 501 amps lu fG10 amps $24060 2 Over I'M amps or volls _ _ $45465 2 -- ----- - - -Reconnect only only 566.15 2 T-.::r rorary Services or reeAer!+ 1 TYPE Or WORK INVOLVED -COMMCf2ClAi_ ONLY Inslatlatkxs,plleratlon,or rela:AlirHn 700 amvt a Mss _ SM0.65 - 7 rue for epch system.................................................... ..... 5 r 5.00 701 amps to 400 amps i $100.30 2 (SEF OAR 9111.260-260) 401 amp%to 600 Amp- $133 75 2 (firer 600 amps to 1000 v01s, - - - - -- Check 1 ype of Work Involved. sea h Circuits"b"above. ❑ Audio and Slerco Systems Vranc New,Alieralion or exiensim per panel Ela)1 he fee for brAnch clicullS Boller Controls with purchase of service or feeder lee. ❑ Clock Systems Fach branch ckcuil SE 65 2 b)the lee for branch chculls - -- --i ❑ Data Telecomnwnicalion Installation without purchase of service or feeder lee. f-1 First Manch circuit $46.85 L l Fire Alarm Inslall;illon :'ach addlllonal brarwh ckcuil V- -_ $6.65 HVA(.: Miscellaneous (Service or feeder rirrl kwhrded) ❑ InshumenlaUon Fact pump or Irrigallon clrcle - 4 $53.40_-- -och sign or oillkse fighikig ..___ $5340 - -- ❑ Signal clrcu"(s)or it Nmiled enAriry Intercom sail Paging Systems panel,alteration or ex(enshNs _ _ $1500 Minor LAbels(10) $125.00 ---- ❑ Landscape Irrigation Conhol' Each additional Inspocilon over EJ Medical the allowable In any of Uie above Per Mspeciton $07.50 ❑ Per hotir $62.50 Nurse Calls In Plant $13.75 ---- -' --- n Outdoor Landscape Lighling' Fees: ❑ Prolective Slgnalirg Enter total of above fees $ _ El e%State£u(charge $ 25%Pian Review Fee __. . _Number of Systems See`Plan Review"sectkxr ori $ front of application ' No Ikenses are requlrad, lk ensos ane required fur all oilier Installations Total Balance au(7 $ Fees: -- Ffrler!,)tal of a,ove fe_'s s Trust Acconnt p__r _-_._ 81/, State Ft ' lerrgr =� Total Balance Vwu, Pdslslformslrlr-feet dr c I(t/lNll(v,l CITY OF TIGARDELECTRICAL PERMIT PERMIT#: ELC2002-00346 in DEVELOPMENT SERVICES DATE ISSUED: 7/25/02 13125 SW Hall Blvd., Tioard, OR 97223 (503) 639-4171 PARCEL: 2S103AC-07800 SITE ADDRESS: 11370 SW FONNER ST SUBDIVISION: PASSMORE PART/MLP200'-00014 ZONING: R-4.5 BLOCK: LOT : 001 JURISDICTION: TIG Proiect Dest:ription: Reconnect elec service. RESIDENTIAL UNIT _ 1 EMP SRVC/FEEDERS MISCELLANEOUS — 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SiGN/OUT LINE LTG: LIMITED ENERGY: 401 - ,00 -3mv: SIGNAL./PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICEIFEEDERBR `NCH CIRCUITS _ ADD1-INSPECTIONS 0 - 200 amp: 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 RFS UNITS: > 600 VOLT NOMINAL: Reconnect only: 1 SVC/FDR >=225 AMPS: CLASS AREA!SPEC OCC: Owner: Contractor: LENNY GRECO WILLAMETTE ELECTRIC INC 11370 SW FONNER PO BOX 230547 TIGARD, OR 97281 Phone: not available Phone: 624-3631 Reg#: LIC 75059 SUP 1965S ELE 34-2830 FEES Required Inspections Type By Date A nount Receipt Elect'I Final PRMT C'fR 725/02 $66.85 2720020000( (`PCT CTR 7/25/02 $5.35 2720020000( _-- Total $72.20 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. ATT=NTION: 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 rules or direct questions to Permit Sigr ature: / Issued By: 7 :� _ 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 INST4LLATION ONLY SIGNATURE OF SUPR. ELEC'N: _,. L_ — DATE: LICENSE N O Cali 639-4175 by 7:00pm for,an Inspection the next business day Electrical Permit Application —' — PDateracelved: Petmltno.::u, �� Tigard City of Tigard 11ro,ject/appl.no_ Expire date: City afTigard Address: 13125 SW I lall Blvd,Tigard,OR 9 223 Date Issued: _ By: {;l'� Iteceipl r,o.: Phone: (503) 639-4171 4� Pax: (503) 598-1960 1 Case rite no.: Payment type: Land use approval: �jd 1 &2 Family dwelling or accessory U Commercial/industrial ❑Multi-family U Tenant improvement /l�New construction U AclditiorJalteratiolt/icplaccntcnt U Other: U Partial JOBSITE1140111MA Job address: 3 Sw ,v,vpti Bldg,no.: Suite no,: Tax map/tax lot/account no.: Lot: Block: Subdivision: _ — Project name:l<N d(r Description and location of work on premises: /� Fstimaled dGlc of completion/insltccliun: CON]11A(1011 APPLICA][ON FEE SCHEDULE' Job no: fee ffax I►racripllan (11y. (es.) told no.ln� Business mune: W F, Newresldmilal-%Ingle or mull f■nily per Address: C) TO 7` dwellingunh.Includes alfaclydgarage. City: I r 2 Slale:U, 7.IP: qPj1 Zj-/ Service included: Phone: . Fax: /e? i' ;, E-mail:� 1000%q ft.or less 4 6 'L 1-34' f y' y Fach additional 5W sq fl or limtkin thereof CCB no.: ?To ret Elec.bus.lic.no: 3 q- zy 3 (.indedenergy,residential 2 City/1 e(ro lie.no.: /5'111 L Luniled enelgy,non-resident ial 2 Each manuractured home or modular dwelling Si nature of su rvbt cuician(re wired) N Service and/or feeder 2 d3, f, -- License no: /yG t` S Services or feeders-Installation, Sup.elect.name(print): alieranon onrlocaflon: 1 21x1 amps or less 2 Name(print): 201 amps to 400 snips _ 2 401 amps to 60(1 amps _ 2 Mailing address:_ -� _ 601 l0xl amps — 2 City: Stall f '1.IP: ,— Q: rI000anrpsorvolts 2 Phone: I'ax: Reconnec I? netil; ton–tom_ — I Owner installation:The installation is being made on property I own Temporary senlces orTeton InNdldlon,ahrrdb••r,nrrelnca0on: which is not intended for sale,lease,real,or exchange according to 200 amps or less 2 ORS 447,455,479,670,701. 201 amps to 4110 amps _ 2 Owner's si€,ttattue: Dale: 401 In 600 ams _ 2 Branch circuits-new,ollerallon, or exlendon per panel: NAttte: Y A. Fre for Houich circuits with purchase of Address: service or feeder Fee,each branch circuit 2 City: Slalc: L7IP_ B. IF for branch circuitswithout purchase of service or feeder fee,first branch circuit: 2 Phone; I'a x: I'. Ittail: Fach additional branch circuit: Mise.(Service or feeder not Included): irrigation 2 O Setvlxova225aups rnntx urcial U IkdEachum pump p or g ation circle__ •Servi:e over 320 amps-rating or 1&2 U Ilanrdous hKnuon Fach sign or outline lighting fandlydwdlings U Building over Ilt,lxxt R-it.Ric lr.l lour or Signal citcuit(s)or u limited energy panel, U Sysiemover6flO volts nonunal nxlrr Rsrllermal units in unr stm(wir dleration,orextensiou° t U Bulldingovcr Uva stories U Ferdrrs,41st amps or more •Descti•aion U oLcupant local over 92 persons U Marufnclured stiuctures or RV pntk Each additional inspection over the allowable In any or the date: U E.gren/lightingplan U Othrr. ----_-__-- _ — Per Inspection Submit—_sets of plana with any of the al►ove. IrtvesU scion fee 711e above are not applicable to ternporary construction service. Other Pemlit fee.....................$ Na allkmadictioro acted credit carts,please call Judsdlictioe for men htfrxmtlion Nolicc: Inns pennil application U Visa U MuterCard expires it A pennil is not(1hlAntrll Plan review(at _ %) $ Credit erd numlxr. _ scilhin IRO days a(lcr Il hAs bState surchara(8%).... g een Ea res Accepted As complete. TOTAI. .................. .... sme eartrto r u shown one it erd s Csrdholdeislgniture Anitiont 11x11613(11A1M OM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED - RESIDENTIAL ,'1NLY Complcrte Fee Schedule Below: --- — —i --- Restricted Energy fee...................................................... 575.00 Nrimber of inspections per pertnil allowed (FOR ALL SYSTEMS) Service included; Items Cost Total Check Type of Work Involved: Residential•per unit 1000 sq it or less $145 15 — 4 ❑ Audio and Stereo Systems Each additional 590 sq It or portion thereof $33.40 _ 1 Burglar Alarm Limited Energy $75.00 Each Manuf d I lome or Mwular ❑ Garage Door Opener' Dwelling Service or l ceder _ $90 90 _ 2 Services or feeders ❑ liealiny,Ventilation arid Air Conditioning Sysl•!ni' Installation,alteration,or relocation 200 amps or less $80.30 2 Cl Vacuum Systems' 201 amps to 410 amps $106.85 2 401 amps to 600 amps $160.60 ` 2 011ier —--- 601 amps to tODU amps __ 1240.60 2 Over 1000 amps or volts — $45465 ,-- 2 -----_---__. -----------__.-- -- ----- Reconnect only $66.86 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation $66.85 _ 2 $75.00 200 amps or less Fee for each system.............. 201 amps to 400 amps — $100.30 _ 2 (SEE OAR 918-260 26U) 401 amps to 600 amps _ ___ $133 75 — 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits Now,alteration or extension per panel Boller Controls a)the foo for branch circuits wph purchase of service or Clock Systems feeder fee. Each branch circuit $6.65 _ 2 b)i he lee kx branch circadls Data Telecommunication Installation without purchase of service or feeder lee. Fire Alarm Installation First branch circuit --__ $46.85 Each additional branch circuit $6.65-- ❑ HVAC Miscellaneous (Service a feeder not Included) Inslrun,�ntauon Each pump or Inigalion circle _ $53.40 Each s!pn nx oritline lighling __ $5340 Intercom and Paging Systems Signal ckr.ull(s)or a Ihniled energy panel,alteration or extension _ — $75.00 _ ❑ Mina Labels(10) $125.00 Landscape litigation Control' Each additional Inspection over Medical the allowable In any of the above Per Inspection - $`i2.50 Per hair _,— $6250 Nurse Calls In Plant _ $13.75 �. ❑ Outdoor Landscape Lighting' Fees: • Ej Protect!�e Signaling Etter total of above fees $ Other_—_------- ------- - - 8%Stale Surcharge $ .__— of Systems 25%Plan Review Fee - ---_ Number See'Plan Review'section on $ ' No licenses are n;uired Licenses are required for all olher Inslallatlons front of applk;ation. ---__-- _ — -- --- ---, Total Balance Due $ Fees: Enter total of abuve foes ElTrust Account q - �__ 8%State Surcharge -_- Tofal Balance Due i lisl5\fonne4lrfees doc 111/04'lx) CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)539-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUR -.�. Received Date Requested __ ,,,,.,y�� M .�_.1✓L A'w�e°- _yBUP _ Location z _ —Suite _ r MEC Contact Person P M, Contractor_ _ _ Ph SWR BUILDING Tenant/Ownor —. _ ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&BeLM Shear Anchors __ -- Ext Sheath/Shear t �d v se,- tJ.F�Y Int Sheath/Shear - Framing Insulation 1 Drywall Nailing Firewall I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: - /� r Final PASS PART FAIL PLUNGING - � Post& Beam -- Under Slab Rough-In - Water Service Sanitary Se%Nbf' Rain Drains 4 • Catch Basin/Manhole Storm Drain — Shower Pan Other:a PART FAIL_ ICAL_ Post& Beam - _ Rough-In Gas Line Smoke Dampers -- __ Final PASS PART FAIL - ----- - ------ -- - ELECTRICAL Service ---- - - --- -- Rough-In UG/Slab ---- - — Low Voltage Fire Alarm — - --- Final Reinspection fee of$ required before nert Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE [] Please call for reinspection RE: _ - _ Unable to inspect-no access Fare Supply Line ADA Approach/Sidewalk D11b - �� b Inspector l/` - Other: Ext Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITYY ®F TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2002-00014 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/15/02 SITE ADDRESS: 11370 SW FONNER ST PARCEL: 2S103AC-02101 SUBDIVISION: ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT 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: 120 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS- RAIN DRAIN: ft Remarks: Installing additional 120' sanitary sewer to e:,isting 95'. _ FEES " ^� Owner: ---- Type By Date Amount Receipt CHARLES MARTIN PRMT GTR 1;16/07_ _ $101.•10 27200200000 TIGARD, CSR 97223 11370 FONNER ST 5PCT CTR 1/16/02 $8.11 27200200000 _ — Total $109.51 Phone 1: Contractor: MOORE UNDERGROUND INC 292.43 SE STONE RD GRESHAM, OR 97080 REQUIRED INSPECTIONS Phone 1: 503-663-0212 Final Inspection Reg #: LIC 126605 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 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By" Permittee Signature: Call (503) 539-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application "Datereceived:/—Ib —Q Permit no.:F h')0e*. 660 City of Tigard Sewer pen,lit nv.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City of Tigard Phone: (503) 639-4171 Project/appl.no.; Expiredate: Fax: (503)598-1960 Date issued: Byf Receipt no.: Land use approval; Case file no.: Payment type: !,YJ &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New constriction Addition/alteration/replacement U Food service J Others JOR Sul I.-INVORMATION Job address: M.7r glop Qt Fee(ea.) Total Bldg.no.: Suite no.. New I-and 2-family dwellings only: Tax map/tax lot/account no.: (Includes 100 it.foreachutitityconnection) SFR(1)bath L,ol: Block: Subdivision: SFR(2)bath Project name: _ SFR(3)bath - City/county: ZIP: Each additional bath/kitchen Description and location of work on premises: r Siteutllitles: I Catch basin/area drain _ Est.date of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin.ft.) _ Manufactured home utilities Business name: y ve, Manholes _ Address: Rain drain connector Cit I Stated ZIP. ' wq Sanitary sewer(no.lin.ft.) _7J _ Phone: L Fax: --JJZ� E-mail: Storm sewer(no.lin. ft.r CCB no.: Plumb.bus.reg.no: Water service(no.lin.ft.) City/metro iic.no.: cJ(J�C> Flxhtre or item: Contractor's representative signature: Absorption valve Back flow preventer _ r'nin name: DC� Backate: / 1L water valve Basins lavatory _ Nan:e: fl�cJvl wl Clothes washer AvtDishwasher Address: ( Drinking fountain(s) _ City: State: _1' j IP: Ejectors/sump tors/sump Phone: Fax: E-mail: Expansion tank _ ixturc/sewer cap Name(print): Floor drains/floor sinks/hub Mailing address: Garbage disposal --� --- Hose bibb City: State: ZIP: Ice maker — Phone: Fax: I E-mail: lntercc for/grease trap (honer installation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on die property I own as per ORS Chapter 447. Sink(s),basin(%),lays(s) — — Owner's signature: Date: Sump Tubs/shower/shower pan Jnnte: UtW�ater il — osetAddress: eater City: State: ZIP:Phone: Fax E-mail: I— — ' o Not all Jurisdictionsrcept credit carets,please call Jurisdiction for more itJorrrraion. N ,UeC:This permit application Minimum fee... ....... ...$ lU _41U UVisa UMaster('ardPlan review(al _ r%) $ e(pires if a permit is not obtained Credit card Hawithin 1 R(1 drys atter U has mner:-------- --- — —_�L State surcharge(R96) ....$ _ I Fs�lma _a been — Name or centhoidrr u shown on,rrdit card ¢ accepted as complete. TOTAL ....................... / _ S Cardholder sipmure ,_ Amaaii� 4U)4616(&MCOM) PLUMBING PERMIT FEES: PRICC TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) QTY (ea)_ AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink _ 16.50 the dwelling and the first100 ft. QTY ,(ea) AMOUNT Lavatory 16.60 for each utility connection) One_1)bath $249.20 Tub or Tub/Shower Comb. 16.60 _ Two 2 bath $350.00 Shower Only 16.60 Three l3)bath $399.00 Water Closet 16.60 — — SUBTOTAL _ Urinal 16.60 _ 8%STATE SURCHARGE Dishwasher 16,60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 --_ —__- —TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drdin/Floor Sink 2" 16,60 3" 1666 - PLEASE COMPLETE: 4" 1660 _ Water Heater O conversion O like kind 1660 uantity be Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit _ Capped MFG Ilome Now Water Service 46.40 Sink _ MFG Home New San/Storm Sewer —+ 4640 Lavatory Hose Bibs 16.60 Tub or Tub'Shower Combination Roof Drains 16,60 — Shower Only Drinking Fountain v 16.60 Water Closet Other Fixtures(Specify) 16.60 Urinal Dishwasher Garbage Ois osal Laundry Room Trak Washing Machine _ Sewer-1st 100' 5500 Floor Drain/Sink: 2" �ou 3" — Sewer-each additional 100' 46 40 4- Water Service- 1 st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures _ S eci Storm&Rain Drain-1 st 1011' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 — Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 2755 — Catch Basin 16.60 — Inspection of Existing Plumbing or Specially 62.50 Requested Inspections perRu COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 1660 _ QUANTITY TOTAL — --- -- Isometric or riser diagram is required if ` Ouanii y Total Is >9 'SUBTOTAL — S°o STATE SURCHARGE "PLAN REVIEW 25%OF SUHTOTAL _ Required only it fixture qty total is,9 TOTAL $ r *Minimum permit fee is$72 50.BN,state surcharge.except Residenha Backllow Prevention Device,which is$36 25-8%state surcharge 'All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. I:WstsVormslplm-fees.dor 12/26/01 CITY OF TI aARD 24-Flour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISIN Euslness Line: (50:x)639-41 i i fIn Received _--___ Date (requested _ AM -____- _ PM BUP Location Suite_ _-_ MEC Contact Person —__ __ _^_ Ph(_____^) __ __ ALM Contractor __ _— ---___-- — Ph( _13_x ___ SWR BUILDING Tenant/Owner _ _ _ ELC Footing Foundation ELC - Access: Ftg Drain ELR __—_--_---_--- Crawl Drain Slab Inspection Notes: �Q , ,, SIT _ — Post& Beam --- - �7� � `�`A �� - �'�[_�-'� Shear Anchors U --" — Ext Sheath/Shear 7 ���0 O � Int Sheath/Shear Framing -- -- - - --- --- - -— InsuIaL m Drywall Nailing4- -� Firewall Fire Sprinkler - - - - - - -- — -- Fire Alarm Susp'd Ceiling ------ Root Other. - -- ----_ —� Final PASS_PART FAIL - - - ---� PLUMBING __- Post 8-Beam Under Slab Rough-In —'--- — —_ —, __..— Water Service - - Sanitary Sewer Rain Drains - ----- -- Catch Basin/Manhole Storm Drain -- Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough-In Gas Line Smoke Dampers - -- ---- -- Final PASS PART FAIL_ - -- ---- ----- - - ------- ELECTRICAL ough-In aluw — UG/Slab Low Voltage) Fire Alarm T El Reinspection fee of$ —�— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PARFAIL SITE __ _ °lease call for reinspection RE: Unable to inspect -no access Fire Supply Line - - -- _- ADA Inspector Date Ext ae �s ( __.-- _C _— Approach/Sidewalk D �--- Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART f•.'�IL