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14399 SW FERN STREET W m rn i r m c� i e 14399 SW FERN STREET __ `T RAT i `J EXCAVATINU Specializing in Underground Utilities City of Tigard Mike Sheehan April 16, 1997 11Ib. Inspector Dear Mr. Sheehan, On .lol y 12, 11916 , v:c ;iistalled a s;Ariian, se%cr, wailer litiv .and a rain drain, 161' Windwcod Homes at 14399 SW Fern St. Lot 39 }lillshire Village. Do to a misunderstanding, our crew inadvertently hack fiIled the sewer and water Iities beiore the inspection at the above address. I would like to assu.re that this was not done intentionally and that the workmanship of' this and all jobs we install are performed to meet a very high standard. This is a standard we have taken pride in 16r over 20 years of bi.isiness in this area. It is for this reason we do not hesitate to insure that the sanitary sewer and water line was installed to code and guarantee all ofour workmanship he tree of any defect or fault of ours. Please feel to call us regarding this installation if you have any further question. Sincerely, Bob Strauss STRAUSS FXCAVATD G, INC. 24175 S.W. Davis Slreei Millsboro, Oregon, 97123 (503) 649-8117 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639.4175 Business Phone: 639-4171 Footing Rain Dmin Cover/Service FINAL: Foundation Water Line Ceiling -��Pl''u''m��``bb, Post/Beam Mach. Shear/Sheath Framing <_Ii •W Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect. Post/Bean;Struct. Mach. Rough-in Gyp. Bd. San. Sewer Gas Line Appr/Sdwlk Reins. Other: —� Date: A.M. P.M.__ Entry: Address: _ — — Tenant: __� _ Ste:r_ ©! BLIP: Con/Own: _S C� ! r0 MEC: PLM: ELC: _ _ THE FOLLOWING CORRECTIONS ARE REQU ED: ELR: ___� - 'PCFCO12 Inspector: ._____ Date:ROVED — DISAPPROVED!CALL FOR REINSP. CITY OF T'G A R D CERTIFICATE OF OCCUPANCY PERMIT#: MST11600320 DEVELOPMENT SERVICES DATE ISSUED: 07/24/1996 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104BC-02800 ZONING: R-7 JURISDICTION: TIG SISTE ADDRESS: 1439 SW FERN ST UBDIVISION: HILLSHIRE WOODS FILE C BLOCK: LOT:039 CLASS OF WORK: NEW Y TYPE OF USE: SF TYPE OF CONSTR: 5N OCCUPANCY GRP: R3 TENANT NAME: REMARKS: PATH I Find Building Inspection and Certificate of Occupancy Approved 4/17/97 by Rick Bolen, Building Inspector Owner: Phone: Contractor: WINDWOOD HOMES 14076 SW BENCHVIEW TERRACE TIGARD, OR 97224 Phone: 590-4700 Reg #: This Certificate grants Occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Code ,for the group, occupancy, and use under which the referenced permit was I issued. I BUILDING INSPECTOR _ BUILDI OFFICIAL POST IN CONSPICUOUS PLACE CITY OF . "TARD BUILDING INSPECTION DIVISION MST 24-Hour Inspecti. -+e: 639-4175 Business Line: 639-4171 --- -- - --- BUP Date Requested —__AM_ PM s-- BLD _ Location - '9;7 —------- Suite — MEC ----- Contact Person Ph PLM Contractor Ph :SWR BUILDING - Tenant/Owner ELC Retaining Wall ----_--- EL.R ;7- Footing Access: Foundation� FPS _ Fig Drain SGN — Crawl Drain Inspection Notes --- Slab SIT Post& Beam -- ------ Ext Sheath/Shear Int Sheath/Shear ----- Framing Insulation - __ _--- --- -----_____-------- -- Drywall Nailing -- ----------- Firewall ---- _ --- Fire Sprinkler Fire Alarm ---- ------ _ _ — -- ------- Susp'd Ceiling Root —_ -- -- -- Misc: - -- --_-�_ Final PASS PART FAIL ----_---- ._T_-- - -__ lr[uw-w ost& Beam - -- - Under Slab Top Out -- Water Service Sanitary Sewer — - --- tains irkl- 105 PARI FAIL MECHANICAL - Post& Beam Rough In Gas Line - -- - - - Smoke Dampers Fina! --- - - PA PART FAIL. �LEGTRt L --- S-arvice Rough In -- - - --- - -- - - UG/Slab Low Voltage - - - Alarm ---------------- ------ F�� i � PART FAIL _-_- SITE — --- - — -- 8aL'c M/Grading - -- -- -- — ----- Sanitary Sewer Storm Drain I Remspectlon fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I 1 Please call for reinspection RE: [ [Unable to inspect-no access ADA Approach/Sidewalk Other Date Inspector - �7 _ -----—Ext _ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. i CITE CF TIGARD MASTER . . . I PERMIT ##. . . . . . . : MST96-0320 DATE ISSUED: 07/:'4/96 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 PARCEL: 2S 104BC--HW039 SITE ADDRESS. . . : 14399 SW FERN ST SUBDIVISION. . . . : HII_LSHIRE WOODS ZONING: R-7 FID SLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .. .. Remarkss PATH I -------------------------------------------------- ------------- BUILDING ------------------------------------------ REISSUE:MST96-0316 STORIES.......: 2 FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED----------- - CLASS OF WORK.:NEW HEIGHT........: 25 FIRST....: 850 sf GARAGE.....: 400 sf LEFT..........: 17 SMOKE DETECTRS: Y TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 701 sf FRONT.........: 20 PARKING WES: 1 TYPE OF CONST.:5N DWELLING UNITS: 1 FiNBSMENT: 0 sf RIGHT.........: 17 OCCUPANCY GRP.:R3 BDRM: 3 BA?H: 3 TOTAL------: 1551 sf VALUE-1: 107128 REAR..........: 49 ------------------•---------------------------------------------- PLUBI4G -----------------------------------___-_�__ ---------------- SINKS.........: 1 WATER CLOSETS.: 3 WASHING MACH-: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS,........: 0 LAVATORIES....: 4 DISHWASHERS...: 1 FLOOR DRAINS.. : 0 SEWER LINE ft: 0 SF RAIN DRAINSs I CATCH BASINS-: 0 TUB/SHOWERS...t 2 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATER LINE ft: 100 BCKFLW PREVNTR: 1 GREASE TRAPS..: 0 OTHER FIXTURES: 0 - -------------------------------------------------------- MEEHANICAL -- --.. ------ -------- ------ ----- ---- --- - ----------- FUEL TYPES------------- FURN ( 100 ..: 1 BOIL/CMV ( 3HP: 0 VENT FANS.....: 4 CLOTHES DRYERS: 1 /GAS/ / / FURN )=100K ..s 0 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: 1 MAX INP.: 0 BTU FLOOR FURNALESs 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 1 --------------------- ELECTRIC"AL --- --------.. --RES?DENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ----BRANCH CIRCUITS---- ----MISCELLANEDU5--- - ---ADD'L INSPECTIONS-- 1000 SF OR LESS: 1 0 - 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PLIC/IRRIGATION: 0 PER INSPECTION: 0 LA ADD'L 500SF.: 2 201 - 460 amp..: 0 201 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0 LIMITED ENLRGY.: 0 421 600 amp..: 0 401 - 600 amp..: 0 EA 4DDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0 MANE HSI/SVC/FDR: 0 601 - 1000 amp.: 0 601+atps-1000 v: 0 MINOR LABEL -10: 0 1000+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ----•------------------------------- Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC: ----------------------------------------- --------- ELECTRICAL - RESTRICTED ENERGY --------- -------_------------ A. SF RE5IDENTIAL--------------------------- B. COMMERCIAL--------------------_-------------------------------------------------------- AUDIO t STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM...... INTERCOM/PAGING: OUTDOOR LNDSC LT: BURF,LAP @.ARM..: 0TH: :: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE JPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR: HVAC...........: DATA/TELE COMM. : NURSE CALLS....: TOTAL N SYSTEMS: 8 Owner: ------- ---- - ------------- ------Contractor: -------------------- TOTAL FEES:f 4054.06 WINDWOOD HOMES WINDWOOD HOMES 1407(. SW BENCHVIEW TERP. 14076 SW BENCHVIEW TL-RRACE '1GARD OR 97224 TIGARD OR 97224 Phone #: 590-4700 Phcne N: 5')0-4700 Reg M... 050196 This permit is issued subject to the regulations contained to the Tsgerd Municipal Code, State of Ore. Specialty Codes and all other appl,cable 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 Pork is suspended for tore than 180 days. --------------—--------------------------------------- REQUIRED INSPECTIONS ----------------------------------------------------------- Footing Insp PLMAInderfloor Framing Insp Gas Fireplace Water Service In Building Final Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Appri5dwlk Insp Erosion Control Post/Beam Struct plumb Top Out Low Voltage Gyp Board Insp Electrical Final Post/Beam Mechan Electrical Sery Fireplace Insp Rain drain Insp Mechanical Final Crawl Drain Electr'cal :tou is Line Insp Water Line Insp Plumb N 1 _ Permittee Signature: cz�. " A) Iss�.(ed 13 -^�- �.L �• Call for inspection - 639-4175 CCLIC O f^fI AIAICf^T T f7h1 PERMIT CITY OF TIGARD DATEI ISSUED:• 07/2.4/)9(,,6 0�i3 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oragon 97223.8199 (503)838-4171 PARCEL: LS 104PC--HW039 SITE ADDRESS. . . : 14399 SW FERN ST SUBDIVISIO^I. . . . : HILLSHIRE WOODS ZONING. R-7 17D • LOT. . . . . . . . . . . . . :39 TENANT NAME. . . . . : USA NO. . . . . . . . . . . FIXTURE UNITS. . . . 0 CLASS O1= WORE. . . :NEW DWELLING UNITS. " : 1 TY;='E OF USE. . . . . :SF NO. OF BUILDINGS: 1 INSTALL TYPE. . . . :BLISWR I MPPRV SURFfaCE: 0 5f (remarks : PATH I owner'. ______.__________.__ .___._.___.__.________.____________._.._____ FEES WINDWOOD HOMES type amol-tnt by date rer_pt 14076 SW BENCHVIE.W TERR PRMT $ x_200. 00 JSD 07/24.196 96-281785 INSP $ 35. 00 JSD 07/24/96 96 81785 l IGARD OR 97224 Ptio rl e #: 590•-4700 C OT1t r'aCt Or: _.._ ____.-----•------------_._- _-- CONTRACTOR NOT ON FILE J235. 00 TOTAL REQUIRED INSPECTIONS -_-- - This Applicant agrees to comply with all the rules and regula��ons Sewer~ Irrspect io1, of the Unified Sewage Agency. The permit expires IB@ days from the date issued, The total amount paid will be forfeited if the permit expires. 'he 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 e�cy will install a lateral. I s e r~m i t t me s f5 i g n a t�.i r e : a-.•. �, ���_,,_. ._ _ �__. _. Call for inspection (. 39-4175 Residential Buildinci Permit Application City of Tigan. i3+25 sw 'la/i Elvd. Tigard, OR 97223 (503) 639-4971 Jobsite Address: e, - Subdivision: LS... wc.'� Lot # offlce Use C1nl_y Contact Date , Initials Valuation: _ — —_ Result LIl— New Construction Only: (Square Footage) Planck/Rec # LO '51 4- Permit of O C (-louse i �� L 1 Garage: 4/ %X►S _ Reissue of t3 116 ��f Map & TL Corner Lot? Y �/ Flag Lott Y L.N Zone r' Owner: ',hL iay' ( Plat # Address. /�fQ �,; ,,�% .> ,r�r�j ,�. r�_ Approvals Required � Planning Setbacks Solar engineering _- - // ether Phone. j__._. 1 %J- 7 �4 �- ---- Contractor: Items Ree wired _ Subcontractors - Address. _ _ Truss Details Other Phone Notes ��t(, i k' I ----- Contractors License # —-- (&ttaph c7py of current Oregon license) Contact Name Contact Phone Subcontracts ArchitectlEnglneer: Plum' .g: Y iii Address: Mecnanical: ;attach copy of current CR tontractor's License) Phone: jOB DESCRIPTION: r .J' Apolicaft-Sigrf6tu Acuticant Phone number Received by: _�� ���> Date Received it — �ioymabvNee )�,�; cjA �.} �� �hr�-rho s �ft)O C�111.�_�^ (i4I ") �/ ; << IaLE' t_� �'✓t" ('j , iv,I AD -.lna t,f �a a ifs�T Permit 0 Ac:ount Description Amount Amt. Pd. Bail. Due �h r �• �.� � Bldg. Permit (BUILD) _3 S 3 Plumb. Permit (PLUMB) 2 _ 22 Mech. Permit (MECN) >Z' It . •s-_� State Tax (TAX) Plumb: Mech: /X Plan Check (PLANCK) Bldg: Plumb: Mech: j c . �� F. �:. l C► - Sewer Ccnnectlon (SWUSA) r,L) Sewer Inspection (SWINSP) 3 } Parks Dev Charge (PKSOC) 105 v /c�S Residential TIF (TIF-R) /'1 70 y-z G, Mass Transit TIF (TIF-MT) . Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF ; IF-IS) Office TIF (TIF-0) Water Quality (WQUAL) _Z�--v_ Water Quantity (WQUANT) �'4' �•,, ` Fire Life Safety (FLS) Eros?on Cntrl Permit (ERPRMT) Eros'nn Planck/USA (ERPLAN) Erosior Planck/CCT (EROSN) TOTALS: Box B. continued Box B: ?. Aeasure change in elevation from front property line to finished floor elevation. If the lot slopes tap from the front lot line to the foundation, the figure is positive. to ft the lot slopes down from the front lot line to the foundation, the figure is negative. ---- Measure distance from finished floor elevation to the affected peak/eave. _ ft 4. If the roof line runs North-South, deduct three feet. If the roof line runs East-West, ft deduct nothing. S. Subtract one foot for each foot of difference in elevation from the front property line to the rear property line, if the lot slopes up from the front to the rear. If the lot has no slope or slopes up from the rear to the front, deduct nothing. ft 6. Total figure for box B: !� ft Box C. Distance to the shade reduction line. Box C: 1. Measure the distance from the North property line to the foundation near the ft affected peak/eave. 2. Measure the distance from the foundation to the affected peak or eave. + ft 3. Total figure for box C. ft It is most useful to draw a vertical line to represent the appropriate Figure found in box 'A'and a honzoncal line to represent the appropriate figure found in box 'C'. The intc.:edton of the vertical and horizontal lines determines the value found in box"D". The value in box 'D'should be compared to the value in box'B'; if the value in box 'B'is less rhan or equal to the value found in box'0', then the building is in compliance with the solar balance code. If you have any questions, please contact us at 639-4171,x304 or at the Community Development Counter. MAXIMUM PERMITTED SHADE POINT HEIGHT (In Feet) 1 Distance I sta ce to North-south lot dimension tin teeU shade 100+ 95 90 85 80 75 70 65 60 55 50 45 40 reduction line from northern lot line in feet) 70 40 40 40 41 42 43 44 65 38 38 38 39 40 41 42 43 60 36 36 36 37 38 39 40 41 42 55 34 34 34 35 36 37 38 39 40 41 50 32 32 32 33 34 35 36 37 38 39 40 45 30 30 30 31 32 33 34 35 36 37 38 39 40 28 28 28 29 30 31 32 33 34 35 36 37 38 35 26 26 26 2' 28 29 30 31 32 33 34 33 36 30 24 24 24 25 26 27 28 29 30 31 32 33 34 5 22 22 22 23 24 25 26 2' 28 29 30 31 32 20 20 20 20 21 22 23 24 25 26 27 28 29 30 15 18 18 18 19 20 21 22 23 24 23 26 2' 28 10 1 16 16 1' 18 19 20 21 22 23 24 25 26 5 14 14 15 16 17 18 19 20 21 22 23 24 Box D. Maximum allowed shade point height: feet h:docsknancywentura wlac chp Revised 21=6,96 Solar Balance Point Standard Worksheet Address Box A calculations: North-South dimension for the lot. Box A: chis dimension is determined by finding the midpoint of the North lot line and drawing an intersecting line perpendicular to that point. First, determine which property line is the North lot line. The North lot line is the line with the smallest angle from a line drawn east-west and intersecting the northern most point of the lot. �.�.� 450... o N 'North-South Dimension for Lot: Measure the distance from the midpoint of the North lot line to the South lot line along the described line. t _ feet NCRM_S -V�T [lox B calculations: Shade point Fwight for your residence. Box B: Determine whether measurements will be based on the peak or eave of your structure. The orientation of the ridge is also important. Which describes Your residence? 1a: If the roof line runs North-South, measurements will (circle cne) be Eased on the peak of the roof. 7!c r —_. 1 b: If the roof line runs East-West and the roof pitch is less than 112, measurements will be based on tyle ear e. ry.eC5 a^41: :c 1c: If the roof line runs East-West and the roof pitch is 5 ' or steeper, measurements will be based on then1E;_tz' peak. �XZ- 117,9,6- /Y399sw !v S 1a m I rr i -- i .CGU HCl f1 Sid CITE( OF TIGARD DEVELOPMENT SERVICES EL_ECTRIC.AL. PERMTT - 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 RESTRICTED ENERGY FBF'<MIT #: ELR97--011.9 DATE I SUED: 04/14/97 PARCEL: r'S104BC-0280.10 SITk= ADDRESS. . . : 14399 SW FERN ST SlIBDIVISION. . . . :HIt_LSH1RE WOODS 70NING: R-7 PD B!_OCV.. . . . . . . . . . . LOT. . . . . . . . . . . . . :39 .JURISDTCTN: Project De sr-i pt i an : Irrigation controller A. RESIDENTIAL__--------- B. COMMFRCTAI.- _-------------------------------._____-----__ AUDIO X. STEREO. . . : AUDIO R STEREO. . : INTERCOM R PAGING. . : BURGLAR ALARM. . . . : BOILER. . . . . . . . . . : I_ANDSCAGF/TRRIGAT. . : GARAGE OFTENER. . . . . CLOCK. . . . . . . . . . . . MEDTCAL. . . . . . . . . . . . . HVAC. . . . . . . . . . . . . . DATA/TELE COMM. . . NURSE CALLS. . . . . . . . . VACI.UM SYSTEM. . . . : FIRE ALARM. . . . . . . OUTDOOR L.ANDSC L.!TE: OTHER: : - X HVAC. . . . . . . . . . . . : PROTECTIVE SIGNAL. . : INS-fRLIMENTAI ION. : OTHER. . : . . TOTAL._ # OF SYSTEMS: 0 Owner: -_- ---- ---.._ .. - - - -- - --- ----- -______--- -- ________ FEES _____------- ---- WTNDWOCID HOMES type amal_tnt by date recpt 1,4076 SW BENCHVIEW TERR PRMT 4 40. 010 JSD 04/14/97 97-293200 TIGARD nR 972i?4. SPCT $ x'. 00 JSD 04/14/97 97-29320 0 Phone #: 5140--4700 Contractor: CEDAR LANDSCAPE $ 42. 00 TOTAL 14375 9W PATRICIA -- ----- REDU I RED INSPECTIONS ------ HTI_L.51AORn OR 971.E:? Elert' l Final Phone #: 503-629-3411 R o q it. _ : 000058 Thi; pertit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ora. Specialty Codes and all other Permit . 8ignature applicable laws. All work will he done in accnrdance with ' approved plans. This pertit will expire if work is not starfed within 199 days of issuance, o^ if work is suspended for tore --—- than 198 days. I s s i.i e d B The installation is being made nn property I own arhi.ch is not intended for sale, lease, or rent. OWNER' S SIGNRTIJRF: DATF: iNSTAI i-AT1ON TGNATlIRF nF SLJPR. ELEC' N: DATE- 1 f-P NSF Nn.o Call for inspection - 639-4175 Community Development RESTRICTED ENERGY ELECTRICAL APFLI�CATION 13125 SW Hall Blvd. Tigard,CCK 97223 PERMIT # 1,�—�- ok �6A Phone(503)639-4171 `/ C) FAX(503)684-7297 DArr ISSUED '� TDD No. (503)684-2772 CITY OF TIGARD Inspection (503) 639-4175 ISSUED BY PLEASE COMPLETE ALL SECf10NS 1. LOCATION OF INSTALLATION 4. TYPE OF WORK Address RESIDENTIAL—Restricted Energy Fee . . . . . . . . . S40.00 /i 117�� (FOR ALL SYSTEMS) City State 7 ZiphC eck Type of Wurk Invoiy9d: PERMITS ARE NON-TRANSrEKARL[AND NON-REFUNDABLE AND EXPIRF.IF WORK ❑ Nudio and Stereo Systems IS NOT STARTED WITHIN t nn I)AYS OF ISSUANCE OR IF WORK 15 SUSPENDED FOR 1 Bn DAYS ❑ Burglar Alarm ❑ 2. CONTRACTOR APPLICATION Garage Door opener* [� Heating, Ventilation and Air Conditioning System' Contractor iJAR ��r�trJscisZOF JowType_ ,C ork/sc`10l ❑/Vacuum Systems* LJ Other Address 143 7S S w Po4r,416';O /96' Date f �� COMMERCIAL—Fee for each system . . . . . . . . . $40.0 (SH OAR Ill 8-260-260) Property Owner _. __ Check Tvoe of Work nvolygd: Contractor's Board Reg. No. SS9 7 ❑ Audio and Stereo Systems ❑ Boiler Controls Phone# �� � `ir ❑ Clock Systems ❑ Data Telecommunication Installations 3. OWNER APPLICATION U Fire Alarm Installation ❑ HVAC Print Owners Name Phone No ❑ Instrumentation ❑ Intercom and Paging Systems Address ❑ Landscape Irrigation Control' City State Zip ❑ Medical This IN-rmit is issued under OAR 918.320.370.This applicant agrees to maks only ❑ Nurse Calls restrir trd anergy installations(100 volt amps or lessl under this permit and to do the ❑ Outdoor Landscape Lighting' following. ❑ Protective Signaling 1. Only use electrical licensed persons to do installations where required.(Certain residential and other transactions are exempt from licensing.These have ❑ Other asterisks(•).All others need licensing). 2. Call for an inspection when all of the installations under this permit are ready for inspection at 503-639-4175. Number of Systems 1 Purchase separate permits for all installations that are not ready in inspection when the inspector is out to Inspect tender this permit, •No licenses are required. Licenses are required for all other installations. 4 Assume responsibility far assufIng that all corrections required by the inspector are done,and 5. Assume responsibility for calling for a final inspection when all of the 5. FEES corrections are completed. The person signing for this permit must be the applicant or a person a. Enter Fees $ authorized to bind the al,plicant. 11 °o � . ;�� Surcharge(.�5 x total above) $ Signature TOTAL •Nuthonly if other than applicant ENERGAP.CHP { CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERM T T PERMIT #. . . . . . . : PL..M97--01 13125 SW Nell Blvd., Tigard,OR 97?.23 (503)639.4171 DATA T SSUF_D: 04-/14/97 PARCEL: `S 104BC-1' 2800 SITE ADDRESS. . . : 14399 SW FERN ST SURD I V I S I ON. . . . : H I l._L.SH I RE WOODS ZONING'. R-7 PD BLOCK. . . . . . . . . . . LOT'. . . . . . . . . . . . . .39 JURISDICTION: CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . 0 BACKFLOW PREVNTRS. . : 1 OCCUPANCY (3RP. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0 3 . RIFS. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0 FT XTUkES—-- --------- — LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 c;TNKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GRf7 ASE TRAPS. . . . . . . . 0 I. AVATORIE_S. . . . : 0 OTHER FIXTURES. . . . : 0 1A)B/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 WATER CLOSF_'rs. : 0 WATER LINE (ft ) . . . : 0 DISHWASHF..RS. . . . 0 RAIN DRAIN (ft ) . . . : 0 Remarks : Residential backflow prevention device (lwnPr. - ----------------------------------------------------- FEES - ------ ---____.._ U)ThJDWrOD HOMES type amol.int by date rer_pt i is07E, SW RENCHVTFW TERR PRMT $ 1.5. 00 TSD 04/14/97 97-293200 rTGARD OR 97224 SPCT $ 0. 75 .7SD 04/14/97 `37- 93G=0i7� Phone #: Cnntrac-tor-•--------------_.--------------- CEDAR LANDSCAPE 14375 SW PATRICIA AVE Ii 1 I I. SRORO OR 97123 --------------.__-------------_---_—_ [+h n n r- #- 503-628-3411 $ 15. 75 TOTAL_ 000058 -.------ REDOI RE'D INSPECTIONS -- --___ This pereit is issued subject to the regulations contained in the RP/Rackf l ow Prev Tigard Municipal Code, ata".e of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 190 days of issuance, or if work is suspended for sore than 190 days. 1 fp�•m'ttP.e S1l�natl.11-e : �!- T r,4 i_i e d B y x �__._ 1 Call. far inspect i.on — 639-4175 :ITY OF TI GARD Plumbing Applicatior. Recd By 13125 SW STALL BLVD. Commercial and Residential Dale Recd C) 7 � TIGARD, OR 97223 Date to P E. Date to DST (503) 639-4171 Permit 0a I.,C7 1 1 S Print or Type Related SWR 0 In:.ompk'jte or illegible applications will not be accepted Called_ Name of DevelopmenUPro)ect FIXTURES (Individual) QTY PRICE AMT Sink 9.00 Job / s l h�L j 1'_X,4,91 Sink 9.00 Address Street Address Suite /-q',q 5i.,,f Z,G- 11 Tub or Tub/Shower Comb. 9.00 Bldg 0 CitylState Zip Shower Only 9.00 7"�-4 i� i i`• Q Name J 11 j Water Closet 9.00 Dishwasher 9.00 Owner Mailing Address Suite Garbage Disposal 9.00 Washing Machine 9 011 CitylState Zip Phone Floor Drain 2- 9.00 Name 3` 9.00 4' 9.00 Occupant Mailing Address Suite Water Healer 9.00 Laundry Room Tray 9.00 City/State Zip Phone Urinal 9.00 Noma Other Fixtures(Specify) 9.00 (�JIAti t.9N�.(Ff'C ftir 9.00 Contractor Malling Address Suite 9.00 /9 7 i) .SiJ j7�/zic�,v ^t Z 9.00 City/State Zip Phone //sl1ryc ck' 77/..1 4,,/rP .�9i/ s.oa -- Oregon Const.Cont.Board Lic.* Exp.Date 9.00 Attach Copy of 15 Y-1 j ( ; J 9.00 Current Plumbing Lic.# Exp.Date Sower- 1st 100' 30.00 Licenses Sewer-each iddillonal 100' 25.00 COT Business Tax or Metro M Exp.Date Water Service- 1st 100' 30.00 Name Water Service-each additional 200' 25.00 Architect Storm S Rain Drain-1st 100' 30.00 or Mailing Address Swte Storm 6 Rain Drain-each additional 100' 25.00 Mobile Home Space 2500 Engineer CityiState Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00 _ Pollution Device tp:,,�ribe work 1`4mv O Addition O Alteration O Repair O Residential Backflow Prevention Device' 15.00 ; to be oone. Residential O Non-residential O Any Trap or Waste Net Connected to a Fixture 9.00 Additional description of work Catch Basin 9.00 Insp of Existing Plumbing 4000 per/hr --- Specially Requested Inspersions 40.00 Existing use of per/hr or property Rain Drain.single family dwelling 30.00 Proposed use of Grease Traps 900 " building or p•operty QUANTITY TOTAL Are you capping. moving or replacing any fixtures? Yes❑v No O Isometric or riser diagram is required A Ouanity Totals >9 (If yes see back of form) _ 'SUBTOTAL rr I hereby acknowledge that I have read this appllcalinn.that the information S aiven is correct.that I am the owner of authorized agent of the owner,and 5%SURCHARGE 7 i trial plans submitted are in compliance with Oregon Sate Laws _ SlgnAture of Owner/Agent Date PLAN REVIEW 25%OF SUBTOTAL / Required only A fixture My total is>9 ".�.k ��.�•L�,� - I 1 9 TOTAL '75 Contact Person Nanta Phone 'Minimum permit fees 525+ 5%surcharge,except Residential Backflow Preventioe Device,which is 515+5%surcharge -- i\dsts\plmapp.doc 8196 PLEASE COMPLETE AS APPROPRIATE TO PROJECT: Fixtures t D 'be capped, moved or replaced Qty Sink Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) '.OMMENTS REGARDING ABOVE: