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10240 SW MCKENNA PLACE a N A cn n X �D J N v v n m 10240 sw rocKenna Place CITY OF TIGARD 13125 S.W. HALL 13LVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE DEXHEIMER ELECTRIC ING 10639 SE FULLER ROAD PORTLAND, OR 97222 Electrical Signature Form Permit #: MST2001-00316 Date Issoed: 8113101 Parcel: 1 S136AA-09600 Site Address: 10240 SW PACKENNA PL Subdivision: VENTURA ESI ATES Block: Lot: 018 Jurisdiction: TIG Zoning: R-4.5 Remarks: New SF detached dwelling. Nath 'i Your company has been indicated as the electrical contractor for the permit indicated above In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of 1he work to the address above, ATTN. Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL_ CONTRACTOR: WINGATE CORP DEXHEIMER ELECTRIC INC 15840 S POPE LANE 10639 SE FULLER ROAD OPEGON CITY, CSP 97r)a5 PORTLAND, OR 97222 Phone #: 503-657-3300 Phone #: 786-0886 Req #: SUP 2514-S LIC 43935 ELE 26-3210 AN INK SIGNATURE_ IS REQUIRED ON THIS FORPM Signature of SuK.arvising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGA►RD MASTER PERMIT PERMIT#: MST2001-00316 DEVELOPMENT SERVICES DATE ISSUED: 8/13/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 10240 SW MCKENNA P,. PARCEL: 1S136AA-09600 SUBDIVISION: VENTURA ESTATES ZONING: R-4.5 BLOCK: LOT: 018 JURISDICTION: TIG REMARKS: New SF detached dwelling. Path 1 BUILDING REISSUE: v STORIES: 2 _ FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1 351 of BASEMENT: of LEFT: 6 SMOKE DETECTOR3: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,445 of GARAGE: 510 of FRONT: 38 PARKING SPACES: 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT: of RIGHT: 5 VALUE: S 254,824 80 OCCUPANCY GRP: R3 BDRM. 4 BATH: 3 TOTAL: 2,188.00 of REAR: 20 PLUMBING _ SINKS: 1 WATER CLOS!TS: 3 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN. 100 TRAPS: LAVATORIES: 4 DISHW.,SHE IS: I FLOOR TRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS: TUBISHOWERS: 3 GARBAGE DISP: t WATER HEATERS: 1 WATER LINES: 100 RCKFLW PREVNTR: I GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN 4 100K: BOILIC'MP<3HP: VENT FANS: 5 CLOTHES DRYER 1 GAS FURN>=100K: 1 UNIT HEATERS: HOODS: 1 OTHEP UVITS 1 MAX INP: btu FLOOk FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL �- RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000;;FOR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPARRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 - 400 amp: 201 •400 amp: let W/O SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 •600 amp: CA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVCIFDR: 101 - 1000 amp: e0l+ampa-1000v: MINOR LABEL: 1000♦amplvolt: Reconnect only: PLAN REVIEW SECTION >-4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM AUDIO S STEREO: FIRE ALARM: IN rERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LAN!)3rAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTkUMENTATIOW MEDICAL: OTHW HVAC: DATA/TELE COMM: NLIRSF CR!LS: TOTAL 0 SYSTEMS: TOTAL FEES: $ 7;893.32 Owner: Contractor: This permit is subbed to the regulations contained In the WINGATE CORP WINGATE CORPORATION Tigard Municipal Code,State of OR. Specialty Codes and 15840 S POPE LANE 15840 S POPE LANE OREGON CITY, OR 97045 OREGON CITY, OR 97045 all other applicable law i. All work *-ill be done accordance with approved plans. This permit wilit l expire N work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg N: LIC 94680 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direct questions to OU NC by calling(503)246-1987 REQUIRED INSPECTIONS Erosion Control Insp 81 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Plumb Final Sewer Inspection Underfloor Insulation Plumb Ton Out Exterior Sheathing Inst Rain drain Insp Final inspection Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Foundation Insp Footing/Foundation Dn Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Mechanical Final r, Issued'ey : �.11��'r[1 Permittee Signature it4 o d ) Call (503) 639-4175 by 7:00 p.m. for an inspection needed the neXt busines4 day __ SEWER CONNECTION PERMIT CITY OF TIGARD DEVELOPMENT SERVICES PERMIT#: SW3/01 oon7 13125 SW Nall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8!113/01 SITE ADDRESS; 10240 SW MCKENNA PL PARCEL: 1S136AA-09600 SUBDIVISION: VENTURA ESTATES ZONING: R-4.5 BLOCK: LOT: 018 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELL ING UNITS- 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL.TYPE: Ll PSWR IMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. Owner --------------_..__ I FEES WINGATE CORP Type By Date Amount Receipt 15840 S POPE LANE OREGON CITY, OR 97045 PRMT CTR 8/13/01 $2,300.00 27200100000 INSP CTR 8/13/01 $35.00 27200100000 Phone: 503-657-3300 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The 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 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 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987. / r Issued Icy' r :7� .�` Permittee Signature:� Call (503) 639-4175 by 7:00 P.M. tor an inspection needed the next husines5 day i.i7 od �' Building Per 2 'J Ptimlit City of Tigard ProjecUappl.no.: Expire date: Ci of Tand Xi Address: 13125 SW Hall Blvd,Tigard,OR 97223 U Phone: (503) 639-4171 ate issued: Byr 4Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: M2 family:simple Complex: t% • 1 &2 family dwelling or accessory U Cornniercial/industrial U Multi-faintly 14 New co:,struction 0 Demolition U Add.,ion/alteration/replacement U Tenant improvement U Firc sprinkler/alarm U Othrr: I Job address: ' u Y k r�rJ ft �� Bldg. nu.: Suite no.: l.ot_ I Blak: Subdivision: U Tax map/tax lot/account no.: I i 5C Fl q Project name: Description and location of wot'c on premises/special conditions: r.1 Name: Mailing address: fbpF, LA 1&2 famUy dwelling: �/ f� City: CA r'' Stated ZIP: Valuation of work........................................ S;l11 ' Phone: (05"}-330o Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: Go E;;S Total number of floc s................................. Phone "'}�3-$$ cti d ax E-mail: New dwelling area(sq.ft.) ......................... 6 G!3g'Ucarpon area(sq.ft.) ........................ 5 I L' Name: —_- -- - Covered d,orch area(&L.f�)......................... Mailing address: Deck arse(sy.1't.) ........................................ � Other structure a rea(sq.ft.) Cl Y: S ZIP: Phone: Fax: Email: Commerci&Uind,tstrlal/mWti-family: Valuation of work ............... .. $ _ Existing bldg.area t:s.rt.) ................. ..... Business namc:_SrkbaE New bldg.r,rea(sq. (l.).............\.. .......... Address: Number of stories City: state:E-mail: — Tyle of construction.......... ....... . ....... Phone: -ax: Occupancy group(s): Ext. ing: CCB no.: New: City/metm lic.no.: Notice:All contractors and subcontractors are required to be 1161111 11 M RJOIALIIIIIIII licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Name }�I lY1a4j�e�_— jurisdiction where work is being performed.if the applicant is Address: exempt from licensing.the following reason applies: City: Stsuc: ZIP: Contact person: — Plan no.: _ - ifione: t I b Fax: E-mail: Name: &JAjA „"t,L:A,, Contact person: 1 afliLLA.) Fees due upon application ........................... $ Address: Date received: City: Slate: ZIP: Amount received ......................................... $-- f'ftone: L -p 6 Fax: E-mail: Please refer to fee schedule. I hereby certify 1 have rczd and examined this application and the Na+Wt iuitldk'eong wLt”cmbt ems,pWw call)urirda'tioo rer mom iotorc,rim attached checklist.All provisions of laws and ordinances governing this U visa J MuterCard c COa' 'd"""b°`' work will be complied with,whetherwLtQed heein or not. _ E,—�1ra Authorized signature: Date: ----Nr_rcd cabc9d_YYrrrn oaadl crd _ — Print nam,e:s_5,s&r E .1 1t`4�IF t��S - — Grdiolder at�arutt — A0cnad Notice:This permit application expires if a permit is not obtained within I t U days after it has been accepted as complete. 44a4613(600 'OM) Electrical Permit Application Date received: Permit il 7-20L City of Tigard Project/appl.ll Expire date: city of now Address: 13125 SW Hall Blvd,,rirard,OR 97223 Date issued: By: Receipt no.: Phone: 11639-4171 Fax: 11598-1960 Case file no.: Payment type: Land use approval: U I &2 family dwellirg or accessory U Commercial/industrial U Multi-family U'I'enant improvement .New construction U Addition/alteratiotl/replacement U Other:—__ U Partial INFORMATION.1011 SFFE Job address: 'L O S,0 (�ILEnIn1(N L_ Bldg nu.: Suite no.: Tax map/tax lot/account no.: Lot: Black: Subdivision: Ty Eft E-11.nkres --- Project name: Description and location of work on premises: S r�— Ni) Estimated date of completion/inspection: ON I�ACTOR APPLICATION FUE SCHEDULE Job no: Lee Max Business name: -- — 1 hvcri�lim+ 01y. Ica.) Iola{ no.hu Address: ( (� 1 U New resil"lial-daglror r�rfamilyler _ dwelling uni Inclu lea arta,heal Karan City: tJDStale:�yZ.IP: Q�ZZZ servlalncluded Phone: Fax: E-mail: 1000 sq.ft.or less 4 Each additional 500 sq.ft.or onion thereof CCB no.: !1,35 —C� Elec.hos. tic.no: 3 Z I C.� Limited energy,residential v _ 2 City/metro lic.no.: Limited energy,nun-residential 2 Each manufactured home or nodular dwelling Si nature of supervil electrician(tequired) Date Z� j Service and/or feeder__ 2 Sup cleat name(print) DRYG Peu .tel NIG I.ucnsrn„ 1_63UL Services or reeden—Inslaltvtion, alteration or relocation: 200 am s or less 2 Name(print): 201 amps to 400 amps 2 —.._.__--- ------------------- — — 401 amps to 6(10 amps __ 2 Mailing address: 601 amps to 1000 amp, _ 2 City: _— Stale: ZIP:` Over IWO amps or volts 2 Phone: Fax: E-mail. Reconnectonly I Owner installation:The installation is being made on property 1 own Temporary servlcesorfeeden- which is not intended for sale,lease,rent,or exchange according to htstsBalion,alteration,orreloatlon: ORS 447,455,479,670,701. 2110 maps or less 2 201 amps to 400 snips 2 Owner's signature: _ _ Dale: 401 to 600 am ps _ 2 Branch circuits-new,alteration, ;US�crvice : or extension per panel: A. Fee for branch circuits with purchase of ss: service or fearer fee,each branch circuit _ w Slate: ZIP: B. Fee for branch circuits without purchase — -- — —--- of service or feeder fee,first branch circuit: 2 : F:+x: C:-mail: Each additional hranch circuit. Mise.(service cr feeder not Included): ce over 225 onps-commercial U Health-care facility Each pump or rmganuu circle 2 over320amps-ratingofl&2 UHazardoushwation L:achsignoroutbnelighting 2 lydwellinga U Building over 10,000 square feet four or Signal circuits)or a limited energy pmm over 600 volts nominal rrwre residential units in one structure alteration,or extension" � 2 U Budding over three stories U Feeders.400 amps or more •Descri tion: _— U Occupant load over 99 persons U Manufactured structures or RV park FAch additional hil over the allowable in any of the above., U Egrem/lighungplan U Other -- -- Perrns,c.uau Submit— sets of plains with any of the above. Investigation fee 11lie above are not applicable to temporary construction>sereice. Other _ _— �_ Permit fee.....................$ al all jurisdictions acredit cards,pease lcall junsdicuova on for ninformation Notice:11tis permit application U Visa U MasterCard expires iC a permit is not obtained Plan review(at _,-,_ %) $ — CmWt card number: —L L within 180 days atter it has been State surcharge li....$ _ Expires accepted as complete. Name of cardt+older as shown on credit card ---1� Cardholder sip al Amount OF 440.4615 1641!M OMI M echan ical Permit Application Date,received: Permit no.://.,j,- City of 'Tigard Projecdappl.no.: Expire date: t uv,j( Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (503)598-1960 Case file no.: Payment type: Land use approval: Building permit no.: O 1 &2 family dwelling or accessory O Commercial/industrial U Multi-family U Tenant improvement ,,W"New construction U Addition/alteration/replace rnent U Other: Job address: 1CZ_ S r4R PL_ACk--. indicate equipment quantities in boxes below. Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ Lot: Block: Subdivision: qtr=OTUA# 12,L See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county_; p1 ZIP: Z3 l UCIV Description and locitioff of work on premises:c2 E9. rte- t l Fee(ea.) Total Est.date of completionlinspection: -- — Description (,My, Res.only Res.only Tenant improvement or change of use: Is existingspace heated or conditioned?O Yes U No Air conditioning unit _ CFM l it con iuon{ng(site p' regwre�j Is existing space insulated?U Yes U No tern ono existing system _ Boiler/compressors State boiler permit no.: Business nameCAM 64 r4 Hp Tons BTU/H _ Address: (pppC. .SF— "F-1..44 Fit smo a damper uctamo c detectors City: C_A_AC_*_ fA A5 SUtte: ZIP: eat pump site plan required) Phone:(05lp-1al t,4 Fax: 1 E-mail: Inst&IVrep ace urnac urner—_ Including ductwork/vent liner O Yes O No _ CCB no.: nstal rep ac re ocate heaters-suspended, City/metro lic.no.: wall,or floor mounted Name(please print): ��-•t K-•(k rj �(� F—i>Q.t C,0 crit for a ha h taancce,oilier anfurnace e r germ tloo: Absorptionunits BTU/11 Name: Chillers III, Address: Com ressurs� HP uns ! 9a1� 1l9t t On: City: Slate: ZIP: Appliance vent Phone: Fax: E-mail: ei exhaust _ Hoods,Type res. rte a azmat hood fire suppression system Name: Exhaust fan with single duct(bath fans) Mailing address: -Exhaust s stem a art from heating or AC City: State: ZIP: FuelP P t distribution up to out ets) Type: --_LPG ._!. NG Oil Phone: Fax: E-mail: •ue i in —cach additional over 4 outlets rocesspiping(sc ematicrequir ) Name: Number of outlets Other 16ted appliance or equ�imrnt: _Address: _ _ _ Decorative lire lace v; State: ZIP: risen-ty -- Fax: E-mail: rrstov pe [stove ant's :ant's signature:� 777� Date: Z�, ••� «•; Nd all jwbdktiau accept cmdir cued,please call iuridkrion fa more idomutlon. Ferrell fee $ ........... .... O Y�aa O MuterClud Notice:"Ibis permit application Minimum fee................S expires if a permit is not obtained Plan review(at — %) $Credit card number _.. — ----L--1— within 18U days after it has been F.,pire' y State surcharge(8%)....$ Nroe d cardholder si dawn on credit cud accepted as complete. TOTAL ...$ Cattliholdn sipature Amount 44GA17(&MCOM) Plumbing Permit Application Date received: Permit no.: City of 'Tigard Sewer permit no.: Building permit no.r Address: 13125 SW Hall Blvd,Tigard,OR 97223 CityojTigard phone: (503) 639-4171 ProjecUappl.no.: Expire date: -�`- Fax: (503) 598-1960 Date issued: By: Receipt no.. Land use approval: Case file no.: Payment type: 1 U I &2 family dwelling of accessory U CommelLial/industnal U Multi-family U Tenant improvement 14New construction U Addi tion/al teratiordre placement U Food service U Other: Job w.Jdress: 10)-HQ S� �G-�� r'll'jP, PL..(-�tz --- Description (Ay.I Fee(ea.) I Total Bldg.no.: --�Suite no.: - New 1-and 2-family dwellings only: - (lucludIAR ---1t.roreach utility connection) Tax map/tax lot/account no.: SFR(1)bath Lot: 1 IBIock: Subdivision:qr=kTJPA ELTATIM1711(2)bat -- -- ---- �- Project.name: SFR(3)bath --- City/county: ZIP: CUT23 Each additional baWkitchen Description and location o work on premises: p4el^j Site utilities: Catch basin/ama drain Est.date of completion/inspection: D wells/leach lineltrench drain Footing drain(no.lin.ft.) Manufactured home utilities Business name: Manholes Address: 1 1 t�JfiN Rain drain connector City: `pJV fL,(� State. A ZIP:q 6 Sanitary sewer(no.lin.ft.) Phone: --4 - 2 Fax: _ E-mail: Storm sewer(no.lin. ft.) CC'?no.: I IS'ZfoI- Plumb.bus.reg.no:3 Water service no.lin.ft.) City/metro lic.no.: Fixture or Item: Contractor's representative signature: Absorption valve Back flow revtnter Print name: [-0�-- i Ddte: . r Backwater valve _ Basins/lavatory Name: Clothes washer -- Dishwasher --- - Drinkin r founW11(s) City: _ State: ZIP: F'Inmc: Fax:- E-mail: Expansion tank Fixture/sewer cap Name(print): Floor drains/floor sinks/hub Mailingaddress: Garbage disposal Hose bibb City' ----- - — State: ZIP: Ice maker Pho►,c: Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and mpaiv made by my regular Roof drain(commercial) employee on the property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: _ Date: _ gum Tubs/shower/shower pan Urinal _ _Name: _—_ -- Water closet - Address: Water heater City: State: ZIP: Other: Phone_ Ft►x: —rE mtil: Total r Nal W iuddbwxr scow cnida cash,please alt}urtsdtcunn «m n Wmmrim. Minimum fee................$ N _ Notice:This permit application Plan review(at _ %) $ U vias U MasterCard expires if a permit is not obtained +-- C"I cud number: __ _ within 180 days after it has been State surcharge(8%).... Nine of cardholder a shown on crodlt card accepted as complete. TOTAL .......................$ . Cardboidn si"ure /.snow 4404616(GWCOM)) J�' s b fIIK J A 44 iD5'IT— F'L-P'c-C- PRIVATE STREET N R 22.03*•� \ j� Pokak-k I I • - I � i I c R , m Q ' sa.00fin' N WINGATE CORPORATION a 15840 S POPE LANE m WINGATE CORPORA11ON OREGON GITY OR 97045 PIAN 15840 S. HOPE LANE 9CAL8: 1' -20' a OREGON CITY,OREGON 91045 r; 503-657.3300 1 y O S-+J (YIC.Kr--14IJ P, ►�L—A C-Z Fr A COMPASS ENGINEERING LOT 18 T ENGINEERING* SURVEYING t PLANNING VENTURA ESTATES Wa ONaI L*MRO° M%°""" l IGARLI, OREGON 1 z CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE I M PLUMBING 411 HARNEY WAY VANCOUVER, WA 98661 Plumbing Signatura Foran Permit #: MST2001-00316 Dutc I3 wed: 8113101 Parcel: 1 S136AA-09600 Site Address: 10240 SW MCKENNA PL Subdivision- VENTURA ESTATES Block: Lot. 018 Jurisdiction: TIG Zoning: R-4.5 Remarks: New CF detached dwelling. Path 1 Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the woik to the address above, ATTN: Building Dept No plumbing inspections will be authorized until this completed form is received OWNLR PLUMBING CONTRACTOR: WINGATE CORP I M PLUMBING 15840 S POPE LANE 411 HARNEY WAY f1RFGCN CITY.. OR 97045 VANCOUVER. WA 98661 Phone a. 503-657-3300 Phone #: 310-2083 Reg #: 1 Ir 115262 PI M 37-357Db AN INK SIGNATURE IS REQUIRED ON THIS FO X � 'f Signat re of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIG,ARD -- PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2002-00075 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 314102 PARCEL: 1 S 136AA-09600 SITE ADDRESS: 10240 SW MCKENNA PL SUBDIVISION: VENTURA ESTATES ZONING: R-4.5 BLOCK: LOT: 018 _ JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH. BACKFLOW PREVNTRS: 1 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: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential backflow preventi, n device. _ _ FEES Owner: — Type By Date Amount Receipt W INGATE CORP PR��1T CTR 3/4/02 $36.25 27200200000 15840 S POPE LANE 5PC:T CTR 3/4/02 $2.90 27200200000 OREGON CITY, OR ;17045 —.. Total $39.15 Phone 1: 503-657-3300 ,;ontractor: I M PLUMBING 4'i I HARNEY WAY VANCOUVER, WA 98661 REQUIRED INSPECTIONS RP/Backflow Preventer Phone 1: 310-2083 Final Inspection Reg #: LIC 115262 PLM 37-357pb 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 130 clays. 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. �ll JKI ISsued B '%i Perrnittee Signature: Call (503) 639-4175 by 7:00 P.M. fur an inspection needed the hext bu nes day Plumbing Permit Application �-" Date received: r' 0q\ Permit no.: Gl7o'ltwZ-��7, City of Tigard ft and Sewer permit no.: Building permit no.: Addren: 13125 SW Hall 131vd.Tiyard,OR 97223 — (•itl of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503) 598-1960 Date issued: By: I Receipt no.:, Land use approval' _ __ Caseftieno.: Payment type: TYPEAF U I &.2 family dwelling or accessory U Commercial/industrial J Multi-Ianuly U Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: ..__ 1 1 1 Description "y. Fec(ea.) 'Total hth address: New I-and 2-family dHcllinRs only: Bldg.no.: Suite no.: (Ineludes100ft.torcachutility connee'tion) Tax map/lax lot/account no.: _ SFR(1)bath _ _ Lot: Block: Subdivision. 1 ' SFR(2)bath Project name: — SFR(3)bath _ City/county: 'LIP: Each additional hath/kitchen SiteuDescription and location of work on premises: __ Catch basin/ _ Catch basin/area drain -T --- Drywells/leach line/trench drain _ Est.date of completion/inspection Footing drain(no.lin. ft.) _ Manufactured home utilities _ Business name:.— 4 -�- tr& ��L �_ Manholes Address; Rain drain connector City: T4— I, &1 StateW 71P: Sanitary sewer(no. lin.ft) _ Phone:''1 -� Fax: Email: Storm sewer(no.lin. ft.) Water service(no. lin.ft.) cc_ no.://5—e�0a _ Plumb.bus.reg.no: 7' ! Fixture or item: City/metrolic.no.: Absorption valve Contractor's representative signature: Back flow preventer Print name: TM Uate: Backwater valve _ Basins/lavatory Clothes washer Name: Dishwasher Address: Drinking fountains) City: State: ZIP: _ Ejectors/sump Phone: Fax: Email: Ex ansiot:tank fixture/sewer cap Floor drains/fluor sinks/Iwb Name(print): Garbage disposal Mailing address: Hose bibb City: _ _ State: ZIP: Ice maker Phone: TFax: E-mail: Interco tor/ tease tra Owner installation/residential maintenance only: The actual installation Primer(s) will be made by lite or the maintenance and repair made by my regular Rtxtf drain(commercial) _ employee on the property I ownaF per ORS Chapter 447. Sink(s), asin(s),iays(s) Owner's si nature: Date: Sum - Tubs/shower/shower pan Urinal Name: Water closet Address: Water heater City: —State: ZIP: _ Other: Phone: E-mail: 1'ota�— Minimum fee................$ aS Na all furisdictlons accept credit cards,plewe all iurls"con ra mar Itdennatiat. Notice:This permit application Plan review(at _ %) $ U Visa U MasterCard expires if a dermil i:t not obtained Slate surcharge(896)....$ •�—++��--�� C"t cad number: _ —L-� within I P` days after it has been TOTAL $Expires ....................... _ accepted as complete. Name of ardholdtt u dKWn an aedit c s Cardholder signature Atttount MU-4616(61001COM) PLUMBING PERMIT FEES: --'--v�- PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES indivlduall_ _ QTY ea AMOUNT (includes all plumbing fixtures In PRICE OTAL Sink `� 16 60 the dwelling and the first100 ft. QTY (ea) AMOUNT 16.60 for each utility connection) - Lavatory _ OnJ1)bath $249.20 _ Tub or Tub/Shower Comb. 16,60 Two(2)bath $350.00 Shower Only 16.60 Three 3 bath $399.00 -"-'- Water Closet 16.60 SUBTOTAL Urinal 16.6-0 8%STATE SURCHARGE Dishwasher - 16,60 PLAN REVIEW 2_5°1.OF SUBTOTAL TOTAL Garbage Disposal 16.60 -- Laundry Tray 16.60 Washing Machine16.60 Floor Drain/Floor Sink x' _ ,sso _ PLEASE COMPLETE: 3^ 16.60 4^ 16.60 - Water Heater O conversion O like kind 16.60 _ Quantic _b Work Pertormed Gas piping requires a separate mechanical Fixture Type: New Piluved Replaced Removed/ Capped ermit. r--- MFG Home New:Nater Service 46.40 Sink _- MFG Home New San/Storm Sewer 46.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 l;ombination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fixtures(Specify) 16.60 Dishwasher Garbage Disposal Laundry Room Tray Washing Machine _ Floor Drain/Sink: 2" Sewer-1 st 100' 55.00 3^ Sewer-each additional 100' 46.40 4- 1 -. -• Water Service-1st 100' r 55.00 Water Heater Other Fixtures Water Service-cacti additional 200' 46.40 _ (Specify) _ Storm&Rain Drain-1st 100' 55.00 - Storm R Rain Drain-oath additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device" 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 62.50 Requested Inspections er/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 _ Grease Traps 16.60 QUANTITY TOTAL - _- Isometric or riser diagram Is required If Quantity Total la >9 *SUBTOTAL 8% -- 8%STATE SURCHARGE - "PLAN REVIEW 25%OF SUBTOTAL - Required only if fixture qty tot."l Is>9 _ TOTAL S "Minimum permit fee is$72 50•8%state surcharge,except Residential Backflow Prevention Device,which is$36 25+8%state surchmge "All New Commercial Buildings require 2 sets of plans with isometric or riser diagram for plan review. I:\dstslforms\plm-fees.doc 12/26/01 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BLIP — Received - Date Requested_ -� AM -__ PM—_--_ BUP _ Location -4 -hl �_I 4, Suite_ MEC Contact Pe son _. --_— - Ph (- ) 3 ��PLM - Contractor— ---- ---- - - - Pt' j --- -- ) SWR - BUILDING Tenant/Owner _ __ _ -- -_ ELC Footing E L C Foundation Access: /?f Q Ftg Drain k -1 ( ' ELR - ------- Crawl Drain --- Slab Inspection Notes: —rte SIT -_ - - -_ - Post&Beam - - -- - ---- - --� :� Shear Anchors Ext Sheath/Shear �"� C 3 - Int Sheath/Shear Framing - - - Insulation li t`� Drywall Nailing lU Y1`i • Y"' �1 -- Firewall Fire Sprinkle Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL P_LU_MBiNG --_ Post&Beam Under Slab - -- -- Rough-In Water' 3rvice Sanitary Sewer Rain Drains -! Catch Basin/Manhole Storm Drain Shower Pan Other: Final _ PASS PART _FAIT_ MECHANICAL -- - Post& Beam Rough-In - - Gas Line Smoke Dampers ---- Final PASS PART VAIL ELECTRICAL Service Rough-In UG/Slab Low Voltage Fir Alarm PART FAIL Reinspection fee of$r_ - _required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. s,T Please call for reinspection HE: Unable to inspect-no access Fire Supply Line ADA Approach/Sidew?" DOW �� - Inspect®r -_Ext —_ Other:.__- rinil DO NOT REMOVE this inspection record rom the 196 site. 'SSS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Date Requested //JJ _ AM— PM -__- BUP -_ Location ___ YtJ �' kp _,Suite _�� MEG _- Contact Person __ __ �� ,�. Ph(—) 7 4> S L PLM Contractor_ - _ Ph(_—) SWR -_ BUILDING TenantlOwner _ _ _ __. ELC Footing Foundation Ac� ELC Fig Drain C= ,(),/ ,/ — `— ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/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 Shower Pan CEW PASS PART FAIL -- ANICAL 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 next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call!or reinspectlon RE: - —_ _ n Unable to inspect-no access Fire Supply Line ADAQi Approach/Sidewalk Qete -�+-- ` Inspectorf� z r_ Ext Other:_ Final DO NOT REMOVE this hispeGtion record from the Job site. PASS PART FAIL J CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Lina: (503) 639-4171 MSTh 's' ! BLIP Received ___--Date Requested— 2 AM—___ __ PM —._- --_ BLIP -- Location D CJ 'YI,_. CZ�� , suite _�.L,....._--- MEC Contact Person — �,� �. _ Ph(—) _7 PLM Contractor _. Ph( ) _ SWR _ BUILDING Tenant/Owner -- -- - ELC -- Footing Foundation ELC Access: Fig Drain FLR Crawl Drain _ �� -- - - -- Slab Inspection Notes: � / SIT Post&Beam Shear Anchors ------ ---- Ext Sheath/Shear 21 q - Int Sheath/Shear - Framing .t?ar-tOdds. Insulation Drywall Nailing - 1�Sc�4AZ ___.ni'�t�«.�� u�%••JrTUi?JL - 4 E Firewall Fire Sprinkler �� =- - --------- - -- - Fire Alarm Susp'd Ceiling - ------------— ---_ Roof Other: - ----- -- - -- - --_-- nAIP - - - ILIQi lL_ FAILI N a_ Post&Beam -"--- ------_�._._.-. �.---�-----_—..-._ Under Slab Rough-In Water Service - --.------- .--- -. -- -- - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain - -- --- --- - ------ Shower Pan Other: Final --- PASS_YA1G_ FAIL.Mg --- --------- -- -- - --- ----- CHANICAL Post Beam -- Rough-In --- --- --- ------ -- --- Gas Line Smoke Dampers --- -- ----- --_ _ -_--_ ASS PART FAIL -- ----- --- - - ELECTRiCAL Service Rough-in -- U' Slab Le Voltage -_-- Fire Alarm Final Reinspection fee of$ required before next ins PASS PART FAIL --- q pection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reinspection RE: _ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Daft- ``-Q - Ilnswwtor �- __- - Other: Final DO NOT REMOVE this Inspection record from the job 911te. PASS PART FAIL n H r C O a " o Con E5 � n � o n n � n r F f� O d