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14125 SW MITCHELL COURT ^ i13HO11W MS 5ZM i i v J J W d = V N � N N J � r 14125 SW MITCHELL CT CITY OF TIGARD _, MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT 0: MEC2005-00017 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 1/11/2005 PARCEL: 2S 104BC-07900 SITE ADDRESS: 14125 SW MITCHELL CT SUBDIVISION: HILLSHIRE CREST ZONING: R-7 BLOCK: LOT:001 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS WIO APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: 3 - 15 HP: COMML.Ih'^IN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30-50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS HER UNITS: FURN >=100K BTU: <= 10000 cfm: OTHER > 10000 cfm: GAS Remarks: Replace furnace&install air cleaner. Owner: FEES HINDMAN, GAVIN Description Date Amount 14125 SW MITCHELL CT [MECH]Permit Fee 1/11/200`. $72.50 TIGARD, OR 97223 [TAX]8%State Surchaq 1/11/200,1 $5.80 Phone: 503-521-1390 Total $78.30 Contractor: OREGON HEATING + A/C INC PO BOX 397 DUNDEE, OR 97115 REQUIRED INSPECTIONS Phone: 538-2953 Mechanical Insp Heating Unt Insp Reg#: LIC 125815 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 oS i-,suance, orf work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-6699. Issued By: y � ,�f Permittee Signature: Call(503)639-4175 by 7:00 P.M.for Inspections needed the next bus Less day Jan 11 05 02: 04p 503-537-2172 p. 2 01/11/'4005 13:41 FAA *U3:)Ud1Va0 t.iit Err .�au ���• EI\ 0 60S^537-2171? P Mgchanic9". Pe it R"4.d City of'lllg'drd n. ll� oe 1)t25 cW 14411 t/t.d.,:.ipard.oft 0 ]2) •`wra Rads• t)trs•sndr ; Ptxm;. 303.6"AI71 FAX: 30].5911.1910 1� 20Q5 4y, Irtipt:Clktn line 30.63'1.1173 /JAM 11 '"' a..1•.•lr« /� eepplr.�uulld•rwdn• i h n.rnc,r wn.v.uti�rsl.o+.us — , COMMERCIAL FEE• 11CRILK'LC - VIE:CHECKLIST Meelfaniad/leant face*an;bYY. an lite value 0f tlr verk (,Kew co"U uetion tion4lierlttion/ncribeemOnt pcfbnitC.Imli�mr an value(rnuntkd to lht:rteutvr dnllarl-trail ❑ Demolition ❑ Other: MW runieal 11'Nler 0&mpro"urnt,labor.--f-d.and?raGl __ __17A . TKGOKlf OF COtOMtW-nO" 1RIZSIDHJV7IAI.EQL'IPMIRYI'I9V6YE�tS�Yi5• L'J I.and 7_fpntily dwellins ❑camntereiallinduarial ❑Aeeesa"building For c*1 rwnnrlen air rwleetllo. ❑Multi-family [I Mester builder Cf!)Eitel: Rntp oa tory.- Pa. Tow/ J JOB Gym &m V1 1)CATI074 MCMI oeaRa _ _ 741 �— - -- A. Air lond(tioaYts Art heal Pante Job site addrm, }a aeeq_ 1!.110 Fterrtaos I OO,p00 D ill Ivwr.•rra I4.UV CityrStaNZIP _ furMtt 1 TU low—, !14 Ssitebldgiapt.rto.: 1 Ptojrstntltrtr Aehat Cross sttaet7dirateiorrs to job aMc: Dee WWW -- }( ie hat water emr.Arnr better(radamorrunic heatm litel-type.nor=fne), -.rel �nwfgC,sat�aMoO.a .Flwrrnt abr/ye Subdiviei0n _ -- Otfiar Tax rnep/petrcel no. - Ester far apeie c—m PESCRtMUN OF WORK - - Water Itnlri _ IQ.OU _. - _— Und nrminc 140D ZAP— Flue vert or tenter header or cm - - � � � N Yea 10.00 J 4 _ -� A Iryltllr spa - 10,00 W IYI 1pv 1000. --� - - Wood fi WL 1000 Chiaatt�f1waflWdvaat :0.00 . 1Pr3TTY OWMR ❑ TiIIAYtT 0111411 Name: _- tavinarReelel ea ini t aad"adlaalsa R cme may~kttchm AdrlrrSe: L flrnl IO.M CityrSlatci7.IP. �. Clothes dryareelrrrl IDOn -- -- 8i"le duct erbsusl(Mtl.ree..Y. Pkon -` 6 Fax:( ) - toike CWV4rvnnra,alit/ roans 6.90 T PM[GVT _ �[] T Othwer?1 Odw-nerYpaeelhue It1.10.Ot1u Elusintstname Fad p4ons CnntncI na 01br Hest foam CIA thr Mcg addlriamal Frnam mc. A ildn`sc Gd brat punT City+Sutr�P: 34 t WaWtuelmdedhink hemr waler limler FkDlacu Q E-mail: COI+TRACT011t - H rlueinces name: MA . /?Eller• �. nddrx-u M'IIUCHAMCAL PERMIT IFERS• n Ia. ----• tY/ �' _ SuMolal City'SUtCZ!P i- Mlni m rn perimi fes(117.30) mPhon Iden review. 2S%M'perrnifree) 0 CCH lie. Burr etsekr�aluxof permit tial W TOTAL.Pe12MTT F7ir•. Aulhoricedai N _. •nere+r+e—r PrkrettM+rOere.ee•t.r.a.�.., .�.. ole Ela rE� Data: O F�1ntTFNoleey ser hr Tri-Ce+.tc RtriYFnr Iwu�.ry Sen L•r tl�uN P*rL—"t nerve: _ . ~ CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2005-00036 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 2/112005 SITE ADDRESS: 14125 SW MITCHELL CT PARCEL: 2S104BC-07900 SUBDIVISION: HILLSHIRE CREST ZONING: R-7 BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: Ol-R GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 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: Replace water heater. Owner: FEES Description Date Amount HINDMAN, GAVIN 14125 SW MITCHELL CT [PLUMB] Permit Fee 211/2005 $72.50 14125 S, OR CHH [TAX] R%State Surcharl 2/1/2005 $1,180 TIGATotal $79.30 Phone: 503-521-1390 Contractor: OWNER REQUIRED INSPECTIONS Phone: Plumbing rough-in Plumbing final Reg#: K J o This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. U Specialty Codes and all other applicable laws. All work will be done in accordance with approved J 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 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued By: i 2Znr Permittee Signature: -Q. Call(503)639-4175 by 7:00 P.M.for an Inspection needed the next bus n as day Feb 01 05 11 : 30a 503-537-2172 P. 2 F06-02-05 03:01A ORL 609 324 93GO P.01 �•• ,. vea , , :eu 503-537-2172 � r.2 YIfD�illDg penrlit ion City of Inv TAW rswirstl• Addmx- 13121 5 s.� OR sawresew s..: ltrldinR rentrN so.: r.�y"Jr "'� P'houe (503)iiwo. - _--_-- - Fs••(SQ)) 591t•1 ^\ !O 6swn der: A � 1. ') DNe heed: :Ml��Rn^el�e rw: Land use approval: y `�S t'1lv�{ car 6r.we.r MSM,, 1 R 2 bmay dw ding or woeiahsy ealstrial a lufult;fae►u Y eEJ Te neat .v orseancteoa eltertiao/rgplaeeaaeet O Food sa vitt U Otter: �Pu+remeas lob ttdthsn: BJdq.m.: WnO.: ata/d Fee EL 7sAi 7-u_as�/t.0 bdwrnrnt eo.: A�nbls Iea n,fwrw�MlY1y eMrsA�i La. Block Ssthd►witse 4fR i hath "Iva norm, SUN Catch llnmhtas drabs Hat. ofc 'sail etiote: wlt�r/traa�_T..' -. Busmras some. Addrs►s:� 7�s�r�•-• rl+atT�e�jtc(a--._"�..____ --- Cify Sa T1 •t�J �m�. ` f Fax: -I E�- OfDllalMiCr aO_10. C(M Be.: `-�anb.bus,r aa: asersRmLv w. City/aetrp YC.a0.• __ __ �L*MV*d #1I c_onM+luUe'� e�resaabsivesi`As[We`_� _"'".- Msssja Yah/C ..R'int UNI '- Tool;.'—' - _- gW"-plCVeyger Qsdenrstsr vdvs _ _ Address- --- r -- State 121P: ei fuc stall: B[ w wank fit]-th—ft—/tt-ya+N-ter-C-� M_ut !: c Ice rhene: Felt _ E-mail: Urnaer usrelbstla✓eesicleutiv dwr. The"Ild llnun" V" be nude by err nr the("An nwrt eau �s tepuir rttade 63 try regular empteyec on the"City 1 mm s• ORF Chapter N7 Owows si Da1C dtgQ .. Nsmr. Addrae; - -�-- — Mea - City _._�L-`i6¢ LIP: rurr lct - --- Phone. --^ F.F. -�.^- Ab !av.0 1«++ewM/p.wwr w.Aii +.►.rtnw ua trrAFtw.F,-"- 'M„w�,�.� klnti team s U vw, O Ma..u(.fd `IwNoe: 'TIP, Pe+*Mt epplipliaw rtc....-..•-- _. r..��.a...►.� I expin a it'a permit U Aa aMsiwxs Plan inview(it %) S 190 dsv i eM d hoe bees 'Suit eun:han;c :) ..S �+ 1!*'I'rlL......._.... ..._.....a' .••��, S secei*aJ n�e.+RpMe 30F law -M►M.7A�Iy1R!'nMt CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)6364176 INSPECTION DIVISION Business Lim: j503)639.4171 MST BUP Received — _Date Requested 2 — A.M-_�V PM SUP _ Location _.� � ��� _Suite MEC Contact Person Ph Contractor _6�vPh(—) `s��_a9S� SWR BUILDING TenanUGwner .____ a .S21 ELC Footing ELC Foundation Access: Fig Drain ELR _ Crawl Drain - — -` Slab Inspection Noten- , SIT Post&Beam -- Shear Anchors - Ext Sheath/Shear %it Sheath/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler -•-- —_ __ Fire Alarm Susp'd Ceiling -- —� Roof Other: — Final - PASS RT FAIL f-IM1111391W — ( �L :z Post&Beam Under Slab r , 111 Rough-In W �l Water Service - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain — Shower Fan Other: - na WS/PART FAIL MEWANICAL _ Post&Beam Rough-In Gas line IL Smoke Dampers _ Final N PASS PART FAIL -- -- — ELECTRICAL Service Rough-In m UG/Slab �- WLow'✓oltage ---- - --------- __m -j Fire Alarm Final Reins tion fee of$ required before next Inspection. PASS PART FAIL P� ^peMion. Pay at City Hall, t 3125 SW Hall Blvd. SITE — Please call for reinspectlon RE: 0 Unable to inspect-no scam Fire Supply line / ADA 9 IS U Approach/Sidewalk Dab- Ext Fetor�_ _= Other: Final DO NOT REMOVE this Inspection record from the job WNW. PASS PART FaY CITY OF TIGARD 24-Hour BUILDING Inspection Line: "175 INSPECTION DIVISION Business Line; MST _ �V BUR Received __ _ Date Requested - AM PM._ OUR Location ___! �� _Suite 1 -7 Contact Person _ _ Ph(—) g c;125 3 PLM — Contractor _ -- Ph( )kft:t-, SWR BUILDING Tenant/Ow�neeer ,ZtvA,, � _ 13 1 d _ ELC Footing Foundation ELC Access: Ftg Drain �_-------- -., ELR _ Crawl Drain Slab Inspection Not ��,� 1, SCT . Post&Besm _ Shear Anchors Z_ Ext Sheath/Shear _ Ir,t Sheath/Shear �- Frsming — Insulation Drywall Nailing - — — Firewall Fire Sprit,kier -— - Fire Alarm Susp'd Ceiling ------ -- Roof Other: -- - Final PASS PART FAIL `- PLUMBING _ -- Post& Beam Ur!jer Slab - Rough-In Water Service — Sanitary Sewer Rain Drains - -- - Catch Basin/Manhole Storm Drain - Shower Pan Other: - Final PASS FAIL M HANIPA --- _-- -- —_ —, __ Post Mam t71 - Rough-In d Gas Line Smoke Dampers ------- - - ---- - - - N '"- PART FAIL - --- - --- - - THICAL. -' Service --'- - - -— -- m Rough-in � LIG/Slab J Low Voltage Fire Alarm Final F] Rei -lion fee of$__�.^.-_—_required before tiext inspection. Pay at City Hall, 13125 SW Hail Blvd. PASS PARV FAIL SITE [] Plw for reinspection RE:__ _ �_ - �_ -� ___� Lj Unable to inspect-no access Fire Supply LineADAC ,�/� Appiiudul't/Sldewalk Do"—- -- - 111spoow- t z - Ext-.- NN Other:_ Final J DO NOT REMOVE this Inspection record from the job elle. PASS PART FAIL CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2003-00574 A.6 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 11/4/03 SITE ADDRESS: 14125 SW MITCHELL CT PARCEL- 23104BC-HC001 SUBDIVISION: HILLSHIRE CREST ZONING. R-7 BLOCK: LOT: 001 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: )RIES: WATER HEATERS. CATCH BASINS: ..TUNES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install 100ft or less of line work to connect existing residence to sewer lateral. Septic tank is to pumped and filled or removed. _ Owner: FEES _ Description Date Amount RIDGECREST HOMES 6600 SW 92ND AVE #210 (PLUMB] Permit Fee 11/4/03 $72.50 PORTLAND, OR 97223 ITnXI 8"G,State Surcharl 11/4/03 $5.80 Total $78.30 - Phone : 503-246-9909 Contractor: CRAFTWORK PLUMBING INC 7736 SW NIMBUS AVE BEAVERTON, OR 97008 REQUIRED INSPECTIONS Sewer Inspection Phone : 644-8698 Final Inspection Reg#: IA' 79666 PI.m 20-1491113 IL R U) This 7)ermit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. W Specialty Codes and all other applicable laws. All work will be done in accordance with p y pp 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 rule adopted b the Oregon i Issued By:��- €L,�f�—C�-�.c_� . = Permittee Signature: Call(503) 639-4175 by 7:00 P.M. for an Inspection needed t next bus es day Building Fixtures Plumbing: Permit Application .�, Received � Pmmbing Date/13 : 1 3 Permit No_? -CO 7 Planning Adti al Sewer City of Tigard RECEIVED Date/By: Permit No.:`7i,Jtzacy_,3_cz,396 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 NOv ' Date/By: Ptrnit No.: - Phone: 503-639-4171 Fax: 03-514 Post-Review Land Use DateBy: Can No.: Internet: www.ci.tigardMa 24-hour Inspection Req Contact l ris.: See P,ge z ror� 1 'ON Name[Method: Su elemental Information. TYPE OF WORK FEE*SCgMME tfor W Inftirmitlon,wo New construction Demolition Description Qty. I Feetea•1 Total Addition/alteration/re lacement Other: i ew I-&2-fank4 dwdll�t - CATEGORY OF CONS'T'RUCTION ada a IM D'ba each a I & 2-Family dwellingCommercial/Industrial SFR 1 bath 249.20 -�-`- SFR 2 bath _ 350.00 Accessory BuildingMulti-Family~ SFR 3 bath y 399.00 Master Builder Other: Each additional bath/kitchen 45.00 !OB SITF IM (UtMATFON and LOCATIONFire s rink!er-1q. ft.: Pae 2 Job site address: /L/ZS 1/ 14e1rL_ eZ_c 707-- Sits Ute+ Suite#: Bldg./Apt.#: Catch basin/area drain 16.60 Project Name: - �f`j Dr ell/leach line/trench drain 16.60 FootiCross street/Directions to job site: Manu drain no.linear ft. Pae 2 Ja/1fi�e�ti T/(1 / 1 G� Manufactured home utilities 116.60 7 ',/ Manholes 16.60 /K/7-L'X1�t- Rain drain connector 16.60 Sanitary sewer no. linear ft. zoo Pae 2 r O Subdivision: Lot M Storm sewer no. linear ft..) Tax map/parcel#: Water service(no. linear ft.) iI Pae 2 DESCRIPTION OF WORK fb tare or Item Absorption valve 16.60 Backflow prevcnter Pae 2 Backwater valve 16.60 Clothes washer 16.60 --- - Dishwasher 16.60 Drinkingfountain 16.60 PROPERTY OWNER TEN T Ejectors/sum 16.60 Name: i L DM _ Expansion tank 16.60 Address: v _ z/O Fixture/sewer ca 16.60 Cit /State/Z _ ?_3 Floor drain/floor sink/hub 16.60 e�YGarbage dis osa! 16.60 Phone: J 2 ,, -&q" I Fax Hose bib 16.60 _ APPLICANT I LICONTACTPERSON Ice maker 16.60 Name: Interceptor/grease trap 16.60 Address: Medica!gas-value: S Pae 2 City/state/Zip: Primer 16.60 -- Roof drain commercial 16.60 Phone: Fax: Sink/basitvlavato 16.60 E-mail: Tub/shower/shower pan 16.60 CONTRACTOR Urinal 16.60 Business Name: k Water closet - 16.60 ' Address: Water heater 16.60 � Z J'� i1/iM - Other, City/State/Zip: i 7Ca F� Other: ^`- Phone: Fax: Plumbing Permit FeW CCB Lic. #: Pl mb. Lic.#: 00-19'3pe Subtotal S Minimum Permit Fee 572.50 $ Authorized �/� Residential Backflow Minimum Fee$36.25 !Z' . 0-0 Signature: Date:,/1_ _1 Plan Review 25%of Permit Fee S State Surcharge(8%of Permit Fee) S iP rase print name) TOTAL PERMIT FEE S Notice: This permit application expires If a permit Is not obtained within All new commerclel buildings require 2 sets of pons wlth Isometric or 180 days after It hai been accepted as complete. riser diagram for plan review. 'Fee methodology set by Tri-County Building Industry Service Board. i�Dsts\Permit FormsTImPetmitApp.doc 01/03 Plu-4ing.Permit Application - City of Tigard Page Supplemental Information Fee Sch dule: Residential Fire Suppression Systems: _ Site Utilities Qtr. Fee(a) Tow Square Footage: _ Permit Fee: _ Foolingdrain I°VX)' 55.00 0 to 2,000 $11500 Footing dram ___Nch additional 100' 46,40 2.001 to 3,600 $16000 Sewer- Is 100' 55.00 (u 3,601 to 7,100— $'120.00 — 7_201 and ater__ $309.00 Sewer-each addu nal 100' 46.40 Water Service- Ist k1o, 55.00 Medical Gas Stems: Water Service each ditional 100' 46.40 Valuation: Permit Fee' _ toren& Rain Chain- I t 100' 55.00 $1.00 to$5,000.00 Minimum fee 572.50 _ Storm&Rain Thain-ea3k additional 100' 46.40 $5.001.00 to$10,0X0.00 $72.50 for the first$5,000.00 and 51.52 for each (Fixture or NM Qty. Fee(a) Totai additional$100.00 or fraction thereof,to and _ Commercial Back Flow Pre including$10,000.00.tion Device 46.40 510,001.00 to 525.000(N) 5148.50 for the first SI0,000.00 and 51.54 Im Residential Backflow Preventi Device each additional$100 00 or fiaction thereof,to minimum pernrit fee S36 25 27.55 and including 525,000.00. Rain Thain,single family dwelling 65.25 525,001.00 to 55(1,000 00 5379.50 for the first$25,000.00 and 51.45 for Inspection ofexisting plumbing or each additional 5100.00 or fraction thereof,to specialty requested inspections-per Ito 72 50 and includi,ig$50,000.00. Subtot 550,001.00 and up $742.00 for the first 550,000.00 and S 1.20 for each additional 5100.00 or fraction thereof. Fixture Work: Are you capping,moving or replacing existing tures? If "Yes",please indicate work performed by fixture, allure to accurately report fixtures could result in increased war fees*. usatity b (Fix re)Werk Peri ed Comments regarding fixture work: Fixture Type: Rylaee New Mead _IdUbs C Ba tis r /Font Bath -Fuh/Shower _ -Jacuzzi/Whirl it Car Wash -Each Stall -[hive 11rru — Cus idor/Water Aspirator Dishwasher -Commercial -Domestic Dunkin rountain Eye Wash Floor Drarn'srnk 2" `-- .4„ Car Wash Drain_ Ga,hage -Domestic *Note: If the i ure work under this permit result-i in an a Dislx,sal -commercial _ -'— n..!rease of sewer Us,a sewer permit will be issued and Of -Industrial fees assessed for the Wer increase must be paid before the Ice Mach./Refri .Drains plumbing permit can b ssued. Oil Separator Gas Station — Rec.Vehicle Du Station _ ..i Shower -Gang m -Stall (; Sink -Bar/Lavatory J I -Badley Commercial -Service -SWIMMIFIg Pool Filter Washer-Clothes Water Extractor Water Closet-Toilet _ Urinal Other Fixtures i:\Dsts\Permit FormsOmPermitApplag1cloc 01103 CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2003-00385 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 11/4/03 PARCEL: 2S 104BC-HC001 SITE ADDRESS; 14125 SW MITCHELL CT SUBDIVISION: HILLSHIRE CREST ZONING: R-7 BLOCK: LOT: 001 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: SF NO.OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for existing dwelling. Owner: FEES RIDGECREST HOMES Descrlptlon Date Amount 6600 SW 92ND AVE #210 - — PORTLAND, OR 97223 [SWUSA] Swr Connect 11/4/03 $2,400.00 (SWUSA]Swr Connect 11/4/03 $0.00 Phone: 503-246-8808 [SWINSP]Swr Inspect 11/4/03 $35.00 [SWINSP] Swr Inspect 11/4/03 $0.00 Contractor: Total $2,435.00 Phone: Reg#: Required Inspections Septic Tank Filled a a Im This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180 Wdays from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee -� the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"TO) and Side ewer" Perm i Issued by: Permittee Signature: Call (503)639-4175 by 7:00 P.M.for an Inspection needed*next business sy �� FROM CLOPTON EXC. (TUE)NOV 11 2003 10:27/ST, 10:26/NO. 6305523713 P 4 . , t FROM FAX No. Nov. 10 2003 03:15PM P3 ICE dlettitlitlll s .r v &MAW" ' LOA O►IAZW— OM AOOT. ��nlfl+p_ �AIO 01lT 1 f , t I j TAX ' T4L . f uor br ne tulMe Iy IthY bA' '— re,,,Pwoww. , THANK YOU CITY OF TIGARD 24-Hour BUILDING to Inspection Line: (503)639-4175 INSPEC710N.DIVISION Business Line: (503)639-4171 MST _— BUP _ _— Received __ Date Raquested 11-7 AM PM BUP Location _ 1 y l.'LS 1�l i'�C. C0 V-1+— Suite MEC Contact Person D � _ Ph(--) m'-&D !j-6Sw PLM _ 3- ©o E7 Contractor — , Ph( 1 SWR BUILDING Tenant/Owner _ __ ELC Footing ELC Foundation Access: Ftg Drain ELR _ Crawl Drain FIA Slab Inspection Notek� �w w t +� � S17 Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - --_ Insulation Drywall Nai'ing �Xr Firewall Fire Sprinkler --- Fire Alarm Susp'd Ceiling Roof r Other: Final PASS_-PART FAIL -- -- --`--'-~- PL Post&Beam Under Slab Rough-Ir Water Service -- --- n tary�ew'�_ r? Ram rains J -- - --- - Catch Basin/Manhole Storm Drain - Shower Pan Other: UPVCS PART FAIL ANICAL Post&Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL --- ELECTRICAL SerVIC9� — Rough-In —, UG/Slab Low Voltage Fire Alarm Final Reins ction fee of$ PASS PART FAIL � � - required before next ins pection. Pay at City Hail, 1312E SW Hell Blvd. SITE _ _ Please call for reinspection RE: __ _ _ Unable to inspect-no access Fire Supply Line ADA - Approach/Sidewalk �Asp�CtOr btu -- Other. _ Final DO 40T REMOVE this InspoWon rmord from the job sib. PASS PART FAIL