Permit CITY TI ARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2004 -00178
. ;'6 " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/26/2004
SITE ADDRESS: 07357 SW BEVELAND RD PARCEL: 2S101AB -01606
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT: 017 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 2
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 3
TUB /SHOWERS: SEWER LINE: 50 ft
WATER CLOSETS: WATER LINE: 250 ft
DISHWASHERS: RAIN DRAIN: 50 ft
Remarks: Site utilities for new office building. Other fixtures are (2) manholes, (1) rain drain connectors and 200' of
footing drain.
FEES
Owner:
Description Date Amount
TOM CLARKE
12448 SW ORCHARD HILL RD [PLUMB] Permit Fee 10/26/2004 $442.20
LAKE OSWEGO, OR 97035 [PLMPLN] Plan Review 10/26/2004 $110.55
[TAX] 8% State Surcharl 10/26/2004 $35.40
Phone : 503 293 - 1226 Total $588.15
Contractor:
HOLLINGSWORTH PLUMBING
13624 DUANE ST
OREGON CITY, OR 97045 -2869 REQUIRED INSPECTIONS
Phone : 503 Sewer Inspection
Water Service Insp
Reg #: LIC 65325 Storm Drain Insp
PLM 26 - 324PB Crawl Drain
Rain Drain Insp
Final Inspection
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 -0100. You may obtain copies of these rules or direct qu io o by calling (503)
246 -6699.
Issued By: - 3 As Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Site Utilities c (tk jo3 -poo Ilp
Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard Receive a 6 v 11 Permit No.: , �,^ "v 1
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C/
Phone: 503.639.4171 Fax: 503.598.1960 �� ' , ;I� Date/By: / 0 / I 0 t.( 1-0 Other Permit No.:
24- Hour Inspection Line: 503.639.4175 ,_.dj c! i Date Ready /By: �Juris: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: I (/y Supplemental Information
TYPE OF WORK FEE* SCHEDULE
For special information use checklist.
® New construction ❑Demolition
. Description 1 Qty. 1 Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling W Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family
SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: S--) s..J R. v� � 12-8. Catch basin or area drain 7 16.60 33 . .•D
City/State /ZIP: -[-I '/ q iz:b O R. _ Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: � Footing dram (no. linear ft.: 2. O) Page 2 Ay. Vd
0.4,4421q.._ or t -'- � Manufactured home utilities 1 10.00 !!
Cross street/directions to job site:
Manholes ' 16.60 33. ,
Yi.._14,...x) - 12. -6 Rain drain connector ( 16.60 g
Sanitary sewer (no. linear ft.: 5) Page 2 ( 6 • D
Storm sewer (no. linear faCT) ) Page 2 1117. CO
Subdivision: Lot no.: Water service (no. linear ft.: 5r.3) Page 2 -iO
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
�/ `t ES Clothes washer 16.60
51.9--c- Dishwasher 16.60
RI PROPERTY OWNER 1 ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: -1-p,- - C L at'- Expansion tank 16.60
Address: 1 4 4 0 S, , , j O Z , � h / A r � � 4 , L . , _ _ 2-4.. Fixture /sewer cap 16.60
City/State /ZIP: LAKE.. C9a-..,e__4 p , Dia, 9 7 p33-- Floor drain /floor sink/hub 16.60
Phone:$03 ) "7 53.- 2_4, 7_i Fax: (53) Z5 .- /S"3 C.. Garbage disposal 16.60
R APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: �I Y .-,0•f G+ ..:7::) C v, ¶TQJLTI tn.> C o OG
ce. Interceptor /grease trap 16.60
Contact name: -r C LAZ t- Medical gas (value: $ ) Page 2
Address: 1 -Z 4 4 8 S p �.c I'f'Ajzzb H I L Kb Primer 16.60
City/State /ZIP: /...."14e_ dSt�E�a t D2 97 0 Roof drain (commercial) 16.60
293
Phone: (6p .2 ) 2_53 ._ / ZZ4. Fax: : ( - I _ i S3 Sink basin /lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Water heater 16.60
Address: Other:
Subtotal
City/State /ZIP: Minimum permit fee: $72.50 ' 20
Phone: ( ,', ) Fax: ( ) ( - Residential backflow minimum permit fee: $36.25 '�`�
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) //O • 56
State surcharge (8% of permit fee) 36', '(D
Authorized signature: 1 ..- S 1/ TOTAL PERMIT FEE 3$8. /5
Print name ..i . M4aD130„,,u� Date: 4 0i/ 04 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i:\Building\Permits\PLMU- PermitApp.doc 12/03 440- 4616T(10 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1' 100' 55.00 53: 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 • 00 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' / 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' / 55.00 55-00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 55-,or, $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 9a,$0 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Q ty. Fee (ea) Total additional $100.00 or fraction thereof, to and
Fixture or Item including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
Fixture Work:
Are you capping, moving or replacing existing fixtures? If
"yes ", please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * .
Quantity by (Fixture) Work Performed •
Fixture Type: Replace
New Moved Existing Capped Comments regarding fixture work:
Baptistry/Font
Bath - Tub /Shower
- Jacuzzi/Whirlpool
Car Wash -Each Stall
-Drive Thru
Cuspidor/Water Aspirator
Dishwasher - Commercial
- Domestic
Drinking Fountain
Eye Wash
Floor Drain /sink - 2"
-3"
-4 „
Car Wash Drain
Garbage - Domestic
Disposal - Commercial *Note: If the fixture work under this permit results in an
- Industrial increase of sewer EDUs, a sewer permit will be issued and
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
Shower -Gang
-Stall
Sink - Bar /Lavatory Quantity Total
- Bradley Isometric or riser diagram is required if fixture quantity
- Commercial
Service total is >9.
Swimming Pool Filter
Washer - Clothes
Water Extractor Plan Review
Water Closet - Toilet Plan review is required if fixture quantity total is >9.
Urinal
Other Fixtures:
i:\ Building \Permits\PLM- PcrmitApp.doc 3/03
CITY TIGARD PLUMBING PERMIT
..I DEVELOPMENT SERVICES PERMIT #: PLM2004 -00177
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/29/2004
SITE ADDRESS: 07307 SW BEVELAND RD PARCEL: 2S101AB 01604
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT: 016 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES: 4
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 4 WATER LINE: 75 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Building plumbing for new office building.
FEES
Owner:
Description Date Amount
PAT GILROY
5100 SW MACADAM AVE SUITE 240 [PLUMB] Permit Fee 11/29/2004 $287.40
PORTLAND, OR 97239 [PLMPLN] Plan Review 11 /29/2004 $71.85
[TAX] 8% State Stu 11/29/2004 $23.00
Phone : 503 225 - 5559 Total $382.25
Contractor:
HOLLINGSWORTH PLUMBING
13624 DUANE ST
OREGON CITY, OR 97045 -2869 REQUIRED INSPECTIONS
Phone : 503 Water Service Insp
Underfloor /Underslab
Reg #: LIC 65325 Top -out Insp
PLM 26 - 324PB Final Inspection
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 -0100. You may obtain copies of these rules or direct quest . . OU ►, b -fling (503)
246 -6699.
Issued By: Permittee Signature: .1 v _
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed th•Wxt business day
,F e
Building Fixtures rn \
tP Permit Application ��
icat r1��4 FOR O FFICE USE ONLY •
City of Tigard Received
�(i y� 1+ � PZi Permit No.: 1312SW HaBlvd., Tigard, OR 97223 [ 1 C? � - Phone: 503.639.4171 Fax: 503.598.1960 \ Other Permit No.:
, `.� O v �c t //yir �Vi�l� � �� Date/By: WI / ° i � oy �J
24- Hour Inspection Line: 503.639.4175
CA
1 �G � � ` � �! ��
Date Ready /By: ` Jut' ' m See Page 2 for
Internet: www.ci.tigard.or.us e V\-- Notified/Method: /Vy A • ,a 1 Supplemental Information
kPN' ;�tjc ;''q6:.,, as sq ,
? ; } e� � r "� , ` � SC ; ,
,. :.
� a ltza,., r4y���a�lr"*f P � fiTYPE,OF WORI{a "�!r, �: >,1d J .. ,> W .'/ � =�1:,, � = ^ �
�.i, ti �': -. ° x� . n• f3'a� s�.��si= ''�t'e: sa.:. rr � �,�-- � :� � � � sin+. _< _ , F. , _ _ '
1 g New construction E] Demolition For special information use checklist.
Description i Qty. 1 Ea. i Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family *dwellings (includes 100 ft. for each utility connection)
'•;�;Ei: ��+'.:',�',± ` "�`- ,.k��'"n evca�.�s:.n,g =ser.� ra.� -a �e�u •:;saat•; ._�.�•c:as;:. - �tt�� ,,
`_ y ; y `r• ra " *�� r tEl Cs ATEGO 9NS ` 'r' s= 'mt SFR 1 bath 249.20
t : +Yn't�� i`:1.-t.3ilN§�k�. : -azo..Li3�..:1F....+F.i;.':,: ,ir ..!SE' '. i,,, .,,, R �� . ,,, N 'f�i.':. ': .. e ..; ...,. ( )
❑ 1- and 2 - family dwelling yj Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
�
t: ? "��'�: n, -y �s`.e ^mss: t�;s -_ :,> > '�: +.:.� �,� =�.�:2r.,�6!s�rr� ;«'�� " 4��r<;: a:. dr, :, zrwe'5:i: *�;a ?:>;1 :� u r; ;:rli��,` : ""G"�.�;v '
k r JOB ` SIT E i KiiiRMATI LOCAT
t , y° "; . t ; . , . ;, � �. *.. .,- � �� V. , , 3. 41.. ,, .'0 1,, : _ ' S u
Job site address: 73C-1 S v./ r3F V et -a.ut> Catch basin or area drain 16.60
City/State /ZIP: TI 7 P Y 1 PQ 91 273 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: GI t _ /1, Q C E. ba Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
- ]2.- ' g J61-4-N f 31) Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.:
Water service (no. linear ft.:7$) Paget 56 • 00
Fixture or item
Tax map /parcel no
Absorption valve 1 6.60
K n
"' ..F e'/ , ; ?, DESCRI -- Al OF E ; , WO R K , x. ` r - ;,, ,, r .3 B ac kfl ow preventer Page 2
1G-NAi 3Jt V1I N{N Backwater valve n ' 16.60 14. la 0
Clothes washer 16.60
Dishwasher 16.60
,, _,,; ;,. <5.. KK =:. vim:,° „E hau + 'e -s.,:; .,_ :i Drinking fountain 16,60
k^ s ®PROPERites , 1- 4.1 .
0 :.. . r„ � . i i iiilmuTI r z
Ejectors /sump 16.60
Name: {�p„'>j &It l._fLfly Expansion tank 16.60
Address: 3/ C SvJ M pt-c ' -7/ j- ..7% 2 Fixture /sewer cap 16.60
City/State /ZIP: - PD, - rp , �� q '7 Z,39 Floor drain /floor sinkhlub r 16.60 �(p . �
�
Phone: (53) 2 - 5 c Fax: ( ) Garbage disposal 16.60
.: u E,,r A a ,E,y > >;, =,aP :a�; :
F,., =, ,r,:F..: e ,, = € . a
^`" s APPLICANT › t t tFk ' ❑ . CONT PERSON`' t , Hose bib h 16.60 33•
a a =:� _ r_ ���rc:.� . _;, � x, -.��� M .“k0,42,-u. Ice maker 16.60
Business name: - c t' ■i E.t2S I F I _� CCts._ 7 iZ3 CO a' C) Interceptor /grease trap 16.60
Contact name: T Z v\ C. LA Medical gas (value: $ ) Page 2
Address: 1 7_4 8 1A( C)124.4,t}iz-?) 4 044- get . Primer F'. f 16.60 14. 110
City/State /ZIP: LA1� OSW �O , OGZ 9 -7°35- Roof drain l (commercial) 16.60
Phone: (5b) - 713 _ . 2 _ (,.. , 2....t Fax: : (5'03) -2_R3 _ / 5-3 Sink basin /lavatory 1 6.60 614 • go
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
•�,t'�:z� :.as ".t%„' "'"`°:'` z'y„ �t> k? �a; ��' '�'•�ti.e�� "Pq w=i�rii = " ' ` a ;:.�a °..` a`<F'.;'eiy'St:; u /_
_,, r , < � , ®NTRACT ' „, ? ' W,214 s t _ Water closet u� I6.60 l�'�
Business name: 1 4o LI_1 �✓✓Ab l2•T'N l.�61 Water heater I 16.60 te .(
Address: ! i 3� 94 �k ,f..1,, E . - --- Other:
(( Cl c p. el7o�S Subtotal
City/State /ZIP:
�f,�i �`' t ) Minimum permit fee: $72.50
Phone: ( ) I„ .• �5 Fax: ( ) _ Residential backflow minimum permit fee: $36.25 A f T
CCB Lie.: ( S3 , 945 -- Plumbing Lic. no.: c9, - � b , Plan review (25% of permit fee) 7� $6--
State surcharge (8% of permit fee) 3.00
Authorized signature: ,,
TOTAL PERMIT FEE 3$ 2 b
Print name: Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i:\ Building\Permits\PLMF - PermitApp.doc 12/03 440- 4616T(10/02/COM /WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information t•
Fee Schedule: Residential Fire Suppression Systems:
6'11 r y a :. w IQh:` ` F (eay."Total >, " - PCr mit,Fee
t Ut >< l> <ties. :.. r �...; .; .:,, .: , , _: : g. � quar F oo ta g e ...• � _: y..,... �. _ ..
Footing drain - l' 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' • 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40 •
Water Service - 1st 100' ' 55.00 Medical Gas Systems:
Water Service - each additional 100' t 46.40 1 ' .Vral Ua at1OI11 { '7, , Pe_ )r t ee „• , , ;,
Storm & Rain Drain - 1st 100' 55.00 '"
$1.00 to $5,000.00 . Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
,•� A , ; ;14 - =1 additional $100.00 or fraction thereof, to and
3,'" � ,r�« µ �}; Qtyrv; Tiee`�(c'a)a .'Total
SUFI il•KC!or'I eM;b; . ' . V ' v ` 1z =t � - . , ;r, :4` including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00'to $50,000.00 , $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or • - • and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and.up , , $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
Fixture Work:
Are you capping, moving or replacing existing fixtures? If .
"yes ", please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * .
� �Qtantltyb formed,, '
E ,j,i e ` �& �' �� r `-- a " v Replad GF �t f
i i
3 l a 6w44 >Ko a sa Capp a, , Comments regarding fixture work:
Baptistry/Font
Bath - Tub /Shower •
- Jacuzzi /Whirlpool '
Car Wash -Each Stall ,
-Drive Thru
• Cuspidor/Water Aspirator . .
Dishwasher - Commercial
- Domestic .
Drinking Fountain •
Eye Wash
Floor Drain /sink - 2"
3„ . •
• •
Car Wash Drain , ` 4
Garbage Domestic . , .
Disposal - Commercial *Note: If the fixture work under this permit results in an
-Industrial, increase of sewer EDUs, a sewer permit will'be issued and
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station) - fe assessed for the sewer increase must b e paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
.Shower -Gang
-Stall
' Sink - Bar /Lavatory • Quantity Total . 1
Bradle Isometric or riser diagram is required if fixture quantity
- Commercial
Service total is >9. ,
Swimming Pool Filter .
Washer - Clothes
Water Extractor ' :t ' Plan Review
Water Closet - Toilet Plan review is required if fixture quantity total is >9.
' Urinal
Other Fixtures:
is\ Building \Pernvts\PLM- PermiiApp.doc 3/03
- , -T . — -. OFFICE COPY_,,
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CITY OF TIGARD
d Approvedse''w"`� et- --v- - [ 4 ] :
_ ,t 6_1.e psi Conditionally Approved [ Y
• 0 "' ®T4,,k -- ypk.l�•� - vClo(dre For only the work as described in:
N ® PERMIT NO.PLM ?.aok-l- o0177
See Leer to: Follow I I:
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Job Address:73 S w c•• L4
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OFFICE COPY
ti
°
CITY OF TIGARD , � 1'L m
BUILDING DIVISION PERMIT #: a 06) Lf ._p U f 7 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ��4Nnypi�lf�l
Inspection Requests (24 Hrs.): (503) 639 -4175 _�� P__..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 7 3 Q 7 CLASS OF WORK:
SUBDIVISION: I LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 qLl - 7 t
Corrections /Comments /Instructions:
— 6 1- 4ili 14/----,Z;;-.7,2 j 7
(1)
/L / _izil-
47 .6.417
Ar.,,imi 4 Araor,,,i , , --,
,' LIIII;11616 i
l / / 1 /, / 1 , f l . . / rte
Iv , .-Airmr i -
_ r A %LLA 1:. i i► ... _� .1
. .1i� . .
. , i :LiL1 G LVl %L
T
0 k'
)/3 n PARTIAL APPROVAL 1 7117 7 CANCEL I l NO ACCESS
6 A___FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \ 9 Date 2-1 D Phone #: (503) 718- .-2-CAKq
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2004 -00177
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2004
Phone: (503) 639 -4171 WNpulP�lllii I
Inspection Requests (24 Hrs.): (503) 639 -4175 ... 'M- L__
INSPECTION WORKSHEET FOR DATE: 'I1/22/2005 TIME: 7 :02AIVI PAGE: 37
SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE:
PROJECT NAME: prukov ICE BUIL.C31T+lG
DESCRIPTION: BO mg plumbing for new office bu
OWNER: GILROY, PAT PHONE #: 503 -225 -5559
CONTRACTOR: HOLLINGSWORTH PLUMBING PHONE #: 503. 655 -5050
Inspection Request Scheduled For: Date: 11/22/2005 Pour Time: °
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 022248-01 503-793-2621 N
Corrections /Comments /Instructions:
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Inspector: Date: 7) Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2004 -04177
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2004
Phone: (503) 639-4171 rim i ' 6 � It
Inspection Requests (24 Hrs.): (503) 639 -4175 ..
INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 100
SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: GILROY BUILDING LOT #: 016 TYPE OF USE:
PROJECT NAME: GILROY OFFICE BUILDING
DESCRIPTION: Building plumbing for new office building. .
OWNER: GILROY, PAT PHONE #: 503 - 225 -5559
CONTRACTOR:
HOLLINGSWORTH PLUMBING PHONE #: 543- 655 -5450
Inspection Request Scheduled For: Date: 9/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 015655 -01 503-793-2621 N
Corrections/Comments/Instructions:
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Inspector: 0 7.1\4-- Date: 47/5/1 Phone #: (503) 718-