Permit CITY OF TIGARD
%1 DEVELOPMENT SERVICES PERMIT LU #WING PERMIT
'LM9e -0219
DATE ISSUED: 07/09/98
PARCEL: 2S1O9DD -02500
SITE ADDRESS...: 12540 SW PRINCE EDWARD CT
SUBDIVISION • ZONING:
BLOCK • LOT • JURISDICTION: KIN
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS 0 TRAPS • 0
STORIES • 0 WATER HEATERS • 1 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS 0 URINALS • 0 GREASE TRAPS . 0
LAVATORIES • 0 OTHER FIXTURES • 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Water heater conversion
Owner: FEES
LUCILLE GREEN type amount by date recpt
12540 SW PRINCE EDWARD CT PRMT $ 25.00 B 07/09/98 KING CITY
KING CITY OR 97224 SPCT $ 1.25 B 07/09/98 KING CITY
Phone #:
Contractor
SERVICE NOW OF OREGON, INC.
PO BOX 551
WEST LINN OR 97068
Phone #: 655 -7558 $ 26.25 TOTAL
Reg #..: 001102
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 sore
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 - 0801-0010 through OAR 952-0801-2480. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
II nA�
Issued By: �� Permittee Signature: I�Q�.f� M y kid
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + ++ + + + + + + + + + + ++++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
JUL -07 —' 98 TUE 22:31 I D: FAX NO: 14130 P02 -.��
•
CITY OF TIGARD Plumbing Application R ecaBy ° .•• . -- ...i ;i :.:
13125 SW HALL BLVD- Commercial and Residential Dale Rec'd ---g =
TIGARD, OR .97223 . ... ... Date to P.E. •
(503) 639 -4171 Date m DST ? ` 'k "' •
.. Permit s l'l
•
Print or Type Related swR s
Incomplete or illegible applications will not be accepted Called
•
Name of Develop nl/Proj On back indicant Work Portents by fixture. •
.Job ' ki) It t412.- . �.titts= (Individual ti -? _
Address StneelAddr�s IM W44
P O 4! 40 6.0 ui c'T Sink • • • • - • 9.00
I C,i state • zip
Lavatory • .. .
Tub or TuteSnewor Comb. 9.00
G U � (� `�7ZZ Shower Only ..9.00
V G 'r,� i ..�� Water Closet `
Owner .. +�K ns Addreoa D •
• 1 silo fe.i,o j , rs Oiatf�►eaher ..... . _... ... 9.00 -
r Sro� Z+P Phone l��Y Garbs D� sal . _..
Name 4 t g7ZZ q ,_ _Washing 9.ao
411- . ' • Floor Drain 2•
G 9.00
Occupant Address Suite s•
. + 9 0D
City /State zips Phone Water Heater com�erslon O Ilke kMa 9.00 %co
• Laundry Room Tray .
Name
N��,P,� ,� AA� __ 9,00
'i/Z� V 7L 1 Other FI
- xn,ras (Specify) I 9.00 .
Contractor AMAcidred8 S idle
t IEt:1t 62/174111e • zz9 e.00 .
Prier tv panne �)r —!S`to �/ zIP Phone 9.00 •
tsauanoe, a copy CCn op_ G17V &,<41 `iUe 9.00
of all uceneea are 0 on at t. Board Uca Exp. Dale — 900
required if . ®l ( d , 12.-Z -1
expired In COT Plumbing L'c, # Sorer - tat 100' 30.00
�. Date
database '6 -304 11- _c38 Sewer - each addNonal 100' 25.00
Name Water Service -1st 100' • 30.00
Architect Water Service - eacn additional 200' 25.00
or Mailing Address - S stOrttt & Rain Drain - let 100 30.00
Storm & Rain Drain - each additional 100' . 25.00
Engineer City/State Zip Phone Mobile Home Space
zs:oo
DeacrIDe worn New 0 .Adtlillon 0 Alteration 0 Repair O ',ornmerdal 8adt Rom Prevention Device or M . tl- -25.00
to be done: Residential 0 Non - residential 0 �P R Pollution
ac
- esIde n ndal lde sactcnow Prevention Device" _ 15.00
addldonal description of wont: Waste Not Connected lea Federe 9.00
- Catch Basin . .. . • . 9.00
.r
Insp. of Existing Plumbing 40
Existing use of Specially Requested Ins 40.00 •
building or property perlfv
Proposed use of
Rain Drain, single family dwelling 30.00
building or progeny Grease Traps 9.00 ..
I hereby acknowledge that I have reatl this appfica8on, the! the Information QUANTITY TOTAL, • given Is once - that I am the owner or this ap zed agent of the owner. and laorretrie or deer algorism is required V ouardy Tow Is > a _ • f
that • tans . ed are in compliance with • !on State Laws. • • . . _ '9UBTOTAI. " -ii:
'
Signer ' . Date
.; { ` F .
3 � j < 7- b9/° SURCHARGE _ 7-.":; -`:
Contact Perso ' rune Phone ` PLAN REVIEW 26 °k OF SUBTOTAL '9 y
•
,�.p � �-- Required only if wa coy. total 9 , .
1 fl r 4 . • ..• .. • • TOTAL f 4,.: .
'Minimum permit fee Is $25 + 5% surcharge, except Residential B . " .
Prevention Device, which is $15 + 5% surcharge
. • • • .. .
, y
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.a.r i1 ;
CITY OF TIGARD BUILDING INSPECTION DIVISION
HVIST C�
p 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
2 /6 2 -2-Date Requested q " 30 -98" PM AM BUD
BLD
Location Suite MEC
Contact Person ,(,(',( pJ Ph e 3q — LI' 3 D-- PLM 7 0 ' 10,2
Contractor / Ph SWR
BUILDING Tenant/Owner S./ et..., ELC
Retaining Wall / ELR
Footing Access:
Foundation FPS
Ftg 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 S ) 1 - q.
Susp'd Ceiling
Roof
Misc:
Final
PAc PART., FAIL
LUMBING
Post & Beam
Under Slab
Top Out •
Water Service
Sanitary Sewer
11,11745* PART FAIL
M CHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE: A / [ ] Unable to inspect - no access
ADA 11 (�
Otheoach /Sidewalk D at e 7/3 U /� U Inspector � ' Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.