Permit o
'''' ' A ' CiTY 0.-F,TIG 4 -1 L t j1p1r . � !Er, , • r l r , i i � :' -'t z T
/�' '� D SERVICES ' ,r- �6 •!'ri o K ,. - -!` t' Iii' Be ���� �'���,I. , - 4 _ .,J \!'t _ i :,, 4 q ' 'r'7�., J 7Z� 11•
L 13125 SWHa11 Blvd. ,',Tigard,;OR,97223�'(503)`639- 41"71` 7r4Tf' I. 3 .J D'. G.;,'�=. °'t :f9+3; ' .
_ I_'!--iRC E:12.'= `42t7i 0.1; C11�` 6').3.'' i'„o: ?, • 81 TE Ae3 - 'e1 T S..' ... f , : ; n1,0:7) is i I?0rf,) T { DR. -
5 1 i?-ln •'' - 1..0t\I; „ x a ' FSE-L) ::'t'` 1-'E I sir -i I S . ` Z i NG ; f ,
DL' "•,..,'„.'„ n ,. n e ., Q L.. DT _ — , o r .• L': _ , 1 f �- �.A t ' I i.�d5i.' . 1, '_
iii �.�f J, y , 1:6
- Ci._.1••:'r."uS :OF VliGEE•}ifti. - . _T
i-r? (("3^' ' � D�ylO� EI',3 J� r,r•5 y Il! ! v;'1 T -�i ILE 1-1,O 1E C-r S fl
�. { 4�J f' ,:{L4,1' _ _, dJ 6. �}v' � �c -, !'�,l_ 4..'1L ,.If e".'3��.,J= S. ,
- TYPE OF USE .; . -'.'_AF1Si'tiIf'�;[.-e r�i�-�CH - a . 9', ' yU %i�C6 -•;i C.3'hi .r E,lth�rTr'i+4, „ ' 1
' C;C.C:UF,?-1J\?t_, i' f rcJ; . 2. e t7a 1 0,0 R 'DPr:11f\1a„ : ,- , _ - . ( i_!- !Z�1: =Eb „ a;F, :,-. „ ,. , ... _ r ,, ,
67 0R I,E S ", _ -.. . r ? i ' ' .W1-21.T .E. - E T ERR.: , n - g„ ' a<i, ' Ci=, i'(:J -H 'BG4E 1 N,,T, . , n . _ ;%r..'._ ' ti'
L,��E5 - �.�-il �J',�;r. t r.r-1 f'�=�„ i.'1 . 0 7 - . , ;-i4� � i "ti 1� _,r�, , .� „i tr
C! I ;`••i `✓c.S , o . .. - - - .. ' ' lil ' ' iU F; = •'ti C1 i - - . „, „ e - . r r• T ' ! ` , ' - - u
,_8ti1 F ht_•_Jn _ ., c DTI !'�_,: A n :r„ 3 L u _ 1G-
Y'F,T�=•i:: C-1.1:1 „ a'i B�Jc�=�.T;,E:f� I_I��;r f' * .) „ +'b y �:a 1
L''i 3 1 ,,-,.: wl�:S F! Ee . 8= o c . e r.',1. tCr`! 1. N: 1.)ITYi:3I tti' . ; I L, -) . n '21 , • •
O'eii L P” n, 5,'- _, i : 5 L c., w at .Ti on i O G =4>2, f t 7' ',.1' !r: _!Di e V e I~ i"s' i. o- -, i ''C'” £ 't' i -[ i _ ,
�1f "`1_ p CO
l N T DUCT 1 f �ti r , r- 1- ) " l' E,'?..i'�. C? 'ci("ry ,.e
CON E-3 , N I . fir. c, iTf'Ci 1T t 17
t 8-4,65_71A _SW s'icriL.CC!I;__5_T” • ' ; MT -- i..5s 1 1 1 t.1 _ =., ;ti E: /'._4 ('J9 - 9CS''3 '5EL % '
C...,P P.i'l sr •_..a2T; d[i
F,' d vas ! La: (TA :',,':.. 91 ,ma y FS .!
4 P h u r1 •& is _ F _ i.,: ,, I ' �� o,
Cu 17i I:: r-Fit._ t; £)1,`-- . —• --,- •__..r. -_ ---4---------:::-•-•--;;--.- --- - °' --- . , ,
rrrr5. :f_lr ' CL 3CA.ri1r - F_,.(= Nii,.:�C::` = T -i \! ';r.r IC - - -
t , ,7,85; ;.:,i 2.'..7.1'...7 ' ,1• �'2E - ,
.6
n , r 7
_ t
•
P F >>
jJ__41, Ir I L1 ll I �J, 4 ! ,. , ..r..!1 e, '__,% $ ' ‘ 1_ , 75 1 Ci•1 Fl!.:
■ - -- — . RE..(R ti .1 RED 1 i~ S Pi,a ',1 D'i\i.- - . —._.. ..,_..
ThiS :_ rzit i5 _:5qc? 5 ECt t0 the rciFUF Et, '_Oi i. ,ui4p::i1 d! in thE, RP /r z.Cjhf - ].0;4 Pt T __ __ - ,
` igard ",,_•r p &, E;➢i'is. rf f.11 37c,niw fi:' `Odes afL all 3jis!r Fi '.;a t1., Ills.i:]e. f_j:.i o r _ —' _ �' ,
rr,l_�i c
Z^Q�.i ".51,� ,fd1ti5', ' 1 :1twor'4 :•!;! 5 earl iit' .' .cor�i' -' iii ti - -- [` ' • ail; rev ed,riais, VP ,o'8 r,i - will', s'};;y},}' -s•ti'r :'- wol',' IG' ! 'no 5t�rtEd T. , 1'.' ,'
.1i
LI it�j ;' IBC:) Ga' .6f issu n-c or ii i�rrL d fcr Cep '' i, e —
. than, l tj �,syl5, P.1 TE1 Oregon di requi1"e5 ';.;01-i t;(1 !'01:LL1 �"ti',F5 • _ r— �- — — -- — - - —
adO3i. err vt%' the Crogo1 '�' itu Not.i?iratibii 1,cili,er. Mess r'tiic5 i1 -c — 'i •
L d" r 3E2--:f11.7;.; � 2 r . �• ` ^ rJ ;•— - - ° - -'-- -`- — - - -
s t jafth4 -. ii) CAI "Ci'iG, thrr',i11ti3O1-1- '.it ' tuil, 'na!4`•` .^. .
-r " __ —__ —
.:' 77 " - t -7- ", -- " -- _
'' Outaiq eo,7i of 't� :iii r'ii, of Ci] 1EC t 'C 1r ti3rtai 't,orOUi call i riii' ...� . . .._. _ . ,L . .. ..,;_____1_ ".
(503) 4r -' '387.' . .. y °'
RO.,1 7i — = � -- ' ________ , i . " i e., - '-.7�- :r ' ; : i - '1')•- - � ! ,
,
_ .
-
'
; �:. 1 .� ! ..���..�- _ . ^•'t•�`•_ --i� . -
.� ��.!�.any. {- -'"•i --i-•-, -;-'_}• a .-�'}"1- -0�.,}_ ..y. �il . ; ... F .. ^. 9� r. F - I_ : r. h • 7° �.•• 4 _ _- i_. �_ j..•_-} .�,.-1-,- 1_- F..{....L - - 1 .7-F. - 1 -1 , , - - - 1 .7-F. - 1 -1 , , - - r, r _ , •'7 y ;. , °,,.^,. , i" J , ^• t _4 1. A 1_ i
f f:: i E.i,3i'."i--4.1 7-6 ii`. r✓��'u, i 1' .`�tli .,I.r1 ,ipP L.1' , i• 4.?.ii Pjl 'V „nIP. vicli': f-�.:'v'iTi - c. as' f1.9.� '
' ;,-t, i .: L .. y .-g, . { .,., l ..: j ,� } ,1J!,1._ _ r ae- y..'''''.•,i. i :.. ir: j.,.{. r:.} t Y ,. ).•,:,•,,;,. E_.e -! ; .1 +.1- , L r * i,,), .•. i.u..�_^. .t
fi t.'. - �7
,; 't T t o " ", �^ e'•�ti ^.�•, i}, - {i, �� ^ i' .;,`', 1. _L'• ^f'•�-,i•-�i "' _f �I.. ,
' +- 1
TY TiGARO n V •'. • '
Plumbing Application Rec By ' t� ; .
;125 SW HALL BLVD. Commercial and Residential Date Recd 1 _ __ __,Q
GARD, OR 97223 DJIQ to P E
03) 639-4171 Cate to DST •s. - �
P sr 7
Permit ermi •-:;
Print or Type � � • �� , v
Incomplete or illegible applications will not be accepted called SWR s ^F
i ;
' Name of Cev lopmenuProlect FIXTURES (Individual) PRICE .AMT :-.41.., "' l •
AMPS ',cx- QTY :, ,
Job A l�r..l 1� r Fi _S Sink
9.00 4• x ,.'
Address S;reef Address Su, a Lavatory 9.00
I a t)f�li f'ek j n Zip Shower Only
h �m .,� r To or ruorshower Camp ti} .. � ''
dI ljq s C.tyiState 1 .) 9.00 a w �; « r:
tvi Ra ) 1 3 lrfl 'Jic i97� 9.00 M
Name J 1 Water Closet
r l 9.00 - i( A x.
(n T . ktiin (1 Ossnwasner T , ,
9.00 " i" 1-it .
Owner ~lading Address �� Garoage Disposal
Cl cVlj f, � Suite
�. 9.00 .,xy � .,»::.:
b of
washing Matrnne I 9.00
��ryfstate ;�-. .
T 1f� e ip Phone Floor Drain `' •• :
3- 9.00 -
4- 9.00 • ..
Occu Mailing Address Suite Water Heater '
9.00 4 : I
Laundry Room Tray 9.00
C4ryrState Zip Phone
Unnal I
I 9.00 - •
Name j I Other Fixtures (Soec fy) 9 00 ,.
Ore/On ( (lcC/f ll'P l /V0r) (.1 r 11 (• , /� \ 1 . 9.00
:ontractor Mai Address Si, to _J I
- 7,5. S1 :)OSi \n Tr- r l 9.00
ry rStat e Phone
Zip 9.00
, nor to issuance Ci _•
eppltcantmust - {1Thi•1 Ok 1 17(()7 �� 5 '� �
C �` l 9.00
u regon oast. Cont. Board Lic.s Exp. Date I I
provide a
contractors � z - 9.00
license Ptu � s 7 1.-:', 1 / ( Sewer • 1st t00'
R- 9.00
information 1 V 7�
f COT Business Tax o ExP• Date 1 l 30.00
or COT , Te Sewer • each additional 100' 25.00 ,..-4.,
d or COT uo Exp. Date
(�(�(»��- 7 9, I /V( Water Service - 1st 100' 30.00 '
Name .eater Service •each aaddionat 200'
25.00
Architect Storm 3 Rain Cram - ;st 100' "' ��
30.00 . °' . • m• ` ,
Or Mailing Address I Suite Storm 3 Rain Crain - each additional 100' 25.00
Mobile Home Space I 25.00 I •
Engineer City/State Zip I Phone Commercial Bata Flow Prevention Device or Anti-
25.00
Pollution Device I
son be work New C Addition 0 alteration 0 Repair C Residential Bacx cw Prevention Crevice' F
ca cone: Residential 0 Non - residential 0 I 15.00 I�� �
zilzonal aescnpuon of worts
:alai Basin Any Trap or Nast: vct Connected to a Fixture
I I 9.00 I w
I I 9.00 - I •
Insp. or :xisung ' umoing I +0.00 ■ '
Perihr • - .tiro use of Speaaily Requested Inspections 40.00 I
<0.00 •
zing or property I Der: hr I '
Rain Cram. singe family dwelling I I 30.30 I
=sea d use f Grease Tra 9.00
icing or property I i
QUANTITY TOTAL I
e you cooping . moving or replacing any fixtures? Yes No lsoTeirc x user - •asram immures I Cusnny real :s , l I
•
yes see back of form) - '
°_reay acknowiedge that I have read this application. that the information 'SUBTOTAL I
:n is correct. that I am the owner or authonzed agent of :he owner, ano
it clans suomittee are ooliance with Cregon State Laws. 5 % SURCHARGE 76 j.:"
el :m
;nature of Owner /Agent . I jI Date PLAN REVIEW 25% OF SUBTOTAL i • 2 ecurea onry I inure crr :a:ai is a 9
nut Person Name TOTAL ,:..j.'.
/
Phone I ��.?,
I I 'Minimum permit fee is 525 - 5% . surcharge. except Residenual Backflow .
! I Prevention Device. which is S15 • 5'.6 surcharge.
is � Y y
'l 4... 14: "l { r.','a: A5I5'.DlmapP COC 8!� i tar =£4�E. F E?>� ; ? ,1 +C� j �' D+
.._�.i___ � �__�._� _ •- a line•' .�. _i� -•, ..r.
EASE COMPLETE AS APP ROPRIATE TO PROD CT:
Fixtures to be capped, moved or replaced Qty
Sink.. s
Lavatory
Tub or Tub /Shower Combination
Shower Only �
Water Closet
Dishwasher � 1
Garbage Disposal I
Washing Machine �
Floor Drain 2"
3"
4" 1
Water Heater
_aundry Room Tray
Jrinal
_DTner Fixtures (Specify)
MMENTS REGARDING ABOVE:
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
-��C , L BUP
1 � Date Requ - sted G 1— f ' C o y AM PM BLD
Location 1005 ZA_M " - Suite MEC
Contact Person 111/ Ph • PLM f a2'
Contractor Ph �g�-- 55. SWR
BUILDING Tenant/Owner 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 Ll � �/ 1/ 4 /4 / //_- i4-4.4v- .2" /
Fire Sprinkler /d„-^ ` /
Fire Sprinkler � (ail/ J
Fire Alarm /
Susp'd Ceiling
Roof
Misc:
Final
P T FAIL
LUMBING
Post & Beam • r� / / �%/
Under Slab �d/ ,/ i�
Top Out
Water Service
Sanitary Sewer
Rai Drains
� PART a;
ANICAL
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 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector Ext 312
Final
PASS PART FAIL ' 0 NOT REMOVE this inspection record from the job site.