Permit '. --:-, ''''A C OF TIG ` 'RD -' - .:' u ..
RD „ ....,
I.
„ ..
. ..-.
.. /�J DEVELOPMENT SERVICES . PLUME z 1 "' i.3 i ; . r - . .
i lJ. - '�"..Y' MI I ii-. - - ,.' 4 1-i Y<l''i E J •
- -13125 SW Hall Blvd. Tigard; OR 97223 (503 639 -4171 DATE:
i='L�R ZL ' is 3 V 04 T'A l.. 02'1S:210: 4.
r. - -
:t' I ,
SITE , Y- �riArftE:1..1�J- ..�.:a...�� �7L'7 � ..r�..,i'1 .,� ".Llr ( -�1'� ..F.
l.ir�7'I •irT'ta1 +!e r"3r r. i U. r bb Iu., t a - '2 :ONI,i1'49 P- .R'b „.',F- .,,
1_.u1.��` L ..41•1,ly I T. t g. '.'T'yT •
r` -.1- i � ,,,n - '^' rs1 - ,ir r rti, 1 ra n t tP ' .C?" •,” (I °C*: = i '� -
1 S. .f-.J. hr L O 1'�1 ' .- , ii i ' .... - LT.-, rei1A-i .. SJ,ti f '[ � -• f C2 •.31.i 1 i3.. ' _ Yl O E i:. 1. .'6 :--Hh'h .l t ,.. C , 0, ` •
E Yr 1:.. : FT USE . . - ` ' SF W,I,,8f 1 1, ! -iS ,t r- `c..1 °4.9 ,, - , , �, � [',•��� )� r'�• 1'ti�.vl � 7•� �. �
, n' � �. 1 11'x' i_, Y..➢�1• �. 1 1 r
CCLl I ip;; l rj r r T {( f. ,i liy.., 11 1'- � { 1,
1' :mob "t'{ ='- r� '1 r�:00'A 't�9 t, i z. `'c1 °;3, A �Y
ST 0 ri I ES . ' , ,- - - iii _ ri' i E' R 1 r T ^.J . • _ 1 l 1 B P•i,C..�' I PT; . , „; ., a '`1,'I' .. , ,
�h, I 1 .E.I', Cif ; L1'
I ."f•URES- ------ _. ._.._-_ _ ' 1._(= ! @iNDRV''iRf ,4•TC- - - r 1 7 ' S • !� 'y) ': RP ?:��15'a' -5 - '. - ,.: -
hl' [ � n , yE 1L� ry
31 r'._rn, -- - - - - -y •16 :' U(I NivE',,, - -.- f, ;_e,EP:-.3: TR,,(IPE-i-.o _ r rir'
T 11As SHOWC RS- - - CP . ,SEWER L_T_NE (f t i'- - 1 ' '
q ti •-:•• E. L r, "r' n -n 1 r r T r�l r- r • : r ,
I , ,
. : 11�.R CLOSET ,a. 4 _ ..iPITE•Fr r_ ('4; -- - . •
DI' G:i"1'.-7-i 31 "i E,: S. „ - ID' RA IN 7111 I N t' ,f 1;' i 4;7
' 1 . " , ' 5 ' i n ' a l . - 1 : 5 - - I a".1, la''•.; 1oT1 Ti f .±_i,:illlti e iiile-v pi 6A reTit ic71. cllev%iire,t -
, I -i _. 1.01Ni „C,ONS, 1 R.LID e ON, •i:‘1t • ';'Pl •f . - ...iiji rk..TT!', sue : �..l . ■ , ' l '.'C i ,- i.; - 1 r ' l ' •
r r
lJ 4 z -(1 `!4 : -1Cr 1 Lt�1_I"s_ 3 - r•'�,• }-'- -_ .5a_:1'C- r - r .' :.%er ' E JIrt
i= '1;E) sir
RTE C01 l-"AL'''cf -ID: {°ilv Jscrlr-' INC 11\11 . -
' 'Ph � ol.1 . -1 5 T 1 „
Y:<C?;.1 4-1. - - rAITnnYIZ1a .. „. �, •
• x - -. ': - "*" . ' - '7 - LJu a RE-1 T 1'',1Si;. -'r: :i'', %,1`'•$5' -':- ...._ -. _ , ,,
1 ,.'1 1 A : . he, e '�- ` r-.. e ' O ?P ' - I. 't K " .,1. A , - •
��,, ,_ permit 'i3 I �SdE� 3v� � „1�� - the Yo :'.i18 iOTr: u1ii cilif'� a' if', Ore -1 s?iC f S. C -� . .r- 1 G` - -
T4Ra1'd 14Iinicipal' C6d,e ' State'. of,'CIhe. S- ei.'i.",iry 1,odes awl a 1 „ Cthe3• `F iti .. 2 .T I s,pp C a. 0 n ' :___ ' _ , h.
• ' a:JD :iC31tte 1,8:r, fill tir4`k ;)1-!i' be done, ill 0 ..IIY.'tI'nce :7ii°1
a proved'a'1er,3., • TM 3, pe "1u1$ iii.11.en•;:a:3 2 ;T aao i3 not, 'start Eti ' ry • ' . _
wibFii, 130. days o,Y' i3s11n�.Cc = or .ii wor , i ' s 'silsi,ETlied ie1 Toro , . r ��' - -�
tharCl80 days, tii iENT1.CIN: , ,Or Coon l3 rec,.. fires 1i.q iG To1.:O;d ril'1,23 - ___ --
._�� �__. =
• adop;•ed'.us the L eCOn Utility", Mot,ifina$;i91•Ce;it,r ,1-vse rules are _ • _ -- - ____ ,_.
yy 'foil .. J C . (s f�-
' L 3i,tA' . il l4 r c fi \I CF ,„ - _ , �� _
i l' '
h iL�3 h !� �lll..{ '3,2-1 =k/� �.�i�i�, uil7;�i %L4,e i,tr ll� �tii_ (�4fJ?._l '
, �LLe (0'i v - _-.._. _.�_.
' Oitain Copies Of these, i'vle4. or dii'et nuest.iti ta C- ,i';�; :IL 'ec!elirli , „ _._. _ ' - ' , -
taZ3) -19, 7, , . ; ..__ _ _
'a; a 7 r � r� - . . / ' C 'r 1 ; 'f_ r?' r? �: c "ii. I!)' ! ..'.. ' ." ' _ :, . _ ' __, ' ' 't' • '',', , ' ' ..,
.,, ,nom,; '
'.t1...t•e�. • ,.q -'4 -A- I :-4•'4;4 -•;F-4 .t4-, *4' ;V -. s-,;••':: :. } - r t tl.�_1, . c _;_ -b I- r :. -15r; i� . : • },a; r �-i.. -+..}_. .f• :•4-:Tllr r , . :L;.-i: +' -I:
.,cba "�: w�:1 4 „_ r .1: la „�, ,. -�s; _ Iff . ,7-';',D,-'w, := ,i3,;.:, " _}�t; ,. °i r ,G i`1 - � i4 , �.a wJ
r l.,,':i, il.'�1 %� ., ,� � 7'
}..- i-'F-i ':!-'-F, ;, 4.... -- ;t -5-- ti ".4.- . = - i + r:; 'i• F + r• - F - ...1_i.'::- i- ^.n•f--'r'=1= -E74-,4,t,-,3- 4.-4- ÷-'4--n- 1.4- .4-:-1'-i-•lr _f, 9 '=:,• 4,,.y.:.1-1-- 1?:4;W- ; ,f., .,, ' •
I,.
,,- s 1 :' ^ p1
;TY -OF TIGARD Plumbing Application Rec d By . ° •' t
a
3125 SW HALL BLVD. Commercial and Residential Date Recd - - ,',' .
GARD, OR 97223 Otte to P E.
03) 6394171
Dote to OST . ,
Permit t_ • �t.vdz . r . a. . `
Print or Type Related SWR s �1 •
Incomplete or illegible applications will not be accepted Catlea
.0.1
Name of Cev IopmenUProleci 5 ' A ,
FIXTURES (individual) QTY PRICE
Job AC NPS li ��-- Sink ^"`�e� r! c •
l� 9.00 :� }
Address S: :eel Address Suite Lavatory
1 I �q 9.00 r
l a u'1 S N elck i fvt l m ` ri •`- rub or Tuo,Shawer CJmo. ' i l'
r s _City /State L..) Z; 9.00 '.,
I ! • • (, Shower u
_ \,� Only
C 9.00 t
I ■ Water Closet ke
Name 9.
f �. 11� rt
Oisnwasner �::... �� '
1 1 9.0000 ' , .•..�; `
Owner Mailing Address Garbage Disposal 9.00 Y ` r�.
��b� I ► S� l tr +►11D(f. � i. Suite
Wasning Macrune :,`.;r'.
I ' .ty'State rp Phone { 9.00 , 1 ,', 4 ,
n� q I Floor Drain 2-
1 f�40 (� 1� 1 -7 (L}r= •0L1
3. 9 9.00 s
�art)e� `► ' z . ', .
.00 °��
`, F ..
Occupant bleatin Addre :: 9.00 `
P Suite water Heater
.° .•
O C C L
9.00 ; ;:E.l
Laundry Room Tray If 9.00
C,tyrState Zip Phone
Urinal
9 ' :r •
Name Other Fixtures lSoeafy)
l 9.00 . i •
p,r n Pit -e ( ad - cra f _J
itr. \.hC 9.00
:ontractor Ma Address sue
7f �yv . S�nTrr l 9.00
'nor to issuance CityrState Zip Phone 9.00
applicant must N \ `i• Ve I
Ok I ll( J7 r _l t-5`..-:.. �14 I R
Provide all � on on st. Cont. Board Ucs Exp. Da 9.00
g I 9.00
cantracors
(p-7. 7f 1 j
license Plum 1 iiUc. s Exp.'Date ` Sewer • 1st t00'
900 :..;.
information �t 30 00
for COT Sewer - cacti additional 100' .....= , 1`
Business Tax o euo Exp. Oats I 25.00
COT Busin
database), n <Y»��� I Water Service - 1st 100' 1
Name / / �� ^ 30.00
Water Service - eacn aaaitionat 200' � 25.00
Architect storm 3 Rain Crain. 1st 100' �""'
30.00 -to'. .!,
Or Mailing Address I Suite Storm 3 Rain Drain • each additional 100' 25.00 -,
Mobile Home Space
Engineer Cityrstate Zip I Phone 25.00 I I
l Commercial Baca Flovr Prevention Device or Mu- 25.00
Pollution Device
scr oe wont New 3 Addition 0 Alteration 3 Repair 0 Residential BacklDevice'
ow'revention De ( • I "
c3 Done: Residential 0 Non-residential J i 15.00 tci ',
altianal aescnpuon of wont Any Trap or Waste Nct Connece0 to a Fixture
I 9.00
Catch Basin 9.00
insp. of Existing F umoing I I �."
+0 r
penhr r
1'ieg use of Specially Requested Inspections 40.00
w s
mg or property
Rain Crain. single family dwelling oer.hr .
:
:cased use of { 30. ,0
icing or property Grease Traps I ` 9.k;0
QUANTITY TOTAL t
' you 03oping . moving or repining any fixtures? Yes r - No " Isometric x rise n
yes see back of form) - r sgrsrn's recureo .usnrty'r tat is >
'SUBTOTAL �"
areby acknowledge that I have read this application, that the information
:n is correct, that I am the owner or authonzed agent of the owner. ana /< • - «.
.1 clans submitted are in cmoliance with Oregon State Laws. 5 ° /. SURCHARGE r
;nature of Owner /Agent pate PLAN REVIEW 25% OF SUBTOTAL ' �:.
•
Secures Dory I ix:tae cry tout is • e
+tact Person Name TOTAL I
Phone l <}, -j.
'Minimum permit fee is 525 - 5% surcharge. except Resiaenuat BackfIcw �' . •
1 Prevention Device. *r;rcn i $15 • 5% surcnarge ,�•
i.'.dsts'.almapp.doc 81.•8 y ere r
i
• u ' T A APP' • PRIAT T• P: • T:
•
Fixtures to be capped, moved or replaced j Qty
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4 „
\Hater Heater
_aundry Room Tray
JHnal
:ner Fixtures (Specify)
mMENTS REGARDING ABOVE:
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested AM PM BLD
Location �� - c-f-J �..r�. Suite MEC
Contact Person Ph PLM 8 - . Cd' l
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam f/ [i 9 ;
Ext Sheath /Shear �!!' �•' '± ��P�/ti,! %''s "(
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall / /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof : `� A."7
Misc: �.
Final
PASS ,PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Dins
F� I
/iAS PART FAIL
HANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service / �
Rough A ;
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
• : I Inspector � Ext
Final
/ t
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.