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10475 SW CENTURY OAK DRIVE
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CITY OF TIGARD BUILDING INSPECTION DIVISION
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24-Hour Inspection Line: 639-4175 Business Line: 63`J-4171 -� -- - - - -
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loo Date Requested) 7-�2C -C,;Y AM PM _ B D —^
Locatior, -_/L _ MEC
Contact Person �_ .E_c-1 PhPLM
Contractor Cz �- L Ph �% - ��'3 J SWR _
BUILDING Tenant/Owner _ ELC
Retaining Wall _ ELR
Footing
Access: 4
Foundation "��' �/,/� FPS
Fig Drain �y�"-- SIGNJV --
Crawl Drain InSpectiol'YNotes: --- --------- - _--
Slab
Post&Beorn — - ---�- SIT --
Ext Sheath Shear
Int Sheath!Shear
Fro^-ging
I msulation - -- - - _ -- ----- -- -- --
1Drywall Nailing _
Firewall
Fire Sprinkler
-
Fire Aiarm
Su.;p'd Ceiling
Roof - - — ---
Misc.
-anal _ ---PA." ---
PABB --PAW FAIL - - --------- _----. _-_
LUM.BIIN
Posy F. Beam - --._
Unoer Slab
Water Sarv!c:�
Sanitary ewer
Rain Drains
PAS Ph,RT FAIt-
FIANICAL
Post& Re nl ------- — .--- -
Rough In
Gas Line
Smoke Dampers
Final --- -
PASS PART FAIT_
ELECTRICAL
Service
Rough In -
UG/Slab
Low Voltag,,
Fire Alarm
Final
PASS PARI FAIL
SITE
Backfill/Grading --- --' �-
Sanitary Sewer
Storm Drain [ Reinspection fee of$ _ required before next inspection. Pay at City Hall, 131" SW Hall Blvd
Catch Basin [ Please call for reinspection RE r 1 Unable to insect-no access
Fire Supply Line -- p
ADA
Appro-ich/Sidewalk / ` r
Other Date6 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record frond the job site.
CITY OAF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : PLM98-02:35
DATE ISSUED: 07/16/98
PARCEL: 2511ODD-01900
SITE ADDRESF. . . : 10475 SW CENTURY OAK DR
SUBDIVISION. . . . : SUMMERFIELD ZONING: R-7
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :026 JURISDICTION: TIO
--------------------------------- ----------------------------------------------
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. . . . . : 0 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 ) . . . : 100
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . .. . : 0
Remarks : Water service
Owner: ----------------------------------------------------- FEES ---------------
BERNAL CULY type amol-:nt by date rer-pt
10475 SW CENTURY OAK DR PRMT $ 30. 00 B 07/16/98 98-307414
TIGARD OR 97222 5PCT f 1. 50 P 07/16/98 98-307414
Phone #:
Contractor----•-__________________-___-__-_
KENNEDY PLUMBING
13985 SW FARMINGTON RD
BEAVERTON OR 97005 -------_.__-________._.__------------.- ----
Phone #: 643-5535 f 31. 50 TOTAL
Reg #. . : 001009
---- -- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Service In
Tigar:.' Nuricipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All Mork will be done in accordance with
approved plans. This permit will expire if work is not started -
within 181 days of issuance, or if work is suspended for more
than 181 days. ATTENTION: Oregon law requires you to follow rules --
adopted by the Oregon Utility Notification Center. Those rfles are
set forth in OAR 952-6111-1111 through OAR 952-1111-1898. ;au may
obtain copies of these rales or direct questions to [NiN(. by calling -
f5631246-1917.
Issued B r� �^ Permittee Signature:
++++++++..+++++++++++ -++++++++++++++++++++++++++++++++++++ +T++++++++++
Call 639-4175 `iy 7:00 p. m. for an inspection needed the next business day
+++++++++F r++++a++++++++++F++++++++1•+++++*++++h+++++++++++++.4•++- ..4 t++++++++++
'TY OF TIGARD Plumbing Application Recd ft4�wi
x125 SW HALL BLVD. Commercial and Residential Date Rec'e ;
,ARD, OR 97223 Date to P E.
J3) 639-4171 Date to DSr�T --sn�.- _
Permit! , iy
Print or Type Related SWR!
Incomplete or illegible applications will not be accepted caned
Name of Devs fopmei nUProteci FIXTURES zpIdlvidwl) pr' �0 91M I
Job Sink r 9.00
Street Address �wte Vvalory 9.00
Address _
Tue or Tub/Shower Comb. 9.00
Bldg! city/Stats Zip �1 Shower Only 9.W
o Water closet 9.00
V) 't U Dlshwasha 9.00
Owner Met"Addreaa Suite Gubpe Disposal 9.00
c r, rya tv Madtlne 9.00
_pHyfstats Zl� Phone Flow Drain 21 9.00
c �l� �- �(
3' 9.00
7 _ 9.00
Occupant Ii Address Suite_ Wear Beater 9.00
laundry Room Tray _ 0.00
-� Cltyfstats - ZIP Phone Unnal 9.00
Other Fugues(Specify) 9.00
t _ 9.00
'ontractor MapAevess suit 9,00
I rt - i f�CL 1 rn L 71 Cv
9.00
'rtw;n Lm--since /Stas Zip J Phone
applicant must L� �7_ t' 3 9.00
provide an 0 Const.Co L Board Lie.! Exp.Date 9.00
contractors 6, 9.00
nforma ion
kenLie. ��� Exp.Oats Sewer-1st 100'tj
_ 30.00 _
Sewer-each additbnat 100' 25.00
fcr COT COT Business Tax w Metro a Exp.Dr to
Water Service-1 st 100
�atrbasel. ' 30.00
Name "- - - Water Service-each additional 200' 2500
krchitect Storm 6 Ran Oran-1st IOf)' 30.00
or Mating Address --- Su,te -- Storm&Rain Drain-sea,additional 100' 25.00
_ Mobile Home Space 25.00
'ngineer Cityrstare _ Zip Phone Conrneraal Back Flow Prevention Device or Arta- 25.00
Pollution Device
"cube woclt New�Addtoll O Alteration O Repair O kes+dential BaticBaw Prevention Oo.-Kv* 15.00
e done: Resioertlal O Non rssidtrntlal O Any Trap or Waste Not Connected to a Fi"Ure
,diUdescriptiong OO
onal description of work Cath Basra �- - 9.00
t insp.of Existing Plumbing �� 40.00
MrnTv
%tinq se of Specialty Requested Inspections -�i 40.00
a ��
ling or property _ _-- Rain Drain.single family dweiluV -- -- 1 30.00 �I
=Msed use on - Grease Trapp 9.G
ting or property-__ _ __
QUANTTT'f TOTAL w .w
4 you Capping. moving or replacing any fixtures? yes❑ No Isonw x or rum diagram is reourod A Ouw*y Taal is >9
"yes se•back of Toms) _ _ 'SUBTOTAL
•ereby acJuiowledge that I have read this application,that the rnfonmatwn
ens correct,that I am the owner or authorized agent of the owner.and 5% SURCHARGE
.d olans submitted are in compliance with Oregon State Laws. ' ~
gnaturs of Own•rfAgent - Do PLAN REVIEW 2S%OF SUBTOTAL
�` C IIA n� iowurx:am r!Mus air law a>9 _
V_A CA I W 9 ;) TOTAL c.
ntagf non Name Phi • _ - _ )
1 L
ltilmur-oormit to*s S25- 5%surcharge.except Residenlal Backflow
- Pre,nntion Deice,which is S15-5%surcharge
L,ptnlapp.doc 12-06 (dst)
'L EASE COMPLETE AS APPRQpRIATE TO P&2 F
Fixtures to be capped, moved_or replaced - Qty .
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine _
Floor Drain 2^
3"
4"
Water Heater
Laundry Room Tray
Urinal
Gthei Fixtures (Specify)
OMMENTS REGARDING ABOVE:
6
I',plmapr.doc 12.'% (dst)