12237 SW CLYDESDALE COURT 1
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12237 SW CLYDESllALE. CO[Jit'1'
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
_Date Requested �c� �`�� AM _PM BLD
Location le;od37 :5tJ 6(-t' sd C+ Suite _
/' MEC
Contact Person Zi:- �� )Jl't S �u� c X1ti" Ph 14��� `f�,9 PLM
Contractor Ph SWR
FIgUILDING Tenant/Owner ELC
Retaining Wall ELR _
Footing
Foundation Access L + /v✓, FPS
Ftg Drain SGN
Crawl Drain Inspection tes: —
Slab —.— _ — SIT
Post&Beam
Ext Sneath/Shear
Int Sheath/Shear —�
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misr-
Final
iscFinal
PASSPART FAIL - ------ -------------------_...._____---__._______-_.__.__-_�
PLUMBING
Post& Beam —--------- — - -----
Under Slab
Top Out_ -
( Water Seivice
anit�-y Sewer -- - --- —
Rain Drains y _
S PART FAIL
MECHANICAL
Post & Ream --- - --
;''ough !n
Gas line -------
Smoke Uampeis
Final _.__—_._ _..__. ...___.___-__---- --___.. .------ ------_
PASS PART FAIL
ELECTRICAL -
Service
Rough In
UG/Slab
----------
l_ow Voltage --- l- -�----- --- — -
Fire Alarm
Final
PASS PART FAILSITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ t Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall^Ivd
Catch Basin
moire Supply Line l ]Please call for reinspection RE: — [ ]Unable to Inspect-no access
ADA
Approach/Sidewalk. Date Inspector
Other ---- __ _�_-� Ext
Final
_PASS__ PART___FAIL_ DO NOT REMOVE this Inspection record from the job site.
CPLUMBING PERMIT
CITY OF TCGARD
DEVELOPMENT SERVICES PERMIT#: PLM1999-00387
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
DATE ISSUED:
PARCEL: 2S 103AA-04300
SITE ADDRESS: 12237 SW CLYDESDALE CT
SUBDIVISION: CLYDESDALE ZONING: R-4.5
BLOCK: LOT: 023 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE. OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: ''VATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Connect water service to new meter location for city. _
FEES _
Owner: _ Type By Date Amount Receipt
DUNN, STEPHEN W AND —
HPL.PERN, MICHAEL L __--
29572 ,-A\/ANTE Total
LAGUNA NIGUEL, CA 92677
Phone 1:
Contractor: _
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone 1: 503-692-4139 Water Line Insp
Reg #: LIC 000878
PLM 34-166PB
' i GINAL
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 952-0001-0080
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued BPermittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the noxt business day
CITY OF TIGARD P11111lbing Permit Application Plan cheek 0
13125 SW I IAH. BIND. Cortlmeicial and Residential Recd By k. r
TIGARD, OR 97223 Hale Reed
(503) 639-4171 Date to P.E.
Pi int or Type Dale to DT 14 9
Inrontplete or Illegible applications will not be accepted Permilt y -oe3>J7
Related SWR 0
Called--• _
flame a1 DevelopmenuFrelocl
job Sink 11.50
AddfeSS Slreel Addr-es i Sulle lavatory 11.60
(j L�tS L✓���� _ Tub at Tub/Shower Comb. 11.50
-- - -- flldg r �( ('ilylSlglO Zlp
Shower Only 11.50
f lame �/ Water Closet 11.50
r I C.I` ` ' �µ Ulslrv+aslrer 11.50
OWIter ldellirrg Address Slllle Garbage Disposal 11.50
_�_-._ Washing tUachlne 1150
Cdyl5l3lo - lipPhone Floor bralnlFlOor Sink 2' 11.60
fJoine._-�- 3" `. _-- -- 11.60
___ ___ 1' - 11.50
_
OCCII))dtlt IAalling Address -� Suite Wnler Healer O converslon O like kittd 11.64
Gas Alpin r� etc ultes a separate mechanical permit.
City%Slnte-� Zip — Phone loundiyRoom Tray 11.58
linnet-�-� 11.50
IlanieL - --
Other Fiduree(Speclfy) 1500
Collttactor M illq/iddidte--� `-- Sulle s/
�o. Sok 69
11110110 petrnil uyilale ZIP Phone Sewer-til 100' 3860
Issuance,a copyrU t[�c�{r n r Q Z 6 77--41 Ls 1 _ -
- Sewer-each additional 100' 3200
r,l all licenses oro Oregon Const.Cord.Roitid lfe 0 'Exp pale
required If ``�1 S y 17 �/ c, Water Service-101100' I 38
_S1.!- -____. ____ l.-
erplied In COT Plumbing 1 Ic N Exp [tale Water Service eadl additional 200' 3200
dalnhacaL` _ �U "
3_/ _�11.��6_ _ _-1�1._� Stoo
rm d Pain Uraln-Ul 100' - 3800
Name Slonn&Rain Oraln-each sddlllons.100' 3200
Alcllilect _- - GE le Home§pace 32 o0
or klalling AddressSulli Commercial l3ac*Flow ProvenlionN vice or Anll- 32.00
Pollu!lon b°vlce
EIlUtlleur l lly a 71p --� t'hone -ResWenllal Backflow prwen'lon Device* 1900
_ - _ 1 _ _ (lnlganon IUNng devices require a separate
UesaO>o work to be dotto. - - teslrlcted S-ond l-n itI—
f row O Repair O Replace wrlh like kind Yes O flo O Any trap at Waste Not Connected to a Fixture 11.50
Residential • Commercial O Catch Basin 11 50
Addlllon*I descilptleu of work: Corn n o '
G f hu��TiR SeR-b t Y Q. Insp.of Exiting Plumbinp 40.00
fd h Q w M#
flIL )c cf ,o n fc,p _� r + - erfiw
1. - - Specially Requested Inspections 50.00
Are you capping,moving or replachig any nithues? _ Perrtu
Yes O No O Pain Oraln,single family dwelling 15 00
If yea,see hack of folnl ler Indicate work performed by Greece Traps 11.50
fixtilre. FAII IIRE TO ACCURATELY REPORT FIXTURE
WORK COI IL D RESULT 114 IIICREASED SMER_FEES. __ �! QUANTITY TOTALJP
I hereby ocknov.ledge..tial I have read Ihls oppllcallon,Dial Iia Information Isomehic at ilia#dum b grarequired it Ousnlxy Trial Is .e
given Is canntd,Ilial I am the owner or authorized agent of Ilio owner,slid 'SUBTOTAL E, '
Ihul ins subndlled are In conn hgarrr•.e with Oto on Slato Lows ; M '. G0.
Slgru11r10 of 0wI1CrlAponl - nate — -— ------- .` ,-- _
� URCNAROE e
Cru.
Conlacl patron Harm - // f bona -'~"PLAN REVIEW 28%OF SUBTOTAL
Lx61 Ra ultedor NIWue illy total Is as
t
TOTAL � i' a`
'Minlrnum pernrN fee Is 150+5%surcharge,except Residential Baddl
Prevenllon Device.width Is$25+5%surcharge
"All flew Commercial Buildings regnlre plans with Isomehlc or riser agram
and Ilan review
I1d.teVams�plumerp rix er2ro3