13167 SW CLEARVIEW WAY I
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13161 SW clemrview Way ,�
CITY OF TIGARD BUILDING INSPE.'.'fION DIVISION MST
24-Hour Ins[ ction '_ine: 639-4175 Fusiness Line: 639-4171 -- - —
G BUP _
�J U2te Requested 6 AM _PM BLD
Location 4,st.,4-) (.Idx'ari t✓ U.0 J Sr lite MEC _
L -
Contact Person C C2,�'_ Ph 7 o _ MEM)
Contractor _ rh 5 7 q 5;,4V_ SWR
BUILDING Tenant/Owner �:LLL EL.0
Retaining Wall — ELR
Footing ---------
Foundation Access:
?1'l1 ��� �, n�, FPS
Ftg Drain
Crawl Drain Inspection 4otes: add/ �j ,�, SGN
Slab SIT Ilt)i
Post&Beam ) ?
Ext Sheath/Sherr i t2h,u��Ct,) C C�Q. C� Oh ',•< U P� COIt, tt
Int Sheath/Shear . `•
Fra. ng 1
Insulation
Prywall Nailing
Fiiewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _— — --- —
H oof
Final �--�-�---
PASS_- PART FAIL ---
PL
osT&Beam
Under Slab
Top Out �"� 7!— -
Water Service
Sanitary SevAf -
Rain Drains
Fin
ASS PART FAIL
MECHANICAL _ v�
1
Post& Beam ---- - ---- - - -----
Rough In I�
Gas Line ----- ------ - — — ---- ---- —
Smoke Dampers
final -- ---- ------ - ------_
PASS_ PART FAIL
ELECTRICALService h �.
Rough In
C
UG/Slab
Lew Voltage - - - --- ---- ---- ----
Fire Alarm _
Final ..,—
ILL
PASS PART FAIL -_-
SI�E�_
Backfill/Grading
Sanitary ewer
Storm Drain I ) Reinspection fee of$_— .___required before text inspection Pay at tity Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply L le I ] Please call for reinspection RE __— I )Unable to inspect no access
ADA( �; q Approach/Sidewalk Date ��' / Inspector �oL -�,,� Fxt
Ott i ar - - - — --
Final
PASS PART FAIL DO Pi^T REMOVE this inspection record from the job site.
CITY OF TIGARD
DEVELOPMENT SERVV 77S PLUMBING PERMIT
amok 13125 SW Hall Blvd.,Tigard,OR 97223(503)bs,,-4171 PERMIT #. . . . . . . : P'LM98-029c
DATE :ISSUED: 08/21 /98
PARCEL-., 2S 104DC-03400
BITE ADDRESS. . . : t31.67 5W CLE=ARVIEW WY
SUBDIVISION. . . . : BENCHVIEW ESTATES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :034 JURISDICTION: TIl;
CLASSOF WORK. . .-ALT GARBAGE DISPOSALS. : 0i MOBILE HOME S{'ACES. : 0
T'YP'E OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREk NTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . 0
STOF'IES. . . . . . . . . 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIX' UkFS-_._...__...._......._..-__........ LAUNDRY TRn'YE. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
L_.AVATOR IES. . . . OTHER r-i X'TL-RES. . . . : 0
TUS/SHOWERS. . . : 4'' SEWER LINE (ft ) . . . : 0
WNTER CLOSETS. : 0 WATER LINE !ft ) . . . : 0
DISHWASHERS. . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Heniff
Owner. : -- _________________._-________._.__.._.___,_________.____ FEES -----•---------
DAVID HENIF'F' type amo .int by date rrecpt
13167 SW CLEARVIEW LN PRMT $ 15. 00 JSD 08/21/98 98-308507
T IGARD OR 91223 SPCT t 0. '15 JSD 08/21/98 98-308507
Pgone #:
JOHN DARBY LANDSCAPE MAINTENANCE
13152 SW CLEARVIE:W
T I GARD OR 97223 __-_--_-_.__
Phone #: 579-5298 $ j.5. 7`, TOTAL
Reg #. . : 000069
F?EQU I RED I N5P'F CT I ONS
This per%it is issued subject to the regulations contained in the RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and dll other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This persit will expire if work is not started
within 168 days of issuance, or if work is suspended for sore
than 168 days. ATTENTION: Oregon law requires you to follow rules _ _
adopted by the Oregon Utility Notification Center. Those rules are
sei f^rth in OAR 952-8081-8818 through OAR 952-Wl-fP,oW. You say
obtain copies of these rules or direct questions to 'IX by calling
(503)246-1967. _� __ _ 1"
I s i..:e d B y: __._.�__�_ Permittee Signature: .- - --____-
++++-•++++1++; ++++++ ++++•�++++++++++++++++++++++++++++ + +1c�. *+ 44+++++
Call 639--4175 by 7:00 p. m. fnr an i.nsper_tion needed th n t business d,.iy
+++++•t++++*+++++++++++4.+++++++++++++++++++++*++++++++++++++++++++•: +++++ +++++
CITY OF TIGARD Plumbing Permit Application Plan Check#_._n?
13125 SW HALT_ BLVD. Commercial and Residential Recd By
TIGARD, OR 97223 Date Recd
(503) 639-4171 Da!::to P.E.
Print or Type Dace to° _
Incomplete or illegible applications Will not b(: accepted Permit#
Related SWRR# _
Called__-
F-! — Name of Development/Project FIXTURES (Indivldua.) QTY PRICE ,AMT
Job ` ) C 4 Sing -�� 4.00
Address Street Address // Suite Lavatory — 9.00
Tub or Tub/Shower Com). 9.00
---- Bldg 0 - C;ty/S(al�,�et� Zip Shower Only 9.00
Name (lam Water Closet � - — 9.00
` —R Py l' 1- Dwasher _- 9.00
Owner Mailing Addressr Suite Garb ige Disposal 9.00
Washing Machina 9.00
City/State Zi Phone Floor Drain/Floor Sink 2 9.00
-- 3. -- 9.00
am yy�
00
Occupant Mailing Address Suite '✓Vater Heater O conversion O like kind 9.0,'1
_Gas piping requires a_separate mechanical permit,
City/State Zip Phone Laundry Room Tray 9.00-
l_ Urinal 9.00 -
Name — --
A (1_ ,„ ) , - -' Other Fixtures(Specify) - goo
Contractor Mailing Address /�_ Suite - 9.00 1315;�5,LL,) C/e J - - 9.00
Prior to purmit Cityy//•�ttate ip�y=� I C 7/ Sewer-1st 100' 30.00
issuance,a co %f �/� ". ( - -- --
Sewer-each additional 100' 25.00
of all licenses are Oregon Const.Cant,Board Lic rY xp. Dal
required if / Water Service-1st 100' -- _ 3000
expired in COT Plumbing Lic.# Exp.Dale Water Service-each additional 200' 25.00
database _ _ _ Storm&Rain Drain-1st 100' 30.00
Name -` Storm&Rain Drain-each additional 100' 25.00
Architect _ Mobile Home Space 25.00
Or Mailing Address _ Suite Commercial Back flow Prevention Device or Anti- 25.00
Pollution Device__
Engineer City/State Zip Phone Residentisi Backflow Prevention Device' 1500
(Irrigation timing devices require a separate
Describe work to be done -restricted energy permit.)
New 0 Repair 0 Replace with like kind Yes O No O Any Trap or Waste Not Connected to a Fixture 410
Residential O Commercial 0 _ •atch Basin 9 011
Additional description of work — --- 4?00
Insp of Existing Plumbing
_ error
Specially Requeslt_''nspections — 4000
_ er/ht
family dwelling 30 00
Are you capping,moving or replacing any fixtures" Rain Drain,single
Grease Traps 9.00
Yes O flu O
If yes,see back of form to it clicate -)rk performed by - QUANTITY TOTAL
fixture FAILURE TO ACCURATELY "!:PC.RT FIX-i URE Isometric or riser diegjram Is required M Ouantlty Total is >s _
'.'YORK COULD RESUi T IN INCREASED SEWER FEES — --
`SUBT( T!
I hereby acknowledge u,et I have read this application,that the information
given is r cl,lh2r I am the owner or authorized agent of the owner,and 5%SURCHARGE f
�t�h I s brjdted a,e in r m liance with Ore on-State Laws.
41 �;, /, _ bate **PLAN REVIEW 26%OF`'..UBTO'rAL
o
Rcoulrea onry r xture qty total is>9
te TOTAL Cj
o �t P roe o:r NamePhone _ _
��/r^ •Mlnlmum perrnit ree is 525{5%surcharge,except Residential Backflow
(, Ptevention Devir-e,which is$15+ 5%surcha-ge
"All New Commercial Buildings require plans with isometric or riser diagram
and plan review
i rdstsk+�wnerx,dnc •nree
PLEASE COMPLETE*
Fixture Type - Quantity by Work Performed
New Moved Replaced Removed'Capped
Sink
Lavatory _ --- ------ �_� - _
_Tab or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage
Washing M;chine
I Floor Drain/Floor Sink 2"
Water F�eater '--
Laundry Room _—_--
Urinal
COMMENTS REGARDING ABOVE:
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