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11335 SW GREENBURG RD.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BUP _
_Date Requested, 1611 y AM —_PM BLU
Location_ �,�') � �.�-�� 2 f _ MEC ------
Contact Person — _— ! ph FLM '�� 61�' - GCS 3�
Contractor Ph _ _ SWR ��'l�l f Z2-C'
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation Access: FPS
Fig Drain
Crawl Drain Inspection Notes: SGN
Slab — ---------- --- SIT
Post& Beam --
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall /
Fire Sprinkler _
Fire Alarm
Susp'd Ceiling
Roof
Mwc:
Final _
PASS PART FAIL ------- -_--
PLUMBING �~^ —
Post& Beam _
Under Stab
Top Out — —
anita Sew W---" -
Rain Drains Aloe'
Fi
ASS PART F!,I L.
ArtICAL
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 I I Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch basin
Fire Supply Line I 1 Please call for reinspection RE:__. [ ]linable to inspect-no access
ADA
Approach/Sidewalk �'�t"
Other Dat
e C nspectar
_-_ _J . _ _ _--__ Ext
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
/A CITY OF TIGARD PLUMB:NGPERMIT
DEVELOPMENT SERVICES PERMIT#: PLM1999-00325
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-41'11 DATE ISSUED: 10/11/1999
PARCEL: 1 S135CA-00900.
SITE ADDRESS: 11335 SW GREENBURG RD
SUBDIVISION: ZONING: R-12
BLOCK: LOT: — JURISDICTION: TIG__W-____—_._
CLASS OF WORK: ALT OARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW Pr.EVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: T URINALS: GREASE TRAF-S:
LAVATORIES: OTHER FIXTURES:
TUB!SHOWERS: SEWER LINE: 200 ft
WATER CLOSETS: WATER LINE: Ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Istalla.ion of a sewer tine for an existing single family dwelling. Existing spetic system must be dra;ned, filled,
capped or removed.
FEES
_
Owner: _
Type By Date Amount Receipt
ROGERS, ALICE M PRMT GEO 10/11/1995 $70.00 99-318963
11:335 SW GREENBURG RD 5PCT GEO 10/11/1995 $5.60 99-318963
TIGARD, OR ;,7223 —
Total $75.60
Phone 1:
Contractor: _
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDAI_E#8
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Phone 1: 239-8801 Sewer Inspection
Insp existing/capped fixtures
Reg #: LIC 00049418 Final Inspection
PLM 26-53 3ph
ORIGINAL
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 lav 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 rule_ s or direct questions to OUNC by calling (503) 246-1987.
Issued d % �f�-� �` � ---- Permittee Signatu
Y: re:
_.
Call (503) 6:3�9-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD Plumbing (Permit Application Plan Check# _
13125 SW HALL BLVD. Commercial and Residential Recd By
TIGARD, OR 97223 Date Recd
(503) 639-4171 Date to P.E. _
Print or Type Date to DST-
Incomplete or illegible applications will not be accepted Permit#e4ei"I�rri�r- 3�S
Reiated SWR
Called
Name of DuveluNnielrUr i rIXTUR13 (individual) �R QTY PRICE AMT
.fob - 4�. / t'CyC /�C)`'T,�S Sink 11.50
Address Street Address Suit Lavatory 11.50
335 Si J >tir Tub or Tub/Shower Comb. 11.50
- ---- Bldg L Cl/Stale iShower Only 11.50
14 �- Water Closet/Urinal (Specify) 11.50
C 1(5y Dishwasher 11.50
Owner Mail pp Ad_dressg Suite Urinal 11.50
Garbage Disposal 11.50
City/State Zip Phone -
- f_ y3 Laundry Tray 11.50
Name Washing Machine/Laundry Tray (Specify) 11.50
611Z10 A-W4 Floor Drain/Floor Sink 2" 11.50
Occupant Mailing Address Suite 3" 11.50
• 4"City/Stale Zip I Phone _ 11.50
_-_
LWater Heater O conversion O like kind 11.50
(�l ame Gas I Inq rec(ulres a separate mechanical permit.
W1 ! u r C �ij Q MFG Home New Water Service 28.00
C`ol ntractor M iling Address tYt ieSuiteMFG Home New San/Storm Sewer 28.00
,tk), Hose Bibs 11.50
Prior to permit City/State Zip Phone Roof Drains 11.50
Issuance,a copy e51� ,� 0-7c,30 23`1 -W'� Drinking Fountain 11.50
of all licenses are Oregon Const.Cont.Board Lic.# Exp gate
-••rr: ;; /_ CI 1 Other Fixtures(Specify) _ 15.00
i
expired in COT Plumbing LIc. Exp.Date
database ell,
Narfle - - -
A.�H^ • t _ _ _ _ Sewer•1st 100' 38.00
or 1 Mailing Address _ Suite Sewer-each additional 100' 32 00 • r?0
Engineer City/State Zip Phone
-- Water Service-1st 100' 38.00
Water Service-each additional 200' 32.00
Describe work to be done: Storm&Rain Drain-f at 100' 38.00
New O Repair U Replace with like kind: Yes O No O Storm&Rain Drain-each additional 100' 32.00
Pesidential O Commercial O
Additional description of%ork: - Commercial Back Flow Prevention Device 32.00
Residential Backflow Prevention Device' 19.00
Catch Basin 11.50
Are you Capping, moving or replacing any fixtures? Insp.of Existing Plumbing or Specially Requested 50.00
Yes O N.y O Inspectionsper/hr
If yes, see back of form to Ir dicate work performed by Rain Drain,single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES.
I hereby acknowledge that I have read this application,that the information QUANTITY TOTAL
given Is correct,that I am the owner or authorized agent of the owner,and Isometric or riser diagram is required if Quantity Total is >9
that plans submitted are in compliance with Oregon State Laws. 'SUBTOTAL ; /-
Slpnature of Owner/Agent Date
8% SURCHARGE
Co tdct Person Name Phone
Cr
"PLAN REVIEW 25%OF SUBTOTAL.
1 BATH HOUSE$178.00 Required only d fit a qty trtal is>9
2 BATH HOUSE$250.00 TOTAL KO-1
3 BATH HOUSE$285.00
(This foe Includes all plumbing fixtures In tho dwell!ng and the first *Minimum permit toe is$51)+9%surcharge,except Residential Eackflow Prevention
100 feet of sanitary sewer storm sewer and water service) Device,which is$25*s%surcharge
All Now commercial Buildings require plans with isometric or riser diagram and
plan review
Grp 1��t!A� �'� Y �c? .2`✓ r41-
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Rernoved/3apped
Sink _-- --_-i— _
Lavatory - --------- --- ----_—_ ----
Tub or Tut,/Shower Combination
Shower Only —
Water Closet -^
Di::hwasher
Urinal __ispo_ -al-
Laundry
Garbage Dsal
Laundry Room Tray
Washing (Machine
Floor Drain/Floor Sink 2"
311
411
Water Heater-
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
IIdSMVimntVdimaf`n rh+r t:vlrla _
/ SEWER
CITY OF TIGARD ,
DEVELOPMENT SERVICES PERMITM SWR1999-00220
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/11/1999
SITE ADDRESS; 1 !3:35 SW GREENBURG RD PARCEL: 1S135CA-00900
SUBDIVISION: ZONING: R-12
-. ____ BLOCK:__ LOT: _ _ ` JURISDICTION: TIG
TENANT NAME: ROGERS, ALICE M
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: SF NO, OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Installation of a new sewer. Existing spetic system must be drained/filled, capped or removed.
Owner:
ROGERS,ALICE M - FEES- ---
11335 SW GREENBURG RD Type By Date Amount Receipt
TIGARD, OR 97223 PRMT GEO 10/11/199`: $2,300.00 99-318962
INSf GEO 10/11/199E $35.00 99-318962
Phone: - -- _
Total $2,335.00
Contractor:
APOLLO DRAIN + ROOTER SERVICE T
2208 NW BIRDSDALE#8
GRESHAM, OR 97030
Phone: 239-8801
Reg #: LIC 00049418
PLM 26-533pb
Required_ Inspections
Sewer Inspection
Septic Tank Filled
ORIGINAL
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a latera' ATTENTION. Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAP, 952-001-0010 through OAR 952-001-0088.
You .nay obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued by: �
Permittee Signature:
Call (503, F39-4175 by 7:00 P.M. for an Inspection needed the next business day