10560 SW KENT STREET t
0
CA
0
X
m
z
--i
Cl)
r�F
IsmaS max MS 095At
CITY OF TIGARD BUILDING INSPEk T;ON DIVISION
24-HOLI Inspection Line: 639-4175 Business Line: 639-4171 MST
_
_ -
--- _—Date Requested_ �� AM PM BUP
-- --.— BLD
Location
Suite —_�---- MtC
Contact Person _ Ph PLM
Contractor Y Ph SWR
BUILDING Tenant/ wn , ELC
Retaining Wall ELR
Footing
Foundation h^cess: —
FPS
Ftg Drain
crawl r iin
Slab Inspection Note. r. SGN
_
Post 3 Beam ----- SIT
Ext Sheath/St-ear
Int Sheath/Shear
I-raining
Inswation --
Drywall Nailing
Firewall
Firr Sprinkler
Fire Alarm -- — — --
Susp'd Ceiling ' _ it
Roof �� ,�, .. -
Final
PASS PART PAIL
Post R Beam
Under Slab --
Top Out -- - —— -- - ---
Water Service I -
nitary Sewer --. _-- — - --- --------
Rain Drains
AS PART FAIL —Y
— - --
ANIC/AL --- -
Post& Bearr ---- ------ -_ - --_---_
Rough In — - - ~-
Gas Line
Smoke Dampers
Final ----- -- - ----
PASS PART FAIL
ELECTRICAL — --- _
Service
Rough In -----
UG/Slab
Low Voltage ---—- - - -------
Fire Ah. m
Final --
PASS PART FAIL Backfill/Grau,ny — ---- _ --
Sanitary Sewer ----
Storm Drain ]Reinspection fee of$ _—_�—required beft rr,next inspection. Pay at City Hall, 13125 SW Hall Blvd
Caich Basin
Fire Supply Line ( )Please call for reinspection RE ( ]Unable to inspect-no access
ADA
Approach/Sidewalk j
Other Date (L��/ __ Inspector_ Ext
Final ` `!—
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
I
CITYOF T I G A R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM1999-00179
13125 SW Hall Blvd., Tigard, OR 9722 (503) 639-4171 DATE ISSUED: 6/11/99
SITE ADDRESS: 10560 SW KENT ST PARCEL: 2S115AA-02300
SUBDIVISION: DOVER LANDING NO.2 ZONING: R-4.5
BLOCK: LOT: 062 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSAL::: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXI URES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIE::- OT0ER FIXTURES:
TUB/SHOWERS: CEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Add residential backflow prevention device.
Owner. _ -- FEES
Type By Date Amount Receipt
CARTER, SHARON L
10560 SW KENT ST PRMT GEO 6/11/99 $25.00 99-316059
TIGARD, OR 97224 MISC GEO 6/11/99 $1.25 99-316059
Total $26.25
Phone 1:
Contractor:
REQUIRED INSPECTIONS
Phone 1: RP/Backflow Preventer T`
Reg #: Final Inspection
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard MUnicioal Code, State of OR
Specialty Codes an(, -ill other applicahle 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 ac.opted 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 B : �`� � ?r � �> Permittea 'i n
Y �' G. _ _ S g ature;���G_.
Cal' 503) -4175 by 7:00 P.M. for an inspection needed the next business da;
CiTY OF TIGARD Plumbing Permit Application Plan Check
13125,PW HALL BLVD. Commercial and Residential Recd By _
TIGARD, OR 97223 Date Recd
(563) 639-4171 Date to P.E
Print or Type rate to DST
Incomplete or illegible applications will not be accepted Related SWR Q�!-oo� 9
Related SWR
Caller
Name of Development/Project FIXTURES (Individual) QTY PRICE AMT
Sit ik 11.50
Address Street Address Suite Lavatory — 11.50
(,,Li S iLe
Tub or Tub/Sh,wer Comb, 11.50
Bldg# City/State ZipShower Only 11.50
7Oj --
___ Name L Water Close 11.50
/1 r(--y C a-Y �-e_Y Dishwasher 11.50
Owner Mailing Address Suite Garbage Disposal 11.50
S(.oC SL` Wa3hingMachine 11.50
C_It I '/State Zip I Phone —
AY�( V� rl�2`2�� _y j�j Floor Drain/Floor Sink 2' 11.50
—--- 3" 11.50
Nampl /
'--,0 1� C r j C, I J Uwe 4" 11.50
;cupant Mailing Address Suite Water Heatet O conversion O like kind 11.50
Gas i in requires a separate mechanical permit.
City/State Zip Phone Laundry Room Tray 11.50
Urinal 11.50
— Name
Other Fixtures(Specify) 16,00
Contractor Mailing Address Suite
Prior to permit City/State Zip Phone Sewer-1 at 100' 38.00
issuance„a copy _ -- --- --
Sewer-each addi•ional 100' 32.00
of all licenses are Oregon Cnnst.Cont Board Lic.# Exp.Date - -- —
required if Water Service-1st 100' 38,00
expired in COT Plumbing Lic.# Exp.Date Water Service-each additional 200` 32.00
database Storm&Rain Drain-1st 100' 38.00
Name Storm&Rain Drain-each additional 100' 3200,
Architect _ Mobile Home Space — 32.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Antl- 3200.
Pollution Device
Engineer City/state` Zip Phone Residential Backflow Prevention Device' 19.00
tIrrtgation timing dP••';,es require a separate
Describe wurk to be done: restricted energ,�ermil)
New O Repair O Replare with like kindYes O No O Any Trap or W,ste Not Connected to a Fixture 11.50
Pu6idential Commercial O Catch Basin 11.50
Additional description of work: um
Insp of Existing Plbing 50.00
L,
r i r1 L ks r S ,5 t`—y'Y.. _-_ _per/hr
nY ? Specially Requested Inspections 50.00
Are you capping,movingor replacing ixtures
per/hr
r/hr
Yes O No JY Rain Drain,single family dwelling 4500
If yes,see back of form to indicate work performed by Grease Traps 11 50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. V QUANTITY TOTAL
I hereby acknowledge that I have read this application,that the information Isometric or riser diagram Is required d Quantity Total is >9
given Is correct.that I am the owner or authorized agent of the owner,and "SUBTOTAL
that plans submitted are in compliance with Oregon State Laws S
SignaRure on Uwner/Agent. DAte_ 6%SURCHARGE
I - _ l
L'Wiii—fAct Person Name Phone '"PLAN REVIEW 25%OF SUBTOTAL
R y Required only N fixture fatal is>9 _
_ �—
BATH HOUSE$178.00 �� " TOTAL �G
I BATH HOUSE$250.00
BATH HOUSE$286.00 ` 'Mlnimurn permit fee c;$50+5%surcharge,except Residential Backflow
(This fee Includes all plumbing fixtures In tho dwelling and ttlq flrq` Preventi.)n bevice,which is$25+5%surcharge
100 feet of sanitary sewer storm sewer and water servlcs), -All New Commercial Buildings require plans with isometric or riser diagram
and Man review
I Wstskform°lplumapp doc W.199
PLEASE COMPLETE:
Fixtu-b., 1'vpe _ Quantity by Work Perff;r_med
_ - — New (Moved Replaced I�or,ioved/Capped
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only � —�
Water Closet
Dishwasher ---
Garbage Disposal --
Washing Machine - I --- - -
Floor Drain/Floor Sink 2" -
411
Water Heater --
Laundry Roam Tray -
Urinal
Other Fixtures (Specify) i—
COMMENTS REGARDING ABOVE:
1 WsfsVtxmslphxnepp do WM