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11480 SW DAWN'S COURT
CITY OF TIGARD BU!.' r0,NG INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
—Date Requested ry AM_ PM _ BLD
Location— � _ Im Suite MEC
Contact Person
Ph (1' S S z �� PLM �Q���
Contractor Ph _("'q SWR
BUILnING Tenant/Owner EL(_
Retaining Wall ELR _
Footing Acces2/2:�
Foundation FPS
Ftg Drain
Crawl Drain Inspection otes'. Q �j(L SGN
Slab -----`_A_-� `'1 ly�(�l�kC/� - SIT
Post& Beam — --
Ext Sheath/Shear
Int Sheath/Shear —
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler 42
Fire Alarm �.
Susp'd Ceiling
Roof
Disc:
Final ✓�
PART FAIL_ — --
�PASS
G f�
Post& Beam I ---'-T
Under Slab
Top Out .--
Water Service _
Sanitary Sewer
Rain Drains
C-
A PART FAIL --- _
MECHANICAL
Post& Beam l u
Rough In i
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 —— ------------ —-- �—
Sanitar, Sewer
Storm Drain ( J Reinspection fee of$ _ — required before next inspection. Pay at City Hall, 13125 E N Hall Blvd
Catch l::;sin
Fire Supply Line ( I Please call for reinspection RE..--- ,, ( J Unable to inspect-no access
ADA
Otherach/Sidewalk - Date t✓� Ins pecter ,' ) —__Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the jots alter
CITYOF T I G,A R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM1999-00135
13125 SW Hall Blvd., Tigara, OR 97223 (503) 639-4171 DATE ISSUED: 4/30/99
SITE ADDRESS: 11480 SW DAWN'S CT
PARCEL: 1 S134DC-06400
SUBDIVISION: DAWNS INLET ZONING: R-4.5
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: AI-T GARBAGE.. DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUBIS;AUWERS: SEWER LINE: ft ORIGINAL
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install a residential backflow prevention device.
Owner: FEES
-- — Type By Date Amount Receipt
ROHRBACH, SHIRLEY A
11480 SW �Hv`/N'S CT PRMT GEO 4/30/99 $15.00 99-314973
TIGARD, OR 97223 MISC GEO _ 4/30199 $075 99-314973
Total $15.75
Phone 1:
Contractor:
OWNER
REQUIRED INSPECTIONS
Phonc 1: RP/Backflow Preventer
Reg #: Final Inspection
This pe,,mit is issued subject to the regulations contained ir. 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 By: _ �iL�`_; ', Perm"ttee Sign ure: 1 Y
Call (503) 639-4175 by 7:OU P.M. for 3n inspection needed the n b siness da
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 F.E. _
Print or Type Date to DST`
Incomplete or illegible applic�itions will not be accep+ed Permit
Related SWR#
Called-----
Name
alled__ _Name of Development/Project r FIXTURES (individual)- QTY PRICE AMT
Job q , C/ 5( (-� 1/P WAJ.5 (l sink
Address Street Address SuiteLavatory - - 9.00
_ Tub or Tub/Shower Comb. 9.00
------ Bldg# City/Stale Zip Shower Only - �- 9.00
Name.y I Water Closet 9.00
�lL 12 re� r -Zrr It 4T,cA Dishwasher 0.00
Owner 'Mailing AddresT- , Suite Garbage Disposal 9.00
Washing Machine 9.00
Cityy//}State �ZIXq Phone Floor Drain/Floor Sink 2" 9.00
Name 3" 9.00
4" 9.00
Occupant Mailing Address- Sulte� Water Heater C^onversion O like kind 9.00
_ n Gas piping s aPing requireseparate mechanical permit.
City/State Zip Phone Laundry Room Tray 9.00
- _ -_ Urinal �- -� 9.00
Name -
Other Fixtures(Epecity) 9.00
Contractor Mailing Address Suite Y - 9.00
_ v-- 9.00
Prior to permit City/State Zip Phone Sewer-1 st_100' 30.00
Issuance,a copy - -
---- Sewer-each additional 100' 25.00
of all licenses are Oregon Const.Cont Board Lic.# Exp.Dal,-
required if Water Servire-1 st 100' 30.00
expired In COT Plumbing L.Ic.# - Exp.Date Water Service-each additional 200' - 25.00
database_ Sloan&Rain Drain-1st 100' 30.00
Name Storm&Pain Drain-each additional 100' 25.00
Architect Mobilf,Hume Space - 25.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pol!utlon Device
Engineer City/Stale Zip Phone Residential Backflow Prevention Device" 15.00
(irrigation timing devices require a separate
Describe work to be done: restricted energy permit). -_
New O Repair O Replace with like kind: Yes O No O Any Trap or Waste Not Connected to a Flr7ure 9.00
Residential O Commercial O 1 944- Catch Basin - 9.00
Additional description of work: -� - -
r
Insp.
T1 /TIns .of Existing Plumbing 40.00Prf3�
-- -
er/hr
D re 6jCTC-� 012)O 7� Specially Requested Irspections 40.00
, tC (tom- �_� er/hr --
Are you capping, moving o rep ting any fixtures? GDrat!.single family dwelling 30.00
Yes O No O Grease Traps 900
If yes, see back of form to Indicate work performed by - -- ----
fixture. FAILURE TO ACCURATELY RL,jOR r FIXTUREQUANTITY TOTAL
Isometric or riser diagram Is r_oquirod B Quantity Total Is >9
WORK COULD RESULT IN INCREASED SEWER FEES. _ - `SUBTOTAL
I hereby acknowledge that I have read this application,that the Information
given is correct,that I am the owner or authorized agent of the owner,and �-- 6%SURCHARGE
that plans submitted are in compliance with Oregon Stats Laws.
Signature of Owner/Agepft Datq **PLAN REVIEW 25%OF SUBTOTAL
cf Re ulred only n lialwti qty total Is>9
LEL C o-�tiu rc�/_ ,t ;/� _ TOTAL --
ContiO 11190tn Name Phone
-Minimum permit fee is$25+5%surcharge,except Residential Backflow
tF Prevention Device,which is$15+5%surcharge
"AII New Commercial Buildings require plans with Isometric or riser diagram
and plan review
r.lds1rs4*jnapp dot 7/2198
PLEASE COMPLETE:
Fixture Type _ - Quantity by Work Performed
New �Moved Replaced Removed/Capp,a_d
Sink
Lavatory - ------ - -------- ---- -- - —
Tub or Tub/Shower Combination - -- -- - ---__.� --
Shower Only
--__
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain/Floor Sink 2" �W
311
Water Heater
Laundry Room
Urinal _
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
%dstmpkx app d,-M'199