12356 SW 132ND COURT ADDRESS:
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isarc'cordslmicrotlm\targets\buildit ig.doc
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CITY OF TIGARD BUILDING INSPECTION DIVISION c .
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: 13-31-31
r-'3 I"3 1A.M. P.M. MST:
Location: ,7 3 S ��(,{ ? 13_ BUR
Tenant: ! Suite:— Bldg: NEC: � c
Contractor:— 'Phone: ——1—L '-'r J 7 PLM:
Owner: Phone: ELC:
ELR:
BUILDING BLDG(con't) ING MECHANICAL ELECTRICAL SIT: SITE
Site Post/Beamobi Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ce;ling Water Line
Slab Framing Top Out. Gas Line Routh-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Record tet Vault
Bsmt Damp Drywall Storm Furnsi a Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab ���
Shear/Sheath Fire Spk1r/A1m Crawl/Found Dr Heat Pump Low Volt
Approved roved Approved Approved Apix6ved
Appr/Sdwlk Nut Approved Not pproved Not Approved Not Approved Not Approved
FINAL A"I�• FINAL FINAL FINAL
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D Call for reinspection O Reinspection fre oCS` required before next 'In
Lwtion C]Unable to inspect
Inspector: s _ Date: �� �� _ Page of
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : PLM98-0075
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 03/19/98
PARCEL: 2SI04AB-10100
SITE ADURESS. . . : 12356 SW 132ND CT
SUBDIVISION. . . . : MORNING HILL NO. 6 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LO) . . . . . . . . . . . . . : 130 JURISDICTION: TIG
---------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : I
OCCUPANCY GRP. . :R3 ;7LOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 DATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES-------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
ISINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . 0
' ' LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. , . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE ( ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Pemar,ks : Add residential. backflow prevention device to An existing single family
dwelling.
lOwner: ------------------------------------------------------ FEES ---------------
WOOLEPY, CAL & ROSEMARY type amount by date rerpt
1c'-,- j6 SW 132ND COURT VIRMT $ 15. 00 GEO 03/19/98 ?8-3042"'0
TIGARD OR 971::-.23-0000 5PCT $ 0. 75 GEO 03/19/98 98-304--60
Vlhone #: 590-4297
Contr-act or---------------- ------------------
TRYON CREEK LANDSCAPE INC
11400 S14 NORTH DAKOTA ST
TIGARD OR 97223 ------------------------------------.-...
Phone #: $ 15. 75 TOTAL
Reg #. . : 000115
------- REQUIRED INSPECTIONS -------
This permit is -.ssued subject to the regulations contained in the RFI/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Cndes and ali other Final Ins por-+- ion
applicable laws. All work will be done in accordance with
approved plans. This permit will pxplre if work is not started
within 180 days of issuance, or if work is suspended ;or more
than 180 day;. ATTENTION: Oregon law requires you to allow rules
cc
adopted by the Oregon Utility Notification Center. Those rules are
V) set forth in OAR 9'52-0001-0050 through OAR 952-900I-0080. You may
obtain copies of these rules or direct questions to OLIC by calling
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I u e d B Flpv-mittee Signature
C.
++++++++++++f+++++++++++++++++++++++++++++++++++++++++++++++ + +.............
Call 639-4175 by 7-.00 p. m. for ar. inspection needed the next business day
.................. L+—+.....................f-+++++,+I...............4........... ...
Recd By
CITY OF TIGARD Plumbing Permit Application
13125 SW HALL BLVD. Commercial and Residential Date Recd
_
TIGARD, OR 97223 Date to P.E.
Date to DST
(503) 639-4171 Permit# C� I� Z�
Print or Type Related SWR 0
Incomplete or illegible applications will not be accepted Called-
Name of Development/Project On back Indicate Work Performed by fixture.
Job FIXTURES (Individual) QTY PRICE AMT
Address Street Address Suite` Sink 9.00
_ Lavatory 9.00
Bldg# ity/State Zip Tub or Tub/Shower Comb. 9.00
Na e / �— Shower Only 9,00
001 Q.f i C.,p I + e *VW Water Closet 9.00
Owner Mailing Addre s Suite Dishwasher 9.00
C. — Garbage Disposal 9.00
City/Stste Z-i Phone --
"fo _ Zg> Washing Machine — 9.00
Name 'L lI Floor Drain 2" 9.00
_ 3' 9.00
Occupant Mailing Aodress i Suite 4- 9.00
City/State Zip Phone
Water Heater O conversion O like kind 9.00
-__
Laundry Room Tray 9.00
Name linnal 9,00
t( e-- 4t5;K_ ib Gther Fixtures(Spe.ify) 9.00
Contractor Mailing Address Suite —
9.00
Pr,r to permit City'State Zip Ph net 9.00
issuance,a copy - 7-zz:S &iN-Zt9.00
of all licenses are Oregon Const.Cont Board Lic# Exp,Pate o ,
required if I l$Z Sewer-1st 100" 30.00
expired in COT Plumbing Lic.# Exp.Date
database Sewer-each additional 100' 25.00
Name Water Service-1st 100' 30.00
Architect Water Service-each additional 200' 25.00
Or Mailing Address Suite Storm&Rain Drain-1st 100' 30.00
Sturm B Rain Drain-each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 2500
Commercial Back Flow Prevention F ;we or Anti- 25,00
Describe work New O Addition O Alteration O Repair O Pollution Device
to be done: Residential O Nur-residential O Residential Bar-"ow Prevention Device' 15.00
Additional description of work` Any Trap or Waste Not Connected!o a Fixture 9.00
Catch Basin
9.00
Insp.of Existino Plumbing 40.00
per/hr
Existing use of l Specially Requested Inspections 40.00
building or properly_ M1�- YN per/hr
V Rain Drain,single family dwelling 20.00
Proposed use of Grease Traps 900
cc building or property �)Cko^-e
QUANTITY TOT,.L
I hereby acknowledge that I have read this application,!hat the information ,
> _
K p JB11 ty total is >9
F- given is correct,that I am the owner or authorized agent of the owner,and Isometric or riser dlrain is, 'SUBTOTAL
J that tans submitted are in compliance with Ore oq n State Laws.
r Sign of Owner/Agent Det 6%SURCHARGE
w 1 PLAN REVIEW:26%OF SUBTOTAL
Cont n Name Ph ne
f 1, [ Requked only d future qty -^tal is,9
S�re y I.JC-p'-I`1tK" fj2-It-2l7 — TOTAL
'Minimum permit fee is$25+5%surcharge,except Residential Backflow
Prevention Device,which Is$15+5%surcharge
I tdststpmam doc U97
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink
-avatory
-rub or Tub/Shower Combination _
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine _
Floor Drain _ 2"
311
4"
Water Heater
Laundry Room Tray _
Urinal _
Other Fixtures
,,OMMENTS REGARDING ABOVE:
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