12900 SW PACIFIC HIGHWAY STES C-E-1 ADDRESS.
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i:\records\microfIm',targets\buiIding.doc
January 6, 1997
y� CITY OF TIGARD
/ 1 (I - Cl 7 OREGON
Q 22 ? r l
zo
Our records indicate that ether no inspections iLwe t*ren conducted on the project authonzed by the above
noted prnnt OR inspc=onts) have been conducted but tie have no record of any subsequent or final
inspa-tions within the past 15 days Oregon Adnunistrative Rule(OAR)918-260-270 require;initial
inspections be requested within 24 hours of completion of installation and inspections for corrections to
be made within IS da-vs.
Permits and inspections required by the Tigard Mtuucipal Code are an important part(if your project.
Permits help to ensure that work is done in compliance with mirumum code requimmet.,ts_ Inspections are
intended to protect the or Wutts of buildings and building owners. As the eie=cal c m wor,you are
responsible for obtaining the required inspections,
The City would tike to work with you to cl
mirurrwn code has been achic —
41W ORTANT MESSAGE
If you arc ready to schedule the item ins AVf1ft
6394175 within 15 .da sBe GOR_—=
y P to
/^/0 q-7property,your name.Your phone number, DATE �7 TIM E�-- -_p.M.
cannot be guaranteed.but you may request n
M L?l&L &Z If I —
I
If you treed additional time to cotmpkte; OF
You may request an additional iS days_ P
address t—
of property,your narne,a day time PHONE—
AREA CDD! XTVN910N
1F YOU ARF: UNSURE ABOUT WEA" TELEPHONED I PLEASE CALL
.ANY QUESTIONS, please contact the B
CAME — -.--- - -i
_ TD PEE YOU 1 'i WILL CALL AGAIN
serve vote, plisse have the following iaforr ___
day time phone number. wANTB m SEE You mm -�_-
RETURNM YOUR CALL I I EPEML ATTENTION
Thank you for your cooperation in this ma
localh'and at the state level, if work has F MESSAGE " G -OU3If
��' (/
ouLstandine. Your prompt anenuon trill rl .,
regwred inspections. --�--FLf- o b j
z--- r2 —
Jeanne Temple (1) y L_ja_Qpt1 'Vi2.)
Bwldirp Division
i:`xnAMV *40W_rupsedw SIGNED—____ _--
U iH0 IN U.3 ll
TOTAL OFFICE PRODUCTS TOPS 30025
and printers, Inc. 2 228-2395
13125 SW Hall Blvd., Tigard, OR 97223 (503) 631y 1/ 1 ILvv (ouj)
CITY OF TIGARD BUILDING INSPECTION NOTICE 11
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/3eivice FINA
Foundation Water Line Ceiling (-Plumh.
Post/Beam Mach. Shear/Sheath Framing -Mer h.
Plbg.Und/Flr/Slab Plbg.Top Out insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg,
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: C J —
Date: A.M. P.M. Entry:
Address:
MST: —
�/ 4 BLIP:
Cpq/Own: MEC:
PLM
tse�7a 1, ELC:
THE FOLLOWING CORRECTIONS ARE F(EQUIRED: ELR:
Inp tor: Date:
_APPROVED —__DISAPPROVED/UALL FOR REINSP. CF) CO
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT '
13,125 SW Hell Blvd.Tigard,Oregon 97223.8188 (503)839-7171 PLUMB I'JG PERMIT
1.1-JRM I T #. . . . . . . PL_M95-03,30
639--4171 DATE" ISSUED- 10/31/95
PARCEL- 2S 102BD--01 r)017i
SITE: ADDRESS. - :« : 12900 5W PAC I r I C I-IWY
SUBDIVISION. . . . : FREWING TRACTS SUBDIVISION 70UING: C----G
. . . . . . . . . . . LOT LOT. . . . . . . . . . . . . :D
CLASS—OF�WORK. . 'ALT GARBAGE DI SPIT pI....S. . ; 1hOf?Il_r_- IAOMF SPACES. :
TYPE OF USE. . . . :DUP WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . :
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . .. TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . . WATER HEATE-RS. . . . . . : C:ATC.I-I BASINS. . . . . . . .
FIXTURE S—•_--.—___-__._._.._... I.._AUNDRY TRAYS. . . . . . : 5F F±AII\I DRAINS. . . . . :
SINKS,. . . . . . . . . . . URINALS. . . . . . . . . . . . GREACE- TRAPS. . . . . . . .
LI-4VATORIES. . . . . : OTHEf I''IXTURES. . . . . .. i
TU1-1/SHOWERS. . . . : :_wE R L I NP (ft) . . . :
WATE:*R CLOSE:TS. . ; WOTER LINU (ft ) . . . . a
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Rerc�arks : 'rie r^emecdiation tower dischar-ge to existing sanitar-y cleanol_rt.
Owner: __...__.__..__.__.___-----_____.__---_______.._.__..-------__.__.___.._ FEES
MARII._YN HENDE:RSON type amnf.mt by date recpt
11795 SW KATHERINE F P'RMT $ 25. 00 BON 10/31/95 95—:'7232-;
5PC'T $ 1. 25 BON 10/3.t/95 95.--2 7 i�'3 2.
TIGARD OR 972'2:3
Phone #;
CorJv-actor;
SEMINOLE ENVIRONMENTAL. INC.
IC2632 SILVErRTON RD NE
SILVER T ON OR 9-7381 ......
Phone #; A73-5404 « 25 Tr_"n'
----— RE.0L.7 Rr--D I NSPECT I ONS ----_.--
This pereit is issued subject to the regulations contained in the Mis•, . Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other F:nal Inspecti -rn �,�__•._�•__ __
applicable laws. All work will be done in accordance with _ _ __—______�•_, _ ___._ __.___.._..._.__� _..
aooroved plans. '.• ,, Nei.,.,ill expire if work is r ` started
within 180 days of issuance, or if .,nrk is suspended fer om
than 18Q days. l
s i_r e(d F'y
Call fur inspection 639-4175
City of 'Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13, 125.SW Hall Blvd. Permit #FLM�fS
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE t ST. SURCHARGE
"m• 1 D". ^_l-- New Single Family Residences Only
�.,A sir, PIAzA _
Ad&«• ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Jab ? 41 00 Sk' f004 ❑ 3 BATH HOUSE $225.00
Address cnps.t. - zp Fee includes all plumbing fixtures in the dwelling and the first 100 feet
„ of water service, sanitary sewer and storm sewer. See fees below.
�^•
"• -k •=��-•^«•� I � FIXTURES QTY PRICE AMr
Milli e`__Q_ej0h Sink - 9 n
M.*ro�.4 MA Lavatory 9.00 ,
Owner d_L6 54J i/-A4LE('I1\ Q Sl Tub or Tub/Shower Comb 900
cjh,at•,• zip Shower Only 900
1;4,A(L �� -_ [ ] Water Closet 9.00
"^ .^•m••1 h-...•) Dishwasher 9.00
S4 i Garbage Disposal 9.00
Occupant ,.ra.4a *.•• Washing Machine 9.00-
1-Lc)1 5o (Jul.1'tl tL' Floor Drain 9.00
�•• Water Heater 9.00
Laundry Roam Tray - 9.00
N.
Urinal 9.00
C rA i A d Ie Other Fixtures (Specify) 9.00
.r^a,dr... an... 0-ee--
5N 01
Contractor I y 7`,• 1 I f Qw1ac��Q {, ,2 r ,
9.00 _
"y ro 9.00
Sewer 1st 161, 30.00
••"•a•"•"•^"" Ur'19" T•,1. Sewer -ea. Addit. 100' 25.00
0 Water Service 1st 100' - e 30.00
I hereby anknowled a that I nave read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authon;:ed agent of
the owner, that pians submitted are in compliance with Slate laws, that Slotm &Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addi`. 100' 25.00
number given is correct. (If exempt from State registration, please
y,ve reason below.) Mobile Home Space 25.00
Back Flow Prevention -�
Device or Anti-Pollution Device 9.00
•�• �M a ^r °i'• Any Trap or Waste Not
Connected to a Fixture 900
Describe work new (_) addition (_) alteration (A repair O Catch Basin - 9.00
to be done residential O non-residential Insp. of Exist. Plumbing 40 00/hr
Specially Requested Inspections 40.00/hr
Existing use of � - --
building or property IN t[ (2 - Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of �
building car property
'(Except residential backflow
t)revention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL 7
PERMI'i S BECOME VOID IF WORK OR CONSTt.Jr.TION
AUTHORIZED IS NOT COMMENCED WITHIN 180 r)AYS, OR IF 5%SURCHARGE Z�j
CONSTRUCTION OR WORK IS SUSPENDED OR.-ABANDONED ---
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED- PLAN REVIEW 25% OF SUBTOTAL ��" 7
TOTAL ..�.�'. Zr)
Special Conditions _ _
-� _ Date issued _1D 7fI Ir by , �`�-
: � 11 � I t 11'11 'I I;i I � •C
I�I�JI+11'- 1)V(�� I l� l!Itil 1!,1) I L i' •',1 I� ' : 1 : " I 1 �I•II {t 11 I ' .. iil , I/U�.I
HC.)J t1?1.`-:iCi � i .t�..�t,"! ,,I,I F .I I! I , n it� : • I : t � Ili PI I l'l� t ! I I:' . I
1-11110 1(flit t I► I'll,I`II CJI , II'If tl h ! f t t l•! I'r.I II : III ,! u ; 1 III t
F'! .IllYllt I NIS F'F h'1,� ,�.,: , I t 1 � I; ,• ! I
1'I,..,PsWIH, it Ii It 11t1
I
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Ph ): 639-4175 Business Phone: 639-4171
Inspection: ��"�
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation •Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time: AM PM
r 1 �
Address:
Builder: (� �((1 e r Permit #: .c��..
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: 5C Date:y
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
08/28/95 15:05 V509 684 7297 CITY OF TIGARD id 602/002
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
\ Tjard, OR 97223 Planck/Rec. #
Permit #
Phone (503) 639-4171 Date ISsued `
FAX (503) 684-1-297 Issued by
CITY OF TIGARD TDD No. (503) 684-2772
Insp-1jon (5031 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 7r _ Number of inspections per permit allowed
Address—/ Service included: Items Cost(ea) Sum
C:IrylStateiZip -r 01
4a. Residential•per unil
roan eq,N.or leP s 11 n[m
Loch addxlond Sao on h or
Name (or name of b ins�s)���✓_L 1._ �tz��Rjl
portron that*& $25 00 -
(( Limned liner 1125na 2
Commercial Residential❑ �X MoM Manufd Nene ar Modular
D"ohne serVKM ar Beerier uie 00 �-
2a. Contractor installation only: 4b.Seevicee or Faadan
inetallal;an allaretian,or relaoarnn 2
Electncai C tractorlJl/!!! /` 6yd� �-!r.rm.4C':r��C-�rC (: 200 amts or!carr �_ .� ' �U 2
(\`\ - r 701 a,"08M 4Mamps WOO
Address F .) 401 amp IQ eco rugs $120.00 2
City ucn e State ZpZj= sot amps lc 1000 am pe $16000 _ 2
owr lam amp a or voso s3 00 2
Phan$ No. - - Amon.ea" $5000
Contraollor's License No. -!;-U 4 L C_�
Contractor's Board Reg, No. 4a Tempor'ery Services or Feeders
.� natalisi on,ailor„I on ar rawation
160
Signature of Supr. Elec'n 1, 1 L 201 para at lass b 00
211 amps 401 amMps S75 00
License No.__L ayt Phone NO 401&mss to coo Write $ton 00
poor 501 amps to low Vola
2b. For owner installations: "°"'b atov'
4d.Branch Circuits
Print Owner's Narne� Now,aftnioan orederaion per pond
Address J_ N The IN for bench eiretltt with 2
_ Age's orwrivillea or ftedloir kv
City_ State ZIP__ ss 00
C F lath branch eirouA
Phone No. 5;The Ise for branch erreuna*acinar 2
TTte installation is being made onroperty I own which is pumho"0111irl"Of ball t`
p oval enrich drmuil $99
not intended for sale, lease or rent. Eadr mWilrorMi Ixame cirnvll S500
Owner's Signaturoa � 44L Miscalls nexus
(Service or feeder not included) z
Esoh pump or ingalon drdo $40.00
�. Plan Review section (if required): W tier or sulllra 4himo tYeO ao
Signal mmvil(s)fit a limned energy 2
Please chock appropriate Item and enter tee in section 513. wiei,moratlon or adanmon
4 or mora rTASidantial units in ona Stnlctisro MVnor Llaela(11) $1 oil 00
Service and te+ado3r 225 amps or more 4f.F-cft additional inspection over
System over Hou volts nominai the allowable in any of the above
Classified area or structure containing special Occupancy Par Ioapvction $35.00
as cesenbed in N.E,C, Chapter 5 Par hour $96.00
In Plant __- $5500
Submit 2 0012 of plans with appecation where any of the above
apply. Not requited fot temporary constrUotion services. 5. Fees: _ _ C,4,
NOTICE 5a.Enter total of above lows $
S%SLir-harge(.05 X total teas) 3 0
subtonic s S o
PERMITS BECOME VOID IF WORK Or7 CONSTRUCTION 5b.Enter 211%of lime A for
AUTHORIZED IS NOT COMMENCED WITHIN too D�.Y9,OR IF flan Review if required(Sec 3) 8
CONSTRUCTION OR WORK 19 SUSPENDED OR ABANDONED FOR Subrotal $
A PERIOD OF 160 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. 0 Trust Account to S
Balance Due
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f-tli 'lirlll ill Iriill .. lll.I, ri,,�i.I4r
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I11 I`IIYMIIII 1 1111!IllfII I '(Vil _11'j -1i 't II ; � UI� 11.11 I ': I ' Ir
1 i I I l: Ili11'! I! {'F_I•li'rlf l , 6'�.. l;it;r I .. I Illi !I
1;'->400 `aW 1"•11V., 1f 1I_; IIWr
11 f t 1. (Ihil Il.WA I E'(l 1 1'
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