11495 SW 90TH AVENUE iy
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 C?usinass Line: 639•A171 MST
I/'� /^ BUFF
---T Date Requested_ �AM PM BLD
—�Location / c� Suite��-- MEC
Contact Person — Ph — _ PLM
Contractor p;; SWR J
BUII-D!NG Tenant/Owner _ ELC
Retaining Wall — _--! ELR -
Fooi,.g Access:
Foundation FPS
Flg Drain ---
Crawl Drain Inspection Notes: SGN
Slab _
Post& Beam __-_ __ SIT
Ext Sheath/Shear 1
Int Sheath/Shear
Framing
Insulation
Drywall
-
Drywall Nailing �Z �ir%✓� _
Firewall —"
Fire Sprinkler
Fire Alarm "—
Susp'd Coiling
Roof
Misc:
PASS PART FAIL ----- -4_l-
PLUMBING
Post& Beam - —
Under Slab
Top Out - — _ --- -- - -- - --— —
Water Service
Sanitary Sewer
Rain Drains
fts PART FAIL
MEINKNICAL - -- --
Post R Beam -- - -- - - -
Rough In - -- --
Gas Line T. - --- --- _
Smoke Dampers
Final - - ----
PASS PART FAIL -- --- --
ELECTRICAL
Service
i
Rough In _-�-
n _
UG/Slab
i Low Voltage
Fire Alarm
� Final ---- --- .--- ---
f ASS PART Fi _—___---- - ------SITE
Backfill/Grading - - -- - - —
Sanitary Sewer
Storm Drain [ ]Reinspection tee of$ _ required before next inspection. Pay at City Fall, 13125 S1A'Hall Blvd
Catch Basin
Fire Supply line ( [ Please call for reinspection RE: [ )Unable to inspect-no access
ADAAppr
Otheoach/Sidewalk Date _ t� _ Inspector _' /' Ext
Final I - ��
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY Off' TIGARD PL-UtieING PERMIT
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 PERMIT #. . . . . . . : PLM98-0361
DATE ISSUED: 09/30/98
PARCEL : IS135DB-00500
SITE ADDRESS. . . : 11,495 SW 90TH AVE
SUBDIVISION. . . . : TIGARDVILLE PARK ZONING: R-4. 5
BLOCK. . . . . . . . . . , LOT. . . . . . . . . . . . . :005 JURISDICTION: TIG
CLASS OF WORK. . -Al-T GARBAGE Dl�)POSALS. : 0 MOBILE HOME SPACES. . 0
TYPE OF USE. . . . :SF WASHING Mi40d. ., . . . . : 0 BACKFLOW PREVNTRS. . : V,
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . : 117'
STORIES. . . ., . . . . : 0 WATER HEATERS. . . . . : Q1 CATCH BASINS. . . . . . . : 0
F I X TU LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : f7i
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . : 0 GRFASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 120
WATER CI-OSFTS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . 0 PAIN DRAIN (ft ) - . : 0
Remarks : Whitp replace Sewer line On private property only
Owner: FEES
BARBRA WHITE type Amol-int by gate recpt
11495 SW 90TH PFMT $ 55. 00 JSD 09/30/98 98-309615
TIGAFD OR 9722-23 5PICT $ 2. 75 JSD 09/30/98 98--309615
Phone #: 639-5605
Contv-artoi------------------------------------
ROTO ROOTER SERVICE R PLUMBING
HOFFMAN SOUTHWEST CORP
4248 NF 148TH AVE
PORTI-AND OR 97230
Phone #: 682-9774 $ 57. 75 TOTAL
Reg #. . : 0001.379
REDUIRED INSPECTIONS
This pervi► is issued subj,,ct to the regLlations contained in the Sewer, Inspection
Tigard Municipal Code, State of Ore. Specialty Lodes and all other Final Inspection
applicable laws. All worth will be done in accordance with
approved plans. This permit will expire if worn is not started
within 180 days of issuance, or if wcrk 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 DAR 952-900I-0010 through DAR 952-0001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
0 (503)246-1987,
7
Issued Permittee Signati.tre : oe
++++++++++++++++++++++++++++++++++++++ h+++++++++•++++-1-i++++++++++++++++•+ ++++++
Call 639-4175 by 7-00 p. m. for an inspectinn needed the next blASiness day
+...................................4-++4+4....................4-#............4-+++
CITY OF TIGARD Plumbing Permit Application Plan';heck0
13125 SWHALL BLVD. Commercial and Residential Recd By '
TIGARD, OR 97223 Date Recd 09 ICIq '
(503) 639-4171 Date to P.E. _
Print or Type Dale to DS?
Incomplete or applications will not be accepted Permit# / •-1
Related SWR#
Called Ct T
Name of Development/Project FIXTURES (individual) QTY —VR15q AMT
Jot) Sink 900
Address Street Address _ Suite Lavatory �^ 9.00
Tub or Tub/Shower Comb, 9.00
Bldg# City/State Zip Shower On.y 9.00
--- 2
Narr Water Closet 9.00
i L
Dishwasher ' 9.00
Owner ailing Address Suite Garbage Disposal 9.00
-cYd�15�e g5t Washing Machine 9.00
Ciw/S!ata Zip Phone
ne
Floor Drain/Floor Sink 2" 9.00
Nafne 3" 9.00
4" 9.00
Occupant Mailing Address Suite tyaer Heater O conversion O like kind goo
Vo-_pi ip n9 requires a separate mechanical permit. _
,-;ty/slate Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Na e -
Other Fixtures(Specify) 9.00
Contractor Mailing Address Suite 9.00
S ' .46 9.00
Prior to permit City/State Zip Phone Sewer-1st 100' ✓ 30.00
issuance,a copy �yi��P cy, 5P7n7 z' Sewer-each additional 100' _ a l5 00 P'
of all licenses are Oregon st.Cont.Board Lic.# Exp.Date
required ifC�, S , -Od Water Service-1st 100' 30.00
expired in COT Plunibing Lic,# Exp.Date Water Service-each additional 200' 25.00
database - 6 r Q Storm&Rain Drain-1 at 100' 30.OU
Name Stolm&Rain Drain-each additional 100' 25.00
Architect _ Mobile Home Space 25.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Engineer Cily/State Zip Phone Residential Backflow Prevention Device' 1500
(Irrigation liming d-vires require a separate
Describe work to be done: realricled energy permit.) _
New O Repair O Replace with like kind: Yes O No V- Any Trap or Waste Not Connected to a Fixture 9.00
Residential A Commercial O Catch Basin 900
Additional description of work:
�i Insp,of Existing Plumbing 40.00
i� e "�d.4l.-r,k >C'e,.tQ',Cr n t Pr/hr
� f Specially Requested inspections pe 00
perlhr
Rain-Drain,Are you capping, moving or replacing any fixtures? Grease Traps
single family dwelling 30 00
Yes O No O Grease Traps 9 00
If yes,see back of form to work performed by —
QUANTITY TOTAL
fixture. FAILURE TO ACCU,7ATELY ^EPORT FIXTURE Isometric or riser diagram Is required M puantMy Total is >9
WORK COULD RESULT IN INCRE;ZZO SEWER FEES. *SUBTOTAL (�
I hereby acknowledge that 1 have read this application,that the Information _ _
given Is correct,that i am the owner or authorized agent of the owner,and 6%:URCHARGE r>
that plans submitted are in compliance with Oregon Stale Laws.
Signature of Own fAgegl Date **PLAN REVIEW 26%OF SUBTOTAL
.� �
Required only If 0:1we qty total is>9
TOTAL
Contact Person Name Phone _ �t
'Minimum permit fee is$25*5%surcharge,except Residential Backflow
L c7 Prevention Device,which Is$15«5%surcharge
"All New Commercial Buildings require plans with isometric or riser diagrim
and plan review
I�dstsNlumspp dx:MIN
PLEASE COMPLETE:
Fixture Type Quantity by Work d RPerformed —
New Move Replaced Removed/Capp_ed
Sink _
Lavatory
Tub or Tub/Shower Combination _ — -
Shower Only --
Water Closet_ _
Dishwasher
Garbage Disposal _ ---
Washing Machine __
F!oor Drain/Floor Sink 2" -
Water Heater -
Laundry Room Tray _
Urinal _A
Other Fixtures (Specify)
COMMP'^ REGARD NG ABOVE:
J
I\dstslplumepp dor 7r198
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : PLM96-0:544
DATE ISSUED: :11/14/96
PARC.IL.: 1513 DB-00f"00
G I TE ADDRESS. . . : 1. 149:_"; SW 90TH AVP`
S,UBUJUSION. . . . : TIGARDVILLE PAPK ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . .5
CLASS OF WORK. . :ADD GARBAGE DISPOSALS. 0 MOBILE HOME SPACES. : 0
TYPE" O' USE. . . . :SF WASHING MACH. . . . . . . 1 BACKFLOW PREVNTRS. . : 0,
O-CUPP. ICY GRP'. . :R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
51-ORT'._S. . . . . . . . . 0 WATER HEATERS. . . . . 0 CATCH BASING. . . . . . . . 0
FIXTURES— ----_____.____. LAUNDRY TRAYS. . . . : Qi SF= RAIN DRA I N3. . . . . : U
SINKS. . . . . . . . . . . 0 UR I{MALS. . . . . . . . . . . . 0 GREASE TRAP'S. . . . . . . . 0
!__AVATORIE:S. . . . . : 0 OTHER FIXTURES. . . . .. 1.
TUB/SHOWERS. . . . : Of SEWER L...INE (ft) . . . : 0
WATER CLOSETS. . : 0 WATER LINE (ft) . . . : 0
DISHW(,SHE:RS. . . . : 0 RAIN DRAIN (ft) . . . : 0
Remarks: Adding fixtr_rres
Owner: _..___...___.__.______.___---____.____.__._______.___.______._..... FEES
KEITH WHITE type amr by date recpt
11495 SW 90TH PRMT $ ti,lr DGT 11/ 14/96 96- 28654 i
5PCT $ 1.. `, DST 11/1.4/96 96-2865471
TIGARD OR
Phone #: 639-5605
MODERN f--ILUMB I NG
1. 1120 SW INDUSTRIAL WAY
TUAL_AT I N OR 97062 _._---.._.._..-
F"'h o n e #: 691---6166 $ 26. 25 TOTAL
Reg #. . : 87906
------- REQUIRED TNSPECTIONS -- - —
This permit is issvd subject to the regulations contained in the Misr_. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. Rll work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, ar if work is suspended for more
than 180 days.
i'er mi.ttep Si. natur�e�:/ ,
I s s _red By :
1 for-, inspection 639-4175
CITY OF TIGARD / - Plumbing Application Recd By—_
13125 SW HALL._ BLVD. Commercial and Residential Date Recd
_
TIGARD, OR 97223 Date to P.E.Date to DST
(503) 639-4171 Permit# aL`"'Hy
Print or Type Related SWR#_�,1Ar
Incomplete or illegible applications will not be accepted Called _
Name of Devlopment/project
Job t �� L LC r1151 1�
1 E1A 0 SE 5140 00 s
Address rar 7ffiUSE Ytt
Street A dress Suite `�'„��e+ '�
,95 00
l C `Fc. . .. ,
. �Ct � .Feeridlidesalt umbin fixturesInthedwellt eflri100 feet of:�
Bldg# City/State- Zip waler_servlce s nitary sewer arid storm sewer�See fees below >}+r� r;l,'r,
Name FIXTURES (individual) QTY PRICE AMT
" L Sink 9.00
Owner Mailing Address Zuite Lavatory 9.00
Tub or Tub/Shower Comb. 9.00
City/Slate Lp I Phone
12f3 -��S Shower Only -- r,.00 —
Name Water Closet 9.00
Dishwater 9.00
Occupant Mailing Address Suite Garbage Disposal 9.00
Washinq Machine j 9.00 ?
City/Stale Zip Phone Floor Drain 2" 9.00
Name
�1 o6E_ '}(��t n� Yti�b�' !�, 4- ! 9.00
Contractor Mailing Address -'%011eT Water Healer
100 St,� r YVc�L, r ' 1 s.00
Cc A L Laundry Room Tray 200
City/State t Z�� p�) one a Unnal 9.00
U f ( I�0 0
Orr »n r',. Cont.Board Lic.# Ex .Date Other Fixtures(Specify) C� ! q.00 ri '
Attach Copy of j -1 q C) r C 9.00
Currant Plumbing Lic.#, ''11 II Jt Exp.Date 9.00
License r`�l �7��IS Z�S Sewer-1st 100" 9.00
COT Busines T or Metro# Exp.Data
�� Sewer-each additional 100' 30.00
Name I r Water Service- 1st 100' 25.00
Water Sei iir.e-each additional 200' 30.00
Architect Mailing Address Suite Storm&Rain Drain-1s1 100' 25.00
Storm&Rain Drain-each additional 100' 30.00
Or _
Engineer City/State Zip Phone Mobile Home Space 25.00
9 Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New O Addition O Alteration It Repair O Pollution Device
to be done: ResidenttaIV Non-residential O Residential Backflow Prevention Device' 15.00
Additional description of work _ Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 900
Insp.of Existing Plumbing 40.00
per hr
Existing use of
Specially Requested Inspections 40.00
building or property— per hr
Rain Drain,single family dwelling 30.01
Proposed use of —
building or property Grease Traps 9.00
Are you capping any fixtures? Yes❑ No p QUANTITY TOTAL
- !sometric or riser diagram Is required if Quandy To sl is a 9
I hereby acknowledge that I have read this application, 'tial the information -
�+�: s.0• u
given is correct.that 1 am the owner or authorized agent of the owner,and "SUB'iOTAL � '�6...,....,.
that plans submitted are in compliance with Oregon State Laws. 5% SURCHARGE
Sign of Owner/ gent Date '•?`, `
PLAN REVIEW 25'/°OF SUBTOTAL --fith-q .:ori", /fid
on arson amo ho
Required only g fixture a total is,9
Ct NPhone 1 — _
TOTAL
Mlniraum permit fee is$25+.5%surcharge,excepl Residential Backflow
i:ldststplmapp.doc
Prevention Device,which is$15+5%sure arge