10115 SW HIGHLAND DRIVE-1 I
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CITY OF TIGARD BUILDING INSPECTION DIVISiON
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: — 10 — 18— 1 k — I'm. — P.M. MST:
Location: L'on 0
BUR
- 4115 A k-kA
Tenant: rj ",-I — ____ Suite: —Bldg: MFC:
Contractor
Phone: /Bldg:
PLM:
Owner: Phone: a'?9— (1,!?7�� ELC:
EI R:
BUILDING BLDG(con't7MECHANICAL ELECTRICAL- SITE
Site Post/Bellm llost/licani Posulicaill Cover/Service Sewer/Storni
Fooling Roof UndFl/Slab Rough-111 ('citing Water Line
Still) Framing Top Out Gas Line Rough-111 116 Sprinkler
Foull(lat loll Insulation Sewer I I(Xxvl)llct Rctonnect Vioill
lisillt Damp I)r)iva)l StormFurnace Temp Service misc.
Masonn ceiling Rain Dran� A/C I JG Slat)
Shear/Sheath Fire Spkir/Alm Crawl/Found Dr I lent Pump Low Volt
Approved Ail) . -1 Approved Approved Approved
Sd%klk Not ApprovedNF ot ove(I Not Al)l)io%,e(; Not Approved Not Approved
FINAL 1 _- , FINAL FINAL FINAL
---- -------
rl Call lot teinspecti-i rl Reinspection fee required Kt inspection Cl I moble to inspect
tor. Date: Ll/I
of
Inle0
CITY CF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 5lM Hall Blvd., Tigard,OR 97223 :' )3,1639-4171 F'F R M T'T ft. . . . . . . .. E I M98016,,
DAI'F ISF:UPD: V►6/12 !98
PARCEL_: ;`S111CC--1`000
',V, E C-IDDRES9. . . : 10115 SW HIG111-AND DR
1.3UDD t V I S I ON. . . . : GLIMhiF:RF I ELM NO. 4 ZONING: P- 7 PD
3L-0CK. . . . .. . . . . . : LOT. . . . . . . . . . . . . : :'01 JURISDICTION: TTG
CLASS OF WORK. . : PEI"' GARBAGE M SPOSAL.S. : V1 MOBILE HOME SPACES. : 0
TYPE OF US7. . . . :SF WArHTNG MACH. . . . . . : 0 BACKFL...OW PREVNTRS. . : 0
'31,17C11PANC'Y GRF='. . :R;?, FLOOR I7Rf•..NS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
3Tf)RTF=. . . . . . . . . . 0 WA"rE:R HEW'.ATFR5. . . . . .. i. CATCH BASIN,. . . . . . . . 0
FrIXTURF...S. •_ .._ ...._...._ LAUNDRY TRAYS. , . .. . : 0 s_,F" RAIN DRAINS. . . . . . 0
L I NKS. . . . . . . . . . N L IR I NAILS. . . . . . . . . . . 0 CREASE=. I'RAPS. . . . . . . : 0
.AV!4TORIE:S. . . . : 0 OTHER F'IXTLJI US. , . . : 0
TUB/SHOWERS. . . : 0 SEWER TNF (ft ) . . . : 0
WAI-ETR Cl__LISF_TS. : 0 WAIT'*R I....INE (ft ) . . . : 0
I" 1 SHWASHERS. . . . : 0 Rn T N DRII I N (ft ) . . . : 0
QPmA-r,ks : Regi tir-ement of water �reate!r- (witti I i ke kind) in residence.
. . ...... _._._._.___._.._..___.._._..._._.._.. ...____.____...— FEES
V TCTCIR WYKOOP type ctrnol-int by d at e er_pt
101 151 SW HI C-iHL_AKID DR F'RMI 6 ?5. 00 DL.H 06/12/98 98- 306477
TIGARD OR 97224 15Pr.T $ 1. 2!j7 I7l..li 4hF„'ij'/'?,3 98 .3064
"'hone #: 598--0974
RESCUE ROOTER
P(7 BOX 1728
WT.t_SCINVIL.LE OR 97070 ___.... ---..._ ___._....__.........._.._
sone #: ?4 3,--1175:' 26. 1`5 TOTAL
REDUIREnD TNSPECTICINS ._.._._._._.
permit is issued subject to the re",,iations conta ed in the F i nal 3nspert i on
and Municipal Code, State of [Ire. Specialty Codes and all other
icable laws. All work will be Jene in accordance with
,•oved plans. This permit will expire if work is not started
`rein IM days cf issuance, or if work is suspended for more
than IN days. ATTENTION: D egon law requires you to follow ides _ ___ _ •�___ __ __ �... _�__
adopted by til. Oregon Ut,14'.y Notification Center, Those rules are ____—„
aL forth in OAR 952-MI-0010 through OAR 952-KOI-1080. You may
` 3in ropies of thtse rules or, direct questions to DUNG by calling .......
?)246-1987.
I fl . / Permittee 9i nat+_rre :__
i ++++++++' ++++++++++++++++++++++++4+4-4-+4++-4+++++++4-++++-4 ++4++i•+++++++++•+++++++
] G39 4175 by 7 :00 p. m. fo -- i.t -, ins pert ion needed thre nFxt L+r.rsiness day
++++++++•t++-+++•4++++++•+++•-4-+++++++++++ +•++++4++•++++•+•!-++•t+++++++++++•+-+++++++++4 +
CITY OF IGARD Plumbing Permit Application Plan Check s
13125 SW HALL BLVD. Commercial and Residential Recd By .
TIGIARD, OR 97223 nate Recd
(503) 639-4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit#/&L.7f7T �7
Related SWR#
Called_
F_ Name of Development/Prole On back Indicate Work Performed ry fixture.
Job FIXTURES (In!!':iduaQ QTY PRICE AMT
Address Street Address Suite Sink 9.00
1� i k�_ Lavatory 9.00
BIgd * City/Statlii Zipr Tub or Tub/Shower Comb 9.00
Name
Shower Only 9.00
I \j
_L ,�,� 1 i1 -� Water Closet 9.00
Owner Mailing Address - Suite Dishwasher 9.00
Garbage Disposal 9.00
City/State Zip Phone
—�_--� �) r Washing Machine .00
LLA, _, 9
� \ r Y C 1' �� Floor Drain 2" 9.00
Nam _
�� 'L 1 /.' Y9.00
Occupant Mailing-Address Suite 4" — 9.00
a
Wat9r Heater O conversion like kindf j 5 00 --�
City/State Zip Phone ----
Laundry Room rray 9.00
Name Udnr,l 9.00
�rJ�e Other Fixtures(Specify) 9.00
Contractor 19 gAddresad Suite - I 90C -
J
9
Pnor to permit City/State Zip Phone —
issuance,a copy1i 7� 9 SL.+er-1 st 100' 3000
ln-r 17J t�1111LI.��2 � f _
of all Iicens,!s are Oregon Const Cont.Board Lic 1f Exp.Date Sev;er-each additiunal 100' 25.00
required if z l Y^ G Water Service-tat 100' 39.00
expired in CGT Plumbir, Lic / Exp.Date Water Servic(,-each additional 200' 25.110
se -2j n 3 3 - `1
database
Name Storm G Rain Lrain- 1st 100' 30.00
Architect Storm&Rain Drain-each additional 100' 25.00 Mobile Home Space 25 00
Or
Mailing Andress Suite —
Commercial Back Flow Prevention Device or Anti- 25.00
CitylState ZIP Phone Polluflon Device
Engineer Residential Backflow Prevention Device* 15.00
Describe work New O Addition O Alteration O Repair 0 Any Trap or Waste Ne t Connected to a Fixture 9.00
to be done: Residential k° Non-residenVal O_ Catch Basin 9.00
Additional descnptlon of work: V — Insp.of Existing F,umbing 40 00
_ er/l.r _
Specially Re,,jested Insp(.Mion3 40.00
_ per/hr
Ficin Drain,single family dwelling 3000
Existing use of Grease Traps 9.00
building or property —_,—
Proposed use of QUANTITY TOTAL
building or pmnerty Isometric riser diagram is_r-gwred K GuandV Total is >9
'SUBTOTAL
1 hereby acknowledge that I hava read this application,that the information 5°/.SURCHARGE • r
given is correct,that I am the owner u,authorized ayenl of the owner,and d+r
that plans submitted are in compliance with Oregon Stat o Laws. _ �. r2e•. '+
SIgnatu Own�rlAgent Cats a ulnadony�drlrmrroEVIEW gt�trnal ls5°9 OF SUBTOTAL
_ ' TOTAL C
orttact Parson Name Phone —
( 'Minimum permit fee is$25+5%surcharge,except Residential Backflow
Prevention Device,which is$15+5%surcharge
-All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I r4°Ubwm�app dx:Sl5/9e
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed/Capped
Sink _
Lak,,-Atcry _
'Tub or Tub/Shower Combination _
Shower Only
Water Closet
Dishwasher _
Garbage Disposal
Washing Machine
Floor Drain 2"
311
411
Water Heater _ — ' X
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
nDkun�aDp� 5/S/98