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10655 SW HALL BO'.JLEVARJ
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phom. 6394171
Date Requested: _ /' 3( A.M. `(P.M. MST:
Location: /4,i_-(J �,C' _ BUP:
Tenant: Suite: __I31dg: ^_ MEC:
r �-
Contractor: !y i (:L•')1 f f C i/l L.EIZ- l t.Cy- Phone: _ _ PLM:
clvcner: 71, 'i ,l L C ; ' ! 77-Phone: 1� �LJ 7.2= _ ELC:_
IsLR:
SIT:
BUILDING BLDG(con's) PLUMBINf,; MECHANICAL ELECTRICAL SITE
Site Post/Beam polb"Cairi Post/Beam Cover/Service C J lu:[!.S n
Footing Roof Undl'1/Slab Rough-In Ceiling Water
Slab Framing Top(hit ` Gas Line Rough-In IR3_$p-Tiler
I'oundation Insulation Sewer (.'U r 4lood/Duct Itec:omiect Vault
l3smt Damp
Drywall Storm , u t��f'urnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found� 1 teat Pump Low Volt _
Approved to Approved Approved Approved
Appr/Sdwlk Not Approved of vcd Not Approved Not Approved Not Approved
FINAL - FINAL FINAL FINAL
D Call for reinspection O Reinspection fee of$ required before next inspection 0 Unable to inspect
Inspector:1/! 7,Z— _ — Date:I/ 2Z -t�p/ Page /—of—
CITY OF TIGARD
. ....
DEVELOPMENT SERVICES F' FPERMITIT
PERMITT ##.. .. .. .. . . . : F'LM98-0012
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 01.122198
PARCEL: 1 S I.35AD-00900
SITE ADDRES`;. . . : 10655 SW HALL BLVD
SUBDIVISION. . . . : ASHBROOK FARM ZONING:
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :013 ,JURISDICTION: TIG
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY BRP. . : R,-- FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER HEATER,. . . . . : 0 CATCH BASINS. . . . . . . : 0
F I XTI.IRES— --_.____.__.___. I...AUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : N
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER L.INF_ (ft ) . . . : 7,00
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Rema:,ks : Jt.tve
Owner,: - ___.___.___.___,____.__._._________.___—.----________---.___.___..__ FEES _.----------_,_...__
MRS JOVE type amol_tnt by date recpt
10655 SW HALL. BL.VD PRMT $ 55. 00 JSD 01/22/98 98-302691
'f IGARI) OR 97223 SPCT $ 2. 75 JSD O1/22/98 98-30269t
Phone #: 246-1472
MODERN PLUMBING
11120 SW INDUSTRIAL.. WAY
TUAL.AT I N OR 97062
Phone #: 691-6166 $ 757. 75 TOTAL
Rey #. . : 000879
------- REQUIRED INSPECTIONS --- ---
This permit is issued subject to the regulations contained in the Water Line I n s p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Sery i r_e In
applicable laws. All work will be done in accordance with Final Inspection
approved plr.ns. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for #ore -r
than 188 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are _
set forth in OAR 9552-8801-8810 through OAR 952-0001-8888. You may
obtain copies of these rules or direct questions to Ol1NC by calling
(583)246-1987.
I ._s ted By• _ Permittee Cignati.tr e:� ��
�_ ,
+.++++++++++++++++++++ +++++++++++++++++i.t+t++t+-4-++++++++++++++++++++++++++++++
Call. 639-4175 by 7:00 p. m. fore an inspection needed the next business day
++++•t+++++++++++++ F+++++++++++++++++++++++-F+++++++++++++++++++++++++++..#- -+++ f4
CITY OF TIGARD Plumbing Application
Recd By��'7
Date Rec d
13125 SW HALL BLVD. Commercial and Residential Date to P E.
�-'�
TIGARD', OR 97223 Dale to DST
(503) 639-4171 Permit
Print or Type Related SWR*_
Incomplete or illegible applications will not be accepted Called
fName of Devi oprnenUprole ct - ^ 74Z V� ,- 'VqI ;New sin 90 Family Realdp s Onlrix irt+aFta SKr z�u
I Job f f ix ;� ,;,�• s " r .
Pill
BATH HO SE 5140.00,,.� ,�, p�2 6ATFi!OUSE 1185.00fir.
Address Street Address Suite i,�,;;r:r?' �, h .�,3 BATH NOUS $225.00 r x
w♦y.w -�... JM
G(p ;S Fee'Indudes all'p umbing fixtures tri 6i finelllnp and the?first 100 feet or'e+ 4<
Bldg a City/State Zip water service,sanitary sewer and storm sewer;.See fees below
Name��/� ,p FIXTURES(individual) QTY PRICE AMT
uSink - - -- -9.00
Owner Mailing Address Suite Lavatory 9.00 -�
55 5 i ti L4,a-(( _ Tub or Tub/Shower Comb. 9.00
City/ late Zip Phone __-_
_ --
7--c 6 -""t"-�"r 11 Shower Only -- 9.00
Name Water Closet 9.00
Dishwater 900
Occupant Mailing Address Suite Garbaye Disposal _ 9.00
Washing Machine 900
City/State Zip Phone Floor Drain 2' 9.00
--- - �-----
Name 9.00
/ _
fi/C)Q C 1E�l (JILLyt *L i1 _ 4 9.00
Contractor Mailing Address Sud. Water Heater 9.00
// (' 3cc.) Laundry Room Tray A.00
City/State U12L Z I p Phone Linnal 900
- -
Oregon Const.Cont, Board Lica Exp.D to Other Fixtures(Specify) _ 9.U0
Attach Copy of )�1 SLC (� ' / - -- 9.00
Currant PlumbingLic. np,1 Exp.Date 9.00
License 3 y1 5-n 1,6/ r Sewer- 1st 100' 9.00 v
COT Business Tax or Metro# Exp D to Sewer-each additional 100' 30.00
/ Water Service- 1 st 100' - i 2500
-
Name _
Water Service•each additional 200' 30.00
Architect Mailing Address Suite - Storm&Rain Drain-1st 100' 25.00
Storm&Rain Drain-each additional 100' 30.00
or _
Engineer Cd Zi Phone Mobile Home Space 25.00
City/State p
Commercial Back Flow Prevention Device or Anti- 25.00
DeiGnbe work New O Addition O Alteration Repair O - Pollution Device
to be done: Residential O 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 9.00
�er I'`A� - Insp.of Existing Plumbing per hr
_..�j..(� 1 (/ (;r _ per hr
Existing use of Specially Rnquested Inspections - 40.00
building or property _ per hr
Rain Drain.single family dwelling 30.00 ^
Proposed use of
building or property Grease Traps 9.00
AreoY u ca ping any fixtures? Yes❑ No _ QUANTITY TOTAL Eis
Isometnc or nser diaorant is reawred it Ouanly Total is >9 f
I hereby acknowledge that I have read this applicati n,that the information - '- *SUBTOTAL *'
given is rortec'.that I am the owner or authorized agent of the owner,and
that plans submitted are in compliance with Oregon State Laws --------- , r ��
Signature of Owner/Agent Date 5/o SURCHARGE
�G PLAN REVIEW 25%OF SUBTOTAL
Regwred only d fixture qty total is_>9
Contact
/Person
l INa a Phone NOTAL .�;•F? r
'Minimum permit fee,.i$25+5%surcharge,except Residential Backflow
i\dsts\ptmap doc / Prevention Device•which is$15+5%surcharge