7420 SW HERMOSO WAY-1 . I
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7420 HERMOSO -
CITY OF TIGARD BUILDING INSPECTION DIVISION
2-4-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BUP
—____----Date Requested
r,� J 3'���1 h1_ --PM �., .- BLD _—_�—
Locp'inn --) ` Suite MEC --Contact PPr;on �( rjt3rl'� _ Ph 11e?2 ' / �� " PLM
Contractor PhSWR
,BUILDING Tenant/Owner -- ELC
Retaining Wail - - — ELR --
Footing Access: V - -
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes. SGN --
Slab SIT
Post& Beam --- —
Ext Sheath/Shear
Int Sheath/She;., - ------- "" --
F raining
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm - --- - -
Susp'd Ceiling
Roof ----
Misc.
Final
P ART FAIL - - -- --
Post eam ----------- _
Under Slab
To Out - -- -
ater Serv`Ice� ��
Sanifary SewerRajLLU --
rains -- ---._-.-.- - ---
S, `)PART FAIL
Post& Beam _--
Rough In
Gas Line ---- ----
Smoke Dampers -�
Final
PASS PART FAIL
ELECTRICAL -- - -
Service
Rough In -- -- - --
UG/Slab
Low Voltage —•---_____._�. -.-__._�..__....._--.___-..___
Fire Alarrn
Final ----_ _ _---------- - —____ ___----- ---
PASS PART FAIL
SITE
Backfill/Grading - - -- ----- ----- ------ - ----
Saoitary Sewer
Storm Drain [Reinspection fee of$_ -- —required before next inspNction. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line l 1 Please call fcr reinF, action RF _ -_ [ )IJnable to .nspect- no acceF3
ADA �,
Approach/Sidewalk '1..`)
!ether Date _ _ Inspector ( - _— Ext _—
Final
PASS PART- FAIL DO NOT REMOVE this inspection record from the job sine.
CITY OF TI GA R V __— PLUMB NG PERMIT
DEVELOPMENT SERVICES PERMIT#: PIL'M1999-00136
13125 SW Hall Blvd.,Tigard, OR 97:�3 (503) 639-4171 DATE ISSUED: `�!- 3C-1113
SITE ADDRESS: 07420 SW HERMOSO WY PARCEL: 2S101AB-01700
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK. ALT GARBAGE DISPOSALS: MOBILE '.TOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RA:N DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER. LINE: 30 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water service
Owner: FEES
- �— – C
ALAN ROTH Type By Date Amount kaceint
74300 SW HERIVIOSC WAY PRM'I BON 4/30/99 $:.0.00 99-314994
TIGARD. OR 972.23 MISC BON 4/30/99 __$1.50 99-314994
Total $31.50
Phone 1: 639-4139
Contractor:
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN, OR 97062 R!'QIJIRED INSPECTIONS
Phone 1: 503-692.-4139 Water Service Insp
Reg #: LIC 000878 Final Inspection
PI-M 34-166PB
This permit is issued subject to the regulations contained in tate Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work 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 OAR 952-0001-0010 through OAR 952-0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 2�446-4 87,
Issued By: 1/��VL�Y �� �� Permittee Signature: ' t
Call (503) 639-4175 by 7:00 P.M. for an inspe:;tion neede he next business day
CITY OF TIGARD Plumbing Permit Application Plan.;heels,# _
13125 SW HALL BLVD. Commercial and Residential Recd By T —
flUARD•, OR 97223 Date Recd r . 1_
(503) 639-4171 Date to P.E. _
Print or Tr,ne Date to D
Incomplete or illegible applicF. vill not be accepted Permit*
Related SWR#
Called
Name of DekelopmenUProject FIXTURES (indiv!dua;) — QTY PRICE AMTi
Job Sink --- _ 9.00
Address `Sttr�uet Address Suite Lavatory v 900
�IC�V�_ k� fl�i __ Tub or Tub/Shower Comb 9.00
Bldg# �/State Zip
Dy � Shower Only -- 9 00k � y
_
Nanp e / Water Closet — 9.00
c) [a)It Dishwasher 9.00
Owner Mailing Address Suife Garbage Disposeo.UO
Wast -1g Machine ---- —
City/State Zip 4.00-
Pone — _—
Fnor DrainlFlnor Sink. 2" — 9.0L -
M�01 �-V�[_L g" 9.00
r — _ 4 9.00
Occupant Marling Ar,tress Suite Water Heater O convc•sion O like kind 9.00
_ Gas piping requlres a separate mechaniS2Lparr,dt. _
CitylStale ^� Zip Phone Laundry Room Tray 9.00
A.me — Urinal 9.00
Other Fixtures(specify) 9.00
Contractor al- / dress Suite 9.00
t r ; C -----
9.00_
--1
Prior to permit City/Stat ZIP Phone - Sewer-1st 100' — 30.00
issuance.a copy r 0b -` 1 _
— ---- -- ---
Sewer-each additir nal 100' 25.00
of all licenses are Ore on Const.Cont.Board Lic,# Exp.Date _
required If /z_ _ Water Service-1 st 100' -- ��r 3000 ----; SIT
expired In GOT Plumbing Lic.# / Exp.Dae Water Service-each additional 2.00' 2.5.00
database c�- 66 _ - Storm&Rain Drain-1st 100' 30.00
Narae Sturm&Rain Drain-each additional 100' — 25.00
Architect _- Mloblle Horne 51.tar�e Y 25,00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anil- 2.5.00
Pollution Device
Engineer City/Slate Zip Phone Residential Backflow Prevention Device' -15.00
__— I -- (Irrigation timing devices require a separate
Describe work to be done; restricted e_ne�permit)New O Repair V, Replace with like kind. Yes No O Any Trap or Waste Not Connected to a Fixture 9.00
Residential Commercial O — — Catch Basin — 9`00
Additional description of work --_— --
� Insp.of Existing Plumbing 40.00
�e
Specially Requested Inspe tions 40rr
U
single family dwelling 30 00
Are you capping,moving or replacing any fixture—S?---- Rain Drain, __�_. —
Yes O No 0 V ease traps 9.00
If yes,see back of form to indicate work performed by �— ----
fixture. FAILURE TO ACCURATELY REPORT FIXTUREQUANTITY TOTAL
Isometric or riser oiagram Is required If Quantity Total is >9
_WORK COULD RESULT IN INCREASED SEWER FEES. - *SUBTOTAL
I hereby acknowledge that I have read this application,that the information _ �(
given Is correct,that I am the owner or authorized agent of the owner,and — 5% SURCHARGE y2�
thalplans subrnitted are in comp,�ance with Oregon State Laws.
Signature of Owner/A t — Date ""PLAN REVIEW 25%OF SUBTOTAL
Required only If fixture qty total is>9
TOTAL _ ;
C erect Person a Phone _ I JI r I
'Minimum permit fee is$25+5%surcharge,except Residential Backflow
Prevention Device,which is$15+51n surcharge
-All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I klslekg-,lumaPq doc 7r,M
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Mo
—_ -----�—_—� ��—._._._ •d
ved Replaced Removed/CapN
-- i
Lavatory--------- ----- --- —�.._� __ ___ _
Tub or Tub/Shower Combination ----
Shower_Only
___ _
Water Closet - --
Dishwasher -----
Garbage Disposal _ - -
Washing Machine --�--
Floor Drain/Floor Sink 2"
411
Water Heater -- - _ -__ _ -- -- -- -- -
, Laundry Boom
Urinal
Other Fixtures (Specify) - -
COMMENTS REGARDING ABOVE:
I%dstMpl-jn-app doc 7/7M