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14275 SW MISTLETOE DFS
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line,- 639.4171 – --
I3UP -
Date Requested AM- .__PM BLD —
LocationZk2 I - —2,L' Suite MEC
Contact Person // Ph ,----- PLM
Contractor /e"-ln HQ -� Ph „�.��r�� SWR ---
BUILDING Tenant/Owner ELC _----
Retaining Wall ELR _
Footing ACC
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH St3�
Crawl Drain Ins1 --
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing _ _ ---
Insulation
Drywall Nailing
Firewall
Fire Sprinkler — — --
Fire Alarm
Susp'd Ceiling -------- - —
Roof
Misc: — — --- -----
Final
PASS PART FAIL — --- -
PLUMBING _
Post R Beam
Under Slab —_—
Top Out
Water Service
Sanitary Sewer
ROIFI-qrains
AS PART FAIL —
HANICAL
Post&Beam --
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL _
ELECTRICAL
Service _
Rough In
N UG/Slab — --
Low Voltage p --
Fire Alarm
m Final
PASS PART FAIL —
SITE _ _ —
Backfill/Grading
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW HIM Blvd
Catch Basin [ ]Please call for reinspection RE:_
Fire Supply Line _ [ ]Unable to inspect no access
ADA
Approach/Sidewalk
Other Date Inspector _Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
64 4
13125 SW Hell Blvd.,Tigard,OR 91223 (503)639111 PERMIT N. . . . . . . : PLM97-0152
DATE ISSUED: 04/29/97
PARCEL: 281O4CC-00800
SITE ADDRESS. . . : 14275 $W MISTLETOE DR
SUBDIVISION. . . . : HILLSHIRE ESTATES NO. 2 ZONINGt R-7 PD
BLOCK. . . . . . . . . . e LOT. . . . . . . . . . . . . : 113 JURISDICTIONt TIG
----------------------------------------------------------------------------------
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . 0 BACKFLOW PREVNTRS. . t 1
OCCUPANCY GRP. . tR3 FLOOR DRAINS. . . . . . 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . t 0 WATER HEATERS. . . . . s 0 CATCH BASINS. . . . . . . t 0
FIXTURES-------------- LAUNDRY TRAYS. . . . . , 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . r 0 URINALS. . . . . . . . . t 0 GREASE TRAPS. . . . . . . : 0
LAVATORIES. . . . s 0 OTHER FIXTURES. . . . a 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . . 0
WATER CLOSETS. : 0 WATER LINE (ft) . . . : 0
DISHWASHERS. . . . e 0 RAIN DRAIN (ft). . . : 0
Remarkst Installation of backflow prevention device.
Owner: ----------------------------------------------------- FEES --------------
RONAL_D OUIMET type amount by date recpt
14275 SW MISTLETOE PRMT f 15. 00 DRA 014/29/97 97--293889
TIGARD OR 97223 SPCT f 0. 75 DRA 04/29/97 97-293869
Phone tk:
Contractor--------------------------------
OWNER
--------------------------------------
Phone M: f 15. 75 TOTAL
Reg #. . t 99999
------- REQUIRED INSPECTIONS ------ -
This peroit is issued subject to the regulations contained in the RP/Backflow Prey
Tigard Municipal Code, Skate of Oro. Specialty Coles and all ether Final Inspect ion
applicable laws. All stork will be done in accorde r, with
approved plans. This permit still expire if work is ant started _
a stithin 101 days of issuance, or if work is suspetsdod for more _
than 10 days.
J _
m Permitte Sign ture —
JIssl_ted B
Call for inspection — 639-4175
r
CITY OF TIGARD Plumbing Application Rec1Bv
13125 SW HALL BLVD. Commercial and Residential Oi1e Raic0 �=7
71GARD, CSR 97223 Date to P E
1503) 939-4171 Dat*to D T_ D
Permit
Print Or Type Related SWR,
Incomplete or illegible applications will not be accepted called
Nime of Ceveiopm@nvF r tl FIXTURES (Individual) QTY PRICE AMT
Job Sink
9.00
Address S roar Address` Swte Lavatory 9A0
rub or TubiShower Camp 900
SI t7$ C.tyrStare Zip —only 9 Y)
N Water Closet 9.00
/ / l C,7— Oistw�asner_ 9 00
Owner M ding Atldress Suite Garbage Orsposal
1 _5� 9�
�(S TL ICI'�E washing Machine 900
tv,Slate 'rp Phone floor Cram 2" r:::49 00
Name 3. — 9.00
•- -T 9.00
Occupant &tailing Address Suite Water Hester 9.00
Laundry Room Tray 9.00
GtyrState Zip Phone Unna!
9.00
N Cther Fixtures ISpsGfyl .. _ 9.00
9.00
:ontractor Mailing Address Suits 9.00
Pnor to Issuance C,tyrStale Zip Phone 9.00
aoplicant must 900
provide all Oregon Const Cont.Board L.0 s Exp Date 9.00
contraCars
900
.
license Plumbing Lic,s Exp.Oats Sewer-t st 100' 30 00
nfonnation
or COTCOT Business Tax at Metro a =xp Oats Sewer-each aaditronal 100' 25.00
oatabasel Water Servies.1st ICO' 30.00
Name dater Senna-each additional:00' 25.00
Architl Storm d Rain Drain- ist 100' 30.00
or Maiiing Address Suite Stone d Rsin Oran-etch additional 100' 25.00
MaMls Home Spses 25.00
Engineer C;ty,Slate Zip Phone Commeraal Baca Flow Preventwrt Davies or Ant,- 25.00
Polhrtion D@vita
I
=esenbe work New Addition�llterahon C Recair Q ( Residential 9acklew-1•evenhon:@vice' 15A0
'o be sane. Residential 0 Von-resxtential :J :any Trrp or,Ags''e Nct Canneeled to a Fixture 9 00
Arai!:onsi description of Mork
Catch 3asin 900
L Insp.o'l=_xubng:umbing X0.00
_ er�hr
.Isung use of Saeaalty Requested Insoeetiont +0.00
puilaing or orocerty oenhr
Rain Drain.single'amity awellinq I !0 J0
j ' acosed use of Grease Traps Y 9 0
cuidirg or prcoertyR
QUANTITY TOTAL I j
cu ca0pirg inovirg or replacing any ixtures7 Yra No v"ref='asram f-ecvved t Cuanrcy-mall 0 B i
I H Its see back a.form) 'SUBTOTAL /
-e•eoy acknowledge'hit;'lave read;his application.that the information I r�
-we^ s,:orrea that I am'me owner or autnon=ea agent of the owner and 5% SURCHARGE � 7
-at= uC,^ 'rtt
s ed ite - =mChARMwith Cre on-qtAto Laws.
Si atury I Owns gent Date PLAN REVIEW 25%OF SUBTOTAL '
4saurs+7 SMy 1!xtt;re pr�_ot&I s►4
Z 7 I TOTAL C
?ontact Person Name Phone L '7
r
_ 'Minimum Permit Ise�s S25-5't sarcrtarge.except Resid
`J ential Backflow
7ri'S-y7` Prevention Device.+rnre.n is S15-5%surcharge
;:'asts,.punspp.doe 81"
'LEASE COMPLETE AS APPROPRIATE TO PROJECT: 91
Fixtures to be capped, moved or replaced Qty '
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only _
Water Closet
Dishwasher
Garbage Disposal
LWashing Machine
Floor Drain 2"
3„
4"
Water Heater
Laundry Room Tray
Urinal All
Other Fixtures (Specify)
i
'OMMENTS REGARDING ABOVE:
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