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10490 SW LADY MARj.JN OR -
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour inspection Ling: 639-4175 Bus`nebs Line: 639.4171 - —
r}��j RUP
— __— Date RertuesteL', AmZ��" PN BLD --- —
Location I oq9 0 L C L �'y�• Suite — MEC
Contact Person _ ------- - Ph -- -- ` L/
contractor
Ph 9 R
BUILDING Tenant/Owner —_ — —_ ELC —
Retaining Wall EI_R
Footing FPS
Foundation NOT REQUESTED -
Fty Drain FOUND DURING RESEARCH ` SCN �_.--._---
Slab Crawl Drain NO INSPECTION(S) FOUND IN FILE v � '' — SIT
Post&Beim
Fxt Sheath'Shear —
Int Sheath/Si;ear
Framing __— ----- —t— - -- -- -- - ---
Drywall Nailing -+s-i. ----- ---_---- ----- ----
Firewall
Fire Sprinkler —
Fire Alarm
Susp d Ceiling
Roof
Misc:
inal —-- -------
PA9.5--_PART FAIL — —- ----
UMBING � --- ----- -----
Pcst&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
EnaANICAL
Post& Beani -- - -- -- — —
Rough In -----_ —
Gas Line - — - - ——
Smok3 Dampers
Final --- ---
PASS PART FAIL
ELECTFcICAL
Service -- - . ___�- --- -- -------- -- --
Rough In
UG/Slab _ .- -- - ------ -
Low Voltage
Fire Alarm - - -- -- -- - - — - --- ------
Final
PASS PART FAIL
SITE
Bach(i!I/Gradiny -- — —�- �—
Sanitary Sewer
Storm Drain I ]Reinspection fee of S required before next inspection. Pau at City Hall, 13125 SW Hall Blvd
Catch Basin ]Please call for reinspection RE: ___ ( ]Unable to inspect-no access
Fire Supply Line
ADA `
Approach/Sidewalk �2� -- Ext
Other Date - - Inspector - - - - - -_— - --- ---
Final
PASS PART PAIL 00 NOT REMOVE this inspection: -#-cord from the job site.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTEIENT
13125 SW Hall Blvd.Tiga,d,Oisgon 97223a0199 (503)615v- 171 F'LUMLING PERMIT
17'LT-11 I T #.
DATE ISSUED: 08/02/95
PArCEL: 2S 111 EB -04301,11
ADDRES3 3. 10490 SW LADY MAPA DR
1A)I V 16 1 ON. . . . MARION ESTATES ZONING: R-3. 5
LOT. . . . . . . . . . . . . .0 1,C'
-W MOBILE HOME SPACE],. .
0F WURY". . .NI" OARBAG'
OF USE. . . . :SF WASHING MACH. BACKFLOW F'REw,,TR" . . 1
0C("'Ur'f)NCY GRIP. . '. R3 FLOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . .
GrORIES. . . . . . . . . I WATER HE$:.-TERS. . . . . . ; CATCH BASINS. . . . . . .
FIXTURES—.__ LALJNDR',( TPAYG. . . . . . .. OF RAIN DRAINS. . . . .
S I NV.3. . . . . . . . . . .. URINALS. . . . . . . . . . . , . GREASE TRAPS. . . . . . . .
OTHI:p r'i.x*,1"unr_,si.
UB/")HOWE RG. . . . SEWER LINE (ft ) . . . .
WAI"L;i WATER LINE ( Ft ) . . . .
D I SHWASHL PS. . . . RAIN DRAIN !ft ) . _
lr'�Stallaticlrl of a r-evidential backflow devise
Uwnev. FEE0
D l'.'i V I L) i JOF"F'M01,,( type a m o t by .late
104910 '-',W LADY MOK'ION DR PR M T 211,5. 00 JDA 06/02/915
5rc 1- '1 1. 25 JDA 00/1ZIL. 5
Ti bi'i r
(;EASIDNI', TURF MIND TPP-ES
U. BOX 583
-r -INN OR 9706A
Ii4a 503 631 7346 11 S TOTAL.
REQUTRET) INSPECT I
persit i:, isvied subject to the egulAtiors contained in the
RR/Back fluv4 Pt�ev
,ard Municip-1 Cu,'ij State of Dre. Specialty Codes and all other Final Iri,.ipertiun
applicable la*s. All work 44ill it done in accordance with
approved plans. This persit will expire if work is not started
,�ithin 181 days of :,ssuance, or if workis suspended f.:r aort
than 1W days.
fc?v ir)spection 171-')
City of Tigard P UMBir..a PERMIT APPLICATION Planck/Rec. #T'3_1
13125 SW Hall Blvd. Permft # <tl'--018.
1 igard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE +ST. SUR'#HARGE
ft—a o..*W,4N New Single Familhir esidence OnN_
O 1 SATIi HOUSE 5140.110 ❑ 2 BATH HOUSE 31W.00
.lobi f ❑ 3 BATH HOUSE $225.00
Address �.r. J ar Fee includes all plumbing fixtures in the dwelling and the first too feet
- 1 L2
of water service, sanitary sewer and storm sewer. See fees belay.
FIXTURES QTY PRICE AMT
Sink 9.00
wri Lavatory 900
Tub or Tub/Shower Comb 900
Owns r
b Shower Only
Water Closet 900
Dishwasher 900
Garbage Dusposel 9.00
Orcupant ,�,� ,.,� !- �» Washing 'Aachine 900
Floor Drain 9.00
Water Heater _ 900 _
Laundry Room Tray 900 -
,r Unnal 900
/ Other Fixhue3 (Specify) 900
w�E � '— 9()0
ontractor - 900
-----
c.�a«.1 a 900
Sewer 1st 100' 3000
a. T.w Sewer -ea Addit 1C,-) 25 00
Water Service 1st 100'_ 3000
1.- 2500
I hereby acknowledge that I have read this application, that the Water Service ea Addd 200'
information given is correct, that I am the owner or authonzed agent of Storrs b Rain Drain 1st 100' 301111
the owner, that plans ,ubmrtted are in compliances with `:tate laws, It'll _
I am registered with the Construction Contractor's Board, the! the Storm R Rain Drain Addd 100' 25 00
number given is correc' (if exempt fro n State registration, pk!ase Mobile Hone Space 25.00
give reason below) _
Back Flow Prevention
Device or Anti-Po'lution Device 900
,� ,,,�,+, -6• l �+� Any Trap or Waste Not
Connected to a Fixture 900
Descnbe work nww a gdditn 0 afteraUcnO iwour 15
Catch Bann - 900
M be done r"Womft O r4f1-residential Insp of Exist dumbing 40 00/hr
--�-�� — Sper.ially Remus,ted Inspections 40 00/hr
Existing use of R-n Drain, tingle lamity dwelling 30 00
building or propert/ ----- - ----
Residential beckflrnv prevention
devices 1500
Proposed use of
budding or prope tY _— -__.—____-- *(Except r*sldentlal backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS 13ECOME VOID IF WORK OR CONSTRUCTION S%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25%OF SUBTOTAL
COMMENCED
rOTAL
Special Conditions
Date Issued by_-----
. I
City of Tigard pI,UMBING PERMIT APPLICATION Planck/Rec.
13125 SW Hall Blvd. Permit # ?l_ 4 ii--01`1
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
— r Now single Family Resi lances Onhr
C t BATH HOUSE 1140.00 Q 2 BATH HOUSE 1195.00
Job ^U I Jt. �1 ( 1 ,i�f 1. ❑ ]BATH HOUSE 5225.00
Address Iar ( Fee includes aM plumbing PoRures in;; dw.*v and the &at 100 heat
�. }.. of water sa.: +. sanitary sewer and stiomr sevear r. See hebelow.
2 IRXTURES OTy PRICE AWT —
Sink 9.00
.ry
,«.. ►�+ Lavatory — 900 —
Tub or Tub/Shower Comb 9,00
Owner — --- 9 00
ar Shower Only _ _
Water Closet 900
Dishwasher _ 9 00 _
fu Garbage Disposal 9.00
Occupant , — +... Washing Machine 9.00
.r.M
Floor Drain 9.00
s Water Heater 900
Laundry Room Tray 9.00
Unnai 900
r- - - } Other Fixtures (Specify) 900
900
Contractor
9.00
� —��
�L
9.00
Sewer 1st 100' 3000
,��.�,,,�. ., �r w • r Sewer -ea. Addit. 100' 25.00 t
Water Service I st 100' —
I hereby acknowledge that I have read this applicabon. that the Water Service ea. Addit. 200' 25.00
information given is correct. that I am the owner or authert2ad agent M Stone d Rain Dein 1st 100'
the owner, that plans submitted are n compliance with State laws. that _
3000
I am registered with the Construction Contractor's Board. that the Storm b Rain Drain Addd. 100' 25.00
number given is correct (If exempt from State registration. pleaseMobilo Home Space — 1`)00
gree reason below) -
• Baca Flow Prevention
I Devroe or Anti-Pollution Device y 9.00
mow. �„ y►�-++�' a+ Any Trap or Waste Not
Connected to a Fixti.re 900
-Describe work new-7—ad—a.,77,7 alturatwn rspar 0 Catch Basin 9.00
to be ck" residential O not,reeidenbal Insp of Exist. Plumbing 40 00/hr -
-' �— Specially Rerluested Insiaecnonr 4000thr
Existing use of Rair Drain. single family dwelling 70 oo
budding or property —
Resioemial backflow prevention
devices 15 JO
Pr000sm use of
building or property (Furse( residential backflow
preventlos dmces)
NOTICE 'Minimum Fee $25.00 SUBTOTAL ? CC
PERMITS BECOME VOID IF WCR<OR CONSTRUCTION 5:r. SURCHARGE
AUTHCRIZED IS NOT "nMMENC":'1 WITHIN 180 DAYS, OR IF
CONSTRUCTICl: .'.)R WCRt IS SUSPENDED OR ABANDONED
FOR A PERICJ OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL
:CMMENCED
-^� TOTAL
Special Conditions ---- —
Date issued --