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11720 SW LYNN STREET
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Aour Inspection Line: 6394175 Business Line: 639-4171
SUPDate Requested___ <1) AM ✓ PM
-�-- - - BLD
Location— Suite MEC
Contact Person _/ e < �. . 1=[t -' fI[IIA
Contractor — — Ph SWR —
BUILDING — Tenant/Owne, ELC _
Retaining Wall ELR —
Footing Access: -�--—
^oundation FPS
Ftg Drain ---� --
Crawl Drain Inspection Notes: SGN _—
Slab - 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 --
P UMBING
Post& Beam --- --- -
Under Slab
To O,ut .. -
�V
nitary Sewer
Rain Drains
F h —,--►-- --
PA PART FAIL
..CHANICAL Post&Beam ------------
Rough In
Gas Line - ----_ —_ --_-- —�---
Smoke Dampers
Final - -- — ----- - — —
PASS PART FAIL
ELECTRICAL --�--- ---- - -- — -----
Service
Rough In -- ---- - ---- -- -- ---
UG/Slab
Low Voltage — — - --
Fire Alarm
Final -- — —-- .—
PASS PART FAIL
SITE � ---------- ----------_.� ------- --------
Backfill/Grading ------ -- _—__—_- ------------ _ —_---
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ] Please call for reinspection RE _--_— _— [ ]Unable to inspect -no access
ADP,
Approach/Sidewalk
Other Ext-)"Date / l,� -, /� � 7
_----_— --�+- �` -- Inspector
Final
PASS PART FAIL DO NOT REMOVE this Inspoction record from the )oh site.
CITY OF TIGARD
DEVELOPMENT SERVICES PL.-UMBTNG PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : PLM98- 0233
DATE ICISUED: 07/10/98
PARCEL_: 25103BA-00133
S 1 1 E: NDDRESS. . . : 1 1.720 SW LYNN ST
SUBDIVISION. . . . : LE RON HE=IGHTS NO. 2 ZONING: R-4. 5
BLOCK. . . . . . . . . . . i-.OT. . . . . . . . . . . . . .023, JURISDICTION: TIG
--------------------------------------------- ------------------------------------
CLASS OF WORK. . :O i'R GARBAGE DISPOSAL,. . : 0 MObII_F !AOM'-- SPACES. : 0
TYPE= OP USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PRE:VNTRS. . : 0
OCCUPANCY GRP'. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS„ . . . . . 0 CATCH BASINS. . . . . . . : 0
FIXTIJRES--------.---•--- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 I-)RINALS. . . . . . . . . . . . 0 GREOSE TRAPS. . . . . . . . 0
I-P,VATORIF_S. . . . : 0 OTHER FIXTURES. . . . : 11
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) „ . . : i CAO
WATER CLOSET'S. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Installation of .a sewer line to rk single family dwelling.
Owner-. -- —_ ___ -----------------. .----- ---- -- ----- --__— FEES ---------------
HOWARD
----------_--_--
HOWARD CORNUTT X JANICE CORNUTT type amoi_int by date rer_pt
11720 SW LYNN ST PRMT $ 30. 00 DLH 07/15/98 98-30738(-;
TIGARD OR 97223 5PCT $ 1.. 50 Dl-H 07/15/98 '38--307386
Phone #:
HOWARD C'.OHNUTT
11720 514 LYNN ST
TIGARD OR, 97223
Phone #: 244-3040 $ 31 . 50 TOTAL
Reg #. . :
------- RE01-1I RED INSPECTIONS -..-__—_ ......
This permit is Issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 198 days of issuance, or if work is suspended for more
than 188 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set fnrth in OAR 952-8881-8810 through OAR 952-8881-8888. you may
obtain copies of th*se rules or direct questions to [UNC by calling
(503)246-1987.
l s s'_1 e d B Y :. _1t_lL_�'� Permittee 5 i g n a t ij r e���-
C
�+++•++++4-++•+-++++++++•f++++++++++++++++++++A-++++++++++++++++++++++++.++++++++++++
Call 639-4175 by 7:00 p. m. for an inspe^tion needed the next bLisiness O.-Ay
+ 4-4-++,#-++-f+4--4-+4++++++.1•++4.f++++++...4-++4-+++++++4+++4-++4-+4 t++++++++++++++++ r+i•++4
CITY OF TIGARD Plumbing Permit Application
13125 SSM HALL BLVD. Plan Check
Commercial and Residential Recd By-14-)L -
TIG.4RD, OR 97213 ate Rec'd - -�
D5 ,
(503/ 639-4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will nv)t b4 accepted Permit* P�
Related SWR x __
Called `
Name of Development/Project FIXTURES (In tivldual) --
QTYRICE
PAfYIT
Job `E'roAll Ali, 5 Sink__— --
___ 9.00
Address Street Address 1,./ Suite Lavatory � -----�— 9 00
/ j-70V V Tub or Tub/Shower Comb. — - -
Bldg II City/S to Zip 9 00
r, 14 1`1frE Z Zj Shower Only — - — 9.00
N
a
me Water Closet _ 9.00
�IWQ/^LQ'i7 v Dishwasher — --- 9.00
Owner Mailing Addrerss Suite Garbage Disposal -
�� 1*7 _ 900
City/State Zip Phone S03 Washing Machine --' -- _g 00
33 Floor Drain/Floor Sink 2' 9.00
N �., ------
9.00
4-1
_ 4
_
Occupant Mailing Address Suite 900
Water Heater -%ar„Jon O like kind -
s o0
Gas(IiPin regi. scnarati,_mechanical pe mil.
City/State Zlp Phone Laundry Room fray _ - —
9.00
---_ ..- Name Urinal �--- ----- - ---- - -' -9.00
'All /r Othpr Fixtures(Specify) - 900
Contractor Mailing Address` Suite
9.00
Prior to per nit City/State Zl _ aOjo-�,
issuance,a rnoy - gyp_ Phone so3 Sewer-1st 100'
�' /Zl�` 5 yG 3 ;ewer-each additional 100' 25.00
of all licenses are O�!,on;ons.Cont.Board Llc.rt Exp Date -
required if Water Service 1st 1o0' 30.00
expired In COT Plumbing Lic,a Exp.Date Water Service-each additional 200' 25.00
database __
Storm&Rain Drain-1st 100' _ 30.00
Archltect
Storm&Rain Drain-each additional 100' 25.00
Mobile Home Space
Or Mailing Address Suite _ 2600
Commercial Back Flow Prevention Device or Anti• 25 00
Pollution Device
Engineer Clty/State ZIP Phone Re.3idential Backflow Prevention Device*
15.00 —
_ (Irrigation timing devices require a separate
Dee tribe work io be done: -- restrjrted eneriLpermit.)
New O Repair O Reolace with like kind: Yes 0 No O Any Trap or"aste Not Connected to a Fixture 9.00
Residential O Commerael O _- - __-
Additional description of wo•k: - _Catch Basin 9'.10
I,.p of Existing Plumbing 4000
er/hr _-�
Specially Requested Inspections - 4000
Rain Drain -- per/hr
Are you capping moving or replacing any fixtures? ,ease Trasingle family d aelling 30 00
Yes O No O Grps — —
9 00
If yes, see back of form to indicate work performed by — —
fixture. FAILURE TO ACCURATELY REPORT FIXTUF;E QUANTITY TOTAL
WORK COULD RESULTIN INCREASED_SEWER FEEF;, Isometric or reser diagram is required n Quantity Total is
I hereby acknowledge That I_have read this application,that the Ifonnatlon 'SUBTOTAL -
given is correct,that I am the owner or authorized agent of thF owner,and - ---5%SURCHARGE
that ions submitted aie In compliance with Oregon Slate Laws. c;,
Signature of Owner/Agent - -**PLAN REVIEW 26%OF SUBTOTAL
j�! _G. Re ulred only if f Aure qty total is>9 T::�
orttact Person Name Phone X71 TOTAL
O W'cu(A % �� ')u -;YI/_,j U y •Minimum permit fee is$25+5%surcharge,except Residential Backflow
_-/ Prevention Privice,which is$15+5%surcharge
All New Commercial Buildings require plans with Isometric or riser diagram
and plan review J
Ni
I%dnlAplumapp doc 7/2/98 i
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PLEASE COMPLETE:
FiAture Type Quantity by Work Performed
New Moved Replaced Removedl_Capped
Sinky
Lavatory -- ---- ___ -- -- — ----
Tub_or Tub/Shower Combination
Shower Only -
Water Closet -
Dishwasher_
Garbage Disposal -- --
Washing Machine, --- _ ---_� __-.--- -. -- - -------
Floor Drain/Flocs Sink 2" -
------ - -3„ --_ --- -- - -- ---- - -- --
_ 4" -�
_Water Heater --_ ---- --- - --- -._- _ ___
Laundry Room Tray - - -- - --- -- --- - ----------�
Urinal --------------- --- -- -- - -- --------
Other Fixtures (Specify) _ ----
COMMENTS REGARDING ABOVE: