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11720 SW LYNN STREET a y O cn r z z U) m m l 1 11720 SW LYNN STREET �i 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 N r^ I 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: