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I CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 �$'int stilt `
Footing Rain Drain "
Cover/Service
Foundation Water Line Ceiling -Plu4 lyk�0
Post/Beam Mech, Shear/Sheath Framing c
S itl Thr P rpt
Plbg.Und/Flr/Slab Plbg.Top Out Insulation ,
t Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
1 1�1�t�rt�!Iii`9f�r 4 yp"A 4
San. Sewer Gas Line Appr/Sdwlk Reins. � �r;'���t� ,{��;}�,�'� ,y � •
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Other:
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t Date: _ _ P,M. _ Entry:
Address: nef
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Tenant: Ste: MST:
Con/Own: BUP!MEC:
- - —--- PLM: 7_SZQ
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR: _
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Ins actor: _ Date:
_APFROVED DISAPPROVED/CALL FOR R"NSP. CF CO
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RX 1,, I, CITY OF TIGARD BUILDING INSPECTION NOTICE
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Inspection Line: 639-4175 Business Phone: 639-4171
Footir^ Rain Drain CoveriCArvice FINAL +a;� �'rt+ e ��
Foundation Water Line Ceiling Plum.
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Post/Beam Mech, Shear/Sheath Framing MQch. I r rn+ kt {'r ` •
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i M ! Flbg.Und/Flr/Slab Plbg, Top Out Insulation -Elec .
Post/Beam Struct. Mech. Rough-in G Bd.
9 Gyp. -Bldg.
{ San. Sewer e A r/Sdwlk , 'fir :r ''t •
pP Reins. j u
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Other: ___ j es�1,u�.� r"1A�t "�,}t fl; •'.
Date: ,
� '`'G A.M. P.M. try: µ( ', t + '` iso+r��,1 •
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Address:
.F t� Tenant: �e I r tA!',
Ste. MS I:
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BLIP:
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9 MEC: LJ
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector:
/• --_— - - Date: J4 ��` fW.
4'RPM0VED _DISAPPROVED/CALL FOR REINSP. CF CO
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a' CITY OF TIGARD BUILDING INSPECTION NOTICE �" 3 ,
Inspection Line: 639-4175 Business Phone: 639-4171'':
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech Hough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _ - ----� �
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Date: I l_ —. A,M. P.M. Entry: _
Address: -
Tenant: — .._ ate:
Con/�_�Z G _. �OC�---- PMEC
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THE FOLLOWING CORRECTIONS ARE REQUIRED: EL _
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Inspector. —_ ^- — Date:
—APPROVED _DISAPPROVED/CALL FO "INBP'''1 CF CO
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Q. Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FIN,kL:
Foundation Water Line Ceiling Qlumb
.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Baam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: IN°"�Tx S
� 38 aew
Date: Q- A.M. M, Entry: H �,
Address:
Tenant:
--- Ste: MST: ------- U ,
BLIP:
Con/Own: -- — MEC.
Z0 -7 ,� PLM:
(� ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR
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Date-.
_APPROVED -DISAPPROVED/CALL FOR REINSP. CF CO
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CITY CSF TIGARD �,r . .�2. . ..PEm I
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COMMUNITY DEVELOPMENT DEPARTMENT DATE zsaucn: 10/01/96
13125 5W Nall Blvd.Tigard,Oregon 07223.8199 (503)839-4171 Pf1 RC:EL: 1 S 1 3 5DC•-01 01210
SITE. ADDRESS. . . : 11 "),25 L)O LINCOLN AVE
W"URDIVISION. . . . : TIGARDVIL_L.E PARK TONING: R•-4. 5
6w'I".. • . . . . • . . . . L )7. • . • . . . . . . . . . :9 .
CLASS OF WORK. . :ALT I'I_oon f uRN. ,. . . 0 EVAP COOLERS: 0
TYPE: OF USE. . . . :SF UNIT HEATERS_ : 0 VENT F`nNS. . . : 0
OCCUPANCY GRP. . . R3 VENTS W/O ADPL: 0 VENT SYSTEMS: 0 t>•
STORIES. . . . . . . . .. 0 BOILERS/COMPRESSORS HOODC. . . . . . . : 0
FUEL TY'C _...__..__.._-._..._.___ fir•-„ HP. : 0 DOMES. I NC T NI:: 171
/GAS/ / / 3- 1 HP. . . . : 0 COMML.. INCIN: 0
MAX INPUT: ILI PTU 15 30 HP. . . . 0 REPAIR UNITS. 1]i �
F'IRE DAMPERS?. . : HP. . . . : Q! waanTavES. . 0 .
GAS PRESSURE. . . : 115-1. 11P. . . . 0 cI_r? DRYERS. . : P
NO. OF UNITS------------- AIR HANDL T`VG UN I TS OTHER UNITS. : 1
TURN ( 100K ITU: 1 !=: 117.11111710 c:fm • 1 S OUTLET7. . 1w'
1'"URN ) :=100K PTU: 0 > 10000 cfm : 0
k
RE marl<s : Install gas stove, water- heater 9 piping.
Owner. _.___.__.____..__.__._._...__...._____.___..._._...._._ _._.__..____
• FEE, ------------
RON SATHER type amo1-rnt t.y date r•ec:pt
I15LS SW LINCOLN ST PRMT $ "'5. 017.1 DRA 10/01/96 96284567
1PC'T $ 1. _21 D"'A 11 0.1 /'36 96 ��t3/•w6 7,TIrARn OR 972-23
4
C n n t r autos
Phrase it: I .26. ;21 TOTAL
Recl #. . ,. 131,11
p?E"QIJIRE'D INSF''ECTIaN'3 .._._...... - _
This permit is issued subjea to the regulations cer ained in the Mect•r�anicatl Irinp
Tigard Municipal Code, State of Ore. Specialty Code- end all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. ',-.is posit will expire if work is r.t started
within 180 days if issuance, or if work is st nded fir onrethan 186 days.
4 P a Y`m i t't e a at
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C-111. for- ir1Spiec_-tion - 639-.4175
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PLUNGING PERMIT
`1W OF TIGARD DATEIISSUED: . 10/01/966 012E3'3 o.
COMMUNITY DEVELOPMENT DEPARTMENT
13!25 SW Hall Blvd.Tigard,Oregon 07223.8109 (503)839-4171 PArCt--L: t S 135DC ' i 02iV
7[Tr ADDRESS. . . : 11025 CW LINCOLN AVE
St IL-IDIVISION. . . : : TIGARDVILLE PPRK ZONING: R- 4. S
BI�OCI�. . . . . . . . . . . LOT. . . . . • . . . . _...__�._.
"'L.ASS OF WI P.K. . :ALT GARPAGE E :CIS OSAL S. 0 MOBIL!-, I-0ME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . .. . . . : 0 BACKFLOW PREVNTRS. . : 0
"CUPANCY (GRP. . :R3 FLOOR DPr,ING. . . . . . : ,;� TRAPC.. . . . . . . . . . . . . . : 0 �•
STORIES , . . . . . : 2' WnTER HEOTCR;-. . . . 1 CATCH IIASINS. . . . . . . :
- LAUNDRY TRAY7. . . . . : 0 5F PrilN GRAINS. . . . . » 171
s,INKC. . . . . . . . . . s 0 URINkALS. . . . . . . . . . . : III GRC'A'�E TRAPS. . . . . . . 0
LAVATORIES. . . .. - : 0 OTI IEP r XTURCS. . . . 1 0
TUB/GHOWERS. . . . 0 SEWER LINE (ft ) . . . : 'I
WATER Cl- OSET,r,. . : 0 WATER L 11'JE (ft ) . . . : Q1
DISHWASHERS). . . 0 RAIN DRAIN (ft ) . . . : 0
tl� mar-I(,: In4�ta;11 wa'1<ar^ I-irwa•ta�i'.
PON SATIAEP type �.+mol.knt by (Date rer_pt;
SW LIWC�)LN ST PRMT $ *5. 00 DRA 10/01/96 96--284567'
'.:,PCT 4 1. 1)Rn lr�'r/01/'36 9G 28455G7
.,-IGARD OR 972,23
pp )WNER
3
hcrrin #» ! CC. � TOTAL
_.._. REOU I RED INSPECTIONS
- -- --
Thi£ permit is issued subject to the regulations contained in the Misr_. inspection
"igard Municipal Cole, State 5f O1-4. Speriilty Codes and all other F l n iAl Ins pest i u rr
pplicable laws. All .A,rk will be (.one in acr.orda�.-e wits
approved plans. this permit will expire if work is not started ".—_--
within Jae days of issuance, or if r :.Fended for more
A L.i 1 130 days, �.._._.... _.._. ._..._._._.�
......_.._....__............._.......__._.__...__....._...._ ...........__. t
1 e r m i t t e
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_ Call for- inspection S39- 417G
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Plan CheekO
CITY OF TIGARD Mechanicai Permit Application Recd B
13125 SW HALL BLVD. Commercial and Residential Date Recd c-1
TIGARD, OR 97223 Date to P E. 1411T C.r
(503) 639-4171, x304 Date��DST
Print or Type Permit#
IncCa ledomplet,; or illegible applications will not be accepted _ ----- _
Name of DevetopmenUPro(ect Description
Table 1A Mec' al Code OT` PRICE AMT
Job °Street Address I Suite, A) Permit FL 0 40- 10.00
Addres ` f= �,U`�•�IJLL�_. — tr
Bldgs Cay 5taie Lp 2,7- B) Supplemental Permit 3.00
pine
(Cf name ot�usmessi , I 1 ) Fumace to 100 000 BTU 6.00 �1D
Owner _;d' o�-�-- incl.ducts&vents
Mailing Address 2.) Fumace7 100,000 BTU+ 50
1 �?� �,l ). Lt►JtAt_ incl.ducts S vents _
Cn e Zipnno a 3) Floor Fumace
1 1 O 121 (p�� lP-1 incl.vent
Name ame of business) 4) Suspet.ued heater,wall heater 6-00
or floor mounted heater
Occupant ailing.ddress 5) Vent not incl in 300
appliance permit _
CityiState Zip Phone 6) Boder or comp,heat pump,air cond 6.00
to 3 HP:absorp unit to 100K BTU _
-- Na 7) Boder or comp,heat pump,air cond. 11 00
�--'�' 3-15 HP:absorp unit to 500K BTU
Contractor Mailing address 8.) Boder or comp,heat pump,air conj 1500
15-30 HP,absorp unit 5-1 mil BTU
Attach copy of C ty(State Zip Phone 9.) Boder or comp,heat pump,air cond. 22.50
Current Licenses 30-50 HP;absorp u"d 1-1.75 and BTU
Oregon Consf Cont Board Uc A Exp Date 10) Boiler or comp,heat pump,air cond. 37.50
50 HP',absorp unit 1.75 and BTU _
COT Busreas Tax or Metro 0 Exp Dais 11 ) Air handling unit to V 4.50
_10,000 CFM _
Architect sine _ 12) Air handling unit i 7.50
10.000 CTM+
or Maduig Address — 13) Non portable 4.50
evaporate cooler
Engineer CityiState zipPhone 14) Vent fan connected 3.00
to a single duct
Descnbe work New O Addition O Alteration Repair O 15.) Ventilation system not 4.50
to be done Residential O Non-iesidential O included in appliance permit
Additional Desenption of work 16) Hood served by mechanical exhaust 4.50
17) Domestic incinerators _ 750
Existing use of 18) Commercial or industnaltype 3000
budding or property_ _ _ _ incinerator _
19 1 Repair units 4.50
Proposeu use of 20) Woodstove 450
budding or property
21) Clothes dryer.etc. ' 4.50
Type of fu oil O natural ga�v electnc O 22) Other units �' 450
I h y laoIll: ge that r.have
read this application,'hat the 23) Gas piping one to four outl6ts 2.00
n_dGn.l coredthat I am the owner or authorized agent of
ownea ubmed are in compliance with Oregon Statte 1241 More than 4-per outlet (each) .50
0
nature of er/Agent Date QTY.SUBTOrAL
SUBTOTAL y'
Contact Person Name F hone 5016 SURCHARGE 15
PIAN REVIEW 25%OF SUBTOTAL
TOTAL
i dst\rmechpmt doe (rev 7/96) �r �^^� •Minimum permit fee is 325+5"0,urcharge
Recd By-
cITY OF TIGARD Plumbing Application
Date Recd (c' (-"16
I M 25 SW HALL BLVD. Commercial and Residential Date to P.E. ori
TIGARD, OR 97223 Date to Ds
(503) 639-4171 Permit X LK'E 7(r''r ;L S;
Print or Type Relalr'SVIR# Ali
I Incomplete or illegible applications will not be accepted Called
Name of Devlopment/prolectr �(ew Shale Family. esld�ncbe Onlr.:1 ' + •• £^�. w�
Job
�(j 1 BATH HOUSE 5140 00 Y BAT}( 5REE 11.96 00:�
AddresssStrA�A 5� I - Sui:e ;; x i 4,p 3 BA-H HOUSE$2 00 ,
` 11 J�•�.U _ Fee Includes aC plumblr g'fixtures In the dwelllhp'art� �tl 00 i
Bldg# Cd (State Zi water service,sanitary s>wer and stunri hewer. Sea testi hebw r
-- FIXTURES(individual) oTY rPRICE AMT
Sink 9.00
Owner �;ailing AddLess Suite Lavatory _ 9170
Tub or Tub/Shower Comb 9.b0
c _
Shower Only 900 aw
Name b y Water Closet 9.00
Dishwater 9.00
Occupant Mailing Address Su'le Gerbage Disposal 9.00
Washing Machine 9.00
-- -` City/State T Zip Phone - I Floor Drain 2_ 9.00
3"
Namq,�-*j 4 --- 9.00
Contractor Mailing Add,ess Suit(, Water Heater l 9.00
Laundry Room Tray 9.00
City/State Zip Phone Urinal 9.00
Oregon Const.Cont.board Uc.# Exp.Gate Other Fixtures(Specify) 900
Attach Copy of - 9.00
Current Plumbing Lic.S Exp.Date 9.00
License _ _ Sewer 1st 100" 9.00
COT Business Tax or Metro# Exp.Dale Sewer-each additional 100' 30.On
Name - Water Service-1st 100' 25.00
Water Service-each additional 200' 30.00
Mallin Address Suite _ `storm&Rain Drain-1st 100' 25.00
or
Architect g
Stora C Rain Dwin-each additional 100' 30,00
_ _
Engineer CitylSlate Zip P)ione -- Mobile Home Space 25.00
g I L/ Commercial Back Flow Prevention Device or,Anti- - 2500
Describe work New O Addition O Alteration Ql Repair O Pollution Device -_
to be done: Residential O Non-residential O Residential Backflow Prevention Device' 15.00
Additional description of work Any Trap or Waste Not Connected to a Fixture 9.00
Catch Qasin 9.00
Insp of Existing Plumbing 40.00
_ per hr
Existing use of Specially Requested Inspections 40.00
building or property per hr _
Proposed use of I Rain Drain.single family dwellingA_- 30.00
building or property Grease Traps 9,00
Are cel in any fixtures? Yes p No❑ QUANTITY TOTAL 4i
Isometric or user diagram a required if puanity Total is >9
I hereb know a that I have read this appliration,that the information "SUBTOTAL
given co act.1 at I am the owner or authorized agent of the owner,and
the ens s bmi od are in cc,npiiance with Oregon State Laws `- 5%SURCHARGE
ature U.-let/Agent Date L
l Q • ) •9 to PLAN REVIEW 25%OF SUBTOTAL
— Required only d fixture city totals>9 i
Co act Pera n Name Phone - --` YOTAL
(, etc
- - -— 'Minimi, n permit fee is$25+5%surcharge,except Reside:tial Backf,)w
i'\dstslplmapp doc
Prevention Device,which is E15+5%surcharge
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CHI.:.r.K 0- MCIUN r 51A
RON 11ASIAAMOIJINJ r y 0. 00
ADD RE LiS t 1192t- '-M L.INC;IJL.N El PAYMHO DP41k,
TIGARD OP �W 0 1)1 V I S I LIN
OF PAYMNI AMOLIN) 14111) PUkPUbE 01- 1191"fML-Ni Obli-JON I 1'(1.11)
P".). 00 BOILD ply 1{
i'-'lLl.JMSIN(3 PEHM PLM96-0--188 il,J. 00
i'lCULN -1-4 F
TOTAL AMOUNT PAW 5 la