11950 SW LINCOLN AVENUE-1 'D
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11950 SW LINCOLN AVE ST
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
---------Date Requested_v 5-L� AM PM
BLIP
Location- O Sc,./ .�� jL ,� BLD
Suite I MEC
Contact Person °"-'ro+�yL� - —-� ph y " •Z G �� _ PLM >/-�u
Contractor _ Ph SWR -- —
BUII.L,ING l Tenant/Owner _ � EL t: — _A
Retaining Wall ELR
Footing Access: M0.,L,-, S -�`
Foundation �f c GPS
Fig Drain l_c�c:v cSS VQ F-r G 'P+ ---
1;rawl Drain Inspection Notes: SGN
Slay Lt SST -
Post& Beam
Ext Sheath/Shear p� "' /Z� L r a
Int Sheath/Shear l� - -- - ------ --
Framing
Insulation - "-- - --- - -- —
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm --_-
Susp'd Ceiling ���- q/� LJ C,
Roof _ --_-—
Misc:_ — �11_� G �2
Final -f
PASS PART FAIL 1 �'
'ost& Bearn —
Under Slab ItA-(
Water Servi
Sanitary Sewer
Rain Diains
SS PART FAIL
Post& Beam ----_-----------------
Rough In
Gas Line
Smoke Dampers
Final ---------
PASS PART FAIL
ELECTRICAL --
Servicc
Rough In
UG/Slab _
Low Voltage ---- -- —
Fire Alarm
Final
PASS _PART FAIL —_
SITE � - -------- -—----_-_.--------- -
Backfill/Grading
Sanitary Sewer
Storm Dain [ ]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
ADA /
Approach/Sidewalk �- Date 1P.- _ / ( -�-F
Other � 7 " U / Inspector � c�l/.�, Ext
inal
LPASS PART FAIL_ DO NOT REMOVE this inspection record from the job site.
ITYOF TIGARD – "L-UMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2001 00199
DATE 153UED:
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2S102AB-01001
SITE ADDRESS: 11950 SW LINCOI N AVE 01
SUBDIVISION: MONPOE SQUAF,E APARTMENTS ZONING: P,-7
BLOCK: LOT: ^T JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: SR3 3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
_ SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: S'_:WER LINE: ft
WATER CLOSETS: WATER LINE: 85 ft
'DISHWASHERS: RAIN DRAIN: ft
Remarks: Instpllation of water service line
_----FEES
__F E_E S
Owner: -- – — Type By Date Amount Receipt
LOCKWOOD, MICHAEI. P TANYA PRMT CTR' 05/16/2001 $72.50 27200100000
c/o SERFS, JOEL L 5PCT CTR 05/16/2001 $5.80 27200100000
2610 SO SHORE BLVD _ — ---
LAKE OSWEGO, OR 97034 Total –_ g" 10 �–
Phone 1:
Contractor:
DETEMPLE CO INC
1951 NW OVERTON ST
PORTLAND, OR 97209 REQUIREC, 44SPECTIONS
Phone 1: 503-227-2641 Water Service Inp
Reg tt: LIC 2510 Final Inspection
PLM 26-25PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not staved within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Thcse rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies cf these rules or d;rect questions to OUNC by calling (503) 246-1987.
Issued By: Permittee Signature: - 1 Gc niC��t `Y l 1(
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Plumbiiag Permit A ppUCUti
City of 11yard ----- ---
a Sewer permit ao.: B,rilding permit no.:
Address: 13125 SW ball Blvd,Tigar1,OR 97223
City ofTelford phone: (503) 094171 PinlecVappl.no_ t3xpiredate-.
Fax: (503) 598.1960 Date issued: By: ltceeipr ao.:
Land use approval: _ :sae filo no...
type:
I ME
U 1 &2 family dwalUng or accessory ,0 Cornnuucial/industrial 13 Multi-family O Tenant improvement
U New construction AAddlNca/altcnttion/et.placement Ll Food service 0 Other:
s
Job address: (� t �` i + Iksct�tion Fee(ea,) Total
Bldg.no.: Suite no.: -- en l-■u 2-f■etily dwelllrhea only:
Tax map/tax IoUaccottthf no. (includes190ff.foreachutilMrco■oection)
SFR(1)bath
Lot: - Block: Subdivision: SPR(2)hath --
Proj:et name: / ' SPR(3)bath
City/county. ZIP: !"- Gac addition�u bat1►/luiche" _ __ _
Descripti d locadau of work on remises: Sileut6Wies:
Lt_\..c•�.t- ` [� , Catch basin/area drain
Est.data of compledontinspectien: U wells/leach IineAmn_h drain -_
Footing drain(no..nr R.)PLUMBING ca-,akcrout.
Manufactured home utilities _
Business name: 1. Manhofic
Address: Rain drain connector
City: State: 7 ; 1j]
Sanitary sewer(no.lin.fl.)
Phone:a2 z-a(' (-JLjpsx:," j Storm sewer(no.fin.ft)
CCB nes.: a;'_r I t, Plumb.bus.reg.no - _ - Water service(no.Un.ft.)
City/melrdlic.no.: 19VI, Fixture or item:
lbso tion valve --
_Cuntrrctoes representative si ■turn: -- - --
• +-1._,c- Back flow revenrer
Print name: P 'V^; ' ( , :te.' t - -P---- — - —
Backwater valve
s BasinsAavatory _ -
Name: �, i -� -- -- �— Clothes washer _ -
Dishwasltrr _
Address: Drinking fountain(s)
City: Statc: ?SI': Ejecion dsum ---_
Phone: Fax: &mail: Expansion anion tank
Fixture/sewer cap
Name(print): Floor drains/floor amks/hub —
Mailing address: — - -�- Garbage dirposal -
Hose bibb
City: _ State: tIP: Ice maker -- -
Phone: Fax:- ��E mail: Interceptor/grease trap --
Owner installaliorvresidential maintenance only: The actual installation nmet(s) -will he made by tr►e or the maintenance and repair made by my regular Roof drain 'commercial)
employe.on flu:property I own as per ORS Chapter r47. Sink(s),basin(s),lays(s)
Owner's signature. We: Sump -
Tubs/showcr/shower pan -
NJtinal
Name:
---- ------ - Water closet _
Address: Water heater _
City:_ - _ l State: a Q': _ Other
-Phone: Fax: Email: - —Total
NCA AU ludubcdow WCW"`tit cmda.a""CA jwia&-t:e r.7 n'°"YJcrmrba. Notice:This permit application Minimum fee...........•...$
U Visa O WnetCardPlan review(at _ %) $
express if a Ixmhtl is not obtained .-
ctrdltnsdwtuba+r. i____---___._-___--____ / / State surcharge(8%) ....k "5
---�,-ah;--- within IBO days sflcr it has beon - ..
accepted as complete. TOTAL ......................._
Nrmr d wd4olbx ae Yrwn o+cnedTetd—� P P
f
Car@kJdcr dPALWO Aaaa4 4"16 40112M
(4
12/05/00 TI1E 17::2 ITI/RX NO 95'l31 Q00R
12/05/ 0 TUE 17:14 FA..X 503 598 1960 CITY OF TIGARD VIooa
PLUNIBING PERMIT FEES:
---- --- ^P)=1C. TQTA� j Npw 1 and 2-family dwellings only:
FIX WRE5 i dividual) QTY ea' A b,UW (Includes all plumbing fittlr-res in PRICE TOTAL
��--- 16.6) the dwelling and the flrstl0b r:. QTY (08) AMOUNT
Sink for each utiii connection _
Lavatory 16.61 One_ 1 bath $249.20
16.6) 1------------ —
Tub or Tub1Sh6wer Comb. Two 2 bat350.00h
Shower Only Three 3 bath
Water Closet 16.6) SUBTOTAL _
Urinal 18.6) BYe STATE SURCHARGE
Dishwasher 16.81 PLAN REVIEW 25ht OF SUBTOTAL
16.6) -- -- TOTAL --- - _
Garbage Disposal _
Laundry Tray 16.6)
Washing Machine 16.61
FloorDraln/Floor Sink 2" 1667 -- PLEASE COMPLETE:
3" 16.6)
4" 15,67 - -- - - - --
16,8) __ QMoved Replacuantity b Work Performed__
Water Heater—0conversion U like kindpe: New ed aerhoved/
Gas piping requires a separate mor:hanlral Fixture Ty -
Permit Caped
MFG Home New Water Service 46 4T- Sink -
MFG Ilome New San/Storm Sower 46.47 Lavatory �_
Tub or Tub/Shower
Hose Bibs 16.61 Combination
Root Drains 16,6)- Shower Only - —
Drinking Fountain —� 16.67 Water Closet
166J Urinal
Other Fixtures(Speci y) .
Dishwasher
GarbagjDls osal _
--- -
Laundry Room Tray
Washl 21LMachlne _-
Poor Uraln/Sink: 2"
Sever-1st 100' 55.00 3^
Sewer-each additional 100' 40.40 4"
Water Service-1 el 100' r 58,00 Waror Healer
48.40 - Other Fixtures
Water Service-each additional 200' S eclfY�__ T
Slorrtl 8 Rain Drain-tet 100' 55 co _
Storm 8 Rain Drain-each addlNonal 10-0 --
Commercial Back Flow Prevention Device 46.40 --
Residential Backi. +Prevention Device'
Catch Basin
iispection of Existing Plumbing or Specially 72.°D
erAir __ COMMENTS REGARDING ABOVE:
Requested Inspections
Rain Drain,single family dwelling 65.15
Grease Traps 16.Eo ---------- - - -__-
QUANTITY TOTAL
Isurna!oc or riser diagram is required If _-
Duer Uty Tinel Is
'SUBTOTAL -'- -�-
8%STATE SURCHARGE -'
**PLAN REVIEW 25%OF SUBTOTAL
—Required only if Ilxiure qtY total I—e
TOTAL $ �-
"Minimum permit fee Is 172.50*8%state surcharge,except Reslderlial Backflow
Prevention Device,which Is 13aas*a%state surcharge,
"All New Commercial Buildings requ!ru plant with Isorrietrle or deer diegram and
plan review
I\dsts\fofms\pim fees doc 10/10/00
12/05/00 TUE 17:22 ITX/RX NO 95731 Q003