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12238 SW CLYDESDALE COURT )f0000f
CITY Of TIO„RC CVILIDMU INSPECTION (DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST _
BUP
Cate Requested 2131q AM % PM
BLD
�
Location �- ` i / ' 'f n Suite MEC
Contact Person eQ - LI�I,ybt /}(,�� Ph L �-�f/ —
—T—_ � PLM
Contractor Ph SWR
BUILDING Tenant/OwnerELC _
Retaining Wall — - — EI_R
Footing Access:
Foundation FPS
Ftg Drain -
Crawl Drain Inspection Dotes: SGN
Slab -- -- -- ----- __ - --�a- - SIT
Post& Bram
Ext Sheath/Shear
Int Sheath/Shear --
Framing
Insulation --�-_�-- --�---�---- -- --
Drywall Nailing
Firewall -------
Fire Sprinkler ------ - - ----- --- --- - --_.- _----- --—
Fire Alarm
Susp'd Ceiling
Roof -------- ------------
Mite: _------- --- - --
Final -- --- _._._..----------------- ------ -- _�
PASS PART FAIL - - ------..._ -------- -- - --
PLUMBING
Post& Beam --- __
Under Slab
1 op Our ,,
Wattr Service
Sanitary newer - - - — ---------------_ --
Rain Drains
i -
PART FAIL _
ECHANICAL -
Post& Beam ----
Rough In
Gas Line - -- —- - - —
Smoke Dampers
Final ------- --- -
PASS PART FAIL
ELECTRICAL ----- - -- - -
Service
-----------
Rough In --
UG/Slab
Low Voltage
Fire Alarm _
Final —
PASS PAPT FAIL _ -`_-- -- -----^__.�- --- _--
SITE
Backfill/Grading -_-- - - - -- ----- -- —
Sanitary Sewer
Storm Drain [ j Reinspection fee of$_ required hefore next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ j Please call for reinspection RE: _ _ —_ [ j Unable to inspect n�access
Fire Supply Line _-_-
ADA
Approach/Sidewa k
Z,Z
Other Date inspector-_ _ _Ext
Final
I PASS PART FAIL_ DO NOT REMOVE this Inspection record from the job site.
\ CITY O F TIGARD — PLUMBING PERMIT
[DEVELOPMENT SERVICES PERMIT#: PLM1999-00382
13125 SVI Hall Blva.,Tigard. OR 97223 (503) 639-4171 DATE ISSUED:
PARCEL: 2S 103AA-04200
SITE ADDRESS: 12238 SW CLYDESL_ALE CT
SUBDIVISION: CLYDESDALE ZONING: R-4.5
BLOCK: LOT: 02.2 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
-TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES LAUNDRY TRAYS: SF QAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB;SHOWERS: SEWER LINE: ft
WATER CLOSETS. WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Connect water service to new meter location for city.
FEES
Owner:
— Type By Date Amount Receipt
HEWLETT, CLIFFORD M AND
PEG(7J ----_ --
,z238 SW CLYDESDALE COURT Total
TIGARD, OR 97223
Phone 1:
Contractor:
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone 1: 503-692-4139 Water Line Insp
Reg#: LIC 000878 Final Inspection
PLM 34-166PB
ORIGINAL
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 riot started 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
Notificatl.on Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You May obtain copies of these rules or direct questions !o OUNC by calling (503) 246-1987.
Issued BPermittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD Piturd)MU Permit Application Plan Check r,
13125 SW I IAL-l_ BIND. Comryteicial and Residential Recd By
TIGARD, OR 97223 Data Recd I
(503) 639-4171 pale to P.E.
Print or Type Dale to D
Incomplete or illegible applications will riot be accepted Permit#rTi- I q q 9
Related SWR M
Called__
_ ..-.._ flame of bevelopmenurrnject -------- ,�?�t#fslizlt It!r11� 1 e; ,e.�t.;d t i! toxg msox
jot) Slnk _ 11.50
Actdfess StreetAdddiess tt Salle levalory - 11.60
jZ 7 R rWeV cIfc• r^1r�t _ luh or Tublshower Comb. 1150
1111g r cnyrsinlo ZIP shower only
Tl c' - -- WaterGlosel - - 11.60
flame -
I Q W11.50
a,� r I Ulslevaslr4r
Owner Melling Addicts Garbage Dlsposal -� 11.50
Wsshing Machine 11 50
CdylSlalO Ylp i'han° •Floor nraiNFloor Slnk 2' i 11.60
- __ — - - - -- -- --- - -- 3• 11.60
alling AJJresf i Suile f W81er Healer O conversion O like kktd 11 50
occupant IA
Gas piping requires a!!pante machanlcal permill _
CNyfSlnle- Zip Plrone -- I sundry Room Trey 11.80
—------- -._---- ---- - - -- lllirtel 11.50
Mania� (1ttGe OlheiK&fes(Specity) 1500
Qh�S ��� Mbt_n _
(3011trartor 1 ding Addict a �L
.0. P Ok U_ _
el
Prior to permit CRYTS-i oto r Zip Phone Bower-1st 100' - _- -3 00
Issuance,a copy TU r LcT{r n � 0 L �c/Z"�l�� -
_1 _1��____ - _--. Sewer—each additional 100' 3200.
of all Ucenses aro Oregon Carni Cont Board I Ic r Exp nate -- ---- -
tequlrcd It - ! �S j� I-Z // Water Service tel 100' I I6 00 3 G 0
'CLQ y-- _
erphed In COT f'lurilbing 1 Ic/r P _! Erp [Zara Water SeWce-esch additional 200' 92
00
database u Storm R Reln Violn-1st 100' 3000
Name Slom)a Reln Oraln-aachiddllionel 100' 3200
Architect _ Gblle Home Space 32.00
Or fAelling Addresi -- - Suite Commercial lack flow Proven gon )evic a or AM- 32.00
P uIkdlon Device_ _
Entiliteer nllylSlele Zip I'Itone Resldenllat Backflow Prevenllon Co.Devi - 1900
(lnlgatlon Ilming devices require s separate
pesaN�a work to be donor resbicled ever-- ^ -�--- - ------ -..g petmil-1 - —
liew O Repair 0 Replace with like kind Yes O No o My trap or Waste Not Connected to s Fixture 11.50
Rosidential 40 Comincrdal o Catch Basin 11.50
Addlllortal descrlpllon of work: Ccrn h 0 Sir Q• hop of Existing PlumMng 6000
f0 ►1 Q w M'2-h1- Lo c y{r o_n fvFL c r� -----
oneeYA
- :-- Spedslly Regrtesled Inspections 50.170
Ate you capping,rnovhlg or replacing ally fixtules? _ rer�nu- _
Yes 0 No o Rain Oten,single family dwelling 45 00
If yes,see back of form to Indicate work petfonned by Grease Traps' 11•w
fixture. FAIL(IRE TO ACCURATELY REPORT FIXTURE _
WORK COMID RESULT IN IIICR_EASED S[WER FEES. `� QUANTITY TOTAL
I irsreby acknowledge That I have rend this appllra11on,If w1 the Inlotmathin Iwrnehk a titter a wn b rsulred d Qua"Trial U •a '1 it '+a r'• �
given is corrarl,11w I am the owner or aullioQ, agent of Iho owner,slid *SUBTOTAL
Ihut�rlarts subn1llted are in curl IlrLrre Wllh Oregon State Laws. __
81011811114 of OwngqrlAgont Date - - - -JV URCMR(IE
WC S � 11 /Ia r � y
Canlacl Person Nrho o ein � "Pt AN REVIEW 25%OF SUBTOTAL ''' '-
A �1' �i y� 6 r'{z.` 1 Re niod ar a ax1u! total k s rl _' I' if�
TOTAL _.
•Minhnum P ennN fee Is$50+5%surcharge,except Residential Backflow
r •I �• Prevention Device,which Is$25 4 5%surcharge
nt11q�h�tS r � .. r .( t1Yf►d'fl � k -
4uo t ! r(1 nJ1, 4 r fj A�-s' I�tu)' "All New Commercial Buildings require plans Wilt laumehlc or visor diaprarn
8111 plan review
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