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12020 SW BURLHEIGHTS ikEgf
CITU OF TIGARD BUILDING INSPECTION DIVISION
2,'-Hour inspection Line: 6394175 Business Phonc: 639-4171
Date Requested: (3- )_ q -7 A.M. _ P.M._ MST:
Location: BUR
Tenant. Suite:_ _Bldg: MEC:
Contractor:'�'� l�/I U�1/Lt�L(/����-- _---Phone: ._�r�n" •�tr PLM: 0_ 1 L
Owner: _ __Phone: `-- — -- — ELC:
ELR:
—•...� SIT:
BUILDVfG BLLKi(can't) PLUMBING._� _ MECHANICAL ELECTRICAL SITE
Site Post/Beamolr suEe_dm Post/Beam Cover/Service ScAultonn
Footing Roof UndFUSlab Rough-In Ceiling 'at er Lme
Slab Framing Top Out Gas Line Rough-In .S� I
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service Mise.
Masonry Ceiling Rain(rain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Nunp Low Volt
90
Approved my Approved Approved Approved
Appr/Sdwlk Not Arproved Not Not Approved Not Approved IJ-,t Approved
FINAL FINAL FINAL FINAL
0 Call for reinspect.an 173 Reinspection fee of S_ requi-ed before next inspection CI Unable to inspect
Inspector:—��,� v Date: �/�/7 f �� Page_ of�_
CITY OF TIGARD
DEVELOPMENT SERVICES 1'_VJMBTNG PERMI-
PFRMTT 44. . . . . . . :
13 0 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 rATE ISSUED: 07/31 /9'7
PARCEL: 1S1131,4CP--0[,300
Tr- Ci5l'-RES! . B1JQ!..!Ar7 ,
SURI..Woor h40. ;-, 70NThIG: 3
. . . . . . . . . I-OT. . . .
TCj*.\I. TTf-i
x11- WORT,. ni..T GARSnGE 0 MOP TLr. !1011r.-
IUSE. . . . :sr WASHING MACH. . . . . . : 0 BACKFLOW PRCVNTRS. . 0
C1Jr1r11\:rV ORF'. . : R:"*,2 r-LonR ORA ThIS. . . . . . 0 TRAPS. . . . . . . . . . .. 0
ORTE'r-_ . . . . . . . : 0 WATER HEiITERS. . . . . 0 CATCH BASJINS. . . . . . . 0
XTUr- t-nuNDRY TRAYS. . . . . 0 rr RAINI DRAINS. . . . . : 0
NKS, . . . . . .. 0 URTNnL.S. . . . . . . . . . . 0 GREASE TRAPEj.. . . . . . . .. 0
VATORIF'J. . . . : t?r 0T11t7F( r1YT1JRr..5. . . . 0
3/0110WERG'. . . 0 SEWER LIrJE (ft ) . . . 0
TEP CLOSET�. 0 WOTFR LINIf" (f0 _ . 0
SHWOSHERS. . . . 0 RAT14 DRAIN; (ft ) . . . : 0
Mal-I<S . vJt_AtcT-
------------ FEES
CJ
3 t4r,51413URN ffl
aQUIit try
ate i-ecpt
020 SW PUPLHr.TGHTS rRIT $ 30. ok;� B 07/31 /97
onm.) np, 5rrT 4 1. w0 P x+7/3,1/97 '�J 7
cme ff :
.14 7Tt)FrnRr) RD.
r)J_.r.)TTM CIR '7Y7062
3t� 50 TOT111 .
.I T-1 5 0,_� -6378 [3
PEC)UTRED INSr:'F*FTT'-
pprvt is issued subject to the regulations contained it the Water Lira. InEp
lird Municipal Code, State of Ore, Specialty Codes and all ether FiTial Trit.,ppr-tiari
!icab',,, lass. All woik will be done in accordance wit'
-oved pans. This pervit will expire if work is not started
An 180 days of issuance, or if work is suspended for tore
1 18? ATTENTION: Oregon law requires you to fallow rules
)t-.d b, t`rp ^velon Utili�y Notification Center, 'hose rules are
forth r OAR 952-Mi-0010 through OAR Fe-MI-WO. You nay
cf these rules or direct questions tc 01INC, by caJJ4.jg
PEi-m i tt ee iullat W-e
F++++++++++•+++++++++++++.,.1-++-.< 4 4 4+4 +-i++++•1.++f++++4 4-r 4 I ++++..a.+-4 4 1_ i f f4++-A-++4+
1 C,39 41 771 by, 6:00 p. m. ay) i Tispp..C-,.t i at) tie eded th(a iie>(t bi-ts i ne s s day
++1+4-+..F+++4-++-4.......f-++++++-►+++4 1 ++++++++++++++4++++++
r9i r•. •-_- ,�,., I I q, �j-1--0, 111: F•H;•; Cau: I#156 P02 .
City of Tigard !:'t_UMBING p'EiWlI tAPPLIC_,.I (g4 Planck;Rec. #
13125 1SW Hall Blvd. Permit #
Fig,-.,'d, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST, SURCHARGE
NOW 11f!2lo Q L
aFaTRv c�t
� RorfdanUnto
�. .� � NF� I .
O 1 UAIII IIOti E$140.00 U 2 nATH HOUSE $195.00
Job A _/ ) 0/", g7`�3 U 3 BATH IIOUSF. $225.00
Address Bare,.. a. I I-cru incudes all piu nbrng fixtures In the dwelling and the first 100 fent
- rr wotei sruioico. zanitary :tower and :toren sower Use fees below.
FIXTURE �RiC.
r 9 QTY 7 AMT
lavatory g:p0
UWfl9rIc�y St," 3eL} / ti90-2v :uoorTub/Shower comb -�— 9.00
IV Shower OnN 900
'7'/ 6A-(!L) (: ?L 2 3 Water Closet' - 9 n0
N"to?1411,:"own«u Dishwashnr —'
._.._.---------
9.00
Occupant M� We
e�11. Garbage Dlspwal _ 9.00
shlog Merhlne 9.00
1G�✓► noor Drain 9.00
WWater Healer
9.00
Laundry Room Tray 9.00
Urinal
r __ , � 9.00
I S'7As1 MM ,7?/ 9Y-� Other Fixtures (specify) 9.00
wrno�+M4q vn4n� --- 9.00
Contractor
STA CSU:•
9.00
`.y ZQ6-2- Sewer t sl 100' --- 30.00
'"•r •'w"w" ° �'°°' -- -30WOrez. 11411N. 100' — 2D 00
_ 7f 3 _ rWater Sanies tat 1W' r 30.00 0 —
I hereby acknowledge Urat I have read this application, of the Water Service ail.AddtL 2Q0' 26.00
Information gNen Is oorred, that I ern the owner or authorized went of
the owner, that plans submitted aro In oompllanc4 with State Inws, that Storm d Rain Urain tat 100' 30.00
1 am registered with the Construction Contractor's BwO, that the Storm R Rain Draln Addit, 100' 25.00
numb given Is coned. (II exernp' from Slate registration, please
give below.) Mobile Horne Space 25.00
_ knack Flow Prevention
/ c / �� C Device or Anti-Pollution Device 9.00
_ r
° •"" ' ""'�""r ="+ Any Trap or ante Not
Connected to a Fixture 9.00
Describe work new addklon �'�alterstion ( repau ) Catch Basin 9.00
to be done residenlial non-residential Q Insp. of ExISL Plumbing 40 00/hr
`Existing we of Specially Requested Inspections 4 .UOmr
building or property �- Rain Drain, single family dwelling 30LOO _
Residential backflow prevention
devices 15.00
llivuo5!'d use of
—_� "lE''cep!rocJdswrtJeJ 6AcM7ow
_ prevendon deylcss)
NO rICE "Minimum Fee $25.00 SI19T'OTAL
Pt°RMITS BECOME VOID IF WORK OR UU14STRUCTION �6'/.SURCHARGE ' SU
AUTHORIZED IS NUT COMMFNCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED Oft ADANDONEU
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
GUMMENOLD PLAN REVIEW 26% OF$URI01 AL
f ✓1 gv
TOTAL _
:special Conditions
Date Issued by _--
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