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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639 4171
Cover/Service FINAL:
Footing Rain Drain
I �
-Plumb . .
Water Line Ceg Gt�a �
Foundation
Post/Beam Mech. Shear/Sheath Framing eoh
-Elect.
. a�„M1 1 R
Plbg.Und/Flr/Slab Plbg.Top Out ` `4 'iK
d +
Post/Beam Struct. Mech. Rough-in Gyp. Bd. Bldg
a .
Gas Line APP r/Sdwlk Reins.
San. Sewer
Other: _ ,-�-- J'!
Date: LOA.M. —P.M.
. Entry:.
Address:
Ste: MST: —--
Tenant: �'�� - BUP:
MEC:
Con/Own. PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _.
inspe r: --
�.., Date: _
APPROVED DISAPPROVED/CALL FOR REINSP. C CO
• r
rs i
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service
Foundation Water Line Ceiling -Plumb. `
•
Post/Bekrn Mech. ShearlSheath Framing -Mech.
Plbg.Und/Fb/Slab PI Top Out Insulation -Elect.
Post/Beam Struct. ech. ouh-in Gyp. Bd. -Bldg. , •
San. Sewer as Lin Appr/Sdwlk Reins. M
1
Other: _ LIU `
Date: _. A.M. P.M. Entry.
Address: —Y
tenant: Ste:__ MST:
BUP: "' r
Co nkOwr 6 35 e _. MEC: o
PLM:
ELC: __ t
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: i
Inspector: Date: y
—APPROVED —DISAPPROVED/CALL FOR REINSP. CFF CO
CITYT I GAR® P'I. #. . . P' RMIT
OF FET�MII` #. . . . . . . : PLM56-IZ11>';',
COMMUNITY DEVELOPMENT DEPARTMENT
DATE ISSUED: 0`��/:'9196
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839.4171 PARCEL' 2 S 1 1 1 BLL•-'0011711 f
I
SITE ADDRESS— . : 09.750 SW INEZ ST #L. 36
� ZONING:
! SUBDIV151ON. . . . a TIGARDVILLE HEIGHT'S O
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :36
_ _ --•---------•------._.- ---
CLASS TOF-WORK. . :ALT' -- _ GARBAGE. DISPOSALS- : 0 MOBILE HOME SPAC"-S. : �
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW P'REVNfRS. . : 0 -
OCCUPANCY GRP'. . : R3 FLOOR DRAINS. . . . . . : In TRAPS. . . . . . . . . . . . . .
STORIES. .. . . . . . . It"r WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : Q'
LAUNDRY TRAYS. . . . . : Vi SF RAIN DRAINS. . . . .
SINKS. . . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE "f RAPS. . . . . . . .
I._AVPTORIE.S. . . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. . : i WATER LINE. ('ft ) . . . 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft) . . . 0
,p
Remarks : Corliss
Owner: __.__._._-___._..____.._._____...____.._..._._____.-___ .---_.______..__.___--___-._
--- FEES --•--____..._------ -- '
JIM & CORA CORLISS type amal_tnt by date rPcpt
9750 SW INEZ ST PRMT $ 25. 00 JGD 05/29/96 96•-27992L
3PCT $ 1. 25 JSD 05/29/96 96-`799'x'_'.'
l lIiARD OR 97224-0000
Phone #: 503-639-9630
Contractor:
PQYBORN' S PLUMBING INC
1.9990 SW C:I POLE RD
TUALATIN OR 97162
Phone #: 503 -692••-4139 $ 26. 25 TOTAL
08785 REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mi sc. lnspert i on
Tigard Municipal Code, State of Ore. Sper.ialty Codes and all other Final Inspect ion
G applicable laws. All wurk will he done in accordanc? with _ -- ---- - --
approved plans. This permit will expire if work is net started mm�_ •,__.____. _ .-_.. -- -- -- --- —
4ithin 188 days of issuance, or if work is suspended for morethan 188 days.
1'e r m i t t e e S i g n a t u r•e : _.. ____- _ _ _.._._----__.._.._--_._ _._._.-.-_.-._
Call for inspection 639-4175
1..
)
i
C City Planck/Rec. #
City of Tigard PLUMBING PERMIT_APPLIGATION _.._
-13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 039-417'1
MINIMUM 0)'25.00 PERMIT FEE * ST. SURCHARGE
No-�,ow.Mnm.n, - New F�ingle, Fam'.l'y Residences Oul S
,wAw ❑ 1 BATH HOUSE$140.00 0 2.BATH HOUSE 5195.00
Job I j,-s Ll 0 3 BATH HOUSE $225.00
AC(Uress awerw m Fee includes all plumbing fixtures in the dwelling and the first 100 feet -
�� r�ra--i l4' of Water service, sanitary sewer and storm sewer. See fees below.
r+.m.i«n.,"-11 / cIXTURES QTY PRICE AMT
fi Sink -- goo
.,..no AISN. ten• Lavatory 9.00
�pl Tub or Tub/Shower Comb. 9.00
Owner -
cM, Zip Showar Only 9.00
Water Closet 9.00
UIShWa3her 9.00
! C'arbage Disposal 9.00
Occupant M,�a,,,„, Ph-; ashing Machine 9.00
Floor Drain 9.00
Water Heater 9.00 ,'
Laundry Room Tray 9.00
Urinal 9.00
Other-Fix':ures (Specify) 9.00
M.�o gym... Pham 9.00
Contractor /C7 ` 7 /l Q --� 9,00
� - -- 9.00
Sewer 1st 100 30.00
cm,a.. 11"MIM Sewer -ea. Aodit. 100'- 25.00 - ---
WaterService 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of Storm ,3 Rain Drain 1st 100' 30.00
the owner, that plans submitted are in compliance with State laws, that
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please ---m --
Mobile Hoe Space - 25.00
give reason below.) ---
Back Flow Prevention
Device or Anti-Pollution Device 9.00
Dot. Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new v addition (T-alteration repair Q Catch Basin 9.00
to be done residential non-residential Q Insp of Exist. Plumbing^ 40.00/hr_
Specially Requested Inspections 40.00lhr
Existing use of `1 G�� Rain Drain, single family dwelling 30.00
building or property _,i _-.
Residential backflow prevention
devices 15.00
Proposed use of
building or property c�GG ,C _
'IErcept resident/al backflow
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
0c,
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR IF 5"/. SURCHARGE /
CONS-i RUCTION OR WORK IS SUSPENDED OR ABANDONED ---
FOR.A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
PIAN REVIEW 25',o OF SUBTOTAL
COMMENCED.
TO rAL
Special Conditions
Date is ce f by
i _J
MECHANICAL
PERMIT
CITY OF TIGARD
F'F_RMIT #. . . . . . . : MEC96--01;7
COMMUNITY DEVELOPMENT DEPARTMENT DATE: ISSUED: 05/2`1/96
13125 SW Hell Blvd.Tigard,(Dragon 97223.8199 (503)939-4171
PARCEL: E'S 1 1 l 1:aD--00101
SITE ADDRESS. . . : 09750 SW 1 NE Z ST #I_.. 36
SUBDIVISION. . . . : TIGARDVILLE. HEIGHTS "ZONING: R-3. 5 �
BLC'CK. . . . . . . . . . . LOT. . . . . . . . . . . . . :36
CLASS OF WORK. . :ALT _-_-� FLOOR TURN. . . . : 0 EVAP COULERS: 0
T'YF-'E OF' USE. . . - :SF UNIT HEATERS. . : 0 VENT FANS_ . :. : 0 �
OCCUPANCY GRP. . :R?, VENTS W/O APPI._: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL_ TYPES-___._____-__._ 0-3 HID. . . . 0 DOMES. INCIN: QI
/GAS/ / / 3-15 IIP. . . , 0 COMML. INCIN: 0 •
MAX INPUT : 0 LTU 15-3lzi HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS'?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
.JAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
I
NO. OF IJN I T a____ _---- AIR HANDLING UNIIS OTHER UNITS. : 0
F URN ( 1.00K BTU: 0 (_ 10000 c f m : 0 GAS OUTLETS. : c'
F•URN ) =100K BTU: 0 > 10000 cfm : 0
Remarks: Corliss - piping and two appliance connections
Owner-: _______.__._---.__.-----..___.___.___._.___________.._____.__..________ FEES --- ------- ---
JIM & CORA CORLIGS type amol_tnt tay date rer_pt
9.750 SW INEZ ST PRMT g 25. 00 JSD 05/29/96 96--•2'79922
1. 25 J5D 05/29/96 96-2'79922
T IGARD OR 97224-0000
Phone #: 503-6:39-9630
Cont Tact or,:
RAYBORN' S PLUMBING
19990 G)W C I PULE RD
T'UALW IN OR 9706'Phone #: 503--692-4139 26. 25 TOTAL_
Reg #. . : 087852
- ---- - REQUIRED INSPECTIONS
This pL-sit is )Issued subject to the regulations contained in the Gas Line I n s p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection _�� �—.,__•____._.
applicable laws. All work will be done in cccordance with Filial Inspection
approved plans. This permit will expire if work is not started
within 168 days of issuance, or if work is suspended for more _
than 160 days.
l e r01 i t t e e 91 pT7 Ut^e+ a l
I55i.led -------
by. c,
639-4175
C. forinspection -
" _. 1
City of Tigard MECHANICAL PERMIT Planck/Rec. #
1.3125 SW Hall Blvd.
APPLICATION Permit # ;���-� �''�- og� 1
Tigard, OR 97211-23
(503) 639-4171
escnpUun r �
01-Y PRICE AMT
Table 3A Mechanical Code
^� .0- -0- 10.00
Job ;1.v /r.l 1) Permit Fee
Address
? G9 v ; ; 2) Supplemental PesTnit 3.00
61�c .l
Furnace to ,
t 1) incl. ducts &vents 6.00
r o_ Furnace 5 +
2) incl. ducts &vents 7.50
Owner
Floor urnance
3) incl. vent 6.OG
Suspended eater, wailheatrjr
4) or floor mounted heater 6.00
--ate'— — 'Fent not inc7in
Occupant 5) appliance nermit 3.00
epair T lea ing, re rig.
6) cooling, absorption unit 6.00
o er or comp, ea pump, air cond.
��� r �,�• �� 7?/,� 7) to 3 HP; absorp unit to 100K BTU 6.00
�`
u �olTef or comp Fe—at pump, air cnnr
8) 3-15 HP; absorp ,,ad to 500K BTU 11.10
Contractor „-5.,. w offer or comF neat pump, air cond.
9) 15-30 HP; absorp 7nit .5-1 mil BTU 1500
Boiler or comp, Feat pump, au cond.
10) 30-50 HP; absorp unit 1-1.75 mil BTU 22.50
ere y ac now ge that have readIs app kation, that the — of er or comp, heat pump, air�r
information given is correct, that I am the owner or authorized 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with Air an rng unit to 4.50
State laws, that I am registered with tl�a Construction Contractor's 12) 10,000 CFM
Board, that the number given is corn ct. (If exempt from State it aning unr. 750
registration, please give reason below.) — 13) 10,000 CTM +
-- 'Non porta6Te
14) evaporate cooler 4.50
l— ent an conripcte7--
15) to a single duct 3.00
ent„ation system not
16) included in appliance permit 450
a. Hood serve y
17) mechanical exhaust :4.50
escn a wor new l a rtwn ateration repair i,-) ommercia or industrial
000
18) type incinerator 3 .
to be done residential Q non-residential Q Other i e., woo stove, water
xisting use o 4.50
building or property „�; 19) heater, solar, clothes dryers, etc.
Proposed use of 20) Gas piping one to four outlets 2.00
building or property
21) More than 4-per outlet (each) 2.00
Type of fuel -oil 0natural gas Q LPG 0 electric
Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID iF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Conditions --
Cate issued by --
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