12110 SW KING ARTHUR STREET F,
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12110 KING ARTHUR -
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business I-ine: 639-4171
MST _
BLIP
..Date Requested AM —PPA BLD
-- _
Location Suite MEC
Contact person _ Ph �'1 — S c� PLM 4fIC ! �1
CGr(tractor Ph SWR �--
BUILDRdG Tenar,./O% -ler ELC
Retaining Wain ELR
Footing .arcceS :
Foundation
/ C� j__�.�}
Ftg Drain { �- 1 ` FPS
Crawl Drain Inspection Notes: SGN
Slab ,.C ►"`y�� jF.� t�!8L cl.�. SIT
Post& Bearo ,cam + 6 �{' -
Ext Sheath/Shear
Int Sheath/Shear —"-
Fray ling _
Insulai;�n - -�-- - - —
Drywall Nursing - -
Firewall --_---- ----------- ----- __.-.-.--
Fire Sprinkler
Fire Alarm
Sus- J Ceiling i - -------- ---- —
Misc: �-
Final -
PASS PART FAIL
PLUMBING
Post& Seam --
Under Slah
lop Out
Water "rvic.t
Sanitary sewer
t;
Trains ASA
PART F,\IL
CHANICAL --- - - - - --
Post& Beam - - - ----- -----
Rough In
Gas Line
Smoke Dampers T
Final - ----- - - - - -
PASS PART FAIL I
ELECTRICAL -----_.. . ------ --- --- --_
Service -
Rough In --- --- ----
UG/Slab
Low Voltage -_-__--
Fire Alarm
IFilral --
PASS PART FAIT_
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain j Reinspection fee of$ required before next inspection. P ry at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f j Please call for reinspection RE _ _ _ ( j Unable to inspect-no access
ADA f
Approach/Sidewalk
Othei Date_—_ -12/.
Inspector�W�2 ---- Ext ..
Final
PASS PART FAlt_ DO NOT REMOVE this inspection record from the job s°•te.
CITY OF TIGARD �l
DEVELOPMENT SERVICES rDLUMIATNO 'PERMTT
13125 SW Hall Blvd., Tigard OR 97223(503)619•;111 F-!F*RMTT # PI-M,*39-P,, -,
DATE ISSUF71): 02/01 /q9-
PARM. :
rr. (DAISES — . 1c?1- 10 SM FINL' :411TIIUR AVE
nD,V If.,1('114. . . . - ZONING-
OCK. » . . . . . . . * L.OT. .. . . . . . . . .. . . . JURISDICTION: VIN
(ITO OF- WORK. . :OTR (33ARM-43E DTrsrr,,,0)AL-P). V1 mn3TI...F HOME'
nF USE. . . . Sr WnSHING '1ACH. . . . . . .. 0 BOCKFI.-OW PREVNITW3. . 0
CUPANCY GRA''. . : R,'], FL.0(1P Dr`AING). . . . . .
DRIES. . . . . . . . . 0 WATER HFnTERS). . . . . . 1. CATCH BASINS. . . . . . . 0
I-MINDRY TRAYS. . . . . : 0 9F RAIN DRAMS- - 0
. . . . . . .1 0 URINALS. . . . . . . . . . . : 0 GREASE TRnPS. . . . . . . .. el
"'VATORIES. . . . : 0 0T14rP FTYTUP17S.. . . . ; 0
11/13HnW F R 1.1. . . : 0 S5EWFR I. T NF ( Ft ) . . . : 0
T'rR - 0 WATER LINE (ft) 04
5Hwnt-3)HE RS. . 0 RICIN DRAIN (ft ) . . . 0
nal-ki . Rr,'Pla�-e t-Ieatpt- with lfkp kind,
fievl." 1---------------- --I---- ---I---,----- --
NDA PALLET type �moimt by date )--ecpt
110 f,W KING (-)RTH(JR PRMT $ 25. 00 DES 02/01,,99 KING CITY
'Irl rTTY OR 5PCT t 1 - 25) DEIA V12101199 VTNE-3 CITY
r7rsmjr winTFR
PrP SM 17,-'Fs
W'tl.' ONVILLE OR 97070
"!r") Tr)TV11 ,
0,1-11 RED I NSPECT I M.1r,
This permit is issoed subject to the regulations contained in the. Mi irk. I n S[loct i OTI
Tigard Municipal Code, State of Ore. Specialty Codes and all o+',Pr Final. ITIspect ion
applicablF laws. All world will be done in accordance with
approved plans, This permit will expire if worN is not started
within IN days of issuance, or if work is suspender for more
than 180 days, AT7WION- Oregon law requires ,au to follow rules
gdopted by the Oregon Utility Notification Center. Those rules are
qFt forth in OAR ?T-MI-0210 througtW W-WI FOR. You may
obtain copies of these rules or direct question, to OINC by calling .......
I-m i t t 13 1 g n t
1 -A 1 1 1 1 I. 1 1 4 1 t , 4 1 1 1 f I t 6+-I-f'1 4 �+-1 1 -4 t 4 1.+..+-f 4-f.-r.a F.4 4+-V.1-+++++i.4.4,+4 4--
M i I i-r(, Hip nvvi-
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f 4,4-1 + 4' 1 t l 4,4 4.4,++++4 +,.1_.}.{ t 1 4 4 4+4,
FEB-01-'99 MON 1 L 1L: FAX NO: #091 P02
CITY OF TIGARD Plumbing Permit Application
13125 SW HALL BLVD. Commercial and Residential Plan check"—
TIGARDr OR 97223 Roc'd By
(503) 639.4171 Date Roc'd
Date to P.L,
Print or Type Date to DST
Incomplete or illegible applications will not be accepted P°nnita
t
Related SWR!
Called _�-
Nartra OT raev9lopmerrUPmded, '--
Job
Address 'beet.ddraip � Lavalo - ��
/ S da ry
t)Id ty ~� --'- Tub or Tutvshower Cortrb. 9
Mg City/Stals Z O,pp
2Z Shower Only 9.00
omeCA 'oset
LL � Dlehwasherf- t Dl1
Owner M tl A-vyiC_s bubo Oaftae I5 posal 9.
city/Slate 21p phone Washing Marhkw '- --- 9.00
Drain/Floor Sink 2° 9.00
Name - _ .
Occupant Melling Mdrnan- --- Supe
�• _ 9.00
Mratro�f ljpl/O ccxwentort Me kind p.
_ �.
Chrrg' --Zrp--= Phone ae re wren a a orale rnedlaMCal pe m+.r. -
Laundry Room Lay 900
101 N...�-I` (ZOOT- Other Fighras ISI>l+dy) - n VU
Contractor
MIMI;Address sutra - -- A---
I'ner to pernit -5y7 ele=�71 - �'�� -i�
",nuance,a raspy W11ISL,/J lite `7 �Q Cab;)�c�J�/ 9rrwer-lel 100' to 00
— Sewer-each eddhlonal 10G'
nl e11 licenses are Oregon Const Co,W Board Lie.1 Eup.Date
raquhwd h Water r3arvice•1st 1D0' - -. 90.oG
H:r,lred In cot F,lyrn4iny U/c s � p.Date Wal°r 3ervicw-"em `�;donal tort_—
datstwen SL( J
28.00
- -r -- 61orm b Rain a:n-1el IGO. 30.00
Nance Slonn A,Raln:XaM-ear• addhlonal 100 -
Architect _ 25-M
_ MobBai+;, gpace 25.00
Of bt•IIInp Addteea ----! huge - -
CoMminocial Bede Flow Prevonrlen Ihrvlou or Anfl. 15,00
Pnrluilon Device
Fngineer rAbrMoto - -Z,r- pin. R+rsldpnUal Bee*now Preverrlhm Devlaa• -� _
t s.00
(IrtlpaUa Ifming devices mglNre a aoparaM
>.acrlAr.rcvk ro by done:
r„w Cr Rnpatr O Replaco when Ilka kind Yrs No O
' Any Trap or aaNarallotCe
n •tdIne4rrridantial O Commerrist C 9.00
Catch Basin ”' --J
,tdillorwl daacrlptlal of work: `---� -' 9.00
11 /� Msp.of t xlatlrq PplmbkK+ — i0.00
Specially Rearrested Inapettione 40,00
ro you capping,moving or roplaclnA any fi�tureaT Rain Drain,single Femlly dweHlryl - 3c,ou
Yes O No O Greaaa Treys - — -- —6-00
yea, ince back of form to indleat,e work performed by
.ture. FAILURE TO ACCURATELY REPORT FIXTURE c1UA1�ITITY TOTAL
URK COULD RESULT IN INCREASED SEWER FEES. i'a"`a"9""i0Kd1p"""I'"rq"tr'""o'r"r><y7rl�I' 'a
t-hy acknowtedpa Ihrtt I hew read Ihla application,thr,t tfe tnle/mallon *SUB T07AL
rn 19 correi,i,that I■m IMA nwnar or authurized agent lir the owner.and ---' -__----- �_�
t plena 8ubmhhrd are In corn Ilance wlrh Orn nn State Lawn, bX SURCWARCQE ! AT
inat41ry of Owner/Awnl `f ie -4 - - =PLAN RFVI-�211•iL OF SaE•TOTAL
nlac Pa � ' 1 (� F2°u r`d !ftaure gy.1d.1 i. s '
{^t n n Hams 1plhons TO AL 345
V 1� t [ "tutlnlmrund _5`90 J pvrmlt to i28+316 ourdralpe,arcapl RealdeMlal BarJrgaw M
-- - --------- _- rre-Minn Nvicn,which is$11+5%sumllarge
"All Now Commemlal Bullaings require prmny with Is°matric er neer diagram
and plan rsoew