16095 SW KING CHARLES AVENUE i
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16095 SW f{INC; CHARLES AVE
'IT'Y OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 539-4175 Business Line: 639-•417-1 -
BLIP
Date Requested AM PM _ Ei.D
c
Location_-� �_ � .,cy : t-?.E�� SJte MEC
Contact Person s �c•,� Ph 9&, 3 k& PLM �S 3 Z
Contractor Ph _ S%."R _
Tub- n r' Tenant/ovirr- (, �L. i ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain _!
Crawl i „n Inspection Notes. SGN
Slab _ —_--- _._... _ SIT
Post 8.Beam -- —
Ext Sheath/Shear
Int Sheath/Shear
Fraoing -- -------- ----- - --- —^T��---
Insulation
Drywall Nailing _
Firawall �--------___-..--__----
Fi7e Sprinkler ---
Fire Alarm
Susp'd Ceiling _ r'
Roof -
Mises -
Final
PASS PART FAIL
(PLUMBING `
Post S Ream -
iIJndcr Slab
TJo Out ------- -
Wil,:r Service ( _
Sanitary Sewer
Rain-Drains
A5S " PART FML
iMECMANiCAL i 11 ost&Beam
I ough In
oas Line ----- --- --- - -- -
Smoke Dampers
Final
PASS PART FAIT_
ELECTRICAL ___-----
Service
Rough In -
UG/S lab
Low`ioltage
Fire Alam
F ial
PASS PART FAI!..
SITE
Backfill/Grading ---._.__. __----__
Sanitw y sewer
Storm Drain [ J Reinspectlon fee of$ equimt before next inspe(,;+o,i. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
oupply Line I 1 Please call for reinspection RE:__- -___ ____..w. �____�_ f 1 Unable to Inspect-no access
ADA yrs
Approrich/Sidewalk ;
Other Date _, -( �L_ Inspector Ext
Final
PASS PART FA.L DO NOT REMOVE this inspection record from the J,)b site.
CITYO TIGARD _, PLUMBING PERMIT
DEVELOPPAENT SERVICES PERMIT#: PLM2001-00532
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE I;SUED: 10/25/01
SITE ALDRESS: 16095 SW KING CHARLES AVE PARCEL: 2S110CC-05900
SUBDIVISION: KING CITY NO, 3 ZONING:
BLOCI':_ LOT: 033 .'JRISDICTION: KIN
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING Mt.C!f: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN '-:-,AIN: ft
Remarks: Install back flow preventer
Owner: =EES ---
ACKER Type By Date Y Amount 'ieceipt
16095 SW KING CHARLES AVE PRMT JMT 10/25/01 $36.25 KING CITY
KING CITY, OR 97224 5PCT JMT 10/25/01 $2.90 KING CITY
_ Total $39.15
Phone 1: _ —
Contractor:
SEVEN DEES LAND"-'CAPING
7355 SE ,JOHNSON CPEEK BLVD
PORTLAND, OR 97206
REQUIRED INSPECTIONS
Phur.e 1: 777-7777 RP/Backflow Pieventer
Rn- #: LIC 5009
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and a!I other applicable laws. All work will be don,= in accordance with approved plans.
Th;s permit will expire if work is not started within 180 days of issuan-,e. or if work is suspended for more
than 180 days. ATTENTION: Oregon law r^quires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 trlrough OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUN C by calling (503) 246-1987.
r
Issued By: �V Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection need(-d the next`business day
10/24/2001 12:26 5036393771
CITY OF KING CITY PAGE IY�
TRI-COUNTYICECENTER
I�1 umbo Arg Permit Application
111151mrs Dam
SIRVIC[f.ENTFR [ l nrnr-.��r- w
-- Permit no.: L �Ml 65 ;i =
� ------- Datc mceived: --- -�-
r Cityof King City�.� Sewer permit no.. Building permit no.:13125 SW Hall Blvd. ifnT. t2 lfl
'�- - Prop-rt/appl.no.: Expire date
Tigard.OR 97223 __.
('lack;.ands Phone: (543,634-4171.FAX:(503t,0#*V�7 I)auFl.(1NMENT Date issued: By- Receipt no.:
Miltnomah ---
`.'iashington Case file na; Payment type:
„ N t , f 5 Lana use approval:
I & 2 f inuly dwelling or accessrxy J Conunercial/utdustnal J Multi-tamily J"tenant improvement
v New construction
U Addition/alter.Ati(in/replacement J Fa)d service J Other:
MscriptIon (4jt : Fee(ea.) Total
Job address: y - ✓ ..- -�'� New 1-and 2-famiIy dwellirtgs tmly:
Bldg. no.: --_ ---- (Includes 100 A.for eaeta utility rnnneetlon)
Tax map/tax lot/account no.: _ �__- SFR (1)bath
Lot lock: Subdivision: SFR(2) bath
project name: SFR(3)bath __ - ---
Li'rh adc(iti��,ial batFi�filt�:lit:n ---
^iiy/county: SUP n f, -
I ,sctiption and loc on o qry Pre ( arch hasirt/area drain
N ells/leach line/tapnch dr6n
Est.date of complctiort/inspt�n: — Fixiung drain(no.lin.R.)
RACTORPLU1,%1.j11NfA (ANTManufactured home-utU.ities _
Business name: l S- CSG anholes _-
Address: _ A Pu - Rain drain connector
Ill ll 1 of Sanitary sewer(no.lin.ft.)W
City: Storm sewer
Mon ax:7"J�a 99 E-mail: Water service
^CCB Plumb.bus,reg.no: Fixture or item:
City/metro lic.no.: X ` L Absorption valve — _--
Contractor s representative signature: BAC flow preventer -
Print name: /dfJ Date: packwater valve
BasinsAavatory -
- _- Clur .�s wash, --
Nance: 1► - Z;ish..asher_���"__ --- —
Address: �',t - Thinking fountain(s)
City: State Z^-�. erectors/sum
Phos Fax: E-mail: Gpanaion tank
ixture/sewer cap
moor-"mains/flocx sink ub
_Name(print): _ _ -— .r�i> a dis vel
Ivlalling address: _ dose b _
City: - State: � ': — TCe makerPhone:
'Fax.ax. E-mail: _ _ lnterreptorlgrease tra��_
Owner lnslalluritrn/r�sldPnHal nuuntenance only:The art i,tstAflation Prirncr(s)
wW he made by rite or the maintenance and repair wade try my regularoof drnin—(commercial)
employee on the piopeny I own as per ORS Chapter 447. Slnk(s),basin(s),lays t
Owner's.signature: Date: Swap
TuSWss tF-ower/shower n
rine — -
Name: - aier closet _ -
Address: _ ater tTeat�r
Ot al -- -Ph ane: Fax E mail otnl
Minimum fee ................$ _�'•Z --
I of all j!vlfdlctioni necept cndit outdo,please call)urifdictice for more ial motion. expire; This permit oppiltatainion Plan review(at —%) S
Zi Visa O Mamtctr-AM expires if permit is iter nbtainPd State lurcharge(8%).....$
redia card number, -- stir within IPO dgv.r alter It hes been TOTAL.
arerpred as complete.
Name o c of et o f own on pre 1,card S
Cardholder%12 V Arboum — 44"616 r6MI"O r