16100 SW KING CHARLES AVENUE 0
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16100 SW KING CHARLES AVENUE
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-1171
I /
Date Requested: -�/ ` e- A.M __. /P.M MST: —
Location:
Tenant:_ t, Suite: B _ _ NEC:
Contractor: Phone: PLM: 1— --- -
�. --- _G — C� —
Owner._.t 4_'L - _Phone: a q 3 ELC:
ELR:
_ SIT:
BUILDING -it_J) cont) PLttMBI_NG i MECHANICAL ELECTRICAL SITE
Site Post/Be un POST11't;M,M—, Post/13eam Cover/Service Sewer/Storm
F,)otin- Roof tJndl,'i/Slab Rough-In Ceiling Wate, ,_ine
Slab Framing 'fop Jut Gas Line Rough-In UG 5prinklcr
Faundttion Insulation Sewer Ilc'" f Hood/Duct Recomte.t Vault
Bsmt Gam I all Storm
p hyw Furnace •fetnp service MISC.
Mason-v Ceiling Rain DaiA A/C W,Slab
Sheer/?heath I'irC SpklriAlm Cmwl/Found Dr Iteat Pump Low Volt _
Approved !c We Appr,)ved Approved Approved
Aper/:,d, 11 Nol.Ap}n•oved yrnved Not Approved Not Approved ,Jot Approved
FINAL �� FINA[`,, FINAL FINAL FINAL
Cl Call for remT.%-cti M Reinspection fee of� uirA before ne).t inspection 17 Unable to inspect
hlsprctor: '� � �____.` _._ Date •/ Page—of
CITY OF T IGARD
DEVELOPMENT SERVICESPLUMBING PERMIT
PERMIT #. . . . . . . ; PLM97-0139
13125 SW Hall Blvd., Tigard,OR 97223 (503)63'-.4171 DATE ISSUED: 0(j/03/97
PnRrEL: 2SI '.5BB-04200
SITE ADDRESS. . . : 161.00 SW KING CHARLES AVE
SUBDIVISION. . . . : ZONING:
BLOCrl. . . . . . . . . . LOT. . . . . . . . . . . . . JURISDT�TION; KIN
A
Cl-ASS OF WORK. REP GAR543F DISPOSALS. : IL MOBILE HOME SPACES. : 0
TYPE OF US.-:. . . . :SF Wf:.iSHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP,. . :H2 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 1. CATCH BASINS. . . . . . . : 0
FIXTURES--- ------------ L AiANDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . 0
LAVATORIES. . . . : 0 OTFL.R FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWEF LINE (ft ) . . . : CA
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . ; 0 RPIN DRAIN (ft ) . :
Remarks : ins-L1 J water- tieater-/r-eplar.e existing water heater
llwnet-: ------------------------------------------------------- PEES ----------------
'IE'LEN BROWN type Rmol.tnt by date r'Pept
9,100 SW KING CHARLES AVE PRMC $ 25. 00 TAT 06/03/97 KING CITY
KING CITY OR 972E4 5PC7 t 1. 25 1AT 06/03/97 KING CITY
Pho. e #: 6-_'4-8661
GEORGE MORLAN PLUMBING & APLIANCES
12585 SW PACIFIC 1-1WY
_rJ9ARD OF'( 9722.3
Phone #'. 503-624-6855 26. 25 TOTAL
Reg *. . : 000027
REQUIRED INSPECTIONS
This permit is issued subject to the regulations cor aired in the Water Line InFp
Tigard Municipal Code, State of Or,#, Specialty Codes and all other Roi.qjh-in Insp
applicPhle laws. All work will be done in accordance with PLM/Under-flour ____
appro�:d
LM/UndPr-f1oov-
appro�:d plans. This permit will expire if work is not start0 Fin,-Al Inspection
within 180 days of issuance, or if work is suspended fnr more
than 184 days.
Plpt-mittep Siqnatk4Kee /0 '2
Issi-ted By :
11 for insrie(-tion F-39-417r:,
i
JUN-02-r`� MON 13: 15 Ib: FAX NO: 4054 P02 _
TY OF TIGARD Plumbing Application Recd By
312S SW HALL BLVD. Commercial and Residential Uaia Recc
-iGARD, OR 97223 Dar-to P E -
503) 639-4171 ju ,, r I.t_� Date to Dsr
Permit a
Print or Type
ype Related SWR -
Incorrp!ete or illegible applications will not be accepted CaUea
--T Narna ofIJevelopment/P'ro;ect FIJCTUREs (Indlvtdu�l) pTy PRICE AMT 1
Jots Sink _ 9,00
Slreel Addrexs -� !—' — 3.U0Ardi:9S —I
ru0 or Tub/Showa Comb - —
9 00
-- aldq• 1 i'7r3;a u/l ?ip LG r Shower Only - _- 9.00
1/� s.00
Name /' / ___
r�`-/C 41117 /r Xl,r Di•,hwaaher - 0.00
Owner Malting Addryaa Ville Gamage Disposal - i 9.00 --�
/ of r1-1J 4f11r �uaflK wasning Mecltlnt --- -- —�
citylstate — Ph-,rtw 9.00
Floor Drain L2' 9.00
S..z, _ ! 8.00
9.00
OGGu ,r. Moiling Addreea Slple WSW Heater_ 9.00
LavrAryRourn Tray _ 900
t,tryr5iate Zip Unnal 9.00
Namo - —> Omer Plxl,ays(Speafy) 9.U0
Contractor MailingAAArasa , [[ Sulls- _ -- 900
7_ 5 f rSri �i1C/j�iC Tfllt _ --_ — s.00
I fprioi to issuanrA City/t ate 74 zl Phone __ _
appllr}lnt rnuxt f,i � f1�3 COT-/-��
prnme all Urtgon Conol,Cont. oartf Lic.lt Exp. Date
rnntractors (V - 17 T
Ilt:enae rlurnbing Lk,0-- FF,D Date Sewer--1st 100• - -- -- 30.60
nfnrmallrn Z�—lp8 %!, % % Sewer call additional t00W -
Z5 00
- COT GOT Business Tai a Metra-2— E,1 P. Dare
nyya1er 3yr�ce_est tOU' -- t0.0i
atabastt
Name
- Water Service-each addnional 2W 15 00
Architect 5tenrt 8 Rair t7rain-tet 100' 30.00
Or Malpfig AtfUrets Sloan&—Rain;57,,-n-eao atiditional 100' 25.W ��JI
MuGi?a Home Sp.ce -T5—00 I
Engineer Gih/SIa1e ~- Zlp F,none nntrtterdal Dark flow Pre.rnrivn Devito or And. 25.00 JJJ
Pollution Devta
)u be worn Now O AcIO111Dr1 r�j Alwatlpn O t:lepair O (1BSIEan!ial ac d.r..anden evict' --- 11 00
oe Anne. ResiAenllal V Non resldennel O_ Any Trap or'-rvasin!dnt Cennomea to a Fixture 9.00
.CdltlOnel aeautptlon of"orfs (S IR /c,.f fru M^ Cetcn c�pflr ----_�._-___.__ 9 00
--
/ r,p.of E1114ting Plumbing 00.00
olly
penhr
strny uee of -' Sprr
RRequested equeed Inspections 4000
[ 7lZ�f�� perms,
�ning or property --�...__. _
------ _ r<arn Drain,singly fanuly dnclling 30 0
•roposae use if / Greare r��pe 8.W
Ading or property (C )
QUANTITY TOTAL - --,to you capping• moving or repimt:ing any fixtures? Yes 7 No rJ Icomolrtt or riser diagram!s requww tt Ouanitr Total is r 9
ilf yes moo back of forrttl _ _ - 'SUBTOTAL
^eraby acknowledoc tPM I have read Ihis appll'atfon,flat thM infr,mauon
,nn ix 1:17neQ th'v I am;hv owner nr aulhonzel agent or the minor.and S%SURCHARGE �.
Ial plana submittfia are In cximpliance with Orap on Slate Lamit. OR SUBTOTAL ��2<
PLAN REVIEW 26%. 1•y1
gnature of Ownvr/Agonf• :)ata
r "'7 PMm►J onh A%ture ct, 3 toter� .9
TOTAL
.onlact Parson Name ��- ~ — — Pliant
/^���l- `( 'Minlmurn pemik hM is 325*5%su dtarpe ezcept RF-As+nllal'iacknnw
�r�l• �J�`''vJ r�„ 0 Prevention Device, toltrch is 315+ S'% surcharge
I:iplmapp.doc 12/96 (e it)