11265 SW 83RD AVENUE i
b
S-1
w
. Av
-�'
tee,- ��, ��� �• r' � ��-�� �
CITY OF TIGARD BUILDING INSPECTION DWISION
24-Hour inspection Line: 6394175 Business Phone: 6394171
-11
Date Requested: x"' _ A.M. _ _ RM. MST:
Location:_ 1 I `f � ZJ � �— BUP:
Tenant: _ Suite:—Bldg: MEC:_ q
Contractor: Phone: Y q 6'U 5� /PLM: 7 1
(timer:i +!`(.0 �t - ��.� Phone: �j, . CI'4• E' �� ELC:
ELR:
_ SIT:
BUILDING BLDG(con't) OLIMPM, MECHANICAL ELECTRICAL .'ITE
Site Post/Beam Postfleam Cover/Service Sewer/Storm
Footing Roof Undl'I/Slab Rough-In Ceiling Water Line
Slab Framing 'lop Out Gas kine Rough-In UG Sprinkler
Foundation Insulation Sewer IloodA-lucl Reconnect Vault
Rslnt Damp Drywall Storm Ftunace Ternp Service AUSC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire SpUriAlm Crnwl/Found Ir I+,:at Pump L,ow Volt
--� Approved Approved "pproved Approved Approved
Appr/Sdwlk Not Approved Ngopprovtti Not Approved Not Approved Not Approved
IINAL FINAL, FINAL FINAL.
1 n l l I o l It'll+`. I I n (1 I?c m m wo loll ICA•u t S required belbre next inspection El Unable to 11111p ict
It slx•clor / Dnic �� Page^ _Of
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
PERM I T #. . . . . . . : PL. .97-0126
13125 SWHall Blvd., Tlgard,OR97223 (503)6;!9.4171 DATE ISSUED: 04/15/97
PARCEL: 1 S 136CB-03100
S I TE ADDRESS. . . 1. 1.265 SW 83RP. AVE
SUBDIVISION. . . . : STEVE 9 HUGHIE' S PI_ALL ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .3 JURISDICTION: TIG
CLASS OF WORK. . :REP GARBAGE DISPOSALS. : 0 MOB T LF_. HOME_ SPACES. : 0
TYPE OF USE. . . . .-GF WASHING MACH. . .. . . : 0 PACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 14ATER HEATERS. . . . . : 1. CATCH BASINS. . . . . . . : 0
FIXTURES------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 L.IR.T.NALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . . v'
l_.AVATn?I ES. . . . : 0 OTHF9 F I XTl_1RES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 �
WATER CLOSETS. : 0 WATER LINE (ft ) . . . - 0 I
DT HWASHERF. . . . : 0 RAIN DRAIN (ft ) . . . : 0 i
Remar^ks : Water- heater- replacement, like kind.
nwn car,: --------_.._____..____________ ------- FEES
ROBERT DAVIDSON type amos_(nt I,y date r-ecpt
1. 1265 9W 83RD AVE PRMY $ 25. 00 DQA 04/15/97 97-293282:
TIGARD OP 97223 SPCT $ 1. 25 ORA 04/15/97 97-2932t32
Phone #: 63.9--6621
G_ORGF_ MORL.AN PLUMBING
'-5529 SF FOSTER RD
*SEE ALSO MORLAN PLUMPING*
PORTLAND OR 97206 -------------------------------_.—._ ----.
P11one #: 77t-1145 $ 26. 25 TOTAL
Req #. . : 200734
------- REOU I RFD INSPECTIONS)
This pef:it is issued suh.Ject to the regulations contained in the Mi sc. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final. Inspection
applicable laws. All work will be done in acco.,dance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 188 days.
(Ek Tsso_ied y . _--
Call for inspection - 639-41.75
CITY OF TIGAIRD Plumbing Application Recd 8)
13125 SW FALL BLVD. Commercial and Residential Cate Recd u !5
TIGARD, OR 97223 r Date to P E.
U Date to DST
(503) 639-4 71 l
`O Permit s 7��
Print or Type Retateo SWR s ---
Incomplete or illegibie applications will not be accepted called_
!
Name of Cevelopment/Proiect --� [FIXTURES (individual) QTY PRICE AMT
Job oink 90,
Street Address Lavatory -`
Add
Address ucre 9.00
S�^l �V S
l I Tub or TubiShower Comb.
—7q.00
Bldgs GtyrSlale 7,p Shower Only ).00
ti✓Gl �� `1 1 L 3 water Closet
varve _, 9A0
Ounwasher 9.00
Nail Address r i - Gait age Dtsoosal
O11VT1Ar Ing< �/7 Suite _ __ � 9.(.0
ZGJ (" ?f )I"l� (lUe. Nar•rnng Machine 1.00
Citymate-./ Zip Phone / Floor Dram 2' 9.00
3' 9.00
Pgrnil —
ie 4 9.00
Occupant Meirrq Address Swte water Heater I 9.00 O
Laundry Room Tray
C,tyrSlate ZipPhone Unnal 9.00
Name �/ Other Fixtures(Specify) 9.00
/r'��1�/l✓� 9.00
Contractor Nail' i Address A Suite 9.00
.00
GtyrSlate Zip Phone "-- -- I -� 9 9.00
�' rvl �� C1�Z Z 7 (y -2 y T /
Ortgon Const.Cant.Board Lbc.s Exp. Dale 9.00
AAisde Ca,-v of9.00
current
f'Artloing Lic so Exp Date Sewer- 1st 100' 3000
Llc
b�� O�� Sewer-eau)additional 100' 25.00
COT Business Tax or Metro s Exp.Dale Water Service- tst t00'
30.00
Name water Service-each additional 200' - 25,00
Architect Storm S Rain Drain- 1st 100' —26--00
or I Nailing address Si.;e Storm d,lain Crain-each additional 100' 25 00
I Mobile Home Space 25.00
I EngineerI C.tyiState Zip I Phone Commercial Back Flow Prevention Device ur Anti- 25.00
Pollution Device
Describe work New O Addition O Alteration O Repair 0 Residential Backflow Prevention Device' 15.00
I be done Residential O Von-residential O Any Trap ar'N,it-,Not C.rnnected to a r'ixture 900
Add0x%W desrnFcon of worn Catch Basin 9,00
-,: !r,-p of Existirg P!umoing 4000
~ J
N `9 Soeaai Re uestiW per/hr
�-
E-10-4us of ty n spec ions I 4000
1- oerthr
.- wild or Property Rain Crain smg,e family dwetling I 3000
J
Proposed use of Grease Traps I 9.00
building or property _
QUANTITY TOTAL
- Are yoc gypping , moving or replacing any fixtures? Yes 0 No Isometric x user:149ram u reourea R Cusn"Total s >9
(If yes see back of form) 'SUBTOTAL
I herebv acxnowledge that I ha,a read this 3eplication,that the information
given s:orrect, chat I am the cwner or authonzed agent of the owner and 5% SURCHARGE
hat c13113 submitted are n_omoliance with Oregon State Laws
Signature of OwneriAgent DateI PLAN REVIEW 25;4 OF SURTO AL f
�G�_ C ecuired only i'lmuc 7tv 'arae %>a
l l -_ �� � // TOTAL
Contact Person Name I Phone i
2,-1
l 'Minimum permit ffoec $25 • 595 surcharge except Residential Backnaw
I N �✓ cLr r Preventionw
Cev'ce.which s S 15•5'4 surcharge
i'dstsipirrapp dor 9198
ASE C 064 01 T E AS APPi-�QPjIA'TE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub/Shower Combination _
Shower Only
Water Closet
Dishwasher
Garbage Disposal _
Washing Machine _
Floor Drain 2" _
3"
_ 4"
Water Heater
Laundry Room Tray__
Urinal _
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE: