10905 SW 121ST AVENUE J
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ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 639.4175 Business Phone: 6394171
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Date Requested: Q —�- A.M. P.M NIST:
Location: C.�! S( L� l .CZ �.�1 -- ---. _ BLT:
Tenant: _ Suite: Bldg: MEC
Contractor:— Alone:� ;'hone: ��(�/� PLM:��.._�1L'
(homier: / 1 Lt �� Phone: ► L1J - `�S��- — ELC:
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SIT:
BUILDING BLDG(coni) LLOM B IN CG MECHANICAL ELECTRICAL SITE
Site I'ost/13wm Post/Beam Cover/Service Sewer/Stonn
Fooling Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framin„ Top Out I/LOL', Gas Line Rough-bi UG Spri4ler
Pounchitirnt Insulation S, nr l��r Iiood/lluct Reconnect Vault
Bsmt Damp I"all Storm ;G��L Furnace Tcmp Service MIST
Masonry Ceiling Rain Drain A/C: UG Slab
Shcar/Sheath Fire Spklr/Alm C'rawl/romIh Ileat Purap Low Volt
Approv .I Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
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�C'all for reinspection f7 Reinspection fee of S required before next inspection O Unable to inspect
Inspector:.tor: /_� -- _ Date: �� Page of —
CITY OF TIGARD BUILDING INSPECTION DIVISION f
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
Date Requested: _ t l + A.M. P.M. MST:
Location: � ;?� -�L ,_�{ -P BUP: _
Tenant:_ _ Suite:—_` Bldg: MEC:
Contractor: — V Phone: / PLM:
nwn�'r: ,^ phone: ( tx. - -�.
�- ELC:
F"LR:
.. SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service ;fewer/Storm
Footing Roof UndF1/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Cas Line Rough-In UG Sprinkler
Foundation Insulation Sewer 1: I food/Duct Reconnect Vault
Bsint Damp Drywall ern Furnace Temp Service MISC.
Masonry Ceiling Rain]rain A/C UG Slab
Shear/Sheath F irc Spklr/Alm Craw1fFound lh I feat Piunp Low Volt _
Approved Approved ,i Approved Approved Approved
Appr/Sdwlk Not Approved Not r,l.�s'ved Not Approved Not Approved Not Approved
FINAL F ,AL FINAL FINAL FINAL
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C3 Call for reinspection O Reinspection fee bf S_ r94uired before next inspection C]Unable to inspm-
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lnslwctor i Date: Z4 -A-) ' Page .of_
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : PL M97-0165
DALE ISSUED: 05/07/97
PARCEL: IS134BC-9171011
SITE ADDRESS. . . : 1.0905 SW 121ST AVE
S(JTADIVISION. . . . : WOODSPRING CONDOS ZONING: R-7
BI....00K. . . . . . . . . . .. 1_01.. . . . . . . . . . . . . : 11 JURISDICTION: TIG
CLASS OF WORN;. . :ALT _-- -GARBAGE_ DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . ;SFA WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : i COTCH BASINS. . . . . . . : 0
F I XTLJRES--- ------ --- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
STNKS. . . . . . . . . . Vi URINAI...S. . . . . . . . . . . . GREASE TRAPS. . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : w,
TUB/SHOWE:RS. . . : 0 SEWER LINE (ft) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DTSHWA&,4ERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
^marks : Flectr-ir_ to electr•ir_ water heater replacement
FEES -------._----_-
NANCY CARNES type amol_1nt by date r,ecpt �
tO9O5 SW 121ST AVE PRMT $ 25. 00 JSD O5/O7/97 97-294270
TIGARD OR 972-123 SPCT $ 1. 25 JSD 05/O7/97 97--2:94270
Phone #: 685-5472.
Contractor-- -----•------------------------
GEORGE MORLAN PI_.I.JMBING
5529 SE FOSTER RD
PORTLAND OR 97206 -----------------__--_-_._...___________ ._
Phone #: 771--1145 $ 26. 25 TOTAL
Req #. . : O00027
- -------- REG!IIRED INSPECTIONS -------
This permit is Issued subject to the regulations contained in the Misr. inspect; i an
Tioard Municipal Code, State of Orr. Soer.ialty C^des and all other Final Inspection
applicable laws. All Mork will bz done in accordance with _......
;ipnroved plans. This permit Mill expire if work is no!, started
within 188 days of issuance, or if work is suspended for more
o than 188 days. -- - - --
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Permittee S i g n a t�.r r• ti _. _�^.- �_.____..._...-__ �_.-__--- _ ____-__.. �__
I s s�_1ed Pte"
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-J Call for inspection - 639-4175
-ITY OF TIGARD
Plumbing Application Recd By
1312S SW SW HALL BLVD. Commercial and Residential Dam Recd-4' (--(- 1
TIGARD, OR 97223 Date to P E.
(503) 639-4171 Dam to os
Permits 4-1-1 17 6<
Print or Type Related SWR s
Incomplete or illegible applications will not be accepted Called
lvame of Ilevalopment/Propct FiXTURES,;l�divldual) p'�: r
Job Sink 0.00
Address Street Address Swte Lavatory _ 900
L�J 1 Tub a TuWShowar Comb. _ 9
Bldg .00
aty/state Zip i Shower Only 6.00
Name Water Closet _ 9.00
Dishwasher 9.00
Owner Mading Address Suite Garos9e Dlapoem 9.00
7/ f� '�. w.,lw�,M,Chne 9.ter
City/Stated (,� Z1P Phone Flow Drain 2•
` j-�� r.. 417 . , 9.00
Name tr' 3• a no
_ 4• 9.00
Occupant MiZ Add— ss Surte Water Neater
9.00
Landry Room Tray 9.00
Gty/Slate Zip Phone Urinal
9.00
Name Other Rmturea(Specify) 9.00
9.00
Contractor Mang Address /, Suite 9
4
(Prix to issuance Chy/stsm Zip Phots _ 9.00
applicant mtrrt9.00
provide all
Orayori Conset.Cont.Beard Lis Exp.Pat@ T Too—
con"doirs
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Name Pit m-v Lia>♦ Expinformation .Date 8.00
Sewer-tit 100'
f Sewer-each additional 100 -
30.00
fw COT COT Business Fax or Metros Exp.Date 25.00
database). Water Service-1st 100' 30.00
Name Water Service-each additional 200' 25.00
Architect Storm a Ra.+Drain-to tar 30.00
or Maie V Address Suite Storm&Rain[Xan-sari addriRmilil 10(Y 25.00
Mobile Home space 25.00
Engineer Cityislats Zip Phone Commercial Back Flow Prevention Devroe or Anti 25.00
Pollution Device
Describe work New O Addition O Alteration O Repair e) Residential Baektlow Prevention Device' 15.110
to be done Res,dantial O Non-resutent.al O
Addrbonad description of►.0 r% Any Tref or Wrste Not Connected to a Filmue 9.00
F a"
'r Catch Baur
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�"'•r ,•��;,. /� 9,00 t/�/ �;1 /i'+ i,' J Insp.of Fmsbnq Ptumbkng ,U()O
n _ perror_
cxnting use OfSPeaalty Requested Irnpeclkxts 40.00
jl building or property_ ) ' __
perfir
V) - Rain Draat satgb hmdy dvn .erg 30.00
'roposed use of ' J Grease Traps
I _ ')uriding or property_ - 9.00
J kng QUANTITY TOTAL
c A m you caPP . mowing or rtrplaang any fbaures7 Yes to No d Iswner,c a riser A'ugrtrn n recur"1 Ouan,ty Tar is >9
j )If yes see beck of form) _ 'SUBTOTAL
w i hereby acknowledge that I have reart this application,that the rnfonnabon
:even is correct.that I am the 0"(0(authorized agent of the owner.and 5% SURCHARGE
hat plans submitted are,n compliance with Orem State Laws.
Signature of OwnirfAgent , Date PLAN REVIEW 25%OF SUBTOTAL rr gavureC onh
if airy I"is,9
TOTAL
.antact Parson Marne Phone
j�� Minimum permit , is$25 • 5%surcharge,except Resxlentixl Backflow
Prevention Device,writ;, •515•5%surcharge
/ /� 7 ( l 7 V: plmapp-doc 1196 (dst)
'_LEASE COMPLETE A PPRQPRIATE 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 Brain 2"
3"
4"
Water Heater
Laundry Raom Tray
Urinal _
Other Fixtures (Specify)
OMMENTS REGARDING ABOVE:
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klpbnapp.doc 11,96 (dst)