16865 SW MATADOR LANE euel JOpp3eW MS 9999
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16865 SW MATADOR LN
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (5031639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received Date Requested 1..Z.AM -.--.PM —_____ OUP _
Location 4-4uite -_. _ MEC
Contact Person - --- --__---- -- Ph(--) - PLM
Contractor ___ ---_..._----_ -_----_-_--- Ph(--) 1-:71 SWR
BUILDING Tenant/Owner _ ______ -_ ELC --
Footing ELC
Foundation Access: -Z '— ---
Fog Drain ELR
Crawl Drain
Slab Inspection otes:✓ SIT - -----
Post&Beam _-----
Shear Anchors
Ext Sheath/Shdar --_�-
Int Sheath/Shear
Framing _ -_------- ------- --- ---
Insulation
Drywall Nailing --- --- -- --- - -- - - _
Firewall
Fire Sprinkler --- - --- ----
Fire Alarm _
Susp'd Ceiling - -- -
Roof
Other: -
Final
PASS PART FAIL -- - - - - -
PLUMBING
Post& Beam Y
tinder Slab ----- --- ---
. ou
ater Service --- ---- - - -_ --- _. _ --_
Sanitary Sewer
Rain Drains ------------- -
Catch Basin/Manhole
Storm Drain - -
MASSPART FAIL - --� --
ANICAL
Post&Beam
Rough-In -- -
Gas Line
IL Smoke Dampers - -- - - -'
Final
U) PASS PART FAIL - ----- - --
t ELECTRICAL
J Service
m Rough-In ---------.__ --- -_._ -_- - -
UG/Slab
WLow Voltage _---
FirF Alarm
Final Reinspection fee of$ -_—___ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FML
SITE - r Please call for reinspection RF_: _�._ -- - Unable to inspect-no access
L_
Fire Supp!y Line '
ADADtib ------ 109POCUMN _ / Fuld
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00396
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 10/14/02
SITE ADDRESS: 1G865 SW MATADOR LN PARCEL: 2S116AD-16400
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
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: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Set shower pan and install shower valve
__ FEES
Owner:
Description Date Amount
D.E. STEM PSON
MATADOR LN [PC.UM[3] Permit Fee 10/14/02 $72.50
16865 SW M
KING CITY, AT 97224 [PLUMB] Permit Fee 10/14/02 $0.00
[TAX]8%State Tax 10114!0:.'. $540
[TAX]8%State Tax 10/14!02 )0
Phone 1: 503-603-0459 ---
T otal $78.30
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND,OR 97206 REQUIRED INSPECTIONS
Phone 1: 503-771-9449 Final Inspection
Reg#: LIC 42671
PLM 34-70PB
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J This permit is issued subject to the regulations contained in the Tigard Municipal Coda, Statc of OR.
F0 Specialty Codes and all other applicable laws. All work will be done in accordance with approved
0 plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
W
for more than 180 da-vs ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Issued By: _ Permittee Signature:
--
Call (5 3) 639-4175 by 7:00 P.M.for an Inspection needed the next busl e s day
In/09/2002 10:40 5035393771 CITY OF KING CITY PAGE 02/02
TRI-COUNTY ••"~
SERVICf(ENTER' Plumbing Pe 11t Application
City of King Ci , Dane reoelved: PoMfit -&D3
\`\ t3125 SW Hall Olvd ;I °•u '��V��,r SewerpvMkno.: Ruddingjmrmit"a.,,
Clackamas Phone:
OR 97223 t►roJsctlappl.no.: E'xt>irr dais:
(503)639-4171. P :003) 7297, -------- -
Multnomah i 7��1 date 1Ksued: Ry: Reoelpt no..
wuhington -
M u N r . r e Land use approval: r`!, Case rite no.; Payment type;
vir r�F-
2
2 farnJly dwellinS or accessory C;ommercial/induatrlal O Muhl-fyirttily ClTetw,t Improvement
New construction AddidoNulmmdon/replacementi I to Food service Q ot�t�or
Job address' �j j ci(� �p r �,n . Far(ea, Total
}3Idj no._4_ SUW no.: ew 11-and Umnr dw*Ur%p t
Tax map/tax lot/Account no.: — — (inciadee 100 R for etch etaity ooanK,*ft)
Lor. 91ock: S1 (1)bath
7r,)
Prti}act name: Ste v� 3 3
bath
City/coutltY: a ZIP: _ c �tddtiional txhen
Description and( do ork onrami
p _ l� !C Site utaftiea;
a �n .-._t tn5{c?I 1 Catch baein/ama"n
lr dare of com lednNtns don: -- ell atc� t�nehren _N1n`
00 �`dratn(no. n. _
Business name: C ow !v anufartwrd hoe udtltFeS—
Address: 1 • Manholes"
j Cit : art,drain eunneotor
r State ZIP: St►t:tita�s�:_i�vRr 170.
Phone: r Fax' mall: — tonil sewer(no )
CCB o,c P1u nb�bus, _ P Water cer+1`ce(tno. in. )
�e�.L_ g.no:
City/metro Ilc. no.: jqAj Ft"Ury or Itomt
Contractor's rept+eaenrjtive siRttsnuc;
Absorption valve
Print name; Date: BacK ow evtttur
ac atCr valve -
_w svatory
.N2tne: Clothes%yashC.
Add":_ Ishwaaher
City; StAte: ZIpY �rinkin�outi �e
... : Pax: jtctar sunt
Phone
matt: x anion --
_ lA t7redsewcr ca
Name(print): �e S�e Floor drtlns on,a ub
�taiJirg addr_ass: Ja-rr�t� 0INB" 8Pt,�1
t1 c it�L.� Stt!e: ZIP: ose bibb
Phone; O _ Fax: au;J: Ice mrke-r
rn wrap inn nn/re+ldentleJ m*24gtonance o :'I1te ac�tallation Prm�� / �'tt�p
IAU be made by me nr the maintenance and tb trade b m re ular primo 'a)
employee-on the pmpetty I own ss per DRS C pier 44,,y Y R Roof drain cntnmm )
J 9
Si (s).b7is e)r,lnvtt(a)
pp Uw►ur's sl �rc� L'7ttt0: Sum
WI tjtWshow0rj3hgww pan 0
_j flame: Drina
-\ddress: - ater closet
ater
State: Z[p; - he.!heater
'hone: Pax: cher
_ ail: To
ut 13.urlWIc Ma terceeMU CTg11t cue,Moue cytr/urtwdteuea r r" le. Notieer This oymu lie Mlnlmum fee................$
Vis. d MulerCud P a/P Atyoe
edu card number aspl ur(f a pmNt Is not oblwnad Plan t'rview(at —S6) S
e*ptres WAIn ISO days Utir a Am t+Mn 5tite surcharge(ft).....S
volar or cWh.ldr,a rheWn os nra,t nerd errepted as oomptel.. TOTAL.........:..............S FV
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